Science.gov

Sample records for nurse-based case management

  1. Effects of a 3-Year Nurse-Based Case Management in Aged Patients with Acute Myocardial Infarction on Rehospitalisation, Mortality, Risk Factors, Physical Functioning and Mental Health. A Secondary Analysis of the Randomized Controlled KORINNA Study

    PubMed Central

    Kirchberger, Inge; Hunger, Matthias; Stollenwerk, Björn; Seidl, Hildegard; Burkhardt, Katrin; Kuch, Bernhard; Meisinger, Christa; Holle, Rolf

    2015-01-01

    Background Home-based secondary prevention programs led by nurses have been proposed to facilitate patients’ adjustment to acute myocardial infarction (AMI). The objective of this study was to conduct secondary analyses of the three-year follow-up of a nurse-based case management for elderly patients discharged from hospital after an AMI. Methods In a single-centre randomized two-armed parallel group trial of hospitalized patients with AMI ≥65 years, patients hospitalized between September 2008 and May 2010 in the Hospital of Augsburg, Germany, were randomly assigned to case management or usual care. The case-management intervention consisted of a nurse-based follow-up for three years including home visits and telephone calls. Study endpoints were time to first unplanned readmission or death, clinical parameters, functional status, depressive symptoms and malnutrition risk. Persons who assessed three-year outcomes and validated readmission data were blinded. The intention-to-treat approach was applied to the statistical analyses which included Cox Proportional Hazards models. Results Three hundred forty patients were allocated to receive case-management (n = 168) or usual care (n = 172). During three years, in the intervention group there were 80 first unplanned readmissions and 6 deaths, while the control group had 111first unplanned readmissions and 3 deaths. The intervention did not significantly affect time to first unplanned readmission or death (Hazard Ratio 0.89, 95% confidence interval (CI) 0.67–1.19; p = 0.439), blood pressure, cholesterol level, instrumental activities of daily life (IADL) (only for men), and depressive symptoms. However, patients in the intervention group had a significantly better functional status, as assessed by the HAQ Disability Index, IADL (only for women), and hand grip strength, and better SCREEN-II malnutrition risk scores than patients in the control group. Conclusions A nurse-based management among elderly patients with

  2. Case management.

    PubMed

    Rosenstein, A H; Propotnik, T

    1997-03-01

    Providing cost-effective high quality healthcare services ranks as the number one concern for anyone involved with the healthcare delivery system. While quality of care should always be the number one priority, controlling healthcare costs receives most of the attention. With limited healthcare dollars and providers assuming more of the financial risk for services rendered, a whole assortment of cost-containment strategies are being introduced in an effort to maintain some semblance of financial viability. Healthcare providers can approach cost control from two different angles. On the fixed-cost operational overhead side, traditional cost-containment techniques have focused on downsizing, maximizing productivity, staffing redesign, improved purchasing contracts, standardization, inventory control, and other more individualized restructured service models. On the variable-cost clinical side, cost control has been approached by introducing a variety of cost-containment strategies designed to improve efficiency and effectiveness of provider performance. While many of these strategies, previously discussed in the Journal of Healthcare Resource Management have stressed the importance of education, guidelines, pathways, and other clinical "tools for improvement," the success of many of these tools resides in the ability to provide real-time intervention. Real-time intervention rather than the more passive retrospective variance analysis has the greatest potential for producing cost savings by actually making a recommendation that prevents the unwanted event from occurring. In many institutions, the case manager bears the responsibility for monitoring and managing these programs. This article describes various case management models currently used by different institutions. PMID:10166062

  3. Managing Case Managers: Case Management in Service Integration. Resource Brief.

    ERIC Educational Resources Information Center

    Marks, Ellen L.

    As the case management approach has become increasingly popular, a new phenomenon has emerged. A client may have several case managers, each employed by a different project, and these managers may not be aware of each other. The National Center for Children in Poverty has recently conducted research on case management in service integration…

  4. "Tuberculosis Case Management" Training.

    ERIC Educational Resources Information Center

    Knebel, Elisa; Kolodner, Jennifer

    2001-01-01

    The need to isolated health providers with critical knowledge in tuberculosis (TB) case management prompted the development of "Tuberculosis Case Management" CD-ROM. Features include "Learning Center,""Examination Room," and "Library." The combination of audio, video, and graphics allows participants to practice acquired skills in a simulated…

  5. Case Management Directors

    PubMed Central

    Bankston White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. This is Part 2 of a two-part article written for case management directors, particularly new ones. Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes. This article attempts to answer the following questions: Are case management directors prepared for an expanded role that affects departments and organizations outside of their own?How does a case management director manage the transition of care of patients while managing required relationships outside the department?How does the director manage program outcomes in such a complex department? Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Findings/Conclusions: Part 1 found that case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations

  6. Case Management Directors

    PubMed Central

    Bankston-White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care for patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. The purpose of this two-part article is to provide case management directors, particularly new ones, with a framework for understanding and fulfilling their role. We have divided the guide into seven tracks of responsibility. Part 1 discusses the first four tracks: (1) staffing and human resources, (2) compliance and accreditation, (3) discharge planning, and (4) utilization review and revenue cycle. Part 2 addresses (5) internal departmental relationships (organizational), (6) external relationships (Community agency), and (7) quality and program outcomes. Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems, and have frontline case managers reporting to them. Findings/Conclusions: Case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. New directors would benefit from mentoring and networking with one another. Implications for Case Management: As new regulations and models of care bring increased emphasis and focus to transitions of care, the role of the case management director continues to evolve, growing in importance and complexity. The growing financial impact of readmissions also brings added scrutiny and increased pressure to get the transitions of care right the first time. To operate most effectively, case management directors must understand the full range of their

  7. Case Management: A Resource Manual.

    ERIC Educational Resources Information Center

    Adams, Anne Thomas; Franklin, Sundra; Taylor, Rebecca

    This resource manual has been developed to assist both case managers and management staff in implementing a case management system as an infrastructure for delivering services that will facilitate the positive growth and development of youth and the achievement of individual and organizational performance goals. (The goal of case managers is to…

  8. What's funny about case management?

    PubMed

    Saxton, S E

    1997-01-01

    Humor is an effective tool to prevent and resolve burnout, a common problem associated with the practice of case management. Easily accessed by almost everyone, humor has many physiological and psychological benefits. The conscious use of humor in an organization requires a commitment at all levels in order for the organization to benefit as a whole. Offering formal seminars, using humor in company newsletters, and encouraging cartoon or joke sharing impacts on the physical and mental health of the employees. Techniques for bringing laughter to the workplace are outlined, as well as examples from the practice of case management. PMID:9335722

  9. Case Studies in Broadcast Management.

    ERIC Educational Resources Information Center

    Coleman, Howard W.

    This collection of case studies, based on factual situations which have challenged broadcast managers in recent years, is designed to stimulate thinking about and solving of "real world" problems in commercial radio and television operations. Topics of a serious, long-run nature include enlarging the radio audience; station revenue and economy;…

  10. Integrative Medicine and Case Management.

    PubMed

    Powell, Suzanne K

    2016-01-01

    The evolution of the integration of health care modalities has changed. The National Institutes of Health founded office of the National Center for Complementary and Alternative Medicine in the early 1990s to investigate integrative therapies through scientific research. In December 2014, the name and mission were updated to the National Center for Complementary and Integrative Health. Case managers, the coordinators of health care, must understand the changes to "integrative medicine" and the allure of the alternative modalities. PMID:27035081

  11. The impact of staff case manager-case management supervisor relationship on job satisfaction and retention of RN case managers.

    PubMed

    Hogan, Tierney D

    2005-01-01

    A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff. PMID:16205207

  12. 75 FR 27375 - Postal Rate Case Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... From the Federal Register Online via the Government Publishing Office POSTAL REGULATORY COMMISSION Postal Rate Case Management AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is seeking comments relevant to management of an anticipated exigent postal rate case. It...

  13. Case Studies for Management Development in Bangladesh.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    Eight case studies appropriate for use in a course in management development were prepared and are provided in this document. The typical case describes a real business situation in which a real manager had to reach a decision. The case gives quantitative and qualitative information that is, or may be, relevant to that decision. Questions for…

  14. Study on Case Teaching of Financial Management

    ERIC Educational Resources Information Center

    Che, Zhenghong; Che, Zhengmei

    2011-01-01

    Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

  15. NASW Standards for Social Work Case Management.

    ERIC Educational Resources Information Center

    National Association of Social Workers, Washington, DC.

    This document presents the standards for social work case management created by the National Association of Social Workers (NASW). Social work case management is defined as "a method of providing services whereby a professional social worker assesses the needs of the client and the client's family, when appropriate, and arranges, coordinates,…

  16. Reviewing case management in community psychiatric care.

    PubMed

    Bush, Tony

    Case management is a process of psychiatric care provision that uses a structured and focused approach to effectively assess individual patient's needs. The aim of this article is to examine the current status of case management in NHS community mental health care in terms of therapeutic impact and relevance. PMID:16209396

  17. Iowa Case Management for Rural Drug Abuse

    ERIC Educational Resources Information Center

    Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

    2009-01-01

    Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

  18. Managing severe peripartum hyponatraemia: A case report

    PubMed Central

    Lim, Jerry; Laing, Christopher M; MacCallum, Niall S; Brealey, David A

    2014-01-01

    We present a case of severe peripartum hyponatraemia that occurred following a major obstetric haemorrhage causing both an ischaemic stroke and Sheehan's syndrome and outline the investigations and management strategy required.

  19. Multimedia case management system implemented in Java

    NASA Astrophysics Data System (ADS)

    Stewart, Howard D.; Davis, Midge L.; Handy, Dale L.; Kvarfordt, Kent B.; Ford, Glenn

    1999-01-01

    Managing the timely access of information is a major challenge facing law enforcement agencies. One of the areas of greatest need is that of the case management process. During the course of FY98, the Office of National Drug Control Policy (ONDCP), the Counterdrug Technology Assessment Center (CTAC), the Idaho National Engineering and Environmental Laboratory (INEEL), and the Criminal Investigative Bureau (CIB) of the state of Idaho, created a Northwest testbed to develop and integrate a multimedia case management system. A system was developed to assist investigators in tracking and maintaining investigative cases and improving access to internal and external data resources. In this paper, we discuss the results of our case management system development and the ability to present state and federal information incorporating object oriented and multimedia techniques. We then outline our plans for future research and development.

  20. Case Studies in Managing Psychological Depth.

    ERIC Educational Resources Information Center

    Ringer, Martin; Gillis, H. L.

    This paper outlines a model for assessing and managing psychological depth in outdoor and experiential group work, and presents two case studies of the complexity of such management in real life. The model contains eight levels of emotional risk and presents four criteria for assessing the level to which a particular event or discussion may lead…

  1. Recognizing and managing boundary issues in case management.

    PubMed

    Walsh, J

    2000-01-01

    Much of the literature on worker-client boundaries in clinical practice is based on assumptions that the relationship between the two parties is structured and formal. These assumptions do not always apply in community-based case management practice, where the worker and client interact in a wide variety of settings and circumstances. The relative informality of case management makes the establishment of appropriate worker-client boundaries both critical and difficult. In this article key principles for recognizing and managing boundary issues are presented and discussed. PMID:11107659

  2. Outage management: A case study

    SciTech Connect

    Haber, S.B.; Barriere, M.T. ); Roberts, K.H. . Walter A. Haas School of Business)

    1992-01-01

    Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission's (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.

  3. Outage management: A case study

    SciTech Connect

    Haber, S.B.; Barriere, M.T.; Roberts, K.H.

    1992-09-01

    Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission`s (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.

  4. Case managers' roles and functions: Commission for Case Manager Certification's 2004 Research, Part I.

    PubMed

    Tahan, Hussein A; Huber, Diane L; Downey, William T

    2006-01-01

    The Commission for Case Manager Certification (CCMC) conducted its third case managers' role and functions study in 2004. The purpose of this research was to validate the currency and relevancy of the certified case manager examination. The results of this study are shared in 2 parts of an article. Part I discusses the process the CCMC used for the development of the Case Manager's Role and Functions Survey Instrument (CMRFSI). The research leads to the identification of 6 new essential functions and 6 new knowledge areas, which describe case management practice. These findings were based on the survey of a large national sample of practicing case managers. Part II continues the analysis of the survey results and focuses on identifying the empirical activity and knowledge domains of case management practice, using factor analysis. It also discusses the similarities and differences found among various subgroups of case managers who were compared on the basis of certain demographic variables. In addition, it summarizes future changes in the field of case management as perceived by those who participated in the study. PMID:16444117

  5. Case managers' roles and functions: Commission for Case Manager Certification's 2004 research, part II.

    PubMed

    Tahan, Hussein A; Downey, William T; Huber, Diane L

    2006-01-01

    The Commission for Case Manager Certification (CCMC) conducted its third case managers' role and functions study in 2004 for the purpose of validating the currency and relevancy of the certified case manager examination. The results of this study are shared in an article of 2 parts. Part I, which was published in the previous issue of this journal, discussed the process the CCMC used for the development of the Case Managers' Role and Functions Survey Instrument and the identification of new 6 essential functions and 6 knowledge areas that describe case management practice. These findings were based on the survey of a large national sample of practicing case managers. Part II continues the analysis of the results and focuses on identifying the empirical (statistically derived) activity and knowledge domains of case management practice, using exploratory factor analysis. It discusses the similarities and differences found among various subgroups of case managers who were compared on the basis of certain demographic variables. In addition, Part II summarizes future changes in the field of case management as perceived by those who participated in the study. PMID:16582699

  6. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    .... (2) Not use case management (including targeted case management) services to restrict an individual's access to other services under the plan. (3) Not compel an individual to receive case management services... services (including targeted case management services), as defined in § 440.169 of this chapter, the...

  7. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    .... (2) Not use case management (including targeted case management) services to restrict an individual's access to other services under the plan. (3) Not compel an individual to receive case management services... services (including targeted case management services), as defined in § 440.169 of this chapter, the...

  8. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    .... (2) Not use case management (including targeted case management) services to restrict an individual's access to other services under the plan. (3) Not compel an individual to receive case management services... services (including targeted case management services), as defined in § 440.169 of this chapter, the...

  9. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Primary care case management services. 440.168... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.168 Primary care case management services. (a) Primary care case management services means case management...

  10. Case Management of Adolescents with Chronic Disease.

    ERIC Educational Resources Information Center

    Lankard, Bettina A.

    This training guide presents a model for optimum delivery of the primary duties, tasks, and steps required in the comprehensive case management of adolescents with chronic disease. Using a team approach to coordinated health care, the guide involves the patient and family as key members of the care team along with the physician, nurse, dietitian,…

  11. Case management: entry-level practice for occupational therapists?

    PubMed

    Baldwin, Tina M; Fisher, Thomas

    2005-01-01

    As American businesses have sought means to control employee health benefits, managed care has evolved. This evolution has brought greater demand for case management. Case management is not a profession but a practice area within one's own profession. Case managers come from a variety of disciplines and work in a variety of practice settings, which include medical, psychosocial, educational, vocational, and rehabilitation. PMID:16061158

  12. The Science Manager's Guide to Case Studies

    SciTech Connect

    Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.; Vallario, Robert W.

    2001-09-24

    This guide takes the science manager through the steps of planning, implementing, validating, communicating, and using case studies. It outlines the major methods of analysis, describing their relative merits and applicability while providing relevant examples and sources of additional information. Well-designed case studies can provide a combination of rich qualitative and quantitative information, offering valuable insights into the nature, outputs, and longer-term impacts of the research. An objective, systematic, and credible approach to the evaluation of U.S. Department of Energy Office of Science programs adds value to the research process and is the subject of this guide.

  13. Critical path case management: the headache clinic.

    PubMed

    Sobkowski, D A; Maquera, V

    1996-01-01

    A practical application of a neurology case management healthcare delivery mode results in increased access to specialty providers, shorter follow-up periods, and improved continuity of medical care. The program described in the following sections was developed at a naval hospital for the ongoing evaluation of therapeutic schemes to optimize headache therapy and, 1 year after implementation, shows improvement in patient outcomes and resource use. PMID:9192570

  14. Electronic case management with homeless youth.

    PubMed

    Bender, Kimberly; Schau, Nicholas; Begun, Stephanie; Haffejee, Badiah; Barman-Adhikari, Anamika; Hathaway, Jessica

    2015-06-01

    Case management, a widely practiced form of service brokerage, is associated with a variety of positive outcomes for homeless youth, but it may be difficult to implement, as youth face logistical barriers to attending in-person meetings. As part of a larger clinical trial, the current study investigates the feasibility of providing electronic case management (ECM) to homeless youth, using cell-phones, texts, email, and Facebook. Youth were given prepaid cell-phones and a case manager who provided four ECM sessions every 2-3 weeks over a 3-month period. Contact logs were used to record how many youth engaged in ECM, how many attempts were necessary to elicit engagement, and youths' preferred technology methods for engaging. Although engagement in the number of ECM sessions varied, the majority of youth (87.5%) engaged in at least one ECM session. Youth (41%) most commonly needed one contact before they engaged in an ECM session, and the majority responded by the third attempt. While youth most commonly answered calls directly, their chosen method of returning calls was texting. The majority of youth (80%) described ECM positively, reporting themes of convenience, connection, and accountability. The use of ECM, particularly of texting, offers promising implications for providing services to homeless youth. PMID:25748603

  15. Case managers reorganize to challenge claims denials.

    PubMed

    1999-08-01

    A combination of diminished reimbursement, decreased funding for residency programs, an epidemic of claims denials, and the skilled nursing crisis has imperiled teaching hospitals across the country. Increasingly, these hospitals are looking to case management departments as potential saviors. In the short term, that could mean more staff and a beefier budget, but if your department can't produce, cuts later on could be drastic. The University of Pennsylvania Health System in Philadelphia lost $90 million in FY1998 and responded by cutting 1,100 positions--9% of its work force. The case management department lost eight positions and is trying to take up the slack with a massive reorganization of its care delivery system and a rigorous education program designed to reduce claims denials. At Georgetown University Medical Center in Washington, DC, however, case management staff and resources have been increased for now. The department is using its new-found prosperity to thoroughly screen all incoming patients for appropriateness of admission, upgrade its discharge planning capabilities, and hire a full-time employee to appeal denied claims. PMID:10557727

  16. Case management: planning and coordinating strategies.

    PubMed

    Walden, T; Hammer, K; Kurland, C H

    1990-01-01

    In summary, planning a case management system involves moving through sequenced stages; namely, (1) a developmental stage; (2) a phase-in stage; and (3) an operational stage. During the developmental stage, before processes have been formalized, attention is given to the political realities, the formation of a representative planning group, formulating goals and objectives, obtaining administrative support, information gathering, assessment of needs, resource procurement, program structure and design, selection of a case management model, participatory decision making, determining organizational fit, and beginning networking. During the phase-in or early implementation state, the formal stage of system introduction, attention is given to the establishment of interorganizational relationships, contracting for services, job descriptions, work assignments, training, problem solving, and conflict resolution. During the operational or full implementation stage, a period when the system should become more stabilized, attention needs to be given to managing movement of the client through the system, the flow of information, program updating, quality assurance, recordkeeping, resource management, evaluating, and system refurbishing. In practice, these stages will interact and overlap. Closure, if the system is to remain viable and open to change, should never occur. PMID:10110505

  17. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... case management providers; or (iii) The methodology under which case management providers will be paid..., including for foster care programs, services such as, but not limited to, the following: (1)...

  18. Case management's value is finally recognized. What happens now? .

    PubMed

    2015-10-01

    In recent years, case management has been recognized as a key in improving healthcare quality and reducing costs, but while hospitals are giving case managers more responsibilities, many administrators are not approving an increase in staff to handle the extra work. Case managers can help their hospital succeed with the Centers for Medicare & Medicaid Services' Value-based Purchasing program, the readmission reduction program, and bundled payments. Case management directors should make sure the hospital's senior leadership understands the roles and responsibilities of case managers and how their interventions can affect outcomes and the bottom line. The number of caseloads depends on the case management model, the responsibilities of case managers, and whether they have assistants or case management extenders who can take over some tasks and allow the licensed staff to work at the top of their licenses. Don't let technology replace communication and patient-centered interactions. PMID:26427224

  19. Case Management in Community Corrections: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

    2012-01-01

    Case management is commonly regarded as the foundation of effective service provision across a wide range of human service settings. This article considers the case management that is offered to clients of community corrections, identifying the distinctive features of case management in this particular setting, and reviewing the empirical evidence…

  20. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... chapter. (b) Targeted case management services means case management services furnished without regard to....240 (related to comparability). Targeted case management services may be offered to individuals in any defined location of the State or to individuals within targeted groups specified in the State plan. (c)...

  1. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... chapter. (b) Targeted case management services means case management services furnished without regard to....240 (related to comparability). Targeted case management services may be offered to individuals in any defined location of the State or to individuals within targeted groups specified in the State plan. (c)...

  2. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case management services. (a) Case management services means services furnished to assist individuals, eligible under the... 42 Public Health 4 2011-10-01 2011-10-01 false Case management services. 440.169 Section...

  3. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Case management services. 440.169 Section 440.169 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case management services. (a) Case management services...

  4. Case Management Takes Hold in Long-Term Care.

    ERIC Educational Resources Information Center

    Rose, Stephen M.; And Others

    1992-01-01

    Includes "Empowering Case Management Clients" (Rose); "Case Management in Rural Japan" (Maeda, Takahashi); "Coordinated-Care Teams" (Brodsky, Sobol); "Comparing Practice in the United States and the United Kingdom" (Sturges); "Business of Case Management Flourishing in the U.S." (Cress); and "Community Options Bring Change to Long-Term Care in…

  5. Management case study: Tampa Bay, Florida

    USGS Publications Warehouse

    Morrison, Gerold; Greening, Holly; Yates, Kimberly K.

    2011-01-01

    Tampa Bay, Florida, USA, is a shallow, subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of seagrasses and other selected habitat types, to support estuarine-dependent faunal guilds. Over the past three decades, nitrogen controls involving sources such as wastewater treatment plants, stormwater conveyance systems, fertilizer manufacturing and shipping operations, and power plants have been undertaken to meet these and other management objectives. Cumulatively, these controls have resulted in a 60% reduction in annual total nitrogen (TN) loads relative to earlier worse-case (latter 1970s) conditions. As a result, annual water-clarity and chlorophyll a targets are currently met in most years, and seagrass cover measured in 2008 was the highest recorded since 1950. Factors that have contributed to the observed improvements in Tampa Bay over the past several decades include the following: (1) Development of numeric, science-based water-quality targets to meet a long-term goal of restoring seagrass acreage to 1950s levels. Empirical and mechanistic models found that annual average chlorophyll a concentrations were a primary manageable factor affecting light attenuation. The models also quantified relationships between TN loads, chlorophyll a concentrations, light attenuation, and fluctuations in seagrass cover. The availability of long-term monitoring data, and a systematic process for using the data to evaluate the effectiveness of management actions, has allowed managers to track progress and

  6. Diversity in case management modalities: the Summit model.

    PubMed

    Peterson, G A; Drone, I D; Munetz, M R

    1997-06-01

    Though ubiquitous in community mental health agencies, case management suffers from a lack of consensus regarding its definition, essential components, and appropriate application. Meaningful comparisons of various case management models await such a consensus. Global assessments of case management must be replaced by empirical studies of specific interventions with respect to the needs of specific populations. The authors describe a highly differentiated and prescriptive system of case management involving the application of more than one model of service delivery. Such a diversified and targeted system offers an opportunity to study the technology of case management in a more meaningful manner. PMID:9211044

  7. Quick management of accidental tritium exposure cases.

    PubMed

    Singh, Vishwanath P; Badiger, N M; Managanvi, S S; Bhat, H R

    2012-07-01

    Removal half-life (RHL) of tritium is one of the best means for optimising medical treatment, reduction of committed effective dose (CED) and quick/easy handling of a large group of workers for medical treatment reference. The removal of tritium from the body depends on age, temperature, relative humidity and daily rainfall; so tritium removal rate, its follow-up and proper data analysis and recording are the best techniques for management of accidental acute tritium exposed cases. The decision of referring for medical treatment or medical intervention (MI) would be based on workers' tritium RHL history taken from their bodies at the facilities. The workers with tritium intake up to 1 ALI shall not be considered for medical treatment as it is a derived limit of annual total effective dose. The short-term MI may be considered for tritium intake of 1-10 ALI; however, if the results show intake ≥100 ALI, extended strong medical/therapeutic intervention may be recommended based on the severity of exposure for maximum CED reduction requirements and annual total effective dose limit. The methodology is very useful for pressurized heavy water reactors (PHWRs) which are mainly operated by Canada and India and future fusion reactor technologies. Proper management will optimise the cases for medical treatment and enhance public acceptance of nuclear fission and fusion reactor technologies. PMID:22349318

  8. Ensuring the quality of asthma case management.

    PubMed

    Aït-Khaled, N; Enarson, D A

    2006-07-01

    An evaluation based on recording the number of patients and evaluating their treatment outcomes provides the information necessary to plan the provision of care, determine the analysis of the situation and revise practice if the results are not satisfactory. The standardised tools proposed for this evaluation are: a district register for new persistent asthma patients, quarterly reports of case finding and an annual report of cohort patient follow-up. The main indicators of quality of care based on register information given by the cohort analysis are the percentage of defaulters and the percentage of patients whose asthma is controlled or well controlled after 1 year of follow-up. The services involved in asthma management should be adapted to the local situation in each country. In particular, the health service structure and national guidelines must be respected, and services involved in asthma management should be implemented in stages. Operational research within the services is essential to ensure that the services provided are appropriate. This type of research involves the health personnel responsible for patient management, provides them with new knowledge and helps them to resolve problems they are confronted with on a regular basis. It also inspires critical thinking, which is crucial to both research and practice. PMID:16848332

  9. Applying e-health to case management.

    PubMed

    Adams, J M

    2000-01-01

    The healthcare industry is only beginning to understand e-health. E-health can be defined as the use of technology to directly improve healthcare delivery-affording patients the opportunity to participate in their own healthcare management, provider, and institution. The market is changing rapidly, and innovations, partnerships, and mergers are taking place daily. For healthcare institutions, setting a long-term, yet adaptable e-health strategy is of vital importance for the continued success of the organization. For clinicians, an understanding of and familiarity with technologies can significantly improve workflow, organization, and patient interaction. For the patient, technology can be leveraged as a means to take initiative and responsibility for his/her own health. This article defines e-health and explains the implications and benefits of e-health to nurses and their patients. The article also identifies unique opportunities e-health/e-commerce can provide case managers in promoting patient connectivity, care management, and economy in cost of care. PMID:16397993

  10. Reconceptualizing case management in theory and practice: a frontline perspective.

    PubMed

    Yarmo Roberts, Deborah

    2002-08-01

    'Case management' in the health and social service sector is controversial, highly political and saturated with conflicting agendas among stakeholders. Research was conducted recently to explore the role of case managers in three evolving, Australian-based, long-term care, case management models. The findings have relevance to countries worldwide that contend with delivering quality care that is cost effective. The research captures the perspectives of 51 open-ended interviews with front-line case managers who have first-hand knowledge of the models' effect on their clients and on their own roles. Contrary to the rhetoric that case management is client-centred, case management is concluded to be 'system centred' based on a unilateral approach taken by each of the three models. Case managers had a limited ability to attain necessary services for clients. Success was dependent on the range of case managers' skills and experience, relationship with the client, degree of job satisfaction, level of influence in the health and social system and ability to collaborate with relevant professionals. The relationship between the three primary influences (system, model, client) affecting case managers' pursuit of achieving appropriate client services was also reviewed. A reconceptualized multidimensional approach, or 'neo-process-centred' case management, is proposed. The revised approach can be applied to existing and new models and has direct implications for policy makers, management and practitioners aspiring to improve client care within existing constraints. PMID:12184835

  11. Case management insider. The 2-midnight rule--a game-changer for case management.

    PubMed

    Cesta, Toni

    2014-04-01

    As a case manager or case management leader, it is important for you to stay in touch with how CMS continues to roll out the two-midnight rules as well as the manner of auditing on a go-forward basis. It is also important that your department continue to have a close working relationship with the billing department in your hospital to ensure that the hospital remains compliant with this new rule. Finally, it is also critical that your emergency department and its physicians are kept up to date on the rule and its implications for hospital admissions. Having a case management presence in the emergency department will help to ensure a sound review process at this important route of entry to the hospital. A working team should be created to review the cases that fall outside of the rule, and these cases should also be presented to the utilization review committee so that the hospital can continue to learn and move forward. Finally, listen to the CMS National Provider Calls (www.cms. gov/NPC) to gain additional and updated information as it becomes available! For additional information on the two-midnight rule go to www.cms.gov and search for CMS-1599-F. PMID:24697139

  12. Case management: a management system for quality and cost effective outcomes.

    PubMed

    Dees, J P; Anderson, N L

    1996-08-01

    1. Case management is an effective strategy for occupational health nurses to use to reduce corporate health insurance, workers' compensation, and disability expenditures. 2. Case management has evolved from a reactive to a proactive strategy useful in many arenas. While there are differences among group health, workers' compensation, and disability, the basic case management process is the same. 3. Early intervention and comprehensive assessment are the foundation of a successful case management process. 4. Occupational health nurses have extensive clinical, interpersonal, and management skills enabling them to excel as case managers. PMID:8852236

  13. Case management in the social health maintenance organization demonstrations

    PubMed Central

    Yordi, Cathleen L.

    1988-01-01

    In this article, case management departments and roles during the early years of the social health maintenance organization (S/HMO) demonstrations are compared. These organizations provide acute and chronic care services under a prepaid plan for the elderly. Eligibility criteria for case management and chronic care services at each site are compared, followed by a description of the resultant case mix of members receiving chronic care benefits. Case managers principal activities are described, and a preliminary assessment is made about the strength of the linkages that have been developed between the case management component of these plans and the larger health care system. PMID:10312977

  14. 75 FR 23582 - Annular Casing Pressure Management for Offshore Wells

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... published the proposed rule Annular Casing Pressure Management for Offshore Wells (74 FR 38147). The comment... the published proposed rule 1010-AD47 Annular Casing Pressure Management for Offshore Wells (74 FR... subsea wellhead. (3) hybrid well, a riser or the production casing pressure is greater than 100...

  15. Case Studies for Management Development in Bangladesh. Second Book.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    These 15 case studies developed by faculty at institutions in Bangladesh are appropriate for use in a course in management development. The typical case describes a real business situation in which a real manager had to reach a decision. The case gives quantitative and qualitative information that is, or may be, relevant to that decision.…

  16. Intensive case management for severe mental illness

    PubMed Central

    Dieterich, Marina; Irving, Claire B; Park, Bert; Marshall, Max

    2014-01-01

    Background Intensive Case Management (ICM) is a community based package of care, aiming to provide long term care for severely mentally ill people who do not require immediate admission. ICM evolved from two original community models of care, Assertive Community Treatment (ACT) and Case Management (CM), where ICM emphasises the importance of small caseload (less than 20) and high intensity input. Objectives To assess the effects of Intensive Case Management (caseload <20) in comparison with non-Intensive Case Management (caseload > 20) and with standard community care in people with severe mental illness. To evaluate whether the effect of ICM on hospitalisation depends on its fidelity to the ACT model and on the setting. Search methods For the current update of this review we searched the Cochrane Schizophrenia Group Trials Register (February 2009), which is compiled by systematic searches of major databases, hand searches and conference proceedings. Selection criteria All relevant randomised clinical trials focusing on people with severe mental illness, aged 18 to 65 years and treated in the community-care setting, where Intensive Case Management, non-Intensive Case Management or standard care were compared. Outcomes such as service use, adverse effects, global state, social functioning, mental state, behaviour, quality of life, satisfaction and costs were sought. Data collection and analysis We extracted data independently. For binary outcomes we calculated relative risk (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data we estimated mean difference (MD) between groups and its 95% confidence interval (CI). We employed a random-effects model for analyses. We performed a random-effects meta-regression analysis to examine the association of the intervention’s fidelity to the ACT model and the rate of hospital use in the setting where the trial was conducted with the treatment effect. Main results We included 38 trials

  17. Examining End-of-Life Case Management: Systematic Review

    PubMed Central

    Thomas, Roger E.; Wilson, Donna M.; Birch, Stephen

    2014-01-01

    Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL) case management identified 17 research articles, with content analysis revealing two themes: (a) seeking to determine or establish the value of EOL case management and (b) identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care. PMID:24999433

  18. Knowledge Management Analysis: A Case Study

    ERIC Educational Resources Information Center

    Mecha, Ezi I.; Desai, Mayur S.; Richards, Thomas C.

    2009-01-01

    It is imperative for businesses to manage knowledge and stay competitive in the marketplace. Knowledge management is critical and is a key to prevent organizations from duplicating their efforts with a subsequent improvement in their efficiency. This study focuses on overview of knowledge management, analyzes the current knowledge management in…

  19. A Case of Telecommunications (Mis)Management; [and] A Case of Telecommunications (Mis)Management: Case Analysis.

    ERIC Educational Resources Information Center

    Fin, T. Andrew; Rogers, Priscilla S.; Taylor, James R.

    1999-01-01

    Presents a series of analyses of a case involving implementing a new voice-mail system, noting a newly appointed manager's failure to obtain feedback about the planned transition and evaluate user needs; successful introduction of any new technology is variable and suggests a degree of incrementalism; and four major issues arising in similar cases…

  20. Effective Case Study Methodologies in the Management of IT Courses.

    ERIC Educational Resources Information Center

    Buffington, James R.; Harper, Jeffrey S.

    Many Association to Advance Collegiate Schools of Business (AACSB) accredited schools require undergraduate Management Information Systems (MIS) majors to take a course in the management of information technology. Over half of these schools utilize case studies in the teaching of this course. Case studies are an important vehicle for teaching…

  1. Case Management: Effects of Improved Risk and Value Information

    ERIC Educational Resources Information Center

    Weissert, William G.; Hirth, Richard A.; Chernew, Michael E.; Diwan, Sadhna; Kim, Jinkyung

    2003-01-01

    Purpose: The purpose of this study was to determine the impact on resource use of providing case managers with information on the potential for patients to benefit from home care services. Design and Methods: Twenty-four case managers working in the Arizona Long Term Care System (ALTCS) were randomized into treatment and control groups. Members of…

  2. Identifying costs for capitation in psychiatric case management.

    PubMed

    Baker, J J; Chiverton, P; Hines, V

    1998-01-01

    This article presents an example of how one hospital identified costs for capitation in psychiatric case management. An 18-month postacute case management pilot project collected data on a nurse-specific and patient-specific basis. Costs were identified using activity-based costing methodology. PMID:9502055

  3. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Primary care case management services. 440.168 Section 440.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.168 Primary care case management services. (a)...

  4. 34 CFR 303.23 - Service coordination (case management).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., the system of payments for services in the State, and other pertinent information. (Authority: 20 U.S... 34 Education 2 2011-07-01 2010-07-01 true Service coordination (case management). 303.23 Section... Service coordination (case management). (a) General. (1) As used in this part, except in §...

  5. Laparoscopic management of recurrent pheochromocytoma: A case report.

    PubMed

    Garg, Harshit; Uppal, Manpreet; Sreedharan, Sreesanth Kelu; Aggarwal, Sandeep

    2016-01-01

    Recurrence of pheochromocytoma after a total adrenalectomy is uncommon. Such recurrent tumours are mostly managed by the open technique, with very few studies reporting laparoscopic management. We hereby report a case of successful laparoscopic management of a recurrent pheochromocytoma after total adrenalectomy for left adrenal pheochromocytoma. PMID:27279402

  6. Laparoscopic management of recurrent pheochromocytoma: A case report

    PubMed Central

    Garg, Harshit; Uppal, Manpreet; Sreedharan, Sreesanth Kelu; Aggarwal, Sandeep

    2016-01-01

    Recurrence of pheochromocytoma after a total adrenalectomy is uncommon. Such recurrent tumours are mostly managed by the open technique, with very few studies reporting laparoscopic management. We hereby report a case of successful laparoscopic management of a recurrent pheochromocytoma after total adrenalectomy for left adrenal pheochromocytoma. PMID:27279402

  7. 38 CFR 62.31 - Supportive service: Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... management services. 62.31 Section 62.31 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... management services. Grantees must provide case management services that include, at a minimum: (a... appointments for participants) to help participants obtain needed supportive services, such as medical,...

  8. Public Management of Science Case Studies.

    ERIC Educational Resources Information Center

    American Univ., Washington, DC. Coll. of Public Affairs.

    Presented are six papers pertaining to the management of science, research, and development by federal agencies. The papers were prepared by students in a management of science course offered at the American University, Washington, D.C. Federal agencies reviewed include: National Aeronautics and Space Administration (NASA); Department of…

  9. Privileged Emotion Managers: The Case of Actors

    ERIC Educational Resources Information Center

    Orzechowicz, David

    2008-01-01

    Theatre provides a unique set of conditions for the management of emotions. Drawing on participant observation from one repertory theater, three university productions, and interviews with stage actors, directors, and acting instructors, I conceptualize actors as privileged emotion managers. Actors access structural resources that enable their…

  10. Interdependency Management in Universities: A Case Study

    ERIC Educational Resources Information Center

    Braun, Dietmar; Benninghoff, Martin; Ramuz, Raphaël; Gorga, Adriana

    2015-01-01

    There remains uncertainty in scientific discussions regarding the governance of universities in new public management regimes in terms of who actually "rules" in the university. Apparently, a strengthened management leadership is confronted with continuing elements of academic self-regulation and professional autonomy in knowledge…

  11. Critical factors in case management: practical lessons from a cardiac case management program.

    PubMed

    Stafford, Randall S; Berra, Kathy

    2007-08-01

    Case management (CM) is an important strategy for chronic disease care. By utilizing non-physician providers for conditions requiring ongoing care and follow-up, CM can facilitate guideline-concordant care, patient empowerment, and improvement in quality of life. We identify a series of critical factors required for successful CM implementation. Heart to Heart is a clinical trial evaluating CM for coronary heart disease (CHD) risk reduction in a multiethnic, low-income population. Patients at elevated cardiac risk were randomized to CM plus primary care (212 patients) or to primary care alone (207). Over a mean follow-up of 17 months, patients received face-to-face nurse and dietitian visits. Mean contact time was 14 hours provided at an estimated cost of $1250 per patient for the 341 (81%) patients completing follow-up. Visits emphasized behavior change, risk-factor monitoring, self-management skills, and guideline-based pharmacotherapy. A statistically significant reduction in mean Framingham risk probability occurred in CM plus primary care relative to primary care alone (1.6% decrease in 10-year CHD risk, p = 0.007). Favorable changes were noted across individual risk factors. Our findings suggest that successful CM implementation relies on choosing appropriate case managers and investing in training, integrating CM into existing care systems, delineating the scope and appropriate levels of clinical decision making, using information systems, and monitoring outcomes and costs. While our population, setting, and intervention model are unique, these insights are broadly relevant. If implemented with attention to critical factors, CM has great potential to improve the process and outcomes of chronic disease care. PMID:17718658

  12. Nursing case management for children with failure to thrive.

    PubMed

    MacPhee, M; Hoffenberg, E

    1996-01-01

    The case management approach is described for children with nonorganic failure to thrive in the pediatric tertiary care setting. An advanced practice nurse facilitated the organization of a planning committee, the construction of a care path, and the evaluation of the case management model. A 4-day care path is presented to show staff nursing functions in the nurse case manager role. Special issues are discussed for developing care paths for organic-based failure to thrive where parent reports can help guide health care interventions. PMID:8847607

  13. Walking a tightrope: case management services and outpatient commitment.

    PubMed

    Sullivan, W Patrick; Carpenter, Jenneth; Floyd, Destinee F

    2014-01-01

    Effective case managers in community mental health are successful at forging a working alliance with recipients. This article explores one key aspect of case management practice, serving involuntary clients, specifically those on outpatient commitment orders. In 19 intensive interviews, a subset of a larger study, case managers shared their perceptions of the utility of outpatient commitment with a focus on how such orders impacted the professional relationship. We argue that the use of advance psychiatric directives and shared decision-making processes can reduce the need for coercive practice. PMID:25222837

  14. Embracing case management for computerization of care pathways.

    PubMed

    Mei, Jing; Li, Jing; Yu, Yiqin; Li, Xiang; Liu, Haifeng; Xie, Guotong

    2014-01-01

    The computerization of care pathways (CPs) has drawn considerable attention, for improving quality of health care and reducing costs. A well-known big challenge of implementing CPs is their flexibility and ad hoc variations in execution of clinical tasks. We observe that case management suits well to address this problem, and this paper proposes a CMMN-based CP model, where CMMN (Case Management Model and Notation) is becoming an industry standard. Via an experimental experience on modelling CHF (congestive heart failure) ambulatory CP, we illustrate that the usage of case management paves the way to popularize CPs, particularly for its quick deployment and execution in industrial products. PMID:25160134

  15. Media Management Education and the Case Method.

    ERIC Educational Resources Information Center

    Hoag, Anne; Brickley, Dale J.; Cawley, Joanne M.

    2001-01-01

    Traces the development and pedagogical theory of the case study method. Offers an overview of current discourse on its effectiveness. Presents results from a quasi-experiment. Finds that students exposed to the case method improved their problem solving skills measurably and significantly over a 15-week semester, outperforming the control group…

  16. Is your staffing ratio appropriate for your case management model?

    PubMed

    2015-03-01

    Case managers may be working longer hours and have more responsibilities to help their hospital comply with health care reform initiatives, but before rushing to the C-suite to ask for more staff, case management directors should take a hard look at the roles and responsibilities of the department, experts say. They recommend: Look at your staffing ratio and determine if it is appropriate for your case management model and if it is in line with staffing ratios at similar hospitals with similar models. Make a list of all the tasks that case managers are asked to do and break out those that don't affect outcomes or cost of care and those that don't require licensure. Get these assigned to other employees. Before you approach management to ask for more staff, do your homework and have hard data to back up your request. Consider hiring case management extenders to take over clerical tasks and free up case managers to work at the top of their licenses. PMID:25730955

  17. Human Error in Throat Pack Management: Report of Two Cases.

    PubMed

    Baranger, Violaine; Bon Mardion, Nicolas; Dureuil, Bertrand; Compère, Vincent

    2016-06-15

    Throat packs are frequently used after tracheal intubation during ear, nose, and throat surgery. We report 2 cases of complications related to throat packs retained at the end of surgery. Miscommunication between anesthesiology and surgery teams on throat pack management led to an upper gastrointestinal endoscopy examination under general anesthesia in the first case and to severe respiratory distress requiring tracheal reintubation in the second case. Our 2 case reports highlight the importance of good communication between anesthesiology and surgery teams and of standardized procedures and checklists for the management of throat packs to ensure patient safety. PMID:27301056

  18. Preparing health care organizations for successful case management programs.

    PubMed

    Bonvissuto, C A; Kastens, J M; Atwell, S R

    1997-01-01

    This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program. PMID:9335724

  19. Case III: Managing Conflict--The Case of the Faculty Stuck in the Middle.

    ERIC Educational Resources Information Center

    Trombly, Robert M.; Comer, Robert W.; Villamil, Juanita E.

    2002-01-01

    Explores techniques of conflict management as well as the positive and negative factors that may exert progressive or detrimental influences. Presents a case scenario, drawn from a faculty development workshop, involving a dental school faculty member, and highlights central issues of the case and relevant management concepts. (EV)

  20. ED case managers save $4.5 million.

    PubMed

    2011-08-01

    Emergency department case managers at Lee Memorial Health System in Fort Myers, FL saved more than $4.5 million by ensuring that patients were in the right status and transferring patients who did not meet admission criteria to a more appropriate level of care. Case managers and social workers cover the emergency department at peak hours, seven days a week. Case managers screen patients for admission criteria and make sure admission orders are complete and correct. Case managers and social workers coordinate community services and placement for patients who don't meet admission criteria. Social workers intervene when there are concerns about abuse and neglect, and they facilitate placement to other acute care facilities. PMID:21789904

  1. Effectiveness of case management for homeless persons: a systematic review.

    PubMed

    de Vet, Renée; van Luijtelaar, Maurice J A; Brilleslijper-Kater, Sonja N; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D; Wolf, Judith R L M

    2013-10-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

  2. Effectiveness of Case Management for Homeless Persons: A Systematic Review

    PubMed Central

    de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

  3. Nurse's Breakout Session Injury/Illness Case Management

    NASA Technical Reports Server (NTRS)

    Hesselgesser, Connie

    2001-01-01

    An overview of the work related injury and illness case management model developed at the Johnson Space Center was presented. The major accomplishments and the challenges of implementation were discussed.

  4. The employer's case for health management.

    PubMed

    Coulter, Christopher H

    2006-01-01

    Employers' past solutions to rising health benefit costs--adopting managed care strategies, cost shifting to employees and reducing benefits-are no longer effectively controlling costs and are depressing the value of health benefits for employee recruitment and retention. An alternative strategy is to implement health management approaches that improve the health status of employees. These programs reduce medical costs and have a documented positive impact on workers' compensation, disability costs, absenteeism and productivity. Further, this approach is complementary to health care consumerism as a strategy for health improvement and benefit cost reduction and results in improved employee health, outlook and satisfaction. PMID:16792389

  5. Draugen HSE-case - occupational health risk management

    SciTech Connect

    Glas, J.J.P.; Kjaer, E.

    1996-12-31

    The Draugen HSE-Case serves as a risk management tool. Originally, risk management included only major safety hazards to personnel, environment and assets. Work Environment risks such as ergonomics, psycho-social factors and exposure to chemicals and noise, was not given the same attention. The Draugen HSE-Case addresses this weakness and extends all work environment risks. In order to promote line responsibility and commitment, relevant personnel is involved in the Case development. {open_quotes}THESIS{degrees}, a software application, is used to systematize input and to generate reports. The Draugen HSE-case encompasses: HSE risk analyses related to specific activities; Control of risk related to work environment; Established tolerability criteria; Risk reducing measures; Emergency contingency measures; and Requirements for Competence and Follow-up. The development of Draugen HSE-Case is a continuous process. It will serve to minimize the potential of occupational illnesses, raise general awareness, and make occupational health management more cost-effective.

  6. Managing Change: A Case Study in Evolving Strategic Management.

    ERIC Educational Resources Information Center

    Thor, Linda; Scarafiotti, Carol; Helminski, Laura

    1998-01-01

    Presents Rio Salado College as a case study of an institution that aligns itself with the needs of learners by altering its organizational values and practices. Emphasizes the need for institutions to embrace change and innovation to accommodate the needs of its learners. Contains 11 references. (YKH)

  7. Data management for genomic mapping applications: A case study

    SciTech Connect

    Markowitz, V.M.; Lewis, S.; McCarthy, J.; Olken, F.; Zorn, M.

