Preparing Addiction Specialists to Include Case Management and Vocational Rehabilitation Services in the Treatment Model for Problem Gamblers

ERIC Educational Resources Information Center

Glenn, Margaret K.; Diaz, Sebastian R.; Hawley, Carolyn

2009-01-01

Professionals in the field of addictions view problems associated with recovery management across multiple domains. This exploratory study utilized concept mapping and pattern matching methodology to conceptualize the resulting 7 domains of concern for treatment and aftercare of problem and pathological gamblers. The information can be used by…

Intervention into a turbulent urban situation: A case study. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Caldwell, G. M., Jr.

1973-01-01

The application is reported of NASA management philosophy and techniques within New Castle County, Delaware, to meet actual problems of community violence. It resulted in restructuring the county approach to problems of this nature, and development of a comprehensive system for planning, based on the NASA planning process. The method involved federal, state, and local resources with community representatives in solving the problems. The concept of a turbulent environment is presented with parallels drawn between NASA management experience and problems of management within an urban arena.

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…

A Qualitative Study on Classroom Management and Classroom Discipline Problems, Reasons, and Solutions: A Case of Information Technologies Class

ERIC Educational Resources Information Center

Erdogan, Mehmet; Kursun, Engin; Sisman, Gulcin Tan; Saltan, Fatih; Gok, Ali; Yildiz, Ismail

2010-01-01

The purpose of this study was to investigate classroom management and discipline problems that Information Technology teachers have faced, and to reveal underlying reasons and possible solutions of these problems by considering the views of parents, teachers, and administrator. This study was designed as qualitative study. Subjects of this study…

A case study of hospital operations management.

PubMed

Cheng, T C

1987-12-01

This paper discusses a study to investigate various operations management problems in a newly opened, modern regional hospital in Hong Kong. The findings of the study reveal that there exist in the hospital a number of current and potential problem areas. Recommendations for solving these problems are suggested with a view to improving the overall operational efficiency and effectiveness of the hospital.

The Use of Computer-Based Data Banks in the Teaching of Clinical Problem-Solving and Medical Case Management to Veterinary Students

ERIC Educational Resources Information Center

Conzelman, Gaylord M.; And Others

1975-01-01

Describes a program at the School of Veterinary Medicine, University of California at Davis to give students experience in diagnosis and management of urinary tract diseases. Students request from computer data banks that laboratory information they deem most useful in the medical management of each clinical problem. (JT)

Small Business Management. Addendum to Small Business Management Education Curriculum Volume III.

ERIC Educational Resources Information Center

Minnesota Univ., St. Paul. Dept. of Agricultural Education.

A supplement to a previous volume (CE 009 649), this document contains handouts, case problems, schedules, and seminar information keyed to specific units of instruction. The contents by year and unit areas are as follow: year I, unit 1--time management (two-page handout concerning four problems to avoid; year I, unit 2--warranty register (a…

Good practices in managing work-related indoor air problems: a psychosocial perspective.

PubMed

Lahtinen, Marjaana; Huuhtanen, Pekka; Vähämäki, Kari; Kähkönen, Erkki; Mussalo-Rauhamaa, Helena; Reijula, Kari

2004-07-01

Indoor air problems at workplaces are often exceedingly complex. Technical questions are interrelated with the dynamics of the work community, and the cooperation and interaction skills of the parties involved in the problem solving process are also put to the test. The objective of our study was to analyze the process of managing and solving indoor air problems from a psychosocial perspective. This collective case study was based on data from questionnaires, interviews and various documentary materials. Technical inspections of the buildings and indoor air measurements were also carried out. The following four factors best differentiated successful cases from impeded cases: extensive multiprofessional collaboration and participative action, systematic action and perseverance, investment in information and communication, and process thinking and learning. The study also proposed a theoretical model for the role of the psychosocial work environment in indoor air problems. The expertise related to social and human aspects of problem solving plays a significant role in solving indoor air problems. Failures to properly handle these aspects may lead to resources being wasted and result in a problematic situation becoming stagnant or worse. Copyright 2004 Wiley-Liss, Inc.

Environmental problem solving

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, A.

Human influences create both environmental problems and barriers to effective policy aimed at addressing those problems. In effect, environmental managers manage people as much as they manage the environment. Therefore, they must gain an understanding of the psychological and sociopolitical dimensions of environmental problems that they are attempting to resolve. The author reappraises conventional analyses of environmental problems using lessons from the psychosocial disciplines. The author combines the disciplines of ecology, political sociology and psychology to produce a more adaptive approach to problem-solving that is specifically geared toward the environmental field. Numerous case studies demonstrate the practical application of theorymore » in a way that is useful to technical and scientific professionals as well as to policymakers and planners.« less

Overview of Medicaid capitation and case-management initiatives

PubMed Central

Freund, Deborah A.; Neuschler, Edward

1986-01-01

Case-management programs have grown in number and in acceptance in the Medicaid program since 1981. In this article, we review their structure and incentives as well as what is known about their impact on cost and use. These programs also have been difficult to implement, posing myriad management challenges for prepaid program managers and State administrators. We highlight the problems in the following areas: eligibility, enrollment, rate setting, and management information systems. PMID:10311923

Sexual Behaviors in Autism: Problems of Definition and Management.

ERIC Educational Resources Information Center

Realmuto, George M.; Ruble, Lisa A.

1999-01-01

Explores the problems of definition of sexual behaviors in individuals with autism and describes a case that highlights the difficulties of management. After failure of behavioral and educational programs, a testosterone-suppressing medication was used resulting in suppression of public masturbation behaviors and retention of the participant's…

Managing Strategic Change through TQM: Learning from Failure.

ERIC Educational Resources Information Center

Redman, Tom; Grieves, Jim

1999-01-01

Case study of a manufacturing firm that implemented total quality management (TQM) found that the initiative may have failed because the company was undergoing rapid, radical structural change. Other problems included short-term focus, communication problems, and employee concerns about job security. TQM may be more compatible with continuous…

A four-tier problem-solving scaffold to teach pain management in dental school.

PubMed

Ivanoff, Chris S; Hottel, Timothy L

2013-06-01

Pain constitutes a major reason patients pursue dental treatment. This article presents a novel curriculum to provide dental students comprehensive training in the management of pain. The curriculum's four-tier scaffold combines traditional and problem-based learning to improve students' diagnostic, pharmacotherapeutic, and assessment skills to optimize decision making when treating pain. Tier 1 provides underpinning knowledge of pain mechanisms with traditional and contextualized instruction by integrating clinical correlations and studying worked cases that stimulate clinical thinking. Tier 2 develops critical decision making skills through self-directed learning and actively solving problem-based cases. Tier 3 exposes students to management approaches taken in allied health fields and cultivates interdisciplinary communication skills. Tier 4 provides a "knowledge and experience synthesis" by rotating students through community pain clinics to practice their assessment skills. This combined teaching approach aims to increase critical thinking and problem-solving skills to assist dental graduates in better management of pain throughout their careers. Dental curricula that have moved to comprehensive care/private practice models are well-suited for this educational approach. The goal of this article is to encourage dental schools to integrate pain management into their curricula, to develop pain management curriculum resources for dental students, and to provide leadership for change in pain management education.

Use of case-based reasoning to enhance intensive management of patients on insulin pump therapy.

PubMed

Schwartz, Frank L; Shubrook, Jay H; Marling, Cynthia R

2008-07-01

This study was conducted to develop case-based decision support software to improve glucose control in patients with type 1 diabetes mellitus (T1DM) on insulin pump therapy. While the benefits of good glucose control are well known, achieving and maintaining good glucose control remains a difficult task. Case-based decision support software may assist by recalling past problems in glucose control and their associated therapeutic adjustments. Twenty patients with T1DM on insulin pumps were enrolled in a 6-week study. Subjects performed self-glucose monitoring and provided daily logs via the Internet, tracking insulin dosages, work, sleep, exercise, meals, stress, illness, menstrual cycles, infusion set changes, pump problems, hypoglycemic episodes, and other events. Subjects wore a continuous glucose monitoring system at weeks 1, 3, and 6. Clinical data were interpreted by physicians, who explained the relationship between life events and observed glucose patterns as well as treatment rationales to knowledge engineers. Knowledge engineers built a prototypical system that contained cases of problems in glucose control together with their associated solutions. Twelve patients completed the study. Fifty cases of clinical problems and solutions were developed and stored in a case base. The prototypical system detected 12 distinct types of clinical problems. It displayed the stored problems that are most similar to the problems detected, and offered learned solutions as decision support to the physician. This software can screen large volumes of clinical data and glucose levels from patients with T1DM, identify clinical problems, and offer solutions. It has potential application in managing all forms of diabetes.

Case management in early psychosis intervention programme: Perspectives of clients and caregivers.

PubMed

Wong, Horng Hien; Yong, Yee Huei; Shahwan, Shazana; Cetty, Laxman; Vaingankar, Janhavi; Hon, Charlene; Lee, Helen; Loh, Christopher; Abdin, Edimansyah; Subramaniam, Mythily

2017-12-14

This qualitative study explored the perspectives of clients and caregivers on case management provided by the Singapore Early Psychosis Intervention Programme (EPIP), with the intent to understand the salient aspects of case management from their perspective. Clients and their caregivers were recruited from the EPIP outpatient clinics. Focus group discussions (FGDs) were conducted at a community centre outside the hospital with 47 clients and 19 caregivers. Facilitators were experienced researchers who were not involved in the care of the clients and trained in qualitative research methodologies. All FGDs were audio recorded and transcribed verbatim with all participants' identifiers omitted to protect confidentiality. Qualitative data analysis was conducted using thematic analysis. There were 11 themes that emerged from the FGDs: therapeutic alliance, holistic monitoring, collaborative role with other care providers, counselling and guidance, crisis management, bridging role, client-centred care, client empowerment and strength building, psychoeducation/education on illness, support and problem solving. "Problem solving" surfaced only from the client FGDs; the remaining themes were common to both groups. The voices of clients and caregivers are important to EPIP case management service. This study has provided insights into their perspectives, understandings and lived experiences of case management and its impact on clients and caregivers. © 2017 The Authors Early Intervention in Psychiatry Published by John Wiley & Sons Australia, Ltd.

Enhancing the role of case managers with specialty populations: development and evaluation of a palliative care education program.

PubMed

Howell, Doris; Prestwich, Catherine; Laughlin, Emmy; Giga, Nasreen

2004-01-01

Palliative home care is an important component of the care system for patients at the end of life and case management is considered an essential element of the Canadian home care system. Case managers play a critical role in allocating resources, thus influencing the costs and the viability of palliative home care. Case management education programs focused on care coordination with specialty palliative care populations are nonexistent. An education program targeted at improving the knowledge and skills of case managers in allocating resources to palliative care populations was developed and pilot-tested in a metropolitan Canadian city home care program. Core curriculum was based on an initial learning needs assessment and used case-based problem solving to enhance case-management skills. An improvement in knowledge was noted on posttests and case managers described increased comfort and confidence in their role as case managers to this patient population. Home care organizations caring for palliative care populations must ensure case managers are prepared for case management roles with specialty populations if the home is to be rendered an appropriate and viable care setting for patients at the end of life.

SEMINAR PUBLICATION: MANAGING ENVIRONMENTAL PROBLEMS AT INACTIVE AND ABANDONED METALS MINE SITES

EPA Science Inventory

Environmental problems associated with abandoned and inactive mines are addressed along with some approaches to resolving those problems, including case studies demonstrating technologies that have worked. New technologies being investigated are addressed also.

Erase the battle lines: how to cut out conflicts with MCO case managers.

PubMed

1999-02-01

With managed care penetration increasing, it's more important than ever for hospital case managers to find ways to resolve the inevitable conflicts that arise with their managed care-based counterparts. Typical conflicts include struggles over authorization, vendor selection, lack of contact, and access to the patient. Some conflicts can be resolved simply by increasing the level of communication--usually by having managed care case managers stationed in the hospital itself. But even when contact is only by telephone, there are steps you can take to ease the tension. One way is simply to keep managed care case managers informed regarding such things as return admissions by problem patients. Effective discharge planning practices also can strengthen bonds, especially when it comes to patients with complex care needs.

Embracing the Open-Source Movement for the Management of Spatial Data: A Case Study of African Trypanosomiasis in Kenya

PubMed Central

Langley, Shaun A.; Messina, Joseph P.

2011-01-01

The past decade has seen an explosion in the availability of spatial data not only for researchers, but the public alike. As the quantity of data increases, the ability to effectively navigate and understand the data becomes more challenging. Here we detail a conceptual model for a spatially explicit database management system that addresses the issues raised with the growing data management problem. We demonstrate utility with a case study in disease ecology: to develop a multi-scale predictive model of African Trypanosomiasis in Kenya. International collaborations and varying technical expertise necessitate a modular open-source software solution. Finally, we address three recurring problems with data management: scalability, reliability, and security. PMID:21686072

Embracing the Open-Source Movement for the Management of Spatial Data: A Case Study of African Trypanosomiasis in Kenya.

PubMed

Langley, Shaun A; Messina, Joseph P

2011-01-01

The past decade has seen an explosion in the availability of spatial data not only for researchers, but the public alike. As the quantity of data increases, the ability to effectively navigate and understand the data becomes more challenging. Here we detail a conceptual model for a spatially explicit database management system that addresses the issues raised with the growing data management problem. We demonstrate utility with a case study in disease ecology: to develop a multi-scale predictive model of African Trypanosomiasis in Kenya. International collaborations and varying technical expertise necessitate a modular open-source software solution. Finally, we address three recurring problems with data management: scalability, reliability, and security.

Children's Problem Behaviour and Techniques to Classroom Management: A Case Study of a Preschool Classroom in Klang Valley

ERIC Educational Resources Information Center

Kamarulzaman, Wirawani binti; Zhi Siew, Pang

2015-01-01

Classroom management is a skill that every teacher should be equipped well with. Although it is common for children to misbehave once in a while in classrooms, inability for teachers to handle the situation will make the problem behaviour worsen. The study explores some of the problem behaviour that occurred in a classroom in a preschool at Klang…

Enabling and enacting 'practical action' in catchments: responding to the 'wicked problem' of nonpoint source pollution in coastal subtropical Australia.

PubMed

Patterson, James J; Smith, Carl; Bellamy, Jennifer

2015-02-01

Enabling and enacting 'practical action' (i.e., purposeful and concerted collective action) in catchments is a key challenge in responding to a wide range of pressing catchment and natural resource management (NRM) issues. It is particularly a challenge in responding to 'wicked problems,' where generating action is not straightforward and cannot be brought about solely by any single actor, policy or intervention. This paper responds to the critical need to better understand how practical action can be generated in catchments, by conducting an in-depth empirical case study of efforts to manage nonpoint source (NPS) pollution in South East Queensland (SEQ), Australia. SEQ has seen substantial concerted efforts to manage waterway and catchment issues over two decades, yet NPS pollution remains a major problem for waterway health. A novel framework was applied to empirically analyze practical action in three local catchment cases embedded within the broader SEQ region. The analysis focuses on 'enabling capacities' underpinning practical action in catchments. Findings reveal that capacities manifested in different ways in different cases, yet many commonalities also occurred across cases. Interplay between capacities was critical to the emergence of adaptive and contextual forms of practical action in all cases. These findings imply that in order to enable and enact practical action in catchments, it is vital to recognize and support a diversity of enabling capacities across both local and regional levels of decision making and action. This is likely to have relevance for other 'wicked' catchment and NRM problems requiring local responses within broader multiscalar regional problem situations.

Case Studies in Broadcast Management.

ERIC Educational Resources Information Center

Coleman, Howard W.

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

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

PubMed

Mahoney, K

1992-01-01

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

Applying Cases to Solve Ethical Problems: The Significance of Positive and Process-Oriented Reflection

PubMed Central

Antes, Alison L.; Thiel, Chase E.; Martin, Laura E.; Stenmark, Cheryl K.; Connelly, Shane; Devenport, Lynn D.; Mumford, Michael D.

2015-01-01

This study examined the role of reflection on personal cases for making ethical decisions with regard to new ethical problems. Participants assumed the position of a business manager in a hypothetical organization and solved ethical problems that might be encountered. Prior to making a decision for the business problems, participants reflected on a relevant ethical experience. The findings revealed that application of material garnered from reflection on a personal experience was associated with decisions of higher ethicality. However, whether the case was viewed as positive or negative, and whether the outcomes, process, or outcomes and processes embedded in the experience were examined, influenced the application of case material to the new problem. As expected, examining positive experiences and the processes involved in those positive experiences resulted in greater application of case material to new problems. Future directions and implications for understanding ethical decision-making are discussed. PMID:26257506

Nurse case management: negotiating care together within a developing relationship.

PubMed

Yamashita, Mineko; Forchuk, Cheryl; Mound, Bronwyn

2005-01-01

TOPIC/PROBLEM: The purpose of this study was to explicate the process of nurse case management involving clients afflicted with chronic mental illness. Grounded theory was the method of choice. Interviews were conducted with nurses in inpatient, transitional, and community settings in four cities in southern Ontario, Canada. Negotiating care together within a developing relationship emerged as the basic social process. "Building a trusting relationship" was identified as the foundation of case management. Salient differences were found between the three settings, yet the basic social process was consistent across settings. This underscores the therapeutic relationship as the basis for nurse psychiatric case management.

Playing the Ponies: A $5 Million Embezzlement Case

ERIC Educational Resources Information Center

Howe, Martha A.; Malgwi, Charles A.

2006-01-01

Fraud is a pervasive problem, and educating future business leaders, managers, and auditors about fraud is one way to attack the problem. This instructional fraud case chronicles the actual details surrounding a major embezzlement at a regional high school (RHS) that culminated in long federal and state prison sentences for the school's treasurer.…

The Case Study Approach to Teaching Languages for Business: Problems and Benefits.

ERIC Educational Resources Information Center

Grosse, Christine Uber

Business case studies, descriptions of management problems or decisions that require students to analyze and decide on an appropriate course of action, are suitable for classroom study of commercial language because the technique emphasizes situational analysis and communicative activities such as role playing. The principles underlying the case…

Case managers and the use of Medicare, Part D.

PubMed

Hensley, Melissa Anne

2011-01-01

The purpose of this study was to examine the experiences and opinions of community-based mental health case managers with the Medicare prescription drug benefit. A qualitative approach, consisting of analysis of data from 3 case manager focus groups, was used to achieve an understanding of the role that case managers played in beneficiaries' access to and use of prescription medicines. Two urban nonprofit community-based mental health agencies. Adults who are disabled by mental illness depend on case managers for information about their prescription drug insurance, help with formulary and plan switching information, and assistance with tasks related to medication adherence in the community. Common themes in the case managers' discussion were managing beneficiary problems, stress for beneficiaries, information and paperwork issues, and cynicism regarding health care reform. The critical role of case managers in the use of Medicare Part D is not well understood or appreciated. Case managers need to be informed about Medicare Part D and ready to advocate for their clients in the community. In addition, it is important for case managers to understand how Medicare Part D affects not only older adults, but also adults living with serious and persistent mental illness.

Case Managers' Perspectives On What They Need To Do Their Job

PubMed Central

Eack, Shaun M.; Greeno, Catherine G.; Christian-Michaels, Stephen; Dennis, Amy; Anderson, Carol M.

2013-01-01

Objective To identify the perceived training needs of case managers working on community support teams in a community mental health center serving a semi-rural/suburban area. Methods Semi-structured interviews were conducted with 18 case managers and 3 supervisors to inquire about areas of training need in case management. Interviews were coded and analyzed for common themes regarding training needs and methods of training improvement. Results Identified training needs called for a hands-on, back to basics approach that included education on the symptoms of severe mental illness, co-morbid substance use problems, and methods of engaging consumers. A mentoring model was proposed as a potential vehicle for disseminating knowledge in these domains. Conclusions Case managers identify significant training needs that would address their basic understanding of severe mental illness. Programs targeting these needs may result in improved outcomes for case managers and the individuals with psychiatric disabilities. PMID:19346211

The Case of Web-Based Course on Taxation: Current Status, Problems and Future Improvement

NASA Astrophysics Data System (ADS)

Qin, Zhigang

This paper mainly introduces the case of the web-based course on taxation developed by Xiamen University. We analyze the current status, problems and future improvement of the web-based course. The web-based course has the basic contents and modules, but it has several problems including unclear object, lacking interaction, lacking examination module, lacking study management module, and the learning materials and the navigation are too simple. According to its problems, we put forward the measures to improve it.

Managers with Impact: Verstile and Inconsistent

ERIC Educational Resources Information Center

Skinner, Wickham; Sasser, W. Earl

1977-01-01

Based on analysis of 31 management case studies, the authors conclude that managers who are consistent in the way they tackle day-to-day problems are likely to be much less successful than managers who analyze each situation individually and adjust their approach accordingly. (Author/JG)

The impact of training in problem-based interviewing on the detection and management of psychological problems presenting in primary care.

PubMed Central

Scott, J; Jennings, T; Standart, S; Ward, R; Goldberg, D

1999-01-01

BACKGROUND: The vast majority of mental health problems present to primary care teams. However, rates of under-diagnosis remain worryingly high. This study explores a GP-centred approach to these issues. AIM: To examine the impact of training in problem-based interviewing (BPI) on the detection and management of psychological problems in primary care. METHOD: The detection and management of psychological problems by 10 general practitioners (GPs) who had received PBI training 12 months earlier was compared with that of 10 control GPs matched for age, sex, clinical experience, and practice setting; and had originally applied for, but had not been able to attend, BPI training. Consecutive attendees at one randomly selected surgery undertaken by each GP were invited to participate in the study. Two hundred and eighty patients living in Newcastle upon Tyne met inclusion criteria and gave informed consent. The presence or absence of psychological problems was assessed using patient self-ratings on the 28-item version of the General Health Questionnaire (GHQ) and blind independent observer ratings of the brief Present State Examination (PSE). Patient satisfaction with interviews was rated using the Medical Interview Satisfaction Scale (MISS). After each consultation, the GPs (blind to subjective and observer ratings) recorded their assessment and management of the patients' problems on a Practice Activity Card (PAC). RESULTS: In comparison with control GPs, index GPs demonstrated significantly greater sensitivity in the detection of psychological problems in the GHQ-PAC ratings. The absolute decrease in misdiagnosis of GHQ cases was 9% and of PSE cases was 15%. Patients meeting GHQ criteria for caseness were more likely to be prescribed psychotropic medication by an index GP than compared with a control GP. Length of interview did not differ between the groups and mean scores on the MISS suggested that patients attending PBI-trained GPs, compared with control GPs, were as satisfied or slightly more satisfied with their consultation. CONCLUSION: In comparison with control GPs, PBI-trained GPs were better at recognizing and managing psychological disorders. The potential benefits of BPI training are discussed in light of other attempts to improve mental health skills in primary care. PMID:10562742

Theoretical Framework for Plastic Waste Management in Ghana through Extended Producer Responsibility: Case of Sachet Water Waste.

PubMed

Quartey, Ebo Tawiah; Tosefa, Hero; Danquah, Kwasi Asare Baffour; Obrsalova, Ilona

2015-08-20

Currently, use and disposal of plastic by consumers through waste management activities in Ghana not only creates environmental problems, but also reinforces the notion of a wasteful society. The magnitude of this problem has led to increasing pressure from the public for efficient and practical measures to solve the waste problem. This paper analyses the impact of plastic use and disposal in Ghana. It emphasizes the need for commitment to proper management of the impacts of plastic waste and effective environmental management in the country. Sustainable Solid Waste Management (SSWM) is a critical problem for developing countries with regards to climate change and greenhouse gas emission, and also the general wellbeing of the populace. Key themes of this paper are producer responsibility and management of products at end of life. The paper proposes two theatrical recovery models that can be used to address the issue of sachet waste in Ghana.

Improving nurses' perceptions of competency in diabetes self-management education through the use of simulation and problem-based learning.

PubMed

Tschannen, Dana; Aebersold, Michelle; Sauter, Cecilia; Funnell, Martha M

2013-06-01

Nurses who provide case management can improve care practice and outcomes among patients who have type 2 diabetes through appropriate training and systems of care. This study was conducted to improve ambulatory care nurses' perceptions of competency in empowerment-based skills required for diabetes self-management education after participation in a multifaceted educational session that included problem-based learning and simulation. After participation in the multifaceted educational session, nurses (n = 21) perceived that the education provided an excellent opportunity for knowledge uptake and applicability to their respective work settings. The learning strategies provided opportunities for engagement in a safe and relaxed atmosphere. The simulation experience allowed participants to deliberately practice the competencies. These nurses considered this a very effective learning activity. Through the use of problem-based learning and simulation, nurses may be able to more efficiently and effectively develop the necessary skills to provide effective case management of chronic disease. Copyright 2013, SLACK Incorporated.

Modified stretched exponential model of computer system resources management limitations-The case of cache memory

NASA Astrophysics Data System (ADS)

Strzałka, Dominik; Dymora, Paweł; Mazurek, Mirosław

2018-02-01

In this paper we present some preliminary results in the field of computer systems management with relation to Tsallis thermostatistics and the ubiquitous problem of hardware limited resources. In the case of systems with non-deterministic behaviour, management of their resources is a key point that guarantees theirs acceptable performance and proper working. This is very wide problem that stands for many challenges in financial, transport, water and food, health, etc. areas. We focus on computer systems with attention paid to cache memory and propose to use an analytical model that is able to connect non-extensive entropy formalism, long-range dependencies, management of system resources and queuing theory. Obtained analytical results are related to the practical experiment showing interesting and valuable results.

Fidget Spinner Ingestions in Children-A Problem that Spun Out of Nowhere.

PubMed

Reeves, Patrick T; Nylund, Cade M; Noel, James M; Jones, David S; Chumpitazi, Bruno P; Milczuk, Henry A; Noel, R Adam

2018-06-01

The Consumer Product Safety Risk Management System's injury and potential injury database records 13 cases of fidget spinner ingestion since 2016. In addition to a database query, we report 3 additional cases of fidget spinner ingestion to describe patient presentations and subsequent management strategies. Published by Elsevier Inc.

Cause-and-effect analysis of risk management files to assess patient care in the emergency department.

PubMed

White, Andrew A; Wright, Seth W; Blanco, Roberto; Lemonds, Brent; Sisco, Janice; Bledsoe, Sandy; Irwin, Cindy; Isenhour, Jennifer; Pichert, James W

2004-10-01

Identifying the etiologies of adverse outcomes is an important first step in improving patient safety and reducing malpractice risks. However, relatively little is known about the causes of emergency department-related adverse outcomes. The objective was to describe a method for identification of common causes of adverse outcomes in an emergency department. This methodology potentially can suggest ways to improve care and might provide a model for identification of factors associated with adverse outcomes. This was a retrospective analysis of 74 consecutive files opened by a malpractice insurer between 1995 and 2000. Each risk-management file was analyzed to identify potential causes of adverse outcomes. The main outcomes were rater-assigned codes for alleged problems with care (e.g., failures of communication or problems related to diagnosis). About 50% of cases were related to injuries or abdominal complaints. A contributing cause was found in 92% of cases, and most had more than one contributing cause. The most frequent contributing categories included failure to diagnose (45%), supervision problems (31%), communication problems (30%), patient behavior (24%), administrative problems (20%), and documentation (20%). Specific relating factors within these categories, such as lack of timely resident supervision and failure to follow policies and procedures, were identified. This project documented that an aggregate analysis of risk-management files has the potential to identify shared causes related to real or perceived adverse outcomes. Several potentially correctable systems problems were identified using this methodology. These simple, descriptive management tools may be useful in identifying issues for problem solving and can be easily learned by physicians and managers.

Organization Development: A Case Study in Blockages.

ERIC Educational Resources Information Center

McIntyre, Martin

1981-01-01

Organization Development is a management science that defines and solves organizational problems. Procedures include: (1) diagnosis of problem; (2) gathering of data related to problem; (3) obtaining feedback; (4) developing various change strategies; (5) developing an action plan; and (6) implementing the plan. (CJ)

A prototype case-based reasoning human assistant for space crew assessment and mission management

NASA Technical Reports Server (NTRS)

Owen, Robert B.; Holland, Albert W.; Wood, Joanna

1993-01-01

We present a prototype human assistant system for space crew assessment and mission management. Our system is based on case episodes from American and Russian space missions and analog environments such as polar stations and undersea habitats. The general domain of small groups in isolated and confined environments represents a near ideal application area for case-based reasoning (CBR) - there are few reliable rules to follow, and most domain knowledge is in the form of cases. We define the problem domain and outline a unique knowledge representation system driven by conflict and communication triggers. The prototype system is able to represent, index, and retrieve case studies of human performance. We index by social, behavioral, and environmental factors. We present the problem domain, our current implementation, our research approach for an operational system, and prototype performance and results.

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…

Using Analytics to Transform a Problem-Based Case Library: An Educational Design Research Approach

ERIC Educational Resources Information Center

Schmidt, Matthew; Tawfik, Andrew A.

2018-01-01

This article describes the iterative design, development, and evaluation of a case-based learning environment focusing on an ill-structured sales management problem. We discuss our processes and situate them within the broader framework of educational design research. The learning environment evolved over the course of three design phases. A…

Case-Based Learning in Virtual Groups--Collaborative Problem Solving Activities and Learning Outcomes in a Virtual Professional Training Course

ERIC Educational Resources Information Center

Kopp, Birgitta; Hasenbein, Melanie; Mandl, Heinz

2014-01-01

This article analyzes the collaborative problem solving activities and learning outcomes of five groups that worked on two different complex cases in a virtual professional training course. In this asynchronous virtual learning environment, all knowledge management content was delivered virtually and collaboration took place through forums. To…

Using an Epistemic Game to Facilitate Students' Problem-Solving: The Case of Hospitality Management

ERIC Educational Resources Information Center

Wang, Shwu-Huey; Wang, Hsiu-Yuan

2017-01-01

Hospitality students are required to be able to address challenging cases or problems in the work environment. However, traditional lecture- or exam-based instruction leaves a gap between theory and practice. On the other hand, modern youth live and socialise in an increasingly digital environment, and one of their biggest pastimes is playing…

[Designing and Operating a Comprehensive Mental Health Management System to Support Faculty at a University That Contains a Medical School and University Hospital].

PubMed

Kawanishi, Chiaki

2016-01-01

In Japan, healthcare professionals and healthcare workers typically practice a culture of self-assessment when it comes to managing their own health. Even where this background leads to instances of mental health disorders or other serious problems within a given organization, such cases are customarily addressed by the psychiatrists or psychiatric departments of the facilities affected. Organized occupational mental health initiatives for professionals and workers within the healthcare system are extremely rare across Japan, and there is little recognition of the need for such initiatives even among those most directly affected. The author has some experience designing and operating a comprehensive health management system to support students and faculty at a university in the Tokyo Metropolitan Area that contains a medical school and university hospital. At this university, various mental health-related problems were routinely being allowed to develop into serious cases, while the fundamental reforms required by the health management center and the mental health management scheme organized through the center had come to represent a challenge for the entire university. From this initial situation, we undertook several successive initiatives, including raising the number of staff in the health management center and its affiliated organizations, revising and drafting new health management rules and regulations, launching an employment support and management system, implementing screenings to identify people with mental ill-health, revamping and expanding a counselling response system, instituting regular collaboration meetings with academic affairs staff, and launching educational and awareness-raising activities. This resulted in the possibility of intervention in all cases of mental health crisis, such as suicidal ideation. We counted more than 2,400 consultations (cumulative total number; more than half of consultations was from the medical school, postgraduate medical course, or hospitals) on a campus comprising 8,700 people, in which our problem-solving approach was able to achieve a certain degree of success in a majority of cases. Amid the increasing prevalence of mental ill-health and signs of worsening mental health problems in all areas of society, I look forward to the establishment of occupational mental health systems that are suited to medical institutions.

Problems and Issues in Using Emerging Computer Technologies To Manage and Evaluate Instructional Programs 1, 2, 3.

ERIC Educational Resources Information Center

Atwood, Nancy K.

School districts have begun examining the feasibility of, and in some cases are developing and implementing automated systems for, managing and evaluating instructional programs. This paper describes and analyzes the issues and problems that emerged over the course of three projects--a large suburban school in the West, a consortium of five small…

A Multi-Centre Audit of the Use of Medication for the Management of Behavioural Problems in Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Unwin, Gemma L.; Deb, Shoumitro

2008-01-01

The aim was to investigate prescribing practices surrounding the use of medication for the management of behavioural problems in adults with intellectual disabilities with reference to a national guideline development project. A case note review methodology was employed to explore adherence to the audit criteria that were derived from the…

Practical Problems with Medication Use that Older People Experience: A Qualitative Study

PubMed Central

Notenboom, Kim; Beers, Erna; van Riet-Nales, Diana A; Egberts, Toine C G; Leufkens, Hubert G M; Jansen, Paul A F; Bouvy, Marcel L

2014-01-01

Objectives To identify the practical problems that older people experience with the daily use of their medicines and their management strategies to address these problems and to determine the potential clinical relevance thereof. Design Qualitative study with semistructured face-to-face interviews. Setting A community pharmacy and a geriatric outpatient ward. Participants Community-dwelling people aged 70 and older (N = 59). Measurements Participants were interviewed at home. Two researchers coded the reported problems and management strategies independently according to a coding scheme. An expert panel classified the potential clinical relevance of every identified practical problem and associated management strategy using a 3-point scale. Results Two hundred eleven practical problems and 184 management strategies were identified. Ninety-five percent of the participants experienced one or more practical problems with the use of their medicines: problems reading and understanding the instructions for use, handling the outer packaging, handling the immediate packaging, completing preparation before use, and taking the medicine. For 10 participants, at least one of their problems, in combination with the applied management strategy, had potential clinical consequences and 11 cases (5% of the problems) had the potential to cause moderate or severe clinical deterioration. Conclusion Older people experience a number of practical problems using their medicines, and their strategies to manage these problems are sometimes suboptimal. These problems can lead to incorrect medication use with clinically relevant consequences. The findings pose a challenge for healthcare professionals, drug developers, and regulators to diminish these problems. PMID:25516030

Integrated Project Management: A Case Study in Integrating Cost, Schedule, Technical, and Risk Areas

NASA Technical Reports Server (NTRS)

Smith, Greg

2004-01-01

This viewgraph presentation describes a case study as a model for integrated project management. The ISS Program Office (ISSPO) developed replacement fluid filtration cartridges in house for the International Space Station (ISS). The presentation includes a step-by-step procedure and organizational charts for how the fluid filtration problem was approached.

Pitfalls in Evaluating the Effectiveness of Case Management Programs for Homeless Persons: Lessons from the NIAAA Community Demonstration Program.

ERIC Educational Resources Information Center

Orwin, Robert G.; And Others

1994-01-01

Evaluation findings of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Community Demonstration Program show few clear indications of the effectiveness of case management approaches. This article identifies phenomena that explain the lack of positive effects and suggests that evaluation problems may explain apparent negative…

Case Management of Young Children with Behaviour and Mental Health Disorders in School

ERIC Educational Resources Information Center

Browne, Graeme; Cashin, Andrew; Graham, Iain

2012-01-01

When young children with behaviour and mental health disorders do not receive appropriate specialised support their problems can escalate over time. Their parents find the transition to and early years of schooling stressful and difficult. This paper argues that case management can be an effective strategy for this group of children. Although…

TelePain: Primary Care Chronic Pain Management through Weekly Didactic and Case-based Telementoring.

PubMed

Flynn, Diane M; Eaton, Linda H; McQuinn, Honor; Alden, Ashley; Meins, Alexa R; Rue, Tessa; Tauben, David J; Doorenbos, Ardith Z

2017-12-01

Chronic pain is a significant problem among military personnel and a priority of the military health system. The U.S. Army Surgeon General's Pain Management Task Force recommends using telehealth capabilities to enhance pain management. This article describes the development and evaluation of a telehealth intervention (TelePain) designed to improve access to pain specialist consultation in the military health system. The study uses a wait-list controlled clinical trial to test: 1) effectiveness of the intervention, and 2) interviews to assess barriers and facilitators of the intervention implementation. The intervention involves a didactic presentation based on the Joint Pain Education Curriculum followed by patient case presentations and multi-disciplinary discussion via videoconference by clinicians working in the military health system. A panel of pain specialists representing pain medicine, internal medicine, anesthesiology, rehabilitation medicine, psychiatry, addiction medicine, health psychology, pharmacology, nursing, and complementary and integrative pain management provide pain management recommendations for each patient case. We use the Pain Assessment Screening Tool and Outcomes Registry (PASTOR) to measure patient outcomes, including pain, sleep, fatigue, anxiety, and depression. This article reports some of the challenges and lessons learned during early implementation of the TelePain intervention. Weekly telephone meetings among the multisite research team were instrumental in problem solving, identifying problem areas, and developing solutions. Solutions for recruitment challenges included additional outreach and networking to military health providers, both building on.

Implementation Authentic Task to Enhance Problem Solving and Self-Management for Physics College Students

NASA Astrophysics Data System (ADS)

Festiyed; Djamas, D.; Pilendia, D.

2018-04-01

The purpose of this study is to enhance the problem solving and self-management abilities of student teachers through individual and group authentic task. Preliminary results showed that the learning outcomes in high category, nevertheless problem solving and self-management abilities are still low and average categories (scattered at interval 40 ≤ N ≤ 65). Initiative to improve this condition is needed. Action research is the alternative solution for that condition through planning, acting, evaluating, and reflecting. This study is allowed in 4 cycles. The acting step result with integrated discuss method, case study, and presentation including self-assessment for individual and group. This method was effective to enhance problem solving and self-management abilities. The final learning outcomes seen from the correlation between student self-assessment and lecture-assessment (r=0.19). Its means there are unidirectional relationship between the result of self-assessment and lecture-assessment. The Conclusion of the research was effective to enhance problem solving and self-management ability.

Crisis management during anaesthesia: embolism

PubMed Central

Williamson, J; Helps, S; Westhorpe, R; Mackay, P

2005-01-01

Background: Embolism with gas, thrombus, fat, amniotic fluid, or particulate matter may occur suddenly and unexpectedly during anaesthesia, posing a diagnostic and management problem for the anaesthetist. Objectives: To examine the role of a previously described core algorithm "COVER ABCD–A SWIFT CHECK" supplemented by a specific sub-algorithm for embolism, in the management of embolism occurring in association with anaesthesia. Methods: The potential performance of this structured approach for each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved. Results: Among the first 4000 incidents reported to AIMS, 38 reports of embolism were found. A sudden fall in end-tidal carbon dioxide and oxygen saturation were the cardinal signs of embolism, each occurring in about two thirds of cases, with hypotension and electrocardiographic changes each occurring in about one third of cases. Conclusion: The potential value of an explicit structured approach to the diagnosis and management of embolism was assessed in the light of AIMS reports. It was considered that, correctly applied, it potentially would have led to earlier recognition of the problem and/or better management in over 40% of cases. PMID:15933290

Different approaches for centralized and decentralized water system management in multiple decision makers' problems

NASA Astrophysics Data System (ADS)

Anghileri, D.; Giuliani, M.; Castelletti, A.

2012-04-01

There is a general agreement that one of the most challenging issues related to water system management is the presence of many and often conflicting interests as well as the presence of several and independent decision makers. The traditional approach to multi-objective water systems management is a centralized management, in which an ideal central regulator coordinates the operation of the whole system, exploiting all the available information and balancing all the operating objectives. Although this approach allows to obtain Pareto-optimal solutions representing the maximum achievable benefit, it is based on assumptions which strongly limits its application in real world contexts: 1) top-down management, 2) existence of a central regulation institution, 3) complete information exchange within the system, 4) perfect economic efficiency. A bottom-up decentralized approach seems therefore to be more suitable for real case applications since different reservoir operators may maintain their independence. In this work we tested the consequences of a change in the water management approach moving from a centralized toward a decentralized one. In particular we compared three different cases: the centralized management approach, the independent management approach where each reservoir operator takes the daily release decision maximizing (or minimizing) his operating objective independently from each other, and an intermediate approach, leading to the Nash equilibrium of the associated game, where different reservoir operators try to model the behaviours of the other operators. The three approaches are demonstrated using a test case-study composed of two reservoirs regulated for the minimization of flooding in different locations. The operating policies are computed by solving one single multi-objective optimal control problem, in the centralized management approach; multiple single-objective optimization problems, i.e. one for each operator, in the independent case; using techniques related to game theory for the description of the interaction between the two operators, in the last approach. Computational results shows that the Pareto-optimal control policies obtained in the centralized approach dominate the control policies of both the two cases of decentralized management and that the so called price of anarchy increases moving toward the independent management approach. However, the Nash equilibrium solution seems to be the most promising alternative because it represents a good compromise in maximizing management efficiency without limiting the behaviours of the reservoir operators.

U.S. Army Medical Department Journal, July-September 2005

DTIC Science & Technology

2005-09-01

problems exposed by the press in Oct 03, Fort Lewis formalized Remote Care the Remote Care Program with protocols agreed by senior level commanders...workload of MAMC, like most of the formal work of the case management practice to identify key AMEDD, has not decreased with combat deployments and, in...and return to SRCMP within 72 hours, receive a formal case couches with sitting and standing Soldiers drinking coffee and number, Case Manager, and

Scripted Collaboration in Serious Gaming for Complex Learning: Effects of Multiple Perspectives when Acquiring Water Management Skills

ERIC Educational Resources Information Center

Hummel, Hans G. K.; van Houcke, Jasper; Nadolski, Rob J.; van der Hiele, Tony; Kurvers, Hub; Lohr, Ansje

2011-01-01

This paper examines how learning outcomes from playing serious games can be enhanced by including scripted collaboration in the game play. We compared the quality of advisory reports, that students in the domain of water management had to draw up for an authentic case problem, both before and after collaborating on the problem with (virtual) peer…

The use of interlocking prostheses for both temporary and definitive management of infected periprosthetic femoral fractures.

PubMed

Konan, Sujith; Rayan, Faizal; Manketelow, Andrew R J; Haddad, Fares S

2011-12-01

Infected periprosthetic fractures around total hip arthroplasties are an extremely challenging problem. We describe our experience of managing infected periprosthetic femoral fractures using interlocking long-stem femoral prostheses either as temporary functional spacers or as definitive implants. The Cannulock (Orthodesign, Christchurch, United Kingdom) uncoated stem was used in 12 cases, and the Kent hip prosthesis (Biomet Merck, Bridgend, United Kingdom), in 5 cases. Satisfactory outcome was noted in all cases, and in 11 cases, revision to a definitive stem has been undertaken after successful control of infection and fracture union. The use of interlocking stems offers a relatively appealing solution for a complex problem and avoids the complications that would be associated with resection of the entire femur or the use of large quantities of bone cement. Copyright © 2011 Elsevier Inc. All rights reserved.

Theoretical Framework for Plastic Waste Management in Ghana through Extended Producer Responsibility: Case of Sachet Water Waste

PubMed Central

Quartey, Ebo Tawiah; Tosefa, Hero; Danquah, Kwasi Asare Baffour; Obrsalova, Ilona

2015-01-01

Currently, use and disposal of plastic by consumers through waste management activities in Ghana not only creates environmental problems, but also reinforces the notion of a wasteful society. The magnitude of this problem has led to increasing pressure from the public for efficient and practical measures to solve the waste problem. This paper analyses the impact of plastic use and disposal in Ghana. It emphasizes the need for commitment to proper management of the impacts of plastic waste and effective environmental management in the country. Sustainable Solid Waste Management (SSWM) is a critical problem for developing countries with regards to climate change and greenhouse gas emission, and also the general wellbeing of the populace. Key themes of this paper are producer responsibility and management of products at end of life. The paper proposes two theatrical recovery models that can be used to address the issue of sachet waste in Ghana. PMID:26308016

Mr. Traore introduces team supervision. Case scenarios for training and group discussion.

PubMed

1993-01-01

This supplement to "The Family Planning Manager" presents a case example and five case discussion questions to illustrate the concept of team supervision. In contrast to traditional supervision, where an emphasis is placed on inspection and the uncovering of deficiencies, team supervision uses a facilitative, advocacy-oriented approach. Problem-solving and decision-making responsibilities are assumed by the clinic staff, who identify and analyze problems in group meetings. Thus, the focus shifts from assessing individual performance to evaluating how well they meet clinic objectives as a team. In the team meetings, the visiting supervisor asks the team as a whole to analyze clinic problems and ensures that all staff members are aware of the significance of their contributions. The supervisor also clarifies the division of labor required for implementing solutions and performance standards. Staff are asked if they have concerns they would like communicated to the next organizational level. The supervisory report of the visit can serve as a guide for implementing the recommendations. This approach may require that supervisors and clinic managers receive training in problem solving, motivating staff, team building, and providing constructive feedback.

Is there a role for a test controller in the development of new ATC equipment?

NASA Technical Reports Server (NTRS)

Westrum, Ron

1994-01-01

Earl Wiener points out that human factors problems fixed during the R & D stage are paid for once. When they are not fixed during R & D, they are then paid for every day. How users are involved in the R & D process to assist in developing equipment is a critical issue. Effective involvement can produce real improvements. Ineffective involvement can produce inefficient kludges or systems that are actually dangerous. The underlying problem is the management of information and ideas. To develop a really generative system a great deal would have to change in the way that the FAA innovates. Use of test controllers would solve only some of the problems. For instance, we have cockpit resource management now for pilots; we may have it soon for controllers. But the management of ideas in the innovation process also needs intellectual resource management. Simply involving users is not enough. Brought in at the wrong point in the development process, users can block or compromise innovation. User involvement must be carefully considered. A test controller may be one solution to this problem. It might be necessary to have several kinds of test controllers (en route versus TRACON, for instance). No doubt further problems would surface in getting test controllers into operation. I would recommend that the FAA engage in a series of case studies of controller involvement in the innovation process. A systematic comparison of effective and ineffective cases would do much to clarify what we ought to do in the future. Unfortunately, I have been unable to find any cases where test controllers have been used. Perhaps we need to create some, to see how they work.

It Is More about Telling Interesting Stories: Use Explicit Hints in Storytelling to Help College Students Solve Ill-defined Problems

ERIC Educational Resources Information Center

Hseih, Wen-Lan; Smith, Brian K.; Stephanou, Spiro E.

2004-01-01

A team consisting of three faculty members from Agricultural Economics, Agribusiness management, and Food Science with two research assistants at Penn State University has been working for three years on creating a food product case library for a problem-based learning and case-based instruction course. With the assistance of experts from the food…

"It's not my problem" (yet). With readmissions under the microscope, CIOs know chronic disease management is moving front and center.

PubMed

Lawrence, Daphne

2009-09-01

Chronic disease management is a system initiative, not just for primary care or ambulatory. The business case is currently poor for chronic disease management, but may soon change due to reform. Chronic disease management can help prevent costly readmissions. Care management plans are often a component of an EMR.

Theater Logistics Management: A Case for a Joint Distribution Solution

DTIC Science & Technology

2008-03-15

Multinational (JIIM) operations necessitate creating joint-multinational-based distribution management centers which effectively manage materiel...in the world. However, as the operation continued, the inherent weakness of the intra-theater logistical distribution management link became clear...compounded the distribution management problem. The common thread between each of the noted GAO failures is the lack of a defined joint, theater

A Case Study Approach to Marine and Aquatic Issues.

ERIC Educational Resources Information Center

Snively, Gloria

1993-01-01

Suggests using case studies of resource management conflict involving marine and aquatic resource issues to increase student involvement in decision-making processes. Provides information for a potential case involving oyster farms and six steps to help students explore problems and make decisions. (MDH)

Management of starvation in a Role 1 setting.

PubMed

Jeffery, S M T; Freshwater, D A

2012-01-01

Historical reports from war and natural disasters first identified the dangers of reintroducing food after a period of starvation or malnutrition. The development of advanced nutritional support for hospitalised patients gave rise to the concept of refeeding syndrome, further highlighting the problems and leading to the development of guidelines and protocols for managing malnutrition. In this paper we present a case of starvation in the maritime setting and review the pathophysiology of starvation and refeeding. We discuss the problems associated with managing acute starvation in a Role 1 setting without access to higher medical care, and present guidance for its management.

Using Case Studies to Teach Interdisciplinary Water Resource Sustainability

NASA Astrophysics Data System (ADS)

Orr, C. H.; Tillotson, K.

2012-12-01

Teaching about water resources and often emphasizes the biophysical sciences to understand highly complex hydrologic, ecologic and engineering systems, yet most impediments to improving management emerge from social processes. Challenges to more sustainable management often result from trade-offs among stakeholders (e.g., ecosystem services, energy, municipal use, and agriculture) and occur while allocating resources to competing goals of economic development, social equity, and efficient governance. Competing interests operating across multiple scales can increase tensions and prevent collaborative resolution of resource management problems. Here we discuss using specific, place-based cases to teach the interdisciplinary context of water management. Using a case approach allows instructors to first explore the geologic and hydrologic setting of a specific problem to let students understand where water comes from, then how it is used by people and ecosystems, and finally what conflicts arise from mismatches between water quality, quantity, timing, human demand, and ecosystem needs. The case approach helps students focus on specific problem to understand how the landscape influences water availability, without needing to first learn everything about the relevant fields. We look at geology, hydrology and climate in specific watersheds before addressing the human and ecosystem aspects of the broader, integrated system. This gives students the context to understand what limits water availability and how a water budget constrains possible solutions to sustainability problems. It also mimics the approach we have taken in research addressing these problems. In an example case the Spokane Coeur D'Alene basin, spanning the border between SE Washington and NW Idaho, includes a sole source aquifer system with high exchange between surface water and a highly conductive aquifer. The Spokane River does not meet water quality standards and is likely to face climate driven shifts in precipitation which will alter both water availability and dilution capacity. Possible stakeholders include not only municipal, agricultural and industrial water users but also several levels of regulatory governance as the watershed crosses state lines and includes tribal lands. While the water system is bound by the limits of stratigraphy and hydrology, there are feedbacks to the physical system revealed feedbacks to the physical system resulting from decisions, preferences, and beliefs of the stakeholders. The complexity of these feedbacks are most easily explored through discussion of the specific case, which can then be generalized. The course design encourages participation and let students discuss, argue, and think critically about real problems they can identify with and that interest them. Walking through the cases shows students how complicated environmental problem-solving can be in a way that they internalize and how these ideas are then transferable to other situations.

A New Process for Organizing Assessments of Social, Economic, and Environmental Outcomes: Case Study of Wildland Fire Management in the USA

EPA Science Inventory

Ecological risk assessments typically are organized using the processes of planning (a discussion among managers, stakeholders, and analysts to clarify ecosystem management goals and assessment scope) and problem formulation (evaluation of existing information to generate hypothe...

A new process for organizing assessments of social, economic and environmental outcomes: case study of wildland fire management in the U.S.A.

EPA Science Inventory

Ecological risk assessments typically are organized using the processes of planning (a discussion among managers, stakeholders and analysis to clarify ecosystem management goals and assessment scope) and problem formulation (evaluation of existing information to generate hypothes...

The pear thrips problem

Treesearch

Bruce L. Parker

1991-01-01

As entomologists, we sometimes like to think of an insect pest problem as simply a problem with an insect and its host. Our jobs would be much easier if that were the case, but of course, it is never that simple. There are many other factors besides the insect, and each one must be fully considered to understand the problem and develop effective management solutions....

Tongue-tied: Confused meanings for common fire terminology can lead to fuels mismanagement

Treesearch

Theresa B. Jain; Russell T. Graham; David S. Pilliod

2004-01-01

The ineffective and inconsistent use of terminology among fire managers, scientists, resource managers and the public is a constant problem in resource management. In fire management and fire science, the terms fire severity, burn severity and fire intensity are defined in a variety of ways, used inconsistently and, in some cases, interchangeably.

Apollo management: A key to the solution of the social-economical dilemma - The transferability of space-travel managerial techniques to the civil sector

NASA Technical Reports Server (NTRS)

Puttkamer, J. V.

1973-01-01

An analysis has been conducted to find out whether the management techniques developed in connection with the Apollo project could be used for dealing with such urgent problems of modern society as the crisis of the cities, the increasing environmental pollution, and the steadily growing traffic. Basic concepts and definitions of program and system management are discussed together with details regarding the employment of these concepts in connection with the solution of the problems of the Apollo program. Principles and significance of a systems approach are considered, giving attention to planning, system analysis, system integration, and project management. An application of the methods of project management to the problems of the civil sector is possible if the special characteristics of each particular case are taken into account.

Exploring Teachers' Perceptions of Wikis for Learning Classroom Cases

ERIC Educational Resources Information Center

Quek, Choon Lang; Wang, Qiyun

2014-01-01

This paper explores three potential affordances (social, technical and pedagogical) of wikis in the context of designing 32 teachers' learning of classroom management cases. Two learning environments were designed and two groups of the teacher-participants posted their own written and audio cases, identified problems, discussed and proposed…

Perceived Need and Receipt of Behavioral Health Services at Drop-In Centers among Homeless Youth.

