Case managers' expectations about employment for people with psychiatric disabilities.
Abraham, Kristen M; Stein, Catherine H
2009-01-01
The importance of employment in lives of people with psychiatric disabilities is well documented. Yet, the role of case managers in facilitating or inhibiting employment opportunities for consumers is only beginning to be understood. This study examined the psychometric properties of a newly developed self-report measure designed to assess case managers' employment-related expectations of consumers. Psychometric properties of a 24-item self-report measure, Expectations for the Employability of People with Serious Mental Illness (EESMI), were examined using a sample of 107 case managers. EESMI items tap individual and social systems factors related to employment for people with psychiatric disabilities. Construct validity was assessed by relationships between EESMI scores and scores on measures of general expectations and opinions of people with serious mental illness, case manager burnout, and social desirability. EESMI consists of three empirically derived subscales with good internal consistency. Case managers' scores on EESMI correlated positively with scores on general expectations and opinions about people with mental illness scales and were generally unrelated to social desirability scores. EESMI scores were positively related to case managers' perceptions of the employability of consumers on their caseloads. EESMI is a psychometrically sound measure of mental health professionals' employment-related expectations of consumers. Reliable and valid assessment is basic to the study of mental health professionals' role in increasing employment opportunities for people with psychiatric disabilities. Study limitations and directions for future research are discussed.
Wang, Yun-Tung; Lin, Yi-Jiun
2017-02-01
Purpose The aim of this study is to explore whether/which vocational rehabilitation case manager (VRCMer) factors were significantly associated with the vocational rehabilitation service (VRS) program outcomes in Taiwan. Method This study used the 2011 VRS Program for People with Disabilities Database in a metropolitan city in Taiwan (N = 466) to do a secondary data analysis using hierarchical logistic regression. Results This study found that the employment rate and stable employment rate created by the 2011 VRS program in a metropolitan city in Taiwan were 48.7% and 42.1%, respectively. For the predictors of employment/stable employment, "occurrences of the services provided by the VRCMer" variable was definitely dominant. In addition, "level of the disability" was the second-ranking predictor, and was significantly negatively correlated with both employment and stable employment outcomes. Conclusions Vocational rehabilitation case manager factors in this study were significantly correlated with VRS program outcomes for people with disabilities in Taiwan after controlling for the clients' socio-demographic variables. The results indicate that greater input by VRCMers for people with disabilities equates to better employment outcomes in metropolitan Taiwan. Implications for Rehabilitation This is the first study to build an inferential statistical model in attempt to explain and predict the association between vocational rehabilitation case manager factors and vocational rehabilitation service program outcomes for people with disabilities in Taiwan. In cases of severe disability, a vocational rehabilitation case manager should seek out more in-kind and in-cash resources, and choose a suitable job coach to cooperate in assisting the client to become employed. Based on the findings, government has to continue implementing opportunities for people with disabilities to attain higher and better quality educational levels, for increasing their employment rate. Vocational rehabilitation case managers should raise the referral rate and cooperation with job coaches as this directly affects the quality of services and clients' employment rate.
24 CFR 700.130 - Service coordinator.
Code of Federal Regulations, 2010 CFR
2010-04-01
... service coordinator may be employed directly by the grantee, or employed under a contract with a case... the case management agency providing service coordination shall not provide supportive services under... services to the grantee for CHSP. (d) The service coordinator shall: (1) Provide general case management...
Making the business case for health and productivity management.
Sullivan, Sean
2004-06-01
Health and productivity management (HPM) is an important innovation for businesses concerned with rising health care costs. Like any innovation, however, it will not be adopted rapidly unless it is tailored to the needs of employers. For the last 6 years the Institute for Health and Productivity Management has studied the needs of American employers and sponsored employer driven case studies of health care and productivity. From these studies and the work of academic experts we have fashioned a set of programs to effectively communicate the advantages of health and productivity measurement and management. To make the business case for health and productivity management, researchers need to (1) demonstrate the relative advantage of HPM, (2) keep the evidence simple, (3) show that HPM is compatible with employer practices, and (4) communicate the results within and across corporate departments.
Population-based worksite obesity management interventions: a qualitative case study.
Romney, Martha C; Thomson, Erin; Kash, Kathryn
2011-06-01
Due to the increased prevalence of obesity and associated direct and indirect costs to employers, weight management programs have become an integral component of employer and insurer benefits plans. The programs vary in foci, scope, breadth, and implementation. The aim of this study was to explore promising employer-sponsored population-based obesity management programs. A case study that utilized a telephonic semi-structured questionnaire was conducted with small and large organizations located in different regions of the United States that had been recruited to participate. Eight employers and 1 health care advocacy coalition who met the inclusion criteria were interviewed about features of their weight management programs. The case study revealed a number of themes consistent with reports in the literature and reflecting cited best practices. Key findings include confirmation that weight management is a significant component of the wellness strategy in all participating organizations because employers are invested in population health programs and cost savings. Based upon their experience and knowledge, occupational health specialists are responsible for designing, implementing, managing, and evaluating employee health programs. Almost all employers utilize electronic media as a prominent component of wellness and disease management initiatives. Experience has shown that incentives-both financial and nonmonetary-are effective motivators for employee engagement and outcomes. However, while employers report success, favorable outcomes have been difficult to quantify.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-28
... communities by providing: Job and skills training combined with intensive case management and supportive... obtained jobs, and the direct assistance and case management services which have facilitated employment... skills in order to obtain employment or find more sustainable work. Grants may encompass terms of up to...
The "wins" of change: evaluating the impact of predicted changes on case management practice.
Stanton, Marietta P; Barnett Lammon, Carol Ann
2008-01-01
A variety of strategies were employed to identify current and future trends that would impact the practice of case management. Historical review, consultation with case management experts, literature review, and environmental scanning by practicing case managers were strategies employed to determine the impact of current and future trends on case management. The trends identified in this article have implications for case managers in a variety of settings. Case managers participating in the environmental scanning process to evaluate the impact of the identified trends on their organization included representation from acute care, home care, behavioral health, workers' compensation, and private insurance settings. The top 7 trends identified by experts in the field of case management included pay for performance, recovery audit contractors, Medicare demonstration projects, transitions of care, informatics in healthcare and case management, metrics for case management, and the impact of an aging population in case management. Practicing case managers were asked to react to these trends in terms of likelihood of occurrence in their organization and impact of these trends on their case management practice. Case management will ultimately have a higher degree of accountability for its practice if metrics to evaluate and reimbursement for case management become a reality. A multitude of performance measures exist that will be monitored and be tied to reimbursement. To ensure that agencies are accomplishing these performance measures, case management will potentially have a growing importance. Case managers perceive that these trends have a predominantly positive impact on case management.
A Case for Advanced Skills and Employability in Higher Education.
ERIC Educational Resources Information Center
Holmes, Alison; Miller, Stuart
2000-01-01
Case Studies to Advance Skills and Employability is a project designed to introduce a vocational dimension into academic curriculum. Key employability skills are developed as students work on real-life case situations in such areas as public sculpture, waste management, human organizations, and environmental issues. (SK)
Case management after long-term absence from work in China: a case report.
Tang, Dan; Yu, Ignatius Tak Sun; Luo, Xiaoyuan; Liang, Youxin; He, Yonghua
2011-03-01
Return-to-work (RTW) after occupational injuries is an important and challenging issue. Case managers are expected to play a vital role in successful RTW. In China, RTW intervention is in its early phase and requires further research and practice. This case report describes Mr. H's RTW process for illustrating the work of a case management team in China. Suggestions on developing and optimizing the process in China are given. After 9 years of absence from work due to severe burn injuries at work, Mr. H was referred for RTW interventions. Mr. H received social and occupational rehabilitation services of 3 months, and the following workplace visits and work trials. After the job placement, the case manager continued the liaison with the worker and employer. Mr. H showed positive changes in occupational and social adjustment after the case management interventions. This was reflected from the shift from the contemplation to action stage on the Lam Assessment of Stages of Employment Readiness. Despite he did not show significant changes on functional capacity and fear avoidance beliefs, Mr. H passed the job credential test and was offered a maintenance technician position at a new company. Both the worker and the employer were satisfied with the outcome of the case management. The RTW interventions carried out by the case managers appeared to be effective within the Chinese system. The results suggested that professional training of case managers, RTW-related policies and technological standards, early integrated interventions should be further developed in China. Disability Adjustment Group Therapy and RTW Support Groups perhaps are useful approaches in workers' returning to work.
2014-01-01
Background The use of the biopsychosocial model of health and case management for effective vocational rehabilitation (VR) has been confirmed for many health conditions. While Case and Condition Managers (CCMPs) use this approach in their everyday work, little is known about their views on training needs. A review of the training curriculum for General Practitioners’ (GPs) revealed little training in VR and the biopsychosocial model of care. This study aims to identify Case and Condition Managers and GPs perceptions of their training needs in relation to employability and VR. Methods 80 Case and Condition Managers and 304 GPs working in NHS Lanarkshire, providing a comparison group, were invited to participate in this study. A self-completion questionnaire was developed and circulated for online completion with a second round of hardcopy questionnaires distributed. Results In total 45 responses were obtained from CCMPs, 5 from occupational health nurses (62% response rate) and 60 from GPs (20% response rate). CCMPs and the nursing group expressed a need for training but to a lesser extent than GP’s. The GP responses demonstrated a need for high levels of training in case/condition management, the biopsychosocial model, legal and ethical issues associated with employment and VR, and management training. Conclusions This survey confirms a need for further training of CCMPs and that respondent GPs in one health board are not fully equipped to deal with patients employability and vocational needs. GPs also reported a lack of understanding about the role of Case and Condition managers. Training for these professional groups and others involved in multidisciplinary VR could improve competencies and mutual understanding among those advising patients on return-to-work. PMID:24884477
Collaboration between Supported Employment and Human Resource Services: Strategies for Success
ERIC Educational Resources Information Center
Post, Michal; Campbell, Camille; Heinz, Tom; Kotsonas, Lori; Montgomery, Joyce; Storey, Keith
2010-01-01
The article presents the benefits of successful collaboration between supported employment agencies and human resource managers when working together to secure employment for individuals with disabilities. Two case studies are presented: one involving a successful collaboration with county human resource managers in negotiating a change in the…
Benavides, Fernando G; Torá, Isabel; Miguel Martínez, José; Jardí, Josefina; Manzanera, Rafael; Alberti, Constança; Delclós, Jordi
2010-01-01
To compare the length of nonwork-related sick leave among cases managed by an insurance company versus those managed by the National Institute of Social Security (NISS). We performed a retrospective cohort study of 289,686 cases of sick leave lasting for more than 15 days that began in 2005 after certification by a primary care physician in Catalonia, were reported to the Catalonian Institute of Medical Evaluations, and were followed to term. Of the total, 156,676 cases were managed by the NISS. To account for repeat episodes (approximately 25% of the total), the Wang-Chang estimator was used to calculate the median duration and percentiles; comparisons were made using log-logistic regression with shared gamma frailty models, with calculation of time ratios (TR) and their corresponding 95% confidence intervals (95% CI). The median duration of sick leave was 43 days for cases managed by the NISS and 39 days for those managed by the insurance company. This difference was statistically significant both for men employed under contract (TR=0.87; 95% CI: 0.85-0.88) and for those who were self-employed (TR=0.78; 95% CI: 0.75-0.80) as well as for women under contract (TR=0.85; 95% CI: 0.84-0.87) and self-employed women (TR=0.84; 95% CI: 0.81-0.88). These differences persisted after adjustment was performed for age and health region. For sick leave lasting more than 15 days, these results confirm that cases managed by an insurance company ended earlier than for those managed by the NISS, both for contract and self-employed workers. Further research is needed to explore the reasons for these differences. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.
25 CFR 20.318 - What case management responsibilities does the social services worker have?
Code of Federal Regulations, 2011 CFR
2011-04-01
... 25 Indians 1 2011-04-01 2011-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In working...
25 CFR 20.318 - What case management responsibilities does the social services worker have?
Code of Federal Regulations, 2013 CFR
2013-04-01
... 25 Indians 1 2013-04-01 2013-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In working...
25 CFR 20.318 - What case management responsibilities does the social services worker have?
Code of Federal Regulations, 2012 CFR
2012-04-01
... 25 Indians 1 2012-04-01 2011-04-01 true What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In working...
25 CFR 20.318 - What case management responsibilities does the social services worker have?
Code of Federal Regulations, 2014 CFR
2014-04-01
... 25 Indians 1 2014-04-01 2014-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In working...
25 CFR 20.318 - What case management responsibilities does the social services worker have?
Code of Federal Regulations, 2010 CFR
2010-04-01
... 25 Indians 1 2010-04-01 2010-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In working...
Disease management: a leap of faith to lower-cost, higher-quality health care.
Short, Ashley; Mays, Glen; Mittler, Jessica
2003-10-01
With managed care's promise to reduce costs and improve quality waning, employers and health plans are exploring more targeted ways to control rapidly rising health costs. Disease management programs, which focus on patients with chronic conditions such as asthma and diabetes, are growing in popularity, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. In addition to condition-based disease management programs, some health plans and employers are using intensive case management services to coordinate care for high-risk patients with potentially costly and complex medical conditions. Despite high expectations, evidence of both disease management and case management programs' success in controlling costs and improving quality remains limited.
O'Donnell, Lolita T
2007-01-01
To describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute hospital setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice in case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the organizations that employ them and the healthcare needs of the patients that they advocate for. 3. Aside from the importance of linking patient care outcomes with accountability, nurse case managers may need to advocate for policy change and system reform.
Strategic Human Resources Management of Employer Cooperative Education Programs.
ERIC Educational Resources Information Center
Nielsen, Richard P.; Porter, Ralph C.
1982-01-01
This article discusses effective strategic planning and management of employer cooperative education programs. It examines types of planning, the need for such programs, and implementation strategies. Several case studies are considered: Dayton-Hudson, IBM, AT&T, Delta Airlines, and Rockwell International. (CT)
ERIC Educational Resources Information Center
Cox, Andrew M.; Al Daoud, Mohammad; Rudd, Stephanie
2013-01-01
Ensuring that graduates are employable is an important priority for universities. It is challenging for fields such as Information Management (IM), that are not fully understood by employers and where there is no very clearly defined entry level job market. This paper takes a graduate identity perspective to explore how IM graduates from the…
Tahan, Hussein M; Watson, Annette C; Sminkey, Patrice V
2015-01-01
The purpose of this national role and function study was to identify the essential activities and necessary knowledge areas for effective case manager practice from the perspective of those currently functioning in various care settings and across diverse professional disciplines. The national study covered all case management practices and/or work settings across the full continuum of health care. This cross-sectional descriptive study used the practice analysis method and online survey research design. It employed a purposive sample of case managers, in which 52,370 individuals received an invitation to participate. Data collection completed over a 4-week period, resulting in 7,668 useable survey responses (nearly a 15% response rate). The study identified the common activities and knowledge areas necessary for competent and effective performance of case managers, as is highlighted in this article, which is the first of a 2-part series on the role and function study. The results informed the needed update of the test specifications for the Certified Case Manager (CCM) certification examination, as will be delineated in Part 2 of the article series, to ensure that it continues to be substantiated in current practice. Of special note are the emergence of specific activity and knowledge domains in the area of case management ethical, legal, and practice standards, and an increase in the number of employers requiring certified case managers to fill vacant positions and compensating them financially for such qualifications. This study helps keep the CCM credentialing examination evidence-based and maintain its validity for evaluating competency of case managers. Specifically, the study identified essential activities and knowledge domains that define competent case management practice. Findings can be used for developing programs and curricula for the training and development of case managers. The study instrument also can be used for further research of case management practice.
Newnam, Sharon; Petersen, Alan; Keleher, Helen; Collie, Alex; Vogel, Adam; McClure, Rod
2016-10-17
Case managers within injury compensation systems are confronted with various emotional demands. Employing the concept of emotional labour, this paper explores distinctive aspects of these demands. The findings are drawn from focus groups with 21 Australian case managers. Case managers work was characterised by extra-role commitments, emotional control, stress and balancing tensions arising from differing stakeholder expectations about outcomes related to compensation and return to work. By examining the experiences of case managers, the findings add to the literature on the emotional labour of front line service workers, especially with respect to the demands involved in managing the conflicting demands of work.
Employment of Personnel at the Tucson Border Patrol Station
2017-06-09
RESEARCH METHODOLOGY How should the Tucson Border Patrol Station optimally employ personnel? Using a case study research methodology141 provided...BORSTAR provide better capabilities to respond and greater mobility in risk management.155 The methodologies of case study comparatives include the...35 CHAPTER 3 RESEARCH METHODOLOGY
O'Donnell, Lolita T
2007-01-01
The purpose of this study was to describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute care setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice of case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the organizations that employ them and the healthcare needs of the patients that they advocate for. 3. Aside from the importance of linking patient care outcomes with accountability, nurse case managers may need to advocate for policy change and system reform.
