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Sample records for attempt case management

  1. Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program.

    PubMed

    Park, Soyoung; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

    2015-10-01

    Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the participation group (n = 262) and the refusal group (n = 227) according to their participation in the case management program. Demographic and clinical characteristics of each group were examined. Results showed that the refusal group had low risks for suicide in terms of risk factors related with psychopathologies and presenting suicide behavior. That is, the refusal group had less patients with co-morbid medical illnesses and more patients with mild severity of depression compared to the participation group. However, the refusal group had more interpersonal conflict, more isolation of social integrity, and more impaired insight about suicide attempt. The results suggest that nonparticipation in the case management program may depend upon the patient's impaired insight about the riskiness of suicide and lack of social support. PMID:26425048

  2. Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program.

    PubMed

    Park, Soyoung; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

    2015-10-01

    Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the participation group (n = 262) and the refusal group (n = 227) according to their participation in the case management program. Demographic and clinical characteristics of each group were examined. Results showed that the refusal group had low risks for suicide in terms of risk factors related with psychopathologies and presenting suicide behavior. That is, the refusal group had less patients with co-morbid medical illnesses and more patients with mild severity of depression compared to the participation group. However, the refusal group had more interpersonal conflict, more isolation of social integrity, and more impaired insight about suicide attempt. The results suggest that nonparticipation in the case management program may depend upon the patient's impaired insight about the riskiness of suicide and lack of social support.

  3. Coping Card Usage can Further Reduce Suicide Reattempt in Suicide Attempter Case Management Within 3-Month Intervention.

    PubMed

    Wang, Ying-Chuan; Hsieh, Ling-Yu; Wang, Ming-Yu; Chou, Cheng-Hsiang; Huang, Min-Wei; Ko, Huei-Chen

    2016-02-01

    This randomized controlled trial was designed to evaluate the effectiveness of using crisis coping cards (n = 32) in the case management of suicide prevention compared with case management without the use of coping cards (n = 32) over a 3-month intervention period. The generalized estimating equation was used to examine the interaction effect between treatments and time on suicide risk, depression, anxiety, and hopelessness. Results indicated that subsequent suicidal behaviors, severity of suicide risk, depression, anxiety, and hopelessness were reduced more in the coping card intervention group compared to the case management only group. Moreover, for the survival curves of time to suicide reattempt, the coping card group showed a significantly longer time to reattempt than the case management only group at 2-month and 3-month intervention periods.

  4. A very unusual case of attempted suicide

    PubMed Central

    Jabłoński, Sławomir; Dziwińska, Katarzyna; Terlecki, Artur

    2016-01-01

    We would like to present a case report of a very unusual suicide attempt. A 48-year-old female patient tried to commit suicide by stabbing herself with a kitchen knife into her neck. Suicide by self-stabbing is uncommon, constituting only 1-3% of suicide attempts. Patients with self-inflicted stab wounds may have a higher incidence of surgical interventions based on the stab location. Surprisingly, the mortality associated with this kind of wound is low. Most medical centers have very limited experience with this infrequent injury. There are only a few case reports and small series published in the literature of the subject. PMID:27516789

  5. A very unusual case of attempted suicide.

    PubMed

    Misiak, Piotr; Jabłoński, Sławomir; Dziwińska, Katarzyna; Terlecki, Artur

    2016-06-01

    We would like to present a case report of a very unusual suicide attempt. A 48-year-old female patient tried to commit suicide by stabbing herself with a kitchen knife into her neck. Suicide by self-stabbing is uncommon, constituting only 1-3% of suicide attempts. Patients with self-inflicted stab wounds may have a higher incidence of surgical interventions based on the stab location. Surprisingly, the mortality associated with this kind of wound is low. Most medical centers have very limited experience with this infrequent injury. There are only a few case reports and small series published in the literature of the subject. PMID:27516789

  6. A case of attempted suicide by self-hanging.

    PubMed

    Braye, S G; Guy, G

    1985-03-01

    A young man arrived at the accident and emergency department after attempting suicidal self-hanging. He was cyanosed and showed severe respiratory distress. His posture, hyperreflexia and state of consciousness suggested decerebration. A dire prognosis was expected. Four days later he recovered. No residual physical or mental sequelae were found during follow up. The "post-suspension syndrome" in our case was similar to those recorded in several continental reviews. Apart from a case report of a "miraculous deliverance" following an unsuccessful judicial hanging at Oxford in 1650, no other report of this syndrome has been made in the English literature. This syndrome has an excellent prognosis and requires very little active intervention to ensure a favourable outcome.

  7. 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.

  8. 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

  9. Penetrating Brain Injury after Suicide Attempt with Speargun: Case Study and Review of Literature

    PubMed Central

    Williams, John R.; Aghion, Daniel M.; Doberstein, Curtis E.; Cosgrove, G. Rees; Asaad, Wael F.

    2014-01-01

    Penetrating cranial injury by mechanisms other than gunshots are exceedingly rare, and so strategies and guidelines for the management of PBI are largely informed by data from higher-velocity penetrating injuries. Here, we present a case of penetrating brain injury by the low-velocity mechanism of a harpoon from an underwater fishing speargun in an attempted suicide by a 56-year-old Caucasian male. The case raised a number of interesting points in management of low-velocity penetrating brain injury (LVPBI), including benefit in delaying foreign body removal to allow for tamponade; the importance of history-taking in establishing the social/legal significance of the events surrounding the injury; the use of cerebral angiogram in all cases of PBI; advantages of using dual-energy CT to reduce artifact when available; and antibiotic prophylaxis in the context of idiosyncratic histories of usage of penetrating objects before coming in contact with the intracranial environment. We present here the management of the case in full along with an extended discussion and review of existing literature regarding key points in management of LVPBI vs. higher-velocity forms of intracranial injury. PMID:25071701

  10. Attempted suicide or hitting the nail on the head. Case report.

    PubMed

    Spiers, A S

    1994-12-01

    A case is reported of attempted suicide by hammering nails through the skull into the brain. This unique attempt at self-destruction was unsuccessful and the treatment, initially by an untrained first-aider and then by a neurosurgeon, was surprisingly simple. There were no long-term sequelae. PMID:7861109

  11. Sleep problems and suicide attempts among adolescents: a case-control study.

    PubMed

    Koyawala, Neel; Stevens, Jack; McBee-Strayer, Sandra M; Cannon, Elizabeth A; Bridge, Jeffrey A

    2015-01-01

    This study used a case-control design to compare sleep disturbances in 40 adolescents who attempted suicide with 40 never-suicidal adolescents. Using hierarchical logistic regression analyses, we found that self-reported nighttime awakenings were significantly associated with attempted suicide, after controlling for antidepressant use, antipsychotic use, affective problems, and being bullied. In a separate regression analysis, the parent-reported total sleep problems score also predicted suicide attempt status, controlling for key covariates. No associations were found between suicide attempts and other distinct sleep problems, including falling asleep at bedtime, sleeping a lot during the day, trouble waking up in the morning, sleep duration, and parent-reported nightmares. Clinicians should be aware of sleep problems as potential risk factors for suicide attempts for adolescents.

  12. Alcohol Abuse and Suicide Attempt in Iran: A Case-Crossover Study

    PubMed Central

    Ghanbari, Behrooz; Malakouti, Seyed Kazem; Nojomi, Marzieh; Leo, Diego De; Saeed, Khalid

    2016-01-01

    Alcohol use and its disorders are associated with increased risk of suicidal behaviors Research has shown that 6-8% of those who use alcohol have a history of suicide attempt. Given the prohibition of alcohol use legally, the increased alcohol consumption, and the lack of strong evidence in favor of its use associated with suicide in Iran, this study was conducted to determine the link between suicide attempt and alcohol abuse. The case-crossover method was used in this research. Out of 305 referrals to the emergency room due to a suicide attempt, 100 reported drinking alcohol up to six hours before their attempt. Paired Matching and Usual Frequency were employed to analyze the data with STATA 12.0. The probability of attempting suicide up to six hours after drinking alcohol appeared increased by 27 times (95% CI: 8.1-60.4). Separate analysis for each of these hours from the first to the sixth hour after alcohol use was also performed. Fifty percent of attempted suicides happened one hour after alcohol use. Relative risk for the first and second hour was 10% and 5% respectively. Alcohol use is a strong proximal risk factor for attempted suicide among Iranian subjects. Prevention of alcohol use should be considered in setting up of the national Suicide attempt prevention program. PMID:26925903

  13. Attempted Serial Neonaticides: Case Report and a Brief Review of the Literature.

    PubMed

    Barros, Alcina Juliana Soares; Rosa, Regis Goulart; Telles, Lisieux Elaine de Borba; Taborda, José Geraldo Vernet

    2016-01-01

    Neonaticide is an infant murder occurring on the day of birth. The case reports found in the literature are often focused on the mother as the agent in the context of pregnancy denial, dissociative symptoms, or psychosis. However, this report describes a rare case of attempted serial neonaticides, in which the acts were committed by a nurse at the nursery of a referral hospital in Brazil. The authors describe a forensic psychiatric evaluation for criminal responsibility and correlate the information from this particular case with relevant forensic themes, namely neonaticide, Munchausen by proxy syndrome, and serial healthcare killers. PMID:26259153

  14. Attempted Serial Neonaticides: Case Report and a Brief Review of the Literature.

    PubMed

    Barros, Alcina Juliana Soares; Rosa, Regis Goulart; Telles, Lisieux Elaine de Borba; Taborda, José Geraldo Vernet

    2016-01-01

    Neonaticide is an infant murder occurring on the day of birth. The case reports found in the literature are often focused on the mother as the agent in the context of pregnancy denial, dissociative symptoms, or psychosis. However, this report describes a rare case of attempted serial neonaticides, in which the acts were committed by a nurse at the nursery of a referral hospital in Brazil. The authors describe a forensic psychiatric evaluation for criminal responsibility and correlate the information from this particular case with relevant forensic themes, namely neonaticide, Munchausen by proxy syndrome, and serial healthcare killers.

  15. "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…

  16. The effectiveness of control strategies for dementia-driven wandering, preventing escape attempts: a case report.

    PubMed

    Padilla, Daniel Valle; González, María Teresa Daza; Agis, Inmaculada Fernández; Strizzi, Jenna; Rodríguez, Raquel Alarcón

    2013-03-01

    One of the most complicated aspects of caring for patients with dementia is dementia-driven wandering due to its adverse ramifications. We report a case of an 80-year-old man who had been previously diagnosed with dementia (with a score of 6 on the Reisberg Global Deterioration Scale - GDS). The patient went to an Adult Day Care Center on a daily basis where he demonstrated wandering behavior with a high rate of escape attempts (the number of times the Center's glass exit door was approached). The objective of this study is to present effective non-pharmacological intervention strategies for dementia-driven wandering; assessed strategies included: environmental (subjective barriers), cognitive/behavioral (cognitive training with differential reinforcement), and combined (subjective barriers + cognitive/behavioral). The results showed that all of these three strategies significantly decreased the number of escape attempts.

  17. An Unusual Case of Suicide Attempt Using Intravenous Injection of Kerosene.

    PubMed

    Hasan, M N; Sutradhar, S R; Ahmed, S M; Chowdhury, I H

    2016-07-01

    Kerosene belongs to the hydrocarbon group of compounds, used as a fuel for lamps, as well as heating and cooking in developing countries. Accidental kerosene poisoning and intoxication usually occur by inhalation or by occupational percutaneous absorption. Adults usually ingest kerosene for the purpose of self-harm, and children may ingest accidentally. Suicidal attempt using intravenous kerosene is an extra ordinary and very rare occurrence. A very few data are available regarding effects of intravenous administration of kerosene and its management. PMID:27612910

  18. Attempted suicide by cop: a case study of traumatic brain injury and the insanity defense.

    PubMed

    Bresler, Scott; Scalora, Mario J; Elbogen, Eric B; Moore, Y Scott

    2003-01-01

    Over the years, there have been a number of well-publicized incidents involving persons who seemingly maneuver police officers into shooting them. Such cases, while relatively rare compared with most forms of violence, nevertheless pose difficult challenges to law enforcement agencies. Relatively little is known about persons who engage in suicide by cop incidents. To our knowledge, there has been no published indepth research on instigators of suicide by cop who survived. In this paper, we present a case study of an individual who engaged in and lived through three separate "attempted suicide by cop" incidents. After describing relevant history as well as events of the most recent incident, we compare the case with the extant literature on suicide by cop and analyze commonalities and differences. Finally, we examine the legal considerations involved, with particular attention devoted to the role the individual's traumatic brain injury played in applying the insanity defense.

  19. A Case of Attempted Suicide in Huntington's Disease: Ethical and Moral Considerations.

    PubMed

    Furfari, Kristin; Zehnder, Nichole; Abbott, Jean

    2016-01-01

    A 62-year-old female with Huntington's disease presented after a suicide attempt. Her advance directive stated that she did not want intubation or resuscitation, which her family acknowledged and supported. Despite these directives, she was resuscitated in the emergency department and continued to state that she would attempt suicide again. Her suicidality in the face of a chronic and advancing illness, and her prolonged consistency in her desire to take her own life, left careproviders wondering how to provide ethical, respectful care to this patient. Tension between the ethical principles of autonomy and beneficence is central in this case. The patient's narrative demonstrated that her suicide was an autonomous decision, free from coercion or disordered thinking from mental illness. Beneficence then would seem to necessitate care aligned with the patient's desire to end her life, which created ethical uneasiness for her family and careproviders. The case highlights several end-of-life ethical considerations that have received much recent attention. With ongoing discussions about the legalization of aid in dying across the country, caregivers are challenged to understand what beneficence means in people with terminal illnesses who want a say in their death. This case also highlights the profound moral distress of families and careproviders that arises in such ethically challenging scenarios.

  20. Delayed akathisia and suicidal attempts following epidural droperidol infusion--a case report.

    PubMed

    Hung, Y C; Ho, Y Y; Shen, C L

    1999-09-01

    Epidural administration of droperidol has been used to prevent postoperative nausea and vomiting (PONV) caused by opioids, but the adverse reactions were relatively neglected. We present a patient who received patient-controlled epidural analgesia (PCEA) with bupivacaine-morphine-droperidol mixture for one and half days following hemorrhoidectomy, developed paroxysmal adverse reactions of akathisia, dysphoria, and suicidal attempts 3 days after the initiation of the treatment. The use of droperidol in PCEA for prevention of nausea and vomiting therefore needs to be re-evaluated according to the serious side effects occurring in our case.

  1. 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

  2. A Case Report of Prolonged Apnea during ECT in a Patient with Suicidal Attempt by Organophosphorus Poison.

    PubMed

    Moudi, Sussan; Alijanpour, Ebrahim; Manouchehri, Ali-Asghar; Jafarian, Hasan

    2012-01-01

    Organophosphorus pesticides have been used in some cases for suicidal attempts. Such poison can affect plasma cholinesterase activity. The case was a 47-year-old man hospitalized due to suicide attempt with swallowing agricultural poison. The patient, diagnosed with major depressive disorder (MDD), underwent treatment with electroconvulsive therapy (ECT). At the first ECT session, the patient developed apnea for 45 minutes following receiving 20 mg succinylcholine. The patient was intubated; after restoration of respiration depth and rate, the patient was extubated. Collectively, in cases with history of suicide attempts, taking organophosphorus pesticides should be warn for pre-ECT anesthesia. PMID:24644472

  3. A Case Report of Prolonged Apnea during ECT in a Patient with Suicidal Attempt by Organophosphorus Poison

    PubMed Central

    Moudi, Sussan; Alijanpour, Ebrahim; Manouchehri, Ali-asghar; Jafarian, Hasan

    2012-01-01

    Organophosphorus pesticides have been used in some cases for suicidal attempts. Such poison can affect plasma cholinesterase activity. The case was a 47-year-old man hospitalized due to suicide attempt with swallowing agricultural poison. The patient, diagnosed with major depressive disorder (MDD), underwent treatment with electroconvulsive therapy (ECT). At the first ECT session, the patient developed apnea for 45 minutes following receiving 20 mg succinylcholine. The patient was intubated; after restoration of respiration depth and rate, the patient was extubated. Collectively, in cases with history of suicide attempts, taking organophosphorus pesticides should be warn for pre-ECT anesthesia. PMID:24644472

  4. An attempt at the computer-aided management of HIV infection

    NASA Astrophysics Data System (ADS)

    Ida, A.; Oharu, Y.; Sankey, O.

    2007-07-01

    The immune system is a complex and diverse system in the human body and HIV virus disrupts and destroys it through extremely complicated but surprisingly logical process. The purpose of this paper is to make an attempt to present a method for the computer-aided management of HIV infection process by means of a mathematical model describing the dynamics of the host pathogen interaction with HIV-1. Treatments for the AIDS disease must be changed to more efficient ones in accordance with the disease progression and the status of the immune system. The level of progression and the status are represented by parameters which are governed by our mathematical model. It is then exhibited that our model is numerically stable and uniquely solvable. With this knowledge, our mathematical model for HIV disease progression is formulated and physiological interpretations are provided. The results of our numerical simulations are visualized, and it is seen that our results agree with medical aspects from the point of view of antiretroviral therapy. It is then expected that our approach will take to address practical clinical issues and will be applied to the computer-aided management of antiretroviral therapies.

  5. [Are near-death experiences following attempted suicide important for suicide risk assessment? A case report].

    PubMed

    Kralovec, Karl; Plöderl, Martin; Aistleiner, Ursula; Fartacek, Clemens; Fartacek, Reinhold

    2009-01-01

    We describe a 59-year old patient who reported a near-death experience following attempted suicide. The near-death experience induced reduction of suicidality. Previous studies suggested a high prevalence of near-death experiences following attempted suicide and that near-death experiences may decrease rather than increase subsequent suicide risk. Implications for suicide risk assessment are discussed.

  6. Copycat suicidal attempt by a 7 year old boy after watching homicidal behavior in media: a case report

    PubMed Central

    2009-01-01

    Introduction Suicidal behavior in media may promote others towards suicide. No published study was found about suicidal attempt in children less than 10 years old after watching a homicidal behavior. Case presentation This is a report of a 7 year old boy referred because he hanged himself after watching homicidal behavior of hanging in a fictional movie. Discussion To the author's knowledge, there was no published report of copycat suicidal attempt in a 7 year old child after watching a homicidal behavior in media. This report warns about an imitative effect of movie watching of homicidal behavior on suicidal attempt. PMID:19138418

  7. Characteristics of Impulsive Suicide Attempts and Attempters.

    ERIC Educational Resources Information Center

    Simon, Thomas R.; Swann, Alan C.; Powell, Kenneth E.; Potter, Lloyd B.; Kresnow, Marcie-jo; O'Carroll, Patrick W.

    2002-01-01

    Examined impulsive suicide attempts within a population-based, case-control study of nearly lethal suicide attempts among adolescents and young adults. Impulsive attempts were more likely among those who had been in a physical fight and less likely among those who were depressed. Findings suggest inadequate control of aggressive impulses as a…

  8. [Case management: a concept analysis].

    PubMed

    Yu, Chien-Tai; Feng, Ming-Chu; Ko, Nai-Ying

    2013-08-01

    While the case management approach has been increasingly applied to healthcare worldwide in recent years, significant differences in application exist among discrete medical systems. This paper applies a methodology outlined by Walker and Avant to analyze the case management concept. This methodology is designed to assist medical staff to understand a concept in order to better achieve concept goals. The case management approach works to leverage organizational strategies to resolve case-specific circumstances and issues in order to accomplish organizational goals. Defining attributes of case management include: (1) highly complex cases; (2) the use of multidisciplinary professional teams to resolve case problems in the most cost-effective manner; (3) the use of case managers to manage the effective integration and operation of the multidisciplinary team; and (4) helping cases improve and make effective use of medical system resources.

  9. A Cognitive Therapy Intervention for Suicide Attempters: An Overview of the Treatment and Case Examples

    ERIC Educational Resources Information Center

    Berk, Michele S.; Henriques, Gregg R.; Warman, Debbie M.; Brown, Gregory K.; Beck, Aaron T.

    2004-01-01

    Although suicidal behavior is a serious public health problem, few effective treatments exist to treat this population. This article describes a new cognitive therapy intervention that has been developed for treating recent suicide attempters. The intervention is based on general principles of cognitive therapy and targets the automatic thoughts…

  10. Is religiosity a protective factor against attempted suicide: a cross-cultural case-control study.

    PubMed

    Sisask, Merike; Varnik, Airi; Kolves, Kairi; Bertolote, Jose M; Bolhari, Jafar; Botega, Neury J; Fleischmann, Alexandra; Vijayakumar, Lakshmi; Wasserman, Danuta

    2010-01-01

    This cross-cultural study investigates whether religiosity assessed in three dimensions has a protective effect against attempted suicide. Community controls (n = 5484) were more likely than suicide attempters (n = 2819) to report religious denomination in Estonia (OR = 0.5) and subjective religiosity in four countries: Brazil (OR = 0.2), Estonia (OR = 0.5), Islamic Republic of Iran (OR = 0.6), and Sri Lanka (OR = 0.4). In South Africa, the effect was exceptional both for religious denomination (OR = 5.9) and subjective religiosity (OR = 2.7). No effects were found in India and Vietnam. Organizational religiosity gave controversial results. In particular, subjective religiosity (considering him/herself as religious person) may serve as a protective factor against non-fatal suicidal behavior in some cultures. PMID:20112143

  11. Superior thyroid artery pseudoaneurysm and arteriovenous fistula following attempted internal jugular venous access and its management

    PubMed Central

    Khera, Pushpinder Singh; Moses, Vinu; Ahmed, Munawwar; Kakde, Shailesh

    2015-01-01

    Vascular injury during common jugular venous (IJV) access is a rare complication, usually involving injury to the common carotid artery. We describe a previously unreported complication of iatrogenic injury of IJV access involving a branch of the superior thyroid artery, and its endovascular management. PMID:25709159

  12. Analysis of hydrogen cyanide in air in a case of attempted cyanide poisoning.

    PubMed

    Magnusson, R; Nyholm, S; Åstot, C

    2012-10-10

    A 32-year-old man attempted to poison his ex-girlfriend with hydrogen cyanide by hiding the pesticide Uragan D2 in her car. During the police investigation, chemical analysis of the air inside the car was performed. Hydrogen cyanide was detected through on-site air analysis using a portable Fourier transform infrared (FTIR) spectroscopy gas analyzer and colorimetric gas detection tubes. Furthermore, impinger air-sampling was performed for off-site sample preparation and analysis by gas chromatography-mass spectrometry (GC-MS). All three independent techniques demonstrated the presence of hydrogen cyanide, at concentrations of 14-20 ppm. Owing to the high volatility of hydrogen cyanide, the temperature and the time since exposure have a substantial effect on the likelihood of detecting hydrogen cyanide at a crime scene. The prevailing conditions (closed space, low temperature) must have supported the preservation of HCN in the car thus enabling the identification even though the analysis was performed several days after the hydrogen cyanide source was removed. This paper demonstrates the applicability of combining on-site FTIR measurements and off-site GC-MS analysis of a crime scene in order to ensure fast detection as well as unambiguous identification for forensic purposes of hydrogen cyanide in air. PMID:22704552

  13. Analysis of hydrogen cyanide in air in a case of attempted cyanide poisoning.

    PubMed

    Magnusson, R; Nyholm, S; Åstot, C

    2012-10-10

    A 32-year-old man attempted to poison his ex-girlfriend with hydrogen cyanide by hiding the pesticide Uragan D2 in her car. During the police investigation, chemical analysis of the air inside the car was performed. Hydrogen cyanide was detected through on-site air analysis using a portable Fourier transform infrared (FTIR) spectroscopy gas analyzer and colorimetric gas detection tubes. Furthermore, impinger air-sampling was performed for off-site sample preparation and analysis by gas chromatography-mass spectrometry (GC-MS). All three independent techniques demonstrated the presence of hydrogen cyanide, at concentrations of 14-20 ppm. Owing to the high volatility of hydrogen cyanide, the temperature and the time since exposure have a substantial effect on the likelihood of detecting hydrogen cyanide at a crime scene. The prevailing conditions (closed space, low temperature) must have supported the preservation of HCN in the car thus enabling the identification even though the analysis was performed several days after the hydrogen cyanide source was removed. This paper demonstrates the applicability of combining on-site FTIR measurements and off-site GC-MS analysis of a crime scene in order to ensure fast detection as well as unambiguous identification for forensic purposes of hydrogen cyanide in air.

  14. Case Management: Service or Symptom?

    ERIC Educational Resources Information Center

    Netting, F. Ellen

    1992-01-01

    Provides overview of case management, its history, and contemporary models. Examines challenges that case management poses for social work profession: covering up issue that health and human services delivery system is nonsystem; maintaining client-centered perspective in cost-obsessed environment; dealing with quality control; coping with…

  15. Five-Year Olds, but Not Chimpanzees, Attempt to Manage Their Reputations

    PubMed Central

    Engelmann, Jan M.; Herrmann, Esther; Tomasello, Michael

    2012-01-01

    Virtually all theories of the evolution of cooperation require that cooperators find ways to interact with one another selectively, to the exclusion of cheaters. This means that individuals must make reputational judgments about others as cooperators, based on either direct or indirect evidence. Humans, and possibly other species, add another component to the process: they know that they are being judged by others, and so they adjust their behavior in order to affect those judgments – so-called impression management. Here, we show for the first time that already preschool children engage in such behavior. In an experimental study, 5-year-old human children share more and steal less when they are being watched by a peer than when they are alone. In contrast, chimpanzees behave the same whether they are being watched by a groupmate or not. This species difference suggests that humans' concern for their own self-reputation, and their tendency to manage the impression they are making on others, may be unique to humans among primates. PMID:23119015

  16. Health policy and case management.

    PubMed

    Mark, D D

    2000-01-01

    The purpose of this article is to analyze the performance of and support for case management using a policy framework in order to increase case managers' awareness of policy making and facilitate successful planning for future policy initiatives. Feldstein's (1996) theory of opposing legislative outcomes indicates that legislation can be viewed on a continuum, ranging from legislation that meets the needs of the public to legislation considered to be in the self-interest of the participants and legislators. The current health care system requires that case managers working for publicly funded health care organizations balance the need for stewardship of U.S. tax dollars and the health care needs of consumers. It is apparent from the literature that case managers are successfully achieving this balance. However, certain conditions should exist that allow for case manager decision-making that promotes effective and efficient utilization of health care resources. Case managers must work within the context of the health care policy environment. Realizing that it is more likely that the conflicts between stewardship and the provision of health care services will continue, case managers' knowledge and influence regarding policy making becomes imperative in order to ensure that these conflicting goals do not become mutually exclusive.

  17. Rehabilitation approaches to dysphagia that was developed for a patient who attempted to commit suicide by hanging: a case report.

    PubMed

    Kii, Y; Mizuma, M

    2014-04-01

    We report our experience with a case of attempted suicidal hanging presenting with dysphagia, in which rehabilitation approaches resulted in improvement. A 36-year-old man was discovered collapsed at home. From the finding of a broken cord nearby, attempted suicide by hanging was suspected. He was transported to hospital after 40 minutes, and regained consciousness after emergency treatment. There were no noteworthy findings on brain magnetic resonance imaging, cervical spine computed tomography, or vocal cord examination. There were no noteworthy psychiatric disorders or cognitive abnormalities. On hospital day 10, he showed signs of dysphagia. Videofluoroscopic examination of swallowing revealed piriform sinuses residue and aspiration after ingestion of jelly in any posture. Rehabilitation approaches were started based on the diagnosis of dysphagia due to impaired transit through the piriform sinuses. The patient achieved independent oral intake by 40 days after the injury. In this case, dysphagia was considered attributable to compression of the vagus nerves running along the lateral aspects of the neck by the cord used in the hanging. If compression is brief, full functional recovery can be expected. Implementation of rehabilitation approaches is also important in this situation.

  18. The Managerial Nature of Case Management.

    ERIC Educational Resources Information Center

    Wolk, James L.; And Others

    1994-01-01

    Contends that case managers engage in the practice of management. Employs Mintzberg's seminal research on chief executive behavior to argue that case managers' work is similarly characterized by brevity, variety, and fragmentation. Notes that case managers perform the 10 roles developed by Mintzberg. Describes roles and presents case managers'…

  19. 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…

  20. Case management: unraveling the confusion.

    PubMed

    Bower, K

    1998-01-01

    I'm going to close with some of my ideas about the characteristics that case managers exhibit. I have a great deal of professional respect for case managers. I think that you are a tenacious lot. One of the major things that case managers do is help create new alternatives to problems. You open doors; no ... you first build the door and then you open it. You're creative, persistent, and resourceful. You are sometimes asked to solve all of an organization's problems. I think that is a tremendous burden, and that you can get confused because of that role conflict and confusion. What model is best for my organization? Within that is my patient population. What is it that they need? What are the current issues that you are seeing? How is my case management role different from other roles? How large a scope of practice can I handle and be reasonably successful with the patients with whom I'm dealing? How many different kinds of approaches and models are needed within my organization? Look toward the future; think about the future in terms of your crystal balls. What trends do you see building in either the demographics or the health and social environments that are going to influence health care in the future? What effect will the aging of our population have on you and your case management practice? What issues are going to be related to those trends? How many more people do we have living in fragmented families? What's going to happens in terms of resources available for patients? How can case management influence those changes? I don't think we're going to see the pace of change in the health care industry slow down. We will continue to have health care organizations address social issues in addition to pathophysiologic ones. No matter what the role and how it evolves, case management will always be at the junction of change in health care. This will be difficult at times to deal with. It will also be a source of satisfaction for those in the role because of the

  1. Retaining a Legacy while Avoiding Trademark Infringement: A Case Study of One University's Attempt to Develop a Consistent Athletic Brand Identity

    ERIC Educational Resources Information Center

    Alessandri, Sue Westcott

    2007-01-01

    This case study chronicles Syracuse University's athletic department's attempt to achieve consistency in its identity program by changing its identity during 2004, and then again in 2005. The changes were owing to high-level personnel changes on both the academic and athletic sides of the university. This case details the many issues arising from…

  2. 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.

