Federal Micro and Macro management of Health Systems Part 2

December 19th, 2009

Actions on the management of the establishments – middle management

The autonomy of the service providers together with the strengthening of its capacity management will together with the changes in forms of professional work, the way reform is operational.
The autonomy and management capacity can be increased in many different ways and at present can not speak of an optimal model for facilities management health, as there is the model optimal care. Any legal formula can be useful depending on the environment in which to develop and all organizational alternatives may be valid. The partnerships between various public bodies or private transfer of the management public assets to private entities, the delegation of powers to Public institutions can serve as examples, but each country can find appropriate formulas to apply health which probably already being used in other sectors.

Organizational needs of the services rapidly changing function of the changes in the demographic and epidemiological population profile, medical technology and communication and conceptual changes in the forms of care. The practical effect is, however, much slower because it is conditioned by infrastructure existing the knowledge and skills the human resource and capacity constraints investment the countries.

Understanding the needs of the people, separation of duties, management autonomy and the availability of different mechanisms of purchase of services that have been described in the macro should be used to carry out diverse experiences in the service organization to allow adaptation to different environments.

Management actions on the care process: micro

It’s called micro – the set of tools and techniques to analyze clinical practice from perspective of efficiency. It is probably the least known area of management and applied in Latin America. The most relevant decisions health systems are taken the health professionals, especially the physicians, direct care users and services at this level makes most of health spending. Investigations into variability in clinical practice show that doctors make decisions based, in large part, scientifically unproven belief that using inadequate resources for this cause can be very important. This is due mainly the high level of uncertainty surrounding medical decisions: on the diagnosis and information provided by the further examination of the efficacy and effectiveness of treatments and their timing. Clinical management tries to reduce inefficiencies due to these causes and involve medical management resources.

Federal Micro and Macro management of Health Systems Part 1

December 18th, 2009

Shares of improving the management of the health systems can be classified into three levels: actions about the bodies of the system, grouped under the name macro; actions on facilities providing health services or middle management and actions on the process of health care or micromanagement. The improved system performance will be achieved with the combination of three levels auctions. The management changes should be strongly targeted major objectives of health systems (population coverage, improving equity, increasing allocative efficiency, containment of spending growth health), So that they are real instruments for achieving themselves.

Changes in management of system without clearly defined objectives will lead you in the direction of groups with higher wishing pressure capability, regardless of what these changes are.

Actions on system management: macro

The health systems of Latin America need to increase coherence between supply and services needs of the population (overlapping partially with the demand expressed). Therefore, the planning based on these needs to be reinforced. The definition of priorities, performance guaranteed baskets of services or any other form of marking the supply of system must be following the study of population needs and developing health plans.
The ability to regulation the system must adapt to induced reforms changes. The regulation is quite simple in the integrating systems from providing financing to services in a single organism, but its complexity increases rapidly with separation measures functions and decentralization. The relationship between changes and regulatory capacity and as increased costs and management information that it produces, it must be carefully valued.

The implementation of allocation mechanisms financial resources consistent with the goals organization is probably the most powerful incentive is the lead financier for the production of the health establishments. In order to allocation mechanisms work properly it is necessary that the allocator and the service provider is independent and therefore there is an organic separation or functional procurement functions and service provision. This separation has an additional two positive effect: buyer and supplier organizations have different objectives, competitive among themselves, which encourage efficiency in both. The buyer wants to maximize the delivery of services to the insured resources available, while supplier will produce services they have purchased with minimum consumption of inputs. This is a cultural change of great importance within the systems coming from a model of vertical integration of functions.

Rare Cancer of the Ovary is One of the Most Serious Gynecological Cancers

December 12th, 2009

Although it is rare, ovarian cancer tends to recur and to be very difficult to handle. Faced with this evil woman, therapeutic vaccination is a groundbreaking approach brings high hopes.
Is ovarian cancer relapse formidable vaccine contra les recidivist ovaries cancer?

The ovarian cancer is rare: there are about 4 500 new cases diagnosed each year in France, but in the same 3500 women die. The mortality rates approaching 75% in fact the most serious of gynecological cancers. He represents the 5th cause of cancer death in women. The average age of onset is 60 years with a peak incidence between 75 and 79 years, but it can reach younger women or girls.

5 to 10% of cases are genetic in origin, found in families with a gene predisposing Mutated BRCA1 or BRCA2. Despite effective treatment, a screening often delayed due to the discretion of symptoms, largely explains the very poor prognosis of this cancer. The treatment is both surgeries, in order to completely remove the tumor, chemotherapy, associating carboplatin and paclitaxel infusion of 6 courses.