Defense.gov - Special Report: Veterans Employment
. Veterans' employment case manager Angela Eberle helped Rivera rewrite his resume and translated his Obama launched the Veterans Employment Center, the first online one-stop shopping tool for veterans Jobs Troops, Vets Want 'Fair Shot' at Employment, Battaglia Says First Lady Asks Governors to Aid
Family medical leave--management strategies.
Morris, Judy A; Strasser, Patricia B
2004-12-01
Employers are recognizing the impact of lost productivity on total benefit costs. In a recent report based on 2002 benefit data, lost productivity represented 71% of the full cost of health/absence benefits (Integrated Benefits Institute, 2004). Occupational health nurse managers can develop FMLA leave management policies and programs to assure that leave is provided when appropriate, to help curb FMLA abuse and fraud, and to assist employers in defending adverse employment actions based on attendance. A review of employer policies and FMLA implementation also assesses compliance with the Act and provides the basis for appropriate responses in the case of legal actions and employee complaints to the U.S. Department of Labor.
An employer's experience with infertility coverage: a case study.
Silverberg, Kaylen; Meletiche, Dennis; Del Rosario, Gina
2009-12-01
A case study of Southwest Airlines, a Fortune 500 company, demonstrates that a well-designed infertility coverage plan can control resource use. This successful model could be used by employers who wish to ensure that their employees have access to high-quality, cost-effective infertility services in a managed-care environment.
The Development of Employability Skills in Novice Workers.
ERIC Educational Resources Information Center
Smith, Erica; Comyn, Paul
This research study attempts to determine how teenage workers develop their employability skills in their first formal jobs. Case studies were carried out in 12 Australian enterprises of varying sizes and drawn from different industry areas. In each case study the following staff were interviewed: senior managers and/or human resources management…
Health benefits for the terminally ill: reality and perception.
Gabel, J R; Hurst, K M; Hunt, K A
1998-01-01
This paper examines the availability and scope of hospice benefits as well as employers' attitudes and knowledge about care for the terminally ill. Data are drawn from a national random sample of 1,502 employers with 200 or more workers and from focus groups with employee benefits managers and their insurance advisers, brokers, and consultants. Major findings are that 83 percent of employers offer explicit hospice benefits, with most other firms covering hospice through high-cost case management. Most employers support the concept of hospice care because they believe that it reduces medical expenses.
A case management tool for occupational health nurses: development, testing, and application.
Mannon, J A; Conrad, K M; Blue, C L; Muran, S
1994-08-01
1. Case management is a process of coordinating an individual client's health care services to achieve optimal, quality care delivered in a cost effective manner. The case manager establishes a provider network, recommends treatment plans that assure quality and efficacy while controlling costs, monitors outcomes, and maintains a strong communication link among all the parties. 2. Through development of audit tools such as the one presented in this article, occupational health nurses can document case management activities and provide employers with measurable outcomes. 3. The Case Management Activity Checklist was tested using data from 61 firefighters' musculoskeletal injury cases. 4. The activities on the checklist are a step by step process: case identification/case disposition; assessment; return to work plan; resource identification; collaborative communication; and evaluation.
Collaborations in leadership: the nurse case management and nursing administration connection.
Carr, Dana Deravin
2009-01-01
With a multiple decade's long surge in managed care and the growth of case management as a profession, there is increasing recognition of the leadership role that case managers employ daily as they coordinate and facilitate patient-centered initiatives. Now, more than ever, case managers are being called upon to further expand their leadership capabilities and take a more active role in professional partnering to ensure the continued attainment of clinical, fiscal, and quality outcomes. All settings, particularly acute care hospitals and integrated delivery systems. The collaboration between nurse case managers and nursing administration provides a framework for the establishment of a collegial and supportive working relationship: one that is built on the strength of mutual goals, shared leadership abilities, respect, and professional loyalty.
Code of Federal Regulations, 2010 CFR
2010-01-01
... Management § 91.1049 Personnel. (a) Each program manager and each fractional owner must use in program... regulations. The program manager must provide oversight of those crews. (b) Each program manager must employ...) Program manager flight, duty, and rest time considerations, and in all cases within the limits set forth...
Involving Employers in Training: Case Studies. Research and Evaluation Report Series 97-J.
ERIC Educational Resources Information Center
Isbell, Kellie; Trutko, John W.; Barnow, Burt S.; Nightengale, Demetra; Pindus, Nancy
This document contains in-depth descriptions and assessments of 17 exemplary employer-based training (EBT) programs that were studied as part of an examination of EBT programs. The case studies are based on site visits to each firm, during which interviews were conducted with company management, supervisors of workers in training, individuals…
Demand management and case management: a conservation strategy.
Bryant, C D R Anna K
2007-01-01
This article reviews the history and development of managed competition, and explores the possibilities of a new demand management strategy in the context of nurse case management to offer less costly, higher quality care for a greater number of patients. The article examines the history and principles of healthcare demand management, its implementation in the hospital and clinical practices of nurse case managers, and its impacts in reducing costs while maintaining care levels. The article develops and analyzes the conflicts and common ground between demand management and case management. First, demand-side strategies can be effective in reducing costs while maintaining quality of nursing care; second, nurse case managers should employ patient education, self-care, and staffing solutions to manage demand. Nurse case managers must apply demand management principles carefully. Their goal is not to restrict care, but to maintain the highest levels of care possible within the limits of their practice's resources and staffing. Two critical themes emerge: (1) demand management is a potential alternative to market-driven managed competition and (2) nursing case management can affect an effective form of demand management. However, the long-term implications of these nursing case management strategies on healthcare staffing need further exploration.
The Effects of Cognitive Conflict Management on Cognitive Development and Science Achievement
ERIC Educational Resources Information Center
Budiman, Zainol Badli; Halim, Lilia; Mohd Meerah, Subahan; Osman, Kamisah
2014-01-01
Three teaching methods were compared in this study, namely a Cognitive Conflict Management Module (CCM) that is infused into Cognitive Acceleration through Science Education (CASE), (Module A) CASE without CCM (Module B) and a conventional teaching method. This study employed a pre- and post-test quasi-experimental design using non-equivalent…
Ethics in an operations management course.
Rudnicka, Ewa A
2005-10-01
Graduates of the management major at the University of Pittsburgh at Greensburg find employment in a variety of organizations. As future managers with employees from different professions, students expressed an interest in discussing ethics cases in the operations management class. The semester starts with students familiarizing themselves with various professional and corporate codes of ethics. Throughout the semester a number of short ethics' cases in operations' areas such as inventory management, scheduling, facility location, and product design are introduced to illustrate ethical issues that a manager and his/her employees might face. Students prepare individual responses before the in-class discussions. The semester ends with a long group ethics case discussion and formal case presentations. In the end-of-semester survey, students responded very favorably to an ethics component in the operations management class.
Knowledge Management in Preserving Ecosystems: The Case of Seoul
ERIC Educational Resources Information Center
Lee, Jeongseok
2009-01-01
This study explores the utility of employing knowledge management as a framework for understanding how public managers perform ecosystem management. It applies the grounded theory method to build a model. The model is generated by applying the concept of knowledge process to an investigation of how the urban ecosystem is publicly managed by civil…
Case and Administrative Support Tools
Case and Administrative Support Tools (CAST) is the secure portion of the Office of General Counsel (OGC) Dashboard business process automation tool used to help reduce office administrative labor costs while increasing employee effectiveness. CAST supports business functions which rely on and store Privacy Act sensitive data (PII). Specific business processes included in CAST (and respective PII) are: -Civil Rights Cast Tracking (name, partial medical history, summary of case, and case correspondance). -Employment Law Case Tracking (name, summary of case). -Federal Tort Claims Act Incident Tracking (name, summary of incidents). -Ethics Program Support Tools and Tracking (name, partial financial history). -Summer Honors Application Tracking (name, home address, telephone number, employment history). -Workforce Flexibility Initiative Support Tools (name, alternative workplace phone number). -Resource and Personnel Management Support Tools (name, partial employment and financial history).
Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats.
Swanson, Jeffrey; Weissert, William G
2017-08-01
Case management programs often designate a nurse or social worker to take responsibility for guiding care when patients are expected to be expensive or risk a major decline. We hypothesized that though an intuitively appealing idea, careful program design and faithful implementation are essential if case management programs are to succeed. We employed two theory perspectives, principal-agent framework and street-level bureaucratic theory to describe the relationship between program designers (principals) and case managers (agents/street-level bureaucrats) to review 65 case management studies. Most programs were successful in limited program-specific process and outcome goals. But there was much less success in cost-saving or cost-effectiveness-the original and overarching goal of case management. Cost results might be improved if additional ideas of agency and street-level theory were adopted, specifically, incentives, as well as "green tape," clear rules, guidelines, and algorithms relating to resource allocation among patients.
Effectiveness of case management for homeless persons: a systematic review.
de Vet, Renée; van Luijtelaar, Maurice J A; Brilleslijper-Kater, Sonja N; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D; Wolf, Judith R L M
2013-10-01
We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness.
Effectiveness of Case Management for Homeless Persons: A Systematic Review
de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.
2013-01-01
We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309
Nelson, Travis
2013-01-01
Early childhood caries presents unique treatment challenges that often require advanced behavior management techniques, such as general anesthesia or procedural sedation. In some cases, use of these pharmacologic adjuncts is undesirable or not possible. The interim therapeutic restoration is a treatment method that, while sometimes employed in such cases, can often produce unsatisfactory results in primary anterior teeth. This is often due to insufficient bulk of material and lack of retention. The purpose of this report was to describe a simple alternative technique (resin modified glass ionomer strip crowns) that may be employed to deliver esthetic anterior restorations to marginally cooperative children in the dental clinic setting and to report on two cases in which it was successfully used. \\\\\\Department of Pediatric Dentistry, University of Washington, Seattle, Wash., USA. tmnelson@uw.edu
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)
5 CFR 550.805 - Back pay computations.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 550.805 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY... employment (including a business enterprise) undertaken to replace the employment from which the employee was..., in the case of erroneous payments received from a Federal employee retirement system, must be...
5 CFR 550.805 - Back pay computations.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 550.805 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY... employment (including a business enterprise) undertaken to replace the employment from which the employee was..., in the case of erroneous payments received from a Federal employee retirement system, must be...
5 CFR 550.805 - Back pay computations.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 550.805 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY... employment (including a business enterprise) undertaken to replace the employment from which the employee was..., in the case of erroneous payments received from a Federal employee retirement system, must be...
5 CFR 550.805 - Back pay computations.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 550.805 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY... employment (including a business enterprise) undertaken to replace the employment from which the employee was..., in the case of erroneous payments received from a Federal employee retirement system, must be...
Kornfeld, R; Rupp, K
2000-01-01
The Social Security Administration (SSA) initiated Project NetWork in 1991 to test case management as a means of promoting employment among persons with disabilities. The demonstration, which targeted Social Security Disability Insurance (DI) beneficiaries and Supplemental Security Income (SSI) applicants and recipients, offered intensive outreach, work-incentive waivers, and case management/referral services. Participation in Project NetWork was voluntary. Volunteers were randomly assigned to the "treatment" group or the "control" group. Those assigned to the treatment group met individually with a case or referral manager who arranged for rehabilitation and employment services, helped clients develop an individual employment plan, and provided direct employment counseling services. Volunteers assigned to the control group could not receive services from Project NetWork but remained eligible for any employment assistance already available in their communities. For both treatment and control groups, the demonstration waived specific DI and SSI program rules considered to be work disincentives. The experimental impact study thus measures the incremental effects of case and referral management services. The eight demonstration sites were successful in implementing the experimental design roughly as planned. Project NetWork staff were able to recruit large numbers of participants and to provide rehabilitation and employment services on a substantial scale. Most of the sites easily reached their enrollment targets and were able to attract volunteers with demographic characteristics similar to those of the entire SSI and DI caseload and a broad range of moderate and severe disabilities. However, by many measures, volunteers were generally more "work-ready" than project eligible in the demonstration areas who did not volunteer to receive NetWork services. Project NetWork case management increased average annual earnings by $220 per year over the first 2 years following random assignment. This statistically significant impact, an approximate 11-percent increase in earnings, is based on administrative data on earnings. For about 70 percent of sample members, a third year of followup data was available. For this limited sample, the estimated effect of Project NetWork on annual earnings declined to roughly zero in the third followup year. The findings suggest that the increase in earnings may have been short-lived and may have disappeared by the time Project NetWork services ended. Project NetWork did not reduce reliance on SSI or DI benefits by statistically significant amounts over the 30-42 month followup period. The services provided by Project NetWork thus did not reduce overall SSI and DI caseloads or benefits by substantial amounts, especially given that only about 5 percent of the eligible caseload volunteered to participate in Project NetWork. Project NetWork produced modest net benefits to persons with disabilities and net costs to taxpayers. Persons with disabilities gained mainly because the increases in their earnings easily outweighed the small (if any) reduction in average SSI and DI benefits. For SSA and the federal government as a whole, the costs of Project NetWork were not sufficiently offset by increases in tax receipts resulting from increased earnings or reductions in average SSI and DI benefits. The modest net benefits of Project NetWork to persons with disabilities are encouraging. How such benefits of an experimental intervention should be weighed against costs of taxpayers depends on value judgments of policymakers. Because different case management projects involve different kinds of services, these results cannot be directly generalized to other case management interventions. They are nevertheless instructive for planning new initiatives. Combining case and referral management services with various other interventions, such as longer term financial support for work or altered provider incentives, could produc
26 CFR 1.1402(a)-8 - Community income.
Code of Federal Regulations, 2011 CFR
2011-04-01
... (CONTINUED) INCOME TAXES (CONTINUED) Tax on Self-Employment Income § 1.1402(a)-8 Community income. (a) In... the management and control of such trade or business, in which case all of such gross income and... rule, the term “management and control” means management and control in fact, not the management and...
An exercise in controversy. Case study: revising a physician employment agreement.
Fitzgerald, Paul E; Burkett, Steven H; Key, Charles M
2003-01-01
The physician employment agreement at a faculty practice plan did not meet the needs of a modern health care employer or its medical staff. This article describes the communication among medical group management, medical leadership and the medical staff during the revision of the agreement, as well as the process used to develop a new document.
Neighbors, Charles J.; Kuerbis, Alexis; Riordan, Annette; Blanchard, Kimberly A.; McVeigh, Katharine H.; Morgan, Thomas J.; McCrady, Barbara
2009-01-01
Objective. We examined abstinence rates among substance-dependent women receiving Temporary Assistance for Needy Families (TANF) in intensive case management (ICM) over 24 months and whether ICM yielded significantly better employment outcomes compared with a screen-and-refer program (i.e., usual care). Methods. Substance-dependent (n = 302) and non–substance dependent (n = 150) TANF applicants in Essex County, New Jersey, were recruited. We randomly assigned substance-dependent women to ICM or usual care. We interviewed all women at 3, 9, 15, and 24 months. Results. Abstinence rates were higher for the ICM group than for the usual care group through 24 months of follow-up (odds ratio [OR] = 2.11; 95% confidence interval [CI] = 1.36, 3.29). A statistically significant interaction between time and group on number of days employed indicated that the rate of improvement over time in employment was greater for the ICM group than for the usual care group (incidence rate ratio = 1.03; 95% CI = 1.02, 1.04). Additionally, there were greater odds of being employed full time for those in the ICM group (OR = 1.68; 95% CI = 1.12, 2.51). Conclusions. ICM is a promising intervention for managing substance dependence among women receiving TANF and for improving employment rates among this vulnerable population. PMID:19059855
Keleher, Myra P; Stanton, Marietta P
2016-01-01
The purpose of this article is to explore the most important factors that an employer utilizes in selecting an occupational health care provider for their employees injured on the job. The primary practice setting is the attending physician's office who is an occupational health care provider. The responding employers deemed "work restrictions given after each office visit" as their most important factor in selecting an occupational health care provider, with a score of 43. This was followed in order in the "very important" category by communication, appointment availability, employee return to work within nationally recognized guidelines, tied were medical provider professionalism and courtesy with diagnostics ordered timely, next was staff professionalism and courtesy, and tied with 20 responses in the "very important" category were wait time and accurate billing by the provider.The selection of an occupational health care provider in the realm of workers' compensation plays a monumental role in the life of a claim for the employer. Safe and timely return to work is in the best interest of the employer and their injured employee. For the employer, it can represent hard dollars saved in indemnity payments and insurance premiums when the employee can return to some form of work. For the injured employee, it can have a positive impact on their attitude of going back to work as they will feel they are a valued asset to their employer. The case managers, who are the "eyes and ears" for the employer in the field of workers' compensation, have a valuable role in a successful outcome of dollars saved and appropriate care rendered for the employees' on the job injury. The employers in the study were looking for case managers who could ensure their employees received quality care but that this care is cost-effective. The case manager can be instrumental in assisting the employer in developing and monitoring a "stay-at-work" program, thereby reducing the financial exposure for the employer.