  3. Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study

    PubMed Central

    Shafiee-Kandjani, Ali Reza; Amiri, Shahrokh; Arfaie, Asghar; Ahmadi, Azadeh; Farvareshi, Mahmoud

    2014-01-01

    Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty-three patients hospitalized in the other wards for a variety of reasons were selected as the adjusted control group. Millon Clinical Multiaxial Personality Inventory, 3rd version (MCMI-III) was used to assess the personality profiles. Results. The majority of the suicide attempters were low-level graduates (67.8% versus 47.1%, OR = 2.36). 79.7% of the suicide attempters were suffering from at least one maladaptive personality profile. The most common maladaptive personality profiles among the suicide attempters were depressive personality disorder (40.7%) and histrionic personality disorder (32.2%). Among the syndromes the most common ones were anxiety clinical syndrome (23.7%) and major depression (23.7%). Conclusion. Major depression clinical syndrome, histrionic personality disorder, anxiety clinical syndrome, and depressive personality disorder are among the predicators of first suicide attempts for the patients hospitalized in the public hospital due to the medicine poisoning. PMID:27433491

  4. 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...

  5. Fleurs-de-lis in the forest: "absolute" monarchy and attempts at resource management in eighteenth-century France.

    PubMed

    Graham, Hamish

    2009-01-01

    The notion of "resource management" has inspired some historians to rethink the nature of the state authority in early modern Europe. Like recent work on parts of Italy and Germany, this article investigates the development and implementation of legislation that sought to regulate the management and exploitation of forests. This was self-interested policymaking: as ancien régime France strove to match Britain's naval, colonial and maritime strength, the monarchy's priority was ship timbers. Yet the most sought-after pieces of wood were large, heavy and difficult to transport. According to standard accounts, such resources became rare during the eighteenth century, and the French navy turned increasingly to timber supplies from abroad. This article offers a wider view, by finding ways to analyse bureaucratic records created by the royal forestry officials (Eaux et Forêts), which have been largely neglected by historians. A regional case study suggests that, besides extending the authority of royal agents to acquire timbers for the naval dockyards, the application of Louis XIV's Ordinance on Waterways and Forests (1669) generated huge amounts of information about the extent, nature and location of mature timber reserves across France.

  6. Education for Effective Case Management Practice.

    ERIC Educational Resources Information Center

    Dickerson, Pamela S.; Mansfield, Jerry A.

    2003-01-01

    Managed care organization employees (n=115) attended case management training that included case studies, problem solving and communication skills, and focus on internal capability. Three-month follow-up showed that case managers now ask more questions, have more confidence, mentor new employees, and work with greater accuracy. (SK)

  7. Notifying Parents Following a College Student Suicide Attempt: A Review of Case Law and FERPA, and Recommendations for Practice

    ERIC Educational Resources Information Center

    Baker, Thomas R.

    2005-01-01

    Decisions by university officials not to notify a student's parents following a suicide attempt on campus have been severely criticized by some observers. Although courts have not imposed a parental notice requirement, the practice is advantageous to students in many situations. The author recommends a system of notification that relies primarily…

  8. 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

  9. The managerial nature of case management.

    PubMed

    Wolk, J L; Sullivan, W P; Hartmann, D J

    1994-03-01

    Case managers have been viewed as engaging in direct practice, community practice, or both. This article offers a third view: Case managers also engage in the practice of management. Employing Mintzberg's seminal research on chief executive behavior, the authors argue that case managers' work is similarly characterized by brevity, variety, and fragmentation. Case managers perform the 10 roles developed in Mintzberg's original study. These roles are divided into three groups: interpersonal, including figurehead, leader, and liaison; informational, including monitor, disseminator, and spokesperson; and decision-making, including entrepreneur, disturbance handler, resource allocator, and negotiator. Case managers' tasks associated with each role are presented. Considering their work as managerial in nature will help case managers more effectively assist clients in goal achievement.

  10. 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…

  11. 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…

  12. Conservative management of broken guidewire: Case reports

    PubMed Central

    Ho, David W; Dinaram, Temujin; Lazar, Jason M; Marmur, Jonathan D

    2014-01-01

    Fractures of coronary guidewires during percutaneous coronary intervention within a coronary vessel lumen are a rare but serious complication. There have been several cases reported in the literature, some managed with surgical intervention, others with medical therapy. We present two prospective cases from our center. Both cases were managed successfully with medical therapy. PMID:27489659

  13. CASE MANAGEMENT INSIDER. Thinking of Separating Utilization Management and Case Management? Think Again!

    PubMed

    Cesta, Toni

    2016-03-01

    Case management should be designed as a fully patient-centric model with all the roles and functions of the case manager and social worker performed as part of a package of services provided to the patient, not as a series of tasks that are disjointed and performed in isolation of each other. When case management models separate these roles, they create an environment in which these roles no longer interface and no longer are applied with the patient's current and long-term care needs in mind. Be very cautious when implementing such models and as you can see above, the argument that the collaborative model is less expensive simply does not hold true. Whenever possible, try to keep your case management roles and functions as integrated as possible for the greatest success and achievement of outcomes! PMID:26964417

  14. Considering Patients' Mental Capacity When Giving Them Bad News May Help Their Well-Being: A Case of Suicide Attempt after Being Informed of Lung Cancer Diagnosis

    PubMed Central

    Kato, Satoshi; Takeuchi, Mitsuo

    2014-01-01

    Mental capacity is a central determinant of patients' ability to make autonomous decisions about their care and deal with bad news. Physicians should be cognizant of this when giving patients bad news in efforts to help them to cope with the illness and to avoid a deterioration of their mental well-being. To show the importance of this concept, a case of suicide attempt with lung cancer is exemplified. A 76-year-old woman attempted suicide after receiving a diagnosis of lung cancer. Her recent life had been emotionally turbulent and she did not have sufficient mental capacity to accept and cope with this truth. She developed depression before attempting suicide. PMID:24963431

  15. Rapid improvement of depressive symptoms in suicide attempters following treatment with milnacipran and tricyclic antidepressants - a case series.

    PubMed

    Kirino, Eiji; Gitoh, Masao

    2011-01-01

    Suicide is a serious social problem in many countries, including Japan. The majority of people who commit suicide suffer from depression. Suicide attempt patients suffering from serious physical injuries are initially treated in hospital emergency departments. The present post hoc analysis examined data from patients admitted to an emergency hospital for treatment of physical injuries, resulting from a suicide attempt, and initial psychiatric treatment for depression and prevention of future suicide attempts. The effects on depressive symptoms were studied in two groups of patients using the 17-item Hamilton depression scale (HAMD). One group (n = 6) had received intravenous tricyclic antidepressants (TCA) (amitriptyline or clomipramine) while the other group (n = 7) had been treated orally with milnacipran, a serotonin and norepinephrine reuptake inhibitor antidepressant. Prior to treatment the four highest scoring items on the HAMD scale were the same in both groups namely, item 1 (depressed mood), item 3 (suicidality), item 7 (interest in work and activities), and item 10 (psychic anxiety). After 1 week of treatment, mean global HAMD scores were significantly reduced in both groups. Treatment resulted in a significant reduction of five HAMD items in the TCA group, whereas in the milnacipran group 12 HAMD items were significantly reduced. Suicidality (item 3) was significantly improved by 1 week treatment with milnacipran, but not by TCAs. Milnacipran rapidly improved a wide range of depressive symptoms, including suicidality within the first week. The improvement with milnacipran would appear to be, at least, equivalent to that achieved with TCAs, possibly affecting a wider range of symptoms. Since milnacipran has been shown in comparative studies to be better tolerated than TCAs, this antidepressant offers an interesting option for the treatment of suicidal patients in an emergency setting. PMID:22247614

  16. Ipsilateral carpal, metacarpal, and ankle fractures resulting from an attempted basketball slam-dunk. A case report.

    PubMed

    McClelland, S J; Fithian, D C

    1988-01-01

    A 23-year-old male recreational basketball player sustained an open ankle fracture and ipsilateral carpal and metacarpal fractures as a result of a fall while attempting a slam-dunk. The wrist and hand fractures were treated nonoperatively. The open ankle fracture required irrigation, debridement, and open reduction/internal fixation. In addition to the prerequisite leaping ability, long-term success in "playing above the rim" requires experience, exceptional physical agility, and the mental discipline to anticipate and avoid slam-dunk opportunities with high risk for personal injury.

  17. [The case manager, a geriatrics healthcare coordinator].

    PubMed

    Dauriac, Christine

    2013-01-01

    The case manager mobilises the resources available within a geographic sector determined by the Centre for the autonomy and integration of Alzheimer's patients in order to respond to complex cases of elderly patient care. PMID:23951867

  18. Suicide Attempt Characteristics, Diagnoses, and Future Attempts: Comparing Multiple Attempters to Single Attempters and Ideators

    ERIC Educational Resources Information Center

    Miranda, Regina; Scott, Michelle; Hicks, Roger; Wilcox, Holly C.; Munfakh, Jimmie Lou Harris; Shaffer, David

    2008-01-01

    The study compares psychiatric diagnoses and future suicide attempt outcomes of multiple attempters (MAs), single attempters (SAs) and ideators. The results conclude that MAs strongly predict later suicide attempts and diagnosis than SAs and ideators.

  19. 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…

  20. 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,…

  1. 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

  2. The Practice of Case Management "As Lived."

    ERIC Educational Resources Information Center

    McClam, Tricia; Woodside, Marianne

    1998-01-01

    The role of the case manager today is explored through interviews with human-services professionals. Identifies eight themes that describe the case manager's work and skills: multiple roles, organizational abilities, communication skills, setting-specific knowledge, ethical decision making, boundaries, objectivity, and personal qualities.…

  3. Histopathological pattern of gonads in cases of sex abnormalities in dogs: An attempt of morphological evaluation involving potential for neoplasia.

    PubMed

    Dzimira, Stanislaw; Nizanski, Wojciech; Ochota, Malgorzata; Madej, Janusz A

    2015-10-01

    Disturbances in sex differentiation (DSD - disorder of sexual development) may result from disturbances in sex chromosomes or a disturbed development of gonads, or from genotypic disturbances. The objective of this article is to describe the histological structure of gonads in dogs showing sexual disturbances and a case of a cancer resembling gonadoblastoma in one of the animals. Among the 10 examined dogs with disturbances of sex development only a single case of a gonadoblastoma was observed. In animals with sex disturbances, similarly to humans, there exists a potential tendency for neoplastic lesions in dysgenetic gonads. As a rule, its frequency in population is confined due to the early procedure of castration of non-breeding dogs. In the present study dogs demonstrated phenotypical traits of bitches with developmental anomalies such as hyperplastic clitoris with vestigial os penis (baculum), or abnormalities in the location and structure of the vulva. The material for the study included canine gonads of various breeds, sampled from phenotypical bitches, aged 7 months to 4 years - patients of the Department of Reproduction and Clinic of Farm Animals, Faculty of Veterinary Medicine, University of Environmental and Life Sciences in Wroclaw (Poland) in years 2006-2013. The organs were surgically removed from the abdomen and sent for histopathological examination for the purpose of determining their histological structure. The 10 examined cases of altered gonads included 6 bilateral cases of testes (60%), 2 cases of bilateral ovotestis (20%), one case of co-manifestation of testis and ovotestis (10%), and a single case of a testis and a neoplastically altered gonad (gonadoblastoma) (10%).

  4. [Cytological, etiological and prognostic aspects of male infertility. Attempt at classification apropos of 1,303 cases].

    PubMed

    Alexandre, C

    Study of 1303 cases of male sub-fertility led to a certain number of practical conclusions: - From a diagnostic viewpoint, the "fertility" of an individual, which is difficult to assess, depends more on the motility than the number of spermatozoa. This is most faithfully reflected in the crossed penetration test which defines the quality of penetration of a control mucus. The value of electron microscopic cytological study in the case of total asthenospermia or major monomorphous teratospermia, reflecting an irreversible constitutional abnormality of the ultrastructure of the spermatozoon, is emphasised. - From a therapeutic viewpoint, recent progress has involved the technique of surgical treatment for varicocoele as well as hormone therapy. It is essential not to neglect empirical "minor aids" indicated in the case of unexplained abnormalities (homologous artifical insemination in the case of abnormalities in the volume of the ejaculate, retard androgen therapy in the case of polyzoospermia). - From a prognostic viewpoint. The distinction must be drawn between aetiologies of good prognosis (80% of our success) responsible for transient abnormalities in spermatogenesis (infections, metabolic disturbances, varicocoele) and aetiologies with an unfavourable prognosis since they cause tubulopathies of greater or lesser severity with a lesional impairment of spermatogenesis.

  5. RESULTS OF A DATING ATTEMPT -CHEMICAL AND PHYSICAL MEASUREMENTS RELEVANT TO THE CASE OF THE CRETACEOUS TERTIARY EXTINCTIONS

    SciTech Connect

    Asaro, Frank; Michel, Helen V.; Alvarez, Luis W.; Alvarez, Walter

    1980-09-01

    In Gubbio, Italy, a l em layer of clay between extensive limestone formations marks the boundary between the Cretaceous and Tertiary Periods. This clay layer was known to have been deposited about 65 million years ago when many life forms became extinct, but the length of time associated with the deposition was not known. In an attempt to measure this time with normally deposited meteoritic material as a clock, extensive measurements of iridium abundances (and those of many other elements) were made on the Gubbio rocks. Neutron activation analysis was the principal tool used in these studies. About 50 elements are searched for in materials like the earth's crust, about 40 are detected and about 30 are measured with useful precision. We were not able to determine exactly how long the clay deposition took. Instead the laboratory studies on the chemical and physical nature of the Cretaceous-Tertiary boundary led to the theory that an asteroid collision with the earth was responsible for the extinction of many forms of life including the dinosaurs.

  6. Hospital program weds case, disease management.

    PubMed

    1997-10-01

    To lower its readmission rates and inpatient length of stay for three high-volume chronic conditions, Memorial Hospital in Colorado Springs, CO, developed a program that combines clinical pathways with a cross-continuum disease management program. Community physicians refer patients to the program. Hospital-based care managers guide patients in the acute setting before handing them off to outpatient case managers, who coordinate the patient's transition to home care. Clinicians at Memorial sold administrators on the "care-case management" approach by arguing that increased inpatient efficiency would offset potential revenue shortfalls due to fewer admissions.

  7. Iowa Case Management for Rural Drug Abuse.

    PubMed

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

    2009-07-01

    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 (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. RESULTS: Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. CONCLUSION: Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time.

  8. Iowa Case Management for Rural Drug Abuse

    PubMed Central

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

    2011-01-01

    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 (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. Results Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. Conclusion Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time. PMID:22065018

  9. 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.

  10. Self-injection of household cleaning detergents into a ventriculoperitoneal shunt reservoir during a suicide attempt: a case report and literature review.

    PubMed

    Signorelli, Jason W; Osbun, Joshua W; Arias, Eric J; Reynolds, Lauren C; Chyatte, Douglas; Reynolds, Matthew R

    2016-09-01

    Self-injection of household cleaning detergents (more specifically, commercial toilet bowl cleaner) into the reservoir of a ventriculoperitoneal shunt (VPS) has never been reported in the neurosurgical literature. A right-handed 41-year-old female with a past medical history significant for bipolar depression (with multiple prior hospital admissions for suicide attempts) and pseudotumor cerebri (status-post VPS placement from a right frontal approach) successfully injected ∼5 ml of toilet bowl cleaner into her ventricular shunt reservoir during a suicide attempt. She was found unresponsive by a family member 48 h after this event and presented to our hospital in moribund neurological condition (bilaterally fixed and dilated pupils with decerebrate posturing). Head computed tomography (CT) demonstrated marked ventriculomegaly. She was taken emergently to the operating room for placement of a left frontal ventriculostomy. Cerebrospinal fluid (CSF) sampled intraoperatively showed numerous Gram-positive cocci (later determined to be Staphylococcus epidermidis). For this reason, her right-sided shunt system was also removed in its entirety. She was treated with broad-spectrum intravenous and intraventricular antibiotics for her bacterial ventriculitis and her CSF was aggressively drained to treat her hydrocephalus. Once her infection had resolved, the shunt was replaced (using a right parietal approach) and she went on to make an excellent neurological recovery. Here, the authors present the case of a patient who self-injected household cleaning detergents into her VPS reservoir-and, likely, the ventricular system-during a suicide attempt and subsequently developed hydrocephalus and ventriculitis. Following this infrequent clinical scenario, consideration should be given to temporary ventriculostomy placement and shunt removal. Moreover, in patients with a known history of psychiatric co-morbidities-and particularly those patients with prior suicide attempts

  11. Self-injection of household cleaning detergents into a ventriculoperitoneal shunt reservoir during a suicide attempt: a case report and literature review.

    PubMed

    Signorelli, Jason W; Osbun, Joshua W; Arias, Eric J; Reynolds, Lauren C; Chyatte, Douglas; Reynolds, Matthew R

    2016-09-01

    Self-injection of household cleaning detergents (more specifically, commercial toilet bowl cleaner) into the reservoir of a ventriculoperitoneal shunt (VPS) has never been reported in the neurosurgical literature. A right-handed 41-year-old female with a past medical history significant for bipolar depression (with multiple prior hospital admissions for suicide attempts) and pseudotumor cerebri (status-post VPS placement from a right frontal approach) successfully injected ∼5 ml of toilet bowl cleaner into her ventricular shunt reservoir during a suicide attempt. She was found unresponsive by a family member 48 h after this event and presented to our hospital in moribund neurological condition (bilaterally fixed and dilated pupils with decerebrate posturing). Head computed tomography (CT) demonstrated marked ventriculomegaly. She was taken emergently to the operating room for placement of a left frontal ventriculostomy. Cerebrospinal fluid (CSF) sampled intraoperatively showed numerous Gram-positive cocci (later determined to be Staphylococcus epidermidis). For this reason, her right-sided shunt system was also removed in its entirety. She was treated with broad-spectrum intravenous and intraventricular antibiotics for her bacterial ventriculitis and her CSF was aggressively drained to treat her hydrocephalus. Once her infection had resolved, the shunt was replaced (using a right parietal approach) and she went on to make an excellent neurological recovery. Here, the authors present the case of a patient who self-injected household cleaning detergents into her VPS reservoir-and, likely, the ventricular system-during a suicide attempt and subsequently developed hydrocephalus and ventriculitis. Following this infrequent clinical scenario, consideration should be given to temporary ventriculostomy placement and shunt removal. Moreover, in patients with a known history of psychiatric co-morbidities-and particularly those patients with prior suicide attempts

  12. 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

  13. Negative Life Events and Attempted Suicide in Rural China

    PubMed Central

    Zhang, Wen-Chao; Jia, Cun-Xian; Zhang, Ji-Yu; Wang, Lin-Lin; Liu, Xian-Chen

    2015-01-01

    Objective This study aimed to examine the association between negative life events (NLEs) and attempted suicide in rural China. Methods Six rural counties were selected from disease surveillance points in Shandong province, China. A total of 409 suicide attempters in rural areas between October 1, 2009, and March 31, 2011, and an equal number of matched controls were interviewed. We compared negative life events experienced within 1 month, 1–3 months, 3–6months, and 6–2 months prior to attempted suicide for cases and prior to interview for controls. We used multivariate logistic regression to examine the association between NLEs and attempted suicide. Results Suicide attempters experienced more NLEs within the last year prior to suicide attempt than controls prior to interview (83.1% vs. 33.5%). There was a significant dose-response relationship between NLEs experienced within the last year and increased risk of attempted suicide. Timing of NLEs analysis showed that NLEs experienced in the last month and 6–12 months prior to suicide attempt were significantly associated with elevated risk of attempted suicide, even after adjusting for mental disorders and demographic factors. Of NLEs, quarrelling with spouse, quarrelling with other family members, conflicting with friends or neighbors, family financial difficulty, and serious illness were independently related to attempted suicide. Conclusion NLEs are significantly associated with increased risk for attempted suicide in rural China. Stress management and intervention may be important to prevent suicidal behavior in rural China. PMID:25611854

  14. 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.

  15. 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.

  16. IFN-α-2a (Interferon) and ribavirin induced suicidal attempt in a patient of chronic HCV: A rare case report.

    PubMed

    Inder, Deep; Rehan, H S; Yadav, Madhur; Manak, Seema; Kumar, Pawan

    2011-04-01

    Interferons (IFNs) are proteins produced by cells, fibroblasts and macrophages, in response to viral invasion, and mediates immune response. IFN-α and ribavirin are the approved treatment for HCV infection, but also carries a risk of neuropsychiatric adverse effects, viz. insomnia, irritability, mood changes, and depression.We present a case report of depression induced by IFN-α and ribavirin, leading to attempted suicide. Following the episode, antidepressant paroxetine (20 mg o.d.) and zolpidem (10 mg h.s) were added with psychotherapy. No significant improvement was observed. Patient was given a drug dechallenge (IFN-α and ribavirin). Dramatic improvement was seen over 1 month. Following rechallenge with combination, patient again experienced depressive symptoms with suicidal ideation. IFN-α and ribavirin were promptly stopped. Naranjo causality assessment scale revealed probable association with IFN-α and ribavirin. The report intends to improve awareness among clinicians to facilitate early diagnosis and intervention of similar cases. PMID:21572662

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. Communication action for case managers. Techniques to manage conflict.

    PubMed

    Marino, T Y; Kahnoski, B

    1998-01-01

    The art of communication can facilitate case management in an optimum sense. It can also create conflict issues if handled inappropriately. In this article, the authors explore the basic tenets of the communication process. On this basic foundation, conflict and approaches to conflict resolution are explored. Specifically, Kare Anderson's Triangle Talk model is used in conjunction with a specific case that demonstrates the potential for positive communication outcomes. The model offers three principles, which are discussed individually. Good communication skills are a prime component of therapy and case management. It is important to the case outcome that the communication is done well. However, it is unusual for health care providers to have specialized training in the skills of conflict negotiation. The authors offer the reader an opportunity to apply what is presented in this article in a self-study module at the end. PMID:9526394

  2. "Site-Based Management" and Reform. Toledo Public Schools, a Case in Point.

    ERIC Educational Resources Information Center

    Lopez, Thomas R.; Balzer, David M.

    The expression "site-based management" (SBM) has become part of the rhetoric of reform of U.S. public schools. The United States has been involved in school reform efforts for many years now, including attempts at SBM. The case of the Toledo (Ohio) public schools serves as a prime example of an urban school district that, like many others, shows…

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... care case management services. (a) Primary care case management services means case management related services that— (1) Include location, coordination, and monitoring of primary health care services; and (2... 42 Public Health 4 2010-10-01 2010-10-01 false Primary care case management services....

  4. Critical factors for successful hospital-based case management.

    PubMed

    Williams, F G; Warrick, L H; Christianson, J B; Netting, F E

    1993-01-01

    Six hospitals were funded to develop programs for long-term case management. Factors that should be considered when developing hospital-based case management are discussed within three areas: organizational placement, program management, and financial viability.

  5. 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,…

  6. "Managing after the Merger" Case Analysis.

    ERIC Educational Resources Information Center

    Cusella, Louis P.

    2000-01-01

    Responds to a case study for management communication classes (presented in this same issue) that focuses on issues of performance appraisals and employee feedback after a merger. Notes cultural differences between the companies; examines the supervisor's differential evaluations of his employees and his communicative dynamics; examines the…

  7. Linking case management and community development.

    PubMed

    Austin, Carol D; McClelland, Robert W; Gursansky, Di

    2006-01-01

    Case management, in various forms, is now institutionalized as a core part of policy and programs designed to deliver home- and community-based services to older adults. The case management role, in theory, requires attention to both client and system goals, although in practice the system goals that have received most attention have been gatekeeping and resource allocation. While case managers have been admonished to find and develop resources in the community, this has primarily taken the form of including informal services in individual client care plans. What has been missing is focused attention to the potential of the community as a nurturing environment with the capacity to support older adults and their caregivers. Sustainable care for older adults cannot be achieved by formal service and family support alone. This article proposes the creation of linkages between case managers, who build the service arrangements for older people, and community developers, who are responsible for building community capacity and social capital. It is argued that this linkage is essential for establishing the foundations of a caring community with the capacity to support older people.

  8. Nursing case management. Resolving the DRG paradox.

    PubMed

    Zander, K

    1988-09-01

    Nursing Case Management as described here was developed in less than ideal conditions: a full census, a 30 per cent increase in patient volume over five years, a nursing shortage, no grants or outside funding, no clinical specialists or clinical ladder, and no computerized documentation system. No more staff or salary was added as we focused our attention on the new tools, roles, and structures necessary to achieve cost and quality outcomes. However, nursing case management has worked because of some very key elements: 1. A firm commitment to the belief that staff nurses must be accountable for the outcomes of the care that they have planned, given, managed, and continuously evaluated. 2. A combination of top-down organizational development strategies with excellent staff nurse involvement at each juncture. 3. Negotiation and collaboration with physicians and hospital administration at key turning points. This includes the relentless articulation of patient-centered care. 4. A willingness to learn and risk together as a whole department--across levels, across specialties. This includes a constant balance of moving from concrete examples and problems to reconceptualizing the issues. 5. Listening, responsiveness, humor, and acknowledging contributions of everyone. More than any other principal, the case manager must be a central caregiver to a patient to ensure cost/quality outcomes. Otherwise case management only adds to the cost of health care by adding another level of bureaucracy. Nurses have always managed the care of patients, but to stay effective and committed, they need to take increased authority in their patients' entire episode of care and develop formal collaborative practice groups. In other words: "Prospective payment has changed the health care product from a day of care (or a visit) to an entire case or episode of illness. More than just a new way of paying for care, it has changed our way of planning, managing, and thinking about health care

  9. Telehealth technology in case/disease management.

    PubMed

    Park, Eun-Jun

    2006-01-01

    Case managers can better coordinate and facilitate chronic illness care by adopting telehealth technology. This article overviews four major categories of telehealth technology based on patients' roles in self-management: surveillance, testing peripherals and messaging, decision support aids, and online support groups related to patients' subordinate, structured, collaborative, and autonomous roles, respectively. These various telehealth technologies should be selected on the basis of patients' care needs and preferences. Moreover, when they are integrated with other clinical information systems, case management practice can be better performed. However, the specific role functions and skill sets needed to be competent in telehealth environments have not yet been clearly identified. Considering role ambiguity and stress among telehealth clinicians, clarifying relevant roles is an urgent task.

  10. Irreducible rectal prolapse: emergency surgical management of eight cases and a review of the literature.

    PubMed

    Seenivasagam, T; Gerald, H; Ghassan, N; Vivek, T; Bedi, A S; Suneet, S

    2011-06-01

    The management of irreducible rectal prolapse is controversial. Surgeons may attempt conservative management by application of sugar. When surgery becomes inevitable the choice of procedure varies. We reviewed eight cases and noted the clinical findings and the results of conservative and surgical management. In four cases sugar was applied first, and failed. Emergency surgery always gave good outcomes. The procedures included simple reduction, rectopexy, laparotomy with resection, Delorme's repair, and perineal resection. Our experience and review of the literature indicate that surgery should be performed early in irreducible prolapse. Perineal resection may be the most suitable emergency procedure.

  11. Perinatal conditions and parental age at birth as risk markers for subsequent suicide attempt and suicide: a population based case-control study.

    PubMed

    Niederkrotenthaler, Thomas; Rasmussen, Finn; Mittendorfer-Rutz, Ellenor

    2012-09-01

    Restricted fetal growth and young maternal age have been associated with increased risk of suicidal behaviour later in life. Research investigating the independent and interacting effects of these risk factors with parental mental health and socio-economic status is scarce. A case-control study was effected through record linkage between Swedish registers. Individuals born 1973-1983 who were hospitalized due to a suicide attempt (n = 17,159) or committed suicide (n = 1,407) were matched to ≤10 controls by sex, month and county of birth. Controlling for parental conditions, significantly increased odds ratios (OR) for suicide attempt were found for low birth weight (OR = 1.12, 95 % CI 1.01-1.25), short birth length (OR = 1.15, 95 % CI 1.08-1.22), short and light for gestational age (OR = 1.23, 95 % CI: 1.10-1.38), short but not light for gestational age (OR = 1.18, 95 % CI: 1.09, 1.29), teenage motherhood (OR = 1.66, 95 % CI 1.53-1.80), young fatherhood (OR = 1.33, 95 % CI 1.27-1.39) and multiparity (OR = 1.40, 95 % CI 1.31-1.50). For completed suicide, increased odds ratios were found for low birth weight (OR = 1.65, 95 % CI 1.16-2.35), teenage motherhood (OR = 1.44, 95 % CI 1.09-1.90) and young fatherhood (OR = 1.20, 95 % CI 1.02-1.41). There was a synergy effect between teenage motherhood and parental psychiatric inpatient care with regard to suicide attempt in offspring [synergy index = 1.53 (95 % CI 1.27-1.84)]. Low birth weight and length, and short and light for gestational age may increase the risk of subsequent suicidal behaviour, and more research is needed to investigate underlying mechanisms. Public health implications from this study include measures to improve pre- and perinatal parental mental health, particularly in teenage pregnancies.

