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At least 19 recordsLinked to original sources
PubMed1978

[The influence of different straw-based ration type on fermentation and production of volatile fatty acids in the rumen of lactating cows. 3. Rumenal fermentation processes and milk yield criteria after using a low-fiber straw pellet batch as basal ration component and a fully pelleted straw-based ration].

Lactating Black-Pied (DSR) cows were used to study, over a period of 100 days, the influence of different basal ration types (I-treated wheat straw pellets, low-fibre; II- monodiet pellets containing 48% of wheat straw; III = conventional rations based on fresh forage and arable root crops) on the molar fermentation pattern and the daily rate of VFA production and some milk yield criteria. Ration types I and II results in almost equal fermentation patterns of the VFA; as against the conventional ration types (III) a significantly higher molar acetate propertion as well as a highly significantly decreased molar proportion of iso-acids were found. The daily rated of VFA production relativated to energy intake were as follows (in the order of the ration types mentioned): 4.9, 4.2 and 5.0, and 3.3, 2.5 and 3.3 moles per 1,000 anergetic feed equivalents (cattle) after 30 and 100 days of feeding, respectively. In both trials, only about 80% of the relative VFA production of the straw pellet-concentrate (I) and conventional (III) ration types were found when feeding fully pelleted diets (II). On account of the relatively wide variation of the experimental results no statistically secured findings were obtained as to the milk yield criteria, but ration type II produced some 200 and 300 kg milk less thant ration types I and III, respectively, during the 100-day experimental period.

Animal Feed↗
PubMed2000

[Determining priorities in German public health--triad between rationing, rationalization and rational allocation].

Is there a crisis of the German health system? Will necessary medical services be rationed? These or similar questions have been intensely discussed in the public ever since the realization of reforming the health system by the Red-Green coalition. Opposers of the health structure reform 2000 have especially regarded the global budget, which was meanwhile stopped by the Federal Council, as an enormous threat for a functionable health system. Many actors of the health system have uttered deep apprehensions regarding a reform of the health system. As various attempts of legal controlling have proved during the last ten years, it will be necessary in our society to negotiate the health services which we will be able to afford in future at which price, and which we want to realize. Even presently it is not possible to guarantee maximum medical care according to the latest technology. The future question in the german health care system will no more be whether it will be necessary to set priorities, but only how they will have to be established.

Cost Control↗
PubMed1996

The rationing agenda in the NHS. Rationing Agenda Group.

The Rationing Agenda Group has been founded to deepen the British debate on rationing health care. It believes that rationing in health care is inevitable and that the public must be involved in the debate about issues relating to rationing. The group comprises people from all parts of health care, none of whom represent either their group or their institutions. RAG has begun by producing this document, which attempts to set an agenda of all the issues that need to be considered when debating the rationing of health care. We hope for responses to the document. The next stage will be to incorporate the responses into the agenda. Then RAG will divide the agenda into manageable chunks and commission expert, detailed commentaries. From this material a final paper will be published and used to prompt public debate. This stage should be reached early in 1997. While these papers are being prepared RAG is developing ways to involve the public in the debate and evaluate the whole process. We present as neutrally as possible all the issues related to rationing and priority setting in the NHS. We focus on the NHS for two reasons. Firstly, for those of us resident in the United Kingdom the NHS is the health care system with which we are most familiar and most concerned. Secondly, focusing on one system alone allows more coherent analysis than would be possible if issues in other systems were included as well. Our concern is with the delivery of health care, not its finance, though we discuss the possible effects of changing the financing system of the NHS. Finally, though our position is neutral, we hold two substantive views--namely, that rationing is unavoidable and that there should be more explicit debate about the principles and issues concerned. We consider the issues under four headings: preliminaries, ethics, democracy, and empirical questions. Preliminaries deal with the semantics of rationing, whether rationing is necessary, and with the range of services to which rationing relates. Under ethics and democracy are the substantive issues of principle and theory. The final section deals with empirical questions and those relating to the practicality of various strategies.

Attitude to Health↗
PubMed1976

Ration digestibility and mineral balance in lactating cows fed rations containing dried whey.