PubMed

Pedersen, Eric R; Tucker, Joan S; Klein, David J; Parast, Layla

2018-06-03

Homeless youth are a population in need of housing assistance and case management, as well as services to address behavioral health problems. This study examines youth's perceived need for and receipt of services through drop-in centers. Surveys of 273 homeless youth. Cross-sectional. Descriptive analyses with bivariate and multivariable regression models. About one-third to half of the sample met criteria for behavioral health problems, yet half or less of those meeting criteria reported a need for services targeting the problems. Most youth who perceived a need for services received relevant services through a drop-in center, with the exception of care for substance use problems. Youth with behavioral health problems were more likely to perceive a need for services related to housing and case management than those addressing behavioral health problems more directly. Multivariable regression analyses indicated that the factors most strongly associated with perceived need for services were not behavioral health problems, but rather race/ethnicity, traveler status, trouble meeting basic needs, delinquency, abuse/victimization experiences, and trading sex. Findings can help to develop outreach and intervention efforts to reach homeless youth and help promote the use of behavioral health services. © Health Research and Educational Trust.

Attaining Success for Beginning Special Education Teachers.

ERIC Educational Resources Information Center

McCabe, Marjorie; And Others

1993-01-01

Three case studies are presented that highlight problem scenarios relating to beginning special education intern teachers and explain how the teachers attained success. The cases focus on classroom management, adaptation of the core curriculum, and knowledge of instructional practices. (JDD)

Optimizing human resources: a case for preventive health and stress management.

PubMed

Ivancevich, J M; Matteson, M T

1980-01-01

Traditionally, medical treatment in this country has focused on treatment of problems and illness after they've reached the point of crisis and pain. But now, managers are beginning to realize that preventive health and stree management can save money for the organization while improving the quality of worklife for employees.

Developmental Visual Dysfunction: Models for Assessment and Management.

ERIC Educational Resources Information Center

Erhardt, Rhoda Priest

This book describes transdisciplinary management of multiply disabled children with vision problems and presents four theoretical models of visual assessment and three illustrative case studies in a sequence appropriate to the learning process. The first three models are intended to lead to assessment and management of the child and the last to…

Report to Congress on the U.S. Department of Energy`s Environmental Management Science Program: Research funded and its linkages to environmental cleanup problems, and Environmental Management Science Program research award abstracts. Volume 2 of 3 -- Appendix B

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The Department of Energy`s Environmental Management Science Program (EMSP) serves as a catalyst for the application of scientific discoveries to the development and deployment of technologies that will lead to reduction of the costs and risks associated with cleaning up the nation`s nuclear complex. Appendix B provides details about each of the 202 research awards funded by the EMSP. This information may prove useful to researchers who are attempting to address the Department`s environmental management challenges in their work, program managers who are planning, integrating, and prioritizing Environmental Management projects, and stakeholders and regulators who are interested in the Department`smore » environmental challenges. The research award information is organized by the state and institution in which the lead principal investigator is located. In many cases, the lead principal investigator is one of several investigators at a number of different institutions. In these cases, the lead investigator (major collaborator) at each of the additional institutions is listed. Each research award abstract is followed by a list of high cost projects that can potentially be impacted by the research results. High cost projects are Environmental Management projects that have total costs greater than $50 million from the year 2007 and beyond, based on the March 1998 Accelerating Cleanup: Paths to Closure Draft data, and have costs or quantities of material associated with an Environmental Management problem area. High cost projects which must remain active in the year 2007 and beyond to manage high risk are also identified. Descriptions of these potentially related high cost Environmental Management projects can be found in Appendix C. Additional projects in the same problem area as a research award can be located using the Index of High Cost Environmental Management Projects by Problem Area, at the end of Appendices B and C.« less

Using Design Thinking to Write and Publish Novel Teaching Cases: Tips from Experienced Case Authors

ERIC Educational Resources Information Center

Sheehan, Norman T.; Gujarathi, Mahendra R.; Jones, Joanne C.; Phillips, Fred

2018-01-01

With increasing calls for a greater connection between management education and practice, teaching cases play a vital role in the business curriculum. Cases not only allow instructors to expose students to practical problems but also let educators contribute to the scholarship of teaching and learning. An important reason why faculty members may…

Recent advances in applying decision science to managing national forests

USGS Publications Warehouse

Marcot, Bruce G.; Thompson, Matthew P.; Runge, Michael C.; Thompson, Frank R.; McNulty, Steven; Cleaves, David; Tomosy, Monica; Fisher, Larry A.; Andrew, Bliss

2012-01-01

Management of federal public forests to meet sustainability goals and multiple use regulations is an immense challenge. To succeed, we suggest use of formal decision science procedures and tools in the context of structured decision making (SDM). SDM entails four stages: problem structuring (framing the problem and defining objectives and evaluation criteria), problem analysis (defining alternatives, evaluating likely consequences, identifying key uncertainties, and analyzing tradeoffs), decision point (identifying the preferred alternative), and implementation and monitoring the preferred alternative with adaptive management feedbacks. We list a wide array of models, techniques, and tools available for each stage, and provide three case studies of their selected use in National Forest land management and project plans. Successful use of SDM involves participation by decision-makers, analysts, scientists, and stakeholders. We suggest specific areas for training and instituting SDM to foster transparency, rigor, clarity, and inclusiveness in formal decision processes regarding management of national forests.

Use of multicriteria analysis (MCA) for sustainable hydropower planning and management.

PubMed

Vassoney, Erica; Mammoliti Mochet, Andrea; Comoglio, Claudio

2017-07-01

Multicriteria analysis (MCA) is a decision-making tool applied to a wide range of environmental management problems, including renewable energy planning and management. An interesting field of application of MCA is the evaluation and analysis of the conflicting aspects of hydropower (HP) exploitation, affecting the three pillars of sustainability and involving several different stakeholders. The present study was aimed at reviewing the state of the art of MCA applications to sustainable hydropower production and related decision-making problems, based on a detailed analysis of the scientific papers published over the last 15 years on this topic. The papers were analysed and compared, focusing on the specific features of the MCA methods applied in the described case studies, highlighting the general aspects of the MCA application (purpose, spatial scale, software used, stakeholders, etc.) and the specific operational/technical features of the selected MCA technique (methodology, criteria, evaluation, approach, sensitivity, etc.). Some specific limitations of the analysed case studies were identified and a set of "quality indexes" of an exhaustive MCA application were suggested as potential improvements for more effectively support decision-making processes in sustainable HP planning and management problems. Copyright © 2017 Elsevier Ltd. All rights reserved.

First-Order Frameworks for Managing Models in Engineering Optimization

NASA Technical Reports Server (NTRS)

Alexandrov, Natlia M.; Lewis, Robert Michael

2000-01-01

Approximation/model management optimization (AMMO) is a rigorous methodology for attaining solutions of high-fidelity optimization problems with minimal expense in high- fidelity function and derivative evaluation. First-order AMMO frameworks allow for a wide variety of models and underlying optimization algorithms. Recent demonstrations with aerodynamic optimization achieved three-fold savings in terms of high- fidelity function and derivative evaluation in the case of variable-resolution models and five-fold savings in the case of variable-fidelity physics models. The savings are problem dependent but certain trends are beginning to emerge. We give an overview of the first-order frameworks, current computational results, and an idea of the scope of the first-order framework applicability.

Groundwater overexploitation: why is the red flag waved? Case study on the Kairouan plain aquifer (central Tunisia)

NASA Astrophysics Data System (ADS)

Massuel, Sylvain; Riaux, Jeanne

2017-09-01

In many parts of the world, groundwater users regularly face serious resource-depletion threat. At the same time, "groundwater overexploitation" is massively cited when discussing groundwater management problems. A kind of standard definition tends to relegate groundwater overexploitation only as a matter of inputs and outputs. However, a thorough state-of-the-art analysis shows that groundwater overexploitation is not only a matter of hydrogeology but also a qualification of exploitation based on political, social, technical, economic or environmental criteria. Thus, an aquifer with no threat to groundwater storage can rightly be considered as overexploited because of many other prejudicial aspects. So, why is groundwater overexploitation so frequently only associated with resource-depletion threat and so rarely related to other prejudicial aspects? In that case, what really lies behind the use of the overexploitation concept? The case of the Kairouan plain aquifer in central Tunisia was used to analyze the way that the overexploitation message emerges in a given context, how groundwater-use stakeholders (farmers, management agencies and scientists) each qualify the problem in their own way, and how they see themselves with regard to the concept of overexploitation. The analysis shows that focusing messages on overexploitation conceals the problems encountered by the various stakeholders: difficulties accessing water, problems for the authorities in controlling the territory and individual practices, and complications for scientists when qualifying hydrological situations. The solutions put forward to manage overexploitation are at odds with the problems that arise locally, triggering tensions and leading to misunderstandings between the parties involved.

A Study and Model of Operating Level Financial Management Philosophy Under RMS.

DTIC Science & Technology

The lack of financial management education has prevented base level managers from using PRIME data as intended. This study examines the Air Force...operating level financial management philosophy before and after PRIME and the environment of PRIME adoption. A model in the form of two case problems...with solutions is created to portray the financial management concepts under PRIME to help educate base level Air Force logistic managers. The model

Implementing a pilot work injury management program in Hong Kong.

PubMed

Lai, Hon-Sun; Chan, Chetwyn C H

2007-12-01

This paper reports the results of implementing a pilot case management system for work injuries in Hong Kong. The case management approach was characterized by use of a case manager who worked closely with each of the reported injury cases. The case manager undertook the roles of assessor, referral agent, counselor, work-site liaison, and return-to-work (RTW) expert. A quasi-experimental study design was used. The study compared the RTW and workers' compensation outcomes in injured workers in a cleaning company in a case management group (n = 296) and a conventional rehabilitation group (n = 137). Outcomes of the intervention were followed up at 6 months. The results indicated that the RTW rate was 97.0% and 94.2% for the case management and conventional rehabilitation groups respectively, with no significant differences between them. Participants in the case management group had significantly fewer days of sick leave (mean = 27.5 and 41.6 days, respectively) and lower compensation costs (mean = HK$7,212.2 and $20,617.3, respectively) than those in the comparison group. Age of the participants was found to influence the outcomes with those who were between 41 and 50 years old and received case management intervention had shorter sick leave and lower cost of compensation than their conventional rehabilitation counterpart. The majority of the participants who had returned to work in both the case management (95.8%) and the conventional rehabilitation (96.2%) groups were found to maintain their work status 6 months after the intervention. The findings suggested that applying the case management approach to the Hong Kong workers' compensation system was more effective overall. Nevertheless, the inherent problems associated with implementing such an approach within the existing system, which focuses on compensation and medical interventions, remained unresolved.

Real Time Locations Systems or Outsourcing: A Case Study

ERIC Educational Resources Information Center

Lawrence, Cameron; Firth, David; Khumalo, Floyd

2013-01-01

Information Technology has transformed almost all aspects of modern healthcare and is playing a vital role in the administration of hospitals around the world. This case study examines one hospital's struggle to solve crucial operational problems related to the efficient management of medical equipment inventory. This case study is the result of…

Optimizing medication safety in the home.

PubMed

LeBlanc, Raeanne Genevieve; Choi, Jeungok

2015-06-01

Medication safety among community-dwelling older adults in the United States is an ongoing health issue impacting health outcomes, chronic disease management, and aging in place at home. This article describes a medication safety improvement project that aimed to: (1) Increase the ability of participants to manage medications, (2) Identify and make necessary medication changes, (3) Create an accurate up-to-date medication list to be available in the home, and (4) Provide communication between the primary care provider, participant, and case manager. An in-home medication assessment was completed for 25 participants using an evidence-based medication management software system. This process was used to review medications; identify medication-related problems; create a shared medication list; and convey this information to the primary care provider, case manager, and client while addressing needed medication changes. Educational interventions on management and understanding of medications were provided to participants to emphasize the correct use of medications and use of a personal medication record. Outcome improvements included provision of an accurate medication list, early identification of medication-related problems, identification of drug duplication, and identification of medication self-management challenges that can be useful for optimizing medication safety-related home healthcare and inform future interventions.

Lymphoedema of the lower limbs: management problems in a developing country.

PubMed

Adigun, A I; Ogundipe, O K

2008-01-01

Lymphoedema is a clinical condition involving the extremities that is characterized by accumulation of protein rich fluid within the intercellular space of the skin and the subcutaneous tissue. It most frequently occurs in the extremities. Developing countries are mostly faced with cases of secondary lymphoedema where patients present lately. In addition to swollen limbs, there are lot of skin changes on the affected limb, these create a lot of problems to the managing clinician. We hereby present five cases out of several patients managed to highlight the challenges. We review the case notes of three patients managed by our unit and present the summary of each patient. Majority of our patients present late to the hospital, mainly because of the socio-cultural and spiritual beliefs concerning the aetiology of the condition. Most of them have visited the spiritualist, herbalist and the clergymen for solution. Clinicians in the developing countries are seriously handicapped by lack of modern equipment for both diagnostic and therapeutic management of these clinical conditions. Chronic lymphoedema is a major cause of permanent disability. Excisional surgery such as Charles procedure even though old is still very much relevant in our environment. Patients need to be enlightened on the need for early presentation, adequate post-operative care and prolonged follow-up.

Clinical Case Management versus Case Management with Problem-Solving Therapy in Low-Income, Disabled Elders with Major Depression: A Randomized Clinical Trial

PubMed Central

Alexopoulos, George S.; Raue, Patrick J.; McCulloch, Charles; Kanellopoulos, Dora; Seirup, Joanna K.; Sirey, Jo Anne; Banerjee, Samprit; Kiosses, Dimitris N.; Areán, Patricia A.

2015-01-01

Objective To test the hypotheses that (1) clinical case management integrated with problem-solving therapy (CM-PST) is more effective than clinical case management alone (CM) in reducing depressive symptoms of depressed, disabled, impoverished patients and that (2) development of problem-solving skills mediates improvement of depression. Methods This randomized clinical trial with a parallel design allocated participants to CM or CM-PST at 1:1 ratio. Raters were blind to patients’ assignments. Two hundred seventy-one individuals were screened and 171 were randomized to 12 weekly sessions of either CM or CM-PST. Participants were at least 60 years old with major depression measured with the 24-item Hamilton Depression Rating Scale (HAM-D), had at least one disability, were eligible for home-based meals services, and had income no more than 30% of their counties’ median. Results CM and CM-PST led to similar declines in HAM-D over 12 weeks (t = 0.37, df = 547, p = 0.71); CM was noninferior to CM-PST. The entire study group (CM plus CM-PST) had a 9.6-point decline in HAM-D (t = 18.7, df = 547, p <0.0001). The response (42.5% versus 33.3%) and remission (37.9% versus 31.0%) rates were similar (χ2 = 1.5, df = 1, p = 0.22 and χ2 = 0.9, df = 1, p = 0.34, respectively). Development of problem-solving skills did not mediate treatment outcomes. There was no significant increase in depression between the end of interventions and 12 weeks later (0.7 HAM-D point increase) (t = 1.36, df = 719, p = 0.17). Conclusion Organizations offering CM are available across the nation. With training in CM, their social workers can serve the many depressed, disabled, low-income patients, most of whom have poor response to antidepressants even when combined with psychotherapy. PMID:25794636

Endodontic treatment and esthetic management of a primary double tooth with direct composite using silicone buildup guide.

PubMed

Kulkarni, Vinaya Kumar; Ragavendra, T Raju; Deshmukh, Jeevanand; Vanka, Amit; Duddu, Mahesh Kumar; Patil, Anand Kumar G

2012-04-01

Gemination and fusion are morphological dental anomalies, characterized by the formation of a clinically wide tooth. Gemination occurs when one tooth bud tries to divide, while fusion occurs if two buds unite. The terms double teeth, double formation, conjoined teeth, geminifusion, vicinifusion and dental twinning are often used to describe fusion and gemination. Double teeth are associated with clinical problems such as poor esthetics, spacing problems and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. This report presents a case of primary double tooth in a 6-year-old boy involving maxillary left central incisor. The anomalous tooth was carious and pulpally involved. This was treated conservatively by endodontic treatment and esthetic rehabilitation was done with direct composite restoration using a silicone buildup guide. The treated tooth was followed up until exfoliation.

Endodontic treatment and esthetic management of a primary double tooth with direct composite using silicone buildup guide

PubMed Central

Kulkarni, Vinaya Kumar; Ragavendra, T. Raju; Deshmukh, Jeevanand; Vanka, Amit; Duddu, Mahesh Kumar; Patil, Anand Kumar G.

2012-01-01

Gemination and fusion are morphological dental anomalies, characterized by the formation of a clinically wide tooth. Gemination occurs when one tooth bud tries to divide, while fusion occurs if two buds unite. The terms double teeth, double formation, conjoined teeth, geminifusion, vicinifusion and dental twinning are often used to describe fusion and gemination. Double teeth are associated with clinical problems such as poor esthetics, spacing problems and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. This report presents a case of primary double tooth in a 6-year-old boy involving maxillary left central incisor. The anomalous tooth was carious and pulpally involved. This was treated conservatively by endodontic treatment and esthetic rehabilitation was done with direct composite restoration using a silicone buildup guide. The treated tooth was followed up until exfoliation. PMID:22629077

When More is Less: The Case of Disconnected Information Systems in Indonesian Public Health Facilities

NASA Astrophysics Data System (ADS)

Wahid, Fathul; Teduh Dirgahayu, Raden; Hamzah, Almed; Setiaji, Hari

2018-03-01

The clear majority of previous studies have found that the absence of information systems to properly manage data is one of the main challenges in improving public health management. The present study offers an alternate perspective, revealing other emerging problems in cases where there are many information systems in place but without sufficient orchestration. The national government of Indonesia has been coercive in its implementation of various information systems without involving users at public health facilities, which has created many problems on the ground. The problems identified relate to the quality of the disconnected information systems currently in use, the lack of human resource development, unclear procedures, uncoordinated reports and the absence of an incentive scheme. The present study also highlights some practical implications, including the use of a more holistic perspective in designing and developing an integrated public health information infrastructure.

Dealing with sub-trochanteric fracture in a child with osteopetrosis : A case report.

PubMed

Behera, P; Khurana, A; Saibaba, B; Aggarwal, S

2016-12-01

Osteopetrosis is a rare hereditary condition which may have autosomal recessive or autosomal dominant inheritance. Patients tend to present most commonly with fractures but involvement of cranial nerves and hematopoetic system is not uncommon. Patients with infantile and intermediate type tend to present more often with problems other than orthopaedic problems. While diagnosis can be made on the basis of radiographs, management needs to be customized for every patient. Non operative and operative management both have their advantages and disadvantages. We are here reporting a case of sub-trochanteric fracture in an eight-year-old child which was managed successfully with a dynamic hip screw (DHS). Surgery could be performed successfully by taking precautions during reduction, drilling and screw placement. At the latest follow up, which was after one and half years of surgery, the fracture had united well and the child faced no limitations of activities. Thus, open reduction and fixation with DHS can be considered as an effective management modality for pediatric sub-trochanteric fractures in osteopetrosis.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, P E

Tips and case histories on computer use for idea and outline processing: Productivity software to solve problems of idea hierarchy, transitions, and developments is matched to solutions for communicators. One case is text that ranges from methods and procedures to histories and legal definitions of classification for the US Department of Energy. Applications of value to writers, editors, and managers are for research; calendars; creativity; prioritization; idea discovery and manipulation; file and time management; and contents, indexes, and glossaries. 6 refs., 7 figs.

Caregivers as money managers for adults with severe mental illness: how treatment providers can help.

PubMed

Elbogen, Eric B; Wilder, Christine; Swartz, Marvin S; Swanson, Jeffrey W

2008-01-01

To review the prevalence, benefits, and problems associated with families who, either informally or formally as representative payees, manage money for adults with severe mental illness. Based on empirical research and clinical cases, suggestions are offered for minimizing downsides and capitalizing upon benefits of family money management. The findings and case vignettes demonstrate four specific strategies for treatment providers: facilitating collaboration, increasing knowledge about disability funds, improving money-management skills, and developing plans for financial decision-making. By following these recommendations and becoming aware of whether their clients had family money managers, clinicians can promote independent functioning and family support for a substantial number of people with severe mental illness.

An early 19th-century Canadian surgical practice: the casebook of John Mackieson of Charlottetown, 1795–1885

PubMed Central

Shephard, David A.E.; Grogono, Basil J.S.

2002-01-01

A casebook written by Dr. John Mackieson (1795–1885), of Charlottetown, contains the records of 49 surgical cases he managed between 1826 and 1857. In view of the rarity of first-hand accounts of surgical practice in Canada in the mid-19th century, Mackieson’s case records are a significant source of information. These cases are discussed in order to delineate Mackieson’s approach to the surgical problems he faced in his general practice. His case records also illustrate some of the general problems that beset surgeons in that era. PMID:11939660

Participatory research towards co-management: lessons from artisanal fisheries in coastal Uruguay.

PubMed

Trimble, Micaela; Berkes, Fikret

2013-10-15

Participatory research has become increasingly common in natural resources management. Even though participatory research is considered a strategy to facilitate co-management, there is little empirical evidence supporting this. The objective of the present paper is to analyze the contributions of participatory research to help encourage the emergence of co-management, based on a case study in Piriápolis artisanal fishery in coastal Uruguay (where management has been top-down). We argue that participatory research involving artisanal fishers, government, and other stakeholders (university scientists and NGOs) can be a key stimulus towards co-management. We build this argument by considering "seven faces" by which co-management can be analyzed: (1) as power sharing; (2) as institution building; (3) as trust building; (4) as process; (5) as learning and knowledge co-production; (6) as problem solving; and (7) as governance. Our findings show that participatory research had an impact on these various faces: (1) power was shared when making research decisions; (2) a multi-stakeholder group (POPA), with a common vision and goals, was created; (3) trust among participants increased; (4) the process of group formation was valued by participants; (5) stakeholders learned skills for participation; (6) two problem-solving exercises were conducted; and (7) a diversity of stakeholders of the initial problem identified by fishers (sea lions' impact on long-line fishery) participated in the process. The case shows that participatory research functions as a platform which enhances learning and knowledge co-production among stakeholders, paving the way towards future co-management. Copyright © 2013 Elsevier Ltd. All rights reserved.

Factors influencing household participation in solid waste management (Case study: Waste Bank Malang)

NASA Astrophysics Data System (ADS)

Maryati, S.; Arifiani, N. F.; Humaira, A. N. S.; Putri, H. T.

2018-03-01

Solid waste management is very important measure in order to reduce the amount of waste. One of solid waste management form in Indonesia is waste banks. This kind of solid waste management required high level of participation of the community. The objective of this study is to explore factors influencing household participation in waste banks. Waste bank in Malang City (WBM) was selected as case study. Questionnaires distribution and investigation in WBM were conducted to identify problems of participation. Quantitative analysis was used to analyze the data. The research reveals that education, income, and knowledge about WBM have relationship with participation in WBM.

Using Toyota's A3 Thinking for Analyzing MBA Business Cases

ERIC Educational Resources Information Center

Anderson, Joe S.; Morgan, James N.; Williams, Susan K.

2011-01-01

A3 Thinking is fundamental to Toyota's benchmark management philosophy and to their lean production system. It is used to solve problems, gain agreement, mentor team members, and lead organizational improvements. A structured problem-solving approach, A3 Thinking builds improvement opportunities through experience. We used "The Toyota…

Productivity and Job Security: Attrition--Benefits and Problems.

ERIC Educational Resources Information Center

National Center for Productivity and Quality of Working Life, Washington, DC.

Three case studies are presented to document different approaches to providing the job security which would encourage acceptance of technological changes that could result in productivity improvements. The intent is to assist union and management practitioners in handling similar problems in their own firms. Focus is on the utility of attrition…

Linkability: Orientation for the 21st Century.

ERIC Educational Resources Information Center

Hoag, Erin; Kisiel, Valerie

This document outlines the steps necessary to develop computer-based student service programs that will improve service quality and alleviate the problems associated with staff shortages and heavy case loads. The analysis phase of the process entails that the project manager complete the following steps: (1) define the problem; (2) conduct a…

A Senior Medical Student Seminar Designed to Promote Problem-Solving.

ERIC Educational Resources Information Center

Donohue, James F.; Shumway, James M.

1983-01-01

A seminar was developed to increase students' learning opportunities in respiratory disease and to identify common problem areas in hospital medical care. It provided practice in clinical diagnosis and patient management by promoting dialog, faculty feedback, and self-evaluation. Specific case studies are used for discussion. (MSE)

Education's Role in National Development Plans: Ten Country Cases.

ERIC Educational Resources Information Center

Thomas, R. Murray, Ed.

The place education has been assigned in the national development programs of 10 nations is discussed, the problems that these countries have encountered in managing education are examined, and the measures adopted to solve educational problems are assessed. Included are the following papers: (1) "The Nature of National Development…

Massive digoxin ingestion. Report of a case and review of currently available therapies.

PubMed Central

Bremner, W F; Third, J L; Lawrie, T D

1977-01-01

Recent reports of treatment of massive digoxin overdosage have emphasized the success of medical therapy. This report describes a fatal outcome to this problem despite aggressive medical management, including pervenous cardiac pacing and draws attention to deficiencies in current treatment of a serious problem. PMID:328024

A Different Approach to the Generation of Patient Management Problems from a Knowledge-Based System

PubMed Central

Barriga, Rosa Maria

1988-01-01

Several strategies are proposed to approach the generation of Patient Management Problems from a Knowledge Base and avoid inconsistencies in the results. These strategies are based on a different Knowledge Base structure and in the use of case introductions that describe the patient attributes which are not disease-dependent. This methodology has proven effective in a recent pilot test and it is on its way to implementation as part of an educational program at CWRU, School of Medicine.

Crisis management during anaesthesia: difficult intubation.

PubMed

Paix, A D; Williamson, J A; Runciman, W B

2005-06-01

Anaesthetists may experience difficulty with intubation unexpectedly which may be associated with difficulty in ventilating the patient. If not well managed, there may be serious consequences for the patient. A simple structured approach to this problem was developed to assist the anaesthetist in this difficult situation. To examine the role of a specific sub-algorithm for the management of difficult intubation. The potential performance of a structured approach developed by review of the literature and analysis of each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved. There were 147 reports of difficult intubation capable of analysis among the first 4000 incidents reported to AIMS. The difficulty was unexpected in 52% of cases; major physiological changes occurred in 37% of these cases. Saturation fell below 90% in 22% of cases, oesophageal intubation was reported in 19%, and an emergency transtracheal airway was required in 4% of cases. Obesity and limited neck mobility and mouth opening were the most common anatomical contributing factors. The data confirm previously reported failures to predict difficult intubation with existing preoperative clinical tests and suggest an ongoing need to teach a pre-learned strategy to deal with difficult intubation and any associated problem with ventilation. An easy-to-follow structured approach to these problems is outlined. It is recommended that skilled assistance be obtained (preferably another anaesthetist) when difficulty is expected or the patient's cardiorespiratory reserve is low. Patients should be assessed postoperatively to exclude any sequelae and to inform them of the difficulties encountered. These should be clearly documented and appropriate steps taken to warn future anaesthetists.

Current causes and management of violence against women in Nigeria.

PubMed

Aimakhu, C O; Olayemi, O; Iwe, C A B; Oluyemi, F A; Ojoko, I E; Shoretire, K A; Adeniji, R A; Aimakhu, V E

2004-01-01

Violence against women is an important health and human rights issue. It carries with it both short- and long-term sequelae for women that can affect both their physical and psychological wellbeing. Every day obstetric providers treat patients who have been assaulted. Timely identification can interrupt the cycle of violence, prevent further injury and initiate the help-seeking process. The objectives of this study were to survey how often Nigerian obstetrician-gynaecologists see these patients in their practice and to describe the demographics and management of their most recent case so as to give an idea of the extent of the problem. This is especially important as abuse is grossly under-reported because the victims are afraid to report it because of male dominance in society and the fear of losing their homes. We used a self-administered questionnaire survey of 138 practising obstetricians and gynaecologists in Nigeria. Questions were asked about the yearly estimation of cases seen and how recently a case was seen. The type of abuse, risk factors and management of their most recent case was also documented. Most (98.6%) obstetricians surveyed had previously managed a case of violence. The mean estimate of abused women seen was 7.0 per year. Details of the last case managed were recollected by 91.3% of respondents. The majority (51.6%) of patients were pregnant. The assailant was the husband in 69.8% of cases and the most common factor for abuse was as a result of women requesting money for the family needs from their husbands. The most common type of abuse was physical (79.4%), with 34.9% of patients sustaining cuts. Treatment and counselling were the forms of management in most cases. The police were informed in 9.5% of cases and one obstetrician had to give evidence in court. Of the pregnant abused women, 73.8% had live births. Better job opportunities and female empowerment can reduce the risk of violence. Obstetricians should screen routinely for battery, provide education about violence, assess the danger, review safety plans and refer women appropriately. We cannot solve the problem alone, but sensitivity and commitment can begin to make a difference.

Hemi-wedge osteotomy in the management of large angular deformities around the knee joint.

PubMed

El-Alfy, Barakat Sayed

2016-08-01

Angular deformity around the knee joint is a common orthopedic problem. Many options are available for the management of such problem with varying degrees of success and failure. The aim of the present study was to assess the results of hemi-wedge osteotomy in the management of big angular deformities about the knee joint. Twenty-eight limbs in 21 patients with large angular deformities around the knee joint were treated by the hemi-wedge osteotomy technique. The ages ranged from 12 to 43 years with an average of 19.8 years. The deformity ranged from 20° to 40° with a mean of 30.39° ± 5.99°. The deformities were genu varum in 12 cases and genu valgum in 9 cases. Seven cases had bilateral deformities. Small wedge was removed from the convex side of the bone and put in the gap created in the other side after correction of the deformity. At the final follow-up, the deformity was corrected in all cases except two. Full range of knee movement was regained in all cases. The complications included superficial wound infection in two cases, overcorrection in one case, pain along the lateral aspect of the knee in one case and recurrence of the deformity in one case. No cases were complicated by nerve injury or vascular injury. Hemi-wedge osteotomy is a good method for treatment of deformities around the knee joint. It can correct large angular deformities without major complications.

Feeding problems of infants and toddlers

PubMed Central

Bernard-Bonnin, Anne-Claude

2006-01-01

OBJECTIVE To propose a diagnostic and therapeutic approach to feeding problems in early childhood. QUALITY OF EVIDENCE Articles were retrieved through a MEDLINE search from January 1990 to December 2005 using the MeSH terms eating disorders, infant, and child. Recommended practice is based mainly on levels II and III evidence. MAIN MESSAGE Feeding problems are classified under structural abnormalities, neurodevelopmental disabilities, and behavioural disorders, with overlap between categories. A medical approach also needs an evaluation of diet and an assessment of the interaction between parent and child. Treating medical or surgical conditions, increasing caloric intake, and counseling about general nutrition can alleviate mild to moderate problems. More complicated cases should be referred to multidisciplinary teams. Behavioural therapy aims to foster appropriate behaviour and discourage maladaptive behaviour. CONCLUSION Feeding problems in early childhood often have multifactorial causes and a substantial behavioural component. Family physicians have a key role in detecting problems, offering advice, managing mildly to moderately severe cases, and referring more complicated cases to multidisciplinary teams. PMID:17279184

Alcohol effects on family relations: a case study.

PubMed

Reinaldo, Amanda Márcia Dos Santos; Pillon, Sandra Cristina

2008-01-01

Problems related to alcohol abuse have been associated to different factors, regardless of the causes attributed to this phenomenon. Alcohol consumption and dependence is considered a public health problem and deserve attention because of the social, work, family, physical, legal and violence-related risks it represents. This study aimed to identify the effects of alcoholism on family relations and, by means of case management, to encourage the recovery of these relationships. The results show that the problems caused by alcohol abuse impose profound suffering to family members, which contributes to high levels of interpersonal conflict, domestic violence, parental inadequacy, child abuse and negligence, financial and legal difficulties, in addition to clinical problems associated to it.

The Management of Student Affairs Programs in Community Colleges: Revamping Processes and Structures. Horizons Issues Monograph Series.

ERIC Educational Resources Information Center

Deegan, William L.

Based on a review of the management literature in the fields of business and education and on case studies, interviews, and discussions, this monograph identifies the prerequisites for the successful management of student affairs programs. Chapter 1 presents perspectives on the student affairs profession, summarizes the problems facing the field,…

Who Wants To Be an IPM Super Sleuth? Integrated Pest Management Educational Activities & Resources for Kids of All Ages.

ERIC Educational Resources Information Center

Walejko, Gina K.; Colon, Joseph L.

This guide presents games and activities on integrated pest management (IPM) for home targeting grades 1-7. The activities and games use a problem-solving approach based on pest knowledge to develop an understanding of pest management. Three cases are presented: (1) "Inspection is the Key to IPM Success" includes two…

A new process for organizing assessments of social, economic, and environmental outcomes: case study of wildland fire management in the USA

Treesearch

Randall JF Bruins; Wayne R Jr. Munns; Stephen J Botti; Steve Brink; David Cleland; Larry Kapustka; Danny Lee; al. et

2010-01-01

Ecological risk assessments typically are organized using the processes of planning (a discussion among managers, stakeholders, and analysts to clarify ecosystem management goals and assessment scope) and problem formulation (evaluation of existing information to generate hypotheses about adverse ecological effects, select assessment endpoints, and develop an analysis...

Technical Training Requirements of Middle Management in the Greek Textile and Clothing Industries.

ERIC Educational Resources Information Center

Fotinopoulou, K.; Manolopoulos, N.

A case study of 16 companies in the Greek textile and clothing industry elicited the training needs of the industry's middle managers. The study concentrated on large and medium-sized work units, using a lengthy questionnaire. The study found that middle managers increasingly need to solve problems and ensure the reliability of new equipment and…

Multi-criteria decision assessments using Subjective Logic: Methodology and the case of urban water strategies

NASA Astrophysics Data System (ADS)

Moglia, Magnus; Sharma, Ashok K.; Maheepala, Shiroma

2012-07-01

SummaryPlanning of regional and urban water resources, and in particular with Integrated Urban Water Management approaches, often considers inter-relationships between human uses of water, the health of the natural environment as well as the cost of various management strategies. Decision makers hence typically need to consider a combination of social, environmental and economic goals. The types of strategies employed can include water efficiency measures, water sensitive urban design, stormwater management, or catchment management. Therefore, decision makers need to choose between different scenarios and to evaluate them against a number of criteria. This type of problem has a discipline devoted to it, i.e. Multi-Criteria Decision Analysis, which has often been applied in water management contexts. This paper describes the application of Subjective Logic in a basic Bayesian Network to a Multi-Criteria Decision Analysis problem. By doing this, it outlines a novel methodology that explicitly incorporates uncertainty and information reliability. The application of the methodology to a known case study context allows for exploration. By making uncertainty and reliability of assessments explicit, it allows for assessing risks of various options, and this may help in alleviating cognitive biases and move towards a well formulated risk management policy.

Snakebite in bedroom kills a physician in Cameroon: a case report.

PubMed

Nkwescheu, Armand; Mbasso, Leopold Cyriaque Donfack; Pouth, Franky Baonga Ba; Dzudie, Anastase; Billong, Serge Clotaire; Ngouakam, Hermann; Diffo, Joseph Le Doux; Eyongorock, Hanny; Mbacham, Wilfred

2016-01-01

The World Health Organization (WHO) classifies snake bites as neglected public health problem affecting mostly tropical and subtropical countries. In Africa there are an estimated 1 million snake bites annually with about half needing a specific treatment. Women, children and farmers in poor rural communities in developing countries are the most affected. Case management of snake bites are not adequate in many health facilities in developing countries where personnel are not always abreast with the new developments in snake bite management and in addition, quite often the anti-venom serum is lacking. We report the case of a medical doctor bitten by a cobra in the rural area of Poli, Cameroon while asleep in his bedroom. Lack of facilities coupled with poor case management resulted in a fatal outcome.

Primary Pterygium in a 7-Year-Old Boy: A Report of a Rare Case and Dilemma of its Management

PubMed Central

Noor, Raja Azmi Mohd

2003-01-01

Primary pterygium in children is uncommon but is associated with severe visual problems. Astigmatism is the main visual problem caused by pterygium. Significant amounts of astigmatism occur long before a pterygium encroaches the visual axis. Early surgical intervention is safe and effective. It is associated with significant visual improvement in outcome. This is a case report on seven-year-old Malay boy who presented with a growth over nasal aspect of the right eye of 1 year duration. His right eye visual acuity is affected up to 6/12. The dilemma pased to early surgical interview is the high rate of recurrancean the young age group. This problem is highlighted in this case report. PMID:23386804

Primary pterygium in a 7-year-old boy: a report of a rare case and dilemma of its management.

PubMed

Noor, Raja Azmi Mohd

2003-07-01

Primary pterygium in children is uncommon but is associated with severe visual problems. Astigmatism is the main visual problem caused by pterygium. Significant amounts of astigmatism occur long before a pterygium encroaches the visual axis. Early surgical intervention is safe and effective. It is associated with significant visual improvement in outcome. This is a case report on seven-year-old Malay boy who presented with a growth over nasal aspect of the right eye of 1 year duration. His right eye visual acuity is affected up to 6/12. The dilemma pased to early surgical interview is the high rate of recurrancean the young age group. This problem is highlighted in this case report.

Simultaneous personnel and vehicle shift scheduling in the waste management sector.

PubMed

Ghiani, Gianpaolo; Guerriero, Emanuela; Manni, Andrea; Manni, Emanuele; Potenza, Agostino

2013-07-01

Urban waste management is becoming an increasingly complex task, absorbing a huge amount of resources, and having a major environmental impact. The design of a waste management system consists in various activities, and one of these is related to the definition of shift schedules for both personnel and vehicles. This activity has a great incidence on the tactical and operational cost for companies. In this paper, we propose an integer programming model to find an optimal solution to the integrated problem. The aim is to determine optimal schedules at minimum cost. Moreover, we design a fast and effective heuristic to face large-size problems. Both approaches are tested on data from a real-world case in Southern Italy and compared to the current practice utilized by the company managing the service, showing that simultaneously solving these problems can lead to significant monetary savings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Conflicting Expertise and Uncertainty: Quality Assurance in High-Level Radioactive Waste Management.

ERIC Educational Resources Information Center

Fitzgerald, Michael R.; McCabe, Amy Snyder

1991-01-01

Dynamics of a large, expensive, and controversial surface and underground evaluation of a radioactive waste management program at the Yucca Mountain power plant are reviewed. The use of private contractors in the quality assurance study complicates the evaluation. This case study illustrates high stakes evaluation problems. (SLD)

A CASE STUDY IN RISK MANAGEMENT ISSUES: PERCHLORATE IN POTABLE WATER

EPA Science Inventory

Risk management brings together many issues. While some of these are scientific in nature, many come down to policy and even emotion. As a result, striking a balance among competing objectives can be difficult. This is especially true when problems are localized or solutions are ...

Labor-Management Cooperation: The American Experience.

ERIC Educational Resources Information Center

Siegel, Irving H.; Weinberg, Edgar

This book examines the wide range of opportunities, the attendant problems, and the potential benefits of labor-management cooperation. Cooperative arrangements are considered at different economic levels, and 65 cases are discussed. The first of 10 chapters sets up a conceptual framework for the review of American experience in cooperation.…

Meniere's Disease in Childhood: Implications for Management in the School Environment.

ERIC Educational Resources Information Center

Hance, Susan E.

1990-01-01

The symptoms of Meniere's disease, including tinnitus, fluctuating hearing loss, and vertigo, present specific problems in the school setting. The paper reviews the literature on Meniere's Disease in childhood, focusing on incidence, symptoms, diagnosis, etiology, treatment, and implications for management in the school environment. A case study…

Process evaluation of an interorganizational cooperation initiative in vocational rehabilitation: the Dirigo project.

PubMed

Ståhl, Christian; Andersén, Åsa; Anderzén, Ingrid; Larsson, Kjerstin

2017-05-11

This study analyzes the process of establishing and developing a cooperative vocational rehabilitation project with special focus on organizational and professional aspects. In the project, officials from the Swedish Social Insurance Agency and the Swedish Public Employment Service worked cooperatively with participants on long-term sick leave, youths with disability benefits, and people receiving social allowances. The officials used Motivational Interviewing (MI) as a method when meeting participants, and were able to offer flexible and tailored case management. The goal was to improve work ability and promote self-sufficiency. The process evaluation was carried out through continuous data collection throughout the project (2012-2014), resulting in a total of 28 individual interviews and 17 focus groups with officials and managers. The material was categorized through an inductive content analysis, and analyzed using social capital as a theoretical frame. The evaluation points to how issues related to design, organization and management contributed to the project not reaching its goals, e.g. problems with recruitment of participants, the funding structure, and staffing problems on the managerial level. Still, officials reported positive effects of close cooperation, which was perceived as facilitating the case management by fostering a mutual understanding and access to resources and rehabilitation measures from more than one authority. Cooperative work combined with the use of MI and flexible case management seem to promote an increased trust between officials from different authorities and participants, which in the study is conceptualized as bonding and bridging social capital (between officials) and linking social capital (between officials and participants). The organizational problems combined with the relatively large differences in approaches between the project and regular practice obstructed implementation, where the authorities involved did not appear to be ready for implementing methodologies that require organizational restructuring.

Problems of Accreditation and Quality Assurance of Engineering Education in Developing Countries.

ERIC Educational Resources Information Center

Bordia, Surek

2001-01-01

Discusses the relationship between funding, management, and quality assurance in engineering education in developing countries. Presents a few case studies on problems of accreditation and quality assessment in larger developing countries such as India and the Philippines, and also in very small developing countries such as Papua New Guinea, Fiji,…

Managing Chronic Pain in People with Learning Disabilities: A Case Study

ERIC Educational Resources Information Center

Lewis, Sarah; Bell, Dorothy; Gillanders, David

2007-01-01

Chronic pain is a prevalent, under-diagnosed problem in the learning disability population. This is in part due to communication problems, unrecognized pain behaviours and the effects of medication. As a consequence, chronic pain often goes untreated and causes ongoing distress. This paper initially describes the main research that has been…

Factors driving collaboration in natural resource conflict management: Evidence from Romania.

PubMed

Hossu, Constantina Alina; Ioja, Ioan Cristian; Susskind, Lawrence E; Badiu, Denisa L; Hersperger, Anna M

2018-02-03

A critical challenge in natural resource management is to bring all stakeholders together to negotiate solutions to critical problems. However, various collaborative approaches to heading off conflicts and resolving natural resource management disputes have been used. What drives these efforts, however, still needs further research. Our study provides a systematic look at the drivers likely to initiate collaborative problem-solving efforts in four cases in Romania. We use Emerson's et al. (2012) framework for collaborative governance and multi-value qualitative comparative analysis (mvQCA) to analyze cases involving endangered species, restrictions on forest harvest, conflicts associated with infrastructure development projects, and disputes over the management of environmentally sensitive areas. Our findings contribute to the already existing collaborative governance literature indicating which of the four factors: uncertainty, interdependence, consequential incentives, and leadership, in which combination, are necessary and sufficient to spur collaborative resource management efforts. Our results showed that in Romania the initiation of collaboration is best explained by positive consequential incentives (i.e., financial opportunities) which has determined leaders to take initiative. This study provides additional information for the complicated process of natural resource management which is often overriding collaboration by investigating what enables and constrains collaborative efforts in a country where natural resources were managed and used according to the principles of central planning.

ERTS-1 applied for structural and morphological investigtions case studies. 1: Los Angeles, California. 2: Coastal plain, New Jersey

NASA Technical Reports Server (NTRS)

Kedar, E. Y.

1973-01-01

Two major earth's resources management problems, the application of ERTS-1 imagery for geomorphotectonics, and subsequently seismic-risk, earthquake, and mineral exploration applications are discussed. Case studies are presented for Los Angeles, California, and New Jersey coastal plain.

Case Study Method in Business Education in the USA

ERIC Educational Resources Information Center

Velushchak, Maryna

2014-01-01

Business Education is dynamic in nature and needs diverse information to deal with different business problems. To understand the peculiar situations and to manage them effectively, case studies are widely used. Researchers in education have already demonstrated that students' active participation in the educational process increases their…

Decision PBL: A 4-year retrospective case study of the use of virtual patients in problem-based learning.

PubMed

Ellaway, Rachel H; Poulton, Terry; Jivram, Trupti

2015-01-01

In 2009, St George's University of London (SGUL) replaced their paper-based problem-based learning (PBL) cases with virtual patients for intermediate-level undergraduate students. This involved the development of Decision-Problem-Based Learning (D-PBL), a variation on progressive-release PBL that uses virtual patients instead of paper cases, and focuses on patient management decisions and their consequences. Using a case study method, this paper describes four years of developing and running D-PBL at SGUL from individual activities up to the ways in which D-PBL functioned as an educational system. A number of broad issues were identified: the importance of debates and decision-making in making D-PBL activities engaging and rewarding; the complexities of managing small group dynamics; the time taken to complete D-PBL activities; the changing role of the facilitator; and the erosion of the D-PBL process over time. A key point in understanding this work is the construction and execution of the D-PBL activity, as much of the value of this approach arises from the actions and interactions of students, their facilitators and the virtual patients rather than from the design of the virtual patients alone. At a systems level D-PBL needs to be periodically refreshed to retain its effectiveness.

Managing Multiple Sources of Information in an Independent K-12 Private School: A Case Study in a Student Information Systems Evaluation

ERIC Educational Resources Information Center

Yares, Ali Chava Kaufman

2010-01-01

Information is everywhere and finding the best method to manage it is a problem that all types of organizations have to deal with. Schools use Student Information Systems (SIS) to manage Student Data, Financial Information, Development, Human Resources, Admission, Financial Aid, Enrollment, Scheduling, and Health Information. A survey of 107…

Fishery management problems and possibilities on large southeastern reservoirs

USGS Publications Warehouse

Parsons, John W.

1958-01-01

In recognition of these problems, the development and application of sound management procedures may be accomplished by controlling species composition and availability of fish through water level control, timber clearing, application of selective toxicants, commercial fishing, introduction of new fish species, and the management of tailwaters and tributaries. Extended research and interagency cooperation are necessary to properly develop and apply sound management. Promotion of angling and regulation of the fishery may best be realized by providing adequate fishing facilities, elimination of certain restricted areas, and in some cases revision of laws and regulations. Biologists must not only meet the present demands for improved sport fishing but must also balance fish yield by increasing the use of food fish by sport and commercial operations.

Electrophoresis as a management tool

USGS Publications Warehouse

Morgan, R.P.; Chapman, J.A.; Noe, L.A.; Henny, C.J.

1974-01-01

The theme of this 1974 Northeast Fish and Wildlife Conference is 'A New Era'. Indeed, it is a new era for improved techniques to assist in management of our fish and wildlife resources for the maximum benefit of all. In some cases, the new techniques are primarily used in research.on fish and wildlife, and the results from the research are used to aid management and enforcement agencies in the decision-making process. One of the newer techniques that is being applied to problems in fisheries and wildlife is electrophoresis. In this paper, we review briefly the techniques of electrophoresis and illustrate research problems in wildlife and fisheries where the use of electrophoresis is now assisting or may potentially aid in management decisions.

Indoor air quality: A psychosocial perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boxer, P.A.

1990-05-01

The incidence of indoor air quality problems has increased dramatically over the past decade. Investigation of these problems has yielded a definitive cause in only one third of the cases. Psychosocial factors may play a key role in the development and propagation of symptoms attributed to poor indoor air quality. Guidelines for managing indoor air quality problems from the organizational perspective are based upon psychosocial principles and elements of risk perception.

Depression is More Than Just Sadness: A Case of Excessive Anger and Its Management in Depression

PubMed Central

Sahu, Anamika; Gupta, Preeti; Chatterjee, Biswadip

2014-01-01

People with depressive illness often have symptoms of overt or suppressed anger. Those with anger traits face exaggerated problem during symptomatic period of depression. Pharmacological management helps in control of depressive and anxiety symptoms, but rarely address anger symptoms. Non-pharmacological management like cognitive-behavioral therapy (CBT) is effective in depression as well as in anger management, but is not used frequently in anger associated or exacerbated by depression. We present the case of a 27-year-old male suffering from moderate depressive episode with associated anger outburst. He underwent CBT, which resulted in a significant decrease in anger symptoms as well as in severity of depression. PMID:24701016

Depression is More Than Just Sadness: A Case of Excessive Anger and Its Management in Depression.

PubMed

Sahu, Anamika; Gupta, Preeti; Chatterjee, Biswadip

2014-01-01

People with depressive illness often have symptoms of overt or suppressed anger. Those with anger traits face exaggerated problem during symptomatic period of depression. Pharmacological management helps in control of depressive and anxiety symptoms, but rarely address anger symptoms. Non-pharmacological management like cognitive-behavioral therapy (CBT) is effective in depression as well as in anger management, but is not used frequently in anger associated or exacerbated by depression. We present the case of a 27-year-old male suffering from moderate depressive episode with associated anger outburst. He underwent CBT, which resulted in a significant decrease in anger symptoms as well as in severity of depression.

Sustainability or Collapse: Interplay Between Decadal Climate Variability and Human Activities Matters

NASA Astrophysics Data System (ADS)

Lu, Y.; Hu, H.; Tian, F.

2016-12-01

The Aral Sea Crisis and the deterioration of Tarim River Basin are representative cases of emergent water deficit problems in arid areas. Comparing cases of water deficit problems in different regions and considering the in the perspective of socio-hydrology is helpful to obtain guidance on integrated management of arid area basins. Analyzing the interplay between decadal climate variability and human activities in both basins, the important role of human activities is observed. Decadal climate variability tempts people to adapt fast to increasing water resources and slowly to decreasing water resources, while using unsustainable technical measures to offset water shortage. Due to this asymmetry the situation deteriorates with technically enhanced capabilities of societies to exploit water resources, and more integrated long-term management capacity is in high demand.

The individualized service plan as a clinical integration tool: qualitative analysis in the Quebec PRISMA experiment

PubMed Central

Somme, Dominique; Hébert, Réjean; Bravo, Gina; Blanchard, François; Saint-Jean, Olivier

2007-01-01

Introduction One aspect of clinical integration involves case managers' tools and particularly the individualized service plan. Methods We examined individualized service plan content and use in the PRISMA experiment. We analyzed 50 charts, and conducted and recorded interviews regarding individualized service plan use with all the case managers concerned (n=13). Results Delays between starting case management and writing the individualized service plan were long and varied (0–596 days, mean: 117 days). During the interviews, the individualized service plan was described as the ‘last step’ once the active planning phase was over. The reasons for formulating plans were mainly administrative. From a clinical viewpoint, individualized service plans were used as memoranda and not to describe services (842 interventions not mentioned in the plans) or needs (694 active problems not mentioned). Case managers felt uncomfortable with the individualized planning task and expected a tool more adapted to their needs. Conclusion Although a majority of the case managers' charts contained an individualized service plan, implementation of this tool seems tenuous. Because of the discrepancy between the potential usefulness expected by case managers and their actual use, a working committee was created to develop proposals for modifying the instrument. PMID:19503736

[Implementation and (cost-)effectiveness of case management for people with dementia and their informal caregivers: results of the COMPAS study].

PubMed

van Mierlo, Lisa D; MacNeil-Vroomen, Janet; Meiland, Franka J M; Joling, Karlijn J; Bosmans, Judith E; Dröes, Rose Marie; Moll van Charante, Eric P; de Rooij, Sophia E J A; van Hout, Hein P J

2016-12-01

Different forms of case management for dementia have emerged over the past few years. In the COMPAS study (Collaborative dementia care for patients and caregivers study), two prominent Dutch case management forms were studied: the linkage and the integrated care form. Evaluation of the (cost)effectiveness of two dementia case management forms compared to usual care as well as factors that facilitated or impeded their implementation. A mixed methods design with a) a prospective, observational controlled cohort study with 2 years follow-up among 521 dyads of people with dementia and their primary informal caregiver with and without case management; b) interviews with 22 stakeholders on facilitating and impeding factors of the implementation and continuity of the two case management models. Outcome measures were severity and frequency of behavioural problems (NPI) for the person with dementia and mental health complaints (GHQ-12) for the informal caregiver, total met and unmet care needs (CANE) and quality adjusted life years (QALYs). Outcomes showed a better quality of life of informal caregivers in the integrated model compared to the linkage model. Caregivers in the control group reported more care needs than those in both case management groups. The independence of the case management provider in the integrated model facilitated the implementation, while the rivalry between multiple providers in the linkage model impeded the implementation. The costs of care were lower in the linkage model (minus 22 %) and integrated care model (minus 33 %) compared to the control group. The integrated care form was (very) cost-effective in comparison with the linkage form or no case management. The integrated care form is easy to implement.

Use of film digitizers to assist radiology image management

NASA Astrophysics Data System (ADS)

Honeyman-Buck, Janice C.; Frost, Meryll M.; Staab, Edward V.