  12. Attempted Non-Family Abductions.

    ERIC Educational Resources Information Center

    Finkelhor, David; And Others

    1995-01-01

    Examined cases of attempted nonfamily abductions, to determine child and family characteristics that may serve as risk factors for such incidents. The prevalence and risk-marker findings from this study reinforce the need to continue teaching "stranger danger" and suggest that children living in stressful or unstable family environments may be in…

  13. Designing measurements to assess case management outcomes.

    PubMed

    Mateo, M A; Matzke, K; Newton, C

    1998-01-01

    Evaluating outcomes begins with determining the goals of case management. As the emphasis on the delivery of cost-effective patient care increases, comparing outcomes across settings is desirable and essential. A key component to comparing how an organization rates with similar institutions is to identify commonly used measures. Conducting a literature search, benchmarking, participating in initiatives of accrediting bodies, and establishing ways to collect and manage reliable and valid data are vital in laying the groundwork for an organization's ability to join evaluation projects across settings. PMID:9526390

  14. Designing measurements to assess case management outcomes.

    PubMed

    Mateo, Magdalena A; Matzke, Karen; Newton, Cheryl

    2002-01-01

    Evaluating outcomes begins with determining the goals of case management. As the emphasis on the delivery of cost-effective patient care increases, comparing outcomes across settings is desirable and essential. A key component to comparing how an organization rates with similar institutions is to identify commonly used measures. Conducting a literature search, benchmarking, participating in initiatives of accrediting bodies, and establishing ways to collect and manage reliable and valid data are vital in laying the groundwork for an organization's ability to join evaluation projects across settings. PMID:12478228

  15. 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... Minerals Management Service 30 CFR Part 250 RIN 1010-AD47 Annular Casing Pressure Management for...

  16. Influences on Case-Managed Community Aged Care Practice.

    PubMed

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen

    2016-10-01

    Case management has been widely implemented in the community aged care setting. In this study, we aimed to explore influences on case-managed community aged care practice from the perspectives of community aged care case managers. We conducted 33 semistructured interviews with 47 participants. We drew these participants from a list of all case managers working in aged care organizations that provided publicly funded case management program(s)/packages in Victoria, Australia. We used a multilevel framework that included such broad categories of factors as structural, organizational, case manager, client, and practice factors to guide the data analysis. Through thematic analysis, we found that policy change, organizational culture and policies, case managers' professional backgrounds, clients with culturally and linguistically diverse backgrounds, and case management models stood out as key influences on case managers' practice. In the future, researchers can use the multilevel framework to undertake implementation research in similar health contexts. PMID:26318797

  17. 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.

  18. Secondary Prevention of Attempted Suicide in Adolescence.

    ERIC Educational Resources Information Center

    Cotgrove, Andrew; And Others

    1995-01-01

    Studies adolescents discharged from a hospital following suicide attempt who were randomly allocated to a treatment group receiving standard management plus a token allowing readmission to the hospital on demand, or a control group receiving standard management only. Results suggest lower rates of repeat suicide attempts in the group that received…

  19. Geriatric case managers: integration into physician practices.

    PubMed

    Netting, F E; Williams, F G

    1999-01-01

    Integration of case management proved to be a key variable in a national demonstration at nine sites of alternative models designed to enhance primary care of frail elders. Numerous semistructured interviews of participants revealed a number of areas important to achieving successful integration. These areas include making favorable first impressions, building relationships, learning to collaborate, having proximity and contact, communicating, and demonstrating benefits to patients and physicians.

  20. 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

  1. Young People's Risk of Suicide Attempts after Contact with a Psychiatric Department--A Nested Case-Control Design Using Danish Register Data

    ERIC Educational Resources Information Center

    Christiansen, Erik; Larsen, Kim Juul

    2012-01-01

    Background: There seems to be an increased risk of children and adolescents committing or attempting suicide after contact with a psychiatric department. Children and adolescents living in families with low socio-economic status (SES) might have an especially increased suicide attempt risk. Methods: A complete extraction of Danish register data…

  2. Socio-Demographic, Clinical and Behavioral Characteristics Associated with a History of Suicide Attempts among Psychiatric Outpatients: A Case Control Study in a Northern Mexican City

    PubMed Central

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Arnaud-Gil, Carlos Alberto; Hernández-Tinoco, Jesús; Molina-Espinoza, Luis Fernando; Rábago-Sánchez, Elizabeth

    2014-01-01

    Background: Little is known about the epidemiology of suicide attempts among psychiatric outpatients in Mexico. This study was aimed to determine the socio-demographic, clinical and behavioral characteristics associated with suicide attempts in psychiatric outpatients in two public hospitals in Durango, Mexico. Methods: Two hundred seventy six psychiatric outpatients (154 suicide attempters and 122 patients without suicide attempt history) attended the two public hospitals in Durango City, Mexico were included in this study. Socio-demographic, clinical and behavioral characteristics were obtained retrospectively from all outpatients and compared in relation to the presence or absence of suicide attempt history. Results: Increased prevalence of suicide attempts was associated with mental and behavioral disorders due to psychoactive substance use (F10-19) (P=0.01), schizophrenia, schizotypal and delusional disorders (F20-29) (P=0.02), mood (affective) disorders (F30-39) (P<0.001), and disorders of adult personality and behavior (F60-69) (P<0.001). Multivariate analysis showed that suicide attempts were associated with young age (OR=1.21, 95% CI: 1.06-1.39; P=0.003), female gender (OR=2.98, 95% CI: 1.55-5.73; P=0.001), urban residence (OR=2.31, 95% CI: 1.17-4.57; P=0.01), memory impairment (OR=1.91, 95% CI: 1.07-3.40; P=0.02), alcohol consumption (OR=2.39, 95% CI: 1.21-4.70; P=0.01), and sexual promiscuity (OR=3.90, 95% CI: 1.74-8.77; P<0.001). Conclusions: We report the association of suicide attempts with socio-demographic, clinical and behavioral characteristics in psychiatric outpatients in Mexico. Results may be useful for an optimal planning of preventive measures against suicide attempts in psychiatric outpatients. PMID:24711751

  3. Case histories in pharmaceutical risk management.

    PubMed

    McCormick, Cynthia G; Henningfield, Jack E; Haddox, J David; Varughese, Sajan; Lindholm, Anders; Rosen, Susan; Wissel, Janne; Waxman, Deborah; Carter, Lawrence P; Seeger, Vickie; Johnson, Rolley E

    2009-12-01

    The development and implementation of programs in the U.S. to minimize risks and assess unintended consequences of new medications has been increasingly required by the Food and Drug Administration (FDA) since the mid 1990s. This paper provides four case histories of risk management and post-marketing surveillance programs utilized recently to address problems associated with possible abuse, dependence and diversion. The pharmaceutical sponsors of each of these drugs were invited to present their programs and followed a similar template for their summaries that are included in this article. The drugs and presenting companies were OxyContin, an analgesic marketed by Purdue Pharma L.P., Daytrana and Vyvanse, ADHD medications marketed by Shire Pharmaceuticals, Xyrem for narcolepsy marketed by Jazz Pharmaceuticals, and Subutex and Suboxone for opioid dependence marketed by Reckitt Benckiser Pharmaceuticals Inc. These case histories and subsequent discussions provide invaluable real-world examples and illustrate both the promise of risk management programs in providing a path to market and/or for keeping on the market drugs with serious potential risks. They also illustrate the limitations of such programs in actually controlling unintended consequences, as well as the challenge of finding the right balance of reducing risks without posing undue barriers to patient access. These experiences are highly relevant as the FDA increasingly requires pharmaceutical sponsors to develop and implement the more formalized and enforceable versions of the risk management term Risk Evaluation and Mitigation Strategies (REMS). PMID:19767156

  4. Attempted Suicide Triggers in Thai Adolescent Perspectives.

    PubMed

    Sukhawaha, Supattra; Arunpongpaisal, Suwanna; Rungreangkulkij, Somporn

    2016-06-01

    The study goal was to describe attempted suicide triggers in Thai adolescents. A descriptive exploratory qualitative study approach was used utilizing in-depth interviews with twelve adolescents who had attempted suicide and six of their parents. Content analysis was conducted. Attempted suicide triggers were (1) severe verbal criticisms and expulsion to die by a significant family member, (2) disappointed and unwanted by boyfriend in first serious relationship, (3) unwanted pregnancy, and (4) mental illness leading to intense emotions and irresistible impulses. These attempted suicide triggers should be of concern and brought into suicide prevention management programs such as emotional management, effective communication for adolescents and family. PMID:27256938

  5. 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…

  6. 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…

  7. Inpatient Hospitalization in Addiction Treatment for Patients with a History of Suicide Attempt: A Case of Support for Treatment Performance Measures†

    PubMed Central

    Glass, Joseph E.; Ilgen, Mark A.; Winters, Jamie J.; Murray, Regan L.; Perron, Brian E.; Chermack, Stephen T.

    2010-01-01

    This study attempts to validate substance use disorder (SUD) treatment performance measures (PM) in a naturalistic treatment setting. Despite its significance in healthcare systems and in SUD populations, suicidality is one patient characteristic that remains unexplored in the context of SUD PMs. The current study focused on the extent to which the care processes encouraged by SUD PMs were associated with improved outcomes in patients with a prior suicide attempt as compared to those without. We abstracted Addiction Severity Index and health services data from the VA medical record for 381 veterans who initiated outpatient SUD treatment and completed baseline intake measures at a Midwestern VA hospital. Cox proportional hazard regressions examined how baseline characteristics, prior suicide attempts, and PM status predicted the time until hospitalization for psychiatric or substance use problems. Prior suicide attempts significantly interacted with treatment engagement, and hospitalization risk was significantly higher among individuals with a prior suicide attempt who did not meet PMs. This study provides initial observational evidence that past suicide attempts may be a factor that should be considered when defining performance standards that influence the processes of SUD treatment. Future research on PMs should take into account the differences on indicators of high risk and poor treatment outcomes. PMID:21053754

  8. Integrating end-of-life care with disease management programs: a new role for case managers.

    PubMed

    Lazarus, A

    2001-03-01

    Case managers are crucial to any well-designed disease management program. However, in the progressive course of serious illness, patients, their families, and MCOs need the skills of case manager more than ever to help them through end-of-life care choices. The author describes what case managers will need in their "toolbox" to provide insight to these health plan members.

  9. Management case study: Tampa Bay, Florida

    USGS Publications Warehouse

    Morrison, Gerold; Greening, Holly; Yates, Kimberly K.; Wolanski, Eric; McLusky, Donald S.

    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

  10. 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

  11. 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.

  12. Telecare for diabetes mellitus: case managers' experiences.

    PubMed

    Chang, Chi-Ping; Lee, Ting-Ting; Chou, Chun-Chen; Mills, Mary Etta

    2013-10-01

    Diabetes is a metabolic disorder that, if not treated promptly and appropriately, can cause complex health complications and mortality. Changes in societal structure have fostered an increase in the incidence of diabetes and made the traditional hospital visit model less efficient for meeting the care needs of these patients. The care models that apply technology, such as telecare or so-called telehealth, may be useful in working with diabetes patients. The current study applied qualitative research methodology through interviews with nine diabetes case managers involved in telecare services. To identify the participants' acceptance and perceived effectiveness of telecare services, content analysis of the interview data was used. The following four major themes were identified in the study results: (1) improved case management, (2) setting appropriate expectations for care outcome, (3) acknowledging patients' sense of losing privacy, and (4) disease prevention and interdisciplinary cooperation. The study findings may serve as an indicator of the need for further promotion, appraisal, and validation of the telecare services model, to enhance the comprehensiveness of diabetes care.

  13. 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.

  14. 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

  15. 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

  16. 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

  17. 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.

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

    PubMed Central

    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

  19. The role of the case manager in a disease management program.

    PubMed

    Huston, Carol J

    2002-01-01

    Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

  20. The role of the case manager in a disease management program.

    PubMed

    Huston, C J

    2001-01-01

    Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

  1. Assessing the Risk of Re-Offending for Juvenile Offenders Using the Youth Level of Service/Case Management Inventory

    ERIC Educational Resources Information Center

    Bechtel, Kristin; Lowenkamp, Christopher T.; Latessa, Edward

    2007-01-01

    The purpose of the Youth Level of Service Case Management Inventory (YLS/CMI) is to assess, classify, and assist agencies with developing treatment and service plans according to the offender's criminogenic risk factors. Given the limited research in the predictive validity for this instrument, the current study attempts to examine this issue on a…

  2. Implementation of Network Leader Sponsored Supply Chain Management Systems: A Case Study of Supplier IT Business Value

    ERIC Educational Resources Information Center

    Miller, Mark S.

    2010-01-01

    This qualitative multiple-case study was conducted to explore and understand how the implementation of required relationship-specific supply chain management system (SCMS) dictated by the network leader within a supplier network affects a supplier organization. The study, on a very broad sense, attempted to research the current validity of how the…

  3. 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.…

  4. Prehospital airway management: A prospective case study.

    PubMed

    Wilbers, N E R; Hamaekers, A E W; Jansen, J; Wijering, S C; Thomas, O; Wilbers-van Rens, R; van Zundert, A A J

    2011-01-01

    We conducted a one-year prospective study involving a prehospital Emergency Medical Service in the Netherlands to investigate the incidence of failed or difficult prehospital endotracheal intubation. During the study period the paramedics were asked to fill in a registration questionnaire after every endotracheal intubation. Of the 26,271 patient contacts, 256 endotracheal intubations were performed by paramedics in one year. Endotracheal intubation failed in 12 patients (4.8%). In 12.0% of 249 patients, a Cormack and Lehane grade III laryngoscopy was reported and a grade IV laryngoscopy was reported in 10.4%. The average number of endotracheal intubations per paramedic in one year was 4.2 and varied from zero to a maximum of 12. The median time between arrival on the scene and a positive capnograph was 7 min.38 s in the case of a Cormack and Lehane grade I laryngoscopy and 14 min.58 s in the case of a Cormack and Lehane grade 4 laryngoscopy. The incidence of endotracheal intubations performed by Dutch paramedics in one year was low, but endotracheal intubation was successful in 95.2%, which is comparable with findings in international literature. Early capnography should be used consistently in prehospital airway management. PMID:21612142

  5. Alcohol Consumption and Nearly Lethal Suicide Attempts.

    ERIC Educational Resources Information Center

    Powell, Kenneth E.; Kresnow, Marcie-jo; Mercy, James A.; Potter, Lloyd B.; Swann, Alan C.; Frankowski, Ralph F.; Lee, Roberta K.; Bayer, Timothy L.

    2002-01-01

    Presents a case-control study of the association between nearly lethal suicide attempts and facets of alcohol consumption; namely, drinking frequency, drinking quantity, binge drinking, alcoholism, drinking within 3 hours of suicide attempt, and age began drinking. In bivariate analyses, all measures were associated with nearly lethal suicide…

  6. 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

  7. Our Attempts in Astronomy

    NASA Astrophysics Data System (ADS)

    Vanichai, Yupa

    During the last decade of twentieth century astronomical articles in Thai scientific magazines were out of date. Interacting galaxies blackholes and other celestial objects beyond solar system were hardly found. While a pocket book for deep space was purposefully written by a lecturer a website of astronomy for Thais was planned by the cooperation of two computer programmers. An obseravatory with 600-mm reflector was the first attempt by a Thai engineer. The product of the first 150-mm reflector Dosonian made in Thailand is sold in low price. Future optical programs are now being planned to be made by Thais. These people have recently worked together to develope astronomy in Thailand.

  8. Case management and the chronic care model: a multidisciplinary role.

    PubMed

    Schaefer, Judith; Davis, Connie

    2004-01-01

    The core functions of case management, assessment, planning, linking, monitoring, advocacy, and outreach assume a new perspective in the context of systems that have adopted the Chronic Care Model. This article considers case management through the experience of three systems that have implemented the Chronic Care Model. A movement toward condition neutral case management, focused on care that is more wholly patient centric, is also examined.

  9. Science plus management equals successful remediation -- A case study

    SciTech Connect

    Buehlman, M.D.; Rogers, D.T.; Payne, F.C.

    1997-12-31

    In the past, owners of contaminated sites attempted to remediate as quickly as possible, usually by excavating contaminated soil or pumping and treating contaminated groundwater. Often, they started remediation before identifying all potential types and sources of contaminants, and before conducting a thorough hydrogeologic study. Such premature action usually resulted in the selected remedy not working, the contamination spreading, or unnecessary remedial activities. Today, successful site remediation is recognized as a complex and time-consuming undertaking--requiring a combination of careful scientific study, effective negotiation with the regulatory agencies and skillful management of multidisciplinary efforts. A case study involving a Brownfields site in southeastern Michigan clearly illustrates the elements of successful remediation. The site`s soil was contaminated with polychlorinated biphenyls (PCBs) and its groundwater with a variety of chlorinated solvents. The original estimate for remediation had exceeded $30 million. Several phases of investigation were conducted to evaluate the nature and sources of contaminants, the site`s hydrogeology, potential risks to human health and the environment, and feasible remedial technologies. Multiple cleanup criteria were established for different affected areas based on the results of the investigations, changes that were taking place with the state cleanup regulations and standards and subsequent negotiations with state and federal regulators. Innovative remedial technologies were selected. The result was a remediation that met or exceeded all soil and groundwater cleanup objectives, was performed on schedule, and was highly cost-effective. The final cost was limited to $3 million--one-tenth of the original estimate.

  10. Hospital-based case management: results from a demonstration.

    PubMed

    Warrick, L H; Netting, F E; Christianson, J B; Williams, F G

    1992-12-01

    The Flinn Foundation Hospital-based Coordinated Care case management demonstration was designed to help patients discharged from six participating hospitals be linked to community services by a case manager. One unexpected result was that about half of the clients served were referred from the community, not from the hospital. We examine the characteristics of hospital-based case management clients, the predictors of their continuation in case management, and their health status over 1 year, focusing on the differences between hospital- and community-referred clients.

  11. 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…

  12. Management of recalcitrant Trichomonas vaginalis in pregnancy: a case report.

    PubMed

    Tayal, Sarup

    2016-02-01

    A case report of a pregnant woman with recalcitrant Trichomonas vaginalis is described. This case was managed with suppressive treatment with metronidazole during pregnancy and cleared with paromomycin vaginal treatment after delivery.

  13. An Action Research in Young Children (3-5) with Activities on Solid Waste Management in Greece: An Attempt for Assessment.

    ERIC Educational Resources Information Center

    Apanomeritaki, Olga

    This action research project sought to increase the waste management and recycling knowledge among 20 children age 4 and 5 years enrolled in a preschool program in Thessaloniki, Greece. A structured interview was developed to assess the children's pre-intervention knowledge of waste management and recycling. It indicated that most children knew…

  14. Attempted suicide and pregnancy

    PubMed Central

    Czeizel, Andrew E.

    2011-01-01

    Abstract: Background: The aim of the Budapest Monitoring System of Self-Poisoning Pregnant Women was to evaluate the potential congenital abnormality inducing effect of extremely large doses of drugs among pregnant women who attempted suicide. This system was appropriate to describe the characteristics of these pregnant women as a secondary finding from this model. Methods: All self-poisoned patients were cared for at a toxicological inpatient clinic in Budapest, between 1960 and 1993. Of a total of 1,044 pregnant women identified from the three different periods of the project, only 19 (1.8%) died. Women who survived were visited at home to reveal birth outcomes, and their exposed children were examined medically to identify congenital abnormalities and tested to estimate their cognitive-behavioral status. The previous or subsequent children of these pregnant women were used as controls with a similar examination protocol. Results: In general, self-poisoned pregnant women were young (peak age was between 18 and 20 years), 62% had their first pregnancy, 55% were unmarried, they had lower socioeconomic status, 46% were smokers and 22.5% drinkers, but depression/panic disorder occurred only among 17 pregnant women. Suicide attempts with drugs were most frequent in the fourth post-conceptional week and second month of pregnancy. In general they used smaller doses of drugs for suicide than non-pregnant age-matched women. Of 1,044 self-poisoned pregnant women, 926 had known pregnancy outcomes and 411 (44.4%) delivered live-born babies. Conclusions: The self-poisoning model appears to have several benefits (e.g., dose-response estimation of drugs) in comparison with other methods when evaluating teratogenic/fetotoxic effect of drugs. It is suggested that an international monitoring system of self-poisoned pregnant women should be established to provide a larger data base. PMID:21483214

  15. An attempt to extend the Habitat Harshness Hypothesis to tidal flats: A case study of Anomalocardia brasiliana (Bivalvia: Veneridae) reproductive biology

    NASA Astrophysics Data System (ADS)

    Corte, Guilherme Nascimento; Yokoyama, Leonardo Querobim; Amaral, A. Cecília Z.

    2014-10-01

    The Habitat Harshness Hypothesis (HHH) predicts that populations inhabiting the intertidal area of a dissipative beach should produce more gametes and have a longer reproductive cycle than those inhabiting an intermediate or reflective beach. This hypothesis was proposed for the exposed morphodynamic continuum between the reflective and dissipative states; however, no attempt has been made thus far to verify whether the HHH is valid for tidal flats. In this study, we analysed the reproductive cycle of Anomalocardia brasiliana in an intermediate beach and in a tidal flat and compared the results to determine whether the reproductive cycles of A. brasiliana were in agreement with the predictions of the HHH and to examine the possibility of extending this hypothesis to tidal flats. A continuous spawning season and synchrony between sexes were observed at both sites, although the reproductive effort was higher in the intermediate beach. The results of this first attempt did not support the extension of the HHH to tidal flats. It is possible that hypotheses that take into account only physical variables may not be the most adequate for describing environments with such a high species richness and high abundance as tidal flats. Nevertheless, other studies are necessary to confidently expand or refute the HHH with regard to tidal flats, and this topic should be considered as a priority in future investigations in sandy beach ecology.

  16. Case study: applying management policies to manage distributed queuing systems

    NASA Astrophysics Data System (ADS)

    Neumair, Bernhard; Wies, René

    1996-06-01

    The increasing deployment of workstations and high performance endsystems in addition to the operation of mainframe computers leads to a situation where many companies can no longer afford for their expensive workstations to run idle for long hours during the night or with little load during daytime. Distributed queuing systems and batch systems (DQSs) provide an efficient basis to make use of these unexploited resources and allow corporations to replace expensive supercomputers with clustered workstations running DQSs. To employ these innovative DQSs on a large scale, the management policies for scheduling jobs, configuring queues, etc must be integrated in the overall management process for the IT infrastructure. For this purpose, the concepts of application management and management policies are introduced and discussed. The definition, automatic transformation, and implementation of policies on management platforms to effectively manage DQSs will show that policy-based application management is already possible using the existing management functionality found in today's systems.

  17. An Attempt at Quantifying Factors that Affect Efficiency in the Management of Solid Waste Produced by Commercial Businesses in the City of Tshwane, South Africa

    PubMed Central

    Worku, Yohannes; Muchie, Mammo

    2012-01-01

    Objective. The objective was to investigate factors that affect the efficient management of solid waste produced by commercial businesses operating in the city of Pretoria, South Africa. Methods. Data was gathered from 1,034 businesses. Efficiency in solid waste management was assessed by using a structural time-based model designed for evaluating efficiency as a function of the length of time required to manage waste. Data analysis was performed using statistical procedures such as frequency tables, Pearson's chi-square tests of association, and binary logistic regression analysis. Odds ratios estimated from logistic regression analysis were used for identifying key factors that affect efficiency in the proper disposal of waste. Results. The study showed that 857 of the 1,034 businesses selected for the study (83%) were found to be efficient enough with regards to the proper collection and disposal of solid waste. Based on odds ratios estimated from binary logistic regression analysis, efficiency in the proper management of solid waste was significantly influenced by 4 predictor variables. These 4 influential predictor variables are lack of adherence to waste management regulations, wrong perception, failure to provide customers with enough trash cans, and operation of businesses by employed managers, in a decreasing order of importance. PMID:23209483

  18. Pediatric Emergency Department Suicidal Patients: Two-Site Evaluation of Suicide Ideators, Single Attempters, and Repeat Attempters

    ERIC Educational Resources Information Center

    Asarnow, Joan Rosenbaum; Baraff, Larry J.; Berk, Michele; Grob, Charles; Devich-Navarro, Mona; Suddath, Robert; Piacentini, John; Tang, Lingqi

    2008-01-01

    The study examines ideators, single attempters, and repeats attempters of suicide to clarify optimal strategies for emergency department management and risk assessment to help them in reducing youth suicide and suicide attempts. Depression was found to be a strong predictor of suicide/suicide attempts along with substance use, externalizing…

  19. Myocardial Injury without Electrocardiographic Changes after a Suicide Attempt by an Overdose of Glimepiride and Zolpidem: A Case Report and Literature Review.

    PubMed

    Chou, Shengpu; Ayabe, Seiji; Sekine, Nobuo

    2015-01-01

    A 40-year-old diabetic man was admitted to our hospital for poor glycemic control. During hospitalization, he took 42 mg glimepiride and 50 mg zolpidem as a suicide attempt. The following day, the creatine kinase-MB fraction and troponin I levels were elevated to 112 IU/L and 8.77 ng/mL, respectively, without any electrocardiographic abnormalities. The patient recovered completely without any complications. Four weeks later, coronary computed tomography angiography and myocardial perfusion scintigraphy revealed moderate one-vessel coronary disease without the evidence of myocardial ischemia or old infarction. Cardiac-specific markers must be considered in sulfonylurea-induced hypoglycemic patients, particularly when the patient is unconscious and does not exhibit any clinical manifestations. PMID:26521901

  20. Problems in Office Management: Cases in Practice

    ERIC Educational Resources Information Center

    Hemby, K. Virginia; Smith, Vincent W.

    2006-01-01

    Office managers face an increasing array of job responsibilities in today's business environment. To prepare new office administration employees and managers, educational institutions must maintain a progressive curriculum to meet position demands. Using a population of members of the Association of Professional Office Managers, this study was…

  1. 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…

  2. 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 §...

  3. 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…

  4. 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

  5. Case management for special populations. Moving beyond categorical distinctions.

    PubMed

    Falik, M; Lipson, D; Lewis-Idema, D; Ulmer, C; Kaplan, K; Robinson, G; Hickey, E; Veiga, R

    1993-01-01

    Case management has evolved as a flexible, pragmatic, and compassionate strategy for improving client access and care continuity within fragmented systems of health and social services. The first-generation case management programs have been designed for various settings that serve different "target" populations with varying social, medical, and psychological needs. This proliferation of categorical case management programs is a mixed blessing. While a categorical focus reflects both historical and public financing priorities, it creates a potentially duplicative and inefficient system in an era of limited resources. As the federal government assumes a more substantial role in supporting case management, greater attention is being given to accountability--demonstrating value-added benefits and identifying best practices for structuring case management. The essential first step is reaching agreement on two critical dimensions of case management, major goals and essential services. This article, based on a review of the literature, examines the extent to which seemingly disparate programs for special populations share common attributes, and thus present opportunities for structuring client-focused rather than categorical case management programs. The authors seek to stimulate a dialogue that would lead to specification of common goals and essential services, and a cross-cutting framework for designing client-focused case management programs. PMID:8130742

  6. Surviving a Suicide Attempt

    PubMed Central

    Al-Harrasi, Ahmed; Al Maqbali, Mandhar; Al-Sinawi, Hamed

    2016-01-01

    Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors) and protective factors (like religious affiliation and family support). All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor. PMID:27602193

  7. Surviving a Suicide Attempt

    PubMed Central

    Al-Harrasi, Ahmed; Al Maqbali, Mandhar; Al-Sinawi, Hamed

    2016-01-01

    Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors) and protective factors (like religious affiliation and family support). All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor.

  8. Surviving a Suicide Attempt.

    PubMed

    Al-Harrasi, Ahmed; Al Maqbali, Mandhar; Al-Sinawi, Hamed

    2016-09-01

    Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors) and protective factors (like religious affiliation and family support). All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor. PMID:27602193

  9. Implementing computer information systems for hospital-based case management.

    PubMed

    Williams, F G; Netting, F E; Engstrom, K M

    1991-01-01

    Like all health care services, case management is a process that relies on information. Based on the experiences in implementing computer information systems in six hospital-based case management programs, several financial, technical, and management issues are reviewed. These issues, which are also relevant for other specialized hospital-based programs, include information priorities, user acceptance, quantifying data, data entry methods, data security, and systems integration. The lessons learned regarding these issues are discussed, and categories of software alternatives are presented.

  10. CASE MANAGEMENT INSIDER. The Top 10 Mistakes You May Be Making In Your Case Management Department! Part 4.

    PubMed

    Cesta, Toni

    2015-10-01

    We have now completed our review of the top 10 mistakes you may be making in your case management department. I've included tips and strategies for correcting these mistakes if you are facing them in your organization. If you follow these suggestions, you will help to keep your case management practice and your department on track and moving forward!

  11. 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…

  12. Psychopathology Associated with Suicide Attempts among Rural Adolescents of China

    ERIC Educational Resources Information Center

    Liu, Xianchen; Tein, Jenn-Yun; Sandler, Irwin N.; Zhao, Zhongtang

    2005-01-01

    This case control study examined the relationship between psychopathological profiles and self reported suicide attempts among rural adolescents of China. Cases consisted of 142 adolescents who reported a suicide attempt in the past 6 months in a questionnaire survey (n = 1,365). An equal number of adolescents without reporting a suicide attempt,…

  13. Transgenerational Patterns of Suicide Attempt.

    ERIC Educational Resources Information Center

    Sorenson, Susan B.; Rutter, Carolyn M.