Despite the excellent results of this first line therapy, the problem remains high recurrence rate. Women who suffer from cancer at late stage are put into complete remission in 80% of cases but 75% of them relapse after an average 16 to 18 months. “Treatment of relapse has progressed,” says Professor Pujade-Lauraine, chief of medical oncology at the Hotel-Dieu. “However, the median survival does not exceed 3 to 4 years, which is particularly disappointing, especially compared with the percentage of patients in remission initially” he added. “The challenge today is to develop a treatment subsequent to first-line treatment, may prevent relapse” said Professor Jacques Dauplat, chief of surgical oncology center Jean Perrin1.
An original therapeutic approach: immunotherapy

All tests for years with conventional treatments are improving the rate of relapse, ended in failure. A totally new approach to treatment is a therapeutic vaccine that would prevent recurrence after initial successful treatment. The principle of this approach immunotherapeutic based on injection of a molecule called Abagovomab patients suffering from ovarian cancer. The vaccine stimulates the immune system of women so that it selects and destroys tumor cells to prevent tumor recurrence. Focus on principle rather conventional Vaccine:

* This molecule is an antigen designed to resemble the CA125 antigen, a protein found in large quantities on the surface of tumor cells in ovarian cancer. The Abagovomab is nevertheless sufficiently different from the CA125 in order to induce, once injected, the immune response of the patient against him, and thereby against the CA125 antigen, very close.

* A classic immune response occurs when: the antibodies induced by the patient specifically recognize antigens CA125 in the tumor cells and bind to leading, ideally elimination of tumor cells carrying the antigen, now recognized as foreign. If the system works in practice is therefore the patient herself who synthesizes antibodies eradicating the tumor. Thanks to the vaccine based Abagovomab, the immune system should be able to recognize and attack tumor cells that have the protein CA125.

This could bring hope that the immune system starts to fight all residual tumor cells and that they succeed and to prevent any recurrence of the disease. “The medical community has great hopes on the immunotherapy. She hopes treatment that will prevent recurrence often fatal cancer of the ovary, “said Professor Pujade-Lauraine.
Ovarian cancer: an international study on a vaccine

Driving in 9 countries, the clinical MIMOSA2 testing the effectiveness of the vaccine based Abagovomab.

Launched in 2006 by Menarini pharmaceutical group, this trial represents the first phase III study of this size, to test the Abagovomab in consolidation therapy in women with ovarian cancer and who responded completely the first-line chemotherapy. The goal is to answer this question; does this vaccine capable of preventing the recurrence of high risk patients? Beyond this, the criteria are also studied overall survival, safety, treatment and duration of the immune response. France has since the end of 2008 among the countries involved.

The first results are expected in early 2011 and the final conclusions will be known in 2015. If Abagovomab meets these expectations, patients may fully benefit from the advanced first-line treatment in this disease and see their hopes of survival increased significantly in years to come.

Possible Link Between Deodorant and Breast Cancer

November 30th, 2009

I admit that this news surprised me, on occasion I have received emails which ensured that possibility, but had always considered a harmful propaganda operation by a particular brand of deodorant to another competition, so they do not given much credibility.

But a recent study by scientists from the Keele University raises the possibility that frequent use of antiperspirants antiperspirant effect promotes the occurrence of breast cancer, results have been published in the journal Journal of Inorganic Biochemistry.

In reaching this conclusion, the experts carried out with 17 women whom they had been subjected to a mastectomy finding in breast tissue high levels of aluminum, A substance that makes up 90 per cent of officers in most antiperspirants deodorants that try to avoid sweating. Moreover, increased concentration of this element was in the chest area near the armpit, which generally applies this type of product and where the majority of tumors detected in this class.

Although the study “only” has been conducted with 17 patients evidence as less worrisome results.

Effect of Deodorant on Mammogram

Effect of Deodorant on Mammogram

November 29th, 2009

A mammogram is an x-ray of the breast by small doses of X-rays can detect anomalies in the breast that the physician can not detect by self. Thanks to mammography, women around the world can prevent breast cancer by detecting early small tumors that cause the disease. Women who perform the mammogram regularly up to 50% have lower risk of dying from breast cancer.

For women, it is very important to periodically review their breasts to detect any mass strange that may appear. It is important to examine their breasts themselves, touching them to detect any anomaly. It also requires consideration by the same doctor if detected something. The mammogram should be performed usually after 40 years. Once do every two years, and after 50, once every year. It is important that all women do so, because mammography is the most accurate method to detect abnormalities early and reduce the risk of dying from breast cancer. In addition, women under 40 who have relatives history of breast cancer, mammography should practice for early detection of cancerous tumors that are more likely to have.