1996-05-01

The purpose of this development effort was to evaluate the possibility of using digital technologies to solve image management problems in the Department of Radiology at the University of Florida. The three problem areas investigated were local interpretation of images produced in remote locations, distribution of images to areas outside of radiology, and film handling. In all cases the use of a laser film digitizer interfaced to an existing Picture Archiving and Communication System (PACS) was investigated as a solution to the problem. In each case the volume of studies involved were evaluated to estimate the impact of the solution on the network, archive, and workstations. Communications were stressed in the analysis of the needs for all image transmission. The operational aspects of the solution were examined to determine the needs for training, service, and maintenance. The remote sites requiring local interpretation included were a rural hospital needing coverage for after hours studies, the University of Florida student infirmary, and the emergency room. Distribution of images to the intensive care units was studied to improve image access and patient care. Handling of films originating from remote sites and those requiring urgent reporting were evaluated to improve management functions. The results of our analysis and the decisions that were made based on the analysis are described below. In the cases where systems were installed, a description of the system and its integration into the PACS system is included. For all three problem areas, although we could move images via a digitizer to the archive and a workstation, there was no way to inform the radiologist that a study needed attention. In the case of outside films, the patient did not always have a medical record number that matched one in our Radiology Information Systems (RIS). In order to incorporate all studies for a patient, we needed common locations for orders, reports, and images. RIS orders were generated for each outside study to be interpreted and a medical record number assigned if none existed. All digitized outside films were archived in the PACS archive for later review or comparison use. The request generated by the RIS requesting a diagnostic interpretation was placed at the PACS workstation to alert the radiologists that unread images had arrived and a box was added to the workstation user interface that could be checked by the radiologist to indicate that a report had been dictated. The digitizer system solved several problems, unavailable films in the emergency room, teleradiology, and archiving of outside studies that had been read by University of Florida radiologists. In addition to saving time for outside film management, we now store the studies for comparison purposes, no longer lose emergency room films, generate diagnostic reports on emergency room films in a timely manner (important for billing and reimbursement), and can handle the distributed nature of our business. As changes in health care drive management changes, existing tools can be used in new ways to help make the transition easier. In this case, adding digitizers to an existing PACS network helped solve several image management problems.

Caregivers as Money Managers for Adults with Severe Mental Illness: How Treatment Providers Can Help

ERIC Educational Resources Information Center

Elbogen, Eric B.; Wilder, Christine; Swartz, Marvin S.; Swanson, Jeffrey W.

2008-01-01

Objective: To review the prevalence, benefits, and problems associated with families who, either informally or formally as representative payees, manage money for adults with severe mental illness. Methods: Based on empirical research and clinical cases, suggestions are offered for minimizing downsides and capitalizing upon benefits of family…

Fire in the Wildland–Urban Interface

Treesearch

Evan Mercer; Wayne Zipperer

2012-01-01

In this chapter we provide an overview of the socio-economic and ecological effects and trends of wildfire in the WUI, methods for assessing wildfire risk in the WUI, approaches to managing the wildfire problem including fuels management, home construction and design, and community action programs. This overview is combined with two case studies analyzing wildfire risk...

Integrating Six Sigma Concepts in an MBA Quality Management Class

ERIC Educational Resources Information Center

Weinstein, Larry B.; Petrick, Joseph; Castellano, Joseph; Vokurka, Robert J.

2008-01-01

Instructors face enormous challenges in presenting effective instruction on concepts and tools of quality management. Most textbooks focus on presenting individual concepts or tools and fail to address complex issues confronted in real-world problem-solving situations. The supplementary use of cases does not help students to understand the dynamic…

Fire weather technology for fire agrometeorology operations

Treesearch

Francis Fujioka

2008-01-01

Even as the magnitude of wildfire problems increases globally, United Nations agencies are acting to mitigate the risk of wildfire disasters to members. Fire management organizations worldwide may vary considerably in operational scope, depending on the number and type of resources an organization manages. In any case, good fire weather information is vital. This paper...

Child sexual abuse: report of 311 cases with review of literature.

PubMed

Essabar, Laila; Khalqallah, Abdenbi; Dakhama, Badr Sououd Benjelloun

2015-01-01

Child sexual abuse (CSA) is a global problem that has significant consequences for public health; it has been a prominent topic of public concern for more than a decade, but many basic facts about the problem remain unclear or in dispute. We conducted a study of 311 cases of CSA in order to highlight the epidemiological features and negative impact on victims' well-being and to emphasize the need for a multidisciplinary approach to the primary prevention and management of CSA. We noted an increase in cases number with male predominance. Most of our patients came from lower socioeconomic classes. The perpetrators were male in 100% of cases; acquaintances in 70% of cases and family members in 22 cases. Physical examination were normal in 61% of cases, however, a range of psychological and physical effects were identified with dramatic health consequences: three cases of attempted suicide, five pregnancies and one case of HIV virus infection.

A Framework to Evaluate Wildlife Feeding in Research, Wildlife Management, Tourism and Recreation.

PubMed

Dubois, Sara; Fraser, David

2013-10-11

Feeding of wildlife occurs in the context of research, wildlife management, tourism and in opportunistic ways. A review of examples shows that although feeding is often motivated by good intentions, it can lead to problems of public safety and conservation and be detrimental to the welfare of the animals. Examples from British Columbia illustrate the problems (nuisance animal activity, public safety risk) and consequences (culling, translocation) that often arise from uncontrolled feeding. Three features of wildlife feeding can be distinguished: the feasibility of control, the effects on conservation and the effects on animal welfare. An evaluative framework incorporating these three features was applied to examples of feeding from the literature. The cases of feeding for research and management purposes were generally found to be acceptable, while cases of feeding for tourism or opportunistic feeding were generally unacceptable. The framework should allow managers and policy-makers to distinguish acceptable from unacceptable forms of wildlife feeding as a basis for policy, public education and enforcement. Many harmful forms of wildlife feeding seem unlikely to change until they come to be seen as socially unacceptable.

Environmental strategies: A case study of systematic evaluation

NASA Astrophysics Data System (ADS)

Sherman, Douglas J.; Garès, Paul A.

1982-09-01

A major problem facing environmental managers is the necessity to effectively evaluate management alternatives. Traditional environmental assessments have emphasized the use of economic analyses. These approaches are often deficient due to difficulty in assigning dollar values to environmental systems and to social amenities. A more flexible decisionmaking model has been developed to analyze management options for coping with beach erosion problems at the Sandy Hook Unit of Gateway National Recreation Area in New Jersey. This model is comprised of decision-making variables which are formulated from a combination of environmental and management criteria, and it has an accept-reject format in which the management options are analyzed in terms of the variables. Through logical ordering of the insertion of the variables into the model, stepwise elimination of alternatives is possible. A hierarchy of variables is determined through estimating work required to complete an assessment of the alternatives for each variable. The assessment requiring the least work is performed first so that the more difficult evaluation will be limited to fewer alternatives. The application of this approach is illustrated with a case study in which beach protection alternatives were evaluated for the United States National Park Service.

Modeling Soil Sodicity Problems under Dryland and Irrigated Conditions: Case Studies in Argentina and Colombia

NASA Astrophysics Data System (ADS)

Pla-Sentís, Ildefonso

2014-05-01

Salt-affected soils, both saline and sodic, my develop both under dryland and irrigated conditions, affecting negatively the physical and chemical soil properties, the crop production and the animal and human health.Among the development processes of salt-affected soils, the processes of sodification have been generally received less attention and is less understood than the development of saline soils. Although in both of them, hydrological processes are involved in their development, in the case of sodic soils we have to consider some additional chemical and physicochemical reactions, making more difficult their modeling and prediction. In this contribution we present two case studies: one related to the development of sodic soils in the lowlands of the Argentina Pampas, under dryland conditions and sub-humid temperate climate, with pastures for cattle production; the other deals with the development of sodic soils in the Colombia Cauca Valley, under irrigated conditions and tropical sub-humid climate, in lands used for sugarcane cropping dedicated to sugar and ethanol production. In both cases the development of sodicity in the surface soil is mainly related to the effects of the composition and level of groundwater, affected in the case of Argentina Pampas by the off-site changes in dryland use and management in the upper zones and by the drainage conditions in the lowlands, and in the case of the Cauca Valley, by the on-site irrigation and drainage management in lands with sugarcane. There is shown how the model SALSODIMAR, developed by the main author, based on the balance of water and soluble componentes of both the irrigation water and groundwater under different water and land management conditions, may be adapted for the diagnosis and prediction of both problems, and for the selection of alternatives for their management and amelioration.

Female circumcision: obstetric issues.

PubMed

Baker, C A; Gilson, G J; Vill, M D; Curet, L B

1993-12-01

Female circumcision is a problem unfamiliar to most Western obstetrician-gynecologists. We present a case illustrative of the unique management problems posed by these patients during labor. A method of releasing the anterior vulvar scar tissue to allow vaginal delivery is described. Sensitivity and a nonjudgmental approach as to what is culturally appropriate care for these women are of paramount importance.

Case Studies of Software Development Tools for Parallel Architectures

DTIC Science & Technology

1993-06-01

Simulation ............................................. 29 4.7.3 Visualization...autonomous entities, each with its own state and set of behaviors, as in simulation , tracking, or Battle Management. Because C2 applications are often... simulation , that is used to help the developer solve the problems. The new tool/problem solution matrix is structured in terms of the software development

Little Reason for Being: A Case of School District Dissolution.

ERIC Educational Resources Information Center

Ellis, Pam

In 1980, Tonnelly Central School District became the first school district in New York State to be dissolved pursuant to Section 1505 of Education Law, marking the first use of dissolution and annexation as a means by which to address the programmatic and management problems encountered in the operation of a central school district. Problems faced…

Diagnostic reframing of intractable environmental problems: Case of a contested multiparty public land-use conflict

Treesearch

Stanley T. Asah; David N. Bengston; Keith Wendt; Kristen C. Nelson

2012-01-01

Intractable conflicts are omnipresent in environmental management. These conflicts do not necessarily resist resolution but need to be fundamentally transformed in order to reach agreement. Reframing, a process that allows disputants to create new alternative understandings of the problem, is one way of transforming these conflicts. Cognitive and interactional...

A duality theorem-based algorithm for inexact quadratic programming problems: Application to waste management under uncertainty

NASA Astrophysics Data System (ADS)

Kong, X. M.; Huang, G. H.; Fan, Y. R.; Li, Y. P.

2016-04-01

In this study, a duality theorem-based algorithm (DTA) for inexact quadratic programming (IQP) is developed for municipal solid waste (MSW) management under uncertainty. It improves upon the existing numerical solution method for IQP problems. The comparison between DTA and derivative algorithm (DAM) shows that the DTA method provides better solutions than DAM with lower computational complexity. It is not necessary to identify the uncertain relationship between the objective function and decision variables, which is required for the solution process of DAM. The developed method is applied to a case study of MSW management and planning. The results indicate that reasonable solutions have been generated for supporting long-term MSW management and planning. They could provide more information as well as enable managers to make better decisions to identify desired MSW management policies in association with minimized cost under uncertainty.

Unresolved questions associated with the management of ventricular pre-excitation syndrome.

PubMed

Brembilla-Perrot, Béatrice; Girerd, Nicolas; Sellal, Jean-Marc

2018-05-13

many recent recommendations concern the management of pre-excitation syndrome. In clinical practice, they are sometimes difficult to use. The purpose of the authors was to discuss the main problems associated with this management. This article is protected by copyright. All rights reserved Three problems are encountered: 1) the reality of the absence of symptoms or the interpretation of atypical symptoms, 2) the electrocardiographic diagnosis of pre-excitation syndrome that can be missed and 3) the exact electrophysiological protocol and its interpretation used for the evaluation of the prognosis Because of significant progress largely related to the development of curative treatment, it seems easy to propose ablation in many patients despite the related risks of invasive studies and to minimize the invasive risk by only performing ablation for patients with at-risk pathways. However, there is a low risk of spontaneous events in truly asymptomatic patients and the indication of accessory pathway ablation should be discussed case by case. This article is protected by copyright. All rights reserved.

Management of Acute Isolated Soleal Vein Thrombosis in a Pregnant Patient With an Osteopathic Approach to Evaluation.

PubMed

Martingano, Daniel; Eisenberg, Justin; Aglialoro, George C

2016-01-01

In pregnant women, the risk of venous thromboembolism increases 4 to 5 fold over that in nonpregnant women. Deep vein thromboses in the calf occur in approximately 6% of cases, with a 20% incidence of propagation, but new imaging methods suggest a higher rate. Nevertheless, the management of isolated soleal vein thrombosis is currently one of the most debated issues in the field of venous thromboembolism, and a clear set of principles for the management of this unique clinical problem remains undefined. The authors present the case of a 37-year-old woman with a history of recurrent spontaneous abortions and cervical insufficiency who presented with a short cervix and acute right isolated soleal vein thrombosis. Long-term anticoagulantion therapy was recommended. Future studies on the risk of isolated soleal vein thrombosis propagation in the setting of pregnancy are required to identify the most effective treatment options for this clinical problem.

Driving for successful change processes in healthcare by putting staff at the wheel.

PubMed

Erlingsdottir, Gudbjörg; Ersson, Anders; Borell, Jonas; Rydenfält, Christofer

2018-03-19

Purpose The purpose of this paper is to describe five salient factors that emerge in two successful change processes in healthcare. Organizational changes in healthcare are often characterized by problems and solutions that have been formulated by higher levels of management. This top-down management approach has not been well received by the professional community. As a result, improvement processes are frequently abandoned, resulting in disrupted and dysfunctional organizations. This paper presents two successful change processes where managerial leadership was used to coach the change processes by distributing mandates and resources. After being managerially initiated, both processes were driven by local agency, decisions, planning and engagement. Design/methodology/approach The data in the paper derive from two qualitative case studies. Data were collected through in-depth interviews, observations and document studies. The cases are presented as process descriptions covering the different phases of the change processes. The focus in the studies is on the roles and interactions of the actors involved, the type of leadership and the distribution of agency. Findings Five factors emerged as paramount to the successful change processes in the two cases: local ownership of problems; a coached process where management initiates the change process and the problem recognition, and then lets the staff define the problems, formulate solutions and drive necessary changes; distributed leadership directed at enabling and supporting the staff's intentions and long-term self-leadership; mutually formulated norms and values that serve as a unifying force for the staff; and generous time allocation and planning, which allows the process to take time, and creates room for reevaluation. The authors also noted that in both cases, reorganization into multi-professional teams lent stability and endurance to the completed changes. Originality/value The research shows how management can initiate and support successful change processes that are staff driven and characterized by local agency, decisions, planning and engagement. Empirical descriptions of successful change processes are rare, which is why the description of such processes in this research increases the value of the paper.

Investigating the Wicked Problems of (Un)sustainability Through Three Case Studies Around the Water-Energy-Food Nexus

NASA Astrophysics Data System (ADS)

Metzger, E. P.; Curren, R. R.

2016-12-01

Effective engagement with the problems of sustainability begins with an understanding of the nature of the challenges. The entanglement of interacting human and Earth systems produces solution-resistant dilemmas that are often portrayed as wicked problems. As introduced by urban planners Rittel and Webber (1973), wicked problems are "dynamically complex, ill-structured, public problems" arising from complexity in both biophysical and socio-economic systems. The wicked problem construct is still in wide use across diverse contexts, disciplines, and sectors. Discourse about wicked problems as related to sustainability is often connected to discussion of complexity or complex systems. In preparation for life and work in an uncertain, dynamic and hyperconnected world, students need opportunities to investigate real problems that cross social, political and disciplinary divides. They need to grapple with diverse perspectives and values, and collaborate with others to devise potential solutions. Such problems are typically multi-casual and so intertangled with other problems that they cannot be resolved using the expertise and analytical tools of any single discipline, individual, or organization. We have developed a trio of illustrative case studies that focus on energy, water and food, because these resources are foundational, interacting, and causally connected in a variety of ways with climate destabilization. The three interrelated case studies progress in scale from the local and regional, to the national and international and include: 1) the 2010 Gulf of Mexico oil spill with examination of the multiple immediate and root causes of the disaster, its ecological, social, and economic impacts, and the increasing risk and declining energy return on investment associated with the relentless quest for fossil fuels; 2) development of Australia's innovative National Water Management System; and 3) changing patterns of food production and the intertwined challenge of managing transnational water resources in the rapidly growing Mekong Region of Southeast Asia. .

Sex Discrimination at Saint Ambrose University: The Moral and Legal Consequences of Unethical Behavior

ERIC Educational Resources Information Center

Martin, Jennifer; Beese, Jane A.

2015-01-01

This case was developed for use in a learning-centered course with a focus on administrative leadership and ethical behavior. This case describes the experience of a new faculty member at Saint Ambrose University, as she discovers a wide range of ethical and management problems in her department. The case unfolds as we track her efforts to deal…

Spouse Abuse: The Problem and a Proposal for Military Police Intervention

DTIC Science & Technology

1984-12-01

relation to law enforcement, by visiting 17 police departments9 interviewing police managers , surveying 130 police officers, and interviewing social...about presenting a lot of information, while managing to gain and hold the interest of the audience. Since spouse abuse is such a controversial subject...available for domestic violence victims and batterers. The author was also invited to attend a meeting with the Family * Advocacy Case Management Team

University ERP Implementation in Germany: Qualitative Exploratory Case Study of Administrative Staff Experiences

ERIC Educational Resources Information Center

Thelen, Anja

2015-01-01

Enterprise Resource Planning (ERP) implementations are expensive, time-consuming, and often do not lead to the expected outcome of integrated IT systems. Many German universities are implementing ERP systems as Campus Management Systems (CMS) and a solution to any problem, need, or requirement the organization has. This exploratory case study…

Inclusive Education in an International School: A Case Study from Hong Kong

ERIC Educational Resources Information Center

Chan, Twiggy; Yuen, Mantak

2015-01-01

This case study provides an overview of current policy, practices and problems concerning inclusion in one international secondary school in Hong Kong. A total of 13 interviews were conducted with the school management team, teachers, students and parents, supplemented by 12 classroom observations and two "student-shadowing" exercises.…

Forest fire management to avoid unintended consequences: a case study of Portugal using system dynamics.

PubMed

Collins, Ross D; de Neufville, Richard; Claro, João; Oliveira, Tiago; Pacheco, Abílio P

2013-11-30

Forest fires are a serious management challenge in many regions, complicating the appropriate allocation to suppression and prevention efforts. Using a System Dynamics (SD) model, this paper explores how interactions between physical and political systems in forest fire management impact the effectiveness of different allocations. A core issue is that apparently sound management can have unintended consequences. An instinctive management response to periods of worsening fire severity is to increase fire suppression capacity, an approach with immediate appeal as it directly treats the symptom of devastating fires and appeases the public. However, the SD analysis indicates that a policy emphasizing suppression can degrade the long-run effectiveness of forest fire management. By crowding out efforts to preventative fuel removal, it exacerbates fuel loads and leads to greater fires, which further balloon suppression budgets. The business management literature refers to this problem as the firefighting trap, wherein focus on fixing problems diverts attention from preventing them, and thus leads to inferior outcomes. The paper illustrates these phenomena through a case study of Portugal, showing that a balanced approach to suppression and prevention efforts can mitigate the self-reinforcing consequences of this trap, and better manage long-term fire damages. These insights can help policymakers and fire managers better appreciate the interconnected systems in which their authorities reside and the dynamics that may undermine seemingly rational management decisions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Using systems thinking in patient safety: a case study on medicines management.

PubMed

Brimble, Mandy; Jones, Aled

2017-06-29

Systems thinking is used as a way of understanding behaviours and actions in complex healthcare organisations. An important premise of the concept is that every action in a system causes a reaction elsewhere in that system. These reactions can lead to unintended consequences, sometimes long after the original action, and so are not always attributed to them. This article applies systems thinking to a medicines management case study, to highlight how quality-improvement practitioners can use the approach to underpin planning and implementation of patient-safety initiatives. The case study is specific to transcribing in children's hospices, but the strategies can be applied to other areas. The article explains that, while root cause analysis tools are useful for identifying the cause of, and possible solutions to, problems, they need to be considered carefully in terms of unintended consequences, and how the system into which the solution is implemented can be affected by the change. Analysis of problems using a systems-thinking approach can help practitioners to develop robust and well informed business cases to present to decision makers.

Building co-management as a process: problem solving through partnerships in Aboriginal country, Australia.

PubMed

Zurba, Melanie; Ross, Helen; Izurieta, Arturo; Rist, Philip; Bock, Ellie; Berkes, Fikret

2012-06-01

Collaborative problem solving has increasingly become important in the face of the complexities in the management of resources, including protected areas. The strategy undertaken by Girringun Aboriginal Corporation in north tropical Queensland, Australia, for developing co-management demonstrates the potential for a problem solving approach involving sequential initiatives, as an alternative to the more familiar negotiated agreements for co-management. Our longitudinal case study focuses on the development of indigenous ranger units as a strategic mechanism for the involvement of traditional owners in managing their country in collaboration with government and other interested parties. This was followed by Australia's first traditional use of marine resources agreement, and development of a multi-jurisdictional, land to sea, indigenous protected area. In using a relationship building approach to develop regional scale co-management, Girringun has been strengthening its capabilities as collaborator and regional service provider, thus, bringing customary decision-making structures into play to 'care for country'. From this evolving process we have identified the key components of a relationship building strategy, 'the pillars of co-management'. This approach includes learning-by-doing, the building of respect and rapport, sorting out responsibilities, practical engagement, and capacity-building.

Building Co-Management as a Process: Problem Solving Through Partnerships in Aboriginal Country, Australia

NASA Astrophysics Data System (ADS)

Zurba, Melanie; Ross, Helen; Izurieta, Arturo; Rist, Philip; Bock, Ellie; Berkes, Fikret

2012-06-01

Collaborative problem solving has increasingly become important in the face of the complexities in the management of resources, including protected areas. The strategy undertaken by Girringun Aboriginal Corporation in north tropical Queensland, Australia, for developing co-management demonstrates the potential for a problem solving approach involving sequential initiatives, as an alternative to the more familiar negotiated agreements for co-management. Our longitudinal case study focuses on the development of indigenous ranger units as a strategic mechanism for the involvement of traditional owners in managing their country in collaboration with government and other interested parties. This was followed by Australia's first traditional use of marine resources agreement, and development of a multi-jurisdictional, land to sea, indigenous protected area. In using a relationship building approach to develop regional scale co-management, Girringun has been strengthening its capabilities as collaborator and regional service provider, thus, bringing customary decision-making structures into play to `care for country'. From this evolving process we have identified the key components of a relationship building strategy, `the pillars of co-management'. This approach includes learning-by-doing, the building of respect and rapport, sorting out responsibilities, practical engagement, and capacity-building.

Marine reserves solve an important bycatch problem in fisheries

PubMed Central

Hastings, Alan; Gaines, Steven D.; Costello, Christopher

2017-01-01

Management of the diverse fisheries of the world has had mixed success. While managing single species in data-rich environments has been largely effective, perhaps the greatest challenge facing fishery managers is how to deal with mixed stocks of fish with a range of life histories that reside in the same location. Because many fishing gears are nonselective, and the costs of making gear selective can be high, a particular problem is bycatch of weak stocks. This problem is most severe when the weak stock is long-lived and has low fecundity and thus requires a very long recovery time once overfished. We investigate the role that marine reserves might play in solving this challenging and ubiquitous problem in ecosystem-based management. Evidence for marine reserves’ potential to manage fisheries in an ecosystem context has been mixed, so we develop a heuristic strategic mathematical model to obtain general conclusions about the merits of managing multispecies fisheries by using reserves relative to managing them with nonspatial approaches. We show that for many fisheries, yields of strong stocks can be increased, and persistence of weak stocks can be ensured, by using marine reserves rather than by using traditional nonspatial approaches alone. Thus, reserves have a distinct advantage as a management tool in many of the most critical multispecies settings. We also show how the West Coast groundfish fishery of the United States meets these conditions, suggesting that management by reserves may be a superior option in that case. PMID:28794280

Operant Conditioning and Education.

ERIC Educational Resources Information Center

de Noronha, Mario

A case study of a learning disabled 8-year-old with behavior disturbancs is presented to highlight the use of operant conditioning in cutting down educational costs and easing the teacher's class management problems. (CL)

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.

Anesthesia for cesarean delivery in an achondroplastic dwarf: a case report.

PubMed

Huang, Jeffrey; Babins, Noah

2008-12-01

There are more than 100 different types of dwarfism. Achondroplasia is the most common form of this rare condition. The incidence of achondroplasia in the United States is about 15 per 1 million births. Although inherited as an autosomal dominant condition, 80% of cases result from spontaneous mutation. Underdevelopment and premature ossification of bones result in characteristic craniofacial and spinal abnormalities. Limited neck extension, foramen magnum stenosis, a large tongue, large mandible, and atlanto-axial instability can lead to increased difficulty of airway management. Severe kyphosis, scoliosis, spinal stenosis, and unpredictable spread of local anesthetics in the epidural space and subarachnoid space lead to reluctance to apply regional anesthesia in this patient group. In addition, pregnancy in a person with achondroplasis poses more problems for anesthetic selection. These problems include potential hypoxia, severely decreased functional residual capacity, risk of gastric aspiration, and supine hypotension. In this case report, we describe the anesthetic management of an achondroplastic dwarf who underwent cesarean delivery.

Reflective action assessment with a prospective clinical problem solving tool in the context of rehabilitation medicine: an illustrative case study.

PubMed

Kellett, David; Mpofu, Elias; Madden, Richard

2013-06-01

This study describes a case formulation approach applying a prospective ICF derived clinical tool to assess rehabilitation needs for a community dwelling stroke survivor with care from an outpatient rehabilitation medicine clinic. Case history data on the person were assessed for rehabilitation management planning using a prospective tool to interlink current with projected future functional status in everyday settings. Implicit assessment with reflective action informed decision points at each stage of the rehabilitation process. As a result of reflective action using the prospective tool, rehabilitation management led to significant changes in client participation after limitations to mobility and self care were mapped to the living conditions of the stroke survivor. The context sensitive rehabilitative plan resulted in higher subjective health-related quality of life in the stroke survivor and significant other and enhanced their capacity for participation. Reflective action informed assessment applying ICF concepts to clinical problem solving resulted in positive gains in health-related quality of life in a stroke survivor.

Consensus oriented fuzzified decision support for oil spill contingency management.

PubMed

Liu, Xin; Wirtz, Kai W

2006-06-30

Studies on multi-group multi-criteria decision-making problems for oil spill contingency management are in their infancy. This paper presents a second-order fuzzy comprehensive evaluation (FCE) model to resolve decision-making problems in the area of contingency management after environmental disasters such as oil spills. To assess the performance of different oil combat strategies, second-order FCE allows for the utilization of lexical information, the consideration of ecological and socio-economic criteria and the involvement of a variety of stakeholders. On the other hand, the new approach can be validated by using internal and external checks, which refer to sensitivity tests regarding its internal setups and comparisons with other methods, respectively. Through a case study, the Pallas oil spill in the German Bight in 1998, it is demonstrated that this approach can help decision makers who search for an optimal strategy in multi-thread contingency problems and has a wider application potential in the field of integrated coastal zone management.

Interdisciplinarity in an Era of New Public Management: A Case Study of Graduate Business Schools

ERIC Educational Resources Information Center

Ryan, Suzanne; Neumann, Ruth

2013-01-01

In an era of rapid knowledge transmission and creation spurred on by advances in technology and globalisation, calls for interdisciplinarity to solve "wicked" problems are common. In the same era, universities are increasingly adopting new public management practices. The extent to which these practices affect knowledge production is an…

The Use of Mindfulness to Enhance a Special Educator's Self-Efficacy: A Qualitative Case Study

ERIC Educational Resources Information Center

Kynaston, Kristina

2017-01-01

The problem addressed in this study was that few special educators have strategies to cope with the stressors of teaching, building self-efficacy, and managing classroom behavior. Special educators who work with students who have disabilities have unique needs when it comes to behavior management, building classroom community, and increasing…

Integrating Academic Management with Business Planning Activities: The Case of University of Education, Winneba (UEW), Ghana

ERIC Educational Resources Information Center

Owusu-Ansah, Collins; Afful, Deborah

2015-01-01

Currently, public universities are facing chronic problem of underfunding. In a bid to explore more alternative and innovative ways of addressing such underfunding challenges, authorities of universities have sought to inject business activities into the management of the universities. They are now forced to search for additional sources of income…

The Entrepreneurial Experience: Confronting Career Dilemmas of the Start-up Executive. The Jossey-Bass Management Series.

ERIC Educational Resources Information Center

Dyer, W. Gibb, Jr.

This book presents the personal, professional, and family dilemmas that entrepreneurs face at each stage of their careers and discusses strategies to manage such problems successfully. The material was gathered in the following ways: (1) interviews with 14 entrepreneurs; (2) 70 case studies of entrepreneurial firms; (3) analysis of biographies of…

Management Strategies for Hydrocephalus in Alobar Holoprosencephaly: A Case Report and Discussion.

PubMed

Sarica, Can; Yucetas, Cem; Ozen, Ali; Ucler, Necati; Konca, Capan; Akar, Selahattin

2018-06-14

Holoprosencephaly is a rare congenital malformation resulting from an impaired midline division of the prosencephalon into distinct cerebral hemispheres. Hydrocephalus is a frequent problem among the few survivors with alobar holoprosencephaly (aHPE), its most severe form. The literature about neurosurgical management of hydrocephalus in this condition is limited and dispersed, and there are still some points that need to be resolved. We report the case of a newborn with aHPE, hydrocephalus, and central diabetes insipidus. We delineate the complexity of the management of these patients and emphasize the benefits of using an initial programmable shunt valve. Further discussion about management strategies includes reviewing previous reports and the benefits of shunting for hypothalamic osmoreceptor function. © 2018 S. Karger AG, Basel.

Sequential decision making in computational sustainability via adaptive submodularity

USGS Publications Warehouse

Krause, Andreas; Golovin, Daniel; Converse, Sarah J.

2015-01-01

Many problems in computational sustainability require making a sequence of decisions in complex, uncertain environments. Such problems are generally notoriously difficult. In this article, we review the recently discovered notion of adaptive submodularity, an intuitive diminishing returns condition that generalizes the classical notion of submodular set functions to sequential decision problems. Problems exhibiting the adaptive submodularity property can be efficiently and provably near-optimally solved using simple myopic policies. We illustrate this concept in several case studies of interest in computational sustainability: First, we demonstrate how it can be used to efficiently plan for resolving uncertainty in adaptive management scenarios. Secondly, we show how it applies to dynamic conservation planning for protecting endangered species, a case study carried out in collaboration with the US Geological Survey and the US Fish and Wildlife Service.

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.

Perioperative management of paraganglioma and catecholamine-induced cardiomyopathy in child- a case report and review of the literature.

PubMed

Jia, Xixi; Guo, Xiangyang; Zheng, Qing

2017-10-17

Paragangliomas are catecholamine-secreting tumors of the paraganglia. Perioperative mortality of children with paraganglioma is high, but preoperative therapy and anesthetic management of paraganglioma resection are controversial in children. The literatures on catecholamine-induced cardiomyopathy are limited to several case reports,with few reports of studies on children. Here we report the anesthetic management of a child with paraganglioma and catecholamine-induced cardiomyopathy, and the possible perioperative anesthesia problems of the paraganglioma resection are discussed. Preoperative and intraoperative anesthetic management of Pheochromocytomas children should follow the same principles as for adults, The most important aspects are the control of blood pressure liability and maintenance of adequate blood volume. Pheochromocytomas patient may have cardiomoyopathy due to myocardial toxicity of excessive circulating catecholamines level. The perioperative management of catecholamine-induced cardiomyopathy should include lowering sympathetic activation by means of α-and β-adrenergic receptor blocker and diuretics administration in case of volume overload.

Orthodontic management of bilateral maxillary canine-first premolar transposition and bilateral agenesis of maxillary lateral incisors: a case report.

PubMed

Di Palma, Elena; Di Giuseppe, Biagio; Tepedino, Michele; Chimenti, Claudio

2015-01-01

Maxillary canine-first premolar transposition (Mx.C.P1) is an uncommon dental positional anomaly that may create many orthodontic problems from both esthetic and functional points of view. In this report we show the orthodontic management of a case of Mx.C.P1 associated with bilateral maxillary lateral incisor agenesis and unilateral mandibular second premolar agenesis The patient was treated with a multibracket appliance and the extraction of the lower premolar. treatment was completed without the need for any prosthetic replacement.

Water Resources Research Grant Program project descriptions, fiscal year 1986

USGS Publications Warehouse

,

1986-01-01

Information is presented on the 43 projects funded by the United States Geological Survey 's Water Resources Grant Program in fiscal year 1986. The report gives the grant number; project title; performing organization; principal investigator(s); dates; and a project description which includes (1) identification of the water related problems and problem-solution approach, (2) contribution to problem solution, (3) objectives, (4) approach, and (5) result users. The 43 projects include 14 in the area of groundwater management, 6 in surface-water management, 2 in systems-operating/planning, 3 in irrigation management, 8 in desalination/reuse, 6 in economic/institutional studies, and 4 in climate variability. The reports contain tables showing (1) funding according to research topic, (2) projects funded to type of submitting organization, (3) proposals received, research topic, and funding levels, and (4) submitting organization. A comparison is given to fiscal year 1985 in each case. (USGS)

Participative management in health care services.

PubMed

Muller, M

1995-03-01

The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalization of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management. A continuum of interactive decision-making and problem-solving is described, the different role-players involved, as well as the levels of interactive decision-making and problem-solving. The most appropriate decision-making strategy should be employed in pro-active and reactive decision-making. Applicable principles and assumptions in each element of participative management is described. It is recommended that this proposed model for participative management be refined by means of a literature control, interactive dialogue with experts and a model case description or participative management, to ensure the trustworthiness of this research.

Effect of case management on glycemic control and behavioral outcomes for chinese people with type 2 diabetes: A 2-year study.

PubMed

Yuan, Xiaodan; Wang, Fengmei; Fish, Anne Folta; Xue, Cunyi; Chen, Tao; Liu, Chao; Lou, Qingqing

2016-08-01

To examine the effect of case management on glycemic control and behavioral outcomes in adults with Type 2 diabetes in China. Participants were randomly assigned to a 1-year case management (CM) group (n=60) or control group (n=60). Monthly case management visits included identifying individuals' diabetes-related problems, setting goals, planning self-care, and evaluating progress. During a 1-year follow-up, all participants attended visits every 3 months without intervention. In the CM vs. the control group, HbA1c was reduced at 6 months compared to baseline (P=0.034), with trends at 12 and 24 months, and empowerment ability improved (P<0.05). Also in the CM vs. controls, total self-care behaviors, the frequency of exercise, blood glucose testing, and foot care were higher (P<0.001) at 12 months, and the percentage of individuals with HbA1c ≤7.0% was higher (P=0.035) at 24 months. The case management intervention in China was effective at 6 months and, based on trends in HbA1c at 12 and 24 months and results for behavioral outcomes, the intervention shows promise and warrants more research. A case management approach can enhance behavior change and glycemic control in Chinese with diabetes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Case Report: Severe Imported Influenza Infections Developed during Travel in Reunion Island.

PubMed

Allyn, Jérôme; Brottet, Elise; Antok, Emmanuel; Dangers, Laurence; Persichini, Romain; Coolen-Allou, Nathalie; Roquebert, Bénédicte; Allou, Nicolas; Vandroux, David

2017-12-01

We report two cases of severe influenza infection imported by tourist patients from their country of origin and developed during travel. While studies have reported cases of influenza infections acquired during travel, here we examine two cases of severe influenza infection contracted in the country of origin that led to diagnosis and therapeutic problems in the destination country. No international recommendation exists concerning influenza vaccination before travel, and few countries recommend it for all travelers. Our study suggests that travel should be canceled when infectious signs are observed before departure. Influenza is a very common infection that is often benign, but sometimes very severe. The most severe cases include shock, acute respiratory distress syndrome (ARDS), myocarditis, rhabdomyolysis, and multiple organ failure. Management can require exceptional therapies, such as extracorporeal membrane oxygenation. A number of studies have focused on influenza infection in travelers. Cases of influenza acquired during travel have been reported in this literature, but no study has examined cases of influenza imported from the country of origin and developed while abroad. The latter situation may lead to 1) diagnostic problems during the nonepidemic season or in places where diagnostic techniques are lacking and 2) therapeutic difficulties resulting from the unavailability of techniques for the management of severe influenza infection in tourist areas. Here, we report two cases of extremely severe influenza infection imported by tourists from their country of origin and developed during travel.

Caregiver Stress and Physical Health: The Case for Stress Management Therapy

ERIC Educational Resources Information Center

Long, C.; Krisztal, E.; Rabinowitz, Y.; Gillispie, Z.; Oportot, M.; Tse, C.; Singer, L.; Gallagher-Thompson, D.

2004-01-01

It is well known that providing care for a loved one with memory problems puts a person at risk for both mental and physical health problems. In the last several decades, research on chronic stress suggests that the body's physical response to stress becomes severely dysregulated as a result of chronic stress lifestyles such as caregiving. This…

A New Computational Technique for the Generation of Optimised Aircraft Trajectories

NASA Astrophysics Data System (ADS)

Chircop, Kenneth; Gardi, Alessandro; Zammit-Mangion, David; Sabatini, Roberto

2017-12-01

A new computational technique based on Pseudospectral Discretisation (PSD) and adaptive bisection ɛ-constraint methods is proposed to solve multi-objective aircraft trajectory optimisation problems formulated as nonlinear optimal control problems. This technique is applicable to a variety of next-generation avionics and Air Traffic Management (ATM) Decision Support Systems (DSS) for strategic and tactical replanning operations. These include the future Flight Management Systems (FMS) and the 4-Dimensional Trajectory (4DT) planning and intent negotiation/validation tools envisaged by SESAR and NextGen for a global implementation. In particular, after describing the PSD method, the adaptive bisection ɛ-constraint method is presented to allow an efficient solution of problems in which two or multiple performance indices are to be minimized simultaneously. Initial simulation case studies were performed adopting suitable aircraft dynamics models and addressing a classical vertical trajectory optimisation problem with two objectives simultaneously. Subsequently, a more advanced 4DT simulation case study is presented with a focus on representative ATM optimisation objectives in the Terminal Manoeuvring Area (TMA). The simulation results are analysed in-depth and corroborated by flight performance analysis, supporting the validity of the proposed computational techniques.

VOP memory management in MPEG-4

NASA Astrophysics Data System (ADS)

Vaithianathan, Karthikeyan; Panchanathan, Sethuraman

2001-03-01

MPEG-4 is a multimedia standard that requires Video Object Planes (VOPs). Generation of VOPs for any kind of video sequence is still a challenging problem that largely remains unsolved. Nevertheless, if this problem is treated by imposing certain constraints, solutions for specific application domains can be found. MPEG-4 applications in mobile devices is one such domain where the opposite goals namely low power and high throughput are required to be met. Efficient memory management plays a major role in reducing the power consumption. Specifically, efficient memory management for VOPs is difficult because the lifetimes of these objects vary and these life times may be overlapping. Varying life times of the objects requires dynamic memory management where memory fragmentation is a key problem that needs to be addressed. In general, memory management systems address this problem by following a combination of strategy, policy and mechanism. For MPEG4 based mobile devices that lack instruction processors, a hardware based memory management solution is necessary. In MPEG4 based mobile devices that have a RISC processor, using a Real time operating system (RTOS) for this memory management task is not expected to be efficient because the strategies and policies used by the ROTS is often tuned for handling memory segments of smaller sizes compared to object sizes. Hence, a memory management scheme specifically tuned for VOPs is important. In this paper, different strategies, policies and mechanisms for memory management are considered and an efficient combination is proposed for the case of VOP memory management along with a hardware architecture, which can handle the proposed combination.

Global Lakes Sentinel Services: Monitoring Water Quality Trends in Deep, Clear Lakes to Detect Causes and Effects of Changes in Trophic Status

NASA Astrophysics Data System (ADS)

Poser, Kathrin; Peters, Steef; Hommersom, Annelies; Giardino, Claudia; Bresciani, Mariano; Cazzaniga, Ilaria; Schenk, Karin; Heege, Thomas; Philipson, Petra; Ruescas, Ana; Bottcher, Martin; Stelzer, Kerstin

2015-12-01

The GLaSS project develops a prototype infrastructure to ingest and process large amounts of Sentinel-2 and Sentinel-3 data for lakes and reservoirs. To demonstrate the value of satellite observations for the management of aquatic ecosystems, global case studies are performed addressing different types of lakes with their respective problems and management questions. One of these case studies is concentrating on deep clear lakes worldwide. The aim of this case study is to evaluate trends of chlorophyll-a concentrations (Chl-a) as a proxy of the trophic status based on the MERIS full resolution data archive. Some preliminary results of this case study are presented here.

An Etiological Approach to Sexual Offender Assessment: CAse Formulation Incorporating Risk Assessment (CAFIRA).

PubMed

Craig, Leam A; Rettenberger, Martin

2018-05-19

Case formulations (CF) have been the cornerstone of effective practice in clinical psychology since the 1950s and now form one of the core competencies in clinical and forensic assessment. The use of CFs within forensic settings is becoming more relevant when working with offenders who have experienced significant trauma, suffered from personality disorder, and have displayed sexually abusive behavior. Furthermore, most North American and European jurisdictions insist that expert witnesses adopt an idiosyncratic approach to risk assessment and consider the characteristics of the individual as part of a wider formulation of the problem behavior. This article focuses specifically on CF incorporating risk assessment procedures of sexual offenders. While empirical support for the use of risk analysis and formulation in managing offending behavior generally, and sexual offending behavior in particular, is limited, there is mounting evidence to suggest that CF can improve understanding of an individual's problem sexual behaviors. We argue that by integrating risk formulations into the CF provides a conceptually robust link between the etiologically development of the problem sexual behavior and effective assessment and risk management of sexual offenders. As forensic treatment programs increasingly moved toward strength-based approaches, in keeping with the Risk-Need-Responsivity principles Andrews and Bonta (2004), and the Good Lives Model Ward and Stewart (Prof Psychol Res Pract 34:353-60, 2003) of offender rehabilitation, the use of CFs in the assessment, treatment, and management of sexual offenders is indispensable. We present an etiological framework for understanding risk in an individual sexual offender by integrating a case formulation model to include the use of (static, stable, and acute) actuarial and clinical risk assessment measures as well as protective risk factors, referred to as the CAse Formulation Incorporating Risk Assessment (CAFIRA) model.

Students' Research Experiences during Consulting Projects: Three Themes Emerging from Case Studies

ERIC Educational Resources Information Center

Phillips, Carissa M. Holler

2010-01-01

Student consulting projects, an advanced form of problem-based learning, allow students to apply the skills developed in their classes on behalf of client organizations. A review of selected case studies in business education and other management education literature shows that research is an integral part of this consulting process. More than…

Assessing the Value of Educational Competencies of Healthcare Leaders and Organizational Factors: A Case Study Analysis

ERIC Educational Resources Information Center

Munz, James A.

2017-01-01

This qualitative research study addressed the problem that the healthcare industry has no clear evidence of the academic competencies that influence the attainment of organizational success. The study was based on one case study at a Commission on Accreditation of Healthcare Management Education (CAHME) accredited Masters of Health Administration…

Typhoid and dengue coinfection: case reports.

PubMed

Bansal, Rohit; Bansal, Priya; Tomar, Laxmikant Ramkumarsingh

2015-01-01

Both dengue and typhoid fever have emerged as major public health problems in India. Coinfection with both these diseases is rarely reported. Here we report two confirmed cases of concurrent illness of dengue with typhoid fever; both patients were managed as outpatients and recovered completely. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Contingency contracting with school problems

PubMed Central

Cantrell, Robert P.; Cantrell, Mary Lynn; Huddleston, Clifton M.; Wooldridge, Ralph L.

1969-01-01

Contingency contracting procedures used in managing problems with school-age children involved analyzing teacher and/or parental reports of behavior problem situations, isolating the most probable contingencies then in effect, the range of reinforcers presently available, and the ways in which they were obtained. The authors prepared written contracts delineating remediative changes in reinforcement contingencies. These contracts specified ways in which the child could obtain existing individualized reinforcers contingent upon approximations to desired appropriate behaviors chosen as incompatible with the referral problem behaviors. Contract procedures were administered by the natural contingency managers, parents and/or teachers, who kept daily records of contracted behaviors and reinforcers. These records were sent to the authors and provided feedback on the progress of the case. Initial results of this procedure have been sufficiently encouraging to warrant recommending an experimental analysis of contingency contracting as a clinical method. PMID:16795222

A Study on Governance and Human Resources for Cooperative Road Facilities Management

NASA Astrophysics Data System (ADS)

Ohno, Sachiko; Takagi, Akiyoshi; Kurauchi, Fumitaka; Demura, Yoshifumi

Within today's infrastructure management, Asset Management systems are becoming a mainstream feature. For region where the risk is low, it is necessary to create a "cooperative road facilities management system". This research both examined and suggested what kind of cooperative road facilities management system should be promoted by the regional society. Concretely, this study defines the operational realities of a previous case. It discusses the problem of the road facilities management as a governance. Furthermore, its realization depends on "the cooperation between municipalities", "the private-sector initiative", and "residents participation" .Also, it discusses the problem of human resources for governance. Its realization depends on "the engineers' promotion", and "creation of a voluntary activity of the resident" as a human resources. Moreover, it defines that the intermediary is important because the human resources tied to the governance. As a result, the prospect of the road facilities management is shown by the role of the player and the relation among player.

A virtual patient software program to improve pharmacy student learning in a comprehensive disease management course.

PubMed

Douglass, Mark A; Casale, Jillian P; Skirvin, J Andrew; DiVall, Margarita V

2013-10-14

To implement and assess the impact of a virtual patient pilot program on pharmacy students' clinical competence skills. Pharmacy students completed interactive software-based patient case scenarios embedded with drug-therapy problems as part of a course requirement at the end of their third year. Assessments included drug-therapy problem competency achievement, performance on a pretest and posttest, and pilot evaluation survey instrument. Significant improvements in students' posttest scores demonstrated advancement of clinical skills involving drug-therapy problem solving. Students agreed that completing the pilot program improved their chronic disease management skills and the program summarized the course series well. Using virtual patient technology allowed for assessment of student competencies and improved learning outcomes.

Interorganizational transfer of technology - A study of adoption of NASA innovations

NASA Technical Reports Server (NTRS)

Chakrabarti, A. K.; Rubenstein, A. H.

1976-01-01

The paper describes a study on the effects of top management support, various techno-economic factors, organizational climate, and decision-making modes on the adoption of NASA innovations. Field research consisted of interviews and questionnaires directed to sixty-five organizations. Forty-five test cases where different decisions for adoption of ideas for new products or processes were made on NASA Tech Briefs were studied in relation to the effects of various factors on the degree of success of adoption, including: (1) the degree of general connection of the technology to the firm's existing operation, (2) the specificity of the relationship between the technology and some existing and recognized problem, (3) the degree of urgency of the problem to which the technology was related, (4) maturity of technology available to implement the technology, (5) availability of personnel and financial resources to implement the technology, (6) degree of top management interest, (7) the use of confrontation in joint-decision, (8) the use of smoothing in decision-making, and (9) the use of forcing in decision-making. It was found that top managements interest was important in the product cases only, and that the success of process innovations was dependent on the quality of information and the specificity of the relationship between the technology and some recognized existing problem.

Case vignettes of movement disorders.

PubMed

Yung, C Y

1983-08-01

This paper reports five movement disorders cases to serve as a basis for discussion of the problems encountered in the clinical management of these cases, and the pathophysiological mechanisms involved in these disorders as presented. Case 1 is a description of the subjective experience of a patient with acute orofacial dystonia from promethazine. Case 2 is the use of clonazepam is post-head injury tics. Case 3 is the complication from discontinuation of haloperidol and benztropine mesylate treatment. Case 4 is myoclonus in subacute sclerosing Panencephalitis, and Case 5 is rebound tremor from withdrawal of a beta-adrenergic blocker.

Urban containment policies and the protection of natural areas: the case of Seoul's greenbelt

Treesearch

David N. Bengston; Yeo-Chang Youn

2006-01-01

Countries around the world have responded to the problems associated with rapid urban growth and increasingly land-consumptive development patterns by creating a wide range of policy instruments designed to manage urban growth. Of the array of growth management techniques, urban containment policies are considered by some to be a promising approach. This paper focuses...

Curriculum Issues in the Relationship between Language, Culture and Learning: The Case of Food and Beverage Management Teaching.

ERIC Educational Resources Information Center

Sutton, John; Tse, Peter S. M.

1997-01-01

Hotel management students in Hong Kong (n=65) reported that foundation courses were essential to their careers, but 61% had problems understanding the curriculum. Causes were cultural differences in food styles and/or the fact that most Cantonese-speaking students were learning in their second language (English) and most of the multicultural…

[Chronic fatigue syndrome: from misunderstood illness to cause of job fitness management problem and of work total disability in a physiotherapist. Case report].

PubMed

Belotti, L; Bigoni, F; Pezzoli, F; Mosconi, G

2007-01-01

The aim of this paper is to report the case of a Physiotherapist working in a big hospital, affected by Chronic Fatigue Syndrome (CFS). After the diagnosis, made in an High Specialized Center, the Occupational Health Physician, with the cooperation of the Nursing Managing Direction, the Chief of the Department of Rehabilitation and the Physiotherapists Coordinator, had to cope with the job fitness management. Afterwards the patient, in accordance with the Physician of a Trade Union Medical Office and the Occupational Health Physician, tried to obtain the disability pension, that at the end was given by the Medical Commission of the ASL.

A new approach to design and use of management information.

PubMed

Daft, R L; MacIntosh, N B

1978-01-01

Information, that is both accurate and timely, is probably the most important resource needed by managers to make sound decisions regarding the problems and issues facing their organizations. Unfortunately, sophisticated information systems often fail to meet this need. Managers complain that the data produced by information systems arrive too late, are too general and lack accuracy. Daft and MacIntosh studied the system problems of a number of organizations, discovering that understanding their work activities is critical to the design of successful information systems. The authors also considered the volume of information, preciseness of information and the way in which it is handled by users to develop a model describing information systems. The article illustrates how the model was applied successfully to four case situations.

Using an Ishikawa diagram as a tool to assist memory and retrieval of relevant medical cases from the medical literature.

PubMed

Wong, Kam Cheong

2011-03-29

Studying medical cases is an effective way to enhance clinical reasoning skills and reinforce clinical knowledge. An Ishikawa diagram, also known as a cause-and-effect diagram or fishbone diagram, is often used in quality management in manufacturing industries.In this report, an Ishikawa diagram is used to demonstrate how to relate potential causes of a major presenting problem in a clinical setting. This tool can be used by teams in problem-based learning or in self-directed learning settings.An Ishikawa diagram annotated with references to relevant medical cases and literature can be continually updated and can assist memory and retrieval of relevant medical cases and literature. It could also be used to cultivate a lifelong learning habit in medical professionals.

Models of Shelter Management Training and Delivery Systems.

DTIC Science & Technology

1980-05-31

case study can be pre- sented orally, in writing, through a dramatization, or on film. Advantages: the case can be designed to focus on a problem or...develop a good, complex case study ; it may not be possible to use a case with more than one group (Ax & Kohls, 1977; Bauman, 1977; U.S. Civil Service...Although public information on self-protection continued to be distributed, the shelter program remained incomplete (e.g., an AIR study in 1966 noted that

[Primary carcinoma of the thyroid growing in thyroglossal duct cyst: presentation of two cases].

PubMed

Godlewska, Paulina; Bruszewska, Elzbieta; Kozłowicz-Gudzińska, Izabella; Prokurat, Andrzej I; Chrupek, Małgorzata; Zegadło-Mylik, Maria A; Kluge, Przemysław

2007-01-01

Thyroglossal duct remnants (TGDR), most often cysts, are the most common type of developmental abnormalities of the thyroid gland. In about 1 to 2% of TGDR neoplastic transformation occurs. Papillary carcinoma of the thyroid may be encountered in over 90% of such cases. Two cases of primary papillary carcinoma of the thyroid in TGDR in young girls are presented. The diagnostic and therapeutic problems are shared, and up-to-date management guidelines in similar cases are discussed.

[Female incontinence surgery: state of the art].

PubMed

Marson, Francesco; Ammirati, Enrico; Gurioli, Alberto; Destefanis, Paolo; Gontero, Paolo; Frea, Bruno

2015-01-01

Female urinary incontinence represents a medical and social problem with huge impact regarding both patient's quality of life and social costs. The diagnosis is important for therapeutic choice and should consider some factors: the degree of urethral mobility, urodynamics parameters, patient's will and expectations, information about surgical complications and risks. Nowadays suburethral sling evolution and bulking therapy for selected cases consent to perform miniinvasive surgery; the most relevant problem concerns the management of postoperative complications: in this sense autologous slings are used after urethrolisis. In most difficult cases, it is possible to consider artificial sphincter as the best option.

[Lyme-Arthritis--a case report].