Including dried whey in rations of nonruminants usually increases digestibilities and mineral retention, presumably because of the lactose in the whey. A trial with total collection had five lactating cows per treatment to determine the effects of 5% dried whey product in the concentrate on digestibility of the ration and on absorption and retention of calcium, magnesium, and phosphorus. Rations included corn silage ad libitum, 3 kg alfalfa hay, and either control or dried whey product in concentrate ration at 1 kg/3 kg milk produced. Rations were balanced for content of nitrogen, calcium, magnesium, and phosphorus. Digestibilities of dry matter, nitrogen, and energy were not increased with dried whey product in the ration. Apparent absorption of calcium, magnesium, and phosphorus was not affected significantly by inclusion of whey in the ration. Productive (milk plus retained) calcium and magnesium were not increased when dried whey product was in the ration although productive phosphorus was slightly higher with the dried whey product. Adding small amounts of dried whey to a ruminant's ration will not increase mineral absorption and retention probably because tthe lactose in dried whey is fermented in the rumen and unavailabe for aiding absorption from the small intestine.

Animal Feed↗
PubMed1995

Dilemmas in rationing health care services: the case for implicit rationing.

With tension between the demand for health services and the cost of providing them, rationing is increasingly evident in all medical systems. Until recently, rationing was primarily through the ability to pay or achieved implicitly by doctors working within fixed budgets. Such forms of rationing are commonly alleged to be inequitable and inefficient and explicit rationing is advocated as more appropriate. Utilisation management in the United States and quasi-markets separating purchasing from provision in the United Kingdom are seen as ways of using resources more efficiently and are increasingly explicit. There is also advocacy to ration explicitly at the point of service. Mechanic reviews the implications of these developments and explains why explicit approaches are likely to focus conflict and dissatisfaction and be politically unstable. Explicit rationing is unlikely to be as equitable as its proponents argue and is likely to make dissatisfaction and perceived deprivation more salient. Despite its limitations, implicit rationing at the point of service is more sensitive to the complexity of medical decisions and the needs and personal and cultural preferences of patients. All systems use a mix of rationing devices, but the clinical allocation of services should substantially depend on the discretion of professionals informed by practice guidelines, outcomes research, and other informational aids.

Disclosure↗
PubMed1993

Exploring the relationship between rationality and bounded rationality in medical knowledge-based systems.

If our goal in Artificial Intelligence in Medicine (AIM) is to engineer systems health-care providers will both use and, in the process, improve their performance, we must concentrate on the development of causal theories of knowledge and problem solving. One broad direction in pursuing this goal is understanding the relationships between existing models of rationality and bounded rationality for similar tasks. Models of rationality refer to those approaches in which the optimal properties of the models are deductively provable, i.e. in which the processing is rational. Representative models of rationality used in AIM are deductive logical models, statistical models such as Bayesian inference models, and decision-analytic models. Models of bounded rationality are those which do not guarantee such optimal properties nor yield to deductive correctness proofs. These models have their roots in cognitive psychology. In this article we show how explicating the relationship between models of rationality and bounded rationality might be done in the case of abductive tasks in medicine. This is done by positioning these modeling approaches within the same framework (an abstract computational model) and interpreting in this context both computational complexity results concerning the nature of the task and empirical results studies of human problem-solving behavior.

Artificial Intelligence↗
PubMed1995

Rationing health care: from needs to markets? The politics of destruction: rationing in the UK health care market.

Rationing health care is not new. As governments world wide struggle to contain the costs of health care, health policy analysts debate how rationing should be done. However, they too often neglect how the mechanisms for funding and allocating health care resources are themselves vehicles for rationing treatment. In the UK, where health care rationing debates currently abound, there has been no formal evaluation of the role of the market in allocating scarce health care resources. The market in health care has increased administration, fragmented services, eroded local accountability, and decreased choice. This fragmentation, and the associated competition between purchasers and providers, means that resource allocation can no longer be monitored and evaluated in a national context. The loss of a population focus has left a vacuum in planning. Services cannot be planned rationally, and so are not able consistently to avoid duplication or to respond cogently to estimates of need. The loss of accountability means that decisions about the allocation of health care resources are no longer open to scrutiny by local people. Increasingly, especially in social and long term care the cost of care is being transferred to the individual. The new mechanisms for resource allocation are distributing resources unfairly: away from the poor, the sick and the elderly. The great myth of the market is that it has enabled decision-making to become explicit. This is not the case. To make health care resource allocation appear rational and acceptable to the public, health authorities have resorted to exercises in consumer consultation, and value laden guidelines where clinical cloaks are used to disguise political decisions on funding. In the UK, until the true role of the internal market is acknowledged, myths and subterfuge will conceal the winners and losers in the new system of rationing health care.