    1991-01-01

    Using data from 2,304 community residents, found self-reports of suicide attempts were more common among persons with than without family history of suicide. Nearly one in four suicide attempters reported family history of suicide. Being female and unmarried, respondent mental disorder, parent mental disorder, and parent suicide attempt exerted…

  14. Attempted Suicide among Iranian Population

    ERIC Educational Resources Information Center

    Sheikholeslami, Homayoun; Kani, Camellia; Ziaee, Amir

    2008-01-01

    Predictors of suicide attempts in Iran, to distinguish any similarities and differences of these predictors between suicide attempts in Iran and other developed and developing countries and to investigate the relation between general psychiatric symptoms and repetition of suicidal attempts were assessed. The validated Farsi version of the General…

  15. Attempting to detect and record brushland in the northeastern United States using MSS data - Schoharie County, N.Y., as a case study

    NASA Technical Reports Server (NTRS)

    Baumann, Paul R.

    1990-01-01

    Before county and local governments will utilize satellite data extensively for landcover inventories, digital image processing techniques must be developed to identify transitional land-use conditions and create large-scale, readable land-cover maps. This study examines a satellite-based land-cover inventory done for Schoharie County, New York and reviews the problems encountered in identifying and mapping brushland - a significant transitional land use - within the county and region. Brushland throughout the Northeast represents a barometer for measuring the shift away from agricultural land use to second-home property. Detecting and locating brushland on a regular basis can greatly assist county and local government officials in planning and managing a county's future.

  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. 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.

  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. 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.

  20. 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)

  1. Case management and clinical pathways for the pediatric orthopaedic patient.

    PubMed

    Kyzer, S P

    1997-01-01

    Clinical pathways are for predictable, routine, high volume kinds of patients and procedures. Case management is a strategy that is for unpredictable, complex, high cost/high risk kinds of patients. PMID:9155432

  2. 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.

  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. Idiopathic Gingival Fibromatosis: Case Report and Its Management

    PubMed Central

    Jaju, Prashant P.; Desai, Ankit; Desai, Rajiv S.; Jaju, Sushma P.

    2009-01-01

    Idiopathic gingival fibromatosis is a rare condition. We present a case of idiopathic gingival fibromatosis with its multidisciplinary approach of management. The clinical, radiographic, and histopathological features have been described in detail. PMID:20339448

  5. Attempted suicide among Iranian population.

    PubMed

    Sheikholeslami, Homayoun; Kani, Camellia; Ziaee, Amir

    2008-08-01

    Predictors of suicide attempts in Iran, to distinguish any similarities and differences of these predictors between suicide attempts in Iran and other developed and developing countries and to investigate the relation between general psychiatric symptoms and repetition of suicidal attempts were assessed. The validated Farsi version of the General Health Questionnaire-28 (GHQ-28) was used to assess multiple dimensions of quality of life of suicide attempters as depression, anxiety, social dysfunction, and somatic symptoms. Pivotal differences emerged in the clinical profiles of suicide attempters living in a developing country versus developed countries. In developing countries, those who attempt suicides are more likely to have no psychiatric disorder and are less likely to have used alcohol as part of the suicide attempt, but are more likely to have been assaulted physically or verbally. The results on the GHQ-28 indicate that the process through which individuals move from suicidal thought to action may decrease multiple dimensions of quality of life.

  6. 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.

  7. 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…

  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.

  9. 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.

  10. The management of premolar supernumeraries in three orthodontic cases.

    PubMed

    McNamara, C M; Foley, T F; Wright, G Z; Sandy, J R

    1997-01-01

    This paper reviews the incidence, etiology and location of supernumerary teeth with emphasis on premolar supernumeraries and examines the management of supernumerary premolars of three patients undergoing orthodontics. These cases demonstrate that the management of premolars is assessed individually and treatments based on potential complications, which may occur during the orthodontic and surgical management of the dentition. Progress and posttreatment radiographs are recommended for the assessment of late forming supernumerary teeth. PMID:9643197

  11. 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

  12. 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.

  13. Amnioinfusion among women attempting vaginal birth after cesarean delivery.

    PubMed

    Strong, T H; Vega, J S; O'Shaughnessy, M J; Feldman, D B; Koemptgen, J G

    1992-05-01

    Eighteen of 901 women (2%) attempting vaginal birth after cesarean delivery (VBAC) received amnioinfusion. No untoward effects occurred in the subjects or their fetuses. We conclude that, though amnioinfusion in the setting of a VBAC attempt is needed only infrequently, it appears to be a reasonable intrapartum management option. The usual safeguards for a VBAC attempt should be followed.

  14. 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...

  15. Management of traumatic macular holes: case report.

    PubMed

    Brasil, Oswaldo Ferreira Moura; Brasil, Oswaldo Moura

    2008-01-01

    Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months.

  16. 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…

  17. 42 CFR 440.169 - 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. 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...

  18. 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...

  19. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 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...

  20. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 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...

  1. 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…

  2. 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

  3. Gastric band migration following laparoscopic adjustable gastric banding (LAGB): two cases of endoscopic management using a gastric band cutter.

    PubMed

    Rogalski, Pawel; Hady, Hady Razak; Baniukiewicz, Andrzej; Dąbrowski, Andrzej; Kaminski, Fabian; Dadan, Jacek

    2012-06-01

    Laparoscopic adjustable gastric banding (LAGB) is one of the most frequently used minimally invasive and reversible procedures for the treatment of morbid obesity. Migration of the gastric band into the gastric lumen is a rare late complication of LAGB. Previous attempts at endoscopic removal of migrated bands have included the use of endoscopic scissors, laser ablation and argon plasma coagulation (APC). We report two cases of successful endoscopic management of gastric band migration using a gastric band cutter. PMID:23256012

  4. Cognitive Distortions and Suicide Attempts.

    PubMed

    Jager-Hyman, Shari; Cunningham, Amy; Wenzel, Amy; Mattei, Stephanie; Brown, Gregory K; Beck, Aaron T

    2014-08-01

    Although theorists have posited that suicidal individuals are more likely than non-suicidal individuals to experience cognitive distortions, little empirical work has examined whether those who recently attempted suicide are more likely to engage in cognitive distortions than those who have not recently attempted suicide. In the present study, 111 participants who attempted suicide in the 30 days prior to participation and 57 psychiatric control participants completed measures of cognitive distortions, depression, and hopelessness. Findings support the hypothesis that individuals who recently attempted suicide are more likely than psychiatric controls to experience cognitive distortions, even when controlling for depression and hopelessness. Fortune telling was the only cognitive distortion uniquely associated with suicide attempt status. However, fortune telling was no longer significantly associated with suicide attempt status when controlling for hopelessness. Findings underscore the importance of directly targeting cognitive distortions when treating individuals at risk for suicide.

  5. Adapters, strugglers, and case managers: a typology of spouse caregivers.

    PubMed

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

    2014-11-01

    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.

  6. Management of dentinogenesis imperfecta: a review of two case reports.

    PubMed

    Rafeek, Reisha N; Paryag, Amit; Al-Bayaty, Haytham

    2013-01-01

    Dentinogenesis imperfecta (DI) is an inherited disorder that affects dentin and often manifests as tooth discoloration; in addition, the dentition is also extremely susceptible to wear. Treatment of DI focuses primarily on protecting affected dentin, reducing sensitivity, and improving esthetics. Routine restorative materials, such as amalgams and composites, may be used. In more severe cases, the treatment of choice is full coverage crowns, while bonding of veneers may be used to improve the esthetics of the anterior teeth. This study presents two cases of Type II DI in the same family and the management of each case. Restorative management included amalgams, composite veneers, crowns, bridges, and overdentures.

  7. 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.

  8. 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.

  9. 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.

  10. Successful management of chylous ascites: A report of two cases.

    PubMed

    Alam, Shaan E; Kar, Sunny M; Kar, Pran M

    2016-03-01

    Chylous ascites consists of the accumulation of chyle in the peritoneal cavity. Diagnosis is established by cytochemical analysis of the fluid revealing fat globules and high triglyceride content. The majority of cases are caused by pathology that interferes with abdominal retroperitoneal lymphatic drainage. We present two cases of postoperative chylous ascites, one following a bilateral nephrectomy, the other following orthotopic heart transplantation. Treatment is typically conservative with the aim to alleviate abdominal distension and reduce the flow of lymph into the mesenteric lymph nodes. Postsurgical chylous ascites has high cure rate with conservative therapy alone. Therapeutic paracentesis, diuretics, salt restriction, a high-protein, low-fat, mediumchain triglyceride diet, and parenteral nutrition are considered in chronic cases. The effects of longterm paracentesis on patients remains to be seen. In patients requiring renal replacement therapy, removal of chyle during peritoneal dialysis is often attempted.

  11. Temperament Characteristics of Suicide Attempters.

    ERIC Educational Resources Information Center

    Mehrabian, Albert; Weinstein, Lisa

    1985-01-01

    In a preliminary study of a single group of suicide attempters, male and female subjects did not differ in temperament characteristics. Data from both sexes indicated that suicide-prone individuals have unpleasant, arousable, and submissive temperaments, with arousability a strong discriminator of suicide attempters relative to the general…

  12. Cardiovascular collapse with attempted pericardial drain withdrawal

    PubMed Central

    Kraus, Molly B; Spitznagel, Rachel A; Kugler, Jane A

    2016-01-01

    Cardiac tamponade is a rare but serious emergency condition in the pediatric population. As treatment, a pericardial drain is often placed to evacuate the fluid. We present a case of a 4-year-old girl with cardiac tamponade secondary to renal failure. After the tamponade resolved, she suffered cardiovascular collapse upon attempted drain withdrawal. This case highlights an unusual cause for cardiovascular collapse, which occurred on blind removal of a pericardial drain. PMID:27625522

  13. Cardiovascular collapse with attempted pericardial drain withdrawal

    PubMed Central

    Kraus, Molly B; Spitznagel, Rachel A; Kugler, Jane A

    2016-01-01

    Cardiac tamponade is a rare but serious emergency condition in the pediatric population. As treatment, a pericardial drain is often placed to evacuate the fluid. We present a case of a 4-year-old girl with cardiac tamponade secondary to renal failure. After the tamponade resolved, she suffered cardiovascular collapse upon attempted drain withdrawal. This case highlights an unusual cause for cardiovascular collapse, which occurred on blind removal of a pericardial drain.

  14. Cardiovascular collapse with attempted pericardial drain withdrawal.

    PubMed

    Kraus, Molly B; Spitznagel, Rachel A; Kugler, Jane A

    2016-01-01

    Cardiac tamponade is a rare but serious emergency condition in the pediatric population. As treatment, a pericardial drain is often placed to evacuate the fluid. We present a case of a 4-year-old girl with cardiac tamponade secondary to renal failure. After the tamponade resolved, she suffered cardiovascular collapse upon attempted drain withdrawal. This case highlights an unusual cause for cardiovascular collapse, which occurred on blind removal of a pericardial drain. PMID:27625522

  15. [Attempted suicide of youth with Asperger's disorder].

    PubMed

    Mikami, Katsunaka; Ohya, Akitoshi; Akasaka, Kuni; Matsumoto, Hideo

    2006-01-01

    Research of Asperger's disorder is increasing through strong interest in this disorder. However, there are few reports on suicide attempts among youths with this disorder. We examined the clinical characteristics of serious suicide attempts of adolescents, and indicated the frequency of pervasive developmental disorders among them. In the present study, we reported a suicide attempt using briquettes by a youth with Asperger's disorder aged 23, who had a history of two suicide attempts by hanging. In this case, we examined the predisposing factors to suicide and possible intervention to prevent a re-attempt. As a result, in this case, we suggested that low self-esteem due to repeated serious social failures and feelings of isolation, although there was a social support system, were psycho-social predisposing factors. Moreover, the "conflict" between the patient and his parents, who should have provided social support for him, had made him feel alone. This "conflict" was composed of 1) the primary symptoms of Asperger's disorder (deficit of emotional reciprocity and unreasonable insistence on restricted thoughts.) and 2) his parents' insufficient comprehension of Asperger's disorder. This "conflict" was distinct from the conflict of interpersonal friction based on emotional interaction. In order to prevent a suicide re-attempt, we mainly intervened in the problem of low self-esteem due to repeated serious social failures and having feelings of isolation. We concluded that to prevent a suicide re-attempt in patients with Asperger's disorder, it is important to diagnose and treat the disorder and comorbidity, and it is more important to recognize and aggressively intervene in psycho-social predisposing factors.

  16. The assemblage of compliance in psychiatric case management.

    PubMed

    Brodwin, Paul

    2010-08-01

    In the post-asylum era, case managers perform much of the face-to-face work of pharmaceutical compliance for people with severe and persistent mental illness. Their work demands careful orchestration of the assemblage of compliance, including the actual medications, the ideology of biopsychiatry, the division of professional labor, and certain mundane tools. Ethnographic vignettes from an Assertive Community Treatment (ACT) team show how case managers use this assemblage in their everyday routines, but also how it undercuts key elements of the original ACT mission. Reflecting its roots in the deinstitutionalization movement, the ACT model gives case managers limitless responsibilities for clients' lives, but then narrowly defines their role as the prosthetic extension of psychiatric authority. To produce compliance, case managers depend on the medication cassette, analyzed here as a human/non-human hybrid woven into their ordinary work. The medication cassette has pre-scripted uses that enlist clinicians in biopsychiatric thinking and also silently impose compliant behavior on clients. The elements in the assemblage of compliance depend on each other, but they do not form a seamless whole, as evidenced by the dilemmas and micropolitics of the clinical front-line. Theoretical notions of assemblages and technologies of compliance, drawn from science and technology studies, illuminate a core conundrum of practice in psychiatric case management.

  17. Sociodemographic profile of suicide attempters among the rural agrarian community of central India

    PubMed Central

    Mishra, Kshirod Kumar; Gupta, Neha; Bhabulkar, Sneha

    2015-01-01

    Background: Suicides, attempted suicides and different form of suicidal behaviors are on the rise in most part of the world. It is generally assumed that official suicidal rate are underestimated from the true rate by 20-100 % due to prevailing socio-cultural issues, religious attitude, stigma attached, and legal process involved. Attempted suicides occur 8-20 times more frequently than complete suicide. Statistics on attempted suicide or deliberate self harm are not usually available officially. Materials and Methods: All the cases of attempted suicide who were admitted and referred for psychiatric evaluation and management to a rural medical college of central India during a period of one Year (April 13-March-14), following initial recovery they were evaluated on a semi-structured performa on socio demographic profile, mode of attempt and reason for attempt. Data collected was analyzed using suitable statistical methods. Results: Total 68 cases were evaluated during the study period. 43% of the cases were involved in farming. Among 85% of the study population pesticide consumption was the common mode of attempt, which is easily available among the agrarian community of rural India. Interpersonal conflict in the family due to indebtedness, financial loss due to crop failure was the commonest reason for attempt. Conclusion: Though there is reduced reporting in the incidents of suicide cases in media from this region, still quite a number of people attempt suicide due to financial constraint from crop failure, ongoing indebtedness, and poor socioeconomic condition culminating into poor mental health among the rural agrarian community of central Maharashtra. PMID:27212825

  18. 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

  19. Integrated dementia care in The Netherlands: a multiple case study of case management programmes.

    PubMed

    Minkman, Mirella M N; Ligthart, Suzanne A; Huijsman, Robbert

    2009-09-01

    The number of dementia patients is growing, and they require a variety of services, making integrated care essential for the ability to continue living in the community. Many healthcare systems in developed countries are exploring new approaches for delivering health and social care. The purpose of this study was to describe and analyse a new approach in extensive case management programmes concerned with long-term dementia care in The Netherlands. The focus is on the characteristics, and success and failure factors of these programmes.A multiple case study was conducted in eight regional dementia care provider networks in The Netherlands. Based on a literature study, a questionnaire was developed for the responsible managers and case managers of the eight case management programmes. During 16 semistructured face-to-face interviews with both respondent groups, a deeper insight into the dementia care programmes was provided. Project documentation for all the cases was studied. The eight programmes were developed independently to improve the quality and continuity of long-term dementia care. The programmes show overlap in terms of their vision, tasks of case managers, case management process and the participating partners in the local dementia care networks. Differences concern the targeted dementia patient groups as well as the background of the case managers and their position in the local dementia care provider network. Factors for success concern the expert knowledge of case managers, investment in a strong provider network and coherent conditions for effective inter-organizational cooperation to deliver integrated care. When explored, caregiver and patient satisfaction was high. Further research into the effects on client outcomes, service use and costs is recommended in order to further analyse the impact of this approach in long-term care. To facilitate implementation, with a focus on joint responsibilities of the involved care providers, policy

  20. Hospital overcrowding: an opportunity for case managers.

    PubMed

    Simmons, Florence M

    2005-01-01

    Hospital overcrowding is primarily a shortage of inpatient beds, not a lack of emergency department capacity, as initially assumed. According to Asplin et al., many factors contribute to overcrowding, including inadequate or inflexible nurse-to-patient staffing ratios, isolation precautions, or delays in cleaning rooms after patient discharge; an overreliance on intensive care or telemetry beds; inefficient diagnostic and ancillary services on inpatient units; and delays in discharging hospitalized patients to postacute-care facilities. Hospital overcrowding presents a challenge for hospital employees and clients, often leading to frustration and dissatisfaction. Overcrowding also has a direct effect on patient care, including compromised patient safety, increased costs, increased length of stay, and increased mortality and morbidity rates. The emergency department is changed from a temporary holding area to an extended patient care unit, decreasing its ability to handle new admissions and to manage a mass casualty. Beds in the critical care units become filled with inappropriate patients if floor beds are not available, making placement of seriously ill patients difficult. Trauma patients may have to be diverted to other hospitals to receive the appropriate level of care. Patients who require specialty services may have to wait for extended periods to obtain a bed in a referral center.

  1. 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

  2. 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

  3. 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

  4. 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

  5. Coordinated care partnership: case management with physician practices.

    PubMed

    Anker-Unnever, L; Netting, F E

    1995-01-01

    This article describes the Coordinated Care Partnership Project, operated by The St. Joseph Healthcare System. Funded as one of several demonstration sites by The John A. Hartford Foundation, this project places social work and nurse care managers in selected primary care physician practices in Albuquerque, NM. Lessons learned from the first year of operation are presented, along with implications for the role of case management in primary care practice.

  6. 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

  7. [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

  8. [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.

  9. Non-pharmacological management of nasal polyp: a case report.

    PubMed

    Rastogi, Rajiv; Murthy, B T C; Vinudha

    2009-01-01

    Nasal polyp causes difficulty in breathing due to blockage of nasal passage. The pathogenesis of nasal polyposis is not known. The primary medical therapy available for nasal polyposis is steroid administration. Antihistamines, decongestants and cromolyn sodium provide little benefit. With this background of nasal polyp pathophysiology and the existing management, a case of nasal polyp was treated with the cleansing process of yoga i.e. neti kriya and naturopathy with good result. This isolated case report warrants a need for controlled clinical trial of neti kriya to establish its role in the management of nasal polyposis.

  10. Broad Ligament Pregnancy - Success Story of a Laparoscopically Managed Case.

    PubMed

    Nayar, Jayashree; Nair, Sobha S

    2016-07-01

    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 6(th) case report of such a rare ectopic pregnancy managed endoscopically successfully. PMID:27630914

  11. Volunteers in hospital-based case management programs.

    PubMed

    Netting, F E; Williams, F G; Jones-McClintic, S; Warrick, L

    1989-01-01

    This article examines the use of volunteers within hospital-based long-term care case management programs. As hospitals diversify into long-term care, the roles played by volunteers are also diversifying. A brief description of the involvement of volunteers with the frail elderly is followed by a comparison of the roles and relationships of volunteers within existing hospital auxiliaries and long-term care case management programs. Three models for structuring hospital-based volunteer programs that address the needs of the frail elderly within diverse communities are presented. Implications surrounding the involvement of volunteers beyond hospital walls are discussed.

  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. [Fluctuations and seasonality in suicidal attempts].

    PubMed

    Polewka, Andrzej; Szkolnicka, Beata; Targosz, Dorota; Groszek, Barbara; Kroch, Stanisław; Chrostek Maj, Jan; Zieba, Andrzej

    2004-01-01

    The aim of the study was to analyze seasonality and temporal fluctuations in suicide attempts by persons living in Krakow and hospitalized in the Department of Clinical Toxicology CMUJ in the years 2000-2002. The research focussed on the frequency of suicide attempts in relation to the time of the day, day of the week, and month of the year. Temporal fluctuations in the frequency of suicide attempts have been assessed on the basis of the data from medical documentation concerning 2757 suicide attempts by individuals ranging in age from 14 to 90 years. The group consisted of 1607 females and 1150 males. According to the results of the research, seasonality and temporal fluctuations in the frequency of suicide attempts is different for males and females. In the case of the males examined, no dependence between the frequency of suicide attempts and a particular month or season has been observed. In the case of females, on the contrary, the data indicate the existence of a seasonal pattern with the peak in the spring (or early part of the summer), and in the autumn--in October and November. In males, the peak day for attempted suicide was Monday, whereas in females--Sunday and Monday. As regards the time of the day, both the results of the present research and data collected by WHO/EURO indicate that suicide attempts occurred most frequently in the evening, late in the evening or in the early part the night. In conclusion, it has been emphasized that the majority of suicide attempts, especially by females, occurs late in the evening or early in the night. This finding seems to be of particular importance for suicide prevention--it can contribute to the increase in the effectiveness of the organization of work in the Crisis Intervention Centres and make therapists and patients' families aware of the existence of periods of an increased suicide risk. The research has been conducted owing to the cooperation between the department of Clinical Toxicology, CMUJ and the

  14. Epidermolysis bullosa: dental and anesthetic management of two cases.

    PubMed

    Wright, J T

    1984-02-01

    Epidermolysis bullosa (EB) is a group of rare genetic disorders which are of dental interest because of their specific oral manifestations and management difficulties. Two cases of recessive EB which may be classified clinically as the atrophicans-gravis Herlitz type are described. Dental therapy consisted of extractions and stainless steel crown restorations, with inhalation general anesthesia. The need for and advantages of early preventive and restorative dental care are illustrated by the cases presented.

  15. Conservative Management of Fetus Papyraceus: A Report of Two Cases

    PubMed Central

    Dahiya, Pushpa; Bains, Ranjita

    2014-01-01

    The term fetus papyraceus is used to describe a mummified fetus associated with multiple gestations where one fetus dies and is flattened between the membranes of living fetus and uterine wall. Though the maternal and fetal complications in affected cases can be severe, we report of two cases of fetus papyraceus managed conservatively without any complications. Successful outcome is related to careful monitoring during pregnancy. PMID:24715942

  16. 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…

  17. Evaluation of Probation Case Management (PCM) for Drug-Involved Women Offenders

    ERIC Educational Resources Information Center

    Chan, Monica; Guydish, Joseph; Prem, Rosemary; Jessup, Martha A.; Cervantes, Armando; Bostrom, Alan

    2005-01-01

    Based on availability of case management services, drug-involved women offenders entered either a probation case management (PCM) intervention(n = 65) or standard probation(n = 44). Participants were placed in the case management condition until all slots were filled, then placed in standard probation until case management slots opened.…

  18. Suicide Attempts in the United States Army

    PubMed Central

    Ursano, Robert J.; Kessler, Ronald C.; Stein, Murray B.; Naifeh, James A.; Aliaga, Pablo A.; Fullerton, Carol S.; Sampson, Nancy A.; Kao, Tzu-Cheg; Colpe, Lisa J.; Schoenbaum, Michael; Cox, Kenneth L.; Heeringa, Steven G.

    2015-01-01

    Importance The U.S. Army suicide attempt rate increased sharply during the wars in Afghanistan and Iraq. Comprehensive research on this important health outcome has been hampered by a lack of integration among Army administrative data systems. Objective To identify risk factors for Regular Army suicide attempts during the years 2004–2009 using data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Design, Setting, and Participants There were 9,791 medically documented suicide attempts among Regular Army soldiers during the study period. Individual-level person-month records from Army and Department of Defense administrative data systems were analyzed to identify socio-demographic, service-related, and mental health risk factors distinguishing suicide attempt cases from an equal-probability control sample of 183,826 person-months. Main Outcome and Measures Suicide attempts were identified using Department of Defense Suicide Event Report records and ICD-9 E95x diagnostic codes. Predictor variables were constructed from Army personnel and medical records. Results Enlisted soldiers accounted for 98.6% of all suicide attempts, with an overall rate of 377/100,000 person-years, versus 27.9/100,000 person-years for officers. Significant multivariate predictors among enlisted soldiers included socio-demographic characteristics (female gender, older age at Army entry, younger current age, low education, non-hispanic white), short length of service, never or previously deployed, and the presence and recency of mental health diagnoses. Among officers, only socio-demographic characteristics (female gender, older age at Army entry, younger current age, and low education) and the presence and recency of mental health diagnoses were significant. Conclusions and Relevance Results represent the most comprehensive accounting of U.S. Army suicide attempts to date and reveal unique risk profiles for enlisted soldiers and officers, and highlighting the

  19. Case management of childhood tuberculosis in children's hospitals in Khartoum.

    PubMed

    Osman, T; El Sony, A

    2014-07-08

    No published information is available on the case management of childhood tuberculosis (TB) in Sudan. The aim of this study was to describe the case management of childhood TB in 4 children's hospitals in Khartoum State, Sudan. Data on 467 children aged 0-14 years registered in 2009 were collected from patient records; 52.9% males and 53.0% aged 5-14 years. Most cases were registered as new cases (89.5%) and most had pulmonary TB (72.4%). Of all cases, 31.0% had sputum smear microscopy done, 35.8% had X-ray and none had a record of being culture confirmed. Category III regimen was given to 58.5%. Reported outcomes were: cured (1.5%), completed treatment (14.6%), transferred out (13.1%), default (17.3%), death (4.3%) and treatment failure (0.6%). Age was significantly associated with treatment outcome, while sex, type of patient, site of TB and treatment category were not significant. Case management of childhood TB is suboptimal in this region.

  20. 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…

  1. Responding to the Increased Needs of College Students: A Case Study of Case Management

    ERIC Educational Resources Information Center

    Shelesky, Kristin; Weatherford, Ryan D.; Silbert, Janelle

    2016-01-01

    The psychological needs of college students lead to overwhelming demand on college counseling centers' resources. In this article, we review models of case management in Higher Education including the administrative, behavioral intervention, and counseling center models. We also present a case study of the 3-year development of a counseling center…

  2. Attempted suicide, suicidal intent, and alcohol.

    PubMed

    Nielsen, A S; Stenager, E; Brahe, U B

    1993-01-01

    The purpose of the present study was to relate suicidal intent to the suicide method chosen and the medical lethality of the suicidal act, and to discuss how ingestion of alcohol impacts these three factors. The study was based upon interviews with 139 suicidal patients admitted to the Department of Psychiatry of Odense University Hospital. The results indicated a tendency for suicide attempters using wrist-cutting to score low on the Suicidal Intent Scale. Patients using kinds of self-injury other than self-poisoning or wrist-cutting scored high. In the case of self-poisoning, suicidal intent did not influence the choice of toxic agent, nor was the choice of method and/or choice of toxic agent affected by alcohol ingestion. A correlation between suicidal intent and the lethality of the suicide attempt was seen only among patients without a diagnosis of alcohol dependence. Alcohol-dependent patients who made highly lethal attempts scored relatively low on the Suicidal Intent Scale. The results indicate that the lethality of the suicidal act is only an incomplete guide to a patient's suicidal intent. However, it should be stressed that, despite the fact that alcohol-dependent suicide attempters may not strongly wish to die, they are nonetheless at high risk for making fatal suicide attempts.

  3. 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

  4. 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.

  5. 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

  6. Making Managers Accountable or Making Managers? The Case of a Code for Management in a Higher Education Institution.

    ERIC Educational Resources Information Center

    Prichard, Craig

    1996-01-01

    Over the last decade, many groups of professionals in the public sector have been reoriented as individual managers. In British higher education, individual department heads have been pressured to develop private-sector-manager-like identities and relations with their colleagues. This case study revealed considerable resistance to managerialism in…

  7. Predictors of Suicide Attempts in Clinically Depressed Korean Adolescents

    PubMed Central

    Kwon, Ahye; Song, Jungeun; Yook, Ki-Hwan; Jon, Duk-In; Jung, Myung Hun; Hong, Narei; Hong, Hyun Ju

    2016-01-01

    We examined predictors of suicide attempts in clinically depressed adolescents in Korea and gender differences in suicidal behavior. In total, 106 adolescents diagnosed with depressive disorder were recruited in South Korea. We assessed various variables that might affect suicide attempts, and used a structured interview for the diagnosis of depression and comorbidities and to evaluate suicidality. Demographic and clinical characteristics of the subjects were compared between suicide attempt and non-suicide attempt groups and we examined significant predictors of suicide attempts. Gender differences in suicidal ideation and suicidal behavior were also analyzed. Among 106 depressed participants, 50 (47.2%) adolescents were classified in the suicide attempt group. Generally, the suicide attempt and non-suicide attempt group shared similar clinical characteristics. The suicide attempt group had more females, more major depressive disorder diagnoses, more depressive episodes, and higher suicidal ideation than the non-suicide attempt group. Suicidal ideation was the only significant predictor of suicidal attempt, regardless of gender. Higher suicidal ideation frequency scores and more non-suicidal self-injurious behaviors were shown in the female suicide attempt group than the male suicide attempt group. It is recommended that suicidal ideation be assessed regularly and managed rigorously to decrease suicide risks in depressive adolescents. PMID:27776392

  8. 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.