20 CFR 668.340 - What are INA grantee allowable activities?
Code of Federal Regulations, 2010 CFR
2010-04-01
...; (7) Career counseling; (8) Provision of employment statistics information and local, regional, and... and specialized testing and assessment; (2) Development of an individual employment plan; (3) Group counseling; (4) Individual counseling and career planning; (5) Case Management for seeking training services...
ERIC Educational Resources Information Center
Gatti, Mario; Grazia Mereu, Maria; Tagliaferro, Claudio
Changing occupational profiles in the hotel industry in France, Italy, and Spain were examined in case studies that included interviews with hotel managers, human resource managers, and individuals employed in hotel occupations identified as new or entailing new skills. The study focused on the following topics: (1) changes in the hotel industry…
Street, A; Strong, J; Karp, S
2001-01-01
One of the most frequently cited reasons for poor recruitment to multicentre randomized clinical trials is the additional workload placed on clinical staff. We report the effect on patient recruitment of employing a data manager to support clinical staff in an English district general hospital (DGH). In addition, we explore the effect data managers have on the quality of data collected, proxied by the number of queries arising with the trial organizers. We estimate that the cost of employing a data manager on a full-time basis is 502 per patient recruited but may amount to 326 if the appointment is part-time. Data quality is high when full responsibility lies with a data manager but falls when responsibility is shared. Whether the costs of employing a data manager to recruit patients from a DGH are worth incurring depends on the value placed on the speed at which multicentre trials can be completed, how important it is to broaden the research base beyond the traditional setting of teaching hospitals, and the amount of evaluative data required.
Kramer, Erik J; Dodington, James; Hunt, Ava; Henderson, Terrell; Nwabuo, Adaobi; Dicker, Rochelle; Juillard, Catherine
2017-09-01
Violent injury is the second most common cause of death among 15- to 24-year olds in the US. Up to 58% of violently injured youth return to the hospital with a second violent injury. Hospital-based violence intervention programs (HVIPs) have been shown to reduce injury recidivism through intensive case management. However, no validated guidelines for risk assessment strategies in the HVIP setting have been reported. We aimed to use qualitative methods to investigate the key components of risk assessments employed by HVIP case managers and to propose a risk assessment model based on this qualitative analysis. An established academic hospital-affiliated HVIP served as the nexus for this research. Thematic saturation was reached with 11 semi-structured interviews and two focus groups conducted with HVIP case managers and key informants identified through snowball sampling. Interactions were analyzed by a four-member team using Nvivo 10, employing the constant comparison method. Risk factors identified were used to create a set of models presented in two follow-up HVIP case managers and leadership focus groups. Eighteen key themes within seven domains (environment, identity, mental health, behavior, conflict, indicators of lower risk, and case management) and 141 potential risk factors for use in the risk assessment framework were identified. The most salient factors were incorporated into eight models that were presented to the HVIP case managers. A 29-item algorithmic structured professional judgment model was chosen. We identified four tiers of risk factors for violent reinjury that were incorporated into a proposed risk assessment instrument, VRRAI. Copyright © 2017 Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Enomoto, Ernestine K.; Conley, Sharon
2007-01-01
Schools employ educational technology to comply with pressures for greater accountability and efficiency in conducting operations. Specifically, schools use "management information systems" designed to automate data collection of student attendance, grades, test scores, and so on. These management information systems (MIS) employed…
ERIC Educational Resources Information Center
Malloch, Margaret; Martino, John; Waterhouse, Peter; Townsend, Ray
Australian employers' appraisal and use of vocational education and training (VET) qualifications were examined through case studies of 15 small, medium, and large organizations in 8 of Australia's "old" and "new" economy industries. Data were collected through interviews with management/employer representatives, middle…
ERIC Educational Resources Information Center
Sard, Barbara
This paper describes the Family Self-Sufficiency (FSS) program, an employment and savings incentive program for low-income families that have Section 8 vouchers or live in public housing. It consists of both case management services to help participants pursue employment and other goals and escrow accounts into which the public housing agency…
Health and safety management systems: liability or asset?
Bennett, David
2002-01-01
Health and safety management systems have a background in theory and in various interests among employers and workplace health and safety professionals. These have resulted in a number of national systems emanating from national standard-writing centres and from employers' organizations. In some cases these systems have been recognized as national standards. The contenders for an international standard have been the International Organization of Standardization (ISO) and the International Labour Organization (ILO). The quality and environmental management systems of ISO indicate what an ISO health and safety management standard would look like. The ILO Guidelines on Safety and Health Management Systems, by contrast, are stringent, specific and potentially effective in improving health and safety performance in the workplace.
Giesen, Marie-Jeanne; Keizer, Ellen; van de Pol, Julia; Knoben, Joris; Wensing, Michel; Giesen, Paul
2017-05-09
To explore the potential impact of demand management strategies on patient decision-making in medically non-urgent and urgent scenarios during out-of-hours for children between the ages of 0 and 4 years. We conducted a cross-sectional survey with paper-based case scenarios. A survey was sent to all 797 parents of children aged between 0 and 4 years from four Dutch general practitioner (GP) practices. Four demand management strategies (copayment, online advice, overview medical cost and GP appointment next morning) were incorporated in two medically non-urgent and two urgent case scenarios. Combining the case scenarios with the demand management strategies resulted in 16 cases (four scenarios each with four demand management strategies). Each parent randomly received a questionnaire with three different case scenarios with three different demand strategies and a baseline case scenario without a demand management strategy. The response rate was 47.4%. The strategy online advice led to more medically appropriate decision-making for both non-urgent case scenarios (OR 0.26; CI 0.11 to 0.58) and urgent case scenarios (OR 0.16; CI 0.08 to 0.32). Overview of medical cost (OR 0.59; CI 0.38 to 0.92) and a GP appointment planned the next morning (OR 0.57; CI 0.34 to 0.97) had some influence on patient decisions for urgent cases, but not for non-urgent cases. Copayment had no influence on patient decisions. Online advice has the highest potential to reduce medically unnecessary use. Furthermore it enhanced safety of parents' decisions on seeking help for their young children during out-of-hours primary care. Valid online information on health symptoms for patients should be promoted. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Code of Federal Regulations, 2010 CFR
2010-04-01
... service, such as development of an individual employment plan with a case manager or individual counseling and career planning, before the individual may receive training services. (b) The case file must...
Liukko, Jyri; Kuuva, Niina
2017-07-01
This article explores which concrete factors hinder or facilitate the cooperation of return-to-work (RTW) professionals in a complex system of multiple stakeholders. The empirical material consists of in-depth interviews with 24 RTW professionals from various organizations involved in work disability management in Finland. The interviews were analyzed using thematic content analysis. The study revealed several kinds of challenges in the cooperation of the professionals. These were related to two partly interrelated themes: communication and distribution of responsibility. The most difficult problems were connected to the cooperation between public employment offices and other stakeholders. However, the study distinguished notable regional differences depending primarily on the scale of the local network. The main areas of improvement proposed by the interviewees were related to better networking of case managers and expansion of expertise. The article argues for the importance of systematic networking and stresses the role of public employment services in the multi-actor management of work disabilities. The article contributes to existing work disability case management models by suggesting the employment administration system as an important component in addition to health care, workplace and insurance systems. The study also highlights the need for expansion of expertise in the field. Implications for Rehabilitation Cooperation between RTW professionals in public employment offices and other organizations involved in work disability management was considered inadequate. In order to improve the cooperation of RTW professionals, the stakeholders need to create more systematic ways of communication and networking with professionals in other organizations. There is a need to expand the expertise in work disability management and rehabilitation, partly by increasing the role of other professionals than physicians.
ERIC Educational Resources Information Center
Konakli, Tugba
2013-01-01
The aim of this research is to determine the impact of school managers' altruist behaviors upon organizational cynicism by examining the relationship between school managers' altruist behaviors according to teachers and teachers' perceptions of organizational cynicism. The research sample consisted of 250 teachers employed in 15 primary schools,…
The Vocational Skills Gap for Management Accountants: The Stakeholders' Perspectives.
ERIC Educational Resources Information Center
Hassall, Trevor; Joyce, John; Montano, Jose Luis Arquero; Anes, Jose Antonio Donoso
2003-01-01
Develops a case study that examines the process of the professional education and training of management accountants. Identifies the relative importance of a specified range of vocational skills needed for a chartered management accountant, and prioritizes areas for development and training based on opinions of employers and students. (Author/LRW)
ERIC Educational Resources Information Center
Ipsen, Catherine; Seekins, Tom; Ravesloot, Craig
2010-01-01
Research studies report a negative relationship between employment and secondary conditions. Access to health promotion programs to manage secondary conditions, however, is limited for people with disabilities due to employment, financial, and insurance barriers. Vocational rehabilitation (VR) is one possible delivery point to overcome these…
Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea.
Oh, Jinjoo; Oh, Seieun
2017-12-01
The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.
Steele, Lloyd; Coote, Nicky; Klaber, Robert; Watson, Mando; Coren, Michael
2018-05-04
To understand the case mix of three different paediatric services, reasons for using an acute paediatric service in a region of developing integrated care and where acute attendances could alternatively have been managed. Mixed methods service evaluation, including retrospective review of referrals to general paediatric outpatients (n=534) and a virtual integrated service (email advice line) (n=474), as well as a prospective survey of paediatric ambulatory unit (PAU) attendees (n=95) and review by a paediatric consultant/registrar to decide where these cases could alternatively have been managed. The case mix of outpatient referrals and the email advice line was similar, but the case mix for PAU was more acute.The most common parental reasons for attending PAU were referral by a community health professional (27.2%), not being able to get a general practitioner (GP) appointment when desired (21.7%), wanting to avoid accident and emergency (17.4%) and wanting specialist paediatric input (14.1%). More than half of PAU presentations were deemed most appropriate for community management by a GP or midwife. The proportion of cases suitable for community management varied by the reason for attendance, with it highestl for parents reporting not being able to get a GP appointment (85%), and lowest for those referred by community health professionals (29%). One in two attendances to acute paediatric services could have been managed in the community. Integration of paediatric services could help address parental reasons for attending acute services, as well as facilitating the community management of chronic conditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
78 FR 20324 - Proposed Information Collection Activity: Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-04
..., document the experiences of program participants, examine differences in service receipt and educational experiences between program and control group members, describe the intervention as it was implemented in each... leadership/ managers, instructional staff, case managers/advisors, partners and employers; (d) a brief survey...
ERIC Educational Resources Information Center
Varnavas, Andreas P.; Soteriou, Andreas C.
2002-01-01
Presents and discusses the approach used by the Higher Hotel Institute in Cyprus to incorporate total quality management through establishment of a customer-driven management culture in its hospitality education program. Discusses how it collects and uses service-quality related data from future employers, staff, and students in pursuing this…
ERIC Educational Resources Information Center
Marriott, Helen
2013-01-01
Employing the language management framework, this paper reports on multilingual use among the staff of a major metropolitan university in Melbourne and covers both simple and organised management. It describes a top-down attempt to survey staffs' (academic and general) background in Languages other than English (LOTE), LOTE usage and evaluative…
Conservative management of a spleen trauma using radiofrequency.
Stella, Mattia; Percivale, Andrea; Pasqualini, Massimo; Pittaluga, Michele; Gandolfo, Nicola; Pellicci, Riccardo
2005-01-01
Conservative operative management of a splenic injury has become more and more employed in order to preserve the immune function of the organ. A case of a rupture of the spleen successfully treated with the use of a radiofrequency thermal energy generator is eported. The parenchymal tear was coagulated by a one cooled tip needle electrode. There were no postoperative complications and the function of the spleen was preserved. The technique cannot be applied in case of lesion of the major vessels or in case of avulsion of the hilum. This technique integrates to the others to make the operative conservative management of a splenic injury more and more feasible.
Pancreatic and duodenal injuries: keep it simple.
Rickard, Matthew J F X; Brohi, Karim; Bautz, Peter C
2005-07-01
The management of pancreatic and duodenal trauma has moved away from complex reconstructive procedures to simpler methods in keeping with the trend towards organ-specific, damage control surgery. A retrospective case note review was undertaken over a 30-month period to evaluate a simplified protocol for the management of these injuries. Of 100 consecutive patients there were 51 with pancreatic injury, 30 with a duodenal injury and 19 with combined pancreaticoduodenal trauma. Overall mortality was 18.0%, with a late mortality (after 24 h) of 9.9%. This is comparable to previous studies. Morbidity from abscesses, fistulas and anastomotic breakdown was acceptably low. The concept of staged laparotomy can be successfully applied to wounds of the pancreas and duodenum. Debridement of devitalized tissue and drainage can be employed for most cases of pancreatic trauma. Most duodenal injuries can be managed with debridement and primary repair. Temporary exclusion and reoperation should be employed for unstable patients.
[Return to work management of people with temporary disability].
Okreglicka, Małgorzata
2011-01-01
There is a large and growing body of scientific evidence that return to work usually provides significant overall health benefit, and staying off work needlessly results in poorer overall health outcomes. Thus, employers, employees (patients), and insurers all benefit from individuals returning to work in usual time periods. Disability duration guidelines can be an important tool helping the injured workers to get back on the job. The return to work process needs to be accepted by all parties (physicians, employees, employers, insurers) as defensible, fair and evidence-based. "The medical disability advisor--Workplace guidelines for disability duration" by Presley Reed is the backbone of communication, understanding and measurement in case management programs, having great impact on many parties and steps during a case life cycle.
Employment of the Disabled in Large Corporations.
ERIC Educational Resources Information Center
Rabby, Rami
1983-01-01
Large corporations are in a unique position to employ the disabled, but they sometimes lack the motivation to do so. The author discusses elements of a corporate policy for the disabled, ways of formulating and disseminating it, assignment of responsibility, changes in management attitudes, and the special case of the multinational company.…
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-15
... either before or after their job loss, including employment and case management services, job training.... Under WIA, individuals are able to access services tailored to their employment and training needs... placement, counseling, training, and supportive services to enable individuals who need such assistance to...
The principles of effective case management of mental health services.
Rapp, Charles A; Goscha, Richard J
2004-01-01
This paper identifies ten principles or active ingredients of case management that are common to interventions that produced statistically significant positive outcomes for people with serious psychiatric disabilities. Twenty-two studies employing experimental or quasi-experimental designs were selected for inclusion in this review. The use of the principles for systems design is briefly discussed. The term case management is used throughout this article because it is the term that is used in the studies reviewed. We acknowledge that this term is considered pejorative to many people with psychiatric disabilities. People with psychiatric disabilities are not "cases" and they do not need to be "managed." A more accurate reflection of what this service entails is that it is the services or resources that are managed in order to help people reach their goals. Until a more appropriate title becomes globally recognized, the term should be used with sensitivity to the negative connotations it carries.
Bernstein, Richard H
2007-01-01
"Care management" purposefully obscures the distinctions between disease and case management and stresses their common features: action in the present to prevent adverse future outcomes and costs. It includes identifying a high-need population by referrals, screening, or data analysis, assessing those likely to benefit from interventions, intervening, evaluating the intervention, and adjusting interventions when needed. High-risk individuals can be identified using at least 9 techniques, from referrals and questionnaires to retrospective claims analysis and predictive models. Other than referrals, software based on the risk-adjustment methodology that we have adapted can incorporate all these methodologies. Because the risk adjustment employs extensive case mix and severity adjustment, it provides care managers with 3 innovative ways to identify not only high-risk individuals but also high-opportunity cases.
King, Robert
2009-05-01
In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Routine monitoring of caseload, especially by a workplace supervisor, may be effective in reducing work-related stress and enhancing case manager personal efficacy.
Using Podcasting to Facilitate Student Learning: A Constructivist Perspective
ERIC Educational Resources Information Center
Ng'ambi, Dick; Lombe, Annette
2012-01-01
The paper employs two case studies to develop an approach for using podcasts to enhance student learning. The case studies involve two cohorts of postgraduate students enrolled on a blended course, over two years. In both cases, the institutional learning management system was used as a server to host the podcasts, giving students discretion on…
Denny's: Communicating Amidst a Discrimination Case.
