Sample records for ruminant health management

  1. Factors Affecting Mitigation of Methane Emission from Ruminants: Management Strategies

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    Afshar Mirzaei-Aghsaghali


    Full Text Available Nowadays, greenhouse gas emission which results in elevating global temperature is an important subject of worldwide ecological and environmental concern. Among greenhouse gases, methane is considered a potent greenhouse gas with 21 times more global warming potential than carbon dioxide. Worldwide, ruminant livestock produce about 80 million metric tons of methane each year, accounting for about 28% of global emissions from human related activities. Therefore it is impelling animal scientists to finding solutions to mitigate methane emission from ruminants. It seems that solutions can be discussed in four topics including: nutrition (feeding, biotechnology, microbiology and management strategies. We have already published the first review article on feeding strategies. In the current review, management strategies such as emphasizing on animals - type and individual variability, reducing livestock numbers, improving animal productivity and longevity as well as pasture management; that can be leads to decreasing methane production from ruminant animal production are discussed.

  2. Tube cystostomy for management of obstructive urolithiasis in ruminants

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    P. Tamilmahan


    Full Text Available Aim: The aim of this study was to evaluate the simple tube cystostomy procedure for management of urethral obstruction cases in ruminants. Materials and Methods: Tube cystostomy was used to treat a total of 58 ruminants, which included 35 buffalo calves and 23 goats. Diagnosis of the disease was made with the history of anuria, clinical signs, and physical examinations. Physical parameters like heart rate, respiratory rate, rectal temperature dehydration status of animals by skin tenting test, and intraoperative findings were compared. Results: Young ruminants were most commonly affected and the mean age was 4-5 months in both species. Only male were considered for the study in which buffalo calves were not castrated but in goat's 73.91% animal were castrated and 34.7% not castrated. Rupture of bladder was more common in buffalo calves as compared to goats. The confirmed cases of obstructive urolithiasis were selected for tube cystostomy with Foley's catheter. Postoperatively all cases were administered with broad spectrum antibiotic, anti-inflammatory agent, and caliculolytic agents like ammonium chloride. Postoperative complications recorded only in 10 animals and remaining 48 animals had an uneventful recovery. Conclusion: Tube cystostomy is a simple and effective procedure particularly in intact urinary bladder, which can be adopted at field level.

  3. Role of probiotics in nutrition and health of small ruminants. (United States)

    Abd El-Tawab, M M; Youssef, I M I; Bakr, H A; Fthenakis, G C; Giadinis, N D


    Small ruminants represent an important economic source in small farm systems and agriculture. Feed is the main component of livestock farming, which has gained special attention to improve animal performance. Many studies have been done to improve feed utilisation through addition of feed additives. For a long period, antibiotics have been widely used as growth promoters in livestock diets. Due to their ban in many countries, search for alternative feed additives has been intensified. Probiotics are one of these alternatives recognised to be safe to the animals. Use of probiotics in small ruminant nutrition has been confirmed to improve animal health, productivity and immunity. Probiotics improved growth performance through enhancing of rumen microbial ecosystem, nutrient digestibility and feed conversion rate. Moreover, probiotics have been reported to stabilise rumen pH, increase volatile fatty acids production and to stimulate lactic acid utilising protozoa, resulting in a highly efficient rumen function. Furthermore, use of probiotics has been found to increase milk production and can reduce incidence of neonatal diarrhea and mortality. However, actual mechanisms through which probiotics exert these functions are not known. Since research on application of probiotics in small ruminants is scarce, the present review attempts to discuss the potential roles of this class of feed additives on productive performance and health status of these animals.

  4. Some Ruminations about Prison Mental Health Work. (United States)

    Toch, Hans


    Describes incidents involving mental health services in prison facilities that illustrate "Catch-22" situations, in many of which inmates perceive clinicians as people who "come to watch you drown instead of throwing you a rope." Proposes a supplementation of "administrative clinical" thinking with nonbureaucratic,…

  5. Management of Sub-acute Ruminal Acidosis in Dairy Cattle for Improved Production: A Review


    Kafil Hussain; Amjad Ul Islam; Surinder Kumar Gupta


    Sub-acute ruminal acidosis (SARA) is a well-recognized digestive disorder that is an increasing health problem in most dairy herds. Feeding diets high in grain and other highly fermentable carbohydrates to dairy cows increases milk production, but also increases the risk of SARA. Sub-acute ruminal acidosis is defined as periods of moderately depressed ruminal pH, from about 5.5 to 5.0. Sub-acute ruminal acidosis may be associated with laminitis and other health problems resulting in decreased...

  6. Ruminant Nutrition Symposium: Productivity, digestion, and health responses to hindgut acidosis in ruminants. (United States)

    Gressley, T F; Hall, M B; Armentano, L E


    Microbial fermentation of carbohydrates in the hindgut of dairy cattle is responsible for 5 to 10% of total-tract carbohydrate digestion. When dietary, animal, or environmental factors contribute to abnormal, excessive flow of fermentable carbohydrates from the small intestine, hindgut acidosis can occur. Hindgut acidosis is characterized by increased rates of production of short-chain fatty acids including lactic acid, decreased digesta pH, and damage to gut epithelium as evidenced by the appearance of mucin casts in feces. Hindgut acidosis is more likely to occur in high-producing animals fed diets with relatively greater proportions of grains and lesser proportions of forage. In these animals, ruminal acidosis and poor selective retention of fermentable carbohydrates by the rumen will increase carbohydrate flow to the hindgut. In more severe situations, hindgut acidosis is characterized by an inflammatory response; the resulting breach of the barrier between animal and digesta may contribute to laminitis and other disorders. In a research setting, effects of increased hindgut fermentation have been evaluated using pulse-dose or continuous abomasal infusions of varying amounts of fermentable carbohydrates. Continuous small-dose abomasal infusions of 1 kg/d of pectin or fructans into lactating cows resulted in decreased diet digestibility and decreased milk fat percentage without affecting fecal pH or VFA concentrations. The decreased diet digestibility likely resulted from increased bulk in the digestive tract or from increased digesta passage rate, reducing exposure of the digesta to intestinal enzymes and epithelial absorptive surfaces. The same mechanism is proposed to explain the decreased milk fat percentage because only milk concentrations of long-chain fatty acids were decreased. Pulse-dose abomasal fructan infusions (1 g/kg of BW) into steers resulted in watery feces, decreased fecal pH, and increased fecal VFA concentrations, without causing an

  7. Diagnosis, Treatment and Management of Haemonchus contortus in Small Ruminants. (United States)

    Besier, R B; Kahn, L P; Sargison, N D; Van Wyk, J A


    Haemonchus contortus is a highly pathogenic, blood-feeding nematode of small ruminants, and a significant cause of mortalities worldwide. Haemonchosis is a particularly significant threat in tropical, subtropical and warm temperate regions, where warm and moist conditions favour the free-living stages, but periodic outbreaks occur more widely during periods of transient environmental favourability. The clinical diagnosis of haemonchosis is based mostly on the detection of anaemia in association with a characteristic epidemiological picture, and confirmed at postmortem by the finding of large numbers of H. contortus in the abomasum. The detection of impending haemonchosis relies chiefly on periodic monitoring for anaemia, including through the 'FAMACHA' conjunctival-colour index, or through faecal worm egg counts and other laboratory procedures. A range of anthelmintics for use against H. contortus is available, but in most endemic situations anthelmintic resistance significantly limits the available treatment options. Effective preventative programmes vary depending on environments and enterprise types, and according to the scale of the haemonchosis risk and the local epidemiology of infections, but should aim to prevent disease outbreaks while maintaining anthelmintic efficacy. Appropriate strategies include animal management programmes to avoid excessive H. contortus challenge, genetic and nutritional approaches to enhance resistance and resilience to infection, and the monitoring of H. contortus infection on an individual animal or flock basis. Specific strategies to manage anthelmintic resistance centre on the appropriate use of effective anthelmintics, and refugia-based treatment schedules. Alternative approaches, such as biological control, may also prove useful, and vaccination against H. contortus appears to have significant potential in control programmes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Review article: the pathophysiology, differential diagnosis and management of rumination syndrome. (United States)

    Tack, J; Blondeau, K; Boecxstaens, V; Rommel, N


    Rumination syndrome, characterised by the effortless, often repetitive, regurgitation of recently ingested food into the mouth, was originally described in children and in the developmentally disabled. It is now well-recognised that rumination syndrome occurs in patients of all ages and cognitive abilities. To review a scholarly review on our current understanding of the rumination syndrome. The review was conducted on the basis of a medline search to identify relevant publications pertaining to the pathophysiology, clinical diagnosis and management of rumination syndrome. The Rome III consensus established diagnostic criteria for rumination syndrome in adults, children and infants. A typical history can be highly suggestive but oesophageal (high resolution) manometry/impedance with ingestion of a meal may help to distinguish rumination syndrome from other belching/regurgitation disorders. The pathophysiology is incompletely understood, but involves a rise in intra-gastric pressure, generated by a voluntary, but often unintentional, contraction of the abdominal wall musculature, at a time of low pressure in the lower oesophageal sphincter, causing retrograde movement of gastric contents into the oesophagus. To date, controlled trials in the treatment rumination syndrome are lacking. The mainstay of treatment for rumination syndrome is explanation and behavioural treatment which consists of habit reversal techniques that compete with the urge to regurgitate. Chewing gum, prokinetics, baclofen and even antireflux surgery have been proposed as adjunctive therapies, but high quality studies are generally lacking. Rumination is an under-recognised condition with incompletely understood pathophysiology. Behavioural therapy seems effective, but controlled treatment trials are lacking. © 2011 Blackwell Publishing Ltd.

  9. Prevalence of Fasciola species in ruminants under extensive management system in Ibadan southwestern Nigeria. (United States)

    Adediran, O A; Adebiyi, A I; Uwalaka, E C


    Fasciolosis is a zoonotic trematode of ruminants and a common parasite in cattle in Nigeria. With the increasing numbers of small household cattle herds kept under extensive management system as well as the more usual small ruminants, there is a possibility therefore that parasites common to these ruminants but better adapted to cattle such as Fasciola may also be on the increase within the small ruminant population as they graze freely over the same wide area and sometimes freely mix. The aim of the study is to determine the prevalence of Fasciola spp in sheep, goats and cattle in Ibadan during the short wet season, (August-October 2011). Faecal samples were collected per rectum from 440 each of goats and sheep and 291 cattle. Helminth ova were recovered using sedimentation technique for faecal examination. A total of 40 goats (9.1%), 53 sheep (12.0%) and 158 cattle (54.3%) were positive for Fasciola ova which reflects an increase in prevalence in small ruminants. This implies that the entire Ibadan is endemic for Fasciola spp and small ruminants may serve as an important link in the epidemiology of Fasciola spp infection. More so, this has implications for the scavenging household animals which receive little or no medical attention and man that may acquire this trematode by inadvertently eating vegetables with encysted Fasciola metacercariae.

  10. Productivity, digestion, and health responses to hindgut acidosis in ruminants (United States)

    The role of large intestinal or hindgut fermentation in ruminant nutrition has received little research attention in recent decades. Though the contribution of the hindgut to total tract nutrient digestion is substantially less than the contribution from the rumen, hindgut fermentation impacts anima...

  11. Negative thoughts and health: associations among rumination, immunity, and health care utilization in a young and elderly sample

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    Thomsen, Dorthe Kirkegaard; Mehlsen, Mimi Yung; Hokland, Marianne


    OBJECTIVE: In the present study, it was tested whether rumination-negative, recurrent thoughts-would be associated with immune parameters and health care utilization. Because rumination has been associated with sadness and subjective sleep quality, it was tested whether these factors mediated the...... associations were found for the young participants. CONCLUSION: The results suggest that rumination may be associated with health-related measures in the elderly. Thus, negative thoughts may be detrimental to health, independently of negative affect.......OBJECTIVE: In the present study, it was tested whether rumination-negative, recurrent thoughts-would be associated with immune parameters and health care utilization. Because rumination has been associated with sadness and subjective sleep quality, it was tested whether these factors mediated...... displayed a positive association with total leukocyte count, total lymphocyte count, and number of B cells among the elderly, and this was not mediated by sadness or subjective sleep quality. Rumination was also positively associated with number of telephone consultations during the follow...

  12. Efficacy study of Styplon Vet Bolus as supportive therapy in management of hemorrhagic conditions of ruminants

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    B R Ravikumar

    Full Text Available On-field trial was conducted in dairy animals to evaluate efficacy of Styplon Vet Bolus (M/s Himalaya Drug Company, Banglore, India as supportive therapy in management of hemorrhagic conditions (Hematuria, hemoagalectia, bleeding wounds, uterine bleeding and epistaxis of ruminants. Styplon Vet 1-2 boli twice daily was administered to cows and buffaloes, and ½ bolus twice daily for sheep till they recover clinically. The results indicated that Styplon Vet Bolus is a safe and effective styptic in ruminants. [Vet World 2009; 2(12.000: 470-471

  13. Regulation of carnitine status in ruminants and efficacy of carnitine supplementation on performance and health aspects of ruminant livestock: a review. (United States)

    Ringseis, Robert; Keller, Janine; Eder, Klaus


    Carnitine has long been known to play a critical role for energy metabolism. Due to this, a large number of studies have been carried out to investigate the potential of supplemental carnitine in improving performance of livestock animals including ruminants, with however largely inconsistent results. An important issue that has to be considered when using carnitine as a feed additive is that the efficacy of supplemental carnitine is probably dependent on the animal's carnitine status, which is affected by endogenous carnitine synthesis, carnitine uptake from the gastrointestinal tract and carnitine excretion. The present review aims to summarise the current knowledge of the regulation of carnitine status and carnitine homeostasis in ruminants, and comprehensively evaluate the efficacy of carnitine supplementation on performance and/or health in ruminant livestock by comparing the outcomes of studies with carnitine supplementation in dairy cattle, growing and finishing cattle and sheep. While most of the studies show that supplemental carnitine, even in ruminally unprotected form, is bioavailable in ruminants, its effect on either milk or growth performance is largely disappointing. However, supplemental carnitine appears to be a useful strategy to offer protection against ammonia toxicity caused by consumption of high levels of non-protein N or forages with high levels of soluble N both, in cattle and sheep.

  14. Invited review: Practical feeding management recommendations to mitigate the risk of subacute ruminal acidosis in dairy cattle. (United States)

    Humer, E; Petri, R M; Aschenbach, J R; Bradford, B J; Penner, G B; Tafaj, M; Südekum, K-H; Zebeli, Q


    Rumen health is of vital importance in ensuring healthy and efficient dairy cattle production. Current feeding programs for cattle recommend concentrate-rich diets to meet the high nutritional needs of cows during lactation and enhance cost-efficiency. These diets, however, can impair rumen health. The term "subacute ruminal acidosis" (SARA) is often used as a synonym for poor rumen health. In this review, we first describe the physiological demands of cattle for dietary physically effective fiber. We also provide background information on the importance of enhancing salivary secretions and short-chain fatty acid absorption across the stratified squamous epithelium of the rumen; thus, preventing the disruption of the ruminal acid-base balance, a process that paves the way for acidification of the rumen. On-farm evaluation of dietary fiber adequacy is challenging for both nutritionists and veterinarians; therefore, this review provides practical recommendations on how to evaluate the physical effectiveness of the diet based on differences in particle size distribution, fiber content, and the type of concentrate fed, both when the latter is part of total mixed ration and when it is supplemented in partial mixed rations. Besides considering the absolute amount of physically effective fiber and starch types in the diet, we highlight the role of several feeding management factors that affect rumen health and should be considered to control and mitigate SARA. Most importantly, transitional feeding to ensure gradual adaptation of the ruminal epithelium and microbiota; monitoring and careful management of particle size distribution; controlling feed sorting, meal size, and meal frequency; and paying special attention to primiparous cows are some of the feeding management tools that can help in sustaining rumen health in high-producing dairy herds. Supplementation of feed additives including yeast products, phytogenic compounds, and buffers may help attenuate SARA

  15. Assessment of farmer knowledge of large ruminant health and production in developing village-level biosecurity in northern Lao PDR. (United States)

    Nampanya, S; Rast, L; Khounsy, S; Windsor, P A


    The purpose of this study was to determine baseline knowledge and identify knowledge gaps of farmers on biosecurity, risk of transmission of transboundary diseases and large ruminant health and production in three provinces of northern Laos, Hua Phan (HP), Luang Prabang (LPB) and Xieng Khoung (XK). The survey was conducted in six villages that are project sites for an Australian Centre for International Agricultural Research (ACIAR) project, with two villages located in each of the three provinces. A census survey was conducted by interview with all 238 farmers participating in the ACIAR project, using a structured questionnaire. The interviews were conducted in Lao language and took 1-2 h per farmer. The answers were recorded in Lao and the survey data were translated into English and transcribed into Microsoft Excel, and a linear mixed model in the Genstat statistical analysis package was used to compare quantitative traits between the target provinces. The results showed that the prediction mean of farmer knowledge scores on parasitic disorders, infectious disease, reproduction and nutrition management were significantly different between the target provinces. The prediction mean of farmer knowledge scores on infectious disease questions ranged between 5.11 in HP to 8.54 in XK of 24 marks (P < 0.001). The prediction mean of total knowledge scores was 13.48 in LPB and 19.29 in XK of 42 marks (P < 0.001). The results indicate both the need for and scope required to attain improvements in farmer knowledge of large ruminant health and production. It was concluded that a participatory research and extension programme to address village-level biosecurity and reduce disease risks, plus enhance large ruminant production capabilities of smallholder producers, is a valid and potentially important strategy to address transboundary disease risk and rural poverty in northern Laos. © 2010 Blackwell Verlag GmbH.

  16. Ruminant Nutrition Symposium: Modulation of metabolism through nutrition and management (United States)

    The primary role of the dairy cow is to help provide high-quality protein and other nutrients through lactation to the human diet. It is clear that these high-producing and long lactations are stressful on the cows, and minor changes in nutrition and management can have significant impacts on profi...

  17. Peripartal rumination dynamics and health status in cows calving in hot and cool seasons. (United States)

    Paudyal, S; Maunsell, F; Richeson, J; Risco, C; Donovan, A; Pinedo, P


    Our objective was to evaluate the effect of season of calving, associated with variable levels of heat stress, on the dynamics of rumination during the prepartum period and early lactation of cows that were healthy or affected by peripartal health disorders. Three weeks before the estimated due date, 210 multiparous Holstein cows at the University of Florida Dairy Unit were affixed with a neck collar containing rumination loggers, providing rumination time (RT) in 2-h periods. One blood sample was collected in a subpopulation of cows (n=76) at 12 to 48h postcalving to assess metabolic status by determining serum calcium, nonesterified fatty acid, and β-hydroxybutyrate concentrations. The occurrence of peripartal health disorders (dystocia, clinical ketosis, clinical hypocalcemia, metritis, and mastitis) was assessed by University of Florida veterinarians and trained farm personnel. We analyzed the dynamics of daily RT over ± 14d relative to parturition in cows that were healthy or affected by specific health disorders by season of calving [hot season, June to September (n=77); cool season, November to April (n=118)] using repeated measures analysis and comparison of least squares means at different time points relative to calving. Rumination was consistently reduced on the day of calving in both healthy and sick cows in both the hot and cool seasons. Only hot-season calvings had shorter average daily RT prepartum and postpartum in cows affected by severe negative energy balance and subclinical ketosis. Dystocia during the hot season was associated with shorter daily RT prepartum; for cool-season calvings, cows with dystocia had reduced RT postpartum. We also observed reduced RT in cows with ketosis prepartum and postpartum in both the hot and cool seasons. Daily RT was reduced postpartum in cows with hypocalcemia and mastitis that calved during the cool season, and it was shorter in cows with metritis in both the hot and cool seasons. Our results indicated that

  18. Psychological rumination and recovery from work in intensive care professionals: associations with stress, burnout, depression and health. (United States)

    Vandevala, Tushna; Pavey, Louisa; Chelidoni, Olga; Chang, Nai-Feng; Creagh-Brown, Ben; Cox, Anna


    The work demands of critical care can be a major cause of stress in intensive care unit (ICU) professionals and lead to poor health outcomes. In the process of recovery from work, psychological rumination is considered to be an important mediating variable in the relationship between work demands and health outcomes. This study aimed to extend our knowledge of the process by which ICU stressors and differing rumination styles are associated with burnout, depression and risk of psychiatric morbidity among ICU professionals. Ninety-six healthcare professionals (58 doctors and 38 nurses) who work in ICUs in the UK completed a questionnaire on ICU-related stressors, burnout, work-related rumination, depression and risk of psychiatric morbidity. Significant associations between ICU stressors, affective rumination, burnout, depression and risk of psychiatric morbidity were found. Longer working hours were also related to increased ICU stressors. Affective rumination (but not problem-solving pondering or distraction detachment) mediated the relationship between ICU stressors, burnout, depression and risk of psychiatric morbidity, such that increased ICU stressors, and greater affective rumination, were associated with greater burnout, depression and risk of psychiatric morbidity. No moderating effects were observed. Longer working hours were associated with increased ICU stressors, and increased ICU stressors conferred greater burnout, depression and risk of psychiatric morbidity via increased affective rumination. The importance of screening healthcare practitioners within intensive care for depression, burnout and psychiatric morbidity has been highlighted. Future research should evaluate psychological interventions which target rumination style and could be made available to those at highest risk. The efficacy and cost effectiveness of delivering these interventions should also be considered.

  19. Evaluation of the Impact of Ruminant Trans Fatty Acids on Human Health: Important Aspects to Consider. (United States)

    Kuhnt, Katrin; Degen, Christian; Jahreis, Gerhard


    The definition and evaluation of trans fatty acids (TFA) with regard to foodstuffs and health hazard are not consistent. Based on the current situation, the term should be restricted only to TFA with isolated double bonds in trans-configuration. Conjugated linoleic acids (CLA) should be separately assessed. Ideally, the origin of the consumed fat should be declared, i.e., ruminant TFA (R-TFA) and industrial TFA (non-ruminant; I-TFA). In ruminant fat, more than 50% of R-TFA consists of vaccenic acid (C18:1 t11). In addition, natural CLA, i.e., c9,t11 CLA is also present. Both are elevated in products from organic farming. In contrast to elaidic acid (t9) and t10, which occur mainly in partially hydrogenated industrial fat, t11 is partially metabolized into c9,t11 CLA via Δ9-desaturation. This is the major metabolic criterion used to differentiate between t11 and other trans C18:1. t11 indicates health beneficial effects in several studies. Moreover, CLA in milk fat is associated with the prevention of allergy and asthma. An analysis of the few studies relating to R-TFA alone makes clear that no convincing adverse physiological effect can be attributed to R-TFA. Only extremely high R-TFA intakes cause negative change in blood lipids. In conclusion, in most European countries, the intake of R-TFA is assessed as being low to moderate. Restriction of R-TFA would unjustifiably represent a disadvantage for organic farming of milk.

  20. Is there an association between rumination and self-reported physical health? A one-year follow-up in a young and an elderly sample

    DEFF Research Database (Denmark)

    Thomsen, Dorthe Kirkegaard; Mehlsen, Mimi Yung; Olesen, Frede


    Cross-sectional studies have suggested an association between rumination and subjective health. The aim of the present study was to investigate in a longitudinal design whether rumination was related to self-reported physical health. A total of 96 young (age range 20-35) and 110 elderly (age range...... 70-85) participants completed questionnaires measuring rumination, negative affect, life events, and self-reported physical health at baseline and at 1-year follow-up. Multiple linear regressions showed a significant association between self-reported physical health at time I only for the elderly...... and negative affect mediated the association. At follow-up, rumination was significantly associated with self-reported physical health only for the young and the association was only partly mediated by negative affect. In conclusion, rumination is associated with poorer self-reported physical health...

  1. Relationships between rumination time, metabolic conditions, and health status in dairy cows during the transition period. (United States)

    Soriani, N; Trevisi, E; Calamari, L


    The main objective of this experiment was to monitor the rumination pattern during the transition period in primiparous (PR) and pluriparous (PL) dairy cows and to investigate its relationships with metabolic conditions, milk yield, and health status. The study was carried out in an experimental free-stall barn and involved 32 Italian Friesian cows (9 PR and 23 PL) during the transition phase. The rumination time (RT) was recorded with an automatic system (HR-Tag), and data were calculated and summarized in 2-h intervals. Blood samples were collected during the transition phase to assess biochemical variables related to energy, protein, and mineral metabolism, as well as markers of inflammatory conditions and some enzyme activity. Daily milk yield, BW, nutritional condition, and health status were also recorded. The average RT before calving (-20 to -6 d) was 463 min/d in PR (range 270 to 620) and 522 min/d in PL (range 411 to 640). In the early lactation [15 to 40 d in milk (DIM)], the average RT was 504 min/d in PR (range 400 to 585) and 562 min/d in PL (range 414 to 685) and was positively correlated with milk yield (r = 0.36; P Cows with reduced RT before calving maintained reduced RT after calving and suffered a greater frequency of disease than cows with greater RT in late pregnancy. Moreover, cows characterized by mild inflammatory conditions and without health disorders or only mild health disorders during the puerperium showed a greater average rumination time (over 520 min/d) during the first 10 d of lactation. Conversely, the decreased RT (450 min/d) during the first few days of lactation was observed in cows with subclinical diseases or health disorders. Cows affected by clinical mastitis during the trial showed a reduction of RT and a change in its variability already some days before the drug treatment. Our results suggest that the automatic measurement of RT is useful to predict calving time and to quickly obtain information on health status of the

  2. Use of rumination and activity monitoring for the identification of dairy cows with health disorders: Part III. Metritis. (United States)

    Stangaferro, M L; Wijma, R; Caixeta, L S; Al-Abri, M A; Giordano, J O


    The objectives of this study were to evaluate (1) the performance of an automated health-monitoring system (AHMS) to identify cows with metritis based on an alert system (health index score, HIS) that combines rumination time and physical activity; (2) the number of days between the first HIS alert and clinical diagnosis (CD) of metritis by farm personnel; and (3) the daily rumination time, physical activity, and HIS patterns around CD. In this manuscript, the overall performance of HIS to detect cows with all disorders of interest in this study [ketosis, displaced abomasum, indigestion (companion paper, part I), mastitis (companion paper, part II), and metritis] is also reported. Holstein cattle (n=1,121; 451 nulliparous and 670 multiparous) were fitted with a neck-mounted electronic rumination and activity monitoring tag (HR Tags, SCR Dairy, Netanya, Israel) from at least -21 to 80 d in milk (DIM). Raw data collected in 2-h periods were summarized per 24 h as daily rumination and activity. An HIS (0 to 100 arbitrary units) was calculated daily for individual cows with an algorithm that used rumination and activity. A positive HIS outcome was defined as an HIS of cows (n=459) at -11±3, -4±3, 0, 3±1, 7±1, 14±1, and 28±1 DIM. The overall sensitivity of HIS was 55% for all cases of metritis (n=349), but it was greater for cows with metritis and another disorder (78%) than for cows with metritis only (53%). Cows diagnosed with metritis and flagged based on HIS had substantial alterations in their rumination, activity, and HIS patterns around CD, alterations of blood markers of metabolic and health status around calving, reduced milk production, and were more likely to exit the herd than cows not flagged based on the HIS and cows without disease, suggesting that cows flagged based on the HIS had a more severe episode of metritis. Including all disorders of interest for this study, the overall sensitivity was 59%, specificity was 98%, positive predictive value was

  3. Ruminant self-medication against gastrointestinal nematodes: evidence, mechanism, and origins☆ (United States)

    Villalba, Juan J.; Miller, James; Ungar, Eugene D.; Landau, Serge Y.; Glendinning, John


    Gastrointestinal helminths challenge ruminants in ways that reduce their fitness. In turn, ruminants have evolved physiological and behavioral adaptations that counteract this challenge. Ruminants display anorexia and avoidance behaviors, which tend to reduce the incidence of parasitism. In addition, ruminants appear to learn to self-medicate against gastrointestinal parasites by increasing consumption of plant secondary compounds with antiparasitic actions. This selective feeding improves health and fitness. Here, we review the evidence for self-medication in ruminants, propose a hypothesis to explain self-medicative behaviors (based on post-ingestive consequences), and discuss mechanisms (e.g., enhanced neophilia, social transmission) that may underlie the ontogeny and spread of self-medicative behaviors in social groups. A better understanding of the mechanisms that underlie and trigger self-medication in parasitized animals will help scientists devise innovative and more sustainable management strategies for improving ruminant health and well-being. PMID:24971486

  4. Ruminal Prevotella spp. may play an important role in the conversion of plant lignans into human health beneficial antioxidants.

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    Ana L B Schogor

    Full Text Available Secoisolariciresinol diglucoside (SDG, the most abundant lignan in flaxseed, is metabolized by the ruminal microbiota into enterolignans, which are strong antioxidants. Enterolactone (EL, the main mammalian enterolignan produced in the rumen, is transferred into physiological fluids, with potentially human health benefits with respect to menopausal symptoms, hormone-dependent cancers, cardiovascular diseases, osteoporosis and diabetes. However, no information exists to our knowledge on bacterial taxa that play a role in converting plant lignans into EL in ruminants. In order to investigate this, eight rumen cannulated cows were used in a double 4 × 4 Latin square design and fed with four treatments: control with no flax meal (FM, or 5%, 10% and 15% FM (on a dry matter basis. Concentration of EL in the rumen increased linearly with increasing FM inclusion. Total rumen bacterial 16S rRNA concentration obtained using Q-PCR did not differ among treatments. PCR-T-RFLP based dendrograms revealed no global clustering based on diet indicating between animal variation. PCR-DGGE showed a clustering by diet effect within four cows that had similar basal ruminal microbiota. DNA extracted from bands present following feeding 15% FM and absent with no FM supplementation were sequenced and it showed that many genera, in particular Prevotella spp., contributed to the metabolism of lignans. A subsequent in vitro study using selected pure cultures of ruminal bacteria incubated with SDG indicated that 11 ruminal bacteria were able to convert SDG into secoisolariciresinol (SECO, with Prevotella spp. being the main converters. These data suggest that Prevotella spp. is one genus playing an important role in the conversion of plant lignans to human health beneficial antioxidants in the rumen.

  5. Consequences of plant phenolic compounds for productivity and health of ruminants. (United States)

    Waghorn, Garry C; McNabb, Warren C


    Plant phenolic compounds are diverse in structure but are characterised by hydroxylated aromatic rings (e.g. flavan-3-ols). They are categorised as secondary metabolites, and their function in plants is often poorly understood. Many plant phenolic compounds are polymerised into larger molecules such as the proanthocyanidins (PA; condensed tannins) and lignins. Only the lignins, PA, oestrogenic compounds and hydrolysable tannins will be considered here. Lignins slow the physical and microbial degradation of ingested feed, because of resilient covalent bonding with hemicellulose and cellulose, rather than any direct effects on the rumen per se. The PA are prevalent in browse and are expressed in the foliage of some legumes (e.g. Lotus spp.), but rarely in grasses. They reduce the nutritive value of poor-quality diets, but can also have substantial benefits for ruminant productivity and health when improved temperate forages are fed. Beneficial effects are dependent on the chemical and physical structure, and concentration of the PA in the diet, but they have been shown to improve live-weight gain, milk yield and protein concentration, and ovulation rate. They prevent bloat in cattle, reduce gastrointestinal nematode numbers, flystrike and CH4 production. Some phenolic compounds (e.g. coumestans) cause temporary infertility, whilst those produced by Fusarium fungi found in pasture, silage or stored grains can cause permanent infertility. The HT may be toxic because products of their metabolism can cause liver damage and other metabolic disorders.

  6. Emotional versus cognitive rumination: are they differentially affecting long-term psychological health? The impact of stressors and personality in dental students. (United States)

    Hamesch, Ulla; Cropley, Mark; Lang, Jessica


    In the process of recovery from work, rumination is considered as an important mediating variable in the relationship between work demands and psychological health outcomes. Past research differentiated affective rumination from problem-solving pondering. The aim of the present study was to test a moderated mediation model for these two distinct ruminative states and to show how personality (i.e. neuroticism and conscientiousness) can alter the mediating effect. The present study is based on 119 surveys from dental students with a time lag of 6 months. Participants filled out questionnaires assessing specific study-relevant performance demands, rumination and personality and a screening measure for psychological health status. Neuroticism was found to moderate the demand-affective rumination association, but conscientiousness did not moderate the demand-problem-solving pondering association. Moderated mediation analysis revealed that affective rumination mediates the impact of demands on psychological health only for individuals low in neuroticism. Findings are discussed regarding potential interventions for dental students to prevent negative psychological health outcomes due to increased work-related demands in the long term. Copyright © 2014 John Wiley & Sons, Ltd.

  7. Acidosis ruminal en bovinos lecheros: implicaciones sobre la producción y la salud animal - Ruminal acidosis in dairy cattle: implications for animal health and production


    Granja Salcedo, Yury Tatiana; Ribeiro Junior, Carlos Stefenson; Toro Gomez, Daniela Juliana; Rivera Calderón, Luis Gabriel; Machado, Mirela; Manrique Ardila, Adalberto


    Ruminal acidosis is a major problem in the production of cattle fed diets rich in concentrates, especially in cows of high milk production. During rumen acidosis rumen pH is depressed due to the accumulation of volatile fatty acids and the decline of the mechanisms responsible for rumen buffering. Among the main causes of acidosis include consumption of diets high in fiber carbohydrates and lack of effective fiber added to them. The increase in ruminal acidity and osmolality by the accumulati...

  8. Dynamics of small ruminant development in Central Java-Indonesia

    NARCIS (Netherlands)

    Gede Suparta Budisatria, I.


    Small ruminants are an important but neglected resource in developing countries. Small ruminant production systems are complex. The multiple goals related to small ruminants, combined with the complexity of their management, and the resources and social arrangements involved, make small ruminants

  9. Health care engineering management. (United States)

    Jarzembski, W B


    Today, health care engineering management is merely a concept of dreamers, with most engineering decisions in health care being made by nonengineers. It is the purpose of this paper to present a rationale for an integrated hospital engineering group, and to acquaint the clinical engineer with some of the salient features of management concepts. Included are general management concepts, organization, personnel management, and hospital engineering systems.

  10. The ties that bind: Ingroup ties are linked with diminished inflammatory immune responses and fewer mental health symptoms through less rumination. (United States)

    Ysseldyk, Renate; McQuaid, Robyn J; McInnis, Opal A; Anisman, Hymie; Matheson, Kimberly


    The present research explored whether components of social identity, namely ingroup ties, affect, and centrality, were differentially linked to mental health and inflammatory immune responses, and whether rumination mediated those relations. Study 1 (N = 138) indicated that stronger ingroup ties were associated with fewer mental health (depressive and post-traumatic stress) symptoms; those relations were mediated by the tendency for individuals with strong ties to rely less on ruminative coping to deal with a stressful life event. Study 2 (N = 54) demonstrated that ingroup ties were negatively associated with depressive symptoms, dispositional rumination, as well as stress-linked inflammatory elements at the physiological level. Consistent associations for centrality and ingroup affect were absent, suggesting that ingroup ties may have unique health benefits.

  11. Prevalence of Linguatula Serrata Infection in Domestic Ruminants in West Part of Iran: Risk Factors and Public Health Implications

    Directory of Open Access Journals (Sweden)



    Full Text Available Linguatulosis is one of the neglected parasitic zoonoses. Domestic ruminants are the important source for human infection. The main goal of the present investigation was to evaluate the prevalence of nymphal stages of L. serrata in domestic ruminant in Hamedan province, western Iran. The mesenteric and mediastinal lymph node of 1080 animals were taken randomly from different slaughterhouses of Hamedan province. All lymph nodes were examined for nymphal stage of L. serrata using parasitological methods (digestion technique. The nymph of L. serrata was found in 31.4% (69/220 of goats, 15% (60/400 of sheep, and 7.4% (34/460 of cattle (P=0.457. The infection rate in beef cattle, dairy cattle and native cattle was 1.3%, 6.4% and 12.6%, respectively (P=0.981. No evidence of correlation between gender, age groups, and L. serrata infection rate in sheep and cattle (P>0.05. In goats, the infection rate in >2yr old (48% was higher than .2yr old (8.6% (P<0.0001, OR=5.6; also the infection rate was 23.7% and 35.7% in male and female goats, respectively (P=0.065. This is the first report of linguatulosis in domestic animals from western Iran. The results indicate that linguatulosis may partly be responsible for economic losses in domestic ruminant husbandry in this region. Therefore, designing control strategies for a better management in animals farm to reduce the risk of zoonotic outbreaks is highly recommended

  12. Health care operations management

    NARCIS (Netherlands)

    Carter, M.W.; Hans, Elias W.; Kolisch, R.


    Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully

  13. Growth, ruminal measurements, and health characteristics of Holstein bull calves fed an Aspergillus oryzae fermentation extract. (United States)

    Yohe, T T; O'Diam, K M; Daniels, K M


    calves were treated for respiratory ailments and respiratory treatment cost was lower for AMF compared with control. Several factors may have contributed to an overall lack of observed treatment effect in this study, including include the use of a low-forage (compared with concentrate) diet, immunocompetent calves, and the selected product dose and routes of delivery. Dietary inclusion (2 g/d) of an extract of A. oryzae did not affect calf growth, intake, and ruminal or health measurements. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  14. Contrast radiography of the lower urinary tract in the management of obstructive urolithiasis in small ruminants and swine

    International Nuclear Information System (INIS)

    Palmer, J.L.; Dykes, N.L.; Love, K.; Fubini, S.L.


    Contrast radiographic visualization of the small ruminant and porcine lower urinary tract is an infrequently used modality for the evaluation and management of obstructive urolithiasis. The administration of contrast medium through a tube cystostomy catheter used to divert urine flow until the resolution of the obstruction may provide an easy method to evaluate the status of the urethral obstruction. Contrast fluoroscopy is utilized to monitor and visualize therapeutic flushing of the urethra. A review of 26 patients seen at the Veterinary Medical Teaching Hospital suggested that among the radiographic techniques used, positive contrast normograde cystourethrography through the tube cystostomy catheter allowed the best visualization of the lower urinary tract structures and enabled assessment of the resolution of the obstructive lesion

  15. Integrated Building Health Management (United States)

    National Aeronautics and Space Administration — Abstract: Building health management is an important part in running an efficient and cost-effective building. Many problems in a building’s system can go undetected...

  16. Integrated Health Management Definitions (United States)

    National Aeronautics and Space Administration — The Joint Army Navy NASA Air Force Modeling and Simulation Subcommittee's Integrated Health Management panel was started about 6 years ago to help foster...

  17. Paratuberculosis on small ruminant dairy farms in Ontario, Canada: A survey of management practices. (United States)

    Bauman, Cathy A; Jones-Bitton, Andria; Menzies, Paula; Jansen, Jocelyn; Kelton, David


    A cross-sectional study was undertaken (October 2010 to August 2011) to determine the risk factors for dairy goat herds and dairy sheep flocks testing positive for paratuberculosis (PTB) in Ontario, Canada. A questionnaire was administered to 50 producers during a farm visit in which concurrently, 20 randomly selected, lactating animals over the age of 2 years underwent sampling for paratuberculosis testing. Only 1 of 50 farms (2.0%) was closed to animal movement, whereas 96.6% of dairy goat farms and 94.1% of sheep farms purchased livestock from other producers. Only 10.3% of dairy goat, and no dairy sheep farms used artificial insemination. Manure was spread on grazing pastures by 65.5% and 70.6% of dairy goat and dairy sheep farms, respectively. Because of the high true-prevalence of paratuberculosis infection detected, no risk factor analysis could be performed. This study demonstrates that biosecurity practices conducive to transmission of PTB are highly prevalent in Ontario small ruminant dairy farms.

  18. Square Pegs and Round Holes: Ruminations on the Relationship between Performance Appraisal and Performance Management (United States)

    Gravina, Nicole E.; Siers, Brian P.


    Models of comprehensive Performance Management systems include both employee development and evaluative components. The Organizational Behavior Management discipline focuses almost exclusively on the developmental component, while the Industrial and Organizational Psychology discipline is focused on use of performance appraisals. Performance…

  19. Ruminant feeding systems in Southeast Asia

    International Nuclear Information System (INIS)

    Jalaludin, S.


    Ruminant production in Southeast Asia is not a very large industry but has the potential for expansion because there is an adequate feed supply of conventional and non-conventional types. Grazing ruminants on permanent pasture and wasteland is the most common method of animal management practised by small scale farmers. Programmes to improve pasture in the grazing resources should be implemented. Introducing ruminants into plantations is a viable proposition. Further increases in ruminant productivity can be attained if the technology on utilizing crop residues and by-products can be transferred to farmers and applied more widely. (author). 39 refs, 11 tabs

  20. Review: Towards the agroecological management of ruminants, pigs and poultry through the development of sustainable breeding programmes. II. Breeding strategies. (United States)

    Phocas, F; Belloc, C; Bidanel, J; Delaby, L; Dourmad, J Y; Dumont, B; Ezanno, P; Fortun-Lamothe, L; Foucras, G; Frappat, B; González-García, E; Hazard, D; Larzul, C; Lubac, S; Mignon-Grasteau, S; Moreno, C R; Tixier-Boichard, M; Brochard, M


    Agroecology uses ecological processes and local resources rather than chemical inputs to develop productive and resilient livestock and crop production systems. In this context, breeding innovations are necessary to obtain animals that are both productive and adapted to a broad range of local contexts and diversity of systems. Breeding strategies to promote agroecological systems are similar for different animal species. However, current practices differ regarding the breeding of ruminants, pigs and poultry. Ruminant breeding is still an open system where farmers continue to choose their own breeds and strategies. Conversely, pig and poultry breeding is more or less the exclusive domain of international breeding companies which supply farmers with hybrid animals. Innovations in breeding strategies must therefore be adapted to the different species. In developed countries, reorienting current breeding programmes seems to be more effective than developing programmes dedicated to agroecological systems that will struggle to be really effective because of the small size of the populations currently concerned by such systems. Particular attention needs to be paid to determining the respective usefulness of cross-breeding v. straight breeding strategies of well-adapted local breeds. While cross-breeding may offer some immediate benefits in terms of improving certain traits that enable the animals to adapt well to local environmental conditions, it may be difficult to sustain these benefits in the longer term and could also induce an important loss of genetic diversity if the initial pure-bred populations are no longer produced. As well as supporting the value of within-breed diversity, we must preserve between-breed diversity in order to maintain numerous options for adaptation to a variety of production environments and contexts. This may involve specific public policies to maintain and characterize local breeds (in terms of both phenotypes and genotypes), which could

  1. Health physics information management

    International Nuclear Information System (INIS)

    Schauss, R.D.


    The records that men have kept over the centuries have made the civilizations of man possible. Recorded history shows that our progress is closely correlated to man's ability to communicate recorded facts to others, and to effectively use knowledge gained by others. During the past few decades our ability to store and use information, and to reach larger audiences has grown dramatically. The advent of computers is discussed and their evolution to the state-of-the-art is described. Data bases, batch and on-line processing, centralized and distributed processing as well as other computer jargon are generally explained and examples are given as they apply specifically to health physics programs. It is proposed that systems designed to manage information cannot be adapted to health physics problems without extensive involvement of the HP who must use the computerized program. Specific problems which arise during the development of a computerized health physics program are explained

  2. 9 CFR 93.409 - Articles accompanying ruminants. (United States)


    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Articles accompanying ruminants. 93.409 Section 93.409 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.409 Articles accompanying ruminants...

  3. Intelligent Vehicle Health Management (United States)

    Paris, Deidre E.; Trevino, Luis; Watson, Michael D.


    As a part of the overall goal of developing Integrated Vehicle Health Management systems for aerospace vehicles, the NASA Faculty Fellowship Program (NFFP) at Marshall Space Flight Center has performed a pilot study on IVHM principals which integrates researched IVHM technologies in support of Integrated Intelligent Vehicle Management (IIVM). IVHM is the process of assessing, preserving, and restoring system functionality across flight and ground systems (NASA NGLT 2004). The framework presented in this paper integrates advanced computational techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of INM. These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, the objective of this pilot program is to develop and integrate technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear the INM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition, to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission

  4. Health infrastructural challenges to health management information ...

    African Journals Online (AJOL)

    Aim: This study aims to assess health management information systems at the ... workers' ability to practice and use the health data generated at their Primary Health ... Only 2 (5.7%) of the health centres surveyed were capable of operating the ... The government at all levels should ensure collective effort and political will to ...

  5. Invited review: effect, persistence, and virulence of coagulase-negative Staphylococcus species associated with ruminant udder health. (United States)

    Vanderhaeghen, W; Piepers, S; Leroy, F; Van Coillie, E; Haesebrouck, F; De Vliegher, S


    The aim of this review is to assess the effect of coagulase-negative staphylococci (CNS) species on udder health and milk yield in ruminants, and to evaluate the capacity of CNS to cause persistent intramammary infections (IMI). Furthermore, the literature on factors suspected of playing a role in the pathogenicity of IMI-associated CNS, such as biofilm formation and the presence of various putative virulence genes, is discussed. The focus is on the 5 CNS species that have been most frequently identified as causing bovine IMI using reliable molecular identification methods (Staphylococcus chromogenes, Staphylococcus simulans, Staphylococcus haemolyticus, Staphylococcus xylosus, and Staphylococcus epidermidis). Although the effect on somatic cell count and milk production is accepted to be generally limited or nonexistent for CNS as a group, indications are that the typical effects differ between CNS species and perhaps even strains. It has also become clear that many CNS species can cause persistent IMI, contrary to what has long been believed. However, this trait appears to be quite complicated, being partly strain dependent and partly dependent on the host's immunity. Consistent definitions of persistence and more uniform methods for testing this phenomenon will benefit future research. The factors explaining the anticipated differences in pathogenic behavior appear to be more difficult to evaluate. Biofilm formation and the presence of various staphylococcal virulence factors do not seem to (directly) influence the effect of CNS on IMI but the available information is indirect or insufficient to draw consistent conclusions. Future studies on the effect, persistence, and virulence of the different CNS species associated with IMI would benefit from using larger and perhaps even shared strain collections and from adjusting study designs to a common framework, as the large variation currently existing therein is a major problem. Also within-species variation should

  6. Managing anthelmintic resistance in small ruminant livestock of resource-poor farmers in South Africa. (United States)

    Vattaa, A F; Lindberg, A L E


    Gastrointestinal parasitism is one of the most important disease complexes of sheep and goats impacting on the resource-poor livestock farmer. Of the responsible nematodes, Haemonchus contortus, a blood-sucking worm of the abomasum, poses possibly the greatest threat. Over the past several decades, the worm has been controlled through the use of anthelmintics, but the emergence of anthelmintic resistance has threatened this chemotherapeutic approach. In Africa, the overall prevalence of anthelmintic resistance has not been extensively investigated, particularly within the resource-poor farming sector, but resistance has been reported from at least 14 countries with most of the reports emanating from Kenya and South Africa and the majority concerning H. contortus. While levels of resistance under commercial sheep farming systems in South Africa is considered to be amongst the worst in the world, resistance has also been reported from the resource-poor farming sector. Increases in productivity and reproduction of livestock and the development of markets for sale of animals are seen by international funding bodies as a way out of poverty for communities that keep livestock. This must lead to the greater need for parasite control. At such times, the risk of levels of anthelmintic resistance escalating is much greater and there is therefore a need to look at alternatives to their use. Proposed strategies include the appropriate, but judicious use of anthelmintics by application of the FAMACHA system and the use of alternatives to anthelmintics such as strategic nutrient supplementation. It is also very clear that there is a strong demand for knowledge about animal diseases, including helminthosis, and their effective management in the resource-poor livestock farming communities. This is an important challenge to meet.

  7. Stress Managment and Health Promotion

    Directory of Open Access Journals (Sweden)

    Asghar Dadkhah


    Full Text Available Health promotion approach is utilized to address the prevention, management and early intervention for stress management and also to promote positive mental and psychological health. Stress affects everyone and must be managed effectively to reduce its chronic and deleterious effects this study consists of two sections: in first section the principals of health promotion in different human existence levels, prevention of disease related to stress, the effect of stress on human well-being, and stress management were discussed. In second section the role of rehabilitation specialists (Medical technologist, nurses, occupational therapists, physiotherapists, respiratory therapists, and social workers in stress management were counted.

  8. Operations management in health care. (United States)

    Henderson, M D


    Health care operations encompass the totality of those health care functions that allow those who practice health care delivery to do so. As the health care industry undergoes dramatic reform, so will the jobs of those who manage health care delivery systems. Although health care operations managers play one of the most vital and substantial roles in the new delivery system, the criteria for their success (or failure) are being defined now. Yet, the new and vital role of the operations manager has been stunted in its development, which is primarily because of old and outdated antipathy between hospital administrators and physicians. This article defines the skills and characteristics of today's health care operations managers.

  9. Health Applications for Corporate Health Management. (United States)

    Steigner, Guido; Doarn, Charles R; Schütte, Michael; Matusiewicz, David; Thielscher, Christian


    Many corporate organizations around the world are looking at new ways to improve the health and well-being of their employees. Many have begun to use m-health approaches and unique applications (apps) to provide assistance. In Germany, both m-health and occupational health management (OHM) are growing quickly. Therefore, we hypothesized that the combination-apps usage in OHM-is growing as well. We studied the usage of health apps in large corporations for health management of employed individuals. To understand the environment in Germany, a two-part study was conducted. First, an extensive literature search was done and second, interviews were conducted with 12 of the 20 biggest companies' health management representatives. Using key search terms, 5,445 peer-reviewed journal articles traced with German databases and on PubMed were reviewed. Interestingly and somewhat surprising to the authors, none of them covered our specific topic. Interviews were conducted with 60% of the companies indicated. Only 3 out of 12 companies use apps. Four companies are piloting apps. With one exception, apps cover well-known areas such as food coaching, physical motion, smoking cessation, stress prevention, and other health-related subjects. One app used sensors in work clothing to prevent unhealthy motion. With a few exceptions, there has been no evaluation of the utility and utilization of apps. Current app usage in corporate health management in Germany is surprisingly low. Apps need to be better evaluated. Main obstacles-which could be resolved in the future-are legal restrictions (especially on data security), the lack of company-owned smart phones, misfit of apps and corporate health strategy, a lack of app evaluation, and high app prices.

  10. Public health financial management competencies. (United States)

    Honoré, Peggy A; Costich, Julia F


    The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs.

  11. Disaster Management: Mental Health Perspective. (United States)

    Math, Suresh Bada; Nirmala, Maria Christine; Moirangthem, Sydney; Kumar, Naveen C


    Disaster mental health is based on the principles of 'preventive medicine' This principle has necessitated a paradigm shift from relief centered post-disaster management to a holistic, multi-dimensional integrated community approach of health promotion, disaster prevention, preparedness and mitigation. This has ignited the paradigm shift from curative to preventive aspects of disaster management. This can be understood on the basis of six 'R's such as Readiness (Preparedness), Response (Immediate action), Relief (Sustained rescue work), Rehabilitation (Long term remedial measures using community resources), Recovery (Returning to normalcy) and Resilience (Fostering). Prevalence of mental health problems in disaster affected population is found to be higher by two to three times than that of the general population. Along with the diagnosable mental disorders, affected community also harbours large number of sub-syndromal symptoms. Majority of the acute phase reactions and disorders are self-limiting, whereas long-term phase disorders require assistance from mental health professionals. Role of psychotropic medication is very limited in preventing mental health morbidity. The role of cognitive behaviour therapy (CBT) in mitigating the mental health morbidity appears to be promising. Role of Psychological First Aid (PFA) and debriefing is not well-established. Disaster management is a continuous and integrated cyclical process of planning, organising, coordinating and implementing measures to prevent and to manage disaster effectively. Thus, now it is time to integrate public health principles into disaster mental health.

  12. Intelligent Integrated System Health Management (United States)

    Figueroa, Fernando


    Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

  13. Managed consumerism in health care. (United States)

    Robinson, James C


    The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations.