PubMed

von Ameln-Mayerhofer, Andreas

2016-05-01

Lyme disease is a serious infectious disease which, if untreated, does not recover and leads to further complications that might be severe. This exemplary case report describes a possible secondary Borrelia infection. It underlines that early antibiotic therapy in the correct dosage is essential. Furthermore, problems are discussed that might occur in context of the decision process concerning the best antibiotic substance and the optimal application route. Last but not least, possible problems associated with the discharge from hospital are discussed. In conclusion, early diagnosis together with an on-time optimal antibiotic therapy are fundamental in the clinical management of Lyme disease.

The effectiveness of collaborative care for people with memory problems in primary care: results of the CAREDEM case management modelling and feasibility study.

PubMed

Iliffe, Steve; Waugh, Amy; Poole, Marie; Bamford, Claire; Brittain, Katie; Chew-Graham, Carolyn; Fox, Chris; Katona, Cornelius; Livingston, Gill; Manthorpe, Jill; Steen, Nick; Stephens, Barbara; Hogan, Vanessa; Robinson, Louise

2014-08-01

People with dementia and their families need support in different forms, but currently services are often fragmented with variable quality of care. Case management offers a way of co-ordinating services along the care pathway and therefore could provide individualised support; however, evidence of the effectiveness of case management for dementia is inconclusive. To adapt the intervention used in a promising case management project in the USA and test its feasibility and acceptability in English general practice. In work package 1, a design group of varied professionals, with a carer and staff from the voluntary sector, met six times over a year to identify the skills and personal characteristics required for case management; protocols from the US study were adapted for use in the UK. The feasibility of recruiting general practices and patient-carer dyads and of delivering case management were tested in a pilot study (work package 2). An embedded qualitative study explored stakeholder views on study procedures and case management. Four general practices, two in the north-east of England (Newcastle) one in London and one in Norfolk, took part in a feasibility pilot study of case management. Community-dwelling people with dementia and their carers who were not already being case managed by other services. A social worker shared by the two practices in the north-east and practice nurses in the other two practices were trained to deliver case management. We aimed to recruit 11 people with dementia from each practice who were not already being case managed. Numbers of people with dementia and their carers recruited, numbers and content of contacts, needs identified and perceptions of case management among stakeholders. Recruitment of practices and patients was slow and none of the practices achieved its recruitment target. It took more than 6 months to recruit a total of 28 people with dementia. Practice Quality and Outcome Framework registers for dementia contained only 60% of the expected number of people, most living in care homes. All stakeholders were positive about the potential of case management; however, only one of the four practices achieved a level of case management activity that might have influenced patient and carer outcomes. Case managers' activity levels were not related solely to time available for case management. Delivery of case management was hindered by limited clarity about the role, poor integration with existing services and a lack of embeddedness within primary care. There were discrepancies between case manager and researcher judgements about need, and evidence of a high threshold for acting on unmet need. The practice nurses experienced difficulties in ring-fencing case management time. The model of case management developed and evaluated in this feasibility study is unlikely to be sustainable in general practice under current conditions and in our view it would not be appropriate to attempt a definitive trial of this model. This study could inform the development of a case management role with a greater likelihood of impact. Different approaches to recruiting and training case managers, and identifying people with dementia who might benefit from case management, are needed, as is exploration of the scale of need for this type of working. Current Controlled Trials ISRCTN74015152. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 18, No. 52. See the NIHR Journals Library website for further project information.

The Design of an Information Management Program for Headquarters, Department of the Army. Phase 2. Detailed Report.

DTIC Science & Technology

1980-02-26

information management problems identified by Arthur Young & Companyt , Phase I and Phase II study for Headquarters, Department of the Army. The discussions...current HQDA operations were conducted to allow Arthur Young & Company to determine what is needed and what is feasible for managing HQDA’s information...answering these inquiries, and what costs were involved in satisfying the information request. The selection of individual case studies was based upon

Developing Collaboration in Complex Events: A Model for Civil-Military Inter-Organizational Problem-Solving and Decision-Making

DTIC Science & Technology

2011-06-01

2009, p.2). Given the wide adoption of principles and structures associated with the Incident Command System (ICS) in emergency management , it was...relationships in disaster response but also the factors that might lead to a more effective response and management . The cases were analysed...team was guided by the following considerations: 1. Use of an extended timeline – The model was conceptualized within a risk management paradigm in

Teleconsultation in paediatric orthopaedics in Djibouti: evaluation of response performance.

PubMed

Bertani, A; Launay, F; Candoni, P; Mathieu, L; Rongieras, F; Chauvin, F

2012-11-01

Djibouti has no paediatric orthopaedics department and three options are available for difficult cases: transfer of the patient to another country; overseas mission transfer to Djibouti by a specialised surgical team; and management by a local orthopaedic surgeon receiving guidance from an expert. The extreme poverty of part of the population of Djibouti often precludes the first two options. Telemedecine can allow the local orthopaedic surgeon to receive expert advice. HYPOTHESES AND STUDY DESIGN: We prospectively recorded all the paediatric orthopaedics teleconsultations that occurred between November 2009 and November 2011. Our objective was to assess the performance of the teleconsultations. We hypothetized that this option was influential in decision making. We assessed the influence of the teleconsultation on patient management (i.e., change in the surgical indication and/or procedure). We then used the electronic patient records to compare the actual management to that recommended retrospectively by two independent orthopaedic surgeon consultants who had experience working overseas. Finally, we assessed the clinical outcomes in the patients. Of 48 teleconsultations for 39 patients, 13 dealt with diagnostic problems and 35 with therapeutic problems. The teleconsultation resolved the diagnostic uncertainties in 90% of cases. Advice from the expert modified the management in 37 (77%) teleconsultations; the change was related to the surgical indication in 18 cases, the surgical technique in 13 cases, and both in six cases. Agreement between the advice from the independent consultants and the treatment delivered by the local surgeon was 2.2/3. Clinical outcomes were good or very good in 31 (81%) of the 38 treated patients. This study establishes the feasibility and usefulness of paediatric orthopaedics teleconsultations in Djibouti. The introduction of telemedicine has changed our approach to challenges raised by patients in remote locations or precarious situations. Input from experts considerably benefits patient management. III, prospective comparative study. Copyright © 2012. Published by Elsevier Masson SAS.

Management of unerupted maxillary deciduous central incisor: a case report.

PubMed

Shakra, Karam Abu

2014-01-01

Failure of eruption of primary teeth can be considered rare, especially in maxillary anterior teeth. The problem can be either mechanical obstruction of eruption or a failure of the eruption mechanism. This case report presents failure of eruption of the maxillary right deciduous central incisor in a 4-year-old girl. The unerupted primary tooth was removed surgically. The histological finding revealed fibroma with reactive giant cells. Periodic follow-up visits were advised to monitor the developing dentition and to ensure enough space for the permanent incisor. How to cite this article: Shakra KA. Management of Unerupted Maxillary Deciduous Central Incisor: A Case Report. Int J Clin Pediatr Dent 2014;7(1):58-60.

Complete remission of plantar fasciitis with a gluten-free diet: relationship or just coincidence?

PubMed

Paoloni, Marco; Tavernese, Emanuela; Ioppolo, Francesco; Fini, Massimo; Santilli, Valter

2014-09-01

We report the case of a 46-year-old woman with no known history for gluten sensitivity who presented severe heel pain, and was successfully managed with a gluten-free diet. Previously she had been unsuccessfully treated with several conservative remedies. The presence of musculoskeletal problems in patients with gluten sensitivity is not rare. To the best of our knowledge, however, this is the first case report mentioning the successful management of plantar fasciitis with a gluten-free diet. The case report highlights the importance of considering gluten sensitivity among other possible differential diagnosis for musculoskeletal pain insensitive to traditional therapies. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

PubMed

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

2015-01-01

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

Internet of things and Big Data as potential solutions to the problems in waste electrical and electronic equipment management: An exploratory study.

PubMed

Gu, Fu; Ma, Buqing; Guo, Jianfeng; Summers, Peter A; Hall, Philip

2017-10-01

Management of Waste Electrical and Electronic Equipment (WEEE) is a vital part in solid waste management, there are still some difficult issues require attentionss. This paper investigates the potential of applying Internet of Things (IoT) and Big Data as the solutions to the WEEE management problems. The massive data generated during the production, consumption and disposal of Electrical and Electronic Equipment (EEE) fits the characteristics of Big Data. Through using the state-of-the-art communication technologies, the IoT derives the WEEE "Big Data" from the life cycle of EEE, and the Big Data technologies process the WEEE "Big Data" for supporting decision making in WEEE management. The framework of implementing the IoT and the Big Data technologies is proposed, with its multiple layers are illustrated. Case studies with the potential application scenarios of the framework are presented and discussed. As an unprecedented exploration, the combined application of the IoT and the Big Data technologies in WEEE management brings a series of opportunities as well as new challenges. This study provides insights and visions for stakeholders in solving the WEEE management problems under the context of IoT and Big Data. Copyright © 2017 Elsevier Ltd. All rights reserved.

Remain in Your Seats: Crisis Management for the Alumni Travel Director.

ERIC Educational Resources Information Center

Bonenberger, Lynne M.

1991-01-01

Three alumni travel directors offer advice on taking control when tour crises arise. The cases cited involved irresponsible tour agents, problem travelers, and on-location disasters. Both precautions and creative solutions are emphasized. (MSE)

What should the management of incest pregnancies be? An ethical view presented via three cases.

PubMed

Yuksel, B; Kilic, S; Akin Su, F; Tasdemir, N; Uzunlar, O; Mollamahmutoglu, L

2008-01-01

Incest is a taboo and a neglected social problem. Especially in the adolescent population, which is a very sensitive period of development, it becomes harder for the patients to share their secret with either legal or health authorities. Sometimes pregnancy becomes the only vehicle to uncover this secret. There is a contradiction whether their pregnancies should continue or not. Some authors believe abortion is the best choice for the victim to pull herself together, whereas others advocate that it is just another trauma that will not solve the problem but merely hide it. In this report, three paternal incest cases and their pregnancies will be presented. The aim is not only to discuss the different points of view regarding the management of these pregnancies but also to make the clinicians think about the different choices before making a decision.

Linking guidelines to Electronic Health Record design for improved chronic disease management.

PubMed

Barretto, Sistine A; Warren, Jim; Goodchild, Andrew; Bird, Linda; Heard, Sam; Stumptner, Markus

2003-01-01

The promise of electronic decision support to promote evidence based practice remains elusive in the context of chronic disease management. We examine the problem of achieving a close relationship of Electronic Health Record (EHR) content to other components of a clinical information system (guidelines, decision support and workflow), particularly linking the decisions made by providers back to the guidelines. We use the openEHR architecture, which allows extension of a core Reference Model via Archetypes to refine the detailed information recording options for specific classes of encounter. We illustrate the use of openEHR for tracking the relationship of a series of clinical encounters to a guideline via a case study of guideline-compliant treatment of hypertension in diabetes. This case study shows the contribution guideline content can have on problem-specific EHR structure and demonstrates the potential for a constructive interaction of electronic decision support and the EHR.

Linking Guidelines to Electronic Health Record Design for Improved Chronic Disease Management

PubMed Central

Barretto, Sistine A.; Warren, Jim; Goodchild, Andrew; Bird, Linda; Heard, Sam; Stumptner, Markus

2003-01-01

The promise of electronic decision support to promote evidence based practice remains elusive in the context of chronic disease management. We examine the problem of achieving a close relationship of Electronic Health Record (EHR) content to other components of a clinical information system (guidelines, decision support and work-flow), particularly linking the decisions made by providers back to the guidelines. We use the openEHR architecture, which allows extension of a core Reference Model via Archetypes to refine the detailed information recording options for specific classes of encounter. We illustrate the use of openEHR for tracking the relationship of a series of clinical encounters to a guideline via a case study of guideline-compliant treatment of hypertension in diabetes. This case study shows the contribution guideline content can have on problem-specific EHR structure and demonstrates the potential for a constructive interaction of electronic decision support and the EHR. PMID:14728135

Clinical problem solving: monster on the hook--case problems in neurosurgery.

PubMed

Muh, Carrie R; Boulis, Nicholas M; Chandler, William F; Barkan, Ariel L; Mosunjac, Marina B; Oyesiku, Nelson M

2011-03-01

Nonfunctioning and functioning pituitary tumors can present in numerous ways. They may be difficult to diagnose correctly and, even with proper treatment, may lead to complications. We present the case of a patient who presented with a large, invasive sellar mass and underwent both medical and surgical treatment for this lesion. The patient's course did not progress as was expected from his initial workup. The patient's history, physical examination, laboratory values, pathologic specimens, and radiologic findings are discussed. His management before, during, and after medical therapy and surgery is reviewed by pituitary experts from 2 different institutions. Aspects of diagnosis and management of sellar lesions are presented and reviewed in the literature. Neurosurgeons frequently treat patients with sellar lesions and should remember that despite modern laboratory, pathologic, and radiologic techniques, the diagnosis and treatment of these lesions is not always clear.

Epidemiological profile of snake-bite cases from Haryana: A five year (2011-2015) retrospective study.

PubMed

Bhargava, Saurabh; Kaur, Ramanjeet; Singh, Rajvinder

2018-02-01

Varieties of venomous snakes inhabit in the world which accidentally take thousands of human lives every year. This severe medical emergency constantly persuades national and international health agencies to look at efficient epidemiological profiling of snake-bite cases for the proper management of this sympathetic problem. Establishing the accurate database of snake-bite in humans from different localities of India may perhaps lack certainty due to few inevitable reasons such as consideration of this problem as less emergent problem in disparity to pesticide poisoning, difficulty in the accessibility to rural and tribal areas where chances of snake-bite remain ceiling, lack of inspiring models of snake-bite management training, reduced reporting system, and pitiable maintenance of hospital data in India. Therefore, the present modest study was carried out to explore valuable information regarding snake-bite problem in Haryana. Factual data on snake-bite incidences happened from 2011 to 2015 were collected from government hospitals and medical institutes of Haryana. This retrospective study disclosed a few characteristic points related to the frequency of snake-bite cases, gender involved, anti-snake venom (ASV) treatment, and numbers of deaths with snake-bite. Records revealed a total of 6555 cases of snake-bite including 130 deaths reported in Haryana during the study period. A significant variation in the occurrence of snake-bite cases was also recorded in different areas of Haryana. There was a huge database of recorded snake-bite cases from government medical institute but district wise survey disclosed the maximum number of snake-bite incidences, especially amongst males from Panchkula. The present study has provided a more updated and comprehensive record of snake-bite from Haryana during 2011-2015. A huge burden of snake-bite amongst human was found in Haryana; hence, the findings of this study purposely enlighten people about the size of this problem in the selected region. However, this study also remained limited due to lack of information on a few important parameters and availability of homogeneous data. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Problem Formulation in Knowledge Discovery via Data Analytics (KDDA) for Environmental Risk Management

PubMed Central

Li, Yan; Thomas, Manoj; Osei-Bryson, Kweku-Muata; Levy, Jason

2016-01-01

With the growing popularity of data analytics and data science in the field of environmental risk management, a formalized Knowledge Discovery via Data Analytics (KDDA) process that incorporates all applicable analytical techniques for a specific environmental risk management problem is essential. In this emerging field, there is limited research dealing with the use of decision support to elicit environmental risk management (ERM) objectives and identify analytical goals from ERM decision makers. In this paper, we address problem formulation in the ERM understanding phase of the KDDA process. We build a DM3 ontology to capture ERM objectives and to inference analytical goals and associated analytical techniques. A framework to assist decision making in the problem formulation process is developed. It is shown how the ontology-based knowledge system can provide structured guidance to retrieve relevant knowledge during problem formulation. The importance of not only operationalizing the KDDA approach in a real-world environment but also evaluating the effectiveness of the proposed procedure is emphasized. We demonstrate how ontology inferencing may be used to discover analytical goals and techniques by conceptualizing Hazardous Air Pollutants (HAPs) exposure shifts based on a multilevel analysis of the level of urbanization (and related economic activity) and the degree of Socio-Economic Deprivation (SED) at the local neighborhood level. The HAPs case highlights not only the role of complexity in problem formulation but also the need for integrating data from multiple sources and the importance of employing appropriate KDDA modeling techniques. Challenges and opportunities for KDDA are summarized with an emphasis on environmental risk management and HAPs. PMID:27983713

Problem Formulation in Knowledge Discovery via Data Analytics (KDDA) for Environmental Risk Management.

PubMed

Li, Yan; Thomas, Manoj; Osei-Bryson, Kweku-Muata; Levy, Jason

2016-12-15

With the growing popularity of data analytics and data science in the field of environmental risk management, a formalized Knowledge Discovery via Data Analytics (KDDA) process that incorporates all applicable analytical techniques for a specific environmental risk management problem is essential. In this emerging field, there is limited research dealing with the use of decision support to elicit environmental risk management (ERM) objectives and identify analytical goals from ERM decision makers. In this paper, we address problem formulation in the ERM understanding phase of the KDDA process. We build a DM³ ontology to capture ERM objectives and to inference analytical goals and associated analytical techniques. A framework to assist decision making in the problem formulation process is developed. It is shown how the ontology-based knowledge system can provide structured guidance to retrieve relevant knowledge during problem formulation. The importance of not only operationalizing the KDDA approach in a real-world environment but also evaluating the effectiveness of the proposed procedure is emphasized. We demonstrate how ontology inferencing may be used to discover analytical goals and techniques by conceptualizing Hazardous Air Pollutants (HAPs) exposure shifts based on a multilevel analysis of the level of urbanization (and related economic activity) and the degree of Socio-Economic Deprivation (SED) at the local neighborhood level. The HAPs case highlights not only the role of complexity in problem formulation but also the need for integrating data from multiple sources and the importance of employing appropriate KDDA modeling techniques. Challenges and opportunities for KDDA are summarized with an emphasis on environmental risk management and HAPs.

Clinical-outcome-based demand management in health services.

PubMed

Brogan, C; Lawrence, D; Mayhew, L

2008-01-01

THE PROBLEM OF MANAGING DEMAND: Most healthcare systems have 'third-party payers' who face the problem of keeping within budgets despite pressures to increase resources due to the ageing population, new technologies and patient demands to lower thresholds for care. This paper uses the UK National Health Service as a case study to suggest techniques for system-based demand management, which aims to control demand and costs whilst maintaining the cost-effectiveness of the system. The technique for managing demand in primary, elective and urgent care consists of managing treatment thresholds for appropriate care, using a whole-systems approach and costing the care elements in the system. It is important to analyse activity in relation to capacity and demand. Examples of using these techniques in practice are given. The practical effects of using such techniques need evaluation. If these techniques are not used, managing demand and limiting healthcare expenditure will be at the expense of clinical outcomes and unmet need, which will perpetuate financial crises.

Promoting Positive Behavior Using the Good Behavior Game: A Meta-Analysis of Single-Case Research

ERIC Educational Resources Information Center

Bowman-Perrott, Lisa; Burke, Mack D.; Zaini, Samar; Zhang, Nan; Vannest, Kimberly

2016-01-01

The Good Behavior Game (GBG) is a classroom management strategy that uses an interdependent group-oriented contingency to promote prosocial behavior and decrease problem behavior. This meta-analysis synthesized single-case research (SCR) on the GBG across 21 studies, representing 1,580 students in pre-kindergarten through Grade 12. The TauU effect…

75 FR 54378 - Draft Environmental Impact Statement; Stehekin River Corridor Implementation Plan; Lake Chelan...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-07

.... While the COE failed to secure funds to do a detailed five-year study, its emergency management team recommended extensive bank hardening with rock, and dredging of the river channel. Estimated one-time cost is... floods. Until now, the NPS has addressed problems on a case-by-case basis throughout the valley with the...

The Dynamics and Intricacy of Budgeting in Secondary Schools in Lesotho: Case Studies of Three High Schools

ERIC Educational Resources Information Center

Mncube, V. S.; Makhasane, Sekitla

2013-01-01

This paper reports on the qualitative study that used in-depth interviews and document reviews on financial management practices in their schools. The participants were school principals of the case study schools. The findings of the study highlighted problems regarding the implementation of the policy--despite the Manual for Principals of…

Imported chloroquine-resistant Plasmodium vivax in Singapore: case report and literature review.

PubMed

Lim, Poh Lian; Mok, Ying Juan; Lye, David C; Leo, Yee Sin

2010-01-01

Chloroquine-resistant Plasmodium vivax (CRPV) infection is emerging as a clinically significant problem. Detailed travel history is crucial to the management of imported malarial cases. We report a 58-year-old business traveler who returned from Indonesia and experienced relapse due to CRPV. The epidemiology and diagnostic challenges of CRPV for travel medicine clinicians are reviewed.

Epidermis and Enamel

PubMed Central

Barsley, Robert E.; Bernstein, Mark L.; Brumit, Paula C.; Dorion, Robert B.J.; Golden, Gregory S.; Lewis, James M.; McDowell, John D.; Metcalf, Roger D.; Senn, David R.; Sweet, David; Weems, Richard A.

2018-01-01

Abstract Critics describe forensic dentists' management of bitemark evidence as junk science with poor sensitivity and specificity and state that linkages to a biter are unfounded. Those vocal critics, supported by certain media, characterize odontologists' previous errors as egregious and petition government agencies to render bitemark evidence inadmissible. Odontologists acknowledge that some practitioners have made past mistakes. However, it does not logically follow that the errors of a few identify a systemic failure of bitemark analysis. Scrutiny of the contentious cases shows that most occurred 20 to 40 years ago. Since then, research has been ongoing and more conservative guidelines, standards, and terminology have been adopted so that past errors are no longer reflective of current safeguards. The authors recommend a comprehensive root analysis of problem cases to be used to determine all the factors that contributed to those previous problems. The legal community also shares responsibility for some of the past erroneous convictions. Currently, most proffered bitemark cases referred to odontologists do not reach courts because those forensic dentists dismiss them as unacceptable or insufficient for analysis. Most bitemark evidence cases have been properly managed by odontologists. Bitemark evidence and testimony remain relevant and have made significant contributions in the justice system. PMID:29557817

Epidermis and Enamel: Insights Into Gnawing Criticisms of Human Bitemark Evidence.

PubMed

Barsley, Robert E; Bernstein, Mark L; Brumit, Paula C; Dorion, Robert B J; Golden, Gregory S; Lewis, James M; McDowell, John D; Metcalf, Roger D; Senn, David R; Sweet, David; Weems, Richard A

2018-06-01

Critics describe forensic dentists' management of bitemark evidence as junk science with poor sensitivity and specificity and state that linkages to a biter are unfounded. Those vocal critics, supported by certain media, characterize odontologists' previous errors as egregious and petition government agencies to render bitemark evidence inadmissible. Odontologists acknowledge that some practitioners have made past mistakes. However, it does not logically follow that the errors of a few identify a systemic failure of bitemark analysis. Scrutiny of the contentious cases shows that most occurred 20 to 40 years ago. Since then, research has been ongoing and more conservative guidelines, standards, and terminology have been adopted so that past errors are no longer reflective of current safeguards. The authors recommend a comprehensive root analysis of problem cases to be used to determine all the factors that contributed to those previous problems. The legal community also shares responsibility for some of the past erroneous convictions. Currently, most proffered bitemark cases referred to odontologists do not reach courts because those forensic dentists dismiss them as unacceptable or insufficient for analysis. Most bitemark evidence cases have been properly managed by odontologists. Bitemark evidence and testimony remain relevant and have made significant contributions in the justice system.

Case studies in organic contaminant hydrogeology

NASA Astrophysics Data System (ADS)

Baker, John A.

1989-07-01

The effective management of domestic solid waste and hazardous, toxic, and radioactive waste is a major problem in the area of environmental geology and water sciences over the world. This series of case studies of organic contaminants from both solid and hazardous waste disposal facilities provides examples of these problems. The facilities were investigated to determine risks and liabilities before acquisition, to determine the site hydrogeologic conditions for design of appropriate groundwater monitoring plans, and/or to determine the potential for groundwater contamination. The results of these studies and investigations by Waste Management Inc. (WMI) and its consultants have shown certain relationships in the distribution of organic pollutants to the different geologic and hydrogeologic charac teristics of each facility. In each of the case studies, all 129 priority pollutants were analyzed in private wells and/or monitoring wells at the request of regulatory agencies. The 31 volatile organic compounds (VOCs) of the priority pollutant list were the majority of the organic compounds detected and these data are evaluated in each case study. The case studies are on disposal facilities located in glacial tills, carbonaceous weathered clay soils, weathered shale, limestone bedrock, dolomite bedrock, and alluvial and sedimentary deposits. A brief discussion of groundwater quality impacts and remedial measures also is included.

Effectiveness of a coordinated and tailored return-to-work intervention for sickness absence beneficiaries with mental health problems.

PubMed

Martin, Marie H T; Nielsen, Maj Britt D; Madsen, Ida E H; Petersen, Signe M A; Lange, Theis; Rugulies, Reiner

2013-12-01

Sickness absence and exclusion from the labour market due to mental health problems (MHPs) is a growing concern in many countries. Knowledge about effective return-to-work (RTW) intervention models is still limited, but a multidisciplinary, coordinated and tailored approach has shown promising results in the context of musculoskeletal disorders. The purpose of this study was to assess the effectiveness of this approach as implemented among sickness absence beneficiaries with MHPs. In a quasi-randomised, controlled trial, we assessed the intervention's effect in terms of time to RTW and labour market status after 1 year. We used two different analytical strategies to compare time to RTW between participants receiving the intervention (n = 88) and those receiving conventional case management (n = 80): (1) a traditional multivariable regression analysis controlling for measured confounding, and (2) an instrumental variable (IV) analysis controlling for unmeasured confounding. The two analytical approaches provided similar results in terms of a longer time to RTW among recipients of the intervention (HR = 0.50; 95 % CI 0.34-0.75), although the estimate provided by the IV-analysis was non-significant (HR = 0.70; 95 % CI 0.23-2.12). After 1 year, more recipients of the intervention than of conventional case management were receiving sickness absence benefits (p = 0.031). The intervention delayed RTW compared to conventional case management, after accounting for measured confounding. The delayed RTW may be due to either implementation or program failure, or both. It may also reflect the complexity of retaining employees with mental health problems in the workplace.

Exploring representations and experiences of case-management users: towards difficulties and solutions to leading qualitative interviews with older people with complex living conditions.

PubMed

Balard, Frédéric; Corre, Stéphanie Pin Le; Trouvé, Hélène; Saint-Jean, Olivier; Somme, Dominique

2013-01-01

By matching needs to resource services, case management could be a useful tool for improving the care of older people with complex living conditions. Collecting and analysing the users' experiences represents a good way to evaluate the effectiveness and efficiency of a case-management service. However, in the literature, fieldwork is very rarely considered and the users included in qualitative research seem to be the most accessible. This study was undertaken to describe the challenges of conducting qualitative research with older people with complex living conditions in order to understand their experiences with case-management services. Reflective analysis was applied to describe the process of recruiting and interviewing older people with complex living conditions in private homes, describing the protocol with respect to fieldwork chronology. The practical difficulties inherent in this type of study are addressed, particularly in terms of defining a sample, the procedure for contacting the users and conducting the interview. The users are people who suffer from a loss of autonomy because of cognitive impairment, severe disease and/or psychiatric or social problems. Notably, most of them refuse care and assistance. Reflective analysis of our protocol showed that the methodology and difficulties encountered constituted the first phase of data analysis. Understanding the experience of users of case management to analyse the outcomes of case-management services requires a clear methodology for the fieldwork.

Case management by nurses in primary care: analysis of 73 'success stories'.

PubMed

Elwyn, Glyn; Williams, Meryl; Roberts, Catherine; Newcombe, Robert G; Vincent, Judith

2008-01-01

There is interest as to whether case management reduces unplanned patient admission to hospital. However, very little is known about how the intervention is delivered and what the most salient outcome measures are. Qualitative study embedded in a wider evaluation. Primary health care. Analysis of case manager case reports in a service innovation evaluation study. Case management provides home-based care to frail elderly patients using a process of assessment and medication review. This often leads to new diagnoses, to the co-ordination of further care and the tailoring of services to suit the needs of individuals. The benefits reported are complex and relate to improving a patient's quality of life more than the prevention or otherwise of admission to hospital. The type of attention provided by these roles seems to be absent from current NHS arrangements. The role enables time to be spent assessing the individual needs of patients who live at the margins of independent living. The case managers describe having the time and the skills to assess a mix of clinical and social problems, and then accessing the correct networks to help elderly people with multiple illnesses navigate a complex system of providers. More weight should be given to the ability of this intervention to result in improved quality of life for patients, and to the investigation of costs and benefits.

Research and Practice of Uav Remote Sensing in the Monitoring and Management of Construction Projects in Riparian Areas

NASA Astrophysics Data System (ADS)

Yu, J.; Gan, Z.; Zhong, L.; Deng, L.

2018-04-01

The objective of this paper is to investigate the use of UAV remote sensing in the monitoring and management of construction projects in riparian areas through the case study of embankment construction projects' monitoring in the Three Gorges Reservoir area. A three-step approach is proposed to address the problem: data acquisition with UAV, data processing, and monitoring information extraction. The results of the case study demonstrate that UAV remote sensing is capable of providing fast and accurate measurements and calculations for the needs of monitoring of riparian constructions.

Pouching a draining duodenal cutaneous fistula: a case study.

PubMed

Zwanziger, P J

1999-01-01

Blockage of the mesenteric artery typically causes necrosis to the colon, requiring extensive surgical resection. In severe cases, the necrosis requires removal of the entire colon, creating numerous problems for the WOC nurse when pouching the opening created for effluent. This article describes the management of a draining duodenal fistula in a middle-aged woman, who survived surgery for a blocked mesenteric artery that necessitated the removal of the majority of the small and large intestine. Nutrition, skin management, and pouch options are described over a number of months as the fistula evolved and a stoma was created.

Information Communication and Technology for Water Resource Management and Food Security in Kenya: A Case Study of Kericho and Uasin Gishu Districts

ERIC Educational Resources Information Center

Omboto, P. I.; Macharia, J.; Mbagaya, Grace; Standa, F. N.

2011-01-01

Recent reports on Kenya have indicated food insecurity and destruction of water catchments as serious problems facing the country. Despite the tremendous strides in Information and Communication Technology (ICT), the country has not taken advantage of the technology to improve food security by effectively managing her water resources. A survey on…

An Acuity Tool for Heart Failure Case Management: Quantifying Workload, Service Utilization, and Disease Severity.

PubMed

Kilgore, Matthew D

The cardiology service line director at a health maintenance organization (HMO) in Washington State required a valid, reliable, and practical means for measuring workloads and other productivity factors for six heart failure (HF) registered nurse case managers located across three geographical regions. The Kilgore Heart Failure Case Management (KHFCM) Acuity Tool was systematically designed, developed, and validated to measure workload as a dependent function of the number of heart failure case management (HFCM) services rendered and the duration of times spent on various care duties. Research and development occurred at various HMO-affiliated internal medicine and cardiology offices throughout Western Washington. The concepts, methods, and principles used to develop the KHFCM Acuity Tool are applicable for any type of health care professional aiming to quantify workload using a high-quality objective tool. The content matter, scaling, and language on the KHFCM Acuity Tool are specific to HFCM settings. The content matter and numeric scales for the KHFCM Acuity Tool were developed and validated using a mixed-method participant action research method applied to a group of six outpatient HF case managers and their respective caseloads. The participant action research method was selected, because the application of this method requires research participants to become directly involved in the diagnosis of research problems, the planning and execution of actions taken to address those problems, and the implementation of progressive strategies throughout the course of the study, as necessary, to produce the most credible and practical practice improvements (; ; ; ). Heart failure case managers served clients with New York Heart Association Functional Class III-IV HF (), and encounters were conducted primarily by telephone or in-office consultation. A mix of qualitative and quantitative results demonstrated a variety of quality improvement outcomes achieved by the design and practice application of the KHFCM Acuity Tool. Quality improvement outcomes included a more valid reflection of encounter times and demonstration of the KHFCM Acuity Tool as a reliable, practical, credible, and satisfying tool for reflecting HF case manager workloads and HF disease severity. The KHFCM Acuity Tool defines workload simply as a function of the number of HFCM services performed and the duration of time spent on a client encounter. The design of the tool facilitates the measure of workload, service utilization, and HF disease characteristics, independently from the overall measure of acuity, so that differences in individual case manager practice, as well as client characteristics within sites, across sites, and potentially throughout annual seasons, can be demonstrated. Data produced from long-term applications of the KHFCM Acuity Tool, across all regions, could serve as a driver for establishing systemwide HFCM productivity benchmarks or standards of practice for HF case managers. Data produced from localized applications could serve as a reference for coordinating staffing resources or developing HFCM productivity benchmarks within individual regions or sites.

Empirical evidences of owners’ managerial behaviour - the case of small companies

NASA Astrophysics Data System (ADS)

Lobontiu, G.; Banica, M.; Ravai-Nagy, S.

2017-05-01

In a small firm, the founder or the owner-manager often leaves his or her own personal “stamp” on the way things are done, finding solutions for the multitude of problems the firm faces, and maintaining control over the firm’s operations. The paper aims to investigate the degree to which the owner-managers are controlling the operations of their firm on a day-to-day basis or even getting involved into the management of the functional areas. Our empirical research, conducted on a sample of 200 small and medium-sized enterprises (SME) from the North-Western Romania, Maramures (NUTS3 level - RO114), shows that owner-managers tend to be all-powerful, making decisions based on their experience. Furthermore, the survey highlights the focus of owner-managers on two functional areas, namely the production, and sales and marketing. Finally, the correlation analysis states that in the case of small firms, the owner-manager is more involved in managing the functional areas of the firm, as compared to the medium-ones.

A Virtual Patient Software Program to Improve Pharmacy Student Learning in a Comprehensive Disease Management Course

PubMed Central

Casale, Jillian P.; Skirvin, J. Andrew; DiVall, Margarita V.

2013-01-01

Objective. To implement and assess the impact of a virtual patient pilot program on pharmacy students’ clinical competence skills. Design. Pharmacy students completed interactive software-based patient case scenarios embedded with drug-therapy problems as part of a course requirement at the end of their third year. Assessment. Assessments included drug-therapy problem competency achievement, performance on a pretest and posttest, and pilot evaluation survey instrument. Significant improvements in students’ posttest scores demonstrated advancement of clinical skills involving drug-therapy problem solving. Students agreed that completing the pilot program improved their chronic disease management skills and the program summarized the course series well. Conclusion. Using virtual patient technology allowed for assessment of student competencies and improved learning outcomes. PMID:24159213

Implementation of nutrition care service development plan at Banning Memorial Hospital: a case study.

PubMed

Ben Oumlil, A; Rao, C P

1992-01-01

Health care service markets in general and hospital care service markets in particular are characterized by many competitive developments. Hence, hospital marketing managers are forced to respond to these emerging competitive pressures. However, in formulating appropriate marketing management strategies, hospital managers need to have detailed knowledge about consumers and their behaviors in the marketplace. This paper focuses on the Nutrition Care division of the Department of Nutrition Service at a hospital and its venture into new service development. This case study is intended to emphasize the significance of acquiring adequate knowledge of customers in the health care services industry. It particularly emphasizes the critical role that this type of information concerning customer behavior plays in the development and implementation of an appropriate business expansion strategy. Furthermore, the aim of this case study is to help the reader to relate the acquired marketing information to the problem at hand, and make the appropriate marketing management decision.

Oral rehabilitation of a 4-year-old child with early childhood caries under general anaesthesia: a case report on long-term outcome.

PubMed

Cuadros Fernández, C; Armengol Olivares, A; Guinot Jimeno, F; Lorente Rodríguez, A I

2014-07-01

Young patients with early childhood caries (ECC) commonly undergo oral rehabilitation under general anaesthesia (GA), often because of problems with behaviour management. Children with a history of ECC are highly susceptible to the development of new caries, even after comprehensive oral rehabilitation. The present paper reports the case of a female patient, aged 4.1 years, with ECC who was referred for treatment to the Department of Paediatric Dentistry of the Universitat Internacional de Catalunya. On account of the requirement for extensive dental treatment, and because of behaviour management problems, her dentition was restored under GA. A combination of restorative approaches and techniques was used, including the placement of composite resins, preformed metal crown restorations, extractions, and space maintainers. The patient was followed for 24 months, both clinically and radiographically. Conclusion This case reflects the need to provide adequate support to children at high risk for ECC, together with their families by developing more acceptable and effective biological and behavioural interventions in order to reduce caries relapse after oral rehabilitation under GA.

An application of the AHP in water resources management: a case study on urban drainage rehabilitation in Medan City

NASA Astrophysics Data System (ADS)

Tarigan, A. P. M.; Rahmad, D.; Sembiring, R. A.; Iskandar, R.

2018-02-01

This paper illustrates an application of Analytical Hierarchy Process (AHP) as a potential decision-making method in water resource management related to drainage rehabilitation. The prioritization problem of urban drainage rehabilitation in Medan City due to limited budget is used as a study case. A hierarchical structure is formed for the prioritization criteria and the alternative drainages to be rehabilitated. Based on the AHP, the prioritization criteria are ranked and a descending-order list of drainage is made in order to select the most favorable drainages to have rehabilitation. A sensitivity analysis is then conducted to check the consistency of the final decisions in case of minor changes in judgements. The results of AHP computed manually are compared with that using the software Expert Choice. It is observed that the top three ranked drainages are consistent, and both results of the AHP methods, calculated manually and performed using Expert Choice, are in agreement. It is hoped that the application of the AHP will help the decision-making process by the city government in the problem of urban drainage rehabilitation.

[AC-STB: dedicated software for managed healthcare of chronic headache patients].

PubMed

Wallasch, T-M; Bek, J; Pabel, R; Modahl, M; Demir, M; Straube, A

2009-04-01

This paper examines a new approach to managed healthcare where a network of care providers exchanges patient information through the internet. Integrating networks of clinical specialists and general care providers promises to achieve qualitative and economic improvements in the German healthcare system. In practice, problems related to patient management and data exchange between the managing clinic and assorted caregivers arise. The implementation and use of a cross-spectrum computerized solution for the management of patients and their care is the key for a successful managed healthcare system. This paper documents the managed healthcare of chronic headache patients and the development of an IT-solution capable of providing distributed patient care and case management.

Family reactions and their management in a parents group with beta-thalassaemia.

PubMed Central

Tsiantis, J; Xypolita-Tsantili, D; Papadakou-Lagoyianni, S

1982-01-01

The parents of children with beta-thalassaemia displayed various patterns of emotion (guilt, death anxiety, denial of feelings) and their behaviour towards the child was inappropriate (overprotective, conspiracy of silence); this could affect his psychosocial development and lead to tension within the family. Some parents were overdemanding and even hostile to hospital staff, thus making the management of cases difficult. The therapeutic team has tried to concentrate on these problems in order to clarify them and give support to the families. This has facilitated communication within the family as well as between the family and hospital staff, and had diminished the problems. PMID:7149759

Family reactions and their management in a parents group with beta-thalassaemia.

PubMed

Tsiantis, J; Xypolita-Tsantili, D; Papadakou-Lagoyianni, S

1982-11-01

The parents of children with beta-thalassaemia displayed various patterns of emotion (guilt, death anxiety, denial of feelings) and their behaviour towards the child was inappropriate (overprotective, conspiracy of silence); this could affect his psychosocial development and lead to tension within the family. Some parents were overdemanding and even hostile to hospital staff, thus making the management of cases difficult. The therapeutic team has tried to concentrate on these problems in order to clarify them and give support to the families. This has facilitated communication within the family as well as between the family and hospital staff, and had diminished the problems.

Buffelgrass-Integrated modeling of an invasive plant

USGS Publications Warehouse

Holcombe, Tracy R.

2011-01-01

Buffelgrass (Pennisetum ciliare) poses a problem in the deserts of the United States, growing in dense stands and introducing a wildfire risk in an ecosystem not adapted to fire. The Invasive Species Science Branch of the Fort Collins Science Center has worked with many partners to develop a decision support model and a data management system to address the problem. The decision support model evaluates potential strategies for resource use and allocation. The data management system is a portal where users can submit, view, and download buffelgrass data. These tools provide a case study showcasing how the FORT is working to address the urgent issue of invasive species in the United States.

What price glory: paid/volunteer? Managers debate the problem.

PubMed

Rosenfeld, J

1983-09-01

There are many ways of being "paid" for a job well done. Money, however, is acknowledged by our society as the primary, and in many cases only, appropriate form of compensation. Yet many hospital gift shop managers are not paid wages, though they may be producing hundreds of thousands of dollars in sales each year. It's a retailing phenomenon, and worthy of the discussion which follows between managers who are paid with money and those who choose to accept other considerations as payment in full.

Somnambulism: Diagnosis and treatment.

PubMed

Bharadwaj, Rahul; Kumar, Suresh

2007-04-01

Somnambulism is an arousal disorder that is usually benign, self-limited and only infrequently requires treatment. Chronic sleepwalking in children has been shown to be associated with behavioral problems and poor emotional regulation. Most cases can be diagnosed with careful noting of case history and epilepsy is an important differential diagnosis. Management with pharmacological and behavioural measures is usually safe and effective. We present two cases of somnambulism that highlight the importance of the diagnosis and treatment of this condition.

Somnambulism: Diagnosis and treatment

PubMed Central

Bharadwaj, Rahul; Kumar, Suresh

2007-01-01

Somnambulism is an arousal disorder that is usually benign, self-limited and only infrequently requires treatment. Chronic sleepwalking in children has been shown to be associated with behavioral problems and poor emotional regulation. Most cases can be diagnosed with careful noting of case history and epilepsy is an important differential diagnosis. Management with pharmacological and behavioural measures is usually safe and effective. We present two cases of somnambulism that highlight the importance of the diagnosis and treatment of this condition. PMID:20711396

Unilateral hypertrophy of the labia minora: A case series.

PubMed

Boulos, Scarlett; Rubin, Adam I; Yan, Albert C; McMahon, Patrick J; Perman, Marissa J

2018-05-01

Asymmetric hypertrophy of the labia minora is a variant of normal anatomy that has not been described in the pediatric dermatology literature. Although often asymptomatic, in some cases, it can cause functional, emotional, and psychological problems. We report the clinical characteristics and outcomes of four children who presented with unilateral labium minus hypertrophy. This case series aims to establish awareness of this condition among pediatric dermatologists and provide recommendations regarding management. © 2018 Wiley Periodicals, Inc.

Using National Health Care Databases and Problem-Based Practice Analysis to Inform Integrated Curriculum Development.

PubMed

Baker, Amy J; Raymond, Mark R; Haist, Steven A; Boulet, John R

2017-04-01

One challenge when implementing case-based learning, and other approaches to contextualized learning, is determining which clinical problems to include. This article illustrates how health care utilization data, readily available from the National Center for Health Statistics (NCHS), can be incorporated into an educational needs assessment to identify medical problems physicians are likely to encounter in clinical practice. The NCHS survey data summarize patient demographics, diagnoses, and interventions for tens of thousands of patients seen in various settings, including emergency departments (EDs), clinics, and hospitals.Selected data from the National Hospital Ambulatory Medical Care Survey: Emergency Department illustrate how instructional materials can be derived from the results of such public-use health care data. Using fever as the reason for visit to the ED, the patient management path is depicted in the form of a case drill-down by exploring the most common diagnoses, blood tests, diagnostic studies, procedures, and medications associated with fever.Although these types of data are quite useful, they should not serve as the sole basis for determining which instructional cases to include. Additional sources of information should be considered to ensure the inclusion of cases that represent infrequent but high-impact problems and those that illustrate fundamental principles that generalize to other cases.

Effective management of low back pain: it’s time to accept the evidence

PubMed Central

Manga, Pran; Angus, Douglas E; Swan, William R

1993-01-01

Low back pain is a ubiquitous and economically costly problem. Unfortunately, the clinical management of low back pain is not yet well understood. Chiropractic management of back pain, long the black sheep of back care, has undergone a transition and is now a more respected and understood alternative to conservative medical care, itself under increased scrutiny due to unsatisfactory outcomes and unacceptable iatrogenic side effects. The substantial amount of clinical and related research on the effectiveness of manipulation for low back pain is summarized here from a larger study, divided into randomized control trials, case-control trials, meta-analyses and descriptive studies. The chiropractic management of low back pain is found to be a more effective way of dealing with this medical, social and economic problem. It is suggested that greater utilization of chiropractors be encouraged such that the “right people are doing the right things at the right time”.

Design of a Recommendation System for Adding Support in the Treatment of Chronic Patients.

PubMed

Torkar, Simon; Benedik, Peter; Rajkovič, Uroš; Šušteršič, Olga; Rajkovič, Vladislav

2016-01-01

Rapid growth of chronic disease cases around the world is adding pressure on healthcare providers to ensure a structured patent follow-up during chronic disease management process. In response to the increasing demand for better chronic disease management and improved health care efficiency, nursing roles have been specialized or enhanced in the primary health care setting. Nurses become key players in chronic disease management process. Study describes a system to help nurses manage the care process of patient with chronic disease. It supports focusing nurse's attention on those resources/solutions that are likely to be most relevant to their particular situation/problem in nursing domain. System is based on multi-relational property graph representing a flexible modeling construct. Graph allows modeling a nursing ontology and the indices that partition domain into an efficient, searchable space where the solution to a problem is seen as abstractly defined traversals through its vertices and edges.

Design of Knowledge Management System for Diabetic Complication Diseases

NASA Astrophysics Data System (ADS)

Fiarni, Cut

2017-01-01

This paper examines how to develop a Model for Knowledge Management System (KMS) for diabetes complication diseases. People with diabetes have a higher risk of developing a series of serious health problems. Each patient has different condition that could lead to different disease and health problem. But, with the right information, patient could have early detection so the health risk could be minimized and avoided. Hence, the objective of this research is to propose a conceptual framework that integrates social network model, Knowledge Management activities, and content based reasoning (CBR) for designing such a diabetes health and complication disease KMS. The framework indicates that the critical knowledge management activities are in the process to find similar case and the index table for algorithm to fit the framework for the social media. With this framework, KMS developers can work with healthcare provider to easily identify the suitable IT associated with the CBR process when developing a diabetes KMS.

Applying the Kanban Method in Problem-Based Project Work: A Case Study in A Manufacturing Engineering Bachelor's Programme at Aalborg University Copenhagen

ERIC Educational Resources Information Center

Balve, Patrick; Krüger, Volker; Tolstrup Sørensen, Lene

2017-01-01

Problem-based learning (PBL) has proven to be highly effective for educating students in an active and self-motivated manner in various disciplines. Student projects carried out following PBL principles are very dynamic and carry a high level of uncertainty, both conditions under which agile project management approaches are assumed to be highly…

[The suffering of professionals working at home with families with multiple problems].

PubMed

Lamour, Martine; Barraco-De Pinto, Marthe

2015-01-01

The management of families with multiple problems often adversely affects the many people involved in their case. This suffering at work affects particularly professionals carrying out home visits. Acknowledging this suffering, enabling these professionals to express and give meaning to their feelings is essential in order to enable them to draw on their skills and creativity. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Tell it like it is.

PubMed

Lee, S L

2000-05-01

Nurses, therapists and case managers were spending too much time each week on the phone waiting to read patient reports to live transcriptionists who would then type the reports for storage in VNSNY's clinical management mainframe database. A speech recognition system helped solve the problem by providing the staff 24-hour access to an automated transcription service any day of the week. Nurses and case managers no longer wait in long queues to transmit patient reports or to retrieve information from the database. Everything is done automatically within minutes. VNSNY saved both time and money by updating its transcription strategy. Now nurses can spend more time with patients and less time on the phone transcribing notes. It also means fewer staff members are needed on weekends to do manual transcribing.

Treatment of Concurrent Substance Dependence, Child Neglect and Domestic Violence: A Single Case Examination Involving Family Behavior Therapy

PubMed Central

Romero, Valerie; Allen, Daniel N.

2012-01-01

Although child neglect and substance abuse co-occur in greater than 60% of child protective service cases, intervention outcome studies are deplorably lacking. Therefore, a home-based Family Behavior Therapy is described in the treatment of a woman evidencing child neglect, substance dependence, domestic violence and other co-occurring problems. Treatment included contingency management, self control, stimulus control, communication and child management skills training exercises, and financial management components. Results indicated improvements in child abuse potential, home hazards, domestic violence, and drug use, which were substantiated by objective urinalysis testing, and tours of her home. Validity checks indicated the participant was being truthful in her responses to standardized questionnaires, and assessors were “blind” to study intent. Limitations (i.e., lack of experimental control and follow-up data collection) of this case example are discussed in light of these results. PMID:23226920

Statistical and methodological issues in the evaluation of case management studies.

PubMed

Lesser, M L; Robertson, S; Kohn, N; Cooper, D J; Dlugacz, Y D

1996-01-01

For the past 3 years, the nursing case management team at North Shore University Hospital in Manhasset, NY, has been involved in a project to implement more than 50 clinical pathways, which provide a written "time line" for clinical events that should occur during a patient's hospital stay. A major objective of this project was to evaluate the efficacy of these pathways with respect to a number of important outcomes, such as length of stay, hospital costs, quality of patient care, and nursing and patient satisfaction. This article discusses several statistics-related issues in the design and evaluation of such case management studies. In particular, the role of a research approach in implementing and evaluating hospital programs, the choice of a comparison (control) group, the exclusion of selected patients from analysis, and the problems of equating pathways with diagnosis-related groups are addressed.

Anesthetic considerations for a pediatric patient with Wolf-Hirschhorn syndrome: a case report.

PubMed

Tsukamoto, Masanori; Yamanaka, Hitoshi; Yokoyama, Takeshi

2017-09-01

Wolf-Hirschhorn syndrome is a rare hereditary disease that results from a 4p chromosome deletion. Patients with this syndrome are characterized by craniofacial dysgenesis, seizures, growth delay, intellectual disability, and congenital heart disease. Although several cases have been reported, very little information is available on anesthetic management for patients with Wolf-Hirschhorn syndrome. We encountered a case requiring anesthetic management for a 2-year-old girl with Wolf-Hirschhorn syndrome. The selection of an appropriately sized tracheal tube and maintaining intraoperatively stable hemodynamics might be critical problems for anesthetic management. In patients with short stature, the tracheal tube size may differ from what may be predicted based on age. The appropriate size ( internal diameter ) of tracheal tubes for children has been investigated. Congenital heart disease is frequently associated with Wolf-Hirschhorn syndrome. Depending on the degree and type of heart disease, careful monitoring of hemodynamics is important.

Complications of correction for focal kyphosis after posterior osteotomy and the corresponding management.

PubMed

Zeng, Yan; Chen, Zhongqiang; Guo, Zhaoqing; Qi, Qiang; Li, Weishi; Sun, Chuiguo

2013-10-01

A clinical retrospective study. To analyze the complications and relevant management of the correction procedure for focal kyphosis. The treatment of focal kyphosis is a difficult problem in spine surgery. The potential complications of surgery should be considered cautiously and managed positively. Eighty-one patients with focal kyphosis were treated by posterior osteotomy and correction. The etiology was posttraumatic in 31 cases, healed tuberculosis in 31 cases, congenital in 17 cases, and iatrogenic in 2 cases. The surgical procedures were pedicle subtraction osteotomy in 19 cases, posterior osteotomy with anterior opening-posterior closing correction in 23 cases, and posterior vertebral column resection with dual axial rotation correction in 39 cases. The intraoperative and postoperative complications were summarized, and the corresponding management was described in detail. The average follow-up time was 31 months. Among patients who underwent pedicle subtraction osteotomy, the intraoperative and postoperative complications included 3 cases of dural tear and 1 case of wound infection. For posterior osteotomy with anterior opening-posterior closing correction, the complications included 4 cases of dural tear, 1 case of wound infection, and 1 case of instrumentation loosening and recurrence of kyphosis . For posterior vertebral column resection with dual axial rotation correction, the complications included 3 cases of dural tear, 5 cases of nerve root injury, 1 case of titanium mesh loosening, 1 case of osteotomy segment migration, 2 cases of transient neurological compromise, and 1 case of instrumentation loosening and kyphosis recurrence. All the complications were treated positively and pertinently. During the posterior osteotomy and correction of focal kyphosis, the risk of surgery increases along with the more severe deformity and the more complicated surgical procedure. However, most complications do not significantly affect the outcome if treated appropriately.

Definition and use of Solution-focused Sustainability Assessment: A novel approach to generate, explore and decide on sustainable solutions for wicked problems.

