Diagnostic error reduction in the United States and Italy through the intervention of diagnostic management teams

A major challenge to most countries is the growing cost of healthcare. The cost of laboratory testing is approximately 3% of the total clinical costs. On the other hand, waste from inappropriate admissions to clinical departments is reported to be as high as 15%. A frequently used approach to save dollars in healthcare is the random reduction in the budget for laboratories, with a focus on reduction of the number of unnecessary laboratory tests. The World Health Assembly has approached the problem by publishing a list of essential in vitro diagnostic tests, in order to achieve a global rationalization of the problem. A much more thoughtful strategy to saving healthcare finance is to improve the efficiency of the diagnostic process. This report presents an opportunity to reduce diagnostic error and increase the efficiency of diagnostic testing. Reduction in time to a correct diagnosis provides a major financial as well as a clinical benefit. In addition, reducing both overutilization and underutilization of laboratory tests while achieving the correct diagnosis is a major benefit to challenged healthcare budgets. One approach taken to achieve major savings in healthcare has been the creation of “Diagnostic Management Teams,” composed of experts in specialty areas of medicine who are primarily based in the clinical laboratory to advise physicians on the selection of only necessary tests and the interpretation of complex test results

Diet and Territory Size of Butterflyfish in Habitats with Varying Coral Cover and Composition

Given the highly stochastic nature of larval supply, coral reef fish may often settle in sub-optimal habitats with limited prey. This study examines the foraging and territorial habits of a coral feeding butterflyfish, Chaetodon baronessa, living in two contrasting habitats with markedly different coral prey. In exposed front reef habitats, where coral prey was highly abundant, C. baronessa was highly selective in its choice of prey and aggressively maintained small territories. In contrast, in back reef habitats where coral prey was scarcer, C. baronessa was more generalist in its choice of prey, and had larger territories that were only weakly defended. The contrasting habits of C. baronessa in different reef habitats are consistent with predictions of optimal foraging theory, in that dietary specialisation and territoriality are reduced to maximise food intake where prey is less abundant

Effective use of data analytics and its impact on business performance within small-to-medium-sized businesses

Business use of data analytics and its potential impact on firm performance have become topics of deep interest within both the business practitioner and academic communities. While previous research has demonstrated relationships between data analytics and firm performance in larger firms, there is limited research on whether and how data analytics is used within and impacts Small-to-Medium-sized Business (SMB) settings. Given the preponderance of SMBs within the US economy, and their contribution to employment and economic activity, it is important for SMB owners to understand what management practices lead to effective use of data analytics that in turn impacts SMB performance. Drawing upon the Resource-Based View (RBV) of the firm and prior empirical research on practices within large firms, this dissertation identifies the resources that are needed to form a Data Analytics Capability (DAC) and examines the relationship between the maturity of DACs and the extent of business value realized. The research model was tested using Partial Least Squares-Structural Equation Modelling (PLS-SEM) analysis of survey data gathered from a sample of 300 SMB firms in the US, complemented with qualitative interviews of SMB owners. The results provide evidence that a more developed DAC can lead to higher Data Analytics Business Value across business functions

Rosario Castellanos : precursora del pluralismo jurídico

1 archivo PDF (21páginas). fhquadragintaquattuorEn la novela, Oficio de tinieblas, de Rosario Castellanos, podemos encontrar un pluralismo jurídico, de tres órdenes jurídicos: el de San Juan Chamula, el de Ciudad Real y el de la Reforma Agraria federal. Rosario Castellanos ha anticipado como nadie la aceptación de de un pluralismo jurídico, al preparar, en nuestra conciencia estética nacional, la dialéctica de la lucha y la unidad de la cultura occidental y de la cultura indígena. Palabras clave: Pluralismo jurídico. Autonomía indígena. Opresión indígena. Resurrección de los ídolos. Cristo tzotzi

Community Change within a Caribbean Coral Reef Marine Protected Area following Two Decades of Local Management