  14. Integrated fly management in European ruminant operations from the perspective of directive 2009/128/EC on sustainable use of pesticides. (United States)

    Durel, Luc; Estrada-Peña, Augustin; Franc, Michel; Mehlhorn, Heinz; Bouyer, Jérémy


    Integrated pest management (IPM) in agriculture animals remains undeveloped as compared to IPM in crops. With respect to the range of external nuisance arthropods that may bother farm animals, development and implementation of systematic IPM strategies are difficult to carry out. However, recurrent outbreaks of blue tongue disease in sheep and cattle, the public threats regarding the prophylactic use of veterinary insecticides and the need to preserve the efficacy of available actives have to lead the reflexion on new control strategies for arthropod pests of livestock. A recent extension of EU regulation on the use of pesticides in crops provides an opportunity to compare IPM strategies and to suggest new lines of reflection for the control of nuisance pests in ruminants under European conditions. In this paper, actions suggested by the Annex III of the Directive 2009/128/CE on Sustainable Use of Pesticides and related National Action Plans from 28 member states of the EU were reviewed from an animal production perspective by a group of veterinary entomologists. Eight lines of action have been identified and thus challenged with respect to current husbandry practices in modern European ruminant operations. Many IPM strategies for crops were identified to be unsuitable for large animals. Suggestions for implementing tools, opportunities and constraint assessment, and needs for support were also discussed. Only control of pest development sites and monitoring of harmful organisms were considered achievable in the near future; both in conjunction with the use of topical insecticides. Complementary actions such as alternatives to chemical control require further researches and industrial development. Marketing of IGR-based feed additives would be of great interest, but development of new compounds for veterinary medicines is very unlikely with respect to the European regulatory environment and associated cost of development.

  15. Gamification and geospatial health management (United States)

    Wortley, David


    Sensor and Measurement technologies are rapidly developing for many consumer applications which have the potential to make a major impact on business and society. One of the most important areas for building a sustainable future is in health management. This opportunity arises because of the growing popularity of lifestyle monitoring devices such as the Jawbone UP bracelet, Nike Fuelband and Samsung Galaxy GEAR. These devices measure physical activity and calorie consumption and, when visualised on mobile and portable devices, enable users to take more responsibility for their personal health. This presentation looks at how the process of gamification can be applied to develop important geospatial health management applications that could not only improve the health of nations but also significantly address some of the issues in global health such as the ageing society and obesity.

  16. Gamification and geospatial health management

    International Nuclear Information System (INIS)

    Wortley, David


    Sensor and Measurement technologies are rapidly developing for many consumer applications which have the potential to make a major impact on business and society. One of the most important areas for building a sustainable future is in health management. This opportunity arises because of the growing popularity of lifestyle monitoring devices such as the Jawbone UP bracelet, Nike Fuelband and Samsung Galaxy GEAR. These devices measure physical activity and calorie consumption and, when visualised on mobile and portable devices, enable users to take more responsibility for their personal health. This presentation looks at how the process of gamification can be applied to develop important geospatial health management applications that could not only improve the health of nations but also significantly address some of the issues in global health such as the ageing society and obesity

  17. Technical note: Ruminal cannulation technique in young Holstein calves:

    DEFF Research Database (Denmark)

    Kristensen, Niels Bastian; Engbæk, Marie; Vestergaard, Mogens


    Ruminal cannulation techniques are frequently used to study fermentation in the ruminant forestomach. Unsatisfactory results with the traditionally applied procedure for cannulation of young calves stimulated the development of a simpler and more robust procedure; this procedure was tested for ef...... no major effect on apparent animal health and performance traits, and the cannula proved useful for multiple samplings of ruminal contents in young calves.......Ruminal cannulation techniques are frequently used to study fermentation in the ruminant forestomach. Unsatisfactory results with the traditionally applied procedure for cannulation of young calves stimulated the development of a simpler and more robust procedure; this procedure was tested...... for effects on performance traits and gross anatomy of the gastrointestinal tract compared with a control group not undergoing surgery. Five calves were ruminally cannulated at approximately 10 d of age and 5 matching calves were used as controls. All calves were fed milk replacer and a diet based on clover...

  18. prevalence of fasciolosis in small ruminants slaughtered at yola

    African Journals Online (AJOL)


    managed under extensive management system by the local farmers. .... prevalent problem of small ruminants in Yola,. Adamawa ... Bailliere Tindal and Company London 800 –. 809. Umar ... Urquhart, G.M., Armour, J., Duncan, J.L., Dunn, A.M..

  19. Reengineering health care materials management. (United States)

    Connor, L R


    Health care executives across the country, faced with intense competition, are being forced to consider drastic cost cutting measures as a matter of survival. The entire health care industry is under siege from boards of directors, management and others who encourage health care systems to take actions ranging from strategic acquisitions and mergers to simple "downsizing" or "rightsizing," to improve their perceived competitive positions in terms of costs, revenues and market share. In some cases, management is poorly prepared to work within this new competitive paradigm and turns to consultants who promise that following their methodologies can result in competitive advantage. One favored methodology is reengineering. Frequently, cost cutting attention is focused on the materials management budget because it is relatively large and is viewed as being comprised mostly of controllable expenses. Also, materials management is seldom considered a core competency for the health care system and the organization performing these activities does not occupy a strongly defensible position. This paper focuses on the application of a reengineering methodology to healthcare materials management.

  20. Review on Mycotoxin Issues in Ruminants: Occurrence in Forages, Effects of Mycotoxin Ingestion on Health Status and Animal Performance and Practical Strategies to Counteract Their Negative Effects

    DEFF Research Database (Denmark)

    Gallo, Antonio; Giubert, Gianluca; Frisvad, Jens Christian


    Ruminant diets include cereals, protein feeds, their by-products as well as hay and grass, grass/legume, whole-crop maize, small grain or sorghum silages. Furthermore, ruminants are annually or seasonally fed with grazed forage in many parts of the World. All these forages could be contaminated...

  1. Is Work-related Rumination Associated with deficits in Executive Functioning?

    Directory of Open Access Journals (Sweden)

    Mark Cropley


    Full Text Available AbstractWork-related rumination, that is, perseverative thinking about work during leisure time, has been associated with a range of negative health and wellbeing issues. The present paper examined the association between work-related rumination and cognitive processes centred around the theoretical construct of executive functioning. Executive functioning is an umbrella term for high level cognitive processes such as planning, working memory, inhibition, mental flexibility; and it underlies how people manage and regulate their goal directed behaviour. Three studies are reported. Study I, reports the results of a cross-sectional study of 240 employees, and demonstrates significant correlations between work-related rumination and three proxy measures of executive functioning: cognitive failures (.33, cognitive flexibility (-.24 and situational awareness at work (-.28. Study II (n = 939, expands on the findings from study 1 and demonstrates that workers reporting medium and high work-related rumination were 2.8 and 5 times, respectively, more likely to report cognitive failures relative to low ruminators. High ruminators also demonstrated greater difficulties with ‘lapses of attention’ (OR = 4.8, ‘lack of focus of attention’ (OR = 3.4, and ‘absent mindedness’ (OR = 4.3. The final study, examined the association between work-related rumination and executive functioning using interview data from 2460 full time workers. Workers were divided into tertiles low, medium and high. The findings showed that high work-related rumination was associated with deficits in starting (OR = 2.3 and finishing projects (OR = 2.4, fidgeting (OR = 1.9, memory (OR = 2.2, pursuing tasks in order (OR = 1.8, and feeling compelled to do things (OR = 2.0. It was argued that work-related rumination may not be related to work demands per se, but appears to be an executive functioning/control issue. Such findings are important for the design and delivery of

  2. Is Work-Related Rumination Associated with Deficits in Executive Functioning? (United States)

    Cropley, Mark; Zijlstra, Fred R H; Querstret, Dawn; Beck, Sarah


    Work-related rumination, that is, perseverative thinking about work during leisure time, has been associated with a range of negative health and wellbeing issues. The present paper examined the association between work-related rumination and cognitive processes centerd around the theoretical construct of executive functioning. Executive functioning is an umbrella term for high level cognitive processes such as planning, working memory, inhibition, mental flexibility; and it underlies how people manage and regulate their goal directed behavior. Three studies are reported. Study I, reports the results of a cross-sectional study of 240 employees, and demonstrates significant correlations between work-related rumination and three proxy measures of executive functioning: cognitive failures (0.33), cognitive flexibility (-0.24), and situational awareness at work (-0.28). Study II ( n = 939), expands on the findings from study 1 and demonstrates that workers reporting medium and high work-related rumination were 2.8 and 5 times, respectively, more likely to report cognitive failures relative to low ruminators. High ruminators also demonstrated greater difficulties with 'lapses of attention' (OR = 4.8), 'lack of focus of attention' (OR = 3.4), and 'absent mindedness' (OR = 4.3). The final study, examined the association between work-related rumination and executive functioning using interview data from 2460 full time workers. Workers were divided into tertiles low, medium, and high. The findings showed that high work-related rumination was associated with deficits in starting (OR = 2.3) and finishing projects (OR = 2.4), fidgeting (OR = 1.9), memory (OR = 2.2), pursuing tasks in order (OR = 1.8), and feeling compelled to do things (OR = 2.0). It was argued that work-related rumination may not be related to work demands per se , but appears to be an executive functioning/control issue. Such findings are important for the design and delivery of intervention programes aimed

  3. Air pollution - health and management

    Energy Technology Data Exchange (ETDEWEB)

    Klug, W; Runca, E; Suess, M J [eds.


    The proceedings of a joint workshop of the World Health Organization and the International Institute for Applied Systems Analysis are presented. The workshop was to review the interaction between man's industrial and urban activities and the environment, and the relationship between ambient air quality and human health, and to examine the effectiveness of proper management on the control and abatement of air pollution. The discussion topics included atmospheric processes and respective modelling, air pollution impact on human health, effects of air pollutants on aquatic and terrestrial ecosystems, air pollution episode cycles and management of control. A selected list of 11ASA and WHO/EURO publications related to air pollution is included. Separate abstracts were prepared for 15 papers in this book.

  4. Premenstrual disorders and rumination. (United States)

    Craner, Julia R; Sigmon, Sandra T; Martinson, Amber A; McGillicuddy, Morgan L


    Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) involve emotional, behavioral, and physical symptoms; however, there is little understanding of psychological factors that contribute to these disorders. It was hypothesized that rumination, a form of depressive self-focused attention, is related to premenstrual distress. Study 1 involved women (N = 735) meeting criteria for No/Mild PMS, Moderate/Severe PMS, and PMDD using retrospective self-report. Study 2 involved women (N = 85) meeting diagnostic criteria for PMS or PMDD (i.e., PMD group) and healthy controls (i.e., No PMD group) following 60-day symptom monitoring. Participants in both studies completed questionnaires of rumination, anxiety sensitivity, and coping styles. Rumination was strongly related to premenstrual disorders using both retrospective and prospective reports, as well as both categorical and continuous approaches to classification of premenstrual distress. Rumination, a transdiagnostic factor in psychopathology, may contribute to the onset and maintenance of premenstrual distress. © 2013 Wiley Periodicals, Inc.

  5. X-33/RLV System Health Management/Vehicle Health Management (United States)

    Mouyos, William; Wangu, Srimal


    To reduce operations costs, Reusable Launch Vehicles (RLVS) must include highly reliable robust subsystems which are designed for simple repair access with a simplified servicing infrastructure, and which incorporate expedited decision-making about faults and anomalies. A key component for the Single Stage To Orbit (SSTO) RLV system used to meet these objectives is System Health Management (SHM). SHM incorporates Vehicle Health Management (VHM), ground processing associated with the vehicle fleet (GVHM), and Ground Infrastructure Health Management (GIHM). The primary objective of SHM is to provide an automated and paperless health decision, maintenance, and logistics system. Sanders, a Lockheed Martin Company, is leading the design, development, and integration of the SHM system for RLV and for X-33 (a sub-scale, sub-orbit Advanced Technology Demonstrator). Many critical technologies are necessary to make SHM (and more specifically VHM) practical, reliable, and cost effective. This paper will present the X-33 SHM design which forms the baseline for the RLV SHM, and it will discuss applications of advanced technologies to future RLVs. In addition, this paper will describe a Virtual Design Environment (VDE) which is being developed for RLV. This VDE will allow for system design engineering, as well as program management teams, to accurately and efficiently evaluate system designs, analyze the behavior of current systems, and predict the feasibility of making smooth and cost-efficient transitions from older technologies to newer ones. The RLV SHM design methodology will reduce program costs, decrease total program life-cycle time, and ultimately increase mission success.

  6. Worry and anger rumination in fibromyalgia syndrome

    Directory of Open Access Journals (Sweden)

    A. Ricci


    Full Text Available The aim of the present study was twofold: 1 to investigate the psychological profile of patients with fibromyalgia syndrome (FS as compared to patients with other chronic pain syndromes (CP and healthy subjects (HS; 2 to examine the associations between anxiety, depression, worry and angry rumination in FS patients. FS patients (N=30, CP patients (N=30 and HS (N=30 completed measurements of anxiety, depression, worry and angry rumination. FS patients showed higher levels of state and trait anxiety, worry and angry rumination than CP patients and HS, and higher levels of depression than HS. Worry and angry rumination were strongly associated in the FS group. FS patients may use worry and rumination as coping strategies to deal with their negative emotional experience, which might impair their emotional wellbeing. Findings from the present study add to our understanding of the psychological profile of FS patients, and have important implications for developing a tailored CBT protocol for pain management in FS patients.

  7. Conceptualizing ORGANIZATIONAL HEALTH - Public health management and leadership perspectives


    Orvik, Arne


    The thesis introduces a new conceptual model of organizational health and discusses its implications for public health management and leadership. It is developed with reference to organizational theories and ideologies, including New Public Management, the use of which has coincided with increasing workplace health problems in health care organizations. The model is based on empirical research and theories in the fields of public health, health care organization and management, and institutio...

  8. Milk hygiene in small ruminants: A review

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalo, C.


    Somatic cell count (SCC), mammary pathogens prevalence, total and specific bacterial counts, antimicrobial residues, macroscopic sediment, water addition, aflatoxins and other contaminants constitute the basis for milk payment-schemes, monitoring and improvement of flock hygiene and health management, and development of analytical surveillance programs in the dairy small ruminants. The present work reviews factors influencing the variation of these variables, including milk analytical methods, storage and preservation, along with management implications during the last two decades. Following farmer and cooperative educational programs, progressive reductions have been reported for total bacterial count and antimicrobial residue occurrence in bulk tank milk. These results were consistent, however, with high values for SCC and specific bacterial populations. Thus, mastitis control programs should be intensified to increase hygiene in milk and economic returns for producers and processors. In addition, the implementation of programs to reduce specific bacterial counts (i.e., psychrotrophs, coliforms, Clostridium spp. spores) and mammary pathogen prevalence (i.e., Staph. aureus, Mycoplasma spp.), as well as the use of combined screening methods for an increased rate of antimicrobial detection, are currently required strategies which are positively valuated by milk processors, industry and consumers. Other contaminants may also be present, but cost-effective screening and analytical systems have not yet been implemented. This review aims to be helpful for troubleshooting milk quality and safety, developing future premium payment systems and industry quality-standards, optimizing management, on-farm risk traceability systems and consumer acceptance.

  9. Milk hygiene in small ruminants: A review

    International Nuclear Information System (INIS)

    Gonzalo, C.


    Somatic cell count (SCC), mammary pathogens prevalence, total and specific bacterial counts, antimicrobial residues, macroscopic sediment, water addition, aflatoxins and other contaminants constitute the basis for milk payment-schemes, monitoring and improvement of flock hygiene and health management, and development of analytical surveillance programs in the dairy small ruminants. The present work reviews factors influencing the variation of these variables, including milk analytical methods, storage and preservation, along with management implications during the last two decades. Following farmer and cooperative educational programs, progressive reductions have been reported for total bacterial count and antimicrobial residue occurrence in bulk tank milk. These results were consistent, however, with high values for SCC and specific bacterial populations. Thus, mastitis control programs should be intensified to increase hygiene in milk and economic returns for producers and processors. In addition, the implementation of programs to reduce specific bacterial counts (i.e., psychrotrophs, coliforms, Clostridium spp. spores) and mammary pathogen prevalence (i.e., Staph. aureus, Mycoplasma spp.), as well as the use of combined screening methods for an increased rate of antimicrobial detection, are currently required strategies which are positively valuated by milk processors, industry and consumers. Other contaminants may also be present, but cost-effective screening and analytical systems have not yet been implemented. This review aims to be helpful for troubleshooting milk quality and safety, developing future premium payment systems and industry quality-standards, optimizing management, on-farm risk traceability systems and consumer acceptance.

  10. Health and radiation protection management

    International Nuclear Information System (INIS)

    Huhn, A.; Vargas, M.; Lorenzetti, J.; Lança, L.


    Quality management and continuous improvement systems are becoming part of daily health services, including radiodiagnostic services, which are designed to meet the needs of users, operating in an environment where the differential is due to the competence and quality of the services provided. The objective of this study is to show the scope of the management of health services, especially radiodiagnosis and radiological protection. Method: Exploratory and descriptive study, based on a review of the literature on the subject. Results: Radiodiagnosis has demonstrated the need for efficient management, especially because ionizing radiation is present in this environment and it is imperative that the professionals working in this area are aware of the need to perform adequate radiological protection for themselves and for users. Conclusion: Universal access to information has changed the attitude of the user and the user has become more demanding in his choices, wanting to understand, express, interact and choose the best quality service in view of the various options available in the market

  11. Impact of Health Behaviors and Health Management on Employment After SCI: Psychological Health and Health Management. (United States)

    Reed, Karla S; Meade, Michelle A; Krause, James S


    Objective: The purpose of this study was to examine the relationship between employment and psychological health and health management as described by individuals with spinal cord injury (SCI) who were employed at least once following injury. Methods: A qualitative approach used 6 focus groups at 2 sites with 44 participants who were at least 10 years post SCI. All had been employed at some point since injury. Heterogeneous and homogeneous groups were delineated based on specific characteristics, such as education, gender, or race. Group sessions followed a semi-structured interview format with questions about personal, environmental, and policy related factors influencing employment following SCI. All group sessions were recorded, transcribed, and coded into conceptual categories to identify topics, themes, and patterns. Inferences were drawn about their meaning. NVivo 10 software using the constant comparative method was used for data analysis. Results: Narratives discussed the relationship between employment and psychological and emotional health and health management. Four themes were identified: (1) adjustment and dealing with emotional reactions, (2) gaining self-confidence, (3) preventing burnout, and (4) attitudes and perspectives. Most themes reflected issues that varied based on severity of injury as well as stage of employment. Conclusions: Individuals with SCI who are successful in working following injury must determine how to perform the behaviors necessary to manage their health and prevent emotional or physical complications. The emotional consequences of SCI must be recognized and addressed and specific behaviors enacted in order to optimize employment outcomes.

  12. Health management of radiation workers

    International Nuclear Information System (INIS)

    Kunugita, Naoki; Igari, Kazuyuki


    People in Japan have expressed great anxiety about possible radiation and radioactivity after the accident at the Fukushima Daiichi Nuclear Power Plant of Tokyo Electric Power Company's (TEPCO), due to the great earthquake and tsunami in eastern Japan on 11 March 2011. A large number of workers were engaged in response and recovery operations, and they were possibly exposed to high doses of radiation as compared to the general population. In the accident at the Chernobyl Nuclear Power Plant in 1986, high doses of radiation to 134 plant staff and emergency personnel resulted in acute radiation syndrome (ARS), which proved fatal for 28 of them. In the Fukushima accident, six workers were exposed to more than 250 mSv of radiation during the initial response phase, but no one showed ARS. It is necessary to continue registration of radiation doses for all workers who were exposed to radiation to facilitate suitable healthcare management in the future. In addition to radiation exposure, a group of workers were also exposed to other health hazards. Frequent occurrence of heat disorders has been a concern for the workers wearing protective clothing with poor ventilation. A comprehensive program to prevent heat illness was implemented by TEPCO under the guidance of the Ministry of Health, Labour, and Welfare. It is important to provide effective systems not only for prevention of radiation exposure but also for general management of other health risks including heat disorders and infection. (author)

  13. [Local anaesthesia in ruminants]. (United States)

    Nuss, Karl; Schwarz, Andrea; Ringer, Simone


    The use of local anaesthesia in ruminants allows many surgical procedures to be conducted free of pain, efficiently and inexpensively in the field. Local anaesthesia combined with sedation and immobilisation of the animal can replace general anaesthesia for many procedures (e. g. castration, claw amputation). The level of difficulty differs among various local anaesthetic techniques: local infiltration of tissue or anaesthesia of the cornual nerve are easily performed, whereas local anaesthesia of the eye, regional anaesthesia in limbs or anaesthesia for umbilical surgery are more difficult to carry out. This article presents an illustrated overview of the most common local anaesthetic procedures in cattle as well as in small ruminants and serves as a practical guide for veterinarians in the field. In principle, these techniques can likewise be applied in other ruminants or artiodactyls.

  14. The contribution of total and free iodothyronines to welfare maintenance and management stress coping in Ruminants and Equines: Physiological ranges and reference values. (United States)

    Ferlazzo, Adriana; Cravana, Cristina; Fazio, Esterina; Medica, Pietro


    In order to acquire a pattern of thyroid involvement in welfare maintenance in Ruminants and Equines, this review summarizes data concerning the reference values of total and free iodothyronines and their modifications in physiological conditions and in different management conditions (pregnancy, lactation, weaning, growth, isolation, restraint, shearing, confinement and transportation). Thyroidal and extrathyroidal tissues efficiently respond to management practices, giving a differentiated contribution to circulating iodothyronine changes. The hormonal response could be mainly attributed to the intracellular deiodination of T 4 to T 3. Triiodothyronine (T 3 ) and free iodothyronines (fT 3 and fT 4 ) result more responsive to management stress, showing different pattern with species and to various conditions, as to environmental conditions in which activities are performed. Intrinsic seasonal changes of iodothyronines and a significant pregnancy effect for T 3 were recorded in mares. Higher, although not significant, T 3 and T 4 concentrations in barren than pregnant mares were observed in donkeys. A positive significant correlation between T 3 and T 4 was described only in pregnant donkeys. Moreover, a significant effect of season on T 3 and fT 3 changes was observed both in pregnant and barren donkeys. A significant lactating effect compared with nonlactating stage for T 3 and T 4 was recorded in mares. In growing foals, body weight (BW) and age were positively correlated with T 3 and negatively correlated with T 4 , fT 4 and fT 3 . Weaning effects were shown for T 3 and fT 4 concentrations, indicating that weaning represents a severe stress and the presence of conspecific does not reduce psychological stress in this phase. Lambs showed significant decreased T 3 and elevated T 4 concentrations two weeks after weaning, with higher concentrations in both males and females compared to 24 h. Significant positive correlations were observed between BW and T 4 , fT 3

  15. Managing Health Information System | Campbell | Nigerian ...

    African Journals Online (AJOL)

    The effective planning, management monitoring and evaluation of health services, health resources and indeed the health system requires a wealth of health information, with its simultaneous effective and efficient management. It is an instrument used to help policy-making, decision making and day to day actions in the ...

  16. Self-rumination, self-reflection, and depression: self-rumination counteracts the adaptive effect of self-reflection. (United States)

    Takano, Keisuke; Tanno, Yoshihiko


    Self-focused attention has adaptive and maladaptive aspects: self-reflection and self-rumination [Trapnell, P. D., & Campbell, J. D. (1999). Private self-consciousness and the Five-Factor Model of personality: distinguishing rumination from reflection. Journal of Personality and Social Psychology, 76, 284-304]. Although reflection is thought to be associated with problem solving and the promotion of mental health, previous researches have shown that reflection does not always have an adaptive effect on depression. Authors have examined the causes behind this inconsistency by modeling the relationships among self-reflection, self-rumination, and depression. One hundred and eleven undergraduates (91 men and 20 women) participated in a two-time point assessment with a 3-week interval. Statistical analysis with structural equation modeling showed that self-reflection significantly predicted self-rumination, whereas self-rumination did not predict self-reflection. With regard to depression, self-reflection was associated with a lower level of depression; self-rumination, with a higher level of depression. The total effect of self-reflection on depression was almost zero. This result indicates that self-reflection per se has an adaptive effect, which is canceled out by the maladaptive effect of self-rumination, because reflectors are likely to ruminate and reflect simultaneously.

  17. Use of Unpalatable Forages by Ruminants: The Influence of Experience with the Biophysical and Social Environment

    Directory of Open Access Journals (Sweden)

    Roberto A. Distel


    Full Text Available Unpalatable forage resources (low nutrient density, potentially toxic metabolites are widespread and represent a challenge for ruminant nutrition, health, and welfare. Our objective was to synthesize the role of biophysical and social experience on the use of unpalatable forages by ruminants, and highlight derived behavioural solutions for the well-being of soils, plants, and animals. Environmental experiences early in life modulate gene expression and promote learning, which alters morpho-physiological and psychological mechanisms that modify behavioural responses and change food and habitat selection. In this process, ruminants can become better adapted to the habitat where they are reared. Moreover, experiential learning provides flexibility in diet selection, which is critical for changing foraging environments. Learned associations between unpalatable and palatable foods, if ingested in appropriate amounts, sequence, and close temporal association, induce the development of preference for the former type of food. In this way, a more uniform use of resources can be achieved from the landscape level down to the individual plant, with the associated benefits to ecosystem integrity and stability. Ruminants can also learn the medicinal benefits of ingesting foods with toxins (e.g., condensed tannins and saponins with antiparasitic properties. This knowledge on behavioural processes can be translated into behavioural applications that provide low-cost solutions to many challenges that producers face in managing sustainable livestock production systems.

  18. Characteristics of effective health care managers. (United States)

    Johnson, Sherryl W


    This article provides an overview of traditional and contemporary management theories. Concerns, characteristics, and skills of effective managers are also presented. Further, a self-assessment (survey) of 7 highly effective health care managers in a South Georgia community was conducted to determine their ratings on 6 management indices. The assessment or Scale of Transformational Leadership uses a Likert-type scale to allow for the evaluation of managers. The scale contains 6 management elements for assessment: attention, meaning, trust, self, vision, and feeling. Individual ratings and group summary skills rating are presented. Findings revealed the order of managerial importance of the elements as follows (from highest to lowest): Management of Trust, Management of Attention, Management of Self, Management of Feeling, Management of Meaning, and Management of Risk. As a second tier, the final ratings are corroborated by health care management interns.

  19. Strategic management of health care information systems: nurse managers' perceptions. (United States)

    Lammintakanen, Johanna; Kivinen, Tuula; Saranto, Kaija; Kinnunen, Juha


    The aim of this study is to describe nurse managers' perceptions of the strategic management of information systems in health care. Lack of strategic thinking is a typical feature in health care and this may also concern information systems. The data for this study was collected by eight focus group interviews including altogether 48 nurse managers from primary and specialised health care. Five main categories described the strategic management of information systems in health care; IT as an emphasis of strategy; lack of strategic management of information systems; the importance of management; problems in privacy protection; and costs of IT. Although IT was emphasised in the strategies of many health care organisations, a typical feature was a lack of strategic management of information systems. This was seen both as an underutilisation of IT opportunities in health care organisations and as increased workload from nurse managers' perspective. Furthermore, the nurse managers reported that implementation of IT strengthened their managerial roles but also required stronger management. In conclusion, strategic management of information systems needs to be strengthened in health care and nurse managers should be more involved in this process.

  20. Occupational health management: an audit tool. (United States)

    Shelmerdine, L; Williams, N


    Organizations must manage occupational health risks in the workplace and the UK Health & Safety Executive (HSE) has published guidance on successful health and safety management. This paper describes a method of using the published guidance to audit the management of occupational health and safety, first at an organizational level and, secondly, to audit an occupational health service provider's role in the management of health risks. The paper outlines the legal framework in the UK for health risk management and describes the development and use of a tool for qualitative auditing of the efficiency, effectiveness and reliability of occupational health service provision within an organization. The audit tool is presented as a question set and the paper concludes with discussion of the strengths and weaknesses of using this tool, and recommendations on its use.

  1. Assessment of implementation of the health management ...

    African Journals Online (AJOL)

    Background Despite Malawi's introduction of a health management information system (HMIS) in 1999, the country's health sector still lacks accurate, reliable, complete, consistent and timely health data to inform effective planning and resource management. Methods A cross-sectional survey was conducted wherein ...


    Directory of Open Access Journals (Sweden)



    Full Text Available The service sector plays an increasingly large modern market economies. By being unable to provide customers a tangible product in the hands of service providers makes the situation more difficult. Their success depends on customer satisfaction, which expect a certain benefit for the money paid, on quality, on mutual trust and many other attributes. What is very interesting is that they may differ from client to client, and there is no guarantee satisfaction to all customers, even if the service provided is the same. This shows the complex nature of services and efforts on service providers would have to be made permanent in order to attract more customers. This paper addresses the issues of continuous quality improvement of health services as an important part of the services sector. Until recently, these services in Romania although under strict control of the state, had a large number of patients who are given very little attention, which is why quality improvement acestoraa was compulsory. Opening and changing economic environment, increasing customer demands, forced hospitals that serve as a nodal point between these services and their applicants to adopt modern management methods and techniques to become competitive and to give patients the quality service expected. Modern society has always sought to provide the means to ensure good health closer to the needs of modern man. These have become more complex and more expensive and naturally requires financial resources increasingly mari.Este why, every time, all the failures alleging lack of money and resources in general. Is it true? Sometimes yes, often, no! The truth is that human and material resources are not used in an optimal way. The answer lies mainly in quality management. We will see what should be done in this regard.

  3. Conceptualizing ORGANIZATIONAL HEALTH - Public health management and leadership perspectives

    DEFF Research Database (Denmark)

    Orvik, Arne

    The thesis introduces a new conceptual model of organizational health and discusses its implications for public health management and leadership. It is developed with reference to organizational theories and ideologies, including New Public Management, the use of which has coincided with increasing...... as the disintegration of such values. Possible implications for public health management and leadership include four different forms. The application of the conceptual model can potentially draw attention to value conflicts and help to clarify contradictory, institutional logics. It can also potentially support health...... workplace health problems in health care organizations. The model is based on empirical research and theories in the fields of public health, health care organization and management, and institutional theory. It includes five dimensions and defines organizational health in terms of how an organization...

  4. Future preparation of occupational health nurse managers. (United States)

    Scalzi, C C; Wilson, D L; Ebert, R


    This article presents the results of a national survey of job activities of corporate level occupational health nurse managers. The survey was designed to identify the relative amount of time spent and importance attributed to specific areas of their current job. In general this sample tended to have more management experience and educational preparation than previously cited studies: over 50% had completed a graduate degree. The scores for importance and time spent were highly correlated. That is, occupational health corporate nurse managers seemed to allocate their time to job responsibilities they considered most important. Management activities related to policy, practice standards, quality assurance, staff development, and systems for client care delivery appear to represent the core responsibilities of occupational health nursing management. Curriculum recommendations for management positions in occupational health include: health policy, program planning, and evaluation; business strategy; applications of management information systems; quality assurance; and marketing.

  5. Project management in health informatics. (United States)

    Ho, Jessica


    This chapter gives an educational overview of: * the concept of project management and its role in modern management * the generic project lifecycle process * processes used in developing a plan for the management of resources - time, cost, physical resources and people * the concept of managing risk in projects * communication processes and practices that are important to the management of projects.


    National Aeronautics and Space Administration — This paper introduces a generic distributed prognostic health management (PHM) architecture with specific application to the electrical power systems domain. Current...

  7. Managing anthelmintic resistance in small ruminant livestock of resource-poor farmers in South Africa : review article

    Directory of Open Access Journals (Sweden)

    A.F. Vatta


    Full Text Available Gastrointestinal parasitism is one of the most important disease complexes of sheep and goats impacting on the resource-poor livestock farmer. Of the responsible nematodes, Haemonchus contortus, a blood-sucking worm of the abomasum, poses possibly the greatest threat. Over the past several decades, the worm has been controlled through the use of anthelmintics, but the emergence of anthelmintic resistance has threatened this chemotherapeutic approach. In Africa, the overall prevalence of anthelmintic resistance has not been extensively investigated, particularly within the resource-poor farming sector, but resistance has been reported from at least 14 countries with most of the reports emanating from Kenya and South Africa and the majority concerning H. contortus. While levels of resistance under commercial sheep farming systems in South Africa is considered to be amongst the worst in the world, resistance has also been reported from the resource-poor farming sector. Increases in productivity and reproduction of livestock and the development of markets for sale of animals are seen by international funding bodies as a way out of poverty for communities that keep livestock. This must lead to the greater need for parasite control. At such times, the risk of levels of anthelmintic resistance escalating is much greater and there is therefore a need to look at alternatives to their use. Proposed strategies include the appropriate, but judicious use of anthelmintics by application of the FAMACHA(c system and the use of alternatives to anthelmintics such as strategic nutrient supplementation. It is also very clear that there is a strong demand for knowledge about animal diseases, including helminthosis, and their effective management in the resource-poor livestock farming communities. This is an important challenge to meet.

  8. Management practices for health physicists

    International Nuclear Information System (INIS)

    Gibson, J.L.


    Th essence of management is obtaining results through the efforts of other people. The efforts obtained, or performance, are enhanced by those who practice management with certain understandings of the work, role and behavior of management, who have the will to manage, and who have requisite skill and aptitude. Discussion of managerial work, role, and behavior comprises the major part of the following paper. The paper concludes with the suggestion that ineffective management is not the result of lack of knowledge about managing, rather ineffective management is more often the result of a lack of will to manage

  9. Software for Intelligent System Health Management (United States)

    Trevino, Luis C.


    This viewgraph presentation describes the characteristics and advantages of autonomy and artificial intelligence in systems health monitoring. The presentation lists technologies relevant to Intelligent System Health Management (ISHM), and some potential applications.

  10. Managing Agricultural Biodiversity for Nutrition, Health, Livelihoods ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Managing Agricultural Biodiversity for Nutrition, Health, Livelihoods and ... on local ecosystems and human resources can provide sustainable solutions to ... and health among the rural and urban poor through increased dietary diversity.

  11. Review on Mycotoxin Issues in Ruminants: Occurrence in Forages, Effects of Mycotoxin Ingestion on Health Status and Animal Performance and Practical Strategies to Counteract Their Negative Effects

    Directory of Open Access Journals (Sweden)

    Antonio Gallo


    Full Text Available Ruminant diets include cereals, protein feeds, their by-products as well as hay and grass, grass/legume, whole-crop maize, small grain or sorghum silages. Furthermore, ruminants are annually or seasonally fed with grazed forage in many parts of the World. All these forages could be contaminated by several exometabolites of mycotoxigenic fungi that increase and diversify the risk of mycotoxin exposure in ruminants compared to swine and poultry that have less varied diets. Evidence suggests the greatest exposure for ruminants to some regulated mycotoxins (aflatoxins, trichothecenes, ochratoxin A, fumonisins and zearalenone and to many other secondary metabolites produced by different species of Alternaria spp. (e.g., AAL toxins, alternariols, tenuazonic acid or 4Z-infectopyrone, Aspergillus flavus (e.g., kojic acid, cyclopiazonic acid or β-nitropropionic acid, Aspergillus fuminatus (e.g., gliotoxin, agroclavine, festuclavines or fumagillin, Penicillium roqueforti and P. paneum (e.g., mycophenolic acid, roquefortines, PR toxin or marcfortines or Monascus ruber (citrinin and monacolins could be mainly related to forage contamination. This review includes the knowledge of mycotoxin occurrence reported in the last 15 years, with special emphasis on mycotoxins detected in forages, and animal toxicological issues due to their ingestion. Strategies for preventing the problem of mycotoxin feed contamination under farm conditions are discussed.

  12. Review on Mycotoxin Issues in Ruminants: Occurrence in Forages, Effects of Mycotoxin Ingestion on Health Status and Animal Performance and Practical Strategies to Counteract Their Negative Effects. (United States)

    Gallo, Antonio; Giuberti, Gianluca; Frisvad, Jens C; Bertuzzi, Terenzio; Nielsen, Kristian F


    Ruminant diets include cereals, protein feeds, their by-products as well as hay and grass, grass/legume, whole-crop maize, small grain or sorghum silages. Furthermore, ruminants are annually or seasonally fed with grazed forage in many parts of the World. All these forages could be contaminated by several exometabolites of mycotoxigenic fungi that increase and diversify the risk of mycotoxin exposure in ruminants compared to swine and poultry that have less varied diets. Evidence suggests the greatest exposure for ruminants to some regulated mycotoxins (aflatoxins, trichothecenes, ochratoxin A, fumonisins and zearalenone) and to many other secondary metabolites produced by different species of Alternaria spp. (e.g., AAL toxins, alternariols, tenuazonic acid or 4Z-infectopyrone), Aspergillus flavus (e.g., kojic acid, cyclopiazonic acid or β-nitropropionic acid), Aspergillus fuminatus (e.g., gliotoxin, agroclavine, festuclavines or fumagillin), Penicillium roqueforti and P. paneum (e.g., mycophenolic acid, roquefortines, PR toxin or marcfortines) or Monascus ruber (citrinin and monacolins) could be mainly related to forage contamination. This review includes the knowledge of mycotoxin occurrence reported in the last 15 years, with special emphasis on mycotoxins detected in forages, and animal toxicological issues due to their ingestion. Strategies for preventing the problem of mycotoxin feed contamination under farm conditions are discussed.

  13. Review on Mycotoxin Issues in Ruminants: Occurrence in Forages, Effects of Mycotoxin Ingestion on Health Status and Animal Performance and Practical Strategies to Counteract Their Negative Effects (United States)

    Gallo, Antonio; Giuberti, Gianluca; Frisvad, Jens C.; Bertuzzi, Terenzio; Nielsen, Kristian F.


    Ruminant diets include cereals, protein feeds, their by-products as well as hay and grass, grass/legume, whole-crop maize, small grain or sorghum silages. Furthermore, ruminants are annually or seasonally fed with grazed forage in many parts of the World. All these forages could be contaminated by several exometabolites of mycotoxigenic fungi that increase and diversify the risk of mycotoxin exposure in ruminants compared to swine and poultry that have less varied diets. Evidence suggests the greatest exposure for ruminants to some regulated mycotoxins (aflatoxins, trichothecenes, ochratoxin A, fumonisins and zearalenone) and to many other secondary metabolites produced by different species of Alternaria spp. (e.g., AAL toxins, alternariols, tenuazonic acid or 4Z-infectopyrone), Aspergillus flavus (e.g., kojic acid, cyclopiazonic acid or β-nitropropionic acid), Aspergillus fuminatus (e.g., gliotoxin, agroclavine, festuclavines or fumagillin), Penicillium roqueforti and P. paneum (e.g., mycophenolic acid, roquefortines, PR toxin or marcfortines) or Monascus ruber (citrinin and monacolins) could be mainly related to forage contamination. This review includes the knowledge of mycotoxin occurrence reported in the last 15 years, with special emphasis on mycotoxins detected in forages, and animal toxicological issues due to their ingestion. Strategies for preventing the problem of mycotoxin feed contamination under farm conditions are discussed. PMID:26274974

  14. The relationship between rumination, PTSD, and depression symptoms. (United States)

    Roley, Michelle E; Claycomb, Meredith A; Contractor, Ateka A; Dranger, Paula; Armour, Cherie; Elhai, Jon D


    Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are highly comorbid (Elhai et al., 2008. J. Clin. Psychiatry, 69, (4), 597-602). Rumination is a cognitive mechanism found to exacerbate and maintain both PTSD and MDD (Elwood et al., 2009. Clin. Psychol. Rev. 29, (1), 87-100; Olatunji et al., 2013. Clin. Psychol.: Sci. Pract. 20, (3), 225-257). Assess whether four rumination subtypes moderate the relationship between comorbid PTSD and MDD symptoms. We consecutively sampled patients (N=45) presenting to a mental health clinic using self-report measures of PTSD and MDD symptoms, and rumination in a cross-sectional design. Repetitive rumination moderates the relationship between PTSD and MDD symptoms at one standard deviation above the mean (β=.044, p=.016), while anticipatory rumination moderates the relationship between PTSD and MDD symptoms at mean levels and higher levels of anticipatory rumination (mean β=.030, p=.042; higher β=.060, p=.008). Repetitive and anticipatory rumination should be assessed in the context of comorbid PTSD and MDD and interventions should focus on reducing these rumination subtypes. Results should be replicated with other trauma populations because the number and complexity of traumatic events may impact the assessed symptoms. Constructs should also be assessed longitudinally, in order to establish causality. We are unable to confirm why rumination styles moderated the relationship between PTSD and depression or why counterfactual thinking and problem-focused thinking did not moderate the relationship between the two constructs. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Immunization against Small Ruminant Lentiviruses

    Directory of Open Access Journals (Sweden)

    Beatriz Amorena


    Full Text Available Multisystemic disease caused by Small Ruminant Lentiviruses (SRLV in sheep and goats leads to production losses, to the detriment of animal health and welfare. This, together with the lack of treatments, has triggered interest in exploring different strategies of immunization to control the widely spread SRLV infection and, also, to provide a useful model for HIV vaccines. These strategies involve inactivated whole virus, subunit vaccines, DNA encoding viral proteins in the presence or absence of plasmids encoding immunological adjuvants and naturally or artificially attenuated viruses. In this review, we revisit, comprehensively, the immunization strategies against SRLV and analyze this double edged tool individually, as it may contribute to either controlling or enhancing virus replication and/or disease.

  16. Population Health Management for Older Adults (United States)

    Tkatch, Rifky; Musich, Shirley; MacLeod, Stephanie; Alsgaard, Kathleen; Hawkins, Kevin; Yeh, Charlotte S.


    Background: The older adult population is expanding, living longer, with multiple chronic conditions. Understanding and managing their needs over time is an integral part of defining successful aging. Population health is used to describe the measurement and health outcomes of a population. Objectives: To define population health as applied to older adults, summarize lessons learned from current research, and identify potential interventions designed to promote successful aging and improved health for this population. Method: Online search engines were utilized to identify research on population health and health interventions for older adults. Results: Population health management (PHM) is one strategy to promote the health and well-being of target populations. Interventions promoting health across a continuum tend to be disease, risk, or health behavior specific rather than encompassing a global concept of health. Conclusion: Many existing interventions for older adults are simply research based with limited generalizability; as such, further work in this area is warranted. PMID:28680938

  17. Medical Waste Management in Community Health Centers. (United States)

    Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz


    Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

  18. Software for Intelligent System Health Management (ISHM) (United States)

    Trevino, Luis C.


    The slide presentation is a briefing in four areas: overview of health management paradigms; overview of the ARC-Houston Software Engineering Technology Workshop held on April 20-22, 2004; identified technologies relevant to technical themes of intelligent system health management; and the author's thoughts on these topics.

  19. Ruminant Nutrition Symposium: Role of fermentation acid absorption in the regulation of ruminal pH. (United States)

    Aschenbach, J R; Penner, G B; Stumpff, F; Gäbel, G


    Highly fermentable diets are rapidly converted to organic acids [i.e., short-chain fatty acids (SCFA) and lactic acid] within the rumen. The resulting release of protons can constitute a challenge to the ruminal ecosystem and animal health. Health disturbances, resulting from acidogenic diets, are classified as subacute and acute acidosis based on the degree of ruminal pH depression. Although increased acid production is a nutritionally desired effect of increased concentrate feeding, the accumulation of protons in the rumen is not. Consequently, mechanisms of proton removal and their quantitative importance are of major interest. Saliva buffers (i.e., bicarbonate, phosphate) have long been identified as important mechanisms for ruminal proton removal. An even larger proportion of protons appears to be removed from the rumen by SCFA absorption across the ruminal epithelium, making efficiency of SCFA absorption a key determinant for the individual susceptibility to subacute ruminal acidosis. Proceeding initially from a model of exclusively diffusional absorption of fermentation acids, several protein-dependent mechanisms have been discovered over the last 2 decades. Although the molecular identity of these proteins is mostly uncertain, apical acetate absorption is mediated, to a major degree, via acetate-bicarbonate exchange in addition to another nitrate-sensitive, bicarbonate-independent transport mechanism and lipophilic diffusion. Propionate and butyrate also show partially bicarbonate-dependent transport modes. Basolateral efflux of SCFA and their metabolites has to be mediated primarily by proteins and probably involves the monocarboxylate transporter (MCT1) and anion channels. Although the ruminal epithelium removes a large fraction of protons from the rumen, it also recycles protons to the rumen via apical sodium-proton exchanger, NHE. The latter is stimulated by ruminal SCFA absorption and salivary Na(+) secretion and protects epithelial integrity. Finally

  20. Schmallenberg virus infection of ruminants: challenges and opportunities for veterinarians

    Directory of Open Access Journals (Sweden)

    Claine F


    Full Text Available François Claine, Damien Coupeau, Laetitia Wiggers, Benoît Muylkens, Nathalie Kirschvink Veterinary Department, Faculty of Sciences, Namur Research Institute for Life Sciences (NARILIS, University of Namur (UNamur, Namur, Belgium Abstract: In 2011, European ruminant flocks were infected by Schmallenberg virus (SBV leading to transient disease in adult cattle but abortions and congenital deformities in calves, lambs, and goat kids. SBV belonging to the Simbu serogroup (family Bunyaviridae and genus Orthobunyavirus was first discovered in the same region where bluetongue virus serotype 8 (BTV-8 emerged 5 years before. Both viruses are transmitted by biting midges (Culicoides spp. and share several similarities. This paper describes the current knowledge of temporal and geographical spread, molecular virology, transmission and susceptible species, clinical signs, diagnosis, prevention and control, impact on ruminant health, and productivity of SBV infection in Europe, and compares SBV infection with BTV-8 infection in ruminants. Keywords: Schmallenberg virus, Europe, ruminants, review

  1. Medication therapy disease management: Geisinger's approach to population health management. (United States)

    Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A


    Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  2. Understanding and managing organizational change: implications for public health management. (United States)

    Thompson, Jon M


    Managing organizational change has become a significant responsibility of managers. Managing the change process within public health organizations is important because appropriately and systematically managing change is linked to improved organizational performance. However, change is difficult and the change process poses formidable challenges for managers. Managers themselves face increased pressure to respond to environmental influences and provide the necessary leadership to their organizations in the change process. In fact, managing organizational change has become a key competency for healthcare managers. This article addresses the important topic of organizational change in public health organizations. It provides a conceptual foundation for understanding organizational change and its relationship to healthcare organizational performance, and then discusses the types and nature of change, using some examples and evidence from those organizations that have successfully managed change. A framework for guiding public health managers in the change management process is provided. The article concludes with suggested management competencies to establish a change-oriented organization with the culture and capacity for change.

  3. A guide to performance management for the Health Information Manager. (United States)

    Leggat, Sandra G

    This paper provides a summary of human resource management practices that have been identified as being associated with better outcomes in performance management. In general, essential practices include transformational leadership and a coherent program of goal setting, performance monitoring and feedback. Some Health Information Managers may feel they require training assistance to develop the necessary skills in the establishment of meaningful work performance goals for staff and the provision of useful and timely feedback. This paper provides useful information to assist Health Information Managers enhance the performance of their staff.

  4. COMPARATIVE GUT PHYSIOLOGY SYMPOSIUM: Comparative physiology of glucagon-like peptide-2: Implications and applications for production and health of ruminants. (United States)

    Connor, E E; Evock-Clover, C M; Walker, M P; Elsasser, T H; Kahl, S


    Glucagon-like peptide-2 (GLP-2) is a 33-amino acid peptide derived from proteolytic cleavage of proglucagon by prohormone convertase 1/3 in enteroendocrine L cells. Studies conducted in humans, in rodent models, and in vitro indicate that GLP-2 is secreted in response to the presence of molecules in the intestinal lumen, including fatty acids, carbohydrates, amino acids, and bile acids, which are detected by luminal chemosensors. The physiological actions of GLP-2 are mediated by its G protein-coupled receptor expressed primarily in the intestinal tract on enteric neurons, enteroendocrine cells, and myofibroblasts. The biological activity of GLP-2 is further regulated by dipeptidyl peptidase IV, which rapidly cleaves the N-terminus of GLP-2 that is responsible for GLP-2 receptor activation. Within the gut, GLP-2 increases nutrient absorption, crypt cell proliferation, and mesenteric blood flow and decreases gut permeability and motility, epithelial cell apoptosis, and inflammation. Outside the gut, GLP-2 reduces bone resorption, can suppress appetite, and is cytoprotective in the lung. Thus, GLP-2 has been studied intensively as a therapeutic to improve intestinal function of humans during parenteral nutrition and following small bowel resection and, more recently, as a treatment for osteoporosis and obesity-related disorders and to reduce cellular damage associated with inflammation of the gut and lungs. Recent studies demonstrate that many biological actions and properties of GLP-2 in ruminants are similar to those in nonruminants, including the potential to reduce intestinal nitro-oxidative stress in calves caused by parasitic diseases such as coccidiosis. Because of its beneficial impacts on nutrient absorption, gut healing, and normal gut development, GLP-2 therapy offers significant opportunities to improve calf health and production efficiency. However, GLP-2 therapies require an extended time course to achieve desired physiological responses, as well as

  5. Participatory management in today's health care setting

    International Nuclear Information System (INIS)

    Burnham, B.A.


    As the health care revolution progresses, so must the management styles of today's leaders. The authors must ask ourselves if we are managing tomorrow's work force or the work force of the past. Participatory management may better meet the needs of today's work force. This paper identifies the reasons participatory management is a more effective management style, the methods used to implement a participatory management program, its benefits (such as higher productivity and more efficient, effective implementation and acceptance of change), and the difficulties experienced

  6. Assessment of time management attitudes among health managers. (United States)

    Sarp, Nilgun; Yarpuzlu, Aysegul Akbay; Mostame, Fariba


    These days, working people are finding it difficult to manage their time, get more done at work, and find some balance in their work and personal lives. Successful time management is often suggested to be a product of organizing skills, however, what works for one person may not work for others. Context current competence assessment formats for physicians, health professionals, and managers during their training years reliably test core knowledge and basic skills. However, they may underemphasize some important domains of professional medical practice. Thus, in addition to assessments of basic skills, new formats that assess clinical reasoning, expert judgment, management of ambiguity, professionalism, time management, learning strategies, and teamwork to promise a multidimensional assessment while maintaining adequate reliability and validity in classic health education and health care institutional settings are needed to be worked on. It should be kept in mind that institutional support, reflection, and mentoring must accompany the development of assessment programs. This study was designed to describe the main factors that consume time, effective hours of work, time management opportunities, and attitudes and behaviors of health professionals and managers on time management concept through assessment by the assessment tool Time Management Inquiry Form (TMIQ-F). The study was conducted at the State Hospital, Social Security Hospital, and University Hospital at Kirikkale, Turkey between October 1999 and January 2000, including 143 subjects defined as medical managers and medical specialists. According to the results, a manager should give priority to the concept of planning, which may be counted among the efficient time management techniques, and educate him/herself on time management.

  7. Physiological Roles of Adipokines, Hepatokines, and Myokines in Ruminants. (United States)

    Roh, Sang-Gun; Suzuki, Yutaka; Gotoh, Takafumi; Tatsumi, Ryuichi; Katoh, Kazuo


    Since the discovery of leptin secreted from adipocytes, specialized tissues and cells have been found that secrete the several peptides (or cytokines) that are characterized to negatively and positively regulate the metabolic process. Different types of adipokines, hepatokines, and myokines, which act as cytokines, are secreted from adipose, liver, and muscle tissue, respectively, and have been identified and examined for their physiological roles in humans and disease in animal models. Recently, various studies of these cytokines have been conducted in ruminants, including dairy cattle, beef cattle, sheep, and goat. Interestingly, a few cytokines from these tissues in ruminants play an important role in the post-parturition, lactation, and fattening (marbling) periods. Thus, understanding these hormones is important for improving nutritional management in dairy cows and beef cattle. However, to our knowledge, there have been no reviews of the characteristics of these cytokines in beef and dairy products in ruminants. In particular, lipid and glucose metabolism in adipose tissue, liver tissue, and muscle tissue are very important for energy storage, production, and synthesis, which are regulated by these cytokines in ruminant production. In this review, we summarize the physiological roles of adipokines, hepatokines, and myokines in ruminants. This discussion provides a foundation for understanding the role of cytokines in animal production of ruminants.

