Sample records for sheep health management

  1. Sheep farmer opinions on the current and future role of veterinarians in flock health management on sheep farms: A qualitative study

    Kaler, Jasmeet; Green, L.E.


    A 2009 UK Government report on veterinary expertise in food animal production highlighted that there was insufficient herd health expertise among veterinarians and lack of appropriate business models to deliver veterinary services to the livestock sector. Approximately two thirds of sheep farmers only contact their veterinarian for emergencies and one fifth have all year round contact. The aim of the current study was to understand sheep farmers’ perception, the current and future role of veterinarians in flock health management using qualitative methodology. The eligibility criteria were male farmers with a flock size of at least 200 adult sheep. Seven focus groups of farmers (n = 45) stratified by three regions and two age groups (≤50 and >50) were conducted. Thematic analysis of the discussions indicated that most farmers considered and used their veterinarian as a fire-fighter, whilst other advice was gathered free of charge when the veterinarian was on the farm for other reasons (typically seeing cattle) or by telephone. A small group of farmers were using their veterinarian or a sheep consultant proactively with regular contact and found this financially beneficial. Farmers indicated that the key barriers to using a veterinarian proactively were inconsistent service, high turnover of veterinarians, lack of expertise of sheep farming among veterinarians and concern about independence of advice. Although economics was also mentioned as a key barrier to using veterinarians more proactively, most farmers did not know where they gained and lost income from their flock; there was heavy reliance on the single farm payment scheme (SPS) and very few farmers kept records from which they could investigate where there were inefficiencies in production. Overall sheep farmers considered sheep farming complex and that each farm was unique and that they themselves were the experts to manage their flock. We conclude that there is an impasse: veterinarians might need to

  2. Potential disease agents in domestic goats and relevance to bighorn sheep (Ovis canadensis) management.

    Drew, Mark L; Weiser, Glen C


    Domestic goats are raised for meat, milk and hair production, in herds for rangeland weed control, and as pack animals. Domestic sheep, goats and wild bighorn sheep are all susceptible to a multifactorial pneumonia. We sampled 43 herd goats from 7 herds and 48 pack goats from 11 herds for viral and bacterial serology, parasitology, and Pasteurellaceae microbiology. The goats in this study were in generally good health, although most goats did harbor various pathogens and parasites including several bacteria, specifically Pasteurellaceae, which have been associated with pneumonia in free-ranging bighorn sheep. It is not known if domestic goats can transmit the Pasteurellaceae or other pathogens found in this study readily to wild bighorn sheep. However, due the possibility of transmission, domestic goats in areas in or near bighorn sheep habitat should be managed to minimize the risk of spreading disease agents to bighorn sheep.

  3. Potential disease agents in domestic goats and relevance to bighorn sheep (Ovis canadensis management.

    Mark L Drew

    Full Text Available Domestic goats are raised for meat, milk and hair production, in herds for rangeland weed control, and as pack animals. Domestic sheep, goats and wild bighorn sheep are all susceptible to a multifactorial pneumonia. We sampled 43 herd goats from 7 herds and 48 pack goats from 11 herds for viral and bacterial serology, parasitology, and Pasteurellaceae microbiology. The goats in this study were in generally good health, although most goats did harbor various pathogens and parasites including several bacteria, specifically Pasteurellaceae, which have been associated with pneumonia in free-ranging bighorn sheep. It is not known if domestic goats can transmit the Pasteurellaceae or other pathogens found in this study readily to wild bighorn sheep. However, due the possibility of transmission, domestic goats in areas in or near bighorn sheep habitat should be managed to minimize the risk of spreading disease agents to bighorn sheep.

  4. Potential disease agents in domestic goats and relevance to bighorn sheep (Ovis canadensis) management

    Weiser, Glen C.


    Domestic goats are raised for meat, milk and hair production, in herds for rangeland weed control, and as pack animals. Domestic sheep, goats and wild bighorn sheep are all susceptible to a multifactorial pneumonia. We sampled 43 herd goats from 7 herds and 48 pack goats from 11 herds for viral and bacterial serology, parasitology, and Pasteurellaceae microbiology. The goats in this study were in generally good health, although most goats did harbor various pathogens and parasites including several bacteria, specifically Pasteurellaceae, which have been associated with pneumonia in free-ranging bighorn sheep. It is not known if domestic goats can transmit the Pasteurellaceae or other pathogens found in this study readily to wild bighorn sheep. However, due the possibility of transmission, domestic goats in areas in or near bighorn sheep habitat should be managed to minimize the risk of spreading disease agents to bighorn sheep. PMID:28282407

  5. Feed resources management of smallholder sheep and goat ...

    The study was conducted with the aid of questionnaires, farm visits and personal interviews, to determine the feed and feed resources management of smallholder sheep and goat producers in the area. Materials fed to sheep and goats included cut forage such as grasses, weeds, herbs, forbs, trees and shrubs, lianas, crop ...

  6. Structured decision making for managing pneumonia epizootics in bighorn sheep

    Sells, Sarah N.; Mitchell, Michael S.; Edwards, Victoria L.; Gude, Justin A.; Anderson, Neil J.


    Good decision-making is essential to conserving wildlife populations. Although there may be multiple ways to address a problem, perfect solutions rarely exist. Managers are therefore tasked with identifying decisions that will best achieve desired outcomes. Structured decision making (SDM) is a method of decision analysis used to identify the most effective, efficient, and realistic decisions while accounting for values and priorities of the decision maker. The stepwise process includes identifying the management problem, defining objectives for solving the problem, developing alternative approaches to achieve the objectives, and formally evaluating which alternative is most likely to accomplish the objectives. The SDM process can be more effective than informal decision-making because it provides a transparent way to quantitatively evaluate decisions for addressing multiple management objectives while incorporating science, uncertainty, and risk tolerance. To illustrate the application of this process to a management need, we present an SDM-based decision tool developed to identify optimal decisions for proactively managing risk of pneumonia epizootics in bighorn sheep (Ovis canadensis) in Montana. Pneumonia epizootics are a major challenge for managers due to long-term impacts to herds, epistemic uncertainty in timing and location of future epizootics, and consequent difficulty knowing how or when to manage risk. The decision tool facilitates analysis of alternative decisions for how to manage herds based on predictions from a risk model, herd-specific objectives, and predicted costs and benefits of each alternative. Decision analyses for 2 example herds revealed that meeting management objectives necessitates specific approaches unique to each herd. The analyses showed how and under what circumstances the alternatives are optimal compared to other approaches and current management. Managers can be confident that these decisions are effective, efficient, and

  7. Reproductive health status of north western Himalayan Gaddi sheep ...

    The study was aimed to provide basic information regarding reproductive status of Gaddi sheep reared by nomadic tribe of Himachal Pradesh. Female genitalia of Gaddi sheep (n=190) were collected from unorganized abattoirs around Palampur over a period of one and half years. Out of total genitalia examined, 80.53% ...

  8. Health management practices and disease prevalence in dairy sheep systems in Argentina Práticas de manejo sanitário e frequência de doenças em ovinos leiteiros na Argentina

    Victor H. Suárez


    Full Text Available A cross-sectional survey of 19 dairy sheep farms in Argentina was carried out with the purpose to know farm management, health practices, and occurrence and mortality of diseases. The survey comprised 40% of all sheep milking farms in Argentina. A questionnaire was conducted by way of personal interviews with sheep owners during farm visits. The proportions of farms reporting routine vaccination for clostridial diseases, contagious ecthyma, pneumonia and mineral and vitamin parenteral administration were 63%, 47.3%, 16.6% and 42.1% respectively. Regular treatment against lice was used in 37.5% of the farms, and 89.5% o the farmers treated against gastrointestinal nematodes (GIN. The mean number of GIN drenches per farm was 2.26±1.78 annually. In 68.4% of the milking flocks the California Mastitis Test was regularly done and 55.6% of the farmer managers had sampled their flocks once a year for Brucella ovis antibodies. During the pre-mating period respectively 68.4% and 50% of farmers clinically examined their rams and ewe for general health and teeth condition. The udders of ewes were frequently inspected at the start of each milking period. The most important parasite problems noticed were GIN (reported by 57.9% of farmers, lice (57.9% and scabies (10.5% and the most frequent infectious diseases were ecthyma (73.7%, pneumonia and other respiratory problems (57.9%, clinical mastitis (55.6%, clostridial diseases (36.9% and foot lameness (35.2%. Photosensitivity (47.4% and ruminal acidosis (42.1% were reported as other frequent toxic or metabolic disorders. Owners mentioned that the mean lifespan or milk productive time per ewe was 4.5±1.4 years. Perinatal lamb mortality was 8.5% and the total flock mortality rates, above the first 24 h of life was 6.9%. The high rates of lamb mortality during the pre-weaning (10.3% and post-weaning (5.9% periods indicate that this problem, as well as the most prevalent diseases, should be the subject of further

  9. Potential disease agents in domestic goats and relevance to bighorn sheep (Ovis canadensis) management

    Drew, Mark L.; Weiser, Glen C.


    Domestic goats are raised for meat, milk and hair production, in herds for rangeland weed control, and as pack animals. Domestic sheep, goats and wild bighorn sheep are all susceptible to a multifactorial pneumonia. We sampled 43 herd goats from 7 herds and 48 pack goats from 11 herds for viral and bacterial serology, parasitology, and Pasteurellaceae microbiology. The goats in this study were in generally good health, although most goats did harbor various pathogens and parasites including s...

  10. Economics of vaccinating extensively managed sheep flocks against Bluetongue disease

    Bluetongue is a serious and recurring threat to sheep producers throughout the world. In the western United States, bluetongue virus (BTV) is transmitted by biting midges in late summer and early autumn, just before lambs are sent to market. No vaccine is currently sold for the most common serotype ...

  11. Sheep and goat fermented meat sausages — health aspects

    Teixeira, A.; Rodrigues, Sandra; Dias, Teresa; Estevinho, Leticia M.


    The most common sausages use only pork meat and are ripened for long periods. However, some countries with great tradition of sheep and goat meat consumption have the habit of eating some processed products of these meats. In Mediterranean countries as well as in other parts of the world, the meat from young lamb or kid is very usual and appreciated. These young milk fed animals producing lightweight carcasses are highly appreciated by consumers and are traditionally comm...

  12. Towards evenly distributed grazing patterns: including social context in sheep management strategies

    Agustina di Virgilio


    Full Text Available Background. A large proportion of natural grasslands around the world is exposed to overgrazing resulting in land degradation and biodiversity loss. Although there is an increasing effort in the promotion of sustainable livestock management, rangeland degradation still occurs because animals’ foraging behaviour is highly selective at different spatial scales. The assessment of the ecological mechanisms modulating the spatial distribution of grazing and how to control it has critical implications for long term conservation of resources and the sustainability of livestock production. Considering the relevance of social interactions on animals’ space use patterns, our aim was to explore the potential effects of including animals’ social context into management strategies using domestic sheep grazing in rangelands as case study. Methods. We used GPS data from 19 Merino sheep (approximately 10% of the flock grazing on three different paddocks (with sizes from 80 to 1000 Ha during a year, to estimate resource selection functions of sheep grazing in flocks of different levels of heterogeneity. We assessed the effects of sheep class (i.e., ewes, wethers, and hoggets, age, body condition and time since release on habitat selection patterns. Results. We found that social rank was reflected on sheep habitat use, where dominant individuals (i.e., reproductive females used more intensively the most preferred areas and low-ranked (i.e., yearlings used less preferred areas. Our results showed that when sheep grazed on more heterogeneous flocks, grazing patterns were more evenly distributed at all the paddocks considered in this study. On the other hand, when high-ranked individuals were removed from the flock, low-ranked sheep shifted their selection patterns by increasing the use of the most preferred areas and strongly avoided to use less preferred sites (i.e., a highly selective grazing behaviour. Discussion. Although homogenization and segregation of

  13. Towards evenly distributed grazing patterns: including social context in sheep management strategies.

    di Virgilio, Agustina; Morales, Juan Manuel


    Background. A large proportion of natural grasslands around the world is exposed to overgrazing resulting in land degradation and biodiversity loss. Although there is an increasing effort in the promotion of sustainable livestock management, rangeland degradation still occurs because animals' foraging behaviour is highly selective at different spatial scales. The assessment of the ecological mechanisms modulating the spatial distribution of grazing and how to control it has critical implications for long term conservation of resources and the sustainability of livestock production. Considering the relevance of social interactions on animals' space use patterns, our aim was to explore the potential effects of including animals' social context into management strategies using domestic sheep grazing in rangelands as case study. Methods. We used GPS data from 19 Merino sheep (approximately 10% of the flock) grazing on three different paddocks (with sizes from 80 to 1000 Ha) during a year, to estimate resource selection functions of sheep grazing in flocks of different levels of heterogeneity. We assessed the effects of sheep class (i.e., ewes, wethers, and hoggets), age, body condition and time since release on habitat selection patterns. Results. We found that social rank was reflected on sheep habitat use, where dominant individuals (i.e., reproductive females) used more intensively the most preferred areas and low-ranked (i.e., yearlings) used less preferred areas. Our results showed that when sheep grazed on more heterogeneous flocks, grazing patterns were more evenly distributed at all the paddocks considered in this study. On the other hand, when high-ranked individuals were removed from the flock, low-ranked sheep shifted their selection patterns by increasing the use of the most preferred areas and strongly avoided to use less preferred sites (i.e., a highly selective grazing behaviour). Discussion. Although homogenization and segregation of flocks by classes


    H. Zaneb, K. Pervez, M. S. Sarwar, S. Sindhu.


    Full Text Available The project was aimed at evaluation of comparative therapeutic efficacy of two treatment regimes for the treatment of lead poisoning in sheep. For this purpose 20, two-months-old, lambs of Buchi breed were used as experimental animals. Five animals were kept as healthy control, whereas the remaining 15 animals were given oral aqueous solution of lead acetate daily. The dose was started from 5 mg/kg bodyweight and was increased gradually till it reached 100 mg/kg body weight by the end of 2nd month when clinical toxicosis was observed. Clinical findings included diarrhea, hindquarter weakness and reduction of feed intake, accompanied by anemia and elevated blood lead levels up to 2.72 ppm. The 15 toxicated animals were divided into three groups A, B and C comprising of 5 animals each. Disodium calcium edetate, which was used to treat animals of group A, resulted in 52.7% fall in blood lead level in 5 days. A combination of disodium calcium edetate and thiamine hydrochloride was used to treat animals of group B, which showed 73.8% fall in blood lead levels. Group C served as untreated control. Thus, combination therapy appears to be more effective for treatment of lead toxicosis.

  15. Market organization and animal genetic resource management: a revealed preference analysis of sheep pricing.

    Tindano, K; Moula, N; Leroy, P; Traoré, A; Antoine-Moussiaux, N


    Farm animal genetic resources are threatened worldwide. Participation in markets, while representing a crucial way out of poverty for many smallholders, affects genetic management choices with associated sustainability concerns. This paper proposes a contextualized study of the interactions between markets and animal genetic resources management, in the case of sheep markets in Ouagadougou, Burkina Faso. It focusses on the organization of marketing chains and the valuation of genetic characteristics by value chain actors. Marketing chain characterization was tackled through semi-structured interviews with 25 exporters and 15 butchers, both specialized in sheep. Moreover, revealed preference methods were applied to analyse the impact of animals' attributes on market pricing. Data were collected from 338 transactions during three different periods: Eid al-Adha, Christmas and New Year period, and a neutral period. The neutral period is understood as a period not close to any event likely to influence the demand for sheep. The results show that physical characteristics such as live weight, height at withers and coat colour have a strong influence on the animals' prices. Live weight has also had an increasing marginal impact on price. The different markets (local butcher, feasts, export market, sacrifices) represent distinct demands for genetic characteristics, entailing interesting consequences for animal genetic resource management. Any breeding programme should therefore take this diversity into account to allow this sector to contribute better to a sustainable development of the country.

  16. Stakeholder Perceptions of Welfare Issues and Indicators for Extensively Managed Sheep in Australia.

    Doughty, Amanda K; Coleman, Grahame J; Hinch, Geoff N; Doyle, Rebecca E


    An online survey was designed to form the basis of a framework for the welfare assessment of extensively managed sheep in Australia. The survey focused on welfare compromise and useful welfare indicators. A total of 952 people completed the survey in its entirety, representing four stakeholder groups: Public (53.6%), Producer (27.4%), Scientist (9.9%), and Service provider (9.1%). Animal welfare was considered to be important by all participating groups in this survey (average score of 3.78/4). Respondents felt the welfare of grazing sheep was generally adequate but improvement was desired (2.98/5), with female members of the public rating sheep welfare significantly worse than other respondents ( p risk to welfare (3.87/5), followed by heat stress (3.79), lameness (3.57) and husbandry practices (3.37). Key indicators recognised by all respondents were those associated with pain and fear (3.98/5), nutrition (4.23), mortality/management (4.27), food on offer (4.41) and number of illness/injures in a flock (4.33). There were gender and stakeholder differences in the perceived importance of both welfare issues and indicators with women and the public consistently rating issues (all p indicators (all p < 0.05) to be of greater significance than other respondents. These results highlight the importance of including all stakeholders and an even balance of genders when developing a welfare framework that can address both practical and societal concerns.

  17. Footrot and interdigital dermatitis in sheep: farmer satisfaction with current management, their ideal management and sources used to adopt new strategies.

    Wassink, G J; George, T R N; Kaler, J; Green, L E


    The aims of this research were to identify management practices that sheep farmers currently use to treat and prevent footrot in sheep and whether they consider that these are successful management tools and to find out how sheep farmers would ideally like to manage footrot in their flock. Over 90% of lameness in sheep in the UK is caused by Dichelobacter nodosus, which presents clinically as interdigital dermatitis (ID) alone or with separation of hoof horn (FR). A questionnaire was sent to 265 farmers to investigate their current management and their satisfaction with current management of the spectrum of clinical presentations of footrot. Farmers were also asked their ideal management of footrot and their interest in, and sources of information for, change. Approximately 160 farmers responded. Farmers satisfied with current management reported a prevalence of lameness 5%. These farmers practised routine foot trimming, footbathing and vaccination against footrot. Whilst 89% of farmers said they were satisfied with their management of FR over 34% were interested in changing management. Farmers identified veterinarians as the most influential source for new information. Farmers reported that ideally they would control FR by culling/isolating lame sheep, sourcing replacements from non-lame parents, trimming feet less, using antibacterial treatments less and using vaccination more. Footbathing was a commonly used management that was linked with dissatisfaction and that also was listed highly as an ideal management. Consequently, some of the ideal managements are in agreement with our understanding of disease control (culling and isolation, sourcing healthy replacements) but others are in contrast with our current knowledge of management and farmers self-reporting of satisfaction of management of footrot (less use of antibacterial treatment, more footbathing and vaccination). One explanation for this is the theory of cognitive dissonance where belief follows behaviour

  18. Fatal Pasteurella haemolytica pneumonia in bighorn sheep after direct contact with clinically normal domestic sheep.

    Foreyt, W J


    Six Rocky Mountain bighorn sheep were raised in captivity from birth (n = 5) or taken from the wild as a lamb (n = 1). After the bighorn sheep were in captivity for over a year, 6 clinically normal domestic sheep were placed on the 2 ha of pasture on which the bighorn sheep were kept. Nasal swab specimens were obtained from all sheep at the time the domestic sheep were introduced. Pasteurella haemolytica was isolated from swab specimens obtained from 4 of 6 domestic sheep, but not from specimens obtained from the bighorn sheep. All 6 bighorn sheep died of acute hemorrhagic pneumonia after exposure to domestic sheep. Death in the bighorn sheep occurred on days 4, 27, 27, 29, 36, or 71 after initial exposure to domestic sheep. Pasteurella haemolytica was isolated from respiratory tract tissue specimens of all bighorn sheep at the time of death. None of the domestic sheep were clinically ill during the study. At the end of the study, 3 of 6 domestic sheep were euthanatized, and at necropsy, P haemolytica was isolated from 2 of them. The most common serotypes in bighorn and domestic sheep were P haemolytica T-3 and A-2. Other serotypes isolated included P haemolytica A-1, A-9, and A-11 in bighorn sheep and A-1 in domestic sheep. On the basis of results of this study and of other reports, domestic sheep and bighorn sheep should not be managed in proximity to each other because of the potential fatal consequences in bighorn sheep.

  19. Reproduction Efficiency and Health Traits in Dorper, White Dorper, and Tsigai Sheep Breeds under Temperate European Conditions

    D. Gavojdian


    Full Text Available The objective of the current pilot study was to evaluate the reproductive performance and health indicators in Dorper, White Dorper, and Tsigai breed ewes managed semi-intensively under European temperate conditions. A total of 544 ewe-year units were observed, with ewes (ranging from 1.5 to 8 years of age managed under identical rearing conditions for a period of two consecutive production cycles (2012 through 2013 and 2013 through 2014. In general, significant (p≤0.001 genotype-related disparities were found in occurrence rates for all health parameters taken into study. Clinical mastitis incidence was significantly lower (p≤0.05 in Dorper (9.4% and White Dorper (10.8% breeds compared to that of Tsigai ewes (17.4%. Significant differences (p≤0.05 for lameness were found between Dorper and Tsigai breeds, with occurrence rates of 8.0% and 2.9%, respectively. Incidence for pneumonia and abortion was not influenced (p>0.05 by the ewes’ genotype. Litter size was significantly lower (p≤0.05 in White Dorper breed than for Dorper and Tsigai ewes, of 1.21, 1.40, and 1.45, respectively. Conception rates and lambs survival were not affected (p>0.05 by genotype. Results suggest that South African Dorper and White Dorper sheep breeds have adapted well to the specific rearing conditions.

  20. Health care engineering management.

    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.

  1. Selling my sheep to pay for medicines - household priorities and coping strategies in a setting without universal health coverage.

    Husøy, Onarheim Kristine; Molla, Sisay Mitike; Muluken, Gizaw; Marie, Moland Karen; Frithof, Norheim Ole; Ingrid, Miljeteig


    The first month of life is the period with the highest risk of dying. Despite knowledge of effective interventions, newborn mortality is high and utilization of health care services remains low in Ethiopia. In settings without universal health coverage, the economy of a household is vulnerable to illness, and out-of-pocket payments may limit families' opportunities to seek health care for newborns. In this paper we explore intra-household resource allocation, focusing on how families prioritize newborn health versus other household needs and their coping strategies for managing these priorities. A qualitative study was conducted in 2015 in Butajira, Ethiopia, comprising observation, semi-structured interviews, and focus group discussions with household members, health workers, and community members. Household members with hospitalized newborns or who had experienced neonatal death were primary informants. In this predominantly rural and poor district, households struggled to pay out-of-pocket for services such as admission, diagnostics, drugs, and transportation. When newborns fell ill, families made hard choices balancing concerns for newborn health and other household needs. The ability to seek care, obtain services, and follow medical advice depended on the social and economic assets of the household. It was common to borrow money from friends and family, or even to sell a sheep or the harvest, if necessary. In managing household priorities and high costs, families waited before seeking health care, or used cheaper traditional medicines. For poor families with no money or opportunity to borrow, it became impossible to follow medical advice or even seek care in the first place. This had fatal health consequences for the sick newborns. While improving neonatal health is prioritized at policy level in Ethiopia, poor households with sick neonates may prioritize differently. With limited money at hand and high direct health care costs, families balanced conflicting

  2. Lead (Pb) in sheep exposed to mining pollution: implications for animal and human health.

    Pareja-Carrera, Jennifer; Mateo, Rafael; Rodríguez-Estival, Jaime


    Livestock from the ancient mining area of Sierra Madrona and Alcudia Valley (Spain) is exposed to elevated levels of lead (Pb), as previous studies based on blood monitoring have revealed. Here we have studied blood, liver and muscle Pb levels in sheep in order to know if Pb exposure could represent a risk for human consumers of the meat and offal of these animals. A cross-sectional study was conducted with ≥4 years old (adults) ewes from the mining area (n=46) and a control area (n=21). Blood samples were taken before the sacrifice at the slaughterhouse, and liver and muscle samples were taken thereafter. At the same time, 2-3 year old rams (subadults, n=17) were blood sampled in the mining area. Blood, liver and muscle Pb levels were higher in the mining than in the control area. Blood Pb concentration in the mining area (n= 44, mean: 6.7μg/dl in ewes and 10.9μg/dl in rams) was above background levels (>6μg/dl) in 73.3 percent of animals. Liver Pb concentration in 68 percent of sheep from the mining area (n=32, mean: 6.16μg/g dry weight, d.w.) exceeded the minimum level associated with toxic exposure (5µg/g d.w.) and 87.5 percent of liver samples were above European Union Maximum Residue Levels (MRL) established for offal destined for human consumption (0.5µg/g w.w.~1.4µg/g d.w.). On the contrary, none of the muscle samples in ewes exceeded the EU MRL (0.1µg/g w.w.~0.34µg/g d.w.) established for meat, which may be related to the decline of blood Pb levels with age observed in the present study. These results suggest a potential health effect for sheep exposed to Pb pollution in this area and implications for food safety, but further research with lamb meat may be necessary to refine the risk assessment for human consumers. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Health care operations management

    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

  4. Integrated Building Health Management

    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...

