Forest insect and disease conditions in Alaska in ...

Description based on: 1979; title from cover.

Managing wireless networks in the healthcare sector:emerging experiences of cultural impacts

The existing body of knowledge has generally supported that organizational culture plays a significant role in shaping group identity, work pattern, communication schemes, and interpersonal relations; all of these cultural elements are important organizational factors that shape workplaces and operational routines. In the context of emerging information technology, it has also been suggested that organizational culture could affect IT implementation and management. However, little is known about how emerging information technology shapes organizational culture, which in turn helps reshape the organization as a whole. The purpose of this paper is thus to build empirical understanding of how IT in general and emerging wireless networks in particular reshapes organizational culture. Case studies conducted in two hospitals situated in southwest U.S.A. illustrated that the implementation of wireless networks indeed helped shape and/or reshape organizational culture in the healthcare sector and in turn enhance healthcare organizations’ competitiveness in the marketplace. For IT managers and practitioners in healthcare institutions, effective strategy to plan and manage emerging ITs such as wireless networks will thus have long-term implications on cultivating organizational culture that could eventually reshape workplace and competitiveness.

Avaliação de tecnologias em saúde, qualidade em saúde, segurança do doente

Tecnologia em saúde: Aplicação de conhecimento e competências sob a forma de dispositivos médicos, medicamentos, vacinas, procedimentos e sistemas desenvolvidos para resolver um problema de saúde e melhorar a qualidade de vida. Classificação das TS - 1. Natureza material: medicamentos, equipamentos, procedimentos médicos e cirúrgicos, sistemas de suporte, sistemas organizacionais e de gestão. 2. Propósito: prevenção, diagnóstico, tratamento, reabilitação. 3. Estadio de difusão: futura, experimental, investigacional, estabelecida, obsoleta. Como sabemos que uma tecnologia tem melhores resultados clínicos ou se causa mais danos do que benefícios? Efetividade clínica e económica.

AN ENTROPIC THEORY OF DAMAGE WITH APPLICATIONS TO CORROSION-FATIGUE STRUCTURAL INTEGRITY ASSESSMENT

This dissertation demonstrates an explanation of damage and reliability of critical components and structures within the second law of thermodynamics. The approach relies on the fundamentals of irreversible thermodynamics, specifically the concept of entropy generation due to materials degradation as an index of damage. All failure mechanisms that cause degradation, damage accumulation and ultimate failure share a common feature, namely energy dissipation. Energy dissipation, as a fundamental measure for irreversibility in a thermodynamic treatment of non-equilibrium processes, leads to and can be expressed in terms of entropy generation. The dissertation proposes a theory of damage by relating entropy generation to energy dissipation via generalized thermodynamic forces and thermodynamic fluxes that formally describes the resulting damage. Following the proposed theory of entropic damage, an approach to reliability and integrity characterization based on thermodynamic entropy is discussed. It is shown that the variability in the amount of the thermodynamic-based damage and uncertainties about the parameters of a distribution model describing the variability, leads to a more consistent and broader definition of the well know time-to-failure distribution in reliability engineering. As such it has been shown that the reliability function can be derived from the thermodynamic laws rather than estimated from the observed failure histories. Furthermore, using the superior advantages of the use of entropy generation and accumulation as a damage index in comparison to common observable markers of damage such as crack size, a method is proposed to explain the prognostics and health management (PHM) in terms of the entropic damage. The proposed entropic-based damage theory to reliability and integrity is then demonstrated through experimental validation. Using this theorem, the corrosion-fatigue entropy generation function is derived, evaluated and employed for structural integrity, reliability assessment and remaining useful life (RUL) prediction of Aluminum 7075-T651 specimens tested.

Adesão dos enfermeiros à notificação de eventos nos serviços de internamento e unidades de cuidados intensivos de um hospital central