  8. Concept Development for Software Health Management (United States)

    Riecks, Jung; Storm, Walter; Hollingsworth, Mark


    This report documents the work performed by Lockheed Martin Aeronautics (LM Aero) under NASA contract NNL06AA08B, delivery order NNL07AB06T. The Concept Development for Software Health Management (CDSHM) program was a NASA funded effort sponsored by the Integrated Vehicle Health Management Project, one of the four pillars of the NASA Aviation Safety Program. The CD-SHM program focused on defining a structured approach to software health management (SHM) through the development of a comprehensive failure taxonomy that is used to characterize the fundamental failure modes of safety-critical software.

  9. [The role of management in health care]. (United States)

    Güntert, Bernhard J


    The situation in the health care sector is affected by a shortage of public funds on the one hand and, on the other hand, by rapid developments in medicine and nursing with an enormous expansion of both diagnostic and therapeutic possibilities. This and the aging population are generating a steadily increasing demand for health care services. The result is an increased cost consciousness in society calling for more professional management in health care organizations. However, the traditional administration of health care organizations, which is closely aligned with health professionals and production processes, was not able to cope with these dynamics or did so only unsatisfactorily. An improved management would surely lead to an optimization of health care delivery processes and a more effective use of resources. The question, however, is whether the effectiveness of the total system can be improved and whether patients' and society's needs can actually be met by classical management approaches.

  10. Participative management in health care services

    Directory of Open Access Journals (Sweden)

    M. Muller


    Full Text Available The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalisation of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management.

  11. Leadership and management in mental health nursing. (United States)

    Blegen, Nina Elisabeth; Severinsson, Elisabeth


    Mental health nurses are agents of change, and their leadership, management role and characteristics exist at many levels in health care. Previous research presents a picture of mental health nurses as subordinate and passive recipients of the leader's influence and regard leadership and management as distinct from the nurses' practical work. The aim was to provide a synthesis of the studies conducted and to discuss the relationship between nursing leadership and nursing management in the context of mental health nursing. A literature search was conducted using EBSCO-host, Academic Search Premier, Science Direct, CINAHL and PubMed for the period January 1995-July 2010. Leadership and management in the context of mental health nursing are human activities that imply entering into mutual relationships. Mental health nurses' leadership, management and transformational leadership are positively related in terms of effectiveness and nurses' skills. It is important to consider mental health nurses' management as a form of leadership similar to or as a natural consequence of transformational leadership (TL) and that ethical concerns must be constantly prioritized throughout every level of the organization. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  12. Health Services management. Health Service use of ionising radiations

    International Nuclear Information System (INIS)


    This circular consolidates and updates advice on the statutory and management responsibilities of Health Authorities in relation to the use of ionising radiations (including radioactive substances) on premises controlled by them and/or by persons employed by them (author)

  13. Integrated Structural Health Management, Phase I (United States)

    National Aeronautics and Space Administration — Cornerstone Research Group Inc. (CRG) proposes to advance the state of the art in composite health management through refinement of an existing technology developed...

  14. The Case for Software Health Management (United States)

    National Aeronautics and Space Administration — Software Health Management (SWHM) is a new field that is concerned with the development of tools and technologies to enable automated detection, diagnosis,...

  15. Battery Health Management System for Electric UAVs (United States)

    National Aeronautics and Space Administration — In summary, this paper lays out a novel battery health management technique for application onboard an electric UAV. This technique is also applicable to other...

  16. Requirements Flowdown for Prognostics and Health Management (United States)

    National Aeronautics and Space Administration — Prognostics and Health Management (PHM) principles have considerable promise to change the game of lifecycle cost of engineering systems at high safety levels by...

  17. Managing terminology assets in Electronic Health Records. (United States)

    Abrams, Kelly; Schneider, Sue; Scichilone, Rita


    Electronic Health Record (EHR)systems rely on standard terminologies and classification systems that require both Information Technology (IT) and Information Management (IM) skills. Convergence of perspectives is necessary for effective terminology asset management including evaluation for use, maintenance and intersection with software applications. Multiple terminologies are necessary for patient care communication and data capture within EHRs and other information management tasks. Terminology asset management encompasses workflow and operational context as well as IT specifications and software application run time requirements. This paper identifies the tasks, skills and collaboration of IM and IT approaches for terminology asset management.

  18. Collective work: a challenge for health management. (United States)

    Scherer, Magda Duarte Dos Anjos; Pires, Denise; Schwartz, Yves


    Based on ergology and work process theorization, the study aims to contribute to reflections on health collective work, emphasizing its specificity and difficulties in building and managing groups of workers. It deals with work as a human activity that dialectically comprises the application of a prescribed protocol and a unique and historical perspective. Health work involves a relationship among individuals who act in the drama of using themselves and manage their own work; it is influenced by the history of health professions and macro-political determinations. In conclusion, this health work complexity needs to be considered in the process of management of professional teams/groups of workers, in a way that actions can interact and enable the implementation of a new health care project in the perspective of comprehensiveness.

  19. Crisis management teams in health organisations. (United States)

    Canyon, Deon V


    Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events.

  20. Effects on roughage inclusion and particle size on digestion and ruminal fermentation characteristics of beef steers (United States)

    Roughage is fed to cattle to promote ruminal health and decrease digestive upset, but inclusion in finishing diets is limited due to the cost per unit of energy. Rumination behavior may be a means to standardize roughage in beef cattle finishing diets, and increasing particle size of roughage could ...

  1. 9 CFR 93.428 - Sheep and goats and wild ruminants from Mexico. (United States)


    ... from Mexico. 93.428 Section 93.428 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.428 Sheep and goats and wild ruminants from Mexico. (a) Sheep and goats intended for importation from Mexico...

  2. Modelling digestive constraints in non-ruminant and ruminant foregut-fermenting mammals. (United States)

    Munn, Adam J; Streich, W Jürgen; Hummel, Jürgen; Clauss, Marcus


    It has been suggested that large foregut-fermenting marsupial herbivores, the kangaroos and their relatives, may be less constrained by food intake limitations as compared with ruminants, due mainly to differences in their digestive morphology and management of ingesta particles through the gut. In particular, as the quality of forage declines with increasing contents of plant fibre (cellulose, hemicelluloses and lignin; measured as neutral-detergent fibre, NDF), the tubiform foregut of kangaroos may allow these animals to maintain food intakes more so than ruminants like sheep, which appear to be limited by fibrous bulk filling the foregut and truncating further ingestion. Using available data on dry matter intake (DMI, g kg(-0.75) d(-1)), ingesta mean retention time (MRT, h), and apparent digestibility, we modelled digestible dry matter intake (DDMI) and digestible energy intake (DEI) by ruminant sheep (Ovis aries) and by the largest marsupial herbivore, the red kangaroo (Macropus rufus). Sheep achieved higher MRTs on similar DMIs, and hence sheep achieved higher DDMIs for any given level of DMI as compared with kangaroos. Interestingly, MRT declined in response to increasing DMI in a similar pattern for both species, and the association between DMI and plant NDF contents did not support the hypothesis that kangaroos are less affected by increasing fibre relative to sheep. However, when DEI was modelled according to DDMIs and dietary energy contents, we show that the kangaroos could meet their daily maintenance energy requirements (MER) at lower levels of DMI and on diets with higher fibre contents compared with sheep, due largely to the kangaroos' lower absolute maintenance and basal energy metabolisms compared with eutherians. These results suggest that differences in the metabolic set-point of different species can have profound effects on their nutritional niche, even when their digestive constraints are similar, as was the case for these ruminant and non-ruminant

  3. Integrated System Health Management Development Toolkit (United States)

    Figueroa, Jorge; Smith, Harvey; Morris, Jon


    This software toolkit is designed to model complex systems for the implementation of embedded Integrated System Health Management (ISHM) capability, which focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, and predict future anomalies), and to provide data, information, and knowledge (DIaK) to control systems for safe and effective operation.

  4. Management of mutual health organizations in Ghana.

    NARCIS (Netherlands)

    Baltussen, R.M.P.M.; Bruce, E.; Rhodes, G.; Narh-Bana, S.A.; Agyepong, I.


    OBJECTIVE: Mutual Health Organizations (MHO) emerged in Ghana in the mid-1990s. The organizational structure and financial management of private and public MHO hold important lessons for the development of national health insurance in Ghana, but there is little evidence to date on their features.

  5. Recent Advances in Ruminant Nutrition

    Directory of Open Access Journals (Sweden)

    Hasan Rüştü Kutlu


    Full Text Available One of the most industrialized animal production branches of ruminant production successfully requires a blending of theoretical knowledge of nutritional principles with practical stockmanship, maintaining health and dealing with numbers. It is well known that high yielding, dairy cows, require balanced diet with adequate nutrients for yielding. This is not provided with only a few feedstuffs. Milk production in dairy cows is related to the improvements in genetic merit of farm animals and also developments in feed science, feed technology and animal nutrition. In particular, feeds and feed technology studies associated with sustainability, economical perspectives and product quality in the last decade have been in advance. In the present work, recent advances in feed sources and feed technology, minerals (macro and trace minerals , vitamins and amino acids, feed additives (antibiotics alternative growth stimulants, rumen modulator, organic acids, antioxidants, enzymes, plant extracts, nutrition-products (meat-milk-progeny quality and functional food production (milk, meat nutrition-reproduction, nutrition-animal health, nutrition-environmental temperature, nutrition-global warming were evaluated.

  6. A cow-level association of ruminal pH on body condition score, serum beta-hydroxybutyrate and postpartum disorders in Thai dairy cattle

    NARCIS (Netherlands)

    Inchaisri, C.; Chanpongsang, S.; Noordhuizen, J.; Hogeveen, H.


    Subacute ruminal acidosis in dairy cows occurs when ruminal pH is below about 5.5. However, the exact threshold level of ruminal pH affecting cow health is still in debate. This investigation was carried out in 505 cows within 31 farms. The postpartum disorders, including dystocia, retained

  7. Managing complaints in health and social care. (United States)

    Holmes-Bonney, Kathy


    An important aspect of allowing patients to take control of their health care is the introduction of new procedures for dealing with complaints. This article examines the concepts that underpin the new Department of Health regulations on complaints management and what they will mean for health and social care professionals. It also explains why these regulations focus on restorative justice rather than blame when adverse events occur.

  8. The use of blood analysis to evaluate trace mineral status in ruminant livestock. (United States)

    Herdt, Thomas H; Hoff, Brent


    This article summarizes effects and evaluation of 8 trace minerals considered significant in ruminant nutrition, both for nutritional deficiencies as well as production-related toxicosis: cobalt, copper, iron, iodine, manganese, molybdenum, selenium, and zinc. Changes in availability, metabolism, and amounts needed for optimum health and productivity in animals are their major effect; frank clinical toxicosis or severe nutritional deficiency are of limited concern in modern production agriculture. The information provided in this article can help to manage the risk of subtle effects that may alter performance and lifetime productivity. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Simulation modeling for the health care manager. (United States)

    Kennedy, Michael H


    This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement.

  10. Quality management in Irish health care. (United States)

    Ennis, K; Harrington, D


    This paper reports on the findings from a quantitative research study of quality management in the Irish health-care sector. The study findings suggest that quality management is what hospitals require to become more cost-effective and efficient. The research also shows that the culture of health-care institutions must change to one where employees experience pride in their work and where all are involved and committed to continuous quality improvement. It is recommended that a shift is required from the traditional management structures to a more participative approach. Furthermore, all managers whether from a clinical or an administration background must understand one another's role in the organisation. Finally, for quality to succeed in the health-care sector, strong committed leadership is required to overcome tensions in quality implementation.

  11. Managing for soil health can suppress pests

    Directory of Open Access Journals (Sweden)

    Amanda Hodson


    Full Text Available A “healthy” soil can be thought of as one that functions well, both agronomically and ecologically, and one in which soil biodiversity and crop management work in synergy to suppress pests and diseases. UC researchers have pioneered many ways of managing soil biology for pest management, including strategies such as soil solarization, steam treatment and anaerobic soil disinfestation, as well as improvements on traditional methods, such as reducing tillage, amending soil with organic materials, and cover cropping. As managing for soil health becomes more of an explicit focus due to restrictions on the use of soil fumigants, integrated soil health tests will be needed that are validated for use in California. Other research needs include breeding crops for disease resistance and pest suppressive microbial communities as well as knowledge of how beneficial organisms influence plant health.

  12. Participative management in health care services. (United States)

    Muller, M


    The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalization of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management. A continuum of interactive decision-making and problem-solving is described, the different role-players involved, as well as the levels of interactive decision-making and problem-solving. The most appropriate decision-making strategy should be employed in pro-active and reactive decision-making. Applicable principles and assumptions in each element of participative management is described. It is recommended that this proposed model for participative management be refined by means of a literature control, interactive dialogue with experts and a model case description or participative management, to ensure the trustworthiness of this research.

  13. The mammary gland in domestic ruminants: a systems biology perspective. (United States)

    Ferreira, Ana M; Bislev, Stine L; Bendixen, Emøke; Almeida, André M


    Milk and dairy products are central elements in the human diet. It is estimated that 108kg of milk per year are consumed per person worldwide. Therefore, dairy production represents a relevant fraction of the economies of many countries, being cattle, sheep, goat, water buffalo, and other ruminants the main species used worldwide. An adequate management of dairy farming cannot be achieved without the knowledge on the biological mechanisms behind lactation in ruminants. Thus, understanding the morphology, development and regulation of the mammary gland in health, disease and production is crucial. Presently, innovative and high-throughput technologies such as genomics, transcriptomics, proteomics and metabolomics allow a much broader and detailed knowledge on such issues. Additionally, the application of a systems biology approach to animal science is vastly growing, as new advances in one field of specialization or animal species lead to new lines of research in other areas or/and are expanded to other species. This article addresses how modern research approaches may help us understand long-known issues in mammary development, lactation biology and dairy production. Dairy production depends upon the knowledge of the morphology and regulation of the mammary gland and lactation. High-throughput technologies allow a much broader and detailed knowledge on the biology of the mammary gland. This paper reviews the major contributions that genomics, transcriptomics, metabolomics and proteomics approaches have provided to understand the regulation of the mammary gland in health, disease and production. In the context of mammary gland "omics"-based research, the integration of results using a Systems Biology Approach is of key importance. © 2013.

  14. Knowledge Management in Health Technology SMEs. (United States)

    Huusko, Juhamatti; Kuusisto-Niemi, Sirpa; Saranto, Kaija


    The purpose of this study was to examine knowledge management's (KM) role in small and medium-sized (SMEs) health technology enterprises, which employ fewer than 250 employees. In this study, KM is understood as the ability to achieve competitive advantage by utilizing management knowledge and making it profitable. The health technology enterprises use modern technology to resolve health-related issues. The research data was acquired from Finnish health technology SMEs. The questionnaire was sent to 140 enterprises, generating 25 responses, or a 17.9% response rate. According to the results, health technology enterprises have not adopted KM concepts, nor do they have the necessary resources to do so. SMEs' KM use is informal: information is transferred informally through human interaction, rather than through information systems. In the SMEs, KM is not perceived as important, although it is seen as associated with the enterprise's financial performance through the potential in making the knowledge profitable.

  15. Women as managers in the health services

    Directory of Open Access Journals (Sweden)

    Jocelyne Kane Berman


    Full Text Available Despite their numerical superiority women do not occupy positions o f power and authority in the health services generally. This is perceived as being due to a variety of factors which prevent women from realising their ful l potential as managers. In other parts of the world, as well as in South Africa, middle class white males have dominated health services, since medicine became a form al science, usurping the traditional role of women healers. Some research indicates that women are inclined to practice “feminine " management styles. It is suggested that the femine I masculine dichotomy is artificial and that qualities which ensure effective management should not be regarded as genderlinked. Leaders in the health services should strive for interdisciplinary, mixed-gender education and training at all levels. Identification and development of management potential in women health-care professionals, role-modelling and sponsor-mentor relationships should be encouraged to allow women to acquire the full range of management skills and to achieve positions of power and authority in the health services.

  16. Applying e-health to case management. (United States)

    Adams, J M


    The healthcare industry is only beginning to understand e-health. E-health can be defined as the use of technology to directly improve healthcare delivery-affording patients the opportunity to participate in their own healthcare management, provider, and institution. The market is changing rapidly, and innovations, partnerships, and mergers are taking place daily. For healthcare institutions, setting a long-term, yet adaptable e-health strategy is of vital importance for the continued success of the organization. For clinicians, an understanding of and familiarity with technologies can significantly improve workflow, organization, and patient interaction. For the patient, technology can be leveraged as a means to take initiative and responsibility for his/her own health. This article defines e-health and explains the implications and benefits of e-health to nurses and their patients. The article also identifies unique opportunities e-health/e-commerce can provide case managers in promoting patient connectivity, care management, and economy in cost of care.

  17. An XML-based framework for personalized health management. (United States)

    Lee, Hiye-Ja; Park, Seung-Hun; Jeong, Byeong-Soo


    This paper proposes a framework for personalized health management. In this framework, XML technology is used for representing and managing the health information and knowledge. Major components of the framework are Health Management Prescription (HMP) Expert System and Health Information Repository. The HMP Expert System generates a HMP efficiently by using XML-based templates. Health Information Repository provides integrated health information and knowledge for personalized health management by using XML and relational database together.

  18. Managing diversity in the health care workplace. (United States)

    Davidhizar, R; Dowd, S; Newman Giger, J


    Cultural diversity is increasing in the United States as increasing numbers of minorities enter the United States from abroad, and cultural diversity is especially prevalent in the health care workplace. In fact, the health care professions are particularly interested in the presence of minorities among caregivers because this often enhances the cultural competence of care delivery. Nevertheless, subtle discrimination can still be found, and managers must be alert that such behavior is not tolerated. Use of the Giger-Davidhizar Cultural Assessment Model can provide managers with information needed to respond to diversity among staff appropriately.

  19. Mapping Health Needs to Support Health System Management in Poland (United States)

    Holecki, Tomasz; Romaniuk, Piotr; Woźniak-Holecka, Joanna; Szromek, Adam R.; Syrkiewicz-Świtała, Magdalena


    In Poland, following the example of other EU countries, the first maps of health needs prepared by the Ministry of Health were presented in 2016. The maps constitute a foundation for rational decision-making in the management of health care resources, being potentially useful for all actors in health system. This refers in particular to the institutions responsible for distribution of funds and contracting health service, but also for decision-makers, who determine the scope of funds to be utilized in the health system, or the structure of benefits provided to patients. Service providers are also addressees of the maps, to give them a basis for planning future activities. The article presents a structured assessment of the current state of affairs, based on recent experience and sets out likely directions for the development of health needs in mapping in Poland in the future. We discuss the criticism addressed toward maps by representatives of various groups acting in health care. It includes the lack of recognition of some of the key health needs, or wrong emphases, where much more attention is paid to the recognition of current resources in the health system, instead of making prognoses regarding the future developments of health needs. Nonetheless, we find that this instrument is potentially of high usability, in case of elimination of the existing weaknesses. PMID:29662876

  20. Urea recycling in ruminants

    International Nuclear Information System (INIS)

    Ohara, Yoshiaki; Niibayashi, Tsunekazu


    The transfer of blood urea into the alimentary tract of goats, as ruminants, was studied by the use of 15 N-urea, 15 N-ammonium chloride and physiological experimental techniques. Blood urea after an intravenous injection of 15 N-urea appeared in the first rumen via two routes, the saliva (approximately 60% of the serum urea concentration) and idrect diffusion from the wall of the first rumen, both as the ammonium-form N. The serum urea levels from diets containing different protein levels were paralleled with the protein levels, the ammonium level in the first rumen being similar to that of the serum urea. The transfer of low protein into the NH 3 pool of the first rumen was 56% of the total NH 3 in the entire alimentary tract, and the quantitative ratio of salivary secretion of diffusion in the first rumen was 1:9. The transfer of high protein was 14% in the entire alimentary tract, and the ratio of saliva to diffusion in the first rumen was 6:1. Thus, when protein uptake was large, salivary secretion was the primary route to the first rumen. Approximately 50% of the entire quantity of blood urea in the alimentary tract appeared in the first rumen, and 35%, in the lower alimentary tract, primarily in the duodenum and jejunum. (Chiba, N.)

  1. Pesti Des Petits ruminants virus infection in animals

    Directory of Open Access Journals (Sweden)

    Chauhan H.C.


    Full Text Available For centuries morbillivirus infections have had a huge impact on both human beings and animals. Morbilliviruses are highly contagious pathogens that cause some of the most devastating viral diseases of humans and animals world wide. They include measles virus (MV, canine distemper virus (CDV, rinderpest virus (RPV and peste des petits ruminants (PPRV virus. Furthermore, new emerging infectious diseases of morbilliviruses with significant ecological consequences of marine mammals have been discovered in the past decades. Phocid distemper virus (PDV in seals and the cetacean morbillivirus (CMV have been found in dolphins, whales and porpoises. Peste des petits ruminants (PPR is a highly contagious ,infectious , an acute or sub acute viral disease of domestic and wild small ruminants characterized by fever, oculonasal discharges, stomatitis, conjunctivitis, gastroenteritis and pneumonia. Goats are more severely affected than sheep. It is also known as pseudorinderpest of small ruminants, pest of small ruminants, pest of sheep and goats, kata, stomatitis- pneumoentritis syndrome, contagious pustular stomatitis and pneumoentritis complex. It is one of the major notifiable diseases of the World Organization for Animal Health (OIE. [Vet. World 2009; 2(4.000: 150-155

  2. Alternatives for optimisation of rumen fermentation in ruminants

    Directory of Open Access Journals (Sweden)

    T. Slavov


    Full Text Available Abstract. The proper knowledge on the variety of events occurring in the rumen makes possible their optimisation with respect to the complete feed conversion and increasing the productive performance of ruminants. The inclusion of various dietary additives (supplements, biologically active substances, nutritional antibiotics, probiotics, enzymatic preparations, plant extracts etc. has an effect on the intensity and specific pathway of fermentation, and thus, on the general digestion and systemic metabolism. The optimisation of rumen digestion is a method with substantial potential for improving the efficiency of ruminant husbandry, increasing of quality of their produce and health maintenance.

  3. Benchmarking and performance management in health care


    Buttigieg, Sandra; ; EHMA Annual Conference : Public Health Care : Who Pays, Who Provides?


    Current economic conditions challenge health care providers globally. Healthcare organizations need to deliver optimal financial, operational, and clinical performance to sustain quality of service delivery. Benchmarking is one of the most potent and under-utilized management tools available and an analytic tool to understand organizational performance. Additionally, it is required for financial survival and organizational excellence.

  4. Health care management modelling: a process perspective

    NARCIS (Netherlands)

    Vissers, J.M.H.


    Modelling-based health care management ought to become just as popular as evidence based medicine. Making managerial decisions based on evidence by modelling efforts is certainly a step forward. Examples can be given of many successful applications in different areas of decision making: disease

  5. Radioactive waste management of health services

    International Nuclear Information System (INIS)

    Silva, Eliane Magalhaes Pereira da; Miaw, Sophia Teh Whei


    In health care establishment, radioactive waste is generated from the use of radioactive materials in medical applications such as diagnosis, therapy and research. Disused sealed sources are also considered as waste. To get the license to operate from Comissao Nacional de Energia Nuclear - CNEN, the installation has to present a Radiation Protection Plan, in which the Waste Management Programme should be included. The Waste Management Programme should contain detailed description on methodologies and information on technical and administrative control of generated waste. This paper presents the basic guidelines for the implementation of a safe waste management by health care establishments, taking into account the regulations from CNEN and recommendations from the International Atomic Energy Agency - IAEA. (author)

  6. Occurrence of brucellosis in small ruminants slaughtered in Lafia ...

    African Journals Online (AJOL)

    Brucellosis caused by Brucella species is a disease of economic and public health importance worldwide. Although present in Nigeria, there is a paucity of information regarding the occurrence of the disease in small ruminants in Nasarawa State. A cross-sectional study was therefore carried out to determine the ...

  7. Creating and managing a paperless health information management department. (United States)

    Greene, Zelda B


    Over the last 10 to 15 years, the health care industry has experienced dramatic changes in health care delivery, consumer needs, and demands. The medical record, a recapitulation of the care patients receive, continues to be one of the most vital components of the health care delivery system. It serves as a crucial administrative, clinical, financial, and research tool. Health information managers, striving to meet ever-changing requirements, have turned to electronic record processing to meet these changes. The following article describes one hospital's journey from a cumbersome paper environment to an electronic environment that not only resulted in improved customer service but also provided employees with renewed job satisfaction and increased skill levels.

  8. Case manager satisfaction in public health. (United States)

    Schutt, Russell K; Fawcett, Jacqueline; Gall, Gail B; Harrow, Brooke; Woodford, Mary Lou


    The purpose of this study was to examine correlates of case managers' satisfaction with their work, services, and service network and to identify connections to service performance and service costs. A decentralized public health program that exemplifies the trend toward more diverse clients and networked services. A mixed method design with 34 case managers. As hypothesized, the case managers' experiences with clients and the service network, and their service effectiveness, were associated with their satisfaction with their jobs and the services they provide. Satisfaction was also positively associated with more timely service delivery. These associations were explained in part by case managers' education and training. Case managers can achieve high levels of job and service satisfaction in outreach programs serving a diverse client population in a decentralized service network. Case managers' job and service satisfaction improves with reduced service problems and service delays and when case managers can devise work-arounds for persistent service problems. Using advanced practice nurses (APN) and providing more on-the-job training may increase case manager satisfaction with their jobs and the services they provide. Special efforts may be needed to prevent a decline in job satisfaction with years of experience.

  9. Ruminal acidosis: strategies for its control


    Jaramillo-López, Esaúl; Itza-Ortiz, Mateo F.; Peraza-Mercado, Gwendolyne; Carrera-Chávez, José M.


    ABSTRACT: Ruminal acidosis in ruminants is a metabolic disorder of gastrointestinal origin that occurs in animals with a high feed intake of cereal grains diets, which affect the performance. According to clinical manifestations it can be classified as: a) acute lactic acidosis with prolonged exposure to ruminal pH ≤ 5.0, triggering a systemic acidosis, with clinical manifestations and changes in biochemical patterns, starting the first twelve hours of ruminal acidosis and it takes 48 to 120 ...

  10. Integrated Systems Health Management for Intelligent Systems (United States)

    Figueroa, Fernando; Melcher, Kevin


    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  11. Managing interoperability and complexity in health systems. (United States)

    Bouamrane, M-M; Tao, C; Sarkar, I N


    In recent years, we have witnessed substantial progress in the use of clinical informatics systems to support clinicians during episodes of care, manage specialised domain knowledge, perform complex clinical data analysis and improve the management of health organisations' resources. However, the vision of fully integrated health information eco-systems, which provide relevant information and useful knowledge at the point-of-care, remains elusive. This journal Focus Theme reviews some of the enduring challenges of interoperability and complexity in clinical informatics systems. Furthermore, a range of approaches are proposed in order to address, harness and resolve some of the many remaining issues towards a greater integration of health information systems and extraction of useful or new knowledge from heterogeneous electronic data repositories.

  12. Software Health Management with Bayesian Networks (United States)

    Mengshoel, Ole; Schumann, JOhann


    Most modern aircraft as well as other complex machinery is equipped with diagnostics systems for its major subsystems. During operation, sensors provide important information about the subsystem (e.g., the engine) and that information is used to detect and diagnose faults. Most of these systems focus on the monitoring of a mechanical, hydraulic, or electromechanical subsystem of the vehicle or machinery. Only recently, health management systems that monitor software have been developed. In this paper, we will discuss our approach of using Bayesian networks for Software Health Management (SWHM). We will discuss SWHM requirements, which make advanced reasoning capabilities for the detection and diagnosis important. Then we will present our approach to using Bayesian networks for the construction of health models that dynamically monitor a software system and is capable of detecting and diagnosing faults.

  13. Nitrogen metabolism in the ruminant

    International Nuclear Information System (INIS)

    Buttery, P.J.; Lewis, D.


    Selected aspects of nitrogen metabolism in the ruminant are discussed. Particular attention is paid to the effect of rumen ammonia concentration on protein synthesis in the rumen. In order to judge the suitability of microbial protein as a source of protein for the ruminant, it is necessary to be able to assess the amino-acid requirements of the ruminant accurately. Several methods of doing this are discussed. Available data would indicate that under many conditions methionine is the first limiting amino acid. Possible ways of increasing the supply of methionine at the duodenum are discussed. When the amino-acid requirements are fully met, it is to be expected that protein synthesis in the tissues will proceed at its maximal rate. Ways of determining the extent of tissue protein synthesis in vivo are briefly discussed. (author)

  14. Redundancy, resilience, and host specificity of the ruminal microbiota: implications for engineering improved ruminal fermentations (United States)

    Weimer, Paul J.


    The ruminal microbial community is remarkably diverse, containing 100s of different bacterial and archaeal species, plus many species of fungi and protozoa. Molecular studies have identified a “core microbiome” dominated by phyla Firmicutes and Bacteroidetes, but also containing many other taxa. The rumen provides an ideal laboratory for studies on microbial ecology and the demonstration of ecological principles. In particular, the microbial community demonstrates both redundancy (overlap of function among multiple species) and resilience (resistance to, and capacity to recover from, perturbation). These twin properties provide remarkable stability that maintains digestive function for the host across a range of feeding and management conditions, but they also provide a challenge to engineering the rumen for improved function (e.g., improved fiber utilization or decreased methane production). Direct ruminal dosing or feeding of probiotic strains often fails to establish the added strains, due to intensive competition and amensalism from the indigenous residents that are well-adapted to the historical conditions within each rumen. Known exceptions include introduced strains that can fill otherwise unoccupied niches, as in the case of specialist bacteria that degrade phytotoxins such as mimosine or fluoroacetate. An additional complicating factor in manipulating the ruminal fermentation is the individuality or host specificity of the microbiota, in which individual animals contain a particular community whose species composition is capable of reconstituting itself, even following a near-total exchange of ruminal contents from another herd mate maintained on the same diet. Elucidation of the interactions between the microbial community and the individual host that establish and maintain this specificity may provide insights into why individual hosts vary in production metrics (e.g., feed efficiency or milk fat synthesis), and how to improve herd performance. PMID

  15. Technical note: ruminal cannulation technique in young Holstein calves: effects of cannulation on feed intake, body weight gain, and ruminal development at six weeks of age. (United States)

    Kristensen, N B; Engbaek, M; Vestergaard, M; Harmon, D L


    Ruminal cannulation techniques are frequently used to study fermentation in the ruminant forestomach. Unsatisfactory results with the traditionally applied procedure for cannulation of young calves stimulated the development of a simpler and more robust procedure; this procedure was tested for effects on performance traits and gross anatomy of the gastrointestinal tract compared with a control group not undergoing surgery. Five calves were ruminally cannulated at approximately 10 d of age and 5 matching calves were used as controls. All calves were fed milk replacer and a diet based on clover grass silage and sodium hydroxide-treated wheat. Ruminal fluid was collected from cannulated calves once weekly for 3 consecutive weeks. All calves were euthanized at 43+/-3 d of age. No apparent adverse effects of cannulation were observed. Feed intake, BW gain, and gross anatomy of the gastrointestinal tract were not affected by cannulation. Minimum ruminal pH increased with sampling week, but average ruminal pH, total volatile fatty acids concentration, and volatile fatty acids proportions were not affected by sampling week. In conclusion, the implemented surgical technique was found to have no major effect on apparent animal health and performance traits, and the cannula proved useful for multiple samplings of ruminal contents in young calves. Copyright 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  16. Conflict management styles in the health professions. (United States)

    Sportsman, Susan; Hamilton, Patti


    The purpose of the study was to determine prevalent conflict management styles chosen by students in nursing and to contrast these styles with those chosen by students in allied health professions. The associations among the level of professional health care education and the style chosen were also determined. A convenience sample of 126 students in a comprehensive university completed the Thomas-Kilmann Conflict Mode Instrument (TKI), which requires respondents to choose behaviors most characteristic of their response to conflict and classifies these behaviors as one of five styles. There was no significant difference between the prevalent conflict management styles chosen by graduate and undergraduate nursing students and those in allied health. Some of the students were already licensed in their discipline; others had not yet taken a licensing exam. Licensure and educational level were not associated with choice of styles. Women and men had similar preferences. The prevalent style for nursing students was compromise, followed by avoidance. In contrast, avoidance, followed by compromise and accommodation, was the prevalent style for allied health students. When compared to the TKI norms, slightly more than one half of all participants chose two or more conflict management styles, commonly avoidance and accommodation at the 75th percentile or above. Only 9.8% of the participants chose collaboration at that level. Implications for nurse educators, researchers, and administrators are discussed.

  17. Innovation in health service management: Adoption of project management offices to support major health care transformation. (United States)

    Lavoie-Tremblay, Mélanie; Aubry, Monique; Cyr, Guylaine; Richer, Marie-Claire; Fortin-Verreault, Jean-François; Fortin, Claude; Marchionni, Caroline


    To explore the characteristics that influence project management offices acceptance and adoption in healthcare sector. The creation of project management offices has been suggested as a promising avenue to promote successful organisational change and facilitate evidence-based practice. However, little is known about the characteristics that promote their initial adoption and acceptance in health care sector. This knowledge is important in the context where many organisations are considering implementing project management offices with nurse managers as leaders. A descriptive multiple case study design was used. The unit of analysis was the project management offices. The study was conducted in three university-affiliated teaching hospitals in 2013-14 (Canada). Individual interviews (n = 34) were conducted with senior managers. Results reveal that project management offices dedicated to project and change management constitute an innovation and an added value that addresses tangible needs in the field. Project management offices are an innovation highly compatible with health care managers and their approach has parallels to the process of clinical problem solving and reasoning well-known to adopters. This knowledge is important in a context where many nurses hold various roles in project management offices, such as Director, project manager, clinical expert and knowledge broker. © 2017 John Wiley & Sons Ltd.

  18. New public management in Iran's health complex: a management framework for primary health care system. (United States)

    Tabrizi, Jafar Sadegh; HaghGoshayie, Elaheh; Doshmangir, Leila; Yousefi, Mahmood


    New public management (NPM) was developed as a management reform to improve the efficiency and effectiveness in public organizations, especially in health sector. Using the features of private sector management, the managers of health organizations may try to implement the elements of NPM with the hope to improve the performance of their systems.AimsOur aim in the present study was to identify the elements and infrastructures suitable for implementing NPM in the Iranian health complex. In this qualitative study with conventional content analysis approach, we tried to explore the NPM elements and infrastructures in Iranian public health sector. A series of semi-structured interviews (n=48) were conducted in 2016 with a managers in public and private health complex. Three focus group discussions with nine faculty members were also conducted. A data collection form was used to collect the demographic characteristics and perspectives of the participants.FindingsFrom the perspective of managers, managerialism, decentralization, using market mechanism, performance management, customer orientation and performance budgeting were the main elements of NPM in the Iranian context. The most important infrastructures for implementing this reform were as follows: education and training, information technology, the proper use of human resources, decision support systems, top management commitment, organizational culture, flexibility of rules, rehabilitating of the aging infrastructures, and expanding the coverage of services. The NPM was generally identified to be an effective replacement for the traditional administration method. These reforms may be helpful in strengthening the public health complex and the management capacity, as well. NPM also seems to be useful in interacting the public health sector with the private sector in terms of personnel and resources, performance, reward structure, and methods of doing business.

  19. Smart Information Management in Health Big Data. (United States)

    Muteba A, Eustache


    The smart information management system (SIMS) is concerned with the organization of anonymous patient records in a big data and their extraction in order to provide needful real-time intelligence. The purpose of the present study is to highlight the design and the implementation of the smart information management system. We emphasis, in one hand, the organization of a big data in flat file in simulation of nosql database, and in the other hand, the extraction of information based on lookup table and cache mechanism. The SIMS in the health big data aims the identification of new therapies and approaches to delivering care.

  20. Strategi Pengelolaan Usaha Jasa Rumah Pemotongan Hewan Ruminansia Secara Berkelanjutan (MANAGEMENT STRATEGY FOR SUSTAINABLE RUMINANT-CATTLE SLAUGHTERHOUSE (RC-S SERVICES

    Directory of Open Access Journals (Sweden)

    Maya Dewi Dyah Maharani


    Full Text Available Uncontrolled cattle slaughtering may result in reduce water quantity and quality, number of cattle, and product of animal origin that does not fit the criteria of safety-healthy-whole-halal. The research objective was to analyze and measure important variables which might be required in developing a modelas well as to formulate strategic plans for managing sustainable abattoir services. Analysis methods used in this study were: Multidimensional Scaling (MDS or rap-slaughterhouse, Monte Carlo Analysis, and Analytical Hierarchy Process (AHP. Results of the analysis showed that the important variables were, i.e.: water availability and animal health status (ecological dimension; willingness to conduct hygienic and sanitation procedures at business scale level, service business orientation, availability of animal and slaughtering schedule management (economical dimension; workers safety and security (sociological dimension, noncompliance of the use of infrastructure by managers, workers and service users; lack off ulfillment of the requirements of the building frame (dimension regulations; and processing technology (technological dimension. The priority strategic analysis concluded that supply services of product of animal origin is eligible to be considered as components required in the food security program through the development and renovation program of effective slaughter houses. ABSTRAK Pemotongan hewan yang tidak terkendali mengakibatkan penurunan ketersediaan jumlah dan mutu air, hewan, dan pangan asal ternak yang tidak sesuai kriteria aman-sehat-utuh-halal (ASUH. Tujuan penelitian adalah menganalisis dan mengukur peubah-peubah penting yang diperlukan untuk menyusun model dan merancang rencana strategik pengelolaan usaha jasa rumah pemotongan hewan ruminansia secara berkelanjutan. Metode analisis yang digunakan adalah Multi Dimensional Scaling (MDS atau rap-slaughterhouse, Monte Carlo, dan Analytical Hierarchy Process. Hasil analisis

  1. Health and Stress Management and Mental-health Disability Claims. (United States)

    Marchand, Alain; Haines, Victor Y; Harvey, Steve; Dextras-Gauthier, Julie; Durand, Pierre


    This study examines the associations between health and stress management (HSM) practices and mental-health disability claims. Data from the Salveo study was collected during 2009-2012 within 60 workplaces nested in 37 companies located in Canada (Quebec) and insured by a large insurance company. In each company, 1 h interviews were conducted with human resources managers in order to obtain data on 63 HSM practices. Companies and workplaces were sorted into the low-claims and high-claims groups according to the median rate of the population of the insurer's corporate clients. Logistic regression adjusted for design effect and multidimensional scaling was used to analyse the data. After controlling for company size and economic sector, task design, demands control, gratifications, physical activity and work-family balance were associated with low mental-health disability claims rates. Further analyses revealed three company profiles that were qualified as laissez-faire, integrated and partially integrated approaches to HSM. Of the three, the integrated profile was associated with low mental-health disability claims rates. The results of this study provide evidence-based guidance for a better control of mental-health disability claims. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  2. Rumination and Performance in Dynamic, Team Sport

    Directory of Open Access Journals (Sweden)

    Michael eRoy


    Full Text Available People high in rumination are good at tasks that require persistence whereas people low in rumination are good at tasks that require flexibility. Here we examine real world implications of these differences in dynamic, team sport. In two studies, we found that professional male football (soccer players from Germany and female field hockey players on the US national team were lower in rumination than were non-athletes. Further, low levels of rumination were associated with a longer career at a higher level in football players. Results indicate that athletes in dynamic, team sport might benefit from the flexibility associated with being low in rumination.

  3. FAILSAFE Health Management for Embedded Systems (United States)

    Horvath, Gregory A.; Wagner, David A.; Wen, Hui Ying; Barry, Matthew


    The FAILSAFE project is developing concepts and prototype implementations for software health management in mission- critical, real-time embedded systems. The project unites features of the industry-standard ARINC 653 Avionics Application Software Standard Interface and JPL s Mission Data System (MDS) technology (see figure). The ARINC 653 standard establishes requirements for the services provided by partitioned, real-time operating systems. The MDS technology provides a state analysis method, canonical architecture, and software framework that facilitates the design and implementation of software-intensive complex systems. The MDS technology has been used to provide the health management function for an ARINC 653 application implementation. In particular, the focus is on showing how this combination enables reasoning about, and recovering from, application software problems.

  4. Making Technology Ready: Integrated Systems Health Management (United States)

    Malin, Jane T.; Oliver, Patrick J.


    This paper identifies work needed by developers to make integrated system health management (ISHM) technology ready and by programs to make mission infrastructure ready for this technology. This paper examines perceptions of ISHM technologies and experience in legacy programs. Study methods included literature review and interviews with representatives of stakeholder groups. Recommendations address 1) development of ISHM technology, 2) development of ISHM engineering processes and methods, and 3) program organization and infrastructure for ISHM technology evolution, infusion and migration.

  5. Management continuity in local health networks

    Directory of Open Access Journals (Sweden)

    Mylaine Breton


    Full Text Available Introduction: Patients increasingly receive care from multiple providers in a variety of settings. They expect management continuity that crosses boundaries and bridges gaps in the healthcare system. To our knowledge, little research has been done to assess coordination across organizational and professional boundaries from the patients' perspective. Our objective was to assess whether greater local health network integration is associated with management continuity as perceived by patients. Method: We used the data from a research project on the development and validation of a generic and comprehensive continuity measurement instrument that can be applied to a variety of patient conditions and settings. We used the results of a cross-sectional survey conducted in 2009 with 256 patients in two local health networks in Quebec, Canada. We compared four aspects of management continuity between two contrasting network types (highly integrated vs. poorly integrated. Results: The scores obtained in the highly integrated network are better than those of the poorly integrated network on all dimensions of management continuity (coordinator role, role clarity and coordination between clinics, and information gaps between providers except for experience of care plan. Conclusion: Some aspects of care coordination among professionals and organizations are noticed by patients and may be valid indicators to assess care coordination.

  6. Crisis Management in the Health Sector: Qualities and characteristics of health crisis managers

    Directory of Open Access Journals (Sweden)

    Manwlidou Zacharoula


    Full Text Available The rapidly evolving nature of today’s health systems and the need to adapt to modern demands,require that these systems are staffed with skilled health crisis managers. Based on that scenario, crisis managerswith good knowledge and training, adequate experience, as well as virtues of excellent organizational skills,operational planning, mental power and social sensitivity, can play a key role in dealing successfully with crisesin the health sector.

  7. Quality dimensions in health evaluation: manager's conceptions. (United States)

    Bosi, Maria Lúcia Magalhães; Pontes, Ricardo José Soares; Vasconcelos, Suziana Martins de


    To understand manager's perceptions and experiences in regards to qualitative evaluations in basic health care. A qualitative study, based on the critical interpretive approach, was performed in 2006, in the city of Fortaleza, Northeastern Brazil. The sample consisted of the group responsible for planning basic health care at the state level. In order to obtain the empirical data, the focus group technique was utilized. Two central themes emerged concerning the perceptions about quality and the dimensions of quality employed in health evaluations, which were revealed in distinct ways. The concepts of quality evaluation and qualitative evaluation did not appear clearly understood, confusing qualitative evaluation with formal quality evaluations. Likewise, the inherent multidimensionality of quality was not recognized. Despite the criticism expressed by the participants regarding the improper quantification of certain dimensions, the necessary technical skills and understanding were not observed for the approach to include the distinct dimensions of quality in the evaluation process. The conceptions of managers responsible for the planning of basic health care at the state level revealed an important disassociation from the premises of qualitative evaluation, especially those evaluations oriented by the fourth generation approach. Therefore, the model adopted by these actors for the evaluation of program and service quality did not consider their multidimensionality.

  8. Familiarity with modern health management trends by West African ...

    African Journals Online (AJOL)

    Familiarity with modern health management trends by West African Surgeons. ... of the West African College of Surgeons, which was held in Calabar, Nigeria, from ... We recommend for a well-focussed short time duration health management ...

  9. Development and validation of health service management competencies. (United States)

    Liang, Zhanming; Howard, Peter F; Leggat, Sandra; Bartram, Timothy


    Purpose The importance of managerial competencies in monitoring and improving the performance of organisational leaders and managers is well accepted. Different processes have been used to identify and develop competency frameworks or models for healthcare managers around the world to meet different contextual needs. The purpose of the paper is to introduce a validated process in management competency identification and development applied in Australia - a process leading to a management competency framework with associated behavioural items that can be used to measure core management competencies of health service managers. Design/methodology/approach The management competency framework development study incorporated both qualitative and quantitative methods, implemented in four stages, including job description analysis, focus group discussions and online surveys. Findings The study confirmed that the four-stage process could identify management competencies and the framework developed is considered reliable and valid for developing a management competency assessment tool that can measure management competence amongst managers in health organisations. In addition, supervisors of health service managers could use the framework to distinguish perceived superior and average performers among managers in health organisations. Practical implications Developing the core competencies of health service managers is important for management performance improvement and talent management. The six core management competencies identified can be used to guide the design professional development activities for health service managers. Originality/value The validated management competency identification and development process can be applied in other countries and different industrial contexts to identify core management competency requirements.

  10. [Community health in primary health care teams: a management objective]. (United States)

    Nebot Adell, Carme; Pasarin Rua, Maribel; Canela Soler, Jaume; Sala Alvarez, Clara; Escosa Farga, Alex


    To describe the process of development of community health in a territory where the Primary Health Care board decided to include it in its roadmap as a strategic line. Evaluative research using qualitative techniques, including SWOT analysis on community health. Two-steps study. Primary care teams (PCT) of the Catalan Health Institute in Barcelona city. The 24 PCT belonging to the Muntanya-Dreta Primary Care Service in Barcelona city, with 904 professionals serving 557,430 inhabitants. Application of qualitative methodology using SWOT analysis in two steps (two-step study). Step 1: Setting up a core group consisting of local PCT professionals; collecting the community projects across the territory; SWOT analysis. Step 2: From the needs identified in the previous phase, a plan was developed, including a set of training activities in community health: basic, advanced, and a workshop to exchange experiences from the PCTs. A total of 80 team professionals received specific training in the 4 workshops held, one of them an advanced level. Two workshops were held to exchange experiences with 165 representatives from the local teams, and 22 PCTs presenting their practices. In 2013, 6 out of 24 PCTs have had a community diagnosis performed. Community health has achieved a good level of development in some areas, but this is not the general situation in the health care system. Its progression depends on the management support they have, the local community dynamics, and the scope of the Primary Health Care. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  11. Integrated environment, safety, and health management system description

    International Nuclear Information System (INIS)

    Zoghbi, J. G.


    The Integrated Environment, Safety, and Health Management System Description that is presented in this document describes the approach and management systems used to address integrated safety management within the Richland Environmental Restoration Project

  12. ISWHM: Tools and Techniques for Software and System Health Management (United States)

    Schumann, Johann; Mengshoel, Ole J.; Darwiche, Adnan


    This presentation presents status and results of research on Software Health Management done within the NRA "ISWHM: Tools and Techniques for Software and System Health Management." Topics include: Ingredients of a Guidance, Navigation, and Control System (GN and C); Selected GN and C Testbed example; Health Management of major ingredients; ISWHM testbed architecture; and Conclusions and next Steps.

  13. Health and poverty: health management by the woman

    Directory of Open Access Journals (Sweden)

    Alvarez Maria de la Luz


    Full Text Available The goal this follow-up study was to relate the mother's marital satisfaction to family health status in a low SES. The random sample was made up of 30 families with children under 7 years old: 15 considered as sick (Group A and 15 as healthy (Group B. Both group had similar demographic characteristics (age of father and mother, persons per family group and age of children and SES. Results showed that mothers were those mainly in charge of their family groups. Mothers of Group A were significantly less understanding and more dissatisfied than those of Group B ( p < .05 and p < .01. Mothers of Group A had significantly more arguments with their partners than those of Group B (p < .006. Health care was learned less from the child's own mother in group A than in B (p < .05. Health was considered by mothers of Group A as something that "must be taken care of" more than by those of Group B (p < .01. The behaviours of mothers in choosing one of the health systems was similar in both groups. Dissatisfied mothers were associated more with sick family members during the 6 month follow-up. It is suggested that the satisfaction of the mother is a factor that needs further investigation because health is managed by mothers is the large majority of families.

  14. Health and poverty: health management by the woman

    Directory of Open Access Journals (Sweden)

    Maria de la Luz Alvarez


    Full Text Available The goal this follow-up study was to relate the mother's marital satisfaction to family health status in a low SES. The random sample was made up of 30 families with children under 7 years old: 15 considered as sick (Group A and 15 as healthy (Group B. Both group had similar demographic characteristics (age of father and mother, persons per family group and age of children and SES. Results showed that mothers were those mainly in charge of their family groups. Mothers of Group A were significantly less understanding and more dissatisfied than those of Group B ( p < .05 and p < .01. Mothers of Group A had significantly more arguments with their partners than those of Group B (p < .006. Health care was learned less from the child's own mother in group A than in B (p < .05. Health was considered by mothers of Group A as something that "must be taken care of" more than by those of Group B (p < .01. The behaviours of mothers in choosing one of the health systems was similar in both groups. Dissatisfied mothers were associated more with sick family members during the 6 month follow-up. It is suggested that the satisfaction of the mother is a factor that needs further investigation because health is managed by mothers is the large majority of families.

  15. Sharing Earth Observation Data When Health Management (United States)

    Cox, E. L., Jr.


    While the global community is struck by pandemics and epidemics from time to time the ability to fully utilize earth observations and integrate environmental information has been limited - until recently. Mature science understanding is allowing new levels of situational awareness be possible when and if the relevant data is available and shared in a timely and useable manner. Satellite and other remote sensing tools have been used to observe, monitor, assess and predict weather and water impacts for decades. In the last few years much of this has included a focus on the ability to monitor changes on climate scales that suggest changes in quantity and quality of ecosystem resources or the "one-health" approach where trans-disciplinary links between environment, animal and vegetative health may provide indications of best ways to manage susceptibility to infectious disease or outbreaks. But the scale of impacts and availability of information from earth observing satellites, airborne platforms, health tracking systems and surveillance networks offer new integrated tools. This presentation will describe several recent events, such as Superstorm Sandy in the United States and the Ebola outbreak in Africa, where public health and health infrastructure have been exposed to environmental hazards and lessons learned from disaster response in the ability to share data have been effective in risk reduction.

  16. Health risk assessment for program managers

    International Nuclear Information System (INIS)

    Jump, R.A.; Williamson, D.S.


    This paper presents the findings of a sensitivity analysis into the independent variables that determine the levels of health risks posed by buried plutonium and americium at a typical contaminated site in an arid region. Environmental Restoration Program Managers often must make decisions concerning cleanup levels, remediation alternatives, schedules, cost estimates, etc. based upon extraordinarily safe assumptions about risk assessment calculation inputs. This study reveals to the Program Manager which variables are major drivers to the calculated levels of risk posed by transuranic radionuclides and which ones have second order effects or less. The findings of this study should indicate which inputs should be the focus of attention during negotiations with regulators and of further empirical investigation

  17. The RF spectrum: managing community health concerns

    International Nuclear Information System (INIS)

    Maclean, I.


    In this presentation I would like to share with you the way in which the Australian Communications Authority (ACA) goes about 'managing' community issues relating to the RF spectrum. In particular, I would like to refer to community issues associated with concerns about health. I will refer only briefly to the siting of mobile phone base stations as that will be covered elsewhere. Before getting into the community issues, I would like to provide some context about the ACA and the arrangements it has for regulating radiofrequency electromagnetic radiation (RF EMR). Copyright (2001) Australasian Radiation Protection Society Inc

  18. Managing change in health care organizations. (United States)

    Margulies, N


    The forces for change seem more potent today than ever before; increased technological advancement and rapid "societal upheavals" create a more critical need for change and a more significant need for skills to manage and channel change toward meaningful ends. The area of health care delivery is probably one of the fields most impinged upon and most affected by these turbulent times. Organizational development is presented herein as an approach to assist people in health care organizations with the problems of adaptation and change. A specific change strategy, action research, is discussed and a concrete case example is presented to illustrate the ways in which the action research model can be applied. Advantages and pitfalls are discussed in the concluding section.

  19. Investigation of Integrated Vehicle Health Management Approaches (United States)

    Paris, Deidre


    This report is to present the work that was performed during the summer in the Advance Computing Application office. The NFFP (NASA Faculty Fellow Program) had ten summer faculty members working on IVHM (Integrated Vehicle Health Management) technologies. The objective of this project was two-fold: 1) to become familiar with IVHM concepts and key demonstrated IVHM technologies; and 2) to integrate the research that has been performed by IVHM faculty members into the MASTLAB (Marshall Avionic Software Test Lab). IVHM is a NASA-wide effort to coordinate, integrate and apply advanced software, sensors and design technologies to increase the level of intelligence, autonomy, and health state of future vehicles. IVHM is an important concept because it is consistent with the current plan for NASA to go to the moon, mars, and beyond. In order for NASA to become more involved in deep exploration, avionic systems will need to be highly adaptable and autonomous.