    1992-05-01

    In this paper we describe a new approach to the construction of data management systems for genomic mapping applications in molecular biology, genetics, and plant breeding. We discuss the architecture of such systems and propose an incremental approach to the development of such systems. We illustrate the proposed approach and architecture with a case study of a prototype data management system for genomic maps.

  8. Essentials of Enrollment Management: Cases in the Field

    ERIC Educational Resources Information Center

    Black, Jim

    2004-01-01

    In AACRAO's new publication Essentials of Enrollment Management: Cases in the Field experts in enrollment management representing all types of institutions reveal the evolution of the enrollment strategies implemented at their institutions, the results, and the lessons learned. The introductory chapter provides an overview of themes and models…

  9. A CASE STUDY OF ENVIRONMENTAL DATA MANAGEMENT

    EPA Science Inventory

    In order to support our ongoing research in watershed ecology and global climate change, we gather and analyze environmental data from several government agencies. This case study demonstrates a researcher’s approach to accessing, organizing, and using intersectoral data. T...

  10. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Case management services. 441.18 Section 441.18 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES General Provisions § 441.18 Case...

  11. Covert Conditioning: Case Studies in Self-Management.

    ERIC Educational Resources Information Center

    Yager, Geoffrey G.

    The self-management of thoughts and mental images was used in a series of empirical case studies to influence behavior changes. The target behaviors in the cases reported were smoking, overeating, fingernail biting, thinking self-depreciative thoughts, and responding assertively. Self-monitoring, covert positive reinforcement, covert…

  12. Cost-Effectiveness of Case Management in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.

    2006-01-01

    Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…

  13. School Nurse Case Management: Achieving Health and Educational Outcomes

    ERIC Educational Resources Information Center

    Bonaiuto, Maria M.

    2007-01-01

    Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management…

  14. CASE MANAGEMENT INSIDER. Re-Engineering Your Case Management Department: It's Simple, It's Just Not Easy, Part 1.

    PubMed

    Cesta, Toni

    2016-07-01

    This month, we have begun our discussion of the reasons why this is a very good time for hospitals to review and re-engineer their case management models and departments, including the Affordable Care Act and value-based purchasing, among others. Next time, we will discuss the elements you need to review when re-engineering your own case management department. PMID:27434941

  15. Integration of case tools for software project management

    SciTech Connect

    Paul, R.; Shinagawa, Y.; Khan, M.F.

    1996-12-31

    Building and maintenance of high quality large software projects is a complex and difficult process. Tools employing software metrics are becoming an effective aid for management of such large projects. In this paper, we briefly trace the evolution of such tools from their beginnings up until the current trends of integrated CASE tools. We present a generic integrated CASE environment incorporating a formal set of software metrics with a suite of advanced analytic techniques. The proposed integrated CASE environment is an enhancement of currently used tools, and can enable more efficient and cost-effective management of large and complex software projects.

  16. Species Conservation and Management: Case Studies

    USGS Publications Warehouse

    Akcakaya, H.R.; Burgman, M.A.; Kindvall, O.; Wood, C.C.; Sjogren-Gulve, P.; Hatfield, J.S.; McCarthy, M.A.

    2004-01-01

    This edited volume is a collection of population and metapopulation models for a wide variety of species, including plants, invertebrates, fishes, amphibians, reptiles, birds, and mammals. Each chapter of the book describes the application of RAMAS GIS 4.0 to one species, with the aim of demonstrating how various life history characteristics of the species are incorporated into the model, and how the results of the model has been or can be used in conservation and management of the species. The book comes with a CD that includes a demo version of the program, and the data files for each species.

  17. Management case study: Tampa Bay, Florida

    USGS Publications Warehouse

    Morrison, G.; Greening, H.S.; Yates, K.K.

    2012-01-01

    Tampa Bay, Florida,USA, is a shallow,subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of sea grasses and other selected habitat types, to support estuarine-dependent faunal guilds.

  18. Heavy Metal Risk Management: Case Analysis

    PubMed Central

    Kim, Ji Ae; Lee, Seung Ha; Choi, Seung Hyun; Jung, Ki Kyung; Park, Mi Sun; Jeong, Ji Yoon; Hwang, Myung Sil; Yoon, Hae Jung; Choi, Dal Woong

    2012-01-01

    To prepare measures for practical policy utilization and the control of heavy metals, hazard control related institutions by country, present states of control by country, and present states of control by heavy metals were examined. Hazard control cases by heavy metals in various countries were compared and analyzed. In certain countries (e.g., the U.S., the U.K., and Japan), hazardous substances found in foods (e.g., arsenic, lead, cadmium, and mercury) are controlled. In addition, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) recommends calculating the provisional tolerable weekly intake (PTWI) of individual heavy metals instead of the acceptable daily intake (ADI) to compare their pollution levels considering their toxicity accumulated in the human body. In Korea, exposure assessments have been conducted, and in other countries, hazardous substances are controlled by various governing bodies. As such, in Korea and other countries, diverse food heavy metal monitoring and human body exposure assessments are conducted, and reducing measures are prepared accordingly. To reduce the danger of hazardous substances, many countries provide leaflets and guidelines, develop hazardous heavy metal intake recommendations, and take necessary actions. Hazard control case analyses can assist in securing consumer safety by establishing systematic and reliable hazard control methods. PMID:24278603

  19. Integrating behavior change theory into geriatric case management practice.

    PubMed

    Enguidanos, S

    2001-01-01

    Case management practices have continued to grow despite a lack of clear evidence of their efficacy. With the expanding segment of the elderly population, there is a critical need to develop and identify programs that will address the many needs of the aging. Geriatric Case Management has been the avenue selected by many health care providers to address these issues, focusing on maintaining health status and improving linkages with medical and community resources. Studies testing the effectiveness of these models have failed to demonstrate their effectiveness in reducing depression, reducing acute care service use, and improving or maintaining health status. The Geriatric Case Management models presented in these lack an evidence-based, theoretical framework that provides definition and direction for case management practice. This article introduces behavior change theories as a method of structuring and delineating the case management intervention. The Transtheoretical Model and the Theory of Planned Behavior are discussed and methods of integrating these theories into practice are discussed. PMID:11878076

  20. Adapters, Strugglers, and Case Managers: A Typology of Spouse Caregivers

    PubMed Central

    Davis, Linda Lindsey; Chestnutt, Deborah; Molloy, Margory; Deshefy-Longhi, Tess; Shim, Bomin; Gilliss, Catherine L.

    2015-01-01

    Although family home care problems are frequently described in the health care literature, the ways in which families and other informal caregivers manage those problems are not often addressed. We conducted a descriptive analysis of interviews in which spouses caring for a partner with Alzheimer’s or Parkinson’s disease were asked to describe difficult home care problems and how they managed those problems. Analysis of these interviews indicated three recurring management styles. Adapters told stories about applying pre-existing skills to manage home care problems. Strugglers told stories of reoccurring home care problems for which they had few or no management strategies. Case Managers’ interview stories focused on the challenges of finding and coordinating home care services. These findings suggest that caregiving burden might be influenced more by the caregiver’s management style than the demands of the care situation. Suggestions for tailoring support programs for the three types of caregivers are proposed. PMID:25189535

  1. [Managing methotrexate toxicity: a case report].

    PubMed

    Fernández Megía, M J; Alós Almiñana, M; Terol Castera, M J

    2004-01-01

    High-dose methotrexate is included in chemotherapy regimens used to treat a number of malignant neoplasms. Methotrexate plasma concentration is considered the best toxicity predictor. Monitoring methotrexate plasma concentrations is standard practice in the identification of at-risk patients, the titration of folinic acid doses, and the establishment of corrective measures. Methotrexate is a kidney-cleared weak acid, and renal function impairment may retard methotrexate clearance. A case of severe methotrexate-induced toxicity secondary to renal failure is reported in a patient with non-Hodgkin s lymphoma receiving methotrexate at a dose of 1 g/m2. Corrective measures included folinic acid rescue therapy, cholestyramine resin administration, hydration and urine alkalinization, urine pH monitoring, and extracorporeal clearance techniques. PMID:15504095

  2. Case vignette: the vicissitudes of managed care.

    PubMed

    Austad, Carol Shaw; Cummings, Nicholas A; Macklin, Ruth; Newman, Russ

    1992-01-01

    Lee Wilson, age 26, was referred to Dr. Jackson for psychotherapy 5 weeks ago by a friend. Lee has been feeling increasingly depressed about longstanding family issues and the recent breakup of a 2-year relationship with a live-in companion. Over the course of the once-per-week sessions, Dr. Jackson notes persistent suicidal ideation, with vague plans to act if, as Lee puts it, "things get any worse." Just before the sixth session, Dr. Jackson is contacted by a reviewer for the managed care health insurance program covering Lee's therapy. The reviewer informs Dr. Jackson that the company will not authorize payment for further psychotherapeutic care. Dr. Jackson knows that Lee is in need of continued treatment and fears that terminating therapy at this time could result in increased suicide risk. Lee's income could cover only a small portion of Dr. Jackson's usual fee. Dr. Jackson does not wish to abandon Lee, but he already provides a significant amount of reduced-fee service to other clients. Is the health insurance carrier's stance ethical? Should Dr. Jackson be expected to treat Lee for the foreseeable future at a greatly reduced fee? How should Dr. Jackson handle this situation? PMID:11651366

  3. Management of maxillofacial injuries in bear mauling cases: a review of 20 cases

    PubMed Central

    2016-01-01

    Objectives As the craniofacial and neck regions are prime areas of injury in bear attacks, the careful management of soft and hard tissue injuries and selection of reconstructive options is of the utmost importance. This study will review the incidence and patterns of bear mauling in eastern India reported to our department and the various modalities used for their treatment over a period of 7 years. It also documents the risks of infection in bear mauling cases and the complications that have occurred. Materials and Methods Twenty cases were treated over the study period. Cases were evaluated for soft and hard tissue injuries including tissue loss and corresponding management in the craniofacial region. Cases were also evaluated for other associated injuries, organ damage and related complications. Results Various modalities of treatment were used for the management of victims, ranging from simple primary repairs to free tissue transfers. Simple primary repairs were done in 75% of cases, while the management of the injured victims required reconstruction by local, regional or distant flaps in 25%. Free tissue transfers were performed in 15% of cases, and no cases of wound infection were detected in the course of treatment. Conclusion Knowledge of various reconstructive techniques is essential for managing maxillofacial injuries in bear mauling cases. Modern reconstructive procedures like free tissue transfer are reliable options for reconstruction with minimal co-morbidity and dramatic improvement in treatment outcomes. PMID:26904490

  4. Building Perinatal Case Manager Capacity Using Quality Improvement

    PubMed Central

    Fitzgerald, Elaine

    2015-01-01

    ABSTRACT Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote and support breastfeeding. A positive change was observed in infant feeding knowledge and case manager self-efficacy to promote breastfeeding. Among the 24 mothers participating in this QI initiative, 100% initiated and continued breastfeeding at 1 week postpartum, and 92% were breastfeeding at 2 weeks postpartum. PMID:26937160

  5. Management of Multiple Impacted Teeth: A Case Report and Review

    PubMed Central

    Ajith, Sreedevi D; Shetty, Smitha; Hussain, Huma; Nagaraj, Tejavathy; Srinath, M

    2014-01-01

    Interdisciplinary care for the management of impacted teeth provides a holistic method of treating patients. Careful planning is necessary to reach the desired treatment goals. This article attempts to highlight the importance of diagnosis and adequate treatment planning for successful eruption of impacted teeth. The concept of forced eruption to improve the bone morphology of the impacted teeth has been used to treat a case of multiple impacted teeth. This paper reviews the diagnosis and management of impacted teeth. A case report of multiple impacted maxillary anterior teeth of a 13-year-old female patient has been presented. How to cite the article: Ajith SD, Shetty S, Hussain H, Nagaraj T, Srinath M. Management of multiple impacted teeth: A case report and review. J Int Oral Health 2014;6(3):93-8. PMID:25083041

  6. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series

    PubMed Central

    Pattnaik, Naina; Satpathy, Anurag; Mohanty, Rinkee; Nayak, Rashmita; Sahoo, Surjeet

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions. PMID:26664762

  7. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series.

    PubMed

    Pattnaik, Naina; Satpathy, Anurag; Mohanty, Rinkee; Nayak, Rashmita; Sahoo, Surjeet

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions. PMID:26664762

  8. Management of diabetic foot ulcers: evaluation of case studies.

    PubMed

    Torkington-Stokes, Rachel; Metcalf, Daniel; Bowler, Philip

    2016-08-11

    This article explores local barriers to diabetic foot ulcer healing, and describes the use of a dressing designed to manage exudate, infection and biofilm (AQUACEL® Ag+ dressing (AQAg+)) on recalcitrant diabetic foot ulcers. The authors consider four case studies that demonstrate how managing local barriers to wound healing with antimicrobial and anti-biofilm dressings in protocols of care can improve outcomes for patients. PMID:27523769

  9. Case management training needs to support vocational rehabilitation for case managers and general practitioners: a survey study

    PubMed Central

    2014-01-01

    Background The use of the biopsychosocial model of health and case management for effective vocational rehabilitation (VR) has been confirmed for many health conditions. While Case and Condition Managers (CCMPs) use this approach in their everyday work, little is known about their views on training needs. A review of the training curriculum for General Practitioners’ (GPs) revealed little training in VR and the biopsychosocial model of care. This study aims to identify Case and Condition Managers and GPs perceptions of their training needs in relation to employability and VR. Methods 80 Case and Condition Managers and 304 GPs working in NHS Lanarkshire, providing a comparison group, were invited to participate in this study. A self-completion questionnaire was developed and circulated for online completion with a second round of hardcopy questionnaires distributed. Results In total 45 responses were obtained from CCMPs, 5 from occupational health nurses (62% response rate) and 60 from GPs (20% response rate). CCMPs and the nursing group expressed a need for training but to a lesser extent than GP’s. The GP responses demonstrated a need for high levels of training in case/condition management, the biopsychosocial model, legal and ethical issues associated with employment and VR, and management training. Conclusions This survey confirms a need for further training of CCMPs and that respondent GPs in one health board are not fully equipped to deal with patients employability and vocational needs. GPs also reported a lack of understanding about the role of Case and Condition managers. Training for these professional groups and others involved in multidisciplinary VR could improve competencies and mutual understanding among those advising patients on return-to-work. PMID:24884477

  10. Case studies of emergency management of screwworm.

    PubMed

    Reichard, R

    1999-04-01

    Screwworm myiasis, caused by infestation of even minor wounds by the obligative parasitic larval stages of the New World screwworm (NWS) (Cochliomyia hominivorax) or Old World screwworm (OWS) (Chrysomya bezziana) flies, is a major cause of livestock morbidity and mortality in tropical and sub-tropical regions of the world. The two parasites occur in different hemispheres but are remarkably homologous. Animal health emergencies result from the invasion of new territories by the parasites or, in the case of NWS, reinfestation of areas from which the parasite had been eradicated after great effort and expense. The author reviews the biology of the parasites and the effects of screwworm, in addition to prevention of infestation upon the introduction of animals. Examples of three programmes or events are described. The first is the eradication of previously exotic NWS from an epizootic in Libya before the parasite spread to become enzootic in the Mediterranean Basin and eventually other areas of the Eastern Hemisphere. The second example reviews the serious consequences of the extension of the range of OWS into Iraq where conditions at the time were favourable for propagation and unfavourable for control. The third example describes the NWS programme strategy in North and Central America which, for forty years, has been to progressively achieve eradication and then protection of areas from north to south on that continent, employing the sterile insect technique (SIT). Outbreaks in areas where screwworm has already been eradicated divert costly programme resources and slow progress southwards, and are considered emergencies. Some problems encountered and the solutions found during the height of the eradication programme in Mexico are described. Although to date eradication of screwworms has only been accomplished with the application of SIT, this technique alone will not eradicate the pest. The author describes other elements which are required to control or eradicate

  11. [Case management. The nursing business of care or cost].

    PubMed

    Sandhu, B K; Duquette, A; Kérouac, S; Rouillier, L

    1992-01-01

    Less money spent on health services, cost-effectiveness, better productivity and more efficiency are some of the driving forces of contemporary "neo-liberalism" and political trends. How can nursing services and the profession's human values adapt in this difficult context? The authors describe the newest modality of patient care delivery system: nursing case management. They examine the factors and assumptions that led up to its development and point out the validity of asking some serious questions before embarking on the euphoria of case management. PMID:1291932

  12. Managing Bullying and Managing Difference: A Case Study of One Secondary School

    ERIC Educational Resources Information Center

    Dixon, Roz; Smith, Peter; Jenks, Chris

    2004-01-01

    Much work on school bullying focuses on developing our understanding of the various factors that contribute to bullying and its management. This case study focuses on the possible connections between parts and offers a metaperspective of one mainstream secondary school. Demonstrating that bullying and its management is embedded within the network…

  13. Management of a hypoplastic lower urinary tract: a case report.

    PubMed

    Alagaratnam, Swethan; Sengamalai, Manoharan; Mushtaq, Imran

    2011-06-01

    This case relates to a child with an antenatal diagnosis of severe bilateral hydronephrosis with congenital anomalies of the ureters, bladder, and urethra. We describe the presentation and surgical management, highlighting the complexity of this anomaly and the surgical technique used to reconstruct the lower urinary tract. To our knowledge, there has not been a similar case in the literature and the use of a segment of colon for ureteric substitution in children has not been previously reported in the literature. PMID:21683188

  14. Student Affairs Case Management: Merging Social Work Theory with Student Affairs Practice

    ERIC Educational Resources Information Center

    Adams, Sharrika D.; Hazelwood, Sherry; Hayden, Bruce

    2014-01-01

    Case management is a functional area in higher education and student affairs that emerged after the mass shootings at Virginia Tech in 2007. Although new to higher education, case management emerged from established social work practice. This article compares social work theory and case management standards with a new case management model for…

  15. Case I: Managing People--The Case of the Frustrated Faculty Member.

    ERIC Educational Resources Information Center

    Glickman, Gerald N.; Comer, Robert W.; Filler, Steven J.; Fine, James Burke

    2002-01-01

    Presents an overview of some critical theories in human relations management. Offers a hypothetical case, drawn from a faculty development workshop, involving a dental school faculty member and her dean, for discussion and application of principles. Finally, presents the central issues of the case along with a review of relevant management…

  16. Case III: Managing conflict--the case of the faculty stuck in the middle.

    PubMed

    Trombly, Robert M; Comer, Robert W; Villamil, Juanita E

    2002-04-01

    The need for administrative faculty members to have superior leadership and management skills to handle their increasingly complex responsibilities is well established. As a part of the 2000-01 ADEA Leadership Institute curriculum, fellows were responsible for developing situational case studies for a faculty development workshop to develop participants' leadership and management skills. The case presented here involved managing conflicts in the dental academic setting. The foundation of conflict management centers on communication techniques including transparent communication, open discussion, open confrontation, and active listening. Management options such as avoidance, accommodation, competition, negotiation, and collaboration are potential strategies for the faculty leader. This case study involves a fictitious public dental school, New Horizons University, which has embarked on solutions to address limited resources, but unwittingly has created conflicts between individuals and groups of faculty members. The case discussion analyzes the cause of conflicts, presents the positive and negative potential of the conflicts, reviews techniques of conflict management, and discusses specific management concepts regarding resource allocation and equity theory. PMID:12014569

  17. Technology Solutions Case Study: Moisture Management of High-Walls

    SciTech Connect

    2013-12-01

    Moisture management of high-R walls is important to ensure optimal performance. This case study, developed by Building America team Building Science Corporation, focuses on how eight high-R walls handle the three main sources of moisture—construction moisture, air leakage condensation, and bulk water leaks.

  18. Medical Training Skills Curriculum for Case Management Assistants.

    ERIC Educational Resources Information Center

    Family Planning Council of Southeastern Pennsylvania, Philadelphia.

    This manual helps service care providers working with HIV-infected people learn how HIV affects the body's major systems, emphasizing the structure and functions of each system and direct and indirect effects of HIV on each system. The curriculum was developed for case management assistants (CMAs) who work in homes of HIV-infected people. Lessons…

  19. School Asthma Screening and Case Management: Attendance and Learning Outcomes

    ERIC Educational Resources Information Center

    Moricca, Michelle L.; Grasska, Merry A.; BMarthaler, Marcia; Morphew, Tricia; Weismuller, Penny C.; Galant, Stanley P.

    2013-01-01

    Asthma is related to school absenteeism and underperformance in elementary students. This pilot study assessed whether school nurse case management (CM) in children identified with asthma impacts academic performance and school absenteeism in one school. A validated questionnaire was used to identify children at risk for asthma and CM was provided…

  20. Magic from Social Networks that Talk to Management: Four Cases

    ERIC Educational Resources Information Center

    Sugarman, Barry

    2010-01-01

    Purpose: The purpose of this paper is to understand how social networks can help to produce the "magic" of extraordinary results for organizations. Design/methodology/approach: In this exploratory study four cases (from published reports) are compared in order to illustrate different management approaches to utilizing the power of networks.…

  1. Management Science in Higher Education Institutions: Case Studies from Greece

    ERIC Educational Resources Information Center

    Saiti, Anna

    2010-01-01

    Regardless of the source of funding, university quality is based on knowledge, teaching, and research, and hence cannot be run like private enterprises as they are expert organisations that provide solely a public service. The purpose of this paper is to investigate, through the analysis of case studies, whether or not management theory,…

  2. 34 CFR 303.23 - Service coordination (case management).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... be persons who, consistent with § 303.344(g), have demonstrated knowledge and understanding about— (1..., the system of payments for services in the State, and other pertinent information. (Authority: 20 U.S... 34 Education 2 2010-07-01 2010-07-01 false Service coordination (case management). 303.23...

  3. Management of Federally Sponsored Libraries: Case Studies and Analysis.

    ERIC Educational Resources Information Center

    Missar, Charles D., Ed.

    This book provides insight into how managers of federally sponsored libraries view their roles and carry out their duties. Seven federally supported libraries were selected to serve as case studies. These libraries represent a cross-section of various types, and the nine chapters are written by librarians from these facilities. The discussion…

  4. Practices of Management Development: A Malaysian Case Study

    ERIC Educational Resources Information Center

    Law, Kian Aun

    2008-01-01

    This paper deals with a case study of Management Development (MD) practices at Malaysian Assurance Alliance (MAA). The aim of this research is to investigate how a large Malaysian insurance corporation developed and integrated MD initiatives with current organizational needs and tasks. Attempts were made to map and categorize the MD initiatives…

  5. 38 CFR 62.31 - Supportive service: Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Supportive service: Case management services. 62.31 Section 62.31 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) SUPPORTIVE SERVICES FOR VETERAN FAMILIES PROGRAM § 62.31 Supportive service:...

  6. Case Management and Rehabilitation Counseling: Procedures and Techniques. Fourth Edition

    ERIC Educational Resources Information Center

    Roessler, Richard T.; Rubin, Stanford E.

    2006-01-01

    "Case Management and Rehabilitation Counseling" discusses procedures that are useful to rehabilitation professionals working in many settings. Specifically, this book reviews the finer points relating to diagnosing, arranging services, monitoring program outcomes, arranging for placement, planning for accommodations, ethical decision making,…

  7. Impact of School Nurse Case Management on Students with Asthma

    ERIC Educational Resources Information Center

    Taras, Howard; Wright, Sandra; Brennan, Jesse; Campana, Jack; Lofgren, RoseMarie

    2004-01-01

    This project determined asthma prevalence in a large school district, absentee rates, and potential effects of school nurse case management for student asthma over three years. Data were derived from an asthma tracking tool used by nurses in one school district for every student reported as having asthma by their parent. School nurses began…

  8. The Management of Training in Multinational Corporations: Comparative Case Studies.

    ERIC Educational Resources Information Center

    Noble, Charles

    1997-01-01

    Case studies of British and Australian multinational corporations in the food and drink industry investigated how training and development are managed. Competency-based education and industry boards are important elements in both countries. Lack of a training culture in the industry and little innovation in training were observed. (SK)

  9. Managing Educational Change: A Case of Two Leadership Approaches

    ERIC Educational Resources Information Center

    Chow, Alice

    2013-01-01

    This article reports a case study that investigated the ways in which heads of subject departments managed the development and application of new assessment strategies in one secondary school in Hong Kong. The data of the study were gathered through participant observation and interviews with 12 teachers who participated in an assessment for…

  10. Chiropractic management of chronic idiopathic meralgia paresthetica: a case study

    PubMed Central

    Houle, Sébastien

    2012-01-01

    Objectives This report describes the case of a patient with chronic idiopathic meralgia paresthetica associated with bilateral sacroiliac joint dysfunction who was managed with chiropractic care. Clinical Features A 35-year-old white woman presented to a private chiropractic clinic with a complaint of numbness in the right anterolateral thigh region. Neurological assessment revealed a diminution of sensibility and discrimination on the right lateral femoral cutaneous nerve territory. Pain was rated as 8.5 on a numeric pain scale of 0 to 10. Musculoskeletal examination of the pelvic region disclosed bilateral sacroiliac joint dysfunction. Intervention and Outcomes Chiropractic management included pelvic mobilizations, myofascial therapy, transverse friction massage, and stretching exercises. After 3 visits (2 weeks later), result of neurological evaluation was normal, with no residual numbness over the lateral thigh. Conclusion In the present case, chiropractic management with standard and applied kinesiology techniques resulted in recovery of meralgia paresthetica symptoms for this patient. PMID:22942840

  11. A case study in evidence-based wound management.

    PubMed

    Patten, J

    On the first of July 1998, Frank Dobson, the then Secretary of State for Health, revealed the consultation document 'A First Class Service' (Department of Health (DoH), 1998). This article describes a wound management case study which showed how a first class service was provided for a patient with very severe pressure ulcers and complex medical problems. A multiprofessional approach to her complex and challenging problems was maintained. Evidence-based guidelines for the prevention and management of pressure damage were followed, supported by modern researched-based wound management and pressure relief. In addition, risk management strategies were observed, and provided the basis for planning and evaluating her individualized care. PMID:11235289

  12. "Managing after the Merger": Feedback at BAS Case Analysis. Response to "Managing after the Merger" Case Analysis.

    ERIC Educational Resources Information Center

    DeWine, Sue; Eicholtz, Mary M.; Walker, Juanie N.; Walker, Michael G.

    2000-01-01

    Offers two responses to the case study for management communication classes (presented in this same issue) examining issues of performance appraisals and employee feedback in a company after a recent merger. Outlines advice for coaching the supervisor on the performance appraisal process and in his understanding of cultural mergers. Examines…

  13. Energy management study: A proposed case of government building

    SciTech Connect

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

    2015-05-15

    Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

  14. Energy management study: A proposed case of government building

    NASA Astrophysics Data System (ADS)

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

    2015-05-01

    Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

  15. Pathogenesis and Management of Hepatolithiasis: A Report of Two Cases

    PubMed Central

    Kaushal, Gourav; Jacob, Sajini Elizabeth; Barwad, Adarsh; Pottakkat, Biju

    2016-01-01

    Hepatolithiasis or primary intrahepatic stones are prevalent in the Far-East countries such as Korea, Japan and Taiwan. It has been associated with helminthiasis, bacterial infections, environmental and dietary factors. Despite high prevalence of helminthiasis like ascariasis, poor environmental condition and low protein diet, India and Middle-East countries have a low incidence of hepatolithiasis. We report two cases of hepatolithiasis associated with bacterial infections and were surgically managed. The first case is a 45-year-old female presenting with upper abdominal pain and fever. She had multiple calculi in intrahepatic biliary radicles, common bile duct, common hepatic duct and gall bladder. She was managed by cholecystectomy, left lateral liver sectionectomy, choledochoscopy assisted stone clearance of the residual liver and Roux-en-Y hepatico-jejunostomy. The second case is a 60-year-old female presenting with epigastric pain and fever and past history of cholecystectomy for cholelithiasis. She had multiple right and left intrahepatic calculi and managed by left lateral liver sectionectomy with excision of CBD and Roux-en-Y hepatico-jejunostomy. Both the cases showed growth of bacteria in the culture of the intraoperatively collected bile. PMID:27134934

  16. Pathogenesis and Management of Hepatolithiasis: A Report of Two Cases.

    PubMed

    Dey, Biswajit; Kaushal, Gourav; Jacob, Sajini Elizabeth; Barwad, Adarsh; Pottakkat, Biju

    2016-03-01

    Hepatolithiasis or primary intrahepatic stones are prevalent in the Far-East countries such as Korea, Japan and Taiwan. It has been associated with helminthiasis, bacterial infections, environmental and dietary factors. Despite high prevalence of helminthiasis like ascariasis, poor environmental condition and low protein diet, India and Middle-East countries have a low incidence of hepatolithiasis. We report two cases of hepatolithiasis associated with bacterial infections and were surgically managed. The first case is a 45-year-old female presenting with upper abdominal pain and fever. She had multiple calculi in intrahepatic biliary radicles, common bile duct, common hepatic duct and gall bladder. She was managed by cholecystectomy, left lateral liver sectionectomy, choledochoscopy assisted stone clearance of the residual liver and Roux-en-Y hepatico-jejunostomy. The second case is a 60-year-old female presenting with epigastric pain and fever and past history of cholecystectomy for cholelithiasis. She had multiple right and left intrahepatic calculi and managed by left lateral liver sectionectomy with excision of CBD and Roux-en-Y hepatico-jejunostomy. Both the cases showed growth of bacteria in the culture of the intraoperatively collected bile. PMID:27134934

  17. The Impact of Comprehensive Case Management on HIV Client Outcomes.

    PubMed

    Brennan-Ing, Mark; Seidel, Liz; Rodgers, Leslie; Ernst, Jerome; Wirth, Doug; Tietz, Daniel; Morretti, Antonio; Karpiak, Stephen E

    2016-01-01

    In 1990, New York State instituted Comprehensive Medicaid Case Management, also known as Target Case Management (TCM), for people dealing with multiple comorbid conditions, including HIV. The goal of TCM is to assist clients in navigating the health care system to increase care engagement and treatment adherence for individuals with complex needs. HIV-positive individuals engaged in care are more likely to be virally suppressed, improving clinical outcomes and decreasing chances of HIV transmission. The purpose of this study was to understand the impact of TCM management on outcomes for people with HIV. Data were obtained from Amida Care, which operates not-for-profit managed care Medicaid and Medicare Special Needs Plans (SNPs) for HIV clients. Changes in clinical, cost, as well as medical and pharmacy utilization data among TCM clients were examined between January 2011 through September 2012 from the start of case management enrollment through the end of the study period (i.e., up to 6 months after disenrollment). Additionally, CD4 counts were compared between Amida Care TCM clients and non-TCM clients. Notable findings include increased CD4 counts for TCM clients over the one-year study period, achieving parity with non-TCM clients (i.e., Mean CD4 count > 500). When looking exclusively at TCM clients, there were increases in medication costs over time, which were concomitant with increased care engagement. Current findings demonstrate that TCM is able to achieve its goals of improving care engagement and treatment adherence. Subsequent policy changes resulting from the Affordable Care Act and the New York State Medicaid Redesign have made the Health Home the administrator of TCM services. Government entities charged with securing and managing TCM and care coordination for people with HIV should provide thoughtful and reasonable guidance and oversight in order to maintain optimal clinical outcomes for TCM clients and reduce the transmission of HIV. PMID:26849561

  18. The Impact of Comprehensive Case Management on HIV Client Outcomes

    PubMed Central

    Rodgers, Leslie; Ernst, Jerome; Wirth, Doug; Morretti, Antonio

    2016-01-01

    In 1990, New York State instituted Comprehensive Medicaid Case Management, also known as Target Case Management (TCM), for people dealing with multiple comorbid conditions, including HIV. The goal of TCM is to assist clients in navigating the health care system to increase care engagement and treatment adherence for individuals with complex needs. HIV-positive individuals engaged in care are more likely to be virally suppressed, improving clinical outcomes and decreasing chances of HIV transmission. The purpose of this study was to understand the impact of TCM management on outcomes for people with HIV. Data were obtained from Amida Care, which operates not-for-profit managed care Medicaid and Medicare Special Needs Plans (SNPs) for HIV clients. Changes in clinical, cost, as well as medical and pharmacy utilization data among TCM clients were examined between January 2011 through September 2012 from the start of case management enrollment through the end of the study period (i.e., up to 6 months after disenrollment). Additionally, CD4 counts were compared between Amida Care TCM clients and non-TCM clients. Notable findings include increased CD4 counts for TCM clients over the one-year study period, achieving parity with non-TCM clients (i.e., Mean CD4 count > 500). When looking exclusively at TCM clients, there were increases in medication costs over time, which were concomitant with increased care engagement. Current findings demonstrate that TCM is able to achieve its goals of improving care engagement and treatment adherence. Subsequent policy changes resulting from the Affordable Care Act and the New York State Medicaid Redesign have made the Health Home the administrator of TCM services. Government entities charged with securing and managing TCM and care coordination for people with HIV should provide thoughtful and reasonable guidance and oversight in order to maintain optimal clinical outcomes for TCM clients and reduce the transmission of HIV. PMID:26849561

  19. Management challenges in a case of gender identity disorder

    PubMed Central

    Rathi, Anubhav; Bhatia, Manjeet Singh

    2014-01-01

    Gender identity disorder (GID) is a complex disorder and can be defined as a group of disorders whose common feature is a strong and persistent preference for living as a person of the other sex. It is associated with significant impairment in social, occupational, interpersonal, and other areas of functioning. We describe the case of an adolescent, biologically male who was brought to our outpatient department primarily with symptoms of adjustment disorder with GID and the management provided. The role of a psychiatrist in the management, ethical and legal issues involved is also discussed. PMID:25788806

  20. Postanoxic myoclonus: two case presentations and review of medical management.

    PubMed

    Budhram, Adrian; Lipson, David; Nesathurai, Shanker; Harvey, David; Rathbone, Michel P

    2014-03-01

    Postanoxic myoclonus is a rare manifestation after an anoxic event, with fewer than 150 cases reported in the literature. The condition is characterized by myoclonic jerks, which are worse on action than at rest, and postural lapses, ataxia, and dysarthria. The disability caused by postanoxic myoclonus can be profound, and treatment in the rehabilitation setting is exceptionally challenging. We present 2 patients who suffered from postanoxic myoclonus after an anoxic event, both of whom were successfully treated with a combination of levetiracetam, valproic acid, and clonazepam. These cases act as a framework for discussing the management of postanoxic myoclonus in the clinical setting. PMID:24060492

  1. The chiropractic management of two cases of cervical spondylotic radiculopathy

    PubMed Central

    Dufton, John A.; Giantomaso, Tony

    2003-01-01

    Cervical spondylotic radiculopathy (CSR) is one of the potential sources of radiculopathy, particularly in patients aged 40 to 60 years. The hallmark sign of cervical-brachial pain presents in the majority of the cases, however a definitive clinical diagnosis is often difficult in the absence of reliable and valid diagnostic tests. Two cases of presumed CSR illustrate the usefulness of applying a comprehensive mechanical assessment that guides the patient's rehabilitation regardless of the traditional anatomical diagnosis. A brief overview of the epidemiology, clinical presentation, and management of CSR is also presented.

  2. [Rare side effects in management of hyperthyroidism. Case report].

    PubMed

    Sohár, Gábor; Kovács, Mónika; Györkös, Andrea; Gasztonyi, Beáta

    2016-05-29

    The authors present the case history of a patient suffering from hyperthyroidism. The diagnostic procedures revealed the presence of propylthiouracyl induced vasculitis with renal involvement, that recovered completely after the withdrawal of propylthiouracyl and corticosteroid treatment. Thereafter, the patient was treated with thiamasol, that caused agranulocytosis with fever. After transient litium carbonate therapy a succesful thyreoidectomy was performed. Cumulative serious side effects of antithyroid drugs are rare. This case highlights some of the challenges and complications encountered in the management of hyperthyroidism. PMID:27211356

  3. The created environment for physical assessment by case managers.

    PubMed

    Skillen, D L; Anderson, M C; Knight, C L

    2001-02-01

    Goals of gerontological nursing include maximizing health and confronting functional impairments. The health of older adults is often fragile because of age-related change, complicated by chronic illnesses. Identification of changes in health status permits responsive care and consultation but requires proficiency in physical assessment. In 1995, research was conducted in Alberta, Canada, on registered nurse case managers' reported use of assessment skills. Nineteen continuing-care facilities in 1 of 17 provincial health regions participated (N = 189). After expert review and pilot testing, questionnaires were distributed to two independent groups: nurse administrators/staff development coordinators and case managers (response rate = 73%). Qualitative data were subjected to descriptive, interpretive, and pattern coding. Reported are factors constraining or facilitating physical assessment in continuing care. Neuman's concept of the created environment provided a factor-organizing framework. A holistic view of environment and data source triangulation increased confidence in the comprehensiveness and credibility of results. PMID:11216026

  4. [Importance of compliance in nutritional management. Case report].

    PubMed

    Mikulka, Ilona

    2016-04-10

    Disease-related malnutrition is usually caused by the joint action of the underlying disease itself and dietary deficiency. The consequences of malnutrition, if left untreated, are serious, causing a marked decline in physical and psychological health and function, and an increased rate of complications and decreased effectiveness of the medical treatments. In case a functional gastrointestinal tract is present, the recommended form of nutritional management is the use of oral nutritional supplements. However, just like to any other therapy, compliance to oral nutritional supplements is highly influenced by the consistency, taste, smell, volume consumed, and side effects. The aim of the present case report is to illustrate that nutritional management is a successful and effective treatment option of disease-related malnutrition when the selection of the oral nutritional supplement takes into consideration patient's preferences as well. PMID:27039999

  5. Clinical management of hypohidrotic ectodermal dysplasia with anodontia: case report.

    PubMed

    Paschos, Ekaterini; Huth, Karin Christine; Hickel, Reinhard

    2002-01-01

    Ectodermal dysplasia is a rare hereditary disorder with a characteristic physiognomy. The case of a 5-year-old child with hypohidrotic ectodermal dysplasia and complete anodontia is presented. Because of the anodontia and the need for treatment at an early age, the prosthetic management of such a young child can be difficult. Complete dentures were provided to encourage a normal psychological development and to improve the function of the stomatognathic system. PMID:12413164

  6. Surgical Management of Fractured Orthodontic Mini- Implant- A Case Report

    PubMed Central

    Jain, Anoop; Sumra, Nida

    2015-01-01

    The idea of absolute anchorage has always been an elusive goal for clinicians. Orthodontic mini-implants or temporary anchorage devices allow tooth movements previously thought to be impossible or difficult. Although extensive literature exists on use of temporary anchorage devices, their failures have been hardly focused upon, especially implant fracture. The following case report describes successful management of fractured orthodontic mini-implant. PMID:25738088

  7. Oral bullous lichen planus: Case report and review of management

    PubMed Central

    Patil, Archana; Prasad, Shiva; Ashok, L.; Sujatha, G. P.

    2012-01-01

    A 34-year-old female patient with the chief complaint of burning sensation in the oral cavity associated with generalized pruritis, scalp and skin lesions diagnosed as Bullous lichen planus and treated with systemic prednisolone, levamisole, benzydamine oral rinse. Patient is in follow up since 1 year and free of lesions. Here we report the case and review current modalities in the management of oral lichen planus. PMID:23293497

  8. Surgical Approaches and Management of Panfacial Trauma: A Case Report

    PubMed Central

    Dhanasekaran, Vandana

    2015-01-01

    Patients with multiple fractures involving upper third of the face, the mid-face and the lower third are generally referred to as Pan-facial fractures and managing these cases is extremely complicated. Proximity of the maxillofacial region to the important features or senses such as visual function (diplopia), olfaction, respiration (airway management), chewing or mastication (occlusion), deglutition and aesthetics; makes the scenario a little more complex for the surgeon operating in this particular region than the surgeon operating any other part of the body. Inability to directly visualize and reduce all the components of a pan facial injury along with inadequate stability of the fractured bones leads to persistent deformity. It is challenging to follow an established pattern for repairing the pan facial fractures. Each case with this type of fracture is unique and requires skill and expertise of the surgeon to restore the pre-traumatic anatomy and facial aesthetics. Despite all the aggressive treatment, most of the patient’s with pan facial trauma may have some residual deformity which may require another correction surgery later. This article briefs about the management and simple approaches used to reduce and fix a case of pan facial trauma in a 23-year-old male. PMID:26436064

  9. Clinicopathological profile and management of 161 cases of actinic cheilitis*

    PubMed Central

    Lopes, Maria Luiza Diniz de Sousa; da Silva Júnior, Francisco Leonardo; Lima, Kenio Costa; de Oliveira, Patrícia Teixeira; da Silveira, Éricka Janine Dantas

    2015-01-01

    BACKGROUND Actinic cheilitis (AC) is a potentially malignant disorder of the lip caused by chronic exposure to ultraviolet radiation from the sun. OBJECTIVES To evaluate the clinical, demographic, morphological and therapeutic management in AC cases data associating to the histopathological grading. METHODS Demographic, clinical and management data of 161 patients with AC were analyzed. In biopsied cases, two calibrated examiners performed histopathological grading by binary system. RESULTS There was a prevalence of males (79.5%), aged 40 years or older (77.5%), light-skinned (85.7%), experiencing occupational exposure to sunlight (80.3%), with AC presenting clinically as white lesions (33.6%). Conservative treatment was adopted in 78 cases and biopsy in 83 cases (60.2% graded as low-risk AC). There were no significant associations between histopathological grading and gender (p= 0.509), age (p=0.416), ethnicity (p=0.388), occupational exposure to sunlight (p=1.000) or clinical presentation (p=0.803). CONCLUSION This study reinforces the hypothesis that demographic and clinical characteristics of AC are not related to histopathological grading. Advice on protection from sun exposure should be encouraged to avoid progression of AC and invasive therapies. PMID:26375219

  10. Chiropractic management of breast-feeding difficulties: a case report

    PubMed Central

    Holleman, Annique C.; Nee, John; Knaap, Simone F.C.

    2011-01-01

    Objective The purpose of this study is to discuss a chiropractic case of management and resolution of breast-feeding difficulties. Clinical Features The case involves an 8-day-old baby unable to breast-feed since 4 days old. Initial examination revealed cervical, cranial, and sacral restrictions. She was diagnosed with craniocervical syndrome by a doctor of chiropractic. Intervention and Outcome Following history and examination, the infant received gentle chiropractic manipulation based on clinical findings. Immediate improvement and complete resolution of the nursing problems were observed after 3 treatments over 14 days. Conclusion The results of this case suggest that neuromusculoskeletal dysfunction may influence the ability of an infant to suckle successfully and that intervention via chiropractic adjustments may result in improving the infant's ability to suckle efficiently. PMID:22014911

  11. BCG-related renal granulomas managed conservatively: A case series

    PubMed Central

    Al-Qaoud, Talal; Brimo, Fadi; Aprikian, Armen G.; Andonian, Sero

    2015-01-01

    Introduction: The aim of this case series is to present two cases of renal granulomas discovered incidentally post-intravesical Bacillus Calmette-Guerin (BCG) installations and were managed conservatively. Case reports: The first case is a 68-year-old man with bladder and right ureteral orifice carcinoma in situ. After transurethral resection of the right ureteral orifice and bladder tumours, he received 6 + 3 weekly intravesical installations of BCG and then 6 + 3 weekly intravesical installations of BCG with interferon alpha (IFN) in the presence of an indwelling ureteral stent since he had refused cystoprostatectomy. At the 18-month follow-up, his computed tomography scan showed two right renal masses. Biopsy demonstrated non-necrotizing granulomatosis. Serial follow-up with imaging studies showed complete resolution of these masses without anti-tuberculous medications. The second case is a 74-year old man with left renal high-grade papillary urothelial carcinoma. After ureteral meatotomy and insertion of indwelling ureteral stents, he received 6 weekly intravesical installations of BCG followed by 3 weekly installations of BCG and IFN prior to the definitive management with laparoscopic left nephroureterectomy. Final pathology showed pT1 urothelial carcinoma and an incidental finding of BCG-related renal granulamotosis. The patient has been asymptomatic and did not require anti-tuberculous medications. Conclusions: While these two cases demonstrate the ability of intravesical BCG to reach the renal pelvis, patients with a history of intravesical BCG with incidental renal masses may benefit from renal biopsy. These renal granulomas may resolve without anti-tuberculous medications. PMID:26085879

  12. Farmers' use of nutrient management: lessons from watershed case studies.

    PubMed

    Osmond, Deanna L; Hoag, Dana L K; Luloff, Al E; Meals, Donald W; Neas, Kathy

    2015-03-01

    Nutrient enrichment of water resources has degraded coastal waters throughout the world, including in the United States (e.g., Chesapeake Bay, Gulf of Mexico, and Neuse Estuary). Agricultural nonpoint sources have significant impacts on water resources. As a result, nutrient management planning is the primary tool recommended to reduce nutrient losses from agricultural fields. Its effectiveness requires nutrient management plans be used by farmers. There is little literature describing nutrient management decision-making. Here, two case studies are described that address this gap: (i) a synthesis of the National Institute of Food and Agriculture, the Conservation Effects Assessment Project, and (ii) field surveys from three nutrient-impaired river basins/watersheds in North Carolina (Neuse, Tar-Pamlico, and Jordan Lake drainage areas). Results indicate farmers generally did not fully apply nutrient management plans or follow basic soil test recommendations even when they had them. Farmers were found to be hesitant to apply N at university-recommended rates because they did not trust the recommendations, viewed abundant N as insurance, or used recommendations made by fertilizer dealers. Exceptions were noted when watershed education, technical support, and funding resources focused on nutrient management that included easing management demands, actively and consistently working directly with a small group of farmers, and providing significant resource allocations to fund agency personnel and cost-share funds to farmers. Without better dialogue with farmers and meaningful investment in strategies that reward farmers for taking what they perceive as risks relative to nutrient reduction, little progress in true adoption of nutrient management will be made. PMID:26023957

  13. Neurosurgical management of anterior meningo-encephaloceles about 60 cases

    PubMed Central

    Rifi, Loubna; Barkat, Amina; El Khamlichi, Abdeslam; Boulaadas, Malek; El Ouahabi, Abdessamad

    2015-01-01

    Anterior meningo-encephaloceles (AME) are congenital malformations characterized by herniation of brain tissue and meninges through a defect in the cranium, in frontal, orbital, nasal and ethmoidal regions. The management of this complex congenital malformation is controversial according to whether use, an intracranial, extra-cranial or combined approach. This is the first largest series published in Africa, in which we present our experience in the operative management of AME; we share our recommendation in technical consideration for surgical approach with review of the literature. All patients beneficed of neuro-radiological investigations including Plan X rays, Spiral Three dimensional CT scan and MRI. Ophthalmologic and maxillo-facial evaluations were done in all the cases. MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach. The surgical results were evaluated in the follow up on the basis of disappearance of cranio-facial tumefaction with correction of hypertelorism. 60 children with AME were treated in our department between January 1992 and December 2012. The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males). Cranio-facial team operated 21 patients, 16 were operated in two stages by intracranial approach followed by facial approach, 20 cases beneficed the neurosurgical approach and three only the facial approach Some post operative complications were observed: 2 cases of post operative hydrocephalus underwent shunt; CSF fistulas in three cases cured by spinal drainage, one death due to per operative hypothermia, 3 cases of recurrence how needed second surgery. After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics

  14. Empowerment and change management in Aboriginal organisations: a case study.

    PubMed

    McEwan, Alexandra B; Tsey, Komla; McCalman, Janya; Travers, Helen J

    2010-08-01

    The social organisation of work, management styles and social relationships in the workplace all matter for health. It is now well recognised that people who have control over their work have better health and that stress in the workplace increases the level of disease. In the context of organisational change, the potential benefits of empowerment strategies are two-fold: a positive impact on the organisation's effectiveness and enhancements in staff health, wellbeing and sense of control. This case study describes the University of Queensland Empowerment Research Program's experience working with the Apunipima Cape York Health Council in a change management process. Participatory action research and empowerment strategies were utilised to facilitate shifts in work culture and group cohesion towards achieving Apunipima's vision of being an effective lead agency for Indigenous health reform in Cape York. As part of the project, staff morale and confidence were monitored using a pictorial tool, Change Curve, which outlined the phases of organisational change. The project findings indicated that organisational change did not follow a clear linear trajectory. In some ways the dynamics mapped over a period of 18 months mirror the type of struggles individuals commonly encounter as a part of personal growth and development. In this case, one of the factors which influenced the program's success was the willingness of executive employees to actively support and participate in the change management process. PMID:20797370

  15. Case management in a DUI lab: effect on drugs reported.

    PubMed

    Tiscione, Nicholas B; Shan, Xiaoqin; Yeatman, Dustin Tate

    2014-10-01

    An evaluation of an internal laboratory decision to implement a protocol for limiting drug testing based on ethanol concentration in laboratory analysis for driving under the influence (DUI) cases is presented. The described case management strategy is supported by known impairment of ethanol at relatively high concentrations, difficulty assigning a level of contributing impairment from drugs in the presence of high ethanol levels and the likelihood that the drug results may be suppressed at trial. Although the results of this study reinforce the assertion that such protocols lead to the under reporting of drugs in DUI cases, for the majority of cases, 95% in this study, the drug analysis results were not significant and did not warrant the time and resources needed for the additional blood drug testing. Furthermore, the study demonstrated that a high drug positivity rate does not necessarily mean that those drug results are legally or pharmacologically meaningful. Additional research should be conducted with quantitative drug results and casework impact of blood drug screen protocols as previous studies only report drug positivity rates and not whether the drug results would be meaningful to the case. PMID:25217546

  16. Adult-onset laryngomalacia: case reports and review of management.

    PubMed

    Hey, Shi Ying; Oozeer, Nashreen Banon; Robertson, Stuart; MacKenzie, Kenneth

    2014-12-01

    Laryngomalacia is a dynamic airway condition characterised by inward collapse of flaccid supraglottic structures during inspiration. Although the most common cause of stridor in the paediatric population, adult-onset laryngomalacia remains a rare entity and its management, challenging. Two cases of adult-onset laryngomalacia are reported. A review of the English literature is performed and additional publications identified by hand-searching relevant papers; 13 case reports/series comprising 28 cases of adult-onset laryngomalacia were identified, divided into two main groups: idiopathic (6/28) and acquired (22/28). The aetiology of the acquired form includes neurological, traumatic and iatrogenic. Reported therapeutic measures used are laser supraglottoplasty, epiglottopexy, partial epiglottidectomy, defunctioning tracheostomy and intubation whilst correcting the underlying cause. The majority of patients only required one therapeutic procedure (follow-up of 2-24 months). A strong index of suspicion is required to diagnose adult-onset laryngomalacia aided by in-office laryngoscopy. The rarity of this condition prevents management-based randomised controlled trials. PMID:24615649

  17. Case Managers' Attitudes toward the Use of Homework for People Diagnosed with a Severe Psychiatric Disability

    ERIC Educational Resources Information Center

    Kelly, Peter J.; Deane, Frank P.; Kazantzis, Nikolaos; Crowe, Trevor P.