ERIC Educational Resources Information Center
Chin, Teresa; Naidu, Sharmila; Ringel, Jonathan; Snipes, Wayne; DeSilva, Jean; Bienvenu, Sherron Kenton
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. Looks at communication strategies employed by Denny's during its crisis caused by charges of racial discrimination. Includes actual communications instrumental in…
Swanberg, Jennifer E.; Nichols, Helen M.; Ko, Jungyai; Tracy, J. Kathleen; Vanderpool, Robin C.
2017-01-01
Advances in breast cancer screening and treatment have led to an overall 5-year survival rate of 90%. Many of these cancer cases are diagnosed in working women. Few studies have explicitly examined the cancer–work interface, as experienced by low-wage earning women with breast cancer. This study uses in-depth, semistructured interviews with 24 low-wage breast cancer survivors to identify employment decisions and factors that influenced or enabled these decisions, and examine the individual strategies and workplace supports used to manage the cancer–work interface among a subset of women (n = 13) who continued to work. Future research areas and clinical implications are discussed. PMID:28045595
Swanberg, Jennifer E; Nichols, Helen M; Ko, Jungyai; Tracy, J Kathleen; Vanderpool, Robin C
2017-01-01
Advances in breast cancer screening and treatment have led to an overall 5-year survival rate of 90%. Many of these cancer cases are diagnosed in working women. Few studies have explicitly examined the cancer-work interface, as experienced by low-wage earning women with breast cancer. This study uses in-depth, semistructured interviews with 24 low-wage breast cancer survivors to identify employment decisions and factors that influenced or enabled these decisions, and examine the individual strategies and workplace supports used to manage the cancer-work interface among a subset of women (n = 13) who continued to work. Future research areas and clinical implications are discussed.
ERIC Educational Resources Information Center
Alfred, Mary V.
2005-01-01
This study explored the experiences of African American women as they transitioned from welfare to work and develop economic self-sufficiency. The barriers to self-sufficiency included the "work-first" philosophy and case management practices, labor market conditions and employment practices, and personal history. HRD can help minimize…
The Role of the Orthopaedic Surgeon in Workers' Compensation Cases.
Daniels, Alan H; Kuris, Eren O; Palumbo, Mark A
2017-03-01
Workers' compensation is an employer-funded insurance program that provides financial and medical benefits for employees injured at work. Because many occupational injuries are musculoskeletal in nature, the orthopaedic surgeon plays an important role in the workers' compensation system. Along with establishing the correct diagnosis and implementing an appropriate treatment plan, the clinician must understand the fundamental components of the workers' compensation system to manage an injured employee. Ultimately, effective claim management requires collaboration among the employer, the employee, the legal representatives, the insurance company, and the orthopaedic surgeon.
Defined contribution defined: health insurance for the next century.
Marhula, D C; Shannon, E G
2001-01-01
The consumerism movement will dramatically affect the current payer model and present a new series of challenges for managed care organizations. Employers will fuel the changes, as they create health benefit programs that are modeled after retirement programs. In these cases, employers will shift a major portion of financial responsibility to employees, who will be asked to make buying decisions often previously determined by managed care organizations. New business entities known as health navigators will be formed to aid consumers. However, many structural and policy obstacles may slow or transform the consumerism movement.
[Survey of pediatric sedation in Japan--results of questionnaire to universities of dentistry].
Takeuchi, Lisa; Kuratani, Norifumi; Hoshijima, Hiroshi; Kikuchi, Hirosato
2010-12-01
Despite widespread use of sedation for stress management during dental treatment in adults, its prevalence of use for pediatric in patients Japan has not been clarified. We investigated here, the present situation of pediatric sedation by the questionnaire sent to the dental anesthesia departments of university hospitals in Japan. Postal survey was conducted of the dental anesthesia departments of university hospitals (29 institutions) throughout the country. Information was requested on hospital policy of indication and technique of pediatric sedation for dental treatment. The causes for avoiding pediatric sedation were also investigated. The response rate was 86.2% (25/29 institutions). Of these respondents, 16 institutions (64%, 16/25 institutions) employ sedation for pediatric dental treatment stress management. The cases performed were around 1-5 cases every month. However, the criteria for employment of pediatric sedation during dental treatment varied among institutes. They preferred to provide general endotracheal anesthesia for pediatric dental procedures, and tended to avoid sedation without airway security for children. The present survey suggests that pediatric sedation for stress management during dental treatment are employed in more than half of the dental university hospitals. However, there was little consensus regarding pediatric sedation during dental treatment among dental anesthesiologists in Japan.
Jones, Jo; Jackson, Janet; Tudor, Terry; Bates, Margaret
2012-09-01
Strategies for enhancing environmental management are a key focus for the government in the UK. Using a manufacturing company from the construction sector as a case study, this paper evaluates selected interventionist techniques, including environmental teams, awareness raising and staff training to improve environmental performance. The study employed a range of methods including questionnaire surveys and audits of energy consumption and generation of waste to examine the outcomes of the selected techniques. The results suggest that initially environmental management was not a focus for either the employees or the company. However, as a result of employing the techniques, the company was able to reduce energy consumption, increase recycling rates and achieve costs savings in excess of £132,000.
Longo, Caterina; Ragazzi, Moira; Castagnetti, Fabio; Gardini, Stefano; Palmieri, Tamara; Lallas, Aimilios; Moscarella, Elvira; Piana, Simonetta; Pellacani, Giovanni; Zalaudek, Iris; Argenziano, Giuseppe
2013-01-01
Mohs micrographic surgery can be employed in recurrent basal cell carcinoma, although it is a time-consuming technique. Recently, ex vivo fluorescence confocal microscopy (FCM) has been employed to obtain a fast assessment of tumor margins at the bedside. In our case we successfully employed ex vivo FCM to assess the tumor margins and we treated the persistent tumor with intensity-modulated radiation therapy. Our case demonstrates that a multidisciplinary approach is very efficient in managing complex and recurrent tumors and highlights the benefits of FCM as a new technique that can be used in the surgical theater to speed up the entire procedure.
Traumatic brain injury rehabilitation: case management and insurance-related issues.
Pressman, Helaine Tobey
2007-02-01
Traumatic brain injury (TBI) cases are medically complex, involving the physical, cognitive, behavioral, social, and emotional aspects of the survivor. Often catastrophic, these cases require substantial financial resources not only for the patient's survival but to achieve the optimal outcome of a functional life with return to family and work responsibilities for the long term. TBI cases involve the injured person, the family, medical professionals such as treating physicians, therapists, attorneys, the employer, community resources, and the funding source, usually an insurance company. Case management is required to facilitate achievement of an optimal result by collaborating with all parties involved, assessing priorities and options, coordinating services, and educating and communicating with all concerned.
ERIC Educational Resources Information Center
Gultekin, Kubra
2009-01-01
This research study explores knowledge management (KM) in law enforcement, focusing on the POLNET system established by the Turkish National Police as a knowledge-sharing tool. This study employs a qualitative case study for exploratory and descriptive purposes. The qualitative data set came from semi-structured face-to-face and telephone…
Improving Computer Literacy of Business Management Majors: A Case Study
ERIC Educational Resources Information Center
Johnson, David W.; Bartholomew, Kimberly W.; Miller, Duane
2006-01-01
Stakeholders, such as future employers, parents, and educators, have raised their expectations of college graduates in the area of computer literacy. Computer skills and understanding are especially critical for business management graduates, who are expected to use computer technology as a tool in every aspect of their career. Business students…
Contractual obligations and the sharing of confidential health information in sport.
Anderson, L
2008-09-01
As an employee, a sports doctor has obligations to their employer, but also professional and widely accepted obligations of a doctor to the patient (in this case the individual team member). The conflict is evident when sports doctors are asked by an athlete to keep personal health information confidential from the coach and team management, and yet both doctor and athlete have employment contracts specifying that such information shall be shared. Recent research in New Zealand shows that despite the presence of an employment contract, there appears to be a wide range of behaviours among sports doctors when an athlete requests that information about them be kept from team management. Many seem willing to honour requests to keep health information about the athlete confidential, thereby being in breach of the employment contract, while others insist on informing team management against the wishes of the athlete. There are a number of potential solutions to this dilemma from forcing doctors to meet their contractual obligations, to limiting the expectations of the employment contract. This paper suggests that at times it may be appropriate to do both, making the position of the doctor clearer and supporting the ability of this group to resist pressure by coaches and management through having a robust code of ethics.
Endovascular Approach for Management of Bullet Embolization to the Heart.
Mojtahedi, Alireza; Contractor, Sohail; Kisza, Piotr S
2018-05-01
Bullet embolization to the right heart through the vasculature is seen infrequently in cases presenting with penetrating trauma. Patients with unstable hemodynamic status are managed operatively. For a patient with stable hemodynamic parameters, diagnostic evaluation such as computed tomography angiogram, echocardiogram, or angiography could be performed to select the best treatment option. Endovascular treatment is employed infrequently in these cases but can be a viable option for select patients. We present a case of a bullet embolus to the right ventricle treated successfully with endovascular approach and discuss the technical aspects of this approach.
Code of Federal Regulations, 2010 CFR
2010-04-01
... customer-centered case management tool, an IEP is a personal record and must receive confidential treatment. ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the elements of the Individual Employment Plan that is authorized as an intensive service? 669.400 Section 669.400 Employees' Benefits...
Retiree Health Plans for Public School Teachers after GASB 43 and 45
ERIC Educational Resources Information Center
Clark, Robert L.
2010-01-01
Most public elementary and high school teachers are covered by health insurance provided by their employer while they are employed. In most cases, these health plans are managed at the state level. At retirement, teachers with sufficient years of service are allowed to remain in the health plan. Retiree health plans for teachers vary widely across…
NASA Astrophysics Data System (ADS)
Kim, Min-Kook; Daigle, John J.
2012-11-01
Cadillac Mountain—the highest peak along the eastern seaboard of the United States—is a major tourist destination in Acadia National Park, Maine. Managing vegetation impact due to trampling on the Cadillac Mountain summit is extremely challenging because of the large number of visitors and the general open nature of landscape in this fragile subalpine environmental setting. Since 2000, more intensive management strategies—based on placing physical barriers and educational messages for visitors—have been employed to protect threatened vegetation, decrease vegetation impact, and enhance vegetation recovery in the vicinity of the summit loop trail. The primary purpose of this study was to evaluate the effect of the management strategies employed. For this purpose, vegetation cover changes between 2001 and 2007 were detected using multispectral high spatial resolution remote sensing data sets. A normalized difference vegetation index was employed to identify the rates of increase and decrease in the vegetation areas. Three buffering distances (30, 60, and 90 m) from the edges of the trail were used to define multiple spatial extents of the site, and the same spatial extents were employed at a nearby control site that had no visitors. No significant differences were detected between the mean rates of vegetation increase and decrease at the experimental site compared with a nearby control site in the case of a small spatial scale (≤30 m) comparison (in all cases P > 0.05). However, in the medium (≤60 m) and large (≤90 m) spatial scales, the rates of increased vegetation were significantly greater and rates of decreased vegetation significantly lower at the experimental site compared with the control site (in all cases P < 0.001). Research implications are explored that relate to the spatial extent of the radial patterns of impact of trampling on vegetation at the site level. Management implications are explored in terms of the spatial strategies used to decrease the impact of trampling on vegetation.
Kim, Min-Kook; Daigle, John J
2012-11-01
Cadillac Mountain--the highest peak along the eastern seaboard of the United States--is a major tourist destination in Acadia National Park, Maine. Managing vegetation impact due to trampling on the Cadillac Mountain summit is extremely challenging because of the large number of visitors and the general open nature of landscape in this fragile subalpine environmental setting. Since 2000, more intensive management strategies--based on placing physical barriers and educational messages for visitors--have been employed to protect threatened vegetation, decrease vegetation impact, and enhance vegetation recovery in the vicinity of the summit loop trail. The primary purpose of this study was to evaluate the effect of the management strategies employed. For this purpose, vegetation cover changes between 2001 and 2007 were detected using multispectral high spatial resolution remote sensing data sets. A normalized difference vegetation index was employed to identify the rates of increase and decrease in the vegetation areas. Three buffering distances (30, 60, and 90 m) from the edges of the trail were used to define multiple spatial extents of the site, and the same spatial extents were employed at a nearby control site that had no visitors. No significant differences were detected between the mean rates of vegetation increase and decrease at the experimental site compared with a nearby control site in the case of a small spatial scale (≤30 m) comparison (in all cases P > 0.05). However, in the medium (≤60 m) and large (≤90 m) spatial scales, the rates of increased vegetation were significantly greater and rates of decreased vegetation significantly lower at the experimental site compared with the control site (in all cases P < 0.001). Research implications are explored that relate to the spatial extent of the radial patterns of impact of trampling on vegetation at the site level. Management implications are explored in terms of the spatial strategies used to decrease the impact of trampling on vegetation.
Inconsistency in health care professional work: Employment in independent sector treatment centres.
Bishop, Simon; Waring, Justin
2011-01-01
The purpose of this paper is to investigate the impact of recent outsourcing and public-private partnership (PPPs) arrangements on the consistency of professional employment in health care. A case study methodology is applied. The paper finds that multiple arrangements for employment within the ISTC creates numerous sources for inconsistency in employment: across the workplace, within professional groups and with national frameworks for health care employment. These are identified as having implications for organisational outcomes, threatening the stability of current partnerships, and partially stymieing intended behavioural change. The study is a single case study of an independent sector treatment centre. Future research is required to investigate wider trends of employment in heterogeneous outsourcing and PPP arrangements. The paper informs both managers and clinical professionals of the unanticipated complexities and practical challenges that can arise in partnerships and outsourcing arrangements. The paper presents a unique in-depth investigation of employment within recently established ISTCs, and highlights important employment changes for the core health care workforce and high-status professionals in the evolving health care organisational landscape.
Seeing about soil — management lessons from a simple model for renewable resources
NASA Astrophysics Data System (ADS)
Lichtenegger, Klaus; Schappacher, Wilhelm
2014-02-01
Employing an effective cellular automata model, we investigate and analyze the build-up and erosion of soil. Depending on the strategy employed for handling agricultural production, in many cases we find a critical dependence on the prescribed production target, with a sharp transition between stable production and complete breakdown of the system. Strategies which are particularly well-suited for mimicking real-world management approaches can produce almost cyclic behavior, which can also either lead to sustainable production or to breakdown. While designed to describe the dynamics of soil evolution, this model is quite general and may also be useful as a model for other renewable resources and may even be employed in other disciplines like psychology.
Hirai, Akiko; Hirose, Yoshifumi; Gamoh, Masahiro; Satoh, Minako
2005-10-01
We report successful management of tracheobronchial stent insertion under general anesthesia. In thirty-two cases, tracheobronchial stent insertion was performed under general anesthesia. The technique for airway management was chosen depending on the type of stent or the constriction level of the airway portion. We employed tracheostomy in order to avoid repeated intubations during the insertion of Dumon or Dynamic stent. In case of severe airway stenosis, laser resection or balloon dilatation was performed before stent insertion. We had 32 successful cases in 36 trials. Four trials failed due to insufficient expansion in one, mismatches of stent angle in one and pneumomediastinum in one. There was no exacerbation of respiratory condition in failed cases. There was no case who needed percutaneous cardiopulmonary support system. We managed tracheobronchial stent insertion under general anesthesia. Both the airway expansion by laser resection or balloon dilatation before stent insertion and also the insertion of Dumon or Dynamic stent through a tracheostomy were helpful strategies. These techniques facilitated more definitive airway maintenance and stable anesthetic management.
Nair, N Sreekumaran; Lewis, Leslie Edward; Murthy, Shruti; Godinho, Myron Anthony; Lakiang, Theophilus; Venkatesh, Bhumika T
2017-09-15
India contributes to the highest neonatal deaths globally. Case management is said to be the cornerstone of pneumonia control. Much of the published evidence focuses on children aged 1 to 59 months. This scoping review, thus, aims to identify the treatment options for and barriers to case management of neonatal pneumonia in India. This protocol is part of a series of three reviews on neonatal pneumonia in India. Studies addressing treatment of or barriers to case management of neonatal pneumonia in Indian context, published in English in peer-reviewed and indexed journals will be eligible for inclusion. Electronic search will be conducted on nine databases. Hand searching and snowballing will be done for published and grey literature. Selection of studies will be done in title, abstract and full-text stages. A narrative summary will be performed to summarise the details of evidence. As this is a review involving analysis of secondary data which is available in the public domain and does not involve human participants, ethical approval was not required. The findings of the study will be shared with all stakeholders of this research. Knowledge dissemination workshops will be conducted with relevant stakeholders to ultimately transfer the evidence tailored to the stakeholder (eg, policy briefs, publications, information booklets and so on). PROSPERO 2016: CRD42016045449. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Wang, Philip S; Simon, Gregory E; Kessler, Ronald C
2008-04-01
Explore the business case for enhanced depression care and establish a return on investment rationale for increased organizational involvement by employer-purchasers. Literature review, focused on the National Institute of Mental Health-sponsored Work Outcomes Research and Cost-effectiveness Study. This randomized controlled trial compared telephone outreach, care management, and optional psychotherapy to usual care among depressed workers in large national corporations. By 12 months, the intervention significantly improved depression outcomes, work retention, and hours worked among the employed. Results of the Work Outcomes Research and Cost-effectiveness Study trial and other studies suggest that enhanced depression care programs represent a human capital investment opportunity for employers.