Structural change in both the habitat and reef-associated fish assemblages within spatially managed coral reefs can provide key insights into the benefits and limitations of Marine Protected Areas (MPAs). While MPA zoning effects on particular target species are well reported, we are yet to fully resolve the various affects of spatial management on the structure of coral reef communities over decadal time scales. Here, we document mixed affects of MPA zoning on fish density, biomass and species richness over the 21 years since establishment of the Saba Marine Park (SMP). Although we found significantly greater biomass and species richness of reef-associated fishes within shallow habitats (5 meters depth) closed to fishing, this did not hold for deeper (15 m) habitats, and there was a widespread decline (38% decrease) in live hard coral cover and a 68% loss of carnivorous reef fishes across all zones of the SMP from the 1990s to 2008. Given the importance of live coral for the maintenance and replenishment of reef fishes, and the likely role of chronic disturbance in driving coral decline across the region, we explore how local spatial management can help protect coral reef ecosystems within the context of large-scale environmental pressures and disturbances outside the purview of local MPA management.Funding was provided by the Saba Conservation Foundation ((SCF), King Abdullah University of Science and Technology, The Australian National University and Australian Research Council. The funders had no role in study design and analysis, decision to publish, or preparation of the manuscript. Staff of the SCF were involved in data collection

Examining the Roles of Acculturative Stressors and Cultural Factors in Major Health and Safety Issues Among Hispanic/Latino Farmworkers

Statement of the problem: Hispanic/Latino farmworkers are at increased risk of adverse health and safety outcomes. Heightened levels of acculturative stress and the unique cultural characteristics and beliefs reported by this group increase workers’ vulnerability for adverse outcomes. Method: The first project consisted of a systematic review examining threats to the health and safety of Hispanic/Latino agricultural workers attributable to climate change, focusing specifically on their risk for heat-related illnesses (HRI) and cultural factors and beliefs increasing workers’ vulnerability for HRI. The second project was a secondary data analysis focused on identifying potential relationships between acculturative stressors, cultural factors, and workers’ recent utilization of healthcare services in the United States. The final project was an exploratory study identifying COVID-19 associated stress experienced by a largely foreign born group of Hispanic/Latino farmworkers in North Carolina. Like the preceding projects, this study focused on acculturative stressors and cultural beliefs potentially impacting workers’ experiences with COVID-19. Results: The first project determined that Hispanic/Latino farmworkers were indeed at increased risk for HRI. Workers occupational safety behaviors were informed by common cultural beliefs and misconceptions, increasing workers’ risk for HRI. The second project found that there were statistically significant associations between the outcome, workers’ recent utilization of healthcare services in the United States, and the predictors foreign-born status, migrant worker status, work authorization (legal work authorization versus undocumented status), reading English language proficiency, and gender. The third project found that Hispanic/Latino farmworkers surveyed struggled with some level of COVID-19 stress with roughly half of participants reporting concerns about their ability to provide for and see family members as a result of COVID-19. Conclusion: This dissertation identified a number of cultural factors and acculturative stressors impacting Hispanic/Latino farmworkers’ health. Overall, the findings of this dissertation support the need for further research on the relationships between acculturative stressors, cultural factors, and health behaviors among Hispanic/Latino farmworkers. These relationships should be important considerations in research concerning Hispanic/Latino farmworkers

Controversies in medicine: Thyroid nodules ‘‘head or tails’’

Undoubtedly, thyroid nodules are one of the most common pathologies a physician faces in clinical practice. Not only the endocrinologist, but also the internist and the first contact physician, this situation obeys to the fact that this thyroid gland alteration is highly prevalent amongst the general population. Statistics on the prevalence of this pathology vary from series to series. However, the numbers indicate that between 4% and 7% of the general population present one or more nodules on their thyroid and, as in all diseases related to this organ, they are more frequent in female

Determinates de la competitividad

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