PubMed

Zijp, Michiel C; Posthuma, Leo; Wintersen, Arjen; Devilee, Jeroen; Swartjes, Frank A

2016-05-01

This paper introduces Solution-focused Sustainability Assessment (SfSA), provides practical guidance formatted as a versatile process framework, and illustrates its utility for solving a wicked environmental management problem. Society faces complex and increasingly wicked environmental problems for which sustainable solutions are sought. Wicked problems are multi-faceted, and deriving of a management solution requires an approach that is participative, iterative, innovative, and transparent in its definition of sustainability and translation to sustainability metrics. We suggest to add the use of a solution-focused approach. The SfSA framework is collated from elements from risk assessment, risk governance, adaptive management and sustainability assessment frameworks, expanded with the 'solution-focused' paradigm as recently proposed in the context of risk assessment. The main innovation of this approach is the broad exploration of solutions upfront in assessment projects. The case study concerns the sustainable management of slightly contaminated sediments continuously formed in ditches in rural, agricultural areas. This problem is wicked, as disposal of contaminated sediment on adjacent land is potentially hazardous to humans, ecosystems and agricultural products. Non-removal would however reduce drainage capacity followed by increased risks of flooding, while contaminated sediment removal followed by offsite treatment implies high budget costs and soil subsidence. Application of the steps in the SfSA-framework served in solving this problem. Important elements were early exploration of a wide 'solution-space', stakeholder involvement from the onset of the assessment, clear agreements on the risk and sustainability metrics of the problem and on the interpretation and decision procedures, and adaptive management. Application of the key elements of the SfSA approach eventually resulted in adoption of a novel sediment management policy. The stakeholder participation and the intensive communication throughout the project resulted in broad support for both the scientific approaches and results, as well as for policy implementation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Building and Managing Electronic Resources in Digital Era in India with Special Reference to IUCAA and NIV, Pune: A Comparative Case Study

NASA Astrophysics Data System (ADS)

Sahu, H. K.; Singh, S. N.

2015-04-01

This paper discusses and presents a comparative case study of two libraries in Pune, India, Inter-University Centre for Astronomy and Astrophysics and Information Centre and Library of National Institute of Virology (Indian Council of Medical Research). It compares how both libraries have managed their e-resource collections, including acquisitions, subscriptions, and consortia arrangements, while also developing a collection of their own resources, including pre-prints and publications, video lectures, and other materials in an institutional repository. This study illustrates how difficult it is to manage electronic resources in a developing country like India, even though electronic resources are used more than print resources. Electronic resource management can be daunting, but with a systematic approach, various problems can be solved, and use of the materials will be enhanced.

Using integrated research and interdisciplinary science: Potential benefits and challenges to managers of parks and protected areas

USGS Publications Warehouse

van Riper, Charles; Powell, Robert B.; Machlis, Gary; van Wagtendonk, Jan W.; van Riper, Carena J.; von Ruschkowski, Eick; Schwarzbach, Steven E.; Galipeau, Russell E.

2012-01-01

Our purpose in this paper is to build a case for utilizing interdisciplinary science to enhance the management of parks and protected areas. We suggest that interdisciplinary science is necessary for dealing with the complex issues of contemporary resource management, and that using the best available integrated scientific information be embraced and supported at all levels of agencies that manage parks and protected areas. It will take the commitment of park managers, scientists, and agency leaders to achieve the goal of implementing the results of interdisciplinary science into park management. Although such calls go back at least several decades, today interdisciplinary science is sporadically being promoted as necessary for supporting effective protected area management(e.g., Machlis et al. 1981; Kelleher and Kenchington 1991). Despite this history, rarely has "interdisciplinary science" been defined, its importance explained, or guidance provided on how to translate and then implement the associated research results into management actions (Tress et al. 2006; Margles et al. 2010). With the extremely complex issues that now confront protected areas (e.g., climate change influences, extinctions and loss of biodiversity, human and wildlife demographic changes, and unprecedented human population growth) information from more than one scientific discipline will need to be brought to bear in order to achieve sustained management solutions that resonate with stakeholders (Ostrom 2009). Although interdisciplinary science is not the solution to all problems, we argue that interdisciplinary research is an evolving and widely supported best practice. In the case of park and protected area management, interdisciplinary science is being driven by the increasing recognition of the complexity and interconnectedness of human and natural systems, and the notion that addressing many problems can be more rapidly advanced through interdisciplinary study and analysis.

An inventory-theory-based interval-parameter two-stage stochastic programming model for water resources management

NASA Astrophysics Data System (ADS)

Suo, M. Q.; Li, Y. P.; Huang, G. H.

2011-09-01

In this study, an inventory-theory-based interval-parameter two-stage stochastic programming (IB-ITSP) model is proposed through integrating inventory theory into an interval-parameter two-stage stochastic optimization framework. This method can not only address system uncertainties with complex presentation but also reflect transferring batch (the transferring quantity at once) and period (the corresponding cycle time) in decision making problems. A case of water allocation problems in water resources management planning is studied to demonstrate the applicability of this method. Under different flow levels, different transferring measures are generated by this method when the promised water cannot be met. Moreover, interval solutions associated with different transferring costs also have been provided. They can be used for generating decision alternatives and thus help water resources managers to identify desired policies. Compared with the ITSP method, the IB-ITSP model can provide a positive measure for solving water shortage problems and afford useful information for decision makers under uncertainty.

Rebel with a Cause: A School Board Member Calls for Reform in Miami-Dade County Public Schools

ERIC Educational Resources Information Center

Manning, Tom

2011-01-01

This case describes the experience of a new school board member in Miami-Dade County Public Schools, Marta Perez, as she discovers a wide range of ethical and management problems in the school district and attempts to deal with them. Layered throughout the case are challenges pertaining to the school board's roles and responsibilities,…

Sexual Harrassment--A Growing Problem in the Workplace.

ERIC Educational Resources Information Center

Petersen, Donald J.; Massengill, Douglass

1982-01-01

Cites court cases and Equal Employment Opportunity Commission guidelines that affix employer liability for sexual harassment. Offers management advice on developing policies and practices for dealing with sexual harassment that are based on responses from 74 "Fortune 500" firms. (Author/MLF)

Teaching organization theory for healthcare management: three applied learning methods.

PubMed

Olden, Peter C

2006-01-01

Organization theory (OT) provides a way of seeing, describing, analyzing, understanding, and improving organizations based on patterns of organizational design and behavior (Daft 2004). It gives managers models, principles, and methods with which to diagnose and fix organization structure, design, and process problems. Health care organizations (HCOs) face serious problems such as fatal medical errors, harmful treatment delays, misuse of scarce nurses, costly inefficiency, and service failures. Some of health care managers' most critical work involves designing and structuring their organizations so their missions, visions, and goals can be achieved-and in some cases so their organizations can survive. Thus, it is imperative that graduate healthcare management programs develop effective approaches for teaching OT to students who will manage HCOs. Guided by principles of education, three applied teaching/learning activities/assignments were created to teach OT in a graduate healthcare management program. These educationalmethods develop students' competency with OT applied to HCOs. The teaching techniques in this article may be useful to faculty teaching graduate courses in organization theory and related subjects such as leadership, quality, and operation management.

Enhancing Knowledge Sharing Management Using BIM Technology in Construction

PubMed Central

Ho, Shih-Ping; Tserng, Hui-Ping

2013-01-01

Construction knowledge can be communicated and reused among project managers and jobsite engineers to alleviate problems on a construction jobsite and reduce the time and cost of solving problems related to constructability. This paper proposes a new methodology for the sharing of construction knowledge by using Building Information Modeling (BIM) technology. The main characteristics of BIM include illustrating 3D CAD-based presentations and keeping information in a digital format and facilitation of easy updating and transfer of information in the BIM environment. Using the BIM technology, project managers and engineers can gain knowledge related to BIM and obtain feedback provided by jobsite engineers for future reference. This study addresses the application of knowledge sharing management using BIM technology and proposes a BIM-based Knowledge Sharing Management (BIMKSM) system for project managers and engineers. The BIMKSM system is then applied in a selected case study of a construction project in Taiwan to demonstrate the effectiveness of sharing knowledge in the BIM environment. The results demonstrate that the BIMKSM system can be used as a visual BIM-based knowledge sharing management platform by utilizing the BIM technology. PMID:24723790

Enhancing knowledge sharing management using BIM technology in construction.

PubMed

Ho, Shih-Ping; Tserng, Hui-Ping; Jan, Shu-Hui

2013-01-01

Construction knowledge can be communicated and reused among project managers and jobsite engineers to alleviate problems on a construction jobsite and reduce the time and cost of solving problems related to constructability. This paper proposes a new methodology for the sharing of construction knowledge by using Building Information Modeling (BIM) technology. The main characteristics of BIM include illustrating 3D CAD-based presentations and keeping information in a digital format and facilitation of easy updating and transfer of information in the BIM environment. Using the BIM technology, project managers and engineers can gain knowledge related to BIM and obtain feedback provided by jobsite engineers for future reference. This study addresses the application of knowledge sharing management using BIM technology and proposes a BIM-based Knowledge Sharing Management (BIMKSM) system for project managers and engineers. The BIMKSM system is then applied in a selected case study of a construction project in Taiwan to demonstrate the effectiveness of sharing knowledge in the BIM environment. The results demonstrate that the BIMKSM system can be used as a visual BIM-based knowledge sharing management platform by utilizing the BIM technology.

Management of a pregnant woman dependent on haemodialysis.

PubMed

Walsh, Anna-Marie

2002-01-01

This is a case study of a woman who became pregnant whilst receiving haemodialysis in a London teaching hospital. She courageously disregarded the doctors' advise to abort the fetus. The doctors advised her to wait until she had a kidney transplant to become pregnant again, rather than increase maternal and fetal risk on dialysis. She was due to have a live-related transplant from her father in the spring. The case study describes a practical account in detailed measure to equip nurses with the knowledge to provide specialised care to high-risk dialysis expecting mothers. The main problems in this case study were trying to manage the mother's dialysis regime, control her anaemia, ensure good nutritional levels and gain accurate daily weights.

An implementation of wireless medical image transmission system on mobile devices.

PubMed

Lee, SangBock; Lee, Taesoo; Jin, Gyehwan; Hong, Juhyun

2008-12-01

The advanced technology of computing system was followed by the rapid improvement of medical instrumentation and patient record management system. The typical examples are hospital information system (HIS) and picture archiving and communication system (PACS), which computerized the management procedure of medical records and images in hospital. Because these systems were built and used in hospitals, doctors out of hospital have problems to access them immediately on emergent cases. To solve these problems, this paper addressed the realization of system that could transmit the images acquired by medical imaging systems in hospital to the remote doctors' handheld PDA's using CDMA cellular phone network. The system consists of server and PDA. The server was developed to manage the accounts of doctors and patients and allocate the patient images to each doctor. The PDA was developed to display patient images through remote server connection. To authenticate the personal user, remote data access (RDA) method was used in PDA accessing the server database and file transfer protocol (FTP) was used to download patient images from the remove server. In laboratory experiments, it was calculated to take ninety seconds to transmit thirty images with 832 x 488 resolution and 24 bit depth and 0.37 Mb size. This result showed that the developed system has no problems for remote doctors to receive and review the patient images immediately on emergent cases.

Corynebacterium minutissimum vascular graft infection: case report and review of 281 cases of prosthetic device-related Corynebacterium infection.

PubMed

Reece, Rebecca M; Cunha, Cheston B; Rich, Josiah D

2014-09-01

Corynebacterium spp. have proven their pathogenic potential in causing infections, particularly in the setting of immunosuppression and prosthetic devices. We conducted a PubMed literature review of all cases of Corynebacterium prosthetic device infections published in the English language through December 2013. The majority of cases involved peritoneal dialysis and central venous catheters, but prosthetic joints and central nervous system shunts/drains were also involved. The management of these cases in terms of retention or removal of the device was not uniform; however, the overall mortality remained the same among both groups. All of these prosthetic device infections pose potential problems in management when the device cannot be removed safely for the patient, especially with the lack of data on the pathogenicity of Corynebacterium species. However with better identification of species and sensitivities, successful treatment is possible even with retention of the device.

A problem-solving routine for improving hospital operations.

PubMed

Ghosh, Manimay; Sobek Ii, Durward K

2015-01-01

The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. The study was conducted in one hospital setting. Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics. This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.

Ectopic pregnancy in southern Iran: a statistical review of 96 cases.

PubMed

Javey, H

1976-01-01

A review is presented of 96 cases of ectopic pregnacy over a 7-year period. It is noted that in recent years the incidence of this problem has increased. Inadequately diagnosed and treated pelvic inflammatory disease has been found to be the main predisposing factor (40%). The rate of extra-uterine gestation was 1:336 deliveries. In this study, previous fertility was high, and primigravidae constituted only 10.4% of the total. The effect of previous pelvic operations and pelvic infection is discussed; a statistical review of signs and symptoms is tabulated, and the management of the patient and of concomitant problems is presented.

The costs of managing genital warts in the UK by devolved nation: England, Scotland, Wales and Northern Ireland.

PubMed

Coles, V A H; Chapman, R; Lanitis, T; Carroll, S M

2016-01-01

Genital warts, 90% of which are caused by human papillomavirus types 6 and 11, are a significant problem in the UK. The cost of managing genital warts was previously estimated at £52.4 million for 2010. The objective of this study was to estimate the cost of genital warts management up to 2012 in the UK and by jurisdiction. Population statistics and the number of reported genital warts cases in genito-urinary medicine clinics were obtained and extrapolated to 2012. Cases of genital warts treated in primary care were estimated from The Health Improvement Network database. The number of visits and therapy required were estimated by genito-urinary medicine experts. Costs were obtained from the appropriate national tariffs. The model estimated there were 220,875 genital warts cases in the UK in 2012, costing £58.44 million (£265/patient). It estimated 157,793 cases in England costing £41.74 million; 7468 cases in Scotland costing £1.90 million; 7095 cases in Wales costing £1.87 million; and 3621 cases in Northern Ireland costing £948,000. The full National Health Service costs for the management of genital warts have never previously been estimated separately for each jurisdiction. Findings reveal a significant economic burden, which is important to quantify when understanding the value of quadrivalent human papilloma virus vaccination. © The Author(s) 2015.

Decerns: A framework for multi-criteria decision analysis

DOE PAGES

Yatsalo, Boris; Didenko, Vladimir; Gritsyuk, Sergey; ...

2015-02-27

A new framework, Decerns, for multicriteria decision analysis (MCDA) of a wide range of practical problems on risk management is introduced. Decerns framework contains a library of modules that are the basis for two scalable systems: DecernsMCDA for analysis of multicriteria problems, and DecernsSDSS for multicriteria analysis of spatial options. DecernsMCDA includes well known MCDA methods and original methods for uncertainty treatment based on probabilistic approaches and fuzzy numbers. As a result, these MCDA methods are described along with a case study on analysis of multicriteria location problem.

[Forecast of costs of ecodependent cancer treatment for the development of management decisions].

PubMed

Krasovskiy, V O

2014-01-01

The methodical approach for probabilistic forecasting and differentiation of treatment of costs of ecodependent cancer cases has been elaborated. The modality is useful in the organization of medical aid to cancer patients, in developing management decisions for the reduction the occupational load on the population, as well as in solutions problems in compensation to the population economic and social loss from industrial plants.

Administrative Sanctions, Classroom Management, and Intervention Strategies: Building Blocks for School-Wide Discipline. CASE/CCBD Mini-Library Series on Safe, Drug-Free, and Effective Schools.

ERIC Educational Resources Information Center

Evans, Cal

Part of a series of monographs on safe, drug-free, and effective schools, this monograph discusses the new discipline requirements under the Individuals with Disabilities Education Act and the role of administrators in developing a range of intervention strategies to manage the behavior of students with behavior problems. Following an introductory…

The Development of Educational Environment Suited to the Japan-Specific Educational Service Using Requirements Engineering Techniques: Case Study of Running Sakai with PostgreSQL

ERIC Educational Resources Information Center

Terawaki, Yuki; Takahashi, Yuichi; Kodama, Yasushi; Yana, Kazuo

2011-01-01

This paper describes an integration of different Relational Database Management System (RDBMS) of two Course Management Systems (CMS) called Sakai and the Common Factory for Inspiration and Value in Education (CFIVE). First, when the service of CMS is provided campus-wide, the problems of user support, CMS operation and customization of CMS are…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wright, F.M. Jr.; Best, D.A.; Clarke, R.T.

The need for even more efficient reservoir characterization and management has forced a change in the way Mobil Oil provides technical support to its production operations. We`ve learned that to be successful, a good understanding of the reservoir is essential. This includes an understanding of the technical and business significance of reservoir heterogeneities at different stages of field development. A multi-disciplinary understanding of the business of integrated reservoir characterization is essential and to facilitate this understanding, Mobil has developed a highly successful {open_quotes}Reservoir Characterization Field Seminar{close_quotes}. Through specific team based case studies that incorporate outcrop examples and data the programmore » provides participants the opportunity to explore historic and alternative approaches to reservoir description, characterization and management. We explore appropriate levels and timing of data gathering, technology applications, risk assessment and management practices at different stages of field development. The case studies presented throughout the course are a unique element of the program which combine real life and hypothetical problem sets that explore how different technical disciplines interact, the approaches to a problem solving they use, the assumptions and uncertainties contained in their contributions and the impact those conclusions may have on other disciplines involved in the overall reservoir management process. The team building aspect of the course was an added bonus.« less

A study of computer graphics technology in application of communication resource management

NASA Astrophysics Data System (ADS)

Li, Jing; Zhou, Liang; Yang, Fei

2017-08-01

With the development of computer technology, computer graphics technology has been widely used. Especially, the success of object-oriented technology and multimedia technology promotes the development of graphics technology in the computer software system. Therefore, the computer graphics theory and application technology have become an important topic in the field of computer, while the computer graphics technology becomes more and more extensive in various fields of application. In recent years, with the development of social economy, especially the rapid development of information technology, the traditional way of communication resource management cannot effectively meet the needs of resource management. In this case, the current communication resource management is still using the original management tools and management methods, resource management equipment management and maintenance, which brought a lot of problems. It is very difficult for non-professionals to understand the equipment and the situation in communication resource management. Resource utilization is relatively low, and managers cannot quickly and accurately understand the resource conditions. Aimed at the above problems, this paper proposes to introduce computer graphics technology into the communication resource management. The introduction of computer graphics not only makes communication resource management more vivid, but also reduces the cost of resource management and improves work efficiency.

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

PubMed

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

2011-09-01

The purpose of this study is to discuss a chiropractic case of management and resolution of breast-feeding difficulties. The case involves an 8-day-old baby unable to breast-feed since 4 days old. Initial examination revealed cervical, cranial, and sacral restrictions. She was diagnosed with craniocervical syndrome by a doctor of chiropractic. Following history and examination, the infant received gentle chiropractic manipulation based on clinical findings. Immediate improvement and complete resolution of the nursing problems were observed after 3 treatments over 14 days. The results of this case suggest that neuromusculoskeletal dysfunction may influence the ability of an infant to suckle successfully and that intervention via chiropractic adjustments may result in improving the infant's ability to suckle efficiently. Copyright © 2011 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

[School shootings by adult outsiders – psychiatric aspects and risk markers].

PubMed

Hoffmann, Jens; Allwinn, Mirko

2016-01-01

Three cases of rampage killings at German schools by adult outsiders were identified and analyzed. The cases took place between 1913 and 1983. To what extent do psychiatric aspects play a role and are there risk factors that can be identified und used for prevention? For the identification of risk factors the warning behavior typology was utilized which covers eight behavioral factors. Severe mental problems were found in all three cases. The factors of the warning behavior typology were present in different relevance: Pathway (100 %), Fixation (100 %), Identification (33 %), novel aggression (33 %), energy burst (33 %), Leakage (66 %), last resort (66 %), directly communicated threat (0 %). The prevention of such cases seems to be most promising installing a regional and interdisciplinary threat management model. The field of threat management offers a scientific frame with evidence based tools and methods.

Reducing environmental noise impacts: A USAREUR noise management program handbook

NASA Astrophysics Data System (ADS)

Feather, Timothy D.; Shekell, Ted K.

1991-06-01

Noise pollution is a major environmental problem faced by the U.S. Army in Europe. Noise-related complaints from German citizens can escalate into intense political issues in German communities. This in turn hampers efficient operation of military training and often times threatens the Army's mission. In order to remedy these problems, USAREUR has developed a noise management program. A successful noise management program will limit the impact of unavoidable noise on the populace. This report, a component of the noise management program, is a reference document for noise management planning. It contains guidelines and rules-of-thumb for noise management. This document contains procedures which operation and training level personnel can understand and apply in their day to day noise management planning. Noise mitigation tips are given. Basic technical information that will aid in understanding noise mitigation is provided along with noise management through land use planning. Noise management for specific components of the military community, (airfields, base operations, training areas, and housing and recreation areas) are addressed. The nature of noise generated, means of noise abatement at the source, path, and receiver (both physical and organizational/public relations methods), and a case study example are described.

Situation analysis of patients attending TU Teaching Hospital after medical abortion with problems and complications.

PubMed

Ojha, Neebha; Bista, Kesang D B

2013-01-01

In Nepal medical abortion has been approved for use since 2009. There were many cases coming to Tribhuvan University Teaching Hospital coming with problems and complications following medical abortion. Thus the objective of this study was to analyze the cases that came to TUTH following medical abortion with problems and complications. This is a prospective study conducted in the Department of Obstetrics and Gynecology of TUTH. Study was carried from 1st August 2011 to 30th November 2012. Women who came to TUTH with any complaints following medical abortion were interviewed, examined and treatment provided. Relevant clinical finding were noted. There were a total of 57 cases during the study. Most (66.6%) of the women were in age group 20-29 years age. There were 45 (79%) women who had abortion up to 9 weeks. Medical shop was the main place where most of the women (45.6%) directly come to know about medical abortion. More than 34 (77.2%) received the service from medical shops without any supervision. Most 31 (54.4%) presented with incomplete abortion. There were three cases of continuing pregnancy and four presented with ectopic pregnancy. Eighteen (31.6%) cases needed admission. Fifty six percent of the cases were treated with manual vacuum aspiration, six cases underwent laparotomy and there was one maternal mortality. There is a need for proper dissemination and implementation of guideline for management of these women and adequate supervision to reduce the problems and complications.

A framework for using ant colony optimization to schedule environmental flow management alternatives for rivers, wetlands, and floodplains

NASA Astrophysics Data System (ADS)

Szemis, J. M.; Maier, H. R.; Dandy, G. C.

2012-08-01

Rivers, wetlands, and floodplains are in need of management as they have been altered from natural conditions and are at risk of vanishing because of river development. One method to mitigate these impacts involves the scheduling of environmental flow management alternatives (EFMA); however, this is a complex task as there are generally a large number of ecological assets (e.g., wetlands) that need to be considered, each with species with competing flow requirements. Hence, this problem evolves into an optimization problem to maximize an ecological benefit within constraints imposed by human needs and the physical layout of the system. This paper presents a novel optimization framework which uses ant colony optimization to enable optimal scheduling of EFMAs, given constraints on the environmental water that is available. This optimization algorithm is selected because, unlike other currently popular algorithms, it is able to account for all aspects of the problem. The approach is validated by comparing it to a heuristic approach, and its utility is demonstrated using a case study based on the Murray River in South Australia to investigate (1) the trade-off between plant recruitment (i.e., promoting germination) and maintenance (i.e., maintaining habitat) flow requirements, (2) the trade-off between flora and fauna flow requirements, and (3) a hydrograph inversion case. The results demonstrate the usefulness and flexibility of the proposed framework as it is able to determine EFMA schedules that provide optimal or near-optimal trade-offs between the competing needs of species under a range of operating conditions and valuable insight for managers.

Some Unintended Consequences of "Top Down" Organization Development

ERIC Educational Resources Information Center

White, Bernard J.; Ramsey, V. Jean

1978-01-01

An organizational development consultant is expected to perform a thorough and unbiased diagnosis of the organization's functioning. This is an account of a case study of the effect of top management influence on the consultant's awareness and definition of problems. (Author/MLF)

Giant hydatid liver cyst. Management of residual cavity.

PubMed

Salemis, Nikolaos S

2008-01-01

The management of the residual cavity during surgical intervention for giant hydatid liver cysts is often a challenging problem. Herein, is described the case of a 55-year-old female patient who was diagnosed with a giant hydatid cyst occupying almost the entire left lobe of the liver. After partial cystectomy, the residual cavity was managed by combination of suture obliteration with omentoplasty. The patient had an uneventful postoperative course and was discharged eight days later. The clinical presentation, diagnostic work-up and surgical management of the patient are discussed, along with a review of the literature.

A case study in R and D productivity: Helping the program manager cope with job stress and improve communication effectiveness

NASA Technical Reports Server (NTRS)

Bodensteiner, W. D.; Gerloff, E. A.

1985-01-01

Certain structural changes in the Naval Material Command which resulted from a comparison of its operations to those of selected large-scale private sector companies are described. Central to the change was a reduction in the number of formal reports from systems commands to headquarters, and the provision of Program Management Assistance Teams (at the request of the program manager) to help resolve project problems. It is believed that these changes improved communication and information-processing, reduced program manager stress, and resulted in improved productivity.

A case study in the practical use of LANDSAT data

NASA Technical Reports Server (NTRS)

Cox, S.

1982-01-01

The use of computer aided classification of LANDSAT data in developing water quality plans for New Jersey watersheds is used to exemplify how a state natural resource management program benefits from satellite imagery. The transition of a research and development system into an operational remote sensing system to help decision makers is demonstrated. Nontechnial issues that can assist (or hinder) an agency in adopting a new technology are examined. The progress of LANDSAT use by state government from the earliest stage of curiosity through to incorporation in actual state planning methods is charted. Potential applications of LANDSAT data to real information needs and solutions to management problems are examined. The problems and mistakes that occurred in using LANDSAT data in the past are discussed as well as the ways by which these problems were overcome.

Conducting a surveillance problem analysis on poor feedback from Reference Laboratory, Liberia, February 2016.

PubMed

Frimpong, Joseph Asamoah; Amo-Addae, Maame Pokuah; Adewuyi, Peter Adebayo; Hall, Casey Daniel; Park, Meeyoung Mattie; Nagbe, Thomas Knue

2017-01-01

The laboratory plays a major role in surveillance, including confirming the start and end of an outbreak. Knowing the causative agent for an outbreak informs the development of response strategies and management plans for a public health event. However, issues and challenges may arise that limit the effectiveness or efficiency of laboratories in surveillance. This case study applies a systematic approach to analyse gaps in laboratory surveillance, thereby improving the ability to mitigate these gaps. Although this case study concentrates on factors resulting in poor feedback from the laboratory, practise of this general approach to problem analysis will confer skills required in analysing most public health issues. This case study was developed based on a report submitted by the district surveillance officer in Grand Bassa County, Liberia, as a resident of the Liberian Frontline Field Epidemiology Training Program in 2016. This case study will serve as a training tool to reinforce lectures on surveillance problem analysis using the fishbone approach. It is designed for public health training in a classroom setting and can be completed within 2 hours 30 minutes.

Tuberculous meningitis: a uniform case definition for use in clinical research.

PubMed

Marais, Suzaan; Thwaites, Guy; Schoeman, Johan F; Török, M Estée; Misra, Usha K; Prasad, Kameshwar; Donald, Peter R; Wilkinson, Robert J; Marais, Ben J

2010-11-01

Tuberculous meningitis causes substantial mortality and morbidity in children and adults. More research is urgently needed to better understand the pathogenesis of disease and to improve its clinical management and outcome. A major stumbling block is the absence of standardised diagnostic criteria. The different case definitions used in various studies makes comparison of research findings difficult, prevents the best use of existing data, and limits the management of disease. To address this problem, a 3-day tuberculous meningitis workshop took place in Cape Town, South Africa, and was attended by 41 international participants experienced in the research or management of tuberculous meningitis. During the meeting, diagnostic criteria were assessed and discussed, after which a writing committee was appointed to finalise a consensus case definition for tuberculous meningitis for use in future clinical research. We present the consensus case definition together with the rationale behind the recommendations. This case definition is applicable irrespective of the patient's age, HIV infection status, or the resources available in the research setting. Consistent use of the proposed case definition will aid comparison of studies, improve scientific communication, and ultimately improve care. Copyright © 2010 Elsevier Ltd. All rights reserved.

State-of-the-lagoon reports as vehicles of cross-disciplinary integration.

PubMed

Zaucha, Jacek; Davoudi, Simin; Slob, Adriaan; Bouma, Geiske; van Meerkerk, Ingmar; Oen, Amy Mp; Breedveld, Gijs D

2016-10-01

An integrative approach across disciplines is needed for sustainable lagoon and estuary management as identified by integrated coastal zone management. The ARCH research project (Architecture and roadmap to manage multiple pressures on lagoons) has taken initial steps to overcome the boundaries between disciplines and focus on cross-disciplinary integration by addressing the driving forces, challenges, and problems at various case study sites. A model was developed as a boundary-spanning activity to produce joint knowledge and understanding. The backbone of the model is formed by the interaction between the natural and human systems, including economy and governance-based subsystems. The model was used to create state-of-the-lagoon reports for 10 case study sites (lagoons and estuarine coastal areas), with a geographical distribution covering all major seas surrounding Europe. The reports functioned as boundary objects to build joint knowledge. The experiences related to the framing of the model and its subsequent implementation at the case study sites have resulted in key recommendations on how to address the challenges of cross-disciplinary work required for the proper management of complex social-ecological systems such as lagoons, estuarine areas, and other land-sea regions. Cross-disciplinary integration is initially resource intensive and time consuming; one should set aside the required resources and invest efforts at the forefront. It is crucial to create engagement among the group of researchers by focusing on a joint, appealing overall concept that will stimulate cross-sectoral thinking and focusing on the identified problems as a link between collected evidence and future management needs. Different methods for collecting evidence should be applied including both quantitative (jointly agreed indicators) and qualitative (narratives) information. Cross-disciplinary integration is facilitated by functional boundary objects. Integration offers important rewards in terms of developing a better understanding and subsequently improved management of complex social-ecological systems. Integr Environ Assess Manag 2016;12:690-700. © 2016 SETAC. © 2016 SETAC.

Dental management of a pediatric patient with Burkitt lymphoma: a case report.

PubMed

Padmanabhan, M Y; Pandey, R K; Kumar, Archana; Radhakrishnan, Aparna

2012-06-01

Recent advancements in the field of cancer diagnosis and chemotherapy have led to higher rates of survival for children with malignant tumors. More than 75% of pediatric patients diagnosed with malignancies survive more than 5 years. These advancements have resulted in additional responsibilities for dental professionals to diagnose, evaluate, prevent, stabilize, and manage the oral and dental problems that can compromise the quality of life of these children. This case report highlights the importance of professional and self-administered oral prophylactic measures and patient compliance in the successful oral rehabilitation of a pediatric patient with Burkitt lymphoma. © 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

Anorexia Nervosa and Bulimia: Problems of “The Pleasing Child”

PubMed Central

McSherry, J. A.

1984-01-01

Widespread media publicity has resulted in increased case findings of eating disorders such as anorexia nervosa and bulimia. The etiology of these conditions is complex and multifactorial, and they may have devastating effects on physical and psychological health. Family physicians have an important role to play in recognizing, evaluating and managing eating disorders. Severe anorexics—those who have lost 25% or more of the average weight for their age and height—require specialist management, but milder forms respond to treatment which can be undertaken by an interested family physician. Most cases of uncomplicated bulimia can be treated successfully in a family practice setting. PMID:21278973

Factors promoting or potentially impeding school success: disparities and state variations for children with special health care needs.

PubMed

Bethell, Christina; Forrest, Christopher B; Stumbo, Scott; Gombojav, Narangerel; Carle, Adam; Irwin, Charles E

2012-04-01

School success predicts many pathways for health and well-being across the life span. Factors promoting or potentially impeding school success are critical to understand for all children and for children with special health care needs (CSHCN), whose life course trajectories are already impacted by their chronic health problems. The 2007 National Survey of Children's Health was used (1) to estimate national and state prevalence and within and across states disparities in factors promoting school success (engagement, participation, safety) or potentially impeding success (missing school, grade repetition, school identified problems) for all children and CSHCN and (2) to evaluate associations with CSHCN service need complexity and presence of emotional, behavioral or developmental problems (EBD) as well as with school case management policies in states. Among school age children, 60 % experienced all three factors promoting school success (49.3-73.8 % across states), dropping to 51.3 % for CSHCN (39.4-64.7 % across states) and to 36.2 % for the 40 % of all CSHCN who have both more complex service needs and EBD. CSHCN were more likely to experience factors potentially impeding school success. After accounting for child factors, CSHCN living in states requiring case management in schools for children with disabilities were less likely to experience grade repetition (OR 0.65). Within-state disparities between non-CSHCN and CSHCN varied across states. Threats to school success for US children are pervasive and are especially pronounced for CSHCN with more complex needs and EBD. Findings support broad, non-condition specific efforts to promote school success for CSHCN and consideration of state school policies, such as case management.

Dermoscopy for common skin problems in Chinese children using a novel Hong Kong-made dermoscope.

PubMed

Luk, David C K; Lam, Sam Y Y; Cheung, Patrick C H; Chan, Bill H B

2014-12-01

To evaluate the dermoscopic features of common skin problems in Chinese children. A case series with retrospective qualitative analysis of dermoscopic features of common skin problems in Chinese children. A regional hospital in Hong Kong. Dermoscopic image database, from 1 May 2013 to 31 October 2013, of 185 Chinese children (aged 0 to 18 years). Dermoscopic features of common paediatric skin problems in Chinese children were identified. These features corresponded with the known dermoscopic features reported in the western medical literature. New dermoscopic features were identified in café-au-lait macules. Dermoscopic features of common skin problems in Chinese children were consistent with those reported in western medical literature. Dermoscopy has a role in managing children with skin problems.

Evaluating the effectiveness of infant mental health enhanced case management for dependency populations.

PubMed

Congdon, David

2010-10-01

Children who are receiving services for abuse and neglect are likely to have reduced developmental levels and are less prepared for success in school as a result. The progress of 144 children receiving services from The Children's Home Society of Florida was tracked with half being randomly assigned to a control group and half to an experimental group receiving enhanced infant mental health oriented case management services from two social work professionals in each of two locations in Tallahassee and West Palm Beach Florida. Those receiving enhanced case management showed significantly higher results in the following areas: more visits with their parents (for those removed from the family home), more service referrals, more completed assessments for services, more services based on the assessments they received, and more success in completing goals of treatment for which they were referred. Their parents had more contact with professionals to whom they were referred and had more success in completing goals of the treatment for which they were referred. Children who received intensive case management also showed improvement in their developmental skills related to problem solving from inception to completion of services. Implications for further research are considered.

Contextualising eating problems in individual diet counselling.

PubMed

Kristensen, Søren T; Køster, Allan

2014-05-01

Health professionals consider diet to be a vital component in managing weight, chronic diseases and the overall promotion of health. This article takes the position that the complexity and contextual nature of individual eating problems needs to be addressed in a more systematic and nuanced way than is usually the case in diet counselling, motivational interviewing and health coaching. We suggest the use of narrative practice as a critical and context-sensitive counselling approach to eating problems. Principles of externalisation and co-researching are combined within a counselling framework that employs logistic, social and discursive eating problems as analytic categories. Using cases from a health clinic situated at the Metropolitan University College in Copenhagen, we show that even if the structural conditions associated with eating problems may not be solvable through individual counselling sessions, exploration of the complex structures of food and eating with the client can provide agency by helping them navigate within the context of the problem. We also exemplify why a reflexive and critical approach to the way health is perceived by clients should be an integrated part of diet counselling.

The public's view of the competence, dangerousness, and need for legal coercion of persons with mental health problems.

PubMed Central

Pescosolido, B A; Monahan, J; Link, B G; Stueve, A; Kikuzawa, S

1999-01-01

OBJECTIVES: The authors examined Americans' opinions about financial and treatment competence of people with mental health problems, potential for harm to self or others, and the use of legal means to force treatment. METHODS: The 1996 General Social Survey provided interview data with a nationally representative sample (n = 1444). Respondents were given a vignette based on diagnostic criteria for schizophrenia, major depression, alcohol dependence, or drug dependence, or a "control" case. RESULTS: The specific nature of the problem was the most important factor shaping public reaction. Respondents viewed those with "troubles," alcohol dependence, or depression as able to make treatment decisions. Most reported that persons with alcohol or drug problems or schizophrenia cannot manage money and are likely to be violent toward others. Respondents indicated a willingness to coerce individuals into treatment. Respondent and other case characteristics rarely affected opinions. CONCLUSIONS: Americans report greater concern with individuals who have drug or alcohol problems than with persons who have other mental health problems. Evaluations of dangerousness and coercion indicate a continuing need for public education. PMID:10474550

Prototype Development and Redesign: A Case Study

DTIC Science & Technology

1990-03-01

deal with difficult problems of leadership , strategy and management." [Ref. 10:p. 1] Admiral Turner feels that using the case study method "will help...placement officer was a Lieutenant Commander or Commander. Often times they came from leadership positions of executive officer equivalence. They were...ting power. Personnel within the computer organizatin who are used to manual methods and potential users of the system are resisting the change and

Watershed modeling and monitoring for assessing nutrient ...

EPA Pesticide Factsheets

Presentation for the American Water Works Association Water Sustainability Conference. The presentation highlights latest results from water quality trading research conducted by ORD using the East Fork Watershed in Southwestern Ohio as a case study. The watershed has a nutrient enrichment problem that is creating harmful algal blooms in a reservoir used for drinking water and recreation. Innovative modeling and monitoring is combined to understand how to best manage this water quality problem and costs associated with this endeavor. The presentation will provide an overview of the water quality trading feasibility research. The research includes the development and evaluation of innovative modeling and monitoring approaches to manage watersheds for nutrient pollution using a whole systems approach.

Tuberculosis--triumph and tragedy.

PubMed

Singh, M M

2003-03-01

Tuberculosis has been making havoc worldwide with an 11.9 million cases to be involved by the year 2005. In India, about 2 million cases are infected every year. Regarding triumphs and tragedies in the control of tuberculosis some points as follows are discussed. (1) Tuberculosis Control Programmes from National Tuberculosis Programme (NTP) to Revised National Tuberculosis Control Programme (RNTCP) and Directly Observed Treatment, Short course (DOTS). (2) Problem of multidrug resistance (MDR) tuberculosis and (3) HIV and tuberculosis. DOTS being largely based on Indian research. It is now being applied worldwide. MDR is strictly a man made problem. Poor prescriptions, poor case management, lack of coordinated education and haphazard treatment research result in drug resistance. Treatment of MDR is difficult. The drug acceptability, tolerance and toxicity have to be considered. HIV and tuberculosis form a deadly duo. They mean more cases, more costs and more national losses.

Research on image evidence in land supervision and GIS management

NASA Astrophysics Data System (ADS)

Li, Qiu; Wu, Lixin

2006-10-01

Land resource development and utilization brings many problems. The numbers, the scale and volume of illegal land use cases are on the increasing. Since the territory is vast, and the land violations are concealment, it is difficulty for an effective land supervision and management. In this paper, the concepts of evidence, and preservation of evidence were described first. The concepts of image evidence (IE), natural evidence (NE), natural preservation of evidence (NPE), general preservation of evidence (GPE) were proposed based on the characteristics of remote sensing image (RSI) which has a characteristic of objectiveness, truthfulness, high spatial resolution, more information included. Using MapObjects and Visual Basic 6.0, under the Access management to implement the conjunction of spatial vector database and attribute data table; taking RSI as the data sources and background layer; combining the powerful management of geographic information system (GIS) for spatial data, and visual analysis, a land supervision and GIS management system was design and implemented based on NPE. The practical use in Beijing shows that the system is running well, and solved some problems in land supervision and management.

Emerging Technologies for Real-Time Continuous Monitoring of Wellbore Integrity

NASA Astrophysics Data System (ADS)

Freifeld, B. M.

2017-12-01

Assessment of a well's integrity has traditionally been carried out through periodic wireline logging, often performed only when an operational problem was noted at the surface. There are several emerging technologies that can be installed permanently as part of the well completion and offer the ability to monitor operations while providing continuous indicators to evaluate the structural health of a well. Permanent behind casing instrumentation, such as pressure and temperature gauges can monitor for behind casing leakage. Similarly, fiber-optic distributed temperature and acoustic sensing provide additional information for assessing unwanted movement of fluid, which is indicative of problems either inside or outside of casing. Furthermore, these technologies offer the benefit of providing real-time continuous streams of information that serve as leading-indicators of wellbore problems to allow for early intervention. Additional research is still needed to develop best practices for the installation and operation of these technologies, as they increase cost and add additional risks that must be managed.

Evaluation of coastal management: Study case in the province of Alicante, Spain.

PubMed

Palazón, A; Aragonés, L; López, I

2016-12-01

The beaches are complex systems that can be studied from different points of view and meet more than a mission to protect the coast. Their management consists of assigning solutions to problems and for this to be correct all factors involved have to be taken into account. In order to understand how management is done on the coast of the province of Alicante, surveys have been conducted among the managers of the 19 coastal municipalities of Alicante coast, covering the 91 beaches. The aim of the surveys is to try to know the problems and situations relating to the management, depending on different factors such as the level of urbanization and type of sediment. In addition, it has been investigated whether this management is aimed to protect the coastline, maintain the flora and fauna or is just a recreational management since the main economic activity is tourism. The beaches are conceived of as products offered to the user, which is what most concerns its economic importance in an area where the sun and beach tourism has a special share of the GDP. The ignorance as to the major problems regarding their physical functioning and the inability to solve them is due to a complex administrative system with which the coastal system is regulated inefficiently. The integral approach is essential for a complete and effective management of the coastal environment. Copyright © 2016 Elsevier B.V. All rights reserved.

Computer Sciences Applied to Management at Open University of Catalonia: Development of Competences of Teamworks

NASA Astrophysics Data System (ADS)

Pisa, Carlos Cabañero; López, Enric Serradell

Teamwork is considered one of the most important professional skills in today's business environment. More specifically, the collaborative work between professionals and information technology managers from various functional areas is a strategic key in competitive business. Several university-level programs are focusing on developing these skills. This article presents the case of the course Computer Science Applied to Management (hereafter CSAM) that has been designed with the objective to develop the ability to work cooperatively in interdisciplinary teams. For their design and development have been addressed to the key elements of efficiency that appear in the literature, most notably the establishment of shared objectives and a feedback system, the management of the harmony of the team, their level of autonomy, independence, diversity and level of supervision. The final result is a subject in which, through a working virtual platform, interdisciplinary teams solve a problem raised by a case study.

Optimization and resilience in natural resources management

USGS Publications Warehouse

Williams, Byron K.; Johnson, Fred A.

2015-01-01

We consider the putative tradeoff between optimization and resilience in the management of natural resources, using a framework that incorporates different sources of uncertainty that are common in natural resources management. We address one-time decisions, and then expand the decision context to the more complex problem of iterative decision making. For both cases we focus on two key sources of uncertainty: partial observability of system state and uncertainty as to system dynamics. Optimal management strategies will vary considerably depending on the timeframe being considered and the amount and quality of information that is available to characterize system features and project the consequences of potential decisions. But in all cases an optimal decision making framework, if properly identified and focused, can be useful in recognizing sound decisions. We argue that under the conditions of deep uncertainty that characterize many resource systems, an optimal decision process that focuses on robustness does not automatically induce a loss of resilience.

Management of a water distribution network by coupling GIS and hydraulic modeling: a case study of Chetouane in Algeria

NASA Astrophysics Data System (ADS)

Abdelbaki, Chérifa; Benchaib, Mohamed Mouâd; Benziada, Salim; Mahmoudi, Hacène; Goosen, Mattheus

2017-06-01

For more effective management of water distribution network in an arid region, Mapinfo GIS (8.0) software was coupled with a hydraulic model (EPANET 2.0) and applied to a case study region, Chetouane, situated in the north-west of Algeria. The area is characterized not only by water scarcity but also by poor water management practices. The results showed that a combination of GIS and modeling permits network operators to better analyze malfunctions with a resulting more rapid response as well as facilitating in an improved understanding of the work performed on the network. The grouping of GIS and modeling as an operating tool allows managers to diagnosis a network, to study solutions of problems and to predict future situations. The later can assist them in making informed decisions to ensure an acceptable performance level for optimal network operation.

Overall comparative analysis of management and outcomes of cardiac cases reported on board merchant ships.

PubMed

Apostolatos, Charalampos; Andria, Vivian; Licari, Julie

Telemedical assistance has always been the cornerstone of medical care on board. Significant technological progress has provided improved scientific tools and equipment for high-quality communication and prompt management of either minor incidents or major emergencies on board. Med Solutions International is a medical management company, offering services exclusively to the maritime industry. Registered vessels contact the medical team and healthcare professionals provide immediate guidelines for onboard management as well as necessary action thereafter, i.e. examination ashore or urgent medical evacuation. Since cardiac conditions or diseases are potentially the most dangerous when traveling at sea, it is of major importance to analyse and evaluate the overall management and outcomes of cases reporting symptoms of possible heart disease so as to improve telemedical assistance services in future. The study included cases reporting cardiac symptoms from 5 major shipping companies during the year 2016. Data was collected from telecommunication, emails and seafarers' final medical reports. A descriptive analysis of overall management and outcomes was performed. The study showed that the number of confirmed cardiovascular cases on board was very low. Among 551 total cases and 44 cases with reported cardiac symptoms there was only one heart attack, one pulmonary oedema and one suspected myocarditis. In the majority of cases, chest pain was musculoskeletal or due to respiratory infection. Symptoms resulting from issues such as stress or anxiety often present as potential cardiac conditions. Stress may also amplify the severity of symptoms. Language barriers between the seafarer, the master and the doctor often make communication very difficult. According to our findings there are grounds to intensify the prevention process through more efficient pre-employment medical examinations and improve management on board through more intensive training. Communication problems often complicate medical management on board. Effective communication and knowledge of patient's medical history and risk profile is very important to reviewing physician. Effective diagnosis depends on accurate and objective description of symptoms and clinical condition.

Survey of horse transportation in Australia: issues and practices.

PubMed

Padalino, B; Raidal, S L; Hall, E; Knight, P; Celi, P; Jeffcott, L; Muscatello, G

2016-10-01

To survey amateur and professional participants on equine transportation management, practices and outcomes in Australia. An online survey targeting people who organised horse movements at least monthly was made available to a broad cross-section of amateur and professional equine associations. Respondents were invited to provide demographic details and information relating to their routine transportation management practices and their experiences of issues relating to the transportation of horses. Of 797 usable responses involving approximately 17,000 horses and 313,000 individual horse transport events, transport-related behavioural problems were reported by 38% of respondents, particularly at loading. Transport-related health problems had been experienced during or after transportation by horses in the care of 67% of respondents. The most common problems reported were traumatic injuries (45.0%), diarrhoea (20.0%), muscular problems (13.0%), respiratory problems (12.3%), overheating (10.5%) and colic (10.3%). In the 2 years reviewed in the survey, 9.4% of participants reported at least one case of transport-associated pneumonia and 35 horses had died, most commonly from fractures, colic or pneumonia. Although respondents identifying as amateurs transported horses less frequently and over shorter distances, the incidence of transport-related problems was similar between amateurs and professionals. Respondents reported specific precautions before, during and after transportation, although management was often not compliant with the Australian Code of horse transportation. Responses indicated that there remains a substantial risk of adverse welfare and health outcomes for horses transported in Australia and management practices reported may not be compliant with current recommendations for transportation. © 2016 Australian Veterinary Association.

A dynamic feedback-control toll pricing methodology : a case study on Interstate 95 managed lanes.

DOT National Transportation Integrated Search

2013-06-01

Recently, congestion pricing emerged as a cost-effective and efficient strategy to mitigate the congestion problem on freeways. This study develops a feedback-control based dynamic toll approach to formulate and solve for optimal tolls. The study com...

Paraganglioma of the larynx. A case report and clinical review.

PubMed

Shipton, E A; van der Linde, J C

1984-02-04

An 8-year-old Black boy recently underwent surgery for the excision of a non-chromaffin laryngeal paraganglioma. The peri-operative management of this patient is presented. The specific problems involved and their importance to the anaesthesiologist and surgeon alike are discussed.

Best practices: a review of company activity on HIV / AIDS in South Africa.

PubMed

Michael, K

1999-01-01

This article presents the 1998 survey results conducted by the Health Economics and HIV/AIDS Research Division of the University of Natal in South Africa with the goal of documenting the best practices of managing HIV/AIDS in the workplace. The five key areas of the study are: HIV prevention; managing ill health; human resource development and industrial relations; employee benefits and survivor support; monitoring and planning for change in the workplace. The research comprised 14 companies used during the case studies. A few notable cases were observed among companies attempting to create awareness about HIV/AIDS. The Best Practice Survey highlighted issues about the private sectors in South Africa and their HIV management. First, companies conceptualize AIDS as either a health or poverty problem. Second, the environment is affected by the hazards of economic downturns, labor action, and economic inflation while the AIDS problem is neglected. Third, indirect costs were not considered and most companies feel that the conversion to a defined contribution arrangement compensates against escalating payouts for benefits. Fourth, long-term plans of the companies did not utilize the ill health statistics for the past 5 years.

Applying multi-criteria decision-making to improve the waste reduction policy in Taiwan.

PubMed

Su, Jun-Pin; Hung, Ming-Lung; Chao, Chia-Wei; Ma, Hwong-wen

2010-01-01

Over the past two decades, the waste reduction problem has been a major issue in environmental protection. Both recycling and waste reduction policies have become increasingly important. As the complexity of decision-making has increased, it has become evident that more factors must be considered in the development and implementation of policies aimed at resource recycling and waste reduction. There are many studies focused on waste management excluding waste reduction. This study paid more attention to waste reduction. Social, economic, and management aspects of waste treatment policies were considered in this study. Further, a life-cycle assessment model was applied as an evaluation system for the environmental aspect. Results of both quantitative and qualitative analyses on the social, economic, and management aspects were integrated via the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method into the comprehensive decision-making support system of multi-criteria decision-making (MCDM). A case study evaluating the waste reduction policy in Taoyuan County is presented to demonstrate the feasibility of this model. In the case study, reinforcement of MSW sorting was shown to be the best practice. The model in this study can be applied to other cities faced with the waste reduction problems.

Integrating Qualitative and Quantitative Methods in Participatory Modeling to Elicit Behavioral Drivers in Environmental Dilemmas: the Case of Air Pollution in Talca, Chile.

PubMed

Meinherz, Franziska; Videira, Nuno

2018-04-10

The aim of this paper is to contribute to the exploration of environmental modeling methods based on the elicitation of stakeholders' mental models. This aim is motivated by the necessity to understand the dilemmas and behavioral rationales of individuals for supporting the management of environmental problems. The methodology developed for this paper integrates qualitative and quantitative methods by deploying focus groups for the elicitation of the behavioral rationales of the target population, and grounded theory to code the information gained in the focus groups and to guide the development of a dynamic simulation model. The approach is applied to a case of urban air pollution caused by residential heating with wood in central Chile. The results show how the households' behavior interrelates with the governmental management strategies and provide valuable and novel insights into potential challenges to the implementation of policies to manage the local air pollution problem. The experience further shows that the developed participatory modeling approach allows to overcome some of the issues currently encountered in the elicitation of individuals' behavioral rationales and in the quantification of qualitative information.

Strategic management process in hospitals.

PubMed

Zovko, V

2001-01-01

Strategic management is concerned with strategic choices and strategic implementation; it provides the means by which organizations meet their objectives. In the case of hospitals it helps executives and all employees to understand the real purpose and long term goals of the hospital. Also, it helps the hospital find its place in the health care service provision chain, and enables the hospital to coordinate its activities with other organizations in the health care system. Strategic management is a tool, rather than a solution, that helps executives to identify root causes of major problems in the hospital.

Integrated case management for work-related upper-extremity disorders: impact of patient satisfaction on health and work status.

PubMed

Feuerstein, Michael; Huang, Grant D; Ortiz, Jose M; Shaw, William S; Miller, Virginia I; Wood, Patricia M

2003-08-01

An integrated case management (ICM) approach (ergonomic and problem-solving intervention) to work-related upper-extremity disorders was examined in relation to patient satisfaction, future symptom severity, function, and return to work (RTW). Federal workers with work-related upper-extremity disorder workers' compensation claims (n = 205) were randomly assigned to usual care or ICM intervention. Patient satisfaction was assessed after the 4-month intervention period. Questionnaires on clinical outcomes and ergonomic exposure were administered at baseline and at 6- and 12-months postintervention. Time from intervention to RTW was obtained from an administrative database. ICM group assignment was significantly associated with greater patient satisfaction. Regression analyses found higher patient satisfaction levels predicted decreased symptom severity and functional limitations at 6 months and a shorter RTW. At 12 months, predictors of positive outcomes included male gender, lower distress, lower levels of reported ergonomic exposure, and receipt of ICM. Findings highlight the utility of targeting workplace ergonomic and problem solving skills.

Applying the Kanban method in problem-based project work: a case study in a manufacturing engineering bachelor's programme at Aalborg University Copenhagen

NASA Astrophysics Data System (ADS)

Balve, Patrick; Krüger, Volker; Tolstrup Sørensen, Lene

2017-11-01

Problem-based learning (PBL) has proven to be highly effective for educating students in an active and self-motivated manner in various disciplines. Student projects carried out following PBL principles are very dynamic and carry a high level of uncertainty, both conditions under which agile project management approaches are assumed to be highly supportive. The paper describes an empirical case study carried out at Aalborg University Copenhagen involving students from two different semesters of a Bachelor of Science programme. While executing the study, compelling examples of how PBL and the agile project management method Kanban blend could be identified. A final survey reveals that applying Kanban produces noticeable improvements with respect to creating, assigning and coordinating project tasks. Other improvements were found in group communication, knowledge about the work progress with regards to both the individual and the collective and the students' way of continuously improving their own teamwork.