  9. Case Studies in Managing School Library Media Centers.

    ERIC Educational Resources Information Center

    Callison, Daniel; Morris, Jacqueline

    Thirty-two case studies illustrating problem areas and situations that develop in the modern environment of the electronic school library media program are presented for use by library science students and library/media center managers. Based on input from practicing librarians at the elementary and secondary levels, the studies are designed to…

  10. 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…

  11. 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…

  12. 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…

  13. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... in the care plan have been achieved. (v) Whether the individual has declined services in the care plan. (vi) The need for, and occurrences of, coordination with other case managers. (vii) A timeline..., including for foster care programs, services such as, but not limited to, the following: (1)...

  14. 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,…

  15. 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…

  16. 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.…

  17. 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)

  18. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 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...

  19. 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 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...

  20. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 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...

  1. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 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...

  2. 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,…

  3. 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

  4. Prosecuting attempted suicides in London: 1891-1913.

    PubMed

    Lester, David

    2009-12-01

    A study of 30 cases of attempted suicide tried at the Old Bailey criminal court in London (England) from 1891 to 1913 indicated that having made prior attempts was the only predictor of the severity of the sentence. 22 individuals were tried for murdering or attempting to murder their child and also attempting suicide. None of the murderers but half of the attempted murderers were found not guilty, or guilty then released. Mothers used drowning more than did fathers and were more likely to be found not guilty.

  5. [Inadequate management of a difficult airway. Case SENSAR of the trimester].

    PubMed

    2015-01-01

    A clinical case reported to SENSAR is presented (www.sensar.org). A patient came to the operating room for surgery for parathyroidectomy. She had several predictors of difficult airway management, including a story of difficulties in previous intubations in other hospitals, as the patient reported. Therefore, after evaluation in preoperative consultation, fibreoptic bronchoscopy intubation was recommended. The day of surgery after induction of general anesthesia direct laryngoscopy was performed, without recognizing any glottic structure (Cormack-Lehane grade iv). Conventional laryngoscope was changed to a videolaryngoscope (Airtraq(®)) to try to improve the laryngoscopic view, but there were difficulties with handling and insertion of it, causing minor injuries to the lingual mucosa. Finally, tracheal intubation was achieved after several attempts. Analysis of the incident revealed the active error due to lack of experience of the professional who performed intubation maneuvers, favored by latent factors or contributors as were the complex pathology of the patient and the absence of protocols to difficult airway management in the hospital. Communication and analysis of this incident served to highlight the importance of the security protocols in Anesthesia, and as a result a working group that conducted the current algorithm approach to a difficult airway management was formed, established guidelines for further information patient and deals since clinical training and professional practice for the management of airway devices availables in the hospital.

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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

  12. Management of chronic, resistive scabies: a case study.

    PubMed

    Morris Hicks, L E; Lewis, D J

    1995-01-01

    It took about 9 months of diligent effort to resolve Mr. C's chronic, highly resistive case of scabies. In all, Mr. C. had a total of seven treatments with a scabicidal lotion or cream. In addition, other medications were prescribed in an attempt to resolve his skin condition. The treatment of scabies is costly to an institution, in medications, supplies, and additional nursing time required to treat the patient, as well as other patients prophylactically. Therefore it behooves nurses to do a thorough skin assessment on all nursing home care patients at least monthly, recognize early signs of scabies, and be cognizant of the fact that scabies in the elderly patient may have an atypical distribution.

  13. Management challenges in a case of gender identity disorder.

    PubMed

    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.

  14. Short-term case mix management with linear programming.

    PubMed

    Hughes, W L; Soliman, S Y

    1985-01-01

    One short-term economic incentive created by a prospective payment system based on diagnosis-related groups (DRGs) is for hospital managers to optimally and efficiently use the hospital's current mix of services to maximize net contribution. DRGs provide a managerial definition of the hospital's product by determining the number of patients discharged within each of the 467 groupings. Thus, the DRG case mix can be thought of as the hospital's product mix. As in major industry, linear programming models may prove useful in determining the hospital's financially optimal case mix. This article provides a framework for applying the linear programming concept to case mix planning in the hospital setting. It also presents an illustration and interpretation of a linear programming model that provides information about the short-term optimal case mix.

  15. 30 CFR 250.518 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Operations Casing Pressure Management § 250.518 What are the requirements for casing pressure management? Once you install your wellhead, you must meet the casing pressure management requirements of API RP 90... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What are the requirements for casing...

  16. [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

  17. 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.

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

    PubMed

    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.

  19. Mental health case management in Canada: job description analyses.

    PubMed

    Forchuk, Cheryl; Ouwerkerk, Alice; Yamashita, Mineko; Martin, Mary-Lou

    2002-01-01

    The purpose of this study was to examine case managers' (CM) job position descriptions through content analysis. There were 29 case manager job position descriptions examined. The job descriptions could be grouped into four categories: (1) what the individuals should bring to the position, (2) what they did as CM, (3) to whom they were accountable, and (4) what was valued. Themes included focus on client as individual, focus on the external/system, or outer-directed work, and the articulation point between the individual and broader system. The CM works directly and indirectly in the system and community through education, organizing, planning, and networking, as well as through provision of direct care to the individual client. The expectations of the positions are extensive.

  20. [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.

  1. [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

  2. Evaluation of community-based nurse case management activities for symptomatic HIV/AIDS clients.

    PubMed

    Wright, J; Henry, S B; Holzemer, W L; Falknor, P

    1993-01-01

    The purpose of this study was to evaluate case management activities performed by nurse case managers in the California Pilot Care and Waiver Projects for HIV/AIDS patients. Nurse case managers, social workers, and site directors completed a 62-item survey. Significant differences appeared in ratings among the groups on five items. The nurse case managers responding to the survey indicated that a wide variety of nursing skills are used to provide case management services to persons living with AIDS and AIDS-related complex. This survey validates the interdisciplinary case management model in a community-based HIV population.

  3. 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

  4. Clinical Management of Two Root Resorption Cases in Endodontic Practice.

    PubMed

    Mincik, Jozef; Urban, Daniel; Timkova, Silvia

    2016-01-01

    Root resorption is a pathological process involving loss of hard dental tissues. It may occur as a consequence of dental trauma, orthodontic treatment, and bleaching, and occasionally it accompanies periodontal disease. Although the mechanism of resorption process is examined in detail, its etiology is not fully understood. Wide open apical foramen is more difficult to manage and the root canal may often overfill. In this report we present two cases of root resorption and describe means for its clinical management. We conclude that useful measure of a success or failure in managing root resorption is the persistence of the resorption process. It is a clear sign of an active ongoing inflammatory process and shows the clinical need for retreatment. PMID:27648314

  5. Clinical Management of Two Root Resorption Cases in Endodontic Practice

    PubMed Central

    2016-01-01

    Root resorption is a pathological process involving loss of hard dental tissues. It may occur as a consequence of dental trauma, orthodontic treatment, and bleaching, and occasionally it accompanies periodontal disease. Although the mechanism of resorption process is examined in detail, its etiology is not fully understood. Wide open apical foramen is more difficult to manage and the root canal may often overfill. In this report we present two cases of root resorption and describe means for its clinical management. We conclude that useful measure of a success or failure in managing root resorption is the persistence of the resorption process. It is a clear sign of an active ongoing inflammatory process and shows the clinical need for retreatment. PMID:27648314

  6. Clinical Management of Two Root Resorption Cases in Endodontic Practice

    PubMed Central

    2016-01-01

    Root resorption is a pathological process involving loss of hard dental tissues. It may occur as a consequence of dental trauma, orthodontic treatment, and bleaching, and occasionally it accompanies periodontal disease. Although the mechanism of resorption process is examined in detail, its etiology is not fully understood. Wide open apical foramen is more difficult to manage and the root canal may often overfill. In this report we present two cases of root resorption and describe means for its clinical management. We conclude that useful measure of a success or failure in managing root resorption is the persistence of the resorption process. It is a clear sign of an active ongoing inflammatory process and shows the clinical need for retreatment.

  7. Clinical experience with wound biofilm and management: a case series.

    PubMed

    Hurlow, Jennifer; Bowler, Philip G

    2009-04-01

    Biofilm is a relatively new concept in the fields of infectious disease, wound infection, and healing. Although scientific research and "noise" regarding wound biofilm is increasing, little is known about the presentation, diagnosis, potential implications, and management strategies regarding wound biofilms. A series of four clinical cases is utilized to demonstrate the existence of wound biofilm. All patients presented with or developed a film on the wound bed that appeared to be distinct from slough; wounds also were failing to progress. Although the slough in some of the wounds was easily removed with traditional debridement methods, removal of the film required physical disruption with a curette or dry gauze. All wounds eventually progressed to healing. Considering the biofilm concept and available preclinical research, it is evident from this small case series that the appearance of biofilm in wounds is quite different from slough and requires different management strategies for its control. The evolving biofilm paradigm could profoundly change approaches to wound management. Additional research is needed in this evolving aspect of wound management.

  8. Suicide attempt with a mix of synthetic cannabinoids and synthetic cathinones: Case report of non-fatal intoxication with AB-CHMINACA, AB-FUBINACA, alpha-PHP, alpha-PVP and 4-CMC.

    PubMed

    Klavž, Janez; Gorenjak, Maksimiljan; Marinšek, Martin

    2016-08-01

    We report on a case of intoxication with a mix of new psychoactive substances. A 38-year-old male was brought to the emergency department (ED) following the ingestion of an unknown drug in a suicide attempt. During the transport, he became progressively more somnolent and unresponsive to painful stimuli. Urine and stomach content were collected on admission to be screened for drugs of abuse and medicinal drugs. After admission, the patient's next of kin presented five small grip seal plastic bags containing different powders/crystals, and they were sent for analysis along with urine and stomach content to the toxicology laboratory. An easy and rapid sample preparation technique was applied for the extraction of urine and stomach content. Samples were extracted with liquid-liquid extraction (LLE) technique and analysed using gas chromatography-mass spectrometry (GC-MS). A small amount of powder material from the bags was diluted in methanol and injected directly into the GC-MS instrument. Obtained spectra (EI) were evaluated against SWGDRUG library. Five different designer drugs were identified in the powder material, including synthetic cannabinoids (AB-CHMINACA, AB-FUBINACA) and synthetic cathinones (alpha-PHP, alpha-PVP and 4-CMC). With the exception of 4-CMC, all of these substances were also detected in the stomach content along with the prescription drugs. This is the first time that a positive identification of these five drugs has been made by a clinical laboratory in Slovenia.

  9. Attempted suicide in Kuala Lumpur.

    PubMed

    Habil, M H; Ganesvaran, T; Agnes, L S

    A total of 306 patients were admitted to the University Hospital in Kuala Lumpur in 1989 after attempting suicide. Fourteen of them succumbed to injuries. Psychosocial data of 296 patients out of the 306 survivors are reported. Suicidal behaviour is more common in the young and especially amongst the females. Nearly 45.0% of them are from social class IV and V. Persons of Indian ethnic origin are overrepresented, while in Malays suicidal behavior seemed to be less common. Self-poisoning was reported to be the commonest method in attempting suicide. Diagnosis of adjustment disorder was made in 58.5% of the patients. Two-thirds of the patients had an intention score of less than 10 on the Pierce's Scale.

  10. Attempted suicide: an operant formulation.

    PubMed

    Bostock, T; Williams, C L

    1975-06-01

    An alternative formulation of attempted suicide is offered, in which the phenomenon is considered within the context of social learning theory. The suicidal behaviour is viewed as an operant which is reinforced and maintained by the consequent interpersonal contingencies. The modification of the suicidal behaviour then involves alteration of the contingent consequences. This theoretical formulation is elaborated and the treatment principles and practice are outlined.

  11. Epidemiological aspects of suicide attempts among Moroccan children

    PubMed Central

    Mekaoui, Nour; Karboubi, Lamiae; Ouadghiri, Fatima Zahra; Dakhama, Badr Sououd Benjelloun

    2016-01-01

    Suicidal behavior among children has significantly increased in Morocco. We conducted a study on the epidemiological aspect to propose a treatment strategy. Descriptive retrospective study over a period of 3 years (April 2012-April 2015) involving children who visited pediatric medical emergencies of the Children Hospital of Rabat after an autolysis attempt. We observed epidemiological parameters, history, social and family context, the means used, the presumed cause, clinical manifestation, and the management. 66 patients were identified. A female predominance was found (sex =15). The average age was 13 years old. This was a first episode in 97% of cases. Psychiatric history was found in 6 patients. The causes of suicide attempt were unidentified in 65%. The most frequent cause was family conflict (35%). The most frequent method was pharmaceutical drug ingestion (54.4%). Children were asymptomatic (57.6%). Neurological manifestations (30%) were most frequent. Digestive symptoms (12%) and hemodynamic (3%) were also discovered. Patients were hospitalized in a general pediatric service 92.4% of the times, admitted to intensive care 4.5% of the times, and two patients refused to be hospitalized. The treatment consisted of gastric lavage (18%) supplemented by symptomatic measures. The outcome was favorable in 95.4% of cases. We recorded 2 deaths by rat poison poisoning. All patients were advised in writing after leaving to follow up with a psychological treatment. Suicide attempts are the result of an ill being, mostly among children living in a family with conflict. Upstream treatment is essential to identify children at risk. Additionally, a psychiatric care in hospital is essential to avoid recurrences. PMID:27642451

  12. Epidemiological aspects of suicide attempts among Moroccan children.

    PubMed

    Mekaoui, Nour; Karboubi, Lamiae; Ouadghiri, Fatima Zahra; Dakhama, Badr Sououd Benjelloun

    2016-01-01

    Suicidal behavior among children has significantly increased in Morocco. We conducted a study on the epidemiological aspect to propose a treatment strategy. Descriptive retrospective study over a period of 3 years (April 2012-April 2015) involving children who visited pediatric medical emergencies of the Children Hospital of Rabat after an autolysis attempt. We observed epidemiological parameters, history, social and family context, the means used, the presumed cause, clinical manifestation, and the management. 66 patients were identified. A female predominance was found (sex =15). The average age was 13 years old. This was a first episode in 97% of cases. Psychiatric history was found in 6 patients. The causes of suicide attempt were unidentified in 65%. The most frequent cause was family conflict (35%). The most frequent method was pharmaceutical drug ingestion (54.4%). Children were asymptomatic (57.6%). Neurological manifestations (30%) were most frequent. Digestive symptoms (12%) and hemodynamic (3%) were also discovered. Patients were hospitalized in a general pediatric service 92.4% of the times, admitted to intensive care 4.5% of the times, and two patients refused to be hospitalized. The treatment consisted of gastric lavage (18%) supplemented by symptomatic measures. The outcome was favorable in 95.4% of cases. We recorded 2 deaths by rat poison poisoning. All patients were advised in writing after leaving to follow up with a psychological treatment. Suicide attempts are the result of an ill being, mostly among children living in a family with conflict. Upstream treatment is essential to identify children at risk. Additionally, a psychiatric care in hospital is essential to avoid recurrences. PMID:27642451

  13. Psychiatric aspects of murder and attempted murder.

    PubMed

    Medicott, R W

    1976-01-14

    The clinical data and forensic aspects of 28 individuals charged with murder and 10 charged with attempted murder examined over the last 35 years are recorded. The majority of those aged 40 years or over were criminally insane. A positive family history of psychiatric illness was present in the majority of the criminally insane group. Murder and attempted murder in the setting of a stable marriage was almost invariably the result of serious psychiatric illness. After the clearcut cases of schizophrenia and depressive illness were separated there were left a mixed paranoid group and a large group of individuals with severe personality disorders. Of the forensic aspects a case is made for the wider use of "unfitness to plead" in the severely psychotic. The follow-up of cases strongly suggested that those found not guilty on psychiatric grounds were likely to be held for longer periods than those treated as criminals. The author suggests that the public would be better protected if the Crown sought an insanity verdict in some cases rather than oppose it.

  14. 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

  15. Management strategy after diagnosis of Abernethy malformation: a case report

    PubMed Central

    2012-01-01

    Introduction The Abernethy malformation is a rare anomaly with a widely variable clinical presentation. Many diagnostic dilemmas have been reported. Nowadays, with the evolution of medical imaging, diagnosis can be made more easily, but management of patients with an Abernethy malformation is still open for discussion. Case presentation In this case study, we describe a 34-year-old Caucasian man who presented with a large hepatocellular carcinoma in the presence of an Abernethy malformation, which was complicated by the development of pulmonary arterial hypertension. Conclusion This case underlines the importance of regular examination of patients with an Abernethy malformation, even in older patients, to prevent complications and to detect liver lesions at an early stage. PMID:22742057

  16. 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

  17. HIV case manager preparedness for practice in Ryan White CARE Act funded settings.

    PubMed

    Whyte Iv, James; Eccles, David W; Whyte, Maria D; Pappas, Cara; Cesnales, Nicole I

    2013-01-01

    While current research on the factors affecting the HIV epidemic within the general population has considered the role of HIV case managers, much remains to be known about case management effectiveness and how it might be enhanced. This article presents the data from a statewide survey of case management professionals in Florida. The study focused on case managers' preparation for practice and barriers to successful practice. The study results reflect a very broad educational preparation in multiple disciplines with highly varied means of case manager training and orientation at entry to practice. Further, the results highlighted the existence of multiple barriers that challenge the ability of case managers to cope with the demands of case management practice in sites serving people living with HIV/AIDS who are socially and economically challenged. The article concludes with recommendations for changes in the system that would enhance the preparation of case management professionals for entry to practice. PMID:24117030

  18. 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

  19. Multilingualism among University Staff: A Case Study of Language Management at an Australian University

    ERIC Educational Resources Information Center

    Marriott, Helen

    2013-01-01

    Employing the language management framework, this paper reports on multilingual use among the staff of a major metropolitan university in Melbourne and covers both simple and organised management. It describes a top-down attempt to survey staffs' (academic and general) background in Languages other than English (LOTE), LOTE usage and…

  20. Filicide, attempted filicide, and psychotic disorders.

    PubMed

    Valença, Alexandre M; Mendlowicz, Mauro V; Nascimento, Isabella; Nardi, Antonio E

    2011-03-01

    The objective of the study was to describe and discuss the cases of two women who faced criminal charges, one for attempting to murder her three children and the other for killing her 1-year-old boy. After a forensic psychiatric assessment of their level of criminal responsibility, these patients were considered not guilty by reason of insanity and were committed to forensic mental hospitals. These two patients received a diagnosis of paranoid schizophrenia, according to the DSM-IV-TR criteria. In both cases, psychotic symptoms were present before the manifestation of violent behavior, in the form of persecutory delusions, auditory hallucinations, and pathological impulsivity. The investigation into cases of filicide may contribute powerfully to expand our understanding of motivational factors underlying this phenomenon and enhance the odds for effective prevention.

  1. Filicide, attempted filicide, and psychotic disorders.

    PubMed

    Valença, Alexandre M; Mendlowicz, Mauro V; Nascimento, Isabella; Nardi, Antonio E

    2011-03-01

    The objective of the study was to describe and discuss the cases of two women who faced criminal charges, one for attempting to murder her three children and the other for killing her 1-year-old boy. After a forensic psychiatric assessment of their level of criminal responsibility, these patients were considered not guilty by reason of insanity and were committed to forensic mental hospitals. These two patients received a diagnosis of paranoid schizophrenia, according to the DSM-IV-TR criteria. In both cases, psychotic symptoms were present before the manifestation of violent behavior, in the form of persecutory delusions, auditory hallucinations, and pathological impulsivity. The investigation into cases of filicide may contribute powerfully to expand our understanding of motivational factors underlying this phenomenon and enhance the odds for effective prevention. PMID:21210804

  2. 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

  3. 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

  4. 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

  5. Case Management Approaches in Coordinated Community-Oriented Long-Term Care Demonstrations.

    ERIC Educational Resources Information Center

    Capitman, John A.; And Others

    1986-01-01

    Describes variations in case management approaches based on a national evaluation of Medicaid 1115 and Medicare 222 community-based care demonstrations. Presents the costs of producing case management services for selected programs. Less professionalization and less specialization of case management functions are associated with lower service…

  6. Designing a system of case management for a rural nursing clinic for elderly patients with depression.

    PubMed

    Stanton, Marietta P; Dunkin, Jeri W; Williams Thomas, L Kathleen

    2007-01-01

    This article provides an overview of the process and procedures used to develop and implement a system of case management for middle-aged and older depressed adults in a rural health nursing clinic. This system included on-site case management for elderly clients and telephonic follow-up by case managers on an ongoing basis.

  7. Ethical decision-making in case management programs for the elderly.

    PubMed

    Netting, F E; Williams, F G

    1989-01-01

    This article discusses ethical decision-making within six hospital-based case management programs for the frail elderly. Ethical dilemmas are described within each of the following phases of the case management process: client identification, informed consent, assessment, service planning, service coordination/linking, and monitoring and evaluation. Implications for social workers as case managers are examined.

  8. A case of error disclosure: a communication privacy management analysis.

    PubMed

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

    2013-12-01

    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 healthMuch 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

  9. Esthetic management of anterior dental anomalies: A clinical case.

    PubMed

    Chafaie, Amir

    2016-09-01

    Many types of dental abnormality can be observed in the anterior sectors, where they can cause genuine esthetic problems for our patients. While conventional prosthetic treatments offer the best solutions in terms of esthetic result and durability, they involve the sacrifice of significant quantities of mineralized dental material and cannot be undertaken before the periodontal tissues are mature. Other less invasive alternatives should be envisaged as transitional, or sometimes even permanent, solutions for the management of these anomalies in children and adolescents. This article discusses these options and presents a clinical case where composite resin veneers and microabrasion of the enamel were used to treat dental agenesis and enamel dysplasia.

  10. 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

  11. Central bronchial carcinoid: Management of a case and anesthetic perspectives.

    PubMed

    Goswami, D; Kashyap, L; Batra, R K; Bhagat, C

    2016-01-01

    Obstructing lesions of the central airways present with a variety of symptoms and are often associated with pneumonia or asthma-like states. Anesthesia to these patients often presents challenges right from the preoperative stabilization of underlying lung condition, mask ventilation in the supine position to maintaining oxygenation and ventilation in the intraoperative and postoperative period. We present here a case of a young woman with a central bronchial tumor with significant airway obstruction with potential for major bleeding and subsequent anesthetic management without lung sacrificing measures and cardiopulmonary bypass assistance. PMID:26955320

  12. A case of error disclosure: a communication privacy management analysis.

    PubMed

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

    2013-12-01

    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 healthMuch 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

  13. 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

  14. Management of Frey syndrome using botulinum neurotoxin: a case report.

    PubMed

    Ng, Samson; Torjek, Cathy; Hovan, Allan

    2009-11-01

    Frey syndrome is manifested clinically by hemifacial flushing and sweating after a gustatory stimulus. Frey syndrome is usually secondary to traumatic injury in the parotid region and is thought to be the result of misdirected re-sprouting of damaged autonomic nerve fibres. In this case report, we highlight the clinical and psychosocial aspects of Frey syndrome from a patient"s perspective, outline the pathophysiology of the condition and current management strategies, and describe the use of botulinum neurotoxin in the treatment of Frey syndrome. PMID:19900355

  15. Requiring case management meetings to be conducted outside the clinic.

    PubMed

    Strickler, David Charles

    2011-10-01

    In this Open Forum a psychiatric health care consumer recounts his experience with his state's requirement to hold case management meetings outside of the clinic. Over time, the author found that meeting elsewhere amounted to being put on public display, and he felt embarrassed and powerless to change the situation. Requiring people with psychiatric disorders to meet outside a clinical setting may violate the Health Insurance Portability and Accountability Act and human rights. This New Hampshire state policy needs to be changed because it undermines treatment and reinforces the stigma that many consumers already feel because of their disability.

  16. 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

  17. Esthetic management of anterior dental anomalies: A clinical case.

    PubMed

    Chafaie, Amir

    2016-09-01

    Many types of dental abnormality can be observed in the anterior sectors, where they can cause genuine esthetic problems for our patients. While conventional prosthetic treatments offer the best solutions in terms of esthetic result and durability, they involve the sacrifice of significant quantities of mineralized dental material and cannot be undertaken before the periodontal tissues are mature. Other less invasive alternatives should be envisaged as transitional, or sometimes even permanent, solutions for the management of these anomalies in children and adolescents. This article discusses these options and presents a clinical case where composite resin veneers and microabrasion of the enamel were used to treat dental agenesis and enamel dysplasia. PMID:27498052

  18. 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

  19. 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

  20. Managed care and ERISA: synopsis and case law review.

    PubMed

    Gerbasi, Joan B

    2003-01-01

    Managed care organizations (MCOs) have become the predominant health care model in the United States. Through cost containment arrangements with providers, incentives for patients to pursue less costly care and reductions in the provision of unnecessary care, MCOs are more intimately involved in the delivery of health care than their former fee-for-service insurance company counterparts. However, this new role has not implied increased liability, largely because of The Employee Retirement Income Security Act of 1974 (ERISA). This article provides an overview of ERISA and a review of the important legal cases in this area, including the three most recent Supreme Court cases. Courts have struggled with interpreting ERISA, and decisions have been difficult to reconcile. Frustration with this statute and the failure of the U.S. Congress to amend it, has led to more liberal interpretations of ERISA in recent years.

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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

  6. 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.

  7. Hospital waste management in Libya: a case study.

    PubMed

    Sawalem, M; Selic, E; Herbell, J-D

    2009-04-01

    In Libya, as in many developing countries, little information is available regarding generation, handling and disposal of hospital waste. This fact hinders the development and implementation of hospital waste management schemes. The specific objective of this study is to present an appraisal of the current situation regarding hospital waste management in Libya. Procedures, techniques, methods of handling, and disposal of waste are presented, as well as the amounts and compositions of hospital waste. This research was conducted in the form of a case study. Fourteen different healthcare facilities in three cities, Tripoli, Misurata, and Sirt, all located in the northwestern part of Libya, were selected for investigation. The investigation showed that the hospitals surveyed had neither guidelines for separated collection and classification, nor methods for storage and disposal of generated waste. This deficiency indicates the need for an adequate hospital waste management strategy to improve and control the existing situation. The average waste generation rate was found to be 1.3 kg/patient/day, comprised of 72% general healthcare waste (non-risk) and 28% hazardous waste. The average general waste composition was: 38% organic, 24% plastics, and 20% paper. Sharps and pathological elements comprised 26% of the hazardous waste component.

  8. 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

  9. The laparoscopic management of Swyer syndrome: Case series.

    PubMed

    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

  10. After Sample-Delivery Attempt, Sol 62

    NASA Technical Reports Server (NTRS)

    2008-01-01

    NASA's Phoenix Mars Lander collected a soil sample and attempted to deliver some of it to a laboratory oven on the deck during the mission's 62nd Martian day, or sol, (July 28, 2008). The sample came from a hard layer at the bottom of the 'Snow White' trench and might have contained water ice mixed with the soil. This image taken after the attempt to deliver the sample through the open doors to cell number zero on the Thermal and Evolved-Gas Analyzer shows that very little of the soil fell onto the screened opening.

    Not enough material reached the oven, through a funnel under the screen, to proceed with analysis of the sample material.

    Phoenix's Robotic Arm Camera took this image at 7:54 a.m. local solar time on Sol 62. The size of the screened opening is about 10 centimeters (4 inches) long by 4 centimeters (1.5 inches) wide.

    The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  11. 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

  12. 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.

  13. Toe Necrosis, Etiologies and Management, a Case Series

    PubMed Central

    Issa, Abdelfatah Abou; Newman, Mackenzie; Simman, Richard

    2014-01-01

    Toe necrosis may have vast different etiologies. These include ischemia, embolus, and others. (1) The most common etiology is ischemia. It is a reduction in blood supply to a viable tissue that can lead to susceptibility to infection and tissue death. Peripheral ischemia, which is rooted in the lower limbs, is a major risk factor for toe necrosis because the basal metabolic requirements of tissue are not being sufficiently met. As a result, pain, ulcers, and gangrene commonly occur. (2) Other causes of direct and indirect toe necrosis and related lower limb gangrene include mechanical trauma, infectious, pharmacological sensitivity, cancer, blue toe syndrome, and other granulomatous diseases, such as Churg-Strauss syndrome. We present a case series of toes necrosis which resulted from different etiologies and their management. PMID:26199887

  14. 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

  15. 22 CFR 96.43 - Case tracking, data management, and reporting.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Case tracking, data management, and reporting... Accreditation and Approval Responding to Complaints and Records and Reports Management § 96.43 Case tracking, data management, and reporting. (a) When acting as the primary provider, the agency or person...

  16. 22 CFR 96.43 - Case tracking, data management, and reporting.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Case tracking, data management, and reporting... Accreditation and Approval Responding to Complaints and Records and Reports Management § 96.43 Case tracking, data management, and reporting. (a) When acting as the primary provider, the agency or person...

  17. 22 CFR 96.43 - Case tracking, data management, and reporting.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Case tracking, data management, and reporting... Accreditation and Approval Responding to Complaints and Records and Reports Management § 96.43 Case tracking, data management, and reporting. (a) When acting as the primary provider, the agency or person...

  18. 22 CFR 96.43 - Case tracking, data management, and reporting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Accreditation and Approval Responding to Complaints and Records and Reports Management § 96.43 Case tracking, data management, and reporting. (a) When acting as the primary provider, the agency or person maintains... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Case tracking, data management, and...

  19. 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

  20. 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.

