Ageing, learning, technology, and health management

The world’s population is ageing rapidly. Ageing has an impact on all aspects of human life, including social, economic, cultural, and political. Understanding ageing is therefore an important issue for the 21st century. This chapter will consider the active ageing model. This model is based on optimising opportunities for health, participation, and security in order to enhance quality of life. There is a range of exciting options developing for personal health management, for and by the ageing population, that make use of computer technology, and these should support active ageing. Their use depends however on older people learning to use computer technology effectively. The ability to use such technology will allow them to access relevant health information, advice, and support independently from wherever they live. Such support should increase rapidly in the future. This chapter is a consideration of ageing and learning, ageing and use of computer technology, and personal health management using computers.

Policy analysis of disaster health management in China

Humankind has been dealing with all kinds of disasters since the dawn of time. The risk and impact of disasters producing mass casualties worldwide is increasing, due partly to global warming as well as to increased population growth, increased density and the aging population. China, as a country with a large population, vast territory, and complex climatic and geographical conditions, has been plagued by all kinds of disasters. Disaster health management has traditionally been a relatively arcane discipline within public health. However, SARS, Avian Influenza, and earthquakes and floods, along with the need to be better prepared for the Olympic Games in China has brought disasters, their management and their potential for large scale health consequences on populations to the attention of the public, the government and the international community alike. As a result significant improvements were made to the disaster management policy framework, as well as changes to systems and structures to incorporate an improved disaster management focus. This involved the upgrade of the Centres for Disease Control and Prevention (CDC) throughout China to monitor and better control the health consequences particularly of infectious disease outbreaks. However, as can be seen in the Southern China Snow Storm and Wenchuan Earthquake in 2008, there remains a lack of integrated disaster management and efficient medical rescue, which has been costly in terms of economics and health for China. In the context of a very large and complex country, there is a need to better understand whether these changes have resulted in effective management of the health impacts of such incidents. To date, the health consequences of disasters, particularly in China, have not been a major focus of study. The main aim of this study is to analyse and evaluate disaster health management policy in China and in particular, its ability to effectively manage the health consequences of disasters. Flood has been selected for this study as it is a common and significant disaster type in China and throughout the world. This information will then be used to guide conceptual understanding of the health consequences of floods. A secondary aim of the study is to compare disaster health management in China and Australia as these countries differ in their length of experience in having a formalised policy response. The final aim of the study is to determine the extent to which Walt and Gilson’s (1994) model of policy explains how disaster management policy in China was developed and implemented after SARS in 2003 to the present day. This study has utilised a case study methodology. A document analysis and literature search of Chinese and English sources was undertaken to analyse and produce a chronology of disaster health management policy in China. Additionally, three detailed case studies of flood health management in China were undertaken along with three case studies in Australia in order to examine the policy response and any health consequences stemming from the floods. A total of 30 key international disaster health management experts were surveyed to identify fundamental elements and principles of a successful policy framework for disaster health management. Key policy ingredients were identified from the literature, the case-studies and the survey of experts. Walt and Gilson (1994)’s policy model that focuses on the actors, content, context and process of policy was found to be a useful model for analysing disaster health management policy development and implementation in China. This thesis is divided into four parts. Part 1 is a brief overview of the issues and context to set the scene. Part 2 examines the conceptual and operational context including the international literature, government documents and the operational environment for disaster health management in China. Part 3 examines primary sources of information to inform the analysis. This involves two key studies: • A comparative analysis of the management of floods in China and Australia • A survey of international experts in the field of disaster management so as to inform the evaluation of the policy framework in existence in China and the criteria upon which the expression of that policy could be evaluated Part 4 describes the key outcomes of this research which include: • A conceptual framework for describing the health consequences of floods • A conceptual framework for disaster health management • An evaluation of the disaster health management policy and its implementation in China. The research outcomes clearly identified that the most significant improvements are to be derived from improvements in the generic management of disasters, rather than the health aspects alone. Thus, the key findings and recommendations tend to focus on generic issues. The key findings of this research include the following: • The health consequences of floods may be described in terms of time as ‘immediate’, ‘medium term’ and ‘long term’ and also in relation to causation as ‘direct’ and ‘indirect’ consequences of the flood. These two aspects form a matrix which in turn guides management responses. • Disaster health management in China requires a more comprehensive response throughout the cycle of prevention, preparedness, response and recovery but it also requires a more concentrated effort on policy implementation to ensure the translation of the policy framework into effective incident management. • The policy framework in China is largely of international standard with a sound legislative base. In addition the development of the Centres for Disease Control and Prevention has provided the basis for a systematic approach to health consequence management. However, the key weaknesses in the current system include: o The lack of a key central structure to provide the infrastructure with vital support for policy development, implementation and evaluation. o The lack of well-prepared local response teams similar to local government based volunteer groups in Australia. • The system lacks structures to coordinate government action at the local level. The result of this is a poorly coordinated local response and lack of clarity regarding the point at which escalation of the response to higher levels of government is advisable. These result in higher levels of risk and negative health impacts. The key recommendations arising from this study are: 1. Disaster health management policy in China should be enhanced by incorporating disaster management considerations into policy development, and by requiring a disaster management risk analysis and disaster management impact statement for development proposals. 2. China should transform existing organizations to establish a central organisation similar to the Federal Emergency Management Agency (FEMA) in the USA or the Emergency Management Australia (EMA) in Australia. This organization would be responsible for leading nationwide preparedness through planning, standards development, education and incident evaluation and to provide operational support to the national and local government bodies in the event of a major incident. 3. China should review national and local plans to reflect consistency in planning, and to emphasize the advantages of the integrated planning process. 4. Enhance community resilience through community education and the development of a local volunteer organization. China should develop a national strategy which sets direction and standards in regard to education and training, and requires system testing through exercises. Other initiatives may include the development of a local volunteer capability with appropriate training to assist professional response agencies such as police and fire services in a major incident. An existing organisation such as the Communist Party may be an appropriate structure to provide this response in a cost effective manner. 5. Continue development of professional emergency services, particularly ambulance, to ensure an effective infrastructure is in place to support the emergency response in disasters. 6. Funding for disaster health management should be enhanced, not only from government, but also from other sources such as donations and insurance. It is necessary to provide a more transparent mechanism to ensure the funding is disseminated according to the needs of the people affected. 7. Emphasis should be placed on prevention and preparedness, especially on effective disaster warnings. 8. China should develop local disaster health management infrastructure utilising existing resources wherever possible. Strategies for enhancing local infrastructure could include the identification of local resources (including military resources) which could be made available to support disaster responses. It should develop operational procedures to access those resources. Implementation of these recommendations should better position China to reduce the significant health consequences experienced each year from major incidents such as floods and to provide an increased level of confidence to the community about the country’s capacity to manage such events.

