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PubMed1992

The general practice 'management of otitis externa'.

Clinical confusion, treatment failure and recurrence commonly plague the Management of Otitis Externa. The aim of this study was to investigate the clinical attitudes and habits of army general practitioners and to review the recent literature. The results of a questionnaire survey showed that although all the respondents agreed that aural toilet was important, only 50% felt confident in performing aural toilet and packing. There also appeared to be much greater scope for the use of astringents and effective preventative measures in addition to aural toilet. The discussion emphasises and need for careful selection of the most appropriate topical agent, whilst highlighting the roles of practical procedures, bacteriology and prevention. A practical guide to diagnosis and management is offered with the aid of illustrations and an algorithm.

Administration, Topical↗
PubMed2003

Characterization of broiler cake and broiler litter, the by-products of two management practices.

The application of broiler manure and bedding (litter) on land has been a long-used disposal method that benefits plant and soil. For proper manure management, factors such as nutrient content, house cleaning management, application methods, and many land, crop, and climatic factors must be considered. A study was undertaken to characterize broiler cake and broiler litter as the by-products of two management systems in Mississippi. Broiler cake and litter productions were quantified and analyzed for four flocks during 1999 and 2000. The overall means for broiler cake production were 12.50, 13.90, and 10.30 kg m(-2) for producers 1, 2, and 3, respectively. Significantly greater quantities of litter, 27.50, 29.0, and 28.30 kg m(-2) than cake were determined for the same producers. The cake and litter moisture averaged 455 and 277 g kg(-1), respectively. No significant differences were observed between cake and litter total N, NH4-N, total C, total P, and water-soluble P (WP). However, cake had significantly greater Ca, Mg, K, Cu, Fe, Mn, and Zn than litter. Approximately 16.8% of the broiler cake and 15.2% of the broiler litter total P were in the form of water-soluble P. The NH4-N content of the cake and the litter were 12.5% and 11.5% of the cake and litter total nitrogen, respectively. The results also showed the advantage of the decaking practice with respect to the quantity of the manure generated for land application. Approximately 57% of the litter remains in the poultry house with decaking practice after each growth cycle compared to the 0% for total cleanout practice.

Ammonia↗
PubMed1998

Management practices and use of anthelmintics on dairy cattle farms in The Netherlands: results of a questionnaire survey.

In December 1996, a questionnaire about farm management and parasite control measures in calves was sent to 956 randomly chosen dairy cattle farmers in The Netherlands. Another 150 farmers in the vicinity of Deventer who had vaccinated their calves in 1995 against lungworm were approached with the same questions. Our object was to investigate the consequences on worm control of the withdrawal of the lungworm vaccine from the market for reasons of possible BSE contamination of the vaccine. OF the returned questionnaires, 411 (43%) of the 'at random' group and 89 (59.3%) of the 'Deventer' group were valid. The most important data with regard to the farms of the 'at random' group (41) were: mean area 31.6 ha, mean number of calves 23, heifers 23 and milking cows 53. Sheep (mean 37) were present on 18.3% of the farms. With regard to management: 74.5% of the farmers turned the calves in their first year onto pasture, 25.5% kept them indoors. The average time on pasture was ca. 5 months. Rational grazing was practise on 81.4% of the farms, on 18.6% calves were set stocked. The first pasture of the calves was mown before turn-out on 72.9% of the farms. On 48.2% of these farms, calves were always moved to mown pastures. With regard to treatments: 33.8% of the farmers vaccinated their calves against lungworm in the years 1993, 1994 and 1995. Despite the withdrawal of the vaccine from the market in 1996, 7.2% of the farmers vaccinated their calves as recommended, with two doses, and 13.1% with a single dose. At turn-out, 41.5% of the farmers gave the calves a preventive anthelmintic treatment. Of these treatments, 66.9% were sustained of pulse release long acting device. During the grazing season, 36.6% of the farmers treated their calves. After housing 50.3% of the farmers gave a treatment. Signs of lungworm infection were noticed on 18.6% of the farms. Of the 'Deventer' group (89 farmers), 96.6% turned the calves out, Of these farmers, 86.0% had used the lungworm vaccine in 1995. In 1996, 52.7% of the farmers had vaccinated the calves:36.5% with a single dose and 16.2% with the double dose. Of the 35 farmers who did not vaccinate in 1996, 62.9% gave a preventive treatment at turn-out. Clinical signs of lungworm infection were not observed on the 12 farms which vaccinated the calves twice. On 11% of the farms which vaccinated once and on 14% of the farms which did not vaccinate, signs of lungworm infection were observed. It is concluded that more than 80% of Dutch dairy cattle farmers take appropriate measures to control gastrointestinal nematode and lungworm infections in calves in their first grazing season by grazing on aftermath, rotational grazing on mown pastures combined or not with preventive anthelmintic treatments. However, combinations of aftermath grazing and preventive treatment occurred on 30% of the farms. This may be overprotective and may prevent sufficient build up of immunity, causing worm problems at a later age. The withdrawal of the lungworm vaccine from the market did not cause a rise in lungworm problems. Some farmers did vaccinate, despite the withdrawal. The majority used other preventive treatment measures, mainly the application of long acting boli.

