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PubMed1975

[Metabolism and hematology studies of intensively raised fattened lambs under various feeding and management conditions. 3. The effect of weaning age under various management conditions on the blood picture, serum mineral and bilirubin concentration and vitamin A concentration in the liver].

Calcium, phosphorus, magnesium and bilirubin, blood picture and liver vitamin A were studied in six groups of lambs weaned at various ages and fattened under four types of management, in comparison with a control group. Results are shown in graphs and tables, with a comparison with conventionally fattened lambs. Age at weaning had no demonstrable effect on the parameters investigated.

Age Factors↗
PubMed2002

Highlights from the annual scientific assembly: patient-centered approaches to asthma management: strategies for treatment and management of asthma.

Asthma is a chronic inflammatory disease in which the genetic predisposition to allergic disease is the strongest identifiable predisposing factor. (1) Optimal outpatient treatment of asthma includes identifying and minimizing exposure to asthma triggers, whether they Me allergens or irritants. When these triggers are not obvious, referral to an allergist may be appropriate to ideniify potential exacerbating factors. In addition, pulmonary consultation may be helpful in patients who do not have the typical features of asthma on chest radiograph or pulmonary function testing, or who are not responding well to standard therapy. The primary care physician is the most important component in the care of the asthmatic patient, however, managing acute exacerbations, determining long-term medical therapy, and providing preventive measures, such as yearly influenza vaccinations.

Anti-Asthmatic Agents↗
PubMed2002

Managing in the "new" era of managed care.

Are we at the end of an era of reasonable price increases in managed care? Many experts seem to think so. The growth in healthcare costs is occurring so quickly that unless health plans find new ways to hold down costs, many small- to mid-sized companies and individuals may not be able to afford insurance, adding to the already 40 million who are uninsured.

Cost Control↗
PubMed2002

Achieving river integrity through natural resource management and integrated catchment management legislative frameworks.

This paper reports on a project which further refines a model legislative framework first identified in a Land and Water Australia project in 1999. This framework is benchmarked against legislative excerpts from within Australian jurisdictions, as well as the major policy initiatives of the Council of Australian Governments (COAG) water reform agenda, the Commonwealth's National Action Plan on Salinity and Water Quality, and others. The model framework has been heavily influenced by current thinking on ecological systems, good governance, and organisational management. Another important product of the report is a statement of model statutory objectives and principles, suitable for use in water resource legislation.

Australia↗
PubMed2002

Creating and managing a paperless health information management department.

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.

Computer Communication Networks↗
PubMed2003

Clinical management. Where medicine meets management. Whose bright idea?

Managers can fall to act on creative thinking from the ground, often through preoccupation with the short term. Royal National Orthopaedic trust has pioneered voice-activated endosuites, CD-ROM training and cartilage transplants. Without an innovator, shaper and implementer, new projects are almost certain to fall.

Administrative Personnel↗
PubMed2003

CRC Clinical Trials Management System (CTMS): an integrated information management solution for collaborative clinical research.

The Chronic Lymphocytic Leukemia (CLL) Research Consortium (CRC) consists of 9 geographically distributed sites conducting a program of research including both basic science and clinical components. To enable the CRC's clinical research efforts, a system providing for real-time collaboration was required. CTMS provides such functionality, and demonstrates that the use of novel data modeling, web-application platforms, and management strategies provides for the deployment of an extensible, cost effective solution in such an environment.

Biomedical Research↗
PubMed2003

Consumer managed co-operative--a solution for progressing wastewater management in rural areas.

In Finland the question of appropriate wastewater treatment in rural areas has become very prominent during the last years. The new Environmental Protection Act stipulates that wastewaters must be treated to the extent that they cannot have a negative impact on nature. The Ministry of the Environment is currently preparing a decree specifying the requirements. The draft of the decree proposes that on-site treatment units should decrease the BOD load by 90, total phosphorus load by 85 and total nitrogen load by 40 per cent. To meet the new requirements, the old systems that include septic tanks only need more efficient wastewater treatment methods. Whatever technical solution is selected, the house owner must pay for it. At the moment, even the septic tanks are emptied and maintained irregularly. More sophisticated wastewater treatment methods definitely need more maintenance, which cannot be made the sole duty of the house owners. One potential organisational alternative for managing wastewater treatment in rural areas is the co-operative. Finland has one such pioneering co-operative formed for on-site sanitation. Varsinais-Suomi Water Services Co-operative provides the house owner with professional assistance in wastewater treatment at a reasonable cost. Suvisaari Water Services Co-operative is another new organisation selling sewerage services to its members. But its technology is different: this co-operative operates an LPS-sewerage system instead of on-site treatment.

Community Participation↗
PubMed2004

Clinical management where medicine meets management. Down to earth.

Appreciative inquiry is a method that can help NHS staff during periods of change management. Staff turnover and sickness absence are already down at one heart centre that has used the technique. People who have attended the away-days say approachability to senior staff is improved.