    2007-01-01

    The study examined mental health case managers' attitudes toward the use of homework and explored the relationship between clinician attitudes and systematic homework administration practices. A survey examining attitudes toward the use of homework was completed by 122 Australian mental health case managers. Case managers who held more positive…

  18. Child Protective Services Case Management Project. Final Report: Innovations in Protective Services.

    ERIC Educational Resources Information Center

    Texas State Dept. of Human Resources, Austin.

    One of seven reports in the Innovations in Protective Services series, this document reports on the development of a model of case management that clarified what is expected from Child Protective Service (CPS) specialists. By conducting a literature review, studying the role of the CPS case manager, and developing a case management model, the Case…

  19. Management of Ectopically Erupting Maxillary Incisors: A Case Series.

    PubMed

    Suresh, Kotumachagi Sangappa; Uma, H L; Nagarathna, J; Kumar, Pravin

    2015-01-01

    Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543

  20. A Case of Error Disclosure: A Communication Privacy Management Analysis

    PubMed Central

    Petronio, Sandra; Helft, Paul R.; Child, Jeffrey T.

    2013-01-01

    To better understand the process of disclosing medical errors to patients, this research offers a case analysis using Petronios’s theoretical frame of Communication Privacy Management (CPM). Given the resistance clinicians often feel about error disclosure, insights into the way choices are made by the clinicians in telling patients about the mistake has the potential to address reasons for resistance. Applying the evidenced-based CPM theory, developed over the last 35 years and dedicated to studying disclosure phenomenon, to disclosing medical mistakes potentially has the ability to reshape thinking about the error disclosure process. Using a composite case representing a surgical mistake, analysis based on CPM theory is offered to gain insights into conversational routines and disclosure management choices of revealing a medical error. The results of this analysis show that an underlying assumption of health information ownership by the patient and family can be at odds with the way the clinician tends to control disclosure about the error. In addition, the case analysis illustrates that there are embedded patterns of disclosure that emerge out of conversations the clinician has with the patient and the patient’s family members. These patterns unfold privacy management decisions on the part of the clinician that impact how the patient is told about the error and the way that patients interpret the meaning of the disclosure. These findings suggest the need for a better understanding of how patients manage their private health information in relationship to their expectations for the way they see the clinician caring for or controlling their health information about errors. Significance for public health Much of the mission central to public health sits squarely on the ability to communicate effectively. This case analysis offers an in-depth assessment of how error disclosure is complicated by misunderstandings, assuming ownership and control over information

  1. Pineal cyst apoplexy: report of an unusual case managed conservatively.

    PubMed

    Ayhan, Selim; Bal, Ercan; Palaoglu, Selcuk; Cila, Aysenur

    2011-01-01

    Pineal cyst apoplexy is a very rare entity with previously reported symptoms of severe frontal or occipital headache, gaze paresis and visual field defects, nausea or vomiting, syncope, ataxia, hearing loss and sudden death. The treatment options for symptomatic pineal cysts are observation, shunting, aspiration via stereotactic guidance or endoscopy, third ventriculostomy, ventriculocysternostomy, and/or surgical resection by craniotomy and microsurgery. Here, the authors report an unusual case of a 28-year-old male patient with pineal cyst apoplexy, presenting with headache, insomnia, and sexual dysfunction symptoms who is being managed conservatively and observed for two years by an academic tertiary care unit. PMID:22212992

  2. Laparoscopic Management of Hilar Cholangiocarcinoma: a Case Report.

    PubMed

    Puntambekar, Shailesh; Sharma, Vikrant; Kumar, Sanjay; Mitkare, Sainath; Joshi, Geetanjali; Parikh, Hirav

    2016-02-01

    The only option for cure of Klatskin's tumour is surgical excision. The radicality of the procedure is determined by the extent of the tumour and functional parameters of the patient. Complete laparoscopic resection of hilar cholangiocarcinoma with biliary reconstruction is a challenging procedure. The main aim is to achieve pathological negative margins, complete lymph node retrieval and enterobiliary bypass. We present a case report of a patient with hilar cholangiocarcinoma managed laparoscopically. The nodal yield was nine. On 6-month follow-up, the patient was symptom free. The main aim is to study the feasibility of performing this complex procedure completely laparoscopically. PMID:27186042

  3. Management of Ectopically Erupting Maxillary Incisors: A Case Series

    PubMed Central

    Suresh, Kotumachagi Sangappa; Uma, HL; Nagarathna, J

    2015-01-01

    ABSTRACT Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543

  4. [Management of the patient with COPD: home case or hospitalization].

    PubMed

    Aubert, John-David

    2013-05-01

    Acute exacerbation of COPD is one of the most common causes of hospital admission in patients affected with this disease. In most cases, consideration of differential diagnoses and assessment of important comorbidities will allow to make the decision whether or not the patient needs to be hospitalized. A decision to hospitalize will be based on specific symptoms and signs, as well on the patient's history. Contrary to bronchial asthma, a systematic action plan strategy is lacking for COPD. However, a disease management plan involving all the health care providers may have the potential to improve the patient's well being and to decrease costs related to these exacerbations. PMID:23644245

  5. Multidisciplinary Management of a Fused Tooth: A Case Report

    PubMed Central

    Sen Tunc, Emine; Arici, Nursel; Ozkan, Nilüfer

    2013-01-01

    Objective. Fusion is a dental anomaly that arises through the union of two adjacent teeth. The case report presents multidisciplinary management of a fused maxillary anterior tooth. Case Report. A 10-year-old boy was referred to the pediatric dental clinic with the chief complaint of a large upper anterior tooth. Intraoral and radiographic examinations indicated fusion between the permanent maxillary right central incisor and a supernumerary tooth. According to the treatment plan, the fused tooth was sectioned, and the mesial portion was removed. The remaining tooth section was restored with composite resin, and the diastema between the central incisors was closed with orthodontic treatment. After an 18-month followup period, the tooth showed no sign of pathosis. Conclusion. The technique described here offers a simple and effective method for restoring a fused tooth that reestablishes function, shape, and esthetics. PMID:24396611

  6. Management of Acute Patellar Dislocation: A Case Report

    PubMed Central

    Enix, Dennis E.; Sudkamp, Kasey; Scali, Frank; Keating, Robbyn; Welk, Aaron

    2015-01-01

    Objective The purpose of this case study is to describe the evaluation and management of patellar dislocations and the different approaches used from providers in different countries. Clinical Features An individual dislocated her left patella while traveling abroad and received subsequent care in Thailand, China, and the United States. Intervention and Outcome Nonoperative treatment protocols including manual closed reduction of the patella, casting of the leg, and rehabilitation exercises were employed. Conclusion Receipt of care when abroad can be challenging. The patient’s knee range of motion and pain continued to improve when she was diligent about performing the home exercise program. This case highlights the importance of a thorough examination, a proper regimen of care, and patient counseling to ensure a full recovery and minimize the chance of re-injury. PMID:26778935

  7. Meta-case based realization of design rationale management systems

    SciTech Connect

    Paul, G.

    1996-12-31

    System design is an iterative, creative, and cooperative process where informal ideas are transformed into a detailed definition of how a system can be implemented. Design rationale aims at capturing and preserving the why underlying the what, the argument behind the artifact in the design process. Recording deliberations of the design process therefore promises benefits for the overall system engineering life cycle. Providing adequate computer support for design rationale is an interesting issue and a real need for effective application. A design rationale management system (DRMS) supports the capturing, storing and retrieval of interaction rationale in a shared corporate knowledge base and allows organizational learning through long-term and inter-project reuse. The intent of meta-CASE systems is to capture the specification of a required CASE tool and then generate the tool for actual production from the specification. In this paper we identify the requirements for a DRMS and investigate the applicability of meta-CASE tools for the implementation of DRMS`s. Furthermore we describe the experiences gained in the development of two DRMS`s adopting the meta CASE tools MaestroII GED/TCI and Hardy.

  8. Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

    PubMed Central

    Rusnak, James E.

    1987-01-01

    Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The hospital must insure the CMMS project provides a means to implement an integrated on-line hospital information data base for use by departments in operating under a DRG-based Prospective Payment System. This paper presents guidelines for use in selecting a Case Mix Mangement System to meet the hospital's financial and operations planning, budgeting, marketing, and other management needs, while considering the data base implications of the implementation.

  9. Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

    PubMed Central

    Moise, Imelda K.; Mulhall, Peter F.

    2016-01-01

    Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded

  10. Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study.

    PubMed

    Moise, Imelda K; Mulhall, Peter F

    2016-01-01

    Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded

  11. HIPAA Privacy 101: essentials for case management practice.

    PubMed

    DiBenedetto, Deborah V

    2003-01-01

    The Health Insurance Portability and Accountability Act (HIPAA) has significant impact on the delivery of healthcare in the United States. The Administrative Simplification (AS) requirements of HIPAA are aimed at reducing administrative costs and burdens in the healthcare industry. The core components of HIPAA's AS requirements address healthcare transactions, code sets, security, unique identifiers, and privacy of health information. HIPAA's privacy standard limits the nonconsensual use and release of private health information, gives patients new rights to access their medical records and to know who else has accessed them, restricts most disclosure of health information to the minimum needed for the intended purpose, establishes new criminal and civil sanctions for improper use or disclosure, and establishes new requirements for access to records by researchers and others. This article focuses on HIPAA's privacy requirements as related to case management of workers compensation populations, the treatment of protected health information, and how case managers can ensure they provide appropriate services while navigating the requirements of HIPAA's privacy standard. PMID:12555039

  12. Conservative management of a case of tarsal tunnel syndrome

    PubMed Central

    Hudes, Karen

    2010-01-01

    Objective: This case study was conducted to evaluate the treatment and management of a patient presenting with chronic foot pain, diagnosed as tarsal tunnel syndrome. Case: 61 year old female presenting with plantar and dorsal foot pain and burning sensation of 6 months duration. Treatment: Treatment was initiated using custom orthotics only for the first ten weeks of care as the patient did not follow up or initially respond to follow up calls placed by the practitioner. A course of high-velocity, low-amplitude adjustments using a toggle board to the cuboid and the talonavicular joint and fascial stripping was added upon report from the patient that the orthotic therapy alone did not resolve the symptoms. Improvement of pain reported on the Verbal Rating Scale was noted with a complete resolution of the condition at the conclusion of treatment. No pain was reported on a ten month follow up with the patient. Conclusion: Conservative management, including orthotics, manipulation, and fascial stripping may be beneficial in the treatment of tarsal tunnel syndrome. PMID:20520754

  13. [Management of chicken pox purpura fulminans: a pediatric case report].

    PubMed

    Domergue, S; Rodiere, M; Bigorre, M; Guye, E; Captier, G

    2006-06-01

    The authors report a case of a 4 years old girl who had presented a chicken-pox purpura fulminans. Lesions appeared 5 days after chicken-pox start and were quickly evoluted in cutaneous and sub-cutaneous necrosis on external side of thighs and behind side of right calf. A medical management was done with fresh plasma, blood, antithrombine 3, and fibrin. Specifics treatments were done: heparin and activated C protein. Surgical treatment was realised 5 weeks later. It consisted of clean necrosis areas and put a thin skin graft witch was took on the scalp. The evolution was fast good. The follow-up is 3 years without big esthetic and functional consequences. Some cases of this pathology were described in literature with serious lesions. The management should be multidisciplinary. Surgical treatment should be realised when lesions are stabilized. Scalp is a donor site for skin graft very interesting because of big quantity of skin and not esthetic consequence. PMID:16504361

  14. What Did We Learn from the Case Studies about Managing Evaluation?

    ERIC Educational Resources Information Center

    Baizerman, Michael; Compton, Donald W.

    2009-01-01

    Case studies about managing evaluation are examined for perspectives on expertise in managing evaluation. There are lessons on a geography of managing, managing as organizational work, the notions of "competency" and "expertise," and managing evaluation as professional work. Dreyfus and Dreyfus (2004) offer a framework for an introductory…

  15. Chiropractic management of postpartum pubic symphysis diastasis: A case report

    PubMed Central

    Henry, Lucian

    2015-01-01

    This case report describes the chiropractic management of a 30-year-old female patient with severe postpartum pelvic pain secondary to pubic symphysis diastasis. No literature was found on the chiropractic management of postpartum symphysis pubis diastasis. The existing literature concerning chiropractic care for symphysis pubis dysfunction during pregnancy is limited and indicates a potential benefit. Separation of the pubic symphysis may include ligamentous injury to the sacroiliac joints and may lead to chronic pain. Pubic symphysis separation of 17 millimeters was present on digital radiograph. Management consisted of chiropractic adjustments, trigger point release, electrical stimulation, moist heat, sacroiliac belt, and specific stabilizing exercises. The patient’s pain improved immediately following treatment on the initial visit. Pain was reduced from 8/10 VAS at the first visit to 2/10 at the fourth visit. She was able to resume normal activities and reached a final pain level of 1/10. The diastasis was reduced by 7 millimeters at 14-weeks post radiograph for a final separation of just under 10 millimeters. Collaboration between obstetricians, midwives and chiropractors may be warranted. PMID:25729083

  16. Chiropractic management of postpartum pubic symphysis diastasis: A case report.

    PubMed

    Henry, Lucian

    2015-03-01

    This case report describes the chiropractic management of a 30-year-old female patient with severe postpartum pelvic pain secondary to pubic symphysis diastasis. No literature was found on the chiropractic management of postpartum symphysis pubis diastasis. The existing literature concerning chiropractic care for symphysis pubis dysfunction during pregnancy is limited and indicates a potential benefit. Separation of the pubic symphysis may include ligamentous injury to the sacroiliac joints and may lead to chronic pain. Pubic symphysis separation of 17 millimeters was present on digital radiograph. Management consisted of chiropractic adjustments, trigger point release, electrical stimulation, moist heat, sacroiliac belt, and specific stabilizing exercises. The patient's pain improved immediately following treatment on the initial visit. Pain was reduced from 8/10 VAS at the first visit to 2/10 at the fourth visit. She was able to resume normal activities and reached a final pain level of 1/10. The diastasis was reduced by 7 millimeters at 14-weeks post radiograph for a final separation of just under 10 millimeters. Collaboration between obstetricians, midwives and chiropractors may be warranted. PMID:25729083

  17. Evaluation of a case management service to reduce sickness absence

    PubMed Central

    Smedley, Julia; Harris, E. Clare; Cox, Vanessa; Ntani, Georgia; Coggon, David

    2013-01-01

    Background It is unclear whether and to what extent intensive case management is more effective than standard occupational health services in reducing sickness absence in the healthcare sector. Aims To evaluate a new return to work service at an English hospital trust. Methods The new service entailed intensive case management for staff who had been absent sick for longer than four weeks, aiming to restore function through a goal-directed and enabling approach based on a bio-psycho-social model. Assessment of the intervention was by controlled before and after comparison with a neighbouring hospital trust at which there were no major changes in the management of sickness absence. Data on outcome measures were abstracted from electronic databases held by the two trusts. Results At the intervention trust, the proportion of 4-week absences which continued beyond 8 weeks fell from 51.7% in 2008 to 49.1% in 2009 and 45.9% in 2010. The reduction from 2008 to 2010 contrasted with an increase at the control trust from 51.2% to 56.1% – a difference in change of 10.7% (95%CI 1.5% to 20.0%). There was also a differential improvement in mean days of absence beyond four weeks, but this was not statistically significant (1.6 days per absence, 95%CI −7.2 to 10.3 days). Conclusion Our findings suggest that the intervention was effective, and calculations based on an annual running cost of £57,000 suggest that it was also cost-effective. A similar intervention should now be evaluated at a larger number of hospital trusts. PMID:23365116

  18. The laparoscopic management of Swyer syndrome: Case series

    PubMed Central

    Malhotra, Neena; Dadhwal, Vatsla; Sharma, Kandala Aparna; Gupta, Deepika; Agarwal, Sumita; Deka, Dipika

    2015-01-01

    Swyer syndrome, also known as 46 XY pure gonadal dysgenesis, is a rare endocrine disorder. Affected individuals are phenotypically female with female genitalia, normal Mullerian structures, absent testicular tissue, and a 46 XY chromosomal constitution. We report a series of eight cases of Swyer syndrome, of which six were managed by laparoscopic gonadectomy. The two other cases had to undergo an exploratory laparotomy in view of their presentation with adnexal masses. Two of the girls were siblings. The chief presenting complaint was primary amenorrhea. Four girls also presented with a history of poor development of secondary sexual characters. The average age at presentation was 16.19±2.85 years. The average height was 158.33 ±4.63 cm, and the average weight was 49.33±8.44 kg. Breast development was either Tanner 2 or 3 in four girls, whereas three girls had a Tanner 1 underdeveloped breasts. Axillary and pelvic hair was sparse in all the girls. The vagina was well canalized in all the girls. Hormonal evaluation revealed hypergonadotropic hypogonadism with a mean follicle-stimulating hormone (FSH) level of 95.81 mIU/L and a mean luteinizing (LH) level of 24.15 mIU/L. Imaging analysis revealed the presence of a small uterus in all the cases, except one. Bilateral ovaries were either not visualized or streak gonads were present. Adnexal mass was detected in two of the six cases with raised carcinoembryonic antigen (CA) 125 levels in one case. Genetic analysis revealed a karyotype of 46 XY in six girls, 46 XY/45 X in one, and the culture repeatedly failed in one girl. Because of the risk of malignancy, bilateral gonadectomy was performed in all cases. Histopathological analysis revealed that three of the six cases had dysgerminoma. The patients have been started on hormone replacement therapy. Laparoscopy is a minimally invasive modality for the definitive diagnosis and treatment of cases with Swyer syndrome. An early diagnosis of Swyer syndrome is possible

  19. Ayurvedic approach for management of ankylosing spondylitis: A case report.

    PubMed

    Singh, Sarvesh Kumar; Rajoria, Kshipra

    2016-03-01

    Ankylosing spondylitis (AS) is a rheumatic disease with various skeletal and extra skeletal manifestations. No satisfactory treatment is available in modern medicine for this disorder. Various Panchakarma procedures and Ayurvedic drugs have been proved useful for these manifestations. We present a case of AS, which was treated for two months with a combination of Panchakarma procedures and Ayurvedic drugs. Ayurvedic treatments, in this case, were directed toward alleviating symptoms and to reduce severe disability. The patient was considered suffering from Asthimajja gata vata (∼Vata disorder involving bone and bone marrow) and was treated with Shalishastika Pinda Svedana (sudation with medicated cooked bolus of rice) for one month and Mustadi Yapana Basti (enema with medicated milk) with Anuvasana (enema with Asvagandha oil) in 30 days schedule along with oral Ayurvedic drugs for two months. Pratimarsha nasya (nasal drops) with Anu Taila (oil) for one month was given after completion of Basti procedure. Patient's condition was assessed for symptoms of Asthimajja gata vata and core sets of Assessment of Spondylo Arthritis International Society showed substantial improvement. This study shows the cases of AS may be successfully managed with Ayurvedic treatment. PMID:27297511

  20. Get Them Talking: Managing Change through Case Studies and Case Study Discussion. RUSA Occasional Paper, Number 25.

    ERIC Educational Resources Information Center

    Arthur, Gwen, Ed.

    Since 1989, the Reference and User Services Association/Management and Operation of User Services Section's Management of Reference Committee has successfully used case studies to foster structured discussions among public service librarians on a wide variety of issues relating to managing change in reference services. The information offered in…

  1. Epidermolysis bullosa, dental and anesthetic management: a case report.

    PubMed

    Esfahanizade, Katayoun; Mahdavi, Ali Reza; Ansari, Ghassem; Fallahinejad Ghajari, Masoud; Esfahanizadeh, Abdolreza

    2014-09-01

    Epidermolysis bullosa (EB) is a group of rare inherited skin and mucous membrane disorders in which blister formation may arise spontaneously or following a minor friction. Various patterns of inheritance are explicated for the disease. The disease has a profound effect on oral mucosa and may result in high prevalence of dental caries. General anesthesia is sometimes the only choice for dental treatments in patients with EB. The following case report describes the dental and anesthetic management of an 12.5 -year-old girl with dystrophic type of EB. The patient was followed up every 6 months. New carious lesions were detected one year after the treatment, on the last visit. Presenting a perfect dental care to children with this disorder can be challenging for the in charge specialist, both pediatric dentist and anesthesiologist. PMID:25191665

  2. School asthma screening and case management: attendance and learning outcomes.

    PubMed

    Moricca, Michelle L; Grasska, Merry A; BMarthaler, Marcia; Morphew, Tricia; Weismuller, Penny C; Galant, Stanley P

    2013-04-01

    Asthma is related to school absenteeism and underperformance in elementary students. This pilot study assessed whether school nurse case management (CM) in children identified with asthma impacts academic performance and school absenteeism in one school. A validated questionnaire was used to identify children at risk for asthma and CM was provided to link these students to medical care and assure asthma action plans at school. In the 40 children with confirmed diagnosis who received CM, academic performance on standardized testing postintervention was similar to the 76 children who were low risk for asthma. Average days absent due to illness in the CM group were reduced from 5.8 to 3.7 days in the postintervention school year. School nurse screening, CM, and collaboration with a medical provider resulted in early identification, referral, and subsequent treatment of students at risk for asthma and may have contributed to reduced illness absences. PMID:22797976

  3. Conservation markets for wildlife management with case studies from whaling.

    PubMed

    Gerber, Leah R; Costello, Christopher; Gaines, Steven D

    2014-01-01

    Although market-based incentives have helped resolve many environmental challenges, conservation markets still play a relatively minor role in wildlife management. Establishing property rights for environmental goods and allowing trade between resource extractors and resource conservationists may offer a path forward in conserving charismatic species like whales, wolves, turtles, and sharks. In this paper, we provide a conceptual model for implementing a conservation market for wildlife and evaluate how such a market could be applied to three case studies for whales (minke [Balaenoptera acutorostrata], bowhead [Balaena mysticetus], and gray [Eschrictius robustus]). We show that, if designed and operated properly, such a market could ensure persistence of imperiled populations, while simultaneously improving the welfare of resource harvesters. PMID:24640529

  4. Epidermolysis Bullosa, Dental and Anesthetic Management: A Case Report

    PubMed Central

    Esfahanizade, Katayoun; Mahdavi, Ali Reza; Ansari, Ghassem; Fallahinejad Ghajari, Masoud; Esfahanizadeh, Abdolreza

    2014-01-01

    Epidermolysis bullosa (EB) is a group of rare inherited skin and mucous membrane disorders in which blister formation may arise spontaneously or following a minor friction. Various patterns of inheritance are explicated for the disease. The disease has a profound effect on oral mucosa and may result in high prevalence of dental caries. General anesthesia is sometimes the only choice for dental treatments in patients with EB. The following case report describes the dental and anesthetic management of an 12.5 -year-old girl with dystrophic type of EB. The patient was followed up every 6 months. New carious lesions were detected one year after the treatment, on the last visit. Presenting a perfect dental care to children with this disorder can be challenging for the in charge specialist, both pediatric dentist and anesthesiologist. PMID:25191665

  5. Water resources management: case study of Sharkia governorate, Egypt

    NASA Astrophysics Data System (ADS)

    Mohamed, Y. A.; Rashad, M.

    2012-06-01

    Ministry of water resources and irrigation in Egypt is currently implementing projects that expand new cultivated area, and accordingly the supplies of Nile River to the Nile Delta will be negatively affected. So, Enormous interest toward water resources management has been taken in the Egyptian water sector. Conveyance infrastructure and irrigation technology has been gradually improved to ensure efficient distribution and utilization of scarce water resources. The present study is focused on the optimum utilization of water resources in Sharkia governorate, Egypt. Operational and planning distribution model is implemented on the selected case study (Sharkia governorate) to develop appropriate water plan. The gross revenue of all crops is correlated to surface water discharge, ground water discharge, surface water salinity, and ground water salinity. In addition, the effect of varying both surface and groundwater quantities and qualities on the gross revenue has been investigated. Moreover, the effect of limiting rice production on the gross revenue is allocated.

  6. Recurrent spontaneous pneumothorax during pregnancy managed conservatively: a case report.

    PubMed

    Mohamed Faisal, A H; Hazwani, A; Soo, C I; Andrea Ban, Y L

    2016-04-01

    A 36-year-old lady presented with four episodes of right sided pneumothorax during pregnancy requiring multiple chest drain insertion. It was complicated with persistent air leak despite low pressure high volume suction applied to the chest drainage. She delivered safely through spontaneous vaginal delivery with chest drainage. Further imaging by high resolution computed tomography (HRCT) scan of thorax done revealed bilateral scattered pulmonary cysts and sub pleural bullae and was later followed up with respiratory unit. She had no further episodes of pneumothorax postpartum. This case highlights the vital importance of prompt recognition and management of pneumothorax in pregnancy as the patient involved is at higher risk for acute respiratory failure leading to maternal and/or foetal mortality. It is essential for early involvement of obstetric team and to expedite the delivery for a better perinatal and maternal outcome. PMID:27326955

  7. School-Based Interprofessional Case Management: A Literature-Based Rationale and Practitioner-Molded Model.

    ERIC Educational Resources Information Center

    Smith, Albert J., Jr.; Stowitschek, Joseph J.

    1998-01-01

    Describes a school-based interprofessional case management model for children at risk for school failure that has been field tested in elementary and secondary schools. The model has three components: the case manager, the school-based interprofessional management team, and the comprehensive service network. The model has been used as a framework…

  8. Application of integrative information system improves the quality and effectiveness of cancer case management

    PubMed Central

    Lee, Pei-Yi; Chang, Tsue-Rung

    2015-01-01

    Cancer case management provides consecutive care during the entire process through diagnosis to treatment and follow-up. We established an integrative information system with integration of the health information system. This integrative information system shortened the time spent on case screening, follow-up data management, and monthly data summarization of case managers. It also promoted the case follow-up rate. This integrative information system may improve the quality and effectiveness for cancer case management, one important part of cancer nursing. PMID:26089680

  9. Comparison of intensive case management for psychotic and nonpsychotic patients.

    PubMed

    Mohamed, Somaia

    2016-02-01

    While the original goal of intensive community-based service programs such as assertive community treatment (ACT) was reduction of hospital use, this goal has diminished in importance because of the extensive reduction in inpatient bed availability and use. This study sought to identify target populations that benefit most from such programs, hypothesizing that those with psychotic symptoms would show more benefits than others because of improved medication compliance. Administrative outcome data from the Department of Veterans Affairs Mental Health Intensive Case Management program from 2008-2011 were compared among 3 groups: (a) veterans clinically diagnosed with a psychotic disorder who also exhibited at least moderately severe psychotic symptoms (N = 2,502); (b) veterans with a psychotic disorder who did not exhibit such symptoms (N = 2,338); and (c) veterans with no psychotic diagnoses (N = 820). Baseline characteristics were compared to identify potentially confounding differences between the groups. Analysis of covariance (ANCOVA) was used to compare changes in symptoms, substance use, and community functioning 6 months after entry. Two significant differences were observed between the 3 groups after controlling for baseline measures, but not in the hypothesized direction, thus failing to confirm our hypothesis. Although we did not find evidence that patients with psychotic symptoms benefit any more from intensive community-based care than other participants, this study highlights a need to clarify the role of intensive case management (ICM) services in a context in which minimizing inpatient care plays is a less central objective, and tends to encourage offering ACT to selected patients with nonpsychotic disorders. PMID:26168139

  10. Tying it all together: integrating a hospital-based health care system through case management education.

    PubMed

    Czerenda, A J; Best, L

    1994-01-01

    Recognizing the importance of the case manager as a system integrator, United Health Services, Inc. (UHS), a hospital-based health care system located in upstate New York, implemented several diverse case management models. Case managers were working in a variety of settings, often in isolation. It was determined that a system-wide case management education program would accomplish two goals: (a) provide all case managers within the UHS system with similar case management practice skills and language, and (b) provide an opportunity for case managers to meet, share role responsibilities and common case management issues, and use each other as resources. With input from leadership throughout the UHS system, a 4-week case management education program was developed and presented. Participants included multidisciplinary staff who had case management responsibilities within the system. Sessions were taught by UHS staff experts in a number of different disciplines. A teaching guide and manual were developed to supplement the didactic material. Feedback from the program was provided via written participant evaluation and follow-up discussions. PMID:8000326

  11. Case analysis online: a strategic management case model for the health industry.

    PubMed

    Walsh, Anne; Bearden, Eithne

    2004-01-01

    Despite the plethora of methods and tools available to support strategic management, the challenge for health executives in the next century will relate to their ability to access and interpret data from multiple and intricate communication networks. Integrated digital networks and satellite systems will expand the scope and ease of sharing information between business divisions, and networked systems will facilitate the use of virtual case discussions across universities. While the internet is frequently used to support clinical decisions in the healthcare industry, few executives rely upon the internetfor strategic analysis. Although electronic technologies can easily synthesize data from multiple information channels, research as well as technical issues may deter their application in strategic analysis. As digital models transform access to information, online models may become increasingly relevant in designing strategic solutions. While there are various pedagogical models available to support the strategic management process, this framework was designed to enhance strategic analysis through the application of technology and electronic research. A strategic analysis framework, which incorporated internet research and case analysis in a strategic managementcourse, is described alongwith design and application issues that emerged during the case analysis process. PMID:15129900

  12. The management of bilateral posterior fracture dislocations of the shoulder: a case series illustrating management options

    PubMed Central

    Robinson, Peter W; Packham, Iain; Crowther, Mark

    2016-01-01

    Background Although dislocation of the shoulder is a relatively common event, the overwhelming majority of injuries are anterior. Posterior shoulder dislocation is more uncommon, comprising between 3% and 5% of all shoulder dislocations. One percent of shoulder dislocations involve a fracture, whereas only 0.9% of the 1500 cases reported by Neer (J Bone Joint Surg Am 1970; 52:1077–89; J Bone Joint Surg Am 1970; 52:1090–103) concerned posterior fracture dislocations. Bilateral posterior fracture dislocation is an even rarer event, comprising just 5% of all posterior fracture dislocations. Given the rarity and relative poor outcome often observed after these severe injuries, it is important that upper limb function is optimized. Methods Bilateral posterior fracture dislocations of the shoulder pose a difficult clinical challenge that requires careful management planning. To date, there have been three isolated case reports of using contralateral osteochondral humeral autograft and hemiarthroplasty. We report our experiences and clinical outcomes in managing four such cases using a variety and combination of treatments, including the first reported use of reverse shoulder arthroplasty with contralateral osteochondral humeral autografting. Results Shoulders reconstructed with humeral autograft demonstrated superior Oxford Shoulder Scores and an improved range of motion, as measured by a markerless machine vision system, compared to hemiarthroplasty. Conclusions Our results support the use of a contralateral humeral autograft in bilateral posterior shoulder fracture dislocation.

  13. Pharmacologic management of borderline personality disorder: a case study.

    PubMed

    Links, Paul S; Cook, Michele; Quastel, Adam

    2005-01-01

    General principles of the "outcome-focused" model of psychopharmacologic management of patients with BPD are illustrated using the case of Ms. A, a patient with borderline personality disorder (BPD) experiencing impulsivity such as suicidal behavior, chronic insomnia and concurrent substance abuse. The model includes (1) measurement of specific behavioral outcomes related to functioning; (2) assessment of the role of substance use/abuse in patients with BPD; (3) consideration of interventions to clarify and strengthen the boundaries of the therapeutic relationship-including short lengths of time between prescription refills, medication contracts outlining consequences if substances are obtained outside of the relationship, and urine testing to ascertain compliance; (4) an understanding of the psychodynamic meanings attributed to medication while positive and negative medication effects are monitored with treatment response or transference issues, and; (5) use of the N-of-1 approach to test the new medication vs previous medications using patient specific outcomes that are anticipated to change with the pharmacologic management. PMID:16459755

  14. Dyskeratosis congenita- management and review of complications: a case report.

    PubMed

    Sinha, Shivam; Trivedi, Vikas; Krishna, Arvind; Rao, Nidhi

    2013-07-01

    Among the inherited bone marrow failure disorders, dyskeratosis congenita is an X-linked inherited disorder arising as a consequence of short telomere and mutations in telomere biology. Production of the altered protein dyskerin, leads to vulnerable skin, nails, and teeth which lead to higher permeability for noxious agents which can induce carcinogenesis accounting for the classical triad of skin pigmentation, nail dystrophy and oral leukoplakia. This condition is fatal and patients succumb to aplastic anemia, malignancy or immunocompromised state. We present a young male with the classic clinical triad and avascular necrosis of both femoral heads, with no evidence of hematologic anomaly or any malignancy. He was managed for osteonecrosis with uncemented total hip arthroplasty for the symptomatic left hip. Our case represents a benign form of such a fatal and rare condition, which if detected and managed early can result in improved quality of life for the patient suffering from this disorder. This patient is under our meticulous follow-up for the last 2 years in order to determine any late development of complications before being labelled as a variant of this syndrome. PMID:23904924

  15. Environmental management and firm performance: a case study.

    PubMed

    Claver, Enrique; López, María D; Molina, José F; Tarí, Juan J

    2007-09-01

    This study has as its aim to help to clarify the relationship between environmental management and economic performance by integrating it into a wider framework that includes the relationship between environmental strategy and firm performance, the latter being understood as the combination of environmental performance, competitive advantage and economic performance. A case study of the COATO farming cooperative showed us that its environmental management, focused on prevention logic, has had a positive net effect on its environmental performance. Besides, the order in which these practices were adopted favoured the development of new organisational capabilities that have contributed to the appearance of advantages derived from the greater accumulated experience of employees in creating new projects that are designed to reduce residues and pollution. COATO has also obtained a competitive advantage in differentiation thanks to an improved brand image and to its increased credibility in business relationships. Finally, a positive correlation exists between the pioneering proactive strategy adopted by this cooperative and the improvement of its firm performance with respect to the other firms in its sector. PMID:17141938

  16. Reframing tobacco dependency management in acute care: A case study.

    PubMed

    Schultz, Annette S H; Guzman, Randolph; Sawatzky, Jo-Ann V; Thurmeier, Rick; Fedorowicz, Anna; Fulmore, Kaitlin

    2016-08-01

    Effective tobacco dependence treatment within acute care tends to be inadequate. The purpose of the Utilizing best practices to Manage Acute care patients Tobacco Dependency (UMAT) was to implement and evaluate an evidence-based intervention to support healthcare staff to effectively manage nicotine withdrawal symptoms of acute surgical patients. Data collection for this one-year longitudinal case study included: relevant patient experiences and staff reported practice, medication usage, and chart review. Over the year each data source suggested changes in tobacco dependence treatment. Key changes in patient survey responses (N=55) included a decrease in daily smoking and cigarette cravings. Of patients who used nicotine replacement therapy, they reported an increase in symptom relief. Staff (N=45) were surveyed at baseline, mid-point and end of study. Reported rates of assessing smoking status did not change over the year, but assessment of withdrawal symptoms emerged as daily practice and questions about cessation diminished. Also delivery of nicotine replacement therapy products increased over the year. Chart reviews showed a shift in content from documenting smoking behavior to withdrawal symptoms and administration of nicotine replacements; also frequency of comments increased. In summary, the evidence-based intervention influenced unit norms and reframed the culture related to tobacco dependence treatment. PMID:27392584

  17. Paradise nearly Gained. Volume 2: Case Studies of Impact and Diversity for Frontline Management Initiative Practice.

    ERIC Educational Resources Information Center

    Barratt-Pugh, Llandis; Soutar, Geoffrey N.

    This document presents the case studies from a multi-phase study of the impact of Australia's Frontline Management Initiative (FMI), which provides a framework for competency-based development of frontline managers in Australian enterprises. Nineteen organizational case studies and one individual case study of the FMI's impacts are included. The…

  18. Interactive modelling with stakeholders in two cases in flood management

    NASA Astrophysics Data System (ADS)

    Leskens, Johannes; Brugnach, Marcela

    2013-04-01

    New policies on flood management called Multi-Level Safety (MLS), demand for an integral and collaborative approach. The goal of MLS is to minimize flood risks by a coherent package of protection measures, crisis management and flood resilience measures. To achieve this, various stakeholders, such as water boards, municipalities and provinces, have to collaborate in composing these measures. Besides the many advances this integral and collaborative approach gives, the decision-making environment becomes also more complex. Participants have to consider more criteria than they used to do and have to take a wide network of participants into account, all with specific perspectives, cultures and preferences. In response, sophisticated models are developed to support decision-makers in grasping this complexity. These models provide predictions of flood events and offer the opportunity to test the effectiveness of various measures under different criteria. Recent model advances in computation speed and model flexibility allow stakeholders to directly interact with a hydrological hydraulic model during meetings. Besides a better understanding of the decision content, these interactive models are supposed to support the incorporation of stakeholder knowledge in modelling and to support mutual understanding of different perspectives of stakeholders To explore the support of interactive modelling in integral and collaborate policies, such as MLS, we tested a prototype of an interactive flood model (3Di) with respect to a conventional model (Sobek) in two cases. The two cases included the designing of flood protection measures in Amsterdam and a flood event exercise in Delft. These case studies yielded two main results. First, we observed that in the exploration phase of a decision-making process, stakeholders participated actively in interactive modelling sessions. This increased the technical understanding of complex problems and the insight in the effectiveness of various

  19. [Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

    PubMed

    Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

    2010-04-01

    To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform. PMID:20481307

  20. 26 CFR 301.7454-2 - Burden of proof in foundation manager, etc. cases.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Burden of proof in foundation manager, etc... Actions by the United States § 301.7454-2 Burden of proof in foundation manager, etc. cases. (a) Foundation manager. In any proceeding involving the issue whether a foundation manager as defined in...

  1. 26 CFR 301.7454-2 - Burden of proof in foundation manager, etc. cases.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Burden of proof in foundation manager, etc... Actions by the United States § 301.7454-2 Burden of proof in foundation manager, etc. cases. (a) Foundation manager. In any proceeding involving the issue whether a foundation manager as defined in...

  2. 26 CFR 301.7454-2 - Burden of proof in foundation manager, etc. cases.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Burden of proof in foundation manager, etc... Actions by the United States § 301.7454-2 Burden of proof in foundation manager, etc. cases. (a) Foundation manager. In any proceeding involving the issue whether a foundation manager as defined in...

  3. 26 CFR 301.7454-2 - Burden of proof in foundation manager, etc. cases.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Burden of proof in foundation manager, etc... Actions by the United States § 301.7454-2 Burden of proof in foundation manager, etc. cases. (a) Foundation manager. In any proceeding involving the issue whether a foundation manager as defined in...

  4. 26 CFR 301.7454-2 - Burden of proof in foundation manager, etc. cases.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Burden of proof in foundation manager, etc... Actions by the United States § 301.7454-2 Burden of proof in foundation manager, etc. cases. (a) Foundation manager. In any proceeding involving the issue whether a foundation manager as defined in...

  5. Introducing case management for people with dementia in primary care: a mixed-methods study

    PubMed Central

    Iliffe, Steve; Robinson, Louise; Bamford, Claire; Waugh, Amy; Fox, Chris; Livingston, Gill; Manthorpe, Jill; Brown, Pat; Stephens, Barbara; Brittain, Katie; Chew-Graham, Carolyn; Katona, Cornelius

    2014-01-01

    Background Case management may be a feasible solution to the problem of service fragmentation for people with dementia. Aim To adapt a US model of primary care-based case management for people with dementia and test it in general practice. Design and setting Mixed-methodology case studies of case management implementation in four general practices: one rural, one inner-city, and two urban practices. Practice nurses undertook the case manager role in the rural and inner-city practices, and were allocated one session per week for case management by their practices. A seconded social worker worked full time for the two urban practices. Method Participants were community-dwelling patients with dementia who were living at home with a family carer, and who were not receiving specialist care coordination. Case study methods included analysis of case loads and interviews with patients, carers, local NHS and other stakeholders, and case managers. Measures included numbers of patients with dementia and their carers, number of unmet needs identified, and actions taken to meet needs. Case manager records were compared with findings from interviews with patients and carers, and with other stakeholders. Results The number of eligible patients was smaller than expected. No practice achieved its recruitment target. Researchers identified more unmet needs than case managers. The practice nurse case managers reported lack of time and found research documentation burdensome. Patients and carers were positive about case management as a first point of contact with the practice, as a ‘safety net’, and for creating a one-to-one therapeutic relationship. Conclusion Further investigation is required before case management for people with dementia and their carers can be implemented in primary care. PMID:25348998

  6. Productivity--a key to managing cost-per-case. Part 1.

    PubMed

    Orefice, J J; Jennings, M C

    1983-08-01

    Productivity and productivity management are critical to effective case-mix management. Case-mix management expands on traditional productivity management to include the relationship between such intermediate products as patient days, tests and meals, and the ultimate end product, the case. As hospitals search to increase the profitability of specific case types, they must focus on two critical productivity control points. First, they must examine length of stay and ancillary utilization as one level of productivity. Then they must turn to more traditional analyses and review departmental productivity in the production of the intermediate products. No case-mix management system is complete unless it focuses on both of these critical relationships. Part two of this article will explore performance reporting and its role in managing both productivity and case mix. PMID:10315375

  7. Construction waste management based on industrial management models: a Swedish case study.

    PubMed

    Stenis, Jan

    2005-02-01

    This paper describes a methodology for estimating the true internal costs of construction waste, aimed at promoting environmentally friendly waste management. The study employs cost-benefit analysis, contribution margin analysis, the polluter-pays principle and a mathematical model: the model for Efficient Use of Resources for Optimal Production Economy (EUROPE), which has been introduced previously by the author for assigning industrial costs to waste. The calculations are performed on construction waste created in a case study of a building project. Moreover, waste is regarded as, in a business sense, having the same basic status as any normal industrial product, namely the 'equality principle'. Application of the methodology is suggested to create incentives for environmental and profitability improvement in construction companies and other types of industrial sectors. The results of the case study show the generation of construction waste to substantially decrease the final operating income, due to the internal shadow price cost it creates. This paper is intended to reduce the gap between the choice of waste management procedures and their economic impact, the overall objective being to accomplish an improved industrial environmental situation. PMID:15751391

  8. Knowledge Management in Preserving Ecosystems: The Case of Seoul

    ERIC Educational Resources Information Center

    Lee, Jeongseok

    2009-01-01

    This study explores the utility of employing knowledge management as a framework for understanding how public managers perform ecosystem management. It applies the grounded theory method to build a model. The model is generated by applying the concept of knowledge process to an investigation of how the urban ecosystem is publicly managed by civil…

  9. Approaches to Teaching: Adapting Cases in Operations Management for Use in the Technical Writing Classroom.

    ERIC Educational Resources Information Center

    Morrow, John

    1988-01-01

    Describes how technical writing teachers can adapt existing operations management cases for the writing classroom by recognizing communication gaps and filling them with appropriate writing scenarios. (ARH)

  10. 30 CFR 250.518 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...? Once you install your wellhead, you must meet the casing pressure management requirements of API RP 90... there is a conflict between API RP 90 and the casing pressure requirements of this subpart, you...