Information support for health management in regional Sri Lanka : health managers’ perspectives

Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of poor performance and to design strategic reforms to improve HIS in regional Sri Lanka.

Progress and challenges of disaster health management in China : a scoping review

Background Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. Objective This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. Design A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. Results The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. Conclusions One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).

Australian Prawn Farming Manual: Health Management for profit

The Manual is an easy to read guide for running a low disease risk prawn farm in Australia. Using the combined knowledge of Australia's leading scientists, prawn farmers, extensionists and prawn health specialists, this manual captures what is known about the diseases that threaten the Australian prawn farming industry and how the of disease outbreak can be minimised. Funded by ACIAR and developed in collaboration with the Australian Prawn Farmers' Association, the Queensland Department of Primary Industries and Fisheries and the New South Wales Department of Primary Industries, the manual draws on five years of research conducted across the Australiasia region. The contents reflect the knowledge of a wide array of internationally recognised researchers and the wisdom and research gained through the efforts of the Australian prawn farming industry.

QPI64 Sustainable Soil Health Management Workshop Northern Broadacre Cropping Industries

Workshops to increase participants understanding and knowledge by farm businesses and healthy catchments farmers about the role of soil health in supporting sustainable through variable circumstances, farm businesses and healthy catchments.

Monoclonal antibodies in fish and shellfish health management in India

The paper describes the superiority of monoclonal antibodies (MAb) over conventional polyclonal antisera. Studies undertaken indicate that Aeromonas hydrophila isolates are highly heterogenous and variation exists even between isolates from a farm, requiring a large number of MAbs for classification and use of information in vaccine development. However, some of the MAbs could be used for detection of homologous isolates in fish kidney by immunodot assay and evaluation and standardization of biofilm of A. hydrophila for oral vaccination in carps.