Department of Defense Recovering Warrior Task Force
2014-09-02
used by RWs, which DoD must first identify, such as private sector job training, employment skills training, apprenticeships, and internships (JTEST- AI ...employment, other transition support, referrals and warm handoffs within and across sectors , and case management. Communities that are geographically remote...of Medicine76; recognition of the need for private sector participation is coalescing. We see evidence of the private sector’s readiness to embrace
Retiree Health Plans for Public School Teachers after GASB 43 and 45. Conference Paper 2009-03
ERIC Educational Resources Information Center
Clark, Robert L.
2009-01-01
Most public elementary and high school teachers are covered by health insurance provided by their employer while they are employed. In most cases, these health plans are managed at the state level. At retirement, teachers with sufficient years of service are allowed to remain in the health plan. Retiree health plans for teachers vary widely across…
[Delayed reconstructions of soft tissue defects of the face].
Mest'ák, J
2007-06-01
The author describes a non-standard approach to the management of facial soft tissue defects. Significance of delayed reconstructions in defect face injuries and options for their employment in indicated cases are highlighted.
Exporting the Buyers Health Care Action Group Purchasing Model: Lessons from Other Communities
Christianson, Jon B; Feldman, Roger
2005-01-01
When first implemented in Minneapolis and St. Paul, Minnesota, the Buyers Health Care Action Group's (BHCAG) purchasing approach received considerable attention as an employer-managed, consumer-driven health care model embodying many of the principles of managed competition. First BHCAG and, later, a for-profit management company attempted to export this model to other communities. Their efforts were met with resistance from local hospitals and, in many cases, apathy by employers who were expected to be supportive. This experience underscores several difficulties that appear to be inherent in implementing purchasing models based on competing care systems. It also, once again, suggests caution in drawing lessons from community-level experiments in purchasing health care. PMID:15787957
Pai, Ar Vivekananda; Khosla, Manak
2012-07-01
This case report illustrates determination of prognosis and immediate resection carried out, before completing the endodontic therapy, during the surgery employed for managing a nonperiodontal problem. This case showed external pressure resorption in the distobuccal root of maxillary second molar caused by the impingement of impacted third molar. Extraction of third molar was decided when healing was not seen, despite initiating endodontic therapy in second molar. Following elevation of flap and extraction of third molar, the poor prognosis due to severe bone loss around the resorbed root was evident. But due to strategic value of second molar, it was found beneficial to employ resection. Therefore, immediate resection was carried out in the same surgical field before the completion of endodontic therapy. This prevented the need for another surgical entry with its associated trauma to carry out resection separately later. Resection followed by the completion of endodontic therapy and full crown assisted in salvaging the remaining functional portion of the tooth and prevented the occurrence of distal extension with its potential drawbacks.
Occupational health referrals for advice on cancer-related sickness absence.
Wynn, P; Woodcock, K
2011-05-01
Work-related difficulties experienced by employees diagnosed with cancer are widely reported. However, there is limited reliable quantitative evidence that employers treat employees with such diagnoses differently from staff with other chronic disorders. To assess delays to management referral for occupational health advice for employees on long-term sickness absence attributable to cancer, compared with other common causes of long-term health-related absence. An audit of management delays to occupational health referral for all employees with a cancer diagnosis who subsequently applied for ill-health early retirement in a large UK public sector employer. Similar data were collected for two control groups, with musculoskeletal or psychological complaints, matched by age, sex, job title and pension scheme membership. Data were collected for the period 2004-07. Twenty-three cases were identified. Referral to the occupational health services for cases with a cancer diagnosis was delayed on average by 187 days compared with cases with a psychological or musculoskeletal diagnosis (P < 0.001). There is evidence that employers differ in their referral practices for employees with a cancer diagnosis, compared with those with other common disorders leading to long-term absence. This may represent a loss of opportunity for effective vocational rehabilitation or timely support for access to health-related benefits.
Fair Employment Implication for HRD: The Case of Washington vs. Davis
ERIC Educational Resources Information Center
Sharf, James C.
1977-01-01
Examines several decisions of district and appeals courts and the Supreme Courts, both State and Federal, under title VII of the Civil Rights Act of 1964 and their implications for personnel and training management. In a reversal of the appeals court decision, the Supreme Court ruled in the case of Washington vs. Davis that the…
Identity Strategies in Light of a Low-Prestige Occupation: The Case of Retail Apprentices
ERIC Educational Resources Information Center
Duemmler, Kerstin; Caprani, Isabelle
2017-01-01
Occupations differ in their prestige, but little research has examined how workers manage working in a low-prestige occupation. This case study with retail-clerk apprentices in Switzerland uncovers the identity strategies the apprentices employ to help them normalise the situation they find themselves in: they are learning an occupation that is…
ERIC Educational Resources Information Center
Murphy, Francis S.
2005-01-01
Education of potential professional engineers should take account of the type of employment that they will eventually obtain. The quality of an engineering degree course can be judged by assessing whether the correct balance of "essential attributes" has been effectively obtained. This case study is concerned with assessing the balance…
Hudon, Catherine; Chouinard, Maud-Christine; Lambert, Mireille; Diadiou, Fatoumata; Bouliane, Danielle; Beaudin, Jérémie
2017-10-22
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. Thematic analysis review of CM studies. 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. 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. 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. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Analysis of Selection Process for Management Education: Korean Military Case.
1984-06-01
applicable to selecting Korean military officers for postgraduate education in management, is proposed. 1! 6! 6i N 0102. L r * 014- 6601 2 Unclassified...officers uhc can manage the ailitary Fersctrel Ard modern uea~ons efficiently. As a result, the military has begun to educate some of its cfficers in the...referal, advisinj 4 aiplicant- about alternatives in employment, and furthering public relations. Oijectives cf group interview might te to assess
Lindsay, William R; Allan, Ronald; MacLeod, Fiona; Smart, Nicola; Smith, Anne H W
2003-02-01
Success of anger management treatment with individuals who have intellectual disabilities convicted of assault-related offenses has not been verified. We employed a single case design with repeated measures with 6 such men. Recidivism is reported at least 4.5 years and up to 10 years. Modified anger management training incorporating cognitive restructuring and arousal reduction was employed. Participants showed no uniform reductions in emotional or behavioral systems of anger and aggression. Although several retained significant anger feelings, there were reductions in the extent to which they would act in an aggressive fashion. Five have not re-offended; 1 re-offended within 6 months but not in the subsequent 4 years. Anger management treatment seems effective for men with intellectual disabilities in the community who have committed socially and legally unacceptable acts.
NASA Astrophysics Data System (ADS)
Conboy, Kieran; Lang, Michael
This chapter outlines the alternative perspectives of "rationalism" and "improvisation" within information systems development and describes the major shortcomings of each. It then discusses how these shortcomings manifested themselves within an e-government case study where a "structured" requirements management method was employed. Although this method was very prescriptive and firmly rooted in the "rational" paradigm, it was observed that users often resorted to improvised behaviour, such as privately making decisions on how certain aspects of the method should or should not be implemented.
ERIC Educational Resources Information Center
Daud, Salina; Abidin, Nurazariah; Sapuan, Noraina Mazuin; Rajadurai, Jegatheesan
2011-01-01
Purpose: This study seeks to investigate the potential gap between important dimensions of business graduates' attributes and the actual performance of these graduates in their post-graduate employment. These graduates have completed a business-related degree from the business management faculty of a higher education institution (HEI) located in…
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…
Perceived Effects of an MBA Degree on Employability and Career Advancement: The Case of Greece
ERIC Educational Resources Information Center
Mihail, Dimitrios M.; Elefterie, Kristina Antigoni
2006-01-01
Purpose: Given this rapid expansion in business schools and MBA graduate numbers, the purpose of this paper is to assess whether and how graduate management education offered in Greece makes better managers. Design/methodology/approach: To this purpose an empirical research was conducted, interviewing 68 MBA graduates from a Greek business school,…
ERIC Educational Resources Information Center
Harrison, Charles E., Jr.
2010-01-01
Educational leaders have often been ineffective in managing change in their environment. Change vectors were used in the current study to identify areas of needed change, along with a metacognitive approach to organizational change. A qualitative case study was employed to explore the use of such a metacognitive approach to change by a small rural…
ERIC Educational Resources Information Center
Sekiwu, Denis; Kabanda, Milly
2014-01-01
The area of safety and accident prevention is of great concern to managers, because of the increasing number of deaths and accidents at work places. Using a case of Wakiso district, the study sought to investigate the relationship between collective commitment and management of health and safety in Ugandan secondary schools. The study employed a…
Integrated management of depression: improving system quality and creating effective interfaces.
Myette, Thomas L
2008-04-01
Depression is a chronic recurrent condition and is a leading cause of work disability. Improving occupational outcomes for depression will require an integrated approach that incorporates best practices from the clinical, community, and workplace systems. This article briefly reviews recent quality improvement initiatives and promising practices in each system and then shifts to the importance of systems integration. An integrated chronic care model uses a sophisticated case management process to support essential relationships, facilitate key plans, and efficiently link the three systems to optimize clinical, economic, and occupational outcomes. An expanded role for employers and their agents in the management of depression and other chronic diseases is seen as fundamental to maintaining a healthy and productive workforce. To improve occupational outcomes for depression by integrating best practices from the clinical, community, and workplace systems. After a brief review of quality improvement initiatives and promising practices in each system, an integrated chronic care model is introduced. A case management process that links critical systems, supports essential relationships, and facilitates key plans is expected to result in improvements in clinical, economic, and occupational outcomes. Employers should be more engaged with clinical and community partners in the prevention and control of depression in affected employees.
Jubelt, Lindsay E; Graham, Jove; Maeng, Daniel D; Li, Huilin; Epstein, Andrew J; Metlay, Joshua P
2014-11-18
Case managers are employed in medical homes to coordinate care for clinically complex patients. To measure the association of patient perceptions of case manager performance with overall satisfaction and subsequent health care utilization. Retrospective cohort study. Integrated health system in Pennsylvania. Members of the health system-owned health plan who 1) received primary care in the health system's clinics, 2) were exposed to clinic-embedded case managers, and 3) completed a survey of satisfaction with care. Survey assessment of case manager performance and overall satisfaction with care and claims-based assessment of case manager performance and subsequent hospitalizations or emergency department visits. Survey measures were dichotomized into very good versus less than very good. A total of 1755 patients (44%) completed the survey and 1415 met study criteria. Survey respondents who reported very good ratings of case manager performance across all items had a higher probability of reporting very good overall satisfaction with care (92.2% vs. 62.5%; P < 0.001) and had a lower incidence of subsequent emergency department visits (incidence rate ratio, 0.79 [95% CI, 0.64 to 0.98]; P = 0.029) but not hospitalizations (incidence rate ratio, 0.92 [CI, 0.75 to 1.11]; P = 0.37) up to 2 years after the survey compared with survey respondents who reported less-than-very good case manager performance on 1 or more questions on the survey. Satisfaction data demonstrated substantial ceiling effects. Survey nonresponse may have introduced bias in the results. Patients' favorable perceptions of case managers are associated with higher overall satisfaction with care and may lower risk for future acute care use. Robert Wood Johnson Foundation and the U.S. Department of Veterans Affairs.
Bernardo, Jussara Karina; Maia, Elaine A Vilela; Cardoso, Antônio Carlos; de Araújo Júnior, Edson Medeiros; Monteiro Júnior, Sylvio
2002-01-01
In the attempt to restore anterior teeth affected by erosion and bruxism, many clinicians have been frustrated with the constant restorative failures. Frequently, these failures are attributed to the restorative materials employed, especially in cases in which composite resins are used. However, some flaws of the restorations are related to the oversight of occlusal principles. The purpose of this article is to discuss the etiology, signs, and symptoms of incisal wear, with special attention to that caused by bruxism and chemical erosion. Relatively simple management techniques (e.g., occlusal adjustment, adhesive restorations) are proposed, and the diagnosis and management of a representative clinical case is presented. In some cases of bruxism and/or dental erosion, it is possible to acquire space to recuperate the esthetics and function of maxillary incisors affected by incisal wear through a conservative treatment associated with the control of the etiologic factors.
Mother-infant home care drives quality in a managed care environment.
Malnory, M
1997-04-01
Advocates of inpatient managed care employing clinical pathways are confident that this patient management strategy reduces cost while promoting equivalent patient outcomes. Other health care professionals are concerned that cost reductions place patients at higher risk for adverse health events. Research is needed to demonstrate the true impact of cost-containment strategies on clinical outcomes. The article describes a study in progress comparing patients conventionally managed by their physicians with similar patients whose overall management involved a nurse case manager. This study explores the issue of resource costs that can be linked to clinical and financial outcome measures.
ERIC Educational Resources Information Center
Luarn, Pin; Lin, Tom M. Y.; Lo, Peter K. Y.
2003-01-01
Employs a case study method, using in-depth interviews of 29 corporate managers and experts, to understand the current state of mobilization in the life insurance industry. Suggests a conceptual framework and formulates possible research propositions incorporating several variables. Suggests 10 key success factors for implementing mobilization in…
Using a health and productivity dashboard: a case example.
Riedel, John E
2007-01-01
Health and productivity management is complicated and requires some strategies that help simplify the endeavor for employers. The use of a "dashboard" concept implies that raw information about employee health can be arranged in ways that help decision-makers better understand the scope and magnitude of health issues within their work force. In this edition of the Art we look at a case study of the use of a health and productivity dashboard within an employer organization. As health promotion professionals that work in worksite settings struggle with portraying the economic importance of worker health, a health and productivity dashboard (HPD) may provide a very real strategic advantage.
Feasibility trial of GP and case-managed support for workplace sickness absence.
Rannard, Anne; Gabbay, Mark; Sen, Dil; Riley, Richard; Britt, David
2014-07-01
Aim Our aim was to compare the return-to-work rates between individuals supported by their GP plus workplace health advisers (intervention group) and those supported by their GP alone. Workplace sickness absence places a significant cost burden on individuals and the wider economy. Previous research shows better outcomes for individuals if they are supported while still in employment, or have been on sick leave for four weeks or less. Those helped back to work at an early stage are more likely to remain at work. A non-medicalised case-managed approach appears to have the best outcomes and can prevent or reduce the slide onto out-of-work benefits, but UK literature on its effectiveness is sparse. The design was a feasibility-controlled trial in which participants were sickness absentees, or presentees in employment with work-related health problems. Individuals completed health status measures (SF-36; EQ-5D) and a Job Content Questionnaire at baseline and again at four-month follow-up. Findings In the intervention group, 29/60 participants completed both phases of the trial. GP practices referred two control patients, and, despite various attempts by the research team, GPs failed to engage with the trial. This finding is of concern, although not unique in primary care research. In earlier studies, GPs reported a lack of knowledge and confidence in dealing with workplace health issues. Despite this, we report interesting findings from the case-managed group, the majority of whom returned to work within a month. Age and length of sickness absence at recruitment were better predictors of return-to-work rates than the number of case-managed contacts. The traditional randomised controlled trial approach was unsuitable for this study. GPs showed low interest in workplace sickness absence, despite their pivotal role in the process. This study informed a larger Department for Work and Pensions study of case-managed support.
Proving that less is more: linking resources to outcomes.
Ebener, M K; Baugh, K; Formella, N M
1996-01-01
Advocates of inpatient managed care employing clinical pathways are confident that this patient management strategy reduces cost while promoting optimal patient outcomes. Other health care professionals are concerned that cost reductions place patients at higher risk for adverse health events. Research is needed to demonstrate the true impact of cost-containment strategies on clinical outcomes. The article describes a study in progress comparing patients conventionally managed by their physicians with similar patients whose overall management involved a nurse case manager. This study explores the issue of resource costs that can be linked to clinical and financial outcome measures.
Disability management practices in education, hotel/motel, and health care workplaces.