  20. Occupational Safety and Health Management System (OSHMS)

    International Nuclear Information System (INIS)

    Shyen, A.K.S.; Mohd Khairul Hakimin; Manisah Saedon


    Safe work environment has always been one of the major concerns at workplace. For this, Occupational Safety and Health Act 1994 has been promulgated for all workplaces to ensure the Safety, Health and Welfare of its employees and any person at workplaces. Malaysian Nuclear Agency therefore has started the initiative to review and improve the current Occupational Safety and Health Management System (OSHMS) by going for OHSAS 18001:2007 and MS 1722 standards certification. This would also help in our preparation to bid as the TSO (Technical Support Organization) for the NPP (Nuclear Power Plant) when it is established. With a developed and well maintained OSHMS, it helps to create a safe working condition and thus enhancing the productivity, quality and good morale. Ultimately, this will lead to a greater organization profit. However, successful OSHMS requires full commitment and support from all level of the organization to work hand in hand in implementing the safety and health policy. Therefore it is essential for all to acknowledge the progress of the implementation and be part of it. (author)

  1. Characterization of the complete mitochondrial genomes of Nematodirus oiratianus and Nematodirus spathiger of small ruminants


    Zhao, Guang-Hui; Jia, Yan-Qing; Cheng, Wen-Yu; Zhao, Wen; Bian, Qing-Qing; Liu, Guo-Hua


    Background Nematodirus spp. are among the most common nematodes of ruminants worldwide. N. oiratianus and N. spathiger are distributed worldwide as highly prevalent gastrointestinal nematodes, which cause emerging health problems and economic losses. Accurate identification of Nematodirus species is essential to develop effective control strategies for Nematodirus infection in ruminants. Mitochondrial DNA (mtDNA) could provide powerful genetic markers for identifying these closely related spe...

  2. Ruminal acidosis: a review with detailed reference to the controlling agent Megasphaera elsdenii NCIMB 41125


    Meissner, H.H.; Henning, P.H.; Horn, C.H.; Leeuw, K-J.; Hagg, F.M.; Fouché, G.


    Ruminal acidosis is discussed with reference to causes and economic and health implications. Distinction is made between the acute form which with proper adaptation to high energy diets is seldom encountered and the more problematic chronic or sub-acute form, commonly referred to as sub-acute ruminal acidosis (SARA). Apart from stepwise transition from roughage to concentrates, methods adopted to reduce SARA include grain treatment to reduce starch degradation, feed additives such as buffers ...

  3. Review on Ruminant Nutrition Research

    Directory of Open Access Journals (Sweden)

    Budi Haryanto


    Full Text Available Research works in ruminant nutrition have been widely published, especially those related to the energy and protein utilization. The energy and protein requirements for maintenance and production in tropical regions may be different from those in the subtropical areas. Responses of different species of ruminants to energy and protein supplements were also observed. The synchronization of energy and protein availability has been considered as an important strategy in affecting the microbial fermentative process in the rumen and in affecting the animal performance. The inclusion of long-chained unsaturated fatty acids in the diets has been successfully affecting milk production with higher concentration of unsaturated fatty acids. Feedstuffs characteristics in terms of their degradability and fermentation by rumen microbial enzymes have been intensively studied; however, further experimentations are still needed to elucidate the specific fate of its nutritive components in the rumen and tissue levels.

  4. Ribotyping to compare Fusobacterium necrophorum isolates from bovine liver abscesses, ruminal walls, and ruminal contents.


    Narayanan, S; Nagaraja, T G; Okwumabua, O; Staats, J; Chengappa, M M; Oberst, R D


    Restriction fragment length polymorphism analysis of rRNA genes was employed to genetically compare Fusobacterium necrophorum subsp. necrophorum and F. necrophorum subsp. funduliforme isolates from multiple abscesses of the same liver and isolates from liver abscesses, the ruminal wall, and ruminal contents from the same animal. Four livers with multiple abscesses and samples of ruminal contents, ruminal walls, and liver abscesses were collected from 11 cattle at slaughter. F. necrophorum was...

  5. Leucaena leucocephala IN RUMINANT NUTRITION

    Directory of Open Access Journals (Sweden)

    M. Barros-Rodríguez


    Full Text Available It is a common situation in extensive ruminant production systems in tropical countries to have low production indicators due to nutrient deficiencies in the diet. An economic alternative to increase animal production is the incorporation of legumes (fodder and fruits in the diet. This review, presents an analysis of the positive and negative effects of Leucaena leucocephala consumption by ruminants, with particular emphasis on the secondary compound mimosine. Leucaena due to its high nutrient content, rumen by-pass protein supply and its possible effect on the reduction of greenhouse gas (attributed to tannins has become one of the legumes most commonly used in ruminant feeding practices. However, in countries where leucaena has been introduced, its use is still limited to levels below 30% inclusion in the diet, due to the secondary compound mimosine and its isomers (3,4 and 2,3 DHP, which can induce toxicity, even when animals are inoculated with rumen fluid containing the bacteria Synergistes jonesii reported as responsible for degrading these compounds in the rumen. In the Yucatan Peninsula, Mexico, ruminants consuming leucaena can tolerate more than 50% inclusion in the diet, without having a negative impact on production, attributed intake to mimosine and its isomers. We conclude that in animals not adapted, the intake would be limited to low inclusion levels (less than 30% inclusion in the diet, mainly because of mimosine and its derivatives. The decrease in intake or diet digestibility seem to better explain the reduction in methane production, however, in vivo studies are required to clearly establish the mechanism of action. It has been reported the presence of different bacteria to S. jonessi that would have the ability to degrade mimosine and its derivatives, however, the activity of these bacteria and its effectiveness must be confirmed in vivo.

  6. The Ruminant and the Pond


    Lajarin-Encina, Aitor


    The Ruminant and the Pond presents a group of paintings and a film that explore contemporary psycho-social conditions through fictional narratives. Paintings and film explore territories of thinking and emotion engaging the audience in subjective digressions related to ideas of artificiality, relativeness, absurdity, futility or alienation in relation to intersubjective reality perception, production and representation. At the same time the project delves in the specific relationship existin...

  7. Requirements Flowdown for Prognostics and Health Management (United States)

    Goebel, Kai; Saxena, Abhinav; Roychoudhury, Indranil; Celaya, Jose R.; Saha, Bhaskar; Saha, Sankalita


    Prognostics and Health Management (PHM) principles have considerable promise to change the game of lifecycle cost of engineering systems at high safety levels by providing a reliable estimate of future system states. This estimate is a key for planning and decision making in an operational setting. While technology solutions have made considerable advances, the tie-in into the systems engineering process is lagging behind, which delays fielding of PHM-enabled systems. The derivation of specifications from high level requirements for algorithm performance to ensure quality predictions is not well developed. From an engineering perspective some key parameters driving the requirements for prognostics performance include: (1) maximum allowable Probability of Failure (PoF) of the prognostic system to bound the risk of losing an asset, (2) tolerable limits on proactive maintenance to minimize missed opportunity of asset usage, (3) lead time to specify the amount of advanced warning needed for actionable decisions, and (4) required confidence to specify when prognosis is sufficiently good to be used. This paper takes a systems engineering view towards the requirements specification process and presents a method for the flowdown process. A case study based on an electric Unmanned Aerial Vehicle (e-UAV) scenario demonstrates how top level requirements for performance, cost, and safety flow down to the health management level and specify quantitative requirements for prognostic algorithm performance.

  8. Environment, Safety, Health and Waste Management Plan

    International Nuclear Information System (INIS)


    The mission of the Feed Materials Production Center (FMPC) is the production of high qaulity uranium metal for use by the US Department of Energy (DOE) in Defense Programs. In order to accomplish this mission and to maintain the FMPC as a viable facility in the DOE production complex, the facility must be brought into full compliance with all federal and state regulations and industry standards for environmental protection and worker safety. Where past practices have resulted in environmental insult, a comprehensive program of remediation must be implemented. The purpose of this combined Environment, Safety, Health and Waste Management Plan is to provide a road map for achieving needed improvements. The plan is structured to provide a comprehensive projection from the current fiscal year (FY) through FY 1994 of the programs, projects and funding required to achieve compliance. To do this, the plan is subdivided into chapters which discuss the applicable regulations;project schedules and funding requirements;details of the various programs for environment, safety, health and waste management;details of the ongoing National Environmental Policy Act (NEPA);the quality assurance program and the environmental monitoring program. 14 refs., 30 figs., 29 tabs

  9. Managing the health of the elite athlete: a new integrated performance health management and coaching model. (United States)

    Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M


    Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games.

  10. Managing health and safety risks: Implications for tailoring health and safety management system practices. (United States)

    Willmer, D R; Haas, E J


    As national and international health and safety management system (HSMS) standards are voluntarily accepted or regulated into practice, organizations are making an effort to modify and integrate strategic elements of a connected management system into their daily risk management practices. In high-risk industries such as mining, that effort takes on added importance. The mining industry has long recognized the importance of a more integrated approach to recognizing and responding to site-specific risks, encouraging the adoption of a risk-based management framework. Recently, the U.S. National Mining Association led the development of an industry-specific HSMS built on the strategic frameworks of ANSI: Z10, OHSAS 18001, The American Chemistry Council's Responsible Care, and ILO-OSH 2001. All of these standards provide strategic guidance and focus on how to incorporate a plan-do-check-act cycle into the identification, management and evaluation of worksite risks. This paper details an exploratory study into whether practices associated with executing a risk-based management framework are visible through the actions of an organization's site-level management of health and safety risks. The results of this study show ways that site-level leaders manage day-to-day risk at their operations that can be characterized according to practices associated with a risk-based management framework. Having tangible operational examples of day-to-day risk management can serve as a starting point for evaluating field-level risk assessment efforts and their alignment to overall company efforts at effective risk mitigation through a HSMS or other processes.

  11. Health plans' disease management programs: extending across the medical and behavioral health spectrum? (United States)

    Merrick, Elizabeth Levy; Horgan, Constance M; Garnick, Deborah W; Hodgkin, Dominic; Morley, Melissa


    Although the disease management industry has expanded rapidly, there is little nationally representative data regarding medical and behavioral health disease management programs at the health plan level. National estimates from a survey of private health plans indicate that 90% of health plan products offered disease management for general medical conditions such as diabetes but only 37% had depression programs. The frequency of specific depression disease management activities varied widely. Program adoption was significantly related to product type and behavioral health contracting. In health plans, disease management has penetrated more slowly into behavioral health and depression program characteristics are highly variable.

  12. A cow-level association of ruminal pH on body condition score, serum beta-hydroxybutyrate and postpartum disorders in Thai dairy cattle. (United States)

    Chaidate, Inchaisri; Somchai, Chanpongsang; Jos, Noordhuizen; Henk, Hogeveen


    Subacute ruminal acidosis in dairy cows occurs when ruminal pH is below about 5.5. However, the exact threshold level of ruminal pH affecting cow health is still in debate. This investigation was carried out in 505 cows within 31 farms. The postpartum disorders, including dystocia, retained placenta, anestrus, cystic ovary, metritis, clinical mastitis and lameness, were analyzed. Ruminal pH, serum beta-hydroxy butyrate (SBHB), serum urea nitrogen and body condition score (BCS) were measured once during the 3 to 6 weeks postpartum, while BCS was determined once more at 1 week before calving. Ruminal pH was determined by ruminocentesis technique. The ruminal pH was evaluated to study the association with BCS, SBHB and postpartum disorders using linear regression in a generalized linear mixed model with farm as a random effect. The results show that low ruminal pH was associated with dystocia, metritis and lameness. Moreover, a low ruminal pH can be found in cows with a high loss of BCS after calving and also in cows with low SBHB postpartum. These findings confirmed the feasibility of the ruminocentesis technique and the association of low ruminal pH on various postpartum disorders at the individual cow level. However, the consequences of low ruminal pH on dairy cow health still needs more exploration for a better understanding of the physiological mechanisms. © 2014 Japanese Society of Animal Science.

  13. Cyanobacterial toxins: risk management for health protection

    International Nuclear Information System (INIS)

    Codd, Geoffrey A.; Morrison, Louise F.; Metcalf, James S.


    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles

  14. Enabling medication management through health information technology (Health IT). (United States)

    McKibbon, K Ann; Lokker, Cynthia; Handler, Steve M; Dolovich, Lisa R; Holbrook, Anne M; O'Reilly, Daria; Tamblyn, Robyn; J Hemens, Brian; Basu, Runki; Troyan, Sue; Roshanov, Pavel S; Archer, Norman P; Raina, Parminder


    The objective of the report was to review the evidence on the impact of health information technology (IT) on all phases of the medication management process (prescribing and ordering, order communication, dispensing, administration and monitoring as well as education and reconciliation), to identify the gaps in the literature and to make recommendations for future research. We searched peer-reviewed electronic databases, grey literature, and performed hand searches. Databases searched included MEDLINE®, Embase, CINAHL (Cumulated Index to Nursing and Allied Health Literature), Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts, Compendex, Inspec (which includes IEEE Xplore), Library and Information Science Abstracts, E-Prints in Library and Information Science, PsycINFO, Sociological Abstracts, and Business Source Complete. Grey literature searching involved Internet searching, reviewing relevant Web sites, and searching electronic databases of grey literatures. AHRQ also provided all references in their e-Prescribing, bar coding, and CPOE knowledge libraries. Paired reviewers looked at citations to identify studies on a range of health IT used to assist in the medication management process (MMIT) during multiple levels of screening (titles and abstracts, full text and final review for assignment of questions and data abstrction). Randomized controlled trials and cohort, case-control, and case series studies were independently assessed for quality. All data were abstracted by one reviewer and examined by one of two different reviewers with content and methods expertise. 40,582 articles were retrieved. After duplicates were removed, 32,785 articles were screened at the title and abstract phase. 4,578 full text articles were assessed and 789 articles were included in the final report. Of these, 361 met only content criteria and were listed without further abstraction. The final report included data from 428 articles across the seven key

  15. Service Line Management: A New Paradigm in Health Care System

    Directory of Open Access Journals (Sweden)

    Rafat Rezapour Nasrabad


    Full Text Available Health care organizations are required to implement modern management practices and approaches due to the importance of improving quality and increasing efficiency of health care services. Service line management of healthcare services is one of the new approaches that managers of health sectors are interested in. The “service line” approach will organize the management of inpatient and outpatient in clinical services focusing on patient diagnostic clusters. Services specific in each patient diagnostic cluster will be offered by a multidisciplinary team including nurses, physicians, and so no. Accordingly, the present study aims to evaluate the features, process and benefits of service line management approach in the provision of health services. In this descriptive study, internal and external scientific database have been reviewed and the necessary data have been extracted from the latest research projects and related scientific documents. The results showed that the new management approach is based on a paradigm shift from traditional health care system management to healthcare service line management with a focus on managers’ competencies. Four specific manager’s competencies in this new management model are: conceptual, collaborative, interpersonal, and leadership competencies. Theses competencies should be developed in health system managers so as to lead to organizational excellency and improvement of health service quality. The health sector managers should strengthen these four key competencies and act on them. Then they will become effective leaders and managers in the health system.

  16. Linking Peripartal Dynamics of Ruminal Microbiota to Dietary Changes and Production Parameters (United States)

    Derakhshani, Hooman; Tun, Hein M.; Cardoso, Felipe C.; Plaizier, Jan C.; Khafipour, Ehsan; Loor, Juan J.


    During the peripartal period, proper acclimatization of rumen microorganisms to variations in nutritional management can facilitate the transition into lactation. This study characterized the temporal shifts in the composition and functional properties of ruminal microbiota during the periparturient period in dairy cows subjected to a typical two-tiered feeding management approach. Ruminal digesta samples from eight multiparous fistulated Holstein cows were collected on days −14, −7, 10, 20, and 28 relative to parturition. High-throughput Illumina sequencing of the V4 region of the bacterial 16S rRNA gene revealed distinct clustering patterns between pre- and postpartal ruminal microbiota. During the prepartal period, when the voluntary dry matter intake was lower, we observed strikingly lower inter-animal variations in the composition of the ruminal microbiota. Genera Ruminococcus and Butyrivibrio, which are considered major fibrolytic rumen dwellers, were overrepresented in the prepartal rumen ecosystem. In contrast, increased postpartal voluntary DMI was associated with enrichment of bacterial genera mainly consisting of proteolytic, amylolytic, and lactate-producer species (including Prevotella, Streptococcus, and Lactobacillus). These, together with the postpartal enrichment of energy metabolism pathways, suggested a degree of acclimatization of the ruminal microbiota to harvest energy from the carbohydrate-dense lactation diet. In addition, correlations between ruminal microbiota and parameters such as milk yield and milk composition underscored the metabolic contribution of this microbial community to the cow's performance and production. PMID:28127294

  17. Information support for health information management in regional Sri Lanka: health managers' perspectives. (United States)

    Ranasinghe, Kaduruwane Indika; Chan, Taizan; Yaralagadda, Prasad

    Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under-resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much-needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of

  18. Ectoparasites of small ruminants in three selected agro-ecological sites of Tigray Region, Ethiopia. (United States)

    Mulugeta, Y; Yacob, Hailu T; Ashenafi, Hagos


    A study on ectoparasites of small ruminants in three selected agro-ecological sites of Tigray Region, Ethiopia disclosed an overall prevalence of 55.5% and 58% in each examined 750 sheep and goats, respectively. In the sheep population, Melophagus ovinus (19.1%), tick infestations (16%), Damalinia ovis (15.3%), Linognathus africanus (11.5%), and Ctenocephalides felis (9%) were the major ectoparasites. The major ectoparasites identified in goats were tick infestations (29.7%), L. africanus (27.9%), Sarcoptes scabiei var. caprae (12.5%), C. felis (11.1%), and Demodex caprae (6.8%). In sheep, there was a statistically significant difference (P ovinus, L. africanus, and ticks between midland and highland. In goats, the risk of Sarcoptes scabiei var. caprae infestation in midland (odds ratio (OR) = 17.2, P < 0.001) and lowland (OR = 5.2, P < 0.001) was 17.2 times and 5.2 times, respectively, higher than the highland. Favorable climatic conditions, backward level of management, poor level of consciousness and awareness of farmers, and weak animal health extension services are believed to have contributed for widespread distribution and occurrences of ectoparasites. The growing threat of ectoparasites to small ruminant production and the tanning industry needs well-coordinated and urgent control intervention.

  19. Prospective Health: Duke's Approach to Improving Employee Health and Managing Health Care Costs (United States)

    Davidson, H. Clint, Jr.


    If developing a healthy workforce is critical to reining in the skyrocketing cost of health care, then why have so many attempts at preventive health or disease management fallen short? How can employers connect with employees to engage them in changing unhealthy habits or lifestyles? Duke University has launched an innovative new approach called…

  20. Environmental health research in Japan - management of environmental risks

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Masahisa [Lake Biwa Research Institute (Japan)


    Briefly discussed the topics on emerging environmental health risks, their assessment and management, with special emphasis on groundwater management , environmental contamination, source protection, new drinking water and ambient water quality standards; and sophistication in instrumentation in environmental quality measurements, hazards and risk assessment and control, technology development in environmental health risk management.

  1. Environmental health research in Japan - management of environmental risks

    International Nuclear Information System (INIS)

    Masahisa Nakamura


    Briefly discussed the topics on emerging environmental health risks, their assessment and management, with special emphasis on groundwater management , environmental contamination, source protection, new drinking water and ambient water quality standards; and sophistication in instrumentation in environmental quality measurements, hazards and risk assessment and control, technology development in environmental health risk management

  2. Information technology acceptance in health information management. (United States)

    Abdekhoda, M; Ahmadi, M; Dehnad, A; Hosseini, A F


    User acceptance of information technology has been a significant area of research for more than two decades in the field of information technology. This study assessed the acceptance of information technology in the context of Health Information Management (HIM) by utilizing Technology Acceptance Model (TAM) which was modified and applied to assess user acceptance of health information technology as well as viability of TAM as a research construct in the context of HIM. This was a descriptive- analytical study in which a sample of 187 personnel from a population of 363 personnel, working in medical records departments of hospitals affiliated to Tehran University of Medical Sciences, was selected. Users' perception of applying information technology was studied by a researcher-developed questionnaire. Collected data were analyzed by SPSS software (version16) using descriptive statistics and regression analysis. The results suggest that TAM is a useful construct to assess user acceptance of information technology in the context of HIM. The findings also evidenced the perceived ease of use (PEOU) and perceived usefulness (PE) were positively associated with favorable users' attitudes towards HIM. PU was relatively more associated (r= 0.22, p = 0.05) than PEOU (r = 0.014, p = 0.05) with favorable user attitudes towards HIM. Users' perception of usefulness and ease of use are important determinants providing the incentive for users to accept information technologies when the application of a successful HIM system is attempted. The findings of the present study suggest that user acceptance is a key element and should subsequently be the major concern of health organizations and health policy makers.

  3. Effective public health management: The Nigerian experience | Abe ...

    African Journals Online (AJOL)

    Public health management in Nigeria is the process of mobilizing and deploying resources for the provision of effective public health services. To ensure an effective public health, population based strategies would need to be put in place and this would require proper management to yield desired results. This paper ...

  4. Coordinated Management of Academic Health Centers. (United States)

    Balser, Jeffrey R; Stead, William W


    Academic health centers (AHCs) are the nation's primary resource for healthcare discovery, innovation, and training. US healthcare revenue growth has declined sharply since 2009, and is forecast to remain well below historic levels for the foreseeable future. As the cost of education and research at nearly all AHCs is heavily subsidized through large transfers from clinical care margins, our institutions face a mounting crisis. Choices centering on how to increase the cost-effectiveness of the AHC enterprise require unprecedented levels of alignment to preserve an environment that nurtures creativity. Management processes require governance models that clarify decision rights while harnessing the talents and the intellectual capital of a large, diverse enterprise to nimbly address unfamiliar organizational challenges. This paper describes key leadership tactics aimed at propelling AHCs along this journey - one that requires from all leaders a commitment to resilience, optimism, and willingness to embrace change.

  5. Integrated System Health Management (ISHM) and Autonomy (United States)

    Figueroa, Fernando; Walker, Mark G.


    Systems capabilities on ISHM (Integrated System Health Management) and autonomy have traditionally been addressed separately. This means that ISHM functions, such as anomaly detection, diagnostics, prognostics, and comprehensive system awareness have not been considered traditionally in the context of autonomy functions such as planning, scheduling, and mission execution. One key reason is that although they address systems capabilities, both ISHM and autonomy have traditionally individually been approached as independent strategies and models for analysis. Additionally, to some degree, a unified paradigm for ISHM and autonomy has been difficult to implement due to limitations of hardware and software. This paper explores a unified treatment of ISHM and autonomy in the context of distributed hierarchical autonomous operations.

  6. Prognostics and health management of photovoltaic systems (United States)

    Johnson, Jay; Riley, Daniel


    The various technologies presented herein relate to providing prognosis and health management (PHM) of a photovoltaic (PV) system. A PV PHM system can eliminate long-standing issues associated with detecting performance reduction in PV systems. The PV PHM system can utilize an ANN model with meteorological and power input data to facilitate alert generation in the event of a performance reduction without the need for information about the PV PHM system components and design. Comparisons between system data and the PHM model can provide scheduling of maintenance on an as-needed basis. The PHM can also provide an approach for monitoring system/component degradation over the lifetime of the PV system.

  7. Rocket Testing and Integrated System Health Management (United States)

    Figueroa, Fernando; Schmalzel, John


    Integrated System Health Management (ISHM) describes a set of system capabilities that in aggregate perform: determination of condition for each system element, detection of anomalies, diagnosis of causes for anomalies, and prognostics for future anomalies and system behavior. The ISHM should also provide operators with situational awareness of the system by integrating contextual and timely data, information, and knowledge (DIaK) as needed. ISHM capabilities can be implemented using a variety of technologies and tools. This chapter provides an overview of ISHM contributing technologies and describes in further detail a novel implementation architecture along with associated taxonomy, ontology, and standards. The operational ISHM testbed is based on a subsystem of a rocket engine test stand. Such test stands contain many elements that are common to manufacturing systems, and thereby serve to illustrate the potential benefits and methodologies of the ISHM approach for intelligent manufacturing.

  8. Health Management Applications for International Space Station (United States)

    Alena, Richard; Duncavage, Dan


    Traditional mission and vehicle management involves teams of highly trained specialists monitoring vehicle status and crew activities, responding rapidly to any anomalies encountered during operations. These teams work from the Mission Control Center and have access to engineering support teams with specialized expertise in International Space Station (ISS) subsystems. Integrated System Health Management (ISHM) applications can significantly augment these capabilities by providing enhanced monitoring, prognostic and diagnostic tools for critical decision support and mission management. The Intelligent Systems Division of NASA Ames Research Center is developing many prototype applications using model-based reasoning, data mining and simulation, working with Mission Control through the ISHM Testbed and Prototypes Project. This paper will briefly describe information technology that supports current mission management practice, and will extend this to a vision for future mission control workflow incorporating new ISHM applications. It will describe ISHM applications currently under development at NASA and will define technical approaches for implementing our vision of future human exploration mission management incorporating artificial intelligence and distributed web service architectures using specific examples. Several prototypes are under development, each highlighting a different computational approach. The ISStrider application allows in-depth analysis of Caution and Warning (C&W) events by correlating real-time telemetry with the logical fault trees used to define off-nominal events. The application uses live telemetry data and the Livingstone diagnostic inference engine to display the specific parameters and fault trees that generated the C&W event, allowing a flight controller to identify the root cause of the event from thousands of possibilities by simply navigating animated fault tree models on their workstation. SimStation models the functional power flow

  9. Integrated Systems Health Management for Space Exploration (United States)

    Uckun, Serdar


    Integrated Systems Health Management (ISHM) is a system engineering discipline that addresses the design, development, operation, and lifecycle management of components, subsystems, vehicles, and other operational systems with the purpose of maintaining nominal system behavior and function and assuring mission safety and effectiveness under off-nominal conditions. NASA missions are often conducted in extreme, unfamiliar environments of space, using unique experimental spacecraft. In these environments, off-nominal conditions can develop with the potential to rapidly escalate into mission- or life-threatening situations. Further, the high visibility of NASA missions means they are always characterized by extraordinary attention to safety. ISHM is a critical element of risk mitigation, mission safety, and mission assurance for exploration. ISHM enables: In-space maintenance and repair; a) Autonomous (and automated) launch abort and crew escape capability; b) Efficient testing and checkout of ground and flight systems; c) Monitoring and trending of ground and flight system operations and performance; d) Enhanced situational awareness and control for ground personnel and crew; e) Vehicle autonomy (self-sufficiency) in responding to off-nominal conditions during long-duration and distant exploration missions; f) In-space maintenance and repair; and g) Efficient ground processing of reusable systems. ISHM concepts and technologies may be applied to any complex engineered system such as transportation systems, orbital or planetary habitats, observatories, command and control systems, life support systems, safety-critical software, and even the health of flight crews. As an overarching design and operational principle implemented at the system-of-systems level, ISHM holds substantial promise in terms of affordability, safety, reliability, and effectiveness of space exploration missions.

  10. Clicking away at co-rumination: co-rumination correlates across different modalities of communication. (United States)

    Keshishian, Ani C; Watkins, Melanie A; Otto, Michael W


    Co-rumination is associated with positive friendship quality (thought to buffer against anxiety and depression) but paradoxically higher levels of anxiety and depression. With the increasing use of technology for communication among adults, there is little known about co-rumination effects across different modalities of communication. In the current study, we examined co-rumination through four methods (i.e. in person, phone calls, text messaging, and social media) in two separate samples - college students and participants from the community. Classic co-rumination effects were found for in-person communications, and we found that co-rumination by telephone as well as by texting, for a college student sample only, mirrors some of these findings for in-person co-rumination. In studies of co-rumination, evaluation of multiple modes of communication is warranted.

  11. Analysis of Workplace Health Education Performed by Occupational Health Managers in Korea

    Directory of Open Access Journals (Sweden)

    Yeon-Ha Kim, RN, PhD


    Conclusions: “Analysis and planning” skill is priority training area for healthcare professionals and occupational health managers who managed nonmanufacturing industry. It is necessary to develop a training curriculum for occupational health managers that include improving analysis of worksites and plans for a health education program.

  12. Herd health and management of dairy cow (United States)

    Ćaǧlayan, Alper; Yüca, Songül


    Herd management requires multidisciplinary practices including animal feeding, gynecology, artificial insemination, immunology, and similar topics. Animal feeding is the most delicate subject as the fodder expense is 70% of the farm cost and as nearly all of the metabolic diseases arising out as health problem are because of misfeeding. However, a business organization's being able to maintain making profit will be possible by taking a healthy calf from breeding herd every year. For this reason, precision registrations of birth and artificial insemination, following-up pregnant state of animals, and making the other animals pregnant as soon as possible should be primary aim. It should not be forgotten that diarrhea and pneumonia in calves are among the most frequently witnessed infection related health problems. Mastitis, metritis and foot diseases take an important place in mature cows. These diseases can be minimized by vaccinations that are done properly and in suitable time, in-service training of staffs, making shelters suitable for animals welfare, and improving the hygienic conditions.

  13. Disease and health management in Asian aquaculture. (United States)

    Bondad-Reantaso, Melba G; Subasinghe, Rohana P; Arthur, J Richard; Ogawa, Kazuo; Chinabut, Supranee; Adlard, Robert; Tan, Zilong; Shariff, Mohamed


    Asia contributes more than 90% to the world's aquaculture production. Like other farming systems, aquaculture is plagued with disease problems resulting from its intensification and commercialization. This paper describes the various factors, providing specific examples, which have contributed to the current disease problems faced by what is now the fastest growing food-producing sector globally. These include increased globalization of trade and markets; the intensification of fish-farming practices through the movement of broodstock, postlarvae, fry and fingerlings; the introduction of new species for aquaculture development; the expansion of the ornamental fish trade; the enhancement of marine and coastal areas through the stocking of aquatic animals raised in hatcheries; the unanticipated interactions between cultured and wild populations of aquatic animals; poor or lack of effective biosecurity measures; slow awareness on emerging diseases; the misunderstanding and misuse of specific pathogen free (SPF) stocks; climate change; other human-mediated movements of aquaculture commodities. Data on the socio-economic impacts of aquatic animal diseases are also presented, including estimates of losses in production, direct and indirect income and employment, market access or share of investment, and consumer confidence; food availability; industry failures. Examples of costs of investment in aquatic animal health-related activities, including national strategies, research, surveillance, control and other health management programmes are also provided. Finally, the strategies currently being implemented in the Asian region to deal with transboundary diseases affecting the aquaculture sector are highlighted. These include compliance with international codes, and development and implementation of regional guidelines and national aquatic animal health strategies; new diagnostic and therapeutic techniques and new information technology; new biosecurity measures including

  14. Oesophagostomosis, moniaziasis and trichuriasis of small ruminants ...

    African Journals Online (AJOL)

    For this study, the intestines (small and large intestines) were collected from 300 small ruminants (200 goats and 100 sheep) at necropsy and examined by the Hansen and Perry method. Out of the 300 small ruminants examined during the study period, the intestines revealed the presence of Oesophagostomum sp, ...

  15. Health education and caregivers' management of Malaria among ...

    African Journals Online (AJOL)

    Health education and caregivers' management of Malaria among under fives in Ede North L.G.A., Osun State of Nigeria. ... about the dose and regimen of chloroquine drug and (e) had a better attitude towards the management of malaria.

  16. Rumination and Age: Some Things Get Better

    Directory of Open Access Journals (Sweden)

    Stefan Sütterlin


    Full Text Available Rumination has been defined as a mode of responding to distress that involves passively focusing one's attention on symptoms of distress without taking action. This dysfunctional response style intensifies depressed mood, impairs interpersonal problem solving, and leads to more pessimistic future perspectives and less social support. As most of these results were obtained from younger people, it remains unclear how age affects ruminative thinking. Three hundred members of the general public ranging in age from 15 to 87 years were asked about their ruminative styles using the Response Styles Questionnaire (RSQ, depression and satisfaction with life. A Mokken Scale analysis confirmed the two-factor structure of the RSQ with brooding and reflective pondering as subcomponents of rumination. Older participants (63 years and older reported less ruminative thinking than other age groups. Life satisfaction was associated with brooding and highest for the earlier and latest life stages investigated in this study.

  17. Rumination Syndrome and Dental Erosions in Children. (United States)

    Monagas, Javier; Ritwik, Priyanshi; Kolomensky, Andrew; Acosta, Julio; Kay, Danielle; Clendaniel, Lindsey; Hyman, Paul E


    Rumination syndrome is the effortless regurgitation of recently ingested food with subsequent reswallowing or spitting out. Dental erosion (DE) affects 2% to 5% of the population. DE is defined as loss of tooth structure by a chemical process that does not involve bacteria. Our objective was to compare the frequency of DE among children with rumination syndrome with healthy controls. We enrolled 30 patients 4 to 21 years of age diagnosed with rumination syndrome, and 30 age- and sex-matched healthy control subjects. Patients were evaluated by pediatric dentists for presence of DE with Taji et al a validated grading system. Patients with rumination were more likely to have DE (P syndrome, 23 (77%) had DE, compared with 4 (13%) control subjects. DEs are more frequent in patients with rumination syndrome.

  18. Integrated Management System Incorporating Quality Management and Management of Environment, Health and Occupational Safety

    International Nuclear Information System (INIS)

    Manchev, B.; Nenkova, B.; Tomov, E.


    Risk Engineering Ltd is a Bulgarian private company founded in 1990 to provide engineering and consulting services applicable to each and every field of the energy sector. Since its establishment Risk Engineering Ltd develops, implement and apply a System for quality assurance, certified for the first time by BVQI (now Bureau Veritas Certification) in 1999 for conformity with the standard ISO 9001:1994. Later on, in connection with the revision of the standards of ISO 9000 series and introduction of the standard ISO 9001:2000 a Quality Management System in conformity with the standard ISO 9001:2000 was developed, introduced and certified. At present, Risk Engineering Ltd has got developed, documented, introduced and certified by Lloyd's Register Quality Assurance (LRQA) Quality Management System in compliance with ISO 9001:2008 on the process approach basis. On this basis and including the requirements of the ISO 14001:2004 (regarding the environment) and OHSAS 18001:2007 (regarding the health and occupational safety), Risk Engineering Ltd has developed and introduced Integrated Management System aim at achieving and demonstrating good results regarding protection of the environment, health and occupational safety. The processes under control by the Integrated Management System and applicable at the company are divided in two general types: A) Management processes: Strategic management and Management of the human resources. B) Processes describing the main activities: design/development process; project management; management of industrial projects and technical infrastructure project; construction, installation, repair and operation of power industry facilities; commercial activities and marketing; investigation of energy efficiency of industrial systems and certification of buildings regarding energy efficiency; consulting activity in the field of industry and energy as well as consultant in accordance with the Law of the Spatial Planning; management of the

  19. Prognostic Health Management for Avionics System Power Supplies

    National Research Council Canada - National Science Library

    Orsagh, Rolf; Brown, Douglas; Roemer, Michael; Dabney, Thomas; Hess, Andrew


    This paper presents an integrated approach to switching mode power supply health management that implements techniques from engineering disciplines including statistical reliability modeling, damage...

  20. On Management Matters: Why We Must Improve Public Health Management Through Action: Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health". (United States)

    Willacy, Erika; Bratton, Shelly


    Public health management is a pillar of public health practice. Only through effective management can research, theory, and scientific innovation be translated into successful public health action. With this in mind, the U.S. Centers for Disease Control and Prevention (CDC) has developed an innovative program called Improving Public Health Management for Action (IMPACT) which aims to address this critical need by building an effective cadre of public health managers to work alongside scientists to prepare for and respond to disease threats and to effectively implement public health programs. IMPACT is a 2-year, experiential learning program that provides fellows with the management tools and opportunities to apply their new knowledge in the field, all while continuing to serve the Ministry of Health (MoH). IMPACT will launch in 2016 in 2 countries with the intent of expanding to additional countries in future years resulting in a well-trained cadre of public health managers around the world. © 2016 by Kerman University of Medical Sciences.

  1. Factors affecting medical waste management in lowlevel health ...

    African Journals Online (AJOL)

    African Journal of Environmental Science and Technology ... evaluation of medical waste management systems was conducted in the low-level health ... In Ilala, 70% of the health facilities burn wastes in poorly designed incinerators, open pit ...

  2. Sensor Area Network for Integrated Systems Health Management, Phase II (United States)

    National Aeronautics and Space Administration — The term Integrated Systems Health Management (ISHM) is used to describe a capability that focuses on determining the condition (health) of every element in a...

  3. Meeting global health challenges through operational research and management science. (United States)

    Royston, Geoff


    This paper considers how operational research and management science can improve the design of health systems and the delivery of health care, particularly in low-resource settings. It identifies some gaps in the way operational research is typically used in global health and proposes steps to bridge them. It then outlines some analytical tools of operational research and management science and illustrates how their use can inform some typical design and delivery challenges in global health. The paper concludes by considering factors that will increase and improve the contribution of operational research and management science to global health.

  4. Organizational Structure and Management in Romanian Health System


    Boldureanu Daniel; Boldureanu Gabriela


    The health system in Romania in a continuous transformation from a centralized system (type Semashko) exists before 1989 year to one based on social health insurance (type Bismark). This paper examines the management and the organizational structure of the health system in Romania, and the relations between them in the context of the Health Reform Law.

  5. Implementing a routine health management information system in ...

    African Journals Online (AJOL)

    South Sudan has recently acquired statehood. Planning and management of the health care system, based on evidence, requires a constant flow of information from health services. The Division of Monitoring and Evaluation (M&E) of the Ministry of Health developed the framework for the health sector of the country in 2008.

  6. The role of records management professionals in the national health ...

    African Journals Online (AJOL)

    The introduction of information communication technologies (ICTs) in the health sector has brought about electronic health (eHealth) which uses computing, networking and communications technologies to improve health delivery. However, the inclusion of records management and archival concerns during system design ...

  7. Consumer choice of social health insurance in managed competition.

    NARCIS (Netherlands)

    Kerssens, J.J.; Groenewegen, P.P.


    Objective: To promote managed competition in Dutch health insurance, the insured are now able to change health insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to

  8. Financial Management: Implementation of the Data Quality Management Control Program for the Military Health System (D-2002-141)

    National Research Council Canada - National Science Library


    DoD health care managers should read this report. Military health care data is used for a variety of critical purposes, including managing patient care, determining the optimal health care system, and for financial management...

  9. Co-rumination, anxiety, and maladaptive cognitive schemas: when friendship can hurt

    Directory of Open Access Journals (Sweden)

    Carlucci L


    Full Text Available Leonardo Carlucci, Ines D’Ambrosio, Marco Innamorati, Aristide Saggino, Michela Balsamo Department of Psychological Sciences, Health and Territory, “G. d’Annunzio” University, Chieti, Italy Background: This study investigated maladaptive cognitive schemas as mediators of the relationship between co-rumination and anxiety. Methods: Self-report measures of co-rumination, trait cognitive and somatic anxiety, and early maladaptive cognitive schemas were provided to a nonclinical sample of 461 young adults. Mediation of co-rumination and trait somatic and cognitive anxiety by each early maladaptive schema domain was tested using nonparametric, bootstrap-based resampling. Results: Significant associations between co-rumination and trait and cognitive anxiety were mediated by schema domains related to Rejection and Disconnection, Overvigilance and Inhibition, and Impaired Autonomy. The association between co-rumination and somatic anxiety was mediated by domains related to Rejection and Disconnection and Impaired Autonomy. Conclusion: The results of this study showed that those who engage in co-rumination, potentially resulting in clinical levels of anxiety, might benefit from treatment that focuses on themes of rejection sensitivity and belonging, beliefs about autonomy, and when the anxiety is more cognitive, treatment that focuses on hypercriticalness and emotional inhibition too. Keywords: anxiety, communication, domain, mediation, adults

  10. Mineral supplementation for grazing ruminants

    International Nuclear Information System (INIS)

    McDowell, L.R.; Conrad, J.H.; Ellis, G.L.


    Grazing ruminants to which concentrate feeds cannot be economically fed must rely on self-feeding of mineral supplements. A number of factors affect mineral consumption of free-choice mixtures. Livestock exhibit little nutritional wisdom and will select palatable mixtures in preference to mixtures designed to meet their requirements. Palatability and appetite stimulators are often used to achieve a more uniform herd-wide consumption. It is best to formulate free-choice mixtures on the basis of analyses or other available data. However, when no information on mineral status is known, a free-choice complete mineral supplement is warranted. A 'complete' mineral mixture usually includes salt, a low fluoride P source, Ca, Co, Cu, I, Mn and Zn. Selenium, Mg, K, S, Fe or additional elements can be incorporated into a mineral supplement as new information suggests a need. The detriment to ruminant production caused by providing Ca, Se and Cu in excess can be greater than any benefit derived by providing a mineral supplement. In regions where high forage Mo predominates, three to five times the Cu content in mineral mixtures is needed to counteract Mo toxicity. Supplemental minerals are most critical during the wet season, when cattle are gaining weight rapidly and energy and protein supplies are adequate. Economic return on mineral supplementation is high. (author)

  11. Rumination mediates the association between cyber-victimization and depressive symptoms. (United States)

    Feinstein, Brian A; Bhatia, Vickie; Davila, Joanne


    The current study examined the 3-week prospective associations between cyber-victimization and both depressive symptoms and rumination. In addition, a mediation model was tested, wherein rumination mediated the association between cyber-victimization and depressive symptoms. Participants (N = 565 college-age young adults) completed online surveys at two time points 3 weeks apart. Results indicated that cyber-victimization was associated with increases in both depressive symptoms and rumination over time. Furthermore, results of the path analysis indicated that cyber-victimization was associated with increases in rumination over time, which were then associated with greater depressive symptoms, providing support for the proposed mediation effect for women, but not men. Findings extend previous correlational findings by demonstrating that cyber-victimization is associated with increases in symptomatology over time. Findings also suggest that the negative consequences of cyber-victimization extend beyond mental health problems to maladaptive emotion regulation. In fact, rumination may be a mechanism through which cyber-victimization influences mental health problems, at least for women. Mental health professionals are encouraged to assess cyber-victimization as part of standard victimization assessments and to consider targeting maladaptive emotion regulation in addition to mental health problems in clients who have experienced cyber-victimization.

  12. Managing risk: clinical decision-making in mental health services. (United States)

    Muir-Cochrane, Eimear; Gerace, Adam; Mosel, Krista; O'Kane, Debra; Barkway, Patricia; Curren, David; Oster, Candice


    Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.

  13. Review: Towards the agroecological management of ruminants, pigs and poultry through the development of sustainable breeding programmes: I-selection goals and criteria. (United States)

    Phocas, F; Belloc, C; Bidanel, J; Delaby, L; Dourmad, J Y; Dumont, B; Ezanno, P; Fortun-Lamothe, L; Foucras, G; Frappat, B; González-García, E; Hazard, D; Larzul, C; Lubac, S; Mignon-Grasteau, S; Moreno, C R; Tixier-Boichard, M; Brochard, M


    Agroecology uses natural processes and local resources rather than chemical inputs to ensure production while limiting the environmental footprint of livestock and crop production systems. Selecting to achieve a maximization of target production criteria has long proved detrimental to fitness traits. However, since the 1990s, developments in animal breeding have also focussed on animal robustness by balancing production and functional traits within overall breeding goals. We discuss here how an agroecological perspective should further shift breeding goals towards functional traits rather than production traits. Breeding for robustness aims to promote individual adaptive capacities by considering diverse selection criteria which include reproduction, animal health and welfare, and adaptation to rough feed resources, a warm climate or fluctuating environmental conditions. It requires the consideration of genotype×environment interactions in the prediction of breeding values. Animal performance must be evaluated in low-input systems in order to select those animals that are adapted to limiting conditions, including feed and water availability, climate variations and diseases. Finally, we argue that there is no single agroecological animal type, but animals with a variety of profiles that can meet the expectations of agroecology. The standardization of both animals and breeding conditions indeed appears contradictory to the agroecological paradigm that calls for an adaptation of animals to local opportunities and constraints in weakly artificialized systems tied to their physical environment.

  14. Aligning smoke management with ecological and public health goals (United States)

    Jonathan W. Long; Leland W. Tarnay; Malcolm P. North


    Past and current forest management affects wildland fire smoke impacts on downwind human populations. However, mismatches between the scale of benefits and risks make it difficult to proactively manage wildland fires to promote both ecological and public health. Building on recent literature and advances in modeling smoke and health effects, we outline a framework to...

  15. Co-rumination via cellphone moderates the association of perceived interpersonal stress and psychosocial well-being in emerging adults. (United States)

    Murdock, Karla Klein; Gorman, Sarah; Robbins, Maia


    Adolescents' and emerging adults' social interactions increasingly revolve around cellphone use, but little research has investigated the psychological properties of cellphone interactions. The current study explored co-rumination via cellphone; that is, the use of cellphone functions to excessively communicate about problems or negative feelings. Face-to-face co-rumination and co-rumination via cellphone were examined as potential moderators of the association between perceived interpersonal stress and psychosocial well-being (i.e., positive mental health and social burnout) in a sample of 142 college students. Face-to-face co-rumination was not a moderator. However, co-rumination via cellphone was a significant moderator such that higher levels of perceived interpersonal stress were associated with lower levels of well-being only among college students who reported higher levels of co-rumination via cellphone. Co-rumination via cellphone should be further investigated to elucidate its developmental trajectory and mental health correlates. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  16. Managing health care organizations in an age of rapid change. (United States)

    Benjamin, S; al-Alaiwat, S


    Health care managers find their work increasingly difficult, due in part to rapid environmental change that plagues organizational life. Management practices and attitudes that may have been appropriate in previous eras are ineffective today. A study was conducted among managers in the Ministry of Health, State of Bahrain, seeking information about current trends in the macro or external environment that affect the Ministry of Health, as well as internal environmental pressures that may be similar or different. This article provides a clear picture of the context in which managers perform their work and offers recommendations for coping with change in dynamic, complex organizations.

  17. Rumination and behavioural factors in Parkinson's disease depression. (United States)

    Julien, Camille L; Rimes, Katharine A; Brown, Richard G


    Parkinson's disease is associated with high rates of depression. There is growing interest in non-pharmacological management including psychological approaches such as Cognitive Behaviour Therapy. To date, little research has investigated whether processes that underpin cognitive models of depression, on which such treatment is based, apply in patients with Parkinson's disease. The study aimed to investigate the contribution of core psychological factors to the presence and degree of depressive symptoms. 104 participants completed questionnaires measuring mood, motor disability and core psychological variables, including maladaptive assumptions, rumination, cognitive-behavioural avoidance, illness representations and cognitive-behavioural responses to symptoms. Regression analyses revealed that a small number of psychological factors accounted for the majority of depression variance, over and above that explained by overall disability. Participants reporting high levels of rumination, avoidance and symptom focusing experienced more severe depressive symptoms. In contrast, pervasive negative dysfunctional beliefs did not independently contribute to depression variance. Specific cognitive (rumination and symptom focusing) and behavioural (avoidance) processes may be key psychological markers of depression in Parkinson's disease and therefore offer important targets for tailored psychological interventions. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Health information technology: transforming chronic disease management and care transitions. (United States)

    Rao, Shaline; Brammer, Craig; McKethan, Aaron; Buntin, Melinda B


    Adoption of health information technology (HIT) is a key effort in improving care delivery, reducing costs of health care, and improving the quality of health care. Evidence from electronic health record (EHR) use suggests that HIT will play a significant role in transforming primary care practices and chronic disease management. This article shows that EHRs and HIT can be used effectively to manage chronic diseases, that HIT can facilitate communication and reduce efforts related to transitions in care, and that HIT can improve patient safety by increasing the information available to providers and patients, improving disease management and safety. Copyright © 2012 Elsevier Inc. All rights reserved.


    Directory of Open Access Journals (Sweden)

    john frimpong manso


    Full Text Available Ghana Public Health Sector runs a three-tier system of managing health commodities. Suppliers, the Central Medical Store, The Regional Medical Store, Service Delivery Points and the transportation system form the supply chain.  Ghana Health Service logistics system is centralized and the health care delivery system is decentralized. Logistics management in the health system is crucial. This is because there are instances where medicines and health commodities are not available at the Central Medical Stores and the Regional Medical Stores. Consequently, there is no commodity security at the service delivery points. Upon this backdrop the study seeks to assess the logistics management system in order to bring efficiency in the system. The study adopts a multi-case study approach to assess the practices of logistics management, the causes of inadequacy of logistics and the strengths and weaknesses in Ghana Health Service logistics system.  Two categories of participants that is, the key players of health logistics management and end-users were involved in the study.  Four variables; finance for procurement of health commodities, evenly distribution of health commodities, effective supervision and constant monitoring and evaluation were found crucial in effective and efficient logistics management. Moreover, it was found that poor procurement planning and budgeting, lack of financial resources for procurement, poor quantification and forecasting, delay in procurement process and order processing, and delay in receiving insurance claims are some of the causes of inadequacy of logistics in the health systems. It is recommended that Ghana Health Service logistics or supply system must receive constant monitoring and evaluation. Further, Ghana Health Service must ensure that there is effective top-down supervision in the system to bring up efficiency. Again, Ghana Health Service and Ministry of Health must ensure enough funds are secured from the

  20. Occupational health and safety management in micro and small enterprises

    DEFF Research Database (Denmark)

    Hasle, Peter


    Occupational health and safety management (OHSM) in micro and small enterprises may look like an odd ex-pression. Most owner-managers do not think of OHSM as something to give priority. They are occupied with management of the core business which in many cases constitute a simple fight for survival...


    Directory of Open Access Journals (Sweden)

    Camila Dubow


    Full Text Available The article proposes a critical reflection, based on national law, scholarly, scientific, on the current development of Networks of Health Care, as a strategy for strengthening the Single Health System (SUS. Are weighted inefficiency of traditional ways of organizing care and management, the challenge of Network Health Care for comprehensive care and management mechanisms used in this process. The work provides subsidies for the care practices and health management are reflected, pointing strategies that result in disruptions of paradigms through a refocusing of attention in existing models. For networks of health care can be consolidated, is fundamental to political sensitivity of health managers with a commitment to build a new model of care, through the struggle to consolidate the SUS and the realization of the principles of universality, comprehensiveness and equity.

  2. Applications of Health Management Using Android and RFID

    Directory of Open Access Journals (Sweden)

    Young-Long Chen


    Full Text Available Health management has become increasingly important in personal health care in modern life. The system we have designed provides a method to help facilitate health management through an associated smart phone with Radio Frequency Identification (RFID, which is a new type of application. This system consists of medical knowledge and health management. In the application of medical knowledge, we use the human model as well as the operation of RFID to obtain medical knowledge concerning human organs. The two main functions of the health management system are medication reminders and drug identification. The feature of medication reminders allows users to set the time for taking medication so that patients do not miss taking their medication. The feature of drug identification allows the operators to identify the drugs and can let the users know who needs to take drugs. In addition, we have designed a web page that allows users to understand their health status.

  3. Fluid balance in ruminants: adaptation to external and internal challenges. (United States)

    Olsson, Kerstin


    Ruminants are widespread in hot, arid regions. This demands adaptation to large circadian temperature fluctuations and recurrent periods of food and water shortage. Pregnancy and lactation add to the demands on the adaptive mechanisms due to the greater need for food, water, and electrolytes. The blood volume increases to meet the requirements of the fetoplacental unit and the mammary glands. Unlike urine, the milk cannot be concentrated by antidiuretic hormone (vasopressin). During water deprivation, lactating animals therefore become dehydrated more rapidly than nonlactating animals. Nevertheless, desert-adapted lactating ruminants endure frequent periods of water deprivation without incurring bad health. For the offspring living in hot and dry conditions, it is an advantage that the milk is not concentrated, even if the mother has a high antidiuretic hormone concentration to enable her to concentrate the urine. Since ruminants are prey, they need to drink rapidly when they get access to water. The forestomach allows the animals to store water in the reticulorumen. There is no danger of water intoxication even if they drink to satisfaction in a couple of minutes after having lost as much as 30% of their body weight.