  5. Integrated Health Management Definitions

    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...

  6. Genetic variability of six French meat sheep breeds in relation to their genetic management.

    Huby, Marie; Griffon, Laurent; Moureaux, Sophie; De Rochambeau, Hubert; Danchin-Burge, Coralie; Verrier, Etienne


    Some demographic parameters, the genetic structure and the evolution of the genetic variability of six French meat sheep breeds were analysed in relation with their management. Four of these breeds are submitted to more or less intense selection: the Berrichon du Cher (BCH), Blanc du Massif Central (BMC), Charollais (CHA) and Limousin (LIM); the other two breeds are under conservation: the Roussin de La Hague (RLH) and Solognot (SOL). Genealogical data of the recorded animals born from 1970 to 2000 and of their known ancestors were used. The most balanced contributions of the different flocks to the sire-daughter path was found in the SOL. In the BCH, a single flock provided 43% of the sire-AI sire path, whereas the contributions of the flocks were more balanced in the BMC and LIM (the only other breeds where AI is used to a substantial amount). The distribution of the expected genetic contribution of the founder animals was found to be unbalanced, especially in the BCH and LIM. The effective numbers of ancestors (founders or not) for the ewes born from 1996 to 2000 were equal to 35 (BCH), 144 (BMC), 112 (CHA), 69 (LIM), 40 (RLH) and 49 (SOL). Inbreeding was not analysed in the BMC, due to incomplete pedigree information. From 1980 on, the rates of inbreeding, in percentage points per year, were +0.112 (BCH), +0.045 (CHA), +0.036 (LIM), +0.098 (RLH) and +0.062 (SOL). The implications of the observed trends on genetic variability are discussed in relation to the genetic management of each breed. The need for a larger selection basis in the BCH, the efficiency of the rules applied in the SOL to preserve the genetic variability and the need for a more collective organisation in the CHA and RLH are outlined.

  7. Genetic variability of six French meat sheep breeds in relation to their genetic management

    Coralie Danchin-Burge


    Full Text Available Abstract Some demographic parameters, the genetic structure and the evolution of the genetic variability of six French meat sheep breeds were analysed in relation with their management. Four of these breeds are submitted to more or less intense selection: the Berrichon du Cher (BCH, Blanc du Massif Central (BMC, Charollais (CHA and Limousin (LIM; the other two breeds are under conservation: the Roussin de La Hague (RLH and Solognot (SOL. Genealogical data of the recorded animals born from 1970 to 2000 and of their known ancestors were used. The most balanced contributions of the different flocks to the sire-daughter path was found in the SOL. In the BCH, a single flock provided 43% of the sire-AI sire path, whereas the contributions of the flocks were more balanced in the BMC and LIM (the only other breeds where AI is used to a substantial amount. The distribution of the expected genetic contribution of the founder animals was found to be unbalanced, especially in the BCH and LIM. The effective numbers of ancestors (founders or not for the ewes born from 1996 to 2000 were equal to 35 (BCH, 144 (BMC, 112 (CHA, 69 (LIM, 40 (RLH and 49 (SOL. Inbreeding was not analysed in the BMC, due to incomplete pedigree information. From 1980 on, the rates of inbreeding, in percentage points per year, were +0.112 (BCH, +0.045 (CHA, +0.036 (LIM, +0.098 (RLH and +0.062 (SOL. The implications of the observed trends on genetic variability are discussed in relation to the genetic management of each breed. The need for a larger selection basis in the BCH, the efficiency of the rules applied in the SOL to preserve the genetic variability and the need for a more collective organisation in the CHA and RLH are outlined.

  8. Epidemiology of gastrointestinal nematodes of sheep managed under traditional husbandry system in Kashmir valley.

    Tariq, K A; Chishti, M Z; Ahmad, F; Shawl, A S


    The present study was conducted with the objective to investigate the seasonal epidemiological prevalence of gastrointestinal tract (GIT) nematodes in different age groups, sexes and breeds (genotypes) of sheep through necropsy and faecal analysis over a period of 2 years in Kashmir valley, India. A total of 1533 sheep were examined [faecal examination: 1035 (year 1: 561, year 2: 474); necropsy: 498 (year 1: 232, year 2: 266)]. Out of these, 945 (61.64%) were found infected [faecal examination: 697 (67.34%, year 1: 390 (69.51%), year 2: 307 (46.99%); necropsy: 248 (49.79%, year 1: 123 (53.01%), year 2: 125 (64.69%)] with GIT nematodes. The over all prevalence of GIT nematodes in sheep in year 1 was 64.76 and 58.37% in year 2 (P=0.04). The parasites in decreasing order of prevalence (%) in sheep were Haemonchus contortus (59.6); Ostertagia circumcincta (38.0); Bunostomum trigonocephalum (37.7); Chabertia ovina (37.7); Trichostrongylus spp. (33.9); Nematodirus spathiger (29.4); Oesophagostomum columbianum (28.4); Trichuris ovis (23.5) and Marshallagia marshalli (22.1). Season, sex, age, and genotype were the factors that influenced the epidemiological prevalence of GIT nematodes in sheep in the present study. The maximum nematode infection was observed in summer season and lowest in winter (P=0.0005). Local Kashmiri breed was less infected as compared to other genotypes (P>0.05). Lower age groups were more infected than adult animals (P>/=0.05). Prevalence was higher in rams (males) than eves (females) (P>0.05). The present study will initially be of great significance to add to the existing knowledge of the epidemiology of GIT nematodes of small ruminants and the findings will be quite helpful to devise the appropriate control and prophylactic strategies for GIT nematodiasis of sheep reared under the temperate agro-climatic conditions.

  9. Relationship of litter size with milk yield, udder morphology and udder health of East Friesian sheep

    Zvonimir Prpić


    Full Text Available The aim of this study was to determine relationship between litter size and milk yield, udder morphology, and udder health of East Friesian ewes. For that purpose a total of 80 East Friesian ewes, from 2nd to 4th lactation, with symmetrical udders, without visible (clinical signs of mastitis were involved in this study. Until weaning at average age of 60±5 days lambs suckled their mothers exclusively. During milking period regular milking controls (on a monthly basis were carried out (AT method and, on these occasions, individual milk samples for chemical composition analysis were taken. Three times per lactation (1st, 3rd and 5th milking control, prior to the milking, evaluation and measuring of udder morphology traits were performed. Also, during above-mentioned test-day controls (three times per lactation one sample of half udder milk was taken with purpose of bacterial and somatic cell counts (SCC tests. Ewes with twin and triplet lambs had significantly (P0.05 and depth (P>0.05. Besides that, udders of ewes with twins and triplets had higher cistern, greater teat angle and larger teat dimensions than ewes with singles, although those differences were not statistically significant. Ewes with single lamb had teats more (P<0.05 cranially oriented than ewes with twins and triplets. Significant (P<0.05 differences in somatic cell count (log10SCC between ewes of different litter sizes were determined, regardless of the health status of mammary gland. The higher (P<0.05 prevalence of subclinical mastitis was observed in ewes with twin and triplet lambs than in ewes with singles. In 46% of mammary glands (udder halves of sheep with twins and triplets a subclinical mastitis was established and even 65.8% of them undergone an infection of one or both halves of the udder during the milking period.

  10. The potential for improving welfare standards and productivity in United Kingdom sheep flocks using veterinary flock health plans.

    Scott, P R; Sargison, N D; Wilson, D J


    Data from industry sources detailing variable costs in 2003 revealed that the average farmer keeping 1000 lowland ewes in the United Kingdom spent 3500 UK pounds annually on veterinary fees and medicines. Despite such expenditure, psoroptic mange and cutaneous myiasis are common in the UK, resistance to one or more anthelmintic group is not only common but increasing in frequency and distribution, and abortion outbreaks caused by Toxoplasma gondii and Chlamydophila abortus are frequently reported by veterinary laboratories. Welfare concerns also arise from farmers' intransigence towards tail docking and castration in lambs (mutilations), reported market forces necessitating long distance road transportation to slaughter plants, and an unwillingness to employ veterinary surgeons for obstetrical problems. The spread of sheep scab in the UK over the past decade illustrates the failure of flock owners to effect rudimentary biosecurity and disease control measures. A first step towards improving the health and welfare of sheep would be the immediate implementation of basic good husbandry practices, including ectoparasiticide treatment for sheep scab eradication, prophylaxis for cutaneous myiasis in selected lambs, and appropriate vaccination strategies for clostridial diseases and certain abortion agents. There would also be money from within current farm expenditure to provide veterinary attention for obstetrical problems affecting up to 2% of ewes per annum. Planned use of ecto- and endoparasiticides is urgently needed to maintain the efficacy of these unique drugs.

  11. Trypanotolerance in Djallonke sheep and West African Dwarf goats : Importance of trypanosomosis, nutrition, helminth infections and management factors

    Osaer, S.; Goossens, B.


    The main breeds of sheep and goats in The Gambia, the Djallonke sheep and West African Dwarf goats are trypanotolerant. The Djallonke sheep, however, have a higher degree of trypanotolerance than the WAD goats. This trait is genetically linked although the mechanism of trypanotolerance is different

  12. Dystocia in sheep and goats: outcome and fertility following surgical and non-surgical management

    Zuhair Bani Ismail


    Full Text Available Cesarean section is a life-saving surgical procedure usually undertaken in sheep and goats that fail to deliver vaginally (dystocia. Unfortunately, there are no recent review articles in literature that summarize the results of published case reports and clinical trials concerning indications, surgical approaches and procedures and outcomes following cesarean section in sheep and goats. Therefore, the aim of this article was to compile available data related to dystocia and cesarean section in small ruminants. Fortunately, the incidence of dystocia in small ruminants is considered to be low. It can be caused by either maternal or fetal factors. Maternal-related dystocia is most commonly because of failure of cervical dilation, narrow birth canal and uterine inertia. Those related to fetal causes are usually associated with fetal malposition/presentation, feto-pelvic disproportion/fetal oversize, and fetal malformation. Manual extraction of the fetus may be attempted in most cases, however, early surgical intervention by performing cesarean section ensures satisfactory outcome. Cesarean section is usually performed in lateral recumbency through left paralumbar fossa or left paralumbar fossa oblique celiotomy under local analgesia. The success rates and post-operative complications in sheep and goats are underreported; however, early surgical intervention using aseptic technique usually results in a satisfactory outcome for both the dam and newborn with acceptable prognosis for future breeding soundness.

  13. Health physics information management

    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

  14. Intelligent Vehicle Health Management

    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

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

    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 ...

  16. Diergezondheid en management op biologische boerderijen die geen antibiotica gebruiken = Animal health and farm management on organic farms with no antibiotics

    Smolders, E.A.A.


    On nine milk cattle companies with cows, two with goats and one with sheep, which none of them do not or hardly uses antibiotics, animal health and management have been examined. Reasons not to use antibiotics have to do with resistance, residues, healthier livestock, less stress and economic

  17. Stress Managment and Health Promotion

    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.

  18. Operations management in health care.

    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.

  19. Analyse of relationships between freezing point and selected indicators of udder health state among cow, goat and sheep milk

    Oto Hanuš


    Full Text Available Milk freezing point (MFP is important quality indicator. Aim was to analyse the relationships of MFP to selected udder health milk indicators (MIs by comparison between cows (reference, goats and sheep. Bulk milk samples came from 3 herds of Czech Fleckvieh (B, n 93 and 1 goat herd and sheep flock (White short-haired, W, n 60; Tsigai, C, n 60. Animal nutrition was performed under the typical country conditions. MIs which were investigated: DM, dry matter; SNF, solid non fat; L, lactose (all in %; SCC, somatic cell count (103 ml−1; EC, electrical conductivity (mS cm−1; MFP (°C; Na and K (in mg kg−1. W MFP was −0.5544 ± 0.0293, B −0.5221 ± 0.0043 and C −0.6048 ± 0.0691 °C. The B MFP was related to L (−0.36; P < 0.01, W was not related to L (−0.07; P > 0.05 and C was related to L (0.40; P < 0.01. These facts could be explainable by worse SCC geometric averages for used W (3,646 103 ml−1 and C (560 103 ml−1 milk as compared to B (159 103 ml−1. Only 0.5 and 10.5% of variations in MFP were explainable by variations in DM and SNF in B, 32.7 and 12.8% in W but already 49.4 and 45.0% in C. Higher C values were caused by high MFP variability, 11.8% (C versus 0.8% (B. There is possible to derive the more reliable MFP qualitative limits for more efficient monitoring rules of milk quality problems in B, W and C.

  20. Investigations concerning the prevalence of Coxiella burnetii and Chlamydia abortus in sheep in correlation with management systems and abortion rate in Lower Saxony in 2004.

    Runge, Martin; Binder, Alfred; Schotte, Ulrich; Ganter, Martin


    The intracellular bacteria Coxiella (C) burnetii and Chlamydia (Chl) abortus induce abortion in sheep and also affect humans. While Chl. abortus only infrequently infects humans, C burnetii is the aetiological agent of numerous Q fever outbreaks during the last decades. There is only limited knowledge about the prevalence of both pathogens in sheep, although sheep are involved in almost all Q fever outbreaks in Germany. The aim of our study was to investigate the prevalence of both pathogens in flocks located in Lower Saxony, Germany, in correlation to the management form and abortion rate. Serum samples of 1714 sheep from 95 flocks located in Lower Saxony were investigated by ELISA. 2.7% of these samples were positive, 1.3% showed inconclusive results in the C. burnetii-ELISA. Elevated intra-flock seroprevalences were only detected in three migrating flocks. Chlamydia-specific antibodies could be detected in 15.1% serum samples of mainly shepherded and migrating flocks. In one of these flocks with a high intra-flock seroprevalence for C burnetii (27%) and Chlamydia (44.9%), C burnetii was detected in 21.6% of the placenta samples of normal births and in 12.5% of the colostrum samples by PCR. Aborted fetuses and the corresponding placentas were negative in C burnetii-PCR, but in most of them and also in many other placenta samples Chl. abortus could be detected by PCR and DNA microarray. This survey shows a low overall prevalence of C. burnetii in sheep in Lower Saxony in the year 2004. However, three migrating flocks with a high intra-flock prevalence are localized in the southern parts of Lower Saxony. Spreading of C burnetii could occur, because of the large radius of grazing of all three flocks.

  1. Prevalence of and risk factors associated with ovine progressive pneumonia in Wyoming sheep flocks.

    Gerstner, Shelley; Adamovicz, Jeffrey J; Duncan, John V; Laegreid, William W; Marshall, Katherine L; Logan, James R; Schumaker, Brant A


    To determine the prevalence of antibodies against small ruminant lentivirus (SRLV), the causative agent of ovine progressive pneumonia (OPP), and to identify risk factors associated with OPP in Wyoming sheep flocks. Cross-sectional study. 1,415 sheep from 54 flocks in Wyoming. Flocks were surveyed as part of the National Animal Health Monitoring System (NAHMS) 2011 sheep study. Serum samples obtained from sheep in Wyoming were analyzed for anti-SRLV antibodies by use of a competitive-inhibition ELISA. The prevalence of seropositive animals overall and within each flock was calculated. Respective associations between flock OPP status and various demographic and management variables were assessed. The estimated prevalence of sheep seropositive for anti-SRLV antibodies and OPP-infected flocks in Wyoming was 18.0% and 47.5%, respectively. Within OPP-infected flocks, the prevalence of seropositive sheep ranged from 3.9% to 96%. Flocks maintained on nonfenced range were more likely to be infected with OPP than were flocks maintained on fenced range (OR, 3.4; 95% confidence interval, 1.1 to 10.7). The estimated prevalence of OPP-infected flocks in Wyoming did not vary substantially from that at the regional or national level reported in the NAHMS 2001 sheep study. Compared with results of the NAHMS 2011 sheep study, Wyoming producers were more familiar with OPP than were other US sheep producers, but only 61% of Wyoming producers surveyed reported being very or somewhat familiar with the disease. Results indicated that OPP is prevalent in many Wyoming sheep flocks, which suggested that continued efforts are necessary to increase producer knowledge about the disease and investigate practices to minimize economic losses associated with OPP.

  2. Factors of welfare reduction in dairy sheep and goats

    Antonio Pazzona


    Full Text Available Scientific research on factors causing the reduction of well-being in sheep and goats is rather recent, as are studies of strategies to minimize the adverse effects of environmental challenges and improper management practices on flock welfare. Sheep and goats, considered very rustic animals, are reared prevalently under extensive production systems and are widespread mainly in marginal areas. For these reasons, only few studies on the welfare of these species have been carried out in the past. More recently, the scenario has changed, due to a gradual diffusion of intensive and semi-intensive production systems, especially in dairy sheep and goat breeds, to the growing concern of consumers about the life conditions of farmed animals, and to the issuing of a number of rules and laws on the safety of animal products and well-being of farmed livestock. As a consequence, several research groups have turned their attention to the welfare of sheep and goats. Nevertheless, information on this topic is still scarce. This paper reviews major critical points regarding the endangerment of welfare in farmed sheep and goats. Climatic extremes and seasonal fluctuations in herbage amount and quality are discussed as important causes of the reduction of well-being in extensive production systems, which can impair production efficiency of grazing animals and dramatically affect the welfare and health status of sheep and goats. Space allowance and structures of sheep and goat houses are described as the main potential sources of discomfort for housed flocks, together with inadequate control of micro-environment, and inappropriate milking procedures and human-animal interactions. Recent studies on the impact of high ambient temperature, different ventilation regimes, high stocking densities, reduced airspace and poor litter management on behaviour, immune and endocrine response, and on performance of sheep and goats are discussed. The effects of inadequate milking

  3. Health Applications for Corporate Health Management.

    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.

  4. Demography of Dall's sheep in northwestern Alaska

    Kleckner, Christopher; Udevitz, Mark S.; Adams, Layne G.; Shults, Brad S.


    Dall’s sheep in northwestern Alaska declined in the early 1990s following the severe 1989-90 and 1990-91 winters. In the Baird Mountains of Noatak National Preserve, estimates of adult sheep declined by 50% from 800 in 1989 to under 400 in 1991. Population counts remained low throughout 1991 to 1996, reaching a minimum of 244 adult sheep in 1996. Few lambs were observed during annual midsummer aerial surveys in 1991 to 1994. We suspect that these declines resulted from a combination of poorer nutritional condition and increased vulnerability of sheep to predation resulting from severe winter conditions.As a result of these declines, both subsistence and sport hunting seasons were closed by emergency order in 1991, resulting in substantial management controversy. The affected publics, although willing to accept the closures, questioned the validity of the sheep survey data and strongly emphasized their interest in restoring harvests as soon as populations increased sufficiently. In 1995 the Northwest Arctic Regional Advisory Council, the local advisory committee for the Federal Subsistence Board, passed a motion supporting efforts to initiate research on sheep populations in the region to better understand the factors limiting sheep populations and to evaluate sheep survey methodologies.Currently estimates of Dall’s sheep population size and composition in the western Brooks Range are based on intensive fixed-wing aerial surveys conducted annually since 1986 in areas including the Baird Mountains. The annual variation in recent Baird Mountains aerial counts cannot be explained with reasonable assumptions about reproduction and survival, suggesting that there is some variability in the proportion of the population observed each year or that a substantial number of sheep move during the survey. Prior to our research, no attempt had been made to estimate visibility bias or precision for these surveys.Our understanding of Dall’s sheep population biology comes

  5. Public health financial management competencies.

    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.

  6. Kootenai River Wildlife Habitat Enhancement Project : Long-term Bighorn Sheep/Mule Deer Winter and Spring Habitat Improvement Project : Wildlife Mitigation Project, Libby Dam, Montana : Management Plan.

    Yde, Chis


    The Libby hydroelectric project, located on the Kootenai River in northwestern Montana, resulted in several impacts to the wildlife communities which occupied the habitats inundated by Lake Koocanusa. Montana Department of Fish, Wildlife and Parks, in cooperation with the other management agencies, developed an impact assessment and a wildlife and wildlife habitat mitigation plan for the Libby hydroelectric facility. In response to the mitigation plan, Bonneville Power Administration funded a cooperative project between the Kootenai National Forest and Montana Department of Fish, Wildlife and Parks to develop a long-term habitat enhancement plan for the bighorn sheep and mule deer winter and spring ranges adjacent to Lake Koocanusa. The project goal is to rehabilitate 3372 acres of bighorn sheep and 16,321 acres of mule deer winter and spring ranges on Kootenai National Forest lands adjacent to Lake Koocanusa and to monitor and evaluate the effects of implementing this habitat enhancement work. 2 refs.

  7. Disaster Management: Mental Health Perspective.

    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.

  8. Intelligent Integrated System Health Management

    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

  9. Cartilage Health in Knees Treated with Metal Resurfacing Implants or Untreated Focal Cartilage Lesions: A Preclinical Study in Sheep.

    Martinez-Carranza, Nicolas; Hultenby, Kjell; Lagerstedt, Anne Sofie; Schupbach, Peter; Berg, Hans E


    Background Full-depth cartilage lesions do not heal and the long-term clinical outcome is uncertain. In the symptomatic middle-aged (35-60 years) patient, treatment with metal implants has been proposed. However, the cartilage health surrounding these implants has not been thoroughly studied. Our objective was to evaluate the health of cartilage opposing and adjacent to metal resurfacing implants. Methods The medial femoral condyle was operated in 9 sheep bilaterally. A metallic resurfacing metallic implant was immediately inserted into an artificially created 7.5 mm defect while on the contralateral knee the defect was left untreated. Euthanasia was performed at 6 months. Six animals, of similar age and study duration, from a previous study were used for comparison in the evaluation of cartilage health adjacent to the implant. Cartilage damage to joint surfaces within the knee, cartilage repair of the defect, and cartilage adjacent to the implant was evaluated macroscopically and microscopically. Results Six animals available for evaluation of cartilage health within the knee showed a varying degree of cartilage damage with no statistical difference between defects treated with implants or left untreated ( P = 0.51; 95% CI -3.7 to 6.5). The cartilage adjacent to the implant (score 0-14; where 14 indicates no damage) remained healthy in these 6 animals showing promising results (averaged 10.5; range 9-11.5, SD 0.95). Cartilage defects did not heal in any case. Conclusion Treatment of a critical size focal lesion with a metal implant is a viable alternative treatment.

