852 resultados para Healthcare utilization
Resumo:
Two experiments were undertaken in which grass silage was used in conjunction with a series of different concentrate types designed to examine the effect of carbohydrate source, protein level and degradability on total dietary phosphorus (P) utilization with emphasis on P pollution. Twelve Holstein-Friesian dairy cows in early to mid-lactation were used in an incomplete changeover design with four periods consisting of 4 weeks each. Phosphorus intake ranged from 54 to 80 g/day and faecal P represented the principal route by which ingested P was disposed of by cows, with insignificant amounts being voided in urine. A positive linear relationship between faecal P and P intake was established. In Experiment 1, P utilization was affected by dietary carbohydrate type, with an associated output of 3.3 g faecal P/g milk P produced for all treatments except those utilizing low degradable starch and low protein supplements, where a mean value of 2.8 g faecal P/g milk P was observed. In Experiment 2, where two protein levels and three protein degradabilities were examined, the efficiency of P utilization for milk P production was not affected by either level or degradability of crude protein (CP) but a significant reduction in faecal P excretion due to lower protein and P intake was observed. In general, P utilization in Experiment 2 was substantially improved compared to the Experiment 1, with an associated output of 1.8 g faecal P/g milk P produced. The improved utilization of P in Experiment 2 could be due to lower P content of the diets offered and higher dry matter (DM) intake. For dairy cows weighing 600 kg, consuming 17-18 kg DM/day and producing about 25 kg milk, P excretion in faeces and hence P pollution to the environment might be minimized without compromising lactational performance by formulating diets to supply about 68 g P/day, which is close to recent published recommended requirements for P.
Resumo:
Echinocactus grusonii is common in trade but critically endangered in its natural habitat. With the ultimate aim of developing a certification scheme to aid in the conservation of this species, we have isolated E. grusonii microsatellites from a nonenriched library. Fifty-seven sequences contained a microsatellite array, of which 12 were polymorphic among 30 individuals from a single wild population. All 12 microsatellite primer pairs amplified product in one or more species in a screen of 27 other cactus species.
Resumo:
Cashew (Anacardium occidentale L.) is the most economically important tropical nut crop in the world, and yet there are no sequence tagged site (STS) markers available for its study. Here we use an automated, high-throughput system to isolate cashew microsatellites from a non-enriched genomic library blotted onto membranes at high density for screening. Sixty-five sequences contained a microsatellite array, of which 21 proved polymorphic among a closely related seed garden population of 49 genotypes. Twelve markers were suitable for multiplex analysis. Of these, 10 amplified in all three related tropical tree species tested: Anacardium microcarpum, Anacardium pumilum and Anacardium nanum.
Resumo:
The built environment in which health and social care is delivered can have an impact on the efficiency and outcomes of care processes. The health-care estate is large and growing and is expensive to build, adapt and maintain. The design of these buildings is a complex, difficult and political process. Better use of care pathways as an input to the design and use of the built environment has the potential to deliver significant benefits. A number of variations on the idea of care pathways are already used in designing health-care buildings but this is under-researched. This paper provides a framework for thinking about care pathways and the health-care built environment. The framework distinguishes between five different pathway ‘types’ defined for the purpose of understanding the relationship between pathways and infrastructure. The five types are: ‘care pathways’, ‘integrated care pathways’, ‘patient pathways’, ‘patient journeys’ and ‘patient flows’. The built environment implications of each type are discussed and recommendations made for those involved in either building development or care pathway projects.
Resumo:
The built environment in which health and social care is delivered can have an impact on the efficiency and outcomes of care processes. The health-care estate is large and growing and is expensive to build, adapt and maintain. The design of these buildings is a complex, difficult and political process. Better use of care pathways as an input to the design and use of the built environment has the potential to deliver significant benefits. A number of variations on the idea of care pathways are already used in designing health-care buildings but this is under-researched. This paper provides a framework for thinking about care pathways and the health-care built environment. The framework distinguishes between five different pathway ‘types’ defined for the purpose of understanding the relationship between pathways and infrastructure. The five types are: ‘care pathways’, ‘integrated care pathways’, ‘patient pathways’, ‘patient journeys’ and ‘patient flows’. The built environment implications of each type are discussed and recommendations made for those involved in either building development or care pathway projects.