  11. Management of a rare case of arrhythmogenic right ventricular dysplasia in pregnancy: a case report.

    PubMed

    Anouar, Jarraya; Mohamed, Smaoui; Kamel, Kolsi

    2014-01-01

    Arrhythmogenic right ventricular dysplasia is a rare but not exceptional inherited cardiomyopathy characterized by fibrofatty replacement of the myocardium of the right ventricular which could lead to serious arrhythmia and sudden death. Only a few cases of pregnancies with ARVD have been reported. The aim of this case presentation is to describe the clinical characteristics and anesthetics specificities in management of this disease in pregnancy and in delivery. We report the case of a young woman aged 28 years old with a past history of ARVD treated by medical treatment with radiofrequency ablation. This patient was pregnant and it was scheduled for cesarean section delivery. Preoperative evaluation showed a well tolerated pregnancy inspite of the severity of the ARVD. It was a severe form of ARVD because of RV dilation, the spread of the disease to LV and the history of ventricular tachycardia during an attempted of ablation by radio frequency. The treatment received by the patient was kept until the day of surgery. The act took place under general anesthesia. The postoperative period was uneventful and morphine titration was used for pain relief. The patient exits the hospital 3 days after delivery and breastfeeding was forbidden. We should pay attention on this disease witch is not yet well known and witch is highly risky in the peri-partum period. Even if pregnancy may be tolerated in moderate forms of ARVD, conception and delivery sould be discouraged especially in severe forms. PMID:25852789

  12. Effectively managing partnership evolution: a case study from Chicago.

    PubMed

    Tishuk, Brian S

    Given the continued proliferation of public/ private partnerships as vehicles for sharing best practices, lessons learned and actionable information, the keys to their success become more important to identify. Effective partnerships enhance the resilience of their respective members, which, in turn, improves community resilience. Thus, identifying the attributes of a successful partnership should be a high priority for those looking to foster collaboration between the public and private sectors. This paper will illustrate with two case studies how successful partnerships creatively leverage opportunities and manage the evolution of public/private relationships, while always seeking to institutionalise these collaborative efforts. The first will discuss briefly the development of the most important national partnership within the financial sector. The other focuses on a public/private task force in Chicago, composed of public safety agencies and representatives of critical infrastructure, which owes its existence to an unexpected research project and that needed to be restructured in light of experience. The manner in which the task force formed and evolved yields many lessons for partnerships interested in remaining relevant and effective. PMID:23315246

  13. Management of an iatrogenic radial artery perforation: a case report.

    PubMed

    Buturak, Ali; Demirci, Yasemin; Dağdelen, Sinan

    2013-06-01

    A 73-year-old female patient underwent transradial coronary angiography with stable angina and signs of significant myocardial ischemia revealed by exercise stress test. After insertion of a 6F radial sheath into the right radial artery and intra-arterial administration of heparin plus verapamil, the hydrophilic guidewire could not be advanced under fluoroscopic guidance. Immediately afterwards, radial angiography was performed, which displayed a radial artery perforation with significant contrast extravasation. The perforated segment was crossed meticulously with the same guidewire after additional vasodilator drug administration. Afterwards, a 5F TIG catheter was advanced to the axillary artery and held in place for 20 minutes with application of external compression with a sphygmomanometer cuff at the level of systolic blood pressure. The same maneuver was again performed following cuff deflation and completion of coronary angiography with the 5F catheter. Final angiography displayed complete sealing of the perforation without a need for neutralization of heparin. External compression was continued for two hours, and after documentation of normal triphasic radial artery flow by Doppler ultrasound (DUS), the radial sheath was removed. The patient was discharged the following day with no evidence of hand ischemia and well-palpable radial artery pulse. DUS demonstrated normal radial artery flow one month later. This unusual complication was managed successfully with a simple and easily applicable technique that can be performed in such cases. PMID:23760121

  14. Governance and management of a deepwater port: a case study

    SciTech Connect

    Olcott, E.S.

    1985-10-01

    A deepwater port is many things to many people. Clearly, the Port of Rotterdam, the largest port in the world, is a deepwater port with its 75 feet of water, more than $1.5 billion invested in facilities and its annual volume of more than 280 million metric tons of cargo in a broad commodity mix. Bantry Bay in Ireland, a major import petroleum and trans-shipment facility for Britain and the European continent, is a deepwater port. So also is the Louisiana Offshore Oil Port (LOOP), comprised of a single-point mooring buoy and sophisticated petroleum distribution system, located in deep water off the Gulf coast of the US. And so is the Port of Seattle a deepwater port, located in the natural deep water of Puget Sound. Deep drafts ports abound in Japan where as many as nine ports have been developed with water depths in excess of 55 feet. The multi-purpose port and industrial island located in Delaware Bay, the case study being scrutinized in this article would also be a deepwater port. The author takes no position in this article on the feasibility of the enterprise. A number of models or options are reviewed on how this project might be organized, managed, and governed if a decision were made to move forward with such an undertaking. 15 references, 2 figures.

  15. Multidisciplinary teams of case managers in the implementation of an innovative integrated services delivery for the elderly in France

    PubMed Central

    2014-01-01

    Background The case management process is now well defined, and teams of case managers have been implemented in integrated services delivery. However, little is known about the role played by the team of case managers and the value in having multidisciplinary case management teams. The objectives were to develop a fuller understanding of the role played by the case manager team and identify the value of inter-professional collaboration in multidisciplinary teams during the implementation of an innovative integrated service in France. Methods We conducted a qualitative study with focus groups comprising 14 multidisciplinary teams for a total of 59 case managers, six months after their recruitment to the MAIA program (Maison Autonomie Integration Alzheimer). Results Most of the case managers saw themselves as being part of a team of case managers (91.5%). Case management teams help case managers develop a comprehensive understanding of the integration concept, meet the complex needs of elderly people and change their professional practices. Multidisciplinary case management teams add value by helping case managers move from theory to practice, by encouraging them develop a comprehensive clinical vision, and by initiating the interdisciplinary approach. Conclusions The multidisciplinary team of case managers is central to the implementation of case management and helps case managers develop their new role and a core inter-professional competency. PMID:24708721

  16. Shaping Learning through Space: The Case of Outdoor Management Training.

    ERIC Educational Resources Information Center

    Hall, Roger; Rowland, Caroline

    This paper explores the relationship between experiential learning theory and outdoor management training, and describes a British outdoor management program grounded in adult learning theory. An introduction explores competing paradigms in management education: the managerialist perspective, which focuses on development of skills and…

  17. Content and Workflow Management for Library Websites: Case Studies

    ERIC Educational Resources Information Center

    Yu, Holly, Ed.

    2005-01-01

    Using database-driven web pages or web content management (WCM) systems to manage increasingly diverse web content and to streamline workflows is a commonly practiced solution recognized in libraries today. However, limited library web content management models and funding constraints prevent many libraries from purchasing commercially available…

  18. Case Studies for School Administrators: Managing Change in Education.

    ERIC Educational Resources Information Center

    Benham, Maenette K. P. Ah Nee

    This book examines case-based learning in educational leadership courses, discusses case-based learning as an educational tool, exemplifies methods of writing a case study, and contains 14 case-studies by teachers and administrators. "Stakeholders in a House of Cards," by Audrey Burgher, discusses integrating technology with innovation. "Reforming…

  19. Benefits of photograph transmission for trauma management in isolated areas: cases from the French tele-medical assistance service.

    PubMed

    Dehours, Emilie; Tourneret, Marie-Laure; Roux, Patrick; Tabarly, Julien

    2016-01-01

    French maritime tele-medical assistance is currently performed by a telephone consultation associated with complementary transmission of data (photographs, electrocardiograms, etc.) over the internet. Five case reports are presented to illustrate how photo transmission is useful to managing initial care and monitoring isolated patients. Case reports included: Case 1: management of a hand burn; Case 2: management of a finger wound; Case 3: management of an ocular foreign body; Case 4: management of a subungual haematoma; Case 5: management of phlegmon. In conclusions, photo transmission improves our practice of maritime tele-medical medicine. New high-definition technologies will help in the development of videoconferences on ships. PMID:27364173

  20. Barriers to Implementation of Case Management for Patients With Dementia: A Systematic Mixed Studies Review

    PubMed Central

    Khanassov, Vladimir; Vedel, Isabelle; Pluye, Pierre

    2014-01-01

    PURPOSE Results of case management designed for patients with dementia and their caregivers in community-based primary health care (CBPHC) were inconsistent. Our objective was to identify the relationships between key outcomes of case management and barriers to implementation. METHODS We conducted a systematic mixed studies review (including quantitative and qualitative studies). Literature search was performed in MEDLINE, PsycINFO, Embase, and Cochrane Library (1995 up to August 2012). Case management intervention studies were used to assess clinical outcomes for patients, service use, caregiver outcomes, satisfaction, and cost-effectiveness. Qualitative studies were used to examine barriers to case management implementation. Patterns in the relationships between barriers to implementation and outcomes were identified using the configurational comparative method. The quality of studies was assessed using the Mixed Methods Appraisal Tool. RESULTS Forty-three studies were selected (31 quantitative and 12 qualitative). Case management had a limited positive effect on behavioral symptoms of dementia and length of hospital stay for patients and on burden and depression for informal caregivers. Interventions that addressed a greater number of barriers to implementation resulted in increased number of positive outcomes. Results suggested that high-intensity case management was necessary and sufficient to produce positive clinical outcomes for patients and to optimize service use. Effective communication within the CBPHC team was necessary and sufficient for positive outcomes for caregivers. CONCLUSIONS Clinicians and managers who implement case management in CBPHC should take into account high-intensity case management (small caseload, regular proactive patient follow-up, regular contact between case managers and family physicians) and effective communication between case managers and other CBPHC professionals and services. PMID:25354410

  1. Comprehensive Case Management for Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series 27.

    ERIC Educational Resources Information Center

    Cook, Paddy; Dogoloff, Mary Lou; Harteker, Linda; Nelson, Anne E.; Paul, Michelle M.; Shuman, Deborah J.; Mjoseth, Marcia; Vitzthum, Virginia; Hayes, Elizabeth; Gilbert, Max; Smith, Cara; Nguyen, Y-Lang

    This TIP contains information on the best practice guidelines on case management for substance abuse treatment providers. It serves to educate program coordinators and facilitators about the factors to consider as they decide to modify or implement case management activities. Many substance abuse clients arrive for treatment with a number of other…

  2. HIV Risk Behavior among Delinquent and Mentally Ill Teens: Case Manager Perspectives

    ERIC Educational Resources Information Center

    Smith, Michael D.; Seal, David Wyatt; Hartley, Shannon

    2006-01-01

    An HIV knowledge survey and qualitative interview were administered to 20 case managers in community-based programs for troubled youth to assess HIV knowledge and their perception of client HIV risk behaviors. Participants had good HIV knowledge. Case managers perceived client youth to be at high risk for HIV infection due to unsafe sexual…

  3. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is required for case management? 20.515 Section 20.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.515 What is required for case management? Social services workers must document...

  4. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In...

  5. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In...

  6. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In...

  7. Case Studies, Ethics, Philosophy, and Liberal Learning for the Management Profession

    ERIC Educational Resources Information Center

    Rendtorff, Jacob Dahl

    2015-01-01

    Case studies can be an important methodology for ethics and philosophy in humanistic management and liberal education as well as in the social sciences because they integrate a deeper, reflective, philosophical, and ethical understanding of the organization. A case study approach based on philosophy of management contributes to putting into…

  8. Perceptions about Services and Dropout from a Substance Abuse Case Management Program

    ERIC Educational Resources Information Center

    Sosin, Michael R.; Durkin, Elizabeth

    2007-01-01

    This article uses event history analysis to examine certain determinants of dropout from a case management program that serves homeless adults with substance abuse problems. The examined determinants are perceptions of conventional treatment services: (a) client perceptions concerning the value of the conventional services that case managers help…

  9. Introducing Case Management to Students in a Virtual World: An Exploratory Study

    ERIC Educational Resources Information Center

    Levine, Joanne; Adams, Ruifang Hope

    2013-01-01

    This paper discusses a small, exploratory study introducing students to case management using role-plays conducted in a virtual world. Data from pre- and posttest questionnaires (to assess self-efficacy regarding a range of case management tasks) suggest students felt more confident in their abilities after virtual role-play participation. Also…

  10. Pakistan-Specific Cases for the Advanced Management Course in Public Administration.

    ERIC Educational Resources Information Center

    McLean, Gary N., Ed.

    A compilation of management case studies concerning public administration in Pakistan and accompanying teaching notes, this document is intended to foster discussion in classes such as the advanced management course in public administration at the National Institute of Public Administration in Lahore, Pakistan. Included are case studies entitled…

  11. HIV/AIDS Case Managers and Client HIV Status Disclosure: Perceived Client Needs, Practices, and Services

    ERIC Educational Resources Information Center

    Kalichman, Seth C.; Klein, Susan J.; Kalichman, Moira O.; O'Connell, Daniel A.; Freedman, Jay A.; Eaton, Lisa; Cain, Demetria

    2007-01-01

    People living with HIV/AIDS often need assistance in deciding whether or how to disclose their HIV status to others, and case managers are in a unique position to offer this assistance. The current study surveyed 223 case managers providing services to people living with HIV/AIDS in New York State. The survey was conducted anonymously, and case…

  12. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In...

  13. Family Members as Case Managers: Partnership Between the Formal and Informal Support Networks.

    ERIC Educational Resources Information Center

    Seltzer, Marsha Mailick; And Others

    1987-01-01

    Randomly assigned elderly persons to either experimental group (N=81) in which family members participated in case management training program, or to control group (N=76). Following training, family members in experimental group performed significantly greater number of case management tasks on behalf of elderly relatives than did family members…

  14. Defining, Delivering, and Documenting the Outcomes of Case Management by School Nurses

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.

    2009-01-01

    Case management is a component of school nurse practice that provides an opportunity to demonstrate the contribution that school nurses make to the health and academic success of children, particularly children with chronic health conditions. However, case management programs vary in their mission and scope, leading to confusion about what it…

  15. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In...

  16. Musical hallucinations - a challenge for psychiatric therapeutical management. Case report.

    PubMed

    Focseneanu, B E; Marian, G

    2015-01-01

    Background. Musical hallucinations occur in individuals with and without mental illness, and many patients tend to have intact reality testing. Although literature on musical hallucinations is limited, they have been associated with hearing abnormalities, adverse effects of pharmacological agents, female gender, advances in age and psychiatric illness. Aim. To present the psychiatric management of a case of an old female patient, who suddenly developed verbal and musical hallucinations with a pervasive impact on her daily activities. Method. Female, 71 years old, developed verbal and musical hallucinations 6 months before that have intensified later. She was known with bilateral hypoacusia starting with the age of 45, and magnetic resonance imaging performed 1 year before proved multiple lacunar infarcts. Because of the persistence, most of the time of these auditory hallucinations, the patient experienced pervasive difficulties with her major areas of activities. She was referred to a psychiatric department for evaluation and treatment. Results. The psychiatric consult revealed neither a depressive relapse, nor a mild cognitive impairment, and obsessive-compulsive disorder was suspected with intrusive obsessions. Patient received, as antiobsessional augmentation escitalopram 10mg/ day, an atypical antipsychotic, risperidone, which at 3 mg/ day induced extrapyramidal symptoms and cognitive impairment. Therefore, the dose of risperidone was reduced, extrapyramidal symptoms disappeared, and 300mg/ day of acidum valproicum was initiated. Discussion. Our patient presented with diminished sensory input to the auditory cortex, and it was hard to make a differential diagnosis between an organic and a mental etiology. Conclusion. The integration of musical hallucinations into a psychiatric disorder may be a difficult task, and, their treatment represents a challenge. PMID:26664485

  17. Ethical issues in the introduction of case management for elderly people.

    PubMed

    Corvol, Aline; Moutel, Grégoire; Gagnon, Dominique; Nugue, Mathilde; Saint-Jean, Olivier; Somme, Dominique

    2013-02-01

    As case management is under development in France for elderly people, this study sets out to identify and analyse key situations responsible for ethical dilemmas for French case managers. We based our study on the analyses of individual interviews made with case managers and focus-group discussions, bringing together all case managers working in local organisations running for at least a year. We identified three situations giving rise to ethical dilemmas: in the order of importance, the refusals of care, the practicalities of collecting and sharing personal data and the allocation of resources. These three situations can lead to conflict between the principle of beneficence and those of respect for autonomy, non-maleficence and justice. We describe here how French case managers practically deal with these situations. PMID:22918055

  18. Using Role-Play and Case Studies to Improve Preservice Teacher Attitudes toward Classroom Management

    ERIC Educational Resources Information Center

    Rudolph, Amanda

    2008-01-01

    Classroom management is a concern for preservice teachers (Charles, 2008). Teacher educators struggle to find the most effective ways to teach preservice teachers classroom management. Role-playing, combined with classroom management content, may offer a productive approach. As such, this study focused on the use of role-play with case studies to…

  19. Percutaneous endovascular management of atherosclerotic axillary artery stenosis: Report of 2 cases and review of literature

    PubMed Central

    Vijayvergiya, Rajesh; Yadav, Mukesh; Grover, Anil

    2011-01-01

    With recent advancement in percutaneous endovascular management, most atherosclerotic peripheral arterial diseases are amenable for intervention. However, there is limited published literature about atherosclerotic axillary artery involvement and its endovascular management. We report two cases of atherosclerotic axillary artery stenosis, which were successfully managed with stent angioplasty using self expanding nitinol stents. The associated coronary artery disease was treated by percutaneous angioplasty and stenting. The long term follow-up revealed patent axillary stents in both cases. PMID:21666817

  20. Aging in poverty: making the case for comprehensive care management.

    PubMed

    Judd, Rebecca G; Moore, Brenda A

    2011-10-01

    A model for holistic care management that would enhance outcomes for economically vulnerable older adults who receive an array of disjointed services administered through the older Americans Act (OAA) and local Area Agencies on Aging (AAA) is proposed. Fragmented service delivery is typically wasteful and ineffectual, but comprehensive care management that includes an autonomous care manager, a single interagency plan of care and ongoing monitoring that is client-centered may protect those aging in poverty from negative health outcomes. PMID:21967136

  1. The integrated scheduling system: A case study in project management

    NASA Technical Reports Server (NTRS)

    Bishop, Peter C.; Learned, David B.; Yoes, Cissy A.

    1989-01-01

    A prototype project management system was developed for the Level III Project Office for the Space Station Freedom. The main goal was to establish a framework for the Space Station Project Office whereby Project and Office Managers can jointly establish and review scheduled milestones and activities. The objective was to assist office managers in communicating their objectives, milestones, schedules, and other project information more effectively and efficiently. Consideration of sophisticated project management systems was included, but each of the systems had limitations in meeting the stated objectives.

  2. Sonographic localization and management of metallic fragments: a report of five cases.

    PubMed

    Harcke, H Theodore; Rooks, Veronica J

    2012-08-01

    Ultrasound was used as adjunct to radiographic imaging in the assessment and management of metallic fragments in five cases encountered in forward-deployed military facilities. Although metallic fragments are usually seen well on radiographs, ultrasound can add details of the surrounding soft-tissue structures and clarify location. Portable handheld units are well suited for studies when probe selection and equipment adjustments are correct. In selected cases, ultrasound information can favorably influence case management. PMID:22934382

  3. Change Management and Complexity: The Case for Narrative Action Research

    ERIC Educational Resources Information Center

    Boxelaar, Lucia; Paine, Mark; Beilin, Ruth

    2007-01-01

    Post-modern theorists have challenged the totalizing and unifying ambitions of change management practices. This paper explores how a narrative action research approach may be used to combine our modernist commitment to facilitate change and collaboration in the land management context with a post-modern sensitivity to complexity and difference.…

  4. Crisis Theory and Management: The Case of the Older Person.

    ERIC Educational Resources Information Center

    Duffy, Michael; Iscoe, Ira

    1990-01-01

    Notes that crisis and crisis management literature has devoted little attention to older persons. Discusses theoretical background and clinical implications for crisis management. Asserts that important differences for older persons warrant attention, including the type and number of stressful events that can precipitate crises. Discusses…

  5. Open Source Course Management Systems: A Case Study

    ERIC Educational Resources Information Center

    Remy, Eric

    2005-01-01

    In Fall 2003, Randolph-Macon Woman's College rolled out Claroline, an Open Source course management system for all the classes on campus. This document will cover some background on both Open Source in general and course management systems in specific, discuss technical challenges in the introduction and integration of the system and give some…

  6. Introducing a New Learning Management System: An Institutional Case Study

    ERIC Educational Resources Information Center

    Benson, Robyn; Palaskas, Tom

    2006-01-01

    The introduction of an online learning management system (LMS) raises a number of complex issues involving institutional responses at various levels to the adoption and diffusion of technological change. Issues include those related to governance, management and technical support, as well as to core learning and teaching matters associated with…

  7. Administrative and Caseload Management Information Systems: The Case of Probation.

    ERIC Educational Resources Information Center

    Eskridge, Chris W.

    1984-01-01

    Reviews the concept, present operations, and problems of information systems in general, and in probation administration specifically. Describes two different models of information systems-administrative management information systems and caseload management information systems. Explores the feasibility of statewide, multi-state, and nationwide…

  8. Interdisciplinary Programs Focused Populations: The Case of Health Management Program

    ERIC Educational Resources Information Center

    Davidovitch, Nitza; Yavich, Roman

    2015-01-01

    The Ariel University has a unique interdisciplinary program in healthcare management that targets experienced healthcare professionals who wish to earn an academic degree. Only one academic study has been held so far on the integration of graduates of an academic university-level school in healthcare management in the field. In the current study,…

  9. Case Analysis of Farm Agriculture Machinery Informatization Management Network System

    NASA Astrophysics Data System (ADS)

    Yang, Hui; Wang, Xi; Zhuang, Weidong

    In the process of China's agricultural modernization, especially agricultural machinery modernization, in terms of equipment, we've chose the way that foreign imports (and domestic research) with the combination of self-developed, in the software, it is difficult to fully apply this approach, the specific reasons are: the modernization of China's agriculture development model is diversified, it is difficult to find a unified management model, even in the scale of operations of the representative state-owned farms and the abroad farms are also very different management models. Due to various types of growth models of biological complexity, diverse climatic and geographical environment factors, coupled with the characteristics such as long cycle of agricultural production, high input, high-risk, and decentralized management, industrial management mode it is very difficult to apply. Moreover, the application of modern management tools is also difficult to quantify the benefits, leading to the current research and application are in a state of comparatively dropped behind.

  10. A Randomized Controlled Trial of Consensus-Based Child Abuse Case Management

    ERIC Educational Resources Information Center

    Goldbeck, L.; Laib-Koehnemund, A.; Fegert, J. M.

    2007-01-01

    Objective: This study evaluates the effects of expert-assisted child abuse and neglect case management in the German child welfare and healthcare system as perceived by the case workers themselves. Methods: Case workers with different professions (social workers, counselors, clinic-based and office-based psychotherapists, and physicians)…

  11. Anesthetic management of Shah-Waardenburg syndrome: Experience of two cases and review of literature.

    PubMed

    Ambi, Uday S; Adarsh, E S; Hatti, Ramesh; Samalad, Vijaymahantesh

    2012-04-01

    Waardenburg syndrome (WS) is a rare autosomally inherited and genetically heterogeneous disorder of neural crest cell development. Literature regarding the anesthetic management of these cases is limited. We present 2 cases of Shah-Waardenburg syndrome and discuss them in the context of review of previously published cases. PMID:22754447

  12. Management of A Rare Case of Communicating Internal-External Inflammatory Resorption

    PubMed Central

    Arora, Suraj; Saluja, Priyanka; Setia, Vikas

    2015-01-01

    The present case describes the successful management of a rare case of communicating internal-external resorption in which both internal and external resorption seem to develop independent of each other. The case report highlights the importance of correct diagnosis and need of revision of classification system of resorptive defects. PMID:26155588

  13. Case report: "Management of urethral stricture with Uttara Basti".

    PubMed

    Dudhamal, T S; Gupta, S K; Bhuyan, C

    2010-10-01

    A case of stricture of membranous urethra was treated with medicated oil used as Uttara Basti (administration of medicated oil through urethra) once daily for seven consecutive days. The treatment was repeated at a monthly interval for two months. The patient obtained remarkable improvement in his condition. This case highlights the fact that it is possible to treat the cases of urethral stricture with Uttara Basti. PMID:22557426

  14. WATERSHED NITROGEN MANAGEMENT "UPPER POTOMAC RIVER BASIN CASE STUDY"

    EPA Science Inventory

    Are watershed processes controlling the yield, transport, and transformation of carbon, nitrogen, and phosphorous scientifically understood and amenable to man's control in an ecological management framework? or many large estuarine ecosystems such as the Hudson, Chesapeake Bay, ...

  15. Training managers for high productivity: Guidelines and a case history

    NASA Technical Reports Server (NTRS)

    Ranftl, R. M.

    1985-01-01

    Hughes Aircrafts 13-year productivity study clearly identifies management as the key link in the entire productivity chain. This fact led to the establishment of a long-term series of seminars on personal, managerial, organizational, and operational productivity for all levels and sectors of line and staff management. To inspire the work force to higher levels of productivity and creativity management, itself, must first be inspired. In turn they have to clearly understand the productive and creative processes, fashion an effective productivity improvement plan with sound strategy and implementation, create an optimal environmental chemistry, and provide the outstanding leadership necessary to propel their organizations to achieve full potential. The primary goals of the seminars are to (1) ignite that spark of inspiration, enabling productive action to follow, (2) provide participants a credible roadmap and effective tools for implementation, and (3) develop a dedicated commitment to leadership and productivity throughout the management team.

  16. Advanced information management tools for investigation and case management support in a networked heterogeneous computing environment

    NASA Astrophysics Data System (ADS)

    Clifton, T. E., III; Lehrer, Nancy; Klopfenstein, Mark; Hoshstrasser, Belinda; Campbell, Rachel

    1997-02-01

    The right information, at the right time and place, is key to successful law enforcement. The information exists; the challenge is in getting the information to the law enforcement professionals in a usable form, when they need it. Over the last year, the authors have applied advanced information management technologies towards addressing this challenge, in concert with a complementary research effort in secure wireless network technology by SRI International. The goal of the combined efforts is to provide law enforcement professionals the ability to access a wide range of heterogeneous and legacy data sources (structured, as well as free text); process information into digital multimedia case folders; and create World Wide Web-based multimedia products, accessible by selected field investigators via Fortezza-enhanced secure web browsers over encrypted wireless communications. We discuss the results of our knowledge acquisition activities at federal, regional, and local law enforcement organizations; our technical solution; results of the one year development and demonstration effort; and plans for future research.

  17. Case-Based Learning: Educating Future Human Service Managers

    ERIC Educational Resources Information Center

    Austin, Michael J.; Packard, Thomas

    2009-01-01

    Using teaching cases in professional education programs has gained increased attention in the past several decades. While the use of teaching cases has been an important part of social work education, the majority of current casebooks focus on micro or direct practice issues and settings. Over the past forty years only four major casebooks have…

  18. Forest management strategies for reducing carbon emissions, the French case

    NASA Astrophysics Data System (ADS)

    Valade, Aude; Luyssaert, Sebastiaan; Bellassen, Valentin; Vallet, Patrick; Martin, Manuel

    2015-04-01

    International agreements now recognize the role of forest in the mitigation of climate change through the levers of in-situ sequestration, storage in products and energy and product substitution. These three strategies of carbon management are often antagonistic and it is still not clear which strategy would have the most significant impact on atmospheric carbon concentrations. With a focus on France, this study compares several scenarios of forest management in terms of their effect on the overall carbon budget from trees to wood-products. We elaborated four scenarios of forest management that target different wood production objectives. One scenario is 'Business as usual' and reproduces the current forest management and wood production levels. Two scenarios target an increase in bioenergy wood production, with either long-term or short-term goals. One scenario aims at increasing the production of timber for construction. For this, an empirical regression model was developed building on the rich French inventory database. The model can project the current forest resource at a time horizon of 20 years for characteristic variables diameter, standing volume, above-ground biomass, stand age. A simplified life-cycle analysis provides a full carbon budget for each scenario from forest management to wood use and allows the identification of the scenario that most reduces carbon emissions.

  19. Decentralization of management responsibility: the case of Danish hospitals.

    PubMed

    Pallesen, T; Pedersen, L D

    1993-01-01

    This article examines a specific management reform at three hospitals in a Danish county. Management reform at the hospital level implies a decentralization of responsibility and power to the departmental level. Along with increased responsibility and power, departments get the message: keep your budgets and keep your output level. This preliminary analysis indicates that departmental budgets can be a way of containing costs in clinical departments. Non-staff expenditures especially are subjected to reductions. The system still seems to 'favour' doctors and nurses, but less than in a system with traditional budgetary institutions. The behaviour of the top-management teams shows that the output constraint is not seriously meant. Departments are allowed to reduce capacity, with declining output, with the knowledge of the top-management team. The declining output makes it easier to departments ceteris paribus to keep within their budgets. And that makes it easier for the top-management team to keep the overall hospital budget. The obligation to keep the overall hospital budget is thus an important criterion of success in the eyes of the political masters of hospitals. PMID:10134931

  20. Interim Evaluation of the Pilot Program of the Truancy Case Management Partnership Intervention in the District of Columbia

    ERIC Educational Resources Information Center

    Liberman, Akiva; Cahill, Meagan; Cramer, Lindsey

    2012-01-01

    The Case Management Partnership Initiative (CMPI) addresses chronic truancy by linking truant ninth graders and their families to social services and case management, along with regular interagency case management meetings. A pilot was conducted at Anacostia and Ballou High Schools in 2011-2012. The implementation evaluation found that the pilot…

  1. Expectant management of focal nodular hyperplasia during pregnancy. A case report.

    PubMed

    Kivnick, S; Greenspoon, J S; Kanter, M H; Gee, C; Fullman, H J

    1992-04-01

    A patient with unresectable focal nodular hyperplasia of the liver completed an uncomplicated pregnancy. Although there is a risk of hepatic rupture during pregnancy, expectant management may be an option for some cases of focal nodular hyperplasia. PMID:1593563

  2. The role of right heart angiography in the management of selected cases.

    PubMed Central

    Schullinger, J N; Santulli, T V; Casarella, W J; MacMillan, R W

    1977-01-01

    Three cases of Wilms' tumor with inferior vena cava involvement are presented. All three cases were shown to have nonvisualization of the inferior vena cava on the initial intravenous pyelogram obtained by internal saphenous vein injection. The first case ended fatally, due primarily to delay in diagnosing extension of the tumor into the right atrium. There was no cardiac involvement in the other two cases, both of which were managed successfully. A right heart angiogram demonstrated intraatrial tumor in the first case and helped to identify the presence and extent of caval involvment in the other two. It is recommended that right heart angiography be performed in those cases of Wilms' tumor where the inferior vena cavagram shows non-visualization of the cava or suggests the presences of intraluminal tumor. The immediate availability of two separate surgical teams in the management of such cases is suggested. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4A. Fig. 4B. PMID:190956

  3. Surgical Management of Stuttering Ischemic Priapism: A Case Report and Concise Clinical Review.

    PubMed

    Raslan, M; Hiew, K; Hoyle, A; Ross, D G; Betts, C D; Maddineni, S B

    2016-03-01

    Stuttering priapism is an extremely rare and poorly understood entity. We present a rare case of a 47-year-old Afro-Caribbean gentleman who required proximal shunt procedure to treat his ischemic stuttering priapism after he had failed medical management. We provided a concise review of the literature on the surgical management of ischemic priapism. This case highlighted the importance of prompt surgical intervention in prolonged stuttering priapism to avoid serious psychological and functional complications. PMID:26977408

  4. Load management alternatives to transmission and distribution construction: Toledo-Wren case study

    SciTech Connect

    Englin, J.E.; Klan, M.S.; Lyke, A.J.; Tawil, J.J.; De Steese, J.G.; Tepel, R.C.

    1987-12-01

    This paper describes the development of a method to predict the feasibility of using load management as an alternative to construction of transmission and distribution capacity. A forecasting model was developed and applied to a particular case. Several problems were identified in the test case, necessitating modification of the model. The authors conclude that the modified version of the model allows accurate assessment of the effects of load management and conservation measures on transmission capacity. 13 figs. (JDH)

  5. Anaesthetic management for caesarean section in a case of previously operated with residual pituitary tumour

    PubMed Central

    Shah, Prerana N; Sonawane, Darshana; Appukutty, Jithesh

    2011-01-01

    Successful anaesthetic management for caesarean section in a case with previous pituitary tumour resection, with residual tumour, is reported. The pituitary gland undergoes global hyperplasia during pregnancy. Functional pituitary tumours may exhibit symptomatic enlargement during pregnancy. Growth hormone secreting tumour is associated with acromegaly which has associated anaesthetic implications of difficult airway, systemic hypertension, and diabetes and electrolyte imbalance. Intracranial space occupying lesions can increase intra cranial pressure and compromise cerebral perfusion or cause herniation. We report management of this case. PMID:22223910

  6. Remote Cerebellar Infarction after Supratentorial Craniotomy and Its Management: Two Case Reports

    PubMed Central

    Yoon, Seon-Jin

    2015-01-01

    The cerebellar infarction resulting from supratentorial craniotomy is uncommon event and its management has been controversial. After removal of space occupying lesion on right frontal area, two cases of remote cerebellar infarctions occurred. We reviewed each cases and the techniques to manage such complications are discussed. Early extraventricular catheter insertion and midline suboccipital craniectomy were effectively performed in obtunded patients from cerebellar infarction. PMID:26605273

  7. Case managers' retirement: what has reverse mentoring got to do with it?

    PubMed

    Powell, Suzanne K

    2013-01-01

    With the aging case management workforce, bringing up younger professionals is a vitally current issue. This editorial focuses on the millennial generation of potential case managers, those born between 1980 and 2000, as these are the ages of the most likely "replacements." Traditional mentoring focuses on sponsorship and coaching. Is this enough to bring passion in the younger generation? Adding the model of "reverse mentoring" may be key in engaging these professionals. Reverse mentoring focuses on knowledge sharing and leadership development. PMID:24100527

  8. Complicated endoscopic management of Bouveret's syndrome. A case report and review.

    PubMed

    Moschos, John; Pilpilidis, Ioannis; Antonopoulos, Zissis; Paikos, Dimitrios; Tzilves, Dimitrios; Kadis, Savvas; Katsos, Ioannis; Tarpagos, Anestis

    2005-03-01

    A rare case of gastric outlet obstruction due to a large gallstone (Bouveret's syndrome) presenting with abdominal pain and vomiting is reported. The endoscopic management of the gallstone was unsuccessful because of the size of the stone that got stuck in oesophagus. The final management of the patient was surgical and the gallstone was retrieved via a gastrotomy. The case report is followed by a brief review of Bouveret's syndrome. PMID:15800698

  9. Collective Bargaining for Public Managers (State and Local): Case Materials.

    ERIC Educational Resources Information Center

    Civil Service Commission, Washington, DC. Labor Relations Training Center.

    The book contains exercises for the participants in a collective bargaining course designed to assist public sector managers in attaining a stable and productive labor relations environment. Each exercise has been keyed to an appropriate point in the instructor's manual. A number has been assigned to each exercise; the exercise is designated as…

  10. Managed care and medical education: hard cases and hard choices.

    PubMed

    Friedman, E

    1997-05-01

    As managed care becomes more and more dominant in U.S. health care, it is coming into conflict with medical education. There are historical reasons for this: medical education traditionally excluded physicians who chose to work in health plans, and for profit managed care has tended to avoid subsidizing medical education. In order to improve the climate, three changes are necessary: medical education must understand the tense history of discord between the two; distinctions must be made between responsible and irresponsible managed care plans; and medical educators should not assume they own the moral high ground. Arrogance, a gross oversupply of physicians and especially specialists, scandals and fraud, an often callous attitude toward the poor, and other sins can be laid at medical education's door. The worse threat for both sides is that the public and payers could simply abandon both, leading to underfunding for health professions education, a society that does not trust its health care system, and the loss of superb teaching organizations. To prevent this, managed care and medical education should work together to solve several difficult problems: how to shrink the medical education infrastructure; how to report honestly the uses to which medical education funds are put; and how to identify and end irresponsible behavior on the part of health plans and medical education entities alike. If the two sides can exercise leadership in these areas, they will be able to protect and enhance the singular place of honor that medical education holds in this society. PMID:9159575

  11. Human Performance Technology and Knowledge Management: A Case Study

    ERIC Educational Resources Information Center

    Massey, Anne P.; Montoya-Weiss, Mitzi M.; O'Driscoll, Tony M.

    2005-01-01

    As organizations respond to competitive environments and strive to enhance performance, knowledge management (KM) has increasingly become a strategic activity. A KM strategy entails consciously helping people share and put knowledge into action. A key challenge is how to develop and implement KM solutions that provide performance support to…

  12. The case for disease management in chronic kidney disease.

    PubMed

    Chen, Randolph A; Scott, Susan; Mattern, William D; Mohini, Ravinder; Nissenson, Allen R

    2006-04-01

    Chronic kidney disease (CKD) is a growing epidemic in the United States and worldwide, with nearly two thirds of CKD patients also having diabetes, hypertension, or both. Morbidity and mortality among patients with CKD are high, as are the costs associated with care, which is highly fragmented. Disease management (DM) programs are designed to coordinate the delivery of care to patients, improve clinical outcomes, and reduce costs along the continuum of care. The goals of DM programs in CKD patients are to fill the gaps in current care by focusing on four key areas: (1) slowing the progression of CKD, (2) identifying and managing the complications of CKD, (3) identifying and managing associated comorbid conditions, and (4) smoothing the transition to renal replacement therapy (RRT). To be successful, this approach requires multidisciplinary collaboration among physicians (eg, primary care physicians, endocrinologists, cardiologists, nephrologists, surgeons) and participating caregivers including nurses, dieticians, social workers, and pharmacists. Patient identification, limited reimbursement, late patient referral, and lack of primary care physician and nephrologist knowledge about the importance and details of CKD management are all barriers that must be overcome for such programs to be successfully implemented. Considering the magnitude of the opportunity, DM applied to CKD is a promising approach to the care of this vulnerable population. PMID:16620194

  13. Management of wastes from hospitals: A case study in Pakistan.

    PubMed

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz

    2016-01-01

    Proper management of hospital waste is a critical concern in many countries of the world. Pakistan is the sixth most populous country in the world, with one of the highest urbanisation and population growth rates in South Asia. Data and analyses regarding hospital waste management practices in Pakistan are scarce in scientific literature. This study was meant to determine waste management practices at selected hospitals in a major city in Pakistan, Gujranwala. A total of 12 different hospitals were selected for the survey, which involved quantification of waste generation rates and investigation of waste management practices. The results were analysed using linear regression. The weighted average total, general and infectious hospital waste generation rates were found to be 0.667, 0.497 and 0.17 kg bed-day(-1), respectively. Of the total, 73.85% consisted of general, 25.8% consisted of hazardous infectious and 0.87% consisted of sharps waste. The general waste consisted of 15.76% paper, 13.41% plastic, 21.77% textiles, 6.47% glass, 1.99% rubber, 0.44% metal and 40.17% others. Linear regression showed that waste generation increased with occupancy and decreased with number of beds. Small, private and specialised hospitals had relatively greater waste generation rates. Poor waste segregation, storage and transportation practices were observed at all surveyed hospitals. PMID:26628050

  14. The Art of Strategic Management: A Case-Based Exercise

    ERIC Educational Resources Information Center

    Maranville, Steven

    2011-01-01

    This article contends that the strategic thinking process is composed of two joint, but paradigmatically distinct, activities--analysis and synthesis. Analysis represents the scientific paradigm, whereas synthesis represents the artistic paradigm. Nevertheless, the Strategic Management course is dominated by the scientific paradigm, even though…

  15. Improving Computer Literacy of Business Management Majors: A Case Study

    ERIC Educational Resources Information Center

    Johnson, David W.; Bartholomew, Kimberly W.; Miller, Duane

    2006-01-01

    Stakeholders, such as future employers, parents, and educators, have raised their expectations of college graduates in the area of computer literacy. Computer skills and understanding are especially critical for business management graduates, who are expected to use computer technology as a tool in every aspect of their career. Business students…

  16. Live Case Analysis: Pedagogical Problems and Prospects in Management Education

    ERIC Educational Resources Information Center

    Roth, Kevin J.; Smith, Chad

    2009-01-01

    The selection of an appropriate and effective pedagogy has been a central theme in management education for decades. There currently exists a wide range of pedagogical options designed to match course content with the most appropriate technique(s) for effective learning outcomes. Most recently, a variety of experiential learning methods have been…

  17. Time Management in Higher Education Administration: A Case Study.

    ERIC Educational Resources Information Center

    Lewis, Darrell R.; Dahl, Tor

    How do departmental chairpersons and deans in a major university setting manage their time? What are the major administrative activities and functions associated with such responsibilities? What relationships do these have with an ability to delegate, to control one's time for planning and self-initiated activities, or personal sense of…

  18. Time Management in Higher Education Administration: A Case Study

    ERIC Educational Resources Information Center

    Lewis, Darrell R.; Dahl, Tor

    1976-01-01

    Drawing on data from a staff development project for administrators in a college at a major American university, it was determined that there is considerable commonality across individuals and that it is possible to deal with such issues as time management, job stress, and enjoyment on an organizational level. (Editor/JT)

  19. Development and pilot of Case Manager: a virtual-patient experience for veterinary students.

    PubMed

    Byron, Julie K; Johnson, Susan E; Allen, L Clare V; Brilmyer, Cheryl; Griffiths, Robert P

    2014-01-01

    There is an increasing demand in veterinary education to engage students, teach and reinforce clinical reasoning, and provide access anytime/anywhere to quality learning opportunities. In addition, accrediting bodies are asking for more concrete documentation of essential clinical-skills outcomes. Unfortunately, during the clinical year in a referral hospital setting, students are at the mercy of chance regarding the types of cases they will encounter and the opportunities they will have to participate. Patient- and case-simulation technology is becoming more popular as a way to achieve these objectives in human and veterinary medical education. Many of the current options available to the veterinary medical education community to develop virtual-patient cases are too time-consuming, cost prohibitive, or difficult for the instructor or learner to use. In response, we developed a learning tool, Case Manager, which is low-cost and user-friendly. Case Manager was designed to meet the demands of veterinary education by providing students with an opportunity to cultivate clinical reasoning skills and allowing for real-time student feedback. We launched a pilot test with 37 senior veterinary medical students as part of their Small Animal Internal Medicine clinical rotation. Students reported that Case Manager increased their engagement with the material, improved diagnostic and problem-solving skills, and broadened their exposure to a variety of cases. In addition, students felt that Case Manager was superior to a more traditional, less interactive case presentation format. PMID:24947678

  20. Current applications of case management in schools to improve children's readiness to learn.

    PubMed

    Smith, A J; Armijo, E J; Stowitschek, J J

    1997-01-01

    Recent interest in case management by elementary and secondary schools has arisen out of a growing recognition that schools alone are not prepared to address the myriad of health, education, and social service needs of a large number of students, particularly children living in poverty. Boys and girls entering classrooms hungry, sick, homeless, or otherwise distracted are not ready to learn. Improving readiness to learn is a major agenda among educators. Case management is one approach many schools are beginning to use to collaboratively engage parents, community service agencies, the private sector, and communities at large in pursuit of the goal. A promising school-based case management model has been developed and successfully field tested by the University of Washington. The model operationally defines case management, delineates a delivery structure, and includes an evaluation design. Results from a five-year study sponsored by the U. S. Department of Education are encouraging. Although several challenges persist, the future for school case management use is optimistic. Several enhanced variations of the Center for the Study and Teaching of At-Risk Students (C-STARS) case management model are now being demonstrated across the country. PMID:9573969

  1. Reflections on Case Management in Youth Support Using a Program Example

    ERIC Educational Resources Information Center

    Kennedy, Rosemary; Kennedy, Barry

    2010-01-01

    Using Moxley's (1997) program development framework as an agenda for a dialogue that juxtaposes an academic perspective with that of a seasoned youth program manager, this paper focuses on the relatively unexplored terrain of case management programs. In doing so, it exposes the convergences and divergences between academic and program manager…

  2. Teaching Natural Resource Management-Teaching Techniques and Difficulties in Greek Vocational Lyceum: A Case Study

    ERIC Educational Resources Information Center

    Koutsoukos, Marios; Mouratidis, Antonios

    2016-01-01

    The aim of the present study is to investigate the teaching techniques applied, as well as the difficulties, with which educators in teaching Natural Resource Management are confronted. For research purposes, a case study was conducted on teaching Natural Resource Management in the Third Grade of Vocational Lyceum (EPAL) in Northern Greece. It was…

  3. A Case Study of Classroom Management Practices and the Influence on Classroom Disruptions

    ERIC Educational Resources Information Center

    Rusk, Robert Brian

    2016-01-01

    This qualitative case study explored how the classroom management practices of sampled teachers in a private school in central Oregon influenced classroom disruptions. Through the study, the researcher was able to provide insight on the differences in specific classroom management processes between teachers who had a high number of Positive…

  4. Balancing Macro- and Micro-Sociolinguistic Perspectives in Language Management: The Case of Singapore.

    ERIC Educational Resources Information Center

    Kuo, Eddie C. Y.; Jernudd, Bjorn H.

    1993-01-01

    Shows how both macro- and microsociolinguistic perspectives are necessary to explain national language management. Macrolevel language planning is motivated by tasks of national consolidation by the state, notably in Singapore's case tasks of socio-ethnic integration and economic development. Microlevel language management pertains to individuals'…

  5. Knowledge Management and the Practice of Knowledge Sharing and Learning at Work: A Case Study

    ERIC Educational Resources Information Center

    Elmholdt, Claus

    2004-01-01

    This article offers a critique of knowledge management. The critique is empirically based on the case study of a Danish software production company's (A-Soft) knowledge management strategy of implementing an information technology (IT) tool known as 'knowledge centre' (KC). The article argues: (1) the discourses on knowledge and learning informing…

  6. Paper and Process: How Youth Programs Manage Program Intake, Individual Service Strategy Development, and Case Files.

    ERIC Educational Resources Information Center

    Callahan, Jim; McLaughlin, Brenda

    This guide presents information and materials to help youth programs manage program intake, design an individual service strategy (ISS) as mandated in the Workforce Investment Act, and manage case files. The materials are based on information obtained from staff working in seven successful youth workforce investment programs in Maryland,…

  7. Exploring Weight Management Recommendations across Australian Community Pharmacies Using Case Vignettes

    ERIC Educational Resources Information Center

    Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.

