Planning for better animal health and welfare, Report from the 1st ANIPLAN project workshop, Hellevad, October 2007

’Minimising medicine use in organic dairy herds through animal health and welfare planning’, ANIPLAN, is a CORE-Organic project which was initiated in June 2007. The main aim of the project is to investigate active and well planned animal health and welfare promotion and disease prevention as a means of minimising medicine use in organic dairy herds. This aim will be met through the development of animal health and welfare planning principles for organic dairy farms under diverse conditions based on an evaluation of current experiences. This also includes application of animal health and welfare assessment across Europe. In order to bring this into practice the project also aims at developing guidelines for communication about animal health and welfare promotion in different settings, for example, as part of existing animal health advisory services or farmer groups such as the Danish Stable School system and the Dutch network programme. The project is divided into the following five work packages, four of which comprise research activities with the other focused on coordination and knowledge transfer, through meetings, workshops and publications. These proceedings represent our first results in terms of presented papers and discussions at our first project workshop in Hellevad Vandmølle as well as a review of Animal Health Planning in UK. The content of the workshop proceedings reflect the aim and starting points of all work packages, both in terms of analyses prior to the workshop, and developments during the workshop emanating from group work. Besides a general introduction to the project and the ideas of the project, Christoph Winckler provides an overview of the use of animal based parameters based on the results of the WelfareQuality project. Christopher Atkinson and Madeleine Neale presented concepts, principles and the practicalities of Animal Health Planning and Animal Health Plans based on UK experiences. Pip Nicholas from The University of Wales, Aberystwyth produced a report reviewing the current use of animal health and welfare planning. The entire document is included in these workshop proceedings. This was supplemented through presentations from all countries regarding animal health and welfare planning processes and research. These are summarised together with the concepts developed through dialogue at the workshop in the paper by Nicholas, Vaarst and Roderick. Finally, the Danish Stable School principles were presented by Mette Vaarst followed by discussion on different approaches of communication in farmer groups and at the individual level between farmers and advisors. One important outcome from this workshop is a set of preliminary principles for a good health planning process. We concluded through group discussions followed by a plenary session that a health planning process should aim at continuous development and improvement, and should incorporate health promotion and disease handling, based on a strategy where the current situation is evaluated and form basis for action, which is then reviewed in a new evaluation. It is important that any health plan is farm specific and based on farmer ownership, although an external person(s) should be involved, as well as external knowledge. The organic principles should form the framework for any action (meaning that a systems approach is needed), and the plan should be written. The good and positive aspects on each farm – things that other farmers potentially can learn from. The work and studies in dairy farms within the project will be based on these principles and comprise evaluation and review using animal based parameters as well as finding ways of communication with farmers about animal health and welfare

An investigation of biases in Patient Safety Indicator score distribution among hospital cohorts

Denman Research Forum- 2nd Place, Health Professions-ClinicalThe Centers for Medicare and Medicaid Services (CMS) have implemented a hospital reimbursement system that incentivizes payment proportional to the quality of care delivered and performance on certain metrics. One such metric is the Agency for Healthcare Research and Quality’s Patient Safety Indicator 90 (PSI-90). It is composed of eight individual indicators designed to flag adverse patient events that are potentially preventable, such as post-operative wound dehiscence and accidental lacerations. CMS publicly reports four of these individual PSI scores (6, 12, 14 and 15) in addition to the composite PSI-90. Previous studies question the PSIs’ validity beyond screening purposes and furthermore question the underlying administrative data’s ability to accurately and reliably flag such events. This study looks to analyze biases in PSI score distribution for hospitals depending on teaching status, differences in patient demographics and lastly, interactions between teaching status and patient demographic factors and their ability to account for differences in PSI rates. Significant differences were found between teaching and non-teaching hospitals for PSIs 6, 12, 15 and 90 (p<0.01). Inpatient volume and patient severity (p<0.01) were found to be significantly different between teaching status cohorts. Lastly, significant differences in PSI scores were found between patient severity quartiles for PSI 6, 15 and 90 (p<0.05) and between socio-economic quartiles for PSI 6, 12, 15 and 90 (p<0.05); but interaction between patient severity and teaching status was only significant for PSI 90 (p<0.05) and between socioeconomic and teaching statuses for PSI 6 (p<0.05). These results indicate current PSI score distributions may be biased against teaching hospitals for 4 out of 5 PSI measures. Further studies will involve assessing the adequacy of risk-adjustment methodology for PSI metrics. Until then, use of PSI metrics to determine federal reimbursement can lead to bias against teaching hospitals.A three-year embargo was granted for this item.Academic Major: Health Information Management and System