  4. Group Rumination: Social Interactions Around Music in People with Depression (United States)

    Garrido, Sandra; Eerola, Tuomas; McFerran, Katrina


    One of the most important roles that music serves in human society is the promotion of social relationships and group cohesion. In general, emotional experiences tend to be amplified in group settings through processes of social feedback. However, previous research has established that listening to sad music can intensify negative emotions in people with tendencies to rumination and depression. This study therefore investigated the phenomenon of ruminating with music, and the question of whether listening to sad music in group settings provides social benefits for emotionally vulnerable listeners, or whether it further exaggerates depressive tendencies. Participants recruited via online depression groups and mental health websites were surveyed as to music listening habits. Results revealed that people with depression were more likely to engage in “group rumination” using music, and that this behavior could be partially explained by a general tendency to ruminate using music. Both affective states and coping styles were found to be related to the affective outcomes of group interactions around music. These findings go some way toward clarifying the situations in which group interactions around music are able to provide important social benefits for those involved, and situations in which negative emotions can be amplified by the group context. PMID:28421014

  5. Digital health technology and diabetes management. (United States)

    Cahn, Avivit; Akirov, Amit; Raz, Itamar


    Diabetes care is largely dependent on patient self-management and empowerment, given that patients with diabetes must make numerous daily decisions as to what to eat, when to exercise, and determine their insulin dose and timing if required. In addition, patients and providers are generating vast amounts of data from many sources, including electronic medical records, insulin pumps, sensors, glucometers, and other wearables, as well as evolving genomic, proteomic, metabolomics, and microbiomic data. Multiple digital tools and apps have been developed to assist patients to choose wisely, and to enhance their compliance by using motivational tools and incorporating incentives from social media and gaming techniques. Healthcare teams (HCTs) and health administrators benefit from digital developments that sift through the enormous amounts of patient-generated data. Data are acquired, integrated, analyzed, and presented in a self-explanatory manner, highlighting important trends and items that require attention. The use of decision support systems may propose data-driven actions that, for the most, require final approval by the patient or physician before execution and, once implemented, may improve patient outcomes. The digital diabetes clinic aims to incorporate all digital patient data and provide individually tailored virtual or face-to-face visits to those persons who need them most. Digital diabetes care has demonstrated only modest HbA1c reduction in multiple studies and borderline cost-effectiveness, although patient satisfaction appears to be increased. Better understanding of the barriers to digital diabetes care and identification of unmet needs may yield improved utilization of this evolving technology in a safe, effective, and cost-saving manner. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  6. Health care units and human resources management trends. (United States)

    André, Adriana Maria; Ciampone, Maria Helena Trench; Santelle, Odete


    To identify factors producing new trends in basic health care unit management and changes in management models. This was a prospective study with ten health care unit managers and ten specialists in the field of Health in São Paulo, Southeastern Brazil, in 2010. The Delphi methodology was adopted. There were four stages of data collection, three quantitative and the fourth qualitative. The first three rounds dealt with changing trends in management models, manager profiles and required competencies, and the Mann-Whitney test was used in the analysis. The fourth round took the form of a panel of those involved, using thematic analysis. The main factors which are driving change in basic health care units were identified, as were changes in management models. There was consensus that this process is influenced by the difficulties in managing teams and by politics. The managers were found to be up-to-date with trends in the wider context, with the arrival of social health organizations, but they are not yet anticipating these within the institutions. Not only the content, but the professional development aspect of training courses in this area should be reviewed. Selection and recruitment, training and assessment of these professionals should be guided by these competencies aligned to the health service mission, vision, values and management models.

  7. Health promotion in Swedish schools: school managers' views. (United States)

    Persson, Louise; Haraldsson, Katarina


    Schools are recognized worldwide as settings for health promotion, and leadership has a bearing on schools' ability to be health promoting. School managers have a great influence on what is prioritized in school, which in turn affects students' school performance and health. There is lack of research into school managers' views on health promotion, and what they consider to be central to health promotion. The aim was therefore to examine school managers' views about what health promotion in schools include. An explorative design, qualitative content analysis, was performed. In-depth interviews were conducted with all 13 school managers of a middle-sized municipality in central Sweden. The analysis had both manifest and latent content and three categories: 'Organization and Collaboration', 'Optimize the arena' and 'Strengthen the individual', and 10 subcategories emerged. The theme, 'Opportunities for learning and a good life', describes the latent content of these categories. Taking into account the views of school managers are important because these views help form a more complete picture of how school managers work with health promotion and what is needed to enhance health promotion to improve students' opportunities for learning and a good life. The Ottawa Charter for Health promotion is thereby transformed into practice. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email:

  8. European organic dairy farmers' preference for animal health management within the farm management system. (United States)

    van Soest, F J S; Mourits, M C M; Hogeveen, H


    The expertise and knowledge of veterinary advisors on improving animal health management is key towards a better herd health status. However, veterinary advisors are not always aware of the goals and priorities of dairy farmers. To dairy farmers animal health is only one aspect of farm management and resources may be allocated to other more preferred areas. Veterinary advisors may experience this as non-compliant with their advice. To explore the preferences of European Union (EU) organic dairy farmers for improved animal health management relative to other farm management areas an adaptive conjoint analysis (ACA) was performed. A total of 215 farmers participated originating from organic dairy farms in France (n = 70), Germany (n = 60), Spain (n = 28) and Sweden (n = 57). The management areas udder health and claw health represented animal health management whereas barn, calf and pasture management represented potential conflicting management areas. Results indicate that EU organic dairy farmers differ in their preferences for improved animal health management within the farming system. In general, improved calf management was the most preferred area and improved claw health management was found to be least preferred, the remaining areas were of intermediate interest. Cluster analyses on claw health measures and udder health measures resulted in respectively seven and nine distinct preference profiles. The results indicate a high degree of variation in farmers' preference, which cannot be explained by the typical herd characteristics. With the individual preferences revealed by ACA, a veterinary advisor can now find out whether his intended advice is directed at a favourable or unfavourable management area of the farmer. If the latter is the case the veterinarian should first create awareness of the problem to the farmer. Insights in individual farmers preferences will allow veterinary advisors to better understand why farmers were incompliant with their advice

  9. Ruminal microbe of biohydrogenation of trans-vaccenic acid to stearic acid in vitro

    Directory of Open Access Journals (Sweden)

    Li Dan


    Full Text Available Abstract Background Optimization of the unsaturated fatty acid composition of ruminant milk and meat is desirable. Alteration of the milk and fatty acid profile was previously attempted by the management of ruminal microbial biohydrogenation. The aim of this study was to identify the group of ruminal trans-vaccenic acid (trans-11 C18:1, t-VA hydrogenating bacteria by combining enrichment studies in vitro. Methods The enrichment culture growing on t-VA was obtained by successive transfers in medium containing t-VA. Fatty acids were detected by gas chromatograph and changes in the microbial composition during enrichment were analyzed by denaturing gradient gel electrophoresis (DGGE. Prominent DGGE bands of the enrichment cultures were identified by 16S rRNA gene sequencing. Results The growth of ruminal t-VA hydrogenating bacteria was monitored through the process of culture transfer according to the accumulation of stearic acid (C18:0, SA and ratio of the substrate (t-VA transformed to the product (SA. A significant part of the retrieved 16S rRNA gene sequences was most similar to those of uncultured bacteria. Bacteria corresponding to predominant DGGE bands in t-VA enrichment cultures clustered with t-VA biohydrogenated bacteria within Group B. Conclusions This study provides more insight into the pathway of biohydrogenation. It also may be important to control the production of t-VA, which has metabolic and physiological benefits, through management of ruminal biohydrogenation bacterium.

  10. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents (United States)

    Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy


    Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…

  11. Consumer choice of social health insurance in managed competition

    NARCIS (Netherlands)

    Kerssens, Jan J.; Groenewegen, Peter P.


    Objective To promote managed competition in Dutch health insurance, the insured are now able to change heaith insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to

  12. Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers (United States)

    Roberts, James R.; McCurdy, Leyla Erk


    These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…

  13. Pesticides and public health: integrated methods of mosquito management.


    Rose, R. I.


    Pesticides have a role in public health as part of sustainable integrated mosquito management. Other components of such management include surveillance, source reduction or prevention, biological control, repellents, traps, and pesticide-resistance management. We assess the future use of mosquito control pesticides in view of niche markets, incentives for new product development, Environmental Protection Agency registration, the Food Quality Protection Act, and improved pest management strate...

  14. Management Matters: A Leverage Point for Health Systems Strengthening in Global Health

    Directory of Open Access Journals (Sweden)

    Elizabeth H. Bradley


    Full Text Available Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management – defined here as the process of achieving predetermined objectives through human, financial, and technical resources – is a cross-cutting function necessary for success in all World Health Organization (WHO building blocks of health systems strengthening. Management within health systems is particularly critical in low-income settings where the efficient use of scarce resources is paramount to attaining health goals. More generally, investments in management capacity may be viewed as a key leverage point in grand strategy, as strong management enables the achievement of large ends with limited means. We also sought to delineate a set of core competencies and identify key roles to be targeted for management capacity building efforts. Several effective examples of management interventions have been described in the research literature. Together, the existing evidence underscores the importance of country ownership of management capacity building efforts, which often challenge the status quo and thus need country leadership to sustain despite inevitable friction. The literature also recognizes that management capacity efforts, as a key ingredient of effective systems change, take time to embed, as new protocols and ways of working become habitual and integrated as standard operating procedures. Despite these challenges, the field of health management as part of global health system strengthening efforts holds promise as a fundamental leverage point for achieving health system performance goals with existing human, technical, and financial resources. The evidence base consistently supports the role of management in performance improvement but would benefit from additional research with improved

  15. Care management actions in the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Marcelo Costa Fernandes


    Full Text Available Objective: to identify, from nurses’ speeches, the actions that enable care management in the Family Health Strategy.Methods: descriptive study with a qualitative approach conducted with 32 nurses of primary care. It was used a semistructuredinterview as the data collection technique. The methodological process of the collective subject discourse wasused to organize the data Results: from the nurses’ speeches one identified the categories: complementary relationshipbetween care and management; meeting with community health agents, a care management strategy in nurses’ work;health education activities such as a care management action and a health information system as an essential tool forcare Conclusion: it was possible to observe that nurses understood the importance of coordination and complementaritybetween the activities of the working process of care and management.

  16. Health coaching in diabetes: empowering patients to self-manage. (United States)

    Wong-Rieger, Durhane; Rieger, Francis P


    To effectively manage diabetes mellitus, patients must adhere to treatment recommendations and healthy lifestyle behaviors, but research shows many patients do not do this. Education is effective when combined with self-management support but peer-support programs do not lead to lasting changes. Health coaching, or professional support, can be highly effective if it focuses on developing self-efficacy and skills such as goal-setting, problem-solving and managing cognitive and emotional barriers. This overview discusses the benefits of patient self-management for chronic conditions such as diabetes, core competencies for health coaching, theoretical bases and principles of health coaching interventions, delivery methods and the evidence that health coaching works for diabetes self-management. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  17. Effects of Integrated Health Management Intervention on Overweight and Obesity

    Directory of Open Access Journals (Sweden)

    Yiting Yang


    Full Text Available Overweight or obese adults aged 20~55 years and living in Beijing more than one year were randomly divided into different management groups. A one-year integrated health management intervention was applied in the health management groups. The physical indicators and metabolic indicators changed after one-year intervention on the overweight and obese adults. The annual reduction of the physical indicators was significant in all groups (p<0.05 except the weight loss in the placebo + general management group. The health management and the dietary supplement have statistically significant (p<0.001, p<0.001 effects on the annual reduction of these indicators and interactive effect between them was found on some of these indicators such as bodyweight, body mass index (BMI, body fat ratio (BFR, and hipline (p<0.05. The dietary supplement + health management group had the best annual reduction effects for the indicators among the groups. Integrated health management interventions including both dietary supplements intervention and health management could improve metabolic indicators in overweight and obese adults together with the physical indicators, suggesting the intermediated role of metabolic indictors in controlling obesity.

  18. Association of rumination time with subclinical ketosis in transition dairy cows. (United States)

    Kaufman, E I; LeBlanc, S J; McBride, B W; Duffield, T F; DeVries, T J


    The objective of this study was to characterize the relationship between rumination and subclinical ketosis (SCK) in transition dairy cows. A study was conducted on 4 commercial dairy farms in eastern Ontario, Canada. A total of 339 Holstein dairy cows (107 primiparous and 232 multiparous) were monitored for rumination activity and SCK from 14 d before calving until 28 d after calving. Rumination was recorded daily using an automated monitoring system. A blood sample was taken from the coccygeal vein of each cow for measurement of β-hydroxybutyrate (BHB) once weekly throughout the 6-wk observation period. Cows with BHB ≥1.2mmol/L in any of the 4 postpartum samples were considered to have SCK. Cases of retained placenta, metritis, milk fever, or mastitis during the study period were also recorded. Cows were categorized into 1 of 4 groups: healthy cows (HLT) that had no SCK or any other recorded health problem (n=139); cows treated for at least one health issue other than SCK (HLT+; n=50); cows with SCK (hyperketonemia; HYK) with no other health problems during transition (n=97); or cows (HYK+) that had SCK and one or more other health problems (n=53). Daily rumination time was summarized by week and comparisons were made between HLT and HYK and HYK+. From 2 wk before calving (wk -2) to 4 wk after calving (wk +4), there was no difference in rumination time (409±9.8min/d) among HLT, HYK, and HYK+ cows in their first lactation. Multiparous cows in HLT spent an average of 459±11.3min/d ruminating from wk -2 to wk +4. Multiparous HYK cows ruminated 25±12.8min/d less than HLT cows, whereas HYK+ cows ruminated 44±15.6min/d less than HLT cows. The largest differences in rumination time between HLT and HYK+ cows were seen during wk -1, +1, and +2, when HYK+ cows ruminated 48±17.2, 73±16.0, and 65±19.4min/d less than HLT cows, respectively. In multiparous cows, increased odds of HYK were associated with greater milk yield in the previous lactation, greater loss of

  19. The interplay of management accounting research and NPM health initiatives

    DEFF Research Database (Denmark)

    Malmmose, Margit

    This paper investigates the development of management accounting research in the context of New Public Management (NPM) initiatives in health care. Drawing on concepts from diffusion theory and earlier literature reviews, the paper examines the interplay between management accounting research...... and health care reforms in relation to country of origin, development, theoretical approach, research method and topic. The study thus establishes a different focus; namely the interrelationship between the development of management accounting research and practical socio-political NPM innovations. The study...... shows that management accounting techniques are increasingly adopted in governmental health reforms and diffused across nations, themes and initiatives through time with the result that wider social practices become more and more integrated in management accounting research themes...

  20. Public health response to striking solid waste management. (United States)

    Murti, Michelle; Ayre, Reg; Shapiro, Howard; de Burger, Ron


    In 2009, the City of Toronto, Ontario, Canada, experienced a six-week labor disruption involving 24,000 city workers that included solid waste and public health employees. In an attempt to control illegal dumping and to manage garbage storage across the city during this period, 24 temporary garbage storage sites were established by the city (mostly in local parks) for residents to dispose of their household waste. No other municipality in North America has attempted to operate this many temporary sites for this long a period. Management and nonunion staff from Healthy Environments in Toronto Public Health performed daily inspections, responded to community questions, issued public health orders, and worked closely with Solid Waste Management and the Ministry of the Environment to actively manage the public health concerns associated with these sites. This intensive oversight mitigated public health risks to the community and facilitated an effective, safe solution to the temporary garbage storage problem.

  1. Ergot alkaloid transport across ruminant gastric tissues. (United States)

    Hill, N S; Thompson, F N; Stuedemann, J A; Rottinghaus, G W; Ju, H J; Dawe, D L; Hiatt, E E


    Ergot alkaloids cause fescue toxicosis when livestock graze endophyte-infected tall fescue. It is generally accepted that ergovaline is the toxic component of endophyte-infected tall fescue, but there is no direct evidence to support this hypothesis. The objective of this study was to examine relative and potential transport of ergoline and ergopeptine alkaloids across isolated gastric tissues in vitro. Sheep ruminal and omasal tissues were surgically removed and placed in parabiotic chambers. Equimolar concentrations of lysergic acid, lysergol, ergonovine, ergotamine, and ergocryptine were added to a Kreb's Ringer phosphate (KRP) solution on the mucosal side of the tissue. Tissue was incubated in near-physiological conditions for 240 min. Samples were taken from KRP on the serosal side of the chambers at times 0, 30, 60, 120, 180, and 240 min and analyzed for ergot alkaloids by competitive ELISA. The serosal KRP remaining after incubation was freeze-dried and the alkaloid species quantified by HPLC. The area of ruminal and omasal tissues was measured and the potential transportable alkaloids calculated by multiplying the moles of transported alkaloids per square centimeter of each tissue type by the surface area of the tissue. Studies were conducted to compare alkaloid transport in reticular, ruminal, and omasal tissues and to determine whether transport was active or passive. Ruminal tissue had greater ergot alkaloid transport potential than omasal tissue (85 vs 60 mmol) because of a larger surface area. The ruminal posterior dorsal sac had the greatest potential for alkaloid transport, but the other ruminal tissues were not different from one another. Alkaloid transport was less among reticular tissues than among ruminal tissues. Transport of alkaloids seemed to be an active process. The alkaloids with greatest transport potential were lysergic acid and lysergol. Ergopeptine alkaloids tended to pass across omasal tissues in greater quantities than across ruminal

  2. Power Management for A Distributed Wireless Health Management Architecture (United States)

    National Aeronautics and Space Administration — Distributed wireless architectures for prognostics is an important enabling step in prognostic research in order to achieve feasible real-time system health...

  3. Health care waste management practice in a hospital. (United States)

    Paudel, R; Pradhan, B


    Health-care waste is a by-product of health care. Its poor management exposes health-care workers, waste handlers and the community to infections, toxic effects and injuries including damage of the environment. It also creates opportunities for the collection of disposable medical equipment, its re-sale and potential re-use without sterilization, which causes an important burden of disease worldwide. The purpose of this study was to find out health care waste management practice in hospital. A cross-sectional study was conducted in Narayani Sub-Regional Hospital, Birgunj from May to October 2006 using both qualitative and quantitative methods. Study population was four different departments of the hospital (Medical/Paediatric, Surgical/Ortho, Gynae/Obstetric and Emergency), Medical Superintendent, In-charges of four different departments and all sweepers. Data was collected using interview, group discussion, observation and measurement by weight and volume. Total health-care waste generated was 128.4 kg per day while 0.8 kg per patient per day. The composition of health care waste was found to be 96.8 kg (75.4%) general waste, 24.1 kg (8.8%) hazardous waste and 7.5 kg (5.8%) sharps per day by weight. Health staffs and sweepers were not practicing the waste segregation. Occupational health and safety was not given due attention. Majority of the sweepers were unaware of waste management and need of safety measures to protect their own health. Health care waste management practice in the hospital was unsatisfactory because of the lack of waste management plan and carelessness of patients, visitors and staffs. Therefore the hospital should develop the waste management plan and strictly follow the National Health Care Waste Management Guideline.

  4. Health Technologies for the Improvement of Chronic Disease Management (United States)

    Nikitovic, M; Brener, S


    Background As part of ongoing efforts to improve the Ontario health care system, a mega-analysis examining the optimization of chronic disease management in the community was conducted by Evidence Development and Standards, Health Quality Ontario (previously known as the Medical Advisory Secretariat [MAS]). Objective The purpose of this report was to identify health technologies previously evaluated by MAS that may be leveraged in efforts to optimize chronic disease management in the community. Data Sources The Ontario Health Technology Assessment Series and field evaluations conducted by MAS and its partners between January 1, 2006, and December 31, 2011. Review Methods Technologies related to at least 1 of 7 disease areas of interest (type 2 diabetes, coronary artery disease, atrial fibrillation, chronic obstructive pulmonary disease, congestive heart failure, stroke, and chronic wounds) or that may greatly impact health services utilization were reviewed. Only technologies with a moderate to high quality of evidence and associated with a clinically or statistically significant improvement in disease management were included. Technologies related to other topics in the mega-analysis on chronic disease management were excluded. Evidence-based analyses were reviewed, and outcomes of interest were extracted. Outcomes of interest included hospital utilization, mortality, health-related quality of life, disease-specific measures, and economic analysis measures. Results Eleven analyses were included and summarized. Technologies fell into 3 categories: those with evidence for the cure of chronic disease, those with evidence for the prevention of chronic disease, and those with evidence for the management of chronic disease. Conclusions The impact on patient outcomes and hospitalization rates of new health technologies in chronic disease management is often overlooked. This analysis demonstrates that health technologies can reduce the burden of illness; improve patient

  5. Health Phones: A Potential Game Changer in Health Information Management

    Directory of Open Access Journals (Sweden)

    Geena Mary Skaria


    Full Text Available Health education has to be one of the most effective ways to reduce morbidity and mortality in developing countries. We need to deliver vital messages and information to people at the lower quarter of the society to use changing behaviour and practices which can save and protect their lives. It is in this context, use of mobile phones in delivering vital health information is of significance. This article reviews few projects which successfully use mobile phones for health information delivery.

  6. The Impact of Health Behaviors and Health Management on Employment After SCI: Physical Health and Functioning. (United States)

    Meade, Michelle A; Reed, Karla S; Krause, James S


    Background : Research has shown that employment following spinal cord injury (SCI) is related to health and functioning, with physical health and functioning after SCI frequently identified as a primary barrier to employment. Objective: To examine the relationship between employment and behaviors associated with the management of physical health and functioning as described by individuals with SCI who have been employed post injury. Methods: A qualitative approach using 6 focus groups at 2 sites included 44 participants with SCI who had worked at some time post injury. Heterogeneous and homogeneous groups were created based on specific characteristics, such as education, gender, or race. A semi-structured interview format asked questions about personal, environmental, and policy-related factors influencing employment after SCI. Groups were recorded, transcribed, and entered into NVivo before coding by 2 reviewers. Results: Within the area of behaviors and management of physical health and functioning, 4 overlapping themes were identified: (1) relearning your own body and what it can do; (2) general health and wellness behaviors; (3) communication, education, and advocacy; and (4) secondary conditions and aging. Specific themes articulate the many types of behaviors individuals must master and their impact on return to work as well as on finding, maintaining, and deciding to leave employment. Conclusions: Individuals with SCI who are successfully employed after injury must learn how to perform necessary behaviors to manage health and function in a work environment. The decision to leave employment often appears to be associated with secondary complications and other conditions that occur as persons with SCI age.

  7. American Health Information Management Association. Position statement. Issue: managing health information in facility mergers and acquisitions. (United States)


    Healthcare facility mergers and acquisitions are becoming more common as the industry consolidates. Many critical issues must be considered in mergers and acquisitions, including the management of patient health information. In addition to operational issues, licensure, regulatory, and accreditation requirements must be addressed. To ensure availability of health information to all legitimate users, patient records should be consolidated or linked in the master patient index. A record retention policy should be developed and implemented to meet user needs and assure compliance with legal, regulatory, and accreditation requirements. If health information from closed facilities will be stored for a period of time, its integrity and confidentiality must be preserved, and it must be readily accessible for patient care. The compatibility and functionality of existing information systems should be assessed, and a plan should be formulated for integration of the systems to the extent possible. Such integration may be essential for the organization to successfully meet the demands of integrated delivery systems. Existing databases should be maintained in an accessible form to meet anticipated future needs.

  8. Patient privacy, consent, and identity management in health information exchange

    CERN Document Server

    Hosek, Susan D


    As a step toward improving its health information technology (IT) interoperability, the Military Health System is seeking to develop a research roadmap to better coordinate health IT research efforts, address IT capability gaps, and reduce programmatic risk for its enterprise projects. This report identifies gaps in research, policy, and practice involving patient privacy, consent, and identity management that need to be addressed to improve the quality and efficiency of care through health information exchange.

  9. The strategic planning of health management information systems. (United States)

    Smith, J


    This paper discusses the roles and functions of strategic planning of information systems in health services. It selects four specialised methodologies of strategic planning for analysis with respect to their applicability in the health field. It then examines the utilisation of information planning in case studies of three health organisations (two State departments of health and community services and one acute care institution). Issues arising from the analysis concern the planning process, the use to which plans are put, and implications for management.

  10. Management of health technologies: An international view

    NARCIS (Netherlands)

    Jonsson, E.; Banta, D.


    Health technology includes not only equipment, pharmaceuticals, and medical devices but also surgical and medical procedures Most countries regulate drugs and devices by law, by payment, or by placement of services-a new, multidisciplinary research called health technology assessment assists policy

  11. Reducing Health Cost: Health Informatics and Knowledge Management as a Business and Communication Tool (United States)

    Gyampoh-Vidogah, Regina; Moreton, Robert; Sallah, David

    Health informatics has the potential to improve the quality and provision of care while reducing the cost of health care delivery. However, health informatics is often falsely regarded as synonymous with information management (IM). This chapter (i) provides a clear definition and characteristic benefits of health informatics and information management in the context of health care delivery, (ii) identifies and explains the difference between health informatics (HI) and managing knowledge (KM) in relation to informatics business strategy and (iii) elaborates the role of information communication technology (ICT) KM environment. This Chapter further examines how KM can be used to improve health service informatics costs, and identifies the factors that could affect its implementation and explains some of the reasons driving the development of electronic health record systems. This will assist in avoiding higher costs and errors, while promoting the continued industrialisation of KM delivery across health care communities.

  12. Financial coping strategies of mental health consumers: managing social benefits. (United States)

    Caplan, Mary Ager


    Mental health consumers depend on social benefits in the forms of supplemental security income and social security disability insurance for their livelihood. Although these programs pay meager benefits, little research has been undertaken into how this population makes ends meet. Using a qualitative approach, this study asks what are the financial coping strategies of mental health consumers? Seven approaches were identified: subsidies, cost-effective shopping, budgeting, prioritizing, technology, debt management, and saving money. Results illustrate the resourcefulness of mental health consumers in managing meager social benefits and highlight the need to strengthen community mental health efforts with financial capabilities education.


    African Journals Online (AJOL)

    Poor hygiene of the enclosures and washing the udders instead of teats only may predispose animals to ... management including provision of good quality nutritious feed, clean water, ... antibiotics for prevention and treatment of diseases [7].

  14. Solving a Health Information Management Problem. An international success story. (United States)

    Hannan, Terry J


    The management of health care delivery requires the availability of effective 'information management' tools based on e-technologies [eHealth]. In developed economies many of these 'tools' are readily available whereas in Low and Middle Income Countries (LMIC) there is limited access to eHealth technologies and this has been defined as the "digital divide". This paper provides a short introduction to the fundamental understanding of what is meant by information management in health care and how it applies to all social economies. The core of the paper describes the successful implementation of appropriate information management tools in a resource poor environment to manage the HIV/AIDS epidemic and other disease states, in sub-Saharan Africa and how the system has evolved to become the largest open source eHealth project in the world and become the health information infrastructure for several national eHealth economies. The system is known as Open MRS [ The continuing successful evolution of the OpenMRS project has permitted its key implementers to define core factors that are the foundations for successful eHealth projects.

  15. Health and safety management practices in small and medium ...

    African Journals Online (AJOL)

    Health and safety management practices in small and medium enterprises in the ... on national economies, the construction industry receives additional attention in ... and training were considered key factors of H&S for SMCEs at project level.

  16. Electronic Prognostics for Vehicle Health Management, Phase I (United States)

    National Aeronautics and Space Administration — All electronic systems are prone to wear-out and eventual failure and this has direct implications for Vehicle Health Management for NASA with its long space...

  17. Architecture for Integrated System Health Management, Phase I (United States)

    National Aeronautics and Space Administration — Managing the health of vehicle, crew, and habitat systems is a primary function of flight controllers today. We propose to develop an architecture for automating...

  18. Sensor Area Network for Integrated Systems Health Management, Phase I (United States)

    National Aeronautics and Space Administration — The term Integrated Systems Health Management (ISHM) is used to describe a capability that focuses on determining the condition of every element in a complex System...

  19. Management system of organizational and economic changes in health services

    Directory of Open Access Journals (Sweden)

    Natalya Vasilyevna Krivenko


    Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market

  20. Animal health management practices in zero grazing dairy units in ...

    African Journals Online (AJOL)

    Animal health management practices in zero grazing dairy units in Arusha City, Tanzania. ... African Journal of Food, Agriculture, Nutrition and Development ... findings, majority (84.6%) of the cow's enclosures were of poor hygiene.

  1. 201 the importance of health management of grasscutters in ...

    African Journals Online (AJOL)


    Sep 2, 2010 ... Health problems posed a great danger to management of grass-cutter farms. This has led ... to natural food items, minerals and preferred habitats. Actually, in the .... CONCLUSION. These results indicates that good hygiene,.

  2. Human resources for public health supply chain management in ...

    African Journals Online (AJOL)


    country. Objective: The objective of this needs assessment was to identify the need for ... not to eliminate, the effect of the prevailing inadequate ... Federal Ministry of Health (FMOH),to develop the ... manage outsourcing of these activities, and.

  3. Managing health risks on small dairy farms in Kenya | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)


    Jun 20, 2016 ... ... in Kenya found that eating vegetables contaminated with animal manure or human waste was more ... Research improves secure access to nutritious food ... Integrated pest management yields economic and health benefits.

  4. A Structural Model Decomposition Framework for Systems Health Management (United States)

    National Aeronautics and Space Administration — Systems health management (SHM) is an impor- tant set of technologies aimed at increasing system safety and reliability by detecting, isolating, and identifying...

  5. Use of Diabetes Data Management Software Reports by Health ...

    African Journals Online (AJOL)

    Use of Diabetes Data Management Software Reports by Health Care Providers, Patients With Diabetes, and Caregivers Improves Accuracy and Efficiency of Data Analysis and Interpretation Compared With Traditional Logbook Data: First Results of the Accu-Chek C.

  6. Challenges in managing and sustaining urban slum health ...

    African Journals Online (AJOL)

    Challenges in managing and sustaining urban slum health programmes in Kenya. ... These were hardly implemented in the projects, according to the data gathered. ... Conclusion: Land and income were big issues according to the responses.

  7. Implications of the development of managed health care in the ...

    African Journals Online (AJOL)

    care or the public heatth care sector, and that it may potentially promote ... The MHC approach controls costs through measures such as .... (managers, computer systems, accountants). If it does not, .... Health EconomICS 1994: 3: 351-357.

  8. Health management in past disasters in Iran: A qualitative study

    Directory of Open Access Journals (Sweden)

    Maryam Nakhaei


    Background: Disaster management is relied on prediction of problems and providing necessary preparations in right time and place. In this study researchers intended to explore passed experiences of health disaster management. Method: This study conducted using qualitative content analysis methods. Participants were selected purposefully and data were collected through interviews, observation, and other documents. Results: Transcribed data from 18interviews, field notes and other documents were analyzed. In data analysis reactive management was emerged as main theme. It was included some categories such as ‘exposure shock’, ‘non deliberative relief’, ‘lack of comprehensive health disaster plan’, ‘lack of preparedness’, and ‘poor coordination in health service delivery’ and contextual factors. Discussion: The results clarified deep perception of participants’ experiences about health management in disasters. The professionals' and non-professionals' emotion-based reactions and behaviors, if accompanied with deficiencies in planning and preparedness, can lead to ineffective services, and aggravates the damages.

  9. All-Fiber-Optic Ultrasonic Health Management System, Phase I (United States)

    National Aeronautics and Space Administration — Health management of composite airframe components is essential for safety and reliability of future aircrafts. It reduces the risk of catastrophic failures and...

  10. Corporate social responsibility and the future health care manager. (United States)

    Collins, Sandra K


    The decisions and actions of health care managers are oftentimes heavily scrutinized by the public. Given the current economic climate, managers may feel intense pressure to produce higher results with fewer resources. This could inadvertently test their moral fortitude and their social consciousness. A study was conducted to determine what corporate social responsibility orientation and viewpoint future health care managers may hold. The results of the study indicate that future health care managers may hold patient care in high regard as opposed to profit maximization. However, the results of the study also show that future managers within the industry may continue to need rules, laws, regulations, and legal sanctions to guide their actions and behavior.

  11. Knowledge management in health: a systematic literature review. (United States)

    Rocha, Elyrose Sousa Brito; Nagliate, Patricia; Furlan, Claudia Elisangela Bis; Rocha, Kerson; Trevizan, Maria Auxiliadora; Mendes, Isabel Amélia Costa


    Knowledge has been used as a resource for intelligent and effective action planning in organizations. Interest in research on knowledge management processes has intensified in different areas. A systematic literature review was accomplished, based on the question: what are the contributions of Brazilian and international journal publications on knowledge management in health? The sample totaled 32 items that complied with the inclusion criteria. The results showed that 78% of journals that published on the theme are international, 77% of researchers work in higher education and 65% have a Ph.D. The texts gave rise to five thematic categories, mainly: development of knowledge management systems in health (37.5%), discussion of knowledge management application in health (28.1%) and nurses' function in knowledge management (18.7%).

  12. Toward a Conceptual Knowledge Management Framework in Health (United States)

    Lau, Francis


    This paper describes a conceptual organizing scheme for managing knowledge within the health setting. First, a brief review of the notions of knowledge and knowledge management is provided. This is followed by a detailed depiction of our proposed knowledge management framework, which focuses on the concepts of production, use, and refinement of three specific knowledge sources-policy, evidence, and experience. These concepts are operationalized through a set of knowledge management methods and tools tailored for the health setting. We include two case studies around knowledge translation on parent-child relations and virtual networks in community health research to illustrate how this knowledge management framework can be operationalized within specific contexts and the issues involved. We conclude with the lessons learned and implications. PMID:18066388

  13. Dual-Use Aspects of System Health Management (United States)

    Owens, P. R.; Jambor, B. J.; Eger, G. W.; Clark, W. A.


    System Health Management functionality is an essential part of any space launch system. Health management functionality is an integral part of mission reliability, since it is needed to verify the reliability before the mission starts. Health Management is also a key factor in life cycle cost reduction and in increasing system availability. The degree of coverage needed by the system and the degree of coverage made available at a reasonable cost are critical parameters of a successful design. These problems are not unique to the launch vehicle world. In particular, the Intelligent Vehicle Highway System, commercial aircraft systems, train systems, and many types of industrial production facilities require various degrees of system health management. In all of these applications, too, the designers must balance the benefits and costs of health management in order to optimize costs. The importance of an integrated system is emphasized. That is, we present the case for considering health management as an integral part of system design, rather than functionality to be added on at the end of the design process. The importance of maintaining the system viewpoint is discussed in making hardware and software tradeoffs and in arriving at design decisions. We describe an approach to determine the parameters to be monitored in any system health management application. This approach is based on Design of Experiments (DOE), prototyping, failure modes and effects analyses, cost modeling and discrete event simulation. The various computer-based tools that facilitate the approach are discussed. The approach described originally was used to develop a fault tolerant avionics architecture for launch vehicles that incorporated health management as an integral part of the system. Finally, we discuss generalizing the technique to apply it to other domains. Several illustrations are presented.

  14. Ambiguity among Managers in Small-Scale Enterprises: How to Handle Business and Workplace Health Management

    Directory of Open Access Journals (Sweden)

    Stig Vinberg


    Full Text Available Despite extensive research on health in working life, few studies focus on this issue from the perspective of managers in small-scale enterprises (SSEs. To gain deeper knowledge of managers’ perceptions and strategies for dealing with workplace health management, 13 Norwegian and Swedish SSE managers were interviewed after participating in a workplace health development project. The methodical approach was based on Grounded Theory with a constructivist orientation. The main theme that emerged was ‘ambiguity in workplace health management and maintaining the business’, which was related to the categories ‘internal workplace settings’, ‘workplace surroundings’, and ‘leadership strategies’. The managers experienced ambiguity due to internal and external demands. These requirements were linked to the core challenges in dealing with multitasking leadership, financial decision-making, labour legislation, staff development and maintaining business. However, the managers developed new skills and competence and thereby a more reflexive approach and readiness to create a health-promoting workplace from being part of a development project. The implications are that managers in SSEs need to exchange experiences and discuss workplace health issues with other managers in networks. It is also important that occupational health services and social and welfare organizations use tailor-made models and strategies for supporting SSEs.

  15. Managing Home Health Care (For Parents) (United States)

    ... this topic for: Parents Kids Teens Palliative Care Electronic Health Records When Your Child's in the Pediatric Intensive Care ... Us Contact Us Partners Editorial Policy Permissions Guidelines Privacy Policy & Terms of Use Notice of Nondiscrimination Visit ...

  16. Health Risk Management for Bioenvironmental Engineering (United States)


    with mission objectives. Decisions that include differing objectives, knowledge, and perceptions of those affected by the decision (e.g., workplace ...factors, controlling health care costs, predicting employee absenteeism , encouraging individuals to take a proactive stance concerning personal

  17. Health system strengthening and hypertension management in China. (United States)

    Huang, Kehui; Song, Yu Ting; He, Yong Huan; Feng, Xing Lin


    Non-communicable diseases are the leading causes of global burden of diseases, and hypertension is one of the most important risk factors. Hypertension prevalence doubled in China in the past decade and affects more than 300 million Chinese people. In the review we systematically searched peer-reviewed publications that link health system level factors with hypertension management in China and provide the current knowledge on how to improve a country's health system to manage the hypertension epidemic. A framework was developed to guide the review. The database of PubMed, CNKI were systematically searched from inception to April 13, 2016. Two authors independently screened the searched results for inclusion, conducted data extraction and appraised the quality of studies. Key findings were described according to the framework. Five hundred seventy-two publications were identified, where 11 articles were left according to the inclusion and exclusion criteria. The study periods range from 2010 to 2015. All about 11 researches linked health system factors to the outcome of hypertension management. And the outcomes were just focused on the awareness, treatment and control of hypertension but not hypertension incidence. One study is about the role of health system governance, investigating the performance of different organized community health care centers; three studies were about health financing comparing differences in insurance coverage; three studies were about health information practicing the hypertension guidelines of China or the WHO, and the rest three about mechanisms of health service delivery. No researches were identified about physical resources for health and human resources for health. Hypertension prevalence has been rising rapidly in China and the management of hypertension in China is a detection problem rather than treatment problem. Limited evidence shows the positive effect of health system factors on hypertension management and joint efforts

  18. [Health alert management and emerging risk]. (United States)

    Pillonel, J


    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  19. The importance of mineral in animal foodstuff and its status in ruminants breeding in Malaysia

    International Nuclear Information System (INIS)

    Wan Zahari Mohamed


    A major constraint to maximizing productivity in ruminants in most developing countries are mineral imbalances; specifically deficiencies and toxicities. This paper attempts to present a comprehensive account of their occurences and the severity of mineral deficiencies in grazing ruminants in Malaysia, based on studies under extensive management and improved feeding systems. The importance of minerals in the nutrition of these animals will be highlighted. Data of mineral levels in the blood and tissues of indigenous swamp buffaloes (Bubalus bubalis), Kedah-Kelantan cattle, sheep and goats will be presented. This paper will also review the mineral levels in animal tissues, plants and soil and usage of these data for predicting the mineral status of ruminants as well as the methods of mineral supplementation for deficient animals (author)

  20. Adherence to ministry of health guidelines in management of severe ...

    African Journals Online (AJOL)

    Background: Guidelines have shown to impact positively on the management of medical conditions. The impact of these guidelines has not been evaluated for severe preeclampsia and eclampsia in Kenya. Objective: To evaluate the level of adherence to Kenya Ministry of Health (MOH) guidelines in the management of ...

  1. Setting international standards for the management of public health pesticides

    NARCIS (Netherlands)

    Berg, van den H.; Yadav, R.S.; Zaim, M.


    Recent developments have highlighted the urgency of sound management of public health pesticides in vector-borne–disease–endemic countries. Major shortcomings are evident in national-level management practices throughout the pesticide life cycle from production to disposal; these shortcomings will

  2. Audit Trail Management System in Community Health Care Information Network. (United States)

    Nakamura, Naoki; Nakayama, Masaharu; Nakaya, Jun; Tominaga, Teiji; Suganuma, Takuo; Shiratori, Norio


    After the Great East Japan Earthquake we constructed a community health care information network system. Focusing on the authentication server and portal server capable of SAML&ID-WSF, we proposed an audit trail management system to look over audit events in a comprehensive manner. Through implementation and experimentation, we verified the effectiveness of our proposed audit trail management system.

  3. Herd health and production management in dairy practice.

    NARCIS (Netherlands)

    Brand, A.; Noordhuizen, J.P.T.M.; Schukken, Y.H.


    This text aims to teach students, practitioners and farm advisors how to give management support to the dairy farmer in order to optimize the health, productivity and welfare of his herd. The book covers management practices and farm conditions which have both positive and negative influences on

  4. Management of health, safety and environment in process industry

    DEFF Research Database (Denmark)

    Duijm, Nijs Jan; Fiévez, C.; Gerbec, M.


    The present status of industrial HSE management in a number of EU member states is reviewed, with a focus on the integration of health, safety and environment in single management systems. The review provides insight into the standards and paradigms adopted by industry, and it identifies trends...

  5. Design for sustainable development : environmental management and safety and health

    NARCIS (Netherlands)

    Zwetsloot, G.; Bos, J.


    This is a report on the EU's environmental management and audit scheme and its interaction with the management of safety and health. The focus is on the interactions at company and at policy level. To illustrate the relevance of the interactions at company level, the Annex includes five case studies

  6. Fish health status, research and management in East Africa: past ...

    African Journals Online (AJOL)

    This paper reviews the state of research on fish pathogens in Burundi, Kenya, Rwanda, Tanzania and Uganda from the early 1900s, the period when fisheries management started in the region, to date, and evaluates the current policy, regulatory frameworks, management practices and frameworks for addressing fish health ...

  7. Mental Health Professionals' Suicide Risk Assessment and Management Practices. (United States)

    Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard


    Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

  8. Using systems science for population health management in primary care. (United States)

    Li, Yan; Kong, Nan; Lawley, Mark A; Pagán, José A


    Population health management is becoming increasingly important to organizations managing and providing primary care services given ongoing changes in health care delivery and payment systems. The objective of this study is to show how systems science methodologies could be incorporated into population health management to compare different interventions and improve health outcomes. The New York Academy of Medicine Cardiovascular Health Simulation model (an agent-based model) and data from the Behavioral Risk Factor Surveillance System were used to evaluate a lifestyle program that could be implemented in primary care practice settings. The program targeted Medicare-age adults and focused on improving diet and exercise and reducing weight. The simulation results suggest that there would be significant reductions projected in the proportion of the Medicare-age population with diabetes after the implementation of the proposed lifestyle program for a relatively long term (3 and 5 years). Similar results were found for the subpopulations with high cholesterol, but the proposed intervention would not have a significant effect in the proportion of the population with hypertension over a time period of Systems science methodologies can be useful to compare the health outcomes of different interventions. These tools can become an important component of population health management because they can help managers and other decision makers evaluate alternative programs in primary care settings. © The Author(s) 2014.

  9. Trait Rumination Predicts Elevated Evening Cortisol in Sexual and Gender Minority Young Adults. (United States)

    Zoccola, Peggy M; Manigault, Andrew W; Figueroa, Wilson S; Hollenbeck, Cari; Mendlein, Anna; Woody, Alex; Hamilton, Katrina; Scanlin, Matt; Johnson, Ryan C


    Stress may contribute to illness through the impaired recovery or sustained activity of stress-responsive biological systems. Rumination, or mental rehearsal of past stressors, may alter the body's stress-responsive systems by amplifying and prolonging exposure to physiological mediators, such as cortisol. The primary aim of the current investigation was to test the extent to which the tendency to ruminate on stress predicts diminished diurnal cortisol recovery (i.e., elevated evening cortisol) in a sample of sexual and gender minority young adults. Participants included 58 lesbian, gay, bisexual, and transgender young adults ( M age = 25.0, SD = 4.1) who completed an initial online survey that assessed trait rumination and current depressed mood. Participants completed daily evening questionnaires and provided salivary cortisol samples at wake, 45 min post-wake, 12 h post-wake, and at bedtime over seven consecutive days. Trait rumination predicted significantly higher cortisol concentrations at bedtime, but was unrelated to other cortisol indices (e.g., morning cortisol, diurnal slope, total output). The association with trait rumination was not accounted for by daily negative affect, and was largely independent of depressed mood. These results have implications for identifying and treating those who may be at risk for impaired diurnal cortisol recovery and associated negative health outcomes.

  10. Trait Rumination Predicts Elevated Evening Cortisol in Sexual and Gender Minority Young Adults

    Directory of Open Access Journals (Sweden)

    Peggy M. Zoccola


    Full Text Available Stress may contribute to illness through the impaired recovery or sustained activity of stress-responsive biological systems. Rumination, or mental rehearsal of past stressors, may alter the body’s stress-responsive systems by amplifying and prolonging exposure to physiological mediators, such as cortisol. The primary aim of the current investigation was to test the extent to which the tendency to ruminate on stress predicts diminished diurnal cortisol recovery (i.e., elevated evening cortisol in a sample of sexual and gender minority young adults. Participants included 58 lesbian, gay, bisexual, and transgender young adults (Mage = 25.0, SD = 4.1 who completed an initial online survey that assessed trait rumination and current depressed mood. Participants completed daily evening questionnaires and provided salivary cortisol samples at wake, 45 min post-wake, 12 h post-wake, and at bedtime over seven consecutive days. Trait rumination predicted significantly higher cortisol concentrations at bedtime, but was unrelated to other cortisol indices (e.g., morning cortisol, diurnal slope, total output. The association with trait rumination was not accounted for by daily negative affect, and was largely independent of depressed mood. These results have implications for identifying and treating those who may be at risk for impaired diurnal cortisol recovery and associated negative health outcomes.

  11. Implementing comprehensive health care management for sickle ...

    African Journals Online (AJOL)


    May 28, 2015 ... adopted as the strategy for the management of SCD and this has resulted in the ... Therefore, there is a need to adapt this form of care for the low-resource settings in ..... Omilola B. Patterns and trends of child and maternal ...

  12. An Application of Business Process Management to Health Care Facilities. (United States)

    Hassan, Mohsen M D

    The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella. Furthermore, the suggested application of business process management can guide and relieve them from selecting among these approaches, as well as provide them with specific steps and actions that they can follow. This article fills a gap in the literature by presenting a much needed comprehensive application of business process management to health care facilities that has specific steps and actions for implementation.

  13. Management of Health Information in Malawi: Role of Technology

    Directory of Open Access Journals (Sweden)

    Patrick Albert Chikumba


    Full Text Available This paper is an extended version of the conference paper presented at IST Africa Week Conference 2016 and it discusses in detail the existing technology gaps using DHIS2 (District Health Information System 2.0 as an example, and how Geographic Information System (GIS and mobile application, as specific examples of technology, can enhance health management information system (HMIS in Malawi. The paper focuses on management of health information. When organisation information is made available, it is expected that the decision-makers use it objectively making rational decisions. This can be achieved by how the information is organized, integrated and presented probably through technology. Along with the increase in strengthening HMIS, questions of how to support the management of information at various organizational levels arise. Research on technologies in health management in developing countries has been on single technologies. Therefore, in this paper, the interest is on multiple technologies and how they support each other to enhance health information management. It has been observed that when it comes to health information management, HMIS employs a mix of paper-based and technology-based practices. Taking into account the infrastructure in Malawi, as in many developing countries, this is probably the most feasible approach. Hence, discussions of existing technology gaps include both paper-based and technology-based practices and how to better support health information management practices through this mixed use of media. The case study confirms that technology plays a role in strengthening HMIS. However, this should be supported by enhancing a culture of information management. It has been noted that DHIS2 is the main information system but it requires the enhancement through inclusions of other technologies. The DHIS2 alone cannot do everything.

  14. Priority issues in tropical animal health management | Etuk | Animal ...

    African Journals Online (AJOL)

    The potential of livestock to sustain family and local economies have been acknowledged worldwide. However, the major constraints to the attainment of this potential especially in the tropics have been the incidence of disease and sundry ill health. Thus the development of an effective animal health management strategy ...

  15. Knowledge management, health information technology and nurses' work engagement

    NARCIS (Netherlands)

    Hendriks, P.H.J.; Ligthart, P.E.M.; Schouteten, R.L.J.


    BACKGROUND: Knowledge management (KM) extends the health information technology (HIT) literature by addressing its impact on creating knowledge by sharing and using the knowledge of health care professionals in hospitals. PURPOSE: The aim of the study was to provide insight into how HIT affects

  16. Managing Food Allergies at School: School Mental Health Professionals

    Centers for Disease Control (CDC) Podcasts


    This podcast highlights the role of school mental health professionals in the management of food allergies in schools. It also identifies CDC food allergy resources for schools.  Created: 1/20/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/20/2015.

  17. The Role of Council Health Management Team in the Improvement ...

    African Journals Online (AJOL)

    The Role of Council Health Management Team in the Improvement of Health Services Quality: The Case of Kinondoni and Ilala Municipalities in Dar es ... poor working equipment, lack of commitment on the part of members of the CHMT, lack of effective CHMTs' supervision, as well as the lack of good networking and ...

  18. Public and private roles in plant health management

    NARCIS (Netherlands)

    Oude Lansink, A.G.J.M.


    World-wide, government institutions play an important role in the management of plant health. This paper develops a conceptual framework in which suppliers and demanders jointly determine the optimal level of plant health in a hypothetical market. Next this paper argues that this market falls short

  19. Software for the occupational health and safety integrated management system

    International Nuclear Information System (INIS)

    Vătăsescu, Mihaela


    This paper intends to present the design and the production of a software for the Occupational Health and Safety Integrated Management System with the view to a rapid drawing up of the system documents in the field of occupational health and safety

  20. Evaluation of two communication strategies to improve udder health management

    NARCIS (Netherlands)

    Jansen, J.; Renes, R.J.; Lam, T.J.G.M.


    Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers’ udder health management, tools such as

  1. Software for the occupational health and safety integrated management system

    Energy Technology Data Exchange (ETDEWEB)

    Vătăsescu, Mihaela [University Politehnica Timisoara, Department of Engineering and Management, 5 Revolutiei street, 331128 Hunedoara (Romania)


    This paper intends to present the design and the production of a software for the Occupational Health and Safety Integrated Management System with the view to a rapid drawing up of the system documents in the field of occupational health and safety.

  2. Financial aspects of veterinary herd health management programmes

    NARCIS (Netherlands)

    Ifende, V.I.; Derks, M.; Hooijer, G.A.; Hogeveen, H.


    Veterinary herd health management (VHHM) programmes are meant to support herd health and farmers’ income (Brand and Guard 1996). They were introduced in the Netherlands in the 1970s (Sol and Renkema 1984) and at present many veterinarians provide them to farmers. VHHM comprises a basic structure of

  3. An Examination of Health Information Management by the Deaf (United States)

    Karras, Elizabeth


    Little is known about how Deaf people perceive, access, and utilize interpersonal and media sources for health information. In light of the scarcity of research on health information management among this group, a two-phase study was conducted that included eight focus groups (N=39) and survey data (N=366) with Deaf participants to determine the…

  4. Reusable Rocket Engine Turbopump Health Management System (United States)

    Surko, Pamela


    A health monitoring expert system software architecture has been developed to support condition-based health monitoring of rocket engines. Its first application is in the diagnosis decisions relating to the health of the high pressure oxidizer turbopump (HPOTP) of Space Shuttle Main Engine (SSME). The post test diagnostic system runs off-line, using as input the data recorded from hundreds of sensors, each running typically at rates of 25, 50, or .1 Hz. The system is invoked after a test has been completed, and produces an analysis and an organized graphical presentation of the data with important effects highlighted. The overall expert system architecture has been developed and documented so that expert modules analyzing other line replaceable units may easily be added. The architecture emphasizes modularity, reusability, and open system interfaces so that it may be used to analyze other engines as well.

  5. A new complementary approach for oral health and diabetes management

    DEFF Research Database (Denmark)

    Cinar, Ayse Basak; Freeman, Ruth; Schou, Lone


    BACKGROUND: 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. METHODS: This stratified random prospective study selected type 2 diabetes patients in Turkey (n = 186) (TR) (2010...... 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....