Decision Making, Organizational↗
PubMed1980

Woodpulp fines or corn silage as roughages in complete rations or a pelleted complete ration for young dairy replacements from birth through 18 weeks of age.

Holstein calves, 18 females and 12 males, were assigned randomly to 10 blocks of 3 calves each by sex, and within each block were assigned randomly to one of three experimental rations. All calves received sour colostrum from day 1 through day 35. The respective dry rations were offered beginning at day 8. The three rations consisted of (dry basis): 1) 11% woodpulp fines and 89% concentrate; 2) 33.7% corn silage and 66.3% concentrate; and 3) a commercially available pelleted complete ration. From birth through 8 wk, calves fed woodpulp gained more weight than those fed silage and approximately equal weight to calves fed commercial ration. From 8 through 18 wk. calves fed the latter gained more weight than other calves. Dry matter intake followed the same order as weight gain. Blood samples were obtained biweekly beginning with the 2nd wk from the jugular vein of each calf. There were no differences in glucose 2 through 18 wk. Urea nitrogen of plasma was greater in calves fed commercial ration than in other calves in six of the sampling periods. Calves fed silage had more urea nitrogen in plasma than calves fed woodpulp for three of the sampling periods. Rumen tissue from male calves at 18 wk fed woodpulp showed the most normal appearance in papillae color, density, and length. Calves fed silage had rumen tissue showing short, black, nodular papillae. Calves fed commercial ration showed long, branched, necrotic papillae that were keratotic and loosely attached.

Animal Feed↗
PubMed1978

An evaluation of rational-emotive imagery as a component of rational-emotive therapy in the treatment of test anxiety.

This study evaluated the efficacy of rational-emotive imagery as a component of rational-emotive therapy in reduction of college students' test anxiety. 11 volunteers met for 6 1-hr. group treatment sessions over a 3-wk. period. After 2 initial treatment sessions subjects were randomly assigned to groups given either rational-emotive therapy with rational-emotive imagery or rational-emotive therapy without imagery. Contrary to predictions, improvement between groups on self-report and performance measures was nonsignificant. Failure to obtain differences was attributed to similarities in content of treatment sessions and short treatment time. Combined groups reported significant improvement on all dependent measures. Although the study did not yield the predicted benefits of the imagery, results lend further support to the efficacy of rational-emotive therapy procedures in the reduction of test anxiety.

Adolescent↗
PubMed1992

Symbols, rationality, and justice: rationing health care.

Proposals to ration health care in the United States meet a number of objections, symbolic and literal. Nonetheless, an acceptance of the idea of rationing is a necessary first step toward universal health insurance. It must be understood that universal health care requires an acceptance of rationing, and that such an acceptance must precede enactment of a program, if it is to be economically sound and politically feasible. Commentators have argued that reform of the health care system should come before any effort to ration. On the contrary, rationing and reform cannot be separated. The former is the key to the latter, just as rationing is the key to universal health insurance.

Health Care Rationing↗
PubMed1990

[Measuring energy turnover in the adult swine during feeding of rations with potato starch, potatoes, beets, pressed shreds and coarse fodder as supplements to a basic ration. 1. Energy turnover and energy utilization].

25 rations with a wide variation of the content of various carbohydrates (crude fibre 36-185; water-soluble carbohydrates 25-306, starch 272-683 g/kg DM) were fed to male castrates (n = 8) of a live weight between 90 and 180 kg, and energy metabolism was measured. The rations were composed of a cereal basic ration and various feed-stuffs (potato starch-raw and soaked) potatoes (raw and steamed), sugar beet and products from it, maize pellets, dried roughage lucerne, clover, lupin, grass, rye straw meal) as supplements. The digestibility and metabolisability of the energy of the rations ranged between 88 and 62 or 86 and 60% resp. Between 2 and 4% of the consumed energy were lost in urine. The partial utilization of the metabolizable energy of the rations varied between 80% (processed supplement of potato starch) and 52% (supplement of rye straw). The rations with supplements of dried roughage were relatively well energetically utilized-between 63 and 70%. A regressively calculated difference of 17%-units was regressively calculated between the utilization of metabolizable energy of either precaecal or postileal origin.

Animal Feed↗
PubMed1980

Woodpulp fines or corn silage as roughages in complete rations or a pelleted complete ration for young dairy replacements 18 through 36 weeks of age.