Before going to get a mammogram, women should take some precautions to avoid trouble or faults in the test. The First, talk to your doctor about all the information on the breast that might be important, as prior surgeries, hormone use, history breast cancer family, and so on. It is also important to have the exam or two weeks after your period, since otherwise the breasts could be very sensitive to this test. It is also good advice wear trousers or skirt for the day, as they discover the upper body that will be covered with a robe. A dress could be uncomfortable. Also, do not wear deodorant, talcum powder or lotion under the arms or in the breast, as they may alter the image of the test. Finally, if there is the first time that women were doing the test, it’s good to tell your doctor that you notice changes in your breasts and also take the exam earlier day.

At the time of mammography for breast cancer, a woman must answer some questions about your medical history and discover the top. The doctor may examine before to detect something that might appear on the exam. Then, a lead technologist for women versus equipment that emits X-rays each breast is placed on a special platform device connected to the computer that applies compression to the breast. Compression is necessary to reduce the thickness of the breast and show better all tissues, it is also important for a better image and reduce blur or dark areas caused by the higher tissues. It allows using small doses of X rays and can more easily detect breast lesions. The procedure performed with both breasts.

Mammography is essential to detect cancer early. There are small tumors that the physician can not detect except by this test. If it is detected early, and the tumor is small, the chances of get a treatment and cure are much greater than if the tumor is large and developed. The radiation has no effect in the woman’s body. However, mammography does not detect all cancers, so it is very important to combine these tests with periodic monitoring own physician�s patients.

Finally, it is important to know that you should not do this Review: Women who are pregnant, who are lovers and children 35, unless a family history of breast cancer. In addition, women should not undergo the test if 12 months have not passed after the last mammogram and it is important that women with implants, inform the doctor and they will need more pictures, in different positions, which the other women.

The Importance of Paternity Testing

November 28th, 2009

With the advent of advances and genetic testing, was the possibility of paternity testing. The advances that were made in paternity tests now allow them to be practiced in a more private, non-intrusive and more conducive to the collection of samples. No matter what the reason you want to perform a paternity test, they are now so simple to perform, such as specially designed to obtain swabs for cheeks that can be used in the privacy of your home. The test to determine paternity is highly accurate and the procedure for their use is becoming easier to perform.

The new collection methods (such as saliva samples and swabs of cheek) also will provide you with cheaper alternatives were compared with those available in the market a while back. Genetic testing for paternity is not currently covered by health insurance from Medicaid or other coverage, since it is not considered a medically necessary procedure. You still could get him sent to a DNA test done free.

Reasons for Using a DNA Paternity Test
If there are any kinds of doubt relating to the identification of the true father of the baby, the DNA test during pregnancy could solve this problem. This test could give you peace of mind to you and all the people involved and interested in the topic. A DNA test usually has 99% accuracy with respect to the fact to establish paternity of a person.

Child Custody or Support of It

In order to establish the conventions related to child custody, would be necessary to confirm previously paternity in a court of law. This legal action is especially used in cases which should establish custody of children born from extramarital affairs. For parents who should provide support to their minor children, paternity testing will help them be more confident and thus able to verify conclusively if they were truly the biological parents of the same. Through this trial, the father of the child’s paternity could ensure and give your son or daughter, as is the case, the necessary financial assistance.

Life Insurance Policy and Heritage

Some insurance companies will ask for paternity testing to ensure that it has been medically proven that the child will be getting benefits really had a biological relationship with the father.

Adoption

Adoption agencies will ask for paternity testing to establish its records all information related to the child’s parents or the child, as was the case.

Prenatal Tests

Depending on the stage of pregnancy where you are, you can choose between two prenatal paternity tests available today. One is the Chorionic Villi Sampling (CVS), which may be carried out during weeks 10 to 12 of your pregnancy. To perform this procedure should take a sample of chorionic villi that form the placenta and then, in turn, will take a sample of the father to determine if both agree. The other paternity test is amniocentesis, which may be made from week 12 to week 21 of pregnancy, and in order to do should be withdrawn only a small amount of amniotic fluid surrounding the placenta.

Such procedures shall be conducted in a hospital and DNA samples will be sent to a genetic testing laboratory that specializes in conducting and analyzing paternity testing.