Development of a tool for assessment and care planning for dementia-related problem behaviors in home and community-based services programs: the Problem Behavior Inventory.

PubMed

Phillips, V L; Diwan, Sadhna; Egner, Amanda

2002-01-01

To describe development, validity, and application of the Problem Behavior Inventory (PBI), a tool to assess dementia-related problem behaviors (DRPBs) in community-based populations. Demographic, contact, and disease-specific data were extracted from client files from a Medicaid-funded home and community-based services program. Primary caregivers completed standard surveys relating to the care recipients' memory, mood, and behaviors. The client (care recipient) completed the Mini-Mental Status Exam (MMSE). Cognitively impaired clients, enrolled in the Community Care Services Program (CCSP) during a reference month, and their primary caregivers, were identified by CCSP case managers for participation in the study. Primary caregivers completed the Revised Memory and Behavior Problem Checklist (RMBPC). Clients screening positive for the presence of DRPBs based on caregiver responses to the RMBPC were then assessed using the Problem Behavior Inventory (PBI). Within the CCSP sample, the most prevalent behavior was appearing sad or depressed (67%), while the most frequent behavior was seeking attention, occurring at least daily in 58% of the group. The most bothersome behaviors were being sexually inappropriate, wandering, and misbehaving in public. Examination by behavior category (physical, verbal, mood, etc.) revealed a strong relationship between level of bother and behavior frequency. Frequency of verbal behaviors was positively related to MMSE scores, whereas frequency of ADL-related behaviors was inversely related to MMSE scores. Bother scores were not associated with MMSE scores. This study documents that the PBI is a valid, useful, and feasible tool for assessing DRPBs in community populations. Case managers using the PBI can determine specific problem behavior areas among client populations and for individual clients and institute client-specific interventions to address each issue.

How chemical pollution becomes a social problem. Risk communication and assessment through regional newspapers during the management of PCB pollutions of the Rhône River (France).

PubMed

Comby, Emeline; Le Lay, Yves-François; Piégay, Hervé

2014-06-01

The case study of the polychlorinated biphenyl (PCB) pollutions of the Rhône River (France) offers the possibility of studying criteria for the construction of social problems that result from chemical pollution (2005-2010). We investigated the dynamics of competition that create and define pollution as a social problem and entail its decline. News outlets are crucial for determining how an environmental issue emerges locally or nationally; this study used newspapers to highlight the potential of new outlets as a data source to analyze discourse variability, science-policy-media connections and the hydrosphere. Media coverage was based on a content analysis and textual data analysis of 75 articles. Analytical frameworks such as the Downs Model and the Public Arena Model (Hilgartner and Bosk, 1988) that consider time and stakeholders were tested to determine how human alteration of the hydrosphere can become a social problem and to analyze different communication strategies held by stakeholders. In terms of management, we described the temporal dynamics of the social problem based on the case study and considered an explanation of the selections. We considered the organization of particular stakeholders who define the social problem from its beginning to end by focusing on their discourses, relationships, decision-making and political choices, and scientific studies. Despite some biases, newspapers are useful for retrospectively evaluating the emergence of a social problem in the public arena by describing it through discourse and then understanding the temporal patterns of information. Despite uncertainties and information flow, decisions are made and science is translated to the public. Copyright © 2014 Elsevier B.V. All rights reserved.

Research on Risk Management and Power Supplying Enterprise Control

NASA Astrophysics Data System (ADS)

Shen, Jianfei; Wang, Yige

2017-09-01

This paper derived from the background that electric power enterprises strengthen their risk management under requirements of the government. For the power industry, we explained the risk management theory, analysed current macro environment as well as basic situation, then classified and interpreted the main risks. In a case study on a power bureau, we established a risk management system based on deep understanding about the characteristics of its organization system and risk management function. Then, we focused on risks in operation as well as incorrupt government construction to give a more effective framework of the risk management system. Finally, we came up with the problems and specific countermeasures in risk management, which provided a reference for other electric power enterprises.

Opportunities to enhance contribution of model forests in the sustainable forest resources management (example from Yalova Model Forest).

PubMed

Bekiroğlu, Sultan; Özdemir, Mehmet; Özyürek, Ercan; Arslan, Avni

2016-10-01

Model forests are nongovernmental organizations at local, regional and international level which are mainly focused on reconciling the conflicts between the stakeholders. This is an innovative approach to organization, which has been receiving more and more attraction from increasing number of countries, which gradually increased the number of model forests for the last 25 years. If these organizations reach desired levels of structure, medium, impacts and assets their contribution in sustainable forest resources management will increase ipso facto. The very first model forest of Turkey was created in Yalova Province in 2010. Yalova Province has certain fundamental problems including but not limited to; population growth and unplanned urbanization caused by industrialization, uncontrolled increase in demand for fire wood and non-wooden products of forestry resources, questionable resource management decisions adopted in the past and low-income levels of the people especially those in the rural areas. The main objective of present case study is to analyze Yalova Model Forest (YMF) so as to determine the possible problems that may occur during implementation of sustainable management for forestry resources through a planning approach with multiple stakeholders. As a result of research, it has been revealed that YMF has certain significant structural, environmental and impact-related problems. In order to ensure continuity of YMF's contribution to sustainable forestry resources management, these problems need to be addressed promptly. Copyright © 2016 Elsevier Ltd. All rights reserved.

A nonlinear bi-level programming approach for product portfolio management.

PubMed

Ma, Shuang

2016-01-01

Product portfolio management (PPM) is a critical decision-making for companies across various industries in today's competitive environment. Traditional studies on PPM problem have been motivated toward engineering feasibilities and marketing which relatively pay less attention to other competitors' actions and the competitive relations, especially in mathematical optimization domain. The key challenge lies in that how to construct a mathematical optimization model to describe this Stackelberg game-based leader-follower PPM problem and the competitive relations between them. The primary work of this paper is the representation of a decision framework and the optimization model to leverage the PPM problem of leader and follower. A nonlinear, integer bi-level programming model is developed based on the decision framework. Furthermore, a bi-level nested genetic algorithm is put forward to solve this nonlinear bi-level programming model for leader-follower PPM problem. A case study of notebook computer product portfolio optimization is reported. Results and analyses reveal that the leader-follower bi-level optimization model is robust and can empower product portfolio optimization.

Magnets, children and the bowel: a dangerous attraction?

PubMed

George, Anil Thomas; Motiwale, Sandeep

2012-10-14

Reports of magnet ingestion are increasing rapidly globally. However, multiple magnet ingestion, the subsequent potential complications and the importance of the early identification and proper management remain both under-recognized and underestimated. Published literature on such cases could possibly represent only the tip of an iceberg with press reports, web blogs and government documents highlighting further occurrence of many more such incidents. The increasing number of complications worldwide being reported secondary to magnet ingestion point not only to an acute lack of awareness about this condition among the medical profession but also among parents and carers who will be in most cases the first to pick up on magnet ingestion. There still seems to be no consensus on the management of magnet ingestion with several algorithms being proposed for management. Prevention of this condition remains a much better option than cure. Proper education and improved awareness among parents and carers and frontline medical staff is key in addressing this rapidly emerging problem. The goal of managing such cases of suspected magnet ingestion should be aimed at reducing delays between ingestion time, diagnosis time and intervention time.

Magnets, children and the bowel: A dangerous attraction?

PubMed Central

George, Anil Thomas; Motiwale, Sandeep

2012-01-01

Reports of magnet ingestion are increasing rapidly globally. However, multiple magnet ingestion, the subsequent potential complications and the importance of the early identification and proper management remain both under-recognized and underestimated. Published literature on such cases could possibly represent only the tip of an iceberg with press reports, web blogs and government documents highlighting further occurrence of many more such incidents. The increasing number of complications worldwide being reported secondary to magnet ingestion point not only to an acute lack of awareness about this condition among the medical profession but also among parents and carers who will be in most cases the first to pick up on magnet ingestion. There still seems to be no consensus on the management of magnet ingestion with several algorithms being proposed for management. Prevention of this condition remains a much better option than cure. Proper education and improved awareness among parents and carers and frontline medical staff is key in addressing this rapidly emerging problem. The goal of managing such cases of suspected magnet ingestion should be aimed at reducing delays between ingestion time, diagnosis time and intervention time. PMID:23082048

Evaluating the automated blood glucose pattern detection and case-retrieval modules of the 4 Diabetes Support System.

PubMed

Schwartz, Frank L; Vernier, Stanley J; Shubrook, Jay H; Marling, Cynthia R

2010-11-01

We have developed a prototypical case-based reasoning system to enhance management of patients with type 1 diabetes mellitus (T1DM). The system is capable of automatically analyzing large volumes of life events, self-monitoring of blood glucose readings, continuous glucose monitoring system results, and insulin pump data to detect clinical problems. In a preliminary study, manual entry of large volumes of life-event and other data was too burdensome for patients. In this study, life-event and pump data collection were automated, and then the system was reevaluated. Twenty-three adult T1DM patients on insulin pumps completed the five-week study. A usual daily schedule was entered into the database, and patients were only required to upload their insulin pump data to Medtronic's CareLink® Web site weekly. Situation assessment routines were run weekly for each participant to detect possible problems, and once the trial was completed, the case-retrieval module was tested. Using the situation assessment routines previously developed, the system found 295 possible problems. The enhanced system detected only 2.6 problems per patient per week compared to 4.9 problems per patient per week in the preliminary study (p=.017). Problems detected by the system were correctly identified in 97.9% of the cases, and 96.1% of these were clinically useful. With less life-event data, the system is unable to detect certain clinical problems and detects fewer problems overall. Additional work is needed to provide device/software interfaces that allow patients to provide this data quickly and conveniently. © 2010 Diabetes Technology Society.

Applying a contingency model of strategic decision making to the implementation of smoking bans: a case study.

PubMed

Willemsen, M C; Meijer, A; Jannink, M

1999-08-01

A model of strategic decision making was applied to study the implementation of worksite smoking policy. This model assumes there is no best way of implementing smoking policies, but that 'the best way' depends on how decision making fits specific content and context factors. A case study at Wehkamp, a mail-order company, is presented to illustrate the usefulness of this model to understand how organizations implement smoking policies. Interview data were collected from representatives of Wehkamp, and pre- and post-ban survey data were collected from employees. After having failed to solve the smoking problem in a more democratic way, Wehkamp's top management choose a highly confrontational and decentralized decision-making approach to implement a complete smoking ban. This resulted in an effective smoking ban, but was to some extent at the cost of employees' satisfaction with the policy and with how the policy was implemented. The choice of implementation approach was contingent upon specific content and context factors, such as managers' perception of the problem, leadership style and legislation. More case studies from different types of companies are needed to better understand how organizational factors affect decision making about smoking bans and other health promotion innovations.

Multidisciplinary Approach in the Management of a Complex Case: Implant-Prosthetic Rehabilitation of a Periodontal Smoking Patient with Partial Edentulism, Malocclusion, and Aesthetic Diseases

PubMed Central

Di Francesco, Fabrizio; De Marco, Gennaro; Scognamiglio, Fabio; Aruta, Valeria; Itro, Angelo

2017-01-01

Complex periprosthetic cases are considered as challenges by clinicians. Clinical and radiographic parameters should be considered separately to make the right choice between an endodontically or periodontally compromised treated tooth and implant. Therefore, in order to decide whether the tooth is safe or not, data that have to be collected are specific parameters of both the patient and the clinician. In addition, the presence of periodontal, prosthetic, and orthodontic diseases requires patients to be set in multidisciplinary approach. The aim of this case report is to describe how the multidisciplinary approach could be the best way to manage difficult cases of implant-prosthetic rehabilitation. How to rehabilitate with fixed prosthesis on natural teeth and dental implants a smoker patient who presents with active periodontitis, multiple edentulous areas, dental malocclusion, and severe aesthetic problems was also described. PMID:28421148

Sugammadex Use in a Patient with Wolff-Parkinson-White (WPW) Syndrome

PubMed Central

Şahin, Sevtap Hekimoğlu; Öztekin, İlhan; Kuzucuoğlu, Aytuna; Aslanoğlu, Ayça

2015-01-01

Background: Wolff-Parkinson-White (WPW) syndrome is a disease associated with episodes of supraventricular tachycardia and ventricular pre-excitation or atrial fibrillation. WPW is characterized by an aberrant electrical conduction pathway between atria and ventricles. Case Report: The major anesthetic problem connected with WPW syndrome is the risk of tachyarrhythmias due to accessory pathway. Therefore, it has been proposed that the aim of anesthetic management should be the avoidance of tachyarrhythmia and sympathetic stimulation. Sugammadex was administered as a neuromuscular reversal agent in this case. To our knowledge, this is the first case report of sugammadex use in a patient with WPW. This report presents a case of general anesthesia management in a patient with WPW syndrome. Conclusion: We think that it is appropriate to use sugammadex to reverse rocuronium for the prevention of sudden hemodynamic changes in patients with WPW who underwent general anesthesia. PMID:26185726

Informatics tools to improve clinical research study implementation.

PubMed

Brandt, Cynthia A; Argraves, Stephanie; Money, Roy; Ananth, Gowri; Trocky, Nina M; Nadkarni, Prakash M

2006-04-01

There are numerous potential sources of problems when performing complex clinical research trials. These issues are compounded when studies are multi-site and multiple personnel from different sites are responsible for varying actions from case report form design to primary data collection and data entry. We describe an approach that emphasizes the use of a variety of informatics tools that can facilitate study coordination, training, data checks and early identification and correction of faulty procedures and data problems. The paper focuses on informatics tools that can help in case report form design, procedures and training and data management. Informatics tools can be used to facilitate study coordination and implementation of clinical research trials.

Crisis management during anaesthesia: hypotension.

PubMed

Morris, R W; Watterson, L M; Westhorpe, R N; Webb, R K

2005-06-01

Hypotension is commonly encountered in association with anaesthesia and surgery. Uncorrected and sustained it puts the brain, heart, kidneys, and the fetus in pregnancy at risk of permanent or even fatal damage. Its recognition and correction is time critical, especially in patients with pre-existing disease that compromises organ perfusion. To examine the role of a previously described core algorithm "COVER ABCD-A SWIFT CHECK", supplemented by a specific sub-algorithm for hypotension, in the management of hypotension when it occurs in association with anaesthesia. Reports of hypotension during anaesthesia were extracted and studied from the first 4000 incidents reported to the Australian Incident Monitoring Study (AIMS). The potential performance of the COVER ABCD algorithm and the sub-algorithm for hypotension was compared with the actual management as reported by the anaesthetist involved. There were 438 reports that mentioned hypotension, cardiovascular collapse, or cardiac arrest. In 17% of reports more than one cause was attributed and 550 causative events were identified overall. The most common causes identified were drugs (26%), regional anaesthesia (14%), and hypovolaemia (9%). Concomitant changes were reported in heart rate or rhythm in 39% and oxygen saturation or ventilation in 21% of reports. Cardiac arrest was documented in 25% of reports. As hypotension was frequently associated with abnormalities of other vital signs, it could not always be adequately addressed by a single algorithm. The sub-algorithm for hypotension is adequate when hypotension occurs in association with sinus tachycardia. However, when it occurs in association with bradycardia, non-sinus tachycardia, desaturation or signs of anaphylaxis or other problems, the sub-algorithm for hypotension recommends cross referencing to other relevant sub-algorithms. It was considered that, correctly applied, the core algorithm COVER ABCD would have diagnosed 18% of cases and led to resolution in two thirds of these. It was further estimated that completion of this followed by the specific sub-algorithm for hypotension would have led to earlier recognition of the problem and/or better management in 6% of cases compared with actual management reported. Pattern recognition in most cases enables anaesthetists to determine the cause and manage hypotension. However, an algorithm based approach is likely to improve the management of a small proportion of atypical but potentially life threatening cases. While an algorithm based approach will facilitate crisis management, the frequency of co-existing abnormalities in other vital signs means that all cases of hypotension cannot be dealt with using a single algorithm. Diagnosis, in particular, may potentially be assisted by cross referencing to the specific sub-algorithms for these.

[Gastric band erosion: Alternative management].

PubMed

Echaverry-Navarrete, Denis José; Maldonado-Vázquez, Angélica; Cortes-Romano, Pablo; Cabrera-Jardines, Ricardo; Mondragón-Pinzón, Erwin Eduardo; Castillo-González, Federico Armando

2015-01-01

Obesity is a public health problem, for which the prevalence has increased worldwide at an alarming rate, affecting 1.7 billion people in the world. To describe the technique employed in incomplete penetration of gastric band where endoscopic management and/or primary closure is not feasible. Laparoscopic removal of gastric band was performed in five patients with incomplete penetrance using Foley catheterization in the perforation site that could lead to the development of a gastro-cutaneous fistula. The cases presented include a leak that required surgical lavage with satisfactory outcome, and one patient developed stenosis 3 years after surgical management, which was resolved endoscopically. In all cases, the penetration site closed spontaneously. Gastric band erosion has been reported in 3.4% of cases. The reason for inserting a catheter is to create a controlled gastro-cutaneous fistula, allowing spontaneous closure. Various techniques have been described: the totally endoscopic, hybrid techniques (endoscopic/laparoscopic) and completely laparoscopic. A technique is described here that is useful and successful in cases where the above-described treatments are not viable. Copyright © 2015. Published by Masson Doyma México S.A.

Epidemiological review of scorpion stings in Qatar. The need for regional management guidelines in emergency departments.

PubMed

Alkahlout, Baha H; Abid, Muhammad M; Kasim, Mohammad M; Haneef, Shumaila M

2015-07-01

To review the epidemiology of scorpion sting in Qatar, to explore both the clinical significance, and the role of the emergency department (ED) in the management of such cases. In this retrospective study, we reviewed the records of all scorpion sting cases presented to the ED of Hamad General Hospital, Doha, Qatar between October 2010 and May 2013. A total of 111 cases of scorpion stings were reviewed, 81 (72.9%) were males and 30 (27.1%) were females, with a mean age of 38 years. Localized pain was the most frequent presenting complaint (89 [80.2%]), whereas localized redness (44 [39.6%]) and swelling (38 [34.2%]) were the most common clinical signs. Abroug's classification was used, and all cases  were found to be class I. All patients received symptomatic treatment and were sent home. Scorpion sting problem in Qatar has a low clinical significance. Data from such studies should be utilized to create more specific (local) management guidelines, which should be more efficient with more rational utilization of ED resources.

IT: An Effective Pedagogic Tool in the Teaching of Quantitative Methods in Management.

ERIC Educational Resources Information Center

Nadkami, Sanjay M.

1998-01-01

Examines the possibility of supplementing conventional pedagogic methods with information technology-based teaching aids in the instruction of quantitative methods to undergraduate students. Considers the case for a problem-based learning approach, and discusses the role of information technology. (Author/LRW)

Program Monitoring: Problems and Cases.

ERIC Educational Resources Information Center

Lundin, Edward; Welty, Gordon

Designed as the major component of a comprehensive model of educational management, a behavioral model of decision making is presented that approximates the synoptic model of neoclassical economic theory. The synoptic model defines all possible alternatives and provides a basis for choosing that alternative which maximizes expected utility. The…

Improving Virtual Teams through Knowledge Management: A Case Study

ERIC Educational Resources Information Center

Laughridge, James F.

2012-01-01

Within the dynamic globalized operating environment, organizations are increasingly relying on virtual teams to solve their most difficult problems, leverage their expertise and expand their presence. The use of virtual teams by organizations continues to increase greatly as the technologies supporting them evolve. Despite improvements in…

SWMM 5 - A Case Study of Model Re-Development

EPA Science Inventory

By the turn of the 21st century the U.S. Environmental Protection Agency’s (EPA) Storm Water Management Model (SWMM) already had a 30-year history of extensive use throughout the world for analyzing complex hydrologic, hydraulic, and water quality problems related to urban draina...

Langley Communications: Socializing and Snooping on E-mail.

ERIC Educational Resources Information Center

Rymer, Jone

1998-01-01

Presents a case study for use in business communication classes to help students understand and learn both the context and the strategies for the communication with business management. Deals with a business problem revolving around issues of appropriate e-mail use and privacy. Includes five assignments. (SR)

Sentry Assurance: Bringing Outsiders "In."

ERIC Educational Resources Information Center

Lease, Judy E.

1998-01-01

Presents a case study for use in business communication classes to help students understand and learn both the context and the strategies for communication with business and management. Deals with multiple problems caused by the rapid expansion of an insurance brokerage, including gender issues, clarification of responsibilities and roles, and…

Melding Classroom Instruction With Real-World Problem-Solving.

ERIC Educational Resources Information Center

Gannon, John E.; Fairchild, G. Winfield

1983-01-01

Describes a course used to teach freshwater ecology to graduate and undergraduate students at the University of Michigan Biological Station. Explains how students receive an introduction to lake ecology and work on applied resource management questions concerning local lakes and streams. Gives case study examples. (SB)

Physics and the car business

NASA Astrophysics Data System (ADS)

Compton, W. Dale; Reitz, John R.

1981-01-01

Physicists have made important contributions to many areas of Ford Motor Company activity, particularly in areas of basic and applied research and product development. A number have assumed positions with management responsibility. Many of the technical problems facing the automotive industry today require a fundamental understanding, and the ability of physicists to contribute to the solution of these problems is greater now than it has been in the past. The present paper discusses some of these problems, and also traces a few case histories of physicists at Ford Motor Company; these illustrate the wide diversity of career paths for persons entering industry with a physics background.

Heparin-induced thrombocytopenia and heart operation: management with tedelparin.

PubMed

Altés, A; Martino, R; Gari, M; Cámara, M L; Garín, R; Casas, J I; Fontcuberta, J

1995-02-01

Anticoagulation for cardiopulmonary bypass in the infrequent clinical setting of thrombocytopenia associated with the use of unfractionated heparin is a very serious problem. We describe a case in which a low-molecular-weight heparin (tedelparin) was selected for this purpose based on a platelet aggregation test, permitting adequate anticoagulation during cardiopulmonary bypass for valve replacement. This case report might help establish an adequate anticoagulation protocol when faced with a patient suffering from this condition.

GIS and Game Theory for Water Resource Management

NASA Astrophysics Data System (ADS)

Ganjali, N.; Guney, C.

2017-11-01

In this study, aspects of Game theory and its application on water resources management combined with GIS techniques are detailed. First, each term is explained and the advantages and limitations of its aspect is discussed. Then, the nature of combinations between each pair and literature on the previous studies are given. Several cases were investigated and results were magnified in order to conclude with the applicability and combination of GIS- Game Theory- Water Resources Management. It is concluded that the game theory is used relatively in limited studies of water management fields such as cost/benefit allocation among users, water allocation among trans-boundary users in water resources, water quality management, groundwater management, analysis of water policies, fair allocation of water resources development cost and some other narrow fields. Also, Decision-making in environmental projects requires consideration of trade-offs between socio-political, environmental, and economic impacts and is often complicated by various stakeholder views. Most of the literature on water allocation and conflict problems uses traditional optimization models to identify the most efficient scheme while the Game Theory, as an optimization method, combined GIS are beneficial platforms for agent based models to be used in solving Water Resources Management problems in the further studies.

A Simulation-Optimization Model for the Management of Seawater Intrusion

NASA Astrophysics Data System (ADS)

Stanko, Z.; Nishikawa, T.

2012-12-01

Seawater intrusion is a common problem in coastal aquifers where excessive groundwater pumping can lead to chloride contamination of a freshwater resource. Simulation-optimization techniques have been developed to determine optimal management strategies while mitigating seawater intrusion. The simulation models are often density-independent groundwater-flow models that may assume a sharp interface and/or use equivalent freshwater heads. The optimization methods are often linear-programming (LP) based techniques that that require simplifications of the real-world system. However, seawater intrusion is a highly nonlinear, density-dependent flow and transport problem, which requires the use of nonlinear-programming (NLP) or global-optimization (GO) techniques. NLP approaches are difficult because of the need for gradient information; therefore, we have chosen a GO technique for this study. Specifically, we have coupled a multi-objective genetic algorithm (GA) with a density-dependent groundwater-flow and transport model to simulate and identify strategies that optimally manage seawater intrusion. GA is a heuristic approach, often chosen when seeking optimal solutions to highly complex and nonlinear problems where LP or NLP methods cannot be applied. The GA utilized in this study is the Epsilon-Nondominated Sorted Genetic Algorithm II (ɛ-NSGAII), which can approximate a pareto-optimal front between competing objectives. This algorithm has several key features: real and/or binary variable capabilities; an efficient sorting scheme; preservation and diversity of good solutions; dynamic population sizing; constraint handling; parallelizable implementation; and user controlled precision for each objective. The simulation model is SEAWAT, the USGS model that couples MODFLOW with MT3DMS for variable-density flow and transport. ɛ-NSGAII and SEAWAT were efficiently linked together through a C-Fortran interface. The simulation-optimization model was first tested by using a published density-independent flow model test case that was originally solved using a sequential LP method with the USGS's Ground-Water Management Process (GWM). For the problem formulation, the objective is to maximize net groundwater extraction, subject to head and head-gradient constraints. The decision variables are pumping rates at fixed wells and the system's state is represented with freshwater hydraulic head. The results of the proposed algorithm were similar to the published results (within 1%); discrepancies may be attributed to differences in the simulators and inherent differences between LP and GA. The GWM test case was then extended to a density-dependent flow and transport version. As formulated, the optimization problem is infeasible because of the density effects on hydraulic head. Therefore, the sum of the squared constraint violation (SSC) was used as a second objective. The result is a pareto curve showing optimal pumping rates versus the SSC. Analysis of this curve indicates that a similar net-extraction rate to the test case can be obtained with a minor violation in vertical head-gradient constraints. This study shows that a coupled ɛ-NSGAII/SEAWAT model can be used for the management of groundwater seawater intrusion. In the future, the proposed methodology will be applied to a real-world seawater intrusion and resource management problem for Santa Barbara, CA.

[Retroperitoneal hematoma].

PubMed

Dordević, D; Gigić, A; Milev, I; Novaković, B; Sretenović, Z

1989-01-01

Diagnosis and management of retroperitoneal haematoma is the problem of controversy in actual moment. It appears most frequently in the range of polytrauma or various traumas of abdomen and retroperitoneal organs. Here we report our experience in management of retroperitoneal haematoma. During the ten year period (from 1979 to 1986) we treated surgically, at the department for surgery, 58 injured patients with retroperitoneal haematoma. In 5 cases explorative laparotomy was done, and in other 53 cases there were injuries of intraabdominal and retroperitoneal organs. The haematomas were caused by the ruptures of spleen, liver, kidneys, pancreas, duodenum, small bowel with mesenterium, large bowel, bladder, retroperitoneal large blood vessels and pelvic fractures. In 17 cases retroperitoneal haematoma was associated with the injury of one organ. In 36 cases there were injuries of two or more organs. Retroperitoneal haematoma was caused by blunt trauma in most cases. During the management there were some diagnostic difficulties. In diagnosis we use: clinical status, of patients, radiography, angiography, ultrasonography, but the most secure was laparotomy. There are two treatment approaches, operative and conservative. Retroperitoneal haematoma was a consequence of ruptured solid organs and retroperitoneal blood vessels, and associated with injuries of intraperitoneal organs. All this, mentioned above, is the reasons for detailed exploration of abdominal cavity.

Knowledge management strategies: Enhancing knowledge transfer to clinicians and patients.

PubMed

Roemer, Lorrie K; Rocha, Roberto A; Del Fiol, Guilherme; Bradshaw, Richard L; Hanna, Timothy P; Hulse, Nathan C

2006-01-01

At Intermountain Healthcare (Intermountain), executive clinical content experts are responsible for disseminating consistent evidence-based clinical content throughout the enterprise at the point-of-care. With a paper-based system it was difficult to ensure that current information was received and was being used in practice. With electronic information systems multiple applications were supplying similar, but different, vendor-licensed and locally-developed content. These issues influenced the consistency of clinical practice within the enterprise, jeopardized patient and clinician safety, and exposed the enterprise and its employees to potential financial penalties. In response to these issues Intermountain is developing a knowledge management infrastructure providing tools and services to support clinical content development, deployment, maintenance, and communication. The Intermountain knowledge management philosophy includes strategies guiding clinicians and consumers of health information to relevant best practice information with the intention of changing behaviors. This paper presents three case studies describing different information management problems identified within Intermountain, methods used to solve the problems, implementation challenges, and the current status of each project.

A Framework to Evaluate Wildlife Feeding in Research, Wildlife Management, Tourism and Recreation

PubMed Central

Dubois, Sara; Fraser, David

2013-01-01

Simple Summary Human feeding of wildlife is a world-wide phenomenon with very diverse effects on conservation, animal welfare and public safety. From a review of the motivations, types and consequences of wildlife feeding, an evaluative framework is presented to assist policy-makers, educators and managers to make ethical- and biologically-based decisions about the appropriateness of feeding wildlife in the context of research, wildlife management, tourism and recreation. Abstract Feeding of wildlife occurs in the context of research, wildlife management, tourism and in opportunistic ways. A review of examples shows that although feeding is often motivated by good intentions, it can lead to problems of public safety and conservation and be detrimental to the welfare of the animals. Examples from British Columbia illustrate the problems (nuisance animal activity, public safety risk) and consequences (culling, translocation) that often arise from uncontrolled feeding. Three features of wildlife feeding can be distinguished: the feasibility of control, the effects on conservation and the effects on animal welfare. An evaluative framework incorporating these three features was applied to examples of feeding from the literature. The cases of feeding for research and management purposes were generally found to be acceptable, while cases of feeding for tourism or opportunistic feeding were generally unacceptable. The framework should allow managers and policy-makers to distinguish acceptable from unacceptable forms of wildlife feeding as a basis for policy, public education and enforcement. Many harmful forms of wildlife feeding seem unlikely to change until they come to be seen as socially unacceptable. PMID:26479747

Decision support system for drinking water management

NASA Astrophysics Data System (ADS)

Janža, M.

2012-04-01

The problems in drinking water management are complex and often solutions must be reached under strict time constrains. This is especially distinct in case of environmental accidents in the catchment areas of the wells that are used for drinking water supply. The beneficial tools that can help decision makers and make program of activities more efficient are decision support systems (DSS). In general they are defined as computer-based support systems that help decision makers utilize data and models to solve unstructured problems. The presented DSS was developed in the frame of INCOME project which is focused on the long-term stable and safe drinking water supply in Ljubljana. The two main water resources Ljubljana polje and Barje alluvial aquifers are characterized by a strong interconnection of surface and groundwater, high vulnerability, high velocities of groundwater flow and pollutant transport. In case of sudden pollution, reactions should be very fast to avoid serious impact to the water supply. In the area high pressures arising from urbanization, industry, traffic, agriculture and old environmental burdens. The aim of the developed DSS is to optimize the activities in cases of emergency water management and to optimize the administrative work regarding the activities that can improve groundwater quality status. The DSS is an interactive computer system that utilizes data base, hydrological modelling, and experts' and stakeholders' knowledge. It consists of three components, tackling the different abovementioned issues in water management. The first one utilizes the work on identification, cleaning up and restoration of illegal dumpsites that are a serious threat to the qualitative status of groundwater. The other two components utilize the predictive capability of the hydrological model and scenario analysis. The user interacts with the system by a graphical interface that guides the user step-by-step to the recommended remedial measures. Consequently, the acquisition of information to support the water management's decisions is simplified and faster, thus contributing to more efficient water management and a safer supply of drinking water.

Scabies outbreaks in residential care homes: factors associated with late recognition, burden and impact. A mixed methods study in England.

PubMed

Hewitt, K A; Nalabanda, A; Cassell, J A

2015-05-01

Scabies is an important public health problem in residential care homes. Delayed diagnosis contributes to outbreaks, which may be prolonged and difficult to control. We investigated factors influencing outbreak recognition, diagnosis and treatment, and staff experiences of outbreak control, identifying areas for intervention. We carried out a semi-structured survey of managers, affected residents and staff of seven care homes reporting suspected scabies outbreaks in southern England over a 6-month period. Attack rates ranged from 2% to 50%, and most cases had dementia (37/39, 95%). Cases were diagnosed clinically by GPs (59%) or home staff (41%), none by dermatologists. Most outbreaks were attributable to avoidably late diagnosis of the index case. Participants reported considerable challenges in managing scabies outbreaks, including late diagnosis and recognition of outbreaks; logistically difficult mass treatment; distressing treatment processes and high costs. This study demonstrates the need for improved support for care homes in detecting and managing these outbreaks.

[Peripheral nerves phenolisation in spasticity management - forgotten art or interesting perspective?

PubMed

Kiwerski, Jerzy; Turżańska, Karolina; Pluta, Ryszard; Drelich, Małgorzata; Zarębska, Aneta; Jabłoński, Mirosław

Spasticity is one of the most common obstacles in the process of rehabilitation after permanent central nervous system injury. Statistics show that the problem affects more than 12 billion people all over the world. Treatment of spasticity is necessary for proper rehabilitation, prevention of secondary disability, pain management and also strongly influences quality of life. Nowadays the most common formula used for the treatment of local spasticity is injection of botulinum toxin. Years ago and also nowadays physicians all over the world successfully used phenol as the chemodenervating factor. This technique today almost forgot in Poland but still used in other countries. Peripheral nerves phenolisation had been used in STOCER (Konstancin) since 1965. The procedure was performed once in 59 patients, twice in 13 patients and three times in 7 patients. Evaluation was based on clinical presentation completed with patient self evaluation form. Good - 36 cases (45%), moderate - 34 cases (43%), bad - 9 cases (12%). Peripheral nerve phenolisation seems to be an interesting alternative to botulinum toxin in the management of spasticity.

Using mHealth to Increase Treatment Utilization Among Recently Incarcerated Homeless Adults (Link2Care): Protocol for a Randomized Controlled Trial.

PubMed

Reingle Gonzalez, Jennifer M; Businelle, Michael S; Kendzor, Darla; Staton, Michele; North, Carol S; Swartz, Michael

2018-06-05

There is a significant revolving door of incarceration among homeless adults. Homeless adults who receive professional coordination of individualized care (ie, case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be reincarcerated. This is because case managers work to meet the various needs of their clients by helping them to overcome barriers to needed services (eg, food, clothing, housing, job training, substance abuse and mental health treatment, medical care, medication, social support, proof of identification, and legal aid). Many barriers (eg, limited transportation, inability to schedule appointments, and limited knowledge of available services) prevent homeless adults who were recently released from incarceration from obtaining available case management, crisis management, substance abuse, and mental health services. The aim of the Link2Care study is to assess the effectiveness of a smartphone app for increasing case management and treatment service utilization, and in turn reduce homelessness and rearrest. The goals of this research are to (1) assess the impact of an innovative smartphone app that will prompt and directly link recently incarcerated homeless adults to community-based case management services and resources and (2) utilize in-person and smartphone-based assessments to identify key variables (eg, alcohol or drug use, social support, psychological distress, and quality of life) that predict continued homelessness and rearrest. Homeless adults (N=432) who enroll in a shelter-based Homeless Recovery Program after release from the Dallas County Jail will be randomly assigned to one of the three treatment groups: (1) usual case management, (2) usual case management plus smartphone, and (3) usual case management with a study-provided smartphone that is preloaded with an innovative case management app (smartphone-based case management). Those assigned to smartphone-based case management will receive smartphones that prompt (twice weekly) connections to shelter-based case managers. The app will also offer direct links to case managers (available during normal business hours) and crisis interventionists (available 24 hours a day, 7 days a week) with the touch of a button. Recruitment began in the spring of 2018, and data collection will conclude in 2021. This research represents an important step toward integrated service connection and health care service provision for one of the most underserved, high need, and understudied populations in the United States. ClinicalTrials.gov NCT03399500; https://clinicaltrials.gov/ct2/show/NCT03399500 (Archived by WebCite at http://www.webcitation.org/6zSJwdgUS). RR1-10.2196/9868. ©Jennifer M Reingle Gonzalez, Michael S Businelle, Darla Kendzor, Michele Staton, Carol S North, Michael Swartz. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 05.06.2018.

Municipal Solid Waste Management and its Energy Potential in Roorkee City, Uttarakhand, India

NASA Astrophysics Data System (ADS)

Alam, Tabish; Kulkarni, Kishore

2016-03-01

Energy plays a vital role in the development of any country. With rapid economic growth and multifold urbanization, India faces the problem of municipal solid waste management and disposal. This problem can be mitigate through adoption of environment friendly technologies for treatment and processing of waste before it is disposed off. Currently, urban and industrial wastes throughout India receive partial treatment before its final disposal, except in few exceptional cases. This practice leads to severe environmental pollution problems including major threat to human health. There is an absolute need to provide adequate waste collection and treatment before its disposal. Municipal Solid Waste (MSW) is getting importance in recent years. The MSW management involves collection, transportation, handling and conversion to energy by biological and thermal routes. Based on the energy potential available, the energy conversion through biogas production using available waste is being carried out. Waste-to-energy is now a clean, renewable, sustainable source of energy. The estimation of energy content of MSW in Roorkee city is discussed in this paper. Furthermore this paper also takes into account the benefits of carbon credits.

Multitarget-multisensor management for decentralized sensor networks

NASA Astrophysics Data System (ADS)

Tharmarasa, R.; Kirubarajan, T.; Sinha, A.; Hernandez, M. L.

2006-05-01

In this paper, we consider the problem of sensor resource management in decentralized tracking systems. Due to the availability of cheap sensors, it is possible to use a large number of sensors and a few fusion centers (FCs) to monitor a large surveillance region. Even though a large number of sensors are available, due to frequency, power and other physical limitations, only a few of them can be active at any one time. The problem is then to select sensor subsets that should be used by each FC at each sampling time in order to optimize the tracking performance subject to their operational constraints. In a recent paper, we proposed an algorithm to handle the above issues for joint detection and tracking, without using simplistic clustering techniques that are standard in the literature. However, in that paper, a hierarchical architecture with feedback at every sampling time was considered, and the sensor management was performed only at a central fusion center (CFC). However, in general, it is not possible to communicate with the CFC at every sampling time, and in many cases there may not even be a CFC. Sometimes, communication between CFC and local fusion centers might fail as well. Therefore performing sensor management only at the CFC is not viable in most networks. In this paper, we consider an architecture in which there is no CFC, each FC communicates only with the neighboring FCs, and communications are restricted. In this case, each FC has to decide which sensors are to be used by itself at each measurement time step. We propose an efficient algorithm to handle the above problem in real time. Simulation results illustrating the performance of the proposed algorithm are also presented.

Interactive computerized learning program exposes veterinary students to challenging international animal-health problems.

PubMed

Conrad, Patricia A; Hird, Dave; Arzt, Jonathan; Hayes, Rick H; Magliano, Dave; Kasper, Janine; Morfin, Saul; Pinney, Stephen

2007-01-01

This article describes a computerized case-based CD-ROM (CD) on international animal health that was developed to give veterinary students an opportunity to "virtually" work alongside veterinarians and other veterinary students as they try to solve challenging disease problems relating to tuberculosis in South African wildlife, bovine abortion in Mexico, and neurologic disease in horses in Rapa Nui, Chile. Each of the three case modules presents, in a highly interactive format, a problem or mystery that must be solved by the learner. As well as acquiring information via video clips and text about the specific health problem, learners obtain information about the different countries, animal-management practices, diagnostic methods, related disease-control issues, economic factors, and the opinions of local experts. After assimilating this information, the learner must define the problem and formulate an action plan or make a recommendation or diagnosis. The computerized program invokes three principles of adult education: active learning, learner-centered education, and experiential learning. A medium that invokes these principles is a potentially efficient learning tool and template for developing other case-based problem-solving computerized programs. The program is accessible on the World Wide Web at . A broadband Internet connection is recommended, since the modules make extensive use of embedded video and audio clips. Information on how to obtain the CD is also provided.

Early treatment of penile fractures: our experience.

PubMed

García Gómez, Borja; Romero, Javier; Villacampa, Felipe; Tejido, Angel; Díaz, Rafael

2012-09-01

To report our experience in early surgery of penile fractures. We review retrospectively all the cases that underwent surgery at our center from 1989 to 2009, with a total of 24. The cause of the fracture was sexual intercourse in most cases, and in all of them, surgical management was performed according to clinical presentation and physical exploration. In only 7 cases an ultrasound was performed as a complementary test. Early surgery allows prompt resolution of the problem with excellent functional outcomes and little side effects. The prognosis after emergency surgery was excellent in this review.

Expert knowledge elicitation using computer simulation: the organization of frail elderly case management as an illustration.

PubMed

Chiêm, Jean-Christophe; Van Durme, Thérèse; Vandendorpe, Florence; Schmitz, Olivier; Speybroeck, Niko; Cès, Sophie; Macq, Jean

2014-08-01

Various elderly case management projects have been implemented in Belgium. This type of long-term health care intervention involves contextual factors and human interactions. These underlying complex mechanisms can be usefully informed with field experts' knowledge, which are hard to make explicit. However, computer simulation has been suggested as one possible method of overcoming the difficulty of articulating such elicited qualitative views. A simulation model of case management was designed using an agent-based methodology, based on the initial qualitative research material. Variables and rules of interaction were formulated into a simple conceptual framework. This model has been implemented and was used as a support for a structured discussion with experts in case management. The rigorous formulation provided by the agent-based methodology clarified the descriptions of the interventions and the problems encountered regarding: the diverse network topologies of health care actors in the project; the adaptation time required by the intervention; the communication between the health care actors; the institutional context; the organization of the care; and the role of the case manager and his or hers personal ability to interpret the informal demands of the frail older person. The simulation model should be seen primarily as a tool for thinking and learning. A number of insights were gained as part of a valuable cognitive process. Computer simulation supporting field experts' elicitation can lead to better-informed decisions in the organization of complex health care interventions. © 2013 John Wiley & Sons, Ltd.

Understanding and managing conservation conflicts.

PubMed

Redpath, Steve M; Young, Juliette; Evely, Anna; Adams, William M; Sutherland, William J; Whitehouse, Andrew; Amar, Arjun; Lambert, Robert A; Linnell, John D C; Watt, Allan; Gutiérrez, R J

2013-02-01

Conservation conflicts are increasing and need to be managed to minimise negative impacts on biodiversity, human livelihoods, and human well-being. Here, we explore strategies and case studies that highlight the long-term, dynamic nature of conflicts and the challenges to their management. Conflict management requires parties to recognise problems as shared ones, and engage with clear goals, a transparent evidence base, and an awareness of trade-offs. We hypothesise that conservation outcomes will be less durable when conservationists assert their interests to the detriment of others. Effective conflict management and long-term conservation benefit will be enhanced by better integration of the underpinning social context with the material impacts and evaluation of the efficacy of alternative conflict management approaches. Copyright © 2012 Elsevier Ltd. All rights reserved.

Centralization of dairy farming facilities for improved economics and environmental quality.

PubMed

Inaba, Rokuta; Furuichi, Tohru; Komatsu, Toshihiro; Tanikawa, Noboru; Ishii, Kazuei

2009-01-01

In Japan, most farm animal excreta has been stored directly on farmland. Runoff from this storage has often caused water pollution. Biogasification is anticipated as an important technology to manage excreta properly, but complex problems hinder its introduction. Economic aspects of management have been especially difficult for dairy farmers. For this study, structural problems regarding introduction of biogasification into dairy farming were identified. Subsequently, a desirable system of dairy farming including biogasification was suggested, and an evaluation model of the financial balance was constructed. A case study using current financial balances of several systems of dairy farming was evaluated using the constructed model and actual data. The systems were based on several policy alternatives including the suggested system mentioned above. Results show that a farmer can obtain sufficient income from a system featuring centralization of dairy housing and biogasification facilities and coordinated management by over six farmers.

How multiagency partnerships can successfully address large-scale pollution problems: a Hawaii case study.

PubMed

Donohue, Mary J

2003-06-01

Oceanic circulation patterns deposit significant amounts of marine pollution, including derelict fishing gear from North Pacific Ocean fisheries, in the Hawaiian Archipelago [Mar. Pollut. Bull. 42(12) (2001) 1301]. Management responsibility for these islands and their associated natural resources is shared by several government authorities. Non-governmental organizations (NGOs) and private industry also have interests in the archipelago. Since the marine debris problem in this region is too large for any single agency to manage, a multiagency marine debris working group (group) was established in 1998 to improve marine debris mitigation in Hawaii. To date, 16 federal, state, and local agencies, working with industry and NGOs, have removed 195 tons of derelict fishing gear from the Northwestern Hawaiian Islands. This review details the evolution of the partnership, notes its challenges and rewards, and advocates its continued use as an effective resource management tool.

Meckel’s diverticulum: new solutions for an old problem?

PubMed Central

Chauhan, Abhishek; Suggett, Nigel; Guest, Peter; Goh, Jason

2016-01-01

Meckel's diverticulum (MD) is the most commonly encountered true diverticulum in the small bowel. Although overall a rare cause of gastrointestinal bleeding, it remains an important differential in a child/young adult presenting with lower gastrointestinal bleeding. We present two MD cases, one associated with brisk bleeding resulting in haemodynamic instability and the other in insidious blood loss causing symptoms of chronic iron deficiency. These cases illustrate the heterogeneous nature of the clinical picture associated with Meckel's diverticulae, a condition most gastroenterological and surgical units will encounter. We subsequently discuss the diagnostic and management dilemma Meckel's diverticulae pose and appraise the latest evidence and management strategies in this regard. PMID:28839845

Patient and Nurse Experiences in a Rural Chronic Disease Management Program: A Qualitative Evaluation.

PubMed

Davisson, Erica A; Swanson, Elizabeth A

Rural status confounds chronic disease self-management. The purpose of this qualitative, descriptive study was to evaluate the nurse-led "Living Well" chronic disease management program reporting patient recruitment and retention issues since program initiation in 2013. The Chronic Care Model (CCM) was the guiding framework used to reinforce that interdisciplinary teams must have productive patient interactions for their program(s) to be sustainable. A rural, Midwest county clinic's chronic disease management program. Observations, interviews, and within- and across-case coding were used. Patients' responses were analyzed to identify (1) reasons for recruitment and retention problems and (2) program elements that were viewed as successful or needing improvement. A convenience sample of 6 rural, English-speaking adults (65 years or older, with no severe cognitive impairment) with at least one chronic condition was recruited and interviewed. Themes emerged related to nurse knowledge, availability, and value; peer support; overcoming barriers; adherence enhancement; and family/friends' involvement. Patients reported engagement in self-management activities because of program elements such as support groups and productive nurse-patient interactions. Interdisciplinary communication, commitment, and patient referral processes were identified as reasons for recruitment and retention issues. Findings substantiated that certain elements must be present and improved upon for future rural programs to be successful. Interdisciplinary communication may need to be improved to address recruitment and retention problems. It was clear from patient interviews that the nurse coordinators played a major role in patients' self-management adherence and overall satisfaction with the program. This is important to case management because results revealed the need for programs of this nature that incorporate the vital role of nurse coordinators and align with the CCM value of providing a supportive community health care resource for patients with chronic disease.

A review of the outcomes of the recommendations made during paediatric telepsychiatry consultations.

PubMed

Boydell, Katherine M; Volpe, Tiziana; Kertes, Angela; Greenberg, Natasha

2007-01-01

Little is known about whether the recommendations made during telepsychiatry are actually implemented. We reviewed 100 telepsychiatry consultations, chosen randomly from a paediatric telepsychiatry programme serving rural communities in Ontario. Treatment recommendations had been made for each case reviewed and up to nine recommendations had been made for a single case. Twenty-seven percent of recommendations revolved around monitoring (10%), changing (9%), starting (4%), continuing (3%) and stopping (1%) medication. Case managers associated with 54 of the cases were interviewed to determine whether the recommendations had been implemented and to examine the barriers and facilitators to implementation. The results indicated that cooperation of both child and parent, clear communication of recommendations, involvement of the school and local health providers, stability of the agencies and availability of services were key components in the successful implementation of recommendations. The matter of technology or technological difficulties acting as a barrier to telepsychiatric consultations was not mentioned by case managers, suggesting that it was not a problem.

Silent at school--elective mutism and abuse.

PubMed Central

MacGregor, R; Pullar, A; Cundall, D

1994-01-01

A retrospective case-control study of electively mute children from one city is reported. Eight of 18 children selectively mute in school had suffered definite or probable abuse compared with only one control with a speech or language problem, and no classroom controls. The implications for management are discussed. PMID:8048829

Developing 21st Century Process Skills through Project Design

ERIC Educational Resources Information Center

Yoo, Jeong-Ju; MacDonald, Nora M.

2014-01-01

The goal of this paper is to illustrate how the promotion of 21st Century process skills can be used to enhance student learning and workplace skill development: thinking, problem solving, collaboration, communication, leadership, and management. As an illustrative case, fashion merchandising and design students conducted research for a…

InterCon Travel Health: Case B

ERIC Educational Resources Information Center

Truman, Gregory E.; Pachamanova, Dessislava A.; Goldstein, Michael A.

2010-01-01

InterCon provides services to health insurers of foreign tourists who travel to the United States and Canada. Management wants to implement a new information system that will deal with several operational problems, but it is having difficulty securing the capital resources to fund the system's development. After an initial failure, the chief…

Problems in the Context Evaluation of Individualized Courses

ERIC Educational Resources Information Center

Plomp, Tjeerd; Van der Meer, Adri

1977-01-01

The development of the Individualized Study System (ISS) in The Netherlands from 1970 to 1975 is reviewed and a case study for first-year engineering is described. A classification of ISS courses illustrates the complexity of the system, with advice offered on the management of individualized study systems. (Author/LBH)

Extension Agents and Conflict Narratives: A Case of Laikipia County, Kenya

ERIC Educational Resources Information Center

Bond, Jennifer

2016-01-01

Purpose: This work investigated the narratives of development extensionists in relation to natural resource conflict, in order to understand the competing discourses surrounding the wicked problems of natural resource management in Laikipia County, Kenya. Methodology: Q methodology was used to elicit the conflict narratives present among extension…

Entrepreneurs in the Public Library: Reinventing an Institution.

ERIC Educational Resources Information Center

Clay, Edwin S. III; Bangs, Patricia C.

2000-01-01

Presents a case study that describes how the Fairfax County Public (VA) has reinvented itself as a public service corporation by developing a public-private model for fund development using a top managerial committee. Discusses volunteer programs, partnerships with local utility companies, and staff training in managing patron problem behavior.…

Learning How to Manage Bias: A Case Study of Youth Participatory Action Research

ERIC Educational Resources Information Center

Kirshner, Ben; Pozzoboni, Kristen; Jones, Hannah

2011-01-01

Youth programs that are organized around intellectually challenging, socially relevant projects create opportunities for deep cognitive engagement. One type of authentic project that deserves attention from applied developmental scientists is youth participatory action research (YPAR), in which participants study a problem relevant to young…

Achieving Quality Learning in Higher Education.

ERIC Educational Resources Information Center

Nightingale, Peggy; O'Neil, Mike

This volume on quality learning in higher education discusses issues of good practice particularly action learning and Total Quality Management (TQM)-type strategies and illustrates them with seven case studies in Australia and the United Kingdom. Chapter 1 discusses issues and problems in defining quality in higher education. Chapter 2 looks at…

Sub-Lexical Reading Intervention in a Student with Dyslexia and Asperger's Disorder

ERIC Educational Resources Information Center

Wright, Craig; Conlon, Elizabeth; Wright, Michalle; Dyck, Murray

2011-01-01

Dyslexia is a common presenting condition in clinic and educational settings. Unlike the homogenous groups used in randomised trials, educators typically manage children who have multiple developmental problems. Investigations are required into how these complex cases respond to treatment identified as efficacious by controlled trials. This study…

Increasing Behavior Management Effectiveness through Problem Analysis and Individualization.

ERIC Educational Resources Information Center

Miller, Bernard W.

To reduce disciplinary cases without using suspension or alienating teachers and parents is a challenging task for principals. Forcing teachers to tolerate unruly student behavior is no solution. When both teachers and principals experience failure in eliciting desirable student attitudes and behavior, some relief measures are appropriate. This…

Emerging Models of the New Paradigm.

ERIC Educational Resources Information Center

Howser, Lee; Schwinn, Carole

Working with the Philadelphia-based Institute of Interactive Management, several teams at Jackson Community College (JCC), in Michigan, set out in 1994 to learn and apply an interactive design methodology to selected college subsystems. Interactive design begins with understanding problems faced by the system as a whole, which in the case of JCC…

Diagnosis and Nonsurgical Management of Uterine Arteriovenous Malformation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rangarajan, R. D.; Moloney, J. C.; Anderson, H. J.

Uterine arteriovenous malformation (AVM) is an uncommon problem and traditional treatment by hysterectomy excludes the possibility of future pregnancy. Developments in interventional techniques make transcatheter embolization of the feeding vessel(s) a therapeutic alternative, potentially preserving the patient's fertility. We present a case of successful endovascular treatment of uterine AVM.