Twenty-eight Holstein calves were fed one of three experimental diets from 18 through 36 wk: 1) 50% woodpulp fines, 25% corn silage, and 25% concentrate; 2) 75% corn silage and 25% concentrate; and 3) a commercially available, pelleted, total calf ration. The first two rations were equivalent in roughage, vitamin, and mineral content, and all three rations were equivalent in crude protein. Average daily gain (kg), dry matter intake (% of body weight), and feed/gain for calves fed the three rations were .92, 2.42. 6.28; 1.10, 2.29, 4.07; and 1.12, 3.16, 6.73. Glucose (mg/100 ml), urea nitrogen (mg/100 ml), and B-hydroxybutyrate (mg/100 ml) in plasma from calves at 23 wk were 72.0, 5.2, .7; 72.5, 5.1, 1.9; and 82.4, 12.3, .8. The amount of butyrate (% of total), acetate/propionate, and pH of the rumen fluid from calves at 23 wk were 6.31, 2.79, 6.99; 11.74, 2.76, 7.05; and 9.89, 2.04, 6.73. Papillae length (cm) and density/cm2 ofa the rumen tissue from male calves by biopsy were: 1.83, 48.5; 2.12, 67.1; and 2.12, 27.6. Corn silage and woodpulp fines or corn silage alone can be fed to dairy calves in complete rations with satisfactory results from 18 to 36 wk of age. Additional experimentation is required to optimize quantities and proportions of these roughages in complete rations for young heifers.

3-Hydroxybutyric Acid↗
PubMed1984

[Concentration of ammonia in the urine of dairy cows given green feed rations and winter feed rations].

The concentration of ammonia in urine at a known level of energy yielding nutrients offered in feed rations was determined in 987 dairy cows in four summer feeding seasons and 1420 cows in three winter feeding seasons. The long-term average ammonia levels in urine showed no significant variation with the two types of feed rations. Different feed rations in the feeding seasons had no significant influence on ammonia concentration in the urine of lactating cows. On a long term-average as well as in the overwhelming majority of the winter and summer feeding seasons, high-pregnant cows had significantly higher ammonia contents in urine than the cows in the first and second lactation stage. At feeding rations complying with Czechoslovak Standard CSN 46 7070 the content of ammonia in the urine of lactating cows was lower than the recorded long-time averages and averages for individual stages; on the other hand, in high-pregnant cows the ammonia level was higher in both types of feed rations and the difference from lactating cows increased 3.25 times. This suggests that neither do the feed rations currently used in practice nor those strictly adhering to the Czechoslovak Standard meet the biological demand of high-pregnant cows and often lead to the injury of hepatal parenchyma. Ammonia concentration of 11.7 to 58.7 mmol per litre of urine is considered as a tolerable limit.

Ammonia↗
PubMed2003

The ART of rationing--the need for a new approach to rationing health interventions.

A key element in dealing with HIV/AIDS in South Africa depends on the resolution of the antiretroviral therapy (ART) paradox: while a universal First-World-style ART programme is unaffordable, a rationed treatment programme that includes ART is not only affordable but also vital for basic human rights reasons, to enhance prevention efforts and to keep the fabric of society together. Our recent paper on ART demonstrated how such a rationed programme would be both affordable and highly cost-effective. Traditional rationing mechanisms are unable to provide sufficient guidance as to how to go about this novel form of rationing. An alternative rationing mechanism is therefore proposed which seeks to balance ART in terms of three primary dimensions: total resource allocation to treatment, design of the treatment intervention, and setting targets on numbers to treat. Two secondary dimensions, related to total HIV and social spending, deserve equal attention. The current global context that precipitates and exacerbates the parallel contouring of disease burden and poverty should be constantly challenged.

Anti-HIV Agents↗
PubMed1976

[Protein utilization of mixed feed rations in the lactating pig with reference to the essential amino acid content of the feed proteins. 1. Report. Description of the study methods for protein utilization in the use of peanut extraction residues and dry skim milk in the ration].

A method is discussed which has been used to investigate protein utilization in lactating sows. Two N balance trials were carried out to establish the degree of protein utilization of mixed feed rations. The rations contained barley, oats and flaked potatoes. Extracted pea nut meal or, for comparison, dried skim milk, were added as protein sources. The average biological value achieved was 42% if extracted pea nut meal was fed and 59% if dried skim milk was added. The corresponding PPV data were 33% for the rations containing extracted pea nut meal and 49% for the dried skim milk rations. Balances made for the rate of dietary amino acid intake and amino acid excretion in the milk showed that lysine deficiency occurred when rations were fed containing the extracted pea nut meal.

Amino Acids, Essential↗