Diagnostic and management protocols for equine Cushing's syndrome

Equine Cushing's syndrome is a common problem in aged horses and ponies. It presents with a variable combination of clinical signs; hirsutism is characteristic of the disease, with laminitis frequently being the most devastating consequence. This article describes the diagnostic protocols available and, in view of the fact that complete resolution of the disease is not achievable, discusses how the condition might be managed appropriately to improve the quality of life of affected animals.

Composition and quality of harvest residues and soil organic matter under windrow residue management in young hoop pine plantations as revealed by solid-state C-13 NMR spectroscopy

Solid-state C-13 nuclear magnetic resonance (NMR) with cross-polarisation (CP) and magic-angle-spinning (MAS) was used to: (a) examine the changes in carbon (C) composition of windrowed harvest residues during the first 3 years of hoop pine plantations in subtropical Australia; (b) assess the impacts of windrowed harvest residues on soil organic matter (SOM) composition and quality in the 0-10 cm soil layer. Harvest residues were collected from 0-, 1-, 2- and 3-year-old windrows of ca. 2.5 m width (15 m apart for 0-, 1- and 2-year-old sites and 10 m apart for 3-year-old site). Soils from the 0 to 10 cm soil layer were collected from the 1-, 2- and 3-year-old sites. The 13C NMR spectra of the harvest residues indicated the presence of lignin in the hoop pine wood, foliage and newly incorporated organic matter (NIOM). Condensed tannin structures were found in the decay-resistant bark, small wood and foliage, but were absent in other residue components and SOM. The NMR spectra of small wood samples contained condensed tannin structures because the outer layer of bark was not removed. NIOM showed a shift from foliage-like structures (celluloses) to lignin-type structures, indicating an incorporation of woody residues from the decomposing harvest residues. Suberins were also present in the small wood, foliage and bark. The 13C CP NMR spectra of SOM indicated that in areas where windrows were present, SOM did not show compositional changes. However, an increase in SOM quality under the windrows in the second year after their formation as characterised by the alkyl C/O-alkyl C (A/O-A) ratio was mainly due to inputs from the decomposition of the labile, readily available components of the windrowed harvest residues. (C) 2002 Published by Elsevier Science B.V.

How does residue management impact soil organic matter composition and quality under Eucalyptus globulus plantations in southwestern Australia?

This study investigated the influence of harvest residue management practices on soil organic matter (SOM) composition and quality from two second-rotation Eucalyptus globulus plantations in southwestern Australia, using solid-state 13C nuclear magnetic resonance (NMR) spectroscopy with cross-polarisation and magic-angle-spinning (CPMAS). Soil samples (0–5 cm) were collected every 12 months for 5 years from two sites that had contrasting soil types and fertility. Harvest residue management treatments established at both sites were (a) no harvest residues; and (b) double harvest residues. The use of 13C CPMAS and DD NMR spectroscopy enabled the successful non-destructive detection of SOM quality changes in the two E. globulus plantations. Relative intensities of 13C CPMAS NMR spectral regions were similar at both sites, and for both harvest residue treatments, indicating that SOM composition was also similar. Dipolar dephasing (DD) NMR spectra revealed resonances in SOM assigned to lignin and tannin structures, with larger resonances in the carbonyl and alkyl C regions that were indicative of cuticular material, enabling detection of changes in SOM quality. Retention of double harvest residues on the soil surface increased the soil quality compared with removal of all harvest residues at both sites as indicated by the NMR aromaticities, but this was most noticeable at Manjimup, which had greater initial soil fertility.

Effectiveness of case management and post-acute services in older people after hospital discharge