Williams, Renee M; Westmorland, Muriel G; Shannon, Harry S; Rasheed, Farah; Amick, Benjamin C
2005-03-01
The high costs and the impact of work disability have become a growing concern for workplaces. As a result, workplace disability management approaches have been developed to lower disability costs, protect the employability of workers, and promote early return to work. A stratified random sample of 455 employers in education (n = 157), hotel/motel (n = 110), and health care (n = 188) sectors who completed a mailed Organizational Policies and Practices (OPP) questionnaire is reported. The OPP questionnaire asked questions about eight workplace disability management practices. The article examined the multi-dimensionality, internal consistency, and discriminant validity of the OPP and compares disability management practices across the three sectors. The OPP questionnaire showed good internal consistency (Cronbach's alpha = 0.95) and discriminant validity. A one-way analysis of variance (ANOVA) for each of the eight subscales demonstrated that there were statistically significant differences between the sectors in ergonomic practices (F (2,452) = 15.8, P < 0.001), disability case management (F (2,452) = 4.6, P < 0.01), return to work (F (2,452) = 10.3, P < 0.001), and people-oriented culture (F (2,452) = 4.5, P < 0.01). On examining disability management practices in education, hotel/motel, and health care sectors, the OPP seems to be a promising instrument that can be used to assess and monitor how employers are managing disability.
Marketing quality and value to the managed care market.
Kazmirski, G
1998-11-01
Quantifying quality and marketing care delivery have been long-term challenges in the health care market. Insurers, employers, other purchasers of care, and providers face a constant challenge in positioning their organizations in a proactive, competitive niche. Tools that measure patient's self-reported perception of health care needs and expectations have increased the ability to quantify quality of care delivery. When integrated with case management and disease management strategies, outcomes reporting and variance analysis tracking can be packaged to position a provider in a competitive niche.
Tsiknakis, Manolis; Kouroubali, Angelina
2009-01-01
The paper presents an application of the "Fit between Individuals, Task and Technology" (FITT) framework to analyze the socio-organizational-technical factors that influence IT adoption in the healthcare domain. The FITT framework was employed as the theoretical instrument for a retrospective analysis of a 15-year effort in implementing IT systems and eHealth services in the context of a Regional Health Information Network in Crete. Quantitative and qualitative research methods, interviews and participant observations were employed to gather data from a case study that involved the entire region of Crete. The detailed analysis of the case study based on the FITT framework, showed common features, but also differences of IT adoption within the various health organizations. The emerging picture is a complex nexus of factors contributing to IT adoption, and multi-level interventional strategies to promote IT use. The work presented in this paper shows the applicability of the FITT framework in explaining the complexity of aspects observed in the implementation of healthcare information systems. The reported experiences reveal that fit management can be viewed as a system with a feedback loop that is never really stable, but ever changing based on external factors or deliberate interventions. Management of fit, therefore, becomes a constant and complex task for the whole life cycle of IT systems.
Melloul, Abraham J; Collin, Martin L
2003-04-01
This study focuses on the problem of most efficiently fulfilling the water requirements of society for sustainable water resources management. The goal is to coordinate effectively the social needs of the resident population with operational water resources management planning.The proposed approach consists of a pyramidal hierarchy of water resource management needs, similar to that suggested by psychologist Abraham Maslow for human social needs. The two pyramidal hierarchies can be simultaneously employed to delineate guidelines to synchronize planning for sustainable water resources development with the concerns and expectations of the resident population. In both hierarchies, higher level needs remain irrelevant and difficult to attain until lower level needs of the resident population have been fulfilled. Management planning measures employed with regard to Israel's coastal aquifer have been used to illustrate this approach. Observation of Israel's experience indicates markedly reduced effectiveness where such measures have failed to be properly synchronised with societal needs. Conversely, where hydrological management measures were successfully synchronized with societal concerns, increased efficiency towards attaining sustainable groundwater management was evident.
Wltavsky, Zdenka; Lebar, Lea; Bitenc, Crtomir
2014-06-01
For decades, employment of a person with disabilities has been considered a key indicator of the success of vocational rehabilitation. There is a link between the quality of vocational rehabilitation and a better quality of life for service users; these services have a significant impact on efficiency in the field of work. Very few authors have researched the qualification and skills of rehabilitation experts essential for successfully carrying out their professional activities. The objective of the present study was to investigate the perceived importance attached to the competencies of vocational rehabilitation professionals and the frequency of their application at work in three different countries, which was conducted using a questionnaire that was prepared on the basis of a questionnaire designed by Australian researchers. Basic competencies comprise four sets: vocational counselling, professional practice, personal counselling and rehabilitation case management. Special competencies are composed of two sets: workplace disability case management and workplace intervention and programme management. The questionnaire was completed by 131 respondents, of whom 61 were from Slovenia, 34 were from Austria and 36 were from the UK. t-Tests for two independent samples (sex), analysis of variance (type of education, country) and Pearson's correlation coefficient were used to compare the perception of basic and special competencies. The respondents perceived personal counselling, vocational counselling and management of rehabilitation cases as being the most important, whereas the least importance was assigned to interventions. In practice, the respondents used personal counselling most frequently and very few interventions.
ERIC Educational Resources Information Center
Roberts, Ken; Teshmatullo, Akhamadov; Firdavsiy, Kurbanov; Sarateppo, Boltaev; Tholen, Jochen
2007-01-01
This article arises from case studies in 2006 of 20 businesses in Samarkand (Uzbekistan), surveys of their up to 30-year-old employees (r = 419), follow-up interviews with eight of these employees, and matched samples in Almaty (Kazakhstan) and Bishkek (Kyrgyzstan). The main difference between education in Samarkand (and Uzbekistan in general) and…
The Evolution of End-of-Life Care: Ethical Implications for Case Management.
Fink-Samnick, Ellen
2016-01-01
This article: : Applicable to all health care sectors where case management is practiced. Few topics are more intimate and multifaceted for case managers than engaging with today's culturally diverse patient populations around end-of-life processes. The already prominent focus of this issue has been further elevated by a series of events to receive public attention. These include the Institute of Medicine's 2014 report-Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, rising numbers of patients around the globe requesting to end life on their own terms, and corresponding death with dignity initiatives and legislation.Another vital factor in the end-of-life equation involves how the latest generation of shared decision making influences the management of treatment dialogues among practitioners, patients, as well as insurance companies. Case managers are at the intersection of these complex interactions, working to achieve ethical, as well as legal accountability to the patient, employer, and profession while balancing personal perspectives. Professionals strive to effectively intervene with patients and their support systems facing end-of-life care decisions. It is essential case managers actively consider the intricacies of ethical practice and current contexts including death with dignity legislation, shared decision making, and shifts in regulations and reimbursement for end-of-life care.Case management's ethical envelope will continue to be pushed. To that end amid shifting societal constructs, professionals must have mastery of applicable codes, standards, principles, and rules essential for adherence to ethical practice.
Foundation Level Training. Trainer's Manual.
ERIC Educational Resources Information Center
Oklahoma State Dept. of Human Services, Oklahoma City. Developmental Disabilities Services Div.
This trainer's manual was developed to provide a consistent knowledge and skill base (i.e., a "foundation") for all individuals employed in programs funded by Oklahoma's Developmental Disabilities Services Division. They include van drivers, recreation workers, residential staff, administrators, case managers, secretarial/clerical staff,…
Reported Preparedness of Certified Counselors in Rehabilitation Counseling Knowledge Areas.
ERIC Educational Resources Information Center
Szymanski, Edna Mora; And Others
1993-01-01
Rehabilitation counselors (n=1,535) reported that they were at least moderately prepared in vocational services; foundations of rehabilitation; case management/services; group/family counseling; medical/psychosocial aspects; workers' compensation, employer services, and technology; individual counseling/development; social, cultural, and…
ERIC Educational Resources Information Center
Altunay, Esen; Arli, Didem; Yalcinkaya, Munevver
2012-01-01
The aim of this study was to determine the need of change in primary schools and to reveal out the principals' experiences during the change process by taking the total quality management practices into consideration and finally give suggestions according to the results of the study. In this study by employing qualitative research method, semi…
ERIC Educational Resources Information Center
Friedman, Dana E.
This paper addresses the feasibility of family support programs as a means by which management may constructively respond to the changes in the workforce in order to fulfill its own objectives. The analysis takes into account both theory and practice, applying learned concepts to the design and execution of an actual feasibility study at a small,…
Demonstration of TRAF-NETSIM for traffic operations management : final report.
DOT National Transportation Integrated Search
1991-08-01
The utility of the simulation package TRAF-NETSIM to the traffic engineer is assessed and demonstrated by means of a case study. The methodology employed in performing the analysis is presented in a way that will aid future users of TRAF-NETSIM. The ...
Interprofessional collaboration in family health teams
Goldman, Joanne; Meuser, Jamie; Rogers, Jess; Lawrie, Lynne; Reeves, Scott
2010-01-01
ABSTRACT OBJECTIVE To examine family health team (FHT) members’ perspectives and experiences of interprofessional collaboration and perceived benefits. DESIGN Qualitative case study using semistructured interviews. SETTING Fourteen FHTs in urban and rural Ontario. PARTICIPANTS Purposeful sample of the members of 14 FHTs, including family physicians, nurse practitioners, nurses, dietitians, social workers, pharmacists, and managers. METHODS A multiple case-study approach involving 14 FHTs was employed. Thirty-two semistructured interviews were conducted and data were analyzed by employing an inductive thematic approach. A member-checking technique was also undertaken to enhance the validity of the findings. MAIN FINDINGS Five main themes are reported: rethinking traditional roles and scopes of practice, management and leadership, time and space, interprofessional initiatives, and early perceptions of collaborative care. CONCLUSION This study shows the importance of issues such as roles and scopes of practice, leadership, and space to effective team-based primary care, and provides a framework for understanding different types of interprofessional interventions used to support interprofessional collaboration. PMID:20944025
Case-control study on the prevention of occupational eye injuries.
Ho, Chi-Kung; Yen, Ya-Lin; Chang, Cheng-Hsien; Chiang, Hung-Che; Shen, Ying-Ying; Chang, Po-Ya
2008-01-01
The risk factors for occupational eye injuries have never been published in Taiwan. We conducted a case-control study to analyze the differences among workers on their knowledge, attitude to and practice (KAP) of occupational accident prevention. In the study, a statistical model was also set up for predicting the occupational problem. Subjects, including 31 cases of work-related eye injuries and 62 controls, completed a structured questionnaire on KAP, which revealed that 80.6% and 62.7% of workers in the case and control groups, respectively, did not wear eye protection during work. Furthermore, we found that temporary employment (OR, 10.7; 95% CI, 3.03-36.16) and fewer than 10 years of education (OR, 4.44; 95% CI, 1.73-11.44) were the major risk factors for occupational eye injuries. In addition, we developed a logistic regression model with four predictors (temporary employment, education years less than 10, poor management of industrial health and safety in the workplace, and poor attitude towards accident prevention) for the occurrence of occupational eye injuries. In conclusion, in Taiwan, compulsory regulation of wearing eye protection during work, good education, management of work safety and hygiene and employee (especially temporary worker) commitment to safety and health are strongly recommended prevention strategies.
The importance of subjective claims management.
Beger, C S
1997-01-01
This article discusses the causes and effects of "subjective disability" on today's workforce and employers. As employees feel out of control with both their careers and demands placed upon them, the number of claims characterized by self-reported symptoms are increasing. Subjective disabilities include chronic syndrome, fibromyalgia, psychiatric claims and chronic pain. The author discusses creative strategies in case studies that have helped employers contain the costs of disability claims, while empowering the employee to take control of their own situation and return to work sooner.
Allott, Kelly A; Turner, Luana R; Chinnery, Gina L; Killackey, Eoin J; Nuechterlein, Keith H
2013-08-01
Individual Placement and Support is the most defined and evidence-based approach to supported employment for severe mental illness, including recent-onset psychosis. However, there is limited evidence or detailed guidelines informing the management of mental illness disclosure to educators or employers when delivering individual placement and support. In this paper, we describe the initial disclosure preferences of young people with recent-onset psychosis enrolled in individual placement and support and provide guidance for managing disclosure when delivering Individual Placement and Support with this population. Drawing from sites in Melbourne, Australia and Los Angeles, USA, clients' initial disclosure preferences were examined. We describe approaches to providing individual placement and support when no disclosure is permitted compared with when disclosure is permitted, including two illustrative case vignettes. No disclosure of mental illness or disability was requested by 54-59% of clients; 41-46% of clients permitted partial or complete disclosure. The 'no disclosure' scenario required the individual placement and support worker to provide support 'behind the scenes', whereas when disclosure was permitted, the individual placement and support worker could have contact with instructors/employers and work 'on the front lines'. The case vignettes illustrate how both approaches can lead to successful vocational outcomes. We found that Individual Placement and Support can be provided in an educative, flexible, creative and collaborative manner according to client disclosure preferences. We suggest that disclosure preferences do not prevent successful vocational outcomes, although this supposition requires empirical investigation. © 2013 Wiley Publishing Asia Pty Ltd.
38 CFR 21.92 - Preparation of the plan.
Code of Federal Regulations, 2012 CFR
2012-07-01
...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31... specialist or counseling psychologist designated as case manager has the primary role in carrying out... counseling psychologist has the primary responsibility for the preparation of plans. (Authority: 38 U.S.C...
38 CFR 21.92 - Preparation of the plan.
Code of Federal Regulations, 2011 CFR
2011-07-01
...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31... specialist or counseling psychologist designated as case manager has the primary role in carrying out... counseling psychologist has the primary responsibility for the preparation of plans. (Authority: 38 U.S.C...
38 CFR 21.92 - Preparation of the plan.
Code of Federal Regulations, 2014 CFR
2014-07-01
...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31... specialist or counseling psychologist designated as case manager has the primary role in carrying out... counseling psychologist has the primary responsibility for the preparation of plans. (Authority: 38 U.S.C...
38 CFR 21.92 - Preparation of the plan.
Code of Federal Regulations, 2013 CFR
2013-07-01
...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31... specialist or counseling psychologist designated as case manager has the primary role in carrying out... counseling psychologist has the primary responsibility for the preparation of plans. (Authority: 38 U.S.C...
5 CFR 1201.144 - Hearing procedures; referring the record.
Code of Federal Regulations, 2010 CFR
2010-01-01
... the record to the Special Counsel, the Office of Personnel Management, and the employing agency for... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Hearing procedures; referring the record... PROCEDURES PRACTICES AND PROCEDURES Procedures for Original Jurisdiction Cases Removal from the Senior...
5 CFR 1201.144 - Hearing procedures; referring the record.
Code of Federal Regulations, 2012 CFR
2012-01-01
... the record to the Special Counsel, the Office of Personnel Management, and the employing agency for... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Hearing procedures; referring the record... PROCEDURES PRACTICES AND PROCEDURES Procedures for Original Jurisdiction Cases Removal from the Senior...
5 CFR 1201.144 - Hearing procedures; referring the record.
Code of Federal Regulations, 2011 CFR
2011-01-01
... the record to the Special Counsel, the Office of Personnel Management, and the employing agency for... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Hearing procedures; referring the record... PROCEDURES PRACTICES AND PROCEDURES Procedures for Original Jurisdiction Cases Removal from the Senior...
10 CFR 10.35 - Reconsideration of cases.
Code of Federal Regulations, 2014 CFR
2014-01-01
... DATA OR NATIONAL SECURITY INFORMATION OR AN EMPLOYMENT CLEARANCE Procedures § 10.35 Reconsideration of... Director for Corporate Management and Chief Information Officer or the Commission has made a determination... sensitivity of the Restricted Data or National Security Information to which the individual has or will have...
10 CFR 10.35 - Reconsideration of cases.
Code of Federal Regulations, 2013 CFR
2013-01-01
... DATA OR NATIONAL SECURITY INFORMATION OR AN EMPLOYMENT CLEARANCE Procedures § 10.35 Reconsideration of... Director for Corporate Management and Chief Information Officer or the Commission has made a determination... sensitivity of the Restricted Data or National Security Information to which the individual has or will have...
Organisational Learning through International M&A Integration Strategies
ERIC Educational Resources Information Center
Holland, Wayne; Salama, Alzira
2010-01-01
Purpose: The purpose of this research paper is to explore the learning process associated with international mergers and acquisitions (M&A) integration strategies. Design/methodology/approach: The paper employs a comparative case study methodology, utilising qualitative data through in-depth interviews with top management responsible for…
20 CFR 628.535 - Limitations on job search assistance.
Code of Federal Regulations, 2010 CFR
2010-04-01
.... Job search assistance is designed to give a participant skills in acquiring full time employment. (See... excluding tutoring, standalone skill assessment, counseling, work experience and case management. (See § 627... training services listed in JTPA section 204(b)(1) of the Act, excluding standalone skill assessment...