Postnatal Test

To perform this test, should take samples from all parties involved: the mother, father and child, as the case. In the past, blood samples were taken to determine blood of humans, but the same inconclusive threw evidence because rarest blood groups were shared by at least 10% of the population. Currently available DNA tests far more sophisticated and precise, among which may include blood tests, samples of saliva, cheek swabs and samples taken from different tissues. These methods have enabled paternity tests became much more accessible financially, compared to only blood test that was available until some time ago.

When I Perform a DNA Test During Pregnancy

November 26th, 2009

The DNA of the children have many clues about the information that the child will be born. These clues can be discovered and the information extracted by performing a DNA test during pregnancy. The advance of technology has yielded a DNA test of the child, even before he is born.

A DNA test is performed during pregnancy for fetal DNA testing. Among the many reasons why a DNA test of the fetus may be necessary, is proof of paternity. Other reasons include evidence of abnormalities and inherited genetic diseases. A DNA test can be done fetus during pregnancy, during the period of 10 to 24 weeks after conception. The sample collection method is different for different ages of the developing baby.

If your pregnancy is between 10 and 13 weeks after conception, the method used to collect the DNA sample is chorionic villus sampling. In this procedure, the doctor inserts a thin needle or tube, guided by ultrasound into the uterus through the vagina and cervix to obtain a sample of chorionic villi. The sample obtained will be tested.

If you are between 14 to 24 weeks of pregnancy, the method used to collect the sample from the baby will be done by amniocentesis. This procedure also involves inserting a needle into the uterus. In this procedure, the needle is guided by ultrasound and inserted through the abdomen to remove a small amount of amniotic fluid. The child’s DNA test will be conducted with this sample of fluid.

If more than 24 weeks of pregnancy, the risk of harming your baby while making the collection of the sample for the test is significant. So, doctors advise waiting until your baby is born to test. After the birth of her baby, several methods can be used to sample the baby.

When the paternity of her child is in doubt or if you want to be a hundred percent sure who the father of your child, you can perform a DNA test to confirm or deny the doubts.

If you are doing DNA testing of her fetus solely for the purpose of establishing paternity, physicians should not encourage this test before having a child. This is because the sample collection methods pose some risk to the fetus. If you wait until your baby arrives, you can safely collect samples for the baby.

Although you can perform a DNA test during pregnancy, you should weigh the risks and benefits before deciding to continue his test.

Discover How to Make Weight Control For Health

November 26th, 2009

The healthy lifestyle and maintain a stable weight today is not an easy task. If we look around, we can easily notice the increases of overweight and obese. It was believed that obesity was the result lack of control food and was not considered an illness for many years.

Today, it has been proven that obesity is an illness that affects thousands of people worldwide. It has become a pandemic and common people including children with obesity increasingly.

Healthy weight control and avoid falling into severe essential malnutrition need a diet with high nutrition value, eating sufficient amounts and necessary to eat multiple times a day to maintain metabolism.

The weight should be controlled through healthy diet, which includes all food, proteins, carbohydrates and fats. Ideally for staying thin, it should be include lean protein in your diet, eating carbohydrates during the morning and not composite many ingredients. You should always opt for a food packaging group of proteins and carbohydrates which ESOG freely. You should not combine more than one group of food that most of protein or carbohydrate, than chose to eat them in your quantities portion.

Finally, do not forget to include fiber in your daily diet to maintain a healthy balance and achieve a slim body and beautiful. The fiber has miraculous properties to control weight because it helps to burn fat. You must to try including foods which rich in soluble and insoluble fiber for grease absorption. You can also opt for fiber tablets before each meal two or three ones.

Premature Aging from Tanning

November 24th, 2009

Premature Aging from Tanning

Every year the summer is time to remember the precautions to be taken before the rising temperatures, likewise to be brought to discussion the care must be taken with the hot sun and of course diseases that are related to skin and sunlight.

For several years, dermatologists and other specialists are talking about a disease that has been given for calling Tanorexia, the people who often suffer frequent customers of sun beds, seize every trip to the pool, beach or garden to lie in the sun, and UV rays seem to be their chief delight. To these people obsessed with the perfect tan is called Tanorexia.

The Tanorexia by the word so, tan meaning in English is a disorder whose existence is not one hundred percent accepted by the medical community, but it is increasingly common. “Over the past five years, have a golden skin tone has become a trend,” explains Javier Ruiz Avila, a member of the Academy and the Foundation for Dermatology. Now, who shows a permanent tan reveals a high status, and follow the stereotype of beauty and glamour.

The dermatologist said that this problem is more common in people with an average of 27 years, but cases are detected and adolescents from 14 or 15 years want to have brown skin, freckles on the chest and back, features, from his view of aesthetics are nice.