Objective: To evaluate the benefits of coordinating community services through the Post-Acute Care (PAC) program in older patients after discharge from hospital. Design: Prospective multicentre, randomised controlled trial with six months of follow-up with blinded outcome measurement. Setting: Four university-affiliated metropolitan general hospitals in Victoria. Participants: All patients aged 65 years and over who were discharged between August 1998 and October 1999 and required community services after discharge. Interventions: Participants were randomly allocated to receive services of a Post-Acute Care (PAC) coordinator (intervention) versus usual discharge planning (control). Main outcome measures: Comparison of quality of life and carer stress at one-month post-discharge, mortality, hospital readmissions, use of community services and community and hospital costs over the six months post-discharge. Results: 654 patients were randomised, and 598 were included in the analysis (311 in the PAC group and 287 in the control group). There was no difference in mortality between the groups (both 6%), but significantly greater overall quality-of-life scores at one-month follow-up in the PAC group. There was no difference in unplanned readmissions, but PAC patients used significantly fewer hospital bed-days in the six months after discharge (mean, 3.0 days; 95% CI, 2.1-3.9) than control patients (5.2 days; 95% CI, 3.8-6.7). Total costs (including hospitalisation, community services and the intervention) were lower in the PAC than the control group (mean difference, $1545; 95% CI, $11-$3078). Conclusions: The PAC program is beneficial in the transition from hospital to the community in older patients.

SPAnDX: a process-based population dynamics model to explore management and climate change impacts on an invasive alien plant, Acacia nilotica

This paper describes a process-based metapopulation dynamics and phenology model of prickly acacia, Acacia nilotica, an invasive alien species in Australia. The model, SPAnDX, describes the interactions between riparian and upland sub-populations of A. nilotica within livestock paddocks, including the effects of extrinsic factors such as temperature, soil moisture availability and atmospheric concentrations of carbon dioxide. The model includes the effects of management events such as changing the livestock species or stocking rate, applying fire, and herbicide application. The predicted population behaviour of A. nilotica was sensitive to climate. Using 35 years daily weather datasets for five representative sites spanning the range of conditions that A. nilotica is found in Australia, the model predicted biomass levels that closely accord with expected values at each site. SPAnDX can be used as a decision-support tool in integrated weed management, and to explore the sensitivity of cultural management practices to climate change throughout the range of A. nilotica. The cohort-based DYMEX modelling package used to build and run SPAnDX provided several advantages over more traditional population modelling approaches (e.g. an appropriate specific formalism (discrete time, cohort-based, process-oriented), user-friendly graphical environment, extensible library of reusable components, and useful and flexible input/output support framework). (C) 2003 Published by Elsevier Science B.V.

Balanced scorecard (BSC): uma vis??o metodol??gica para o acompanhamento de sua implementa????o

A Embrapa, na inten????o de operacionalizar a gest??o dos seus planos estrat??gicos (Plano Diretor da Embrapa ??? PDE e Planos Diretores das Unidades ??? PDUs) desenvolveu a metodologia Mogest para a implementa????o do seu Modelo de Gest??o Estrat??gica (MGE), no ??mbito corporativo e de suas 40 unidades de neg??cio, com base na modifica????o do m??todo Balanced Scorecard ??? BSC, de Kaplan. Posteriormente, ap??s a implementa????o dos MGEs, no per??odo de 1999 at?? os dias atuais, inicia-se e desenvolve-se a fase de acompanhamento por meio da elabora????o do m??todo MGE/Acompanha. Este trabalho aborda, de forma modificada, o uso do diagrama elaborado por Norton, apud Coutinho (2002), para acompanhar/avaliar a implementa????o do BSC para uma organiza????o orientada ?? estrat??gia, inserido no m??todo MGE/Acompanha (2000), elaborado pela Equipe MGE e aplicado em uma das unidades de neg??cio da Embrapa. Os resultados mostraram a efici??ncia do m??todo e proporcionaram a internaliza????o do conceito ???painel de bordo???, desenvolvido no software Oracle BSC (OBSC).

Gest??o do conhecimento em organiza????es p??blicas de sa??de no Brasil: diagn??stico de pr??ticas

As organiza????es p??blicas e privadas vivem diante de um cen??rio complexo, em que os fatores econ??micos e sociais de alcance mundial s??o respons??veis pela sua reestrutura????o. Nesse contexto, a Gest??o do Conhecimento (GC) se torna um valioso instrumento estrat??gico para a vida das pessoas e das organiza????es a que pertencem. A cria????o e a implanta????o de processos que gerem, armazenem, gerenciem e disseminem o conhecimento representam o mais novo desafio a ser enfrentado pelas organiza????es. O estudo realizado junto a Centros de Pesquisa Cl??nica (unidades vinculadas principalmente a Hospitais Universit??rios) e organiza????es p??blicas de sa??de integrantes do Programa Nacional de Gest??o P??blica e Desburocratiza????o (GESP??BLICA) tem como objetivo verificar como o tema GC est?? sendo tratado. O artigo identifica as pr??ticas de GC empregadas pelas organiza????es de sa??de abrangidas pelo estudo e sugere recomenda????es para uma dissemina????o mais eficaz do Modelo de Excel??ncia em Gest??o P??blica.