Introdução: A notificação de eventos tornou-se um importante instrumento para a melhoria da qualidade no sistema de saúde. Partilhar a ocorrência de eventos na área dos cuidados de saúde é fundamental para a implementação de mecanismos de prevenção que aumentem a segurança do doente. Objetivo: Conhecer a adesão dos enfermeiros à notificação de eventos nos serviços de internamento e unidades de cuidados intensivos de um hospital central. Metodologia: Estudo exploratório descritivo, com abordagem quantitativa. Resultados: Relativamente aos eventos em que o dano é trágico, a grande maioria das vezes são notificados. Em relação à queda, todos os profissionais com quem ocorreu este evento, notificaram. Os enfermeiros apontam como principais barreiras à notificação de eventos: o esquecimento decorrente do excesso de trabalho; a evolução do evento tornar desnecessária a notificação e a aplicação informática para notificação ser complicada, não ser intuitiva. Conclusões: Após a recolha de dados verificamos, que quando ocorrem eventos, os enfermeiros notificam-nos poucas vezes. Os resultados obtidos apontam algumas orientações para a melhoria da cultura de segurança na instituição, ressalvando-se a necessidade de formação na área da segurança e da notificação antes de o evento acontecer.

Efeitos do processo de acreditação nas práticas profissionais dos assistentes sociais em contexto hospitalar: perspectiva de um painel Delphi

A acreditação de um hospital revela-se um instrumento de extrema importância na melhoria da qualidade dos cuidados de saúde. Subjacente a este processo, estão inerentes alterações ao nível organizacional e individual. Este artigo tem como objetivo, identificar os efeitos do processo de acreditação nas práticas profissionais dos assistentes sociais em contexto hospitalar. Neste sentido, realizou-se um painel de peritos, com recurso à técnica Delphi, no qual participaram 12 peritos multidisciplinares e internacionais, tendo sido conseguida obtenção de consenso em três rondas. Dos resultados obtidos emergiram consensos que permite considerar cinco dimensões de ação relevantes face aos efeitos da acreditação nas práticas profissionais dos assistentes sociais, quanto: 1) especificidades da prática; 2) interação de equipas; 3) eficácia profissional; 4) avaliação e monitorização; 5) ganhos em saúde. São dimensões que correspondem a mudanças e que sugerem uma linha de ação que é influenciada, e determinada pelo processo de acreditação no desenvolvimento de uma cultura de melhoria contínua da qualidade da actividade do Serviço Social e do agir profissional. Os resultados obtidos evidenciam que um processo de acreditação tem efeitos diretos e positivos nas práticas dos assistentes sociais.

Common fish diseases and parasites affecting wild and farmed tilapia and catfish in central and western Uganda

Intensification of aquaculture production in Uganda is likely to result into disease out-breaks leading to economic losses to commercial fish farms and associated natural aquatic ecosystems. This survey assessed health profiles of selected commercial fish farms and adjacent natural aquatic ecosystemsto identify fish diseases and parasites affecting Nile tilapia (Oreochromis niloticus) and African catfish (Clarias gariepinus) in aquaculture systems in Uganda. Fish farms encounter disease out-breaks that cause low survival rates (0 - 30%), especially catfish hatcheries. Health management issues are not well understood by fish farmers, with some unable to detect diseased fish. Current control strategies to control aquatic pathogens include use of chemotherapeutants and antibiotics. Bacterial pathogens isolated included Flavobacterium columnare, Aeromonas sp., Edwardsiella sp., Psuedomonus sp., Steptococcus sp., Staphylococcus sp., Proteus sp., and Vibrio sp. A high occurrence of Flavobacterium columnare exists in both asymptomatic and symptomatic fish was observed. Parasites included protozoans (Ichthyopthirius multiphilis, Trichodina sp. and Icthyobodo sp.) and trematodes (Cleidodiscus sp. and Gyrodactylus sp.). Diagnosis and control of diseases and parasites in aquaculture production systems requires adoption of a regional comprehensive biosecurity strategy: the East African (EAC) region unto which this study directly contributes.

An exploratory study of the relationship between psychosocial hazard and ambulatory physiological response in higher education employees.

Purpose: as exposure to psychosocial hazard at work represents a substantial risk factor for employee health in many modern occupations, being able to accurately assess how employees cope with their working environment is crucial. As the workplace is generally accepted as being a dynamic environment consideration should be given to the interaction between employees and the acute environmental characteristics of their workplace. The aim of this study was to investigate the effects of both acute demand and chronic work-related psychosocial hazard upon employees through ambulatory assessment of heart rate variability and blood pressure. Design: a within-subjects repeated measures design was used to investigate the relationship between exposure to work-related psychosocial hazard and ambulatory heart rate variability and blood pressure in a cohort of higher education employees. Additionally the effect of acute variation in perceived work-related demand was investigated. Results: two dimensions of the Management Standards were found to demonstrate an association with heart rate variability; more hazardous levels of “demand” and “relationships” were associated with decreased SDNN. Significant changes in blood pressure and indices of heart rate variability were observed with increased acute demand.