    Directory of Open Access Journals (Sweden)

    Nitin M. LABHANE


    Full Text Available The study of morphology of embryo is very significant considering the fact that the embryo represents the important step in the determination of the viability of the seed. Ruminate endosperm has been reported in about 58 families of angiosperms. The rumination caused by the activity of the seed coat or by the endosperm itself is quite recurrent in angiosperm. Ruminate endosperm due to seed coat is reported from the family Acanthaceae in Andrographis paniculata. The rumination of endosperm is also considered as phylogenetically important. Rumination of endosperm is very common, however very little is known about rumination in embryo. The present papers reports the de novo development of ruminate embryo in Blepharis repens. The development of ruminate embryo is seen as an adaptation to ensure proper aeration and optimum germination for survival of the species.

  7. Rural health service managers' perspectives on preparing rural health services for climate change. (United States)

    Purcell, Rachael; McGirr, Joe


    To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

  8. Data Management for Evaluating Complications of Health Care


    Streed, Stephen A.; Massanari, R. Michael


    This paper describes the design and operating characteristics of a microcomputer-based data management system for assessing complications associated with the delivery of health care. The system was developed in response to the need to promote “risk management” as an essential component of the Quality Assurance effort within the health care delivery environment. The system herein described allows the epidemiological evaluation of complications of health care in a tertiary care referral center....

  9. Best practices in managing child and adolescent behavioral health emergencies. (United States)

    Feuer, Vera; Rocker, Joshua; Saggu, Babar M; Andrus, Jason M


    Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies.

  10. Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers. (United States)

    King, Robert


    In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Routine monitoring of caseload, especially by a workplace

  11. Research on prognostics and health management of underground pipeline (United States)

    Zhang, Guangdi; Yang, Meng; Yang, Fan; Ni, Na


    With the development of the city, the construction of the underground pipeline is more and more complex, which has relation to the safety and normal operation of the city, known as "the lifeline of the city". First of all, this paper introduces the principle of PHM (Prognostics and Health Management) technology, then proposed for fault diagnosis, prognostics and health management in view of underground pipeline, make a diagnosis and prognostics for the faults appearing in the operation of the underground pipeline, and then make a health assessment of the whole underground pipe network in order to ensure the operation of the pipeline safely. Finally, summarize and prospect the future research direction.

  12. Employee weight management through health coaching. (United States)

    Merrill, R M; Aldana, S G; Bowden, D E


    This study will evaluate the effectiveness of an interactive health coaching intervention at lowering weight. The study involved 5405 overweight or obese employees aged 18-85, who entered the program sometime during 2001-2008. Average body mass index (BMI) significantly decreased from 32.1 at baseline to 31.4 at 3 months, 31.0 at 6 months, and 30.6 at 12 months. Decreasing BMI was more pronounced in older age groups and among women, those using weight loss medication, those with higher BMI, and those with higher motivation and confidence to make behavior changes. When the effects of these variables on the decreasing trend in BMI were simultaneously estimated, only baseline classifications of BMI, health status, and confidence remained significant. Change in BMI through 12 months was -0.7% for those with normal weight, -2.0% for overweight, -3.6% for obese, and -7.1% for morbidly obese individuals at baseline. Among morbidly obese individuals, decrease in BMI through 12 months was -7.6% for those with "high" confidence to lose weight at baseline vs -4.4% for those with low confidence. Better health status at baseline was also related to more pronounced weight loss. Interactive health coaching significantly lowered BMI among participants through 3, 6, and 12 months of follow-up.

  13. [Management committees in health services: an empirical study]. (United States)

    Cecilio, Luiz Carlos de Oliveira


    The aim of the article, based on field data collected from a continuing education program for primary health clinic administrators, was to analyze the functioning of a health service management strategy called "management committees". Different meanings and operational modalities emerged in the committees. Various antimonies appeared in the way the committees operate (autonomy versus heteronomy, reproduction of "instituted" versus "instituting" processes, and communicative versus instrumental reasoning), thus reflecting the level of complexity in this management mechanism. Healthcare provision per se by the clinics only appeared occasionally on the committees' agenda, which mainly focused on administrative issues. The article suggests that further research is needed on the coordinator's involvement in the field of forces constituting the management committee, besides developing pedagogical strategies to support the clinic coordinators and health teams in building the committees. The primary data were submitted to an epistemological discussion anchored in the idea of double hermeneutics, multiple validation of research results, and the relationship between theory and practice.

  14. Using matrix organization to manage health care delivery organizations. (United States)

    Allcorn, S


    Matrix organization can provide health care organization managers enhanced information processing, faster response times, and more flexibility to cope with greater organization complexity and rapidly changing operating environments. A review of the literature informed by work experience reveals that the use of matrix organization creates hard-to-manage ambiguity and balances of power in addition to providing positive benefits for health care organization managers. Solutions to matrix operating problems generally rely on the use of superior information and decision support systems and extensive staff training to develop attitudes and behavior consistent with the more collegial matrix organization culture. Further improvement in understanding the suitability of matrix organization for managing health care delivery organizations will involve appreciating the impact of partial implementation of matrix organization, temporary versus permanent uses of matrix organization, and the impact of the ambiguity created by dual lines of authority upon the exercise of power and authority.

  15. [Organization of health services and tuberculosis care management]. (United States)

    Barrêto, Anne Jaquelyne Roque; de Sá, Lenilde Duarte; Nogueira, Jordana de Almeida; Palha, Pedro Fredemir; Pinheiro, Patrícia Geórgia de Oliveira Diniz; de Farias, Nilma Maria Porto; Rodrigues, Débora Cezar de Souza; Villa, Tereza Cristina Scatena


    The scope of this study was to analyze the discourse of managers regarding the relationship between the organization of the health services and tuberculosis care management in a city in the metropolitan region of João Pessoa, State of Pernambuco. Using qualitative research in the analytical field of the French line of Discourse Analysis, 16 health workers who worked as members of the management teams took part in the study. The transcribed testimonials were organized using Atlas.ti version 6.0 software. After detailed reading of the empirical material, an attempt was made to identify the paraphrasic, polyssemic and metaphoric processes in the discourses, which enabled identification of the following discourse formation: Organization of the health services and the relation with TB care management: theory and practice. In the discourse of the managers the fragmentation of the actions of control of tuberculosis, the lack of articulation between the services and sectors, the compliance of the specific activities for TB, as well as the lack of strategic planning for management of care of the disease are clearly revealed. In this respect, for the organization of the health services to be effective, it is necessary that tuberculosis be considered a priority and acknowledged as a social problem in the management agenda.

  16. Integrating environment health and safety management at Petro-Canada

    International Nuclear Information System (INIS)

    Raymond, G.


    Petro-Canada has developed a tool to integrate, measure, and improve its management systems of environment, health, and safety (EH ampersand S). This tool, called the Total Loss Management System, is described in the areas of general management issues, policies and procedures, evaluations, organization, stewardship, issue management, and performance measures. Petro-Canada's policies on occupational health and safety are consistent with its environmental policy, being structured in the same way. An integrated audit system is used to cover health, safety, industrial hygiene, reliability, environment, and risk management. EH ampersand S matters are integrated at the corporate level in a separate department. Regional divisions review EH ampersand S performance every month, incidents are discussed, and preventive measures are taken as necessary. Regional performances are combined every quarter for ultimate presentation to the Petro-Canada board. New or emerging issues that may affect divisions are assigned an issue sponsor, a member of divisional management who makes sure the issue receives the resources necessary to study and define its impact. Examples of issues include soil contamination, process hazard management, and benzene exposure limits. Performance measures flow from the corporate environment and occupational health and safety policies, and come in two types: those that measure activities to improve performance and those that measure the outcome of the activities

  17. Health Consequences and Management of Explosive Events

    Directory of Open Access Journals (Sweden)

    Abbas Ostadtaghizadeh


    Conclusion: Because of the wide range and adverse impacts of explosions, healthcare authorities and staff should have a good grasp of preventive principles, as well as protection and management of explosion sites. Besides they have to be familiar with treating the injured. It is recommended that training courses and simulated explosive events be designed and run by the healthcare sector.

  18. Occupational health as a management tool


    Pasanen, Laura


    Abstract Optimal work performance of an employee consists of a balance between work and leisure. The personnel is more productive and satisfied if areas such as appropriate workload, healthy working conditions, effective stress management, sufficient recovery, a balanced diet and lifestyle together with a satisfactory level of physical exercise to deal with the daily demands of a job and daily life are taken care of. The wellbeing of employees has become an important issue in the bu...

  19. Stable isotope-labelled feed nutrients to assess nutrient-specific feed passage kinetics in ruminants

    NARCIS (Netherlands)

    Warner, D.; Dijkstra, J.; Hendriks, W.H.; Pellikaan, W.F.


    Knowledge of digesta passage kinetics in ruminants is essential to predict nutrient supply to the animal in relation to optimal animal performance, environmental pollution and animal health. Fractional passage rates (FPR) of feed are widely used in modern feed evaluation systems and mechanistic

  20. 9 CFR 93.436 - Ruminants from regions of minimal risk for BSE. (United States)


    ... each animal's right hip, high on the tail-head (over the junction of the sacral and first cocygeal... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Ruminants from regions of minimal risk for BSE. 93.436 Section 93.436 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...

  1. Effects of roughage inclusion and particle size on performance and rumination behavior of finishing beef steers (United States)

    Roughage is mechanically processed to increase digestibility, and handling and mixing characteristics in finishing diets. Roughage is fed to promote rumen health and decrease digestive upset, but inclusion in finishing diets is limited due to the cost per unit of energy. Rumination behavior may be a...

  2. Recent developments in altering the fatty acid composition of ruminant-derived foods. (United States)

    Shingfield, K J; Bonnet, M; Scollan, N D


    There is increasing evidence to indicate that nutrition is an important factor involved in the onset and development of several chronic human diseases including cancer, cardiovascular disease (CVD), type II diabetes and obesity. Clinical studies implicate excessive consumption of medium-chain saturated fatty acids (SFA) and trans-fatty acids (TFA) as risk factors for CVD, and in the aetiology of other chronic conditions. Ruminant-derived foods are significant sources of medium-chain SFA and TFA in the human diet, but also provide high-quality protein, essential micronutrients and several bioactive lipids. Altering the fatty acid composition of ruminant-derived foods offers the opportunity to align the consumption of fatty acids in human populations with public health policies without the need for substantial changes in eating habits. Replacing conserved forages with fresh grass or dietary plant oil and oilseed supplements can be used to lower medium-chain and total SFA content and increase cis-9 18:1, total conjugated linoleic acid (CLA), n-3 and n-6 polyunsaturated fatty acids (PUFA) to a variable extent in ruminant milk. However, inclusion of fish oil or marine algae in the ruminant diet results in marginal enrichment of 20- or 22-carbon PUFA in milk. Studies in growing ruminants have confirmed that the same nutritional strategies improve the balance of n-6/n-3 PUFA, and increase CLA and long-chain n-3 PUFA in ruminant meat, but the potential to lower medium-chain and total SFA is limited. Attempts to alter meat and milk fatty acid composition through changes in the diet fed to ruminants are often accompanied by several-fold increases in TFA concentrations. In extreme cases, the distribution of trans 18:1 and 18:2 isomers in ruminant foods may resemble that of partially hydrogenated plant oils. Changes in milk fat or muscle lipid composition in response to diet are now known to be accompanied by tissue-specific alterations in the expression of one or more

  3. Guidelines for Management Information Systems in Canadian Health Care Facilities (United States)

    Thompson, Larry E.


    The MIS Guidelines are a comprehensive set of standards for health care facilities for the recording of staffing, financial, workload, patient care and other management information. The Guidelines enable health care facilities to develop management information systems which identify resources, costs and products to more effectively forecast and control costs and utilize resources to their maximum potential as well as provide improved comparability of operations. The MIS Guidelines were produced by the Management Information Systems (MIS) Project, a cooperative effort of the federal and provincial governments, provincial hospital/health associations, under the authority of the Canadian Federal/Provincial Advisory Committee on Institutional and Medical Services. The Guidelines are currently being implemented on a “test” basis in ten health care facilities across Canada and portions integrated in government reporting as finalized.

  4. Dietary strategies to reduce methane emissions from ruminants


    Zijderveld, van, S.M.


    Ruminant products form an important part of the human diet. The demand for ruminant products is expected to increase due to the increase in the size of the human population and its increasing wealth. The production of ruminant meat and milk is associated with a relatively large environmental impact when compared to other animal products. This is, for a large part, caused by the fact that ruminants produce enteric methane, a greenhouse gas, during the digestion of their feed. Many dietary str...

  5. Public health laboratory quality management in a developing country. (United States)

    Wangkahat, Khwanjai; Nookhai, Somboon; Pobkeeree, Vallerut


    The article aims to give an overview of the system of public health laboratory quality management in Thailand and to produce a strengths, weaknesses, opportunities and threats (SWOT) analysis that is relevant to public health laboratories in the country. The systems for managing laboratory quality that are currently employed were described in the first component. The second component was a SWOT analysis, which used the opinions of laboratory professionals to identify any areas that could be improved to meet quality management systems. Various quality management systems were identified and the number of laboratories that met both international and national quality management requirements was different. The SWOT analysis found the opportunities and strengths factors offered the best chance to improve laboratory quality management in the country. The results are based on observations and brainstorming with medical laboratory professionals who can assist laboratories in accomplishing quality management. The factors derived from the analysis can help improve laboratory quality management in the country. This paper provides viewpoints and evidence-based approaches for the development of best possible practice of services in public health laboratories.

  6. Investigation of health care waste management in Binzhou District, China

    International Nuclear Information System (INIS)

    Ruoyan, Gai; Xu Lingzhong; Li Huijuan; Zhou Chengchao; He Jiangjiang; Yoshihisa, Shirayama; Tang Wei; Chushi, Kuroiwa


    In China, national regulations and standards for health care waste management were implemented in 2003. To investigate the current status of health care waste management at different levels of health care facilities (HCF) after the implementation of these regulations, one tertiary hospital, one secondary hospital, and four primary health care centers from Binzhou District were visited and 145 medical staff members and 24 cleaning personnel were interviewed. Generated medical waste totaled 1.22, 0.77, and 1.17 kg/bed/day in tertiary, secondary, and primary HCF, respectively. The amount of medical waste generated in primary health care centers was much higher than that in secondary hospitals, which may be attributed to general waste being mixed with medical waste. This study found that the level of the HCF, responsibility for medical waste management in departments and wards, educational background and training experience can be factors that determine medical staff members' knowledge of health care waste management policy. Regular training programs and sufficient provision of protective measures are urgently needed to improve occupational safety for cleaning personnel. Financing and administrative monitoring by local authorities is needed to improve handling practices and the implementation of off-site centralized disposal in primary health care centers.

  7. Managing equality and cultural diversity in the health workforce. (United States)

    Hunt, Beverley


    This article offers practical strategies to managers and others for supporting overseas trained nurses and managing cultural diversity in the health workforce. Widespread nursing shortages have led managers to recruit nurses from overseas, mainly from developing countries. This paper draws on evidence from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study reported elsewhere in this issue, which indicates that overseas trained nurses encountered widespread discriminatory practices including an overuse of complaints and grievances against them. The researchers also found that the overseas trained nurses responded to their experiences by using various personal strategies to resist or re-negotiate and overcome such discriminatory practices. A research workshop was held in June 2005 at the midpoint of the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study. Twenty-five participants attended the workshop. They were the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study researchers, advisory group members, including the author of this paper and other researchers in the field of migration. The overall aim of the workshop was to share emerging research data from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals and related studies. The final session of the workshop on which this paper is based, was facilitated by the author, with the specific aim of asking the participants to discuss and determine the challenges to managers when managing a culturally diverse workforce. The discussion yielded four main themes collated by the author from which a framework of strategies to facilitate equality and cultural diversity management of the healthcare workers may be developed. The four themes are: assumptions and expectations; education and training to include

  8. Assessment, authorization and access to medicaid managed mental health care. (United States)

    Masland, Mary C; Snowden, Lonnie R; Wallace, Neal T


    Examined were effects on access of managed care assessment and authorization processes in California's 57 county mental health plans. Primary data on managed care implementation were collected from surveys of county plan administrators; secondary data were from Medicaid claims and enrollment files. Using multivariate fixed effects regression, we found that following implementation of managed care, greater access occurred in county plans where assessments and treatment were performed by the same clinician, and where service authorizations were made more rapidly. Lower access occurred in county plans where treating clinicians authorized services themselves. Results confirm the significant effects of managed care processes on outcomes and highlight the importance of system capacity.

  9. Integrated Systems Health Management (ISHM) Toolkit (United States)

    Venkatesh, Meera; Kapadia, Ravi; Walker, Mark; Wilkins, Kim


    A framework of software components has been implemented to facilitate the development of ISHM systems according to a methodology based on Reliability Centered Maintenance (RCM). This framework is collectively referred to as the Toolkit and was developed using General Atomics' Health MAP (TM) technology. The toolkit is intended to provide assistance to software developers of mission-critical system health monitoring applications in the specification, implementation, configuration, and deployment of such applications. In addition to software tools designed to facilitate these objectives, the toolkit also provides direction to software developers in accordance with an ISHM specification and development methodology. The development tools are based on an RCM approach for the development of ISHM systems. This approach focuses on defining, detecting, and predicting the likelihood of system functional failures and their undesirable consequences.

  10. Disability management: the application of preventive measures, health promotion and case management in Italy. (United States)

    La Torre, G; De Giusti, M; Mannocci, A; De Waure, C; Agostinelli, A; Schena, S; Capelli, G; Ricciardi, W; Boccia, A; Damiani, G; von Pinoci, M; Fanton, C; Federico, B


    Disability Management can be defined as a practice to improve workers' health and to reduce the impact and costs of disability. The aim of the study was to estimate the diffusion of DM in Italian companies. A survey was conducted using a questionnaire, the Worksite Disability Management Audit. The questionnaire was structured into five parts addressing the following domains: 1) characteristics of the company; 2) health promotion activities; 3) preventive measures; 4) case management; 5) disability management. We selected public and private companies and collected information by direct interview. Twenty companies entered the survey. Twelve Companies (60%) indicated that health promotion programs and sensibilisation campaigns are usually carried out. The presence of an individual who provided workplace safety indications and materials was stated by 19 companies (95%). Periodical medical examinations are carried out by 19 companies (95%); 16 (80%) have an evaluation process for ergonomics concerns. Risk assessment and analysis are performed by all companies and the security procedures and policies are updated at least once in a year in 40% of cases. Health status monitoring of injured workers is performed in eight (40%) of the companies, while Disability Management is present as a whole in only three companies. This survey highlights that Disability Management is not undertaken in most companies and that, where applied, there is still confusion and disorganization about ways to promote health and manage workers' illness and disability. Hence, there is still the need to promote an all-inclusive evaluation and management of workers' safety, illness and disabilities.

  11. 9 CFR 93.429 - Ruminants for immediate slaughter. (United States)


    ... IMPORTATION OF CERTAIN ANIMALS, BIRDS, FISH, AND POULTRY, AND CERTAIN ANIMAL, BIRD, AND POULTRY PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.429 Ruminants for immediate slaughter. Ruminants, other than sheep and goats, may be imported from Mexico, subject to the...

  12. 9 CFR 93.425 - Declaration for ruminants. (United States)


    ... CERTAIN ANIMALS, BIRDS, FISH, AND POULTRY, AND CERTAIN ANIMAL, BIRD, AND POULTRY PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.425 Declaration for ruminants. For all ruminants offered for importation from Mexico, the importer or his or her agent shall present...

  13. Fungal treated lignocellulosic biomass as ruminant feed ingredient: A review

    NARCIS (Netherlands)

    Kuijk, van S.J.A.; Sonnenberg, A.S.M.; Baars, J.J.P.; Hendriks, W.H.; Cone, J.W.


    In ruminant nutrition, there is an increasing interest for ingredients that do not compete with human nutrition. Ruminants are specialists in digesting carbohydrates in plant cell walls; therefore lignocellulosic biomass has potential in ruminant nutrition. The presence of lignin in biomass,

  14. Dietary strategies to reduce methane emissions from ruminants

    NARCIS (Netherlands)

    Zijderveld, van S.M.


    Ruminant products form an important part of the human diet. The demand for ruminant products is expected to increase due to the increase in the size of the human population and its increasing wealth. The production of ruminant meat and milk is associated with a relatively large environmental

  15. The Role of Parenting in the Development of Rumination


    Douglas, Jessica


    Abstract Background Research suggests that rumination predicts depression in adult and adolescent populations and there is increasing evidence that rumination is a transdiagnostic factor across psychological disorders. Whilst researchers have stressed the importance of understanding the developmental antecedents of rumination and a number of hypotheses have been posited, this area has received little research attention. Additionally, the majority of existing research has ...

  16. Using objectives for managing safety and health

    International Nuclear Information System (INIS)

    Shoemaker, D.R.


    This morning I am going to talk about the International Mine Safety Rating System of the International Loss Control Institute. At the Questa mine we simply call it the ILCI System. The ILCI System has been in effect at Questa since 1982. Today, I want to offer you an outline of the system and a little bit of our experience with the system at Molycorp. In 1965, Molycorp started large-scale open-pit mining at Questa, New Mexico. In 1978 the decision was made to phase out surface mining and develop a large underground mine. Construction started in 1979, and production commenced in 1983. In 1982, with a work force approaching 900, and a 15-man safety department, we had an accident frequency rate twice the national average. At that point, as we were preparing to start underground production, we decided to become part of the International Safety Rating System. The International Safety Rating System (ISRS) is a modern safety program evaluation system. It provides the means for a systematic analysis of each element of the safety program to determine the extent and quality of management control. Auditing has long been an accepted management practice to ensure that critical business operations are performed in an efficient and profitable manner. Likewise, management has inadequate verification of the effectiveness of a safety program without the kind of audit this rating system provides. Today, largely because of the ILCI system our accident/incident rate has dropped to almost half the national average. Our production costs are nearly half of their historical high. A significant part of the savings has come from decreased expenditures for total accident losses as a result of our lower accident rates

  17. Training working memory to reduce rumination.

    Directory of Open Access Journals (Sweden)

    Thomas Onraedt

    Full Text Available Cognitive symptoms of depression, such as rumination, have shown to be associated with deficits in working memory functioning. More precisely, the capacity to expel irrelevant negative information from working memory seems to be affected. Even though these associations have repeatedly been demonstrated, the nature and causal direction of this association is still unclear. Therefore, within an experimental design, we tried to manipulate working memory functioning of participants with heightened rumination scores in two similar experiments (n = 72 and n = 45 using a six day working memory training compared to active and passive control groups. Subsequently the effects on the processing of non-emotional and emotional information in working memory were monitored. In both experiments, performance during the training task significantly increased, but this performance gain did not transfer to the outcome working memory tasks or rumination and depression measures. Possible explanations for the failure to find transfer effects are discussed.

  18. Occupational health management system: A study of expatriate construction professionals. (United States)

    Chan, I Y S; Leung, M Y; Liu, A M M


    Due to its direct impact on the safety and function of organizations, occupational health has been a concern of the construction industry for many years. The inherent complexity of occupational health management presents challenges that make a systems approach essential. From a systems perspective, health is conceptualized as an emergent property of a system in which processes operating at the individual and organizational level are inextricably connected. Based on the fundamental behavior-to-performance-to-outcome (B-P-O) theory of industrial/organizational psychology, this study presents the development of an I-CB-HP-O (Input-Coping Behaviors-Health Performance-Outcomes) health management systems model spanning individual and organizational boundaries. The model is based on a survey of Hong Kong expatriate construction professionals working in Mainland China. Such professionals tend to be under considerable stress due not only to an adverse work environment with dynamic tasks, but also the need to confront the cross-cultural issues arising from expatriation. A questionnaire was designed based on 6 focus groups involving 44 participants, and followed by a pilot study. Of the 500 questionnaires distributed in the main study, 137 valid returns were received, giving a response rate of 27.4%. The data were analyzed using statistical techniques such as factor analysis, reliability testing, Pearson correlation analysis, multiple regression modeling, and structural equation modeling. Theories of coping behaviors and health performance tend to focus on the isolated causal effects of single factors and/or posits the model at single, individual level; while industrial practices on health management tend to focus on organizational policy and training. By developing the I-CB-HP-O health management system, incorporating individual, interpersonal, and organizational perspectives, this study bridges the gap between theory and practice while providing empirical support for a

  19. Analysis of the new health management based on health internet of things and cloud computing (United States)

    Liu, Shaogang


    With the development and application of Internet of things and cloud technology in the medical field, it provides a higher level of exploration space for human health management. By analyzing the Internet of things technology and cloud technology, this paper studies a new form of health management system which conforms to the current social and technical level, and explores its system architecture, system characteristics and application. The new health management platform for networking and cloud can achieve the real-time monitoring and prediction of human health through a variety of sensors and wireless networks based on information and can be transmitted to the monitoring system, and then through the software analysis model, and gives the targeted prevention and treatment measures, to achieve real-time, intelligent health management.


    Directory of Open Access Journals (Sweden)

    Gloria Beatriz, Orzuza


    Full Text Available The passage of time brings us new knowledge, science advances in all its aspects, which translates to all areas of the organization, of management.Health care is undergoing marked changes, the welfare model, which serves as a function of demand is gradually adapting to the actions recommended by the sanitary model that acts more intensely with the communities and the environment, promoting health and preventing disease.The aim of this paper is to reflect the change that occurred in the organizational philosophy of the health system of Misiones. To this end, we first know the concepts of Newtonian and quantum organizations, focused from its philosophical origins. Second, we will refer to the legal framework of the management expenses of the Province government. Third, we analyze the socioeconomic status of the population of Misiones. Fourth, we will refer to the new health paradigm. To finish off highlighting the definitive implementation of a holistic approach, in the health system.

  1. Time based management in health care system: The chosen aspects

    Directory of Open Access Journals (Sweden)

    Joanna Kobza


    Full Text Available Time-based management (TBM is the key element of the whole management process. For many years in health care systems of highly developed countries modern and effective methods of time-based management have been implemented in both primary health care and hospitals (emergency departments and operating rooms. Over the past two decades a systematic review of Polish literature (since 1990 and peer reviewed articles published in international journals based on PubMed/Medline (2001–2011 have been carried out. The collected results indicate that the demographic and health changes in the populations are one of the main challenges facing general practitioners in the nearest future. Time-based management needs new and effective tools and skills, i.e., identification of priorities, well designed planning, delegation of the tasks, proper coordination, and creation of primary care teams that include additional members and human resources management. Proper reimbursement of health services, development of IT in health care system, better collection, storage, processing, analysis and exchange of information and research findings will also be needed. The use of innovative technologies, like telemedicine consultations, provides the possibility of reducing waiting time for diagnosis and treatment and in some cases could be applied in terms of secondary care. To improve the efficiency of operating rooms it is necessary to introduce different solutions, such as operating room coordinator involvement, application of automation to guide decision-making or use of robotic tools to assist surgical procedures. Overcrowded emergency departments have a major detrimental effect on the quality of hospital functions, therefore, efforts should be made to reduce them. Time-based management training among physicians and health care management in Poland, as well as the implementation of practice-based solutions still applied in highly developed countries seem to be necessary

  2. Veterinary dairy herd health management in Europe: constraints and perspectives. (United States)

    Cannas da Silva, J; Noordhuizen, J P T M; Vagneur, M; Bexiga, R; Gelfert, C C; Baumgartner, W


    The nature of veterinary work in dairy health management in Europe has changed over the past years and will change even more dramatically in the near future. The consumers and the media show increasing concern about animal welfare, safety of products of animal origin and traceability of animal products. Farmers in Europe have to produce under strict, often expensive and laborious regulations, while still commercially competing with farmers outside the EU and not subject to the same rules. Veterinarians should adapt their knowledge and skills to the new challenges and developments of the dairy sector. Dairy farmers nowadays ask for support in areas that go beyond clinical activities: environmental protection, welfare, nutrition, grassland management, economics and business management. Bovine practitioners should be able to advise in many different areas and subjects--that is the challenge to our profession. Veterinary education with regards to cattle health management should start with individual animal clinical work, which constitutes the basis of herd health advisory programmes. The bovine practitioner should then look beyond that and regard the herd as the unit. Each diseased cow or group of cows should be detected early enough to avoid financial losses or such losses should be prevented altogether by detecting and managing risk factors contributing to disease occurrence. Herd health and production management programmes represent the first level to optimise dairy farm performance. Expansions to that should further be considered, comprising both animal health and welfare issues, as well as food safety and public health issues. The latter could be addressed by quality risk management programmes following the HACCP-principles. Cattle veterinarians should follow recent developments and invest in new skills and knowledge in order to maintain their usefulness to the modern dairy farmer. Finally we are convinced that the cattle practitioner should evolve into this

  3. [Time based management in health care system: the chosen aspects]. (United States)

    Kobza, Joanna; Syrkiewicz-Świtała, Magdalena


    Time-based management (TBM) is the key element of the whole management process. For many years in health care systems of highly developed countries modern and effective methods of time-based management have been implemented in both primary health care and hospitals (emergency departments and operating rooms). Over the past two decades a systematic review of Polish literature (since 1990) and peer reviewed articles published in international journals based on PubMed/Medline (2001-2011) have been carried out. The collected results indicate that the demographic and health changes in the populations are one of the main challenges facing general practitioners in the nearest future. Time-based management needs new and effective tools and skills, i.e., identification of priorities, well designed planning, delegation of the tasks, proper coordination, and creation of primary care teams that include additional members and human resources management. Proper reimbursement of health services, development of IT in health care system, better collection, storage, processing, analysis and exchange of information and research findings will also be needed. The use of innovative technologies, like telemedicine consultations, provides the possibility of reducing waiting time for diagnosis and treatment and in some cases could be applied in terms of secondary care. To improve the efficiency of operating rooms it is necessary to introduce different solutions, such as operating room coordinator involvement, application of automation to guide decision-making or use of robotic tools to assist surgical procedures. Overcrowded emergency departments have a major detrimental effect on the quality of hospital functions, therefore, efforts should be made to reduce them. Time-based management training among physicians and health care management in Poland, as well as the implementation of practice-based solutions still applied in highly developed countries seem to be necessary.

  4. Oral health and menopouse: Problems and management

    Directory of Open Access Journals (Sweden)

    Hasanuddin Thahir


    Full Text Available Globally, the number of life expectancy in worldwide population has increased compared with 1990. In 2014, the mean life expectancy have reached 75 years old, and even above 80 years in several developed countries. The interesting point is women have shown higher increase of live expectancy compared with men, Women have increased 6.6 years compared with men, 5.8 years. Better health welfare, economic  growth, and lifestyle modification suspected to be contributing in higher life expectancy worldwide. Despite the encouraging news that the age of population is increasing, the concern will be whether this longer age come with the better health condition, including oral and dental health. The presence of teeth inside the mouth is one of significant points to support one’s quality of life. This research involved 66 subjects, age between 35–60 years old, divided into two groups, menopause and non-menopause women. The research shown that tooth loss occurred more in non-menopause women than menopause woman, which is 37% woman has lost as many as 12 teeth, compared with post menopausal the toothloss only occurred in 19.6%. The treatment need of non-surgery periodontal care in non-menopausal woman higher by 37.9%, and surgery care is 23.2%, meanwhile in the menopause group, non surgery care is 30.3% and surgery care is only 9.1%. The conclusion is the teeth extractions mostly take place in the period before menopause compared post-menopausal. Treatment need is also higher before menopausal than after menopause. In order to that, the menopausal women need to have adequate dental care by the patient and the dentist as well

  5. Risk management frameworks for human health and environmental risks. (United States)

    Jardine, Cindy; Hrudey, Steve; Shortreed, John; Craig, Lorraine; Krewski, Daniel; Furgal, Chris; McColl, Stephen


    A comprehensive analytical review of the risk assessment, risk management, and risk communication approaches currently being undertaken by key national, provincial/state, territorial, and international agencies was conducted. The information acquired for review was used to identify the differences, commonalities, strengths, and weaknesses among the various approaches, and to identify elements that should be included in an effective, current, and comprehensive approach applicable to environmental, human health and occupational health risks. More than 80 agencies, organizations, and advisory councils, encompassing more than 100 risk documents, were examined during the period from February 2000 until November 2002. An overview was made of the most important general frameworks for risk assessment, risk management, and risk communication for human health and ecological risk, and for occupational health risk. In addition, frameworks for specific applications were reviewed and summarized, including those for (1)contaminated sites; (2) northern contaminants; (3) priority substances; (4) standards development; (5) food safety; (6) medical devices; (7) prescription drug use; (8) emergency response; (9) transportation; (10) risk communication. Twelve frameworks were selected for more extensive review on the basis of representation of the areas of human health, ecological, and occupational health risk; relevance to Canadian risk management needs; representation of comprehensive and well-defined approaches; generalizability with their risk areas; representation of "state of the art" in Canada, the United States, and/or internationally; and extent of usage of potential usage within Canada. These 12 frameworks were: 1. Framework for Environmental Health Risk Management (US Presidential/Congressional Commission on Risk Assessment and Risk Management, 1997). 2. Health Risk Determination: The Challenge of Health Protection (Health and Welfare Canada, 1990). 3. Health Canada Decision

  6. Safe management of waste from health-care activities

    International Nuclear Information System (INIS)

    Pruess, A.; Giroult, E.; Rushbrook, P.


    The waste produced in the course of health-care activities, from contaminated needles to radioactive isotopes, carries a greater potential for causing infection and injury than any other type of waste, and inadequate or inappropriate management is likely to have serious public health consequences and deleterious effects on the environment. This handbook - the result of extensive international consultation and collaboration - provides comprehensive guidance on safe, efficient, and environmentally sound methods for the handling and disposal of health-care wastes. The various categories of waste are clearly defined and the particular hazards that each poses are described. Considerable prominence is given to the careful planning that is essential for the success of waste management; workable means of minimizing waste production are outlined and the role of reuse and recycling of waste is discussed. Most of the text, however, is devoted to the collection, segregation, storage, transport, and disposal of wastes. Details of containers for each category of waste, labelling of waste packages, and storage conditions are provided, and the various technologies for treatment of waste and disposal of final residues are discussed at length. Advice is given on occupational safety for all personnel involved with waste handling, and a separate chapter is devoted to the closely related topic of hospital hygiene and infection control. The handbook pays particular attention to basic processes and technologies that are not only safe but also affordable, sustainable, and culturally appropriate. For health-care settings in which resources are severely limited there is a separate chapter on minimal programmes; this summarizes all the simplest and least costly techniques that can be employed for the safe management of health-care wastes. The guide is aimed at public health managers and policy-makers, hospital managers, environmental health professionals, and all administrators with an

  7. Health Information Management System for Elderly Health Sector: A Qualitative Study in Iran. (United States)

    Sadoughi, Farahnaz; Shahi, Mehraban; Ahmadi, Maryam; Davaridolatabadi, Nasrin


    There are increasing change and development of information in healthcare systems. Given the increase in aging population, managers are in need of true and timely information when making decision. The aim of this study was to investigate the current status of the health information management system for the elderly health sector in Iran. This qualitative study was conducted in two steps. In the first step, required documents for administrative managers were collected using the data gathering form and observed and reviewed by the researcher. In the second step, using an interview guide, the required information was gathered through interviewing experts and faculty members. The convenience, purposeful and snowball sampling methods were applied to select interviewees and the sampling continued until reaching the data saturation point. Finally, notes and interviews were transcribed and content analysis was used to analyze them. The results of the study showed that there was a health information management system for the elderly health sector in Iran. However, in all primary health care centers the documentation of data was done manually; the data flow was not automated; and the analysis and reporting of data are also manually. Eventually, decision makers are provided with delayed information. It is suggested that the steward of health in Iran, the ministry of health, develops an appropriate infrastructure and finally puts a high priority on the implementation of the health information management system for elderly health sector in Iran.

  8. Strategies for optimizing nitrogen use by ruminants

    DEFF Research Database (Denmark)

    Calsamiglia, S; Ferret, A; Reynolds, C K


    The efficiency of N utilization in ruminants is typically low (around 25%) and highly variable (10% to 40%) compared with the higher efficiency of other production animals. The low efficiency has implications for the production performance and environment. Many efforts have been devoted to improv......The efficiency of N utilization in ruminants is typically low (around 25%) and highly variable (10% to 40%) compared with the higher efficiency of other production animals. The low efficiency has implications for the production performance and environment. Many efforts have been devoted...

  9. Ruminant and industrially produced trans fatty acids

    DEFF Research Database (Denmark)

    Stender, Steen; Astrup, Arne; Dyerberg, Jørn


    % of the fatty acids in trans form compared to the content in ruminant fat which generally does not exceed 6%. In Western Europe, including Scandinavia, the average daily intake of IP-TFA has decreased during the recent decade due to societal pressure and a legislative ban, whereas the intake of RP-TFA has......Fatty acids of trans configuration in our food come from two different sources - industrially produced partially hydrogenated fat (IP-TFA) used in frying oils, margarines, spreads, and in bakery products, and ruminant fat in dairy and meat products (RP-TFA). The first source may contain up to 60...

  10. Roles of managers in academic health centers: strategies for the managed care environment. (United States)

    Guo, Kristina L


    This article addresses survival strategies of academic health centers (AHCs) in responding to market pressures and government reforms. Using six case studies of AHCs, the study links strategic changes in structure and management to managerial role performance. Utilizing Mintzberg's classification of work roles, the roles of liaison, monitor, entrepreneur, and resource allocator were found to be used by top-level managers as they implement strategies to enhance the viability of their AHCs. Based on these new roles, the study recommends improving management practices through education and training as well as changing organizational culture to support management decision making and foster the continued growth of managers and their AHCs.

  11. Economic Techniques of Occupational Health and Safety Management (United States)

    Sidorov, Aleksandr I.; Beregovaya, Irina B.; Khanzhina, Olga A.


    The article deals with the issues on economic techniques of occupational health and safety management. Authors’ definition of safety management is given. It is represented as a task-oriented process to identify, establish and maintain such a state of work environment in which there are no possible effects of hazardous and harmful factors, or their influence does not go beyond certain limits. It was noted that management techniques that are the part of the control mechanism, are divided into administrative, organizational and administrative, social and psychological and economic. The economic management techniques are proposed to be classified depending on the management subject, management object, in relation to an enterprise environment, depending on a control action. Technoeconomic study, feasibility study, planning, financial incentives, preferential crediting of enterprises, pricing, profit sharing and equity, preferential tax treatment for enterprises, economic regulations and standards setting have been distinguished as economic techniques.

  12. Holistic approach to fraud management in health insurance

    Directory of Open Access Journals (Sweden)

    Štefan Furlan


    Full Text Available Fraud present an immense problem for health insurance companies and the only way to fight fraud is by using specialized fraud management systems. The current research community focussed great efforts on different fraud detection techniques while neglecting other also important activities of fraud management. We propose a holistic approach that focuses on all 6 activities of fraud management, namely, (1 deterrence, (2 prevention, (3 detection, (4 investigation, (5 sanction and redress, and (6 monitoring. The main contribution of the paper are 15 key characteristics of a fraud management system, which enable construction of a fraud management system that provides effective and efficient support to all fraud management activities. We base our research on literature review, interviews with experts from different fields, and a case study. The case study provides additional confirmation to expert opinions, as it puts our holistic framework into practice.

  13. Important bioindicators for health management in Romania

    Directory of Open Access Journals (Sweden)

    Barliba I.


    Full Text Available Performance measurement is a coherent, robust, integrated, purposeful, comprehensive, efficient and transparent system. The evaluation of healthcare performance in Romania is based on four categories of bioindicators: human resources, use of services, economic and financial aspects, as well as quality. In this work, we were mainly interested in analyzing and describing these parameters. In order to illustrate the applicability of the hospital performance indicators, we considered the results obtained for these indices from the managers of three hospitals of the same level from Romania, the “Filişanilor” Hospital from Filiaşi, the Rovinari City Hospital and the Şegarcea City Hospital, and herein present them.

  14. Host specificity of the ruminal bacterial community in the dairy cow followng near-total exchange of ruminal contents (United States)

    The purpose of this study was to examine the stability and host specificity of a cow’s ruminal bacterial community following massive challenge with the ruminal microflora from another cow. In each of two experiments, one pair of cows was selected on the basis of differences in ruminal bacterial comm...

  15. An intelligent content discovery technique for health portal content management. (United States)

    De Silva, Daswin; Burstein, Frada


    Continuous content management of health information portals is a feature vital for its sustainability and widespread acceptance. Knowledge and experience of a domain expert is essential for content management in the health domain. The rate of generation of online health resources is exponential and thereby manual examination for relevance to a specific topic and audience is a formidable challenge for domain experts. Intelligent content discovery for effective content management is a less researched topic. An existing expert-endorsed content repository can provide the necessary leverage to automatically identify relevant resources and evaluate qualitative metrics. This paper reports on the design research towards an intelligent technique for automated content discovery and ranking for health information portals. The proposed technique aims to improve efficiency of the current mostly manual process of portal content management by utilising an existing expert-endorsed content repository as a supporting base and a benchmark to evaluate the suitability of new content A model for content management was established based on a field study of potential users. The proposed technique is integral to this content management model and executes in several phases (ie, query construction, content search, text analytics and fuzzy multi-criteria ranking). The construction of multi-dimensional search queries with input from Wordnet, the use of multi-word and single-word terms as representative semantics for text analytics and the use of fuzzy multi-criteria ranking for subjective evaluation of quality metrics are original contributions reported in this paper. The feasibility of the proposed technique was examined with experiments conducted on an actual health information portal, the BCKOnline portal. Both intermediary and final results generated by the technique are presented in the paper and these help to establish benefits of the technique and its contribution towards effective

  16. Ruminant Nutrition Symposium: Improving cell wall digestion and animal performance with fibrolytic enzymes. (United States)

    Adesogan, A T; Ma, Z X; Romero, J J; Arriola, K G


    This paper aimed to summarize published responses to treatment of cattle diets with exogenous fibrolytic enzymes (EFE), to discuss reasons for variable EFE efficacy in animal trials, to recommend strategies for improving enzyme testing and EFE efficacy in ruminant diets, and to identify proteomic differences between effective and ineffective EFE. A meta-analysis of 20 dairy cow studies with 30 experiments revealed that only a few increased lactational performance and the response was inconsistent. This variability is attributable to several enzyme, feed, animal, and management factors that were discussed in this paper. The variability reflects our limited understanding of the synergistic and sequential interactions between exogenous glycosyl hydrolases, autochthonous ruminal microbes, and endogenous fibrolytic enzymes that are necessary to optimize ruminal fiber digestion. An added complication is that many of the standard methods of assaying EFE activities may over- or underestimate their potential effects because they are based on pure substrate saccharification and do not simulate ruminal conditions. Our recent evaluation of 18 commercial EFE showed that 78 and 83% of them exhibited optimal endoglucanase and xylanase activities, respectively, at 50 °C, and 77 and 61% had optimal activities at pH 4 to 5, respectively, indicating that most would likely act suboptimally in the rumen. Of the many fibrolytic activities that act synergistically to degrade forage fiber, the few usually assayed, typically endoglucanase and xylanase, cannot hydrolyze the recalcitrant phenolic acid-lignin linkages that are the main constraints to ruminal fiber degradation. These factors highlight the futility of random addition of EFE to diets. This paper discusses reasons for the variable animal responses to dietary addition of fibrolytic enzymes, advances explanations for the inconsistency, suggests a strategy to improve enzyme efficacy in ruminant diets, and describes differences

  17. Managing the Social Determinants of Health: Part I: Fundamental Knowledge for Professional Case Management. (United States)

    Fink-Samnick, Ellen

    PRIMARY PRACTICE SETTING(S):: Applicable to health and behavioral health settings, wherever case management is practiced. The SDH pose major challenges to the health care workforce in terms of effective resource provision, health and behavioral health treatment planning plus adherence, and overall coordination of care. Obstacles and variances to needed interventions easily lead to less than optimal outcomes for case managers and their health care organizations. Possessing sound knowledge and clear understanding of each SDH, the historical perspectives, main theories, and integral dynamics, as well as creative resource solutions, all support a higher level of intentional and effective professional case management practice. Those persons and communities impacted most by the SDH comprise every case management practice setting. These clients can be among the most vulnerable and disenfranchised members of society, which can easily engender biases on the part of the interprofessional workforce. They are also among the costliest to care for with 50% of costs for only 5% of the population. Critical attention to knowledge about managing the SDH leverages and informs case management practice, evolves more effective programming, and enhances operational outcomes across practice settings.

  18. Fundamental Technology Development for Gas-Turbine Engine Health Management (United States)

    Mercer, Carolyn R.; Simon, Donald L.; Hunter, Gary W.; Arnold, Steven M.; Reveley, Mary S.; Anderson, Lynn M.


    Integrated vehicle health management technologies promise to dramatically improve the safety of commercial aircraft by reducing system and component failures as causal and contributing factors in aircraft accidents. To realize this promise, fundamental technology development is needed to produce reliable health management components. These components include diagnostic and prognostic algorithms, physics-based and data-driven lifing and failure models, sensors, and a sensor infrastructure including wireless communications, power scavenging, and electronics. In addition, system assessment methods are needed to effectively prioritize development efforts. Development work is needed throughout the vehicle, but particular challenges are presented by the hot, rotating environment of the propulsion system. This presentation describes current work in the field of health management technologies for propulsion systems for commercial aviation.

  19. Quality, risk management and governance in mental health: an overview. (United States)

    Callaly, Tom; Arya, Dinesh; Minas, Harry


    To consider the origin, current emphasis and relevance of the concepts of quality, risk management and clinical governance in mental health. Increasingly, health service boards and management teams are required to give attention to clinical governance rather than corporate governance alone. Clinical governance is a unifying quality concept that aims to produce a structure and systems to assure and improve the quality of clinical services by promoting an integrated and organization-wide approach towards continuous quality improvement. Many psychiatrists will find the reduction in clinical autonomy, the need to consider the welfare of the whole population as well as the individual patient for whom they are responsible, and the requirement that they play a part in a complex systems approach to quality improvement to be a challenge. Avoiding or ignoring this challenge will potentially lead to conflict with modern management approaches and increased loss of influence on future developments in mental health services.

  20. Regional governance: strategies and disputes in health region management

    Directory of Open Access Journals (Sweden)

    Adriano Maia dos Santos


    Full Text Available OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes. METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics. RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee’s permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table. The study determined that “facilitators” under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System. CONCLUSIONS The characteristics identified a regionalized system with a conflictive pattern of

  1. Managing organizational change: strategies for the female health care supervisor. (United States)

    Davies, G


    In responding to resistance to change in the current health care organization, the new female supervisor can learn to support her staff in encountering and accepting these changes. The strategies and skills discussed above are characteristic of a supervisory style that may naturally occur for women, but also can be incorporated into the leadership style of men in health care management today. Health care leaders of tomorrow must work from an androgynous framework in which the behavior patterns and responses of each gender are learned and used appropriately by both men and women. Sargent suggests that the best managers are androgynous and that this is the inevitable wave of the future. Whether man or woman, a supervisor should learn, accept, and use methods that are characteristic of both sexes to be successful in managing people. Women and men must learn from each other's strengths and share these diverse skills. Given that women now outnumber men in health care management positions and organizations are changing to a more nurturing environment, the androgynous supervisor will be the successful leader of the future. Finally, women in health care supervisory positions have the potential to bring change where it is badly needed. Women in these roles often have a system wide view of health care policy issues that recognizes less federal commitment to social programs. Many women in health care positions believe that the issues of children, women, the elderly, the poor, and the homeless need focused attention. The growing number of women in health care supervisory and leadership roles is an important factor in changing national health policy for the benefit of these groups.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Retention of health workers in Malawi: perspectives of health workers and district management

    Directory of Open Access Journals (Sweden)

    MacLachlan Malcolm


    Full Text Available Abstract Background Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. Results The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource

  3. Retention of health workers in Malawi: perspectives of health workers and district management. (United States)

    Manafa, Ogenna; McAuliffe, Eilish; Maseko, Fresier; Bowie, Cameron; MacLachlan, Malcolm; Normand, Charles


    Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques.Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the

  4. The Thai-Australian Health Alliance: developing health management capacity and sustainability for primary health care services. (United States)

    Briggs, D S; Tejativaddhana, P; Cruickshank, M; Fraser, J; Campbell, S


    There have been recent calls for a renewed worldwide focus on primary health care. The Thai-Australian Health Alliance addresses this call by developing health care management capability in primary health care professionals in rural Thailand. This paper describes the history and current activities of the Thai-Australian Health Alliance and its approaches to developing health care management capacity for primary care services through international collaborations in research, education and training over a sustained time period. The Alliance's approach is described herein as a distributed network of practices with access to shared knowledge through collaboration. Its research and education approaches involve action research, multi-methods projects, and evaluative studies in the context of workshops and field studies. WHO principles underpin this approach, with countries sharing practical experiences and outcomes, encouraging leadership and management resource networks, creating clearing houses/knowledge centres, and harmonising and aligning partners with their country's health systems. Various evaluations of the Alliance's activities have demonstrated that a capacity building approach that aligns researchers, educators and health practitioners in comparative and reflective activities can be effective in transferring knowledge and skills among a collaboration's partners. Project participants, including primary health care practitioners, health policy makers and academics embraced the need to acquire management skills to sustain primary care units. Participants believe that the approaches described herein were crucial to developing the management skills needed of health care professionals for rural and remote primary health care. The implementation of this initiative was challenged by pre-existing low opinions of the importance of the management role in health care, but with time the Alliance's activities highlighted for all the importance of health care management

  5. Oxidative stability, lipid composition and nutritional value of ruminant meat as affected by animal feeding system, sex and common household treatments


    Boe, Roberta


    Ruminant meats have been suffered from a negative health image related to the nature of their lipid fraction, mainly due to the higher content in SFA. Even so, ruminant edible fats are the major natural source of CLA, provide proteins of high biological value and important micronutrients, such as A, group B, D and E vitamins, minerals and essential fatty acids all these components are associated with potential health benefits. Oxidation of lipids in foods is the major biochemical process that...

  6. The Oral Health Care Manager in a Patient-Centered Health Facility. (United States)

    Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley


    The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Commercial Aircraft Integrated Vehicle Health Management Study (United States)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon Monica; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.; Thomas, Megan A.


    Statistical data and literature from academia, industry, and other government agencies were reviewed and analyzed to establish requirements for fixture work in detection, diagnosis, prognosis, and mitigation for IVHM related hardware and software. Around 15 to 20 percent of commercial aircraft accidents between 1988 and 2003 involved inalftfnctions or failures of some aircraft system or component. Engine and landing gear failures/malfunctions dominate both accidents and incidents. The IVI vl Project research technologies were found to map to the Joint Planning and Development Office's National Research and Development Plan (RDP) as well as the Safety Working Group's National Aviation Safety Strategic. Plan (NASSP). Future directions in Aviation Technology as related to IVHlvl were identified by reviewing papers from three conferences across a five year time span. A total of twenty-one trend groups in propulsion, aeronautics and aircraft categories were compiled. Current and ftiture directions of IVHM related technologies were gathered and classified according to eight categories: measurement and inspection, sensors, sensor management, detection, component and subsystem monitoring, diagnosis, prognosis, and mitigation.

  8. Linking better shiftwork arrangements with safety and health management systems


    Kogi, Kazutaka


    OBJECTIVE: Various support measures useful for promoting joint change approaches to the improvement of both shiftworking arrangements and safety and health management systems were reviewed. A particular focus was placed on enterprise-level risk reduction measures linking working hours and management systems. METHODS: Voluntary industry-based guidelines on night and shift work for department stores and the chemical, automobile and electrical equipment industries were examined. Survey results t...

  9. Active Social Media Management: The Case of Health Care


    Miller, Amalia R.; Tucker, Catherine Elizabeth


    Given the demand for authentic personal interactions over social media, it is unclear how much firms should actively manage their social media presence. We study this question empirically in a health care setting. We show that active social media management drives more user-generated content. However, we find that this is due to an incremental increase in user postings from an organization's employees rather than from its clients. This result holds when we explore exogenous variation in socia...