“Historically, many people have expressed discontent with their color. The whites want to be more �black�, brown pigmented want … “said the specialist Ruiz.

This problem of addiction tan occurs in both men and women. “To maintain that tone tan leather should be at least two or three times every 21 days, it is time that the cells reproduce and restore the natural tone,” said Javier Ruiz.

The proliferation of solariums and tanning beds are also a cause of Tanorexia. The dermatologist explained that treatments are becoming more accessible as there are packages that include from 14 to 16 sessions for the client to go regularly.

Previously, he said the dermatologist, these cases of cumulative sun damage were detected in persons 45 years or older and have now been found in teenagers, away from parental care, do not use blocking.

He added that so-called Tanorexia are very careful in the degree of tanning, because if it is excessive, the skin is burned badly, there is scaling and besides losing the “golden” desired, can come nasty stains.

A tan is unhealthy

As with anorexia Tanorexia are never happy with the color of dermis. The effort to reach his ideal of beauty comes to compulsive and severe degrees. As one who suffers from anorexia is always overweight, those with tanorexia are “not too tanned” or until pale, but are not.

In this process, you can invest much money and damage, perhaps irreparably, the skin around the body.

In 2006, a study by Wake Forest University Tanorexia left to see that, or people with obsession with tanning, may have this strong inclination because the UV rays will cause a pleasurable experience, as you would any other drug.

Exposure to radiation leads a moment of euphoria, because every time someone enters a sunning or solarium, your body produces endorphins that provide a sense of well being to ward off the pain.

“With several tanning sessions is a change in the synthesis of cellular regeneration called photo damage, and these people have more chance of getting cancer. In fact, with each exposure to sunlight is increased by 10 percent this possibility, “said Javier Ruiz.

According to information that given by the physician, from 2000 to date it have increased between 7.5 and 10 percent of cases of skin cancer. This disease, caused not only by sunbathing for aesthetics, but for field work, outdoor activities, etc.., In all cancers, ranks first in males and third in women.

A clear tan, Donatella Versace style, means cell damage. It is best to take the sun, blocking these rays do not make the mark. Faced with a problem like tanorexia or severe burns, there is no more than a specialist approach and treated immediately.

Symptoms tanorexia

Although features of the syndrome have not been officially described by the medical community, the most common symptoms are:

1. Intense anxiety if a session is lost.
2. Competition with people close to the skin get darker.
3. Chronic frustration regarding the color of their skin. The person is convinced that her dermis looks paler than it really is.
4. A tan is already surpassing normal expression shows very sharp lines, i.e. there is premature aging, the skin is dehydrated and needs more treatments and creams and there is rough texture.

More about this tanorexia

The term was adopted by the tanorexia similitude anxiety that occurs in anorexia nervosa, eating disorder characterized by a distorted body image and ideal beauty obsession.

In 2005, a group of dermatologists published a study showing tan addicts in a state out of control these behaviors were similar to those of smokers or alcoholics.

Realities of tan

* When the skin becomes golden hue is due to cell damage. This body is obscured to protect themselves. If it affects this, you may acquire skin cancer.
* 70% of wrinkles are by sun damage.
* In dermatology it is said that there is no healthy tan.
* Already there are creams of this type are less dangerous, because it has filtered ultraviolet lamps for the rays A, the most damaging.
* It is incredible that tanning beds are safer than direct exposure to the sun. They use UVA rays, related to melanoma, a dangerous cancer.
* Department of Dermatology Specialists Health System, University of Michigan warned that 80% of the damage caused by sun exposure (cancer, wrinkles, leathery skin and eye problems) occur before age 18.

You know if you like tan with frequency at least use some sunscreen to prevent further damage, remember that white boys are also attractive.

Carrot can Preventing Premature Aging

November 23rd, 2009

Carrot is a delicious vegetable with many benefits for our health, helping to preventing premature aging, high content of antioxidants and beta carotene. It also due to their high levels of beta-carotene helps to improve eyesight and prevent blindness. It is regarded as an elixir of youth, to help expel gallstones.

It has been shown that it is an antioxidant that protects the body from free radicals that attack the body’s cells and consequently produce degenerative diseases, some cancers and preventing premature aging. To get the most benefit you must eat the carrot crude but bare. For all this and more are considered to carrot as a natural cosmetic skin can rejuvenate and slow aging.

Recent studies have shown that has a natural toxin called falcarinol which can reduce the risk of developing cancer.

Folic acid is another component of the carrot which is essential to prevent anemia and helps reduce the risk of cardiovascular disease. Besides it helps the proper functioning of the digestive system and nervous system.