    2014-01-01

    With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages,…

  8. Water Resources Management in the Lerma-Chapala Basin, Mexico: A Case Study

    ERIC Educational Resources Information Center

    Villamagna, Amy M.; Murphy, Brian R.

    2008-01-01

    Water resources have become an increasingly important topic of discussion in natural resources and environmental management courses. To address the need for more critical thinking in the classroom and to provide an active learning experience for undergraduate students, we present a case study based on water competition and management in the…

  9. Laboratory Management of Drug-Facilitated Sexual Assault Cases.

    PubMed

    LeBeau, M A

    2010-01-01

    Over the past two decades, cases of drug-facilitated sexual assaults (DFSA) have increased in forensic laboratories in many parts of the world. Investigators of DFSA allegations know of the many challenges associated with these cases, but forensic toxicologists find that delays in the reporting of such crimes to law enforcement and subsequent lags in specimen collection are particularly important concerns. These delays are usually a result of the traumatic experience of sexual assaults, as well as the amnesic effect of the drugs typically used to commit DFSA. Unfortunately, such a delay in specimen collection may be the difference between detecting traces of a drug (or metabolite) and reporting a negative result. Therefore, it is imperative for toxicology laboratories to properly prepare for DFSA cases by developing forms, policies, and procedures to ensure that truly meaningful analyses are performed. This article provides guidance in the steps laboratories may take to best prepare themselves to analyze evidentiary specimens from DFSA investigations. PMID:26242459

  10. A Case of Pediatric Q Fever Osteomyelitis Managed Without Antibiotics.

    PubMed

    Khatami, Ameneh; Sparks, Rebecca T; Marais, Ben J

    2015-12-01

    Q fever osteomyelitis, caused by infection with Coxiella burnetti, is rare but should be included in the differential diagnosis of children with culture-negative osteomyelitis, particularly if there is a history of contact with farm animals, and/or granulomatous change on histologic examination of a bone biopsy specimen. We describe a case of Q fever osteomyelitis in a 6-year-old boy in which a decision was made not to treat the patient with combination antimicrobial agents, balancing possible risks of recurrence against potential side effects of prolonged antibiotic treatment. The patient had undergone surgical debridement of a single lesion and was completely asymptomatic after recovery from surgery. This case suggests that a conservative approach of watchful waiting in an asymptomatic patient with chronic Q fever osteomyelitis may be warranted in select cases when close follow-up is possible. PMID:26574586

  11. Identification and management of filament-wound case stiffness parameters

    NASA Technical Reports Server (NTRS)

    Verderaime, V.; Rheinfurth, M.

    1983-01-01

    The high specific strength and the high specific modules made graphite epoxy laminate an expedient material substitute for the Shuttle Solid Rocket Motor steel case to substantially increase the payload performance without increasing the composite case axial growth during thrust build up which was constrained to minimize liftoff excitation effects on existing structural elements and interfaces. Parameters associated with axial growth were identified for quality and manufacturing controls. Included is an innovative method for experimentally verifying extensional elastic properties on a laminate pressurized test bottle.

  12. The Management of Osteoarthritis in Movement Disorders: A Case Discussion

    PubMed Central

    Stafford, Giles H.; Howard, Robin S.; Lavelle, Jonathon

    2013-01-01

    Background A 37-year-old female with a hyperkinetic movement disorder due to chorea–acanthocytosis developed severe painful degenerative arthritis of her left knee as a consequence of repetitive involuntary flexion and extension dystonic and ballistic movements. Case Report Despite profound limitation in her mobility a total knee replacement was successfully undertaken. Discussion The case emphasizes that patients with progressive neurodegenerative disorders may derive relief or resolution of pain by joint replacement even if mobility does not improve following surgery. A multidisciplinary approach to care is essential. PMID:23858393

  13. Care management: quelling the confusion. Case managers help clients access resources appropriate to their needs.

    PubMed

    Westhoff, L J

    1992-06-01

    The vast number of available healthcare services can be confusing to those seeking care. Care managers can resolve these issues by helping the vulnerable and their families find and receive appropriate services. Care management is not limited to the elderly: Others with special needs also benefit from care management. Care managers integrate and coordinate services, providing a continuum between the client and the providers of acute, long-term, home-based, and community-based care. The care management model that most organizations adopt at first is the brokering model. In this model care managers identify the appropriate service package from resources in the community. In the service management model, the care manager authorizes the services provided within specified financial limits. The funding source influences what services he or she can recommend. Another model is managed care. The carrier of a high-risk group of clients or a group of enrollees in a certain healthcare program prospectively pays the organization providing care management. In the acute care setting, providers find the transition to care management challenging because they have been oriented to short, episodic care. These providers must adopt new protocols to be able to work with providers and programs within their own organization or at other organizations. In community-based care, care managers' goal is to help the client and family access appropriate services so the client can function independently within his or her home. Community-based referrals are from family members or agencies and infrequently follow an acute care hospitalization. PMID:10118342

  14. Development of plant maintenance management system (pmms): a case study

    NASA Astrophysics Data System (ADS)

    Che Azhar, N. A.; Mansor, M. A.

    2013-12-01

    In large plant industry, it is not easy to maintain machine performance without using any method such as checklist system. Manual checklist is a common maintenance checklist used in industry. All machine, equipment and parts that need to be checked will be written down for the employee to do maintenance checks. Converting the manual checklist to the Plant Maintenance Management System (PMMS) can improve the way of employees work and make plant management easier. Therefore, a new system was designed to maintain the equipment so that the activities are more efficient and cost effective. The system consists of three frames that connect to each other. The frames divide to section, equipment and checklist. This system also builds to prevent data from arbitrarily changes. Only certain officers or staffs are permitted to make modifications to data. Using this system, a company can make the office environment a paperless environment.

  15. Anaesthetic Management for Cataract Surgery in VACTERL Syndrome Case Report

    PubMed Central

    Khatavkar, Sonal S; Jagtap, S R

    2009-01-01

    Summary Eight year old girl, weighing 14 kg with VACTERL syndrome V: Vertebral anomalies, A: Anal malformation, C: Cardiovascular defect, TE: Tracheal and esophageal malformation, R: Renal agenesis, L: Limb anomalies. underwent cataract surgery under general anaesthesia. She had multiple congenital anomalies like esophageal atresia, imperforate anus (corrected), single kidney & radial aplasia. Anticipating problems of gastro-esophageal reflux & chronic renal failure, successful management was done. PMID:20640087

  16. Hospital waste management and toxicity evaluation: A case study

    SciTech Connect

    Tsakona, M.; Anagnostopoulou, E.; Gidarakos, E.

    2007-07-01

    Hospital waste management is an imperative environmental and public safety issue, due to the waste's infectious and hazardous character. This paper examines the existing waste strategy of a typical hospital in Greece with a bed capacity of 400-600. The segregation, collection, packaging, storage, transportation and disposal of waste were monitored and the observed problematic areas documented. The concentrations of BOD, COD and heavy metals were measured in the wastewater the hospital generated. The wastewater's toxicity was also investigated. During the study, omissions and negligence were observed at every stage of the waste management system, particularly with regard to the treatment of infectious waste. Inappropriate collection and transportation procedures for infectious waste, which jeopardized the safety of staff and patients, were recorded. However, inappropriate segregation practices were the dominant problem, which led to increased quantities of generated infectious waste and hence higher costs for their disposal. Infectious waste production was estimated using two different methods: one by weighing the incinerated waste (880 kg day{sup -1}) and the other by estimating the number of waste bags produced each day (650 kg day{sup -1}). Furthermore, measurements of the EC{sub 50} parameter in wastewater samples revealed an increased toxicity in all samples. In addition, hazardous organic compounds were detected in wastewater samples using a gas chromatograph/mass spectrograph. Proposals recommending the application of a comprehensive hospital waste management system are presented that will ensure that any potential risks hospital wastes pose to public health and to the environment are minimized.

  17. Municipal Solid Waste Management in Kadapa Town: A Case Study.

    PubMed

    Sumithra, S; Sunitha, V; Nagaraju, G

    2014-01-01

    Solid waste management (SWM) is a worldwide phenomenon. It is a big challenge all over the world for human beings. The problem of municipal solid waste management (MSWM) is also prevailing in the environment of Kadapa town in India. Therefore, the present study was undertaken to find out the problems and prospects of municipal solid waste in Kadapa town. A detailed investigation was made regarding the methods of practices associated with sources, quantity generated, collection, transportation, storage, treatment and disposal of municipal solid waste in the study area. The data related to SWM in the study area was obtained through questionnaire, individual field visits, interaction with people and authentic record of municipal corporation. Status of the MSW in Kadapa town was studied. The results indicated that the major constituents of municipal solid waste were organic in nature and approximately one fourth of municipal solid waste was recyclable. Detailed data on solid waste management practices, including collection, recovery and disposal method, has been presented in this paper. PMID:26445765

  18. Case Studies for Management Development in Bangladesh. Third Book. Prepared for the World Bank/Bangladesh Management Education and Training Project.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    This document contains 10 case studies of management situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. Two to four discussion questions follow each case study. Three case studies on the subject of pay and compensation were prepared by Abu Hossain Siddique; the…

  19. Multidisciplinary management of hypohydrotic ectodermal dysplasia – a case report

    PubMed Central

    Joseph, Suja; Cherackal, George J; Jacob, Jose; Varghese, Alex K

    2015-01-01

    Key Clinical Message Hypohydrotic ectodermal dysplasia is a hereditary disorder, which affects ectodermal derivatives. It manifests several abnormalities of the teeth, and is commonly inherited through female carriers. This case report presents a patient with compromised esthetics and function. A multidisciplinary approach was planned involving an oral pathologist, endodontist, orthodontist and a prosthodontist. PMID:25984305

  20. Managing Vocational Institutional Transformation: A Chinese Case Study

    ERIC Educational Resources Information Center

    Gao, X.; Su, Z.; Hu, X.

    2006-01-01

    This paper is a case study of a Chinese educational leader who was in charge of an institution when it was in the process of being upgraded from a secondary vocational school to a self-funded tertiary vocational institution. Using a life history approach, the paper furnishes an informative picture capturing the dual transformation process of the…

  1. Decentralized Management in Prison: A Comparative Case Study.

    ERIC Educational Resources Information Center

    Farmer, J. Forbes

    1994-01-01

    Conducted comparative case study of organizational climates in two prisons Findings from 149 staff members and 442 inmates revealed that flattening organizational structure without decentralizing authority seemed to have negative effects on staff supervisory relations and job satisfaction. Inmates reported better quality of life and more effective…

  2. Dilemmas in Managing Pregnant Women With Ebola: 2 Case Reports

    PubMed Central

    Caluwaerts, Séverine; Fautsch, Tessy; Lagrou, Daphne; Moreau, Michel; Modet Camara, Alseny; Günther, Stephan; Di Caro, Antonino; Borremans, Benny; Raymond Koundouno, Fara; Akoi Bore, Joseph; Logue, Christopher H.; Richter, Martin; Wölfel, Roman; Kuisma, Eeva; Kurth, Andreas; Thomas, Stephen; Burkhardt, Gillian; Erland, Elin; Lionetto, Fanshen; Lledo Weber, Patricia; de la Rosa, Olimpia; Macpherson, Hassan; Van Herp, Michel

    2016-01-01

    We report 2 cases of Ebola viral disease (EVD) in pregnant women who survived, initially with intact pregnancies. Respectively 31–32 days after negativation of the maternal blood EVD-polymerase chain reaction (PCR) both patients delivered a stillborn fetus with persistent EVD-PCR amniotic fluid positivity. PMID:26679622

  3. A Case of Diprosopus: Perinatal Counseling and Management

    PubMed Central

    Thornton, Kimberly M.; Bennett, Timothy; Singh, Vivekanand; Mardis, Neil; Linebarger, Jennifer; Kilbride, Howard; Voos, Kristin

    2014-01-01

    Diprosopus is a rare congenital malformation associated with high mortality. Here, we describe a patient with diprosopus, multiple life-threatening anomalies, and genetic mutations. Prenatal diagnosis and counseling made a beneficial impact on the family and medical providers in the care of this case. PMID:25254133

  4. Dilemmas in Managing Pregnant Women With Ebola: 2 Case Reports.

    PubMed

    Caluwaerts, Séverine; Fautsch, Tessy; Lagrou, Daphne; Moreau, Michel; Modet Camara, Alseny; Günther, Stephan; Di Caro, Antonino; Borremans, Benny; Raymond Koundouno, Fara; Akoi Bore, Joseph; Logue, Christopher H; Richter, Martin; Wölfel, Roman; Kuisma, Eeva; Kurth, Andreas; Thomas, Stephen; Burkhardt, Gillian; Erland, Elin; Lionetto, Fanshen; Lledo Weber, Patricia; de la Rosa, Olimpia; Macpherson, Hassan; Van Herp, Michel

    2016-04-01

    We report 2 cases of Ebola viral disease (EVD) in pregnant women who survived, initially with intact pregnancies. Respectively 31-32 days after negativation of the maternal blood EVD-polymerase chain reaction (PCR) both patients delivered a stillborn fetus with persistent EVD-PCR amniotic fluid positivity. PMID:26679622

  5. Bibliometric Techniques Applied to Issues Management: A Case Study.

    ERIC Educational Resources Information Center

    Lancaster, F. W.; Lee, Ja-Lih

    1985-01-01

    Case study on acid rain illustrates procedures for systematized tracking of issues: using bibliometric methods to list journals to be scanned; using current awareness searches of online databases to supplement journal scanning; using literature monitoring to create significant terms file; and tracking terms through online database index. (10…

  6. Secondary School Art: A Case for Increased Senior Management Support

    ERIC Educational Resources Information Center

    Etherington, Margaret

    2015-01-01

    This case study explores the way that school art in England remains a marginalised subject at secondary level, despite the expansion of art-based career opportunities. A recent government document evaluating art, craft and design education highlights the potential role of head teachers in raising an art department's profile. The current study…

  7. Managing Communication during a School Crisis: A Case Study

    ERIC Educational Resources Information Center

    Gentilucci, James L.

    2007-01-01

    Crisis communication training of school principals is problematic because it overemphasizes media relations and underemphasizes the critical importance of immediate and personal communication with students, staff, and parents--those most affected by school crises. A case study involving the death of a student in a small rural school explains why…

  8. Managing the medical device directive. A practical case study.

    PubMed

    Nielsen, M

    1995-11-01

    Through a case study of a fictional company, this article provides a guide on how to implement CE-marking procedures, as detailed in the Medical Device Directive. The overlap in transitional periods between the Medical Device and Electromagnetic Compatibility Directives is discussed, together with issues such as selection of conformity assessment routes. PMID:10158130

  9. Use of Case Study Methods in Human Resource Management, Development, and Training Courses: Strategies and Techniques

    ERIC Educational Resources Information Center

    Maxwell, James R.; Gilberti, Anthony F.; Mupinga, Davison M.

    2006-01-01

    This paper will study some of the problems associated with case studies and make recommendations using standard and innovative methodologies effectively. Human resource management (HRM) and resource development cases provide context for analysis and decision-making designs in different industries. In most HRM development and training courses…

  10. No Teacher Left behind: Transition Management in Teacher Education--A Case Study

    ERIC Educational Resources Information Center

    DePeza, Hazel Ann Gibbs

    2010-01-01

    This qualitative case study examined the management of the transition and implementation of the process of change from in-service to pre-service teacher education in Trinidad and Tobago in 2006 and explored the perceptions of 21 participants of the transition process. This case study was both exploratory and descriptive. It explored the change…

  11. Diffusion of Innovation: A Case Study of Course Management System Adoption

    ERIC Educational Resources Information Center

    Powell, Phillip, Ed.D.

    2008-01-01

    The purpose of this study was to examine the processes of evaluation, selection, adoption and diffusion of a course management system (CMS). This study incorporated a cross-case analysis using a multiple case study approach, which included two institutions, each having six participants. The participants were placed into three categories: faculty,…

  12. The Use of Case Studies in International Training Programmes for the Management of Educational Change.

    ERIC Educational Resources Information Center

    Gray, Harry

    Experience in running international seminars is synthesized in this paper to provide guidelines on the use of case studies in introducing innovations in educational management. For purposes of international meetings, case studies offer universally available data and material in a form easily assimilated by delegates with varying linguistic…

  13. Utilizing Multimedia Case Studies to Teach the Professional Side of Project Management

    ERIC Educational Resources Information Center

    Elrod, Cassandra C.; Murray, Susan L.; Flachsbart, Barry B.; Burgher, Karl E.; Foth, Drew M.

    2010-01-01

    This research was conducted to evaluate the effectiveness of using a LITEE multimedia case study to teaching concepts in engineering courses. The LITEE Superstar case study was implemented in an engineering Project Management course. Numerous surveys regarding student expectations, outcomes, and attitudes were collected and results are presented…

  14. Turning a hazardous waste lagoon into reclaimed land for wildlife management: A case study

    SciTech Connect

    Leong, A.K.

    1996-12-31

    Brownfields are turning back to green. This paper presents a case study of a former dump site for hazardous waste that has been remediated and will be developed into an enhanced wildlife management habitat. This successful remediation case combined various investigations, remedial designs, risk assessments, ecological studies, and engineering practices. 3 refs., 1 fig., 1 tab.

  15. Recurrent Dermatofibrosarcoma Protuberance and its Management with Radical Excision and Interval Skin Grafting: A Case Report

    PubMed Central

    Ahmad, Imran; Mir, Mohd Altaf; Bariar, Lalit Mohan; Afroz, Nishat

    2016-01-01

    Dermatofibrosarcoma protuberans (DFSP) is very rare tumor of dermis layer of skin with the incidence of only 1 case per million per year. DFSP rarely leads to a metastasis (Less than 5% have metastasis), but DFSP can recur locally. We publish a rare case of a recurrent dermatofibrosarcoma protuberans and its management with radical excision and interval skin grafting. PMID:27308244

  16. True and False Allegations of Child Sexual Abuse: Assessment and Case Management.

    ERIC Educational Resources Information Center

    Ney, Tara, Ed.

    This book addresses the clinical, legal, and ethical issues arising in child sexual abuse cases; the assessment and case management of allegations; research issues; and practice recommendations. Chapter titles are as follows: "Assessing Allegations in Child Sexual Abuse: An Overview" (Tara Ney); "The Nature of Allegations of Child Sexual Abuse"…

  17. Management of abdomen hydatidosis after rupture of a hydatid splenic cyst: a case report

    PubMed Central

    Soultanidis, Chrisostomos; Kirmanidis, Michail A; Tsigalou, Christina; Deftereos, Savvas

    2009-01-01

    We present a case of multiple hydatidosis in an 8-year-old boy that resulted from a ruptured hydatid cyst of the spleen and spread into the peritoneal cavity. We also present a new approach for managing these difficult and high-risk cases. PMID:19918429

  18. Examining Preservice Teachers' Classroom Management Decisions in Three Case-Based Teaching Approaches

    ERIC Educational Resources Information Center

    Demiraslan-Çevik, Yasemin; Andre, Thomas

    2013-01-01

    This study was aimed at comparing the impact of three types of case-based approaches (worked example, faded work example, and case-based reasoning) on preservice teachers' decision making and reasoning skills related to realistic classroom management situations. Participants in this study received a short-term implementation of one of these three…

  19. Learning from Action Evaluation of the Use of Multimedia Case Studies in Management Information Systems Courses

    ERIC Educational Resources Information Center

    Kawulich, Barbara B.

    2011-01-01

    This manuscript shares lessons learned from conducting an action evaluation of the use of multimedia case studies in Management Information Systems (MIS) courses. Three undergraduate MIS classes took part in the study. The purpose for using case studies in these classes was to teach students about the role of MIS in business. An action evaluation…

  20. Minimally invasive management of intrahepatic type II gallbladder perforation: a case report

    PubMed Central

    Alshammari, Dheidan; Tzedakis, Stylianos; Hargat, Julie; Mutter, Didier; Marescaux, Jacques; Pessaux, Patrick

    2016-01-01

    Intrahepatic gallbladder perforation (GBP) is a rare medical entity, which creates a cholecystohepatic communication. We describe the case of a 70-year-old patient who presented with abdominal pain and a Niemeier type II GBP. This case report illustrates the minimally invasive management of a rare and life-threatening pathology. PMID:26904560

  1. Anesthetic management of children with Rubinstein-Taybi syndrome--case reports.

    PubMed

    Agarwal, Shvetank; Ahmad, Yasser Haidar; Talpesh, Monica; Zestos, Maria

    2011-06-01

    A limited number of cases of anesthetic management of Rubinstein-Taybi Syndrome (RTS) have been reported since this syndrome was first diagnosed in 1963. After some well-publicized complications following anesthesia for patients with RTS, there has been great interest in avoiding all precipitant factors and careful monitoring during intraoperative and postoperative periods. This case series examines the cases of three pediatric patients with RTS who presented to the Children's Hospital of Michigan for different surgeries. We aim in this study to share information about this rare syndrome and to emphasize how this case series allowed us to improve our anesthetic management. In each case, we adjusted our techniques using information from preceding cases to avoid complications in the following encounter. PMID:22435286

  2. Phoniatric management of 3 clinical cases of voice disorders involving the recurrent nerve.

    PubMed

    Faure, M A

    2012-01-01

    These three cases involve aphonia or dysphonia as a consequence of entrapment of one of the recurrent nerves, in the absence of any prior surgical history. Depending on the particular case, one to two months was needed to normalize phonatory function; One case relapsed after a year. The phoniatric management of these cases involved: New functional and acoustic pattern, recorded by the patient as a form of daily maintenance; Laryngeal and perilaryngeal manual therapy, applied according to the "osteovox" method. Manual therapy and different phonatory habits, in association with alternative medicine can reduce the time to recovery in the case of cold-induced unilateral paresis. PMID:23074827

  3. Managing and Financing Urban Community Colleges in the '80s: The Case for Strategic Management.

    ERIC Educational Resources Information Center

    Ellison, Nolen M.

    New approaches to planning and management will be required in the 1980s if community colleges are to deal with the challenges posed by declining enrollments and funds and changing public attitudes toward financing higher education. In the past two decades, management development and college planning have emphasized the creation and expansion of…

  4. Teaching and Learning about Managing People: Human Resource Management for Education Settings--A Queensland Case.

    ERIC Educational Resources Information Center

    McCrea, Nadine L.; Ehrich, Lisa C.

    1996-01-01

    Describes the development of a human resource management (HRM) elective for educators aspiring to management positions in various educational settings. The unit is part of a graduate diploma offered within the Faculty of Education at one Australian university. The paper argues the necessity of HRM studies in postgraduate education courses. (SM)

  5. Gaps in Management Education: A Case Study of University of Management and Technology

    ERIC Educational Resources Information Center

    Abdur-Raouf; Kalim, Rukhsana; Siddiqi, Ahmed F.

    2010-01-01

    This paper aims to identify the gaps in management education highlighted by 3 primary stakeholders: students, faculty and alumni. The study tries to address the issue of relevance and compatibility of management education and investigates areas of improvement perceived by respondents. The paper assumes that business departments of universities…

  6. Sex offender polygraph examination: an evidence-based case management tool for social workers.

    PubMed

    Levenson, Jill S

    2009-10-01

    This article will review the use of polygraphy in the assessment and treatment of sexual perpetrators. Such information can be utilized by social workers who are involved in the treatment and case management of child sexual abuse cases. First, the controversial literature regarding the validity and reliability of polygraph examination in general will be reviewed. Next, an emerging body of evidence supporting the utility of polygraph testing with sex offenders will be discussed. Finally, ways that social workers can incorporate this knowledge into their case management and clinical roles will be offered. PMID:20183683

  7. Method of sealing casings of subsurface materials management system

    DOEpatents

    Nickelson, Reva A.; Richardson, John G.; Kostelnik, Kevin M.; Sloan, Paul A.

    2007-02-06

    Systems, components, and methods relating to subterranean containment barriers. Laterally adjacent tubular casings having male interlock structures and multiple female interlock structures defining recesses for receiving a male interlock structure are used to create subterranean barriers for containing and treating buried waste and its effluents. The multiple female interlock structures enable the barriers to be varied around subsurface objects and to form barrier sidewalls. The barrier may be used for treating and monitoring a zone of interest.

  8. Frontoethmoidal encephalocele: Case report and review on management

    PubMed Central

    Dhirawani, Rajesh B.; Gupta, Richa; Pathak, Sanyog; Lalwani, Gaurav

    2014-01-01

    Encephaloceles, especially in the frontoethmoidal region, are a form of neural tube defect affecting patients in Southeast Asia more commonly than those in western countries, where they are more common in the occipital regions. All patients with classical frontoethmoidal encephalocele had swelling over the bridge of nose or inner canthus of eye since birth, with varying degrees of hypertelorism. This paper emphasizes on the clinical features of this pathology and its surgical management, along with, reviewing the evolution of single-stage correction and fine refinements. PMID:25593873

  9. Laboratory Information Management System (LIMS): A case study

    NASA Technical Reports Server (NTRS)

    Crandall, Karen S.; Auping, Judith V.; Megargle, Robert G.

    1987-01-01

    In the late 70's, a refurbishment of the analytical laboratories serving the Materials Division at NASA Lewis Research Center was undertaken. As part of the modernization efforts, a Laboratory Information Management System (LIMS) was to be included. Preliminary studies indicated a custom-designed system as the best choice in order to satisfy all of the requirements. A scaled down version of the original design has been in operation since 1984. The LIMS, a combination of computer hardware, provides the chemical characterization laboratory with an information data base, a report generator, a user interface, and networking capabilities. This paper is an account of the processes involved in designing and implementing that LIMS.

  10. Case managers play important part in employers' culture of health.

    PubMed

    Owen, Mindy

    2006-01-01

    At Duncan Aviation, an aircraft support company based in Lincoln, Nebraska, meetings with the wellness staff are a job requirement. At least quarterly and often monthly, all managers and team leaders are required to schedule a presentation by the company's wellness staff as part of regular department or team meetings. "That way exposure to the wellness team and program is 100%, not just the 10% to 20% that we might have at a 'learn at lunch' program," explained wellness director Craig Johnson. "This is happening on company time. People are being paid to attend the presentation. It's part of the culture here." PMID:16720260

  11. Data management for community research projects: A JGOFS case study

    NASA Technical Reports Server (NTRS)

    Lowry, Roy K.

    1992-01-01

    Since the mid 1980s, much of the marine science research effort in the United Kingdom has been focused into large scale collaborative projects involving public sector laboratories and university departments, termed Community Research Projects. Two of these, the Biogeochemical Ocean Flux Study (BOFS) and the North Sea Project incorporated large scale data collection to underpin multidisciplinary modeling efforts. The challenge of providing project data sets to support the science was met by a small team within the British Oceanographic Data Centre (BODC) operating as a topical data center. The role of the data center was to both work up the data from the ship's sensors and to combine these data with sample measurements into online databases. The working up of the data was achieved by a unique symbiosis between data center staff and project scientists. The project management, programming and data processing skills of the data center were combined with the oceanographic experience of the project communities to develop a system which has produced quality controlled, calibrated data sets from 49 research cruises in 3.5 years of operation. The data center resources required to achieve this were modest and far outweighed by the time liberated in the scientific community by the removal of the data processing burden. Two online project databases have been assembled containing a very high proportion of the data collected. As these are under the control of BODC their long term availability as part of the UK national data archive is assured. The success of the topical data center model for UK Community Research Project data management has been founded upon the strong working relationships forged between the data center and project scientists. These can only be established by frequent personal contact and hence the relatively small size of the UK has been a critical factor. However, projects covering a larger, even international scale could be successfully supported by a

  12. Case management lessons from a public/private partnership to finance long-term care.

    PubMed

    Mahoney, K

    1992-01-01

    In June of 1987, Connecticut's State Task Force on Private and Public Responsibilities for Financing Long-Term Care for the Elderly released its final report. This Governor's Commission, concluding that neither the private nor the public sector had much short-term hope of solving this difficult problem alone, recommended the creation of a public/private partnership. As this partnership was forged, some unique insights were gained into the functions of case management. This case study shows how case management can help coordinate the private and public roles, but it also raises some research questions which must be tackled before case management can fulfill its promise to help stretch and conserve scarce resources. PMID:1467793

  13. Uterocutaneous Fistula Following Cesarean Section: Successful Management of a Case

    PubMed Central

    Maddah, Ghodratollah; Fattahi, Asieh Sadat; Rahnama, Ali; Jamshidi, Shirin Taraz

    2016-01-01

    A uterocutaneous fistula is a rare clinical presentation that occurs following Cesarean section and other pelvic operations. There are only a few reports discussing the treatments. We describe a patient with successful surgical management and review the literature. A 25-year-old woman referred to our department 13 months after her first Cesarean section. She had a history of an abdominal mass and collection 2 months after surgery and some fistula opening with discharge from her previous incision. She had a previous surgical operation and antibiotic therapy without complete response. We performed fistulography to evaluate the tracts. In the operation — she had fistula tracts, one of which was between the uterus and skin. We debrided the necrotic tissue in the uterus, excised the fistula tracts, and drained the uterine cavity. At 8 months’ postoperative follow-up, she had no recurrence. A uterocutaneous fistula is a rare condition with many causes and needs proper investigation and timely medical and surgical management. PMID:26989289

  14. Ubiquitous Indoor Geolocation: a Case Study of Jewellery Management System

    NASA Astrophysics Data System (ADS)

    Nikparvar, B.; Sadeghi-Niaraki, A.; Azari, P.

    2014-10-01

    Addressing and geolocation for indoor environments are important fields of research in the recent years. The problem of finding location of objects in indoor spaces is proposed to solve in two ways. The first, is to assign coordinates to objects and second is to divide space into cells and detect the presence or absence of objects in each cell to track them. In this paper the second approach is discussed by using Radio Frequency Identification technology to identify and track high value objects in jewellery retail industry. In Ubiquitous Sensor Networks, the reactivity or proactivity of the environment are important issues. Reactive environments wait for a request to response to it. Instead, in proactive spaces, the environment acts in advance to deal with an expected action. In this research, a geo-sensor network containing RFID readers, tags, and antennas which continuously exchange radio frequency signal streams is proposed to manage and monitor jewellery galleries ubiquitously. The system is also equipped with a GIS representation which provides a more user-friendly system to manage a jewellery gallery.

  15. A Lymphedema Self-Management Programme: Report on 30 Cases

    PubMed Central

    Hodgson, Pamela; Shay, Carol; Towers, Anna

    2014-01-01

    ABSTRACT Purpose: Compression therapy is the most important element in the treatment and long-term management of moderate and severe lymphedema, but it is not universally accessible in Canada. For those unable to access private lymphedema treatment, physiotherapists at the McGill University Health Centre (MUHC) Lymphedema Clinic began teaching patients and caregivers how to use compression bandages safely and effectively. Methods: A retrospective chart review was combined with structured telephone or in-person interviews with 30 people who had attended a self-bandaging clinic in the MUHC Lymphedema Clinic between 2011 and 2012. Patients were monitored weekly until limb volume plateaued, and a compression garment was then fitted for ongoing maintenance. Monthly or quarterly surveillance continued for 1 year. Follow-up interviews were conducted 3 to 18 months after patients had received their garments. Results: The majority of participants had moderate to severe lymphedema; all achieved reduction of edema in the range of 48% to 92%. More than three-quarters of participants reported a global rate of change (GRC) of ≥80%. Themes derived from the interviews included the importance of bandaging, the feeling of being in control, and difficulties with compression garments. Participants spontaneously expressed satisfaction about having tools to manage their condition themselves. Conclusion: For selected patients with lymphedema, a self-bandaging programme can be a route to lymphedema reduction, independence, and self-efficacy. PMID:25922562

  16. Dental management of oculodentodigital dysplasia: a case report.

    PubMed

    Aminabadi, Naser A; Pourkazemi, Maryam; Oskouei, Sina G; Jamali, Zahra

    2010-06-01

    Oculodentodigital dysplasia is an extremely rare autosomal dominant pleiotropic disorder. The syndrome is characterized by abnormal facial features, central nervous system involvement, syndactyly and clinodactyly of fourth and fifth fingers, dry and lusterless hair, generalized enamel hypoplasia and odontodysplasia. Combination of odontodysplasia, poor oral hygiene, and parental neglect can lead to extensive destruction of tooth structure and the treatment options become limited. Early diagnosis with a proper treatment plan and meticulous oral hygiene program helps eliminate the necessity of multiple tooth extractions. This case report describes the comprehensive dental treatment aimed at rehabilitation of function and aesthetics of the dentition in an 8-year-old boy with oculodentodigital dysplasia. PMID:20587963

  17. A Case for Pharmacogenomics in Management of Cardiac Arrhythmias

    PubMed Central

    Kandoi, Gaurav; Nanda, Anjali; Scaria, Vinod; Sivasubbu, Sridhar

    2012-01-01

    Disorders of the cardiac rhythm are quite prevalent in clinical practice. Though the variability in drug response between individuals has been extensively studied, this information has not been widely used in clinical practice. Rapid advances in the field of pharmacogenomics have provided us with crucial insights on inter-individual genetic variability and its impact on drug metabolism and action. Technologies for faster and cheaper genetic testing and even personal genome sequencing would enable clinicians to optimize prescription based on the genetic makeup of the individual, which would open up new avenues in the area of personalized medicine. We have systematically looked at literature evidence on pharmacogenomics markers for anti-arrhythmic agents from the OpenPGx consortium collection and reason the applicability of genetics in the management of arrhythmia. We also discuss potential issues that need to be resolved before personalized pharmacogenomics becomes a reality in regular clinical practice. PMID:22557843

  18. Clinical management of supernumerary teeth: a report of two cases.

    PubMed

    Mittal, M; Sultan, A

    2010-01-01

    Supernumerary tooth may closely resemble the teeth of the group to which it belongs, i.e. molars, premolars or anterior teeth, or it may bear little resemblance in size or shape to which it is associated. Many complications can be associated with supernumeraries, like impaction, delayed eruption or ectopic eruption of adjacent teeth, crowding, development of median diastema and eruption into floor of the nasal cavity. This may also cause the formation of follicular cysts with significant bone destruction. Early intervention to remove it is usually required to obtain reasonable alignment and occlusal relationship. This article will present the clinical management of an (i) impacted supernumerary tooth impeding the eruption of maxillary central incisor and (ii) erupted supernumerary tooth with midline diastema. PMID:21157058

  19. Managing discovery risks--A Tevatron case study

    SciTech Connect

    Bakul Banerjee

    2004-07-28

    To meet the increasing need for higher performance, Management of Fermi National Accelerator Laboratory has undertaken various projects to improve systems associated with the Tevatron high-energy particle collider located at Batavia, Illinois. One of the larger projects is the Tevatron Beam Position Monitor (BPM) system. The objective of this project is to replace the existing BPM electronics and software system that was originally installed during early 1980s, along with the original construction of the Tevatron.The original system consists of 236 beam position monitors located around the underground tunnel of the accelerator. Above ground control systems are attached to these monitors using pickup cables. When the Tevatron collider is operational, signals received from the BPMs are used to perform a number of control and diagnostic tasks. The original system can only capture the proton signals from the collider. The new system, when fully operational, will be able to capture combined proton and antiproton signals and will be able to separate the antiproton signal from the combined signal at high resolution. This significant enhancement was beyond the range of technical capabilities when the Tevatron was constructed about two decades ago. To take advantage of exceptional progress made in the hardware and software area in past two decades, Department of Energy approved funding of the BPM electronics and software replacement project. The approximate length of the project is sixteen months with a budget of four million dollars not including overhead, escalation, and contingencies. Apart from cost and schedule risks, there are two major risks associated with this research and development project. The primary risk is the risk of discovery. Since the Tevatron beam path is highly complex, BPMs have to acquire and process a large amount of data. In this environment, analysis of data to separate antiproton signals is even more complex. Finding an optimum algorithm that can

  20. Environmental management during economic transition: Ukraine--A case study

    SciTech Connect

    Kempen van, T.H.; Demydenko, A.O.

    1995-12-01

    After dissolution of Soviet Union, each new States had to confront the legacy of an unsustainable, and ultimately failed, economic and political system. Enormous environmental problems resulted from centrally planned economics, which promoted rapid growth through exploitation of the former Soviet Union`s (FSU) vast natural resources. Unconstrained by scarcity-based pricing, extractive and heavy industry ministries created huge, inefficient, and heavily polluting enterprises. The region also experienced extensive forest-cutting, steady deterioration of soils, and contaminated runoff and infiltration from over-excessive application of agrichemicals. The fate of the environment will depend largely on successful transition to a market-based economy. Funds for environmental protection will remain scarce, and poor technology combined with a degraded and overworked infrastructure will slow cleanup of contaminated regions. With failed economies, policy-makers and legislators will be forced to overlook sustainable development as they exploit natural resources in an effort to produce food and obtain hard currency. Ukraine, the second-most populous republic of the FSU, experienced possibly the world`s greatest single environment disaster--the 1986 Chernobyl catastrophe. Today, heavy industry, with its resource-intensive and highly polluting technologies, contributes 61% of Ukraine`s GNP, in comparison with 34% in the European Union. Energy production is grossly inefficient. Environmental agencies in Ukraine are new, with limited legal or economic tools, financial resources, or technical skills. Yet the country has commenced environmental management initiatives that, when combined with economic reforms, will start to improve environmental conditions. This paper presents an overview of Ukraine`s environmental and economic conditions, steps already undertaken to manage the environment, and additional measures needed to improve the situation.

  1. Zolpidem dependence case series: possible neurobiological mechanisms and clinical management.

    PubMed

    Liappas, I A; Malitas, P N; Dimopoulos, N P; Gitsa, O E; Liappas, A I; Nikolaou, Ch K; Christodoulou, G N

    2003-03-01

    Zolpidem is a short-acting imidazopyridine hypnotic that is an agonist at the gamma-aminobutyric acid A type (GABAA) receptor. It has been suggested that it acts selectively on alpha1 subunit-containing GABAA benzodiazepine (BZ1) receptors presenting (contrary to classic benzodiazepines) low or no affinity for other subtypes. Therefore, it has been proposed that it lacks the benzodiazepines-like side-effects, having minimal abuse and dependence potential. Nevertheless, there is a considerable number of zolpidem dependence case reports in the literature. We present eight cases of zolpidem abuse and dependence without criminal record, without history of substance abuse (except for one alcohol abuser), with minor psychiatric disorders, who took zolpidem after physicians prescription in order to deal with their insomnia. However, they became zolpidem abusers not craving its sedative, but its anxiolytic and stimulating action, which helped them to cope with everyday activities. It is possible that, in the high doses that our patients used, zolpidem abandons its selectivity for BZ1 receptors and demonstrates all the actions of classic benzodiazepines. Molecular biology, via possible mutations on GABA receptors, may provide some answers as to why our eight patients (who did not differ much from the thousands of insomniacs who use zolpidem) and other zolpidem abusers, raised the dose progressively, and sought something from the drug other than hypnotic action. PMID:12680751

  2. Surgical management of isolated retroperitoneal Castleman's disease: A case report

    PubMed Central

    XU, JUN; ZHOU, BO; CAO, HUA-LI; WANG, BO; YAN, SHENG; ZHENG, SHU-SEN

    2016-01-01

    Castleman's disease (CD) is an uncommon, poorly understood lymphoproliferative disease. Retroperitoneal forms may present as either a unicentric or multicentric disease. The present study reports the case of a 36-year-old man who was referred to the First Affiliated Hospital, School of Medicine, Zhejiang University (Hangzhou, China), for a detailed examination of an abdominal mass. The abdominal ultrasound and computed tomography scans revealed a solid mass localized in the region between segment 1 of the liver and the pancreas. An endosonography-guided fine-needle aspiration biopsy revealed chronic inflammation and lymphadenosis. The present study reports a rare case, in which the patient was treated with an exploratory laparotomy and resection. The retroperitoneal mass was pathologically diagnosed as CD of the hyaline vascular type. The patient was closely followed-up for 11 months and is presently free of disease. In conclusion, the possibility of unicentric CD should be considered when facing a solid hypervascular retroperitoneal mass. A complete surgical resection may successfully treat the disease without an unnecessarily extensive resection for the unicentric type. PMID:26998133

  3. [Rehabilitation management categories. A new approach to case mix in medical rehabilitation].

    PubMed

    Spyra, K; Müller-Fahrnow, W

    1998-06-01

    Creating typical treatment case groups in medical rehabilitation, in short: Rehabilitee Management Categories (RMKs, Rehabilitanden-Management-Kategorien), is a key issue for quality assurance within the frame of modern concepts of Total Quality Management (TQM), not least utilizing current organization and management concepts (Managed Care). So far, the problem of creating highly homogeneous case groups has remained unsolved on the basis of the present methodological framework. Critical prerequisites for any further scientific work on this problem are being established in the field of medical rehabilitation with the help of the Classification of Therapeutic Services (CTS) as well as development of instruments documenting therapy plans for typical rehabilitation case groups, process-relevant quality features and definitions of therapy goals as a basis for quality screening under the Pension Insurance quality assurance programme in medical rehabilitation. These developments have clearly contributed to expanding the theoretical foundations as well as the prerequisites for empirical grounding of Rehabilitee Management Categories in medical rehabilitation under the Pension Insurance scheme. A project for determination of rehabilitation case groups which is based on these developments, is due to start at the Humboldt University and Technical University, Berlin in the near future within a rehab promotion initiative of the German Pension Insurance system in cooperation with the Federal Ministry of Research and Technology. Conceptually, the determination of Rehabilitee Management Categories by far exceeds all previous approaches as (1) it will be generated by an iterative process of empirical service descriptions and theoretical consensus building among experts, (2) not only static parameters but also process-related details will be recorded, and (3) quality requirements will be defined for the rehabilitation process and outcome. As a result, rehabilitation-relevant case

  4. Surgical management of Giant Lumbar Extradural Schwannoma: Report of 3 cases

    PubMed Central

    Srikantha, Umesh

    2015-01-01

    Standard surgical approach for extradural paraspinal tumours has been through a unilateral facetectomy, inter-transverse or retroperitoneal approach. Some of these approaches destabilise the spine and consequently require a fusion procedure. Access to these tumours through a minimal access route can decrease tissue damage, fasten post-operative recovery and obviate the need for a concomitant fusion procedure. However, proper case selection and adequate pre-operative planning are important in choosing cases for a minimally invasive approach. We discuss three cases of giant extradural, paraspinal schwannomas. One case that was associated with listhesis along with the tumour situated more anteriorly and embedded in the psoas muscle was managed by lateral retroperitoneal route with simultaneous interbody graft followed by posterior interspinous stabilising device. The other two cases were managed by minimal access route using a 22mm fixed tubular retractor, one by a paramedian approach and one by far lateral approach. The technique and merits of the procedure are discussed. PMID:26114087

  5. Client satisfaction with a new group-based model of case management for supported housing services.

    PubMed

    Tsai, Jack; Reddy, Navin; Rosenheck, Robert A

    2014-04-01

    Supportive housing typically offers rental subsidies and individual intensive community-based case management and has become a predominant service model for homeless adults. Alternative case management models have not been adequately explored. This study evaluates satisfaction with a novel group-intensive peer support (GIPS) model of case management for the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program. A total of 95 HUD-VASH clients rated their satisfaction with services and responded to open-ended questions about what they liked best and least about the program. Quantitative and qualitative analyses compared clients who attended groups as part of the GIPS model and those who did not. No significant difference in satisfaction between group and non-group attenders were found. Clients reported what they liked best about the program was the staff; those who attended groups reported what they liked best was the social interaction and peer support. These findings suggest clients who attend groups for their primary source of case management may be as satisfied as those who receive only individual case management. GIPS offers a feasible and acceptable service model and should be further explored along with other alternative models of care in supportive housing services. PMID:24413143

  6. Developing open geographic data model and analysis tools for disaster management: landslide case

    NASA Astrophysics Data System (ADS)

    Aydinoglu, A. C.; Bilgin, M. S.

    2014-10-01

    Disaster Management aims to reduce catastrophic losses of disasters as landslide. Geographic information technologies support disaster management activities for effective and collaborative data management considering complex nature of disasters. Thus, this study aims to develop interoperable geographic data model and analysis tools to manage geographic data coming from different sources. For landslide disaster, 39 scenario-based activities were analyzed with required data according to user needs in a cycle of activities at mitigation, preparedness, response, and recovery phases. Interoperable geographic data model for disaster management (ADYS), enabling up-to-date exchange of geographic data, was designed compliant with standards of ISO/TC211 Geographic Information/Geomatics, Open Geospatial Consortium (OGC), and Turkey National GIS (TUCBS). Open source and free analysis toolbox was developed and tested in case study of the activities such as landslide hazard analysis and disaster warning system to support Provincial Disaster Management Centers of Turkey.