  10. Pneumonia in bighorn sheep: Risk and resilience

    Cassirer, E. Frances; Manlove, Kezia R.; Almberg, Emily S.; Kamath, Pauline; Cox, Mike; Wolff, Peregrine L.; Roug, Annette; Shannon, Justin M.; Robinson, Rusty; Harris, Richard B.; Gonzales, Ben J.; Plowright, Raina K.; Hudson, Peter J.; Cross, Paul C.; Dobson, Andrew; Besser, Thomas E.


    Infectious disease was an important driver of historic declines and extirpations of bighorn sheep (Ovis canadensis) in North America and continues to impede population restoration and management. Domestic sheep have long been linked to pneumonia outbreaks in bighorn sheep and this association has now been confirmed in 13 captive commingling experiments. However, ecological and etiological complexities still hinder our understanding and control of the disease. We provide an overview of the current state of knowledge about the biology and management of respiratory disease in bighorn sheep and propose strategies for moving forward. Epizootic pneumonia in bighorn sheep is polymicrobial. Mycoplasma ovipneumoniae, a bacterium host-specific to Caprinae and commonly carried by healthy domestic sheep and goats appears to be a necessary primary agent. All-age epizootics following introduction of M. ovipneumoniae along with other pathogens into bighorn sheep populations are usually severe (median mortality 47%) but fatality rates vary widely, from 15 – 100%. Disease severity may be influenced by the strain of M. ovipneumoniae, by secondary bacterial and viral pathogens, and by factors affecting transmission and host immunity. Once introduced, M. ovipneumoniae can persist in bighorn sheep populations for decades. Carrier dams transmit the pathogen to their susceptible lambs, triggering fatal pneumonia outbreaks in nursery groups, which limits recruitment and slows or prevents population recovery. The result is that demographic costs of pathogen persistence often outweigh the impacts of the initial invasion and die-off. There is currently no effective vaccine or antibiotic for domestic or wild sheep and to date, no management actions have been successful in reducing morbidity, mortality, or disease spread once pathogen invasion has occurred. Molecular-based strain typing suggests that spillover of M. ovipneumoniae into bighorn sheep populations from domestic small ruminants

  11. Managed consumerism in health care.

    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.

  12. Gamification and geospatial health management

    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.

  13. Gamification and geospatial health management

    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

  14. EFSA BIOHAZ Panel (EFSA Panel on Biological Hazards, 2013. Scientific Opinion on the public health hazards to be covered by inspection of meat from sheep and goats

    Hald, Tine; Baggesen, Dorte Lau

    A risk ranking process identified Toxoplasma gondii and pathogenic verocytotoxin-producing Escherichia coli (VTEC) as the most relevant biological hazards for meat inspection of sheep and goats. As these are not detected by traditional meat inspection, a meat safety assurance system using risk......-based interventions was proposed. Further studies are required on T. gondii and pathogenic VTEC. If new information confirms these hazards as a high risk to public health from meat from sheep or goats, setting targets at carcass level should be considered. Other elements of the system are risk...... the extensive production systems used, and the ranking of chemical substances, which should be regularly updated and include new hazards. Control programmes across the food chain, national residue control plans, feed control and monitoring of environmental contaminants should be better integrated. Meat...

  15. Diagnostic and control functions of the radioisotope methods for the reproduction management of cattle and sheep breeding

    Dimitrov, M.; Georgiev, P.; Vasilev, K.


    The following applications of radioimmunoassay were studied: 1) for early diagnosis of pregnance in caws and sheep by determination of progesterone (PG) in milk and blood plasma via veterinary radioimmunological test STERON - RM 125 ; 2) for diagnosis and treatment of ovarian disturbances in cows by RIA of luteinizing hormone (LH), follicle stimulating hormone (FSH) and PG in blood plasma; 3) for control of the biological efficiency of sheep estrus synchronisation with MAP (vaginal tampons) and Estrophan (PgF 2 α); 4) for control of the reproductive condition of rams and effect of Tribestan in treatment of different forms of impotention by RIA of testosterone in blood. It was established that the use of RIA objectified the process of decision-making in regulation of the reproduction deviations in ruminating farm animals by veterinary means. Conclusions are drawn and suppositions are made for introduction of the radioisotope methods in the reproduction control of cattle and sheep breeding in practice. 4 tabs.; 15 refs

  16. Reengineering health care materials management.

    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.

  17. Air pollution - health and management

    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.

  18. X-33/RLV System Health Management/Vehicle Health Management

    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.

  19. 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...

  20. Gender participation in sheep and goat farming in Najran, Southern Saudi Arabia

    Fahad O. Aldosari


    Full Text Available Sheep and goat farming is a major source of income in the rural areas of Al-Wadiah in Najran region of Southern Saudi Arabia. The study aims to identify the factors and parameters that influence gender participation in sheep and goat farming. Data were collected by interviewing 167 high school students, including 70 male and 97 female students, in Al-Wadiah, by using the simple random sampling technique. Data were statistically analyzed to establish the relationship between gender and participation in sheep and goat farming. The study revealed significant differences between the two genders, for instance, male herders were more experienced, received more benefits, showed greater interest in discussions on topics related to sheep and goat farming, followed information from TV and radio, and received more services offered by veterinary clinics, which proved more beneficial for them. On the other hand, female herders received fewer services, and the veterinary clinics proved less beneficial for them. However, the correlation between the participation of both genders in sheep and goats management was non-significant toward the statement “feeling ashamed of participating in sheep and goat farming.” Generally, sheep and goat rearing proves more beneficial for male participants than female participants, owing to their greater experience and interest in livestock farming. Moreover, they receive more benefits from TV, radio and veterinary clinics to maintain better health of their livestock. Both male and female herders contribute equally to sheep and goat farming by limiting the time spent on their daily routine. This study would enable policymakers and planners to develop more strategies and extension education programs to overcome the identified barriers and improve the livelihood of herders through their enhanced participation in remote areas.

  1. Gender participation in sheep and goat farming in Najran, Southern Saudi Arabia.

    Aldosari, Fahad O


    Sheep and goat farming is a major source of income in the rural areas of Al-Wadiah in Najran region of Southern Saudi Arabia. The study aims to identify the factors and parameters that influence gender participation in sheep and goat farming. Data were collected by interviewing 167 high school students, including 70 male and 97 female students, in Al-Wadiah, by using the simple random sampling technique. Data were statistically analyzed to establish the relationship between gender and participation in sheep and goat farming. The study revealed significant differences between the two genders, for instance, male herders were more experienced, received more benefits, showed greater interest in discussions on topics related to sheep and goat farming, followed information from TV and radio, and received more services offered by veterinary clinics, which proved more beneficial for them. On the other hand, female herders received fewer services, and the veterinary clinics proved less beneficial for them. However, the correlation between the participation of both genders in sheep and goats management was non-significant toward the statement "feeling ashamed of participating in sheep and goat farming." Generally, sheep and goat rearing proves more beneficial for male participants than female participants, owing to their greater experience and interest in livestock farming. Moreover, they receive more benefits from TV, radio and veterinary clinics to maintain better health of their livestock. Both male and female herders contribute equally to sheep and goat farming by limiting the time spent on their daily routine. This study would enable policymakers and planners to develop more strategies and extension education programs to overcome the identified barriers and improve the livelihood of herders through their enhanced participation in remote areas.

  2. Quantitative trait loci linked to PRNP gene controlling health and production traits in INRA 401 sheep

    Brunel Jean-Claude


    Full Text Available Abstract In this study, the potential association of PrP genotypes with health and productive traits was investigated. Data were recorded on animals of the INRA 401 breed from the Bourges-La Sapinière INRA experimental farm. The population consisted of 30 rams and 852 ewes, which produced 1310 lambs. The animals were categorized into three PrP genotype classes: ARR homozygous, ARR heterozygous, and animals without any ARR allele. Two analyses differing in the approach considered were carried out. Firstly, the potential association of the PrP genotype with disease (Salmonella resistance and production (wool and carcass traits was studied. The data used included 1042, 1043 and 1013 genotyped animals for the Salmonella resistance, wool and carcass traits, respectively. The different traits were analyzed using an animal model, where the PrP genotype effect was included as a fixed effect. Association analyses do not indicate any evidence of an effect of PrP genotypes on traits studied in this breed. Secondly, a quantitative trait loci (QTL detection approach using the PRNP gene as a marker was applied on ovine chromosome 13. Interval mapping was used. Evidence for one QTL affecting mean fiber diameter was found at 25 cM from the PRNP gene. However, a linkage between PRNP and this QTL does not imply unfavorable linkage disequilibrium for PRNP selection purposes.

  3. Sheep laterality.

    Anderson, Dean M; Murray, Leigh W


    Turning preferences among 309 white-faced ewes were individually evaluated in an enclosed, artificially lit T-maze, followed by each ewe choosing either a right or left return alley to return to peers. Data recorded included time in the start box, time in the T-maze, exit arm chosen to leave the T-maze, and return alley. Right and left arms of the T-maze were chosen 65.7% and 34.3% of the time, respectively, while right and left return alleys were chosen 32.4% and 67.6%, respectively. Exit arm and return alley were not independently chosen (p laterality was not related (α =.05) to time of day the test was administered, ewe's age or genetics, most recent liveweight, or most recent shorn fleece weight. The mean time spent in the start box (21 s) was not related to exit arm (p =.947) or return alley (p =.779). Mean time (15 s) spent in the T-maze was not related to exit arm (p =.086) or return alley (p =.952). More research will be required to understand sheep turning laterality and how it can impact working facilities and research equipment.

  4. Health and radiation protection management

    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

  5. Impact of Health Behaviors and Health Management on Employment After SCI: Psychological Health and Health Management.

    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.

  6. Health management of radiation workers

    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)

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

    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 ...

  8. Management practices to control gastrointestinal parasites in sheep farms in Minas Gerais, southeastern Brazil Práticas de manejo para controle de parasitas gastrointestinais em fazendas com ovinos em Minas Gerais, Sudeste do Brasil

    Aurora M.G. Gouveia


    Full Text Available Parasite related problems are considered one of the major health problems for sheep breeding, causing considerable economic losses to commercial husbandry. The aim of this study was to determine the technological level and the level of knowledge of farmers regarding management practices to control gastrointestinal parasites in sheep in Minas Gerais state, southeastern Brazil. The analysis was based on 213 questionnaires applied by official veterinarians of the State Government Agency for Animal Health (Instituto Mineiro de Agropecuária, IMA, covering 16.6% of all counties. From two hundred and thirteen sheep farms sampled, 117 farms had their technological level determined. From the samples, 0.9% were characterized as high level, 45.3% as medium, and 53.0% as low technological level. The flock size ranged from 2 to 1843 with an average of 80.5 sheep per farm. The majority of the sheep production systems was extensive/semi-extensive (74.5%. The management practices adopted by the farmers to reduce parasitism were: split young and adult animals (5.6%, change pasture after deworm the animals (5.2%, use quarantine for incoming animals (2.3%, deworm newly arrived sheep (1.5%, and have regular technical assistance (31.9%. Although 76.5% of the farmers medicate the animals, treatments were performed without any major technical criteria, with an average interval of 4.6 months. The most commonly used drug families were macrocyclic lactones (38.5% and benzimidazoles (24.9%. The management practices adopted in Minas Gerais are based on old recommendations and may not return in a good set of strategies to prevent parasite infections. Field observations reinforce the finding where farmers have obtained unsatisfactory results in maintaining the health and productivity level of their enterprises.Problemas relacionados com parasitas são considerados um dos principais problemas sanitários na criação de ovinos, causando consideráveis perdas econômicas para

  9. Waking the health plan giant: Group Health Cooperative stops counting sheep and starts counting key tobacco indicators.

    McAfee, T


    Implementing a comprehensive approach to decreasing tobacco use in a large health plan requires hard work and commitment on the part of many individuals. We found that major organisational change can be accomplished and sustained. Keys to our success included our decision to remove access barriers to our cessation programmes (including cost); obtaining top leadership buy-in; identifying accountable individuals who owned responsibility for change; measuring key processes and outcomes; and finally keeping at it tenaciously through multiple cycles of improvement.

  10. A fuzzy multi-objective linear programming approach for integrated sheep farming and wildlife in land management decisions: a case study in the Patagonian rangelands

    Metternicht, Graciela; Blanco, Paula; del Valle, Hector; Laterra, Pedro; Hardtke, Leonardo; Bouza, Pablo


    Wildlife is part of the Patagonian rangelands sheep farming environment, with the potential of providing extra revenue to livestock owners. As sheep farming became less profitable, farmers and ranchers could focus on sustainable wildlife harvesting. It has been argued that sustainable wildlife harvesting is ecologically one of the most rational forms of land use because of its potential to provide multiple products of high value, while reducing pressure on ecosystems. The guanaco (Lama guanicoe) is the most conspicuous wild ungulate of Patagonia. Guanaco ?bre, meat, pelts and hides are economically valuable and have the potential to be used within the present Patagonian context of production systems. Guanaco populations in South America, including Patagonia, have experienced a sustained decline. Causes for this decline are related to habitat alteration, competition for forage with sheep, and lack of reasonable management plans to develop livelihoods for ranchers. In this study we propose an approach to explicitly determinate optimal stocking rates based on trade-offs between guanaco density and livestock grazing intensity on rangelands. The focus of our research is on finding optimal sheep stocking rates at paddock level, to ensure the highest production outputs while: a) meeting requirements of sustainable conservation of guanacos over their minimum viable population; b) maximizing soil carbon sequestration, and c) minimizing soil erosion. In this way, determination of optimal stocking rate in rangelands becomes a multi-objective optimization problem that can be addressed using a Fuzzy Multi-Objective Linear Programming (MOLP) approach. Basically, this approach converts multi-objective problems into single-objective optimizations, by introducing a set of objective weights. Objectives are represented using fuzzy set theory and fuzzy memberships, enabling each objective function to adopt a value between 0 and 1. Each objective function indicates the satisfaction of

  11. Characteristics of effective health care managers.

    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.

  12. Strategic management of health care information systems: nurse managers' perceptions.

    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.

  13. Occupational health management: an audit tool.

    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.

  14. Mutual relationships among body condition score, live weight, and back tissue development in meat sheep

    Martin Ptáček


    Full Text Available Body tissue development and proportion affect predisposition to optimum functioning of production attributes, health, and fertility of sheep. Therefore, the objective of this study was to determine relationships among indicators of mature ewes’ nutritional status documented by the body condition score and live weight using ultrasonic evaluation of backfat thickness and depth of musculus longissimus lumborum et thoracis. The monitoring was carried out in Suffolk sheep (n = 942 for a period of 2 years. A significant increase (P P P P in vivo. Results of the present study could serve in flock management as a tool for evaluation of the current nutritional status as well as a basic ground for further research focused on development of sheep fattiness and carcass traits evaluation.

  15. Assessment of implementation of the health management ...

    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 ...




    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.

  17. 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...... 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...

  18. Future preparation of occupational health nurse managers.

    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.

  19. Project management in health informatics.

    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...

  1. Copper intoxication in sheep

    Gazaryan, V.S.; Sogoyan, I.S.; Agabalov, G.A.; Mesropyan, V.V.


    Of 950 sheep fed hay from a vineyard sprayed regularly with copper sulfate, 143 developed clinical copper poisoning and 103 died. The Cu content of the hay was 10.23 mg%, of the liver of dead sheep 17-52 mg%, and of the blood serum of affected sheep 0.86 mg%. The symptoms and the histological findings in kidneys and liver are described.

  2. Management practices for health physicists

    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

  3. Software for Intelligent System Health Management

    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.

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

    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.

  5. Importance of birthcoat for lamb survival and growth in the Romane sheep breed extensively managed on rangelands.

    Allain, D; Foulquié, D; Autran, P; Francois, D; Bouix, J


    The Romane sheep breed proved to be adapted to harsh conditions with high prolificacy and lamb survival in outdoor farming, even under bad climate conditions. This breed shows large variability in its fleece type at birth and it has been suggested that lamb survival could be related to birthcoat type. The aim of the present study was to: i) characterize the coat of the lamb at birth and quantify lamb survival in relation to the birthcoat type and its protective properties concerning heat loss in the Romane breed raised under permanent exposure outdoors from birth, and ii) estimate genetic parameters of birthcoat type in relation to lamb survival and live body weight. A total of 7,880 lambs from 104 sires and 1,664 dams were used in a 14-yr experiment. The pedigree file included 9,625 individuals over 15 generations. Birthcoat type, coat surface temperature, coat depth, lamb survival, and growth were measured from birth to weaning. Weather data (temperature, wind speed, relative humidity, and precipitation) were recorded daily during lambing time. Two types of coats were observed at birth: hairy coat (62.9% of lambs) with a long coat depth (average 23.3 mm) or woolly 1 (37.1% of lambs) with a short coat depth (average 8.3 mm). Birthcoat type was an important factor affecting lamb survival and growth from birth in the Romane breed. Total mortality rate was significantly less in hairy-bearing coat lambs than in short-woolly coat ones: 7.0% vs. 9.6%, 11.6 % vs. 14.8%, and 15.7 % vs. 20.1 % at 2, 10, and 50 d, respectively, and the relative risks of death increased by 37%, 67%, and 46 % at 2, 10, and 50 d of age, respectively, in short-woolly lambs. At birth, a significant lower coat surface temperature, indicating less heat loss, was observed in long-hairy coat lambs compared with others (21.1°C vs. 26.1°C). Heavier body weights and better growth performances up to the age of 50 d were observed in long-hairy-bearing coat lambs. Lamb survival was positively correlated

  6. Population Health Management for Older Adults

    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

  7. Medical Waste Management in Community Health Centers.

    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.

  8. Software for Intelligent System Health Management (ISHM)

    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.

  9. Medication therapy disease management: Geisinger's approach to population health management.

    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.

  10. Understanding and managing organizational change: implications for public health management.

    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.

  11. Parturition difficulties in sheep

    Grommers, F. J.; Elving, L.; Eldik, P. van


    The incidence of difficult parturition was recorded in Texel Sheep lambs (224), Milk Sheep lambs (273) and various crossbreeds (1043) in ten spring lambing seasons. at lambing time the ewes were under 24-hour observation. Difficult parturition is defined as necessity for obstetrical assistance as


    Juan Carlos Ángeles Hernández


    Full Text Available Organic production systems are based on natural processes, leveraging local resources and decreasing in soil degradation. Effectiveness of milk production of organic systems vs. conventional production systems is a subject open to debate. There are various studies in which there is a positive effect of organic systems in relation to the welfare and animal health, product quality and environmental impact. However, some authors report lower milk yields production and increased susceptibility to environmental conditions compared with those obtained in conventional systems. The lower milk yields in organic systems in Dairy sheep's production, are related to the limited nutritional value, low genetic potential, and the changing environmental conditions. These systems are mainly a production method for a specific market with premium quality products and high standards in their production processes. Thus, a company organic Dairy sheep production should be considered viable when present a positive global sustainability level, that is socially beneficial, economically viable and environmentally responsible.

  13. A guide to performance management for the Health Information Manager.

    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.

  14. Whole genome structural analysis of Caribbean hair sheep reveals quantitative link to west african ancestry

    Hair sheep of Caribbean origin have become an important part of the U.S. sheep industry. Lack of wool eliminates a number of health concerns and drastically reduces the cost of production. More importantly, Caribbean hair sheep demonstrate robust performance even in the presence of drug resistant ga...

  15. Participatory management in today's health care setting

    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

  16. Assessment of time management attitudes among health managers.

    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.

  17. Concept Development for Software Health Management

    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.

  18. [The role of management in health care].

    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.

  19. Participative management in health care services

    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.

  20. A comparison of the efficacy of three intervention trial types: postal, group, and one-to-one facilitation, prior management and the impact of message framing and repeat messages on the flock prevalence of lameness in sheep.

    Grant, Claire; Kaler, Jasmeet; Ferguson, Eamonn; O'Kane, Holly; Green, Laura Elizabeth


    The aim of this study was to evaluate the effectiveness of three knowledge-transfer intervention trial types (postal, group, one-to-one) to promote best practice to treat sheep with footrot. Further aims were to investigate whether farmer behaviour (i.e. management of lameness) before the trial was associated with uptake of best practice and whether the benefits of best practice framed positively or negatively influenced change in behaviour. The intervention was a message developed from evidence and expert opinion. It was entitled "Six steps to sound sheep" and promoted (1) catch sheep within three days of becoming lame, (2) inspect feet without foot trimming, (3) correctly diagnose the cause, (4) treat sheep lame with footrot or interdigital dermatitis with antibiotic injection and spray without foot trimming, (5) record the identity of treated sheep, (6) cull repeatedly lame sheep. In 2013, 4000 randomly-selected English sheep farmers were sent a questionnaire, those who responded were recruited to the postal (1081 farmers) or one-to-one intervention (32 farmers) trials. A random sample of 400 farmers were invited to join the group trial; 78 farmers participated. A follow-up questionnaire was sent to all participants in summer 2014. There were 72%, 65% and 91% useable responses for the postal, group and one-to-one trials respectively. In both 2013 and 2014, the prevalence of lameness was lower in flocks managed by LC1 farmers than LC2 and LC3 farmers. Between 2013 and 2014, the reduction in geometric mean (95% CI) period prevalence of lameness, proportional between flock reduction in lameness and within flock reduction in lameness was greatest in the one-to-one (7.6% (7.1-8.2%) to 4.3% (3.6-5.0%), 35%, 72%) followed by the group (4.5% (3.9-5.0%) to 3.1% (2.4-3.7%), 27%, 55%) and then the postal trial (from 3.5% (3.3-3.7%) to 3.2% (3.1-3.4%), 21%, 43%). There was a marginally greater reduction in lameness in farmers using most of Six steps but slow to treat lame

  1. Leadership and management in mental health nursing.

    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.

  2. Evaluation of Animal-Based Indicators to Be Used in a Welfare Assessment Protocol for Sheep.

    Richmond, Susan E; Wemelsfelder, Francoise; de Heredia, Ina Beltran; Ruiz, Roberto; Canali, Elisabetta; Dwyer, Cathy M


    Sheep are managed under a variety of different environments (continually outdoors, partially outdoors with seasonal or diurnal variation, continuously indoors) and for different purposes, which makes assessing welfare challenging. This diversity means that resource-based indicators are not particularly useful and, thus, a welfare assessment scheme for sheep, focusing on animal-based indicators, was developed. We focus specifically on ewes, as the most numerous group of sheep present on farm, although many of the indicators may also have relevance to adult male sheep. Using the Welfare Quality ® framework of four Principles and 12 Criteria, we considered the validity, reliability, and feasibility of 46 putative animal-based indicators derived from the literature for these criteria. Where animal-based indicators were potentially unreliably or were not considered feasible, we also considered the resource-based indicators of access to water, stocking density, and floor slipperiness. With the exception of the criteria "Absence of prolonged thirst," we suggest at least one animal-based indicator for each welfare criterion. As a minimum, face validity was available for all indicators; however, for many, we found evidence of convergent validity and discriminant validity (e.g., lameness as measured by gait score, body condition score). The reliability of most of the physical and health measures has been tested in the field and found to be appropriate for use in welfare assessment. However, for the majority of the proposed behavioral indicators (lying synchrony, social withdrawal, postures associated with pain, vocalizations, stereotypy, vigilance, response to surprise, and human approach test), this still needs to be tested. In conclusion, the comprehensive assessment of sheep welfare through largely animal-based measures is supported by the literature through the use of indicators focusing on specific aspects of sheep biology. Further work is required for some indicators

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


    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)

  4. Integrated Structural Health Management, Phase I

    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...