  10. Management of pharmaceutical services in the Brazilian primary health care. (United States)

    Gerlack, Letícia Farias; Karnikowski, Margô Gomes de Oliveira; Areda, Camila Alves; Galato, Dayani; Oliveira, Aline Gomes de; Álvares, Juliana; Leite, Silvana Nair; Costa, Ediná Alves; Guibu, Ione Aquemi; Soeiro, Orlando Mario; Costa, Karen Sarmento; Guerra, Augusto Afonso; Acurcio, Francisco de Assis


    To identify limiting factors in the management of pharmaceutical services in the primary health care provided by the Brazilian Unified Health System (SUS). This study was based on the data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), and it was conducted by interviews with professionals responsible for pharmaceutical services in Brazilian cities, in 2015. To identify the management limiting factors, we considered the organizational, operational, and sustainability indicators of the management. For the analyses, we included the weights and structure of analysis plan for complex samples. The results were expressed by frequencies and measures of central tendency with 95% confidence interval, considering the Brazilian geographic regions. We identified the following limiting factors: lack of pharmaceutical services in the Municipal Health Secretariat organization chart (24%) and in the health plan (18%); lack of participation of managers in the Health Board and the absence of reference to this topic in the agenda of meetings (58.4%); lack of financial autonomy (61.5%) and lack of knowledge on the available values (81.7%); lack of adoption of operational procedures (about 50%) for selection, scheduling, and acquisition; and the fact that most professionals evaluate the organization of pharmaceutical services as good and great (58.8%), despite the worrisome indicators. Pharmaceutical services management is currently supported by a legal and political framework that should guide and contribute to improve the pharmaceutical services in the Brazilian Unified Health System primary health care. However, there is a mismatch between the goals established by these guidelines and what is actually happening.

  11. Government Health Care Contract Incentives: Making Managed Health Care Work in Federal Government Procurements

    National Research Council Canada - National Science Library

    Teskey, Mark S


    Contracting for managed health care systems is a complex undertaking. The current TRICARE contracts captured all the important parts of the system and ensured detailed compliance with the many system requirements...

  12. Health Management Technology as a General Solution Framework (United States)

    Nakajima, Hiroshi; Hasegawa, Yoshifumi; Tasaki, Hiroshi; Iwami, Taro; Tsuchiya, Naoki

    Health maintenance and improvement of humans, artifacts, and nature are pressing requirements considering the problems human beings have faced. In this article, the health management technology is proposed by centering cause-effect structure. The important aspect of the technology is evolvement through human-machine collaboration in response to changes of target systems. One of the reasons why the cause-effect structure is centered in the technology is its feature of transparency to humans by instinct point of view. The notion has been spreaded over wide application areas such as quality control, energy management, and healthcare. Some experiments were conducted to prove effectiveness of the technology in the article.

  13. Health management and controls for earth to orbit propulsion systems (United States)

    Bickford, R. L.


    Fault detection and isolation for advanced rocket engine controllers are discussed focusing on advanced sensing systems and software which significantly improve component failure detection for engine safety and health management. Aerojet's Space Transportation Main Engine controller for the National Launch System is the state of the art in fault tolerant engine avionics. Health management systems provide high levels of automated fault coverage and significantly improve vehicle delivered reliability and lower preflight operations costs. Key technologies, including the sensor data validation algorithms and flight capable spectrometers, have been demonstrated in ground applications and are found to be suitable for bridging programs into flight applications.


    Directory of Open Access Journals (Sweden)

    Kanellopoulos Dimitros


    Full Text Available In order to be the health care system sustainable , management transformations must be based on very precise diagnostic analysis that includes complete and current information. It is necessary to implement an information system that collects information in real time, that watches the parameters that significantly influence the sustainability of the system. Such an information system should point out a radiography(a scan of the system at some time under following aspects:: 1. An overview of system; 2 An overview of the economic situation; 3 A technical presentation ;4. A legal overview; 5. A social overview ; 6. A management overview .Based on these Xrays of the health system, it outlines a series of conclusions and recommendations together with a SWOT analysis that highlights the potential internal (strengths and weaknesses and external potential (opportunities and threats. Based on this analysis and recommendations, the management is going to redesign the system in order to be adapted to the changing environmental requirements. Management transformation is recommended to be by following steps. :1. The development of a new management system that would make a positive change in the health care system 2. Implementation of the new management system 3. Assessment of the changes

  15. Health care managers learning by listening to subordinates' dialogue training. (United States)

    Grill, C; Ahlborg, G; Wikström, E


    Middle managers in health care today are expected to continuously and efficiently decide and act in administration, finance, care quality, and work environment, and strategic communication has become paramount. Since dialogical communication is considered to promote a healthy work environment, the purpose of this paper is to investigate the ways in which health care managers experienced observing subordinates' dialogue training. A qualitative study using semi-structured interviews and documents from eight middle managers in a dialogue programme intervention conducted by dialogue trainers. Focus was on fostering and assisting workplace dialogue. Conventional qualitative content analysis was used. Managers' experiences were both enriching and demanding, and consisted of becoming aware of communication, meaning perceiving interaction between subordinates as well as own silent interaction with subordinates and trainer; Discovering communicative actions for leadership, by gaining self-knowledge and recognizing relational leadership models from trainers--such as acting democratically and pedagogically--and converting theory into practice, signifying practising dialogue-promoting conversation behaviour with subordinates, peers, and superiors. Only eight managers participated in the intervention, but data afforded a basis for further research. Findings stressed the importance of listening, and of support from superiors, for well-functioning leadership communication at work. Studies focusing on health care managers' communication and dialogue are few. This study contributes to knowledge about these activities in managerial leadership.

  16. Permanent education and co-management: experience of a health managing group

    Directory of Open Access Journals (Sweden)

    Diogo Faria Corrêa da Costa


    Full Text Available This paper presents the experience lived by a group of workers of the Regional Center for Action on Health of the 4th. Regional Health State Department of Health of Rio Grande do Sul in Santa Maria. The paper presents an experience of reorganization of the work process in order to tackle the historical fragmentation of activities in the field of health management, and trigger a learning process for institutional support to carry thirty-two municipalities in the area of administrative scope of this coordinating body . To do so, it relies upon the co-management strategies and continuing health education as tools to trigger processes of change and inventing other ways of designing and conducting health work. With this experience, we can dislodge established places, inventing new forms of teamwork and interdisciplinary manner in order to strengthen this group of workers and their practices.

  17. Ruminant Nutrition Symposium: ruminant production and metabolic responses to heat stress. (United States)

    Baumgard, L H; Rhoads, R P


    Heat stress compromises efficient animal production by marginalizing nutrition, management, and genetic selection efforts to maximize performance endpoints. Modifying farm infrastructure has yielded modest success in mitigating heat stress-related losses, yet poor production during the summer remains arguably the costliest issue facing livestock producers. Reduced output (e.g., milk yield and muscle growth) during heat stress was traditionally thought to result from decreased nutrient intake (i.e., a classic biological response shared by all animals during environmental-induced hyperthermia). Our recent observations have begun to challenge this belief and indicate heat-stressed animals employ novel homeorhetic strategies to direct metabolic and fuel selection priorities independently of nutrient intake or energy balance. Alterations in systemic physiology support a shift in carbohydrate metabolism, evident by increased basal and stimulated circulating insulin concentrations. Perhaps most intriguing given the energetic shortfall of the heat-stressed animal is the apparent lack of basal adipose tissue mobilization coupled with a reduced responsiveness to lipolytic stimuli. Thus, the heat stress response markedly alters postabsorptive carbohydrate, lipid, and protein metabolism independently of reduced feed intake through coordinated changes in fuel supply and utilization by multiple tissues. Interestingly, the systemic, cellular, and molecular changes appear conserved amongst different species and physiological states. Ultimately, these changes result in the reprioritization of fuel selection during heat stress, which appears to be primarily responsible for reduced ruminant animal productivity during the warm summer months.

  18. Alternatives for forage evaluation in ruminants

    NARCIS (Netherlands)

    Gosselink, J.M.J.


    The objective of this thesis was to validate and to compare in situ and in vitro techniques with in vivo data. These techniques were also evaluated for future and practical use in feed evaluation for ruminants. The techniques were compared using the digestion data of 98 forages and the energy

  19. Ruminal and Intestinal Digestibility of Leucaena Foliage

    African Journals Online (AJOL)



    Dec 30, 2013 ... Keywords: Intestinal digestibility, protein fodder, mobile nylon bag, a three-step technique ... A potential strategy for increasing the quality and availability of feed for small ruminants in the dry ... to measure intestinal disappearance of DM and CP using the mobile bag method described by De Boer et al.

  20. The transfer of a health insurance/managed care business. (United States)

    Gavin, John N; Goodman, George; Goroff, David B


    The owners of a health insurance/managed care business may want to sell that business for a variety of reasons. Health care provider systems may want to exit that business due to operating losses, difficulty in complying with regulations, the inherent conflict in operating that business as part of a provider system, or the desire to focus on being a health care provider. Health insurers/HMOs may want to sell all or a portion of their business due to operating losses, difficulty in servicing a particular market, or a desire to focus on other markets. No matter what reason prompts a seller to undertake a sale, a sale of health insurance/managed care business can be a complicated transaction involving a multitude of issues. This article will focus first on the ways in which such a sale may be structured. The article will then discuss some transactional issues that may arise in the negotiations for the sale of a health insurance/managed care business. The article will then focus on some particular legal issues that arise in each sale-e.g., antitrust, HIPAA, regulatory approvals, and charitable issues. Finally, this article will provide an overview of tax structuring considerations.

  1. Managing mechanistic and organic structure in health care organizations. (United States)

    Olden, Peter C


    Managers at all levels in a health care organization must organize work to achieve the organization's mission and goals. This requires managers to decide the organization structure, which involves dividing the work among jobs and departments and then coordinating them all toward the common purpose. Organization structure, which is reflected in an organization chart, may range on a continuum from very mechanistic to very organic. Managers must decide how mechanistic versus how organic to make the entire organization and each of its departments. To do this, managers should carefully consider 5 factors for the organization and for each individual department: external environment, goals, work production, size, and culture. Some factors may push toward more mechanistic structure, whereas others may push in the opposite direction toward more organic structure. Practical advice can help managers at all levels design appropriate structure for their departments and organization.

  2. [Local planning: the speech of basic health care center manager]. (United States)

    Cubas, Márcia Regina


    As planning is understood as a management tool, this article offers an argument through the speech framework of Basic Health Care Center Managers in the city of Curitiba-PR, by means of the Collective Subject Speech Methodology on local planning aspects. Its purpose is to bring local managers to a reflection concerning their styles, practices and experiences, as well as to collaborate with central level leading teams towards building their planning processes in an upward, participatory, communicative and strategic way. Considerations of the speeches built from central ideas are presented: planning methodology; inter-sectoriality; territorial basis; team and community participation; training, autonomy and particular profile of local managers; the manager's agenda; and institutional culture.

  3. Modification of spermatozoa quality in mature small ruminants. (United States)

    Martin, G B; de St Jorre, T Jorre; Al Mohsen, F A; Malecki, I A


    This review is based largely, but not entirely, on the assumption that gamete quality is directly linked to sperm output and thus testicular mass, an approach made necessary by the absence of a large body of data on factors that affect gamete quality in ruminants. On the other hand, there is a change in the efficiency of sperm production per gram of testicular tissue when the testis is growing or shrinking, a clear indicator of changes in the rates of cell loss during the process of spermatogenesis, probably through apoptosis. We therefore postulate that the spermatozoa that do survive when the testis is shrinking are of a lower quality than those that are produced when the testis is growing and the rate of sperm survival is increasing. In adult small ruminants in particular, testicular mass and sperm production are highly labile and can be manipulated by management of photoperiod (melatonin), nutrition, genetics and behaviour ('mating pressure'). Importantly, these factors do not act independently of each other - rather, the outcomes in terms of sperm production are dictated by interactions. It therefore seems likely that spermatozoa quality will be affected by these same factors, but definitive answers await detailed studies.

  4. Contingency Management of Health Care Organizations: It Depends. (United States)

    Olden, Peter C

    Managers in health care organizations (HCOs) must perform many processes and activities, such as planning goals, designing organization structure, leading people, motivating employees, making decisions, and resolving conflict. How they do all this strongly affects the performance and outcomes of their organizations and themselves. Some managers develop a usual way of performing their jobs and achieve some success with a preferred method of leading or a favorite approach to motivating. However, their success will be limited if they always rely on a standard "1-size-fits-all" approach. This is because contingency factors influence the effectiveness of a given approach to managing. The "best" approach depends on contingency factors, including the situation and the people involved. Managers should choose an approach to fit with the changing contingency factors. This article explains why and how managers should develop a contingency approach to managing HCOs. The development of contingency theory is briefly described. Practical application of contingency management is explained for leading, motivating, decision making, and resolving conflict. By using a contingency approach, managers can be more effective when managing their HCOs.

  5. Data Analysis of Occupational Health and Safety Management and Total Quality Management Systems

    Directory of Open Access Journals (Sweden)

    Ahmet Yakut


    Full Text Available In our study, Total Quality Management, Occupational Health and Safety on the effects of the construction industry, building sites of Istanbul evaluated with the results of the survey of 25 firms. For Occupational Health and Safety program, walked healthy, active employees in her role increased and will increase the importance of education. Due to non-implementation of the OHS system in our country enough, work-related accidents and deaths and injuries resulting from these accidents is very high. Firms as a result of the analysis, an effective health and safety management system needs to be able to fulfill their responsibilities. This system is designated as OHSAS 18001 Occupational Health and Safety Management System and the construction industry can be regarded as the imperatives.

  6. Evaluation of two communication strategies to improve udder health management. (United States)

    Jansen, J; Renes, R J; Lam, T J G M


    Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers' udder health management, tools such as instruction cards, treatment plans, checklists and software were developed following an argument-based comprehensive "central route." These tools were used during on-farm study group meetings for farmers organized by veterinarians and also during individual veterinarian-farmer interactions. The second strategy aimed at adopting a single management practice to increase the use of milking gloves during milking. This approach followed a straightforward "peripheral" route that used implicit persuasion techniques. Results of an online survey of 374 Dutch dairy farmers showed that most farmers were able and willing to use the educational management tools to increase udder health on their farms. They evaluated the tools positively regardless of the mastitis problems on their farms. This seems to indicate that the central route of communication is most effective when farmers are motivated to work on udder health in general. Results of repeated random telephone surveys before, during, and after the campaign on the use of milking gloves showed that the use of gloves increased from 20.9 to 42.0% of the respondents. Respondents' opinions about milking gloves also changed favorably, indicating that a relatively short peripheral campaign on a single action can have a sustained effect on farmers' behavior. Both communication strategies seem to be potentially successful in disseminating knowledge to a specific target group of farmers and in changing that group's behavior. However, to reach as many farmers as possible, the strategies should be combined. When optimizing these strategies, both the farmers' motivation to work on udder health and the aim of the campaign should be considered

  7. Managing workplace health promotion in municipal organizations: The perspective of senior managers. (United States)

    Larsson, Robert; Åkerlind, Ingemar; Sandmark, Hélène


    Previous research indicates that companies manage workplace health in various ways, but more in-depth empirical knowledge of how workplace health promotion (WHP) is managed in public sector organizations is needed. The aim of this study was to explore how WHP is managed and incorporated into the general management system in two large Swedish municipal organizations. A qualitative descriptive approach was used. Fourteen senior managers were purposefully selected and interviewed using semi-structured interviews. Documents were used as supplementary data. All data were analysed using qualitative content analysis. The management of WHP was described as a set of components that together contribute to the organization's capacity for WHP. The informants described WHP as dominated by fitness programmes and as following a problem-solving cycle, in which the annual employee survey emerged as an important managerial tool. Achieving feasible WHP measures and appropriate follow-ups were described as challenges. The provision of leadership competence for WHP and use of supportive resources were described as additional components. The WHP management approach needs to be broadened to include work environment and organizational factors. Further integration with occupational health and safety and the general management system in the organizations is also needed.

  8. Information security risk management for computerized health information systems in hospitals: a case study of Iran


    Zarei, Javad; Sadoughi, Farahnaz


    Javad Zarei,1 Farahnaz Sadoughi2 1Health Information Management, Health Management and Economics Research Center, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran, 2Health Information Management Department, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran Background: In recent years, hospitals in Iran – similar to those in other...

  9. [EHEC carriage in ruminants and probiotic effects]. (United States)

    Forano, Evelyne; Chaucheyras-Durand, Frédérique; Bertin, Yolande; Martin, Christine


    Enterohaemorrhagic Escherichia coli (EHEC) are Shiga-Toxin producing E. coli (STEC) that cause human outbreaks which can lead to a severe illness such as haemolytic-uraemic syndrome (HUS), particularly in young children. The gastrointestinal tract of cattle and other ruminants is the principal reservoir of EHEC strains and outbreaks have been associated with direct contact with the farm environment, and with the consumption of meat, dairy products, water and fruit or vegetable contaminated with ruminant manure. Several outbreaks occurred these last years in France. In Brazil, although STEC carriage in ruminants is important, human cases due to EHEC are fairly rare. In order to reduce EHEC survival in the ruminant gastrointestinal tract and thus limit contamination of food products, it is necessary to determine the mechanisms underlying EHEC persistence in this ecosystem with the aim of developing nutritional or ecological strategies. The effect of probiotics has been tested in vitro on the growth and survival of EHEC strains and in vivo on the animal carriage of these strains. Various studies have then shown that lactic bacteria or non-pathogenic E. coli strains were able to limit EHEC fecal shedding. In addition, understanding EHEC physiology in the ruminant gut is also critical for limiting EHEC shedding. We found that EHEC O157:H7 is able to use ethanolamine and mucus-derived sugars as nitrogen and carbon sources, respectively. Thus, these substrates represent an ecological niche for EHEC and their utilization confers a competitive growth advantage to these pathogens as they use them more rapidly than the bacteria belonging to the resident intestinal microbiota. Understanding EHEC metabolism and ecology in the bovine intestinal tract will allow proposing probiotic strains to compete with EHEC for nutrients and thus decrease the sanitary risk. © Société de Biologie, 2014.

  10. A survey of the health needs of hospital staff: implications for health care managers. (United States)

    Jinks, Annette M; Lawson, Valerie; Daniels, Ruth


    Developing strategies to address the health needs of the National Health Services (NHS) workforce are of concern to many health care managers. Focal to the development of such strategies are of being in receipt of baseline information about employees expressed health needs and concerns. This article addresses obtaining such baseline information and presents the findings of a health needs survey of acute hospital staff in a trust in North Wales. The total population of trust employees were surveyed (n = 2300) and a 44% (n = 1021) response rate was achieved. A number of positive findings are given. Included are that the majority of those surveyed stated that their current health status is good, are motivated to improve their health further, do not smoke and their alcohol consumption is within recommended levels. There appears, however, to be a number of areas where trust managers can help its staff improve their health. Included are trust initiatives that focus on weight control and taking more exercise. In addition, there appears to be a reported lack of knowledge and positive health behaviour amongst the male respondents surveyed that would imply the trust needs to be more effective in promoting well man type issues. Finally there appears to be a general lack of pride in working for the trust and a pervasive feeling that the trust does not care about its employees that needs to be addressed. It is concluded that the findings of this survey have implications for management practices in the trust where the survey was conducted and also wider applicability to the management of health care professionals. For example, addressing work-related psychological and physical problems of employees are of importance to all health care managers. This is especially so when considering recruitment and retention issues.

  11. Functioning of primary health care in opinion of managers of primary health care units. (United States)

    Bojar, I; Wdowiak, L; Kwiatosz-Muc, M


    The aim of the research is to get to know opinions of primary health care managers concerning working of primary health care and concerning quality of medical services offered by family doctors out-patient clinics. The research among managers of primary health care units took place in all out-patient clinics in Lublin province. Research instrument was survey questionnaire of authors own construction. Results were statistically analyzed. From 460 surveys sent, 108 questionnaires were accepted to analysis. Majority of managers of out-patient clinics of primary health care is satisfied with the way and the quality of work of employed staff. In opinion of 71.3% of managers access to family doctor services is very good. Availability of primary health care services is better estimated by managers of not public units. The occupied local provide comfortable work for the staff in opinion of 78.5% of surveyed managers of out-patient clinics. Managers estimate the level of their services as very good (37.96%) and good (37.96%) comparing to other such a subjects present in the market. Internal program of improving quality is run in 22% of out-patient clinics, which were investigated. Managers of primary health care units assess the quality of their services as good and very good. They estimate positively the comfort and politeness in serving patients as well as technical status of equipment and the lodging. They assess availability of their services as very good. Large group of managers of family doctors practices recognizes neighborhood practices as a competitors.

  12. Reverse quality management: developing evidence-based best practices in health emergency management. (United States)

    Lynch, Tim; Cox, Paul


    The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

  13. Consumer Health Informatics: Promoting Patient Self-care Management of Illnesses and Health. (United States)

    Jung, Minsoo

    Consumer health informatics (CHI) is propelling important changes for medical providers and the lives of patients through information and communications technology. Independently, medical consumers seek, collect, and use health information for decision making. However, when constructing a CHI-based medical platform, high technology must be applied in a fully understandable and usable format for both health care providers and consumers. This study examines the present status of CHI and its effect on medical consumers. For the development of CHI, we discuss the need for tailored health communications and capacity building with chronic patients at the medical center. First, empowerment is a key characteristic needed for medical consumer health care management. However, promoting patient self-care management of illnesses and health is necessary to create conjugation where cooperation with medical service providers is possible. Also, establishing a health care delivery system that will support cooperation is necessary. Second, tailored health communications can uniquely construct the health information of patients, which prevents unnecessary or excessive information from leading patients to confused and inappropriate decisions. Ultimately, through the present environment of health communication, the innovation of a consumer health care information system has become the tide of the times and the positive effect of improved health can be expected.

  14. Does a Culture of Happiness Increase Rumination Over Failure? (United States)

    McGuirk, Lucy; Kuppens, Peter; Kingston, Rosemary; Bastian, Brock


    Promoting happiness within society is good for health, but could the overpromotion of happiness have a downside? Across 2 studies, we investigate 2 emotion norms associated with an emphasis on happiness-the importance of (a) seeking positive emotion, and (b) avoiding negative emotion-and whether these norms have implications for how people respond to, and seek to regulate, their negative emotional experiences. In Study 1, we used an experimental design to show that emphasizing the importance of happiness increased rumination in response to failure. In Study 2, we drew on cross-sectional evidence to investigate the other side of this equation, finding that emphasizing the importance of not experiencing negative emotional states (e.g., depression and anxiety) was also associated with increased rumination, and that this had downstream consequences for well-being. Together, the findings suggest that the overpromotion of happiness, and, in turn, the felt social pressure not to experience negative emotional states, has implications for maladaptive responses to negative emotional experiences. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. [Health agencies and the every day management of bioethics]. (United States)

    Byk, Christian


    Taking into account their acquired experience, would not health agencies become the place where biomedical practices will be managed on an every day basis? Would in a near future these agencies have the role to interprete the principles of the bioethics law to adapt them to concrete issues?

  16. Managing health physics departmental data via a local area network

    International Nuclear Information System (INIS)

    Weber, P.J.; Castronovo, F.P. Jr.


    The authors describe the multiuser data management system that can be accessed simultaneously by all department members, in use at the Dept of Health Physics, Brigham and Women's Hospital, U.S.A., which makes use of the Local Area Network. (UK)

  17. Supply chain management in health services : an overview

    NARCIS (Netherlands)

    de Vries, J.; Huijsman, R.


    Purpose - This paper seeks to concentrate on the question whether any parallels can be found between the industrial sector and health care services with respect to the developments that have taken place in the area of Supply Chain Management. Starting from an analysis of existing literature, it is

  18. Managing Mental Health Crises of Foreign College Students. (United States)

    Oropeza, Barbara A. Clark; And Others


    Notes that student services professionals manage a number of mental health crises as part of their job responsibilities. Examines some issues that arise from assisting foreign college students experiencing such crises, with special focus on psychiatric committal, withdrawal from school, and return to the home country. (Author)

  19. Supporting self-management of chronic health conditions: common approaches. (United States)

    Lawn, Sharon; Schoo, Adrian


    The aims of this paper are to provide a description of the principles of chronic condition self-management, common approaches to support currently used in Australian health services, and benefits and challenges associated with using these approaches. We examined literature in this field in Australia and drew also from our own practice experience of implementing these approaches and providing education and training to primary health care professionals and organizations in the field. Using common examples of programs, advantages and disadvantages of peer-led groups (Stanford Courses), care planning (The Flinders Program), a brief primary care approach (the 5As), motivational interviewing and health coaching are explored. There are a number of common approaches used to enhance self-management. No one approach is superior to other approaches; in fact, they are often complimentary. The nature and context for patients' contact with services, and patients' specific needs and preferences are what must be considered when deciding on the most appropriate support mode to effectively engage patients and promote self-management. Choice of approach will also be determined by organizational factors and service structures. Whatever self-management support approaches used, of importance is how health services work together to provide support. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  20. 76 FR 64110 - Safety and Health Management Programs for Mines (United States)


    ... section of this notice. Comment Dates: MSHA will hold the date for comments open until all meetings are... Identification, including workplace inspections for violations of mandatory health and safety standards. Hazard.... Improved communication. Increased productivity. Increased and improved worker and management involvement in...

  1. Occupational safety and health management and risk governance

    NARCIS (Netherlands)

    Dijkman, A.; Terwoert, J.


    The advancement in new technologies, substances and new ways of working make it necessary to look beyond traditional methods of risk management. General drivers to emerging occupational safety and health (OSH) risks are: globalisation; demographic changes; technical innovations; changes in risk

  2. Health Management Information System in Private Clinics in Ilorin ...

    African Journals Online (AJOL)

    This descriptive survey was conducted among private clinics located in Ilorin, Kwara State, Nigeria to determine the awareness and level of involvement of private clinic operators towards the National Health Management Information System. A total of 37 functional clinics responded to the survey. Structured questionnaire ...

  3. Primary health care management challenges for childhood atopic ...

    African Journals Online (AJOL)

    Kaarina Frieda Meintjes

    primary health care (PHC) management of their children's atopic eczema in a Gauteng district. A qualitative, explorative, descriptive, contextual embedded single case study design ... direct observation until saturation occurred; analysed according to Tesch's ..... needed, it was provided by the researcher as part of the pro-.

  4. Outcomes Assessment in Accredited Health Information Management Programs (United States)

    Bennett, Dorine


    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  5. Training evaluation: a case study of training Iranian health managers. (United States)

    Omar, Maye; Gerein, Nancy; Tarin, Ehsanullah; Butcher, Christopher; Pearson, Stephen; Heidari, Gholamreza


    The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least useful areas were those that dealt with training and

  6. Training evaluation: a case study of training Iranian health managers

    Directory of Open Access Journals (Sweden)

    Butcher Christopher


    Full Text Available Abstract Background The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. Methods The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Results Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least

  7. Health Professionals' Expanding eHealth Competences for Supporting Patients' Self-Management. (United States)

    Kujala, Sari; Rajalahti, Elina; Heponiemi, Tarja; Hilama, Pirjo


    An increasing number of new eHealth services that support patients' self-management has changed health professionals' work and has created a need for a new eHealth competence. In this study, we evaluated the health professionals' eHealth competences and training needs in a public health organization in Finland. The target organization's goal was to increase the number of eHealth services provided to patients, and health professionals and their competences were seen as critical for the adoption of services. Data was collected through an online survey of 701 health professionals working in the target organization. Professionals perceived their basic computer skills as good and they were mostly willing to use eHealth services in patient work. However, health professionals need guidance, especially in their patient work in the new eHealth-enabled environment. They were less confident about their competence to motivate and advise patients to use eHealth services and how to communicate with patients using eHealth solutions. The results also imply that eHealth competence is not merely about an individual's skills but that organizations need to develop new working processes, work practices and distribution of work. We suggest that the training and support needs identified be considered in curricula and lifelong learning.

  8. Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records. (United States)

    Monroe, C Douglas; Chin, Karen Y


    The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.

  9. Organizing and managing care in a changing health system. (United States)

    Kohn, L T


    To examine ways in which the management and organization of medical care is changing in response to the shifting incentives created by managed care. Site visits conducted in 12 randomly selected communities in 1996/ 1997. Approximately 35-60 interviews were conducted per site with key informants in healthcare and community organizations; about half were with providers. A standardized interview protocol was implemented across all sites, enabling cross-site comparisons. Multiple respondents were interviewed on each issue. A great deal of experimentation and apparent duplication exist in efforts to develop programs to influence physician practice patterns. Responsibility for managing care is being contested by health plans, medical groups and hospitals, as each seeks to accrue the savings that can result from the more efficient delivery of care. To manage the financial and clinical risk, providers are aggressively consolidating and reorganizing. Most significant was the rapid formation of intermediary organizations, such as independent practice arrangements (IPAs), physician-hospital organizations (PHOs), or management services organizations (MSOs), for contracting with managed care organizations. Managed care appears to have only a modest effect on how healthcare organizations deliver medical care, despite the profound effect that managed care has on how providers are organized. Rather than improving the efficiency of healthcare organizations, provider efforts to build large systems and become indispensable to health plans are exacerbating problems of excess capacity. It is not clear if new organizational arrangements will help providers manage the changing incentives they face, or if their intent is to blunt the effects of the incentives by forming larger organizations to improve their bargaining power and resist change.

  10. Knowledge Management System in Health & Social Care: Review on 20 Practiced Knowledge Management

    Directory of Open Access Journals (Sweden)

    Muhammad Saiful Ridhwan


    Full Text Available The importance of managing medical information has become very critical in the healthcare delivery system. Medical information nowadays are optimized towards serving different areas such as; diagnosing of diseases, planning and administration, treatment and monitoring of patient outcomes, services and costs. This article provides a review into various Health and Social Care systems which encompasses the Knowledge Management value. For analysis, more than 30 systems that are related to Health and Social Care were gathered via Internet research, only 20 of these systems were finally selected based on recent system development and popularity of the system.Keywords: Health Care, Knowledge, Knowledge Management, Social Care, systemdoi:10.12695/ajtm.2013.6.2.4 How to cite this article:Ridhwan, M.S., and Oyefolahan, I.O. (2013. Knowledge Management System in Health & Social Care: Review on 20 Practiced Knowledge Management. The Asian Journal of Technology Management 6 (2: 92-101. Print ISSN: 1978-6956; Online ISSN: 2089-791X. doi:10.12695/ajtm.2013.6.2.4

  11. Factors Affecting Usage of a Personal Health Record (PHR) to Manage Health (United States)

    Taha, Jessica; Czaja, Sara J.; Sharit, Joseph; Morrow, Daniel G.


    As the health care industry shifts into the digital age, patients are increasingly being provided with access to electronic personal health records (PHRs) that are tethered to their provider-maintained electronic health records. This unprecedented access to personal health information can enable patients to more effectively manage their health, but little is actually known about patients’ ability to successfully use a PHR to perform health management tasks or the individual factors that influence task performance. This study evaluated the ability of 56 middle-aged adults (40–59 years) and 51 older adults (60–85 years) to use a simulated PHR to perform 15 common health management tasks encompassing medication management, review/interpretation of lab/test results, and health maintenance activities. Results indicated that participants in both age groups experienced significant difficulties in using the PHR to complete routine health management tasks. Data also showed that older adults, particularly those with lower numeracy and technology experience, encountered greater problems using the system. Furthermore, data revealed that the cognitive abilities predicting one’s task performance varied according to the complexity of the task. Results from this study identify important factors to consider in the design of PHRs so that they meet the needs of middle-aged and older adults. As deployment of PHRs is on the rise, knowledge of the individual factors that impact effective PHR use is critical to preventing an increase in health care disparities between those who are able to use a PHR and those who are not. PMID:24364414

  12. Evaluation of computerized health management information system for primary health care in rural India

    Directory of Open Access Journals (Sweden)

    Singh Satyavir


    Full Text Available Abstract Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS, New Delhi has a computerized Health Management Information System (HMIS since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR 1674,217 (USD 35,622. Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213. The annual savings is around INR 894,283 (USD 11,924. Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision.

  13. Linking better shiftwork arrangements with safety and health management systems. (United States)

    Kogi, Kazutaka


    Various support measures useful for promoting joint change approaches to the improvement of both shiftworking arrangements and safety and health management systems were reviewed. A particular focus was placed on enterprise-level risk reduction measures linking working hours and management systems. Voluntary industry-based guidelines on night and shift work for department stores and the chemical, automobile and electrical equipment industries were examined. Survey results that had led to the compilation of practicable measures to be included in these guidelines were also examined. The common support measures were then compared with ergonomic checkpoints for plant maintenance work involving irregular nightshifts. On the basis of this analysis, a new night and shift work checklist was designed. Both the guidelines and the plant maintenance work checkpoints were found to commonly cover multiple issues including work schedules and various job-related risks. This close link between shiftwork arrangements and risk management was important as shiftworkers in these industries considered teamwork and welfare services to be essential for managing risks associated with night and shift work. Four areas found suitable for participatory improvement by managers and workers were work schedules, ergonomic work tasks, work environment and training. The checklist designed to facilitate participatory change processes covered all these areas. The checklist developed to describe feasible workplace actions was suitable for integration with comprehensive safety and health management systems and offered valuable opportunities for improving working time arrangements and job content together.


    Teng, Monica; Khoo, Ai Leng; Zhao, Ying Jiao; Lin, Liang; Lim, Boon Peng


    Effective formulary management in healthcare institutions safeguards rational drug use and optimizes health outcomes. We implemented a formulary management program integrating the principles of health technology assessment (HTA) to improve the safe, appropriate, and cost-effective use of medicine in Singapore. A 3-year formulary management program was initiated in 2011 in five public healthcare institutions. This program was managed by a project team comprising HTA researchers. The project team worked with institutional pharmacy and therapeutics (P&T) committees to: (i) develop tools for formulary drug review and decision making; (ii) enhance the HTA knowledge and skills of formulary pharmacists and members of P&T committees; (iii) devise a prioritization framework to overcome resource constraints and time pressure; and (iv) conceptualize and implement a framework to review existing formulary. Tools that facilitate drug request submission, drug review, and decision making were developed for formulary drug inclusion. A systematic framework to review existing formulary was also developed and tested in selected institutions. A competency development plan was rolled out over 2 years to enhance formulary pharmacists' proficiency in systematic literature search and review, meta-analysis, and pharmacoeconomic evaluation. The plan comprised training workshops and on-the-job knowledge transfer between the project team and institutional formulary pharmacists through collaborating on selected drug reviews. A resource guide that consolidated the tools and templates was published to encourage the adoption of best practices in formulary management. Based on the concepts of HTA, we implemented an evidence-based approach to optimize formulary management.

  15. Governance in managing public health resources in Brazilian municipalities. (United States)

    Avelino, George; Barberia, Lorena G; Biderman, Ciro


    This study contributes to the health governance discussion by presenting a new data set that allows for comparisons of the management of health resources among Brazilian municipalities. Research on Brazil is particularly important as the provision of health services was decentralized in 1988 and since then municipalities have been given greater responsibilities for the management of fiscal resources for public health service provision. Based on detailed information on corruption practices (such as over-invoicing, illegal procurement and fake receipts) from audit reports of health programmes in 980 randomly selected Brazilian municipalities, this study deepens understanding of the relationship between health governance institutions and the incidence of corruption at the local level by exploring the extent to which horizontal and vertical accountabilities contribute to reducing the propensity of municipal government officials to divert public health resources for private gain. The results of our multiple regression analysis suggest that the experience of health municipal councils is correlated with reductions in the incidence of corruption in public health programmes. This impact is significant over time, with each additional year of health council experience reducing corruption incidence levels by 2.1% from baseline values. The findings reported in this study do not rely on the subjectivity of corruption measures which usually conflate the actual incidence of corruption with its perception by informants. Based on our results, we provide recommendations that can assist policy makers to reduce corruption. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  16. [The hospital perspective: disease management and integrated health care]. (United States)

    Schrappe, Matthias


    Disease Management is a transsectoral, population-based form of health care, which addresses groups of patients with particular clinical entities and risk factors. It refers both to an evidence-based knowledge base and corresponding guidelines, evaluates outcome as a continuous quality improvement process and usually includes active participation of patients. In Germany, the implementation of disease management is associated with financial transactions for risk adjustment between health care assurances [para. 137 f, Book V of Social Code (SGB V)] and represents the second kind of transsectoral care, besides a program designed as integrated health care according to para. 140 a ff f of Book V of Social Code. While in the USA and other countries disease management programs are made available by several institutions involved in health care, in Germany these programs are offered by health care insurers. Assessment of disease management from the hospital perspective will have to consider three questions: How large is the risk to compensate inadequate quality in outpatient care? Are there synergies in internal organisational development? Can the risk of inadequate funding of the global "integrated" budget be tolerated? Transsectoral quality assurance by valid performance indicators and implementation of a quality improvement process are essential. Internal organisational changes can be supported, particularly in the case of DRG introduction. The economic risk and financial output depends on the kind of disease being focussed by the disease management program. In assessing the underlying scientific evidence of their cost effectiveness, societal costs will have to be precisely differentiated from hospital-associated costs.

  17. Managing the risks of on-site health centers. (United States)

    Gorman, Kathleen M; Miller, Ross M


    This review sought to assess compliance concerns, determine risk management strategies, and identify opportunities for future research to contribute to employers' understanding of the laws and regulations that apply to on-site care. A comprehensive review of databases, professional organizations' websites, and journals resulted in 22 publications reporting on the consequences of noncompliance among on-site health centers accepted for inclusion. None of those studies reported a study design or quantifiable outcome data. Two noncompliance themes were repeated among the publications. First, direct penalties included fines, civil actions, loss of licensure, and, potentially, criminal charges. Second, noncompliance also resulted in indirect costs such as employee mistrust and lowered standards of care, which jeopardize on-site health centers' ability to demonstrate a return on investment. Further research with rigorous methodology is needed to inform employer decisions about on-site health services and associated risk management. Copyright 2011, SLACK Incorporated.

  18. Critical systems for public health management of floods, North Dakota. (United States)

    Wiedrich, Tim W; Sickler, Juli L; Vossler, Brenda L; Pickard, Stephen P


    Availability of emergency preparedness funding between 2002 and 2009 allowed the North Dakota Department of Health to build public health response capabilities. Five of the 15 public health preparedness capability areas identified by the Centers for Disease Control and Prevention in 2011 have been thoroughly tested by responses to flooding in North Dakota in 2009, 2010, and 2011; those capability areas are information sharing, emergency operations coordination, medical surge, material management and distribution, and volunteer management. Increasing response effectiveness has depended on planning, implementation of new information technology, changes to command and control procedures, containerized response materials, and rapid contract procedures. Continued improvement in response and maintenance of response capabilities is dependent on ongoing funding.

  19. Managing information technology human resources in health care. (United States)

    Mahesh, Sathiadev; Crow, Stephen M


    The health care sector has seen a major increase in the use of information technology (IT). The increasing permeation of IT into the enterprise has resulted in many non-IT employees acquiring IT-related skills and becoming an essential part of the IT-enabled enterprise. Health care IT employees work in a continually changing environment dealing with new specializations that are often unfamiliar to other personnel. The widespread use of outsourcing and offshoring in IT has introduced a third layer of complexity in the traditional hierarchy and its approach to managing human resources. This article studies 3 major issues in managing these human resources in an IT-enabled health care enterprise and recommends solutions to the problem.

  20. The four faces of rumination to stressful events: A psychometric analysis. (United States)

    García, Felipe E; Duque, Almudena; Cova, Félix


    To increase the knowledge of rumination and its associations with stressful events, we explored the relationships between 4 types of rumination (brooding, reflection, intrusive, and deliberate rumination) in a sample of 750 adult participants who experienced a highly stressful event. We also explored the predictive value of the different types of rumination on posttraumatic stress symptoms and posttraumatic growth 6 months after the highly stressful event occurred. Participants completed the Ruminative Response Scale and the Event-Related Rumination Inventory. Brooding and reflection rumination were obtained from the Ruminative Response Scale, whereas deliberate and intrusive rumination were obtained from the Event-Related Rumination Inventory. Confirmatory factorial analyses were conducted using the 4 types of rumination to test 3 different models: (a) 4-factor model (brooding, reflection, intrusive, and deliberate rumination), (b) 2-factor model: adaptive rumination (reflection and deliberate) and maladaptive rumination (brooding and intrusive), and (c) 2-factor model: depressive rumination (brooding and reflection) and posttraumatic rumination (intrusive and deliberate). It was observed that the 4-factor model showed the best fit to the data. Moreover, 6 months later it was observed that the most significant predictor of posttraumatic symptoms was intrusive rumination, whereas deliberate rumination was the most significant predictor of posttraumatic growth. Results indicate that the 4 types of rumination are differentiated constructs. Ruminative thoughts experienced after a stressful event predicted posttraumatic consequences 6 months later. Implications of these findings are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Antidepressant Medication Management among Older Patients Receiving Home Health Care (United States)

    Bao, Yuhua; Shao, Huibo; Bruce, Martha L.; Press, Matthew J.


    Objective Antidepressant management for older patients receiving home health care (HHC) may occur through two pathways: nurse-physician collaboration (without patient visits to the physician) and physician management through office visits. This study examines the relative contribution of the two pathways and how they interplay. Methods Retrospective analysis was conducted using Medicare claims of 7,389 depressed patients 65 or older who received HHC in 2006–7 and who possessed antidepressants at the start of HHC. A change in antidepressant therapy (vs. discontinuation or refill) was the main study outcome and could take the form of a change in dose, switch to a different antidepressant, or augmentation (addition of a new antidepressant). Logistic regressions were estimated to examine how use of home health nursing care, patient visits to physicians, and their interactions predict a change in antidepressant therapy. Results About 30% of patients experienced a change in antidepressants versus 51% who refilled and 18% who discontinued. Receipt of mental health specialty care was associated with a statistically significant, 10–20 percentage-point increase in the probability of antidepressant change; receipt of primary care was associated with a small and statistically significant increase in the probability of antidepressant change among patients with no mental health specialty care and above-average utilization of nursing care. Increased home health nursing care in absence of physician visits was not associated with increased antidepressant change. Conclusions Active antidepressant management resulting in a change in medication occurred on a limited scale among older patients receiving HHC. Addressing knowledge and practice gaps in antidepressant management by primary care providers and home health nurses and improving nurse-physician collaboration will be promising areas for future interventions. PMID:25158915

  2. Health-related behaviour among managers of Slovenian hospitals and institutes of public health

    Directory of Open Access Journals (Sweden)

    Jerneja Farkas


    Full Text Available Aim: Behavioural risk factors have a significant impact on health. We aimed to assess health-related behaviour, health status, and use of healthcare services among managers of Slovenian hospitals and institutes of public health. Methods: This was a cross-sectional study which included management (directors, scientific directors, directors’ deputies of Slovenian hospitals and institutes of public health (63 respondents; 57% women; overall mean age: 51±7 years; response rate: 74%. Data were obtained using an anonymous self-administered questionnaire. Results: About 35% of respondents were directors. More than half of the respondents were overweight or obese (52%, the majority were not sufficiently physically active (59% and overloaded with stress (87%. Hypercholesterolemia (36%, spinal disease (17%, and arterial hypertension (16% were most common chronic diseases. Whilst only few participants visited their general practitioner due their health complaints, blood pressure (76%, cholesterol (51%, and glucose (54% were measured within last year in most of the respondents. Conclusion: Our findings point to a high prevalence of overweight and obesity as well as workplace-related stress among Slovenian public health managers. Therefore, effective preventive strategies should be focused on stress management along with promotion of healthy behavioural patterns.

  3. RUMINANT NUTRITION SYMPOSIUM: Use of genomics and transcriptomics to identify strategies to lower ruminal methanogenesis. (United States)

    McAllister, T A; Meale, S J; Valle, E; Guan, L L; Zhou, M; Kelly, W J; Henderson, G; Attwood, G T; Janssen, P H


    Globally, methane (CH4) emissions account for 40% to 45% of greenhouse gas emissions from ruminant livestock, with over 90% of these emissions arising from enteric fermentation. Reduction of carbon dioxide to CH4 is critical for efficient ruminal fermentation because it prevents the accumulation of reducing equivalents in the rumen. Methanogens exist in a symbiotic relationship with rumen protozoa and fungi and within biofilms associated with feed and the rumen wall. Genomics and transcriptomics are playing an increasingly important role in defining the ecology of ruminal methanogenesis and identifying avenues for its mitigation. Metagenomic approaches have provided information on changes in abundances as well as the species composition of the methanogen community among ruminants that vary naturally in their CH4 emissions, their feed efficiency, and their response to CH4 mitigators. Sequencing the genomes of rumen methanogens has provided insight into surface proteins that may prove useful in the development of vaccines and has allowed assembly of biochemical pathways for use in chemogenomic approaches to lowering ruminal CH4 emissions. Metagenomics and metatranscriptomic analysis of entire rumen microbial communities are providing new perspectives on how methanogens interact with other members of this ecosystem and how these relationships may be altered to reduce methanogenesis. Identification of community members that produce antimethanogen agents that either inhibit or kill methanogens could lead to the identification of new mitigation approaches. Discovery of a lytic archaeophage that specifically lyses methanogens is 1 such example. Efforts in using genomic data to alter methanogenesis have been hampered by a lack of sequence information that is specific to the microbial community of the rumen. Programs such as Hungate1000 and the Global Rumen Census are increasing the breadth and depth of our understanding of global ruminal microbial communities, steps that

  4. Ruminant Nutrition Symposium: Molecular adaptation of ruminal epithelia to highly fermentable diets. (United States)

    Penner, G B; Steele, M A; Aschenbach, J R; McBride, B W


    Feeding highly fermentable diets to ruminants is one strategy to increase energy intake. The increase in short-chain fatty acid (SCFA) production and reduced ruminal pH associated with highly fermentable diets imposes a challenge to the metabolism and the regulation of intracellular pH homeostasis of ruminal epithelia. The ruminal epithelia respond to these challenges in a coordinated manner. Whereas the enlargement of absorptive surface area is well documented, emerging evidence at the mRNA and transporter and enzyme activity levels indicate that changes in epithelial cell function may be the initial response. It is not surprising that gene expression analysis has identified pathways involved in fatty acid metabolism, ion transport, and intracellular homeostasis to be the pathways dominantly affected during adaptation and after adaptation to a highly fermentable diet. These findings are important because the intraepithelial metabolism of SCFA, particularly butyrate, helps to maintain the concentration gradient between the cytosol and lumen, thereby facilitating absorption. Butyrate metabolism also controls the intracellular availability of butyrate, which is widely regarded as a signaling molecule. Current data indicate that for butyrate metabolism, 3-hydroxy-3-methylglutaryl-CoA synthase and acetyl-CoA acetyltransferase are potential regulatory points with transient up- and downregulation during diet adaptation. In addition to nutrient transport and utilization, genes involved in the maintenance of cellular tight junction integrity and induction of inflammation have been identified as differentially expressed genes during adaptation to highly fermentable diets. This may have important implications on ruminal epithelial barrier function and the inflammatory response often associated with subacute ruminal acidosis. The objective of this review is to summarize ruminal epithelial adaptation to highly fermentable diets focusing on the changes at the enzyme and

  5. Molecular epidemiology of pathogenic Leptospira spp. among large ruminants in the Philippines. (United States)

    Villanueva, Marvin A; Mingala, Claro N; Balbin, Michelle M; Nakajima, Chie; Isoda, Norikazu; Suzuki, Yasuhiko; Koizumi, Nobuo


    The extent of Leptospira infection in large ruminants resulting to economic problems in livestock industry in a leptospirosis-endemic country like the Philippines has not been extensively explored. Therefore, we determined the prevalence and carrier status of leptospirosis in large ruminants using molecular techniques and assessed the risk factors of acquiring leptospirosis in these animals. Water buffalo and cattle urine samples (n=831) collected from 21 farms during 2013-2015 were subjected to flaB-nested PCR to detect pathogenic Leptospira spp. Leptospiral flaB was detected in both species with a detection rate of 16.1%. Leptospiral DNA was detected only in samples from animals managed in communal farms. Sequence analysis of Leptospira flaB in large ruminants revealed the formation of three major clusters with L. borgpetersenii or L. kirschneri. One farm contained Leptospira flaB sequences from all clusters identified in this study, suggesting this farm was the main source of leptospires for other farms. This study suggested that these large ruminants are infected with various pathogenic Leptospira species causing possible major economic loss in the livestock industry as well as potential Leptospira reservoirs that can transmit infection to humans and other animals in the Philippines.

  6. Self arrangements in occupational safety and health management

    International Nuclear Information System (INIS)

    Ismail Bahari


    The book is written with the awareness of safe work culture where success does not lie to compliance with the law only. Instead it is more of an excellent management based on the principle of self organization. Self arrangements in the management of occupational safety and health do not rest on the shoulders of the employer or the safety management and safety communities, but are committed together with the leadership of the employer. Self arrangements will be more meaningful and successful if those involved have knowledge about the philosophy and principles of why and how this management is done, and so the method can be practiced and eventually cultivated as a working system. (author)

  7. Toward a national health risk management approach in Australia. (United States)

    O'Donnell, Carol


    There has been increasing international consensus about the importance of competition for achieving national growth and community well-being. The Australian government accordingly has introduced policies to promote such competition. Major legislative review and many public inquiries have assisted implementation of national competition policy and the development of national goals and standards related to international agreements to promote health and sustainable development. Since the 1980s, Australia has had legislation that requires the identification and control of health risks arising at work. The management structures necessary for coordinated delivery of national programs designed for effective identification and control of health risks arising in communities to achieve national health and development goals are still being developed, however. Major difficulties related to this development are discussed. National health development programs should be approached primarily through establishment of regional partnerships between bodies responsible for managing community health, local government, and employment placement, in consultation with other relevant organizations and the community. Related research and evaluation programs are required.

  8. How Health Relationship Management Services (HRMS Benefits Corporate Wellness

    Directory of Open Access Journals (Sweden)

    Nik Tehrani


    Full Text Available The typical worker spends about 47 hours a week commuting sitting in cars, trains, buses, or sitting at their desks. These statistics show that maintaining a healthy work and life balance has become progressively important. Workplace wellness and health promotion are of central importance for any organization in today's world. People are becoming highly conscious about their health and seek to ensure that they are provided with best medical services and facilities in case of any health issue. Organizations have switched to proactive strategies for the healthcare of their employees. Billions of dollars are spent on the workforce only after illnesses or injuries have occurred. Over the past several decades, healthcare services have drastically changed, altering the manner in which healthcare was previously managed. Technological advancements in medical systems have revolutionized the healthcare industry, and digital health tracking has been quite successful in monitoring patients’ health. Since patients are continuously monitored, no matter where they are, these systems can indicate patients’ adherence to medical protocols and act as a warning sign for such diseases as heart problems, Alzheimer’s disease, and many others. Health Relationship Management Services (HRMS is a new paradigm which defines comprehensive healthcare for an individual. HRMS is a complete health ecosystem suitable for the workplace, which enables healthcare providers to collect personal health data from various sources, analyze it for positive outcomes, and take action to preserve an employee’s good health to reduce absenteeism or turnover. HRMS can act as a preventative sentinel for corporate well-being as well.

  9. Health effects of radiation exposure and protection from radiation through an industrial health management angle

    International Nuclear Information System (INIS)

    Kobashi, Gen


    This paper outlines fundamental knowledge, health risks, and protection related to radiation in order to carry out appropriate industrial health management to reduce great public anxiety caused by the Fukushima Daiichi Nuclear Power Plant accident developed by the Tohoku earthquake and tsunami of March 11, 2011. Radiation generally causes damage to DNA such as generation of reactive oxygen species in cells, which are also created by exposures of various kinds of physical and chemical factors. This suggests that as well as applying 5 basic measures for industrial health management in the work place, common public health measures and disease prevention, such as keeping good sanitary conditions, healthy lifestyles, home discipline, social supports, efficient health education, etc. are important for us to prevent radiation-related cancer manifestation. Improvement of early detection and treatment for cancer is also important to eliminate the public anxiety. (A.O.)