Michigan Physicians' Conference on Elder Abuse. Final Report.

ERIC Educational Resources Information Center

Sengstock, Mary C.; O'Brien, James G.

The final report describes the Michigan Physicians' Conference on Elder Abuse project. The project conference had four major content areas, including: a general introduction to the problem of elder abuse; clinical symptoms of abuse; legal issues; and referral and case management techniques. Training techniques included lectures, group discussion,…

Consultation and Co-Therapy as Teaching Devices.

ERIC Educational Resources Information Center

Meyer, Margrit

Three counseling situations in which a counseling student sought participatory help from his field instructor are described. In the first case study the counseling student had been working with a marginal family with severe marital and child management problems. Approaches discussed in supervisory conferences had not achieved the desired result…

Problems and constraints in Philippine municipal fisheries: The case of San Miguel Bay, Camarines Sur

NASA Astrophysics Data System (ADS)

Lim, Cristina P.; Matsuda, Yoshiaki; Shigemi, Yukio

1995-11-01

The Philippine fisheries accounted for 3.7% of the gross national product at current prices. The sector employed about 990,872 persons. Of the divisions comprising the industry, municipal fisheries continued to contribute the largest share of fish production. However, the sector is beset with problems, many of which are best examplified by the case of San Miguel Bay (SMB). This paper presents the problems and constraints confronting SMB, a common property resource. This bay's open access condition has led to various problems, such as declining fishery resources, depressed socioeconomic conditions, illegal fishing, increasing population, and conflict among resource users. A poor marketing system, low level of fishing technology, fishermen's noncompliance and authorities' lax enforcement of rules and regulations, as well as lack of alternative sources of income further characterize the condition in SMB. Establishment of fishing rights, improvement of the marketing system, provision of alternative sources of income, and improvement of fishing technology were some of the solutions suggested. One major constraint, however, is financial, Comanagement complemented with other management tools has been proposed in addressing the problems in SMB.

Imaging pediatric magnet ingestion with surgical-pathological correlation.

PubMed

Otjen, Jeffrey P; Rohrmann, Charles A; Iyer, Ramesh S

2013-07-01

Foreign body ingestion is a common problem in the pediatric population and a frequent cause for emergency room visits. Magnets are common household objects that when ingested can bring about severe, possibly fatal gastrointestinal complications. Radiography is an integral component of the management of these children. Pediatric and emergency radiologists alike must be aware of imaging manifestations of magnet ingestion, as their identification drives decision-making for consulting surgeons and gastroenterologists. Radiology can thus substantially augment the clinical history and physical exam, facilitating appropriate management. This manuscript sequentially presents cases of magnet ingestion featuring imaging findings coupled with surgical and pathological correlation. Each case is presented to highlight ways in which the radiologist can make impactful contributions to diagnosis and management. Clinical overview with pitfalls of magnet ingestion imaging and an imaging decision tree will also be presented.

Simulation Model for Scenario Optimization of the Ready-Mix Concrete Delivery Problem

NASA Astrophysics Data System (ADS)

Galić, Mario; Kraus, Ivan

2016-12-01

This paper introduces a discrete simulation model for solving routing and network material flow problems in construction projects. Before the description of the model a detailed literature review is provided. The model is verified using a case study of solving the ready-mix concrete network flow and routing problem in metropolitan area in Croatia. Within this study real-time input parameters were taken into account. Simulation model is structured in Enterprise Dynamics simulation software and Microsoft Excel linked with Google Maps. The model is dynamic, easily managed and adjustable, but also provides good estimation for minimization of costs and realization time in solving discrete routing and material network flow problems.

Environmental cost-effectiveness analysis in intertemporal natural resource policy: evaluation of selective fishing gear.

PubMed

Kronbak, Lone Grønbæk; Vestergaard, Niels

2013-12-15

In most decision-making involving natural resources, the achievements of a given policy (e.g., improved ecosystem or biodiversity) are rather difficult to measure in monetary units. To address this problem, the current paper develops an environmental cost-effectiveness analysis (ECEA) to include intangible benefits in intertemporal natural resource problems. This approach can assist managers in prioritizing management actions as least cost solutions to achieve quantitative policy targets. The ECEA framework is applied to a selective gear policy case in Danish mixed trawl fisheries in Kattegat and Skagerrak. The empirical analysis demonstrates how a policy with large negative net benefits might be justified if the intangible benefits are included. Copyright © 2013 Elsevier Ltd. All rights reserved.

Social Consequences of Nomadic Working: A Case Study in an Organization

NASA Astrophysics Data System (ADS)

Singh, Ramanjit; Wood-Harper, Trevor

This research study identified social challenges that knowledge workers in the Swedish organization TeliaSonera (Telia) face when utilizing wireless technologies to conduct work on the move. Upon collecting the relevant research data, five problem areas were identified: work and life balance, addiction, organizational involvement, nomadic work and control, and individual productivity. Each problem area was examined with the philosophical underpinning of socio-technical design principles. The results confirm that better role boundary management, self-discipline, work negotiation, and e-mail communication skills may be required for the knowledge workers to manage the demands of nomadic working. Similarly, rewarding nomadic work performance, building employee supervisor trust relations, and designing jobs that enhance work and life balance can be imperative.

Improving ostomates' confidence with a discharge-solidifying agent.

PubMed

Slater, Rebecca

Not every person with a stoma will develop problems or even feel that he or she is unable to manage a stoma independently. However, for the individual who does experience problems and struggles to cope, the stoma nurse is pivotal in providing resources and product experience. He or she can enable the ostomate to adapt to the stoma and maintain their quality of life. This article provides an overview of a solidifying agent and case studies illustrating how it can be used to help patients achieve independence.

Perceived poisons.

PubMed

Nañagas, Kristine A; Kirk, Mark A

2005-11-01

Perceived poisoning may manifest in numerous ways; however, all cases share certain characteristics. All are fostered by the wide availability of unreliable information about chemical safety, poor understanding of scientific principles, and ineffective risk communication. Although this problem is still incompletely understood, some approaches have been demonstrated to be useful, such as education about risk, appropriate reassurance, and empathy on the part of the practitioner. Successful management may curtail the spread or exacerbation of symptoms, whereas unsuccessful treatment may cause the problems to escalate, with detrimental effects on both society and patient.

Evolution from safety management system (SMS) to HSE MS: Incorporating health aspects into the HSE management system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jong, G. de

1996-12-31

There is increasing recognition within the E&P industry that protection and promotion of the health of people at work is more than taking care of individual health. It is an organizational issue which can be managed using the same principles as for safety and environment. The synergy`s with safety and environmental management provide the link with the management system. However line managers need to under the critical Health issues: what are they are they relevant? How do we manage them? what are the standards? What are the management tools to be used? How do we monitor performance? What is themore » role of the line? What is the role of the health advisers? What training and competencies are needed for health management? What are the benefits? These questions have to be clarified before acceptance can be achieved for full integration of Health aspects into the HSE Management System. Health Risk Assessment was developed as a tool for systematic identification and assessment of health hazards and risks. It specifies the need for and type of controls and recovery measures, which can subsequently be incorporated in HSE Management System and HSE Cases. Our experience to date indicates that Health can successfully be integrated in HSE Management Systems and HSE Cases by using the same principles as developed for Safety Management Systems and Safety Cases. There are still many problems which need to be addressed but the methodology used appears to be sound and will eventually enhance line management understanding of the health management aspects relevant to the E&P Industry.« less

Case Series of HIV Infection-Associated Arteriopathy: Diagnosis, Management, and Outcome Over a 5-Year period at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University.

PubMed

Orrapin, Saritphat; Reanpang, Termpong; Orrapin, Saranat; Arwon, Supapong; Kattipathanapong, Thanate; Lekwanavijit, Suree; Rerkasem, Kittipan

2015-09-01

Patients infected with human immunodeficiency virus (HIV) can present with 4 pathology types: drug-induced vasospasm (ergotism), arterial limb ischemia, critical limb ischemia, and aneurysm. Although these problems are common vascular problems, they result in increased morbidity and mortality in HIV-infected patients, especially aneurysm. Patients with these problems tend to be diagnosed with difficulty because of atypical symptoms and signs. Because of lack of data in treatment outcome literature, our report explores and provides information on HIV infection-related arteriopathy. There were 17 patients in our 5-year review. There was no death in patients except the aneurysm type. The survival of aneurysm patients was significantly lower than from other pathologies (P = .003). Our case series showed good short-term outcome, and patients were not at risk for less beneficial surgical procedures. © The Author(s) 2015.

Telephone hotline is an important part of overall patient management in upper gastrointestinal malignancies.

PubMed

Bjerring, Ole Steen; Fristrup, Claus; Mortensen, Michael Bau

2012-08-01

As seven out of every ten patients with upper gastrointestinal malignancies (UGIM) are not eligible for curative treatment, life after diagnosis is characterised by a rapid deterioration and uncertainty. To accommodate these issues, we established a telephone hotline. In a two-year period, all patients evaluated for UGIM were given the hotline phone number. The hotline was staffed by either a nurse or a secretary, and subsequently the specialist in charge of the patient would return the call. All calls were registered in a prospective database. The following data were recorded: diagnosis, time from call to return call, problem and solution to the problem. A total of 477 patients were included, and 172 (36%) patients used the Hotline a total of 254 times. Of the 254 calls, 210 (83%) were returned the same day. A total of 104 (41%) calls were made due to elaborative questions and 89% of these were solved over the phone. Dysphagia was the problem in 51 cases which gave rise to an endoscopy in 86% of cases. Pain was the problem in 35. Overall, of the 254 calls, 152 (60%) problems were solved over the phone. Furthermore, 75 calls triggered a hospital visit and 27 calls led to the patient being referred for further examinations. The establishment of a telephone hotline was feasible and it was used by some patients. Most of the callers only made one call. Nearly all calls (96%) were returned the day after the initial call, at the latest. The problem pattern did not differ between disease groups apart from dysphagia in oesophageal cancer. We found that the hotline was an effective and inexpensive part of overall patient management. not relevant. not relevant.

Decomposition method for zonal resource allocation problems in telecommunication networks

NASA Astrophysics Data System (ADS)

Konnov, I. V.; Kashuba, A. Yu

2016-11-01

We consider problems of optimal resource allocation in telecommunication networks. We first give an optimization formulation for the case where the network manager aims to distribute some homogeneous resource (bandwidth) among users of one region with quadratic charge and fee functions and present simple and efficient solution methods. Next, we consider a more general problem for a provider of a wireless communication network divided into zones (clusters) with common capacity constraints. We obtain a convex quadratic optimization problem involving capacity and balance constraints. By using the dual Lagrangian method with respect to the capacity constraint, we suggest to reduce the initial problem to a single-dimensional optimization problem, but calculation of the cost function value leads to independent solution of zonal problems, which coincide with the above single region problem. Some results of computational experiments confirm the applicability of the new methods.

Developing a case mix classification for child and adolescent mental health services: the influence of presenting problems, complexity factors and service providers on number of appointments.

PubMed

Martin, Peter; Davies, Roger; Macdougall, Amy; Ritchie, Benjamin; Vostanis, Panos; Whale, Andy; Wolpert, Miranda

2017-09-01

Case-mix classification is a focus of international attention in considering how best to manage and fund services, by providing a basis for fairer comparison of resource utilization. Yet there is little evidence of the best ways to establish case mix for child and adolescent mental health services (CAMHS). To develop a case mix classification for CAMHS that is clinically meaningful and predictive of number of appointments attended and to investigate the influence of presenting problems, context and complexity factors and provider variation. We analysed 4573 completed episodes of outpatient care from 11 English CAMHS. Cluster analysis, regression trees and a conceptual classification based on clinical best practice guidelines were compared regarding their ability to predict number of appointments, using mixed effects negative binomial regression. The conceptual classification is clinically meaningful and did as well as data-driven classifications in accounting for number of appointments. There was little evidence for effects of complexity or context factors, with the possible exception of school attendance problems. Substantial variation in resource provision between providers was not explained well by case mix. The conceptually-derived classification merits further testing and development in the context of collaborative decision making.

Hemorrhagic cystitis: A challenge to the urologist

PubMed Central

Manikandan, R.; Kumar, Santosh; Dorairajan, Lalgudi N.

2010-01-01

Severe hemorrhagic cystitis often arises from anticancer chemotherapy or radiotherapy for pelvic malignancies. Infectious etiologies are less common causes except in immunocompromised hosts. These cases can be challenging problems for the urologist and a source of substantial morbidity and sometimes mortality for the patients. A variety of modalities of treatment have been described for the management of hemorrhagic cystitis but there is none that is uniformly effective. Some progress has been made in the understanding and management of viral hemorrhagic cystitis. This article reviews the common causes of severe hemorrhagic cystitis and the currently available management options. PMID:20877590

Anesthetic management of achondroplastic dwarf undergoing cesarean section--a case report.

PubMed

Cevik, Banu; Colakoğlu, Serhan

2010-10-01

There are more than 100 different types of dwarfism. Achondroplasia is the most common of these conditions. The aim of this report is to describe the anesthetic management of these patient, discussing the anesthetic considerations and emphasizing the difficulties encountered. A 32-year-old achondroplastic parturient underwent cesarean section under general anesthesia. We did not encounter problems related with airway management. The operation went without any complication. There are risks for both regional and general anesthesia in achondroplastic patients. The most important point is the careful preoperative assessment. Anesthesia plan should be specified to individual basis.

Nationwide trends in the current management of desmoid (aggressive) fibromatosis.

PubMed

Eastley, N C; Hennig, I M; Esler, C P; Ashford, R U

2015-06-01

The optimal management of desmoid fibromatosis remains unclear, leading to significant variability in patient management. To assess this problem, the current approach of clinicians managing this complex condition in the UK was investigated. A hypothetical case of intramuscular limb girdle desmoid fibromatosis in a fit 65-year-old patient was devised. Surgical and non-surgical oncology members of the British Sarcoma Group were questioned on how they would manage this case in three scenarios: primary disease with function-sparing surgery possible, primary disease with neurovascular involvement and disease recurrence after a previous R0 resection. Initial management, management of symptomatic disease progression, follow-up preferences and any differences in respondents' management choices in a younger case were investigated. The responses from 14 sarcoma surgeons and 23 oncologists (14 clinical, nine medical) were analysed. Desmoid fibromatosis management is generally shared by surgeons and oncologists within sarcoma multidisciplinary teams in the UK. Variation exists in the chosen initial management of primary desmoid fibromatosis in the UK, with function-sparing surgery possible (observation 51%, resection 51%), primary desmoid fibromatosis with neurovascular involvement (hormone therapy with non-steroidal anti-inflammatory drugs 51%, radiotherapy 27%, observation 22%) and for cases of desmoid fibromatosis recurrence (radiotherapy 41%, hormone therapy and non-steroidal anti-inflammatory drugs 27%, observation 24%). There was a clear preference of surgical resection of symptomatic disease progression in cases of primary desmoid fibromatosis without neurovascular involvement (60%). By contrast, radiotherapy was the preferred treatment for progression in cases with neurovascular involvement (47%) or cases of recurrence after a previous R0 resection (34%). Clinical follow-up was selected 3 months after intervention in 68% of scenarios. Follow-up imaging was selected 3 or 6 months after intervention in 57% and 21% of cases, respectively. Most respondents would not change their chosen management in younger patients. Several groups have issued formal guidelines for clinicians managing desmoid fibromatosis, including the British Sarcoma Group, the National Comprehensive Cancer Network and the European Society for Medical Oncology. However, these are in some ways contradictory and may not reflect recent publications, potentially explaining the significant variation in the management of desmoid fibromatosis in the UK shown by this survey. We propose a review of current evidence; a national consensus or a desmoid fibromatosis registry may help to standardise desmoid fibromatosis care. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

The Role of Integrated Modelling and Assessment for Decision-Making: Lessons from Water Allocation Issues in Australia

NASA Astrophysics Data System (ADS)

Jakeman, A. J.; Guillaume, J. H. A.; El Sawah, S.; Hamilton, S.

2014-12-01

Integrated modelling and assessment (IMA) is best regarded as a process that can support environmental decision-making when issues are strongly contested and uncertainties pervasive. To be most useful, the process must be multi-dimensional and phased. Principally, it must be tailored to the problem context to encompass diverse issues of concern, management settings and stakeholders. This in turn requires the integration of multiple processes and components of natural and human systems and their corresponding spatial and temporal scales. Modellers therefore need to be able to integrate multiple disciplines, methods, models, tools and data, and many sources and types of uncertainty. These dimensions are incorporated into iteration between the various phases of the IMA process, including scoping, problem framing and formulation, assessing options and communicating findings. Two case studies in Australia are employed to share the lessons of how integration can be achieved in these IMA phases using a mix of stakeholder participation processes and modelling tools. One case study aims to improve the relevance of modelling by incorporating stakeholder's views of irrigated viticulture and water management decision making. It used a novel methodology with the acronym ICTAM, consisting of Interviews to elicit mental models, Cognitive maps to represent and analyse individual and group mental models, Time-sequence diagrams to chronologically structure the decision making process, an All-encompassing conceptual model, and computational Models of stakeholder decision making. The second case uses a hydro-economic river network model to examine basin-wide impacts of water allocation cuts and adoption of farm innovations. The knowledge exchange approach used in each case was designed to integrate data and knowledge bearing in mind the contextual dimensions of the problem at hand, and the specific contributions that environmental modelling was thought to be able to make.

Determinants of HMO success: the case of Complete Health.

PubMed

Widra, L S; Fottler, M D

1992-01-01

The health maintenance organization (HMO) industry has experienced a variety of difficulties and criticisms in recent years. Various hybrid models have been proposed to alleviate these problems. This article presents an in-depth case study of factors associated with the success of one such hybrid: an individual practice association (IPA)-model HMO affiliated with an academic health center. The major success factors identified include the plan design/structure, the strategic orientation/practices, and the stakeholder management orientation practices.

Solid industrial wastes and their management in Asegra (Granada, Spain)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Casares, M.L.; Ulierte, N.; Mataran, A.

ASEGRA is an industrial area in Granada (Spain) with important waste management problems. In order to properly manage and control waste production in industry, one must know the quantity, type, and composition of industrial wastes, as well as the management practices of the companies involved. In our study, questionnaires were used to collect data regarding methods of waste management used in 170 of the 230 businesses in the area of study. The majority of these companies in ASEGRA are small or medium-size, and belong to the service sector, transport, and distribution. This was naturally a conditioning factor in both themore » type and management of the wastes generated. It was observed that paper and cardboard, plastic, wood, and metals were the most common types of waste, mainly generated from packaging (49% of the total volume), as well as material used in containers and for wrapping products. Serious problems were observed in the management of these wastes. In most cases they were disposed of by dumping, and very rarely did businesses resort to reuse, recycling or valorization. Smaller companies encountered greater difficulties when it came to effective waste management. The most frequent solution for the disposal of wastes in the area was dumping.« less

Management in general practice: the challenge of the new General Medical Services contract.

PubMed

Checkland, Kath

2004-10-01

Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Three general practices in England, chosen using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed by such a manager, the limits of his or her authority, and the management of performance in this role.

Management in general practice: the challenge of the new General Medical Services contract

PubMed Central

Checkland, Kath

2004-01-01

Background: Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. Aim: To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. Design of study: In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Setting: Three general practices in England, chosen using purposeful sampling. Method: Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Results: Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. Conclusion: The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed by such a manager, the limits of his or her authority, and the management of performance in this role. PMID:15469672

Teaching medical management and operations engineering for systems-based practice to radiology residents.

PubMed

Brandon, Catherine J; Mullan, Patricia B

2013-03-01

To better prepare radiology residents for providing care within the context of the larger health care system, this study evaluated the feasibility and impact of a curriculum to enhance radiology residents' understanding and ability to apply concepts from medical management and industrial and operational engineering to systems-based practice problems in radiology practice. A multiprofessional team including radiology, medical education, and industrial and operational engineering professionals collaborated in developing a seven-module curriculum, including didactic lectures, interactive large-group analysis, and small-group discussions with case-based radiology examples, which illustrated real-life management issues and the roles physicians held. Residents and faculty participated in topic selection. Pre- and post-instruction formative assessments were administered, and results were shared with residents during teaching sessions. Attendance and participation in case-based scenario resolutions indicate the feasibility and impact of the interactive curriculum on residents' interest and ability to apply curricular concepts to systems-based practice in radiology. Paired t test analyses (P < .05) and effect sizes showed residents significantly increased their knowledge and ability to apply concepts to systems-based practice issues in radiology. Our iterative curriculum development and implementation process demonstrated need and support for a multiprofessional team approach to teach management and operational engineering concepts. Curriculum topics are congruent with Accreditation Council for Graduate Medical Education requirements for systems-based practice. The case-based curriculum using a mixed educational format of didactic lectures and small-group discussion and problem analysis could be adopted for other radiology programs, for both residents and continuing medical education applications. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

One Stage Emergency Pancreatoduodenectomy  for Isolated Injury to Pancreatic Head Following Blunt Abdominal Trauma: Case Report and Review of Literature.

PubMed

Ghosh, Sumanta Kumar

2013-07-01

Major pancreatic injury following blunt abdominal trauma by itself is a relatively rare occurrence, and in vast majority of cases (95%) it is associated with injury to adjacent major vessels and organs; thus making isolated major pancreatic injury even rarer. While most pancreatic injuries are managed by simple measures like debridement and drainage, complex proximal injury poses surgical challenge regarding surgical skill and judgement. Disproportionate approach at any stage of management can contribute  to high mortality and morbidity. Emergency pancreatoduodenectomy plays a limited but important role in managing serious trauma to proximal pancreas and duodenum. Author presents a case where isolated injury to head of pancreas required emergency pancreatoduodenectomy. After a bizarre road accident, a middle aged male underwent emergency laparotomy for intraperitoneal bleeding and during exploration a deep transverse laceration with ampullary disruption was found in the head of the organ. Duodenum in all its part was intact and there was no other injury. The nature and site of injury made emergency pancreatoduodenectomy the only viable option. Leaking pancreatojejunostomy enhances infective complications that lead to late mortality. To circumvent this problem there is enthusiasm for staged surgery with resection and tube pancreatostomy in first stage, leaving the difficult anastomosis for a later date, However, if the patient is haemodynamically stable and operated reasonably early, one stage pancreatoduodenectomy gives good result and avoids repeating surgery with inherent problems and reduces hospital stay. For successful management of pancreatic trauma it is essential to make early diagnosis of duct disruption, with sound application of operative skill and judgement by treating surgeon.

An effective framework for finding similar cases of dengue from audio and text data using domain thesaurus and case base reasoning

NASA Astrophysics Data System (ADS)

Sandhu, Rajinder; Kaur, Jaspreet; Thapar, Vivek

2018-02-01

Dengue, also known as break-bone fever, is a tropical disease transmitted by mosquitoes. If the similarity between dengue infected users can be identified, it can help government's health agencies to manage the outbreak more effectively. To find similarity between cases affected by Dengue, user's personal and health information are the two fundamental requirements. Identification of similar symptoms, causes, effects, predictions and treatment procedures, is important. In this paper, an effective framework is proposed which finds similar patients suffering from dengue using keyword aware domain thesaurus and case base reasoning method. This paper focuses on the use of ontology dependent domain thesaurus technique to extract relevant keywords and then build cases with the help of case base reasoning method. Similar cases can be shared with users, nearby hospitals and health organizations to manage the problem more adequately. Two million case bases were generated to test the proposed similarity method. Experimental evaluations of proposed framework resulted in high accuracy and low error rate for finding similar cases of dengue as compared to UPCC and IPCC algorithms. The framework developed in this paper is for dengue but can easily be extended to other domains also.

Vanishing thyroid gland tumors: Infarction as consequence of FNA?

PubMed

Kholová, Ivana

2016-07-01

Fine-needle aspiration (FNA)-induced secondary changes were described in various organs. Complete replacement of tumor by necrosis causes diagnostic and management problems. Seven cases of totally or partially vanished thyroid lesions were identified from the archive of Department of Pathology, Fimlab Laboratories within 5 year period. Histopathological slides were revised in all cases. Total thyroidectomy or lobectomy samples were from 4 females and 3 males patients aged 37-83 years (mean 67.1 years). Imaging data were available in 6 cases. Cytology slides and data were available only in 3 cases: two revealed follicular neoplasm and one was insufficient according to Bethesda system. In 5 cases, final histopathology revealed total necrosis of the lesion with only one case with available cytological diagnosis of oncocytic follicular neoplasm. In remaining 2 cases, replacement by necrosis was partial. Of note, in three cases, oncocytic metaplasia was present. Total histopathological blocking with thorough check of capsular areas is recommended in necrotic tumors. Vanishing thyroid lesion phenomenon is rare, but in cases of disappearance of tumor, preoperative cytology diagnosis is the only clue for the patient management. Diagn. Cytopathol. 2016;44:568-573. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Farmers' perceptions of land degradation and their investments in land management: a case study in the Central Rift Valley of Ethiopia.

PubMed

Adimassu, Zenebe; Kessler, Aad; Yirga, Chilot; Stroosnijder, Leo

2013-05-01

To combat land degradation in the Central Rift Valley (CRV) of Ethiopia, farmers are of crucial importance. If farmers perceive land degradation as a problem, the chance that they invest in land management measures will be enhanced. This study presents farmers' perceptions of land degradation and their investments in land management, and to what extent the latter are influenced by these perceptions. Water erosion and fertility depletion are taken as main indicators of land degradation, and the results show that farmers perceive an increase in both indicators over the last decade. They are aware of it and consider it as a problem. Nevertheless, farmers' investments to control water erosion and soil fertility depletion are very limited in the CRV. Results also show that farmers' awareness of both water erosion and soil fertility decline as a problem is not significantly associated with their investments in land management. Hence, even farmers who perceive land degradation on their fields and are concerned about its increase over the last decade do not significantly invest more in water erosion and soil fertility control measures than farmers who do not perceive these phenomena. Further research is needed to assess which other factors might influence farmers' investments in land management, especially factors related to socioeconomic characteristics of farm households and plot characteristics which were not addressed by this study.

A Case Study of Singapore’s Counterinsurgency Strategy: An Analysis using the Tools of Operational Design

DTIC Science & Technology

2011-04-01

deal with the problems. It is much harder to govern a country and manage a wide range of policies in a coherent way. The MCP needed to use their...which was labor intensive and required cooks, maids, waiters , laundry, cleaners, tour guides, drivers, souvenir and handicraft makers, but required...1000 to $2500 a month, managed to accrue a lot of personal wealth during their tenures.108 Singapore took on a pragmatic approach and chose to

Gradenigo's syndrome--surgical management in a child.

PubMed

Humayun, Hassan Nabeel; Akhtar, Shabbir; Ahmed, Shakeel

2011-04-01

Otits media is a common problem. Some of its complications that were seen frequently in the preantibiotic era are rare today. We report a case of an 8 year boy who presented with earache, retro-orbital pain and diplopia secondary to a sixth nerve palsy--Gradenigo's syndrome. In this syndrome infection from the middle ear spreads medially to the petrous apex of the temporal bone. Work-up includes CT scan of the temporal bones. Timely management with intravenous antibiotics (+ surgery) is needed to prevent intra-cranial complications.

An outbreak of Salmonella gastroenteritis in an urban jail.

PubMed

Alcabes, P; O'Sullivan, B; Nadal, E; Mouzon, M

1988-12-01

An outbreak of gastroenteritis in New York City's largest jail involved 145 cases over a two-month period. The outbreak was unusual in that two Salmonella strains (serogroups B and D) were involved. Management of the outbreak involved screening kitchen workers by culture of stool samples, and education regarding personal hygiene. Obstacles to investigation and management of the outbreak arose out of the special nature of the jail environment; these included jurisdictional problems and high turnover of the inmate population.

Patterns of illness and injury encountered in amateur ocean yacht racing: an analysis of the British Telecom Round the World Yacht Race 1996-1997.

PubMed

Price, C J S; Spalding, T J W; McKenzie, C

2002-12-01

To quantify the incidence and type of medical problem arising during an amateur circumnavigation yacht race, the BT Global Challenge. All cases from 14 participating yachts in a confidential medical log completed by an appointed medic were reported. A total of 685 cases were reported, of which 299 (43.6%) were injuries and 386 (56.4%) illnesses. The subtype of injury, illness, and three evacuations at sea are described. Injury and other forms of medical problem are relatively common in an amateur long distance ocean yacht race. Most can be adequately managed at sea, provided that optimal communication, training, and equipment are provided and maintained.

Quality Improvement of Ground Works Process with the Use of Chosen Lean Management Tools - Case Study

NASA Astrophysics Data System (ADS)

Nowotarski, Piotr; Paslawski, Jerzy; Wysocki, Bartosz

2017-12-01

Ground works are one of the first processes connected with erecting structures. Based on ground conditions like the type of soil or level of underground water different types and solutions for foundations are designed. Foundations are the base for the buildings, and their proper design and execution is the key for the long and faultless use of the whole construction and might influence on the future costs of the eventual repairs (especially when ground water level is high, and there is no proper water insulation made). Article presents the introduction of chosen Lean Management tools for quality improvement of the process of ground works based on the analysis made on the construction site of vehicle control station located in Poznan, Poland. Processes assessment is made from different perspectives taking into account that 3 main groups of workers were directly involved in the process: blue collar-workers, site manager and site engineers. What is more comparison is made on the 3 points of view to the problems that might occur during this type of works, with details analysis on the causes of such situation? Authors presents also the change of approach of workers directly involved in the mentioned processes regarding introduction of Lean Management methodology, which illustrates the problem of scepticism for new ideas of the people used to perform works and actions in traditional way. Using Lean Management philosophy in construction is a good idea to streamline processes in company, get rid of constantly recurring problems, and in this way improve the productivity and quality of executed activities. Performed analysis showed that different groups of people have very different idea and opinion on the problems connected with executing the same process - ground works and only having full picture of the situation (especially in construction processes) management can take proper problems-preventing actions that consequently can influence on the amount of waste generated on the construction cite which positively influence on the external environment.

Managing Problems Before Problems Manage You.

PubMed

Grigsby, Jim

2015-01-01

Every day we face problems, both personal and professional, and our initial reaction determines how well we solve those problems. Whether a problem is minor or major, short-term or lingering, there are techniques we can employ to help manage the problem and the problem-solving process. This article, based on my book Don't Tick Off The Gators! Managing Problems Before Problems Manage You, presents 12 different concepts for managing problems, not "cookie cutter" solutions, but different ideas that you can apply as they fit your circumstances.

The Role of Stakeholders Related to the Management of Ecological Function of Urban Green Open Space. Case Study: City of Depok, Indonesia

NASA Astrophysics Data System (ADS)

Mangopa Malik, Andy Anton

2017-12-01

Urban green open space is one of the assets that provide substantial benefits to the urban community. One important function of urban green open space is a function of ecology. This study will provide initial explanation on the various studies related to the ecological function of urban green open space. The study of urban space management approach related to ecological function will explain the extent of the role of stakeholders in the urban areas that will further strengthen the importance of the existence of green open space, especially in city of Depok. With so many problems related to the supply and use of green open space in the city of Depok. This approach was originally applied by the private sector and many applications made a great contribution, so it began to be used by the government in managing public assets there. This study will use descriptive method, at the beginning of the study will explain the existence of the reality of urban green open space as part of the urban space by viewing it from theoretical overview of space, function and role of the various problems that occur in it. The results of this study indicate there are six problems in the management of green open spaces in city of Depok. Using the stages in asset management will provide space for participation of existing stakeholders in the management of green open spaces in city of Depok.

Feasibility of using teleradiology to improve tuberculosis screening and case management in a district hospital in Malawi

PubMed Central

Panunzi, Isabella; Spijker, Saskia; Brant, William E; Duran, Laura Triviño; Kosack, Cara S; Murowa, Michael Mitchell

2012-01-01

Abstract Problem Malawi has one of the world’s highest rates of human immunodeficiency virus (HIV) infection (10.6%), and southern Malawi, where Thyolo district is located, bears the highest burden in the country (14.5%). Tuberculosis, common among HIV-infected people, requires radiologic diagnosis, yet Malawi has no radiologists in public service. This hinders rapid and accurate diagnosis and increases morbidity and mortality. Approach Médecins Sans Frontières, in collaboration with Malawi’s Ministry of Health, implemented teleradiology in Thyolo district to assist clinical staff in radiologic image interpretation and diagnosis. Local setting Thyolo district’s 600 000 inhabitants are mostly subsistence-level or migrant farmers living in extreme poverty. Health facilities include one public hospital and 38 primary health centres. Understaffing and the absence of a radiologist make the diagnosis of tuberculosis difficult in a population where this disease affects 66% of patients with HIV infection. Relevant changes From September 2010–2011, 159 images (from 158 patients) were reviewed by teleradiology. Teleradiology changed patient management in 36 cases (23.5%). Two (1.3%) of them were cases of pulmonary tuberculosis not previously suspected by clinical staff. In addition, the radiologist’s review corrected the misdiagnosis of tuberculosis and averted inappropriate treatment in 16 patients (10.5%). Lessons learnt Teleradiology can improve tuberculosis diagnosis and case management, especially if criteria to identify the patients most suitable for referral are developed and the radiologist is conversant with local resources and health problems. Designating a clinical focal point for teleradiology ensures sustainability. Staff need time to adapt to a new teleradiology programme. PMID:22984316

Coordination of short-term and long-term mitigation measures of hydro-meteorological risks: the importance of establishing a link between emergency management and spatial planning

NASA Astrophysics Data System (ADS)

Prenger-Berninghoff, Kathrin; Cortes, V. Juliette; Aye, Zar Chi; Sprague, Teresa

2013-04-01

The management of natural hazards involves, as generally known, the four stages of the risk management cycle: Prevention, preparedness, response and recovery. Accordingly, the mitigation of disasters can be performed in terms of short-term and long-term purposes. Whereas emergency management or civil protection helps to strengthen a community's capacity to be better prepared for natural hazards and to better respond in case a disaster strikes, thus addressing the short-term perspective, spatial planning serves long-term planning goals and can therefore implement long-term prevention measures. A purposefully applied risk mitigation strategy requires coordination of short-term and long-term mitigation measures and thus an effective coordination of emergency management and spatial planning. Several actors are involved in risk management and should consequently be linked throughout the whole risk management cycle. However, these actors, partly because of a historically fragmented administrative system, are hardly connected to each other, with spatial planning only having a negligible role compared to other actors1, a problem to which Young (2002) referred to as the "problem of interplay". In contrast, information transfer and decision-taking happen at the same time and are not coordinated among different actors. This applies to the prevention and preparedness phase as well as to the recovery phase, which basically constitutes the prevention phase for the next disaster2. Since investments in both risk prevention and emergency preparedness and response are considered necessary, a better coordination of the two approaches is required. In this regard, Decision Support Systems (DSS) can be useful in order to provide support in the decision-making aspect of risk management. The research work currently undertaken examines the problem of interplay in the four case study areas of the Marie Curie ITN, CHANGES3. The link between different risk management actors will be explored by means of exploratory questionnaires and interviews with government agencies, local administrations, community and research organizations on each study site. First results provided will address the general role of spatial planning in risk management. Additionally, preliminary observations are made in regard to the coordination of emergency preparedness and long-term spatial planning activities. The observations consider that integration facilitates proactive strategies that aim at preventing disaster occurrence and promote interaction between involved parties. Finally, consideration is given to the potential use of a DSS tool to cover both aspects of spatial planning and emergency management in the risk management cycle.

Modelling inter-supply chain competition with resource limitation and demand disruption

NASA Astrophysics Data System (ADS)

Chen, Zhaobo; Teng, Chunxian; Zhang, Ding; Sun, Jiayi

2016-05-01

This paper proposes a comprehensive model for studying supply chain versus supply chain competition with resource limitation and demand disruption. We assume that there are supply chains with heterogeneous supply network structures that compete at multiple demand markets. Each supply chain is comprised of internal and external firms. The internal firms are coordinated in production and distribution and share some common but limited resources within the supply chain, whereas the external firms are independent and do not share the internal resources. The supply chain managers strive to develop optimal strategies in terms of production level and resource allocation in maximising their profit while facing competition at the end market. The Cournot-Nash equilibrium of this inter-supply chain competition is formulated as a variational inequality problem. We further study the case when there is demand disruption in the plan-execution phase. In such a case, the managers need to revise their planned strategy in order to maximise their profit with the new demand under disruption and minimise the cost of change. We present a bi-criteria decision-making model for supply chain managers and develop the optimal conditions in equilibrium, which again can be formulated by another variational inequality problem. Numerical examples are presented for illustrative purpose.

State-dependent resource harvesting with lagged information about system states

USGS Publications Warehouse

Johnson, Fred A.; Fackler, Paul L.; Boomer, G Scott; Zimmerman, Guthrie S.; Williams, Byron K.; Nichols, James D.; Dorazio, Robert

2016-01-01

Markov decision processes (MDPs), which involve a temporal sequence of actions conditioned on the state of the managed system, are increasingly being applied in natural resource management. This study focuses on the modification of a traditional MDP to account for those cases in which an action must be chosen after a significant time lag in observing system state, but just prior to a new observation. In order to calculate an optimal decision policy under these conditions, possible actions must be conditioned on the previous observed system state and action taken. We show how to solve these problems when the state transition structure is known and when it is uncertain. Our focus is on the latter case, and we show how actions must be conditioned not only on the previous system state and action, but on the probabilities associated with alternative models of system dynamics. To demonstrate this framework, we calculated and simulated optimal, adaptive policies for MDPs with lagged states for the problem of deciding annual harvest regulations for mallards (Anas platyrhynchos) in the United States. In this particular example, changes in harvest policy induced by the use of lagged information about system state were sufficient to maintain expected management performance (e.g. population size, harvest) even in the face of an uncertain system state at the time of a decision.

First contact diagnosis and management of contact lens-related complications.

PubMed

Fagan, Xavier J; Jhanji, Vishal; Constantinou, Marios; Amirul Islam, F M; Taylor, Hugh R; Vajpayee, Rasik B

2012-08-01

To describe the spectrum of contact lens-related problems in cases presenting to a tertiary referral eye hospital. A retrospective case record analysis of 111 eyes of 97 consecutive patients was undertaken over a period of five months at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia. Contact lens-related complications (CLRC) were classified into microbial keratitis, sterile corneal infiltrates, corneal epitheliopathy and contact lens-related red eye (CLARE). Main parameters examined were nature of the first contact, clinical diagnosis, and management pattern. Forty-two percent of the initial presentations were to health care practitioners (HCPs) other than ophthalmologists. Mean duration from the onset of symptoms to presentation was 6.3 ± 10.9 days. Forty-nine percent (n = 54) of patients had an associated risk factor, most commonly overnight use of contact lenses (n = 14, 13 %). Most common diagnosis at presentation was corneal epitheliopathy (68 %) followed by sterile infiltrates (10 %), CLARE (8 %) and microbial keratitis (6 %). No significant differences were found in the pattern of treatment modalities administered by ophthalmologists and other HCPs. HCPs other than ophthalmologists are the first contact for contact lens-related problems in a significant proportion of patients. These HCPs manage the majority of CLRC by direct treatment or immediate referral.

Integrative management of commercialized wild mushroom: a case study of Thelephora ganbajun in Yunnan, southwest China.

PubMed

He, Jun; Zhou, Zhimei; Yang, Huixian; Xu, Jianchu

2011-07-01

The management of wild mushroom is interdisciplinary in nature, whereby the biophysical considerations have to be incorporated into the context of a wide range of social, economic and political concerns. However, to date, little documentation exists illustrating an interdisciplinary approach to management of wild mushrooms. Moreover, the empirical case studies necessary for developing applicable and practical methods are even more rare. This paper adopted an interdisciplinary approach combining participatory methods to improve the habitat management of Thelephora ganbajun, an endemic and one of the most economically valuable mushroom species in Southwest China. The paper documents an empirical case of how an interdisciplinary approach facilitated the development of a scientific basis for policy and management practice, and built the local capacity to create, adopt and sustain the new rules and techniques of mushroom management. With this integrative perspective, a sustainable management strategy was developed, which was found not only technically feasible for farmers, but also acceptable to the government from an ecological and policy-related perspective. More importantly, this approach has greatly contributed to raising the income of farmers. The paper highlights how the integration of biophysical and socioeconomic factors and different knowledge systems provided a holistic perspective to problem diagnosis and resolution, which helped to cope with conventional scientific dilemmas. Finally, it concludes that the success of this interdisciplinary approach is significant in the context of policy decentralization and reform for incorporating indigenous knowledge and local participation in forest management.

Integrative Management of Commercialized Wild Mushroom: A Case Study of Thelephora ganbajun in Yunnan, Southwest China

NASA Astrophysics Data System (ADS)

He, Jun; Zhou, Zhimei; Yang, Huixian; Xu, Jianchu

2011-07-01

The management of wild mushroom is interdisciplinary in nature, whereby the biophysical considerations have to be incorporated into the context of a wide range of social, economic and political concerns. However, to date, little documentation exists illustrating an interdisciplinary approach to management of wild mushrooms. Moreover, the empirical case studies necessary for developing applicable and practical methods are even more rare. This paper adopted an interdisciplinary approach combining participatory methods to improve the habitat management of Thelephora ganbajun, an endemic and one of the most economically valuable mushroom species in Southwest China. The paper documents an empirical case of how an interdisciplinary approach facilitated the development of a scientific basis for policy and management practice, and built the local capacity to create, adopt and sustain the new rules and techniques of mushroom management. With this integrative perspective, a sustainable management strategy was developed, which was found not only technically feasible for farmers, but also acceptable to the government from an ecological and policy-related perspective. More importantly, this approach has greatly contributed to raising the income of farmers. The paper highlights how the integration of biophysical and socioeconomic factors and different knowledge systems provided a holistic perspective to problem diagnosis and resolution, which helped to cope with conventional scientific dilemmas. Finally, it concludes that the success of this interdisciplinary approach is significant in the context of policy decentralization and reform for incorporating indigenous knowledge and local participation in forest management.

Fuzzy cognitive maps for issue identification in a water resources conflict resolution system

NASA Astrophysics Data System (ADS)

Giordano, R.; Passarella, G.; Uricchio, V. F.; Vurro, M.

In water management, conflicts of interests are inevitable due to the variety in quality demands and the number of stakeholders, which are affected in different ways by decisions concerning the use of the resources. Ignoring the differences among interests involved in water resources management and not resolving the emerging conflicts could lead to controversial strategies. In such cases, proposed solutions could generate strong opposition, making these solutions unfeasible. In our contribution, a Community Decision Support System is proposed. Such a system is able to support discussion and collaboration. The system helps participants to structure their problem, to help them learn about possible alternatives, their constraints and implications and to support the participants in the specification of their own preferences. More in detail, the proposed system helps each user in representing and communicating problem perspectives. To reach this aim, cognitive maps are used to capture parts of the stakeholders’ point of view and to enhance negotiation among individuals and organizations. The aim of the negotiation process is to define a shared cognitive map with regard to water management problems. Such a map can be called a water community cognitive map. The system performance has been tested by simulating a real conflict on water resources management that occurred some years ago in a river basin in the south of Italy.

Poisoning by hallucinogenic mushroom hikageshibiretake (Psilocybe argentipes K. Yokoyama) indigenous to Japan.

PubMed

Musha, M; Ishii, A; Tanaka, F; Kusano, G

1986-01-01

Five cases of poisoning by indigenous mushroom Hikageshibiretake (Psilocybe argentipes) are reported. As this mushroom contains psilocybin, in general, clinical features were similar to those seen by pure psilocybin. Acute toxic stuporous state with complete amnesia in the culminating period occurred in one case, psychedelic state with dreamy consciousness in one case and psychotic adverse reactions with vivid visual hallucinations with consciousness in three cases. There were accompanied with anxiety and panic reactions to subjective experiences. Though these toxic effects were usually short-lived, for management of such patients it is important to recognize that horrible emotional reactions and other harmful behavioral problems can also occur.

A Case Study of Obsolescence Management Constraints During Development of Sustainment-Dominated Systems

NASA Astrophysics Data System (ADS)

Welch, Jonathan

This case study focused on obsolescence management constraints that occur during development of sustainment-dominated systems. Obsolescence management constraints were explored in systems expected to last 20 years or more and that tend to use commercial off-the-shelf products. The field of obsolescence has received little study, but obsolescence has a large cost for military systems. Because developing complex systems takes an average of 3 to 8 years, and commercial off-the-shelf components are typically obsolete within 3 to 5 years, military systems are often deployed with obsolescence issues that are transferred to the sustainment community to determine solutions. The main problem addressed in the study was to identify the constraints that have caused 70% of military systems under development to be obsolete when they are delivered. The purpose of the study was to use a qualitative case study to identify constraints that interfered with obsolescence management occurring during the development stages of a program. The participants of this case study were managers, subordinates, and end-users who were logistics and obsolescence experts. Researchers largely agree that proactive obsolescence management is a lower cost solution for sustainment-dominated systems. Program managers must understand the constraints and understand the impact of not implementing proactive solutions early in the development program lifecycle. The conclusion of the study found several constraints that prevented the development program from early adoption of obsolescence management theories, specifically pro-active theories. There were three major themes identified: (a) management commitment, (b) lack of details in the statement of work, and (c) vendor management. Each major theme includes several subthemes. The recommendation is future researchers should explore two areas: (a) comparing the cost of managing obsolescence early in the development process versus the costs of managing later, (b) exploring the costs and value to start a centralized obsolescence group at each major defense contractor location.

Study on Adaptive Parameter Determination of Cluster Analysis in Urban Management Cases

NASA Astrophysics Data System (ADS)

Fu, J. Y.; Jing, C. F.; Du, M. Y.; Fu, Y. L.; Dai, P. P.

2017-09-01

The fine management for cities is the important way to realize the smart city. The data mining which uses spatial clustering analysis for urban management cases can be used in the evaluation of urban public facilities deployment, and support the policy decisions, and also provides technical support for the fine management of the city. Aiming at the problem that DBSCAN algorithm which is based on the density-clustering can not realize parameter adaptive determination, this paper proposed the optimizing method of parameter adaptive determination based on the spatial analysis. Firstly, making analysis of the function Ripley's K for the data set to realize adaptive determination of global parameter MinPts, which means setting the maximum aggregation scale as the range of data clustering. Calculating every point object's highest frequency K value in the range of Eps which uses K-D tree and setting it as the value of clustering density to realize the adaptive determination of global parameter MinPts. Then, the R language was used to optimize the above process to accomplish the precise clustering of typical urban management cases. The experimental results based on the typical case of urban management in XiCheng district of Beijing shows that: The new DBSCAN clustering algorithm this paper presents takes full account of the data's spatial and statistical characteristic which has obvious clustering feature, and has a better applicability and high quality. The results of the study are not only helpful for the formulation of urban management policies and the allocation of urban management supervisors in XiCheng District of Beijing, but also to other cities and related fields.

Confronting uncertainty in wildlife management: performance of grizzly bear management.

PubMed

Artelle, Kyle A; Anderson, Sean C; Cooper, Andrew B; Paquet, Paul C; Reynolds, John D; Darimont, Chris T

2013-01-01

Scientific management of wildlife requires confronting the complexities of natural and social systems. Uncertainty poses a central problem. Whereas the importance of considering uncertainty has been widely discussed, studies of the effects of unaddressed uncertainty on real management systems have been rare. We examined the effects of outcome uncertainty and components of biological uncertainty on hunt management performance, illustrated with grizzly bears (Ursus arctos horribilis) in British Columbia, Canada. We found that both forms of uncertainty can have serious impacts on management performance. Outcome uncertainty alone--discrepancy between expected and realized mortality levels--led to excess mortality in 19% of cases (population-years) examined. Accounting for uncertainty around estimated biological parameters (i.e., biological uncertainty) revealed that excess mortality might have occurred in up to 70% of cases. We offer a general method for identifying targets for exploited species that incorporates uncertainty and maintains the probability of exceeding mortality limits below specified thresholds. Setting targets in our focal system using this method at thresholds of 25% and 5% probability of overmortality would require average target mortality reductions of 47% and 81%, respectively. Application of our transparent and generalizable framework to this or other systems could improve management performance in the presence of uncertainty.

[Regional health systems management: a case study in Rio Grande do Sul, Brazil].

PubMed

Lima, Juliano de Carvalho; Rivera, Francisco Javier Uribe

2006-10-01

This article analyzes the management system in a health district in the State of Rio Grande do Sul, Brazil, through qualitative analysis, using a case study as the methodology and macro-organization theory as the analytical framework. For the current management system in the 6th Health Region, a clear mission statement and wide acceptance by health workers are facilitating factors for the current organizational practices within the health system. Nevertheless, the way health coordinators are currently prioritizing their time has diverted necessary resources from critical problems towards more remedial issues. The 6th Health Region has encouraged social control (or public oversight) in order to improve accountability. However, there is room for improvement in quality assurance management, since there were no well-defined goals, objectives, or accountability. Decentralized consultancy provided to the municipalities and the funding model itself have both promoted decentralization and autonomy, although the strategy requires better regional integration and greater commitment in managerial practices.

Talent management best practices: how exemplary health care organizations create value in a down economy.

PubMed

Groves, Kevin S

2011-01-01

: Difficult economic conditions and powerful workforce trends pose significant challenges to managing talent in health care organizations. Although robust research evidence supports the many benefits of maintaining a strong commitment to talent management practices despite these challenges, many organizations compound the problem by resorting to workforce reductions and limiting or eliminating investments in talent management. : This study examines how nationwide health care systems address these challenges through best practice talent management systems. Addressing important gaps in talent management theory and practice, this study develops a best practice model of talent management that is grounded in the contextual challenges facing health care practitioners. : Utilizing a qualitative case study that examined 15 nationwide health care systems, data were collected through semistructured interviews with 30 executives and document analysis of talent management program materials submitted by each organization. : Exemplary health care organizations employ a multiphased talent management system composed of six sequential phases and associated success factors that drive effective implementation. Based on these findings, a model of talent management best practices in health care organizations is presented. : Health care practitioners may utilize the best practice model to assess and enhance their respective talent management systems by establishing the business case for talent management, defining, identifying, and developing high-potential leaders, carefully communicating high-potential designations, and evaluating talent management outcomes.

Co-simulation coupling spectral/finite elements for 3D soil/structure interaction problems

NASA Astrophysics Data System (ADS)

Zuchowski, Loïc; Brun, Michael; De Martin, Florent

2018-05-01

The coupling between an implicit finite elements (FE) code and an explicit spectral elements (SE) code has been explored for solving the elastic wave propagation in the case of soil/structure interaction problem. The coupling approach is based on domain decomposition methods in transient dynamics. The spatial coupling at the interface is managed by a standard coupling mortar approach, whereas the time integration is dealt with an hybrid asynchronous time integrator. An external coupling software, handling the interface problem, has been set up in order to couple the FE software Code_Aster with the SE software EFISPEC3D.

HIV counselling in prisons.

PubMed

Curran, L; McHugh, M; Nooney, K

1989-01-01

HIV presents particular problem in penal establishments: the nature of the population; conditions in prison; media attention and misinformation; the possibility of transmission within and beyond the prison population; the extra issues that apply to female prisoners. These are discussed in the context of prison policy regarding HIV and the broad strategic approach which is being adopted to manage the problem of HIV within penal institutions. Counselling has a key role in the overall strategy. Pre- and post-test counselling with prisoners is described and the particular problems presented by inmates are discussed and illustrated by reference to case histories. Developments in counselling provision for inmates are outlined.

Dental management for head and neck cancer patients undergoing radiation therapy: comprehensive patient based planning--a case report.

PubMed

Higham, Paola; Quek, Samuel; Cohen, Harold V

2009-01-01

Medical management of the head and neck cancer patient (HNCP) most often will include radiation therapy to the head and neck region. HNCPs with malignant disease require judicious dental treatment planning prior to radiation therapy (RT) and/or chemotherapy. RT can result in a multitude of adverse effects, both reversible and irreversible. We report a case of a patient with squamous cell carcinoma of the throat above the larynx (supraglottic), who did not adhere to dental treatment recommendations for both pre- and post radiation dental management. The focus of this case report is to create awareness within the clinician that, in addition to evaluating the patient for the disease related issues that may affect the oral cavity and dentition, a total management plan should include factors beyond the structural oral problems related to the cancer. Final treatment plans for the HNCP should include medical assessment of past dental history, oral hygiene, potential compliance, or lack of, to dental care recommendations, the emotional state of the patient, socio-economic status of the patient (lifestyle, cost of care), future quality of life, the medical and/or life prognosis of the patient.

[Application of laboratory information system in the management of the key indicators of quality inspection].