Code of Federal Regulations, 2010 CFR
2010-07-01
... seeking to employ individuals with disabilities. (5) In the case of any small business enterprise operated..., including enterprises established under the Randolph-Sheppard program, management services and supervision... and improve small business enterprises operated by individuals with significant disabilities...
Medical and nonmedical factors influencing utilization of delayed pushing in the second stage.
Frey, Heather A; Tuuli, Methodius G; Cortez, Sarah; Odibo, Anthony O; Roehl, Kimberly A; Shanks, Anthony L; Macones, George A; Cahill, Alison G
2013-08-01
To evaluate factors impacting selection to delayed pushing in the second stage of labor. This case-control study was a secondary analysis of a large retrospective cohort study. Cases included women who delayed pushing for 60 minutes or more in the second stage of labor. Controls began pushing prior to 60 minutes from the time of diagnosis of complete dilation. Demographic, labor, and nonmedical factors were compared among cases and controls. Logistic regression modeling was used to identify factors independently associated with delayed pushing. We identified 471 women who delayed pushing and 4819 controls. Nulliparity, maternal body mass index > 25, high fetal station at complete dilation, regional anesthesia use, and start of second stage during staffing shift change were independent factors associated with increased use of delayed pushing. On the other hand, black race and second-stage management during night shift were associated with lower odds of employing delayed pushing. Delayed pushing was more commonly employed in nulliparous women, but 38.9% of multiparous women also delayed pushing. We identified multiple factors associated with use of delayed pushing. This study helps to define current patterns of second-stage labor management. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Medical and Non-Medical Factors Influencing Utilization of Delayed Pushing in the Second Stage
FREY, Heather A.; TUULI, Methodius G.; CORTEZ, Sarah; ODIBO, Anthony O.; ROEHL, Kimberly A.; SHANKS, Anthony L.; MACONES, George A.; CAHILL, Alison G.
2014-01-01
Objective To evaluate factors impacting selection to delayed pushing in the second stage of labor. Study design This case-control study was a secondary analysis of a large retrospective cohort study. Cases included women who delayed pushing for 60 minutes or more in the second stage of labor. Controls began pushing prior to 60 minutes from the time of diagnosis of complete dilation. Demographic, labor, and nonmedical factors were compared among cases and controls. Logistic regression modelling was used to identify factors independently associated with delayed pushing. Results We identified 471 women who delayed pushing and 4,819 controls. Nulliparity, maternal body mass index > 25, high fetal station at complete dilation, regional anesthesia use, and start of second stage during staffing shift change were independent factors associated with increased use of delayed pushing. On the other hand, black race and second stage management during night shift were associated with lower odds of employing delayed pushing. Delayed pushing was more commonly employed in nulliparous women, but 38.9% of multiparous women also delayed pushing. Conclusion We identified multiple factors associated with use of delayed pushing. This study helps to define current patterns of second stage labor management. PMID:23208765
Woods, Jason B.; Lowery, Nicholas J.; Burns, Patrick R.
2012-01-01
Managing complications after attempted hind foot and ankle arthrodesis with intramedullary nail fixation is a challenge. This situation becomes more problematic in the patient with diabetes mellitus and multiple comorbidities. Infection and subsequent osteomyelitis can be a devastating, limb threatening complication associated with these procedures. The surgeon must manage both the infectious process and the skeletal instability concurrently. This article provides a literature review and detailed management strategies for a modified technique of employing antibiotic impregnated polymethylmethacrylate-coated intramedullary nailing. PMID:22396833
Corazzini, Kirsten
2003-01-01
Objective To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. Data Sources/Study Setting Primary data collected on 355 case managers and 26 agency directors employed in June 1999 by 26 of the 27 regional agencies administering the Massachusetts Home Care Program for low-income elders. Study Design Data were collected in a cross-sectional survey study design. A case manager survey included measures of work environment, demographics, and factorial survey vignette clients (N=2,054), for which case managers assessed service eligibility levels. An agency director survey included measures of management practices. Data Collection/Extraction Methods Hierarchical linear models estimated the effects of work environment on the relationship between client receipt of Medicare home health care and care plan levels while controlling for case-mix differences in agencies' clients. Principal Findings Case managers did not supplement extant Medicare home health services, but did allocate more generous service plans to clients who have had Medicare home health care services recently terminated. This finding persisted when controlling for case mix and did not vary by work environment. Work environment affected overall care plan levels. Conclusions Study findings indicate systematic patterns of frontline resource allocation shaping the relationships among community-based long-term care payment sources. Further, results illustrate how nonuniform implementation of upper-level initiatives may be partially attributed to work environment characteristics. PMID:14596390
Fifteen minute consultation: Practical pain management in paediatric palliative care.
Harrop, Emily Jane; Brombley, Karen; Boyce, Katherine
2017-10-01
Pain and distress in the paediatric palliative care population can be very difficult to manage. Clinical scenarios range from the acute management of cancer-related pain at the end of life to the ongoing long-term support of children with complex multimodal pain related to progressive neurological conditions. Understanding the child's underlying condition, possible causes of pain and their preferred mode of communication are important to the delivery of holistic care. Modification of environmental factors, basic care consideration and non-pharmacological measures have a large role to play, alongside conventional analgesics. Medication may also need to be delivered by novel routes such as transdermal patches, continuous subcutaneous infusion of multiple drugs or transmucosal breakthrough analgesic doses. Two cases are used to illustrate approaches to these clinical problems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Garthwaite, Mary A E; Johnson, G; Lloyd, S; Eardley, I
2007-11-01
Acute epididymo-orchitis is a common and increasing problem. This retrospective study reviewed whether the European Association of Urology guidelines for the management of acute epididymo-orchitis, which form the basis of this Trust's present inter-departmental guidelines, are being effectively implemented. Case notes of 53 patients attending the emergency department with acute epididymo-orchitis over a 6-month period were reviewed retrospectively. The hospital results' database was used to confirm the diagnostic tests requested on patients at the time of their initial presentation. Of the study cohort, 26 patients were aged = 35 years and 27 patients were aged > 35 years. The results demonstrated that a sexual history was documented in only 43.4% of cases. A mid-stream urine sample was sent for routine culture in 54.7% of cases whilst urine for the Chlamydia polymerase chain reaction (PCR) test was obtained in 17% and a urethral swab performed in 5.6%. Antibiotics were prescribed in 81% of cases. Of these patients, 46.5% received ciprofloxacin alone (mean age, 52 years; range, 18-87 years), 25.5% received doxycycline alone (mean age, 30 years; range, 18-45 years) and 21% received both ciprofloxacin and doxycycline (mean age, 33 years; range 18-49 years). In 26.4% of cases, verbal advice to attend a genito-urinary medicine clinic was given, whilst a formal telephone referral was made in only one case. Formal urological follow-up was arranged for only three out of 11 patients aged > 50 years. Although a joint emergency department/urology clinical protocol for the investigation and treatment of acute epididymo-orchitis already exists within the Trust, our current management conforms to this in only a minority of cases. Many different strategies can be employed in the implementation of clinical practice guidelines and all are associated with variable degrees of success. The regular movement of junior staff through each department necessitates that the distribution of management protocols and guidelines occurs at frequent intervals throughout the year and that their implementation is continuously monitored so that, if necessary, further implementation strategies can be employed.
Onsite clinical services in the era of managed health care.
Larkin, G N
1997-01-01
Both the employer and employee sustain an array of costs related to illness and injury. Dr. Larkin discusses evolving U.S. health care delivery models and cost designs and presents a case study demonstrating that the provision of workplace health care services can substantially reduce these costs.
Not a Dirty Word: Arts Entrepreneurship and Higher Education
ERIC Educational Resources Information Center
Bridgstock, Ruth
2013-01-01
While the majority of creative, performing and literary artists are self-employed, relatively few tertiary arts schools attempt to develop capabilities for venture creation and management (and entrepreneurship more broadly) and still fewer do so effectively. This article asks why this is the case. It addresses underlying conceptual and…
Convention Center Management: A Systems Analysis & Design Course Project
ERIC Educational Resources Information Center
Guidry, Brandi N.; Totaro, Michael W.
2011-01-01
A challenge faced by many instructors of systems analysis and design courses is the selection or development of projects that provide challenging, yet suitable, learning experiences for the students. Employing a system development project case in undergraduate MIS courses offers students a multitude of opportunities to experientially examine…
Redefining & Leading the Academic Discipline in Australian Universities
ERIC Educational Resources Information Center
Harkin, Damien G.; Healy, Annah H.
2013-01-01
Disciplines have emerged as an alternative administrative structure to departments or schools in Australian universities. We presently investigate the pattern of discipline use and by way of case study examine a role for distributed leadership in discipline management. Over forty per cent of Australian universities currently employ disciplines,…
Resourcing the Training and Development Function. IES Report.
ERIC Educational Resources Information Center
Carter, A.; Hirsh, W.; Aston, J.
A study explored current practice in organizing and resourcing training and development (T&D) using survey responses from over 100 major private and public sector employers and case studies of T&D functions in 6 organizations. Business drivers for T&D were senior management as customers; diagnosis of training as "the…
Code of Federal Regulations, 2010 CFR
2010-01-01
... OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or Career-Conditional Appointment Under Special Authorities § 315.603 Appointment based on former... type of case from this requirement. (b) Review of disapproved recommendations. Agencies shall establish...
Workplace Skills in Practice. Case Studies of Technical Work.
ERIC Educational Resources Information Center
Stasz, Cathleen; And Others
A study was conducted to explore skills and work-related dispositions in technical work. It used a sociocultural approach to examine skills in seven target jobs in worksites representing diverse industries--health care, traffic management, transportation, and semiconductor manufacturing. It explored employers' strategies for obtaining the skills…
Preparing Principals for Social Justice Leadership
ERIC Educational Resources Information Center
Baker-Martinez, Darcy
2012-01-01
The purpose of this study is to examine the experiences of social justice leaders to uncover specific leadership competencies that may inform current principal preparation programs. This study employed a qualitative multiple case study design. The three participants all shared many common strategies on how they manage the multiple forms of…
The determinants of employee participation in occupational health and safety management.
Masso, Märt
2015-01-01
This article focuses on employee direct participation in occupational health and safety (OHS) management. The article explains what determines employee opportunities to participate in OHS management. The explanatory framework focuses on safety culture and safety management at workplaces. The framework is empirically tested using Estonian cross-sectional, multilevel data of organizations and their employees. The analysis indicates that differences in employee participation in OHS management in the Estonian case could be explained by differences in OHS management practices rather than differences in safety culture. This indicates that throughout the institutional change and shift to the European model of employment relations system, change in management practices has preceded changes in safety culture which according to theoretical argument is supposed to follow culture change.
Prosthetic Tricuspid Valve Thrombosis: Three Case Reports and Literature Review
Yaminisharif, Ahmad; Alemzadeh-Ansari, Mohammad Javad; Ahmadi, Seyed Hossein
2012-01-01
A common complication of prosthetic heart valves is thrombosis. Although the incidence of prosthetic valve thrombosis (PVT) in the tricuspid position is high, there are not enough data on the management of it, in contrast to left-sided PVT. Here, we describe three cases of tricuspid PVT with three different management approaches: thrombolytic therapy; close observation with oral anticoagulants; and surgery. The first case was a woman who suffered from recurrent PVT, for which we successfully used Tenecteplase for second and third episodes. We employed Tenecteplase in this case for the first time in the therapy of tricuspid PVT. The second case had fixed leaflets in open position while being symptomless. At six months' follow-up, with the patient having taken oral anticoagulants, the motion of the leaflets was restricted and she was symptomfree. The last case was a woman who had a large thrombus in the right atrium immediately after mitral and tricuspid valvular replacement. The patient underwent re-replacement surgery and a new biological valve was implanted in the tricuspid position. Also, we review the literature on the pathology, signs and symptoms, diagnosis, and management of tricuspid PVT. PMID:23323074
Cusimano-Reaston, MaryRose; Carney, Brendan
2011-01-01
Musculoskeletal Disorders (MSD) often classified as sprains and strains to the low back, neck, shoulder or knee are the leading cost drivers in the workers compensation system. In 2009, soft tissue muscle injuries accounted for 40% of total injury cases requiring days away from work. The demand on U.S. employers to comply with all applicable mandates has exponentially increased as the regulatory landscape grows more complex evidenced by recent legislation from Equal Employment Opportunity Commission (EEOC), American With Disability Act 2.0 and Center for Medicare and Medicaid Services (CMS) Mandatory Reporting Act. Employers should revisit their return to work policies and engage in the interactive process to stay in compliance and avoid legal quagmire. EFA Soft Tissue Management (STM) is a comprehensive and compliant risk management program for objective diagnosis of work-related injuries that directs timely and proper allocation of resources to optimize injured worker (IW) outcomes. This bookend solution comparing pre- and post-loss data is a best practice to accurately determine between compensable acute workplace injury and exacerbation of a preexisting injury from chronic unrelated conditions. The EFA is an evidenced-based objective tool to assist in measuring functional status of the IW and make return to work determinations.
Mattke, Soeren; Serxner, Seth A; Zakowski, Sarah L; Jain, Arvind K; Gold, Daniel B
2009-02-01
Integrated health management programs combining disease prevention and disease management services, although popular with employers, have been insufficiently researched with respect to their effect on costs. To estimate the overall impact of a population health management program and its components on cost and utilization. STUDY DESIGN, SETTING, AND PARTICIPANTS: Observational study of 2 employer-sponsored health management programs involving more than 200,000 health plan members. We used claims data for the first program year and the 2 preceding years to calculate cost and utilization metrics, and program activity data to determine program uptake. Using an intent-to-treat approach and regression-based risk adjustment, we estimated whether the program was associated with changes in cost and utilization. Data on program fees were unavailable. Overall, the program was associated with a nonsignificant cost increase of $13.75 per member per month (PMPM). The wellness component alone was associated with a significant increase of $20.14 PMPM. Case and disease management were associated with a significant decrease in hospital admissions of 4 and 1 per 1000 patient-years, respectively. Our results suggest that the programs did not reduce medical cost in their first year, despite a beneficial effect on hospital admissions. If we had been able to include program fees, it is likely that the overall cost would have increased significantly. Although this study had important limitations, the results suggest that a belief that these programs will save money may be too optimistic and better evaluation is needed.
Wu, Shiau-Jiun; Lu, Po-Liang; Chen, Yen-Hsu; Pan, Hui-Juan; Feng, Ming-Chu
2011-12-01
The Taiwan government currently promotes a case management approach to tuberculosis (TB) treatment to address the growing number of TB and multiple drug-resistant TB cases in Taiwan. The approach aims to improve medical follow-up and monitor quality of care. The efficacy of this case management approach has yet to be evaluated. The current study was designed to evaluate the effect of individualized case manager counseling on TB patient disease knowledge, attitudes, and behavioral intention. This study employed a one-group pretest-posttest quasi-experimental design. Participants first answered an initial questionnaire survey including three structured scales that addressed, respectively, the facets of disease knowledge, attitudes, and behavioral intention. TB case managers then delivered two- stage counseling to participants based on assessed individual needs and outstanding issues identified in questionnaire answers. A second questionnaire survey was administered 30~42 days after the intervention. Data on a total of 96 TB patients were collected. Key study findings were (1) individualized counseling significantly improved TB patient disease knowledge (p < .001) and (2) TB patient attitudes correlated significantly and positively with behavior intention (p < .001). Individualized counseling provided during the early stages of TB helps elevate patient awareness of the importance of treatment, enhances compliance and increases the cure rate.
Analysis of a managed psychiatric disability program.
McCulloch, J; Ozminkowski, R J; Cuffel, B; Dunn, R L; Goldman, W; Kelleher, D; Comporato, A
2001-02-01
The cost of mental illness to employers has been well documented; however, efforts to effectively reduce the costs of psychiatric disability are adversely affected by the fragmentation of health care services. This report is a case study of a program in which a managed behavioral health care organization managed the psychiatric disability of a telecommunications company. Compared with a non-random cohort of claimants not managed under the pilot, the duration of disability was reduced by 23% (17.1 days). Patient and provider satisfaction with the program was high. This study illustrates the potential for effectively reducing the cost of psychiatric disability and the challenges in coordinating health care.
Chemotherapy-induced anemia and oncologist perception on treatment: results of a web-based survey.