  5. The Case for Software Health Management

    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,...

  6. Battery Health Management System for Electric UAVs

    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...

  7. Requirements Flowdown for Prognostics and Health Management

    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...

  8. Managing terminology assets in Electronic Health Records.

    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.

  9. Collective work: a challenge for health management.

    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.

  10. Crisis management teams in health organisations.

    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.

  11. Integrated System Health Management Development Toolkit

    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.

  12. Management of mutual health organizations in Ghana.

    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.

  13. Managing complaints in health and social care.

    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.

  14. Simulation modeling for the health care manager.

    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.

  15. Quality management in Irish health care.

    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.

  16. Managing for soil health can suppress pests

    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.

  17. Participative management in health care services.

    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.

  18. Fat-tailed sheep in Indonesia; an essential resource for smallholders.

    Udo, Henk Mathijs Johannes; Budisatria, I Gede Suparta


    This paper discusses the historical development of fat-tailed sheep in Indonesia, the dynamics of production systems, production and reproduction performances under farmers' conditions, and roles of sheep in livelihoods. In the eighteenth and nineteenth century, fat-tailed sheep from southwest Asia and Africander sheep from South Africa were introduced. Crossing of fat-tailed sheep with the local thin-tailed sheep produced the Javanese fat-tailed sheep. Main motives for the gradual change-over to fat-tailed sheep have been their potential larger body size and the preference of consumers for their meat. Management systems are changing in response to the intensification of land use. The reproductive performances of fat-tailed sheep are good. Households keep four to six animals, housed close to the family quarters. This results in very high levels of faecal bacteria contamination of drinking water sources. Sheep provide a small income, manure, security and help to accumulate capital. Sheep also play a key role in religious festivities. Farmers hardly profit from the increased demand for the feast of sacrifice; animals are sold mainly when the owners have urgent cash needs. Systematic sheep fattening can contribute to higher economic results, if sufficient family labour and crop residues are available.

  19. Knowledge Management in Health Technology SMEs.

    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.

  20. 9 CFR 91.8 - Sheep.



  1. Women as managers in the health services

    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.

  2. Applying e-health to case management.

    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.

  3. An XML-based framework for personalized health management.

    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.

  4. Imported coenurosis in sheep

    Schweizer, G.; Grünenfelder, F.; Sydler, T.; Rademacher, N.; Braun, U.; Deplazes, P.


    Thirteen sheep from a milk producing farm in the Canton of Grisons that presented chronic coenurosis were examined and subjected to treatment trials at the veterinary hospital in Zurich. Symptoms were first observed around two months after the import of two dogs from Italy (Abruzza) of which one was infected with Taenia multiceps and Echinococcus granulosus. The most frequently observed clinical symptoms of the sheep were reduced general condition, circling, reduced menace reflex, apathy, unsteady gait and head tilt. Analyses of cerebrospinal fluid revealed an increased leucocyte count in 3 sheep and eosinophilia in 4 sheep. In 4 animals that underwent computertomography, one or more hypodense, definable lesions were found in the brain. In 2 sheep surgical treatment and in 10 animals medical treatment with either Praziquantel (n=8) or Oxfendazol (n=2) was attempted. Only one animal treated with Praziquantel needed not to be euthanized. At necropsy, one or two coenurus cysts could be found either in a side ventricle (n=2), in the cerebellum (n=3) or in the cerebrum (n=7). The locations corresponded with the clinical findings. Despite Praziquantel or Oxfendazol treatment, living protoscoleces could be found in the parasite cysts [de

  5. Managing diversity in the health care workplace.

    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.

  6. The ecological adaptability of cloned sheep to free-grazing in the Tengger Desert of Inner Mongolia, China

    Xinxin LI,Huijuan WANG,Guanghua SU,Zhuying WEI,Chunling BAI,Wuni-MENGHE,Yanhui HOU,Changqing YU,Shorgan BOU,Guangpeng LI


    Full Text Available Since the birth of the first cloned sheep, somatic cell nuclear transfer technology has been successfully used to clone a variety of mammals. Cloned livestock have no apparent health risks, and the quality and safety of the cloned animal products are similar to non-cloned animals. The social behavior and environmental adaptability of postnatal cloned animals, especially when used for grassland farm production purposes, is unknown. In the present study, the cloned Dorper sheep equipped with GPS location devices were free-grazed in a harsh natural environment similar to conditions commonly experienced by Mongolian sheep. The main findings of this research were as follows. (1 Under free-grazing conditions, the cloned sheep showed excellent climatic and ecological adaptability. In extreme temperature conditions ranging from -30 to 40ºC, the cloned sheep maintained acceptable body condition and behaved as other sheep. (2 The cloned sheep quickly adapted from a herd feeding strategy to the harsh environment and quickly exhibited a grazing regimen as other free-grazing sheep. (3 The cloned sheep exhibited free-grazing patterns and social behavior as other sheep. (4 The cloned sheep in the harsh environment thrived and produced healthy lambs. Overall, the cloned Dorper sheep exhibited excellent ecological adaptation, which is an important consideration for breeding meat sheep by cloning. The Dorper sheep readily adapted to the free-grazing conditions on the Mongolian plateau grassland, which attests to their ability to withstand harsh environmental conditions.

  7. A Nutritional Management Analysis of the Transhumant Sheep and Goat Farms in the Region of Sterea Ellada-Greece



    Full Text Available Transhumance is the seasonal movement of herds between different summer and winter pastures. The main reason of practice of this farming system is the need for a more efficient exploitation of vegetation to meet the nutritional needs of the reared animals. The aim of this paper is to investigate nutritional management practices of transhumant herds in the region of Sterea Ellada.  In the analysis, emphasis is given in the calculation of the coverage of nutritional needs of the reared animals by supplementary feed, translated as Metabolized energy (ME, Digestible Crude Protein (DGP and Dry Matter (DM. Nutritional management is studied in four basic productive stages of ewes and dams. All necessary data were collected from a sample of 140 transhumant herders, via an exhaustive questionnaire that covered all aspects of the production of the farms and managerial practices. Data were subsequently analyzed with descriptive statistic methods. Analysis reveals that grazing tends to be the main nutritional source as approximately 30-50% of the needs of the reared animals on lowlands and more than 90% on uplands is considered to be covered by grazing

  8. Mapping Health Needs to Support Health System Management in Poland

    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

  9. Recognition of lameness and decisions to catch for inspection among sheep farmers and specialists in GB

    Green LE


    Full Text Available Abstract Background Epidemiological studies have used farmer estimates of the prevalence of lameness in their flocks. This assumes that farmers can identify lame sheep. Eight movie clips of sheep with locomotion from sound to moderately lame were used to investigate the ability of farmers and sheep specialists to recognise lame sheep. Each participant was asked to complete a form and indicate, for each movie clip, whether they thought the sheep was lame and whether they would catch it if it was the only lame sheep or if 2 – 5, 6 – 10 or > 10 sheep were equally lame. The farmers' responses were compared with their estimates of flock lameness prevalence and the interval between observing a lame sheep and catching it. Results 178 farmers and 54 sheep specialists participated. Participants could identify even mildly lame sheep but made a separate decision on whether to catch them. This decision was dependent on the severity of lameness and the number of sheep lame in a group. Those who said they would catch the first lame sheep in a group were significantly more likely to catch mildly lame sheep (farmer-reported median prevalence of lameness 5% (IQR: 2%–6%. In contrast, farmers who waited for several sheep to be lame indicated that they would only catch more severely lame sheep (farmer reported median flock lameness 11% (IQR: 9%–15%. Approximately 15% of farmers did not catch individual lame sheep (farmer reported median flock lameness 15% (IQR: 10%–15%. The flock prevalence of lameness increased as time to treatment increased and time to treatment was positively correlated with only catching more severely lame sheep. Conclusion If movie-clips are similar to the flock situation, farmers and specialists can recognise even mildly lame sheep but vary in their management from prompt treatment of the first lame sheep in a group to no individual sheep treatments. The former practices would be appropriate to minimise transmission of footrot, a

  10. Do mechanical doctors dream of electric sheep? Using science fiction to look into the future of public health.

    Orizio, G; Gelatti, U


    At a first glance, it may seem that science fiction (SF) and public health have not much in common. To enlighten that this could be untrue, this paper starts up from their shared 'community perspective' and focuses on several implications of technological development, which can have a great impact on health and have been in some ways anticipated by SF stories. For example, SF has-more or less directly-discussed about the complex relationship between society, medicine and happiness, and it has anticipated several reflections in the field of advances in genetic technology. Beside tackling specific issues, SF has made a deep reflection about technology itself, the way it frightens and the way it could potentially change people and society. While facing these issues, SF raises questions that can be useful to public health as well, in order to rediscover its role in a world rapidly changing.

  11. Monitoring the on-farm welfare of sheep and goats

    Agostino Sevi


    Full Text Available Schemes for on-farm welfare assessment in sheep and goats are not yet available. Factors responsible for this lack of availability are discussed in the first part of this review. Requisites for reliable methods of welfare assessment to be used in sheep and goat farms are discussed, taking into account the peculiarities of the small ruminant production systems in terms of flock management and farm location. Some housing parameters related to structures, design and micro-environment are reviewed and could be included in schemes of welfare assessment on farm. Human-animal interaction, health status of the animals in terms of body condition scoring, skin and hair conditions, lameness and injuries, and management practices in relation to cleanliness, animal handling and moving, milking procedures and abnormal behaviours, are proposed as potential animal-based indicators. When available, validity, reliability and feasibility of the proposed parameters are discussed. The voluntary adhesion to welfare standards in Sardinia and the application of a scientifically validated protocol in Basilicata are reported as examples of practical experiences.

  12. Seroprevalence of toxoplasmosis in sheep in South Africa

    N. Abu Samraa


    Full Text Available Serum samples from 600 sheep were collected from 5 different provinces randomly chosen in South Africa. Two sheep abattoirs (representing formal slaughter of sheep and 1 rural location (representing informal slaughter of sheep per province were also selected randomly. The serum samples were tested for anti-Toxoplasma gondii IgG antibodies using 2 different serological tests : an indirect fluorescent antibody (IFA test and an enzyme-linked immunosorbent assay (ELISA test available as a commercial kit. This study provides the first published data on seroprevalence of toxoplasmosis in sheep in South Africa, although positive titres have been found previously in wild felids, ferrets, chinchillas and a dog. Data on seroprevalence in sheep is considered important because consumption of mutton is universally considered to be a source of zoonotic transfer to humans. Seroprevalence in humans in South Africa was previously found to be 20% and it is postulated that this may be linked to the informal slaughter and consumption of mutton. During this study, the overall national seroprevalence per province in sheep was found to be 5.6 % (IFA and 4.3 % (ELISA, respectively. This is lower than in other countries, possibly because South Africa has an arid climate. Differences in seroprevalence in different areas studied suggested an association with the climate and a significant correlation (P > 0.05 was detected between the prevalence of T. gondii and the minimum average temperature. The seroprevalence was found to be significantly higher (P < 0.01 in sheep originating from commercial farms (7.9 % than in rural sheep in the informal sector (3.4 %. Also, sheep managed extensively had a seroprevalence of 1.8 %, which was significantly lower (P < 0.05 than the seroprevalence in sheep under semi-intensive or intensive management systems (5.3 %. An incidental finding of interest was the considerable movement of sheep to abattoirs and mutton after slaughter. The

  13. 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.

  14. Health care management modelling: a process perspective

    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

  15. Genetic aspects of somatic cell count and udder health in the Italian Valle del Belice dairy sheep

    Riggio, V.


    Mastitis is an inflammation of the udder, which leads to economic loss, mainly consisting of discarded milk, reduced milk production and quality, and increased health costs. Somatic cell count (SCC), and therefore somatic cell score (SCS), is widely used as indicator of mastitis. In this thesis,

  16. Radioactive waste management of health services

    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)

  17. Creating and managing a paperless health information management department.

    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.

  18. Case manager satisfaction in public health.

    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.

  19. Integrated Systems Health Management for Intelligent Systems

    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.

  20. Managing interoperability and complexity in health systems.

    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.

  1. Software Health Management with Bayesian Networks

    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.

  2. Conflict management styles in the health professions.

    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.

  3. Innovation in health service management: Adoption of project management offices to support major health care transformation.

    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.

  4. Sheep and Fasciola hepatica in Europe: the GLOWORM experience

    Laura Rinaldi


    Full Text Available Fasciola hepatica infection challenges health, welfare and productivity of small ruminants throughout the world. The distribution of F. hepatica in sheep in Europe is usually scattered and studies are generally concerned with a single area making it difficult to compare results from different environments, climates and management regimes. In order to elucidate the current scenario in terms of prevalence and intensity of F. hepatica infection in sheep farms across Europe, a standardized cross-sectional survey was conducted in three pilot areas in Ireland, Switzerland and Italy, all part of the EU funded GLOWORM project. Two consecutive field surveys (in 2012 and 2013 were conducted in the three countries in the same period (August-October in 361 sheep farms in total. Harmonized procedures (from farm to laboratory based on pooled samples and the highly sensitive and accurate, diagnostic FLOTAC technique were used. The georeferenced parasitological results were modelled (at the pilot area level following a Bayesian geostatistical approach with correction for preferential sampling and accounting for climatic and environmental covariates. The observed F. hepatica prevalence rates did not differ between the two study years in any of the three pilot areas, but they did vary between the countries showing high values in Ireland (61.6% compared to Italy (7.9% and Switzerland (4.0%. Spatial patterns of F. hepatica distribution were detected by the Bayesian geostatistical approach in Ireland with a high risk of infection in the south-western part of the pilot area there. The latent factor analysis highlighted the importance of year-to-year variation of mean temperature, rainfall and seasonality within a country, while long-term trends of temperature and rainfall dominated between countries with respect to prevalence of infection.

  5. New public management in Iran's health complex: a management framework for primary health care system.

    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.

  6. Smart Information Management in Health Big Data.

    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.

  7. Health and Stress Management and Mental-health Disability Claims.

    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.

  8. FAILSAFE Health Management for Embedded Systems

    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.

  9. Making Technology Ready: Integrated Systems Health Management

    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.

  10. Management continuity in local health networks

    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.

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

    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.

  12. Fatal pneumonia of bighorn sheep following association with domestic sheep.

    Foreyt, W J; Jessup, D A


    During 1979-1980 acute fibrinopurulent bronchopneumonia resulted in high mortality or total loss of herds of bighorn sheep (Ovis canadensis) in California and Washington. Contact with domestic sheep occurred shortly before the onset of disease in each case. Circumstantial evidence indicated that the apparently healthy domestic sheep transmitted pathogenic bacteria to the bighorns, resulting in mortality. Pasteurella multocida and Corynebacterium pyogenes were isolated from pulmonary tissue of dead bighorns. The presence of domestic sheep may have been an important stress which initiated or compounded the disease.

  13. Quality dimensions in health evaluation: manager's conceptions.

    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.

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

    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 ...

  15. Development and validation of health service management competencies.

    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.

  16. [Community health in primary health care teams: a management objective].

    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.




    Full Text Available INTRODUCTION Human temporal bones are difficult to procure now a days due to various ethical issues. Sheep temporal bone is a good alternative due to morphological similarities, easy to procure and less cost. Many middle ear exercises can be done easily and handling of instruments is done in the procedures like myringoplasty, tympanoplasty, stapedotomy, facial nerve dissection and some middle ear implants. This is useful for resident training programme.

  18. Gaucher disease in sheep.

    Karageorgos, Litsa; Lancaster, Malcolm J; Nimmo, Judith S; Hopwood, John J


    Gaucher disease, an autosomal recessive lysosomal storage disorder caused by mutations in the β-glucocerebrosidase gene, was recently discovered in sheep on a "Southdown" sheep stud in Victoria, Australia. Clinical signs include neuropathy, thickened leathery skin, and ichthyosis, with lambs unable to stand from birth. Affected lambs were found to be deficient in glucocerebrosidase activity, and mutational analysis found them to be homozygous for the missense mutations c.1142G>A (p.C381Y) and c.1400C>T (p.P467L). In addition, four silent mutations were detected (c.777C>A [p.Y259Y], c1203A>G [p.Q401Q], c.1335T>C [p.I445I], c.1464C>G [p.L488L]). The human equivalent [C342Y] to the C381Y mutation leads to an acute neuronopathic phenotype in patients. Identification of an acute neuronopathic form of Gaucher disease in sheep provides a large animal model that will enable studies of pathology and evaluation of therapies to treat this common lysosomal storage disorder.

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

    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

  20. ISWHM: Tools and Techniques for Software and System Health Management

    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.

  1. Health and poverty: health management by the woman

    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.

  2. Health and poverty: health management by the woman

    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.

  3. Sharing Earth Observation Data When Health Management

    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.

  4. A bighorn sheep die-off in southern Colorado involving a Pasteurellaceae strain that may have originated from syntopic cattle.

    Wolfe, Lisa L; Diamond, Brandon; Spraker, Terry R; Sirochman, Michael A; Walsh, Daniel P; Machin, Chandra M; Bade, Donald J; Miller, Michael W


    We investigated a pasteurellosis epizootic in free-ranging bighorn sheep (Ovis canadensis) wherein a Pasteurellaceae strain carried by syntopic cattle (Bos taurus) under severe winter conditions appeared to contribute to pneumonia in affected bighorns. Twenty-one moribund or dead bighorn sheep were found on the "Fossil Ridge" herd's winter range, Colorado, USA, between 13 December 2007 and 29 February 2008. Eight carcasses examined showed gross or microscopic evidence of acute to subacute fibrinous bronchopneumonia. All eight carcasses yielded at least one β-hemolytic Mannheimia haemolytica biogroup 1(±(G)) strain, and seven also yielded a β-hemolytic Bibersteinia trehalosi biogroup 4 (CDS) strain; evidence of Pasteurella multocida, Mycoplasma ovipneumoniae, and parainfluenza 3 and bovine respiratory syncytial viruses was also detected. Isolates of β-hemolytic Manneimia haemolytica biogroup 1(G) from a bighorn carcass and a syntopic cow showed 99.5% similarity in genetic fingerprints; B. trehalosi biogroup 4(CDS) isolates were ≥94.9% similar to an isolate from a nearby bighorn herd. Field and laboratory observations suggested that pneumonia in affected bighorns may have been caused by a combination of pathogens including two pathogenic Pasteurellaceae strains--one likely of cattle origin and one likely of bighorn origin--with infections in some cases perhaps exacerbated by other respiratory pathogens and severe weather conditions. Our and others' findings suggest that intimate interactions between wild sheep and cattle should be discouraged as part of a comprehensive approach to health management and conservation of North American wild sheep species.

  5. Health risk assessment for program managers

    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

  6. The RF spectrum: managing community health concerns

    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

  7. Managing change in health care organizations.

    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.

  8. Investigation of Integrated Vehicle Health Management Approaches

    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.

  9. Occupational Safety and Health Management System (OSHMS)

    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)

  10. Requirements Flowdown for Prognostics and Health Management

    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.

  11. Environment, Safety, Health and Waste Management Plan


    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

  12. Managing the health of the elite athlete: a new integrated performance health management and coaching model.

    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.

  13. Breeding Practices in Sheep Farming

    M.A. Shejal


    Full Text Available The sheep is an important economic livestock species, contributing greatly to the Indian economy, especially in arid, semi arid and mountain areas. The current population in world is 1110.78 millions, around 44.85 millions (1987 sheeps in India (ICAR., 2002. Sheeps are mostly reared for meat and wool. The average annual wool production per sheep is between 3.5 to 5.5 kg of fine quality wool in Australia, New Zealand and U.S.S.R., where as in India except Magra sheep which annually yield more than 2 kg wool having staple length 5.8 cm, the average of rest of the wool produced is less than 1.0 kg per sheep of inferior quality (Banerjee G.C., 1998. Therefore many farmers in southern India adapted sheep rearing for meat production than for wool production. For yielding more production from sheep farming one should have sound knowledge of general information related to the reproduction and different breeding practices. [Vet. World 2009; 2(1.000: 43-44

  14. Managing health and safety risks: Implications for tailoring health and safety management system practices.

    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.

  15. Health plans' disease management programs: extending across the medical and behavioral health spectrum?

    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.

  16. Live monitoring of cattle, reindeer and sheep

    Strand, P.


    After the Chernobyl accident the fallout differed considerably from area to area in Norway and specially were found from soil samples that the mountain pasture in Middle and South of Norway were heavily contaminated. These natural ecosystem is important in several nutrition pathways; notably sheep, goat, reindeer and cattle. In June 1986 the Health Directorate imposed action levels for the nuclides Cs-134 and Cs-137. The action levels were 370 Bq/kg for milk and baby food and 600 Bq/kg for all other types of food. In November 1986, the action level for reindeer meat were increased to 6000 Bq/kg, and in June 1987 the level was also increased to 6000 Bq/kg for wild freshwater fish. The most effected meat production were reindeer, sheep and cattle. Almost 20 to 35% of the sheep had activity levels above the action limits. This fact initiated a broad program to establish effective measure to increase the activity levels and to sort out the animals which could be slaughtered. Three main approaches have been utilized in Norway in order to achieve this and to limit the potential health risk: action aimed at reducing uptake from soil to vegetation (plowing, use of fertilizing etc.); action aimed at reducing uptake from fodder to animals (use of cesium binder, change of slaughter time), or reducing unacceptable activity levels in animals (downfeeding); action aimed at reducing intake to human (interdiction, dietary advice). Live monitoring were in several of these actions necessary for a successful result

  17. Sheep internal parasites on Rab and Pag

    Relja Beck


    Full Text Available The purpose of our research was to determine which groups and species of internal parasites endanger the health of sheep on the islands of Rab and Pag. The research was carried out in 10 flocks on both islands taking the fresh dung out of 30% of the total number of sheep in each flock. It was ascertained that the gastrointestinal parasites and protozoa of Eimeria genus are present in most flocks on both islands. The presence of the fluke Dicrocoelium dendriticum was ascertained in considerably larger number of flocks on the island of Rab than on the island of Pag. On the other hand, the presence of parasites of Moniezia and Nematodirus genus was ascertained in larger number of flocks on the island of Pag. In two flocks on Rab parasites of Protostrongylus genus were ascertained while on the island of Pag they were not found in any flock.

  18. Cyanobacterial toxins: risk management for health protection

    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

  19. Bloat in sheep (Ovis aries).

    Colvin, H W; Backus, R C


    1. Most of the field studies on bloat are conducted with cattle and most of the laboratory experiments seeking to explain the various parameters associated with bloat are done with sheep. 2. Based on grazing behaviour, it would be expected that sheep might bloat more severely than cattle because they selectively choose to eat leaves over stems and chew what they ingest more frequently than cattle. Furthermore, sheep appear to select legumes over grasses because the legumes can be eaten more rapidly. However, because they are selective, sheep eat more slowly than cattle. Despite a higher bloat expectation, bloating in sheep is reported to be less of a problem than in cattle. 3. Although frothing of rumen ingesta was described earlier in cattle as the cause of acute legume bloat, experiments with frothy bloat in sheep preceded those in cattle. 4. Anti-frothing agents were used in sheep before cattle to treat acute legume bloat. 5. Experiments devoted to the study of eructation in ruminants were carried out on sheep, then cattle. 6. Convincing evidence that rumen motility does not cease during acute legume bloat was gathered using sheep. 7. Although the transected tracheal technique for the determination of the volume of eructated gas was developed with cattle, the pathway of eructated gas was confirmed with sheep. 8. All the current evidence accumulated from experiments with sheep supports the hypothesis that death due to legume bloat is caused by acute neural, respiratory, and cardiovascular insult resulting from the effect of the distended rumen on thoracic viscera, diaphragm, intercostal muscles, and the abdominal vena cava. 9. Experiments with sheep and cattle being fed scabrous and nonscabrous diets similar in chemical composition show that sheep are more resistant than cattle to the increase in intrarumen pressure, decline in rumen contraction amplitude, and decrease in rumen contraction frequency caused by nonscabrous diets. 10. The sequence of events in the

  20. Enabling medication management through health information technology (Health IT).

    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

  1. Prevalence of Mycoplasma ovipneumoniae in desert bighorn sheep in Arizona

    Justice-Allen, Anne E.; Luedtke, Clint J.; Overstreet, Matthew; Cain, James W.; Stephenson, Thomas R.