  7. The assessment and management of pain in an orthopaedic out-patient setting: A case study.

    PubMed

    Hall, Gillian; Gregory, Julie

    2016-08-01

    The management of pain is an important aspect of an orthopaedic nurse's role. The aim of this paper is to use an individual case study to demonstrate the role of an out-patient orthopaedic nurse in the identification, assessment and management of pain. This paper describes how pain was identified and managed for a patient in the orthopaedic outpatient department, highlighting that pain and its management are not isolated to the in-patient setting. The case study illustrates the importance of recognising pain and taking into account the numerous factors that can influence pain perception. The assessment of an individual patient's pain led to obtaining help from the Acute Pain Team which led to improvement in the patient's pain management and quality of life. The nursing team reflected and discussed the issues identified by this case study which led to changes in practice being introduced. This has resulted in an increased knowledge of and confidence in pain management within the nursing team and development and improvement of pain management practice within the orthopaedic out-patient department. PMID:26711709

  8. Dental management of patient with Williams Syndrome - A case report.

    PubMed

    Wong, Daniel; Ramachandra, Srinivas Sulugodu; Singh, Ashish Kumar

    2015-01-01

    Williams syndrome is a multisystemic rare genetic disorder caused by deletion of 26-28 genes in the long arm of chromosome 7. It is characterized by developmental and physical abnormalities including congenital cardiovascular abnormalities, mental retardation, neurological features, growth deficiency, genitourinary manifestations, gastrointestinal problems, musculoskeletal problems, unique behavioral characteristics, and dental problems. Dental abnormalities include malocclusion, hypodontia, malformed teeth, taurodontism, pulp stones, increased space between teeth, enamel hypoplasia, and high prevalence of dental caries. Authors report a 17-year-old female patient with underlying Williams syndrome. Oral features and problems seen in the patient are listed. Malocclusion and screwdriver shaped teeth were noticed. Generalized widening of the periodontal ligament space with vital teeth was seen. This finding has not been reported in cases of Williams syndrome earlier. Precautions taken during dental treatment in patients with Williams syndrome are also discussed. PMID:26321847

  9. Clinical Management of Glanzmann’s Thrombasthenia: A Case Report

    PubMed Central

    Varkey, Indu; Rai, Kavita; Hegde, Amitha M.; Vijaya, Mangalpady Shenoy; Oommen, Vinod Idicula

    2014-01-01

    Glanzmann’s thrombasthenia (GT) is a rare, genetically inherited platelet disorder in which the platelet glycoprotein IIb/IIIa (GP IIb/IIIa) complex is either deficient or, dysfunctional. The incidence is about 1 in 1,000,000. This case report deals with a 4 year-old girl diagnosed with GT presenting with dental caries and periapical lesions in the primary mandibular first molars. To provide the best care, an interdisciplinary approach was followed by a team consisting of pediatric dentists, pediatricians and anesthesiologists. Complete oral rehabilitation was planned under general anesthesia which included extractions, multiple esthetic restorations and space maintainers with the utmost care to prevent unwarranted bleeding. PMID:24910701

  10. Interdisciplinary Trauma Management in an Elderly Patient, A Case Report

    PubMed Central

    Felt, George T; Soolari, Ahmad

    2014-01-01

    The current report reviews a case of mixed dental trauma consequent to a fall by an older patient. The patient’s teeth were forced out of alignment by the trauma and suffered pulpal necrosis. Treatment involved not only healing the acute injuries, but also attending to some subtle delayed problems that became apparent during treatment. Treatments involving endodontics, periodontics, orthodontics, and restorative dentistry were used to address all of the patient’s concerns. This insured that the traumatic occlusion was corrected, appropriate esthetics was restored and normal speech and function was regained. All signs of trauma were recognized, every treatment step was documented, and appropriate follow-up was provided throughout the recovery period. PMID:25419251

  11. Management of Total Cancer Pain: A Case of Young Adult

    PubMed Central

    Satija, Aanchal; Singh, Suraj Pal; Kashyap, Komal; Bhatnagar, Sushma

    2014-01-01

    Pain due to cancer is one of the most distressing symptoms experienced by the patients at some or the other time during the course of treatment or disease progression. The multidimensional nature of cancer pain is characterized by various dimensions including physical, social, psychological, and spiritual; which together constitute the term “total pain”. Young cancer patients illustrate their unique psychological and developmental needs. This case report highlights the concept of “total cancer pain” in a young adult and demonstrates his distinctive social, spiritual, and psychological sufferings. The report emphasizes that addressing all these concerns is considerably significant in order to provide optimal pain relief to the patient. In the present scenario, it has been done by a skillful multiprofessional team communicating effectively with both the patient and the carer. PMID:25125874

  12. Ortho-surgical management of condylar hyperplasia: Rare case reports

    PubMed Central

    Singh, Virendra; Verma, Ajay; Attresh, Gyanander; Batra, Jitender

    2014-01-01

    Condylar hyperplasia of the mandible is a clinical condition of over-development and growth because of excessive cellular growth of one condylar part of the mandible leading to facial asymmetry, mandibular deviation and enlargement of condyle. The elongation of the condylar neck in turn leads to malocclusion and articular dysfunction. In the past the interceptive and corrective procedures of growth and deformity in condylar hyperplasia were either condylectomy or high condylotomy. However, the deformity ceases after growth is completed. Therefore, other surgical procedures have to be undertaken to correct the manifested deformity of condylar hyperplasia. Further it has to be stressed that no single procedure can completely correct the deformity. So in addition to condylectomy, other orthognathic surgical procedures both on body and ramus and also on maxilla can be undertaken to correct the canting of occlusion. Two rare cases of unilateral hyperplasia encountered in our hospital are presented which required different lines of treatment. PMID:25298720

  13. Tuberculosis lymphadenitis in a well managed case of sarcoidosis.

    PubMed

    Mohapatra, P R; Garg, Kranti; Singhal, Niti; Aggarwal, D; Gupta, R; Khurana, A; Janmeja, A K

    2013-01-01

    Differentiation between tuberculosis (TB) and sarcoidoisis is sometimes extremely difficult. Sequential occurrence of sarcoidosis and TB in the same patient is uncommon. We present the case of a young man, with a proven diagnosis of sarcoidosis who later developed TB after completion of treatment for sarcoidosis. A 32-year-old male patient presented with low-grade fever since two months. Physical examination revealed cervical lymphadenopathy. Initial fine needle aspiration cytology (FNAC) of the cervical lymph node was suggestive of granulomatous inflammation; the chest radiograph was normal. Repeat FNAC from the same lymph node was suggestive of reactive lymphoid hyperplasia. The patient was treated with antibiotics and followed-up. He again presented with persistence of fever and lymphadenopathy and blurring of vision. Ophthalmological examination revealed uveitis, possibly due to a granulomatous cause. His repeat Mantoux test again was non-reactive; serum angiotensin converting enzyme (ACE) levels were raised. This time an excision biopsy of the lymph node was done which revealed discrete, non-caseating, reticulin rich granulomatous inflammation suggestive of sarcoidosis. The patient was treated with oral prednisolone and imporved symptomatically. Subsequently, nearly nine months after completion of corticosteroid treatment, he presented with low-grade, intermittent fever and a lymph node enlargement in the right parotid region. FNAC from this lymph node showed caseating granulomatous inflammation and the stain for acid-fast bacilli was positive. He was treated with Category I DOTS under the Revised National Tuberculosis Control Programme and improved significantly. The present case highlights the need for further research into the aetiology of TB and sarcoidosis. PMID:24660565

  14. An assessment of patient education and self-management in diabetes disease management--two case studies.

    PubMed

    Fitzner, Karen; Greenwood, Deborah; Payne, Hildegarde; Thomson, John; Vukovljak, Lana; McCulloch, Amber; Specker, James E

    2008-12-01

    Diabetes affects 7.8% of Americans, nearly 24 million people, and costs $174 billion yearly. People with diabetes benefit from self-management; disease management (DM) programs are effective in managing populations with diabetes. Little has been published on the intersection of diabetes education and DM. Our hypothesis was that diabetes educators and their interventions integrate well with DM and effectively support providers' care delivery. A literature review was conducted for papers published within the past 3 years and identified using the search terms "diabetes educator" and "disease management." Those that primarily addressed community health workers or the primary care/community setting were excluded. Two case studies were conducted to augment the literature. Ten of 30 manuscripts identified in the literature review were applicable and indicate that techniques and interventions based on cognitive theories and behavioral change can be effective when coupled with diabetes DM. Better diabetes self-management through diabetes education encourages participation in DM programs and adherence to recommended care in programs offered by DM organizations or those that are provider based. Improved health outcomes and reduced cost can be achieved by blending diabetes education and DM. Diabetes educators are a critical part of the management team and, with their arsenal of goal setting and behavior change techniques, are an essential component for the success of diabetes DM programs. Additional research needs to be undertaken to identify effective ways to integrate diabetes educators and education into DM and to assess clinical, behavioral, and economic outcomes arising from such programs. PMID:19108648

  15. Conservative management of Achilles Tendinopathy: a case report

    PubMed Central

    Papa, John A.

    2012-01-01

    Objective: To chronicle the conservative treatment and management of a 77-year old female patient presenting with chronic pain of 8 months duration in the midportion of the achilles tendon diagnosed as achilles tendinopathy. Clinical features: The main clinical feature was pain in the midportion of the achilles tendon, 2 to 6 cm proximal to the calcaneal insertion. Symptom onset was gradual and unrelated to any acute trauma or overt injury mechanism. Intervention and outcome: The conservative treatment approach consisted of medical acupuncture with electrical stimulation, Graston Technique®, eccentric calf training, and rehabilitative exercise prescription. Outcome measures included verbal pain rating scale, lower extremity functional scale (LEFS), and a return to activities of daily living (ADLs). The patient attained long-term resolution of her complaint and at 12 month follow-up reported no recurrence of symptoms. Conclusion: A combination of conservative rehabilitation strategies may be used by chiropractors to treat midportion achilles tendinopathy and allow an individual to return to pain free ADLs in a timely manner. PMID:22997472

  16. Emergent airway management in a case of fibrodysplasia ossificans progressiva

    PubMed Central

    Parekh, Uma R.; Read, Selina; Desai, Vimal; Budde, Arne O.

    2014-01-01

    Fibrodysplasia ossificans progressiva (FOP), or Stone man syndrome, is rare and one of the most disabling genetic conditions of the connective tissue due to progressive extraskeletal ossification. It usually presents in the first decade of life as painful inflammatory swellings, either spontaneously or in response to trauma, which later ossify and lead to severe disability. Progressive spinal deformity including thoracolumbar kyphoscoliosis leads to thoracic insufficiency syndrome, increasing the risk for pneumonia and right sided heart failure. We present the airway management in a 22-year-old male, diagnosed with FOP with severe disability, who required urgent airway intervention as a result of respiratory failure from pnuemonia. Tracheostomy triggers ossification and consequent airway obstruction at the tracheostomy site and laryngoscopy triggers temporomandibular joint ankylosis. Therefore, awake fiber-optic endotracheal intubation is recommended in these patients. Use of an airway endoscopy mask enabled us to simultaneously maintain non-invasive ventilation and intubate the patient in a situation where tracheostomy needed to be avoided. PMID:25425787

  17. Case for Open-Source PEV Charge Management Data Framework

    SciTech Connect

    Markel, T.; Kuss, M.; Foster, J.; Manz, D.; Mahony, M.; Nielsen, M.; Reid, A.; Wilk, R. D.

    2012-01-01

    The future growth of electrified transportation could be enhanced through interaction with smart grid system architectures. This paper summarizes current literature regarding plug-in electric vehicle - renewables integration and highlights areas of need to implement such integration at a multi-utility scale. Future smart grid implementations hold the key to transferring information and control parameters between distributed and centralized decision agents. The discussion highlights the opportunity to leverage federal investments in grid renovation and electric vehicle introduction to create system-wide value from improved reliability and reduced fossil fuel consumption. An approach to scaling a previously defined 'green signal' methodology for electric vehicles will be detailed across a utility grid balancing region. The research will include a synopsis of the communications opportunities and challenges of coordinating the responses of many resources. The results are expected to show that, with some variation in the charge profiles of individual vehicles, the aggregate set can interface with grid management methods to significantly influence the ability to integrate distributed and centralized renewables to improve environmental quality.

  18. Heterotopic pregnancy after GIFT managed with expectancy: a case report.

    PubMed

    Wang, Y L; Yang, T S; Chang, S P; Ng, H T

    1996-09-01

    A 29-year-old female patient visited our out-patient department (OPD) due to primary infertility in March 1993. Hysterosalpingography revealed cervical canal stricture. Gamete intra-Fallopian transfer (GIFT) was performed on Apr. 10, 1993 after ovulation induction. Three oocytes were placed into each Fallopian tube, then the patient was afflicted with lower abdominal discomfort and fullness 2 weeks later. Ovarian hyperstimulation syndrome (OHSS) was diagnosed. Ultrasonography showed intrauterine twin pregnancy and bilateral tubal pregnancy. During admission, supportive care for OHSS and expectant management only for ectopic pregnancies were given. OHSS resolved gradually. After a series of sonographic follow-up, disappearance of fetal heart beat (FHB) in the left ectopic gestational sac, resolution of bilateral ectopic gestational sacs and normal growth of intrauterine pregnancies were noted. On Dec. 16, 1993, the patient received cesarean section (C/S) due to twin pregnancy with vertex and breech presentation at the 37th gestational week. Twin A was female. Birth weight was 2590 gm. Apgar scores at 1 and 5 min. were 7 and 9. Twin B was also female. Birth weight was 2930 gm. Apgar scores at 1 and 5 main. were 8 and 9. Urinary bladder was injured accidentally at C/S. Repairment was done. The patient and her twins were discharged one week later in stable condition. Literature on heterotopic pregnancy after assisted reproductive technique (ART) was reviewed and discussed in this article. PMID:8940796

  19. Pain Management in Four-Limb Amputation: A Case Report.

    PubMed

    Warner, Nafisseh S; Warner, Matthew A; Moeschler, Susan M; Hoelzer, Bryan C

    2015-09-01

    Acute pain following amputation can be challenging to treat due to multiple underlying mechanisms and variable clinical responses to treatment. Furthermore, poorly controlled preoperative pain is a risk factor for developing chronic pain. Evidence suggests that epidural analgesia and peripheral nerve blockade may decrease the severity of residual limb pain and the prevalence of phantom pain after lower extremity amputation. We present the perioperative analgesic management of a patient with gangrene of the bilateral upper and lower extremities as a result of septic shock and prolonged vasopressor administration who underwent four-limb amputation in a single procedure. A multimodal analgesic regimen was utilized, including titration of preoperative opioid and neuropathic pain agents, perioperative intravenous, epidural and peripheral nerve catheter infusions, and postoperative oral medication titration. More than 8 months postoperatively, the patient has satisfactory pain control with no evidence for phantom limb pain. To our knowledge, there have been no publications to date concerning analgesic regimens in four-limb amputation. PMID:26011696

  20. Managing water resources for sustainable development: the case of integrated river basin management in China.

    PubMed

    Song, X; Ravesteijn, W; Frostell, B; Wennersten, R

    2010-01-01

    The emerging water crisis in China shows that the current institutional frameworks and policies with regard to water resources management are incapable of achieving an effective and satisfactory situation that includes Integrated River Basin Management (IRBM). This paper analyses this framework and related policies, examines their deficiencies in relation to all water stress problems and explores alternatives focusing on river basins. Water resources management reforms in modern China are reviewed and the main problems involved in transforming the current river management system into an IRBM-based system are analysed. The Huai River basin is used as an example of current river basin management, with quantitative data serving to show the scale and scope of the problems in the country as a whole. The institutional reforms required are discussed and a conceptual institutional framework is proposed to facilitate the implementation of IRBM in China. In particular, the roles, power and responsibilities of River Basin Commissions (RBCs) should be legally strengthened; the functions of supervising, decision-making and execution should be separated; and cross-sectoral legislation, institutional coordination and public participation at all levels should be promoted. PMID:20107277

  1. An applied simulation model for estimating the supply of and requirements for registered nurses based on population health needs.

    PubMed

    Tomblin Murphy, Gail; MacKenzie, Adrian; Alder, Robert; Birch, Stephen; Kephart, George; O'Brien-Pallas, Linda

    2009-11-01

    Aging populations, limited budgets, changing public expectations, new technologies, and the emergence of new diseases create challenges for health care systems as ways to meet needs and protect, promote, and restore health are considered. Traditional planning methods for the professionals required to provide these services have given little consideration to changes in the needs of the populations they serve or to changes in the amount/types of services offered and the way they are delivered. In the absence of dynamic planning models that simulate alternative policies and test policy mixes for their relative effectiveness, planners have tended to rely on projecting prevailing or arbitrarily determined target provider-population ratios. A simulation model has been developed that addresses each of these shortcomings by simultaneously estimating the supply of and requirements for registered nurses based on the identification and interaction of the determinants. The model's use is illustrated using data for Nova Scotia, Canada. PMID:20164064

  2. Conservative management of a case of traumatic pancreatitis in childhood: a case report.

    PubMed

    Dixit, P; Sharma, V; Singh, K R; Thapa, B R; Rathore, M

    2014-01-01

    Acute pancreatitis (AP) is relatively uncommon in pediatric age group. Traumatic injury is an important cause of AP in children. Ductal disruption resulting from pancreatic trauma usually needs surgical intervention. A three-and-a-half year old child presented with complaints of abdominal pain and distension following blunt trauma abdomen. Computed tomography of abdomen revealed presence of grade III pancreatic injury with fluid collection in lesser sac. The patient was managed with antibiotics and pigtail drainage and he improved. Therapy for traumatic pancreatitis in paediatric patients must be individualised. Even high grade injuries can be managed non-operatively. PMID:24992606

  3. Probation officers' perceptions of youths' risk of reoffending and use of risk assessment in case management.

    PubMed

    Perrault, Rachael T; Paiva-Salisbury, Melissa; Vincent, Gina M

    2012-01-01

    Juvenile probation officers (JPOs) are required to make numerous decisions about the case management of young offenders on a daily basis. This multi-site study examined JPOs' (N=64) perceptions of the typical youth's risk of reoffending before implementation of a risk/needs assessment (RNA) tool, and their self-reported, case management decision-making after implementation of an RNA tool. Results indicated that JPOs tended to overestimate the likely base rates of reoffending while RNA tool estimates were more accurate. Further, most JPOs appeared to be making service referral and placement decisions commensurate with youths' risk levels, regardless of whether they claimed to use the RNA tool in their decisions. Variability in application of risk to case management practices was more a function of the probation office than of the specific JPO. Implications for use of risk assessment in juvenile probation are discussed. PMID:22740174

  4. Crisis Management Systems: A Case Study for Aspect-Oriented Modeling

    NASA Astrophysics Data System (ADS)

    Kienzle, Jörg; Guelfi, Nicolas; Mustafiz, Sadaf

    The intent of this document is to define a common case study for the aspect-oriented modeling research community. The domain of the case study is crisis management systems, i.e., systems that help in identifying, assessing, and handling a crisis situation by orchestrating the communication between all parties involved in handling the crisis, by allocating and managing resources, and by providing access to relevant crisis-related information to authorized users. This document contains informal requirements of crisis management systems (CMSs) in general, a feature model for a CMS product line, use case models for a car crash CMS (CCCMS), a domain model for the CCCMS, an informal physical architecture description of the CCCMS, as well as some design models of a possible object-oriented implementation of parts of the CCCMS backend. AOM researchers who want to demonstrate the power of their AOM approach or technique can hence apply the approach at the most appropriate level of abstraction.

  5. An analysis of case management--the efficient utility of human resources, but to what end?

    PubMed

    Jones, A

    1995-05-01

    Case management has been credited as a modality to reduce the lengths of hospital admission and to utilize human resources more effectively. The approach concentrates on the process of delivering care to constantly improve the productivity levels of health care practitioners. The United Kingdom government policy is certainly progressing towards cost-containment and cost-effective service delivery. However, it needs to be considered if the culture of nursing would be able to adopt the strategy. Firstly, it needs to be questioned if nurses have the managerial and financial acuity to successfully perform the role. Secondly, the adoption of case management may potentially negate the value of some aspects of professionally skilled nursing care which has little cost-benefit analysis but provides the true essence of nursing. With a further advancement of cost-centered care, case management may become the anti-thesis of an inherently caring profession. PMID:7773520

  6. Improving healthcare services using web based platform for management of medical case studies.

    PubMed

    Ogescu, Cristina; Plaisanu, Claudiu; Udrescu, Florian; Dumitru, Silviu

    2008-01-01

    The paper presents a web based platform for management of medical cases, support for healthcare specialists in taking the best clinical decision. Research has been oriented mostly on multimedia data management, classification algorithms for querying, retrieving and processing different medical data types (text and images). The medical case studies can be accessed by healthcare specialists and by students as anonymous case studies providing trust and confidentiality in Internet virtual environment. The MIDAS platform develops an intelligent framework to manage sets of medical data (text, static or dynamic images), in order to optimize the diagnosis and the decision process, which will reduce the medical errors and will increase the quality of medical act. MIDAS is an integrated project working on medical information retrieval from heterogeneous, distributed medical multimedia database. PMID:18560078

  7. Community Health Workers Versus Nurses as Counselors or Case Managers in a Self-Help Diabetes Management Program

    PubMed Central

    Kim, Kim B.; Kim, Miyong T.; Lee, Hochang B.; Nguyen, Tam; Bone, Lee R.; Levine, David

    2016-01-01

    Objectives To confirm the effectiveness of community health workers’ involvement as counselors or case managers in a self-help diabetes management program in 2009 to 2014. Methods Our open-label, randomized controlled trial determined the effectiveness of a self-help intervention among Korean Americans aged 35 to 80 years in the Baltimore-Washington metropolitan area with uncontrolled type 2 diabetes. We measured and analyzed physiological and psychobehavioral health outcomes of the community health worker–counseled (n = 54) and registered nurse (RN)–counseled (n = 51) intervention groups in comparison with the control group (n = 104). Results The community health workers’ performance was comparable to that of the RNs for both psychobehavioral outcomes (e.g., self-efficacy, quality of life) and physiological outcomes. The community health worker–counseled group showed hemoglobin A1C reductions from baseline (−1.2%, −1.5%, −1.3%, and −1.6%, at months 3, 6, 9, and 12, respectively), all of which were greater than reductions in the RN-counseled (−0.7%, −0.9%, −0.9%, and −1.0%) or the control (−0.5%, −0.5%, −0.6%, and −0.7%) groups. Conclusions Community health workers performed as well as or better than nurses as counselors or case managers in a self-help diabetes management program in a Korean American community. PMID:26985607

  8. Distal tibia fractures: management and complications of 101 cases.

    PubMed

    Joveniaux, Pierre; Ohl, Xavier; Harisboure, Alain; Berrichi, Aboubekr; Labatut, Ludovic; Simon, Patrick; Mainard, Didier; Vix, Nicolas; Dehoux, Emile

    2010-04-01

    Distal tibia fractures are complex injuries with a high complication rate. In this retrospective and multicentre study we attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results. Between 2002 and 2004, 104 patients were admitted for 105 distal tibia fractures. One hundred patients (101 fractures) were reviewed with an average follow-up of 19 months (range, 12-46). Internal fixation, external fixation, limited internal fixation (K-wires or screws), intramedullary nailing and conservative treatment were used. Outcome parameters included occurrence of complications, radiographic analysis, evaluation of the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and measures of the ankle range of motion. The average functional score was 76 points (range, 30-100 points), and complications occurred in 30 patients. Predictive factors of poor results were fracture severity, complications, malunion and the use of external fixation. We believe that external fixation must be reserved for trauma with severe skin injury, as a temporary solution in a two-staged protocol. For other cases, we recommend ORIF with early mobilisation. PMID:19554328

  9. Distal tibia fractures: management and complications of 101 cases

    PubMed Central

    Joveniaux, Pierre; Harisboure, Alain; Berrichi, Aboubekr; Labatut, Ludovic; Simon, Patrick; Mainard, Didier; Vix, Nicolas; Dehoux, Emile

    2009-01-01

    Distal tibia fractures are complex injuries with a high complication rate. In this retrospective and multicentre study we attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results. Between 2002 and 2004, 104 patients were admitted for 105 distal tibia fractures. One hundred patients (101 fractures) were reviewed with an average follow-up of 19 months (range, 12–46). Internal fixation, external fixation, limited internal fixation (K-wires or screws), intramedullary nailing and conservative treatment were used. Outcome parameters included occurrence of complications, radiographic analysis, evaluation of the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and measures of the ankle range of motion. The average functional score was 76 points (range, 30–100 points), and complications occurred in 30 patients. Predictive factors of poor results were fracture severity, complications, malunion and the use of external fixation. We believe that external fixation must be reserved for trauma with severe skin injury, as a temporary solution in a two-staged protocol. For other cases, we recommend ORIF with early mobilisation. PMID:19554328

  10. Radiation exposure case management after incorporation of radionuclides.

    PubMed

    Goulko, Guennadi; Dörr, Harald; Meineke, Viktor

    2014-06-01

    The release of radioactive material due to accidents or terroristic actions can result in radioactive contamination of the environment and may lead to intake and incorporation of radionuclides with the consequence of prolonged radiation exposure. In this case, a decision about countermeasures must be carried out as soon as possible to reduce the resulting radiation dose. In order to be prepared for such a scenario, an Assessment and Documentation System has been developed to support the rapid assessment of internal exposures and to assist in decision making. Radionuclide distributions, excretion rates, and resulting exposures have been calculated on the basis of a reference scenario. The documentation of the results in the form of tables and graphs allows the easy and quick interpretation of measurements in terms of exposure and intake. The system in its present status gives information about possibilities of countermeasures; it is the intention of the next steps of development to give advice on the basis of estimated avertable doses. PMID:24776897

  11. Barium Aspiration in an Infant: A Case Report and Review of Management

    PubMed Central

    Jackson, M.; Kapur, N.; Goyal, V.; Choo, K.; Sarikwal, A.; Masters, I. B.; Isles, Alan F.

    2014-01-01

    We describe a case of bilateral inhalation of barium in an infant following a barium swallow for investigation of dusky spells associated with feeds. A bronchoscopy subsequently revealed the presence of a mid-tracheal tracheo-esophageal cleft. To date, little has been reported on barium aspiration in children and there is no consensus for management. We review the literature on barium aspiration, its consequences, and make recommendations for management. PMID:24818122

  12. Perioperative Hemostatic Management in Ehlers-Danlos Syndrome: A Report of 2 Cases and Literature Review.

    PubMed

    Lindsay, Holly; Lee-Kim, YoungNa J; Srivaths, Lakshmi V

    2016-03-01

    Ehlers-Danlos syndrome (EDS) is associated with easy bruising and bleeding complications in the majority. Although bleeding complications are frequently observed during surgery in these patients, the perioperative hemostatic prophylaxis of patients with EDS is not standardized. We present 2 cases of effective perioperative hemostatic management of patients with EDS and review the literature to raise awareness of hemostatic issues during surgery and discuss medical options to consider for perioperative hemostatic management based on our clinical experience and literature review. PMID:26334432

  13. Public Management Reform without Managers: The Case of German Public Schools

    ERIC Educational Resources Information Center

    Mintrop, Rick

    2015-01-01

    Purpose: The purpose of this paper is to discuss the role of principals in light of public management reforms taking place in the German educational system and in reference to the empirical patterns uncovered by the papers contained in the Special Issue. Policy makers have created new expectations and new technologies that seem to suggest to…

  14. Multidisciplinary Management of a Patient with Unusual Hypodontia: A Case Report.

    PubMed

    Khalaf, Khaled; Larmour, Colin J

    2015-01-01

    The congenital absence of a maxillary central incisor is a rare condition. This case report described a 16 years old male presented to the Orthodontic Department at Aberdeen Dental Hospital U.K. with a congenitally absent maxillary right central incisor in association with the congenital absence of both maxillary lateral incisors. Multidisciplinary approach with orthodontic space closure of the maxillary lateral incisors and space opening for the maxillary right central incisor followed by an implant replacement was carried out. The rationale for choosing this treatment option and alternative management options were discussed. A good treatment outcome was achieved to manage such a challenging unusual case. PMID:26720950

  15. Modified Esthetic Splint Design for Management of Multiple Traumatic Injuries in Children: A Case Report.

    PubMed

    Garla, Bharath Kumar; Deshmukh, Seema; Murthy, Prashanth Sadashiva; Satish, G

    2015-09-01

    Traumatic injuries to the dento-alveolar structures are emergencies that compromise the quality of life of the patients. In addition to symptomatic management, definitive functional restoration and suitable rehabilitation becomes a major treatment objective in such cases. The dynamics of the traumatic forces may cause multiple injuries of different grades to the oral and para-oral structures, which makes comprehensive management a greater challenge to the dentist. The present case report elaborates a modified esthetic splint designed to treat multiple dental injuries in children, which can promote healing, restore optimal functionality along with esthetic rehabilitation to psychologically benefit the child during the time of recovery. PMID:26435631

  16. Broad Ligament Pregnancy – Success Story of a Laparoscopically Managed Case

    PubMed Central

    Nair, Sobha S.

    2016-01-01

    Abdominal pregnancies constitute 1% of ectopic pregnancies, among which broad ligament pregnancy is a rare form. The maternal mortality rate has been reported to be as high as 20%. The diagnosis is seldom established before surgery. Laparoscopic management of broad ligament ectopic pregnancy is the ideal form of treatment in appropriately selected patients. We present the case report of successful laparoscopic treatment of a 3x3.5cm broad ligament pregnancy. A search of literature shows that ours is the 6th case report of such a rare ectopic pregnancy managed endoscopically successfully.

  17. Modified Esthetic Splint Design for Management of Multiple Traumatic Injuries in Children: A Case Report

    PubMed Central

    Garla, Bharath Kumar; Deshmukh, Seema; Murthy, Prashanth Sadashiva; Satish, G

    2015-01-01

    Traumatic injuries to the dento-alveolar structures are emergencies that compromise the quality of life of the patients. In addition to symptomatic management, definitive functional restoration and suitable rehabilitation becomes a major treatment objective in such cases. The dynamics of the traumatic forces may cause multiple injuries of different grades to the oral and para-oral structures, which makes comprehensive management a greater challenge to the dentist. The present case report elaborates a modified esthetic splint designed to treat multiple dental injuries in children, which can promote healing, restore optimal functionality along with esthetic rehabilitation to psychologically benefit the child during the time of recovery. PMID:26435631

  18. Implant success lies in complications management: A report of two cases

    PubMed Central

    Rani, Sapna; Devi, Jyoti; Verma, Mahesh

    2016-01-01

    At present, implant supported or retained prostheses are considered as a first therapeutic alternative for patients. Although the success rate of dental implants is very high, no treatment is without complications; same applies to implants also. Implant failure can be due to biological factors, i.e., loss of osseointegration or due to technical complications. This case report presents implant complications involving both factors along with the management of these cases. In implant supported overdenture patient, loss of implant on the right side and implant body fracture of the left side implant is reported and in another patient abutment screw fracture and its management is reported. PMID:27307672

  19. Implant success lies in complications management: A report of two cases.

    PubMed

    Rani, Sapna; Devi, Jyoti; Verma, Mahesh

    2016-01-01

    At present, implant supported or retained prostheses are considered as a first therapeutic alternative for patients. Although the success rate of dental implants is very high, no treatment is without complications; same applies to implants also. Implant failure can be due to biological factors, i.e., loss of osseointegration or due to technical complications. This case report presents implant complications involving both factors along with the management of these cases. In implant supported overdenture patient, loss of implant on the right side and implant body fracture of the left side implant is reported and in another patient abutment screw fracture and its management is reported. PMID:27307672

  20. Performance of community health workers under integrated community case management of childhood illnesses in eastern Uganda

    PubMed Central

    2012-01-01

    Background Curative interventions delivered by community health workers (CHWs) were introduced to increase access to health services for children less than five years and have previously targeted single illnesses. However, CHWs in the integrated community case management of childhood illnesses strategy adopted in Uganda in 2010 will manage multiple illnesses. There is little documentation about the performance of CHWs in the management of multiple illnesses. This study compared the performance of CHWs managing malaria and pneumonia with performance of CHWs managing malaria alone in eastern Uganda and the factors influencing performance. Methods A mixed methods study was conducted among 125 CHWs providing either dual malaria and pneumonia management or malaria management alone for children aged four to 59 months. Performance was assessed using knowledge tests, case scenarios of sick children, review of CHWs’ registers, and observation of CHWs in the dual management arm assessing respiratory symptoms. Four focus group discussions with CHWs were also conducted. Results CHWs in the dual- and single-illness management arms had similar performance with respect to: overall knowledge of malaria (dual 72%, single 70%); eliciting malaria signs and symptoms (50% in both groups); prescribing anti-malarials based on case scenarios (82% dual, 80% single); and correct prescription of anti-malarials from record reviews (dual 99%, single 100%). In the dual-illness arm, scores for malaria and pneumonia differed on overall knowledge (72% vs 40%, p < 0.001); and correct doses of medicines from records (100% vs 96%, p < 0.001). According to records, 82% of the children with fast breathing had received an antibiotic. From observations 49% of CHWs counted respiratory rates within five breaths of the physician (gold standard) and 75% correctly classified the children. The factors perceived to influence CHWs’ performance were: community support and confidence, continued

  1. Conservative management of a large neonatal ovarian cyst: a case report.

    PubMed

    Aamir, Mohd; Punia, Harish; Dalal, Poonam; Sharma, Deepak

    2015-04-01

    We describe a case of a large simple neonatal ovarian cyst, which was managed successfully using "wait and watch" approach and serial ultrasound monitoring. A cystic lesion arising from right ovary was noted in antenatal ultrasound (USG) which was followed up with postnatal USG which revealed a large simple ovarian cyst without any complications. Patient was kept on expectant management with close clinical and USG monitoring. Cyst resolved spontaneously at 10 wk of age. A brief review of literature for likely aetio-pathogenesis and management is also presented. PMID:26023615

  2. Managing acute severe hypertension during coronary angiography: Lessons from a challenging case.

    PubMed

    Zabulon, Audrey; Ozier-Lafontaine, Nathalie; Jocelyn, Inamo

    2016-06-01

    We report the clinical case of a 52-year-old man referred to our catheterization laboratory for an acute coronary syndrome. The coronary angiogram course was soon disrupted by a life-threatening blood pressure chaos lasting for hours. An abdominal paraganglioma was eventually diagnosed, requiring surgery. This case outlines the potential diagnosis and therapeutic missteps in managing such patients and suggests strategies for quick improvement. PMID:26729064

  3. Orthodontic management of a borderline case with ectopic maxillary canine by unilateral premolar extractions

    PubMed Central

    Gaur, Aditi; Maheshwari, Sandhya; Verma, Sanjeev Kumar; Mohd. Tariq

    2016-01-01

    Management of orthodontic cases often requires extraction of permanent teeth. The decision making regarding extractions depends upon the arch length tooth material discrepancies, the growth pattern, general profile, and arch asymmetries. Unique orthodontic problems may command special treatment lines to be taken. The present report describes a case with unilateral buccally blocked out canine and bilateral posterior crossbite, for which unilateral premolar extractions were performed achieve esthetic and functionally stable occlusion. PMID:27041913

  4. Integrative Management of Commercialized Wild Mushroom: A Case Study of Thelephora ganbajun in Yunnan, Southwest China

    NASA Astrophysics Data System (ADS)

    He, Jun; Zhou, Zhimei; Yang, Huixian; Xu, Jianchu

    2011-07-01

    The management of wild mushroom is interdisciplinary in nature, whereby the biophysical considerations have to be incorporated into the context of a wide range of social, economic and political concerns. However, to date, little documentation exists illustrating an interdisciplinary approach to management of wild mushrooms. Moreover, the empirical case studies necessary for developing applicable and practical methods are even more rare. This paper adopted an interdisciplinary approach combining participatory methods to improve the habitat management of Thelephora ganbajun, an endemic and one of the most economically valuable mushroom species in Southwest China. The paper documents an empirical case of how an interdisciplinary approach facilitated the development of a scientific basis for policy and management practice, and built the local capacity to create, adopt and sustain the new rules and techniques of mushroom management. With this integrative perspective, a sustainable management strategy was developed, which was found not only technically feasible for farmers, but also acceptable to the government from an ecological and policy-related perspective. More importantly, this approach has greatly contributed to raising the income of farmers. The paper highlights how the integration of biophysical and socioeconomic factors and different knowledge systems provided a holistic perspective to problem diagnosis and resolution, which helped to cope with conventional scientific dilemmas. Finally, it concludes that the success of this interdisciplinary approach is significant in the context of policy decentralization and reform for incorporating indigenous knowledge and local participation in forest management.

  5. Surgical Management of Traumatic Penile Amputation: A Case Report and Review of the World Literature

    PubMed Central

    Raheem, Omer A; Mirheydar, Hossein S; Patel, Nishant D; Patel, Sunil H; Suliman, Ahmed; Buckley, Jill C

    2015-01-01

    Introduction There is paucity of case reports that describe the successful reimplantation of a penis after amputation. We sought to report on self-inflicted penile amputation and comment on its surgical management and review current literature. Aim To report on self-inflicted penile amputation and comment on its surgical management and review current literature. Methods A 19-year-old male with no prior medical history presented to our university-affiliated trauma center following sustaining a self-inflicted amputation of shaft penis secondary to severe methamphetamine-induced psychosis. He immediately underwent extensive reconstructive reimplantation of the penis performed jointly by plastics and urology teams reattaching all visible neurovascular bundles, urethra, and corporal and fascial layers. The patient was discharged with a suprapubic tube in place and a Foley catheter in place with well-healing tissue. Main Outcome Measures To review the current published literature and case reports on the management of penile amputation with particular emphasis its etiology, surgical repairs, potential complications and functional outcomes. Results We report herein a case of a traumatic penile amputation and successful outcome of microscopic reimplantation and review of the published literature with particular comments on surgical managements. Conclusion We review the literature and case reports on penile amputation and its etiology, surgical management, variables effecting outcomes, and its complications. Raheem OA, Mirheydar HS, Patel ND, Patel SH, Suliman A, and Buckley JC. Surgical management of traumatic penile amputation: A case report and review of the world literature. Sex Med 2015;3:49–53. PMID:25844175

  6. Public Library Planning: Case Studies for Management. The Greenwood Library Management Collection.

    ERIC Educational Resources Information Center

    Sutton, Brett

    This book is the result of a set of case studies that were performed in four American public libraries between 1989 and 1992. The goal of the research was to describe the effect that planning has had in a representative set of libraries, focusing planning as a social phenomenon. The city, county, federated, and suburban library are examined.…

  7. Surgical management of special cases of intractable Meniere's disease: unilateral cases with intact canals and bilateral cases.

    PubMed

    Kitahara, Tadashi; Kondoh, Kazumasa; Morihana, Tetsuo; Okumura, Shin-ichi; Mishiro, Yasuo; Kubo, Takeshi

    2004-05-01

    If a clinician seeks to allow patients with vertigo to return to work as soon as possible, it is very important to determine the appearance of vestibular symptoms during convalescence just after treatment, as well as the long-term results. Apprehensive patients with vertigo may undergo severe psychological torment if treatment requires long-term rest in bed before they can return to daily life. In this paper, we observed postoperative vestibular symptoms (subjective sensation and objective nystagmus) in 50 patients with intractable Meniere's disease, including cases from our previous preliminary report, during the period of convalescence just after endolymphatic sac drainage and steroid instillation surgery (EDSS). All symptoms were eliminated within 8 days after EDSS. There was no significant difference in the duration of any vestibular symptoms between bilateral (n = 8) and unilateral cases (n = 42). This result indicates that EDSS could be as safe a treatment for bilateral Meniere's disease as for unilateral disease. In unilateral cases with intact semicircular canal function (n = 17), postoperative evoked vestibular sensation, positional, and positioning (Dix-Hallpike) nystagmus disappeared significantly earlier than in those with canal paresis (n = 25). This result indicates that EDSS could keep the vestibular peripheral function of patients with unilateral Meniere's disease with intact canals quite stable after surgery. Therefore, EDSS could be recommended as an initial, less-invasive surgical treatment for intractable Meniere's disease, especially in unilateral cases with intact canals and in bilateral cases. PMID:15174769

  8. What is the role of a case manager in community aged care? A qualitative study in Australia.

    PubMed

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen

    2016-07-01

    This study aimed to explore the perceptions of case managers about their roles in providing community aged care in Australia. Purposeful sampling was used and 33 qualitative semi-structured interviews with 47 participants were conducted. Participants were drawn from a list of all case managers working in aged care organisations that provided publicly funded case-managed community aged care programmes in the State of Victoria, Australia. Participant selection criteria included age, gender, job titles, professional backgrounds, practice locations, organisational attributes and organisational size. Data collection was implemented between September 2012 and March 2013. Thematic analysis was performed. Participants believed that case managers performed diverse roles based on clients' needs. They also articulated 16 important roles of case managers, including advisors, advocates, carers, communicators, co-ordinators, educators, empowering clients, engaging clients and families, liaising with people, managing budgets, navigators, negotiators, networking with people, facilitators, problem solvers and supporters. However, they were concerned about brokers, mediators and counsellors in terms of the terminology or case managers' willingness to perform these roles. Moreover, they perceived that neither gatekeepers nor direct service provision was case managers' role. The findings of this study suggest that case managers working in community aged care sectors may be more effective if they practised the 16 roles aforementioned. With the value of helping rather than obstructing clients to access services, they may not act as gatekeepers. In addition, they may not provide services directly as opposed to their peers working in medical care settings. The findings will also assist organisations to design job descriptions specifying case managers' roles and associated job responsibilities. Clear job descriptions will further benefit the organisations in staff recruitment, orientation

  9. Bladder Endometriosis and Endocervicosis: Presentation of 2 Cases with Endoscopic Management and Review of Literature

    PubMed Central

    Fuentes Pastor, Javier; Ballestero Diego, Roberto; Correas Gómez, Miguel Ángel; Torres Díez, Eduardo; Fernández Flórez, Alejandro; Ballesteros Olmos, Gerardo; Gutierrez Baños, Jose Luis

    2014-01-01

    Urinary tract endometriosis and endocervicosis are an uncommon pathologic finding, with a common embryological origin. We present 2 cases of female patients with bladder mass. The first one was a finding of a nodular formation in the bladder during study of a nonviable foetus and the second was an incidental finding of a neoformation in the fundus of the bladder during the realization of an ultrasound. In both cases, we performed a surgical management with transurethral resection. Histopathological examination revealed a bladder endometrioma in the first case and endocervicosis with associated endometriosis in the second. PMID:25184072

  10. Groupware for case management and inter-organizational collaboration: the virtual rehabilitation team.

    PubMed

    Bång, M; Hagdahl, A; Eriksson, H; Timpka, T

    2001-01-01

    This paper presents LINDA, a prototype system designed to support virtual rehabilitation teams. LINDA enables professionals from different welfare-state agencies to collaborate in case management. Our approach to supporting teamwork involves the sharing of minimal case sets across organizational borders needed to provide a shared situation assessment among team members. The system provides a shared workspace for the team; a lightweight client-database, visualization of case histories and plans, and means to communicate effectively in the team using yellow sticker-notes. We present LINDA and discuss how we approached the problem to design groupware to support work under changing and uncertain conditions. PMID:11604695

  11. Vascular airway compression management in a case of aortic arch and descending thoracic aortic aneurysm

    PubMed Central

    Kumar, Alok; Dutta, Vikas; Negi, Sunder; Puri, G. D.

    2016-01-01

    Airway compression due to distal aortic arch and descending aortic aneurysm repair has been documented. This case of tracheal and left main stem bronchus compression due to aortic aneurysm occurred in a 42-year-old man. The airway compression poses a challenge for the anesthesiologist in airway management during aortic aneurysm repair surgery. The fiber-optic bronchoscope is very helpful in decision-making both preoperatively and postoperatively in such cases. We report a case of airway compression in a 42-year-old patient who underwent elective distal aortic arch and descending aortic aneurysm repair. PMID:27397474

  12. Vascular airway compression management in a case of aortic arch and descending thoracic aortic aneurysm.

    PubMed

    Kumar, Alok; Dutta, Vikas; Negi, Sunder; Puri, G D

    2016-01-01

    Airway compression due to distal aortic arch and descending aortic aneurysm repair has been documented. This case of tracheal and left main stem bronchus compression due to aortic aneurysm occurred in a 42-year-old man. The airway compression poses a challenge for the anesthesiologist in airway management during aortic aneurysm repair surgery. The fiber-optic bronchoscope is very helpful in decision-making both preoperatively and postoperatively in such cases. We report a case of airway compression in a 42-year-old patient who underwent elective distal aortic arch and descending aortic aneurysm repair. PMID:27397474

  13. Educating Resident Physicians Using Virtual Case-Based Simulation Improves Diabetes Management: A Randomized Controlled Trial

    PubMed Central

    Sperl-Hillen, JoAnn; O’Connor, Patrick J.; Ekstrom, Heidi L.; Rush, William A.; Asche, Stephen E.; Fernandes, Omar D.; Apana, Deepika; Amundson, Gerald H.; Johnson, Paul E.; Curran, Debra M.

    2014-01-01

    Purpose To test a virtual case-based Simulated Diabetes Education (SimDE) intervention developed to teach primary care residents how to manage diabetes. Method Nineteen primary care residency programs, with 341 volunteer residents in all post-graduate years (PGY), were randomly assigned to a SimDE intervention group or control group (CG). The web-based interactive educational intervention used computerized virtual patients who responded to provider actions through programmed simulation models. Eighteen distinct learning cases (L-cases) were assigned to SimDE residents over 6 months from 2010–2011. Impact was assessed using performance on 4 virtual assessment cases (A-cases), an objective knowledge test, and pre-post changes in self-assessed diabetes knowledge and confidence. Group comparisons were analyzed using generalized linear mixed models, controlling for clustering of residents within residency programs and differences in baseline knowledge. Results The percentage of residents appropriately achieving A-case composite clinical goals for glucose, blood pressure, and lipids was: A-Case 1, SimDE = 21.2%, CG = 1.8%, P = .002; A-Case 2, SimDE = 15.7%, CG = 4.7%, P = .02; A-Case 3, SimDE = 48.0%, CG = 10.4%, P < .001; A-Case 4, SimDE = 42.1%, CG = 18.7%, P = .004. The mean knowledge score and pre-post changes in self-assessed knowledge and confidence were significantly better for SimDE group than CG participants. Conclusions A virtual case-based simulated diabetes education intervention improved diabetes management skills, knowledge, and confidence for primary care residents. PMID:25006707

  14. Outcomes in a Nursing Home Transition Case-Management Program Targeting New Admissions

    ERIC Educational Resources Information Center

    Newcomber, Robert; Kang, Taewoon; Graham, Carrie

    2006-01-01

    Purpose: The Providing Assistance to Caregivers in Transition (PACT) program offers nursing home discharge planning and case management for individuals in the transitional period following a return to the community. The PACT program targeted individuals newly admitted to nursing homes and worked with a family caregiver to develop and implement a…

  15. The Clinical Nurse Specialist in the School Setting: Case Management of Migrant Children with Dental Disease.

    ERIC Educational Resources Information Center

    Good, Mary Ellen

    This paper presents strategies for the clinical nurse specialist (CNS) in the school setting to use in case management of migrant children with dental disease. Although dental disease is the major health problem of all school-age children in the nation, the problem is even more severe for children of migrant farmworkers. Leininger's transcultural…

  16. Process and Outcomes of School Nurse Case Management for Students with Asthma

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Swanson, Melvin; Guttu, Martha

    2014-01-01

    There have been many studies that have examined the impact of school-based asthma programs on students with asthma. However, most studies do not provide adequate elaboration on the components of the program. Therefore, replication of these programs is difficult. This study examines the process of school nurse case management, which includes the…

  17. Investigating Positive Psychology Approaches in Case Management and Residential Programming with Incarcerated Youth

    ERIC Educational Resources Information Center

    Cross, Lara E.; Morrison, William; Peterson, Patricia; Domene, Jose F.

    2012-01-01

    This article examines how a rural Canadian secure custody facility for youth implemented positive psychology principles in its case management protocols and residential programming. A directed content analysis design was utilized to identify specific factors of positive psychology in the facility's policy and programming manual, as well as in…

  18. Enhanced Case Management versus Substance Abuse Treatment Alone among Substance Abusers with Depression

    ERIC Educational Resources Information Center

    Striley, Catherine W.; Nattala, Prasanthi; Ben Abdallah, Arbi; Dennis, Michael L.; Cottler, Linda B.