The future of veterinarians in dairy herd health management

The future of the Veterinary Practice in Dairy Health Management has changed and will change more drastically from our point of view in the next years. The consumer’s pressure and the Media are more and more concerned about animal welfare, traceability of animal products and safety of products of animal origin. On the other hand the Farmers in Europe have to produce under strong rules (competing with other countries outside Europe), which are normally very expensive to put in practice, and the veterinarians should adapt their knowledge to the new challenges, because without their work and cooperation, dairy farming will have no future. In that sense, the old veterinary practice has to go in other ways, otherwise the Veterinarians will loose clients and the animal population in Europe will be reduced. The Dairy farmers will ask for support in other areas besides clinical: efficacy, management, welfare, profitability, nutrition, prophylaxis, economics, reproduction, environmental protection, grassland management, etc. Cattle practitioners should be able to give answers in several subjects and this sets the challenge to our profession - Veterinary preparation has to be very strong in single animal species, particularly in Dairy or beef cows. The cattle practitioner has to look beyond, but he should never forget that “the single animal” has to be looked at as one unit of the herd, which means that without a very good knowledge of the single animal he will be insufficiently prepared to solve herd problems, and the Herd is the sum of several animals. We all know that very often one single animal allows us to implement herd strategies and develop prophylactic programs. We are convinced that the veterinary profession, and in our case the Cattle Medicine should have the ability to evolve, otherwise the Veterinarian as we know him will miss the train in the next years.

Potential and limits of health management reform in Chile

Includes bibliography

Health management contracts in Costa Rica from a comparative perspective

Includes bibliography

Dairy goat health management and milk production on organic and conventional system in Brazil

The aimed of this article is to measure risk factors on health and milk production on organic and conventional dairy goats in Brazil. Two experimental groups (organic and conventional) were evaluated simultaneously. The study design was completely randomized. The organic herd consisted of 25 goats and 15 kids. In the conventional production system, a dairy herd comprising 40 goats and 20 kids participated in the study. Data on milk production and health management were available from January 2007 to December 2009. The abortion rate in the conventional system was 5% (2/40) whereas in organic system no abortion was diagnosed (0/25). The mortality rate at weaning in the conventional system was 5% (2/40) and in the organic system was 8% (2/25). Milk production was lower (2.20 kg/day) in organic than conventional system (2.66 kg/day). Goats and kids in organic farm had a higher FEC (386±104 and 900±204, respectively) (p<0.05) than those in conventional farm (245±132 and 634±212, respectively). In addition, Saanen kids had higher FEC (p<0.001) than goats. Treatment with antiparasitic drugs was higher in conventional system (50%) than organic system (1.3%).

Results of herd health management in veal calf production

The aim of this study was to document experience gained with herd health management in veal calf production and to describe the calves' most frequent health problems. Fifteen farms with an 'all-in-all-out' animal flow system and 20 farms with a continuous animal flow system were investigated and data on animal movements, housing, feeding, medical treatments, and management were collected. Cadavers underwent pathological examination, and data were recorded from the carcasses of slaughtered calves. On the 15 'all-in-all-out'-farms, 2'747 calves were clinically examined by the contract-veterinarian upon arrival at the farm, and 71,1 % of the calves showed at least one sign of illness. The main causes of death were with 54,9 % digestive disorders (a perforating abomasal ulcer being the most frequent diagnosis), followed by respiratory diseases (29,6 %, mainly pneumonia). The meat color of 25 % of the carcasses was red. Calves from farms with the continuous animal flow system, which recruit mainly animals originating from the same farm, showed significantly better results regarding antibiotic use, performance and carcass quality than those calves from farms with the 'all-in-all-out'-system.

A review on bovine besnoitiosis: a disease with economic impact in herd health management, caused by Besnoitia besnoiti (Franco and Borges, 1916).

Bovine besnoitiosis is caused by the largely unexplored apicomplexan parasite Besnoitia besnoiti. In cows, infection during pregnancy often results in abortion, and chronically infected bulls become infertile. Similar to other apicomplexans B. besnoiti has acquired a largely intracellular lifestyle, but its complete life cycle is still unknown, modes of transmission have not been entirely resolved and the definitive host has not been identified. Outbreaks of bovine besnoitiosis in cattle were described in the 1990s in Portugal and Spain, and later several cases were also detected in France. More cases have been reported recently in hitherto unaffected countries, including Italy, Germany, Switzerland, Hungary and Croatia. To date, there is still no effective pharmaceutical compound available for the treatment of besnoitiosis in cattle, and progress in the identification of novel targets for intervention through pharmacological or immunological means is hampered by the lack of molecular data on the genomic and transcriptomic level. In addition, the lack of an appropriate small animal laboratory model, and wide gaps in our knowledge on the host-parasite interplay during the life cycle of this parasite, renders vaccine and drug development a cost- and labour-intensive undertaking.