    To assess the potential for an epizootic of pneumonia to result from either natural immigration or translocation, we compared the seroprevalence to Mycoplasma ovipneumoniae in several populations of desert bighorn sheep in Arizona. We collected blood samples and nasal or oropharyngeal swabs from 124 desert bighorn sheep (Ovis canadensis nelsoni) from 6 populations in Arizona in 2009 and 2010. M. ovipneumoniae organisms were detected by PCR in 22%, whereas antibodies to M. ovipneumoniae were detected in 47% of tested bighorn sheep. Mycoplasma antibodies were not found in 2 of 6 populations, indicating some bighorn sheep populations in Arizona are naïve to this bacterium. In contrast, others had seroprevalence rates up to 80%. We were able to compare seroprevalence rates and titers over time in 9 individuals (7 individuals included in the 124 bighorn sheep sampled in 2009 and 2010, and 2 individuals originally captured in 2006). Antibody titers persisted for 12 months in individuals from the Kofa National Wildlife Refuge (n = 7) while antibody titers appeared to decline in the Kanab Creek population (n = 2). M. ovipneumoniae is present or has been present in several, but not all, populations of bighorn sheep in Arizona. The results demonstrate the importance of routine health testing for future translocation efforts to reduce disease risk for naive populations.

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

    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.

  3. Current practices on sheep and beef farms in New Zealand for depriving sheep of feed prior to transport for slaughter.

    Fisher, M W; Gregory, N G; Muir, P D


    To assess current practices on sheep and beef farms that deprive sheep of feed prior to transport to facilitate effluent management and processing at slaughter. A national telephone survey of 122 sheep and 346 sheep and beef farmers was conducted in March and April 2010. They were asked how long sheep were held off green feed prior to transport and why, what environment the sheep were held in, and if that period ever varied. Of the 468 respondents, 303 (65%) removed their sheep from green feed 3-12 h before transport for slaughter, with longer periods reported in the South than North Island. The main reasons given were to reduce the volume of effluent for transport operators (n=174), to prevent wool staining during transport (n=173), and that sheep were better suited to load and travel empty (n=171). Water was provided during feed deprivation by 313 farmers. The period of food deprivation could be altered in response to requirements of transporters and processors, the weather, and by the class of stock involved, although 115/468 (25%) farmers stated that they never changed their normal protocol. Amongst survey respondents, common practices compared favourably with recommendations to reduce effluent during transportation. Previous studies have investigated the effects of fasting lambs whilst in lairage prior to slaughter and focussed on carcass quality such as carcass weight and tenderness. Changes in liveweight and gastrointestinal tract contents suggest feed deprivation reduces the risk of defaecation and urination contributing to the accumulation of effluent during transport and of carcass contamination during processing. However, the point at which that risk is acceptable to transport and processing is unclear. Fasting results in physiological changes indicative of altered metabolism but it is not clear when those changes are indicative of adaptation to food deprivation or metabolic depletion and compromised welfare. There may be opportunities to improve the

  4. Information support for health information management in regional Sri Lanka: health managers' perspectives.

    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

  5. Characteristics of Smallholder Sheep Production at Selected ...

    The household owners of sheep seldom fed forage to their sheep (17.86%), while 25% of commercial sheep farmers fed forage. The common diseases in the area were diarrhea, pneumonia and mange. The constraints to sheep production in the area included automobile accidents, seasonal lack of feed, diseases, theft and ...

  6. 9 CFR 93.428 - Sheep and goats and wild ruminants from Mexico.


    ... 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...

  7. Prospective Health: Duke's Approach to Improving Employee Health and Managing Health Care Costs

    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…

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

    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.

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

    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

  10. Information technology acceptance in health information management.

    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.

  11. Shared Bacterial and Viral Respiratory Agents in Bighorn Sheep (Ovis canadensis, Domestic Sheep (Ovis aries, and Goats (Capra hircus in Montana

    David S. Miller


    Full Text Available Transmission of infectious agents from livestock reservoirs has been hypothesized to cause respiratory disease outbreaks in bighorn sheep (Ovis canadensis, and land management policies intended to limit this transmission have proven controversial. This cross-sectional study compares the infectious agents present in multiple populations of bighorn sheep near to and distant from their interface with domestic sheep (O. aries and domestic goat (Capra hircus and provides critical baseline information needed for interpretations of cross-species transmission risks. Bighorn sheep and livestock shared exposure to Pasteurellaceae, viral, and endoparasite agents. In contrast, although the impact is uncertain, Mycoplasma sp. was isolated from livestock but not bighorn sheep. These results may be the result of historic cross-species transmission of agents that has resulted in a mosaic of endemic and exotic agents. Future work using longitudinal and multiple population comparisons is needed to rigorously establish the risk of outbreaks from cross-species transmission of infectious agents.

  12. Shared bacterial and viral respiratory agents in bighorn sheep (Ovis canadensis), domestic sheep (Ovis aries), and goats (Capra hircus) in Montana

    Miller, David S.; Weiser, Glen C.; Aune, Keith; Roeder, Brent; Atkinson, Mark; Anderson, Neil; Roffe, Thomas J.; Keating, Kim A.; Chapman, Phillip L.; Kimberling, Cleon; Rhyan, Jack C.; Clarke, P. Ryan


    Transmission of infectious agents from livestock reservoirs has been hypothesized to cause respiratory disease outbreaks in bighorn sheep (Ovis canadensis), and land management policies intended to limit this transmission have proven controversial. This cross-sectional study compares the infectious agents present in multiple populations of bighorn sheep near to and distant from their interface with domestic sheep (O. aries) and domestic goat (Capra hircus) and provides critical baseline information needed for interpretations of cross-species transmission risks. Bighorn sheep and livestock shared exposure to Pasteurellaceae, viral, and endoparasite agents. In contrast, although the impact is uncertain, Mycoplasma sp. was isolated from livestock but not bighorn sheep. These results may be the result of historic cross-species transmission of agents that has resulted in a mosaic of endemic and exotic agents. Future work using longitudinal and multiple population comparisons is needed to rigorously establish the risk of outbreaks from cross-species transmission of infectious agents.

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

    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 ...

  14. Coordinated Management of Academic Health Centers.

    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.

  15. Integrated System Health Management (ISHM) and Autonomy

    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.

  16. Prognostics and health management of photovoltaic systems

    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.

  17. Rocket Testing and Integrated System Health Management

    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.

  18. Health Management Applications for International Space Station

    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

  19. Integrated Systems Health Management for Space Exploration

    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.

  20. Hair sheep in Mexico and Venezuela: Reproduction in Pelibuey and West African Sheep

    Valencia, J.; Lopez Barbella, S.F.


    The literature review is largely limited to recent research conducted on hair sheep in Mexico and Venezuela. Whereas reproduction is the general topic reviewed, much of the research quoted deals with the influence of nutrition, management, climate and disease on various indices of reproduction in the ewe and ram. Areas where information is minimal are also identified, as are research topics which need to be addressed. (author). 90 refs, 5 figs, 2 tabs

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

    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.




    Full Text Available Through our researches were carried out at ICDCOC- Palas, Constantza, we proposed ourselves to establish the poly-parasitism structure on sheep, as well as elaborating efficientical methods for anti-parasitical prophylaxis and fighting in sheep populations and pasture sourfaces, in order to ensuring anti-parasitical protection in sheep exploitations The copro-parasitological examinations was carried ovoscopicaly (flotation - by Willis and Mc. Master methods; sediment – by polyvalent method and larvoscopicaly – by Baermann method. The parasitological examination of coprological smears which were harvested on sheep showed the presence of polyparasitism phenomenon with protozoans (coccidiae: Eimeria spp. and helmints (cestodae: Moniesia expansa; gastro-intestinal nemathodes: Trichostrongylus spp., Nematodirus spp., Strongyloides papillosus and pulmonary nemathodes: Müellerius capillaris, Protostrongylus rufescens, Dictyocaulus filaria. Also, we proposed ourselves to study the paresites and their intermediary stages on pastures which were exploited with sheep, comparatively with mowed pastures. In the ansamble of research activities a special place is occupied by testing differents methods, in order to prevention and fighting of parasitical infestations on sheep and pasture in sheep farms.

  3. Selection signatures in worldwide sheep populations.

    Fariello, Maria-Ines; Servin, Bertrand; Tosser-Klopp, Gwenola; Rupp, Rachel; Moreno, Carole; San Cristobal, Magali; Boitard, Simon; Drögemüller, Cord; The International Sheep Genomics Consortium, ISGC


    The diversity of populations in domestic species offers great opportunities to study genome response to selection. The recently published Sheep HapMap dataset is a great example of characterization of the world wide genetic diversity in sheep. In this study, we re-analyzed the Sheep HapMap dataset to identify selection signatures in worldwide sheep populations. Compared to previous analyses, we made use of statistical methods that (i) take account of the hierarchical structure of sheep popula...

  4. Selection Signatures in Worldwide Sheep Populations

    Fariello, Maria-Ines; Servin, Bertrand; Tosser-Klopp, Gwenola; Rupp, Rachel; Moreno, Carole; Cristobal, Magali San; Boitard, Simon


    The diversity of populations in domestic species offers great opportunities to study genome response to selection. The recently published Sheep HapMap dataset is a great example of characterization of the world wide genetic diversity in sheep. In this study, we re-analyzed the Sheep HapMap dataset to identify selection signatures in worldwide sheep populations. Compared to previous analyses, we made use of statistical methods that (i) take account of the hierarchical structure of sheep popula...

  5. Herd health and management of dairy cow

    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.

  6. Controlling Within-Field Sheep Movement Using Virtual Fencing.

    Marini, Danila; Llewellyn, Rick; Belson, Sue; Lee, Caroline


    Virtual fencing has the potential to greatly improve livestock movement, grazing efficiency, and land management by farmers; however, relatively little work has been done to test the potential of virtual fencing with sheep. Commercial dog training equipment, comprising of a collar and GPS hand-held unit were used to implement a virtual fence in a commercial setting. Six, 5-6 year-old Merino wethers, which were naïve to virtual fencing were GPS tracked for their use of a paddock (80 × 20 m) throughout the experiment. The virtual fence was effective at preventing a small group of sheep from entering the exclusion zone. The probability of a sheep receiving an electrical stimulus following an audio cue was low (19%), and declined over the testing period. It took an average of eight interactions with the fence for an association to be made between the audio and stimulus cue, with all of the animals responding to the audio alone by the third day. Following the removal of the virtual fence, sheep were willing to cross the previous location of the virtual fence after 30 min of being in the paddock. This is an important aspect in the implementation of virtual fencing as a grazing management tool and further enforces that the sheep in this study were able to associate the audio with the virtual fence and not the physical location itself.

  7. Disease and health management in Asian aquaculture.

    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

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

    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.

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

    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

  10. Prognostic Health Management for Avionics System Power Supplies

    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...

  11. 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".

    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.

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

    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 ...

  13. Sensor Area Network for Integrated Systems Health Management, Phase II

    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...

  14. Meeting global health challenges through operational research and management science.

    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.

  15. Protein turnover in sheep

    Buttery, P.J.


    Considerable advances have been made in the knowledge of the mechanisms and control of synthesis and degradation of proteins in animal tissues during the last decade. Most of the work on the measurement of synthetic and degradative rates of the mixed protein fraction from tissues has been conducted in the rat. There have, unfortunately, been few publications describing results of protein turnover studies with ruminants. Consideration is given here to the techniques used to measure protein turnover, and some of the results obtained, particularly with sheep, are summarized. No attempt has been made to discuss directly the situation in parasitized animals; rather the aim is to provide background information which complements other work dealing with the effects of parasites on the nitrogen metabolism of ruminants. (author)

  16. 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.

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

    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.

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

    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 ...

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

    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

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


    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...

  1. Taenia ovis: an emerging threat to the Chinese sheep industry?

    Zheng, Yadong


    Taenia ovis is a tapeworm that is mainly transmitted between dogs and sheep. Although T. ovis infection is not a public health issue, it causes a great financial loss due to condemnation of carcasses.  The first outbreak of T. ovis infection in China occurred in 2015. Reassessment of adverse effects of T. ovis infection on Chinese sheep industry in future is necessary. The first T. ovis outbreak in China suggests that the epidemic situation across the country is underestimated. For the transmission of T. ovis, many factors, including eggs, dogs and wild canids, human behaviours and sheep trade, should be seriously considered. In blocking the transmission chain, regular treatments of the infected dogs using anthelmintics play a crucial step, but at the moment it is difficult to be fully executed in China, largely due to the behaviours, customs and faith of local farmers. Moreover, combined with no clinical symptoms in the infected adult sheep and goats, the lack of pre-mortem diagnostic tools makes it harder to practice a national wide surveillance as well as inspection and quarantine in increasingly frequent free sheep trade activities in China, leading to an inability to restrict T. ovis infection into small areas. Furthermore, the ongoing campaigns against Echinococcus granulosus may have an adverse effect on control of T. ovis infection because of no consideration of a role of dogs in the transmission of the parasite. Lack of national epidemic data, pre-mortem diagnostic reagents and vaccines severely hampers the implementation of disease control campaigns and the restriction of T. ovis infection into small areas. Consequently, sheep and goats are at an increasing risk of T. ovis exposure and the possibility of large-scale outbreaks across China in future is possible, causing great adversity towards sheep industry.

  2. Managing risk: clinical decision-making in mental health services.

    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.

  3. haematology of the west african dwarf sheep under two different

    Dr Olaleye

    The coat is usually white in colour or a mixture of black and white. They weight about 30kg. Although there are a number of studies on the normal haematology of the West Africa Dwarf Sheep (Oduye, 1976, Durotoye 1987, Oyewale, 1991), there is no report on the influence of management on the haematology of these ...

  4. Performance and Grazing Pattern of West African Dwarf Sheep to ...

    Sixty (60) West African Dwarf sheep managed semi intensively and grazing on natural pastures were used in a study to determine the performance and grazing pattern to seasonal forage supply and quality. The animals were allowed to graze for about 6 hours daily for four months each in the dry and wet seasons, ...

  5. Sheep production as a Senecio spp. control tool

    Paulo Mota Bandarra


    Full Text Available Since poisoning by Senecio spp. is one of the main causes of cattle death in southern Brazil, control of these plants is a priority for the local livestock production. After the pasture has been mowed, grazing by 16 sheep was efficient for controlling Senecio brasiliensis and Senecio madagascariensis populations in a 5.5-hectare area that had long been severely infested with these species. A total of 28,629 plants among S. brasiliensis (flower-of-souls, 10,122 and S.madagascariensis (fireweed, 18,507 were almost completely eliminated in a two-year period. The number of sheep was kept at 3.0 stock units/ha, but a variable number of cattle were temporarily stocked according to pasture availability. The major sanitary practice applied to the sheep was anthelmintic administration. Liver biopsies taken from sheep and cattle before and after experimental period didn't reveal any change associable with seneciosis. The performance levels of the sheep were comparable to those observed in flocks managed under traditional extensive grazing systems in southern Brazil.

  6. Aligning smoke management with ecological and public health goals

    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...

  7. Fatal systemic cladosporiosis in a merino sheep flock.

    Haligur, Mehmet; Ozmen, Ozlem; Dorrestein, Gerry M


    Systemic cladosporiosis is described in 25 merino sheep from a flock consisting 250 animals. The fungal pneumonia appeared after an intensive antibiotic treatment, because of a respiratory system disorder. The pen of the flock was humid and crowded, and animals had signs of respiratory distress, coughing, fever and anorexia. All of the ill animals died, and necropsy was performed on 10 sheep. The lesions were characterized by a multifocal pyogranulomatous pneumonia and an abomasitis. Severe hemorrhages were observed in the lungs. At the histopathological examination, severe vasculitis with thrombosis was observed in various organs, especially in the lungs and abomasums, suggestive for a hematogenous dissemination of the infection in these organs. Numerous PAS-positive fungal elements were seen in the pyogranulomatous foci. Dark green fungal colonies were seen in the blood agar and Sabouraud dextrose agar that were identified as Cladosporium cladosporioides. This report highlights that phaeohyphomycosis can cause a severe systemic and fatal disease in merino sheep under insufficient management conditions.

  8. Managing health care organizations in an age of rapid change.

    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.

  9. Health information technology: transforming chronic disease management and care transitions.

    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.


    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

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

    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...


    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.

  13. Applications of Health Management Using Android and RFID

    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.

  14. Digital health technology and diabetes management.

    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.


    E. F. Yilmaz


    Full Text Available In this review the authors analyzed the sheep pox disease, which occurs outbreaks all over the world particularly in Asia and Africa causing substantial losses in trade of animal and animal products. They categorized the sheep pox disease is one of the prioritized groups of diseases against which the World Organization for Animal Health is fighting. Data concerning a sheep poxes’ history, epidemiology, epizootiology, mortality and economic impact, clinical and pathological signs, features of capripoxvirus that forms the disease are given. Diagnosis treatment and vaccine have been investigated as well. The main conclusion is done according which the designing of new vaccine generation against the sheep pox disease could be as an alternative approach against sheep pox.

  16. Health care units and human resources management trends.

    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.

  17. Health promotion in Swedish schools: school managers' views.

    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:

  18. European organic dairy farmers' preference for animal health management within the farm management system.

    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

  19. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents

    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…

  20. Consumer choice of social health insurance in managed competition

    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

  1. Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers

    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…


    Jaime Arroyo


    Full Text Available In order to discuss and analyze the available information concerning the seasonal breeding behavior of sheep in Mexico, this review was conducted. We analyzed the neuroendocrine basis that modulate the annual reproductive cycle in sheep and then discussed the degree of reproductive seasonality in Creole sheep wool, breeds originating in high latitudes and hair sheep, mainly in Pelibuey ewes. The Creole sheep wool show continuous annual reproductive activity and short seasonal anestrous. The females of northern origin, express seasonal reproductive activity, similar to that observed in individuals geographically located at latitudes above 35º. Pelibuey sheep show variable annual reproductive behavior with reduced anestrus or lack thereof.  It is suggested that the neuroendocrine mechanisms regulating seasonal anestrus in ewes, are active in the sheep of northern origin that live in Mexico, in a manner contrary is not activated in Creole and hair sheep.

  3. External and internal modulators of sheep reproduction.

    Blache, Dominique; Bickell, Samantha L


    Several factors such as season, genetics, social interaction and metabolic status control or modulate the reproductive capacity of sheep. In addition to these well-studied factors in sheep, the influence of emotional reactivity on the reproductive success of sheep has started to be investigated over the last two decades. In this paper, after briefly reviewing the impact of classical factors affecting reproduction in sheep, we define emotional reactivity and the expression of its inter-individual variability, named temperament. Then, following a description of the protocol to measure temperament in sheep and discussion on the heritability of temperament traits, we illustrate how this selection affects the reproductive biology of sheep. We will be mainly using results obtained from a unique flock of sheep selected for low or high emotional reactivity. In conclusion, we propose that energy partitioning could be one of the mechanisms by which selection for temperament in sheep affects the different steps of the reproductive cycle.

  4. 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...

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

    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

  6. Care management actions in the Family Health Strategy

    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.

  7. Health coaching in diabetes: empowering patients to self-manage.

    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.

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

    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.

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

    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...

  10. Public health response to striking solid waste management.

    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.

  11. Power Management for A Distributed Wireless Health Management Architecture

    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...

  12. Techniques for capturing bighorn sheep lambs

    Smith, Joshua B.; Walsh, Daniel P.; Goldstein, Elise J.; Parsons, Zachary D.; Karsch, Rebekah C.; Stiver, Julie R.; Cain, James W.; Raedeke, Kenneth J.; Jenks, Jonathan A.


    Low lamb recruitment is a major challenge facing managers attempting to mitigate the decline of bighorn sheep (Ovis canadensis), and investigations into the underlying mechanisms are limited because of the inability to readily capture and monitor bighorn sheep lambs. We evaluated 4 capture techniques for bighorn sheep lambs: 1) hand-capture of lambs from radiocollared adult females fitted with vaginal implant transmitters (VITs), 2) hand-capture of lambs of intensively monitored radiocollared adult females, 3) helicopter net-gunning, and 4) hand-capture of lambs from helicopters. During 2010–2012, we successfully captured 90% of lambs from females that retained VITs to ≤1 day of parturition, although we noted differences in capture rates between an area of high road density in the Black Hills (92–100%) of South Dakota, USA, and less accessible areas of New Mexico (71%), USA. Retention of VITs was 78% with pre-partum expulsion the main cause of failure. We were less likely to capture lambs from females that expelled VITs ≥1 day of parturition (range = 80–83%) or females that were collared without VITs (range = 60–78%). We used helicopter net-gunning at several sites in 1999, 2001–2002, and 2011, and it proved a useful technique; however, at one site, attempts to capture lambs led to lamb predation by golden eagles (Aquila chrysaetos). We attempted helicopter hand-captures at one site in 1999, and they also were successful in certain circumstances and avoided risk of physical trauma from net-gunning; however, application was limited. In areas of low accessibility or if personnel lack the ability to monitor females and/or VITs for extended periods, helicopter capture may provide a viable option for lamb capture.

  13. Health care waste management practice in a hospital.

    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.

  14. Health Technologies for the Improvement of Chronic Disease Management

    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

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

    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.

  16. The Impact of Health Behaviors and Health Management on Employment After SCI: Physical Health and Functioning.

    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.

  17. The genomic architecture of mastitis resistance in dairy sheep.

    Banos, G; Bramis, G; Bush, S J; Clark, E L; McCulloch, M E B; Smith, J; Schulze, G; Arsenos, G; Hume, D A; Psifidi, A


    Mastitis is the most prevalent disease in dairy sheep with major economic, hygienic and welfare implications. The disease persists in all dairy sheep production systems despite the implementation of improved management practises. Selective breeding for enhanced mastitis resistance may provide the means to further control the disease. In the present study, we investigated the genetic architecture of four mastitis traits in dairy sheep. Individual animal records for clinical mastitis occurrence and three mastitis indicator traits (milk somatic cell count, total viable bacterial count in milk and the California mastitis test) were collected monthly throughout lactation for 609 ewes of the Greek Chios breed. All animals were genotyped with a custom-made 960-single nucleotide polymorphism (SNP) DNA array based on markers located in quantitative trait loci (QTL) regions for mastitis resistance previously detected in three other distinct dairy sheep populations. Heritable variation and strong positive genetic correlations were estimated for clinical mastitis occurrence and the three mastitis indicator traits. SNP markers significantly associated with these mastitis traits were confirmed on chromosomes 2, 3, 5, 16 and 19. We identified pathways, molecular interaction networks and functional gene clusters for mastitis resistance. Candidate genes within the detected regions were identified based upon analysis of an ovine transcriptional atlas and transcriptome data derived from milk somatic cells. Relevant candidate genes implicated in innate immunity included SOCS2, CTLA4, C6, C7, C9, PTGER4, DAB2, CARD6, OSMR, PLXNC1, IDH1, ICOS, FYB, and LYFR. The results confirmed the presence of animal genetic variability in mastitis resistance and identified genomic regions associated with specific mastitis traits in the Chios sheep. The conserved genetic architecture of mastitis resistance between distinct dairy sheep breeds suggests that across-breed selection programmes would be

  18. American Health Information Management Association. Position statement. Issue: managing health information in facility mergers and acquisitions.