Adaptation, Psychological↗
PubMed2004

Clinical management. Where medicine meets management. Teach to his own.

A course developed by an Isle of Wight diabetes consultant teaches patients to instruct other patients on self-management of the condition. Supporters say the training is more relevant to diabetes than the expert patient programme. Health professionals' wariness of the scheme has taken its toll on take-up of the service.

Diabetes Mellitus↗
PubMed2004

Clinical management where medicine meets management. Array of hope.

Routine use of genetic profiling for managing some cancers could soon be a reality. Its wider application in cancer care will require substantial public investment in research and development, IT and setting up a service infrastructure. The first commercial test kits for breast cancer prognosis have already been launched in Europe and the US.

Diagnostic Tests, Routine↗
PubMed2006

The unified approach of management and critical incident stress management: helping flight attendants and pilots in the aftermath of September 11.

Experience suggests that effective and appropriate responses of an organization's management after a traumatic incident can help mitigate the reactions of primary, secondary, and tertiary victims. This commentary addresses the managerial response of Southwest Airlines to the trauma induced by September 11. It highlights the effectiveness of the unity between the company, the unions, and the Critical Incident Response Team, as well as the types of interventions that were highly regarded by flight attendants and pilots who received such services. This commentary also defines the phenomenon known as fear of flight.

Aviation↗
PubMed2006

Cost analysis of managing paediatric femoral shaft fractures: flexible intramedullary nailing versus non-operative management.

This retrospective study aimed at comparing the cost of operative treatment versus non-operative treatment in the management of isolated paediatric femoral shaft fracture, in a single Trauma and Orthopaedic unit in a district general hospital in South East England. Patients were divided into three groups according to their treatment, and the cost was analysed depending on their requirements for hospital stay, theatre, physiotherapy, radiographs and plaster cast. Sixty-two children were admitted to our trauma unit with an isolated femoral shaft fracture from January 2001 to April 2005. There is a significant variation in the cost between the 16 patients treated with operative flexible nailing in comparison with those treated non-operatively either by traction alone (31 patients), or by traction followed by cast (15 patients). Operative treatment was shown to reduce the inpatient stay by approximately 75% (mean of 9.8 days in the operative group in comparison to 39.3 days in the non-operative group). It has also reduced the overall cost for treatment by more than 60% in comparison to traction alone and by almost 30% in comparison to using traction followed by casting.

Child↗
PubMed1992

Optimal management of suspected lower-extremity deep vein thrombosis. An evaluation with cost assessment of 24 management strategies.

Traditionally, patients suspected to have lower-extremity deep vein thrombosis have undergone venography, which is invasive, is expensive, and may cause deep vein thrombosis in healthy individuals. Recent studies have shown the safety and efficacy of alternative noninvasive approaches that employ impedance plethysmography or real-time ultrasonography. We compared these tests using decision analysis to model the consequences of 24 different management strategies for ambulatory patients suspected to have deep vein thrombosis. We also calculated the incremental cost per additional life saved for each strategy. Our analysis revealed that the optimal approach was to perform real-time ultrasonography followed by anticoagulation therapy if deep vein thrombosis is found. This approach was both effective and cost saving compared with no testing or treatment. Serial follow-up studies of patients whose initial study suggested no DVT saved additional lives, but at a cost of $390,000 per each additional life saved for patients with one follow-up study and $3.5 million per each additional life saved for patients with a second follow-up study. Venography should play a limited role in the contemporary evaluation of patients suspected to have deep vein thrombosis. Future research should focus on the determination of clinical predictors of patients who should undergo serial examinations.

Anticoagulants↗
PubMed1991

Current management, local management, and survival statistics of high-grade osteosarcoma. Experience in Japan.

To report the current management of high-grade osteosarcoma in Japan, the authors studied the results of 55 cases treated in the authors' institutions and data provided by Osaka University (59 cases), Chiba Oncology Group (97), and Sapporo National Hospital (70). Twenty-five of the 55 cases in the authors' series were treated by limb-salvage surgery, 27 by amputation, and the remainder by chemotherapy. In all 226 cases from the three institutes, 106 were treated by amputation and 120 by limb-salvage surgery. Two local recurrences (4%) were found in the authors' series, three in the Osaka series, and eight in the Chiba series. Five-year accumulative survival rates in this study showed some differences, depending upon the institution or upon the protocol employed: in the authors' series it was 60% overall and 68% for a stronger chemotherapy group; in the Osaka series, it was 50% in a mild chemotherapy group and 72% in an intensive chemotherapy group; and in the Sapporo series, it was 36% and 73%, respectively. This study showed that local control of IIB osteosarcoma was successfully achieved by preoperative adjuvant chemotherapy and wide resection, and that an intensive chemotherapeutic combination of high-dose methotrexate, cisplatinum, and doxorubicin is promising.

Adult↗