    Directory of Open Access Journals (Sweden)

    Piotr Kafel


    Full Text Available The purpose of this paper is to analyze the place of occupational health and safety management system (OHSMS within the integrated management system. Implementation aspects of management systems are discussed, namely the different management system standards used for registration, for example ISO 14001, ISO 9001, OHSAS 18001, ISO 27001, the order in which they were implemented, the time required for each implementation, as well as the scope of integration of these management system standards into a single Integrated Management System and the level of integration. In order to do so, some of the results of a survey carried out in 81 organizations registered to at least two management systems selected from popular international standards, e.g.: ISO 9001, ISO 14001, OHSAS 18001, ISO/IEC 27001, ISO 22000 were used. OHSMS is not the system that is implemented as a first one. Usually it is implemented after or simultaneously with ISO 9001 and ISO 14001 standards. Time of implementation of MSSs in second and further round of implementation is shorter than during the implementation of first standards. There is a higher level of integration of implemented management standards in organizations where one of the standards in OHSMS, than in a companies without OHSMS. The paper analyses those sequences of management systems implementation of safety management systems with other system, that allow organizations to achieve higher levels of integration and presents a possible pattern for the companies initiating the integration process.

  11. Management capacity to promote nurse workplace health and safety. (United States)

    Fang, Yaxuan; McDonald, Tracey


    To investigate regarding workplace health and safety factors, and to identify strategies to preserve and promote a healthy nursing workplace. Data collected using the Delphi technique with input from 41 key informants across four participant categories drawn from a Chinese university and four hospitals were thematically analysed. Most respondents agreed on the importance of nurses' health and safety, and that nurse managers should act to protect nurses, but not enough on workplace safety. Hospital policies, staff disempowerment, workload and workplace conflicts are major obstacles. The reality of Chinese nurses' workplaces is that health and safety risks abound and relate to socio-cultural expectations of women. Self-management of risks is neccessary, gaps exist in understanding of workplace risks among different nursing groups and their perceptions of the professional status, and the value of nurses' contribution to ongoing risks in the hospital workplace. The Chinese hospital system must make these changes to produce a safer working environment for nurses. This research, based in China, presents an instructive tale for all countries that need support on the types and amounts of management for nurses working at the clinical interface, and on the consequences of management neglect of relevant policies and procedures. © 2017 John Wiley & Sons Ltd.

  12. Open source electronic health records and chronic disease management. (United States)

    Goldwater, Jason C; Kwon, Nancy J; Nathanson, Ashley; Muckle, Alison E; Brown, Alexa; Cornejo, Kerri


    To study and report on the use of open source electronic health records (EHR) to assist with chronic care management within safety net medical settings, such as community health centers (CHC). The study was conducted by NORC at the University of Chicago from April to September 2010. The NORC team undertook a comprehensive environmental scan, including a literature review, a dozen key informant interviews using a semistructured protocol, and a series of site visits to CHC that currently use an open source EHR. Two of the sites chosen by NORC were actively using an open source EHR to assist in the redesign of their care delivery system to support more effective chronic disease management. This included incorporating the chronic care model into an CHC and using the EHR to help facilitate its elements, such as care teams for patients, in addition to maintaining health records on indigent populations, such as tuberculosis status on homeless patients. The ability to modify the open-source EHR to adapt to the CHC environment and leverage the ecosystem of providers and users to assist in this process provided significant advantages in chronic care management. Improvements in diabetes management, controlled hypertension and increases in tuberculosis vaccinations were assisted through the use of these open source systems. The flexibility and adaptability of open source EHR demonstrated its utility and viability in the provision of necessary and needed chronic disease care among populations served by CHC.

  13. Managing environmental and health impacts of uranium mining

    Energy Technology Data Exchange (ETDEWEB)

    Vance, R.E.; Cameron, R., E-mail:, E-mail: [OECD Nuclear Energy Agency (France)


    As the raw material that fuels nuclear power plants that generate significant amounts of electricity with full life cycle carbon emissions as low as renewable energy sources, uranium is a valuable commodity. Yet uranium mining remains controversial, principally because of environmental and health impacts created when mining was undertaken by governments to meet Cold War strategic requirements. Uranium mining is conducted under significantly different circumstances today. Since the era of military production, societal expectations of environmental protection and the safety of workers and the public have evolved as the outcomes of the early era of mining became apparent, driving changes in regulatory oversight and mining practices. Key aspects of leading practice uranium mining are presented (conventional worker health and safety, worker radiation protection, public health and safety, water quality, tailings and waste rock management) and compared with historic practices to demonstrate the scale of differences. The application of additional aspects of uranium mine life cycle management (public consultation, environmental impact assessment, analysis of socio-economic impacts/benefits, environmental monitoring, financial assurance, product transport, security and safeguards, emergency planning and knowledge transfer), introduced as the industry matured, enhance overall management practices for the long term. Results from several case studies show that improved management of key aspects of uranium mining, combined with the incorporation of new life cycle parameters, have transformed the industry into the most regulated and arguably one of the safest and environmentally responsible types of mining in the world. (author)

  14. [Health locus of control of patients in disease management programmes]. (United States)

    Schnee, M; Grikscheit, F


    Health locus of control beliefs plays a major role in improving self-management skills of the chronically ill - a main goal in disease management programmes (DMP). This study aims at characterising participants in disease management regarding their health locus of control. Data are based on 4 cross-sectional postal surveys between spring and autumn of 2006 and 2007 within the Health Care Monitor of the Bertelsmann Foundation. Among the 6 285 respondents, 1 266 are chronically ill and not enrolled in a DMP and 327 are participating in a DMP. A high internal locus of control (HLC) occurs significantly less often in DMP patients than in normal chronically ill patients (and healthy people) controlling for age, gender and social class. With increasing age, a high internal locus of control is also significantly less likely. When comparing healthy people, the chronically ill and the DMP participants a social gradient of a high internal locus of control belief can be observed. The weaker internal and higher doctor-related external locus of control of DMP participants should be carefully observed by the physician when trying to strengthen the patients' self-management skills. Evaluators of DMP should take into account the different baselines of DMP patients and relevant control groups and incorporate these differences into the evaluation. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Physicians in health care management: 2. Managing performance: who, what, how and when?


    Lemieux-Charles, L


    Physicians are becoming more involved in performance management as hospitals restructure to increase effectiveness. Although physicians are not hospital employees, they are subject to performance appraisals because the hospitals are accountable to patients and the community for the quality of hospital services. The performance of a health care professional may be appraised by the appropriate departmental manager, by other professionals in a team or program or by peers, based on prior agreemen...

  16. Self-Management Skills in Chronic Disease Management: What Role Does Health Literacy Have? (United States)

    Mackey, Laura M; Doody, Catherine; Werner, Erik L; Fullen, Brona


    Self-management-based interventions can lead to improved health outcomes in people with chronic diseases, and multiple patient characteristics are associated with the development of self-management behaviors. Low health literacy (HL) has been implicated in poorer self-management behaviors and increased costs to health services. However, the mechanisms behind this relationship remain unclear. Therefore, the aim of the current review is to assess the association between HL and patient characteristics related to self-management behaviors (i.e., disease-related knowledge, beliefs, and self-efficacy). The review comprised 3 phases: 1) database searches, 2) eligibility screening, and 3) study quality assessment and strength of evidence. Inclusion criteria specified that a valid HL screening tool was used, that at least one self-management behavior was assessed, and that patients had a chronic condition. An initial search generated a total of 712 articles, of which 31 studies fulfilled the eligibility criteria. A consistent association was found between low HL and poorer disease-related knowledge in respiratory diseases, diabetes, and multiple disease categories. A significant association between low HL and poorer self-efficacy was reported in cardiovascular diseases, diabetes, human immunodeficiency virus, and multiple disease categories. HL was significantly associated with poorer beliefs in respiratory, musculoskeletal, and cardiovascular diseases. The findings from the current review suggest that low HL may affect behaviors necessary for the development of self-management skills. Given that self-management strategies are core components for effective treatment of a range of chronic diseases, low HL poses a considerable health concern. Further research is needed to understand the mediating influence of HL on disease-related knowledge, self-efficacy, and beliefs. From this, HL-sensitive, self-management interventions ought to be devised and implemented. © The Author

  17. Passion for work and emotional exhaustion: the mediating role of rumination and recovery. (United States)

    Donahue, Eric G; Forest, Jacques; Vallerand, Robert J; Lemyre, Pierre-Nicolas; Crevier-Braud, Laurence; Bergeron, Eliane


    The purpose of the present research is to present a model pertaining to the mediating roles of rumination and recovery experiences in the relationship between a harmonious and an obsessive passion (Vallerand et al., 2003) for work and workers' emotional exhaustion. Two populations were measured in the present research: namely elite coaches and nurses. Study 1's model posits that obsessive passion positively predicts rumination about one's work when being physically away from work, while harmonious passion negatively predicts ruminative thoughts. In turn, rumination is expected to positively contribute to emotional exhaustion. The results of Study 1 were replicated in Study 2. In addition, in the model of Study 2, obsessive passion was expected to undermine recovery experiences, while harmonious passion was expected to predict recovery experiences. In turn, recovery experiences were expected to protect workers from emotional exhaustion. Results of both studies provided support for the proposed model. The present findings demonstrate that passion for work may lead to some adaptive and maladaptive psychological processes depending on the type of passion that is prevalent. © 2012 The Authors. Applied Psychology: Health and Well-Being © 2012 The International Association of Applied Psychology.

  18. Characterization of the complete mitochondrial genomes of Nematodirus oiratianus and Nematodirus spathiger of small ruminants. (United States)

    Zhao, Guang-Hui; Jia, Yan-Qing; Cheng, Wen-Yu; Zhao, Wen; Bian, Qing-Qing; Liu, Guo-Hua


    Nematodirus spp. are among the most common nematodes of ruminants worldwide. N. oiratianus and N. spathiger are distributed worldwide as highly prevalent gastrointestinal nematodes, which cause emerging health problems and economic losses. Accurate identification of Nematodirus species is essential to develop effective control strategies for Nematodirus infection in ruminants. Mitochondrial DNA (mtDNA) could provide powerful genetic markers for identifying these closely related species and resolving phylogenetic relationships at different taxonomic levels. In the present study, the complete mitochondrial (mt) genomes of N. oiratianus and N. spathiger from small ruminants in China were obtained using Long-range PCR and sequencing. The complete mt genomes of N. oiratianus and N. spathiger were 13,765 bp and 13,519 bp in length, respectively. Both mt genomes were circular and consisted of 36 genes, including 12 genes encoding proteins, 2 genes encoding rRNA, and 22 genes encoding tRNA. Phylogenetic analyses based on the concatenated amino acid sequence data of all 12 protein-coding genes by Bayesian inference (BI), Maximum likelihood (ML) and Maximum parsimony (MP) showed that the two Nematodirus species (Molineidae) were closely related to Dictyocaulidae. The availability of the complete mtDNA sequences of N. oiratianus and N. spathiger not only provides new mtDNA sources for a better understanding of nematode mt genomics and phylogeny, but also provides novel and useful genetic markers for studying diagnosis, population genetics and molecular epidemiology of Nematodirus spp. in small ruminants.

  19. Roles of conceptus secretory proteins in establishment and maintenance of pregnancy in ruminants. (United States)

    Bazer, Fuller W; Song, Gwonhwa; Thatcher, William W


    Reproduction in ruminant species is a highly complex biological process requiring a dialogue between the developing conceptus (embryo-fetus and associated placental membranes) and maternal uterus which must be established during the peri-implantation period for pregnancy recognition signaling and regulation of gene expression by uterine epithelial and stromal cells. The uterus provide a microenvironment in which molecules secreted by uterine epithelia and transported into the uterine lumen represent histotroph, also known as the secretome, that are required for growth and development of the conceptus and receptivity of the uterus to implantation by the elongating conceptus. Pregnancy recognition signaling as related to sustaining the functional lifespan of the corpora lutea, is required to sustain the functional life-span of corpora lutea for production of progesterone which is essential for uterine functions supportive of implantation and placentation required for successful outcomes of pregnancy. It is within the peri-implantation period that most embryonic deaths occur in ruminants due to deficiencies attributed to uterine functions or failure of the conceptus to develop appropriately, signal pregnancy recognition and/or undergo implantation and placentation. The endocrine status of the pregnant ruminant and her nutritional status are critical for successful establishment and maintenance of pregnancy. The challenge is to understand the complexity of key mechanisms that are characteristic of successful reproduction in humans and animals and to use that knowledge to enhance fertility and reproductive health of ruminant species in livestock enterprises.

  20. Investigation of the use of various plant extracts activity in ruminant (United States)

    Yüca, Songül; Gül, Mehmet; Ćaǧlayan, Alper


    The prohibition of the use of antibiotics and as a result of the adverse effect on health of synthetic products, research has focused on natural feed additives. In recent years, the diet of farm animals many feed additives have been used for various purposes or continues. These include as used in ruminant rations as plant extract thyme, anise, pepper, mint, garlic, rosemary, cinnamon, parsley, bay leaf, coconut, like used herbal extracts and their effects on the performance of ruminants was investigated. Antioxidant, antifungal, antiviral, anti-inflamaotry is known to have effects of plant extract. By stimulating the digestive system of ruminants, they increase the activity of digestive enzymes, to prevent environmental pollution caused by manure, regulations rumen fermentation, inhibition of methane formation and protein degradability in the rumen as well as the animal is known to have many benefits. The structure of essential oils and plant extracts in this collection, examining the use of ruminant livestock events and the importance of the use in animal nutrition into practice will be discussed.

  1. Managing risk selection incentives in health sector reforms. (United States)

    Puig-Junoy, J


    The object of the paper is to review theoretical and empirical contributions to the optimal management of risk selection incentives ('cream skimming') in health sector reforms. The trade-off between efficiency and risk selection is fostered in health sector reforms by the introduction of competitive mechanisms such as price competition or prospective payment systems. The effects of two main forms of competition in health sector reforms are observed when health insurance is mandatory: competition in the market for health insurance, and in the market for health services. Market and government failures contribute to the assessment of the different forms of risk selection employed by insurers and providers, as the effects of selection incentives on efficiency and their proposed remedies to reduce the impact of these perverse incentives. Two European (Netherlands and Spain) and two Latin American (Chile and Colombia) case studies of health sector reforms are examined in order to observe selection incentives, their effects on efficiency and costs in the health system, and regulation policies implemented in each country to mitigate incentives to 'cream skim' good risks.

  2. Management of health-care waste in Izmir, Turkey

    Directory of Open Access Journals (Sweden)

    Ahmet Soysal


    Full Text Available The aim of this study was to evaluate health-care waste in the 18 districts of metropolitan municipality of the third biggest city in Turkey. This cross-sectional study was carried out with 825 health institutions established in the 18 districts of Izmir metropolitan municipality, in 2007. The total amount of health-care waste collected was 4841 tons and 621 kilograms per patient's bed in 2007. Most of the medical wastes were collected from Konak, Karsiyaka and Bornova districts and were 2308, 272 and 1020 tons, respectively. Regarding to overpopulation, the number of health institutions in these districts are more than the number of health institutions in the other administrative districts. There was a statistically significant, positive correlation between the amount of health-care waste collected and population of the 18 districts (r = 0.79, p < 0.001, and number of beds/patients (r = 0.83, p < 0.001. To provide a safe health-care waste management metropolitan municipality must provide hazardous waste separation in health institutions, establish sterilization units for infectious waste, and provide the last storage of medical waste in completely different, safe and special areas apart from the municipal waste storage areas.

  3. Waste management, informal recycling, environmental pollution and public health. (United States)

    Yang, Hong; Ma, Mingguo; Thompson, Julian R; Flower, Roger J


    With rapid population growth, especially in low-income and middle-income countries, the generation of waste is increasing at an unprecedented rate. For example, annual global waste arising from waste electrical and electronic equipment alone will have increased from 33.8 to 49.8 million tonnes between 2010 and 2018. Despite incineration and other waste treatment techniques, landfill still dominates waste disposal in low-income and middle-income countries. There is usually insufficient funding for adequate waste management in these countries and uptake of more advanced waste treatment technologies is poor. Without proper management, many landfills represent serious hazards as typified by the landslide in Shenzhen, China on 20 December 2015. In addition to formal waste recycling systems, approximately 15million people around the world are involved in informal waste recycling, mainly for plastics, metals, glass and paper. This review examines emerging public health challenges, in particular within low-income and middle-income countries, associated with the informal sector. While informal recyclers contribute to waste recycling and reuse, the relatively primitive techniques they employ, combined with improper management of secondary pollutants, exacerbate environmental pollution of air, soil and water. Even worse, insufficient occupational health measures expose informal waste workers to a range of pollutants, injuries, respiratory and dermatological problems, infections and other serious health issues that contribute to low life expectancy. Integration of the informal sector with its formal counterparts could improve waste management while addressing these serious health and livelihood issues. Progress in this direction has already been made notably in several Latin American countries where integrating the informal and formal sectors has had a positive influence on both waste management and poverty alleviation. © Article author(s) (or their employer(s) unless

  4. Performance scorecard for occupational safety and health management systems

    Directory of Open Access Journals (Sweden)

    Hernâni Veloso Neto


    Full Text Available The pro-active and systematic search for best performances should be the two assumptions of any management system, so safety and health management in organizations must also be guided by these same precepts. However, the scientific production evidences that the performance evaluation processes in safety and health continue to be guided, in their essence, by intermittency, reactivity and negativity, which are not consistent with the assumptions referenced above. Therefore, it is essential that health and safety at work management systems (HSW MS are structured from an active and positive viewpoint, focusing on continuous improvement. This implies considering performance evaluation processes that incorporate, on the one hand, monitoring, measuring and verification procedures, and on the other hand, structured matrixes of results that capture the key factors of success, by mobilizing both reactive and proactive indicators. One of the instruments that can fulfill these precepts of health and safety performance evaluation is the SafetyCard, a performance scorecard for HSW MS that we developed and will seek to outline and demonstrate over this paper.

  5. Health Management in Disasters in Iran: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Maryam Nakhaei


    Full Text Available Background:  Disaster  management  relies  on  the  prediction  of  problems  and  providing necessary preparations at the right time and place. In this study, researchers intended to explore previous experiences of health disaster management. Materials and Methods: This study conducted using qualitative content analysis method. Participants  were  selected  purposefully  and  data  were  collected  through  interviews, observation, and relevant documents. Results: Transcribed data from 18 interviews, field notes, and other documents were analyzed. In data analysis, “reactive management” was emerged as the main theme. It included some categories such as “exposure shock,” “nondeliberative relief,” “lack of comprehensive health disaster plan,” “lack of preparedness,” and “poor coordination in health service delivery” as well as contextual factors. Conclusion: The results clarified deep perception of participants’ experiences about health management in disasters. The professionals and nonprofessionals’ emotion-based reactions and behaviors, if accompanied with deficiencies in planning and preparedness, can lead to ineffective services and aggravate the damages

  6. Managing the physics of the economics of integrated health care. (United States)

    Zismer, Daniel K; Werner, Mark J


    The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles

  7. Petroleum and Health Care: Evaluating and Managing Health Care's Vulnerability to Petroleum Supply Shifts (United States)

    Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica


    Petroleum is used widely in health care—primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies—and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services. PMID:21778473

  8. Income statement management in a turbulent health care environment. (United States)

    Covaleski, M A


    This article considers the role of accounting information embedded in the income statement of health care providers in their increasingly difficult economic environment. This turbulent economic environment has resulted from the dramatic shift in power from the seller to the buyer of health care services, with a consequential shift of risks that will mandate that health care providers obtain access to better cost and utilization information. This article looks at the 2 critical components of the income statement--the revenue function and the cost structure-in terms of their importance in the management of enhanced economic performance in both the fee-for-service and the prepaid provision of health care services. Copyright 2001 by W.B. Saunders Company

  9. Using management information systems to enhance health care quality assurance. (United States)

    Rosser, L H; Kleiner, B H


    Examines how computers and quality assurance are being used to improve the quality of health care delivery. Traditional quality assurance methods have been limited in their ability to effectively manage the high volume of data generated by the health care process. Computers on the other hand are able to handle large volumes of data as well as monitor patient care activities in both the acute care and ambulatory care settings. Discusses the use of computers to collect and analyse patient data so that changes and problems can be identified. In addition, computer models for reminding physicians to order appropriate preventive health measures for their patients are presented. Concludes that the use of computers to augment quality improvement is essential if the quality of patient care and health promotion are to be improved.

  10. Can action research strengthen district health management and improve health workforce performance? A research protocol. (United States)

    Mshelia, C; Huss, R; Mirzoev, T; Elsey, H; Baine, S O; Aikins, M; Kamuzora, P; Bosch-Capblanch, X; Raven, J; Wyss, K; Green, A; Martineau, T


    The single biggest barrier for countries in sub-Saharan Africa (SSA) to scale up the necessary health services for addressing the three health-related Millennium Development Goals and achieving Universal Health Coverage is the lack of an adequate and well-performing health workforce. This deficit needs to be addressed both by training more new health personnel and by improving the performance of the existing and future health workforce. However, efforts have mostly been focused on training new staff and less on improving the performance of the existing health workforce. The purpose of this paper is to disseminate the protocol for the PERFORM project and reflect on the key challenges encountered during the development of this methodology and how they are being overcome. The overall aim of the PERFORM project is to identify ways of strengthening district management in order to address health workforce inadequacies by improving health workforce performance in SSA. The study will take place in three districts each in Ghana, Tanzania and Uganda using an action research approach. With the support of the country research teams, the district health management teams (DHMTs) will lead on planning, implementation, observation, reflection and redefinition of the activities in the study. Taking into account the national and local human resource (HR) and health systems (HS) policies and practices already in place, 'bundles' of HR/HS strategies that are feasible within the context and affordable within the districts' budget will be developed by the DHMTs to strengthen priority areas of health workforce performance. A comparative analysis of the findings from the three districts in each country will add new knowledge on the effects of these HR/HS bundles on DHMT management and workforce performance and the impact of an action research approach on improving the effectiveness of the DHMTs in implementing these interventions. Different challenges were faced during the development of

  11. An Agile Enterprise Regulation Architecture for Health Information Security Management (United States)

    Chen, Ying-Pei; Hsieh, Sung-Huai; Chien, Tsan-Nan; Chen, Heng-Shuen; Luh, Jer-Junn; Lai, Jin-Shin; Lai, Feipei; Chen, Sao-Jie


    Abstract Information security management for healthcare enterprises is complex as well as mission critical. Information technology requests from clinical users are of such urgency that the information office should do its best to achieve as many user requests as possible at a high service level using swift security policies. This research proposes the Agile Enterprise Regulation Architecture (AERA) of information security management for healthcare enterprises to implement as part of the electronic health record process. Survey outcomes and evidential experiences from a sample of medical center users proved that AERA encourages the information officials and enterprise administrators to overcome the challenges faced within an electronically equipped hospital. PMID:20815748

  12. Health Care Leadership: Managing Knowledge Bases as Stakeholders. (United States)

    Rotarius, Timothy

    Communities are composed of many organizations. These organizations naturally form clusters based on common patterns of knowledge, skills, and abilities of the individual organizations. Each of these spontaneous clusters represents a distinct knowledge base. The health care knowledge base is shown to be the natural leader of any community. Using the Central Florida region's 5 knowledge bases as an example, each knowledge base is categorized as a distinct type of stakeholder, and then a specific stakeholder management strategy is discussed to facilitate managing both the cooperative potential and the threatening potential of each "knowledge base" stakeholder.

  13. [Training of health-care employees in crisis resource management]. (United States)

    Spanager, Lene; Østergaard, Doris; Lippert, Anne; Nielsen, Kurt; Dieckmann, Peter


    Studies show that human errors contribute to up to 70% of mistakes and mishaps in health care. Crisis resource management, CRM, is a conceptual framework for analysing and training individual and team skills in order to prevent and manage errors. Different CRM training methods, e.g. simulation, are in use and the literature emphasises the need of training the full team or organisation for maximal effect. CRM training has an effect on skill improvement, but few studies have shown an effect on patient outcome. However, these studies show great variability of quality.

  14. An agile enterprise regulation architecture for health information security management. (United States)

    Chen, Ying-Pei; Hsieh, Sung-Huai; Cheng, Po-Hsun; Chien, Tsan-Nan; Chen, Heng-Shuen; Luh, Jer-Junn; Lai, Jin-Shin; Lai, Feipei; Chen, Sao-Jie


    Information security management for healthcare enterprises is complex as well as mission critical. Information technology requests from clinical users are of such urgency that the information office should do its best to achieve as many user requests as possible at a high service level using swift security policies. This research proposes the Agile Enterprise Regulation Architecture (AERA) of information security management for healthcare enterprises to implement as part of the electronic health record process. Survey outcomes and evidential experiences from a sample of medical center users proved that AERA encourages the information officials and enterprise administrators to overcome the challenges faced within an electronically equipped hospital.

  15. Who's in charge here anyway? Managing the management split in mental health organizations. (United States)

    Eilenberg, J; Townsend, E J; Oudens, E


    Most mental health organizations are run by chief executive officers (CEOs) who are not physicians, with medical directors reporting to the CEOs. In this article the historical and organizational origins of this arrangement are reviewed. The well known disadvantages of shared management are discussed, as are the less obvious advantages. Through case vignettes the authors illustrate how bifurcated leadership can promote productive and creative administrative decisions. Guidelines are offered for strengthening collaborations between non-medical and medical mental health program directors.

  16. Rural mental health workforce difficulties: a management perspective. (United States)

    Moore, T; Sutton, K; Maybery, D


    The recruitment, retention and training of mental health workers is of major concern in rural Australia, and the Gippsland region of Victoria is no exception. Previous studies have identified a number of common factors in these workforce difficulties, including rurality, difficulties of access to professional development and training, and professional and personal isolation. However, those previous studies have often focused on medicine and been based on the perspectives of practitioners, and have almost ignored the perspectives of managers of rural mental health services. The study reported in this article sought to contribute to the development of a more sustainable and effective regional mental health workforce by complementing earlier insights with those of leading administrators, managers and senior clinicians in the field. The study took a qualitative approach. It conducted semi-structured in-person interviews with 24 managers of health/mental-health services and senior administrators and clinicians working in organisations of varying sizes in the public and private sectors. Thematic content analysis of the transcribed interviews identified core difficulties these managers experienced in the recruitment, retention and training of employees. The study found that some of the issues commonly resulting in difficulties in recruiting, retaining and developing a trained workforce in rural areas, such as rurality (implying personal and professional isolation, distances to deliver service and small organisations) and a general shortage of trained personnel, are significant in Gippsland. Through its focus on the perspectives of leaders in the management of rural mental health services, however, the study found other key issues that contribute to workforce difficulties. Many, including the unattractive nature of mental health work, the fragmented administration of the mental health system, short-term and tied funding, and shortcomings in training are external to

  17. Survey of community pharmacy residents' perceptions of transgender health management. (United States)

    Leach, Caitlin; Layson-Wolf, Cherokee


    1) To measure the general perceptions and attitudes of community pharmacy residents toward transgender patients and health; 2) to identify gaps in didactic education regarding transgender health care among residents; and 3) to evaluate residents' level of support for pharmacists receiving education in transgender health care. This study was a cross-sectional survey delivered online. Community residency directors were e-mailed a cover letter and a 34-question online survey. The directors were asked to forward the survey to their residents for completion within 4 weeks. Responses were anonymous with no identifiers collected on the survey. Survey responses used a combination of open-response, multiple-choice, and Likert-scale questions aimed at gathering respondents' demographic information, perceptions of managing transgender patients and the need for receiving additional education in transgender health care. Overall, the results of the survey indicated that community pharmacy residents support integrating transgender health management into pharmacy education and recognize that the overwhelming barriers to care for these patients include discrimination and lack of provider knowledge. Significant findings include: 82.7% of community residents think that community pharmacists play an important role in providing care for transgender patients; 98.2% think that they have a responsibility to treat transgender patients; and 71.4% were not educated about transgender patient issues in pharmacy school. Only 36.2% of community residents felt confident in their ability to treat transgender patients. Community pharmacy residents list discrimination and lack of provider knowledge as the major barriers to care for transgender patients. Residents do not feel confident in their ability to treat and manage transgender patients. The majority of residents were not educated about transgender patient issues while in pharmacy school and think that community pharmacists need more education

  18. Applying total quality management concepts to public health organizations. (United States)

    Kaluzny, A D; McLaughlin, C P; Simpson, K


    Total quality management (TQM) is a participative, systematic approach to planning and implementing a continuous organizational improvement process. Its approach is focused on satisfying customers' expectations, identifying problems, building commitment, and promoting open decision-making among workers. TQM applies analytical tools, such as flow and statistical charts and check sheets, to gather data about activities within an organization. TQM uses process techniques, such as nominal groups, brainstorming, and consensus forming to facilitate communication and decision making. TQM applications in the public sector and particularly in public health agencies have been limited. The process of integrating TQM into public health agencies complements and enhances the Model Standards Program and assessment methodologies, such as the Assessment Protocol for Excellence in Public Health (APEX-PH), which are mechanisms for establishing strategic directions for public health. The authors examine the potential for using TQM as a method to achieve and exceed standards quickly and efficiently. They discuss the relationship of performance standards and assessment methodologies with TQM and provide guidelines for achieving the full potential of TQM in public health organizations. The guidelines include redefining the role of management, defining a common corporate culture, refining the role of citizen oversight functions, and setting realistic estimates of the time needed to complete a task or project. PMID:1594734

  19. Understanding human resource management practices in Botswana's public health sector. (United States)

    Seitio-Kgokgwe, Onalenna Stannie; Gauld, Robin; Hill, Philip C; Barnett, Pauline


    Purpose The purpose of this paper is to assess the management of the public sector health workforce in Botswana. Using institutional frameworks it aims to document and analyse human resource management (HRM) practices, and make recommendations to improve employee and health system outcomes. Design/methodology/approach The paper draws from a large study that used a mixed methods approach to assess performance of Botswana's Ministry of Health (MOH). It uses data collected through document analysis and in-depth interviews of 54 key informants comprising policy makers, senior staff of the MOH and its stakeholder organizations. Findings Public health sector HRM in Botswana has experienced inadequate planning, poor deployment and underutilization of staff. Lack of comprehensive retention strategies and poor working conditions contributed to the failure to attract and retain skilled personnel. Relationships with both formal and informal environments affected HRM performance. Research limitations/implications While document review was a major source of data for this paper, the weaknesses in the human resource information system limited availability of data. Practical implications This paper presents an argument for the need for consideration of formal and informal environments in developing effective HRM strategies. Originality/value This research provides a rare system-wide approach to health HRM in a Sub-Saharan African country. It contributes to the literature and evidence needed to guide HRM policy decisions and practices.

  20. Principles of capacity management, applied in the mental health context. (United States)

    Zeitz, Kathryn; Watson, Darryl


    Objective The aim of the paper was to describe a suite of capacity management principles that have been applied in the mental health setting that resulted in a significant reduction in time spent in two emergency departments (ED) and improved throughput. Methods The project consisted of a multifocal change approach over three phases that included: (1) the implementation of a suite of fundamental capacity management activities led by the service and clinical director; (2) a targeted Winter Demand Plan supported by McKinsey and Co.; and (3) a sustainability of change phase. Descriptive statistics was used to analyse the performance data that was collected through-out the project. Results This capacity management project has resulted in sustained patient flow improvement. There was a reduction in the average length of stay (LOS) in the ED for consumers with mental health presentations to the ED. At the commencement of the project, in July 2014, the average LOS was 20.5h compared with 8.5h in December 2015 post the sustainability phase. In July 2014, the percentage of consumers staying longer than 24h was 26% (n=112); in November and December 2015, this had reduced to 6% and 7 5% respectively (less than one consumer per day). Conclusion Improving patient flow is multifactorial. Increased attendances in public EDs by people with mental health problems and the lengthening boarding in the ED affect the overall ED throughput. Key strategies to improve mental health consumer flow need to focus on engagement, leadership, embedding fundamentals, managing and target setting. What is known about the topic? Improving patient flow in the acute sector is an emerging topic in the health literature in response to increasing pressures of access block in EDs. What does this paper add? This paper describes the application of a suite of patient flow improvement principles that were applied in the mental health setting that significantly reduced the waiting time for consumers in two EDs

  1. RECALMIN: The association between management of Spanish National Health Service Internal Medical Units and health outcomes. (United States)

    Zapatero-Gaviria, Antonio; Javier Elola-Somoza, Francisco; Casariego-Vales, Emilio; Fernandez-Perez, Cristina; Gomez-Huelgas, Ricardo; Bernal, José Luis; Barba-Martín, Raquel


    To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Spanish National Health Service. One hundred and twenty-four acute general hospitals with available data of management and outcomes (401 424 discharges). IMU risk standardized mortality rates were calculated using a multilevel model adjusted by Charlson Index. Risk standardized myocardial infarction and heart failure mortality rates were calculated using specific multilevel models. Length of stay was adjusted by complexity. Greater hospital complexity was associated with longer average length of stays (r: 0.42; P International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail:

  2. Integrated approach for managing health risks at work--the role of occupational health nurses. (United States)

    Marinescu, Luiza G


    Currently, many organizations are using a department-centered approach to manage health risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management.

  3. III. Quantitative aspects of phosphorus excretionin ruminants


    Bravo , David; Sauvant , Daniel; Bogaert , Catherine; Meschy , François


    International audience; Ruminant phosphorus excretion and metabolism were studied through a database. Faecal endogenous phosphorus is the main pathway of phosphorus excretion and averages 0.85 of total faecal phosphorus. The remaining 0.15 is unabsorbed dietary phosphorus. Faecal endogenous phosphorus is mainly unabsorbed phosphorus, with saliva being the major source, and is correlated to factors influencing saliva secretion (DM intake, physical dietary characteristics and dietary phosphorus...

  4. Assessing gene function in the ruminant placenta. (United States)

    Anthony, R V; Cantlon, J D; Gates, K C; Purcell, S H; Clay, C M


    The placenta provides the means for nutrient transfer from the mother to the fetus, waste transfer from the fetus to the mother, protection of the fetus from the maternal immune system, and is an active endocrine organ. While many placental functions have been defined and investigated, assessing the function of specific genes expressed by the placenta has been problematic, since classical ablation-replacement methods are not feasible with the placenta. The pregnant sheep has been a long-standing animal model for assessing in vivo physiology during pregnancy, since surgical placement of indwelling catheters into both maternal and fetal vasculature has allowed the assessment of placental nutrient transfer and utilization, as well as placental hormone secretion, under unanesthetized-unstressed steady state sampling conditions. However, in ruminants the lack of well-characterized trophoblast cell lines and the inefficiency of creating transgenic pregnancies in ruminants have inhibited our ability to assess specific gene function. Recently, sheep and cattle primary trophoblast cell lines have been reported, and may further our ability to investigate trophoblast function and transcriptional regulation of genes expressed by the placenta. Furthermore, viral infection of the trophoectoderm layer of hatched blastocysts, as a means for placenta-specific transgenesis, holds considerable potential to assess gene function in the ruminant placenta. This approach has been used successfully to "knockdown" gene expression in the developing sheep conceptus, and has the potential for gain-of-function experiments as well. While this technology is still being developed, it may provide an efficient approach to assess specific gene function in the ruminant placenta.

  5. Fluid therapy in small ruminants and camelids. (United States)

    Jones, Meredyth; Navarre, Christine


    Body water, electrolytes, and acid-base balance are important considerations in the evaluation and treatment of small ruminants and camelids with any disease process, with restoration of these a priority as adjunctive therapy. The goals of fluid therapy should be to maintain cardiac output and tissue perfusion, and to correct acid-base and electrolyte abnormalities. Hypoglycemia, hyperkalemia, and acidosis are the most life-threatening abnormalities, and require most immediate correction. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Public health financial management needs: report of a national survey. (United States)

    Costich, Julia F; Honoré, Peggy A; Scutchfield, F Douglas


    The work reported here builds on the identification of public health financial management practice competencies by a national expert panel. The next logical step was to provide a validity check for the competencies and identify priority areas for educational programming. We developed a survey for local public health finance officers based on the public health finance competencies and field tested it with a convenience sample of officials. We asked respondents to indicate the importance of each competency area and the need for training to improve performance; we also requested information regarding respondent education, jurisdiction size, and additional comments. Our local agency survey sample drew on the respondent list from the National Association of County and City Health Officials 2005 local health department survey, stratified by agency size and limited to jurisdiction populations of 25,000 to 1,000,000. Identifying appropriate respondents was a major challenge. The survey was fielded electronically, yielding 112 responses from 30 states. The areas identified as most important and needing most additional training were knowledge of budget activities, financial data interpretation and communication, and ability to assess and correct the organization's financial status. The majority of respondents had some postbaccalaureate education. Many provided additional comments and recommendations. Health department finance officers demonstrated a high level of general agreement regarding the importance of finance competencies in public health and the need for training. The findings point to a critical need for additional training opportunities that are accessible, cost-effective, and targeted to individual needs.

  7. Rumination in bipolar disorder: evidence for an unquiet mind


    Ghaznavi, Sharmin; Deckersbach, Thilo


    Abstract Depression in bipolar disorder has long been thought to be a state characterized by mental inactivity. However, recent research demonstrates that patients with bipolar disorder engage in rumination, a form of self-focused repetitive cognitive activity, in depressed as well as in manic states. While rumination has long been associated with depressed states in major depressive disorder, the finding that patients with bipolar disorder ruminate in manic states is unique to bipolar disord...

  8. Ruminal Acidosis in Feedlot: From Aetiology to Prevention


    Hernández, Joaquín; Benedito, José Luis; Abuelo, Angel; Castillo, Cristina


    Acute ruminal acidosis is a metabolic status defined by decreased blood pH and bicarbonate, caused by overproduction of ruminal D-lactate. It will appear when animals ingest excessive amount of nonstructural carbohydrates with low neutral detergent fiber. Animals will show ruminal hypotony/atony with hydrorumen and a typical parakeratosis-rumenitis liver abscess complex, associated with a plethora of systemic manifestations such as diarrhea and dehydration, liver abscesses, infections of the ...

  9. Opportunities for Launch Site Integrated System Health Engineering and Management (United States)

    Waterman, Robert D.; Langwost, Patricia E.; Waterman, Susan J.


    The launch site processing flow involves operations such as functional verification, preflight servicing and launch. These operations often include hazards that must be controlled to protect human life and critical space hardware assets. Existing command and control capabilities are limited to simple limit checking durig automated monitoring. Contingency actions are highly dependent on human recognition, decision making, and execution. Many opportunities for Integrated System Health Engineering and Management (ISHEM) exist throughout the processing flow. This paper will present the current human-centered approach to health management as performed today for the shuttle and space station programs. In addition, it will address some of the more critical ISHEM needs, and provide recommendations for future implementation of ISHEM at the launch site.

  10. Oceans and Human Health: Linking Ocean, Organism, and Human Health for Sustainable Management of Coastal Ecosystems (United States)

    Sandifer, P. A.; Trtanj, J.; Collier, T. K.


    Scientists and policy-makers are increasingly recognizing that sustainable coastal communities depend on healthy and resilient economies, ecosystems, and people, and that the condition or "health" of the coastal ocean and humans are intimately and inextricably connected. A wealth of ecosystem services provided by ocean and coastal environments are crucial for human survival and well being. Nonetheless, the health of coastal communities, their economies, connected ecosystems and ecosystem services, and people are under increasing threats from health risks associated with environmental degradation, climate change, and unwise land use practices, all of which contribute to growing burdens of naturally-occurring and introduced pathogens, noxious algae, and chemical contaminants. The occurrence, frequency, intensity, geographic range, and number and kinds of ocean health threats are increasing, with concomitant health and economic effects and eroding public confidence in the safety and wholesomeness of coastal environments and resources. Concerns in the research and public health communities, many summarized in the seminal 1999 NRC Report, From Monsoons to Microbes and the 2004 final report of the US Commission on Ocean Policy, resulted in establishment of a new "meta-discipline" known as Oceans and Human Health (OHH). OHH brings together practitioners in oceanography, marine biology, ecology, biomedical science, medicine, economics and other social sciences, epidemiology, environmental management, and public health to focus on water- and food-borne causes of human and animal illnesses associated with ocean and coastal systems and on health benefits of seafood and other marine products. It integrates information across multiple disciplines to increase knowledge of ocean health risks and benefits and communicate such information to enhance public safety. Recognizing the need for a comprehensive approach to ocean health threats and benefits, Congress passed the Oceans and

  11. Public health emergencies and the public health/managed care challenge. (United States)

    Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra


    The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

  12. Phenomenological aspects of the cognitive rumination construct

    Directory of Open Access Journals (Sweden)

    Leonardo Fernandez Meyer


    Full Text Available Objective: To evaluate the importance of phenomenological aspects of the cognitive rumination (CR construct in current empirical psychiatric research.Method: We searched SciELO, Scopus, ScienceDirect, MEDLINE, OneFile (GALE, SpringerLink, Cambridge Journals and Web of Science between February and March of 2014 for studies whose title and topic included the following keywords: cognitive rumination; rumination response scale; and self-reflection. The inclusion criteria were: empirical clinical study; CR as the main object of investigation; and study that included a conceptual definition of CR. The studies selected were published in English in biomedical journals in the last 10 years. Our phenomenological analysis was based on Karl Jaspers' General Psychopathology.Results: Most current empirical studies adopt phenomenological cognitive elements in conceptual definitions. However, these elements do not seem to be carefully examined and are indistinctly understood as objective empirical factors that may be measured, which may contribute to misunderstandings about CR, erroneous interpretations of results and problematic theoretical models.Conclusion: Empirical studies fail when evaluating phenomenological aspects of the cognitive elements of the CR construct. Psychopathology and phenomenology may help define the characteristics of CR elements and may contribute to their understanding and hierarchical organization as a construct. A review of the psychopathology principles established by Jasper may clarify some of these issues.

  13. Phenomenological aspects of the cognitive rumination construct. (United States)

    Meyer, Leonardo Fernandez; Taborda, José Geraldo Vernet; da Costa, Fábio Antônio; Soares, Ana Luiza Alfaya Galego; Mecler, Kátia; Valença, Alexandre Martins


    To evaluate the importance of phenomenological aspects of the cognitive rumination (CR) construct in current empirical psychiatric research. We searched SciELO, Scopus, ScienceDirect, MEDLINE, OneFile (GALE), SpringerLink, Cambridge Journals and Web of Science between February and March of 2014 for studies whose title and topic included the following keywords: cognitive rumination; rumination response scale; and self-reflection. The inclusion criteria were: empirical clinical study; CR as the main object of investigation; and study that included a conceptual definition of CR. The studies selected were published in English in biomedical journals in the last 10 years. Our phenomenological analysis was based on Karl Jaspers' General Psychopathology. Most current empirical studies adopt phenomenological cognitive elements in conceptual definitions. However, these elements do not seem to be carefully examined and are indistinctly understood as objective empirical factors that may be measured, which may contribute to misunderstandings about CR, erroneous interpretations of results and problematic theoretical models. Empirical studies fail when evaluating phenomenological aspects of the cognitive elements of the CR construct. Psychopathology and phenomenology may help define the characteristics of CR elements and may contribute to their understanding and hierarchical organization as a construct. A review of the psychopathology principles established by Jasper may clarify some of these issues.

  14. Suppurative intracranial processes in 15 domestic ruminants

    Directory of Open Access Journals (Sweden)

    Antônio Carlos Lopes Câmara


    Full Text Available In addition to listeriosis which is relatively common in ruminants, there are three other uncommon suppurative intracranial processes (SIP identifiable in adult ungulates as brain abscess, basilar empyema and suppurative meningitis. The present paper reports the epidemiological, clinical, laboratorial, pathological and microbiological findings of 15 domestic ruminants with SIP. A total of 15 animals were selected (eight sheep, four cattle and three goats; with the definitive diagnoses of basilar empyema (n=3, brain abscess (n=1, listeriosis (n=5 and suppurative meningitis (n=6. Hematology revealed leukocytosis with inversion of the lymphocyte/ neutrophil ratio in 4 cases. In the majority of animals, cerebrospinal fluid (CSF presented light yellow coloration and cloudy aspect due to neutrophilic pleocytosis (15 - 997 leukocytes/µL. Microbiological culture of CSF or central nervous system (CNS fragments resulted on isolation of Trueperella (Arcanobacterium pyogenes,Listeria monocytogenes,Escherichia coli and Stenotrophomonas sp. In a goat with thalamic abscess, microbiological assay was not performed, but Gram positive bacilli type bacteria were observed in histology. The diagnosis of these outbreaks was based on the association of epidemiological, clinical, pathological and bacteriological findings; reiterating that the infectious component remains an important cause of CNS disease in domestic ruminants and also shows the need for dissemination of information about the most effective preventive measures for the ranchers.

  15. Sulfur sources in protein supplements for ruminants

    Directory of Open Access Journals (Sweden)

    Cássio José da Silva


    Full Text Available The present study evaluates the efficiency of different sulfur sources for ruminant nutrition. The fiber digestibility and the amino acid profile were analyzed in the duodenal digesta of crossbred steers fed Brachiaria dictyoneurahay. The sources utilized were elemental sulfur (ES70S, elemental sulfur (ES98S; calcium sulfate in hydrated (HCS, CaSO4.2H2O, and anhydrous (ACS, CaSO4, forms; and ammonium sulfate (AS, (NH42SO4, keeping a nitrogen:sulfur ratio of 11:1. The iso-protein supplements had 50% of protein in the total dry matter (DM. Five Holstein × Zebu steers, which were fistulated in the rumen and abomasum, were distributed in a 5 × 5 Latin square. The different sulfur sources in the supplement did not affect any of the evaluated nutritional factors, such as intake of hay dry matter and protein supplement, crude protein (CP, neutral detergent fiber corrected for ash and protein (NDFap, organic matter (OM, non-fibrous carbohydrate (NFC, ether extract (EE, total digestible nutrients (TDN, NDFap and CP digestibility coefficients, ruminal pH, and ruminal ammonia concentration. The concentrations of amino acids available in the abomasal digesta did not differ significantly in the tested diets. The sulfur sources evaluated in the present study are suitable as supplement for cattle, and their employment may be important to avoid environmental contaminations.

  16. [Resistance to heavy metals in ruminal staphylococci]. (United States)

    Lauková, A


    Ruminal, coagulase-negative, urease and bacteriocin-like substances producing staphylococci were screened for their heavy metal ions and antibiotics resistance. All strains tested were resistant to disodium arsenate at a minimal inhibition concentration (MIC > 5 g/l) and cadmium sulphate (MIC > 4 g/l). MIC = 50-60 mg/l was determined in eight staphylococci screened in mercury chloride resistance test (Tab. I). Silver nitrate resistance was detected in seven of the bacteria used (MIC = 40-50 mg/l). All strains were novobiocin resistant. Staphylococcus cohnii subsp. urealyticum SCU 40 was found as a strain with resistance to all heavy metal ions and 5 antibiotics (Tab. II). In addition, this strain produced bacteriocin-like substance which inhibited growth of six indicators of different origin (Tab. II). The most of staphylococci were detected as heavy metal ion polyresistant strains and antibiotic polyresistant strains producing antimicrobial substances with inhibition effects against at least one indicator of different origin. These results represent the first information on heavy metal ion resistance in ruminal bacteria. They also show relation or coresistance between heavy metal ions and antibiotics. Resulting from this study, staphylococci can be used as a bioindicator model for animal environmental studies. In addition, it can be used for specific interactions studies within the framework of ruminal bacterial ecosystem and also mainly with regard to molecular genetic studies.

  17. Bioremediation of trinitrotolulene by a ruminal microorganism

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Taejin; Williamson, K.J.; Craig, A.M. [Oregon State Univ., Corvallis, OR (United States)


    2,4,6-trinitrotoluene (TNT) has been widely used for the production of explosives because of its low boiling point, high stability, low impact sensitivity, and safe manufacture. More than 1,100 military facilities, each potentially contaminated with munitions waste, are expected to require treatment of more than one million cubic yards of contaminated soils. The cost associated with remediation of these sites has been estimated to be in excess of $1.5 billion. Recently, researchers have studied ruminal microorganisms in relation to their ability to degrade xenobiotic compounds. Many of these organisms are strict anaerobes with optimal redox potentials as low as -420 mV. Ruminal organisms have been shown capable of destroying some pesticides, such as parathion, p-nitrophenol, and biphenyl-type compounds; thiono isomers, and nitrogen-containing heterocyclic plant toxins such as the pyrrolizidine alkaloids. Many of these compounds have structures similar to TNT. A TNT-degrading ruminal microorganism has been isolated from goat rumen fluid with successive enrichments on triaminotoluene (TAT) and TNT. The isolate, designated G.8, utilizes nitrate and lactate as the primary energy source. G.8 was able to tolerate and metabolite levels of TNT up to the saturation point of 125 mg/l.

  18. Recent advances in modeling nutrient utilization in ruminants. (United States)

    Kebreab, E; Dijkstra, J; Bannink, A; France, J


    Mathematical modeling techniques have been applied to study various aspects of the ruminant, such as rumen function, postabsorptive metabolism, and product composition. This review focuses on advances made in modeling rumen fermentation and its associated rumen disorders, and energy and nutrient utilization and excretion with respect to environmental issues. Accurate prediction of fermentation stoichiometry has an impact on estimating the type of energy-yielding substrate available to the animal, and the ratio of lipogenic to glucogenic VFA is an important determinant of methanogenesis. Recent advances in modeling VFA stoichiometry offer ways for dietary manipulation to shift the fermentation in favor of glucogenic VFA. Increasing energy to the animal by supplementing with starch can lead to health problems such as subacute rumen acidosis caused by rumen pH depression. Mathematical models have been developed to describe changes in rumen pH and rumen fermentation. Models that relate rumen temperature to rumen pH have also been developed and have the potential to aid in the diagnosis of subacute rumen acidosis. The effect of pH has been studied mechanistically, and in such models, fractional passage rate has a large impact on substrate degradation and microbial efficiency in the rumen and should be an important theme in future studies. The efficiency with which energy is utilized by ruminants has been updated in recent studies. Mechanistic models of N utilization indicate that reducing dietary protein concentration, matching protein degradability to the microbial requirement, and increasing the energy status of the animal will reduce the output of N as waste. Recent mechanistic P models calculate the P requirement by taking into account P recycled through saliva and endogenous losses. Mechanistic P models suggest reducing current P amounts for lactating dairy cattle to at least 0.35% P in the diet, with a potential reduction of up to 1.3 kt/yr. A model that

  19. Developing management capacity building package to district health manager in northwest of Iran: A sequential mixed method study. (United States)

    Tabrizi, Jafar Sadegh; Gholipour, Kamal; Farahbakhsh, Mostafa; Jahanbin, Hasan; Karamuz, Majid


    To assess districts health managers educational needs and develop management training programmes. This mixed-method study was carried out between August 2014 and August 2015 in Tabriz, Iran. Four focus group discussion sessions and three semi-structured face-to-face interviews were conducted among district health managers and experts of a health centre. Besides, 52 questionnaires were completed to weigh and finalise management education module and courses. Interviews and focus group discussions were tape-recorded, transcribed and analysed using content analysis method. Data was analysed using SPSS17. There were 52 participants, of whom 40(78.8%) were men and 12(21.2%) were women. All of the subjects (100%) took part in the quantitative phase, while 25(48.08%) participated in the qualitative phase. In the qualitative section, 11(44%) participants were heads of unit/departments in provincial health centre and 14(56%) were district health managers. In the quantitative phase, 30(57.7%) participants were district health managers and 8(28.8%) were heads of units/departments. Moreover, 33(63.4%) participants had medical education. The job experience of 3(5.8%) participants in the current position was below five years. Districts health management training programme consisted of 10modules with 53 educational topics. The normalised score out of a total of 100 for rules and ethics was 75.51, health information management 71.19, management and leadership 69.27, district management 68.08, human resources and organisational creativity 67.58,quality improvement 66.6, health resources management 62.37, planning and evaluation 61.87, research in health system 59.15, and community participation was 53.15. Considering district health managers' qualification in health and medicine, they had not been trained in basic management. Almost all the management and leadership courses were prioritised as most necessary.

  20. Leader-Member Exchange Relationships in Health Information Management


    Hunt, T.J.


    This article seeks to raise awareness of the leader-member exchange (LMX) theory of leadership and its potential benefit to the health information management (HIM) profession. A literature review that was conducted identified a leadership challenge for HIM practitioners. The review also provides examples of leadership definitions, and potential benefits of LMX to HIM professionals in leading people and influencing leaders in their organizations. The LMX concept may be an avenue to investigate...