PREVALÊNCIA E PERFIL DAS PESSOAS COM DIABETES CADASTRADAS NO SISTEMA DE INFORMAÇÃO DA ATENÇÃO BÁSICA (SIAB)

Objetivo: Avaliar a prevalência e o perfil das pessoas com diabetes mellitus (DM), autorreferidas. Métodos: Estudo transversal, retrospectivo, realizado com os dados secundários extraídos do Sistema de Informação da Atenção Básica (SIAB). Os dados foram obtidos junto à Secretaria Municipal de Saúde nos meses de março a abril de 2014. Coletaram-se os dados do SIAB referentes à população com diabetes autorreferidas (com 15 anos ou mais) do município de Lajeado-RS, no período de 2011 a 2013, analisados através de estatística descritiva, utilizando-se o programa SPSS versão 21. Resultados: Verificou-se que a prevalência das pessoas com DM se manteve equiparada nos anos estudados (3,0% em 2011, 3,1% em 2012 e 3,0% em 2013). Essa população, na sua maioria, estava acima de 60 anos (60% em 2011, 58% em 2012 e 60% em 2013), é alfabetizada (88% em 2011, 89,9% em 2012 e 90,7% em 2013), com predominância do sexo feminino (63,2% em 2011, 62,9% em 2012 e 63,7% em 2013) e hipertensa (77,5% em 2011, 76,1% em 2012 e 76,9% em 2013). A prevalência de gestantes com diabetes foi de 0,5% em 2012 e 0,3% em 2013, não havendo casos em 2011. Conclusão: A prevalência de DM autorreferida no município é em torno de 3% nos anos analisados, abaixo da média nacional. Constatou-se que a maioria da população com DM é idosa, feminina, alfabetizada, hipertensa, além de haver baixa prevalência de DM em gestantes.

Survey on gill parasites of sturgeon fishes (Acipenseridae) in southern part of Caspian Sea with emphasis on Nitzschia sturionis Ablidgaard, 1794

Sturgeons are important because of producing the expensive caviar. With regard to decreasing of natural stocks of these fishes, cultured sturgeons farms are expanding, so infectious or non-infectious agents can cause problems in this industry. One of the most important infectious diseases, are parasitic diseases, like gill parasites. In this study from March 2007 to June 2008, gills of 122 sturgeons of south west of Caspian Sea, 44 samples of juveniles from freshwater farms and 25 samples of cultured fishes in freshwater were collected and examined. Parasites were separated and determination of species and prevalence of them were done. Nitzschia sturionis and Diclybothrium armatum (monogenea) with general prevalence 8.7% in Acipenser persicus and 25.6% in Acipenser stellatus from sea sturgeons and Trichodina (sp.1, sp.2) and Ichthyophthirius multifiliis from freshwater sturgeons, were separated. Statistical analysis was done according to species, sex, length and weight of fishes. Pathology, morphometric and morphological characters of Nitzschia sturionis were also studied. At the end, we have suggested ways for health management of farms for prevention of parasites entry.

Calidad de atención científico humanístico que presta el personal de enfermería y su relación con el nivel de satisfacción del usuario del Centro de Salud Cojitambo. Azogues, 2014

Antecedentes: el tema de calidad de la atención en salud hoy en día es clave, y urgente de conocer, entender y aplicar por el personal de salud y en particular para el profesional de Enfermería, para lograr la calidad en los servicios de salud es necesario el control, la evaluación objetiva y sistemática de la atención de enfermería ya que se han convertido en una prioridad dentro de la profesión, debido a que el consumidor demanda atención de calidad, existiendo un mayor compromiso con la responsabilidad directa ante él público. Objetivo: determinar la calidad de atención que presta el personal de enfermería del centro de salud “Cojitambo” y su relación con el nivel de satisfacción del usuario. Metodología: se trata de un estudio descriptivo de corte transversal que permitirá determinar la calidad de atención que presta el personal de enfermería del centro de salud “Cojitambo” y su relación con el nivel de satisfacción del usuario. Universo: para el tamaño de la muestra se considera una población infinita con una proporción de insatisfacción del 20% con un nivel de confianza del 96% y una precisión del 4%. Con estos valores el tamaño de la muestra a estudiar es de 385 pacientes. Como técnicas se utilizará la entrevista, observación directa e indirecta, como instrumento el formulario avalado por la Universidad Técnica Particular de Loja en la investigación realizada por el Dr. Carlos Arévalo previa a la obtención de la maestría en gerencias en salud para el desarrollo local, para procesar la información se utilizará los programas Excel, Word y SPSS, los datos serán analizados con estadística descriptiva y presentadas en tablas y gráficas. Uso de resultados: la presente investigación pretenderá obtener datos relacionados con la medición de la calidad de atención que brinda el personal de enfermería y el nivel de satisfacción del usuario que acude al centro de salud Cojitambo.