PubMed

Guo, Ye; Chen, Qian; Wu, Wei; Cui, Wei

2015-03-31

To establish a system of monitoring the key indicator of quality for inspection (KIQI) on a laboratory information system (LIS), and to have a better management of KIQI. Clinical sample made in PUMCH were collected during the whole of 2014. Next, interactive input program were designed to accomplish data collecting of the disqualification rate of samples, the mistake rate of samples and the occasions of losing samples, etc. Then, a series moment of sample collection, laboratory sample arrived, sample test, sample check, response to critical value, namely, trajectory information left on LIS were recorded and the qualification rate of TAT, the notification rate of endangering result were calculated. Finally, the information about quality control were collected to build an internal quality control database and the KIQI, such as the out-of-control rate of quality control and the total error of test items were monitored. The inspection of the sample management shows the disqualification rates in 2014 were all below the target, but the rates in January and February were a little high and the rates of four wards were above 2%. The mistake rates of samples was 0.47 cases/10 000 cases, attaining the target (< 2 cases/10 000 cases). Also, there was no occasion of losing samples in 2014, attaining the target too. The inspection of laboratory reports shows the qualification rates of TAT was within the acceptable range (> 95%), however the rates of blood routine in November (94.75%) was out of range. We have solved the problem by optimizing the processes. The notification rate of endangering result attained the target (≥ 98%), while the rate of timely notification is needed to improve. Quality inspection shows the CV of APTT in August (5.02%) was rising significantly, beyond the accepted CV (5.0%). We have solved the problem by changing the reagent. The CV of TT in 2014 were all below the allowable CV, thus the allowable CV of the next year lower to 10%. It is an objective and effective method to manage KIQI with the powerful management mode of database and information process capability on LIS.

Less Is More: Inpatient Management of a Child with Complex Pharmacotherapy

ERIC Educational Resources Information Center

Kratochvil, Christopher J.; Varley, Christopher; Cummins, Thomas K.; Martin, Andres

2006-01-01

This paper presents a case of an 11-year-old boy who was admitted to an acute inpatient psychiatric setting because of a recent exacerbation of physical aggression, accompanied by long-standing problems with verbal aggression, irritability, dysphoria, and sleep disturbance. His family history was notable for domestic violence, substance abuse by…

Don't Get Lost in the Translation.

ERIC Educational Resources Information Center

Wederspahn, Gary M.

In this era of rapid globalization of business opportunities, many managers face the need to communicate with foreign counterparts who do not speak English. The solution, in many cases, is to use an interpreter. Interpreters, however, may make mistakes, and irritation, embarrassment and even major problems may arise from errors in translation.…

The Interpretation of Problem Based Learning: A Case Study

ERIC Educational Resources Information Center

Li, Huichun

2013-01-01

Currently, there are a large number of higher education institutions transforming their traditional educational approaches to PBL. In order to address the challenges for PBL implementation for a university, it is quite necessary to investigate how the managers and staff members interpret PBL in practice. Through the exploration of a university…

Cross-cultural issues in CRM training

NASA Technical Reports Server (NTRS)

Merritt, A.; Helmreich, R. L. (Principal Investigator)

1995-01-01

The author presents six stages of intercultural awareness and relates them to cockpit resource management training. A case study examines cultural differences between South American and United States flight crews and the problems that can occur when pilots minimize differences. Differences in leadership styles are highlighted and strategies for training South American pilots are provided.

Tax Implications of Forest Property Exchanges

Treesearch

William C. Siegel

1999-01-01

For various reasons, it may be advantageous for woodland owners to voluntarily exchange some or all of their timber and/or timberland for other property. For example, exchanges can be used to consolidate or diversify forest holdings and other investments; to obtain greater cash flow; and eliminate or reduce management problems. In many cases, voluntary exchanges--...

What's under Your Bed? A Fundraising Fiasco

ERIC Educational Resources Information Center

Carver, Cynthia L.; Klein, C. Suzanne; Gistinger, Maria A.

2015-01-01

Student clubs and sports often struggle to raise funds. With limited revenue streams, coaches or advisors and parents routinely find themselves managing candy sales, car washes, raffles, and ticketed fundraisers to support programming. In this case of a swim team fundraiser, school leaders see the range of problems that can occur when a routine…

A Note on Educational Management and the Third Revolution Lithium Regimen: A Reassessment and Commentary.

ERIC Educational Resources Information Center

Snell, Joel C.; Green, Donald W.

1989-01-01

Describes downside of the Third Revolution biological psychiatry. Presents case study in which misapplication of one medication, lithium, jeopardized the professionalism of a college faculty member. Discusses administrative strategies used to resolve the problem and suggests an alternative strategy. Concludes that psychiatric treatment can be…

78 FR 65955 - Migratory Bird Permits; Control Order for Introduced Migratory Bird Species in Hawaii

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... must be postmarked no later than February 3, 2014. ADDRESSES: You may submit comments by one of the... Hawaiian bird species including several threatened and endangered species. Studies indicate that neither.... Though they have altered their management in such cases, the predation continues to be a problem. Having...

Teaching Case: Adapting the Access Northwind Database to Support a Database Course

ERIC Educational Resources Information Center

Dyer, John N.; Rogers, Camille

2015-01-01

A common problem encountered when teaching database courses is that few large illustrative databases exist to support teaching and learning. Most database textbooks have small "toy" databases that are chapter objective specific, and thus do not support application over the complete domain of design, implementation and management concepts…

Economics of Computing: The Case of Centralized Network File Servers.

ERIC Educational Resources Information Center

Solomon, Martin B.

1994-01-01

Discusses computer networking and the cost effectiveness of decentralization, including local area networks. A planned experiment with a centralized approach to the operation and management of file servers at the University of South Carolina is described that hopes to realize cost savings and the avoidance of staffing problems. (Contains four…

Developing Customized Programs for Steel and Other Heavy Industries: A Case Study.

ERIC Educational Resources Information Center

Day, Philip R., Jr.

1984-01-01

This article discusses the successful implementation of a unique customized training program for steel and other industries. A contextual framework for understanding both the process and the product is presented. Traditional labor management problems are examined as well as the DACUM (Developing a Curriculum) procedure of identifying job-related…

Micro-managing arthropod invasions: eradication and control of invasive arthropods with microbes

Treesearch

Ann E. Hajek; Patrick C. Tobin

2010-01-01

Non-indigenous arthropods are increasingly being introduced into new areas worldwide and occasionally they cause considerable ecological and economic harm. Many invasive arthropods particularly pose problems to areas of human habitation and native ecosystems. In these cases, the use of environmentally benign materials, such as host-specific entomopathogens, can be more...

Using Simulation to Develop Entrepreneurial Skills and Mind-Set: An Exploratory Case Study

ERIC Educational Resources Information Center

Costin, Yvonne; O'Brien, Michael P.; Slattery, Darina M.

2018-01-01

Entrepreneurs need to develop a range of skills to be successful, including skills in decision making, risk management, problem solving, communication, and teamwork. Games and simulations are increasingly being used in both academia and business to encourage such skills development. This paper describes a business simulation module whereby…

Sustainable Remediation of Legacy Mine Drainage: A Case Study of the Flight 93 National Memorial.

PubMed

Emili, Lisa A; Pizarchik, Joseph; Mahan, Carolyn G

2016-03-01

Pollution from mining activities is a global environmental concern, not limited to areas of current resource extraction, but including a broader geographic area of historic (legacy) and abandoned mines. The pollution of surface waters from acid mine drainage is a persistent problem and requires a holistic and sustainable approach to addressing the spatial and temporal complexity of mining-specific problems. In this paper, we focus on the environmental, socio-economic, and legal challenges associated with the concurrent activities to remediate a coal mine site and to develop a national memorial following a catastrophic event. We provide a conceptual construct of a socio-ecological system defined at several spatial, temporal, and organizational scales and a critical synthesis of the technical and social learning processes necessary to achieving sustainable environmental remediation. Our case study is an example of a multi-disciplinary management approach, whereby collaborative interaction of stakeholders, the emergence of functional linkages for information exchange, and mediation led to scientifically informed decision making, creative management solutions, and ultimately environmental policy change.

GIS, modeling, and politics: on the tensions of collaborative decision support.

PubMed

Ramsey, Kevin

2009-05-01

A tension exists at the heart of efforts to support collaboration with GIS. Many scholars and practitioners seek to support two separate objectives: (1) problem solving and (2) the exploration of diverse problem understandings. GIS applications designed for problem solving often pre-define the problem space by structuring the kind of information that can be considered or the way in which the problem is conceptualized. In doing so, they necessarily privilege particular perspectives and understandings of the problem while marginalizing others. As a result, these initiatives undermine their second objective. This is problematic in the context of contentious environmental decisions which have broad-reaching impacts on people with diverse perspectives and interests. In such contexts, I argue that equitable collaboration is impossible without first emphasizing the exploration of diverse problem understandings. I support this argument theoretically by turning to the literatures on collaborative planning and spatial decision support, and empirically in my analysis of a case study of an effort to construct a GIS for supporting collaborative water resource management in rural Idaho. Reflecting upon the case, I provide a set of recommendations to those seeking to better negotiate the tensions of supporting collaboration with GIS in the context of contentious environmental and natural resource decisions.

Management of intraductal papillary mucinous neoplasms.

PubMed

Crippa, Stefano; Fernández-del Castillo, Carlos

2008-04-01

Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are being diagnosed with increasing frequency, probably due to the widespread use of cross-sectional imaging. The natural history of these tumors is still largely unknown. Several studies have shown topographical as well as biological differences between main duct and branch duct IPMNs. In the past few years, diagnostic work-up and, in particular, management of these tumors have evolved significantly. Data support the need for resection of main duct IPMNs and the possibility of nonoperative management in selected cases of branch duct tumors. In this systematic review, we analyze the most recent publications related to IPMNs, with particular emphasis on problems related to managing this challenging disease.

Multi-Objective Differential Evolution for Voltage Security Constrained Optimal Power Flow in Deregulated Power Systems

NASA Astrophysics Data System (ADS)

Roselyn, J. Preetha; Devaraj, D.; Dash, Subhransu Sekhar

2013-11-01

Voltage stability is an important issue in the planning and operation of deregulated power systems. The voltage stability problems is a most challenging one for the system operators in deregulated power systems because of the intense use of transmission line capabilities and poor regulation in market environment. This article addresses the congestion management problem avoiding offline transmission capacity limits related to voltage stability by considering Voltage Security Constrained Optimal Power Flow (VSCOPF) problem in deregulated environment. This article presents the application of Multi Objective Differential Evolution (MODE) algorithm to solve the VSCOPF problem in new competitive power systems. The maximum of L-index of the load buses is taken as the indicator of voltage stability and is incorporated in the Optimal Power Flow (OPF) problem. The proposed method in hybrid power market which also gives solutions to voltage stability problems by considering the generation rescheduling cost and load shedding cost which relieves the congestion problem in deregulated environment. The buses for load shedding are selected based on the minimum eigen value of Jacobian with respect to the load shed. In the proposed approach, real power settings of generators in base case and contingency cases, generator bus voltage magnitudes, real and reactive power demands of selected load buses using sensitivity analysis are taken as the control variables and are represented as the combination of floating point numbers and integers. DE/randSF/1/bin strategy scheme of differential evolution with self-tuned parameter which employs binomial crossover and difference vector based mutation is used for the VSCOPF problem. A fuzzy based mechanism is employed to get the best compromise solution from the pareto front to aid the decision maker. The proposed VSCOPF planning model is implemented on IEEE 30-bus system, IEEE 57 bus practical system and IEEE 118 bus system. The pareto optimal front obtained from MODE is compared with reference pareto front and the best compromise solution for all the cases are obtained from fuzzy decision making strategy. The performance measures of proposed MODE in two test systems are calculated using suitable performance metrices. The simulation results show that the proposed approach provides considerable improvement in the congestion management by generation rescheduling and load shedding while enhancing the voltage stability in deregulated power system.

Problematics of open prostatectomy in an Ivorian District Hospital setting.

PubMed

Mgbakor, Anthony Chukwura

2012-09-01

Benign prostatic hypertrophy forms the bulk of urology workload in many sub-Saharan African hospitals. However, its management in secondary hospitals encounters specific problems that are rarely seen in the bigger tertiary institutions. We have tried to describe these difficulties across an account of open prostatectomy in regional secondary referral hospitals in the Côte d'Ivoire. This is a retrospective account of the specific difficulties encountered in the management of 327 consecutive cases of open prostatectomy carried out between August 1991 and September 2007 mainly in two secondary referral hospitals in the Côte d'Ivoire. The difficulties were at different levels: late presentation with 309 (94.5%) of the patients having experienced at least an episode of acute retention of urine, surgery while most patients were still carrying a catheter, minimal investigations carried out, scoring the patients in the IPSS scale, shortage of funds in the course of the management, and surveillance in the immediate postoperative period. The overall results were relatively satisfactory given our conditions of work. The most frequent complications were wound infection (14.7%), bleeding requiring transfusion (8.6%) and re-operation for clot retention (4.3%). We had a case (0.3%) of the rare prostato-rectal fistula which was managed conservatively. There were 4 deaths (1.2%). Open prostatectomy is the only surgical option for the management of benign prostatic hypertrophy in most of the urology centers of sub-Saharan Africa. Concerning its management away from the Tertiary Institutes, the surgery team is faced with specific problems which demand precise adaptations. Despite difficult working conditions, the results are sufficiently encouraging and gratifying to justify its pursuit while Urologists await the availability of equipments for transurethral resection of the prostate and other novel techniques.

Integrating info-gap decision theory with robust population management: a case study using the Mountain Plover.

PubMed

van der Burg, Max Post; Tyre, Andrew J

2011-01-01

Wildlife managers often make decisions under considerable uncertainty. In the most extreme case, a complete lack of data leads to uncertainty that is unquantifiable. Information-gap decision theory deals with assessing management decisions under extreme uncertainty, but it is not widely used in wildlife management. So too, robust population management methods were developed to deal with uncertainties in multiple-model parameters. However, the two methods have not, as yet, been used in tandem to assess population management decisions. We provide a novel combination of the robust population management approach for matrix models with the information-gap decision theory framework for making conservation decisions under extreme uncertainty. We applied our model to the problem of nest survival management in an endangered bird species, the Mountain Plover (Charadrius montanus). Our results showed that matrix sensitivities suggest that nest management is unlikely to have a strong effect on population growth rate, confirming previous analyses. However, given the amount of uncertainty about adult and juvenile survival, our analysis suggested that maximizing nest marking effort was a more robust decision to maintain a stable population. Focusing on the twin concepts of opportunity and robustness in an information-gap model provides a useful method of assessing conservation decisions under extreme uncertainty.

[Gender inequity in health in contexts of environmental risk from mining and industrial activity in Mexico].

PubMed

Catalán-Vázquez, Minerva; Riojas-Rodríguez, Horacio

2015-06-01

Analyze how gender inequity manifests in contexts of poverty in different environmental risk scenarios in Mexico. Qualitative design based on six discussion groups and 54 in-depth interviews with women from six exposed communities: two to environmental manganese in a mining district, two in an industrial corridor, and two bordering a sanitary landfill. A document review of environmental and health studies in each area was done to relate them to the women's perspective on the problem. In the three case studies, by gender roles, women stay at home and do housework and, therefore, are subject to intense environmental exposure when carrying out their daily tasks, such as house cleaning. Interview and discussion group results were found to be related to epidemiological study results. In the case of the mining district, women's perceptions are consistent with study comments on adverse cognitive effects of manganese exposure. In all three cases, there are serious limitations on women's political participation in environmental risk management. Due to conditions of inequity, women are highly exposed to environmental health risks and their social participation in solving environmental problems is quite limited. These results have social and environmental policy implications in the areas studied, especially with regard to risk assessment, management, and communication.

[Reducing the Care-Related Burdens of a Family Caregiver of a Person With Mild Cognitive Impairment: A Home-Based Case Management Program].

PubMed

Chen, Min-Chia; Chiu, Yi-Chen; Wei, Pi-Mei; Hsu, Wen-Chuin

2017-06-01

The long-term care of cognitively impaired patients with concomitant behavioral problems brings great stress and burdens to family caregivers. The present article describes a family caregiver with multiple chronic diseases who concurrently shouldered primary care responsibilities for her husband, a patient with mild cognitive impairment, problematic behaviors, and medication non-adherence issues. The period of care was between September 23rd and December 29th, 2015. Data on physiological, psychological, and social burdens were collected based on a stress process model for family caregiving. We then applied a home-based, individually tailored intervention, which included nursing education, skills training, listening/counseling, and resource connecting, that effectively helped the family caregiver reduce her burdens. Our assessment identified nursing-care-related problems as the primary source of caregiver burden in this case, with identified stressors including a lack of knowledge regarding patient care, medication management problems, sleep disorders, and inadequate social resources. Using continuous care interactions, we established a trust relationship with the family caregiver, prioritized her needs, and provided dementia care knowledge and skills, which gradually improved her caregiving competence. Our instruction included increasing caregiver understanding of the disease course of dementia, related problematic behaviors, and medication management. Our intervention enhanced the disease awareness of the caregiver and helped her become more positive about her caregiving tasks. Therefore, the negative impacts on her family were reduced. Social support and long-term care resources further reduced her burden and improved her quality of life.

Framing risk in pandemic influenza policy and control.

PubMed

Seetoh, Theresa; Liverani, Marco; Coker, Richard

2012-01-01

This article explores differing understandings of 'risk' in relation to pandemic influenza policy and control. After a preliminary overview of methodological and practical problems in risk analysis, ways in which risk was framed and managed in three historical cases were examined. The interdependence between scientific empiricism and political decision-making led to the mismanagement of the 1976 swine influenza scare in the USA. The 2004 H5N1 avian influenza outbreak in Thailand, on the other hand, was undermined by questions of national economic interest and concerns over global health security. Finally, the recent global emergency of pandemic influenza H1N1 in 2009 demonstrated the difficulties of risk management under a context of pre-established perceptions about the characteristics and inevitability of a pandemic. Following the analysis of these cases, a conceptual framework is presented to illustrate ways in which changing relationships between risk assessment, risk perception and risk management can result in differing policy strategies.

Aplastic anemia during pregnancy: a review of obstetric and anesthetic considerations

PubMed Central

Riveros-Perez, Efrain; Hermesch, Amy C; Barbour, Linda A; Hawkins, Joy L

2018-01-01

Aplastic anemia is a hematologic condition occasionally presenting during pregnancy. This pathological process is associated with significant maternal and neonatal morbidity and mortality. Obstetric and anesthetic management is challenging, and treatment requires a coordinated effort by an interdisciplinary team, in order to provide safe care to these patients. In this review, we describe the current state of the literature as it applies to the complexity of aplastic anemia in pregnancy, focusing on pathophysiologic aspects of the disease in pregnancy, as well as relevant obstetric and anesthetic considerations necessary to treat this challenging problem. A multidisciplinary-team approach to the management of aplastic anemia in pregnancy is necessary to coordinate prenatal care, optimize maternofetal outcomes, and plan peripartum interventions. Conservative transfusion management is critical to prevent alloimmunization. Although a safe threshold-platelet count for neuraxial anesthesia has not been established, selection of anesthetic technique must be evaluated on a case-to-case basis. PMID:29535558

Ciguatera fish poisoning and environmental change: a case for strengthening health surveillance in the Pacific?

PubMed

Derne, Bonnie; Fearnley, Emily; Goater, Sarah; Carter, Karen; Weinstein, Philip

2010-09-01

Ciguatera Fish Poisoning (CFP), a significant public health problem in the Pacific, is intrinsically linked to the health of coral reef ecosystems. Incidence data on CFP could therefore be used, in theory, as indicators of disruption to coral reefs. Some disruptions, such as increasing sea surface temperatures, result from global environmental change--therefore suggesting that CFP is likely to become an increasing public health problem in the region. The proactive management of increasing numbers of cases will depend on an understanding of the ecology of the disease, sound health surveillance systems to report cases of CFP including appropriate case definitions, and quantifiable correlations between case numbers and environmental variables. Here, we briefly review the knowledge about these components in Pacific Island Countries and Territories (PICTs), including summarising regional variation in symptoms of CFP cases, investigating media as an enhanced surveillance tool, and summarising regional environmental drivers of CFP cases. We conclude that CFP could be an important indicator of the health of reef ecosystems in the face of global climate change and more novel approaches such as combining environmental and health data, need to be implemented to improve surveillance of CFP.

Is Principled Pragmatism a Viable Framework for Addressing Complex Problems?

NASA Astrophysics Data System (ADS)

Islam, S.

2017-12-01

Complex water problems are connected with many competing and often conflicting values, interests, and tools. These problems can't be addressed through simply applying dogmatic principles or a deal-making pragmatic approach. Because these problems are interconnected and interdependent, a final solution can't be pre-specified. Any intervention to a complex problem requires attention to both principles and pragmatism. Strict adherence to principles without pragmatism is often not actionable; pure pragmatism exercised without guiding principles is not sustainable. In a colloquial sense, pragmatism is often taken to suggest practical, opportunistic, and expedient approaches at the expense of principles. This perception appears to be rooted in the dichotomy between "being pragmatic" and "being ideological". The notion of principled pragmatism attempts to get away from this duality by focusing on how to make ideas clear and actionable. In other words, how to connect our thoughts to action given the context, constraints, and capacity. Principled pragmatism - rooted in equity and sustainability as guiding principles for water management - approach attempts to synthesize symbolic aspirations with realistic assessment to chart a trajectory of actionable subset of implementable solutions. Case studies from the Ganges Basin will show the utility of principled pragmatism for water management in a changing world.

Drainage network optimization for inundation mitigation case study of ITS Surabaya

NASA Astrophysics Data System (ADS)

Savitri, Yang Ratri; Lasminto, Umboro

2017-06-01

Institut Teknologi Sepuluh Nopember (ITS) Surabaya is one of engineering campus in Surabaya with an area of ± 187 ha, which consists of building and campus facilities. The campus is supported by drainage system planned according to the ITS Master Plan on 2002. The drainage system is planned with numbers of retention and detention pond based on the city concept of Zero Delta Q concept. However, in the rainy season, it frequently has inundation problems in several locations. The problems could be identified from two major sources, namely the internal campus facilities and external condition connected with the city drainage system. This paper described the capabilities of drainage network optimization to mitigate local urban drainage problem. The hydrology-hydraulic investigation was done by utilizing the Storm Water Management Model (SWMM) developed by US Environmental Protection Agency (EPA). The mitigation is based on several alternative that based on the existing condition and regarding the social problem. The study results showed that the management of the flow from external source could reduce final stored volume of the campus main channel by 31.75 %.

Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review

PubMed Central

Hudon, Catherine; Chouinard, Maud-Christine; Lambert, Mireille; Diadiou, Fatoumata; Bouliane, Danielle; Beaudin, Jérémie

2017-01-01

Objective The aim of this paper was to identify the key factors of case management (CM) interventions among frequent users of healthcare services found in empirical studies of effectiveness. Design Thematic analysis review of CM studies. Methods We built on a previously published review that aimed to report the effectiveness of CM interventions for frequent users of healthcare services, using the Medline, Scopus and CINAHL databases covering the January 2004–December 2015 period, then updated to July 2017, with the keywords ‘CM’ and ‘frequent use’. We extracted factors of successful (n=7) and unsuccessful (n=6) CM interventions and conducted a mixed thematic analysis to synthesise findings. Chaudoir’s implementation of health innovations framework was used to organise results into four broad levels of factors: (1) environmental/organisational level, (2) practitioner level, (3) patient level and (4) programme level. Results Access to, and close partnerships with, healthcare providers and community services resources were key factors of successful CM interventions that should target patients with the greatest needs and promote frequent contacts with the healthcare team. The selection and training of the case manager was also an important factor to foster patient engagement in CM. Coordination of care, self-management support and assistance with care navigation were key CM activities. The main issues reported by unsuccessful CM interventions were problems with case finding or lack of care integration. Conclusions CM interventions for frequent users of healthcare services should ensure adequate case finding processes, rigorous selection and training of the case manager, sufficient intensity of the intervention, as well as good care integration among all partners. Other studies could further evaluate the influence of contextual factors on intervention impacts. PMID:29061623

Problem-Oriented Corporate Knowledge Base Models on the Case-Based Reasoning Approach Basis

NASA Astrophysics Data System (ADS)

Gluhih, I. N.; Akhmadulin, R. K.

2017-07-01

One of the urgent directions of efficiency enhancement of production processes and enterprises activities management is creation and use of corporate knowledge bases. The article suggests a concept of problem-oriented corporate knowledge bases (PO CKB), in which knowledge is arranged around possible problem situations and represents a tool for making and implementing decisions in such situations. For knowledge representation in PO CKB a case-based reasoning approach is encouraged to use. Under this approach, the content of a case as a knowledge base component has been defined; based on the situation tree a PO CKB knowledge model has been developed, in which the knowledge about typical situations as well as specific examples of situations and solutions have been represented. A generalized problem-oriented corporate knowledge base structural chart and possible modes of its operation have been suggested. The obtained models allow creating and using corporate knowledge bases for support of decision making and implementing, training, staff skill upgrading and analysis of the decisions taken. The universal interpretation of terms “situation” and “solution” adopted in the work allows using the suggested models to develop problem-oriented corporate knowledge bases in different subject domains. It has been suggested to use the developed models for making corporate knowledge bases of the enterprises that operate engineer systems and networks at large production facilities.

[Selected problems of neurofibromatosis with presentation of a case of multiple intracranial and intramedullary tumors].

PubMed

Stachura, Z; Zralek, C; Siemianowicz, S; Kiczka-Zralek, M; Zawadzki, T; Kluczewska, E; Giec-Lorenc, A

1998-01-01

A case of neurofibromatosis type II in a 19-year-old man is described with clinical and neuroimaging (MRI) findings. The diagnostic criteria of neurofibromatosis type I (NF1) and type II (NF2) and the optimal management options are still controversial. The authors suggest that this patient fulfills criteria of neurofibromatosis type II as well as partially neurofibromatosis type I. At present, without molecular analysis of DNA, this assumption can not be verified.

A Cost Containment Case for Occupational Illness and Injury Case Management

DTIC Science & Technology

1988-06-15

hypochondriacs, "worried well" or WW, problem patients, and persistent somatizers (Wagner & Curran, 1984). In order to distinguish the WW from other health care...report that 14 TAERE I-ALES IRELCH TO ASES HEAIZ HELM~ IN A HEMLI MAJNNMM (JIMO2ATWN 1. Somatic ptoatol : Frequency x average intensity of the six... somatic symptoms which include: stomach trouble, headaches, weight gain, appetite loss, tired and nn down, and trouble sleeping (’at do you think is your

New control concepts for uncertain water resources systems: 1. Theory

NASA Astrophysics Data System (ADS)

Georgakakos, Aris P.; Yao, Huaming

1993-06-01

A major complicating factor in water resources systems management is handling unknown inputs. Stochastic optimization provides a sound mathematical framework but requires that enough data exist to develop statistical input representations. In cases where data records are insufficient (e.g., extreme events) or atypical of future input realizations, stochastic methods are inadequate. This article presents a control approach where input variables are only expected to belong in certain sets. The objective is to determine sets of admissible control actions guaranteeing that the system will remain within desirable bounds. The solution is based on dynamic programming and derived for the case where all sets are convex polyhedra. A companion paper (Yao and Georgakakos, this issue) addresses specific applications and problems in relation to reservoir system management.

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. Copyright © 2016 CEO. Published by Elsevier Masson SAS. All rights reserved.

A Comprehensive Rehabilitation Approach in a Patient With Serious Neuropsychiatric Systemic Lupus Erythematosus.

PubMed

Ko, Yong Jae; Lee, Yang Gyun; Park, Ji Woong; Ahn, Sung Ho; Kwak, Jin Myoung; Choi, Yoon-Hee

2016-08-01

Neuropsychiatric systemic lupus erythematosus (NPSLE) involves the central and peripheral nervous system in patients with systemic lupus erythematosus (SLE). It is essential to specify the problems faced by patients with NPSLE because it causes diverse disabilities and impairs quality of life. After performing a comprehensive evaluation, tailored management should be provided for the patient's specific problems. We report here the case of a 30-year-old female with SLE who experienced serious neuropsychiatric symptoms cerebral infarction followed by posterior reversible encephalopathy syndrome and peripheral polyneuropathy. We systemically assessed the patient using the International Classification of Functioning, Disability and Health model as a clinical problem-solving tool and provided comprehensive rehabilitation by focusing on her problems.

Feasibility Study of Case-Finding for Breast Cancer by Community Health Workers in Rural Bangladesh.

PubMed

Chowdhury, Touhidul Imran; Love, Richard Reed; Chowdhury, Mohammad Touhidul Imran; Artif, Abu Saeem; Ahsan, Hasib; Mamun, Anwarul; Khanam, Tahmina; Woods, James; Salim, Reza

2015-01-01

Mortality from breast cancer is high in low- and middle-income countries, in part because most patients have advanced stage disease when first diagnosed. Case-finding may be one approach to changing this situation. We conducted a pilot study to explore the feasibility of population-based case finding for breast cancer by community health workers (CHWs) using different data collection methods and approaches to management of women found to have breast abnormalities. After training 8 CHWs in breast problem recognition, manual paper data collection and operation of a cell-phone software platform for reporting demographic, history and physical finding information, these CHWs visited 3150 women >age 18 and over they could find--from 2356 households in 8 villages in rural Bangladesh. By 4 random assignments of villages, data were collected manually (Group 1), or with the cell-phone program alone (Group 2) or with management algorithms (Groups 3 and 4), and women adjudged to have a serious breast problem were shown a motivational video (Group 3), or navigated/accompanied to a breast problem center for evaluation (Group 4). Only three visited women refused evaluation. The manual data acquisition group (1) had missing data in 80% of cases, and took an average of 5 minutes longer to acquire, versus no missing data in the cell phone-reporting groups (2,3 and 4). One woman was identified with stage III breast cancer, and was appropriately treated. Among very poor rural Bangladeshi women, there was very limited reluctance to undergo breast evaluation. The estimated rarity of clinical breast cancer is supported by these population-based findings. The feasibility and efficient use of mobile technology in this setting is supported. Successor studies may most appropriately be trials focusing on improving the suggested benefits of motivation and navigation, on increasing the numbers of cases found, and on stage of disease at diagnosis as the primary endpoint.

Rehabilitation of a One-day-Old Neonate with Cleft Lip and Palate using Palatal Obturator: A Case Report.

PubMed

Bansal, Rajesh; Kumar Pathak, Ashish; Bhatia, Baldev; Gupta, Sailesh; Kumar Gautam, Keshav

2012-05-01

Feeding a neonate with a complete cleft lip and palate is difficult pursuit due to communication between oral cavity and nasal cavity. A multidisciplinary approach is required to manage the complex problems involved in case of such neonates and their families. Present case is of a 1-day-old neonate having complete bilateral cleft lip and palate for which palatal obturator was constructed. A stepwise simple, easy and uncomplicated procedure for making accurate impressions, maxillary cast and fabrication of palatal obturator in infants with cleft lip and palate has been presented. The objective to present this case report is to emphasize the fact that how these palatal obturators /plates help in feeding, speech/language development, presurgical orthopedics and prevent other associated otorhinolaryngeal problems. How to cite this article: Bansal R, Pathak AK, Bhatia B, Gupta S, Gautam KK. Rehabilitation of a One-day Old Neonate with Cleft Lip and Palate using Palatal Obturator: A Case Report. Int J Clin Pediatr Dent 2012;5(2):145-147.

Management of a stage-structured insect pest: an application of approximate optimization.

PubMed

Hackett, Sean C; Bonsall, Michael B

2018-06-01

Ecological decision problems frequently require the optimization of a sequence of actions over time where actions may have both immediate and downstream effects. Dynamic programming can solve such problems only if the dimensionality is sufficiently low. Approximate dynamic programming (ADP) provides a suite of methods applicable to problems of arbitrary complexity at the expense of guaranteed optimality. The most easily generalized method is the look-ahead policy: a brute-force algorithm that identifies reasonable actions by constructing and solving a series of temporally truncated approximations of the full problem over a defined planning horizon. We develop and apply this approach to a pest management problem inspired by the Mediterranean fruit fly, Ceratitis capitata. The model aims to minimize the cumulative costs of management actions and medfly-induced losses over a single 16-week season. The medfly population is stage-structured and grows continuously while management decisions are made at discrete, weekly intervals. For each week, the model chooses between inaction, insecticide application, or one of six sterile insect release ratios. Look-ahead policy performance is evaluated over a range of planning horizons, two levels of crop susceptibility to medfly and three levels of pesticide persistence. In all cases, the actions proposed by the look-ahead policy are contrasted to those of a myopic policy that minimizes costs over only the current week. We find that look-ahead policies always out-performed a myopic policy and decision quality is sensitive to the temporal distribution of costs relative to the planning horizon: it is beneficial to extend the planning horizon when it excludes pertinent costs. However, longer planning horizons may reduce decision quality when major costs are resolved imminently. ADP methods such as the look-ahead-policy-based approach developed here render questions intractable to dynamic programming amenable to inference but should be applied carefully as their flexibility comes at the expense of guaranteed optimality. However, given the complexity of many ecological management problems, the capacity to propose a strategy that is "good enough" using a more representative problem formulation may be preferable to an optimal strategy derived from a simplified model. © 2018 by the Ecological Society of America.

A reflective lens: applying critical systems thinking and visual methods to ecohealth research.

PubMed

Cleland, Deborah; Wyborn, Carina

2010-12-01

Critical systems methodology has been advocated as an effective and ethical way to engage with the uncertainty and conflicting values common to ecohealth problems. We use two contrasting case studies, coral reef management in the Philippines and national park management in Australia, to illustrate the value of critical systems approaches in exploring how people respond to environmental threats to their physical and spiritual well-being. In both cases, we used visual methods--participatory modeling and rich picturing, respectively. The critical systems methodology, with its emphasis on reflection, guided an appraisal of the research process. A discussion of these two case studies suggests that visual methods can be usefully applied within a critical systems framework to offer new insights into ecohealth issues across a diverse range of socio-political contexts. With this article, we hope to open up a conversation with other practitioners to expand the use of visual methods in integrated research.

Sugammadex Use in a Patient with Wolff-Parkinson-White (WPW) Syndrome.

PubMed

Şahin, Sevtap Hekimoğlu; Öztekin, İlhan; Kuzucuoğlu, Aytuna; Aslanoğlu, Ayça

2015-07-01

Wolff-Parkinson-White (WPW) syndrome is a disease associated with episodes of supraventricular tachycardia and ventricular pre-excitation or atrial fibrillation. WPW is characterized by an aberrant electrical conduction pathway between atria and ventricles. The major anesthetic problem connected with WPW syndrome is the risk of tachyarrhythmias due to accessory pathway. Therefore, it has been proposed that the aim of anesthetic management should be the avoidance of tachyarrhythmia and sympathetic stimulation. Sugammadex was administered as a neuromuscular reversal agent in this case. To our knowledge, this is the first case report of sugammadex use in a patient with WPW. This report presents a case of general anesthesia management in a patient with WPW syndrome. We think that it is appropriate to use sugammadex to reverse rocuronium for the prevention of sudden hemodynamic changes in patients with WPW who underwent general anesthesia.

Rectal misoprostol in management of retained placenta: a contradictory result.

PubMed

Pongsatha, Saipin; Tongsong, Theera

2011-05-01

Retained placenta is one of the common problems in obstetric practice. The most common procedure to manage cases with retained placenta is manual removal of placenta (MROP) under general anesthesia. Recent data indicates that misoprostol may be helpful in decreasing the rate of MROP. To assess the efficacy of rectal misoprostol in women with delayed placental separation. A descriptive, retrospective cohort was conducted. All pregnant women with retained placenta longer than 30 minutes after fetal delivery, either in second or third trimester that received 800 mcg rectal misoprostol were included in the present study. Successful treatment was defined as spontaneous placental expulsion within 30 minutes after rectal misoprostol administration. The rate of spontaneous placental expulsion within 30 minutes after misoprostol administration was very low, only three out of 20 cases (15%). High dose rectal misoprostol does not give a promising result in cases of retained placenta. It is ineffective to facilitate placental separation in cases of retained placenta and does not seem to decrease the rate of MROP.

Cracked tooth syndrome: A report of three cases.

PubMed

Sadasiva, Kadandale; Ramalingam, Sathishmuthukumar; Rajaram, Krishnaraj; Meiyappan, Alagappan

2015-08-01

Cracked tooth syndrome (CTS), the term was coined by Cameron in 1964, which refers to an incomplete fracture of a vital posterior tooth extending to the dentin and occasionally into the pulp. CTS has always been a nightmare to the patient because of its unpredictable symptoms and a diagnostic dilemma for the dental practitioner due to its variable, bizarre clinical presentation. The treatment planning and management of CTS has also given problems and challenges the dentist as there is no specific treatment option. The management of CTS varies from one case to another or from one tooth to another in the same individual based on the severity of the symptoms and depth of tooth structure involved. After all, the prognosis of such tooth is still questionable and requires continuous evaluation. This article aims at presenting a series three cases of CTS with an overview on the clinical presentation, diagnosis and the different treatment options that varies from one case to another.

Cracked tooth syndrome: A report of three cases

PubMed Central

Sadasiva, Kadandale; Ramalingam, Sathishmuthukumar; Rajaram, Krishnaraj; Meiyappan, Alagappan

2015-01-01

Cracked tooth syndrome (CTS), the term was coined by Cameron in 1964, which refers to an incomplete fracture of a vital posterior tooth extending to the dentin and occasionally into the pulp. CTS has always been a nightmare to the patient because of its unpredictable symptoms and a diagnostic dilemma for the dental practitioner due to its variable, bizarre clinical presentation. The treatment planning and management of CTS has also given problems and challenges the dentist as there is no specific treatment option. The management of CTS varies from one case to another or from one tooth to another in the same individual based on the severity of the symptoms and depth of tooth structure involved. After all, the prognosis of such tooth is still questionable and requires continuous evaluation. This article aims at presenting a series three cases of CTS with an overview on the clinical presentation, diagnosis and the different treatment options that varies from one case to another. PMID:26538947

Novel Problem Solving - The NASA Solution Mechanism Guide

NASA Technical Reports Server (NTRS)

Keeton, Kathryn E.; Richard, Elizabeth E.; Davis, Jeffrey R.

2014-01-01

Over the past five years, the Human Health and Performance (HH&P) Directorate at the NASA Johnson Space Center (JSC) has conducted a number of pilot and ongoing projects in collaboration and open innovation. These projects involved the use of novel open innovation competitions that sought solutions from "the crowd", non-traditional problem solvers. The projects expanded to include virtual collaboration centers such as the NASA Human Health and Performance Center (NHHPC) and more recently a collaborative research project between NASA and the National Science Foundation (NSF). These novel problem-solving tools produced effective results and the HH&P wanted to capture the knowledge from these new tools, to teach the results to the directorate, and to implement new project management tools and coursework. The need to capture and teach the results of these novel problem solving tools, the HH&P decided to create a web-based tool to capture best practices and case studies, to teach novice users how to use new problem solving tools and to change project management training/. This web-based tool was developed with a small, multi-disciplinary group and named the Solution Mechanism Guide (SMG). An alpha version was developed that was tested against several sessions of user groups to get feedback on the SMG and determine a future course for development. The feedback was very positive and the HH&P decided to move to the beta-phase of development. To develop the web-based tool, the HH&P utilized the NASA Tournament Lab (NTL) to develop the software with TopCoder under an existing contract. In this way, the HH&P is using one new tool (the NTL and TopCoder) to develop the next generation tool, the SMG. The beta-phase of the SMG is planed for release in the spring of 2014 and results of the beta-phase testing will be available for the IAC meeting in September. The SMG is intended to disrupt the way problem solvers and project managers approach problem solving and to increase the use of novel and more cost and time effective problem solving tools such as open innovation, collaborative research, and virtual collaborative project centers. The HH&P envisions changing project management coursework by including the SMG in the teaching of project management problem solving tools.

Orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft

PubMed Central

Park, Yoon-Hee; Chung, Jee Hyeok; Kim, Sukwha; Choi, Jin-Young

2018-01-01

The purpose of this case report was to introduce the concept of orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft. A 5-year-old boy patient with Tessier number 0 cleft presented congenitally missing maxillary central incisors (MXCI), a bony defect at the premaxilla, a constricted maxillary arch, an anterior openbite, and maxillary hypoplasia. His treatment was divided into three stages: management of the bony defect at the premaxilla and the congenitally missing MXCIs using a fan-type expansion plate, iliac bone grafting, and eruption guidance of the maxillary lateral incisors into the graft area for substitution of MXCIs; management of the maxillary hypoplasia using sequential facemask therapy with conventional and skeletal anchorage; and management of the remaining occlusal problems using fixed orthodontic treatment. The total treatment duration was 15 years and 10 months. Class I canine and Class II molar relationships and normal overbite and overjet were achieved at the end of treatment. Although the long-term use of facemask therapy resulted in significant protraction of the retrusive maxilla, the patient exhibited Class III profile because of continued mandibular growth. However, the treatment result was well maintained after 2 years of retention. The findings from this case suggest that interdisciplinary and customized approaches are mandatory for successful management of maxillary hypoplasia, bony defect, and dental problems in Tessier number 0 cleft. Moreover, considering the potential of orthognathic surgery or distraction osteogenesis, meticulous monitoring of mandibular growth until growth completion is important. PMID:29564221

Using Dust Assessment Technology to Leverage Mine Site Manager-Worker Communication and Health Behavior: A Longitudinal Case Study

PubMed Central

Haas, Emily J.; Cecala, Andrew B.; Hoebbel, Cassandra L.

2016-01-01

Research continues to investigate barriers to managing occupational health and safety behaviors among the workforce. Recent literature argues that (1) there is a lack of consistent, multilevel communication and application of health and safety practices, and (2) social scientific methods are absent when determining how to manage injury prevention in the workplace. In response, the current study developed and tested a multilevel intervention case study at two industrial mineral mines to help managers and workers communicate about and reduce respirable silica dust exposures at their mine sites. A dust assessment technology, the Helmet-CAM, was used to identify and encourage communication about potential problem areas and tasks on site that contributed to elevated exposures. The intervention involved pre- and post-assessment field visits, four weeks apart that included multiple forms of data collection from workers and managers. Results revealed that mine management can utilize dust assessment technology as a risk communication tool to prompt and communicate about healthier behaviors with their workforce. Additionally, when workers were debriefed with the Helmet-CAM data through the device software, the dust exposure data can help improve the knowledge and awareness of workers, empowering them to change subtle behaviors that could reduce future elevated exposures to respirable silica dust. This case study demonstrates that incorporating social scientific methods into the application of health and safety management strategies, such as behavioral modification and technology integration, can leverage managers’ communication practices with workers, subsequently improving health and safety behaviors. PMID:26807445

Towards sustainable groundwater use: Setting long-term goals, backcasting, and managing adaptively

USGS Publications Warehouse

Gleeson, T.; Alley, W.M.; Allen, D.M.; Sophocleous, M.A.; Zhou, Y.; Taniguchi, M.; Vandersteen, J.

2012-01-01

The sustainability of crucial earth resources, such as groundwater, is a critical issue. We consider groundwater sustainability a value-driven process of intra- and intergenerational equity that balances the environment, society, and economy. Synthesizing hydrogeological science and current sustainability concepts, we emphasize three sustainability approaches: setting multigenerational sustainability goals, backcasting, and managing adaptively. As most aquifer problems are long-term problems, we propose that multigenerational goals (50 to 100 years) for water quantity and quality that acknowledge the connections between groundwater, surface water, and ecosystems be set for many aquifers. The goals should be set by a watershed- or aquifer-based community in an inclusive and participatory manner. Policies for shorter time horizons should be developed by backcasting, and measures implemented through adaptive management to achieve the long-term goals. Two case histories illustrate the importance and complexity of a multigenerational perspective and adaptive management. These approaches could transform aquifer depletion and contamination to more sustainable groundwater use, providing groundwater for current and future generations while protecting ecological integrity and resilience. ?? 2011, The Author(s). Ground Water ?? 2011, National Ground Water Association.

Developing a Shuffled Complex-Self Adaptive Hybrid Evolution (SC-SAHEL) Framework for Water Resources Management and Water-Energy System Optimization

NASA Astrophysics Data System (ADS)

Rahnamay Naeini, M.; Sadegh, M.; AghaKouchak, A.; Hsu, K. L.; Sorooshian, S.; Yang, T.

2017-12-01

Meta-Heuristic optimization algorithms have gained a great deal of attention in a wide variety of fields. Simplicity and flexibility of these algorithms, along with their robustness, make them attractive tools for solving optimization problems. Different optimization methods, however, hold algorithm-specific strengths and limitations. Performance of each individual algorithm obeys the "No-Free-Lunch" theorem, which means a single algorithm cannot consistently outperform all possible optimization problems over a variety of problems. From users' perspective, it is a tedious process to compare, validate, and select the best-performing algorithm for a specific problem or a set of test cases. In this study, we introduce a new hybrid optimization framework, entitled Shuffled Complex-Self Adaptive Hybrid EvoLution (SC-SAHEL), which combines the strengths of different evolutionary algorithms (EAs) in a parallel computing scheme, and allows users to select the most suitable algorithm tailored to the problem at hand. The concept of SC-SAHEL is to execute different EAs as separate parallel search cores, and let all participating EAs to compete during the course of the search. The newly developed SC-SAHEL algorithm is designed to automatically select, the best performing algorithm for the given optimization problem. This algorithm is rigorously effective in finding the global optimum for several strenuous benchmark test functions, and computationally efficient as compared to individual EAs. We benchmark the proposed SC-SAHEL algorithm over 29 conceptual test functions, and two real-world case studies - one hydropower reservoir model and one hydrological model (SAC-SMA). Results show that the proposed framework outperforms individual EAs in an absolute majority of the test problems, and can provide competitive results to the fittest EA algorithm with more comprehensive information during the search. The proposed framework is also flexible for merging additional EAs, boundary-handling techniques, and sampling schemes, and has good potential to be used in Water-Energy system optimal operation and management.

Collaboration management framework for OEM - suppliers relationships: a trust-based conceptual approach

NASA Astrophysics Data System (ADS)

Belkadi, Farouk; Messaadia, Mourad; Bernard, Alain; Baudry, David

2017-08-01

Due to the increased competitiveness and the diversity of requirements in today's markets, manufacturing companies need to join their competencies and resources to propose innovative solutions for each specific market, with the possibility to transpose these solutions to another market, by means of slight adaptations. Thus, manufacturing firms must constantly conduct new collaborations with known partners in most cases, but also with new partners. The critical question for managers in this latter case is how to define the best collaborative strategy according to the goals of the project and the specificity of the target market. This paper tackles the problem by proposing a conceptual framework for supporting the management of collaborative situations in the case of Original equipment manufacturers (OEMs). Based on the concept of trust level, the framework proposes a classification of different collaboration modes to be adopted in various contexts of inter-enterprise relationships, in manufacturing sector. The aim is to support the flexible navigation between different collaborative situations by taking into account all decision-making levels from the strategy to the implementation of the information technologies (IT) systems at the operational level.

[Implementation and evaluation of case management in Catalonia: the ISP-SMD program].

PubMed

Balsera Gómez, J; Rodríguez Medina, C; Caba Calvet, R; Vega Prada, R; Ruiz Ureña, H; Berruezo Ortiz, L; Clusa Gironella, D; Rodríguez Montes, M J; Haro Abad, J M

2002-01-01

The pilot study of the Individualized Service Program for people with Severe Mental Disorders (ISP-SMD) consists of the implementation of case management services in Catalonia. The ISP-SMD has been implemented in two health care sectors and will be expanded to the rest of Catalonia in the next years. The program serves people with persistent mental disorders who have serious social or family problems and/or who have inadequate mental health service use (high use of inpatient services, no use of community services). The ISP-SMD is a community intervention program that focuses its activities on direct care and coordination between services. Thirty patients have been included in the evaluation. The results of the pilot study have shown that, compared to the year before entering the program, the patients show better clinical status, they decrease their unmet need level, they have more appropriate use of health services and have lower treatment costs. Satisfaction of the patients, family members and professionals with the program is very high. It is possible to adapt and implement case management services in Catalonia. When implemented, they improve patient quality of life.

[Two cases of rehabilitation in Ehler-Danlos syndrome].

PubMed

Le Tallec, H; Lassalle, A; Khenioui, H; Durufle, A; Plassat, R; Gallien, P

2006-03-01

Ehlers-Danlos syndrome is rare and little known. It comprises a heterogeneous group of heritable connective tissue disorders characterized by articular hypermobility, skin extensibility and tissue fragility. Diagnosis may be difficult and often delayed. Here we describe 2 cases of women with Ehlers-Danlos syndrome. The first had scoliosis with back pain and joint hypermobility. The second presented with hypermobility and joint dislocation, which increased during pregnancy. In these 2 cases, rehabilitation management produced clinical improvement. Orthopaedic complications such joint pain, joint swelling, joint dislocation, back pain, with walking and hand function disability are the main problems in Ehlers-Danos syndrome. Surgery may be necessary to correct dislocated joints but is often not sufficient to resolve the handicap, and physical therapy has an important place in management. Ehlers-Danlos syndrome is an evolving disease that can lead to great impairment. Thus, physicians must be aware of this syndrome to offer the best management, with the appropriate use of orthotic devices, specific strengthening routines, education in proper body mechanics and assistive devices, to prevent joint dislocation and subluxations responsible for pain and handicap.

Transvestism in a person with learning disabilities presenting with behavioural problems.

PubMed

Thomas, P R; DeAlwis, K

1995-10-01

A case of transvestism is reported in a 47-year-old man with learning disabilities. He had developed encephalitis in childhood, which had resulted in moderate learning disabilities and epilepsy, and had been living in institutions from the age of six. He did not have any chance to express his sexual desire and this frustration manifested as aggressive behaviour. Recently, he moved to a community home and his deviant sexual behaviour became apparent. Management of his problems involves organizing a behavioural programme linking his cross dressing with aggressive behaviour.

Postcholecystectomy bile duct injuries: experience with 49 cases managed by different therapeutic modalities.

PubMed

Abdel Wahab, M; el-Ebiedy, G; Sultan, A; el-Ghawalby, N; Fathy, O; Gad el-Hak, N; Abo Elenin, A; Abo Zid, M; Ezzat, F

1996-01-01

In this study we present our experience in the management of iatrogenic biliary injuries. Forty-nine cases with iatrogenic biliary injuries were managed in our center during the period from 1984 to 1995. Forty patients were referred from other hospitals after cholecystectomy, and 9 cases underwent the original operation in our center. Four (0.3%) of our patients after 1300 conventional cholecystectomy, and 5 (0.9%) cases after 550 laparoscopic cholecystectomy. The injuries were recognized intraoperatively in 5 (10%) cases and were immediately repaired, 3 cases by axial anastomosis and T-tube drainage, 2 cases by hepatico-jejunostomy (Roux-en-Y). The injuries were detected in the remaining 44 patients postoperatively from one week up to 2 months, the mode of presentation was jaundice in 39 (89%) cases, biliary fistula with or without jaundice and biliary peritonitis were detected in 13 (30%) and in 4 (9%) cases respectively. Eleven (25%) cases were treated endoscopically by sphincterotomy, stent in 8 cases, dilatation and double stent in two cases, and dilatation using rigid dilators and stent in one case. The remaining 33 (75%) cases were treated surgically by hepatico-jejunostomy in 21 (64%) cases, and hepatico-duodenostomy in 12 (36%) cases. No hospital mortality occurred, but late mortality occurred in two (5%) patients after surgery due to biliary restricture with progressive cirrhosis in one case, and due to advanced colon cancer in the other case, an din one (9%) case after endoscopic treatment. We achieved 87% excellent surgical results during the period of follow-up (36 months), while 80% excellent results were achieved after endoscopic treatment. Good final results (95%, 83%) were achieved after hepatico-jejunostomy and after hepatico-duodenostomy respectively. Postcholecystectomy biliary injuries present a surgical problem needing extra efforts and careful management. Hepatico-jejunostomy appears to be the procedure of choice in repairing these injuries. Immediate surgical repair of bile duct injury offers excellent results with lower morbidity rates. Endoscopic treatment may be a less invasive technique and have a role in some types of injuries, but needs more time for accurate evaluation.

Principles and problems of environmental pollution of groundwater resources with case examples from developing countries.

PubMed Central

Egboka, B C; Nwankwor, G I; Orajaka, I P; Ejiofor, A O

1989-01-01

The principles and problems of environmental pollution and contamination are outlined. Emphasis is given to case examples from developing countries of Africa, Asia, and Latin America with a comparative analysis to developed countries. The problems of pollution/contamination are widespread in developed countries but are gradually spreading from the urban to rural areas in the developing countries. Great efforts in research and control programs to check pollution-loading into the environment have been made in the industrialized countries, but only negligible actions have been taken in developing countries. Pollutants emanate from both point and distributed sources and have adversely affected both surface water and groundwaters. The influences of the geologic and hydrologic cycles that exacerbate the incidences of pollution/contamination have not been well understood by environmental planners and managers. Professionals in the different areas of pollution control projects, particularly in developing countries, lack the integrated multiobjective approaches and techniques in problem solving. Such countries as Nigeria, Kenya, Brazil, and India are now menaced by pollution hazards. Appropriate methods of control are hereby suggested. PMID:2695325