    2013-01-01

    This pilot study evaluated the effectiveness of enhanced case management for substance abusers with comorbid major depression, which was an integrated approach to care. One hundred and 20 participants admitted to drug treatment who also met Computerized Diagnostic Interview Schedule criteria for major depression at baseline were randomized to…

  19. A Case Study of the Development and Project Management of a Web/CD Hybrid Application.

    ERIC Educational Resources Information Center

    Phillips, Rob

    2001-01-01

    Discusses the development of effective interactive learning environments based on a case study of a staff development program for university personnel that combined a Web-based database with CD technology. Topics include aspects of educational design; software design, including feasibility studies; project management, including team issues and…

  20. The Influence of Lean on K-12 District Management: A Case Study

    ERIC Educational Resources Information Center

    Brown, Beverly

    2011-01-01

    For decades, policymakers and educators have focused on public school equity and adequacy, while paying little attention to efficiency. This qualitative single case study was designed to capture explicit information about Lean management, operations, and culture in a K-12 Michigan school district engaged in Lean training and implementation for a…

  1. 30 CFR 250.518 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... management requirements of API RP 90 (incorporated by reference as specified in § 250.198) and the requirements of §§ 250.519 through 250.530. If there is a conflict between API RP 90 and the casing...

  2. Case Management Agency Systems of Administering Long-Term Care: Evidence from the Channeling Demonstration.

    ERIC Educational Resources Information Center

    Kemper, Peter

    1990-01-01

    Examines what was learned from channeling demonstration about potential of case management agency systems for administering home care benefits. Considers both advantages (substitution of lower cost for higher cost services, negotiation of lower prices for services, quality assurance) and disadvantages (difficulty controlling participation rates,…

  3. 75 FR 16486 - Proposed Comment Request for Review of ACF Disaster Case Management Implementation Guide; Office...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... care and mental health care that will help him/her achieve pre- disaster levels of functioning and... recovery plan and advocates for the client's needs to assist him/her in returning to a pre-disaster... to a Case Manager who will capture information about the individual's situation and then serve as...

  4. School Nurse Case Management for Children with Chronic Illness: Health, Academic, and Quality of Life Outcomes

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.; Swanson, Melvin

    2008-01-01

    More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with…

  5. Applying Case-Based Reasoning in Knowledge Management to Support Organizational Performance

    ERIC Educational Resources Information Center

    Wang, Feng-Kwei

    2006-01-01

    Research and practice in human performance technology (HPT) has recently accelerated the search for innovative approaches to supplement or replace traditional training interventions for improving organizational performance. This article examines a knowledge management framework built upon the theories and techniques of case-based reasoning (CBR)…

  6. Evidence-Based Assessment in Case Management to Improve Abnormal Cancer Screen Follow-Up

    ERIC Educational Resources Information Center

    Vourlekis, Betsy; Ell, Kathleen; Padgett, Deborah

    2005-01-01

    The authors describe an evidence-based assessment protocol for intensive case management to improve screening diagnostic follow-up developed through a research project in breast and cervical cancer early detection funded by the Centers for Disease Control and Prevention. Three components of an evidence-based approach to assessment are presented…

  7. Integrated Project Management: A Case Study in Integrating Cost, Schedule, Technical, and Risk Areas

    NASA Technical Reports Server (NTRS)

    Smith, Greg

    2004-01-01

    This viewgraph presentation describes a case study as a model for integrated project management. The ISS Program Office (ISSPO) developed replacement fluid filtration cartridges in house for the International Space Station (ISS). The presentation includes a step-by-step procedure and organizational charts for how the fluid filtration problem was approached.

  8. Student-Centered and Teacher-Centered Classroom Management: A Case Study of Three Elementary Teachers

    ERIC Educational Resources Information Center

    Garrett, Tracey

    2008-01-01

    The major purpose of this case study was to document the classroom management beliefs and practices of three teachers reputed to implement student-centered instruction and to examine the relationship between their instructional and managerial approaches. More specifically, do teachers who use student-centered instruction also implement…

  9. The Impact of Management Decision-Making on Student Success in Community Colleges: A Case Study

    ERIC Educational Resources Information Center

    Alt, Albert G.

    2012-01-01

    This case study examined a multi-college community college district in northern California in a primarily rural area, to understand how their practices compared to management best practices designed to improve student success, barriers that may exist in implementing best practices, and how the institution may improve its own practices. The problem…

  10. Learning through Participatory Resource Management Programs: Case Studies from Costa Rica

    ERIC Educational Resources Information Center

    Sims, Laura; Sinclair, A. John

    2008-01-01

    Based on an ongoing qualitative case study in Costa Rica, this article presents the participatory work that the Instituto Costarricense de Electricidad (ICE) is doing with farmers to protect watersheds from erosion and contamination. Specifically, it includes a description of ICE's Watershed Management Agricultural Programme and how farmers…

  11. Case Management as a Significant Component of Usual Care Psychotherapy for Youth with Disruptive Behavior Problems

    ERIC Educational Resources Information Center

    Zoffness, Rachel; Garland, Ann; Brookman-Frazee, Lauren; Roesch, Scott

    2009-01-01

    Youth with disruptive behavior problems (DBPs) represent the majority of youth served in usual care (UC) psychotherapy, and are at high risk for maladaptive outcomes. Little is known about UC psychotherapeutic strategies utilized with this population. Researchers and clinicians suggest that case management (CM) is a major activity occurring in…

  12. An Exploration of the Working Alliance in Mental Health Case Management

    ERIC Educational Resources Information Center

    Kondrat, David C.; Early, Theresa J.

    2010-01-01

    The working alliance between clients and helpers has been identified as a common factor of treatment effectiveness, yet very little research has explored variables associated with working alliance between mental health case managers and their consumers. This study explored the potential covariates of working alliance within community mental health…

  13. Arbitration Intervention Worker (AIW) Services: Case Management Overlay in a Juvenile Diversion Program

    ERIC Educational Resources Information Center

    Poythress, Norman G.; Dembo, Richard; DuDell, Gary; Wareham, Jennifer

    2006-01-01

    In this issue we describe a clinical trials study of the impact of adding specific case manager overlay services to "treatment as usual" services for youths in a Juvenile Arbitration Program. In this first article we describe the experimental intervention, the Arbitration Intervention Worker (AIW) service, which was provided to a randomly selected…

  14. HEFCE's People Management Self-Assessment Tool: Ticking Boxes or Adding Value? A Case Study

    ERIC Educational Resources Information Center

    McDonald, Claire

    2009-01-01

    This article examines one specific organisational development tool in depth and uses a case study to investigate whether using the tool is more than a tick-box exercise and really can add value and help organisations to develop and improve. The People Management Self-Assessment Tool (SAT) is used to examine higher education institutions' (HEIs)…

  15. Physical Activity in Individuals with Severe Mental Illness: Client versus Case Manager Ratings

    ERIC Educational Resources Information Center

    Bezyak, Jill L.; Chan, Fong; Lee, Eun-Jeong; Catalano, Denise; Chiu, Chung-Yi

    2012-01-01

    The "Physical Activity Scale for Individuals With Physical Disabilities" was examined as a physical activity measure for people with severe mental illness. Case manager ratings were more closely related to body mass index than clients' ratings, challenging the accuracy of self-report physical activity measures for individuals with severe mental…

  16. Enforced Cultural Change in Academe. A Practical Case Study: Implementing Management Systems in Higher Education.

    ERIC Educational Resources Information Center

    Spencer-Matthews, Sarah

    2001-01-01

    An action research project sought to implement a quality management system in an academic department in an Australian higher education institution. The case study revealed that technical change was attained, but adoption of a quality culture achieved only token acceptance. (EV)

  17. Risk management for plausibly hormetic environmental carcinogens: the case of radon.

    PubMed

    Bogen, K T; Layton, D W

    1998-08-01

    Risk management typically involves efforts to reduce human exposures by establishing regulations that limit the concentration of the substance in environmental media. In cases where a substance is widely used in commerce or is naturally occurring in the environment, compliance costs can be substantial because of nationwide requirements to add expensive control technologies. Uncertainties in a dose-response function further impact risk management decisions because they may correspond to large differences in health benefit per unit exposure reduction. These problems are highlighted in the case of plausibly hormetic environmental carcinogens, for which a linear-no-threshold (LNT) dose-response model has been the traditional regulatory default assumption. In this case, model uncertainty is pivotal, and risk management is consequently inherently controversial. However, marginal cost functions that arise for plausibly hormetic carcinogens are expected to possess a common analytic feature that may be particularly useful for this type of risk management problem. Specifically, marginal cost functions in this context are expected to have roots reflecting contaminant concentration values above which regulatory goals may be optimally placed subject to cost constraints. Here we illustrate this heuristic feature in the case of residential radon, using both a LNT model and a biologically plausible hormetic model to predict associated risks of lung cancer mortality. PMID:9756142

  18. A Case Study of Conflict in an Educational Workplace: Managing Personal and Cultural Differences

    ERIC Educational Resources Information Center

    Torpey, Michael John

    2006-01-01

    This article is about conflict in an educational workplace setting. It reports on a case study investigating the emergence, development, and management of conflict among diverse native English speakers working as language instructors within a Japanese university. The example of conflict presented, which deals with divergent assumptions about the…

  19. Parents' Perspectives: An Evaluation of Case Management Interventions in Home Visiting Programs for Young Children

    ERIC Educational Resources Information Center

    Allen, Susan F.

    2007-01-01

    In home visiting programs for children younger than age three, home visitors work with parents to enhance the child's environment. This study examined how the home visitor-parent relationship, amount of contact, and level of need affected the intensity of case management interventions received. Researchers interviewed 90 mothers to measure the…

  20. 32 CFR 105.13 - Case management for Unrestricted Reports of sexual assault.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false Case management for Unrestricted Reports of sexual assault. 105.13 Section 105.13 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM PROCEDURES §...

  1. Data Mining in Course Management Systems: Moodle Case Study and Tutorial

    ERIC Educational Resources Information Center

    Romero, Cristobal; Ventura, Sebastian; Garcia, Enrique

    2008-01-01

    Educational data mining is an emerging discipline, concerned with developing methods for exploring the unique types of data that come from the educational context. This work is a survey of the specific application of data mining in learning management systems and a case study tutorial with the Moodle system. Our objective is to introduce it both…

  2. Designing Support Programs for Adult Freshmen: A Case Study Using a Time Management Workshop.

    ERIC Educational Resources Information Center

    Wratcher, Marcia A.; Jones, Rosalind O.

    A case study of the development of a time management workshop for adult learners at the University of Pittsburgh (Pennsylvania) is presented. This workshop was designed because of the lack of appropriate support programs for adult learners. Many times, programs and materials created for traditional age students are inappropriate and impossible to…

  3. Implementing a Quality Management Framework in a Higher Education Organisation: A Case Study

    ERIC Educational Resources Information Center

    O'Mahony, Kim; Garavan, Thomas N.

    2012-01-01

    Purpose: This paper aims to report and analyse the lessons learned from a case study on the implementation of a quality management system within an IT Division in a higher education (HE) organisation. Design/methodology/approach: The paper is based on a review of the relevant literatures and the use of primary sources such as document analysis,…

  4. A Randomized Trial of Probation Case Management for Drug-Involved Women Offenders

    ERIC Educational Resources Information Center

    Guydish, Joseph; Chan, Monica; Bostrom, Alan; Jessup, Martha A.; Davis, Thomas B.; Marsh, Cheryl

    2011-01-01

    This article reports findings from a clinical trial of a probation case management (PCM) intervention for drug-involved women offenders. Participants were randomly assigned to PCM (n = 92) or standard probation (n = 91) and followed for 12 months using measures of substance abuse, psychiatric symptoms, social support, and service utilization.…

  5. MITOMYCIN C IN THE MANAGEMENT OF PEDIATRIC CAUSTIC ESOPHAGEAL STRICTURES. A CASE REPORT

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Although the incidence of caustic ingestion is declining, the management of caustic esophageal strictures remains a challenge. Mitomycin C (MMC) inhibits fibroblast proliferation and is effective in reducing scar in animal experiments. We report the case of a child with a distal esophageal stricture...

  6. A Case Study of Knowledge Management in the "Back Office" of Two English Football Clubs

    ERIC Educational Resources Information Center

    Doloriert, Clair; Whitworth, Kieran

    2011-01-01

    Purpose: This study aims to explore knowledge management (KM) practice in the "back office" of two English football clubs. Design/methodology/approach: The paper takes the form of a comparative case study of two medium-sized businesses using multi-method data including unstructured interviews, structured questionnaires and document analysis. Data…

  7. Case Study: Using Enrollment Management to Enhance Quality at the University of Hartford.

    ERIC Educational Resources Information Center

    Krotsen, Marsha V.

    1992-01-01

    This case study details some effective techniques the University of Hartford (Connecticut) uses for using data analyses to monitor marketing, recruiting, yield, financial aid packaging, first-year and transfer retention, and other key areas. The importance of teamwork and a unique collaborative approach to enrollment management is emphasized.…

  8. Prioritizing land management efforts at a landscape scale: a case study using prescribed fire in Wisconsin.

    PubMed

    Hmielowski, Tracy L; Carter, Sarah K; Spaul, Hannah; Helmers, David; Radeloff, Volker C; Zedler, Paul

    2016-06-01

    One challenge in the effort to conserve biodiversity is identifying where to prioritize resources for active land management. Cost-benefit analyses have been used successfully as a conservation tool to identify sites that provide the greatest conservation benefit per unit cost. Our goal was to apply cost-benefit analysis to the question of how to prioritize land management efforts, in our case the application of prescribed fire to natural landscapes in Wisconsin, USA. We quantified and mapped frequently burned communities and prioritized management units based on a suite of indices that captured ecological benefits, management effort, and the feasibility of successful long-term management actions. Data for these indices came from LANDFIRE, Wisconsin's Wildlife Action Plan, and a nationwide wildland-urban interface assessment. We found that the majority of frequently burned vegetation types occurred in the southern portion of the state. However, the highest priority areas for applying prescribed fire occurred in the central, northwest, and northeast portion of the state where frequently burned vegetation patches were larger and where identified areas of high biological importance area occurred. Although our focus was on the use of prescribed fire in Wisconsin, our methods can be adapted to prioritize other land management activities. Such prioritization is necessary to achieve the greatest possible benefits from limited funding for land management actions, and our results show that it is feasible at scales that are relevant for land management decisions. PMID:27509745

  9. School nurse case management for children with chronic illness: health, academic, and quality of life outcomes.

    PubMed

    Keehner Engelke, Martha; Guttu, Martha; Warren, Michelle B; Swanson, Melvin

    2008-08-01

    More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with asthma, diabetes, severe allergies, seizures, or sickle-cell anemia in 5 different school districts who were provided case management by school nurses. The children ranged in age from 5 to 19 years. At the end of the school year, children experienced an improvement in quality of life and gained skills and knowledge to manage their illness more effectively. Classroom participation, grades, and participation in extracurricular activities also increased for many children. The study provides evidence of the positive impact school nurses have on children with chronic illness and suggests ways they can measure the outcomes of their interventions. PMID:18757353

  10. Planning for integrated solid waste management at the industrial park level: a case of Tianjin, China.

    PubMed

    Geng, Yong; Zhu, Qinghua; Haight, Murray

    2007-01-01

    Industrial parks play a significant role in the production and use of goods and services. The proper management of solid waste is a major challenge for industrial parks due to the large quantity of wastes and the variability of waste characteristics from these types of developments. Therefore, integrated solid waste management has become very crucial to the industrial park managers. Such an approach requires industrial park managers to assess the overall use of resources, and to seek waste reduction, reuse and recycling opportunities both at the individual company level and among different tenant companies. The adoption of this method can bring both economic and environmental benefits. This paper introduces the planning efforts of a real case in China. It first presents the basic information on Tianjin Economic Development Area (TEDA), and then introduces its current practices on solid waste management. The main focus of this paper is to describe how to plan an integrated solid waste management system at TEDA. Benefits and challenges are all identified and analyzed. The experiences and methods from this case study should be applied in other industrial parks so as to improve the overall eco-efficiency of the whole industrial park. PMID:17055715

  11. Population-based worksite obesity management interventions: a qualitative case study.

    PubMed

    Romney, Martha C; Thomson, Erin; Kash, Kathryn

    2011-06-01

    Due to the increased prevalence of obesity and associated direct and indirect costs to employers, weight management programs have become an integral component of employer and insurer benefits plans. The programs vary in foci, scope, breadth, and implementation. The aim of this study was to explore promising employer-sponsored population-based obesity management programs. A case study that utilized a telephonic semi-structured questionnaire was conducted with small and large organizations located in different regions of the United States that had been recruited to participate. Eight employers and 1 health care advocacy coalition who met the inclusion criteria were interviewed about features of their weight management programs. The case study revealed a number of themes consistent with reports in the literature and reflecting cited best practices. Key findings include confirmation that weight management is a significant component of the wellness strategy in all participating organizations because employers are invested in population health programs and cost savings. Based upon their experience and knowledge, occupational health specialists are responsible for designing, implementing, managing, and evaluating employee health programs. Almost all employers utilize electronic media as a prominent component of wellness and disease management initiatives. Experience has shown that incentives-both financial and nonmonetary-are effective motivators for employee engagement and outcomes. However, while employers report success, favorable outcomes have been difficult to quantify. PMID:21323459

  12. RN Diabetes Virtual Case Management: A New Model for Providing Chronic Care Management.

    PubMed

    Brown, Nancy N; Carrara, Barbara E; Watts, Sharon A; Lucatorto, Michelle A

    2016-01-01

    The U.S. chronic disease health care system has substantial gaps in delivery of services. New models of care change traditional delivery of care and explore new settings for care. This article describes a new model of diabetes chronic care delivery: nurse-delivered care that includes protocol-based insulin titration and patient education delivered solely in a virtual environment. In phase 1, the clinical outcome of time to achievement of glycated hemoglobin (A(1C)) goals (P < .001; 95% confidence interval, 1.68-2.24) was significantly improved by registered nurse (RN) standing order intervention (n = 24) as compared with historical controls (n = 28). In phase 2, patients who were referred to an RN-managed insulin titration protocol with individualized A(1C) goals had a significant (P < .001; 95% confidence interval, 1.680-2.242) reduction in results from a mean of 9.6% at baseline to 7.7% at completion. Average patient age was 66 years, with a mean duration of 11 years diagnosed with diabetes. Safety was demonstrated by the absence of hypoglycemia related to RN protocol adjustment. There were no admissions or emergency room (ER) visits for hypoglycemia. This study demonstrates safety and efficacy of RN virtual chronic disease management for an older population of patients with long-standing diabetes. PMID:26636235

  13. A case report of anesthesia management in the liver transplantation recipient with porphyria -A case report-

    PubMed Central

    Song, Hye Won; Shin, Young Hee; Ko, Justin Sangwook; Gwak, Mi Sook

    2012-01-01

    Porphyrias are a group of diseases characterized by an enzyme deficiency in the heme biosynthesis pathway, resulting in accumulation of precursor molecules in the tissue. Some porphyric patients develop progressive liver disease that requires liver transplantation. This case report describes special anesthetic challenges, including careful selection of drugs and the use of special filters that can exclude harmful wavelengths of ultraviolet, in a patient with porphyria who underwent living donor liver transplantation. Understanding the patient's status and disease process, and avoiding triggering factors of porphyria attacks, are important for successful liver transplantation anesthesia in patients with porphyria. PMID:22323960

  14. Complications and management in Descemet's stripping endothelial keratoplasty: Analysis of consecutive 430 cases

    PubMed Central

    Basak, Samar K; Basak, Soham

    2014-01-01

    Purpose: To analyze the complications and their managements in Descemet's stripping endothelial keratoplasty (DSEK) in consecutive 430 cases by single surgeon in a tertiary eye hospital. Materials and Methods: 430 eyes of 366 patients with endothelial dysfunctions scheduled for DSEK, were analyzed retrospectively. In all cases donor dissection was performed manually, and ‘Taco’ insertion and unfolding technique was used. Intra-operative and postoperative complications with their managements and outcomes were reviewed retrospectively. Periodic endothelial cell density was analyzed for each patient till the last visit. Follow-up period was between 3 to 60 months (mean 18.7 months). Results: 13 (3.0%) eyes had operative complications during donor dissection and 16 (3.7%) had during recipient procedure. In 7 (1.6%) eyes, donor lenticule was replaced with a new one during the surgery. In early postoperative period, 21 (4.9%) eyes had donor dislocation and 12 (2.8%) eyes had air-induced pupillary block; and they were managed immediately. 2 cases had primary graft failure and in 1 case had postoperative bacterial endophthalmitis requiring evisceration. In late postoperative period, 48 (11.3%) eyes had secondary glaucoma and 14 (3.3%) eyes had late secondary graft failure. Endothelial rejection occurred in 5 (1.2%) cases. Mean endothelial cell loss was 19.7% after 3 months and 54.2% after 5 years. Total graft failure in this series was 31 (7.2%) and in 17 cases re-DSEK was performed successfully. Conclusions: Both operative and postoperative complications do occur in DSEK. Most of these complications can be managed by medical or appropriate surgical means. Some of the complications can be avoided and reduced with experience. PMID:24008797

  15. ISMAC: An Intelligent System for Customized Clinical Case Management and Analysis

    PubMed Central

    You, Mingyu; Chen, Chong; Li, Guo-Zheng; Yan, Shi-Xing; Sun, Sheng; Zeng, Xue-Qiang; Zhao, Qing-Ce; Xu, Liao-Yu; Huang, Su-Ying

    2015-01-01

    Clinical cases are primary and vital evidence for Traditional Chinese Medicine (TCM) clinical research. A great deal of medical knowledge is hidden in the clinical cases of the highly experienced TCM practitioner. With a deep Chinese culture background and years of clinical experience, an experienced TCM specialist usually has his or her unique clinical pattern and diagnosis idea. Preserving huge clinical cases of experienced TCM practitioners as well as exploring the inherent knowledge is then an important but arduous task. The novel system ISMAC (Intelligent System for Management and Analysis of Clinical Cases in TCM) is designed and implemented for customized management and intelligent analysis of TCM clinical data. Customized templates with standard and expert-standard symptoms, diseases, syndromes, and Chinese Medince Formula (CMF) are constructed in ISMAC, according to the clinical diagnosis and treatment characteristic of each TCM specialist. With these templates, clinical cases are archived in order to maintain their original characteristics. Varying data analysis and mining methods, grouped as Basic Analysis, Association Rule, Feature Reduction, Cluster, Pattern Classification, and Pattern Prediction, are implemented in the system. With a flexible dataset retrieval mechanism, ISMAC is a powerful and convenient system for clinical case analysis and clinical knowledge discovery. PMID:26495425

  16. Developing an open geographic data model and analysis tools for disaster management: landslide case

    NASA Astrophysics Data System (ADS)

    Aydinoglu, A. C.; Bilgin, M. S.

    2015-02-01

    Disaster management aims to reduce catastrophic losses of disasters. Geographic information technologies support disaster management activities for effective and collaborative data management considering the complex nature of disasters. This study with an original conceptual approach aims to develop interoperable geographic data model and analysis tools to manage geographic data sets coming from different sources. For landslide disaster, 39 scenario-based activities were analysed with the required data according to user needs in a cycle of activities at mitigation, preparedness, response, and recovery phases. An interoperable geographic data model for disaster management (ADYS), enabling up-to-date exchange of geographic data, was designed, compliant with the standards of ISO/TC211 Geographic Information/Geomatics, Open Geospatial Consortium (OGC), and the Turkish National GIS (TUCBS). An open source and free analysis toolbox was developed and tested in the case study of activities such as landslide hazard analysis and a disaster warning system to support the Provincial Disaster Management Centres of Turkey. Open data models and analysis tools make effective activity management and data sharing possible. However, transforming data sets into data exchange formats is laborious.

  17. Economic assessment of managing processionary moth in pine forests: a case-study in Portugal.

    PubMed

    Gatto, Paola; Zocca, Alessia; Battisti, Andrea; Barrento, Maria João; Branco, Manuela; Paiva, Maria Rosa

    2009-02-01

    This paper assesses the private and social profitability of current strategies for managing processionary moth (Thaumetopoea pityocampa) in Portuguese pine forests, looking at economic and environmental costs and benefits. Costs include the expenses for forest treatment and the social costs of threats to human health (dermatitis amongst others); benefits are assessed in terms of both revenue and social benefits such as carbon fixation and recreation. The evaluation was done using Cost Benefit Analysis (CBA) as an analytical framework. While this tool is currently applied to forest and environmental assessment and specific applications to pest management strategies are to be found in agricultural economics, rather few attempts have been made in the field of forest pest management. In order to assess and compare with--without options, a case-study was analysed for the Setúbal Peninsula, south of Lisbon, an area where extensive stands of maritime pine (Pinus pinaster) grow. The exercise has shown that CBA can be a valuable tool for assessing the economic and social profitability of pest management. The results demonstrate that the loss of revenues in the no-management option is not sufficient to make pest management profitable for private forest owners in the short-term. Conversely, a social profit is gained as pest management minimizes health risks for humans and avoids possible recreational losses. PMID:18336989

  18. Case management of chiropractic patients with cervical brachialgia: A survey of French chiropractors

    PubMed Central

    2011-01-01

    Background Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues. Objectives The first objective was to investigate if French chiropractors' management choices appeared reasonable for various neck problem scenarios. The second objective was to investigate if there was agreement between chiropractors on the patient management. The third objective was to see to which degree and at what stages chiropractors would consider to interact with other health-care practitioners, such as physiotherapists, general practitioners and specialists. Method A questionnaire was sent to a randomly selected sample of all French chiropractors known to the national chiropractic college. It consisted of an invitation to participate in the study, a brief case description, and drawings of five stages of how a case of neck pain gradually evolves into a brachialgia to end up with a compromised spinal cord. Each stage offered five management choices. Participants were asked at what stages patients would be treated solely by the chiropractor and when patients would be referred out for second opinion or other care without chiropractic treatment, plus an open ended option, resulting in a "five-by-six" table. The percentages of respondents choosing the different management strategies were identified for the different scenarios and the 95% confidence intervals were calculated. There was a pre hoc agreement on when chiropractic care would or would not be suitable. Consensus was arbitrarily defined as "moderate" when 50- 69% of respondents agreed on the same management choice and as "excellent" when 70% or more provided the same answer. It was expected that inter professional contacts would be rare. Results The response rate was 53% out of 254 potential participants. The first two uncomplicated cases would generally have been treated by the chiropractors. As the patient worsened, the responses tended towards external assistance and for the

  19. Process and impact of mergers of NHS trusts: multicentre case study and management cost analysis

    PubMed Central

    Fulop, Naomi; Protopsaltis, Gerasimos; Hutchings, Andrew; King, Annette; Allen, Pauline; Normand, Charles; Walters, Rhiannon

    2002-01-01

    Objective To study the processes involved in and impact of mergers between NHS trusts, including the effect on management costs. Design Cross sectional study involving in depth interviews and documentary analysis; case study to compare savings in management costs between case trusts and control trusts. Setting Nine trusts (cross sectional study) and four trusts (case study) in London. Participants 96 interviews with trust board members, other senior managers, clinicians, service managers, and representatives of health authorities, regional office, community health councils, local authorities, other trusts in the area, and primary care groups and trusts. Main outcome measures Stated and unstated drivers, and impact of merger on delivery and development of services, management structures, and staff recruitment, retention, and morale. Effects of difference in trust size before and after the merger. Savings in management costs two years after merger. Results Some important drivers for merger are not publicly stated. Mergers had a negative effect on delivery of services because of a loss of managerial focus on services. Planned developments in services were delayed by at least 18 months. Trusts' larger sizes after mergers had unintended negative consequences, as well as predicted advantages. The tendency for one trust's management team to dominate over the other resulted in tension. No improvement in recruitment or retention of clinical and managerial staff was reported. Perceived differences in organisational culture were an important barrier to bringing together two or more organisations. Two years after merger, merged trusts had not achieved the objective of saving £500 000 a year in management costs. Conclusions Important unintended consequences need to be accounted for when mergers are planned. Mergers can cause considerable disruptions to services, and require greater management support than previously acknowledged. Other organisations undergoing restructuring

  20. Administrators in Action--Managing Public Monies and Processing Emotion in School Activities: A Teaching Case Study

    ERIC Educational Resources Information Center

    Tenuto, Penny L.; Gardiner, Mary E.; Yamamoto, Julie K.

    2015-01-01

    This teaching case describes school administrators in action performing day-to-day leadership tasks, managing public funds in school activities, and interacting with others appropriately. The case focuses on administrative challenges in handling and managing school activity funds. A method for processing emotion is discussed to assist…

  1. Implications of case managers' perceptions and attitude on safety of home-delivered care.

    PubMed

    Jones, Sarahjane

    2015-12-01

    Perceptions on safety in community care have been relatively unexplored. A project that sought to understand the multiple perspectives on safety in the NHS case-management programme was carried out in relation to the structure, process, and outcome of care. This article presents a component of the nursing perspective that highlights an important element in the structure of nursing care that could potentially impede the nurses' ability to be fully effective and safe. A single case study of the case-management programme was undertaken. Three primary care organisations from three strategic health authorities participated, and three focus groups were conducted (one within each organisation). In total, 17 case management nurses participated. Data were audiotaped and transcribed verbatim and subjected to framework analysis. Nursing staff attitudes were identified as a structure of care that influence safety outcomes, particularly their perceptions of the care setting and the implications it has on their role and patient behaviour. Greater understanding of the expected role of the community nurse is necessary, and relevant training is required for nurses to be successful in empowering patients to perform more safely. In addition, efforts need to be made to improve patients' trust in the health-care system to prevent harm and promote more effective utilisation of resources. PMID:26636894

  2. Case management for frequent users of the emergency department: study protocol of a randomised controlled trial

    PubMed Central

    2014-01-01

    Background We devised a randomised controlled trial to evaluate the effectiveness and efficiency of an intervention based on case management care for frequent emergency department users. The aim of the intervention is to reduce such patients’ emergency department use, to improve their quality of life, and to reduce costs consequent on frequent use. The intervention consists of a combination of comprehensive case management care and standard emergency care. It uses a clinical case management model that is patient-identified, patient-directed, and developed to provide high intensity services. It provides a continuum of hospital- and community-based patient services, which include clinical assessment, outreach referral, and coordination and communication with other service providers. Methods/Design We aim to recruit, during the first year of the study, 250 patients who visit the emergency department of the University Hospital of Lausanne, Switzerland. Eligible patients will have visited the emergency department 5 or more times during the previous 12 months. Randomisation of the participants to the intervention or control groups will be computer generated and concealed. The statistician and each patient will be blinded to the patient’s allocation. Participants in the intervention group (N = 125), additionally to standard emergency care, will receive case management from a team, 1 (ambulatory care) to 3 (hospitalization) times during their stay and after 1, 3, and 5 months, at their residence, in the hospital or in the ambulatory care setting. In between the consultations provided, the patients will have the opportunity to contact, at any moment, the case management team. Participants in the control group (N = 125) will receive standard emergency care only. Data will be collected at baseline and 2, 5.5, 9, and 12 months later, including: number of emergency department visits, quality of life (EuroQOL and WHOQOL), health services use, and relevant costs

  3. The Use of Octreotide to Manage Symptoms of Bronchorrhea: A Case Report

    PubMed Central

    Pahuja, Meera; Shepherd, Ray W.; Lyckholm, Laurel J.

    2014-01-01

    Octreotide, a synthetic analogue of the hormone somatostatin, is primarily used in palliative medicine because of its antisecretory effect and has been shown to be effective in the management of bowel obstruction, nausea, and diarrhea. Octreotide also has been successfully used for the management of bronchorrhea in both inpatient and outpatient settings. We report the case of a 47-year-old female with a history of bronchioloalveolar cell carcinoma whose copious bronchial secretions were controlled with octreotide. Octreotide should be further evaluated as a first-line treatment for bronchorrhea. PMID:24035070

  4. Conservative Management of Macrodontia in the Mixed Dentition Stage--A Case Report.

    PubMed

    Harker, Ann R; Walley, Sian; Albadri, Sondos

    2015-12-01

    Macrodontia is a rare dental abnormality, which can cause cosmetic concerns. Various management techniques for this condition have been documented in the literature. This case describes the initial management of macrodontia in the mixed dentition stage with the use of a minimally invasive approach to treatment. CPD/Clinical Relevance: The importance of early referral of dental abnormities is highlighted. Short- and long-term treatment options for macrodontia are described, including the impact such anomalies can have on the developing dentition. PMID:26856003

  5. Use of alpha-agonists for management of anaphylaxis occurring under anaesthesia: case studies and review.

    PubMed

    Heytman, M; Rainbird, A

    2004-12-01

    Anaphylaxis is an uncommon but serious complication of anaesthesia. Most current guidelines for the management of anaphylaxis list only epinephrine as a vasopressor to use in the event of cardiovascular collapse. We present two cases of anaphylaxis under anaesthesia where return of spontaneous circulation was refractory to epinephrine, but occurred following the administration of the alpha-agonist metaraminol. Potential advantages and disadvantages of using epinephrine in this setting, the role of alpha-agonists and some potential mechanisms accounting for their role in successful management are reviewed. PMID:15549981

  6. Case managers discuss ethics: dilemmas of an emerging occupation in long-term care in the United States.

    PubMed

    Kane, R A; Penrod, J D; Kivnick, H Q

    1994-01-01

    As case management programs mature, ethical questions undoubtedly arise. Yet there are few, if any, standards by which case managers can guide their actions and decisions. In this article, the authors present the results of a survey of 251 frontline case managers in 10 states who were asked to describe the ethical challenges they face. The respondents were conscious of struggling with difficult, even life-and-death decisions involving important choices in their clients' lives. Generally, the case managers were committed to the ideology of respect for client autonomy but found themselves making uneasy compromises with the concept at every turn. Ethical issues arose not only with the client but also with the client's family, colleagues, and providers. Case managers, long-term care providers, and governmental policymakers could all benefit from both theoretical and practical explorations of desirable approaches to individual and societal long-term care decisions. PMID:8000320

  7. A prototype case-based reasoning human assistant for space crew assessment and mission management

    NASA Technical Reports Server (NTRS)

    Owen, Robert B.; Holland, Albert W.; Wood, Joanna

    1993-01-01

    We present a prototype human assistant system for space crew assessment and mission management. Our system is based on case episodes from American and Russian space missions and analog environments such as polar stations and undersea habitats. The general domain of small groups in isolated and confined environments represents a near ideal application area for case-based reasoning (CBR) - there are few reliable rules to follow, and most domain knowledge is in the form of cases. We define the problem domain and outline a unique knowledge representation system driven by conflict and communication triggers. The prototype system is able to represent, index, and retrieve case studies of human performance. We index by social, behavioral, and environmental factors. We present the problem domain, our current implementation, our research approach for an operational system, and prototype performance and results.

  8. A Clinico-Mycological Study on Suspected Cases of Chromoblastomycosis: Challenges in Diagnosis and Management

    PubMed Central

    Majumdar, Banashree; Jain, Atul; Maiti, Prasanta Kumar; Chatterjee, Gobinda

    2015-01-01

    Introduction Verrucous plaques mimicking chromoblastomycosis are frequently seen in dermatology outpatient departments (OPD). However, no scientific evaluation has been carried out till date from eastern India. So this present endeavour is aimed at a thorough study of those cases to readdress the challenges in diagnosis and management in chromoblastomycosis from this part of the country. Aim The study is to observe the incidence of proved chromoblastomycosis cases from clinically mimicking conditions and to note therapeutic prospects by use of different antifungal agents. Materials and Methods Twenty clinically suspected cases attending dermatology OPD were included in this study. Relevant histories were taken. Apart from routine hematological and biochemical investigations, scrapings from lesions were examined by direct microscopy with KOH wet mount, calcoflour white mount and fungal culture. Histopatholgical examination was also done. Any fungal growth was identified by growth characteristics and morphological features. Results Sclerotic bodies were detected in five samples. Of them three were found to be culture positive. Two growths were identified as Fonsecaea pedrosoi and one as Cladosporium carrionii. Rest 12 cases were diagnosed as either lupus vulgaris (3 cases; 15%), atypical mycobacterial infections (3 cases, 15%), Hypertrophic lichen planus (2, 10%), Hypertrophic DLE plaque (2; 10%), Wart (1, 5%) or fixed cutaneous sporothricosis (1, 5%), zygomycosis (1, 5%). Three cases (15%) were lost in follow up. Cases of chromoblastomycosis were managed with prolonged use of antifungal alone or in combination with saturated solution of potassium iodide and/or debridement. They were followed up for at least six months post treatment. Conclusion A database comprising diagnostic clues and effective therapeutic intervention have been proposed for these rare subcutaneous mycoses. PMID:26816977

  9. Surgical Management and Case-Fatality Rates of Intracerebral Hemorrhage in 1988 and 2005

    PubMed Central

    Adeoye, Opeolu; Woo, Daniel; Haverbusch, Mary; Sekar, Padmini; Moomaw, Charles J.; Broderick, Joseph; Flaherty, Matthew L.

    2009-01-01

    Objective To compare surgical management and case-fatality rates of intracerebral hemorrhage (ICH) in 1988 and 2005. Methods We identified all adult residents (age ≥18) from the five-county Greater Cincinnati region hospitalized with ICH in 1988 and 2005. Demographics, severity of illness, ICH volume, ICH location, rates and timing of surgery, and 30-day case-fatality were compared between the 1988 and 2005 groups. Results In 1988, 171 ICH patients met study criteria (67 lobar, 80 deep cerebral, 10 brainstem, 14 cerebellar), and in 2005, 259 ICH patients met criteria in (91 lobar, 123 deep cerebral, 19 brainstem, and 26 cerebellar). In 1988, 16% of the patients had surgical removal of their ICH versus 7% in 2005 (p=0.003). In both 1988 and 2005, patients treated with surgery were younger (p<0.001) and had a higher percentage of cerebellar hemorrhages than non-surgical patients. Timing of surgery was similar in 1988 and 2005. In 1988, 30-day case fatality was 32% in surgical patients versus 50% in non-surgical patients (p=0.06). In 2005, 30-day case-fatality was 16% (surgical) versus 45% (non-surgical) (p=0.02). Conclusion The frequency of surgery for ICH was lower in 2005 than in 1988, which may reflect recent clinical trial data showing no benefit for surgery over medical management. ICH case-fatality was essentially the same in 1988 and 2005. Innovative clinical trials to improve ICH outcomes are warranted. PMID:19057323

  10. Modern Spirometry Supports Anesthetic Management in Small Animal Clinical Practice: A Case Series.

    PubMed

    Calice, Ivana; Moens, Yves

    2016-01-01

    Modern spirometry, like no other monitoring technique, allows insight into breath-to-breath respiratory mechanics. Spirometers continuously measure volume, airway pressure, and flow while calculating and continuously displaying respiratory system compliance and resistance in the form of loops. The aim of this case series is to show how observation of spirometric loops, similar to electrocardiogram or CO2 curve monitoring, can improve safety of anesthetic management in small animals. Spirometric monitoring cases described in this case series are based on use of the anaesthesia monitor Capnomac Ultima with a side stream spirometry sensor. The cases illustrate how recognition and understanding of spirometric loops allows for easy diagnosis of iatrogenic pneumothorax, incorrect ventilator settings, leaks in the system, kinked or partially obstructed endotracheal tube, and spontaneous breathing interfering with intermittent positive-pressure ventilation. The case series demonstrates the potential of spirometry to improve the quality and safety of anesthetic management, and, hence, its use can be recommended during intermittent positive-pressure ventilation and procedures in which interference with ventilation can be expected. PMID:27487353

  11. Cavernous hemangioma of the bladder: an additional case managed by partial cystectomy and augmentation cystoplasty

    PubMed Central

    Lahyani, Mounir; Slaoui, Amine; Jakhlal, Nabil; Karmouni, Tarik; Elkhader, Khalid; Koutani, Abdellatif; Andaloussi, Ahmed Ibn Attya

    2015-01-01

    Cavernous Hemangioma of the Bladder (CHB) is benign and rare lesions. Clinical presentation has no pathognomonic signs although gross painless hematuria is the most frequent complain. CHB is suspected by cystoscopy and radiologic findings and confirmed by pathologic examinations. Management is controversial due to the bleeding risk of this highly vascularized lesion. Partial cystectomy is the treatment of choice for surgically accessible lesions. However, it appears that small lesions could be treated using transurethral resection. Since CHB is a rare case, we report another case treated successfully with a partial cystectomy associated with an augmentation cystoplasy. PMID:26889312

  12. Multimodal approach for the management of Hunan hand syndrome: a case report.

    PubMed

    Saxena, Ashok Kumar; Mandhyan, Rajani

    2013-03-01

    Hunan hand syndrome, a form of painful contact dermatitis, is a rare case finding. It is usually seen in people with continuous and prolonged exposure to chili peppers. The main ingredient in chili peppers is capsaicin that leads to the clinical condition, Hunan hand syndrome. This is paradoxical to the use of capsaicin as local application for relief of pain in various clinical situations, such as diabetic neuropathy and postherpetic neuralgia. We report a case of Hunan hand syndrome, managed successfully by using a multimodal approach comprised of a continuous stellate ganglion block, gabapentin, local ice water, and fluocinonide application. PMID:22681338

  13. Role of perioperative transesophageal echocardiography in the management of adolescent truncus arteriosus: Rare case report

    PubMed Central

    Nagaraja, P. S.; Singh, Naveen G.; Simha, Parimala Prasanna; Davan, K. R.; Manjunath, V.; Jagadeesh, A. M.

    2015-01-01

    Truncus arteriosus (TA) is a rare congenital heart disease defined as a single arterial vessel arising from the heart that gives origin to the systemic, pulmonary and coronary circulations. The truncal valve in majority of the cases is tricuspid though quadricuspid and bicuspid valves have been reported. Patients with TA typically have a large nonrestrictive sub truncal ventricular septal defect. Survival of these infants beyond 1-year is uncommon. Here, we report a unique case of 12-year-old female patient with persistent TA who underwent surgical repair by using transesophageal echocardiography as a monitoring device during the perioperative management. PMID:25849699

  14. Challenges in the management of a rare case of extensive retroperitoneal haemangioma in a pregnant woman

    PubMed Central

    Tan, Shu-Qi; Lim, Jason Shau Khng; Tan, Yin Ru; Tan, Hak Koon

    2014-01-01

    Haemangioma of the retroperitoneal space is a rare benign capillary malformation, which can grow significantly in pregnancy due to the multiple associated cardiovascular changes. We herein describe the case of a pregnant woman with an extensive right retroperitoneal haemangioma extending from the level of the renal hilum, across the lateral anterior abdominal wall and into the thigh. We also highlight the challenges faced in the management of the patient’s delivery process. To the best of our knowledge, this is the first case of such nature and severity described in the English literature. PMID:25631977

  15. Operative Management of Crossover Femoral-femoral Graft Erosion into Bladder: A Case Report.

    PubMed

    Motiani, Karan; Mahdy, Ayman

    2016-09-01

    Erosion of vascular grafts is not uncommon as seen in the recent literature. There have been many case reports documenting the work up and management of erosion of these grafts into bowel. We report a case of a crossover femoral-femoral graft that eroded into the anterior bladder wall and was incidentally found as an adherent bladder stone during cystoscopy. We demonstrate the importance of having a high level of clinical suspicion for eroding vascular grafts when preoperative imaging shows close proximity of graft to bladder. PMID:27462547

  16. Primitive cerebral melanoma: a diagnostic and management challenge. About 2 cases.

    PubMed

    Mondot, L; Almairac, F; Vandenbos, F; Fontaine, D; Frenay, M; Chanalet, S

    2012-07-01

    In this report of two cases of solitary cerebral meningeal melanoma, a rare tumor that presents both diagnostic and management challenges, the diagnosis of these lesions was based on a solitary leptomeningeal mass on MRI, a high mitotic rate on histology and the absence of extracerebral localizations. Although the radiological patterns can mimic those of other melanocytic tumors, MRI is a useful diagnostic tool for narrowing the differential diagnosis. Surgical removal remains the only effective treatment of these lesions, and can lead to prolonged survival in a few cases. PMID:22169116

  17. Comparison of Diverting Colostomy and Bowel Management Catheter Applications in Fournier Gangrene Cases Requiring Fecal Diversion.