    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.

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

    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.

  20. The strategic planning of health management information systems.

    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.

  1. Management of health technologies: An international view

    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

  2. Reducing Health Cost: Health Informatics and Knowledge Management as a Business and Communication Tool

    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.

  3. Seroepidemiological detection of antibodies against Leptospira spp using microscopic agglutination test in Urmia cows and sheep

    Ramin Ag


    and 1:400 in sheep. There was no gender difference, but age was significant between cows and sheep. Finally, leptospirosis as a zoonotic disease must be seriously considered in Urmia cows rather than in sheep, and therefore, a serious effort must be made to reduce the rate of serological infection and the risk of public health, as well.

  4. Financial coping strategies of mental health consumers: managing social benefits.

    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.


    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].

  6. Solving a Health Information Management Problem. An international success story.

    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.

  7. Characterization of the microbial communities along the gastrointestinal tract of sheep by 454 pyrosequencing analysis

    Jin Wang


    Full Text Available Objective The gastrointestinal tract of sheep contain complex microbial communities that influence numerous aspects of the sheep’s health and development. The objective of this study was to analyze the composition and diversity of the microbiota in the gastrointestinal tract sections (rumen, reticulum, omasum, abomasum, duodenum, jejunum, ileum, cecum, colon, and rectum of sheep. Methods This analysis was performed by 454 pyrosequencing using the V3-V6 region of the 16S rRNA genes. Samples were collected from five healthy, small tailed Han sheep aged 10 months, obtained at market. The bacterial composition of sheep gastrointestinal microbiota was investigated at the phylum, class, order, family, genus, and species levels. Results The dominant bacterial phyla in the entire gastrointestinal sections were Firmicutes, Bacteroidetes, and Proteobacteria. In the stomach, the three most dominant genera in the sheep were Prevotella, unclassified Lachnospiraceae, and Butyrivibrio. In the small intestine, the three most dominant genera in the sheep were Escherichia, unclassified Lachnospiraceae, and Ruminococcus. In the large intestine, the three most dominant genera in the sheep were Ruminococcus, unclassified Ruminococcaceae, and Prevotella. R. flavefaciens, B. fibrisolvens, and S. ruminantium were three most dominant species in the sheep gastrointestinal tract. Principal Coordinates Analysis showed that the microbial communities from each gastrointestinal section could be separated into three groups according to similarity of community composition: stomach (rumen, reticulum, omasum, and abomasum, small intestine (duodenum, jejunum, and ileum, and large intestine (cecum, colon, and rectum. Conclusion This is the first study to characterize the entire gastrointestinal microbiota in sheep by use of 16S rRNA gene amplicon pyrosequencing, expanding our knowledge of the gastrointestinal bacterial community of sheep.

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

    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.

  9. Electronic Prognostics for Vehicle Health Management, Phase I

    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...

  10. Architecture for Integrated System Health Management, Phase I

    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...

  11. Sensor Area Network for Integrated Systems Health Management, Phase I

    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...

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

    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

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

    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.

  14. 201 the importance of health management of grasscutters in ...


    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,.

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


    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.

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


    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.

  17. A Structural Model Decomposition Framework for Systems Health Management

    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...

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

    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.

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

    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.

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

    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.

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

    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.

  2. All-Fiber-Optic Ultrasonic Health Management System, Phase I

    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...

  3. Corporate social responsibility and the future health care manager.

    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.

  4. Knowledge management in health: a systematic literature review.

    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%).

  5. Toward a Conceptual Knowledge Management Framework in Health

    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

  6. Sheep-passaged bovine spongiform encephalopathy agent exhibits altered pathobiological properties in bovine-PrP transgenic mice

    Espinosa, J.C.; Andreoletti, O.; Castilla, J.; Herva, M.E.; Morales, M.; Alamillo, E.; San-Segundo, F.D.; Lacroux, C.; Lugan, S.; Salguero, F.J.; Langeveld, J.P.M.; Torres, J.M.


    Sheep can be experimentally infected with bovine spongiform encephalopathy (BSE), and the ensuing disease is similar to scrapie in terms of pathogenesis and clinical signs. BSE infection in sheep is an animal and human health concern. In this study, the transmission in BoPrP-Tg110 mice of prions

  7. Using sheep genomes from diverse U.S. breeds to identify missense variants in genes affecting fecundity

    Background: Access to sheep genome sequences significantly improves the chances of identifying genes that may influence the health, welfare, and productivity of these animals. Methods: A public, searchable DNA sequence resource for U.S. sheep was created with whole genome sequence (WGS) of 96 rams. ...

  8. Dual-Use Aspects of System Health Management

    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.

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

    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.

  10. Managing Home Health Care (For Parents)

    ... 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 ...

  11. Health Risk Management for Bioenvironmental Engineering


    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

  12. Health system strengthening and hypertension management in China.

    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

  13. [Health alert management and emerging risk].

    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.

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

    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 ...

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

    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

  16. Audit Trail Management System in Community Health Care Information Network.

    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.

  17. Herd health and production management in dairy practice.

    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

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

    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...

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

    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

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

    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 ...

  1. Fatal pneumonia following inoculation of healthy bighorn sheep with Pasteurella haemolytica from healthy domestic sheep.

    Foreyt, W J; Snipes, K P; Kasten, R W


    In a series of three experiments, isolates of Pasteurella haemolytica biotype A, serotype 2, ribotype reference WSU-1, from healthy domestic sheep, were inoculated intratracheally into eight bighorn sheep (Ovis canadensis canadensis) and seven domestic sheep with doses of bacteria ranging from 5.3 x 10(8) to 8.6 x 10(11) colony forming units. Seven of eight inoculated bighorn sheep died from acute pneumonia within 48 hr of inoculation, whereas all seven domestic sheep inoculated with comparable or greater doses of bacteria remained healthy. One contact control bighorn sheep also died 6 days after its penmates received P. haemolytica. Three other noncontact control bighorn sheep remained healthy during the experiments. Pasteurella haemolytica biotype A, serotype 2, ribotype reference WSU-1 in the inocula was recovered from one or more tissues from all bighorns that died; whereas, it was not detected in any bighorn sheep before inoculation. Three different ribotypes of P. haemolytica A2 were recovered from bighorn sheep; however, only the ribotype reference WSU-1 in the domestic sheep-origin inoculum was recovered from all dead bighorn sheep, and was not recovered from bighorn sheep that survived the experiments. Thus, a relatively nonpathogenic and common isolate of P. haemolytica from healthy domestic sheep was lethal in bighorn sheep under experimental conditions.

  2. Mental Health Professionals' Suicide Risk Assessment and Management Practices.

    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.

  3. Using systems science for population health management in primary care.

    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.

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


    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 ...

  5. An Application of Business Process Management to Health Care Facilities.

    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.

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

    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.

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

    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 ...

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

    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

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


    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.

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

    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 ...

  11. Public and private roles in plant health management

    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

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

    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

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

    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

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

    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.

  15. Financial aspects of veterinary herd health management programmes

    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

  16. An Examination of Health Information Management by the Deaf

    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…

  17. Reusable Rocket Engine Turbopump Health Management System

    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.

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

    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....

  19. Rural health service managers' perspectives on preparing rural health services for climate change.

    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.

  20. 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....

  1. Best practices in managing child and adolescent behavioral health emergencies.

    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.

  2. Preliminary bluetongue Transmission with the sheep ked Melophagus ovinus (L.).

    Luedke, A J; Jochim, M M; Bowne, J G


    Five experiments indicated that the sheep ked MELOPHAGUS OVINUS (L.), can transmit bluetongue virus (BTV) in sheep. It was not determined whether these were mechanical or biological transmissions, although the results suggested mechanical transmission. Sheep keds were manually transferred from a BTV-host sheep to 18 susceptible test sheep. Of these, 10 were positive (5 with mild reactions), 6 questionable, and 2 negative for BTV. Three of the mildly reacting sheep and 3 of the questionable sheep had highly intensified reactions on challenge inoculation. Five of the positive sheep were immune on challenge inoculation. Blood from 2 positive reactors was subpassaged into susceptible sheep, which reacted with typical disease signs.

  3. Preliminary Bluetongue Transmissions with the Sheep Ked Melophagus Ovinus (L.)*

    Luedke, A. J.; Jochim, M. M.; Bowne, J. G.


    Five experiments indicated that the sheep ked MELOPHAGUS OVINUS (L.), can transmit bluetongue virus (BTV) in sheep. It was not determined whether these were mechanical or biological transmissions, although the results suggested mechanical transmission. Sheep keds were manually transferred from a BTV-host sheep to 18 susceptible test sheep. Of these, 10 were positive (5 with mild reactions), 6 questionable, and 2 negative for BTV. Three of the mildly reacting sheep and 3 of the questionable sheep had highly intensified reactions on challenge inoculation. Five of the positive sheep were immune on challenge inoculation. Blood from 2 positive reactors was subpassaged into susceptible sheep, which reacted with typical disease signs. PMID:4221988

  4. Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers.

    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

  5. Research on prognostics and health management of underground pipeline

    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.

  6. Employee weight management through health coaching.

    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.

  7. [Management committees in health services: an empirical study].

    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.

  8. Using matrix organization to manage health care delivery organizations.

    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.

  9. [Organization of health services and tuberculosis care management].

    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.

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

    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

  11. Health Consequences and Management of Explosive Events

    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.

  12. 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...

  13. Guidelines for Management Information Systems in Canadian Health Care Facilities

    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.

  14. Public health laboratory quality management in a developing country.

    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.

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

    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.

  16. Managing equality and cultural diversity in the health workforce.

    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

  17. Assessment, authorization and access to medicaid managed mental health care.

    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.

  18. Integrated Systems Health Management (ISHM) Toolkit

    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.

  19. Disability management: the application of preventive measures, health promotion and case management in Italy.

    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.

  20. Using objectives for managing safety and health

    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

  1. Occupational health management system: A study of expatriate construction professionals.

    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

  2. Analysis of the new health management based on health internet of things and cloud computing

    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.

  3. Ectoparasites of sheep in three agro-ecological zones in central Oromia, Ethiopia

    Bersissa Kumsa


    Full Text Available A cross-sectional study was conducted to determine the prevalence and risk factors for ectoparasites infestation in sheep in three agro-ecological zones in central Oromia, Ethiopia, from October 2009 to April 2010. The study revealed that 637 (48.1% of the 1325 sheep examined were infested with one or more ectoparasites. The ectoparasites identified were Bovicola ovis (27.2%, Melophagus ovinus (16.4%, Ctenocephalides sp. (2.3%, Linognathus africanus (1.2%, Linognathus ovillus (0.3%, Sarcoptes sp. (1.2%, Amblyomma variegatum (4.4%, Rhipicephalus evertsi evertsi (1.9%, Rhipicephalus pravus (1.9%, Rhipicephalus (Boophilus decoloratus (1.1%, Rhipicephalus sanguineus (0.9%, Rhipicephalus praetextatus (1.1% and Hyalomma truncatum (1.6%. Statistically significant difference was observed in prevalence of B. ovis amongst study agroecological zones: highland 36.6%, midland 20.9% and lowland 14.0%. Significantly higher prevalence was recorded in highland agroecological zone. A significantly (OR = 0.041, p  0.05 was never recorded in the prevalence of all the identified species of ectoparasites between male and female sheep hosts. However, a significantly (p = 0.006 higher prevalence of B. ovis was recorded between young and adult sheep. The risk of B. ovis infestation was 1.45 times higher in young than the adult sheep. Furthermore, a significantly (p < 0.001 higher prevalence of M. ovinus, B. ovis and Sarcoptes sp. was found between sheep with poor and a good body condition. The ever increasing threat of ectoparasites on overall sheep productivity and tanning industry in Ethiopia warrants urgent control intervention. Further studies on the role of ectoparasites in transmission of diseases to sheep, zoonotic importance, comparative prevalence and load, and the importance of sheep as alternative hosts in different agroecological zones, breeds and management systems in Ethiopia are recommended so as to design applicable control programme in the country.


    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.

  5. Progestogen treatments for cycle management in a sheep model of assisted conception affect the growth patterns, the expression of luteinizing hormone receptors, and the progesterone secretion of induced corpora lutea.

    Letelier, Claudia; García-Fernández, Rosa Ana; Contreras-Solis, Ignacio; Sanchez, María Angeles; Garcia-Palencia, Pilar; Sanchez, Belen; Gonzalez-Bulnes, Antonio; Flores, Juana María


    To determine, in a sheep model, the effect of a short-term progestative treatment on growth dynamics and functionality of induced corpora lutea. Observational, model study. Public university. Sixty adult female sheep. Synchronization and induction of ovulation with progestogens and prostaglandin analogues; ovarian ultrasonography, blood sampling, and ovariectomy. Determination of pituitary function and morphologic characteristics, expression of luteinizing hormone (LH) receptors, and progesterone secretion of corpora lutea. The use of progestative pretreatments for assisted conception affect the growth patterns, the expression of LH receptors, and the progesterone secretion of induced corpora lutea. The current study indicates, in a sheep model, the existence of deleterious effects from progestogens on functionality of induced corpora lutea. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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

    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

  7. Veterinary dairy herd health management in Europe: constraints and perspectives.

    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

  8. [Time based management in health care system: the chosen aspects].

    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.

  9. Oral health and menopouse: Problems and management

    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

  10. Risk management frameworks for human health and environmental risks.

    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

  11. Safe management of waste from health-care activities

    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

  12. Health Information Management System for Elderly Health Sector: A Qualitative Study in Iran.

    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.

  13. Roles of managers in academic health centers: strategies for the managed care environment.

    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.

  14. Economic Techniques of Occupational Health and Safety Management

    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.

  15. Holistic approach to fraud management in health insurance

    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.

  16. Important bioindicators for health management in Romania

    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.

  17. Protostrongylid parasites and pneumonia in captive and wild thinhorn sheep (Ovis dalli).

    Jenkins, E J; Veitch, A M; Kutz, S J; Bollinger, T K; Chirino-Trejo, J M; Elkin, B T; West, K H; Hoberg, E P; Polley, L


    We describe health significance of protostrongylid parasites (Parelaphostrongylus odocoilei and Protostrongylus stilesi) and other respiratory pathogens in more than 50 naturally infected Dall's sheep (Ovis dalli dalli) from the Mackenzie Mountains, Northwest Territories (1998-2002) as well as in three Stone's sheep (O. d. stonei) experimentally infected with P. odocoilei (2000-2002). Histological lesions in the brain and distribution of P. odocoilei in the muscles of experimentally and naturally infected sheep were consistent with a previously hypothesized "central nervous system to muscle" pattern of migration for P. odocoilei. Dimensions of granulomas associated with eggs of P. odocoilei and density of protostrongylid eggs and larvae in the cranial lung correlated with intensity of larvae in feces, and all varied with season of collection. Prevalence of P. stilesi based on the presence of larvae in feces underestimated true prevalence (based on examination of lungs) in wild Dall's sheep collected in summer and fall. Similarly, counts of both types of protostrongylid larvae in feces were unreliable indicators of parasitic infection in wild Dall's sheep with concomitant bacterial pneumonia associated with Arcanobacterium pyogenes, Pasteurella sp., and Mannheimia sp. Diffuse, interstitial pneumonia due to P. odocoilei led to fatal pulmonary hemorrhage and edema after exertion in one experimentally infected Stone's sheep and one naturally infected Dall's sheep. Bacterial and verminous pneumonia associated with pathogens endemic in wild Dall's sheep in the Mackenzie Mountains caused sporadic mortalities. There was no evidence of respiratory viruses or bacterial strains associated with domestic ruminants, from which this population of wild sheep has been historically isolated.

  18. An intelligent content discovery technique for health portal content management.

    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

  19. Managing the Social Determinants of Health: Part I: Fundamental Knowledge for Professional Case Management.

    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.

  20. Conjunctival bacterial and fungal flora in clinically normal sheep.

    Bonelli, Francesca; Barsotti, Giovanni; Attili, Anna Rita; Mugnaini, Linda; Cuteri, Vincenzo; Preziuso, Silvia; Corazza, Michele; Preziuso, Giovanna; Sgorbini, Micaela


    The aim was to identify conjunctival bacterial and fungal flora in clinically normal sheep. Prospective study. Tuscany. 100 eyes from 50 adult Massese female sheep were examined. The sheep included in the study were considered free of anterior ophthalmic abnormalities. Bacteria were identified by morphological assessment, Gram staining, biochemical tests. Identification of filamentous fungi was achieved at the genus level, and Aspergillus species were identified based on keys provided by other authors. Yeast colonies were highlighted, but not identified. Positive cultures were obtained from 100/100 eyes for bacteria, and from 86/100 eyes for fungi. A total of 14 types of bacteria and 5 types of fungi were isolated. Yeasts were isolated from 13/100 eyes. The most frequent fungal isolates were saprophytic fungi. Conjunctival bacterial and fungal flora of clinically normal eyes were reported in sheep. The positivity obtained for conjunctival bacteria was higher compared to findings in the literature by other authors in the same species (100 per cent v 40 per cent), while our results were in line with a recent work performed on mouflons (Ovis Musimon) with a 100 per cent positivity for bacterial conjunctival fornix. In our survey, Gram-positive species were prevalent, as reported by other authors in different species. Few data are available in the literature regarding conjunctival fungal flora in healthy small ruminants. The prevalence of conjunctival fungal flora in this study was higher than findings reported in mouflons (86 per cent v 45 per cent). Differences in fungal prevalence may be due to different methods of managing herds, though further studies are required to verify this hypothesis. The similarities in bacterial and fungal isolates between sheep and mouflons suggest a genera pattern of conjunctival colonisation by bacteria and fungi.

  1. Selection signatures in worldwide sheep populations.

    Fariello, Maria-Ines; Servin, Bertrand; Tosser-Klopp, Gwenola; Rupp, Rachel; Moreno, Carole; San Cristobal, Magali; Boitard, Simon


    The diversity of populations in domestic species offers great opportunities to study genome response to selection. The recently published Sheep HapMap dataset is a great example of characterization of the world wide genetic diversity in sheep. In this study, we re-analyzed the Sheep HapMap dataset to identify selection signatures in worldwide sheep populations. Compared to previous analyses, we made use of statistical methods that (i) take account of the hierarchical structure of sheep populations, (ii) make use of linkage disequilibrium information and (iii) focus specifically on either recent or older selection signatures. We show that this allows pinpointing several new selection signatures in the sheep genome and distinguishing those related to modern breeding objectives and to earlier post-domestication constraints. The newly identified regions, together with the ones previously identified, reveal the extensive genome response to selection on morphology, color and adaptation to new environments.

  2. Fundamental Technology Development for Gas-Turbine Engine Health Management

    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.

  3. Quality, risk management and governance in mental health: an overview.

    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.

  4. Regional governance: strategies and disputes in health region management

    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

  5. Managing organizational change: strategies for the female health care supervisor.

    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)

  6. Retention of health workers in Malawi: perspectives of health workers and district management

    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

  7. Retention of health workers in Malawi: perspectives of health workers and district management.

    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

  8. The Thai-Australian Health Alliance: developing health management capacity and sustainability for primary health care services.

    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

  9. The Oral Health Care Manager in a Patient-Centered Health Facility.

    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.

  10. Vitamin and water requirements of dairy sheep

    Fulvia Bovera


    Full Text Available The authors review the physiological role and the daily requirement of fat-soluble vitamins (A, D, E and K, vitamin C  and water in dairy sheep. Regarding the vitamins, classical clinical symptoms and/or non-specific parameters, such as  lowered production and reproduction rates are associated with their deficiencies or excesses. Until the last decade,  these compounds were considered important only for the prevention of such alterations; currently, there is more  emphasis on their function as the vitamins can play a key role in optimising animal health. In this respect, of particu-  lar interest is the action of the antioxidant vitamins (especially vitamin C, vitamin E and beta-carotene in improving  the efficiency of the immune system. 

  11. Commercial Aircraft Integrated Vehicle Health Management Study

    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.

  12. Sheep Feed and Scrapie, France

    Philippe, Sandrine; Ducrot, Christian; Roy, Pascal; Remontet, Laurent; Jarrige, Nathalie


    Scrapie is a small ruminant, transmissible spongiform encephalopathy (TSE). Although in the past scrapie has not been considered a zoonosis, the emergence of bovine spongiform encephalopathy, transmissible to humans and experimentally to sheep, indicates that risk exists for small ruminant TSEs in humans. To identify the risk factors for introducing scrapie into sheep flocks, a case-control study was conducted in France from 1999 to 2000. Ninety-four case and 350 control flocks were matched by location and main breed. Three main hypotheses were tested: direct contact between flocks, indirect environmental contact, and foodborne risk. Statistical analysis was performed by using adjusted generalized linear models with the complementary log-log link function, considering flock size as an offset. A notable effect of using proprietary concentrates and milk replacers was observed. The risk was heterogeneous among feed factories. Contacts between flocks were not shown to be a risk factor. PMID:16102318

  13. 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...

  14. 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...

  15. Meat quality of goat and sheep sausages

    Teixeira, A.; Pereira, Etelvina; Rodrigues, Sandra


    The main objective of this work was to contribute to the characterization of a new product, based on goat and sheep meat with a strategy, which gives value-added to meat from culled goats and sheep, which have a very low commercial price. Carcasses from animals weighing more than the body weight allowed by PDO label specifications were used to produce fresh sausages. Sheep and goats sausages were produced in a traditional industry, in Northeast Portugal. The following character...

  16. Management of pharmaceutical services in the Brazilian primary health care.

    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.

  17. Government Health Care Contract Incentives: Making Managed Health Care Work in Federal Government Procurements

    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...

  18. Health Management Technology as a General Solution Framework

    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.

  19. Health management and controls for earth to orbit propulsion systems

    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.


    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

  1. Health care managers learning by listening to subordinates' dialogue training.

    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.

  2. Permanent education and co-management: experience of a health managing group

    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.

  3. Atypical scrapie prions from sheep and lack of disease in transgenic mice overexpressing human prion protein.

    Wadsworth, Jonathan D F; Joiner, Susan; Linehan, Jacqueline M; Balkema-Buschmann, Anne; Spiropoulos, John; Simmons, Marion M; Griffiths, Peter C; Groschup, Martin H; Hope, James; Brandner, Sebastian; Asante, Emmanuel A; Collinge, John


    Public and animal health controls to limit human exposure to animal prions are focused on bovine spongiform encephalopathy (BSE), but other prion strains in ruminants may also have zoonotic potential. One example is atypical/Nor98 scrapie, which evaded statutory diagnostic methods worldwide until the early 2000s. To investigate whether sheep infected with scrapie prions could be another source of infection, we inoculated transgenic mice that overexpressed human prion protein with brain tissue from sheep with natural field cases of classical and atypical scrapie, sheep with experimental BSE, and cattle with BSE. We found that these mice were susceptible to BSE prions, but disease did not develop after prolonged postinoculation periods when mice were inoculated with classical or atypical scrapie prions. These data are consistent with the conclusion that prion disease is less likely to develop in humans after exposure to naturally occurring prions of sheep than after exposure to epizootic BSE prions of ruminants.