  1. Conservative Management of Keratocystic Odontogenic Tumour with Enucleation, Excision of the Overlying Mucosa and Electrocauterization – A Case Report

    PubMed Central

    Gambhir, A; Rani, G

    2014-01-01

    ABSTRACT Odontogenic keratocyst remains an enigma for clinicians and researchers, although gains in knowledge in recent years have improved the understanding of this interesting lesion. The diagnostic problems are mainly related to the relative lack of specific clinical and radiographic features that unequivocally point to a proper diagnosis. Of particular interest to clinicians is the biologic behaviour of keratocysts which includes high rates of recurrence and potential existence as a benign odontogenic neoplasm, keratocystic odontogenic tumour. Various surgical modalities have evolved in an attempt to reduce the recurrence rate, including curettage, peripheral ostectomy, removal of overlying mucosa in cases of cortical perforation and osseous resection in the form of marginal or segmental osteotomies. The present case report describes the conservative surgical management of a large keratocystic odontogenic tumour in a young patient with no evidence of recurrence at two years follow-up. PMID:25867564

  2. 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

  3. Nurse case managers: patient care implications at a Pakistani university.

    PubMed

    Walani, Laila

    The role of the nurse in hospital is varied and some are choosing to incorporate more managerial and administrative skills into their clinical role. One such role is that of the nurse case manager (NCM). This particular role concentrates on involving the family and the patient in his or her own care, facilitation of the care plan, and open discussions between the patient, medics and nursing staff. NCMs in the author's hospital have made a remarkable contribution to patient care. It is a challenging and exceedingly demanding role in both developing and developed countries, but one that is increasingly important. The NCMs are involved in coordination, facilitation of core process and mobilization of resources, not only in hospital but at the patient's home. In this short introductory article the role of NCM is highlighted and the author discusses how this diverse role is concerned with patient care. NCMs work with multidisciplinary teams to enhance the patient's care process. Their attention is also given to cost reduction and clinical pathway management.

  4. Successful Management of Live Cervical Ectopic Pregnancy: A Case Report.

    PubMed

    Samal, Sunita; Ghose, Seetesh; Pallavee, P; Porkkodi, P

    2015-12-01

    Cervical pregnancy is a rare form of ectopic pregnancy with potential grave consequences occurring in approximately 1:9,000 deliveries. It is life-threatening as the pregnancy is implanted in the endocervical canal and the trophoblast can penetrate through the cervical wall and into the uterine blood supply resulting in catastrophic haemorrhage. Historically, the treatment had been hysterectomy because of the considerable risk of life-threatening haemorrhage, but in the recent past various conservative management modalities have been applied to preserve fertility. Here, we report a case of successful (both medical and surgical) management of cervical ectopic pregnancy in a young woman. A 29-year-old, gravid 2, para1 and living 1 with previous caesarean section had presented with mild bleeding per vagina for 5 days following 7 weeks of amenorrhoea. Past menstrual, medical, surgical and family history were unremarkable except the previous caesarean section. On examination vital signs were normal but pelvic examination revealed a distended cervix with bulky uterus, without anyadnexal mass or tenderness and no cervical motion tenderness. Further transvaginal sonography showed a live cervical gestation of 7 weeks and 4 days and serum beta-HCG value of 1,03,113mIU/ml. Patient received conservative approach with combination of intraamniotic potassium chloride and methotrexate and suction curettage. Due to conservative approach emergency hysterectomy and blood transfusion was avoided. PMID:26816951

  5. 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

  6. 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…

  7. When attempts at robbing prey turn fatal.

    PubMed

    Dejean, Alain; Corbara, Bruno; Azémar, Frédéric; Carpenter, James M

    2012-07-01

    Because group-hunting arboreal ants spread-eagle insect prey for a long time before retrieving them, these prey can be coveted by predatory flying insects. Yet, attempting to rob these prey is risky if the ant species is also an effective predator. Here, we show that trying to rob prey from Azteca andreae workers is a fatal error as 268 out of 276 potential cleptobionts (97.1 %) were captured in turn. The ant workers hunt in a group and use the "Velcro®" principle to cling firmly to the leaves of their host tree, permitting them to capture very large prey. Exceptions were one social wasp, plus some Trigona spp. workers and flies that landed directly on the prey and were able to take off immediately when attacked. We conclude that in this situation, previously captured prey attract potential cleptobionts that are captured in turn in most of the cases.

  8. When attempts at robbing prey turn fatal.

    PubMed

    Dejean, Alain; Corbara, Bruno; Azémar, Frédéric; Carpenter, James M

    2012-07-01

    Because group-hunting arboreal ants spread-eagle insect prey for a long time before retrieving them, these prey can be coveted by predatory flying insects. Yet, attempting to rob these prey is risky if the ant species is also an effective predator. Here, we show that trying to rob prey from Azteca andreae workers is a fatal error as 268 out of 276 potential cleptobionts (97.1 %) were captured in turn. The ant workers hunt in a group and use the "Velcro®" principle to cling firmly to the leaves of their host tree, permitting them to capture very large prey. Exceptions were one social wasp, plus some Trigona spp. workers and flies that landed directly on the prey and were able to take off immediately when attacked. We conclude that in this situation, previously captured prey attract potential cleptobionts that are captured in turn in most of the cases. PMID:22710934

  9. Moving toward Socially and Environmentally Responsible Management Education--A Case Study of Mumbai

    ERIC Educational Resources Information Center

    Goyal, Ela; Gupta, Mahendra

    2014-01-01

    Educational institutions have a vital role to play shaping the future of our environment. Education provides opportunities for students to become environmentally conscious citizens besides being educated. In this study, an attempt has been made to study the perception of management students and teachers in the city of Mumbai, India, to determine…

  10. The Challenges of 'Teaching by Being': The Case of Participatory Resource Management

    ERIC Educational Resources Information Center

    Buchy, Marlene

    2004-01-01

    In 1997 a new unit, Participatory Resource Management, was developed and offered in the School of Resource, Environment and Society, at the Australian National University. The challenges of the unit were multiple, ranging from introducing social science material into a science curriculum, to attempting to change practitioners' attitudes towards…

  11. Management as Ideology: The Case of "New Managerialism" in Higher Education

    ERIC Educational Resources Information Center

    Deem, Rosemary; Brehony, Kevin J.

    2005-01-01

    The paper explores ideological conceptions of management, especially "new managerialism", with particular reference to their role in the reform of higher education. It is suggested that attempts to reform public services in general are political as well as technical, though there is no single unitary ideology of "new managerialism". Whilst some…

  12. Exploring the Association between Serum BDNF and Attempted Suicide

    PubMed Central

    Eisen, Rebecca B.; Perera, Stefan; Bawor, Monica; Dennis, Brittany B.; El-Sheikh, Wala; DeJesus, Jane; Rangarajan, Sumathy; Vair, Judith; Sholer, Heather; Hutchinson, Nicole; Iordan, Elizabeth; Mackie, Pam; Islam, Shofiqul; Dehghan, Mahshid; Brasch, Jennifer; Anglin, Rebecca; Minuzzi, Luciano; Thabane, Lehana; Samaan, Zainab

    2016-01-01

    Suicide is a leading cause of death and a significant public health concern. Brain-derived neurotrophic factor (BDNF), a protein important to nervous system function, has been implicated in psychiatric disorders and suicidal behaviour. We investigated the association between serum levels of BDNF and attempted suicide in a sample of 281 participants using a case-control study design. Participants were recruited from clinical and community settings between March 2011 and November 2014. Cases (individuals who had attempted suicide) (n = 84) were matched on sex and age (within five years) to both psychiatric controls (n = 104) and community controls (n = 93) with no history of suicide attempts. We collected fasting blood samples, socio-demographic information, physical measurements, and detailed descriptions of suicide attempts. We used linear regression analysis to determine the association between BDNF level (dependent variable) and attempted suicide (key exposure variable), adjusting for age, sex, body mass index, current smoking status, and antidepressant use. 250 participants were included in this analysis. In the linear regression model, attempted suicide was not significantly associated with BDNF level (β = 0.28, SE = 1.20, P = 0.82). Our findings suggest that no significant association exists between attempted suicide and BDNF level. However, the findings need to be replicated in a larger cohort study. PMID:27121496

  13. [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.

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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

  20. 50 CFR 38.15 - Attempt.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.15 Attempt. No person on Midway Atoll National Wildlife Refuge will attempt to commit any offense prohibited by this part....

  1. 50 CFR 38.15 - Attempt.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.15 Attempt. No person on Midway Atoll National Wildlife Refuge will attempt to commit any offense prohibited by this part....

  2. 50 CFR 38.15 - Attempt.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.15 Attempt. No person on Midway Atoll National Wildlife Refuge will attempt to commit any offense prohibited by this part....

  3. 50 CFR 38.15 - Attempt.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.15 Attempt. No person on Midway Atoll National Wildlife Refuge will attempt to commit any offense prohibited by this part....

  4. 50 CFR 38.15 - Attempt.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.15 Attempt. No person on Midway Atoll National Wildlife Refuge will attempt to commit any offense prohibited by this part....

  5. 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.

  6. Adolescent suicide attempts and adult adjustment

    PubMed Central

    Brière, Frédéric N.; Rohde, Paul; Seeley, John R.; Klein, Daniel; Lewinsohn, Peter M.

    2014-01-01

    Background Adolescent suicide attempts are disproportionally prevalent and frequently of low severity, raising questions regarding their long-term prognostic implications. In this study, we examined whether adolescent attempts were associated with impairments related to suicidality, psychopathology, and psychosocial functioning in adulthood (objective 1) and whether these impairments were better accounted for by concurrent adolescent confounders (objective 2). Method 816 adolescents were assessed using interviews and questionnaires at four time points from adolescence to adulthood. We examined whether lifetime suicide attempts in adolescence (by T2, mean age 17) predicted adult outcomes (by T4, mean age 30) using linear and logistic regressions in unadjusted models (objective 1) and adjusting for sociodemographic background, adolescent psychopathology, and family risk factors (objective 2). Results In unadjusted analyses, adolescent suicide attempts predicted poorer adjustment on all outcomes, except those related to social role status. After adjustment, adolescent attempts remained predictive of axis I and II psychopathology (anxiety disorder, antisocial and borderline personality disorder symptoms), global and social adjustment, risky sex, and psychiatric treatment utilization. However, adolescent attempts no longer predicted most adult outcomes, notably suicide attempts and major depressive disorder. Secondary analyses indicated that associations did not differ by sex and attempt characteristics (intent, lethality, recurrence). Conclusions Adolescent suicide attempters are at high risk of protracted and wide-ranging impairments, regardless of the characteristics of their attempt. Although attempts specifically predict (and possibly influence) several outcomes, results suggest that most impairments reflect the confounding contributions of other individual and family problems or vulnerabilites in adolescent attempters. PMID:25421360

  7. Case management decision making: goal transformation through discretion and client interpretation.

    PubMed

    Corazzini, K N

    2000-01-01

    This study examines the decision-making strategies employed by case managers in a state-funded home care program for the elderly. Specifically, this study applies Lipsky's (1980) theory of street-level bureaucracy to gerontological research on case management decision making in an effort to demonstrate the presence of case management discretion, and the impact of that discretion on home care implementation. Drawing upon individual interviews and focus group interviews, results suggest the applicability of the proposed framework, and indicate the need for policy planners to identify factors for case manager discretion that result in undesirable home care goal transformation.

  8. Modeling the costs of case management in long-term care

    PubMed Central

    Davidson, Gestur B.; Penrod, Joan Dobrof; Kane, Rosalie A.; Moscovice, Ira S.; Rich, Eugene C.

    1991-01-01

    A conceptual approach to developing models for analyzing cost is applied to case management in long-term care. This conceptual approach uses four dimensions to classify case management programs. The application results in identifying five case management cost models. Empirical measures of case management costs and a set of determinants of the within-model variation in these costs are suggested for each model. This article discusses several policy relevant hypotheses that could be addressed by the empirical implementation of these cost models. PMID:10114936

  9. 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…

  10. Managing Resource Dependence Difficulties in African Higher Education: The Case of Multiple Exchange Relationships

    ERIC Educational Resources Information Center

    Wangenge-Ouma, Gerald

    2011-01-01

    The paper has a twofold structure and focus. The first part is an examination of the funding challenges facing African universities resulting mainly from public finance difficulties, and the second part is a case study of how some Kenyan and South African public universities have attempted to mitigate resource dependence difficulties through…

  11. Workshop Organization and Management in Adult Education. Case Study of the MOBRAL System.

    ERIC Educational Resources Information Center

    da Costa, Lamartine Pereira

    This case study of the organizational structure of the Brazilian Literacy Movement (MOBRAL) describes the various organizational changes made as the mediating agency attempted to develop a large-scale national program within the existing social structure. Steps in the organization's development are traced from: (1) Beginnings in 1970 under the…

  12. [Gunshot wound to the kidney: case report and therapeutic management].

    PubMed

    Maruschke, M; Hakenberg, O W

    2008-04-01

    Gunshot wounds to the kidney occur with different regional incidence. They are commonly combined with thoracic and abdominal injuries. Gunshot wounds may be caused by low-velocity or high-velocity bullets. The latter are usually used with military weapons and cause a higher degree of tissue damage. The therapeutic management of renal gunshot wounds has changed in recent decades resulting in more organ-preserving strategies. An imperative indication for surgical exploration of the kidney is critical renal bleeding with symptoms of hypovolaemic shock. We report the case of a 23-year-old male admitted to the hospital with combined gunshot wounds from a small-bore weapon with damage of the liver, stomach and the left kidney. There were no signs of thoracic injuries. The patient underwent transabdominal exploration with treatment of the liver and stomach lesions, removal of the bullet and preservation of the left kidney. A percutaneous nephrostomy and drainage of the retroperitoneal region were inserted; antibiotic prophylaxis was given. A 4-week postoperative intravenous pyelogram showed complete integrity of the upper left tract and good renal function.

  13. Science plus management equals successful remediation: A case study

    SciTech Connect

    Buehlman, M.D.; Rogers, D.T.; Payne, F.C.

    1998-09-01

    A case study involving a Brownfields site in southeastern Michigan clearly illustrates the elements of successful remediation. The site`s soil was contaminated with polychlorinated biphenyls (PCBs) and its groundwater with a variety of chlorinated solvents. The original estimate for remediation has exceeded $30 million. Several phases of investigation were conducted to evaluate the nature and sources of contaminants, the site`s hydrogeology, potential risks to human health and the environment, and feasible remedial technologies. Multiple cleanup criteria were established for different affected areas based on the results of the investigations, changes that were taking place with the state cleanup regulations and standards and subsequent negotiations with state and federal regulators. Innovative remedial technologies were selected. The result was a remediation that met or exceeded all soil and groundwater cleanup objectives, was performed on schedule, and was highly cost-effective. The final cost was limited to $3 million--one-tenth of the original estimate. The success of this project involved meticulous scientific study and comprehensive understanding of applicable regulatory requirements and available remediation technologies. It also required effective project management to coordinate the multidisciplinary efforts involved and to maintain the constant vertical and horizontal communications necessary to ensure sound decisions at every step in the process.

  14. 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

  15. HIPAA Business Associate Contracts: the value of contracts for case managers.

    PubMed

    Muller, Lynn S

    2003-01-01

    Case Managers are in the middle of the upcoming HIPAA regulation changes, with the issuance of the Final Privacy Rule. Every case obliges case managers to work with Individually Identifiable Health Information (IIHI) and Protected Health Information (PHI). The purpose of this article is to provide case managers in all practice settings with a clear understanding of a "Business Associate," of a "Covered Entity," and of the specifics of a Business Associate Contract. This information will demonstrate how case managers can benefit from the use of these contracts in their business life. As an essential component of an organization's compliance plan, Business Associate Contracts can become a sword or a shield. This article is particularly helpful to case managers in independent practice, as well as those who work for Covered Entities.

  16. 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

  17. The case for undergraduate medical education in healthcare business and management.

    PubMed

    Hsu, Benson S; Hosokawa, Michael C; Maria, Bernard

    2007-01-01

    Current undergraduate medical education does notprepare students to approach the intricacies of healthcare business. This absence within medical education creates significant challenges for physicians throughout their careers. The field of academic medicine has clearly documented the need for medical education to prepare students for practice management, yet there exist only a small number of attempts at exposing students to healthcare business and management. The authors argue that this curriculum must start at the level ofundergraduate medical education. Furthermore, this curriculum must possess the basic components of support, integration, practicality, application, and continuation. Fulfilling these requirements will allow for the successful adaptation of the healthcare business and management curriculum.

  18. 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…

  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. 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…

  1. An ontological case base engineering methodology for diabetes management.

    PubMed

    El-Sappagh, Shaker H; El-Masri, Samir; Elmogy, Mohammed; Riad, A M; Saddik, Basema

    2014-08-01

    Ontology engineering covers issues related to ontology development and use. In Case Based Reasoning (CBR) system, ontology plays two main roles; the first as case base and the second as domain ontology. However, the ontology engineering literature does not provide adequate guidance on how to build, evaluate, and maintain ontologies. This paper proposes an ontology engineering methodology to generate case bases in the medical domain. It mainly focuses on the research of case representation in the form of ontology to support the case semantic retrieval and enhance all knowledge intensive CBR processes. A case study on diabetes diagnosis case base will be provided to evaluate the proposed methodology.

  2. 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

  3. 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…

  4. 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...

  5. 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…

  6. 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…

  7. Redesigning the work of case management: testing a predictive model for readmission.

    PubMed

    Gilbert, Penny; Rutland, Michael D; Brockopp, Dorothy

    2013-11-01

    The rising cost of healthcare along with pay-for-performance and bundled-payment initiatives have affirmed the importance of case management in today's healthcare market. Case managers have historically functioned as gatekeepers regarding patient length of stay (LOS) and cost per case. While LOS and cost of care remain important components of the case manager's responsibilities, at present they have evolved to a much broader role that includes prevention of readmissions and successful transition through the continuum of care. Medicare beneficiaries readmitted to the hospital within 30 days of discharge are thought to cost the healthcare system $17.4 billion annually. In today's hospitals, case managers are being asked to address this issue with systems and processes developed only as discharge facilitation models. Case managers at one acute care organization recognized the need to move beyond the traditional case management roles and activities related to discharge planning, utilization review, and LOS management. Effective transition from hospital to home or supportive agency is a major component of this case management model. PMID:24511885

  8. 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…

  9. 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...

  10. 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…

  11. 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…

  12. Case management in an acute-care hospital: collaborating for quality, cost-effective patient care.

    PubMed

    Grootveld, Kim; Wen, Victoria; Bather, Michelle; Park, Joan

    2014-01-01

    Case management has recently been advanced as a valuable component in achieving quality patient care that is also cost-effective. At St. Michael's Hospital, in Toronto, Ontario, case managers from a variety of professional backgrounds are central to a new care initiative--Rapid Assessment and Planning to Inform Disposition (RAPID)--in the General Internal Medicine (GIM) Unit that is designed to improve patient care and reconcile high emergency department volumes through "smart bed spacing." Involved in both planning and RAPID, GIM's case managers are the link between patient care and utilization management. These stewards of finite resources strive to make the best use of dollars spent while maintaining a commitment to quality care. Collaborating closely with physicians and others across the hospital, GIM's case managers have been instrumental in bringing about significant improvements in care coordination, utilization management and process redesign. PMID:24844723

  13. Environmental management with knowledge of uncertainty: a methylmercury case study.

    PubMed

    Hope, Bruce K; Lut, Agnes; Aldrich, Greg; Rubin, Jared

    2007-01-01

    In Oregon's Willamette River Basin, health advisories currently limit consumption of fish that have accumulated methylmercury to levels posing a potential health risk for humans. Under the Clean Water Act, these advisories represent an impairment of the beneficial use of fish consumption and create the requirement for a mercury total maximum daily load. A percent load reduction for total mercury was determined by comparing mercury levels in surface water to a water column guidance value linked to the protection of specified beneficial uses. In this case study, we discuss how probabilistic (Monte Carlo) methods were used to quantify uncertainty in the water column guidance value, how they provided decision makers with knowledge as to the probability of any given water column guidance value affording human health protection for methylmercury, and how this knowledge affected decisions as to a mercury load reduction for the Willamette River Basin. Through consultations with stakeholders, a water column guidance value of 0.92 ng/L (a median for higher trophic level fish) was chosen from among a suite of values of differing probabilities. The selected water column guidance value, when compared with ambient total mercury levels, indicated that a 50% probability of achieving the tissue criterion would require a load reduction of about 26%. Having and working with an explicit knowledge of uncertainty was not easy for many decision makers or stakeholders. However, such knowledge gave them more informed choices, a better understanding of what a specific choice of water column guidance value could mean in terms of achieving protectiveness, and led to a lower load reduction than suggested by a purely deterministic analysis. Nonetheless, more attention must be given to developing management, communication, and regulatory frameworks that can effectively use the greater knowledge of uncertainty afforded by probabilistic methods. PMID:17283603

  14. 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

  15. The case manager in Holland behind the dikes: a hole filler or bridge builder?

    PubMed

    Willems, D

    1996-01-01

    The health and social care service system in the Netherlands is fragmented and poorly organized. Facing an increase in the number of elderly citizens, a more consumer-oriented and vocal citizenry, and rising competition at least in part in response to government concerns over runaway costs, Dutch government officials and social researchers have been experimenting with various forms of case management since the mid-1980s. For some types of clients, such as the mentally handicapped, case management seems to be well accepted. Many issues remain to be resolved, however, including (a) the level of clinical expertise needed by case managers for clients with complex medical problems; (b) whether case management tasks are more appropriately carried out by service providers or as a separate function; and (c) how much autonomy service providers will be expected to relinquish under the control of a case manager.

  16. Determinants of client termination in hospital-based case management programs.

    PubMed

    Netting, F E; Warrick, L H; Christianson, J B; Williams, F G

    1994-01-01

    Increasing attention is being focused on hospital-based programs that address the needs of the frail elderly. This article reports results from a demonstration of hospital-based case management (HBCC). Baseline, 3-, 6-, and 12-month assessment data are analyzed to determine why clients terminated from HBCC programs. Subsamples of community- and hospital-originated clients are examined to determine what factors predict case management termination. About half of both hospital- and community-originated clients left case management within 12 months because of death, nursing home placement, referral to another case management agency, relocation out of the service area, or discharge as self-sufficient. Hospital-originated clients were more likely to die within the first 6 months after entering case management than were community-originated clients. Cognitive and functional abilities were important predictors of termination status.

  17. 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…

  18. Management of Pseudohypoparathyroidism Type 1a during Pregnancy and Labor: A Case Report

    PubMed Central

    Singh, Anju; Agarwal, Neelam; Chopra, Seema; Sikka, Pooja; Suri, Vanita; Kumar, Bhupesh; Dutta, Pinaki

    2012-01-01

    Pseudohypoparathyroidism is rare during pregnancy and poses multiple challenges related to its diagnosis and management during pregnancy. We hereby report a case of a young woman who was diagnosed to have type 1a pseudohypoparathyroidism. She was managed by multidisciplinary team and had good maternal and perinatal outcome. Management-related issues are discussed here in detail. PMID:22779017

  19. Case Studies for Management Development in Bangladesh. Fourth Book. Parepared for the World Bank/Bangladesh Management Education and Training Project.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    This document contains five case studies of management and finance situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. One to four discussion questions follow each case study. The titles and authors of the case studies on management are: "Azir Ahmed & Co., Business…

  20. LPG Dependence after a Suicide Attempt

    PubMed Central

    Aldemir, Ebru; Akyel, Betül; Altıntoprak, A. Ender; Aydın, Rezzan; Coşkunol, Hakan

    2015-01-01

    Inhalant abuse is a problem that is getting more common all around the world. The increase in prevalence of inhalant abuse escalates morbidity and mortality rates. About 22% of people using inhalant have died at their first attempt. Particularly propane, butane, or propane-butane mixture has highest mortality rates. Sudden sniffing death syndrome, cardiomyopathy, central nervous system toxicity, hematological abnormalities, kidney toxicity, and hepatocellular toxicities are the major complications of inhalant abuse. Herein we present a patient with inhalant use disorder. At the age of 19, after a stressful life event he had unsuccessfully tried to suicide by inhaling LPG (liquefied petroleum gas, a mixture of butane and propane gases). After he realized that he had hallucinations and felt better during the inhalation, he started to abuse it. He was addicted to LPG for 10 years at the time of admission. Besides being dangerous for the society security, this intense level of LPG inhalation (12 liters a day) not giving any physical harm makes this case interesting. PMID:25664196

  1. LPG Dependence after a Suicide Attempt.

    PubMed

    Aldemir, Ebru; Akyel, Betül; Altıntoprak, A Ender; Aydın, Rezzan; Coşkunol, Hakan

    2015-01-01

    Inhalant abuse is a problem that is getting more common all around the world. The increase in prevalence of inhalant abuse escalates morbidity and mortality rates. About 22% of people using inhalant have died at their first attempt. Particularly propane, butane, or propane-butane mixture has highest mortality rates. Sudden sniffing death syndrome, cardiomyopathy, central nervous system toxicity, hematological abnormalities, kidney toxicity, and hepatocellular toxicities are the major complications of inhalant abuse. Herein we present a patient with inhalant use disorder. At the age of 19, after a stressful life event he had unsuccessfully tried to suicide by inhaling LPG (liquefied petroleum gas, a mixture of butane and propane gases). After he realized that he had hallucinations and felt better during the inhalation, he started to abuse it. He was addicted to LPG for 10 years at the time of admission. Besides being dangerous for the society security, this intense level of LPG inhalation (12 liters a day) not giving any physical harm makes this case interesting. PMID:25664196

  2. 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.

  3. The Teacher Leadership Process: Attempting Change within Embedded Systems

    ERIC Educational Resources Information Center

    Cooper, Kristy S.; Stanulis, Randi N.; Brondyk, Susan K.; Hamilton, Erica R.; Macaluso, Michael; Meier, Jessica A.

    2016-01-01

    This embedded case study examines the leadership practices of eleven teacher leaders in three urban schools to identify how these teacher leaders attempt to change the teaching practice of their colleagues while working as professional learning community leaders and as mentors for new teachers. Using a theoretical framework integrating complex…

  4. Is attempted suicide different in adolescent and adults?

    PubMed

    Parellada, Mara; Saiz, Pilar; Moreno, Dolores; Vidal, Jorge; Llorente, Cloe; Alvarez, Mar; García-Portilla, Paz; Ruiz-Sancho, Ana; Arango, Celso; Bobes, Julio

    2008-01-15

    Attempted suicide may be a different phenomenon in adolescents than in adults. To our knowledge, direct comparisons between these two populations are very scarce. The aim of this study is to analyze the differences between adolescents and adults in methods of attempted suicide, accompanying certainty of death, and intentionality. All cases admitted to one adult (n=173) and one adolescent (n=104) inpatient unit who attempted suicide in the period from January 2003 through October 2005 were included in a prospective, common, national register, with data on methods, circumstances, and intentionality. The methodology followed that of the WHO/Euro Multicenter Study on Parasuicide. A stratified analysis was performed using the Mantel-Haenszel procedure in order to control for the effects of gender and diagnosis. Adolescents used significantly more over-the-counter medicines. Adults were significantly more certain of the possible fatal outcome of their attempt and had a significantly more severe intention when harming themselves. Individuals appear to use the methods that are available to them to attempt suicide. Adolescents may display more impulsive and less lethal directed behavior than adults or, alternatively, they are more frequently admitted for less severe attempts.

  5. Unsuccessful Retrieval Attempts Enhance Subsequent Learning

    ERIC Educational Resources Information Center

    Kornell, Nate; Hays, Matthew Jensen; Bjork, Robert A.

    2009-01-01

    Taking tests enhances learning. But what happens when one cannot answer a test question--does an unsuccessful retrieval attempt impede future learning or enhance it? The authors examined this question using materials that ensured that retrieval attempts would be unsuccessful. In Experiments 1 and 2, participants were asked fictional…

  6. Ecological Correlates of Adolescent Attempted Suicide.

    ERIC Educational Resources Information Center

    Lester, David

    1990-01-01

    Rates of adolescent attempted suicide were correlated with social indicators over electoral wards of Edinburgh, Scotland. Rates were found to be higher in wards where child neglect and misbehavior were more common. Rates of attempted suicides in total population also were related to housing patterns/social class of the wards. (Author/NB)

  7. Selected Risk Factors in Adolescent Suicide Attempts.

    ERIC Educational Resources Information Center

    Adcock, Anthony G.; And Others

    1991-01-01

    Examined stress, depression, attempted suicide, and knowledge of common signs of potential suicide among 3,803 eighth and tenth graders. Found females at greater risk of suicide attempts than males. Both males and females who engaged in sexual intercourse and alcohol consumption were at greater risk than abstainers; such differences were more…

  8. 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…

  9. Career Management in Information Technology: A Case Study.

    ERIC Educational Resources Information Center

    Appelbaum, Steven H.; Ayre, Heather; Shapiro, Barbara T.

    2002-01-01

    Examines career management, development, and performance; reviews the organizational career management program and outcomes of organizational development and performance; and applies R.A. Noe's model to measure outcomes and determine the relationship between programs, performance, and development. (Contains 31 references.) (JOW)

  10. 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,…

  11. 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

  12. 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)…

  13. 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.