Sistema de gestão em segurança e saúde do trabalho (SGSST) integrando a norma OHSAS 18001 e NR-18: proposta para o setor da construção civil

The job security issue is crucial for the development of construction due to the need to ensure the health of workers, which is done by means of laws and production management. Thus, among various other laws, was enacted NR-18, in order to ensure the worker's minimum conditions for the development work. Despite legislative developments on the subject, they have become ineffective against the excessive number of accidents in the construction industry, bringing the company to greater in ensuring the health and safety of its workers. In view of this need for improvement of working environment in a general appearance, both for purposes of ensuring the law obedience as comfort for workers and quality of the organization, the System Health Management and Safety (OHSMS) is a valid tool demonstrates the evolution of business management, as well as OHSAS 18001 which proposes to ensure the efficiency and integration of a system geared to safety and health at work by means of implements and adaptations of it, in order to bring significant improvements to conditions of work, especially in the form of a new culture to be adopted by the company. Addressing the problem, this paper aims to develop a management system by OHSAS 18001 which is consistent with the terms of NR-18 as it is this integration of OHSMS Management System of the company as a usual practice of that aims at an improvement of work safety in the business of Buildings.

The quality of care of diabetic patients in rural Malawi: A case of Mangochi district

Background Diabetes mellitus is a global public health problem. In Malawi, the prevalence of diabetes is 5.6% but the quality of care has not been well studied. Objective The aim of this study was to assess the quality of care offered to diabetic patients in Mangochi district. Methods This was a cross sectional descriptive study. Quantitative data were collected using a questionnaire from a sample of 75 diabetic patients (children and adults) who attended the Diabetes Clinic at Mangochi District Hospital between 20012 and 2013. Qualitative data were also collected using semi-structured interviews with eight Key Informants from among the District Health Management Team. Frequencies and cross-tabulation were obtained from the quantitative data. Patients’ master cards were checked to validate results. Clinical knowledge about diabetes, care practices and resources were the themes analysed from the qualitative data. Results Among the 75 participants interviewed, 46 were females and 29 males. The overall mean age was 48.3 years (45.6 for females and 53.3 for males). More than half of patients had little or no information about diabetes (40.0 % (n=30) and 22.7 (n=17) respectively. The majority of patients were taking their medicines regularly 98.7% (n=74). Only 17.3% (n=13) reported having their feet inspected regularly. Fifty-six percent of patients were satisfied about services provision. Some nurses and clinicians were trained on diabetes care but most of them left. Guidelines on diabetes management were not accessible. There were shortages in medicines (e.g. soluble insulin) and reagents. Information Education and Communication messages were offered through discussions, experiences sharing and posters. Conclusion Quality of diabetes care provided to diabetic patients attended to Mangochi hospital was sub-optimal due to lack of knowledge among patients and clinicians and resources. More efforts are needed towards retention of trained staff, provision of pharmaceutical and laboratory resources and health education.

The French Polynesian experience

French Polyncsia is currently the world's largest producer of cultured black pearls with exports worth US$150 millions annually. The activity has become of prime socio-economic importance the archipelagos with strong support and control of the government. In the mid-1980s, mass mortality of the black-lipped pearl oyster, Pinctada margaritifera, has occurred in several atolls and challenged the development of pearl farming activity. Consequent Studies and surveys have described severa! pathologica! conditions. None of those is considered to pose significant threat to the industry. However, they are monitored by a surveillance program in order to prevent and control emerging diseases. The governmemt of French Polynesia has developed efforts to maintain high quality of the pearls and sustain demand of the markets. This paper reviews a successful model of development based on proactive policy and cooperation among stakeholders.