Animals↗
PubMed1994

A comparative study of internal customer management practices within service sector firms and the National Health Service.

In responding to the UK government's market forces model, some National Health Service (NHS) managers have introduced private sector concepts such as 'customer care' and 'total quality management' (TQM). Private sector firms find that success of these techniques is dependent upon creating an internal marketing orientation across the entire organization. To determine how internal marketing is being applied, a comparative survey of UK service sector firms and NHS units was undertaken using a modified version of Parasuraman's SERVQUAL model. All respondents indicated existence of type 1, 2, 3 and 4 gaps in the internal customer management process within their organizations. Major influencers of service gaps include departments placing internal efficiency ahead of internal customers and insufficient understanding of internal customer requirements. The survey indicated that, in certain areas of managing service quality, the NHS is performing better than its private sector counterparts. Nevertheless, opportunity for enhancing service quality in the NHS is possible through improving the flow of information between departments, stronger orientation towards meeting customer needs, upgrading provision systems and changing intradepartmental culture. The constraint facing the NHS manager is the limited availability of resources. One solution is to allocate resources in relation to service priorities. A directional planning matrix is presented as a tool for developing an optimum internal customer management strategy within an NHS unit.

Data Collection↗
PubMed2003

Practical management of patients with chronic myeloid leukemia receiving imatinib.

The introduction of imatinib, a specific inhibitor of the Bcr-Abl tyrosine kinase, has dramatically changed the management of chronic myeloid leukemia (CML). More than 10,000 patients worldwide have been treated with imatinib in clinical trials, and a large body of information has accumulated about the use of this drug. The purpose of this article is to review practical guidelines in regard to optimal dosing, monitoring, managing common side effects such as myelosuppression, and potential drug interactions. The treatment recommendations are intended to optimize therapy with imatinib while taking into account a patient's specific circumstances.

Antineoplastic Agents↗
PubMedDate not supplied

Drinking water supply and management practices in British Columbia, 1997-98.

BACKGROUND: Questions regarding control over a water fluoridation system in a British Columbia (BC) community led to a drinking water management survey in 1997-98. METHOD: A questionnaire was constructed based on published drinking water control and management criteria and was sent to 91 communities. RESULTS: 73/91 surveys were returned (80% response rate); 31 reported a protected water supply system, 40 reported logging and/or cattle grazing in watershed areas, 25 reported a lack of primary disinfection. Water fluoridation was reported in 12 locations, 3 of which did not monitor fluoride levels. Testing for protozoans was done routinely in 19 locations, 15 using approved laboratories. 15 water contamination events were reported, 9 of biological origin. Statistically significant associations were found between contamination events and: wooden delivery systems, lack of primary chlorination, increased number of protozoan tests, and increased number of personnel. INTERPRETATION: At the time of the survey in British Columbia, a number of communities were vulnerable to preventable drinking water contamination.

British Columbia↗
PubMed2001

Tailoring clinical management practices to meet the special needs of adolescents: sexually transmitted infections.

Sexually transmitted infections are a major health risk to all sexually active adolescents and improving clinical management for this age group is of major importance. Currently, adolescents are managed in the same way as adults. This paper summarizes recommendations by the World Health Organization that services be more responsive to adolescent concerns about confidentiality, risk assessment be more attuned to their sexual behavioral patterns, and services be tailored to give more time for counseling, assessment of stage of maturity and continuity of reproductive health care.

Adolescent↗