  4. The International Sheep and Wool Handbook

    Antonello Cannas


    Full Text Available This revised book is an expanded and updated version of the Australian Sheep and Wool Handbook published in 1991 and focuses on the sheep wool and meat industry. The book is divided in 5 sections, each including several chapters written by well-known and qualified researchers and industry representatives from many countries. The first section on Major sheep and wool industries, in my opinion, is particularly interesting because it explores the sheep and wool industries of leading countries (e.g. Australia, South Africa and New Zealand and continents (Europe and South America, and those of emerging countries (e.g. China.....

  5. Modeling risk of pneumonia epizootics in bighorn sheep

    Sells, Sarah N.; Mitchell, Michael S.; Nowak, J. Joshua; Lukacs, Paul M.; Anderson, Neil J.; Ramsey, Jennifer M.; Gude, Justin A.; Krausman, Paul R.


    Pneumonia epizootics are a major challenge for management of bighorn sheep (Ovis canadensis) affecting persistence of herds, satisfaction of stakeholders, and allocations of resources by management agencies. Risk factors associated with the disease are poorly understood, making pneumonia epizootics hard to predict; such epizootics are thus managed reactively rather than proactively. We developed a model for herds in Montana that identifies risk factors and addresses biological questions about risk. Using Bayesian logistic regression with repeated measures, we found that private land, weed control using domestic sheep or goats, pneumonia history, and herd density were positively associated with risk of pneumonia epizootics in 43 herds that experienced 22 epizootics out of 637 herd-years from 1979–2013. We defined an area of high risk for pathogen exposure as the area of each herd distribution plus a 14.5-km buffer from that boundary. Within this area, the odds of a pneumonia epizootic increased by >1.5 times per additional unit of private land (unit is the standardized % of private land where global  = 25.58% and SD = 14.53%). Odds were >3.3 times greater if domestic sheep or goats were used for weed control in a herd's area of high risk. If a herd or its neighbors within the area of high risk had a history of a pneumonia epizootic, odds of a subsequent pneumonia epizootic were >10 times greater. Risk greatly increased when herds were at high density, with nearly 15 times greater odds of a pneumonia epizootic compared to when herds were at low density. Odds of a pneumonia epizootic also appeared to decrease following increased spring precipitation (odds = 0.41 per unit increase, global  = 100.18% and SD = 26.97%). Risk was not associated with number of federal sheep and goat allotments, proximity to nearest herds of bighorn sheep, ratio of rams to ewes, percentage of average winter precipitation, or whether herds were of native versus mixed

  6. The transfer of a health insurance/managed care business.

    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.

  7. Managing mechanistic and organic structure in health care organizations.

    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.

  8. [Local planning: the speech of basic health care center manager].

    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.

  9. Differences in the microstructure and rheological properties of low-fat yoghurts from goat, sheep and cow milk.

    Nguyen, Hanh T H; Afsar, Saeedeh; Day, Li


    Goat and sheep milks have long been used to produce a range of dairy products due to their nutritional value and health benefits. Information about the microstructure and rheology of goat and sheep yoghurts, however, is scarce. In this study, the microstructure, texture and rheological properties of cow, goat and sheep yoghurts were investigated and compared. The results show that a longer fermentation and gelation time was required for goat yoghurt with a lower storage modulus compared to cow and sheep yoghurts. Cooling resulted in an increase in the storage modulus at different magnitudes for cow, goat and sheep yoghurts. Goat yoghurt had a smaller particle size and a softer gel, which is linked with a more porous microstructure. The results obtained here demonstrate the effect of different milk types on the properties of yoghurts and provide a better understanding into the link between the microstructure and physical properties of the product. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Contingency Management of Health Care Organizations: It Depends.

    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.

  11. Data Analysis of Occupational Health and Safety Management and Total Quality Management Systems

    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.

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

    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

  13. Managing workplace health promotion in municipal organizations: The perspective of senior managers.

    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.

  14. 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...

  15. A survey of the health needs of hospital staff: implications for health care managers.

    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.

  16. Functioning of primary health care in opinion of managers of primary health care units.

    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.

  17. Reverse quality management: developing evidence-based best practices in health emergency management.

    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.

  18. Consumer Health Informatics: Promoting Patient Self-care Management of Illnesses and Health.

    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.

  19. The rate of spread of sheep scab within small groups of Merino and Dorper sheep : short communication

    T. Meintjies


    Full Text Available A single Merino sheep, artificially infested with the sheep scab mite, Psoroptes ovis, and a similarly infested Dorper sheep were placed with 9 uninfested Merino or 9 uninfested Dorper sheep respectively during winter and the rate of spread of infestation on the uninfested sheep observed. The same procedure was repeated in summer. It took 14 and 8 weeks respectively in winter before all sheep in the 2 groups displayed lesions of sheep scab, whereas in summer it took 10 and 12 weeks before all sheep had lesions.

  20. [Health agencies and the every day management of bioethics].

    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?

  1. Managing health physics departmental data via a local area network

    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)

  2. Supply chain management in health services : an overview

    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

  3. Managing Mental Health Crises of Foreign College Students.

    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)

  4. Supporting self-management of chronic health conditions: common approaches.

    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.

  5. 76 FR 64110 - Safety and Health Management Programs for Mines


    ... 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...

  6. Occupational safety and health management and risk governance

    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

  7. Health Management Information System in Private Clinics in Ilorin ...

    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 ...

  8. Primary health care management challenges for childhood atopic ...

    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-.

  9. Outcomes Assessment in Accredited Health Information Management Programs

    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,…

  10. Training evaluation: a case study of training Iranian health managers.

    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

  11. Training evaluation: a case study of training Iranian health managers

    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

  12. Performance and Parasitology of Semi-intensively Managed West African Dwarf Sheep Exposed to Gastrointestinal Helminth Infect-ed Paddocks and Varied Protein-energy Feeds

    Adekayode Olarinwaju SONIBARE


    Full Text Available Background: The performance and parasitology of semi-intensively managed West African dwarf (WAD lambs were evaluated following exposure to gastrointestinal helminth infected paddock and varied protein-energy feeds.Methods: Twenty four lambs obtained from the Department of Animal Breeding and Genetics and brought to Directorate of University farm (DUFARM of Federal University of Agriculture Abeokuta, Ogun state, Nigeria, where the research was carried out in 2014, were grouped into four each containing six animals based on different energy-protein feed combination thus; group 1(G1 low energy low protein, group 2 (G2 low energy high protein, group 3 (G3 high energy low protein and group 4 (G4 high energy high protein. Experimental animals were supplemented with concentrate feed after grazing on daily in a nematode infected paddock. Clinical signs of infection were monitored. Live weight, faecal egg count (FEC, worm counts, packed cell volume (PCV, haemoglobin concentration (Hb and red blood cell count (RBC were determined using standard methods.Results: Anorexia and intermittent diarrhea were the observed signs. Worm counts did not differ significantly (P=0.309 among the groups. The weight and FEC differed significantly (P˂0.05 across the days and among the groups, while haematological parameters increased significantly (P˂0.05 across the days and among the groups.Conclusion: Lambs in G2 followed by G4 showed improved parameters and superior performance when compared to the other groups. It is therefore recommended that feed high in protein content is capable of mitigating deleterious effect of gastrointestinal helminth parasitism.

  13. An ecologic study comparing distribution of Pasteurella trehalosi and Mannheimia haemolytica between Sierra Nevada bighorn sheep, White Mountain bighorn sheep, and domestic sheep.

    Tomassini, Letizia; Gonzales, Ben; Weiser, Glen C; Sischo, William


    The prevalence and phenotypic variability of Pasteurella and Mannheimia isolates from Sierra Nevada bighorn sheep (Ovis canadensis sierrae), White Mountain bighorn sheep (Ovis canadensis nelsoni), and domestic sheep (Ovis aries) from California, USA, were compared. The White Mountain bighorn sheep population had a recent history of pneumonia-associated mortality, whereas the Sierra Nevada bighorn sheep population had no recent history of pneumonia-associated mortality. The domestic sheep flocks were pastured in areas geographically near both populations but were not known to have direct contact with either bighorn sheep population. Oropharyngeal swab samples were collected from healthy domestic and bighorn sheep and cultured to characterize bacterial species, hemolysis, biogroups, and biovariants. Pasteurella trehalosi and Mannheimia haemolytica were detected in all of the study populations, but the relative proportion of each bacterial species differed among sheep populations. Pasteurella trehalosi was more common than M. haemolytica in the bighorn sheep populations, whereas the opposite was true in domestic sheep. Mannheimia haemolytica was separated into 11 biogroups, and P. trehalosi was characterized into two biogroups. Biogroup distributions for M. haemolytica and P. trehalosi differed among the three populations; however, no difference was detected for the distribution of P. trehalosi biogroups between the Sierra Nevada bighorn sheep and domestic sheep. The prevalence odds ratios (pOR) for the distribution of M. haemolytica biogroups suggested little difference between White Mountain bighorn sheep and domestic sheep compared with Sierra Nevada bighorn sheep and domestic sheep, although these comparisons had relatively large confidence intervals for the point estimates. Hemolytic activity of the isolates was not different among the sheep populations for M. haemolytica but was different for P. trehalosi. No clear evidence of association was found in the

  14. Health Professionals' Expanding eHealth Competences for Supporting Patients' Self-Management.

    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.

  15. Genetic diversity of Colombian sheep by microsatellite markers

    Ricardo Ocampo


    Full Text Available In Colombia the sheep production systems are managed under extensive conditions and mainly correspond to peasant production systems so their genetic management has led to increased homozygosity and hence productivity loss. The aim of this study was to determine the genetic diversity in 549 individuals corresponding to 13 sheep breeds in Colombia, using a panel of 11 microsatellite molecular markers. One hundred and fifty seven alleles were found (average of 14.27 alleles/locus, with a range of observed and expected heterozygosity from 0.44 to 0.84 and 0.67 to 0.86, respectively. Thirty-three of 143 Hardy Weinberg tests performed showed significant deviations (p < 0.05 due to a general lack of heterozygous individuals. The Fis ranged from 0.01 in Corriedale to 0.15 for the Persian Black Head breed, suggesting that there are presenting low to moderate levels of inbreeding. Overall, Colombian sheep showed high levels of genetic diversity which is very important for future selection and animal breeding programs.

  16. Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records.

    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.

  17. Organizing and managing care in a changing health system.

    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.

  18. Knowledge Management System in Health & Social Care: Review on 20 Practiced Knowledge Management

    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

  19. Factors Affecting Usage of a Personal Health Record (PHR) to Manage Health

    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

  20. Evaluation of computerized health management information system for primary health care in rural India

    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.

  1. Linking better shiftwork arrangements with safety and health management systems.

    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.

  3. Governance in managing public health resources in Brazilian municipalities.

    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.

  4. [The hospital perspective: disease management and integrated health care].

    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.

  5. Managing the risks of on-site health centers.

    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.

  6. Critical systems for public health management of floods, North Dakota.

    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.

  7. Managing information technology human resources in health care.

    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.

  8. Identification of Single Nucleotide Polymorphism (SNP in Mono Amine Oxidase A (MAO-A Gene as a genetic marker for aggressiveness in sheep

    Eko Handiwirawan


    Full Text Available In the population, there are aggressive sheep in a small number which requires special management those specific animal house and routine management. The purpose of this study was to identify the variation of DNA marker SNP (single nucleotide polymorphism as a genetic marker for the aggressive trait in several of sheep breed. The identification of point mutations in exon 8 of MAO-A gene associated with aggressive behavior in sheep may be further useful to become of DNA markers for the aggressive trait in sheep. Five of sheep breed were used, i.e.: Barbados Black belly Cross sheep (BC, Composite Garut (KG, Local Garut (LG, Composite Sumatra (KS and St. Cross Croix (SC. Duration of ten behavior traits, blood serotonin concentrations and DNA sequence of exon 8 of MAO-A gene from the sheep aggressive and nonaggressive were observed. PROC GLM of SAS Ver. 9.0 program was used to analyze variable behavior and blood serotonin concentrations. DNA polymorphism in exon 8 of MAO-A gene was analyzed using the MEGA software Ver. 4.0. The results show that the percentage of the aggressive rams of each breed was less than 10 percent; except for the KS sheep is higher (23%. Based on the duration of behavior, aggressive sheep group was not significantly different with non aggressive sheep group, except duration of care giving and drinking behavior. It is known that concentration of blood serotonin in aggressive and non aggressive rams was not significantly different. The aggressive trait in sheep has a mechanism or a different cause like that occurs in mice and humans. In this study, aggressive behavior in sheep was not associated with a mutation in exon 8 of MAO-A gene.

  9. Antidepressant Medication Management among Older Patients Receiving Home Health Care

    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

  10. Health-related behaviour among managers of Slovenian hospitals and institutes of public health

    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.

  11. Self arrangements in occupational safety and health management

    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)

  12. Toward a national health risk management approach in Australia.

    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.

  13. Prevalence of Coxiella burnetii in clinically healthy German sheep flocks

    Hilbert Angela


    Full Text Available Abstract Background Current epidemiological data on the situation of Coxiella (C. burnetii infections in sheep are missing, making risk assessment and the implementation of counteractive measures difficult. Using the German state of Thuringia as a model example, the estimated sero-, and antigen prevalence of C. burnetii (10% and 25%, respectively was assessed at flock level in 39/252 randomly selected clinically healthy sheep flocks with more than 100 ewes and unknown abortion rate. Results The CHECKIT™ Q-fever Test Kit identified 11 (28% antibody positive herds, whereas real-time PCR revealed the presence of C. burnetii DNA in 2 (5% of the flocks. Multiple-locus variable number of tandem repeats analysis of 9 isolates obtained from one flock revealed identical profiles. All isolates contained the plasmid QpH1. Conclusions The results demonstrate that C. burnetii is present in clinically inconspicuous sheep flocks and sporadic flare-ups do occur as the notifications to the German animal disease reporting system show. Although C. burnetii infections are not a primary veterinary concern due to the lack of significant clinical impact on animal health (with the exception of goats, the eminent zoonotic risk for humans should not be underestimated. Therefore, strategies combining the interests of public and veterinary public health should include monitoring of flocks, the identification and culling of shedders as well as the administration of protective vaccines.

  14. How Health Relationship Management Services (HRMS Benefits Corporate Wellness

    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.

  15. Evaluation of five treatments to control intestinal parasites in sheep in Ayapango, state of Mexico

    Rafael Heredia


    Full Text Available Aim: Intestinal parasites are one of the most common problems in sheep production systems. However, the strategies used to eliminate these parasites have not yielded satisfactory results. Therefore, the aim of this study was to determine the effect of five anthelmintics (with different active ingredients on the parasite load in sheep. Materials and Methods: In this study, 107 Rambouillet breed sheep were randomly assigned to five groups. Next, fecal samples were taken directly from the rectum and sent to the laboratory for analysis. We then dewormed each group of sheep using different anthelmintic products: Ivermectin 1%/clorsulon 10%, levamisole 12%, closantel sodium 5%, ivermectin 10%, and closantel 5%/albendazole 3.75% with a dosage corresponding to each sheep. At 15 days post-treatment, we took fecal samples and performed a coproparasitoscopic study, using the Faust flotation technique to assess the presence or absence of parasite eggs and the McMaster technique to quantify eggs. Results: Ivermectin/clorsulon was more effective in eliminating parasites than other anthelmintics used, especially in Haemonchus spp. Conclusion: The results of this study indicate that using ivermectin/clorsulon decreases the number of eggs in feces and is one alternative in controlling parasites in sheep, leading to a reduction in the incidence of health problems, and consequently, improved productivity.

  16. Health effects of radiation exposure and protection from radiation through an industrial health management angle

    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.)


    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.

  18. Management capacity to promote nurse workplace health and safety.

    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.

  19. Open source electronic health records and chronic disease management.

    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.

  20. Managing environmental and health impacts of uranium mining

    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)

  1. [Health locus of control of patients in disease management programmes].

    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.

  2. 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...

  3. Self-Management Skills in Chronic Disease Management: What Role Does Health Literacy Have?

    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

  4. Managing risk selection incentives in health sector reforms.

    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.

  5. Management of health-care waste in Izmir, Turkey

    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.

  6. Waste management, informal recycling, environmental pollution and public health.

    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

  7. Performance scorecard for occupational safety and health management systems

    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.

  8. Health Management in Disasters in Iran: A Qualitative Study

    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

  9. Managing the physics of the economics of integrated health care.

    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

  10. Acute coenurosis of dairy sheep from 11 flocks in Greece.

    Giadinis, N D; Psychas, V; Polizopoulou, Z; Papadopoulos, E; Papaioannou, N; Komnenou, A Th; Thomas, A-L; Petridou, E J; Kritsepi-Konstantinou, M; Lafi, S Q; Brellou, G D


    A syndrome of acute neurological dysfunction with increased mortality was observed in lambs of 10 dairy sheep flocks and adult animals in one flock in Central and Northern Greece. Each farmer completed a questionnaire regarding the management and feeding of their flocks. In seven of the 11 flocks the affected animals were grazing pasture, while in the remaining four flocks (5, 8, 9, 10) the animals were fed alfalfa hay (Medicago sativa) and concentrates indoors. A follow-up study of the affected flocks was conducted during the next 12 months. Of 42 sheep with acute coenurosis that were examined, the most prominent neurological abnormalities were ataxia, depression, blindness, scoliosis, coma and dysmetria. Except for the four sheep that were comatose, all other animals had normal body temperatures and their appetites remained normal or were slightly decreased. Haematological findings of 15 examined sheep were within normal limits. The affected sheep were subject to euthanasia. A histopathological examination was performed in 13 cases. Faecal samples from dogs associated with these flocks were negative for taeniid infections. During the following 12 months cases of chronic coenurosis in these flocks were observed. In the 42 animals that were necropsied, the main gross findings were cystic formations between 0.5-1 cm in diameter with translucent walls that were seen lying free on the leptomeninges or partly penetrating the brain tissue, sterile microabscecess and brain necrosis. Histopathological evaluation of tissue sections of 13 brains showed multifocal purulent or pyogranulomatous meningoencephalitis, accompanied by eosinophilic infiltrations. No bacteria were isolated following bacterial culture of brain tissue Parasitological examination of the cysts from five cases revealed whitish specks on the transparent cyst wall and germination membrane representing the scolices. Acute coenurosis was diagnosed in all cases studied. Acute coenurosis can be one of the

  11. Haemophilus somnus (Histophilus somni) in bighorn sheep


    Abstract Respiratory disease and poor lamb recruitment have been identified as limiting factors for bighorn-sheep populations. Haemophilus somnus (recently reclassified as Histophilus somni) is associated with respiratory disease in American bison, domestic sheep, and cattle. It is also harbored in their reproductive tracts and has been associated with reproductive failure in domestic sheep and cattle. Therefore, reproductive tract and lung samples from bighorn sheep were evaluated for the presence of this organism. Organisms identified as H. somnus were isolated from 6 of 62 vaginal but none of 12 preputial swab samples. Antigen specific to H. somnus was detected by immunohistochemical study in 4 of 12 formalin-fixed lung tissue samples of bighorn sheep that died with evidence of pneumonia. Notably, H. somnus was found in alveolar debris in areas of inflammation. The 6 vaginal isolates and 2 H. somnus isolates previously cultured from pneumonic lungs of bighorn sheep were compared with 3 representative isolates from domestic sheep and 2 from cattle. The profiles of major outer membrane proteins and antigens for all of the isolates were predominantly similar, although differences that may be associated with the host–parasite relationship and virulence were detected. The DNA restriction fragment length profiles of the bighorn-sheep isolates had similarities not shared with the other isolates, suggesting distinct phylogenetic lines. All of the isolates had similar antimicrobial profiles, but the isolates from the bighorn sheep produced less pigment than those from the domestic livestock, and growth of the former was not enhanced by CO2. Wildlife biologists and diagnosticians should be aware of the potential of these organisms to cause disease in bighorn sheep and of growth characteristics that may hinder laboratory detection. PMID:16548330

  12. Haemophilus somnus (Histophilus somni) in bighorn sheep.

    Ward, Alton C S; Weiser, Glen C; Anderson, Bruce C; Cummings, Patrick J; Arnold, Karen F; Corbeil, Lynette B


    Respiratory disease and poor lamb recruitment have been identified as limiting factors for bighorn-sheep populations. Haemophilus somnus (recently reclassified as Histophilus somni) is associated with respiratory disease in American bison, domestic sheep, and cattle. It is also harbored in their reproductive tracts and has been associated with reproductive failure in domestic sheep and cattle. Therefore, reproductive tract and lung samples from bighorn sheep were evaluated for the presence of this organism. Organisms identified as H. somnus were isolated from 6 of 62 vaginal but none of 12 preputial swab samples. Antigen specific to H. somnus was detected by immunohistochemical study in 4 of 12 formalin-fixed lung tissue samples of bighorn sheep that died with evidence of pneumonia. Notably, H. somnus was found in alveolar debris in areas of inflammation. The 6 vaginal isolates and 2 H. somnus isolates previously cultured from pneumonic lungs of bighorn sheep were compared with 3 representative isolates from domestic sheep and 2 from cattle. The profiles of major outer membrane proteins and antigens for all of the isolates were predominantly similar, although differences that may be associated with the host-parasite relationship and virulence were detected. The DNA restriction fragment length profiles of the bighorn-sheep isolates had similarities not shared with the other isolates, suggesting distinct phylogenetic lines. All of the isolates had similar antimicrobial profiles, but the isolates from the bighorn sheep produced less pigment than those from the domestic livestock, and growth of the former was not enhanced by CO2. Wildlife biologists and diagnosticians should be aware of the potential of these organisms to cause disease in bighorn sheep and of growth characteristics that may hinder laboratory detection.

  13. Petroleum and Health Care: Evaluating and Managing Health Care's Vulnerability to Petroleum Supply Shifts

    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

  14. Income statement management in a turbulent health care environment.

    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

  15. Using management information systems to enhance health care quality assurance.

    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.

  16. Can action research strengthen district health management and improve health workforce performance? A research protocol.

    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

  17. An Agile Enterprise Regulation Architecture for Health Information Security Management

    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

  18. Health Care Leadership: Managing Knowledge Bases as Stakeholders.

    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.

  19. [Training of health-care employees in crisis resource management].

    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.

  20. An agile enterprise regulation architecture for health information security management.

    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.

  1. Who's in charge here anyway? Managing the management split in mental health organizations.

    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.

  2. Rural mental health workforce difficulties: a management perspective.

    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

  3. Survey of community pharmacy residents' perceptions of transgender health management.

    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

  4. Applying total quality management concepts to public health organizations.

    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

  5. Understanding human resource management practices in Botswana's public health sector.

    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.

  6. Principles of capacity management, applied in the mental health context.

    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

  7. RECALMIN: The association between management of Spanish National Health Service Internal Medical Units and health outcomes.

    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:

  8. Integrated approach for managing health risks at work--the role of occupational health nurses.

    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.

  9. Public health financial management needs: report of a national survey.

    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.

  10. Opportunities for Launch Site Integrated System Health Engineering and Management

    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.

  11. Oceans and Human Health: Linking Ocean, Organism, and Human Health for Sustainable Management of Coastal Ecosystems

    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

  12. Public health emergencies and the public health/managed care challenge.

    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.

  13. Developing management capacity building package to district health manager in northwest of Iran: A sequential mixed method study.

    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.

  14. 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...

  15. Web based Health Education, E-learning, for weight management.

    Heetebry, Irene; Hatcher, Myron; Tabriziani, Hossein


    Obesity is a major health problem across the United States and becoming a progressive world wide problem. An overweight person could access the weight management program and develop a personalized weight reduction plan. The customer enters specific data to personalize the program and in the future an artificial intelligence program can evaluate customer behavior and adjust accordingly. This is an on-line program with class room support, offered as back up when desired by the patient.

