Internationally, healthcare systems are moving towards delivering care in an integrated manner which advocates a multi-disciplinary approach to decision making. Such an…
Internationally, healthcare systems are moving towards delivering care in an integrated manner which advocates a multi-disciplinary approach to decision making. Such an approach is formally encouraged in the management of Atrial Fibrillation patients through the European Society of Cardiology guidelines. Since the emergence of new oral anticoagulants switching between oral anticoagulants (OACs) has become prevalent. This case study considers the role of multi-disciplinary decision making, given the complex nature of the agents. The purpose of this paper is to explore Irish General Practitioners’ (GPs) experience of switching between all OACs for Arial Fibrillation (AF) patients; prevalence of multi-disciplinary decision making in OAC switching decisions and seeks to determine the GP characteristics that appear to influence the likelihood of multi-disciplinary decision making.
A probit model is used to determine the factors influencing multi-disciplinary decision making and a multinomial logit is used to examine the factors influencing who is involved in the multi-disciplinary decisions.
Results reveal that while some multi-disciplinary decision-making is occurring (64 per cent), it is not standard practice despite international guidelines on integrated care. Moreover, there is a lack of patient participation in the decision-making process. Female GPs and GPs who have initiated prescriptions for OACs are more likely to engage in multi-disciplinary decision-making surrounding switching OACs amongst AF patients. GPs with training practices were less likely to engage with cardiac consultants and those in urban areas were more likely to engage with other (non-cardiac) consultants.
For optimal decision making under uncertainty multi-disciplinary decision-making is needed to make a more informed judgement and to improve treatment decisions and reduce the opportunity cost of making the wrong decision.
The process of capturing object form through surface data sampling and generating a CAD model of the part is termed reverse engineering because the process is the opposite…
The process of capturing object form through surface data sampling and generating a CAD model of the part is termed reverse engineering because the process is the opposite of the normal design and manufacturing sequence. In the context of general manufacturing methods, reverse engineering is an important process for instances where a product initially exists as a designer’s model in a medium such as styling foam or modelling clay. The digitisation process can be achieved through spatial measurements taken manually by a co‐ordinate measuring machine (CMM). However, 3D computer vision systems are now being applied to the reverse engineering task owing to their ability to rapidly digitise the more intricate and free‐form surface patches that are common in many modern consumer items. New modelling software reduces the large number of data points into a more manageable number which can be translated into CAD drawings. The CAD drawings permit generation of CNC machine tool cutter paths or production of stereolithography “masters”.
An optical roughness sensor is described that is ideally suited for integration with a co‐ordinate measuring machine (CMM). The CMM provides an extremely stable platform…
An optical roughness sensor is described that is ideally suited for integration with a co‐ordinate measuring machine (CMM). The CMM provides an extremely stable platform for moving the sensor head over the surface specimen. The sensor consists of a fibre optic head, data processing electronics and software for controlling the sensor and calculating surface texture parameters from the sensor’s data. The software controls the data acquisition process, filters the data to remove sensor noise and calculates basic amplitude parameters that describe the texture profile of the surface. Tests have been conducted on surfaces and the results compared with stylus profilometer measurements on the same surface regions. Comparison of the amplitude parameter, Ra, shows differences of between 3 percent and 8 percent across the sample set for profiles in the 0.4 μm Ra range.
The paper outlines a new approach for positioning a patient on the treatment table for radiation therapy sessions. The vision approach utilizes lasers and cameras for…
The paper outlines a new approach for positioning a patient on the treatment table for radiation therapy sessions. The vision approach utilizes lasers and cameras for positioning and has several advantages over the conventional methods.
The positioning is accomplished by comparison of a set of computed tomography (CT) contours (acquired from the patient) with a set of corresponding contours acquired by a 3D vision system from the same region of the patient's body. The overall positioning error calculated by the iterative closest point algorithm is used to reorient the treatment table. Various issues related to the acquisition and generation of the 3D spatial data are discussed.
Positioning is accurate and can detect small movement in the patient's position.
Testing was done on a cast of a human torso and additional testing is required on in a hospital environment to fully test the efficiency of the approach.
The method merges data readily available from standard CT imaging systems and 3D imaging systems. Therefore, the additional hardware requirements are minimal. The system integrates well with existing hardware, software and treatment practices.
The method introduces a new approach to patient positioning employing a combination of sensor technologies. The approach is accurate, reliable, consumes less time and most importantly prevents the use of X‐rays for patient positioning.
Suggests that the population of the EU will still need drugs whether or not the EU continues to have a pharmaceutical industry. Various policies trying to control health…
Suggests that the population of the EU will still need drugs whether or not the EU continues to have a pharmaceutical industry. Various policies trying to control health service drugs bills have affected the drugs industry: increasingly the effects are adverse. The EU Commission is now taking an increasing interest in health care and pharmaceutical industry policy. It is therefore of some urgency to open the debate up by beginning to signal what the EU stands to lose if it loses the pharmaceutical industry in the EU. Although it is highly improbable that the EU will lose all the present pharmaceutical industry in the EU it is likely that it will lose some of it in the next five years, and it is almost certain that the industry in the EU will continue to yield with respect to industry in North America, the Pacific Basin and Asia.
Planning processes for the operations of entire supply chains require examination because business competition demands coherent strategies from them. Research into…
Planning processes for the operations of entire supply chains require examination because business competition demands coherent strategies from them. Research into processes for strategic operations planning has defined the steps and procedures required. Some research has partially addressed planning processes for integrated supply chains. The present research begins to specify a process and investigate how a team of managers from the companies in a supply chain can be helped to formulate strategic plans for operating the whole chain, to benefit each company and to benefit the whole chain. Building on previous research, this theoretically‐based paper proposes a framework to enable such a process. This chain‐wide planning process is illustrated in an Australian meat processing supply chain, with encouraging results.
A typology of interventionism can categorize regulations, taxes, and subsidies both theoretically and as they sequentially unfold in practice. This typology is inspired…
A typology of interventionism can categorize regulations, taxes, and subsidies both theoretically and as they sequentially unfold in practice. This typology is inspired by, but broader than, the Mises interventionist thesis, which, similar to Madison's lament, recognizes the propensity of intervention to expand from its own shortcomings in the elusive quest to achieve economic rationality (Lavoie, 1982, p. 180; Ikeda, 1997, pp. 41–46; Bradley, 2006).