  14. A Case Study of a Three-Year Pilot Program on One District's Attempt to Increase the Gifted Identification of Diverse Elementary School Students by Having a Talent Development Program

    ERIC Educational Resources Information Center

    Franklin, Robin Kesterson

    2009-01-01

    This case study examined ways elementary school students from diverse populations (minorities and children from low socioeconomic status environments) were included in a talent development program, and determined if that inclusion proved to be beneficial for gifted identification. With intentional regard for the idea of talent development, this…

  15. Managing social conflict in complementary and alternative medicine research: the case of antineoplastons.

    PubMed

    Hammer, Mitchell R; Jonas, Wayne B

    2004-03-01

    From December 1991 to December 1995, the National Cancer Institute (NCI) initiated phase II clinical trials of A10 and AS2-1 (antineoplastons) infusions in patients with diagnosed primary malignant brain tumors. Four years and more than a million dollars later, these studies were stopped before it was possible to determine the effectiveness of antineoplastons. Both NCI and Dr Burzynski, the developer of antineoplastons, accused one another of attempting to undermine the project. In an effort to determine why this study failed to be completed, the director of the National Institutes of Health Office of Alternative Medicine (OAM), who sponsored the study, commissioned a detailed analysis of the conflicts that led to the study's closure. The intent was to understand the social dynamics surrounding this failed study and to develop a method for managing and possibly preventing such failures in the future. This clinical trial was extremely complex and comprehensive. It involved hundreds of memoranda, letters, and telephone and fax correspondence among a wide number of parties over a 4-year period. All correspondence and other documents from the OAM as well as documentation from NCI were thoroughly examined. In addition, in-depth interviews with key individuals involved in the antineoplaston study were completed and incorporated into the analysis. At least 10 areas of conflict emerged from the analysis including issues around production, quality, and delivery of antineoplastons; commencement of the trial; the role of Dr Burzynski in the trial; types and combinations of cancers; choice of clinical investigators; need for communication; criteria for patient selection and treatment; and evaluation. Each of these issues clearly represented a difference of opinion between the 2 main parties around scientific protocols. Yet contention around these substantive, "scientific" disagreements reflected conflict in attunement (trust, power, and affiliation) between Dr Burzynski and

  16. [Attempted suicide during the financial crisis in Athens].

    PubMed

    Stavrianakos, K; Kontaxakis, V; Moussas, G; Paplos, K; Papaslanis, T; Havaki-Kontaxaki, B; Papadimitriou, Gn

    2014-01-01

    ) and 95 in 2011, during the financial crisis (mean age 41.0 years, women 65%). There is an increase of suicide attempts by 35.71%. There were no statistically significant differences between the two periods regarding the gender and age of attempters. There was a statistically significant increase of unemployed (p=0.004), as well as of married/widowed/divorced (p=0.02) suicide attempters during the crisis. There was not statistically significant difference in the severity of suicide attempts before and during the economic crisis or the severity of psychopathology of the attempters. The financial crisis is probably associated with upward trend in attempted suicide of the Athens population. Most affected are those who are unemployed, married, widowed, divorced. Suicide prevention programs are essential for the accurate and timely identification and the immediate and effective management of this special high risk group of attempters during the financial crisis.

  17. [Attempted suicide during the financial crisis in Athens].

    PubMed

    Stavrianakos, K; Kontaxakis, V; Moussas, G; Paplos, K; Papaslanis, T; Havaki-Kontaxaki, B; Papadimitriou, Gn

    2014-01-01

    ) and 95 in 2011, during the financial crisis (mean age 41.0 years, women 65%). There is an increase of suicide attempts by 35.71%. There were no statistically significant differences between the two periods regarding the gender and age of attempters. There was a statistically significant increase of unemployed (p=0.004), as well as of married/widowed/divorced (p=0.02) suicide attempters during the crisis. There was not statistically significant difference in the severity of suicide attempts before and during the economic crisis or the severity of psychopathology of the attempters. The financial crisis is probably associated with upward trend in attempted suicide of the Athens population. Most affected are those who are unemployed, married, widowed, divorced. Suicide prevention programs are essential for the accurate and timely identification and the immediate and effective management of this special high risk group of attempters during the financial crisis. PMID:25035179

  18. Developing a formal educational program for case managers: one Canadian experience.

    PubMed

    Fineman, L

    1996-01-01

    This article describes a proposed model for a case management certificate program in Canada. It provides information on the Canadian context within which case management is being developed, and information on the proposed program model. Targeted to case managers, the program is to be offered by a university continuing education division. The article describes the developmental process, students' learning objectives, course content areas, university certificate requirements, and program structure and organization. Further the program model is discussed with reference to flexibility and responsiveness to individual student and employer needs.

  19. Role of Occupational Therapy in Case Management and Care Coordination for Clients With Complex Conditions.

    PubMed

    Robinson, Monica; Fisher, Thomas F; Broussard, Kim

    2016-01-01

    Specific aspects of the profession of occupational therapy support a distinct value for its practitioners participating fully in the development of case management and care coordination systems. The expectation in the 21st century is that the U.S. health care system must be transformed from one that promotes volume of service to one that promotes value of care. Case management and care coordination will be critical components of that transformation. Occupational therapy's principles, education, practice, approach, and perspective offer much to benefit this increased attention to case management and care coordination. Occupational therapy practitioners should promote themselves and their profession as these system changes develop.

  20. Attempted suicide of an adolescent with autism spectrum disorder.

    PubMed

    Mikami, Katsunaka; Onishi, Yuichi; Matsumoto, Hideo

    2014-01-01

    Although the suicide risk of autism spectrum disorder (ASD) has been suggested to be higher than previously recognized, there are few case reports focusing on the process for preventing suicide reattempts. We reported that a 17-year-old male who had attempted suicide by jumping was admitted to our emergency department and hospitalized for lumbar spine fracture. In addition to the diagnosis of adjustment disorder, he was diagnosed as ASD according to his life history. This article presents the characteristics of the suicidal behaviors and the process for preventing a suicide reattempt associated with an adolescent with ASD who attempted suicide. PMID:25084822

  1. 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.

  2. Management of a nail impalement injury to the brain in a non-neurosurgical centre: A case report and review of the literature

    PubMed Central

    Agu, Chika Thaddeus; Orjiaku, Mathew Emeka

    2015-01-01

    A nail impalement injury to the brain usually results from accidents like falls or nail gun miss-fires or suicide attempts or from barbaric punishment for certain crimes which are rarely practiced in some remote areas. We present an unusual, intentional, self-impalement of a 4 in. nail into the brain in a mentally challenged young man. This case report describes the challenges encountered in the management of a patient with impaled nail in the brain in a non-neurosurgical centre. PMID:26745316

  3. Suicide attempt by jumping: a study of gonadal axis hormones in male suicide attempters versus men who fell by accident.

    PubMed

    Markianos, Manolis; Tripodianakis, John; Istikoglou, Christos; Rouvali, Olga; Christopoulos, Markos; Papageorgopoulos, Pavlos; Seretis, Andreas

    2009-11-30

    Low plasma total testosterone (T) levels may influence the sense of well-being and produce depressive symptomatology, increasing the risk of suicide. In a previous study, we reported reduced serum T levels in male psychiatric patients after a suicide attempt. The reduction was more pronounced in subjects who used violent attempt methods, and we discussed the possible influence of stress of hospitalization, serious medical condition and treatment. In order to minimize the influence of such factors, we compared in this study the levels of plasma sex hormones of 15 psychiatric patients (10 suffering from schizophrenia and 5 from depression) who had attempted suicide by jumping with those of a group of 18 male subjects who were hospitalized after accidentally falling from a high height. Compared with a healthy control group of 40 males, both accident and attempt groups had lower T levels. The attempt group showed a trend toward lower T levels compared with levels in the accident group. In the accident group, luteinizing hormone (LH) levels were elevated compared with levels in healthy controls, indicating a normal function of the hypothalamic-pituitary-gonadal (HPG) axis. This was not the case for the attempt group, where low T levels were not accompanied by increases in LH. Cortisol and prolactin were similarly elevated in both patient groups, but were not related to the low T levels. The results indicate that male psychiatric patients who attempt suicide by violent methods may have low total plasma T levels, possibly due to a dysfunction of the HPG axis at the hypothalamic-pituitary level. Monitoring HPG axis function in future studies could prove to be a predictor of suicide at least for male psychiatric attempters, and could lead to preventive strategies.

  4. 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…

  5. The CCMC's national study of case manager job descriptions: an understanding of the activities, role relationships, knowledges, skills, and abilities.

    PubMed

    Tahan, Hussein A; Huber, Diane L

    2006-01-01

    Defining the roles and functions of case managers is crucial in today's healthcare environment and necessary for the case management field. One way to address this issue is through the examination of case managers' job descriptions used in various healthcare organizations. The study reported herein used qualitative analysis procedures and the latent class cluster analysis method to examine a national sample of 1028 job descriptions of case managers. The study identified the activities, role relationships, knowledge, skills, and abilities of case managers working in varied settings. It also described the changes that occurred in the practice of case management, based on these job descriptions, over 5 years: from the mid-1990s until the early 2000s. One benefit of this study was a change in one eligibility criterion of the CCM credential. Another was the development of a taxonomy of case managers' roles and functions that can be used as a step toward standardization of case managers' job descriptions.

  6. Alcohol abuse and suicide attempts among youth.

    PubMed

    Chatterji, Pinka; Dave, Dhaval; Dave, Daval; Kaestner, Robert; Markowitz, Sara

    2004-06-01

    This study uses the Youth Risk Behavior Survey (YRBS) and the National Comorbidity Survey (NCS) to explore the causal relationship between alcohol abuse (binge drinking and clinically defined alcohol use disorders) and suicide attempts among youth. We use an empirical approach that allows one to assess the possible existence and strength of a causal relationship without relying on identifying assumptions. Our results suggest that a causal relationship between binge drinking and suicide attempts is very unlikely. The findings, however, support a causal relationship between clinically defined alcohol use disorders and suicide attempts among girls.

  7. Identifying and Managing a Malpositioned Endotracheal Tube Bite Block in an Orotracheally Intubated Patient: A Case Report.

    PubMed

    Chou, Hui-Ling; Ruan, Sheng-Yuan; Wu, Huey-Dong

    2016-03-01

    The universal bite block is increasingly used in orotracheally intubated patients. Here, we report a case of pilot tube dysfunction caused by a malpositioned universal bite block in an orotracheally intubated patient. We summarize the key points on identifying and managing a malpositioned universal bite block from this case and literature review.A 74-year-old woman was emergently intubated during an episode of hyperkalemia-related cardiac arrest. A universal bite block was used for fixing the endotracheal tube. After her condition stabilized, ventilator weaning was attempted; however, a positive cuff-leak test result was observed.The cuff-leak test revealed a lack of elasticity of the pilot balloon, which was completely deflated after 2 mL of air was removed. Pilot tube dysfunction was highly suspected. The bite block was slightly pulled out, and 8 mL of air was aspirated from the pilot tube. The patient was successfully extubated without stridor and respiratory distress.Our case highlighted that a malpositioned bite block may obstruct the pilot tube, causing unfavorable consequences. While fixing the bite block on an endotracheal tube, it is crucial to ensure that the takeoff point of the pilot tube is located within the C-notch of the bite block.

  8. Emphysematous pyelonephritis: Our experience with conservative management in 14 cases

    PubMed Central

    Sharma, Pramod Kumar; Sharma, Ritu; Vijay, Mukesh K.; Tiwari, Punit; Goel, Amit; Kundu, Anup K.

    2013-01-01

    Context: Emphysematous pyelonephritis (EPN) is a rare, severe, acute, necrotizing infection of the kidney. In this study, we present the clinical details, the management strategies, and the outcome of fourteen patients of EPN managed at our center. Materials and Methods: A retrospective analysis of the hospital records was done. A total of fourteen patients with EPN were admitted in our hospital from August 2007 to February 2011. All the patients were managed conservatively. Follow-up ranged from six months to one year. Results: Of the fourteen patients, four belonged to class I, five to class II, four to class IIIA and one to class IIIB. All the patients had history of fever, 43% had localized flank pain while 36% had vague abdominal discomfort. Renal angle tenderness was the most common sign, seen in 86% of the patients. E. coli was the most common bacteria, which was isolated from urine in 57% of the patients. On the risk factor stratification, three patients had simultaneous presence of 2 or more risk factors (thrombocytopenia-2 patients; renal function impairment-7 patients; shock-1 patient). All the patients were initially managed with aggressive fluid and electrolyte resuscitation, control of blood sugar levels, and broad spectrum antibiotics. Intervention, in the form of percutaneous drainage or DJ stenting, was done in six patients. One patient failed to respond to this minimally invasive modality of treatment and had to undergo an open drainage. Thus, the acute episode was managed with conservative management strategies in all the patients; however, three patients underwent nephrectomy due to poorly-functioning kidney during follow-up. Conclusions: EPN is now being more readily diagnosed, at an early stage, making conservative management of EPN a safe, effective, and feasible option. PMID:24049377

  9. 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.

  10. [Fictitious ambush following an attempted "extended" suicide].

    PubMed

    Braun, Christian; Püschel, Klaus

    2007-01-01

    An unusual case of a 31-year-old-woman who was found near a forest road with self-inflicted injuries and burns is reported. The woman claimed to have been attacked by a man with a knife who then tried to burn her in her car. While she managed to escape, her cat died in the car. The examination of the wounds showed multiple superficial cuts in body regions easily accessible to her own hand. Gas chromatography of skin samples from the cat proved that it had been in in contact with a fire accelerant. On the basis of the examination findings, differential diagnostic aspects with regard to the motivation of the woman for simulating an offence are discussed. In all probability, the woman intended to commit suicide together with the cat through self-immolation, but did not complete the plan.

  11. Policy entrepreneurs and structural influence in integrated community case management policymaking in Burkina Faso

    PubMed Central

    2015-01-01

    Policy entrepreneurs are individuals who attempt to influence the policy process and its outcomes through their opportunistic or incremental actions. Their success in the policy-making process has been associated with the convergence of four factors: behavioural traits; institutional factors; network position and political capital. Policy entrepreneurs have received little study in low- and middle-income country policy research despite observations of individualized decision-making, informal institutions and the unequal distribution and exercise of power in policymaking. This article aims to identify whether policy entrepreneurs were present in the policy process around integrated community case management (iCCM) in Burkina Faso, whether they were successful in achieving policy change, and whether success or failure can be explained using existing policy entrepreneur frameworks from high-income polities. This mixed methods policy study collected data from in-depth qualitative interviews and social network surveys of actors involved in iCCM policymaking [known locally as C-integrated management of childhood illness (IMCI)]; data were analysed based on the framework categories. Interview data pointed to one key individual who played a significant role in the inclusion of pneumonia treatment into the country’s iCCM policy, an issue that had been a point of contention between government policy elites and development partners. Social network data confirmed that this actor was strategically located in the policy network to be able to reach the most other actors and to be able to control the flow of information. Although some development partner actors were as strategically located, none had the same level of authority or trust as was imbued by being a member of the government civil service. The entrepreneur’s mid-level rank in the health ministry may have encouraged him/her to invest political capital and take risks that would not have been feasible or attractive to

  12. Policy entrepreneurs and structural influence in integrated community case management policymaking in Burkina Faso.

    PubMed

    Shearer, Jessica C

    2015-12-01

    Policy entrepreneurs are individuals who attempt to influence the policy process and its outcomes through their opportunistic or incremental actions. Their success in the policy-making process has been associated with the convergence of four factors: behavioural traits; institutional factors; network position and political capital. Policy entrepreneurs have received little study in low- and middle-income country policy research despite observations of individualized decision-making, informal institutions and the unequal distribution and exercise of power in policymaking. This article aims to identify whether policy entrepreneurs were present in the policy process around integrated community case management (iCCM) in Burkina Faso, whether they were successful in achieving policy change, and whether success or failure can be explained using existing policy entrepreneur frameworks from high-income polities. This mixed methods policy study collected data from in-depth qualitative interviews and social network surveys of actors involved in iCCM policymaking [known locally as C-integrated management of childhood illness (IMCI)]; data were analysed based on the framework categories. Interview data pointed to one key individual who played a significant role in the inclusion of pneumonia treatment into the country's iCCM policy, an issue that had been a point of contention between government policy elites and development partners. Social network data confirmed that this actor was strategically located in the policy network to be able to reach the most other actors and to be able to control the flow of information. Although some development partner actors were as strategically located, none had the same level of authority or trust as was imbued by being a member of the government civil service. The entrepreneur's mid-level rank in the health ministry may have encouraged him/her to invest political capital and take risks that would not have been feasible or attractive to a

  13. Near-death experiences and attempted suicide.

    PubMed

    Greyson, B

    1981-01-01

    Attempted suicide is correlated with an increase subsequent risk of committed suicide. However, preliminary data and psychodynamic hypotheses suggest that serious suicide attempts followed by transcendental near-death experiences (NDEs) may decrease rather than increase subsequent overt suicide risk, despite the NDEs' apparent "romanticization" of death. Studies of NDEs and of their influence on suicidal ideation are proposed which may yield greater understanding of self-destructive urges and new strategies of suicide prevention.

  14. Ecological correlates of adolescent attempted suicide.

    PubMed

    Lester, D

    1990-01-01

    Rates of adolescent attempted suicide were correlated with social indicators over the electoral wards of Edinburgh (Scotland). Rates were found to be higher in wards where child neglect and misbehavior were more common. Rates of attempted suicide in the total population also were related to the housing pattern/social class of the wards. The importance of identifying similarities and differences in the patterns of suicidal behavior of adolescents and adults was noted. PMID:2375273

  15. Ecological correlates of adolescent attempted suicide.

    PubMed

    Lester, D

    1990-01-01

    Rates of adolescent attempted suicide were correlated with social indicators over the electoral wards of Edinburgh (Scotland). Rates were found to be higher in wards where child neglect and misbehavior were more common. Rates of attempted suicide in the total population also were related to the housing pattern/social class of the wards. The importance of identifying similarities and differences in the patterns of suicidal behavior of adolescents and adults was noted.

  16. Management on tsunami causing posttraumatic stress disorder: a case report.

    PubMed

    Jarusuraisin, Ngamwong; Kesornsukon, Kanch

    2005-11-01

    On December 26, 2004, tsunamis hit Southeast Asia and caused serious damage and loss of lives. In Thailand, six provinces (Ranong, Phang-Nga, Phuket, Krabi, Trang, and Satun) were impacted. The present study reports the psychiatric assessments such as Thai GHQ-60 and IES. It also reports management techniques of both cognitive behavior therapy and medication. Those were provided to a Thai female patient who was 54 years old. The patient responded to treatment quickly because of early management. The tsunami victim with Posttraumatic Stress Disorder (PTSD) is not an individual. A mass of people who faced or witnessed the tsunami are vulnerable to get PTSD any time during 6 months after trauma. These early management techniques are useful and practical for a mass of victims and survivors.

  17. Colocutaneous fistula management in a dehisced wound: a case study.

    PubMed

    Reed, Terri; Economon, Diana; Wiersema-Bryant, Laurel

    2006-04-01

    A fistula is an abnormal opening between two or more organs or structures. Wound drainage containment is a key component of nonsurgical fistula management and may include pouches, skin barriers, transparent dressings, troughing procedures, saddle bagging, bridging, and condom and suction catheters used in combination with complex or routine pouching. Following extensive abdominal surgery, the wound of a 50-year-old woman dehisced and a colocutaneous fistula formed inside the wound. The wound containing the fistula, which was draining liquid stool, was too large for existing commercial pouching systems. When initial management efforts, including negative pressure wound therapy, failed to achieve containment goals, clinicians adapted the negative pressure wound therapy dressing to surround the fistula, which helped facilitate therapy while providing a platform for an ostomy appliance to contain the fistula drainage. The system was changed every 2 days until discharge. The wound and fistula management combination improved patient comfort and mobility, facilitated healing, and reduced patient dietary restrictions.

  18. Suicidal behaviour. An attempt to modify the environment. Part IV.

    PubMed

    Lukianowicz, N

    1975-01-01

    A study was undertaken of 76 males patients (following suicidal attempts) admitted in 1962 and 1963 to Holywell Hospital, a psychiatric hospital in Antrim, Norther Ireland. Their age, psychiatric condition, personality, intelligence, civil state, social class, religion, etc., were reviewed and the findings were compared with the findings in: (a) 100 suicidal females treated in the same hospital for the same reason in the same 2 years; (b) a group of 45 suicidal males admitted to the same hospital in 1971, and (c) a group of 91 suicidal female subjects treated in Holywell in 1971. The aim of the inquiry was to find out: (a) whether there were any sex-linked differences between these groups; (b) whether there were any changes in methods used in suicidal attempts in the last decade, and (c) whether our hypothesis about gain-motivation in many suicidal attempts was correct. The results of the study showed that: (a) sex and all personal and social factors reviewed were of little significance in the incidence of suicidal attempts and in the methods employed in their execution; (b) in both 1971 groups there was a shift from violent to non-violent means, and (c) two-thirds of all patients, irrespective of sex, social class, religion, etc., not only claimed having tried to achieve some personal gains, but apparently did achieve them by their suicidal behaviour. This seems to support our hypothesis that in many cases suicidal behaviour is in fact an attempt to modify the environment to the patient's benefit.

  19. CSF Leaks and Their Management Following Anterior Cervical Discectomy and Fusion: A Report of 13 Cases and a Review of the Literature.

    PubMed

    Syre, Peter; Bohman, Leif-Erik; Baltuch, Gordon; Roux, Peter Le; Welch, William C

    2014-05-13

    : Study Design. Retrospective chart review and literature review.Objective. To identify cases where a CSF leak occurred during an ACDF and to create a management algorithm based on the findings.Summary of Background Data. Anterior cervical discectomy and fusion (ACDF) is a commonly performed spinal operation. It is effective with very low complication rates. One rare complication of ACDF is a CSF leak. There is limited information on the management of CSF leaks following ACDF and management is on a surgeon-by-surgeon basis.Methods. We reviewed 3 surgeons' case logs and identified cases where a CSF leak was encountered during ACDF and reviewed the patients' medical records, operative reports and imaging to determine how these leaks were managed. We also performed a PubMed search for articles about the presentation and management of CSF leaks following ACDF.Results. Thirteen CSF leaks were identified in 1223 ACDFs, corresponding to a CSF leak rate of 1%. Of these, 9 were successfully treated with intraoperative repair. Postoperative lumbar drainage was used in the remaining 4 patients and was successful in 1 patient. Three patients underwent neck re-exploration and attempted delayed repair. Three patients, including one who was found to have hydrocephalus, ultimately required continuous CSF diversion via shunting. We identified 7 case reports of CSF leak in ADCF in the literature and 1 article that reviewed the prevalence and management of this complication.Conclusion. CSF leak following ACDF is an uncommon complication that can usually be repaired. We provide a stepwise management strategy for CSF leaks in ACDF.

  20. 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

  1. 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

  2. A resilience perspective to water risk management: case-study application of the adaptation tipping point method

    NASA Astrophysics Data System (ADS)

    Gersonius, Berry; Ashley, Richard; Jeuken, Ad; Nasruddin, Fauzy; Pathirana, Assela; Zevenbergen, Chris

    2010-05-01

    In a context of high uncertainty about hydrological variables due to climate change and other factors, the development of updated risk management approaches is as important as—if not more important than—the provision of improved data and forecasts of the future. Traditional approaches to adaptation attempt to manage future water risks to cities with the use of the predict-then-adapt method. This method uses hydrological change projections as the starting point to identify adaptive strategies, which is followed by analysing the cause-effect chain based on some sort of Pressures-State-Impact-Response (PSIR) scheme. The predict-then-adapt method presumes that it is possible to define a singular (optimal) adaptive strategy according to a most likely or average projection of future change. A key shortcoming of the method is, however, that the planning of water management structures is typically decoupled from forecast uncertainties and is, as such, inherently inflexible. This means that there is an increased risk of under- or over-adaptation, resulting in either mal-functioning or unnecessary costs. Rather than taking a traditional approach, responsible water risk management requires an alternative approach to adaptation that recognises and cultivates resiliency for change. The concept of resiliency relates to the capability of complex socio-technical systems to make aspirational levels of functioning attainable despite the occurrence of possible changes. Focusing on resiliency does not attempt to reduce uncertainty associated with future change, but rather to develop better ways of managing it. This makes it a particularly relevant perspective for adaptation to long-term hydrological change. Although resiliency is becoming more refined as a theory, the application of the concept to water risk management is still in an initial phase. Different methods are used in practice to support the implementation of a resilience-focused approach. Typically these approaches

  3. 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

  4. 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…

  5. 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…

  6. 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

  7. 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…

  8. 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…

  9. 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)

  10. The Case for Individualizing Behavior Management Approaches in Inclusive Classrooms

    ERIC Educational Resources Information Center

    Grossman, Herbert

    2005-01-01

    In today's heterogeneous classrooms, one-method-fits-all-students behavior management approaches are ineffective and often harmful. To succeed with all of their students, teachers should determine whether students have emotional disorders, conduct/behavior disorders, robust male-typical behavior patterns, culturally influenced behavior, learning…

  11. 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…

  12. Use of group treatment among case managers in Department of Veterans Affairs supported housing program.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2013-01-01

    Because the predominant supported housing model includes individual intensive community-based case management, use of group treatments in supported housing has not been adequately studied. This study examined practices and attitudes about groups among case managers in the Department of Housing and Urban Development-Department of Veterans Affairs Supportive Housing (HUD-VASH) program. We examined national administrative HUD-VASH data and an online survey of case managers from eight sites in the New England region, where dissemination of a new group-based model is in progress. Compared with other sites nationally, sites in the New England region had more group contacts, possibly reflecting the dissemination project. Among the New England sites (n = 8), administrative data showed that a higher percentage of group contacts was associated with a greater number of clients served and with more contacts per client. Although case manager survey data (n = 55) showed generally positive attitudes about using groups, particularly about the potential effectiveness of groups and peer support, greater reported use of groups was not associated with more positive attitudes about groups. These findings suggest providing group treatments in supported housing programs may help case managers stay connected to clients and case managers appear receptive to using groups, though further research is needed. PMID:23934868

  13. 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…

  14. 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…

  15. Management and Training across Cultures: Importance of Non-Verbal Communication Strategies--A Case Study.

    ERIC Educational Resources Information Center

    Potoker, Elaine

    Noting that cross-cultural and language barriers pose formidable challenges to managers, a case study examined the application of selective nonverbal communication strategies (nonverbal cues, learning by observation, and the organization of learning) for management and training development efforts within diverse cultural environments. Source…

  16. 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'…

  17. 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…

  18. Strategies Nurse Managers Used to Offset Challenges during Electronic Medical Records Implementation: A Case Study

    ERIC Educational Resources Information Center

    Easterling, Latasha

    2015-01-01

    The purpose of this qualitative, descriptive case study was to discover successful approaches used, by nurse managers, to reduce barriers during the implementation of electronic medical record system in one hospital. Fourteen nurse managers were interviewed from an academic health science center in Mississippi. A pilot study was conducted to…

  19. 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…

  20. Radix entomolaris: 2 case reports and clinical guidelines for endodontic management.

    PubMed

    Latha, S Jothi; Velmurugan, N; Kavitha, M; Kumar, A R Pradeep

    2014-01-01

    Variations in dental anatomy and root canal systems are often reported in the dental literature. Among them, Radix entomolaris (RE) is the presence of an additional lingual root in mandibular molars. Though RE appears relatively infrequently, knowledge of the condition will aid in its management. This article presents 2 case reports of RE and clinical guidelines for endodontic management.

  1. 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,…

  2. 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…

  3. 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,…

  4. Successful delayed non-operative management of C2 neurosynchondrosis fractures in a pediatric patient: a case report and review of management strategies and considerations for treatment.

    PubMed

    Shammassian, Berje; Wright, Christina Huang; Wright, James; Onwuzulike; Tomei, Krystal L

    2016-01-01

    Upper cervical synchondrosis fractures are the most common types of cervical fractures in the pediatric population less than 7 years of age (Blauth et al (Eur Spine J 5:63-70, 1996); Connolly et al (Pediatr Radiol 25(Suppl1):S129-133, 1995); Mandabach et al (Pediatr Neurosurg 19(5):225-232, 1993); Schippers et al (Acta Neurochir 138:524-530, 1990)) The vast majority occur through the dentocentral or basilar synchondrosis. We present the second reported case in recent literature of a unilateral neurosynchondrosis fracture. The patient, a 4-year-old male, was initially managed conservatively with a rigid cervical collar for a period of 3 months. Despite multiple counseling sessions with family, the patient remained poorly compliant with cervical immobilization. After 3 months, imaging demonstrated partial fusion with persistent anterolisthesis of C2 on C3. The decision was made to place the child in external halo fixation as an attempt to achieve fusion prior to committing to internal surgical fixation and the associated sequelae. Immobilization with a hard cervical collar is often first line treatment. In the case of failed fusion, debate exists regarding surgical fixation in children. Occipito-atlanto-axial fusion leads to permanent loss of a significant degree of flexion, extension, and rotatory movement. The pediatric population has a strong propensity to fuse; however, compliance is often a barrier to conservative treatment due to age-related behavioral practices. We demonstrate that even with initial failed fusion and progression of deformity while in a cervical collar, conservative management with external halo fixation can potentially obviate the need for internal fixation. PMID:26231564

  5. Superior mesenteric artery dissection as a complication of an endovascular attempt to treat aneurysms of the pancreaticoduodenal arteries.

    PubMed

    Dzieciuchowicz, Łukasz; Snoch-Ziółkiewicz, Magdalena; Oszkinis, Grzegorz; Frankiewicz, Maciej

    2015-10-01

    A case of iatrogenic dissection of the superior mesenteric artery (SMA) in a 42-year old woman during an attempt of endovascular treatment of aneurysms of the pancreaticoduodenal arteries coexisting with a stenosis of the coeliac trunk is presented. The dissection occurred most probably during insertion of an introducer sheath into the SMA. The patient at that moment reported a short-lasting abdominal pain and after that remained asymptomatic. Due to technical difficulties, the attempt of endovascular management of pancreaticoduodenal aneurysms was abandoned. The completion angiography revealed the occlusion of the SMA. The patient underwent an emergency laparotomy; pancreaticoduodenal aneurysms were excised and SMA dissection was repaired with endarterectomy and a patch closure. Postoperative recovery was uneventful and the patient remained asymptomatic during a 30-month follow-up. The case underscores the importance of completion angiography after endovascular interventions in the SMA since the early period of its occlusion may be asymptomatic.