  16. Analytical concepts for health management systems of liquid rocket engines

    Williams, Richard; Tulpule, Sharayu; Hawman, Michael


    Substantial improvement in health management systems performance can be realized by implementing advanced analytical methods of processing existing liquid rocket engine sensor data. In this paper, such techniques ranging from time series analysis to multisensor pattern recognition to expert systems to fault isolation models are examined and contrasted. The performance of several of these methods is evaluated using data from test firings of the Space Shuttle main engines.

  17. Corporate management of quality in employee health plans.

    Maxwell, James; Temin, Peter


    As large companies move their employees into managed care, they must concern themselves with the quality and price of their employees' health care. Based on a survey of Fortune 500 companies, we show that most are integrating several aspects of quality into their purchasing and contracting decisions by focusing on three dimensions--customer service, network composition, and clinical quality. Companies focus on the customer service dimension while the medical community emphasizes clinical quality.

  18. IVHM Framework for Intelligent Integration for Vehicle Health Management

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


    Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, is the process of assessing, preserving, and restoring system functionality across flight and techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of Integrated Intelligent Vehicle Management (IIVM). These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, this framework integrates 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 that IIVM 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 objectives. These systems include the following: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle Mission Planning, Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented

  19. Partnerships in Health Systems: Social Organization as limits and possibilities in the Family Health Strategy Management.

    Silva, Vanessa Costa E; Barbosa, Pedro Ribeiro; Hortale, Virgínia Alonso


    This is a case study in the municipality of Rio de Janeiro about management in the Family Health Strategy based on the Social Organizations model. The aims were to characterize and analyze aspects of the governance system adopted by the Rio de Janeiro Municipal Health Department and identify limits and possibilities of this model as a management option in Brazil's Unified Health System. A qualitative study was performed based on a literature review, document analysisand interviews with key informants. This management model facilitated the expansion of access to primary healthcare through the Family Health Strategy in Rio - where the population covered increased from 7.2% of the population in 2008 to 45.5% in 2015. The results showthat some practices in the contractual logic need to be improved, including negotiation and accountability with autonomywith the service suppliers. Evaluation and control has focus on processes, not results, and there has not been an increase in transparency and social control. The system of performance incentives has been reported as inducing improvements in the work process of the health teams. It is concluded that the regulatory capacity of the municipal management would need to be improved. On the other hand, there is an important and significant process of learning in progress.

  20. [Risk Management: concepts and chances for public health].

    Palm, Stefan; Cardeneo, Margareta; Halber, Marco; Schrappe, Matthias


    Errors are a common problem in medicine and occur as a result of a complex process involving many contributing factors. Medical errors significantly reduce the safety margin for the patient and contribute additional costs in health care delivery. In most cases adverse events cannot be attributed to a single underlying cause. Therefore an effective risk management strategy must follow a system approach, which is based on counting and analysis of near misses. The development of defenses against the undesired effects of errors should be the main focus rather than asking the question "Who blundered?". Analysis of near misses (which in this context can be compared to indicators) offers several methodological advantages as compared to the analysis of errors and adverse events. Risk management is an integral element of quality management.

  1. Protection of environment, health and safety using risk management

    Abraham, G [Ghafari Associates, Inc. 17101 Michegan Avenue Dearborn, MI 48126-2736 (United States); Kummler, R H [Department of Chemical engineering Wayne Stae University Detroit, MI 48202 (United States); louvar, J [Research Services Basf Corporation Wyandotte, MI 48192 (United States)


    Section 304 of the 1990 clean air amendments (CAAA) directed the US occupational safety and health administration (OSFA) to develop a chemical process safety standard to protect workers on-site from accidents involving hazardous substances. OSHA issued 29 CFR 1910.119, process safety management of Highly hazardous chemicals (PSM) in 1992. Section 112 r of the CAAA further mandated that a standard be developed to protect the environment from accidental releases of hazardous substances. The US environmental protection agency (EPA) proposed such a standard in 1993 (58 Fr 54190) and revised their proposal in 1995). The final rule for risk management and accidental release prevention is more comprehensive and extensive than OSHA`s PSM standard. In this paper we will discuss the concepts of both programs, the classes of substances that would trigger a facility`s need for compliance and review the regulations for risk management.

  2. Protection of environment, health and safety using risk management

    Abraham, G.; Kummler, R.H.; louvar, J.


    Section 304 of the 1990 clean air amendments (CAAA) directed the US occupational safety and health administration (OSFA) to develop a chemical process safety standard to protect workers on-site from accidents involving hazardous substances. OSHA issued 29 CFR 1910.119, process safety management of Highly hazardous chemicals (PSM) in 1992. Section 112 r of the CAAA further mandated that a standard be developed to protect the environment from accidental releases of hazardous substances. The US environmental protection agency (EPA) proposed such a standard in 1993 (58 Fr 54190) and revised their proposal in 1995). The final rule for risk management and accidental release prevention is more comprehensive and extensive than OSHA's PSM standard. In this paper we will discuss the concepts of both programs, the classes of substances that would trigger a facility's need for compliance and review the regulations for risk management

  3. Risk assessment and management approaches on mental health units.

    Woods, P


    This exploratory and descriptive study took place in one Canadian province. The study aimed to: (1) to identify and describe the nature and extent of current risk assessment and management approaches used in the adult inpatient mental health and forensic units; and (2) to identify good practice and shortfalls in the nature and extent of the approaches currently utilized. Data were collected from 48 participants through nine focus groups. Participants reported that they used a clinical approach to risk assessment. They had also not considered risk assessment and management as a proactive structured process. Education and training was also limited and skills were developed over time through practice. Five keys issues are discussed as important: reliance on clinical judgement alone is not the best choice to make; the need to consider risk as a whole concept; risk management being more reactive than proactive; education and training; and client involvement in risk assessment. © 2012 John Wiley & Sons Ltd.

  4. Managing corporate governance risks in a nonprofit health care organization.

    Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J


    Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves.

  5. Study protocol for the Fukushima health management survey

    Yasumura, Seiji; Hosoya, Mitsuaki; Yamashita, Shunichi; Kamiya, Kenji; Abe, Masafumi; Akashi, Makoto; Kodama, Kazunori; Ozasa, Kotaro


    The accidents that occurred at the Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake on 11 March 2011 have resulted in long-term, ongoing anxiety among the residents of Fukushima, Japan. Soon after the disaster, Fukushima Prefecture launched the Fukushima Health Management Survey to investigate long-term low-dose radiation exposure caused by the accident. Fukushima Medical University took the lead in planning and implementing this survey. The primary purposes of this survey are to monitor the long-term health of residents, promote their future well-being, and confirm whether long-term low-dose radiation exposure has health effects. This report describes the rationale and implementation of the Fukushima Health Management Survey. This cohort study enrolled all people living in Fukushima Prefecture after the earthquake and comprises a basic survey and 4 detailed surveys. The basic survey is to estimate levels of external radiation exposure among all 2.05 million residents. It should be noted that internal radiation levels were estimated by Fukushima Prefecture using whole-body counters. The detailed surveys comprise a thyroid ultrasound examination for all Fukushima children aged 18 years or younger, a comprehensive health check for all residents from the evacuation zones, an assessment of mental health and lifestyles of all residents from the evacuation zones, and recording of all pregnancies and births among all women in the prefecture who were pregnant on 11 March. All data have been entered into a database and will be used to support the residents and analyze the health effects of radiation. The low response rate (<30%) to the basic survey complicates the estimation of health effects. There have been no cases of malignancy to date among 38 114 children who received thyroid ultrasound examinations. The importance of mental health care was revealed by the mental health and lifestyle survey and the pregnancy and birth survey. This long

  6. Ground Operations Autonomous Control and Integrated Health Management

    Daniels, James


    The Ground Operations Autonomous Control and Integrated Health Management plays a key role for future ground operations at NASA. The software that is integrated into this system is called G2 2011 Gensym. The purpose of this report is to describe the Ground Operations Autonomous Control and Integrated Health Management with the use of the G2 Gensym software and the G2 NASA toolkit for Integrated System Health Management (ISHM) which is a Computer Software Configuration Item (CSCI). The decision rationale for the use of the G2 platform is to develop a modular capability for ISHM and AC. Toolkit modules include knowledge bases that are generic and can be applied in any application domain module. That way, there's a maximization of reusability, maintainability, and systematic evolution, portability, and scalability. Engine modules are generic, while application modules represent the domain model of a specific application. Furthermore, the NASA toolkit, developed since 2006 (a set of modules), makes it possible to create application domain models quickly, using pre-defined objects that include sensors and components libraries for typical fluid, electrical, and mechanical systems.

  7. Solid health care waste management status at health care centers in the West Bank - Palestinian Territory

    Al-Khatib, Issam A.; Sato, Chikashi


    Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank - Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7 m 3 (288.1 tons) of SHCW are generated monthly by the HCCs in the West Bank. This study concluded that: (i) current HCWM practices do not meet HCWM standards recommended by the World Health Organization (WHO) or adapted by developed countries, and (ii) immediate attention should be directed towards improvement of HCWM facilities and development of effective legislation. To improve the HCWM in the West Bank, a national policy should be implemented, comprising a comprehensive plan of action and providing environmentally sound and reliable technological measures.

  8. Implementing health management information systems: measuring success in Korea's health centers.

    Chae, Y M; Kim, S I; Lee, B H; Choi, S H; Kim, I S


    This article analyses the effects that the introduction and adoption of a health management information system (HMIS) can have on both the productivity of health center staff as well as on user-satisfaction. The focus is upon the service provided by the Kwonsun Health Center located in Suwon City, Korea. Two surveys were conducted to measure the changes in productivity and adoption (knowledge, persuasion, decision, implementation and confirmation) of health center staff over time. In addition, a third survey was conducted to measure the effects of HMIS on the level of satisfaction perceived by the visitors, by comparing the satisfaction level between the study health center and a similar health center identified as a control. The results suggest that HMIS increased the productivity and satisfaction of the staff but did not increase their persuasion and decision levels; and, that is also succeeded in increasing the levels of visitors' satisfaction with the services provided.

  9. Aspects Regarding the Coprological Pollution Level in Some Sheep Helminthiasis

    Octavian Negrea


    Full Text Available The investigations on the incidence and intensity of parasitism in some endoparasytes in sheep  performed on 376 animals (260 sheep and 116 young adult sheep Turcana breed, Gilău area, Cluj County, indicated an increased incidence in trihostrongilidys  of 72.7% in young  sheep and 65.0% in adult sheep. The incidence of monesya had different values ​​depending on age group, 45.5% at young sheep and 10.0% in  adult sheep. The data obtained regarding the prevalence of hepatobiliary trematodsys of sheep in the study, indicates similar values ​​for the two categories, 27.2% young sheep and 30.0% for adult sheep. Instead the extensivity of  lung strongilatosys showed notable differences between the two groups of animals, 18.1% at young sheep and 35.0% in adult sheep. The cop microscopic pollution degree with trihostrongily eggs in correlation with age group, indicated a dominance of low infestation (50% young sheep and 61.5% adult sheep. In exchange, the data obtained on parasitism intensity with cestode oncospheres expresses a dominance of medium infestation (60.0% in young sheep and the low (10.0% in adult sheep. The intensity level of Hepatobiliary trematodosys parasitism in the young sheep showed a dominance of small and medium infestations (37.5% and in adult sheep are dominant only at low infestations (45.4%. The larvae strongilatosys  parasitism intensity in the lung detected similar values ​​in the two age groups (50.0% in young sheep and 17.2% in adult sheep.

  10. Circulation of Coxiella burnetii in a Naturally Infected Flock of Dairy Sheep: Shedding Dynamics, Environmental Contamination, and Genotype Diversity

    Joulié, A.; Laroucau, K.; Bailly, X.; Prigent, M.; Gasqui, P.; Lepetitcolin, E.; Blanchard, B.; Rousset, E.; Sidi-Boumedine, K.; Jourdain, E.


    Q fever is a worldwide zoonosis caused by Coxiella burnetii. Domestic ruminants are considered to be the main reservoir. Sheep, in particular, may frequently cause outbreaks in humans. Because within-flock circulation data are essential to implementing optimal management strategies, we performed a follow-up study of a naturally infected flock of dairy sheep. We aimed to (i) describe C. burnetii shedding dynamics by sampling vaginal mucus, feces, and milk, (ii) assess circulating strain divers...

  11. Genetic Testing for TMEM154 Mutations Associated with Lentivirus Susceptibility in Sheep

    Petrik, Dustin T.; Simpson, Barry; Kijas, James W.; Clawson, Michael L.; Chitko-McKown, Carol G.; Harhay, Gregory P.; Leymaster, Kreg A.


    In sheep, small ruminant lentiviruses cause an incurable, progressive, lymphoproliferative disease that affects millions of animals worldwide. Known as ovine progressive pneumonia virus (OPPV) in the U.S., and Visna/Maedi virus (VMV) elsewhere, these viruses reduce an animal’s health, productivity, and lifespan. Genetic variation in the ovine transmembrane protein 154 gene (TMEM154) has been previously associated with OPPV infection in U.S. sheep. Sheep with the ancestral TMEM154 haplotype encoding glutamate (E) at position 35, and either form of an N70I variant, were highly-susceptible compared to sheep homozygous for the K35 missense mutation. Our current overall aim was to characterize TMEM154 in sheep from around the world to develop an efficient genetic test for reduced susceptibility. The average frequency of TMEM154 E35 among 74 breeds was 0.51 and indicated that highly-susceptible alleles were present in most breeds around the world. Analysis of whole genome sequences from an international panel of 75 sheep revealed more than 1,300 previously unreported polymorphisms in a 62 kb region containing TMEM154 and confirmed that the most susceptible haplotypes were distributed worldwide. Novel missense mutations were discovered in the signal peptide (A13V) and the extracellular domains (E31Q, I74F, and I102T) of TMEM154. A matrix-assisted laser desorption/ionization–time-of flight mass spectrometry (MALDI-TOF MS) assay was developed to detect these and six previously reported missense and two deletion mutations in TMEM154. In blinded trials, the call rate for the eight most common coding polymorphisms was 99.4% for 499 sheep tested and 96.0% of the animals were assigned paired TMEM154 haplotypes (i.e., diplotypes). The widespread distribution of highly-susceptible TMEM154 alleles suggests that genetic testing and selection may improve the health and productivity of infected flocks. PMID:23408992

  12. Genetic testing for TMEM154 mutations associated with lentivirus susceptibility in sheep.

    Michael P Heaton

    Full Text Available In sheep, small ruminant lentiviruses cause an incurable, progressive, lymphoproliferative disease that affects millions of animals worldwide. Known as ovine progressive pneumonia virus (OPPV in the U.S., and Visna/Maedi virus (VMV elsewhere, these viruses reduce an animal's health, productivity, and lifespan. Genetic variation in the ovine transmembrane protein 154 gene (TMEM154 has been previously associated with OPPV infection in U.S. sheep. Sheep with the ancestral TMEM154 haplotype encoding glutamate (E at position 35, and either form of an N70I variant, were highly-susceptible compared to sheep homozygous for the K35 missense mutation. Our current overall aim was to characterize TMEM154 in sheep from around the world to develop an efficient genetic test for reduced susceptibility. The average frequency of TMEM154 E35 among 74 breeds was 0.51 and indicated that highly-susceptible alleles were present in most breeds around the world. Analysis of whole genome sequences from an international panel of 75 sheep revealed more than 1,300 previously unreported polymorphisms in a 62 kb region containing TMEM154 and confirmed that the most susceptible haplotypes were distributed worldwide. Novel missense mutations were discovered in the signal peptide (A13V and the extracellular domains (E31Q, I74F, and I102T of TMEM154. A matrix-assisted laser desorption/ionization-time-of flight mass spectrometry (MALDI-TOF MS assay was developed to detect these and six previously reported missense and two deletion mutations in TMEM154. In blinded trials, the call rate for the eight most common coding polymorphisms was 99.4% for 499 sheep tested and 96.0% of the animals were assigned paired TMEM154 haplotypes (i.e., diplotypes. The widespread distribution of highly-susceptible TMEM154 alleles suggests that genetic testing and selection may improve the health and productivity of infected flocks.

  13. The paths to last in pastoral sheep farming in the Cevennes in France

    B. Dedieu


    Full Text Available In a context of uncertainty of future conditions, which are the sustainable paths? We described the long-term action logics relied upon by the farmers to develop their farms or adapt them to their environment. These logics are based on choices related to increasing the farm size, specializing, the techniques used, marketing, production project debts, and technology incorporation. The data comes from sheep farms in the Cevennes, a pastoral Mediterranean region of Southern France, based on trajectory surveys of families, farming, and sheep management over 30 years (1982–2012. Although sheep farming hardly changed over this period, three different long-term action logics were identified: a clannish logic that gives the opportunity for the children to settle on the farm or nearby; a logic centered on sheep tradition with a focus on increasing the herd size; a multiphase logic, i.e. two or three successive sheep management types or combined household activities are explored. The identified action logics were similar to those described in other studies, except that they did not include logics based on increasing herd productivity by use of technologies, an option too removed from the kind of pastoralism practiced in the Cevennes.

  14. Improving hypertension self-management with community health coaches.

    Dye, Cheryl J; Williams, Joel E; Evatt, Janet Hoffman


    Approximately two thirds of those older than 60 years have a hypertension diagnosis. The aim of our program, Health Coaches for Hypertension Control, is to improve hypertension self-management among rural residents older than 60 years through education and support offered by trained community volunteers called Health Coaches. Participants received baseline and follow-up health risk appraisals with blood work, educational materials, and items such as blood pressure monitors and pedometers. Data were collected at baseline, 8 weeks, and 16 weeks on 146 participants who demonstrated statistically significant increases in hypertension-related knowledge from baseline to 8 weeks that persisted at 16 weeks, as well as significant improvements in stage of readiness to change behaviors and in actual behaviors. Furthermore, clinically significant decreases in all outcome measures were observed, with statistically significant changes in systolic blood pressure (-5.781 mmHg; p = .001), weight (-2.475 lb; p definition of controlled hypertension at baseline, the proportion of participants meeting this definition at 16 weeks postintervention increased to 51.0%. This article describes a university-community-hospital system model that effectively promotes hypertension self-management in a rural Appalachian community. © 2014 Society for Public Health Education.

  15. Social enterprise in health organisation and management: hybridity or homogeneity?

    Millar, Ross


    The purpose of this paper is to reflect on social enterprise as an organisational form in health organisation and management. The paper presents a critique of the underlying assumptions associated with social enterprise in the context of English health and social care. The rise of social enterprise models of service provision reflects increasingly hybrid organisational forms and functions entering the health and social care market. Whilst at one level this hybridity increases the diversity of service providers promoting innovative and responsive services, the paper argues that further inspection of the assumptions associated with social enterprise reveal an organisational form that is symbolic of isomorphic processes pushing healthcare organisations toward greater levels of homogeneity, based on market-based standardisation and practices. Social enterprise forms part of isomorphic processes moving healthcare organisation and management towards market norms". In line with the aim of the "New Perspectives section", the paper aims to present a provocative perspective about developments in health and social care, as a spur to further debate and research in this area.

  16. Emergency planning and management in health care: priority research topics.

    Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison


    Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making.

  17. Evaluating Performance of Safety Management and Occupational Health Using Total Quality Safety Management Model (TQSM

    E Mohammadfam


    Full Text Available Introduction: All organizations, whether public or private, necessitate performance evaluation systems in regard with growth, stability, and development in the competitive fields. One of the existing models for performance evaluation of occupational health and safety management is Total Quality Safety Management model (TQSM. Therefore, the present study aimed to evaluate performance of safety management and occupational health utilizing TQSM model. Methods: In this descriptive-analytic study, the population consisted of 16 individuals, including managers, supervisors, and members of technical protection and work health committee. Then the participants were asked to respond to TQSM questionnaire before and after the implementation of Occupational Health & Safety Advisory Services 18001 (OHSAS18001. Ultimately, the level of each program as well as the TQSM status were determined before and after the implementation of OHSAS18001. Results: The study results showed that the scores obtained by the company before OHSAS 18001’s implementation, was 43.7 out of 312. After implementing OHSAS 18001 in the company and receiving the related certificate, the total score of safety program that company could obtain was 127.12 out of 312 demonstrating a rise of 83.42 scores (26.8%. The paired t-test revealed that mean difference of TQSM scores before and after OHSAS 18001 implementation was proved to be significant (p> 0.05. Conclusion: The study findings demonstrated that TQSM can be regarded as an appropriate model in order to monitor the performance of safety management system and occupational health, since it possesses the ability to quantitatively evaluate the system performance.

  18. A knowledge management tool for public health:

    Dobbins Maureen


    Full Text Available Abstract Background The ultimate goal of knowledge translation and exchange (KTE activities is to facilitate incorporation of research knowledge into program and policy development decision making. Evidence-informed decision making involves translation of the best available evidence from a systematically collected, appraised, and analyzed body of knowledge. Knowledge management (KM is emerging as a key factor contributing to the realization of evidence-informed public health decision making. The goal of is to promote evidence-informed public health decision making through facilitation of decision maker access to, retrieval, and use of the best available synthesized research evidence evaluating the effectiveness of public health interventions. Methods The systematic reviews that populate health are identified through an extensive search (1985-present of 7 electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, BIOSIS, and SportDiscus; handsearching of over 20 journals; and reference list searches of all relevant reviews. Reviews are assessed for relevance and quality by two independent reviewers. Commonly-used public health terms are used to assign key words to each review, and project staff members compose short summaries highlighting results and implications for policy and practice. Results As of June 2010, there are 1913 reviews in the registry in 21 public health and health promotion topic areas. Of these, 78% have been assessed as being of strong or moderate methodological quality. receives approximately 35,000 visits per year, 20,596 of which are unique visitors, representing approximately 100 visits per day. Just under half of all visitors return to the site, with the average user spending six minutes and visiting seven pages per visit. Public health nurses, program managers, health promotion workers, researchers, and program coordinators are

  19. Empowering Self-Management through M-Health Applications

    Othman Muhaini


    Full Text Available The advancement in mobile technology has led towards a new frontier of medical intervention that never been thought possible before. Through the development of MedsBox Reminder (MBR application for Android as a pilot project of M-Health, health care information system for patient selfmanagement is made possible. The application acts as an assistant to remind users for their timely medicine intake by notifying them through their mobile phone. MedsBox Reminder application aims to facilitate in the self-management of patient's health where they can monitor and schedule their own medicine intake more efficiently. Development of the application is performed using Android Studio 1.4, Android SDK, MySQL database, SQLite, Java language and Netbeans IDE 8.1. Object-Oriented System Development (OOSD methodology has been adapted to facilitate the development of the application.

  20. Integrating Structural Health Management with Contingency Control for Wind Turbines

    Kai Goebel


    Full Text Available Maximizing turbine up-time and reducing maintenance costs are key technology drivers for wind turbine operators. Components within wind turbines are subject to considerable stresses due to unpredictable environmental conditions resulting from rapidly changing local dynamics. In that context, systems health management has the aim to assess the state-of-health of components within a wind turbine, to estimate remaining life, and to aid in autonomous decision-making to minimize damage to the turbine. Advanced contingency control is one way to enable autonomous decision-making by providing the mechanism to enable safe and efficient turbine operation. The work reported herein explores the integration of condition monitoring of wind turbine blades with contingency control to balance the trade-offs between maintaining system health and energy capture. Results are demonstrated using a high fidelity simulator of a utility-scale wind turbine.