Resumo:
Nowadays the use of information and communication technology is becoming prevalent in many aspects of healthcare services from patient registration, to consultation, treatment and pathology tests request. Manual interface techniques have dominated data-capture activities in primary care and secondary care settings for decades. Despites the improvements made in IT, usability issues still remain over the use of I/O devices like the computer keyboard, touch-sensitive screens, light pen and barcodes. Furthermore, clinicians have to use several computer applications when providing healthcare services to patients. One of the problems faced by medical professionals is the lack of data integrity between the different software applications which in turn can hinder the provision of healthcare services tailored to the needs of the patients. The use of digital pen and paper technology integrated with legacy medical systems hold the promise of improving healthcare quality. This paper discusses the issue of data integrity in e-health systems and proposes the modelling of "Smart Forms" via semiotics to potentially improve integrity between legacy systems, making the work of medical professionals easier and improve the quality of care in primary care practices and hospitals.
Resumo:
Ubiquitous healthcare is an emerging area of technology that uses a large number of environmental and patient sensors and actuators to monitor and improve patients’ physical and mental condition. Tiny sensors gather data on almost any physiological characteristic that can be used to diagnose health problems. This technology faces some challenging ethical questions, ranging from the small-scale individual issues of trust and efficacy to the societal issues of health and longevity gaps related to economic status. It presents particular problems in combining developing computer/information/media ethics with established medical ethics. This article describes a practice-based ethics approach, considering in particular the areas of privacy, agency, equity and liability. It raises questions that ubiquitous healthcare will force practitioners to face as they develop ubiquitous healthcare systems. Medicine is a controlled profession whose practise is commonly restricted by government-appointed authorities, whereas computer software and hardware development is notoriously lacking in such regimes.
Resumo:
Epidemiological studies suggest that low-birth weight infants show poor neonatal growth and increased susceptibility to metabolic syndrome, in particular, obesity and diabetes. Adipose tissue development is regulated by many genes, including members of the peroxisome proliferator-activated receptor (PPAR) and the fatty acid-binding protein (FABP) families. The aim of this study was to determine the influence of birth weight on key adipose and skeletal muscle tissue regulating genes. Piglets from 11 litters were ranked according to birth weight and 3 from each litter assigned to small, normal, or large-birth weight groups. Tissue samples were collected on day 7 or 14. Plasma metabolite concentrations and the expression of PPARG2, PPARA, FABP3, and FABP4 genes were determined in subcutaneous adipose tissue and skeletal muscle. Adipocyte number and area were determined histologically. Expression of FABP3 and 4 was significantly reduced in small and large, compared with normal, piglets in adipose tissue on day 7 and in skeletal muscle on day 14. On day 7, PPARA and PPARG2 were significantly reduced in adipose tissue from small and large piglets. Adipose tissue from small piglets contained more adipocytes than normal or large piglets. Birth weight had no effect on adipose tissue and skeletal muscle lipid content. Low-birth weight is associated with tissue-specific and time-dependent effects on lipid-regulating genes as well as morphological changes in adipose tissue. It remains to be seen whether these developmental changes alter an individual's susceptibility to metabolic syndrome.
Resumo:
The efficiency of energy utilisation in cattle is a determinant of the profitability of milk and beef production, as well as their environmental impact. At an animal level, meat and milk production by ruminants is less efficient than pig and poultry production, in part due to lower digestibility of forages compared with grains. However, when compared on the basis of human-edible inputs, the ruminant has a clear efficiency advantage. There has been recent interest in feed conversion efficiency (FCE) in dairy cattle and residual feed intake, an indicator of FCE, in beef cattle. Variation between animals in FCE may have genetic components, allowing selection for animals with greater efficiency and reduced environmental impact. A major source of variation in FCE is feed digestibility, and thus approaches that improve digestibility should improve FCE if rumen function is not disrupted. Methane represents a substantial loss of digestible energy from rations. Major determinants of methane emission are the amount of feed consumed and the proportions of forage and concentrates fed. In addition, feeding fat has long been known to reduce methane emission. A myriad of other supplements and additives are currently being investigated as mitigators of methane emission, but in many cases compounds effective in sheep are ineffective in lactating dairy cows. Ultimately, the adoption of ‘best practice’ in diet formulation and management may be the most effective option for reducing methane. In assessing the efficiency of energy use for milk and meat production by cattle, and their environmental impact, it is imperative that comparisons be made at a systems level, and that the wider social and economic implications of mitigation policy are considered.