  6. Poststroke suicide attempts and completed suicides

    PubMed Central

    Glader, Eva-Lotta; Norrving, Bo; Asplund, Kjell

    2015-01-01

    Objective: We examined attempted and completed suicides after stroke to determine whether they were associated with socioeconomic status, other patient characteristics, or time after stroke. Methods: This nationwide cohort study included stroke patients from Riksstroke (the Swedish Stroke Register) from 2001 to 2012. We used personal identification numbers to link the Riksstroke data with other national registers. Suicide attempts were identified by a record of hospital admission for intentional self-harm (ICD-10: X60-X84), and completed suicides were identified in the national Cause of Death Register. We used multiple Cox regression to analyze time from stroke onset to first suicide attempt. Results: We observed 220,336 stroke patients with a total follow-up time of 860,713 person-years. During follow-up, there were 1,217 suicide attempts, of which 260 were fatal. This was approximately double the rate of the general Swedish population. Patients with lower education or income (hazard ratio [HR] 1.37, 95% confidence interval [CI] 1.11–1.68) for primary vs university and patients living alone (HR 1.73, 95% CI 1.52–1.97) had an increased risk of attempted suicide, and patients born outside of Europe had a lower risk compared to patients of European origin. Male sex, young age, severe stroke, and poststroke depression were other factors associated with an increased risk of attempted suicide after stroke. The risk was highest during the first 2 years after stroke. Conclusions: Both clinical and socioeconomic factors increase the risk of poststroke suicide attempts. This suggests a need for psychosocial support and suicide preventive interventions in high-risk groups of stroke patients. PMID:25832661

  7. [Adolescents after suicidal attempts. Sociological characteristics].

    PubMed

    Rosa, Krzysztof

    2007-01-01

    Adolescents are thought to be one of the high risk groups for suicidal behaviours. About 400 persons till 20 years old commit suicide every year, and from 10 to 20 times more suicide attempts. The paper discusses differences in sociological profiles of youngsters after suicidal attempts and those who never had suicidal attempts. There were several factors in the scope of interest as: sociodemo-graphic characteristics, family structure, school problems, relationship with peers, history of abusive behaviours of youngsters and their relatives. Some particular elements of suicidal acts (suicidal thoughts, circumstances, events directly preceding the attempts, motives for suicidal attempts) were also described. The study group was comprised of 100 adolescents recruited from consecutive patients presented to the Clinic of Acute Poisonings of the Nofer Institute of Occupational Medicine between January 2001 and June 2002 due to self-poisoning. The reference group (100 youngsters) was randomly selected from the different types of secondary schools situated in the area of Lodz voivodeship. The data were collected with help of standardized surveys. The results obtained point to some differences between the study group. The groups differ in 24 among 31 analysed variables. The average teenager who attempts suicide is a 17 year old girl, living in a big city with a full family (not necessarily biological) who was faced with relational and school problems, and affected by abusive behaviour. Sociological characteristics of individuals attempting suicide together with precise diagnosis of risk factors and risk groups is the important step toward the effective prevention of suicide behaviour. Suicidal behaviour appears to be a significant public health problem, and suicide prevention itself should be the essential component of each mental health promotion program.

  8. 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.

  9. A case of decentered IOL managed with optic buttonholing.

    PubMed

    Gupta, Shikha; Khokhar, Sudarshan; Agarwal, Tushar

    2014-12-01

    We describe an unusual case which presented with late lateral IOL decentration secondary to bag subluxation in the presence of a posterior capsular defect. Instead of approaching the case with the usual IOL exchange with iris-fixated or anterior chamber IOL or by fixating it to the sclera, a relatively non-invasive sutureless method of IOL re-centration was performed by buttonholing the optic into the posterior capsular defect. It enabled a perfect IOL centration with minimal incidence of astigmatism, inflammation, macular edema, secondary glaucoma, or corneal decompensation. PMID:25227431

  10. 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.

  11. Clinical features, testing, and management of patients with suspected prosthetic hip-associated cobalt toxicity: a systematic review of cases.

    PubMed

    Devlin, John J; Pomerleau, Adam C; Brent, Jeffrey; Morgan, Brent W; Deitchman, Scott; Schwartz, Michael

    2013-12-01

    Safety concerns regarding cobalt-containing metal alloy hip prosthetics (Co-HP) have resulted in product recalls, a medical device alert, and issuance of guidance for clinicians. Recently, cases of suspected prosthetic hip-associated cobalt toxicity (PHACT) from Co-HP have been reported. Although little is known about suspected PHACT, these patients may be referred to medical toxicologists for evaluation and management recommendations. We searched MEDLINE, EMBASE, and unpublished abstracts from toxicology scientific meetings for references relevant to PHACT. Authors independently screened publications for inclusion criteria: publication in English, human study population, subject(s) are symptomatic (except for isolated hip pain), and cobalt values in any matrix (blood, serum, urine, CSF, synovial fluid) available for review. Data from 10 cases are reviewed. Patients with suspected PHACT had findings consistent with cobalt toxicity, including thyroid, cardiac, and neurologic dysfunction. Signs and symptoms appeared between 3 and 72 months after arthroplasty (median 19 months). Neurologic symptoms were most common. Ancillary testing varied considerably. All patients had elevated cobalt levels in one or more matrices. Enhanced elimination was attempted in 27 % of patients. At this time, the information currently available regarding patients with suspected PHACT is inadequate to guide clinical decision making. No consensus has been reached regarding the management of Co-HP patients with systemic symptoms. Indications for chelation have not been established and require further study. Improved case definitions, improved surveillance, and controlled studies are needed to elucidate the scope of this problem and guide future investigations. PMID:24222555

  12. UAV-based Natural Hazard Management in High-Alpine Terrain - Case Studies from Austria

    NASA Astrophysics Data System (ADS)

    Sotier, Bernadette; Adams, Marc; Lechner, Veronika

    2015-04-01

    Unmanned Aerial Vehicles (UAV) have become a standard tool for geodata collection, as they allow conducting on-demand mapping missions in a flexible, cost-effective manner at an unprecedented level of detail. Easy-to-use, high-performance image matching software make it possible to process the collected aerial images to orthophotos and 3D-terrain models. Such up-to-date geodata have proven to be an important asset in natural hazard management: Processes like debris flows, avalanches, landslides, fluvial erosion and rock-fall can be detected and quantified; damages can be documented and evaluated. In the Alps, these processes mostly originate in remote areas, which are difficult and hazardous to access, thus presenting a challenging task for RPAS data collection. In particular, the problems include finding suitable landing and piloting-places, dealing with bad or no GPS-signals and the installation of ground control points (GCP) for georeferencing. At the BFW, RPAS have been used since 2012 to aid natural hazard management of various processes, of which three case studies are presented below. The first case study deals with the results from an attempt to employ UAV-based multi-spectral remote sensing to monitor the state of natural hazard protection forests. Images in the visible and near-infrared (NIR) band were collected using modified low-cost cameras, combined with different optical filters. Several UAV-flights were performed in the 72 ha large study site in 2014, which lies in the Wattental, Tyrol (Austria) between 1700 and 2050 m a.s.l., where the main tree species are stone pine and mountain pine. The matched aerial images were analysed using different UAV-specific vitality indices, evaluating both single- and dual-camera UAV-missions. To calculate the mass balance of a debris flow in the Tyrolean Halltal (Austria), an RPAS flight was conducted in autumn 2012. The extreme alpine environment was challenging for both the mission and the evaluation of the aerial

  13. 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.

  14. 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…

  15. Characteristics of Drug Overdose in Young Suicide Attempters

    PubMed Central

    Kweon, Yong-Sil; Hwang, Sunyoung; Yeon, Bora; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Lee, Chung Tai

    2012-01-01

    Objective Few studies have focused on the characteristic features of drug overdose in children and adolescents who have attempted suicide in Korea. The present study examined the characteristics of drug overdose in children and adolescents who visited the emergency room following drug ingestion for a suicide attempt. Methods The medical records of 28 patients who were treated in the emergency room following a drug overdose from January 2008 to March 2011 were analyzed. Demographic and clinical variables related to the suicide attempts were examined. Results The mean age of the patients was 16.6±1.7 years (range 11-19 years), and 20 of the patients (71.4%) were female. Most of the patients (n=23, 82.1%) overdosed on a single drug; acetaminophen-containing analgesics were the most common (n=12, 42.9%). Depression was the most common psychiatric disorder (n=22, 78.6%), and interpersonal conflict was the most common precipitating factor of the suicide attempts (n=11, 39.3%). This was the first suicide attempt for approximately 80% of the patients. About one fourth of the patients (n=7, 25%) had follow-up visits at the psychiatric outpatient clinic. Conclusion Early screening and psychiatric intervention for depression may be an important factor in preventing childhood and adolescent suicide attempts. Developing coping strategies to manage interpersonal conflicts may also be helpful. Moreover, policies restricting the amount and kind of drugs purchased by teenagers may be necessary to prevent drug overdose in this age group. PMID:23430317

  16. [The sense of coherence and risk of suicide attempt].

    PubMed

    Polewka, A; Chrostek-Maj, J; Kroch, S; Mikołaszek-Boba, M; Ryn, E; Datka, W; Rachel, W

    2001-01-01

    The analysis was based upon 79 patients hospitalized for suicide attempts (drug intoxication) in the Department of Clinical Toxicology CM UJ in Kraków from July to December 2000. The purpose of the study was to estimate the sense of coherence level (according to Antonovsky) as a potential suicide attempt predictor. The population of patients was divided into two groups: patients after first suicide attempt (I) and group after reattempting suicide (II). The examination was based on structure interview, analysis of medical documentation and a number of tests including SOC 29 (by Antonovsky), Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), and Beck Hopelessness Scale (HS 20). The most important psychological and independent variable measured in the study was the sense of coherence, introduced first by Aaron Antonovsky as a significant predictor of mental health. The sense of coherence (measured by SOC 29 questionnaire) comprises comprehensibility, manageability and meaningfulness. Both in foreign and in polish studies the SOC 29 level was lower in clinical groups compared to healthy people. The norm in Polish population was 139 scores in SOC 29. In the present study the average total result (men and women) was 112 scores in the group of patients after first suicide attempt, and in the group of repeated suicide attempters the average total result was even lower--only 99 scores, which makes a statistically significant difference. We also observed a statistically significant dependence between the results of SOC 20 questionnaire, the level of depression measured by Beck Depression Inventory and Hamilton Depression Scale, and the level of hopelessness measured by Beck Hopelessness Scale. The above results indicate that the sense of coherence level may make significant risk factor for repeated suicide attempt.

  17. Internet telehealth for pediatric asthma case management: integrating computerized and case manager features for tailoring a Web-based asthma education program.

    PubMed

    Wise, Meg; Gustafson, David H; Sorkness, Christine A; Molfenter, Todd; Staresinic, Anthony; Meis, Tracy; Hawkins, Robert P; Shanovich, Kathleen Kelly; Walker, Nola P

    2007-07-01

    This article reports on the development of a personalized, Web-based asthma-education program for parents whose 4- to 12-year-old children have moderate to severe asthma. Personalization includes computer-based tailored messages and a human coach to build asthma self-management skills. Computerized features include the Asthma Manager, My Calendar/Reminder, My Goals, and a tailored home page. These are integrated with monthly asthma-education phone calls from an asthma-nurse case manager. The authors discuss the development process and issues and describe the current randomized evaluation study to test whether the year-long integrated intervention can improve adherence to a daily asthma controller medication, asthma control, and parent quality of life to reduce asthma-related healthcare utilization. Implications for health education for chronic disease management are raised.

  18. 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.

  19. 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…

  20. 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

  1. 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

  2. Case-Based Modeling for Learning Management and Interpersonal Skills

    ERIC Educational Resources Information Center

    Lyons, Paul

    2008-01-01

    This article offers an introduction to case-based modeling (CBM) and a demonstration of the efficacy of this instructional model. CBM is grounded primarily in the concepts and theory of experiential learning, augmented by concepts of script creation. Although it is labor intensive, the model is one that has value for instruction in various…

  3. 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…

  4. Harlequin syndrome: two new cases and a management proposal.

    PubMed

    Willaert, W I M; Scheltinga, M R M; Steenhuisen, S F; Hiel, J A P

    2009-09-01

    The Harlequin syndrome is a rare autonomic disorder, characterized by unilateral diminished sweating and flushing of the face in response to heat or exercise. We present two new cases and evaluate the data of 83 patients described in the literature. We provide diagnostic and therapeutic guidelines. PMID:19902816

  5. Profiling psychiatric inpatient suicide attempts in Japan.

    PubMed

    Ikeshita, Katsumi; Shimoda, Shigero; Norimoto, Kazunobu; Arita, Keisuke; Shimamoto, Takuya; Murata, Kiyoshi; Makinodan, Manabu; Kishimoto, Toshifumi

    2014-01-01

    Suicide is an adverse event that can occur even when patient are hospitalized in psychiatric facilities. This study delineates the demographic characteristics of suicide attempts in mental hospitals and psychiatric wards of general hospitals in Japan, a country where the suicide rate is remarkably high. Analyses of incident reports on serious suicide attempts in psychiatric inpatients were performed using prefectural incident records between April 1, 2001, and December 31, 2012. Suicide reports were included for 35 incidents that occurred over 11 years, and demonstrated that 83% of patients (n = 29) committed suicide and 17% (n = 6) survived their attempt with serious aftereffects, such as cognitive impairment or persistent vegetative state. The male/female ratio of inpatient suicide was 1.5:1. The mean age of the attempters was 50.5 years (SD = 18.2). The most common psychiatric diagnoses for those with suicide incident reports were schizophrenia spectrum disorders (51.4%) and affective disorders (40%). Hanging (60%) was the most common method of suicide attempt, followed by jumping in front of moving objects (14.3%) and jumping from height (11.4%). Fifty-four percent of suicides (n = 19) occurred within hospital sites and the remainder (46%; n = 16) occurred outside hospital sites (e.g., on medical leave or elopement) while they were still inpatients. PMID:25345233

  6. A case of malignant hyperthermia captured by an anesthesia information management system.

    PubMed

    Maile, Michael D; Patel, Rajesh A; Blum, James M; Tremper, Kevin K

    2011-04-01

    Many cases of malignant hyperthermia triggered by volatile anesthetic agents have been described. However, to our knowledge, there has not been a report describing the precise changes in physiologic data of a human suffering from this process. Here we describe a case of malignant hyperthermia in which monitoring information was frequently and accurately captured by an anesthesia information management system. PMID:21638068

  7. 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…

  8. A case of malignant hyperthermia captured by an anesthesia information management system.

    PubMed

    Maile, Michael D; Patel, Rajesh A; Blum, James M; Tremper, Kevin K

    2011-04-01

    Many cases of malignant hyperthermia triggered by volatile anesthetic agents have been described. However, to our knowledge, there has not been a report describing the precise changes in physiologic data of a human suffering from this process. Here we describe a case of malignant hyperthermia in which monitoring information was frequently and accurately captured by an anesthesia information management system.

  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. 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…

  11. 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"…

  12. Modern management of hypervascular placental polypoid mass following spontaneous abortion: a case report and literature review.

    PubMed

    Marques, Kevin; Looney, Christopher; Hayslip, Clifford; Gavrilova-Jordan, Larisa

    2011-08-01

    Hypervascular placental polypoid mass is a possible source of acute hemorrhage after pregnancy. We present a case report and literature review of a rare case after spontaneous miscarriage. We describe the diagnosis, imaging, and management of placental polyps, which includes the use of iliac artery occlusion catheters with concomitant hysteroscopic resection.

  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. Christ Siemens Touraine syndrome: Two case reports and felicitous approaches to prosthetic management

    PubMed Central

    Renahan, Navanith; Raj, Renju; Varma, R. Balagopal; Kumar, J Suresh

    2015-01-01

    Ectodermal dysplasia is a heterogeneous group of inherited disorders, which exhibit a classic triad of hypohydrosis, hypotrichosis, and hypodontia. Hypohidrotic or anhidrotic ectodermal dysplasia or Christ Siemens Touraine syndrome is the most common condition among ectodermal dysplasia patients. This is a case report on two Christ Siemens Touraine syndrome cases and two different approaches to prosthetic management. PMID:26097372

  15. 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,…

  16. 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.

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

    ERIC Educational Resources Information Center

    Cevik, Yasemin Demiraslan; 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…

  18. Forensic analysis and psycholegal implications of parricide and attempted parricide.

    PubMed

    Weisman, A M; Sharma, K K

    1997-11-01

    In a retrospective archive study, 64 adjudicated adult cases involving the murder or attempted murder of at least one parent, referred for forensic evaluations are described. Biographic, demographic, diagnostic, crime scene, psycholoegal opinion, and disposition data are presented. Results indicated a 40% rate of insanity acquitees. Attempted parricide subjects were more likely to have inpatient psychiatric histories, witnesses present during the criminal act, nonresponsiveness towards their actions, competency raised, and a hospital disposition. Gender and ethnicity were found to have a significant effect on ultimate disposition. Fifty-four percent of the sample opined psychotic were sentenced to prison, suggesting other factors considered by judge and jury. Profile characteristics and typologies are presented. The findings are compared to studies involving parricide and legal strategies involving similar cases.

  19. 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…

  20. Impoverishment of practice: analysis of effects of economic discourses in home care case management practice.

    PubMed

    Ceci, Christine

    2006-03-01

    Home care is a health sector under increasing pressure. Demand is often said to be outstripping capacity, with constant change and retrenchment distinguishing features of the current context. This paper takes a reading of the current conditions of home care using data gathered during a field study of home care case management practices conducted in 2004. As economic discourses become increasingly influential in determining responses to client situations, case managers (and their managers) find themselves with limited capacity to exercise control over their practices. A growing gap between professionally influenced discourses--those presumably intended to guide practice--and organizational priorities creates a dissonance for case managers as the political-ethical dimensions of their practices are displaced by budget "realities." For front-line workers, such displacement cannot be sustained in their face-to-face encounters with clients, leading to a growing sense of frustration and powerlessness among these highly skilled practitioners.

  1. 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.

  2. 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

  3. Decision-making competence and attempted suicide

    PubMed Central

    Szanto, Katalin; Bruine de Bruin, Wändi; Parker, Andrew M; Hallquist, Michael N; Vanyukov, Polina M; Dombrovski, Alexandre Y

    2015-01-01

    Objective The propensity of people vulnerable to suicide to make poor life decisions is increasingly well documented. Do they display an extreme degree of decision biases? The present study used a behavioral decision approach to examine the susceptibility of low-lethality and high-lethality suicide attempters to common decision biases, which may ultimately obscure alternative solutions and deterrents to suicide in a crisis. Method We assessed older and middle-aged individuals who made high-lethality (medically serious; N=31) and low-lethality suicide attempts (N=29). Comparison groups included suicide ideators (N=30), non-suicidal depressed (N=53), and psychiatrically healthy participants (N=28). Attempters, ideators, and non-suicidal depressed participants had unipolar non-psychotic major depression. Decision biases included sunk cost (inability to abort an action for which costs are irrecoverable), framing (responding to superficial features of how a problem is presented), under/overconfidence (appropriateness of confidence in knowledge), and inconsistent risk perception. Data were collected between June of 2010 and February of 2014. Results Both high- and low-lethality attempters were more susceptible to framing effects, as compared to the other groups included in this study (p≤ 0.05, ηp2 =.06). In contrast, low-lethality attempters were more susceptible to sunk costs than both the comparison groups and high-lethality attempters (p≤ 0.01, ηp2 =.09). These group differences remained after accounting for age, global cognitive performance, and impulsive traits. Premorbid IQ partially explained group differences in framing effects. Conclusion Suicide attempters’ failure to resist framing may reflect their inability to consider a decision from an objective standpoint in a crisis. Low-lethality attempters’ failure to resist sunk-cost may reflect their tendency to confuse past and future costs of their behavior, lowering their threshold for acting on suicidal

  4. Candida Glabrata Esophagitis: new case reports and management

    PubMed Central

    Macêdo, Danielle Patrícia Cerqueira; da Silva, Vanessa Karina Alves; de Almeida Farias, Aline Mary; de Melo, Luciana Resende Bandeira; Wilheim, Ana Botler; Neves, Rejane Pereira

    2008-01-01

    Candida esophagitis (CE) is a common opportunistic infection in the immunocompromised host. C. glabrata is rarely cited as agent of CE and has been underestimated due to lack of proper identification. In this study, two cases of C. glabrata esophagitis in AIDS and chagasic patients are reported. Diagnosis of Candida species should be considered an important key for the ideal choice of antifungal therapy against this mycosis. PMID:24031216

  5. Management of Blandin-Nuhn mucocele--a case report.

    PubMed

    Rai, Ashmitha J; Hegde, Amitha M; Shetty, Y Rajmohan

    2008-01-01

    Mucoceles of the glands of Blandin and Nuhn are uncommon and mainly seen on the ventral surface of the tongie. This case report emphasizes the treatment approach of these mucoceles. This patient reported with a second recurrence following conventional treatment, so a novel method was tried by injecting an ultraflow rubber base impression material into the mucocele, after which a surgical excision was done. The present procedure showed a clear demarcated limit of the lesion making the surgical excision easier

  6. 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.

  7. 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.

  8. 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

  9. Factors Associated With Suicidal Attempts in Iran: A Systematic Review

    PubMed Central

    Hakim Shooshtari, Mitra; Malakouti, Seyyed Kazem; Panaghi, Leili; Mohseni, Shohreh; Mansouri, Naghmeh; Rahimi Movaghar, Afarin

    2016-01-01

    Context: Suicide prevention is a health service priority. Some surveys have assessed suicidal behaviors and potential risk factors. Objectives: The current paper aimed to gather information about etiology of suicide attempts in Iran. Data Sources: Pubmed, ISI web of science, PsychInfo, IranPsych, IranMedex, IranDoc as well as gray literature were searched. Study Selection: By electronic and gray literature search, 128 articles were enrolled in this paper. Pubmed, ISI web of science, PsychInfo, IranPsych, IranMedex, IranDoc were searched for electronic search. After reading the abstracts, 84 studies were excluded and full texts of 44 articles were reviewed critically. Data Extraction: Pubmed, ISI web of science, PsychInfo, IranPsych, IranMedex, IranDoc as well as gray literature were searched to find any study about etiologic factors of suicide attempt in Iran. Results: Depressive disorder was the most common diagnosis in suicide attempters that is 45% of the evaluated cases had depression. One study that had used Minnesota multiphasic personality inventory (MMPI) found that Histrionics in females and Schizophrenia and Paranoia in males were significantly influential. Family conflicts with 50.7% and conflict with parents with 44% were two effective psychosocial factors in suicidal attempts. In around one fourth (28.7%) of the cases, conflict with spouse was the main etiologic factor. Conclusions: According to the methodological limitations, outcomes should be generalized cautiously. Further studies will help to plan preventive strategies for suicidal attempts; therefore, continued researches should be conducted to fill the data gaps. PMID:27284284

  10. Perioperative Management of the Direct Oral Anticoagulants: A Case-Based Review.

    PubMed

    Bell, Benjamin R; Spyropoulos, Alex C; Douketis, James D

    2016-10-01

    The periprocedural management of patients on direct oral anticoagulants (DOACs) is a common but potentially challenging clinical problem because there are few prospective studies to guide clinical decisions. Retrospective analyses from randomized trials and observational data suggest that DOACs can be managed in a standardized manner, based on surgical and patient characteristics, that does not result in excess major bleeding or thrombosis. In a case-based manner, this article presents a perioperative DOAC management algorithm and reviews the available and emerging evidence supporting the safety and efficacy of this approach. A free online clinical guidance tool is available from Thrombosis Canada that includes the proposed management algorithm. PMID:27637308

  11. Perioperative Management of the Direct Oral Anticoagulants: A Case-Based Review.

    PubMed

    Bell, Benjamin R; Spyropoulos, Alex C; Douketis, James D

    2016-10-01

    The periprocedural management of patients on direct oral anticoagulants (DOACs) is a common but potentially challenging clinical problem because there are few prospective studies to guide clinical decisions. Retrospective analyses from randomized trials and observational data suggest that DOACs can be managed in a standardized manner, based on surgical and patient characteristics, that does not result in excess major bleeding or thrombosis. In a case-based manner, this article presents a perioperative DOAC management algorithm and reviews the available and emerging evidence supporting the safety and efficacy of this approach. A free online clinical guidance tool is available from Thrombosis Canada that includes the proposed management algorithm.

  12. 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.

  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. Knowledge of renal histology alters patient management in over 40% of cases.

    PubMed

    Richards, N T; Darby, S; Howie, A J; Adu, D; Michael, J

    1994-01-01

    There is great debate as to whether the benefit gained from the knowledge of renal histology outweighs the risk to the patient from the biopsy procedure. We conducted a prospective study of 276 native renal biopsies performed on 266 patients from a single centre in 1991 to assess the effect of the knowledge of renal histology on patient management. Biopsies were performed under ultrasound guidance using the Trucut biopsy needle. The indications for biopsy were: non-nephrotic proteinuria alone (25), haematuria and proteinuria (28), nephrotic range proteinuria (28), acute renal failure (31), haematuria alone (36), and chronic renal failure (128). Two hundred and sixty-three biopsies were successful. The mean number of glomeruli obtained was 23, range 0-115. Eight patients developed macroscopic haematuria of which two required blood transfusion. The result of the biopsy altered management in 24/28 (86%) of cases of nephrotic range proteinuria, 22/31 (71%) of cases of acute renal failure, 58/128 (45%) of cases of chronic renal failure, 9/28 (32%) of cases with haematuria and proteinuria, 3/25 (12%) of cases with non-nephrotic proteinuria alone, and 1/36 (3%) of cases with haematuria alone. management was altered in 42% of cases overall. These data suggest that knowledge of renal histology is essential in the management of patients with renal disease.

  15. Management of superior sagittal sinus injury encountered in traumatic head injury patients: Analysis of 15 cases

    PubMed Central

    Behera, Sanjay K.; Senapati, Satya Bhusan; Mishra, Sudhansu Sekhar; Das, Srikant

    2015-01-01

    Background: Significant dural sinus injury occurs in 1.5- 5% of all head injuries and injury to superior sagittal sinus accounts for 70-80% of these. Its management is also a challenging issue to every neurosurgeon. Materials and Methods: In a period of one year (Aug 2011 to july2012) out of 549 cases of head injuries operated in our department analysis of 15 cases (2.73%) shown to have superior sagittal sinus injury. Three dimensional reconstruction of skull bone during CT scan helped us to diagnose possible dural sinus injury pre-operatively. Results: SSS injury was due to direct impact of fracture segment (5 cases), extension of fracture line over sinus area (4 cases) or due to coronal suture diastases (6 cases). Injury to anterior third of sagittal sinus occurred in 12 cases (80%) and injury to middle third occurred in 3 cases (20%). Small tear over superior sagittal sinus was found in 7 cases (46.66%) and was managed with Gelfoam® compression only and in two cases (13.33%) were large tear, which was managed with sinoraphy. In four cases (36.34%) hitch stitches over Gelfoam® to adjacent bone given and in rest two cases (13.33%) a strip of bone was left over the sinus area and bilateral hitch stitches were applied. Conclusion: Injury to SSS in traumatic head injury patient though rarely encountered during surgery, the management is challenging to every neurosurgeon. Preoperative suspicion and combination of surgical techniques rather than one single technique may be effective in decreasing the sinus related mortality rate. PMID:25767570

  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.

  17. Dilated cardiomyopathy in acromegaly: Case report and anesthesia management.

    PubMed

    Nair, Abhijit S; Nirale, Anand M; Sriprakash, K; Gopal, T V S

    2013-01-01

    Patients who are diagnosed having acromegaly develop a lot of cardiovascular Complications such as hypertension, arrhythmias, systolic and diastolic dysfunction, valvular dysfunction and heart failure. Dilated cardiomyopathy (DCM) with systolic and diastolic dysfunction is relatively rare but is associated with an increased mortality. We report a case of acromegaly diagnosed at 52 years of age in a known diabetic, non-hypertensive male who had DCM with severe left ventricular dysfunction, global hypokinesia, moderate mitral regurgitation, and grade II diastolic dysfunction who was treated with diuretics, digitalis, and vasodilators. He was diagnosed with a growth hormone secreting pituitary macroadenoma and underwent endoscopic excision of the pituitary tumor under general anesthesia.

  18. Clinical Management of Glanzmann's Thrombasthenia: A Case Report.

    PubMed

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

    2014-03-01

    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.

  19. An aeronautic suicide attempt (2). The psychiatrist's comments.

    PubMed

    Spengler, A

    1993-01-01

    A man without previous flying experience stole an aircraft and took off in order to commit suicide. An air traffic controller managed to convince him to land the plane. This article reports the psychiatrist's investigation into the case.

  20. Comment: Transgenerational Patterns of Suicide Attempt.

    ERIC Educational Resources Information Center

    Zimmerman, Shirley L.

    1991-01-01

    Notes that subject of transgenerational patterns of suicide attempt calls for examination of variables extending beyond those examined in previous article (Sorenson and Rutter, 1991). Considers possible significance of such variables as respondent's income, employment status, and length of residence in the community. Contends that scales assessing…