Gest??o p??blica e pesquisa operacional: avalia????o de desempenho em ag??ncias da Previd??ncia Social

O presente trabalho utiliza a metodologia DEA (Data Envelopment Analysis ), para avaliar a efici??ncia das 22 Ag??ncias da Previd??ncia Social ??? Ger??ncia Executiva Fortaleza (APS-GEXFOR). DEA utiliza programa????o linear cujo n??cleo das estruturas anal??ticas ?? formado a partir do modelo original CCR (Charnes, Cooper, e Rhodes). Aplicada ??s DMU (Decision Making Units), define uma Fronteira de Efici??ncia identificando Unidades Eficientes e Ineficientes. Foi utilizado o modelo DEA-CCR implementado pelo software DEA Solver??. A Previd??ncia Social (INSS) disp??e de indicadores de desempenho. Algumas vari??veis utilizadas no modelo implementado derivam desses indicadores, outras informa????es foram disponibilizadas pelos sistemas de informa????o da institui????o. A avalia????o de efici??ncia DEA das APS-GEXFOR permitiu identificar as melhores pr??ticas, mensurar a participa????o de cada vari??vel envolvida na avalia????o da unidade e projetar as unidades ineficientes na fronteira de efici??ncia, identificando metas a serem atingidas para torn??-las eficientes no conjunto observado.

A carreira de gestor p??blico e sua forma????o

Apesar de todo investimento nos ??ltimos anos, do poder p??blico, em qualificar profissionais, criar cursos e institui????es para forma????o de gestores p??blicos, o que parece ainda vigorar s??o as indica????es, para os cargos de gestores de unidades de sa??de. A carreira do Gestor P??blico na ??rea de sa??de deve ser feita atrav??s da Escola Nacional de Administra????o P??blica (ENAP), criada para tal fim, nos moldes atuais da carreira de Especialistas em Pol??ticas P??blicas e Gest??o Governamental (EPPGG) ou por outras Escolas como a Escola Nacional de Sa??de P??blica (ENSP). A????es e press??es de atores internacionais interferem na gest??o governamental, levando os governantes a promoverem reformas em suas administra????es visando atender esses interesses. Reformas administrativas ocorreram, em sua maioria, n??o por vontade do governo vigente, mas sim por v??rios fatores, sejam internos ou externos ao pa??s. Devido ao processo de globaliza????o e ao ide??rio neoliberal, que defendiam menor participa????o de interven????o do Estado na economia, reformas administrativas ocorreram e vem ocorrendo. Nos anos recentes, visando responder ??s demandas de novos conhecimentos e tecnologias colocadas pelo sistema de sa??de brasileiro em r??pida transforma????o, foi criado o espa??o institucional na, Escola de Governo em Sa??de (EGS), implantada na ENSP em 1998, dedicada a mobilizar e potencializar os esfor??os institucionais especificamente dirigidos a colaborar com a amplia????o da capacidade de governo em sa??de. Faremos uma breve exposi????o da forma????o de profissionais para a carreira de gest??o p??blica em alguns pa??ses das Am??ricas, mostrando a diversidade dos modelos de Escolas de Governo.

Improving the public management career: report for the ministry of planning, budgeting e management, federal government of Brazil

This report sets out the findings and recommendations of a review of the Public Management Career (EPPGG) undertaken between 5 and 9 January 2009. The purpose of the review was to clarify EPPGG???s role, functions and profile, and to develop proposals for improving its effectiveness and management, taking account of the context within which such improvements would have to be implemented. Specific objectives were to examine a number of human resources management (HRM) aspects of the career in the light of international practice, including recruitment; initial education; professional development; performance evaluation; deployment; mobility and networking.