Exploring a prototype framework of web-based and peer-reviewed “European Educational Research Quality Indicators” (EERQI)

Digitization, the Internet, and information or webometric interdisciplinary approaches are affecting the fields of Scientometrics and Library and Information Science (LIS). These new approaches can be used to improve citation-only procedures to estimate the quality and impact of research. A European pilot to explore this potential was called “European Educational Research Quality Indicators” (EERQI, FP7 # 217549). An interdisciplinary consortium was involved from 2008-2011. Different types of indicators were developed to score 171 educational research documents. Extrinsic bibliometric and citation indicators were collected from the Internet for each document; intrinsic indicators reflecting content-based quality were developed and relevant data gathered by peer review. Exploratory and confirmatory factor analysis and structural modeling were used to explore statistical relationships among latent factors or concepts and their indicators. Three intrinsic and two extrinsic latent factors were found to be relevant. Moreover, the more a document was related to a reviewer’s own area of research, the higher the score the reviewer gave concerning 1) significance, originality, and consistency, and 2) methodological adequacy. The conclusions are that a prototype EERQI framework has been constructed: intrinsic quality indicators add specific information to extrinsic quality or impact indicators, and vice versa. Also, a problem of “objective” impact scores is that they are based on “subjective” or biased peer-review scores. Peer-review, which is foundational to having a work cited, seems biased and this bias should be controlled or improved by more refined estimates of quality and impact of research. Some suggestions are given and limitations of the pilot are discussed. As the EERQI development approach, instruments, and tools are new, they should be developed further

Evaluation of policy measures for agri-food networks in Italian rural development programmes

The agri-food sector is characterized by very heterogeneous agreements and formal and informal contracts aimed to create stable relationships among firms. In this scenario, the actors are linked by common interest in creating and distributing added value. In the network, the risk and the responsibilities are shared by the participants and the transaction costs are reduced by the presence of dynamic flows of information and knowledge. Consequently, the creation and development of agri-food networks is a main objective of regional administration in their Rural Development Plans. The article item is the presentation and the discussion of the methodology used for the evaluation of Integrated Measures Project (Progetti Integrati di Filiera, PIF) presented by firm networks and agri-food chains in Veneto. The result are demonstrated extremely interesting about the understanding of PIF. Moreover, the comparative study serve to understand the result in terms of competitive advantage and income for the farmers.agri-food networking, food-chain policy, Rural Development Programme, Agricultural and Food Policy, Q18,

Parts and materials application review for space systems

Parts and materials application review for project management of space systems engineerin

Responsiveness of Health Systems: a Barometer of the Quality of Health Services

In the health field, quality is a complex and multidimensional variable. The complexity is shown by different levels of quality, which provide a global picture of the performance of a health system: compliance with mandatory rules, compliance with professional recommendations/references, action of steady improvement aiming at resolving health problems, risk management or excellence seeking, etc. The multidimensional character is provided by various dimensions to be covered by evaluation indicators of the performance of a health system: acceptability in what points the health system meets our expectations; accessibility knowing whether we can receive the services where and when we need them; adequacy knowing whether the care meets our needs and is based on established rules; competence knowing whether knowledge and skills of health services providers are consistent with the care they provide; continuity matching services – coordination, integration, easy access; effectiveness concerning the services in operation and in what point they influence our health; efficiency achieving best results at the lowest cost; security minimizing possible risks in a health area or service. Out of these dimensions – which, from a synergetic perspective, define the overall performance of a health system – we retain for a detailed analysis only those concerning acceptability, adequacy and competence, which determine the responsiveness to the patients’ expectations. Moreover, for working out a methodology for assessing the quality of health services, it is necessary to analyse various standard procedures for assessing the performance of health services initiated and rendered by international organisations and promoted, first of all, by the World Health Organisation. Our paper also deals with actions already taken worldwide, which now are undergoing structural improvements as well as with opportunities for making market surveys (opinion polls) among the beneficiaries of a health system: the citizens.health system; health system responsiveness; health system performance; health condition; determinants of health condition