    PubMed

    Eray, Ismail Cem; Alabaz, Omer; Akcam, Atilgan Tolga; Ulku, Abdullah; Parsak, Cem Kaan; Sakman, Gurhan; Seydaoglu, Gulsah

    2015-12-01

    In some patients of Fournier gangrene originated from perianal region, it is important to prevent fecal contamination in order to provide healing without wound infection. For this purposes, diverting colostomy or bowel management catheter methods were performed. In this study, it is aimed to carry out a comparison of prognosis and cost efficiency between diverting colostomy and bowel management catheter methods applied for preventing fecal contamination in Fournier's gangrene patients. Fourty-eight patients with diagnosis of Fournier's gangrene, serious perianal infections, and preserved sphincters and without rectum injury after debridement were included in the study. The cases were divided into two groups as patients who were subjected to colostomy for fecal diversion and who were subjected to bowel management catheter without colostomy. Then, the groups were compared in terms of age, predisposing factors, duration of hospital stay, mortality, additional surgery requirements, and cost. Fourty-eight patients were included the study. Sixteen patients were treated without colostomy. Decreased duration of total hospital stay, additional surgery requirements, and hospital expense in bowel management catheter group has determined. It is thought that preferring bowel management catheter method instead of colostomy in patients without rectum injury, who require diverting colostomy and have undamaged anal sphincters, can relieve patients, patients' relatives, healthcare organizations, and the national economy of a serious burden. In addition, although patients' satisfaction and workforce loss factors are not taken into consideration in this study, the bowel management catheter method is thought to have positive effects also on these parameters. PMID:26730041

  18. Do expert assessments converge? An exploratory case study of evaluating and managing a blood supply risk

    PubMed Central

    2011-01-01

    Background Examining professional assessments of a blood product recall/withdrawal and its implications for risk and public health, the paper introduces ideas about perceptions of minimal risk and its management. It also describes the context of publicly funded blood transfusion in Canada and the withdrawal event that is the basis of this study. Methods Interviews with 45 experts from administration, medicine, blood supply, laboratory services and risk assessment took place using a multi-level sampling framework in the aftermath of the recall. These experts either directly dealt with the withdrawal or were involved in the management of the blood supply at the national level. Data from these interviews were coded in NVivo for analysis and interpretation. Analytically, data were interpreted to derive typifications to relate interview responses to risk management heuristics. Results While all those interviewed agreed on the importance of patient safety, differences in the ways in which the risk was contextualized and explicated were discerned. Risk was seen in terms of patient safety, liability or precaution. These different risk logics are illustrated by selected quotations. Conclusions Expert assessments did not fully converge and it is possible that these different risk logics and discourses may affect the risk management process more generally, although not necessarily in a negative way. Patient safety is not to be compromised but management of blood risk in publicly funded systems may vary. We suggest ways of managing blood risk using formal and safety case approaches. PMID:21864330

  19. Spontaneous Rectus Sheath Hematoma in the Elderly: An Unusual Case and Update on Proper Management

    PubMed Central

    Galyfos, George; Karantzikos, Georgios; Palogos, Konstantinos; Sianou, Argiri; Filis, Konstantinos; Kavouras, Nikolaos

    2014-01-01

    Spontaneous rectus sheath hematoma (SRSH) is an uncommon medical emergency in the elderly. We present a case of SRSH with an atypical clinical presentation and discuss literature regarding diagnosis and proper management. A 75-year-old female patient was transferred to the emergency department due to acute dyspnoea and confusion. Her medical history revealed a viral infection of the upper respiratory tract, and no coughing or use of anticoagulants. The clinical examination showed tenderness of the left lower abdomen, although palpation was misleading due to patient's obesity. Laboratory investigations showed light anaemia. Ultrasonography and computed tomography revealed a large rectus sheath hematoma of the left abdominal wall. Despite further deterioration of the patient, conservative management including bed rest, fluid replacement, blood products transfusion, and proper analgesia was successful. No surgical intervention was needed. Prompt diagnosis and management of SRSH plays significant role in the prognosis, especially in elder patients. Independently of size and severity, conservative management remains the first therapeutic choice. Only by failure of supportive management, progressive and large hematoma or uncontrollable hemodynamic patients, interventional management including surgery or less invasive newer techniques is indicated. PMID:24839570

  20. The importance of work or productive activity in life care planning and case management

    PubMed Central

    Reid, Christine; Riddick-Grisham, Susan

    2015-01-01

    Abstract INTRODUCTION: The importance of work or productive activity for the well-being, community integration, and quality of life of people living with disabilities is addressed, with implications for life care planning and case management. BACKGROUND: The role of work or productive activity in our society, and consequences of deprivation if rehabilitation services do not address vocational effects of disabilities, is explored. A continuum of productivity options is introduced; types of vocational rehabilitation assessment processes and interventions are described. PURPOSE: The role of vocational rehabilitation services in life care planning and case management is discussed, focusing on quality of life for people living with disabilities. CONCLUSION: Rehabilitation and health care professionals should understand the importance of work or other productive activity, and support the development of appropriate plans to address those needs among people who have disabilities. PMID:26409330

  1. Transformational leadership and the hospice R.N. case manager: a new critical pathway.

    PubMed

    Lafferty, C L

    1998-01-01

    This article asserts that in light of changing conditions in the healthcare environment, transformational leadership is the most appropriate leadership style for the hospice registered nurse case manager. The author defines transformational leadership and, tracing from early leadership theories, demonstrates how the transformational-transactional leadership paradigm emerged from preceding leadership theories. The components of transformational leadership--transformational behavior and transformational characteristics--are linked to hospice theory and hospice-specific nursing practices. The expanding role of the hospice R.N. case manager is addressed in light of transformational leadership and culture building. Specific actions are proposed in the arenas of research, education, and community, corporate, and legislative involvement. PMID:9677956

  2. Case studies illustrating the management of trigeminal neuropathic pain using topical 5% lidocaine plasters

    PubMed Central

    Yilmaz, Zehra; Renton, Tara

    2013-01-01

    Chronic trigeminal pain, with its severe related functional problems, is difficult to treat. Treatment is often empirically based on medications used for other chronic pain conditions. Systemic sodium channel and calcium channel blocking agents may cause a multitude of complications that are often poorly tolerated by the patient. Aim: The aim of this case report was to assess the efficacy of topical 5% lidocaine plasters in reducing pain and reducing adjuvant medication in patients with orofacial neuropathic pain. Method: Fourteen patients with chronic orofacial pain conditions referred to the oral surgery department were instructed to wear 5% lidocaine plasters for 12 hours each day over the painful area. The conditions included post-surgical neuropathy (n = 10), multiple sclerosis-related pain (n = 1), persistent idiopathic facial pain (n = 1), Ramsay Hunt syndrome (post-herpetic neuralgia, n = 1) and trigeminal neuralgia (n = 1). Data were collected on patient demographics, pain levels and medication. Results: Pain levels improved in 12 out of 14 patients. Nine patients had a reduction in adjuvant medication, two of whom completely stopped adjuvant treatment. Conclusion: This case series demonstrates that of the use of 5% lidocaine plasters may play a useful role in the management of chronic trigeminal pain. A suggested novel approach for the management of orofacial pain, for clinicians, is presented. Summary points Management of chronic orofacial pain continues to be a major challenge to the clinician. Patients are often placed on a multitude of medications in an attempt to alleviate pain without success. Topical 5% lidocaine plasters, currently used for the management of post-herpetic neuralgia, offer the option of locally targeting trigeminal pain without the multiple side-effects of systemic medication. This case series demonstrates that lidocaine plasters decrease verbal pain scores in extraoral, trigeminal and neuropathic pain, and reduce the use of other

  3. The management of blood phobia and a hypersensitive gag reflex by hypnotherapy: a case report.

    PubMed

    Noble, Suzanne

    2002-03-01

    Coping with a hypersensitive gag reflex can be a cause for concern for both the patient and the operator. This report describes a case of blood phobia directed solely towards the oral cavity, linked with the inability to tolerate dentures due to a hypersensitive gag reflex. Management by hypnotherapy using a systematic desensitization technique allowed for extraction of teeth and permanent elimination of the gagging problem. PMID:11928343

  4. Acupuncture for the Management of Postdural Puncture Headache: A Case Report

    PubMed Central

    Chang, Alexandra; Acquah, Joseph; Reddy, Sanjay

    2016-01-01

    Postdural puncture headache (PDPH) is a recognized complication of neuraxial anesthesia. This case report documents 1 patient who developed PDPH following epidural anesthesia for postoperative pain control. The patient declined conventional treatments, including an epidural blood patch and intravenous caffeine. This report documents successful use of adjunct acupuncture for the management of PDPH. Additional research on acupuncture as a potential adjunctive therapy for PDPH is needed, particularly for patients who are reluctant to receive more invasive treatments. PMID:26937320

  5. Successful management of aluminium phosphide poisoning using intravenous lipid emulsion: Report of two cases

    PubMed Central

    Baruah, Udismita; Sahni, Ameeta; Sachdeva, Harish C.

    2015-01-01

    Aluminum phosphide (ALP) is a cheap, easily available agricultural pesticide which causes lethal poisoning by liberation of phosphine and inhibition of cytochrome c oxidase thereby leading to cellular hypoxia. Although there is no known specific antidote, clinical trials are still going on. We present here two cases of ALP poisoning who were successfully managed by treatment with lipid emulsion and intravenous magnesium sulfate. PMID:26816450

  6. Esthetic management of a primary double tooth using a silicone putty guide: a case report.

    PubMed

    Agarwal, Ravi; Chaudhry, Kalpna; Yeluri, Ramakrishna; Munshi, Autar Krishen

    2013-03-01

    The term double tooth is often used to describe fusion and gemination. The development of isolated large or joined teeth is not rare, but the literature is confusing when the appropriate terminology is presented. The objective of this paper is to present a case of a primary double tooth in a 5-year-old girl with a history of trauma. The tooth was endodontically treated and esthetic management was carried out using a silicone putty guide. PMID:23600163

  7. Clinical Spectrum and Management of Caustic Ingestion: A Case Series Presenting Three Opposing Outcomes

    PubMed Central

    Vezakis, Antonios I.; Pantiora, Eirini V.; Kontis, Elissaios A.; Sakellariou, Vasileios; Theodorou, Dimitrios; Gkiokas, Georgios; Polydorou, Andreas A.; Fragulidis, Georgios P.

    2016-01-01

    Case series Patient: Fenale, 77 • Female, 46 • Female, 33 Final Diagnosis: Caustic injury Symptoms: — Medication: — Clinical Procedure: Surgery Specialty: Surgery Objective: Unusual clinical course Background: Ingestion of caustic substances is a medical emergency in both the adult and pediatric population and is associated with high morbidity and mortality. The extent of injuries after ingestion of caustic substances depends on the nature, amount, and concentration of the agent and on the exposure time. Acutely, caustic substances may cause massive hemorrhage and gastrointestinal tract perforation; the most markedly affected cases require urgent surgical treatment. Patients surviving the initial event may present with aorto-enteric or gastrocolic fistulae, esophageal strictures, dysphagia, and increased risk of esophageal cancer as long term sequelae. Case Report: The features of three cases of caustic ingestion are reported to demonstrate significantly different complaints presented at the emergency department. Two patients had free gastric perforation, one at presentation, and one delayed. The third patient presented with late severe strictures of the esophagus and pylorus. The outcomes of the three patients are discussed in detail along with the most current management strategies. Conclusions: Among adults, ingestion of caustic substances is usually associated with more severe lesions due to the increased amount of ingested substance, as compared with pediatric patients. The most serious presentation is that of visceral perforation, most commonly of the stomach and rarely of the esophagus. Management involves urgent resuscitation with correction of fluid and electrolyte and acid-base abnormalities and immediate surgical exploration in those patients with signs of perforation. Once the perioperative period is managed successfully, the long-term results can be satisfactory. Managing of strictures or else reconstructive procedures must be well timed to

  8. Anesthetic Management of a Patient with Myasthenia Gravis for Meningioma Surgery - A Case Report.

    PubMed

    Srivastava, V K; Agrawal, S; Ahmed, M; Sharma, S

    2015-01-01

    Myasthenia gravis is a disease of great challenge to the anesthesiologist, because it affects the neuromuscular junction. Anesthetic management involves either muscle relaxant or non-muscle relaxant techniques. This case report documents the safe use of fentanyl, propofol and sevoflurane combination guided by bispectral index, without the use of muscle relaxants in a patient with myasthenia gravis who presented for meningioma surgery. PMID:26620756

  9. [Consideration about data management and biostatistics analysis from a FDA's botanical drug approval case].

    PubMed

    Tang, Jian-yuan; Huang, Fang-hua; Zhu, Fei-peng

    2009-11-01

    FDA approved the first botanical drug of non-simplex ingredient on 31st Oct 2006. The new drug's trade name is Veregen 15% Ointment. Veregen succeeded in coming into the market in U.S, which attracts other countries and regions' attention where traditional herbs have been always used. From the viewpoints of data management and biostatistics method, the authors will think and discuss this case well, and hope to promote domestic new drug investigation. PMID:20329620

  10. [A rare case of surgical management of a patient with thoracic aortic aneurysm].

    PubMed

    Kospanov, N A; Mierbekov, E M; Eshmuratov, T Sh; Kodasbaev, A T; Kirgizbaev, S Zh

    2012-01-01

    Described in the article is a clinical case of successful surgical management of a male patient diagnosed with a syphilitic-origin aneurysm of the thoracic aorta isthmus, complicated by an aortopulmonary fistula. Also presented herein are the clinical pattern, findings of examination, and treatment policy. This is followed by a detailed description of both the course of the surgical intervention and outcomes obtained. PMID:22929686

  11. Glucagonoma and Glucagonoma Syndrome: A Case Report with Review of Recent Advances in Management

    PubMed Central

    Al-Faouri, Ashraf; Ajarma, Khaled; Alghazawi, Samer; Al-Rawabdeh, Sura; Zayadeen, Adnan

    2016-01-01

    The rarity of glucagonoma imposes a challenge with most patients being diagnosed after a long period of treatment for their skin rash (months-years). Awareness of physicians and dermatologists of the characteristic necrolytic migratory erythema often leads to early diagnosis. Early diagnosis of glucagonoma even in the presence of resectable liver metastases may allow curative resection. Herein, we present a typical case of glucagonoma treated at our center and review the literature pertinent to its management. PMID:26981306

  12. Assessment of facilities management process capability: a NHS facilities case study.

    PubMed

    Amaratunga, Dilanthi; Haigh, Richard; Sarshar, Marjan; Baldry, David

    2002-01-01

    Describes a process to assess facilities management (FM) process capabilities: the structured process improvement for construction environments--facilities management (SPICE FM) approach. The SPICE FM framework is a method that FM organizations can use to monitor continuously and subsequently improve their performance. The SPICE FM framework is being tested in a series of case studies to ensure that its outputs are appropriate to the FM sector and of value in the real world. Documents the outcomes of a study undertaken at a facilities directorate of a healthcare NHS trust, in searching its applicability within the NHS. Further describes the study methodology and the key activities undertaken and reviews the key communication and management processes that are in place to support the implementation of the strategic FM objectives within the specific NHS facilities directorate. PMID:12500653

  13. Structured storage in ATLAS Distributed Data Management: use cases and experiences

    NASA Astrophysics Data System (ADS)

    Lassnig, Mario; Garonne, Vincent; Molfetas, Angelos; Beermann, Thomas; Dimitrov, Gancho; Canali, Luca; Zang, Donal; Azzurra Chinzer, Lisa

    2012-12-01

    The distributed data management system of the high-energy physics experiment ATLAS has a critical dependency on the Oracle Relational Database Management System. Recently however, the increased appearance of data warehouselike workload in the experiment has put considerable and increasing strain on the Oracle database. In particular, the analysis of archived data, and the aggregation of data for summary purposes has been especially demanding. For this reason, structured storage systems were evaluated to offload the Oracle database, and to handle processing of data in a non-transactional way. This includes distributed file systems like HDFS that support parallel execution of computational tasks on distributed data, as well as non-relational databases like HBase, Cassandra, or MongoDB. In this paper, the most important analysis and aggregation use cases of the data management system are presented, and how structured storage systems were established to process them.

  14. Conservative management of symptomatic Carpal Bossing in an elite hockey player: a case report

    PubMed Central

    Kissel, Peter

    2009-01-01

    Objective: To present the characteristics and create awareness of symptomatic carpal bossing and discuss potential etiologies and the role of conservative management through the presentation of an athlete with traumatic onset of symptomatic carpal bossing. Clinical features: This case report outlines the presentation and conservative management of an elite eighteen year old hockey player with symptomatic carpal bossing after a traumatic on ice collision. Carpal bossing is a bony, dorsal prominence in the quadrangular joint of the wrist that is inconsistently symptomatic. Intervention and outcome: A conservative treatment plan consisting of education, reassurance, avoidance of aggravation, and soft tissue therapy allowed return to play in two weeks without restrictions or need for surgical consultation. Conclusion: With inconsistent recurrence rates and surgical complications, the role of conservative management for symptomatic carpal bossing deserves further exploration. The conservative practitioner should be aware of the signs and symptoms of symptomatic carpal bossing to institute suitable treatment. PMID:20037693

  15. Managing Astronomy Research Data: Case Studies of Big and Small Research Projects

    NASA Astrophysics Data System (ADS)

    Sands, Ashley E.

    2015-01-01

    Astronomy data management refers to all actions taken upon data over the course of the entire research process. It includes activities involving the collection, organization, analysis, release, storage, archiving, preservation, and curation of research data. Astronomers have cultivated data management tools, infrastructures, and local practices to ensure the use and future reuse of their data. However, new sky surveys will soon amass petabytes of data requiring new data management strategies.The goal of this dissertation, to be completed in 2015, is to identify and understand data management practices and the infrastructure and expertise required to support best practices. This will benefit the astronomy community in efforts toward an integrated scholarly communication framework.This dissertation employs qualitative, social science research methods (including interviews, observations, and document analysis) to conduct case studies of data management practices, covering the entire data lifecycle, amongst three populations: Sloan Digital Sky Survey (SDSS) collaboration team members; Individual and small-group users of SDSS data; and Large Synoptic Survey Telescope (LSST) collaboration team members. I have been observing the collection, release, and archiving of data by the SDSS collaboration, the data practices of individuals and small groups using SDSS data in journal articles, and the LSST collaboration's planning and building of infrastructure to produce data.Preliminary results demonstrate that current data management practices in astronomy are complex, situational, and heterogeneous. Astronomers often have different management repertoires for working on sky surveys and for their own data collections, varying their data practices as they move between projects. The multitude of practices complicates coordinated efforts to maintain data.While astronomy expertise proves critical to managing astronomy data in the short, medium, and long term, the larger astronomy

  16. Nurse case management program of chronic pain patients treated with methadone.

    PubMed

    Lamb, Louise; Pereira, John Xavier; Shir, Yoram

    2007-09-01

    Methadone treatment in chronic pain patients is still limited owing to misconceptions about addiction, safety, and its unique pharmacokinetic and pharmacodynamic properties. Nevertheless, patients with chronic noncancer pain are frequently treated with methadone at our Pain Centre either as the first opioid of choice, for specific pain conditions, or as a second-line opioid in patients developing tolerance or intractable side effects with other opioids. The aim of this study was to examine whether a nurse case management program of chronic pain patients treated with methadone is feasible and safe in trying to improve patients' care in an ambulatory setting. This program consisted of three phases: initial primary education session, telephone follow-up during methadone titration, and a subsequent maintenance period. The nurse case manager functioned autonomously and when required reported to and consulted the physician. The study included 75 subjects and was done over a nine-month period by completing follow-up questionnaires for every call. Of a total of 194 recorded calls, 41% were unscheduled. Forty-four percent of phone calls resulted in a methadone increase and 11% led to a decrease or cessation of methadone. No patients developed serious morbidity or mortality. Fifty-seven percent of patients were either satisfied or very satisfied with their treatment. A nurse-led case management program of methadone in chronic pain patients can improve patient care in an ambulatory setting. PMID:17723930

  17. Effect of diabetic case management intervention on health service utilization in Korea.

    PubMed

    Shin, Soon Ae; Kim, Hyeongsu; Lee, Kunsei; Lin, Vivian; Liu, George

    2015-12-01

    This study is to estimate the effectiveness of a diabetic case management programme on health-care service utilization. The study population included 6007 as the intervention group and 956,766 as the control group. As the indicators of health-care service utilization, numbers of medical ambulatory consultations, days of medication prescribed and medical expenses for one year were used, and we analysed the claim data of the health insurance from 2005 to 2007. The study population was classified into three subgroups based on the number of medical ambulatory consultations per year before this intervention. In the under-serviced subgroup, the intervention group showed a significant increase in the number of consultations (3.2), days of prescribed medication (66.4) and medical expenses (287,900 KRW) compared with the control group. Conversely, in the over-serviced subgroup, the intervention group showed a less decrease days of prescribed medication (1.6) compared with the control group. This showed that the case management programme led the intervention group to optimize their utilization of health-care services by subgroups. It is necessary to evaluate the appropriateness of health-care usage and clinical outcome to show the direct effectiveness of the case management programme by subgroups. PMID:24821209

  18. Examining the Effectiveness of a Case Management Program for Custodial Grandparent Families

    PubMed Central

    Campbell, Lenora; Carthron, Dana L.; Miles, Margaret Shandor; Brown, LaShanda

    2012-01-01

    Researchers have identified complex needs of custodial grandparent families and lack of access to needed resources such as housing, financial and legal assistance, and health care. Case management links these families with needed services while helping them develop skills to promote their health and well-being. This paper describes a case management program for custodial grandparent families using a nurse-social worker case management team. data were collected from 50 grandparents and 33 children using surveys and semi-structured instruments. Physical and mental health outcomes were measured using Short Form-12 Health Survey (SF 12) to measure the perceived quality of health for grandparents and the Child Behavior Checklist to measure the emotional and behavioral functioning of grandchildren. Grandparents more positively perceived their mental health after participating in the program. Perceptions about physical health were generally the same before and after the program. Grandparents' reported that many grandchildren had emotional and behavioral problems in the clinical range. These findings highlight the need for further research on the mental health needs of children being parented by grandparents as well as determining effective models and interventions to minimize adverse effects of parenting on grandparents. PMID:22720151

  19. Medications and fall risk indicators among patients case-managed by physical therapists.

    PubMed

    Arena, Sara K; Rataj, Jillian; Thompson, Melissa; Peterson, Edward L; Bennis, Shawn

    2015-02-01

    The prevalence of medication use among Americans is reported at 48% with significant linear increases with advancing age. A link between specific medication use and fall risk has been established. The purposes of this study are to describe (a) medication categories and (b) medication prevalence associated with fall risk prescribed to individuals case-managed by physical therapists (PTs) in home healthcare (HHC). Descriptive retrospective chart reviews of age, gender, ethnicity, diagnosis, and prescribed medication profiles were obtained from electronic health records (EHRs) of individuals case-managed by PTs at one HHC agency. Descriptive statistics of patient characteristics and medications were analyzed. The chi-square test compared difference by age, gender, and ethnicity. Ninety-five EHRs met criteria for inclusion. Eight hundred and nineteen total medications, comprising 403 medications and 34 medication categories were identified. The highest medication categories prescribed were pain relief (70.5%); cardiovascular agents (65.3%); vitamins, minerals, therapeutic nutrients, and electrolytes (60.0%); gastrointestinal (53.7%); and heart and cholesterol agents (45.3%). Fall risk indicators were identified including medication from a fall risk category (4.2%) and polypharmacy (90.5%). Individuals case-managed by PTs in the HHC setting are prescribed medications from a variety of medication categories including fall risk indicators. This study emphasizes the importance of PTs' review of medications during an initial examination to identify potential adverse events, including falls, which may occur as a result of medication usage. PMID:25654458

  20. Composite endpoints for malaria case-management: not simplifying the picture?

    PubMed

    Cairns, Matthew E; Leurent, Baptiste; Milligan, Paul J

    2014-01-01

    Rapid diagnostic tests (RDTs) for infection with Plasmodium spp. offer two main potential advantages related to malaria treatment: 1) ensuring that individuals with malaria are promptly treated with an effective artemisinin-based combination therapy, and 2) ensuring that individuals without malaria do not receive an anti-malarial they do not need (and instead receive a more appropriate treatment). Some studies of the impact of RDTs on malaria case management have combined these two different successes into a binary outcome describing 'correct management'. However combining correct management of positives and negatives into a single summary measure can be misleading. The problems, which are analogous to those encountered in the evaluation of diagnostic tests, can largely be avoided if data for patients with and without malaria are presented and analysed separately. Where a combined metric is necessary, then one of the established approaches to summarise the performance of diagnostic tests could be considered, although these are not without their limitations. Two graphical approaches to help understand case management performance are illustrated. PMID:25496292

  1. Fibrodysplasia Ossificans Progressiva: Difficulty in Diagnosis and Management A case report and literature review

    PubMed Central

    Kamal, Achmad Fauzi; Novriansyah, Robin; Rahyussalim; Prabowo, Yogi; Siregar, Nurjati Chairani

    2015-01-01

    Introduction: Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant genetic disorder and characterized by postnatal progressive heterotopic ossification of the connective tissue. There are difficulties in diagnosing FOP, thus delayed or misdiagnosis and mismanagement is common. 3D printers have now become widely available and inexpensive, and can be used to rapidly produce life-size models based on CT scans of an individual patient. The availability of patient specific, accurate and detailed models of complex acetabular fractures can aid planning of surgical management on a patient specific basis. Case Report: We present the diagnosis and surgical management of a 9-year old Indonesian girl with FOP. She presented with extensive involvement of cervical spine and both shoulders. Total excision of occipito-cervico-lumbar and paravertebral ossification and also exostoses at bilateral shoulder was done. At three years follow up, she had local recurrence with similar range of movement of the shoulder and cervical spine. Conclusion: FOP is an extremely rare case. It is difficult to diagnose and manage FOP, therefore delayed or misdiagnosis and also inappropriate management is common.

  2. Communicating worst-case scenarios: neighbors' views of industrial accident management.

    PubMed

    Johnson, Branden B; Chess, Caron

    2003-08-01

    The prospect of industrial accidents motivated the U.S. Congress to require in the Clean Air Act of 1990 that manufacturing facilities develop Risk Management Plans (RMP) to submit to the U.S. Environmental Protection Agency (USEPA) by July 1999. Industry worried that the requirement to communicate to the public a "worst-case scenario" would arouse unnecessary and counterproductive fears among industry neighbors. We report here the results of focus groups and surveys with such neighbors, focusing particularly upon their reactions to messages about a hypothetical worst-case scenario and management of these risks by industry, government, and other parties. Our findings confirmed our hypotheses that citizens would be skeptical of the competence and trustworthiness of these managers and that this stance would color their views of industrial-facility accident risks. People with job ties to industry or who saw industrial benefits to the community as exceeding its risks had more positive views of industrial risks, but still expressed great concern about the risk and doubt about accident management. Notwithstanding these reactions, overall respondents welcomed this and other related information, which they wanted their local industries to supply. Respondents were not more reassured by additional text describing management of accidents by government and industry. However, respondents did react very positively to the concept of community oversight to review plant safety. Claims about the firm's moral obligation or financial self-interest in preventing accidents were also received positively. Further research on innovative communication and management of accident risks is warranted by these results, even before recent terrorist attacks made this topic more salient. PMID:12926575

  3. Urethral complications after tension-free vaginal tape procedures: A surgical management case series

    PubMed Central

    Sergouniotis, Fotios; Jarlshammar, Björn; Larsson, Per-Göran

    2015-01-01

    AIM: To analyze the clinical features, diagnostic modalities, and the surgical management of urethral complications after tension-free vaginal tape procedures. METHODS: This study encompasses a retrospective review of nine patients presented with urethral complications after midurethral sling procedures. The patients underwent the procedures during a period from 1999 to 2012 in three different regional hospitals in the southwest part of Sweden. The time from sling placement to diagnosis, the risk factors, clinical features, diagnosis, surgical management, and functional outcome are presented. The presenting symptoms were described as either early onset (< 12 mo) or late onset (> 12 mo) according to when they were first reported. RESULTS: Eight cases of urethral erosion and one case of bladder-neck erosion were detected. The mean interval for diagnoses of the erosions ranged from 3 mo to 11 years. The most common presenting symptoms included de novo urgency with or without incontinence (7/9 patients), urinary retention/voiding dysfunction (4/9 patients), urethritis (4/9 patients), relapse of stress-incontinence (3/9 patients), recurrent urinary tract infections (5/9 patients), and hematuria (1/9 patient). In most cases, voiding dysfunction and urethritis occurred early after the operation. The surgical management applied in most cases was transurethral resection of the intraurethral part of the mesh. The removal of the intraurethral mesh resulted in improvement or complete cure of urgency symptoms in 5/7 patients with urgency. Four patients were reoperated with a new stress-incontinence surgery, one with laparoscopic Burch, and three with retropubic tension-free vaginal tape procedures. CONCLUSION: Urethral complications should be suspected in the case of de novo urgency and relapse of stress-incontinence. Transurethral excision of the intraurethral mesh is the recommended treatment. PMID:26167464

  4. Surgical versus conservative management of adult intussusception: Case series and review

    PubMed Central

    Aydin, Nail; Roth, Andrew; Misra, Subhasis

    2016-01-01

    Introduction Intussusception is the telescoping of a segment of bowel into its adjacent segment. It is a known cause of abdominal pain in the pediatric population, however, it is rare in the adult. Adults do not always present with the typical symptoms seen in young children, making the clinical diagnosis more difficult. The etiology of adult intussusception can be idiopathic, benign, or malignant. Diagnosis is most accurately made with computed tomography, which is sensitive in detecting intussusception as well as potential lead points. Presentation of cases This study presents four adult patients with intussusception. The first three patients are adults with idiopathic intussusception and no evidence of a lead point. The fourth case involves intussusception secondary to a jejunal carcinoid tumor which was treated surgically. Each case has unique features in terms of length and number of intussusceptions, duration of symptoms, and recurrence. Discussion Surgical treatment was once argued to be universally appropriate for adult intussusceptions; however, with increased use of advanced imaging, newer literature is demonstrating that this is not true in all cases. Idiopathic intussusception presents with nonspecific symptoms and can be managed with supportive care when the history and clinical picture indicate low probability of a neoplasm. Conclusion This study aims to raise awareness to the potential diagnosis and management of intussusceptions, particularly the symptomatic idiopathic type in the young adult. PMID:26859872

  5. Essential activities and knowledge domains of case management: new insights from the CCMC role and functions study.

    PubMed

    Tahan, Hussein

    2006-01-01

    The Commission for Case Manager Certification (CCMC) defines case management (CM) as "a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual's health needs. [Case management] uses communication and available resources to promote quality, cost-effective outcomes." The practice of CM spans the entire health-care spectrum, including pre-acute, acute, and post-acute settings, and the involvement of varied care providers, such as nurses, social workers, rehabilitation counselors, physicians, and other allied health professionals. So what does it mean to practice as a case manager? What roles and job functions are performed and what knowledge is required of a professional in the field for effective practice? These highly relevant questions reflect the thinking of the CCMC commissioners when the latest Case Manager Role and Functions study was undertaken. The primary purpose of this research, which is conducted every 5 years by the CCMC, is to capture the current state of CM practice. This type of in-depth research is required to support an evidence-based certification examination such as the one offered by CCMC-the certified case manager (CCM) credential. Moreover, as the first and largest nationally accredited organization to certify US case managers, the CCMC recognizes its responsibility to undertake and promote scientifically conducted research in the field of CM. PMID:16720258

  6. Identification and management of tardive dyskinesia: A case series and literature review.

    PubMed

    Khouzam, Hani Raoul

    2015-01-01

    Tardive dyskinesia (TD) is a serious, disabling and potentially permanent, neurological hyperkinetic movement disorder that occurs after months or years of taking dopamine receptor-blocking agents. The pathophysiology of TD is complex, multifactorial and still not fully understood. Although there is no identified effective and standard treatment for TD, several agents have been tried for the management of this motor disturbance. The aim of this case series is to review the literature in regard to the identification, diagnosis and the treatment of TD with anticholinergics, anticholinergic medication withdrawal, cholinergic agents, botulinum toxin intramuscular injections, tetrabenazine, levetiracetam, propranolol and zolpidem, and to describe one case of TD that responded favorably to clonazepam and two cases of TD that responded favorably to Ginkgo biloba. PMID:26216578

  7. Management of infratentorial subdural hygroma complicating foramen magnum decompression: a report of three cases.

    PubMed

    Bahl, Anuj; Murphy, Mary; Thomas, Nicholas; Gullan, Richard

    2011-05-01

    Decompression of the foramen magnum for symptomatic Chiari malformation attends a small but significant risk of infratentorial subdural extra-arachnoid hygroma when an arachnoid-sparing procedure is attempted. We present three cases whereby an arachnoid-sparing procedure was carried out and resulted in infratentorial subdural hygroma and hydrocephalus. The complication was managed by re-exploration of the posterior fossa and wide arachnoidotomy. In cases whereby the decision has been made to open the dura, we recommend routine arachnoidotomy in foramen magnum decompression, avoiding the risks of infratentorial subdural hygroma. In cases where arachnoid-sparing procedures have been attempted and subdural hygroma subsequently develops, we advocate re-exploration of the posterior fossa rather than cerebrospinal fluid diversion. PMID:21258949

  8. Complete heart block in pregnancy: case report, analysis, and review of anesthetic management.

    PubMed

    Sundararaman, Lalitha; Hochman Cohn, Jennifer; Ranasinghe, J Sudharma

    2016-09-01

    Maternal complete heart block can pose significant challenges for the anesthesiologist in the antepartum, peripartum, and postpartum periods. Some patients may present for the first time in the puerperium with dizziness, weakness, syncope, or congestive heart failure as a result of the additional hemodynamic burden that accompanies pregnancy. Although there is an increase in permanent pacemaker placement in young symptomatic patients before pregnancy, prophylactic placement of pacemakers in asymptomatic parturients is not always indicated. The need for temporary or permanent pacemakers in asymptomatic women should be assessed on a case-by-case basis; many of these patients may be safely managed during labor and delivery without pacing. The parturient with complete heart block must be followed vigilantly during pregnancy and post delivery, as the need for pacemaker insertion can also arise in the postpartum period. We present a case of third-degree heart block in a 26-year-old parturient. PMID:27555134

  9. Retrospective assessment of osteomyelitis. Etiology, demographics, risk factors, and management in 35 cases.

    PubMed

    Koorbusch, G F; Fotos, P; Goll, K T

    1992-08-01

    A retrospective review and analysis of the management of osteomyelitis in 35 patients at a major hospital complex has been made. In this patient population sample, trauma and odontogenic sources were determined to be the most prevalent causes of osteomyelitis of the jaws, which in the vast majority of cases affected the mandible. Alcohol and/or tobacco use was reported in at least one half of the cases surveyed. Surgical exploration and debridement were most frequently used during the treatment of these cases. The microbial causes of these lesions were most frequently mixed infections that originated from the oral cavity. Antimicrobial therapy most often used beta-lactam-bearing antibiotics, although combinations with other agents were often included. These and other data obtained through this study underscore the multifactored causes and therapeutic approaches found in osteomyelitis of the jaws. PMID:1508521

  10. [The management of cases of "conditional" work fitness due to spinal pathologies in health personnel].

    PubMed

    Occhipinti, E

    1999-01-01

    On the basis of the trend in the literature, a process was identified, that uses the results of assessment of exposure to manual handling of patients, in order to practically manage, according to defined priorities, the transfer to other jobs of a large number of cases (about 8-10% of the workforce) that were potentially unfit due to back disorders. Aside from the procedures for clinical classification and grading of the severity of the disorders, which have been dealt with elsewhere, general indications are given for the association of cases of disease with assistance to hospitalised patients according to the spinal involvement required, with appropriate evaluation and classification into different degrees of severity. It is recommended to keep the system of association "cases of disease/workplace" dynamic over time so as to guarantee the best possible working conditions practically and technically achievable, especially for these subjects. PMID:10371831

  11. [Medical management of alleged sexual assault victims in Dakar, Senegal. 25 cases].

    PubMed

    Diouf, A; Gaye, A; Sangare, M; Ba Gueye, M; Diadhiou, F

    1995-04-01

    Sexual assaults constitute a prominent fact of our societies to this end twentieth Century. Then its's very important for physicians to be informed about obstacles encoured to manage assaults victims. Our study presents 25 cases of sexual assaults listed in Obstetrics and Gynecology Clinics of University Center Hospital of Dakar. It works out that: there are adolescents in most cases (85%); delay of examination is too long (11 cases beyond 24 hours) and compromises cytologic exams; injuries evaluation is sometimes negative; no lesion of anal sodomy is found. The authors insist to provide more informations to physicians to overcome evaluation of assault victim which has an impact for legal proceeding against offender. They call gaps to fill up un senegalese jurisprudence about assault victim who gets an accidental pregnancy. PMID:7757135

  12. Improving IT Service Management Processes: A Case Study on IT Service Support

    NASA Astrophysics Data System (ADS)

    Lahtela, Antti; Jäntti, Marko

    IT services and IT service management play a very important role in the today's IT industry. Software as service approach enables IT customers to focus on using the software while IT service providers take care of the installation, configuration, support and maintenance activities. Various process frameworks can be used to improve IT service management processes. The most widely used IT service management framework is the IT Infrastructure Library (ITIL) that provides best practices for IT service providers on how to design, manage and support IT services. Despite the IT service management process frameworks, implementing an effective service support interface between an IT service provider and an IT customer is a big challenge. The research problem in this study is: what types of challenges are related to the service support interface between an IT service provider and IT customers. The main contribution of this paper is present challenges in a service support interface identified during a case study with a large IT service provider company in Finland.

  13. Ocean acidification: Linking science to management solutions using the Great Barrier Reef as a case study.

    PubMed

    Albright, Rebecca; Anthony, Kenneth R N; Baird, Mark; Beeden, Roger; Byrne, Maria; Collier, Catherine; Dove, Sophie; Fabricius, Katharina; Hoegh-Guldberg, Ove; Kelly, Ryan P; Lough, Janice; Mongin, Mathieu; Munday, Philip L; Pears, Rachel J; Russell, Bayden D; Tilbrook, Bronte; Abal, Eva

    2016-11-01

    Coral reefs are one of the most vulnerable ecosystems to ocean acidification. While our understanding of the potential impacts of ocean acidification on coral reef ecosystems is growing, gaps remain that limit our ability to translate scientific knowledge into management action. To guide solution-based research, we review the current knowledge of ocean acidification impacts on coral reefs alongside management needs and priorities. We use the world's largest continuous reef system, Australia's Great Barrier Reef (GBR), as a case study. We integrate scientific knowledge gained from a variety of approaches (e.g., laboratory studies, field observations, and ecosystem modelling) and scales (e.g., cell, organism, ecosystem) that underpin a systems-level understanding of how ocean acidification is likely to impact the GBR and associated goods and services. We then discuss local and regional management options that may be effective to help mitigate the effects of ocean acidification on the GBR, with likely application to other coral reef systems. We develop a research framework for linking solution-based ocean acidification research to practical management options. The framework assists in identifying effective and cost-efficient options for supporting ecosystem resilience. The framework enables on-the-ground OA management to be the focus, while not losing sight of CO2 mitigation as the ultimate solution. PMID:27564868

  14. Nurse Case Management and Housing Interventions Reduce Allergen Exposures: The Milwaukee Randomized Controlled Trial

    PubMed Central

    Breysse, Jill; Wendt, Jean; Dixon, Sherry; Murphy, Amy; Wilson, Jonathan; Meurer, John; Cohn, Jennifer; Jacobs, David E.

    2011-01-01

    Objective We examined the impact of a combination of home environmental interventions and nurse case management services on total settled dust loadings and on allergen concentrations in the homes of asthmatic children. Methods Using a randomized longitudinal controlled trial study design, we randomly assigned homes of asthmatic children in Milwaukee to either a control (n=64) or an intervention (n=57) group. Control group homes received a visual assessment, education, bed/pillow dust mite encasings, and treatment of lead-based paint hazards. The intervention group received these same services plus nurse case management that included tailored, individual asthma action plans, provision of minor home repairs, home cleaning using special vacuuming and wet washing, and integrated pest management. Dust vacuum samples were collected from measured surface areas of floors in the TV room, kitchen, and child's bedroom at baseline and at three-, six-, and 12-month follow-up visits. Dust loading (mass per surface area) is a means of measuring total dust and the total amount of allergen present. Results For the intervention group, geometric mean dust loadings declined significantly from baseline (39 milligrams per square foot [mg/ft2]) to post-intervention (11 mg/ft2) (p<0.001). Baseline dust loading, treatment group, visit, and season were significant predictors of follow-up dust loadings. Mean post-intervention dust loadings were 72% higher in the control group. The total amount of allergen in settled house dust declined significantly following the intervention because total dust loading declined; the concentration of allergens in settled dust did not change significantly. Conclusion The combination of nurse case management and home environmental interventions promotes collaboration between health and housing professionals and is effective in reducing exposures to allergens in settled dust. PMID:21563716

  15. Clinical Spectrum and Management of Caustic Ingestion: A Case Series Presenting Three Opposing Outcomes.

    PubMed

    Vezakis, Antonios I; Pantiora, Eirini V; Kontis, Elissaios A; Sakellariou, Vasileios; Theodorou, Dimitrios; Gkiokas, Georgios; Polydorou, Andreas A; Fragulidis, Georgios P

    2016-01-01

    BACKGROUND Ingestion of caustic substances is a medical emergency in both the adult and pediatric population and is associated with high morbidity and mortality. The extent of injuries after ingestion of caustic substances depends on the nature, amount, and concentration of the agent and on the exposure time. Acutely, caustic substances may cause massive hemorrhage and gastrointestinal tract perforation; the most markedly affected cases require urgent surgical treatment. Patients surviving the initial event may present with aorto-enteric or gastrocolic fistulae, esophageal strictures, dysphagia, and increased risk of esophageal cancer as long term sequelae. CASE REPORT The features of three cases of caustic ingestion are reported to demonstrate significantly different complaints presented at the emergency department. Two patients had free gastric perforation, one at presentation, and one delayed. The third patient presented with late severe strictures of the esophagus and pylorus. The outcomes of the three patients are discussed in detail along with the most current management strategies. CONCLUSIONS Among adults, ingestion of caustic substances is usually associated with more severe lesions due to the increased amount of ingested substance, as compared with pediatric patients. The most serious presentation is that of visceral perforation, most commonly of the stomach and rarely of the esophagus. Management involves urgent resuscitation with correction of fluid and electrolyte and acid-base abnormalities and immediate surgical exploration in those patients with signs of perforation. Once the perioperative period is managed successfully, the long-term results can be satisfactory. Managing of strictures or else reconstructive procedures must be well timed to allow for psychological and nutritional rehabilitation. PMID:27197994

  16. A case of severe ectopic ACTH syndrome from an occult primary – diagnostic and management dilemmas

    PubMed Central

    Griffin, Katherine; Amer, Saima

    2015-01-01

    Summary Resection of primary tumour is the management of choice in patients with ectopic ACTH syndrome. However, tumours may remain unidentified or occult in spite of extensive efforts at trying to locate them. This can, therefore, pose a major management issue as uncontrolled hypercortisolaemia can lead to life-threatening infections. We present the case of a 66-year-old gentleman with ectopic ACTH syndrome from an occult primary tumour with multiple significant complications from hypercortisolaemia. Ectopic nature of his ACTH-dependent Cushing's syndrome was confirmed by non-suppression with high-dose dexamethasone suppression test and bilateral inferior petrosal sinus sampling. The primary ectopic source remained unidentified in spite of extensive anatomical and functional imaging studies, including CT scans and Dotatate-PET scan. Medical adrenolytic treatment at maximum tolerated doses failed to control his hypercortisolaemia, which led to recurrent intra-abdominal and pelvic abscesses, requiring multiple surgical interventions. Laparoscopic bilateral adrenalectomy was considered but decided against given concerns of technical difficulties due to recurrent intra-abdominal infections and his moribund state. Eventually, alcohol ablation of adrenal glands by retrograde adrenal vein approach was attempted, which resulted in biochemical remission of Cushing's syndrome. Our case emphasizes the importance of aggressive management of hypercortisolaemia in order to reduce the associated morbidity and mortality and also demonstrates that techniques like percutaneous adrenal ablation using a retrograde venous approach may be extremely helpful in patients who are otherwise unable to undergo bilateral adrenalectomy. Learning points Evaluation and management of patients with ectopic ACTH syndrome from an unidentified primary tumour can be very challenging.Persisting hypercortisolaemia in this setting can lead to debilitating and even life-threatening complications and hence

  17. Drivers in current and future municipal solid waste management systems: cases in Yokohama and Boston.

    PubMed

    Contreras, Francisco; Ishii, Satoshi; Aramaki, Toshiya; Hanaki, Keisuke; Connors, Stephen

    2010-01-01

    Despite some progress, municipal solid waste (MSW) still poses pressure on cities and remains one of the major challenges in environmental management. There is no single solution to the problem since the drivers behind MSW systems may vary significantly from city to city. In this context, the development of a common strategy to attain a sustainable management has been increasingly difficult. This paper presents an issue-driven analytical framework to evaluate the past, present and future MSW management strategy for the cities of Yokohama and Boston considering four driver categories while evaluating if the relevance of these drivers has changed over time. These categories represent: (i) legal drivers (e.g. laws and regulations); (ii) technology development and institutional drivers (e.g. available technologies); (iii) regional and international drivers (e.g. solid waste flow as recyclable resources); and (iv) socio-economic drivers (e.g. population trends and public awareness). The analysis indicated that solid waste management capacity for both cases was under stress due to different reasons. In the case of Boston, the moratorium for disposal facilities played an important role while increasing population was a key driver for the city of Yokohama. The future management scenario suggests that various waste-to-energy alternatives and strong solid waste reduction policies will play a key role for Boston. In Yokohama, a shift on waste composition and generation triggered by a demographic change may open the path for new technologies while also considering the international demand of solid waste as a recyclable resource. PMID:19942650

  18. The political economy of a public health case management program's transition into medical homes.

    PubMed

    Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

    2015-11-01

    Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. PMID:26460509

  19. Occam's razor in the management of ventriculoperitoneal shunt dysfunction: Diagnosis and management of an unusual pediatric case.

    PubMed

    Dadlani, Ravi; Dadlani, Reena; Ghosal, Nandita; Hegde, Alangar

    2015-01-01

    Ventriculoperitoneal (VP) shunt surgery is probably the commonest surgical procedure in neurosurgery. Belying its technical simplicity is the myriad complications associated with it. Shunt malfunction is a common complication associated with this surgery, second only to shunt related infections, which may be associated with it. Sterile cerebrospinal fluid (CSF) eosinophilia (CE) has been reported with VP shunts, which may or may not be related to the dysfunction. Eosinophilia in the CSF has also been associated with a number of other conditions including parasitic infestations in the brain. This may be unrelated to the shunt surgery. We present a case of a child, operated earlier for hydrocephalus, who presented with sub-acute loss of vision and bilateral oculomotor paresis. CSF from a chamber tap revealed eosinophilia. The commonest presenting symptom of shunt malfunction is raised intracranial pressure. There are no reports in the literature of VP shunt malfunction presenting with bilateral oculomotor paresis and decreased visual acuity. The associated CE complicated the clinical picture, especially since the initial brain radiology was normal. We discuss the clinical differential diagnosis of this very interesting presentation, management dilemmas and outcome in this child. This rare clinical presentation was found to be the result of a shunt malfunction and not due to any rare parasitic infestation of the brain. Occam's razor dictates that the simplest explanation in a given situation is usually the most accurate, as is seen in this case. PMID:25972962

  20. Placenta Previa Percreta: A Case Report of Successful Management via Conservative Surgery

    PubMed Central

    Canonico, Silvia; Arduini, Maurizio; Epicoco, Giorgio; Luzi, Giuseppe; Arena, Saverio; Clerici, Graziano; Affronti, Giuseppe

    2013-01-01

    Placenta percreta is one of the most serious complications of placenta previa and is frequently associated with severe obstetric hemorrhage usually necessitating hysterectomy. We present a case of placenta previa percreta diagnosed by ultrasound and magnetic resonance imaging techniques, in which we accomplished conservative management of postpartum hemorrhage. The management we propose includes the following steps: preventive catheterization of the descending aorta via transhumeral access; Stark cesarean delivery; uterotonics drugs; Affronti endouterine square hemostatic sutures; intrauterine application of Bakri balloon and partial filling with 100 mL of normal saline; B Lynch suture, hysterorrhaphy, and filling a Bakri balloon with up to 500 mL of normal saline; reversible radiological embolization; and/or surgical ligation of the uterine arteries. The bleeding stopped following placement of Affronti sutures combined with external (B-Lynch suture) and internal (Bakri balloon) uterine compression. Our experience indicates that this conservative method can be considered an option in the management of selected cases of pregnancy at high risk for intrapartum hemorrhage. PMID:23401816