Cortinovis, Diego; Beretta, Giordano; Piazza, Elena; Luchena, Giovanna; Aglione, Stefania; Bertolini, Alessandro; Buzzoni, Roberto; Cabiddu, Mary; Carnaghi, Carlo; Danova, Marco; Farina, Gabriella; Ferrari, Vittorio; Frascaroli, Mara; Reni, Michele; Tansini, Giuseppe
2013-01-01
Anemia prevalence and incidence in chemotherapy-treated patients is high. Erythropoiesis-stimulating agents (ESAs) are frequently employed in the management of chemotherapy-induced anemia. However, other treatments such as red blood transfusion or iron supplementation are normally used. Recent international guidelines raised some concern about ESAs employment with a possible impact in chemotherapy-induced anemia management and changes in clinical practice behavior. To evaluate opinions about chemotherapy-induced anemia clinical management preference, the Associazione Italiana Oncologia Medica (AIOM) Lombardy section coordinators sent via email a 12-item questionnaire about their knowledge on CIA and usual therapeutic strategies to manage this adverse event to AIOM Lombardy onco-hematologist members. From January 2011 to March 2011, 81 questionnaires were collected with an approximated share of 30%. The survey was completed mainly by oncologists (91%) aged 35-50 years (50%). Chemotherapy-induced anemia was considered to have clinical impact in changing cancer therapeutic strategy by nearly 60% of the respondents. ESAs were administered largely (80%) with concomitant iron supplementation in 52%; 38% jointly used blood transfusion as part of the therapy. Nearly 20% of those who replied correctly employed transferrin saturation levels as a marker to guide iron supplementation. Physician prescribers strictly followed the guidelines to start and stop ESAs even if 14% were negatively influenced by new ASCO recommendations. ESA biosimilars were considered future substitutes of originators in 45% of the cases. Chemotherapy-induced anemia was perceived as an adverse event with a mild impact on clinical practice. ESAs were largely employed, however the number of transfusions and lack of employment of markers of iron depletion suggested that adherence to guidelines could be theoretically met but with some discordances regarding the most appropriate strategies in daily clinical practice.
Health-related quality of life and satisfaction with case management in cancer survivors.
Hsu, Ya-Hui; Chai, Hsiu-Ying; Lin, Yu-Fen; Wang, Chao-Hui; Chen, Shu-Ching
2017-12-01
To (i) investigate the characteristics of health-related quality of life and satisfaction with case management and (ii) to identify factors associated with health-related quality of life in cancer survivors. The level of health-related quality of life can reflect treatment efficacy and satisfaction with cancer care. A cross-sectional study design was adopted. Subjects from the outpatient setting of a cancer centre in northern Taiwan were recruited by consecutive sampling. A set of questionnaires were employed, including a background information form, case management service satisfaction survey (CMSS) and The European Quality of Life Scale (EQ-5D). Descriptive statistics were used to examine levels of health-related quality of life and satisfaction with case management. Pearson's correlation was used to identify relationships between treatment characteristics, satisfaction with case management and health-related quality of life. Multiple stepwise regression was used to identify factors associated with health-related quality of life. A total of 252 cancer patients were recruited. The three lowest scores for items of health-related quality of life were mobility, self-care and usual activities. Cancer survivors with higher mobility, less pain and discomfort, and lower anxiety and depression were more likely to have better health-related quality of life. Mobility, pain and discomfort, and anxiety and depression are important predictive factors of high health-related quality of life in cancer survivors. In clinical care, patients' physical mobility, pain and discomfort, and anxiety and depression are important indicators of health-related quality of life. Case managers should include self-care and symptom management into survivorship care plans to improve health-related quality of life during survival after treatment concludes. © 2017 John Wiley & Sons Ltd.
Participative management in health care services.
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.
[Gastric band erosion: Alternative management].
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.
Firing without fear. Heading off litigation in employee terminations.
Elliott, C L; Kaiser, G
1989-03-01
Under most state laws, employee handbooks carry the status of employment contracts, or such contracts are implied through various employment conversations. Unlike in the past, when a management decision to discharge an employee could be challenged only for statutory or public policy reasons, today's employer may have to prove that he or she did not violate an employee's contractual right to employment. Employers can reduce the risk of employment liability through practical steps such as careful monitoring and documenting of the hiring, performance appraisal, and disciplinary processes, and a credible grievance procedure. Many employers have found, however, that taking these steps does not always prevent litigation. Certain legal precautions, such as written disclaimers and other handbook revisions, can result in the dismissal of such actions before trial and will deter many plaintiffs' attorneys from taking the case. The strongest legal protection in termination situations is a release of all claims executed by the employee and supported by severance pay or other valuable consideration to which the employee would not be otherwise entitled.
7 CFR 1717.1204 - Policies and conditions applicable to settlements.
Code of Federal Regulations, 2014 CFR
2014-01-01
... debt settlement. The employment could be on a temporary basis to manage the system during the time the... actions taken, in progress, or planned by the borrower (and its member systems, if applicable) to take... those of its member systems in the case of a power supply borrower. The following conditions will apply...
7 CFR 1717.1204 - Policies and conditions applicable to settlements.
Code of Federal Regulations, 2012 CFR
2012-01-01
... debt settlement. The employment could be on a temporary basis to manage the system during the time the... actions taken, in progress, or planned by the borrower (and its member systems, if applicable) to take... those of its member systems in the case of a power supply borrower. The following conditions will apply...
ERIC Educational Resources Information Center
Ashburner, Jill K.; Bobir, Natasha I.; van Dooren, Kate
2018-01-01
After leaving school, young people with autism spectrum disorder often struggle with social, educational and employment participation. A post-school transition programme underpinned by individualised case management, where mentees are guided to complete self-selected projects by mentors with multimedia skills, was evaluated using a qualitative…
ERIC Educational Resources Information Center
Denton, Edward A.
2011-01-01
Increased uses of educational technology by students and teachers in recent years have compelled elementary principals to expand educational technology resources and replace educational technology resources at the end of it's service life. The purpose of this study was to investigate strategies and practices employed by elementary principals…
ERIC Educational Resources Information Center
Karky, Nandini
2013-01-01
A qualitative inquiry into the presence of international students in an Indian Technical University, through the voices of the faculty, who are appointed as international students' counselors. A case study methodology was employed with document analysis and interviews to perceive how technical faculty managed students from varying cultural…
SUCCESS Program Planning/Evaluation Report for 1992-93. Focus on Program Evaluation.
ERIC Educational Resources Information Center
Sallade, Ronald; Erickson, Cynthia L.
To address the needs of at-risk children, Project SUCCESS of the Des Moines (Iowa) public schools provides employment, health, mental health, and social services in a comprehensive one-stop shopping manner at public schools. Coordinated services are provided through direct provision of services, case management, and referral as appropriate. The…
Matching Applicants with Services: Initial Assessments in the Milwaukee County W-2 Program.
ERIC Educational Resources Information Center
Gooden, Susan; Doolittle, Fred; Glispie, Ben
The initial client assessment procedures used by case managers in the Wisconsin Works (W-2) program in Milwaukee County, Wisconsin, were examined. Data were collected through the following activities: (1) observations of 100 financial and employment planner (FEP)-applicant intake interviews; (2) an examination of administrative data to learn how…
38 CFR 21.344 - Facility offering training or rehabilitation services.
Code of Federal Regulations, 2011 CFR
2011-07-01
... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.344 Facility offering training or rehabilitation services. (a) Approval of leaves of absence required. Leaves of absence normally must be approved... facility. (c) Conditions permitting approval of leaves of absence. (1) The case manager may approve leaves...
38 CFR 21.344 - Facility offering training or rehabilitation services.
Code of Federal Regulations, 2013 CFR
2013-07-01
... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.344 Facility offering training or rehabilitation services. (a) Approval of leaves of absence required. Leaves of absence normally must be approved... facility. (c) Conditions permitting approval of leaves of absence. (1) The case manager may approve leaves...
38 CFR 21.344 - Facility offering training or rehabilitation services.
Code of Federal Regulations, 2012 CFR
2012-07-01
... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.344 Facility offering training or rehabilitation services. (a) Approval of leaves of absence required. Leaves of absence normally must be approved... facility. (c) Conditions permitting approval of leaves of absence. (1) The case manager may approve leaves...
38 CFR 21.344 - Facility offering training or rehabilitation services.
Code of Federal Regulations, 2014 CFR
2014-07-01
... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.344 Facility offering training or rehabilitation services. (a) Approval of leaves of absence required. Leaves of absence normally must be approved... facility. (c) Conditions permitting approval of leaves of absence. (1) The case manager may approve leaves...
38 CFR 21.344 - Facility offering training or rehabilitation services.
Code of Federal Regulations, 2010 CFR
2010-07-01
... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.344 Facility offering training or rehabilitation services. (a) Approval of leaves of absence required. Leaves of absence normally must be approved... facility. (c) Conditions permitting approval of leaves of absence. (1) The case manager may approve leaves...
Return to work: a case of PTSD, dissociative identity disorder, and satanic ritual abuse.
Precin, Patricia
2011-01-01
This case study investigated an intervention that enabled an individual with Posttraumatic Stress Disorder (PTSD), Dissociative Identity Disorder (DID), and satanic ritual abuse to return to work after discharge from psychiatric inpatient treatment. The Occupational Questionnaire [88] revealed past difficulties in organization, awareness of time, communication, cooperation, frustration tolerance, competition, stress management, goal setting, and amnesia resulting in incomplete tasks and sporadic attendance at work. The Role Checklist [72] identified alters valuing work and employed in the past. The Modified Interest Checklist [70] identified running as an interest that 24 alters shared. Based on the initial evaluations, three times a week treadmill running was used as an intervention that built work skills (as measured by the Clerical Work Sample of the Valpar Component Work Sample Series [97]) necessary to sustain gainful employment upon discharge. After intervention, this individual improved in awareness of time, stress management, and goal setting abilities and was less amnestic as per the Occupational Questionnaire [88] and four additional alters expressed an interest in work according to the Modified Interest Checklist [70].
Increase Return on Investment of Software Development Life Cycle by Managing the Risk - A Case Study
2015-04-01
for increasing the return on investment during the Software Development Life Cycle ( SDLC ) through selected quantitative analyses employing both the...defect rate, return on investment (ROI), software development life cycle ( SDLC ) DE FE N SE A C Q U IS IT IO N UN IVERSITY ALU M N I A SSO C IATIO N R...becomes comfortable due to its intricacies and learning cycle. The same may be said with respect to software development life cycle ( SDLC ) management
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.
Trends in Management of Intracranial Meningiomas: Analysis of 49,921 Cases from Modern Cohort.
Agarwal, Vijay; McCutcheon, Brandon A; Hughes, Joshua D; Carlson, Matthew L; Glasgow, Amy E; Habermann, Elizabeth B; Nguyen, Quoc-Bao; Link, Michael J; Van Gompel, Jamie J
2017-10-01
We sought to characterize patterns and treatment for intracranial meningiomas in the Surveillance, Epidemiology, and End Results set of cancer registries. SEER data was queried from 2004-2012 for cases of intracranial meningioma using appropriate topography and histology codes. A total of 49,921 patients with intracranial meningioma were identified. The vast majority of cases were associated with a benign histology (n = 47,047, 94.2%). There were 21,145 patients (42.4%) who underwent surgical management, 2783 who received radiation alone (5.6%), and 25,993 who underwent surveillance only (52.1%). Surgical management decreased in frequency from 48.8% of all cases in 2004 to 38.3% of cases in 2012 (P < 0.001). Radiation alone remained stable over time with a range of 4.8%-6.3% of cases. Observation increased from 45.0% of cases in 2004 to 56.7% of cases in 2012 (P < 0.001). On unadjusted analysis, surgical management was associated with younger age and larger tumor size. The incidence of tumors <2 cm in size increased significantly over the study period from 29.7% in 2004 to 41.7% in 2012 (P < 0.001). After adjusting for tumor size, multivariable analysis demonstrated that the odds of observation as a primary management strategy were greater in 2012 relative to 2004 (odds ratio 1.33, 95% confidence interval 1.21-1.45). The incidence of intracranial meningiomas increased, while tumor size at the time of diagnosis decreased. Moreover, the number undergoing no treatment increased as a treatment strategy and was more likely employed for older patients, those of African-American race, and those with smaller tumors. Copyright © 2017 Elsevier Inc. All rights reserved.
Demou, Evangelia; Brown, Judith; Sanati, Kaveh; Kennedy, Mark; Murray, Keith; Macdonald, Ewan B
2015-01-01
Sickness absence (SA) is multi-causal and remains a significant problem for employees, employers and society. This makes it necessary to concurrently manage a particular disabling condition and consider the working environment and employee-employer relationship. To describe and examine the components of a novel SA management service Early Access to Support for You (EASY) and discuss their potential influence on the intervention. A new sickness absence model, starting from day one of absence, was created called EASY. EASY is planned to support both employees and managers and comprises elements already found to be associated with reduction of SA, such as maintaining regular contact; early biopsychosocial case-management; physiotherapy; mental-health counselling; work modification; phased return-to-work; and health promotion activities. During the EASY implementation period, the SA rate at a health board reversed its trend of being one of the highest rates in the Scottish National Health Service (NHS) and EASY was considered helpful by both managers and employees. This paper describes an innovative occupational health intervention to sickness absence management based on the bio-psychosocial model to provide early intervention, and discusses the pros and cons of applying cognitive behavioural principles at an early stage in sickness-absence events, in order to improve return-to-work outcomes.
Simulation validation and management
NASA Astrophysics Data System (ADS)
Illgen, John D.
1995-06-01
Illgen Simulation Technologies, Inc., has been working interactive verification and validation programs for the past six years. As a result, they have evolved a methodology that has been adopted and successfully implemented by a number of different verification and validation programs. This methodology employs a unique case of computer-assisted software engineering (CASE) tools to reverse engineer source code and produce analytical outputs (flow charts and tables) that aid the engineer/analyst in the verification and validation process. We have found that the use of CASE tools saves time,which equate to improvements in both schedule and cost. This paper will describe the ISTI-developed methodology and how CASe tools are used in its support. Case studies will be discussed.
Atighechian, Golrokh; Maleki, Mohammadreza; Aryankhesal, Aidin; Jahangiri, Katayoun
2016-07-24
Oil spill in fresh water can affect ecological processes and accordingly it can influence human health. Iran, due to having 58.8 % of the world oil reserves, is highly vulnerable to water contamination by oil products. The aim of this study was to determine environmental factors affecting the management of the oil spill into one of the river in Iran using the PESTLE analysis. This was a qualitative case study conducted in 2015 on an oil spill incident in Iran and its roots from a disaster management approach. Semi-structured interviews were conducted for data collection. Seventy managers and staffs with those responsible or involved in oil spill incident management were recruited to the study. Qualitative content analysis approach was employed for the data analysis. Document analysis was used to collect additional information. Findings of the present study indicated that different factors affected the management of the event of oil spill onto one of the central river and consequently the management of drink water resources. Using this analysis, managers can plan for such events and develop scenarios for them to have better performance for the future events.
Atighechian, Golrokh; Maleki, Mohammadreza; Aryankhesal, Aidin; Jahangiri, Katayoun
2016-01-01
Introduction: Oil spill in fresh water can affect ecological processes and accordingly it can influence human health. Iran, due to having 58.8 % of the world oil reserves, is highly vulnerable to water contamination by oil products. Aim: The aim of this study was to determine environmental factors affecting the management of the oil spill into one of the river in Iran using the PESTLE analysis. Material and methods: This was a qualitative case study conducted in 2015 on an oil spill incident in Iran and its roots from a disaster management approach. Semi-structured interviews were conducted for data collection. Seventy managers and staffs with those responsible or involved in oil spill incident management were recruited to the study. Qualitative content analysis approach was employed for the data analysis. Document analysis was used to collect additional information. Results: Findings of the present study indicated that different factors affected the management of the event of oil spill onto one of the central river and consequently the management of drink water resources. Using this analysis, managers can plan for such events and develop scenarios for them to have better performance for the future events. PMID:27698608
Barriers to community case management of malaria in Saraya, Senegal: training, and supply-chains.
Blanas, Demetri A; Ndiaye, Youssoupha; Nichols, Kim; Jensen, Andrew; Siddiqui, Ammar; Hennig, Nils
2013-03-14
Health workers in sub-Saharan Africa can now diagnose and treat malaria in the field, using rapid diagnostic tests and artemisinin-based combination therapy in areas without microscopy and widespread resistance to previously effective drugs. This study evaluates communities' perceptions of a new community case management of malaria programme in the district of Saraya, south-eastern Senegal, the effectiveness of lay health worker trainings, and the availability of rapid diagnostic tests and artemisinin-based combination therapy in the field. The study employed qualitative and quantitative methods including focus groups with villagers, and pre- and post-training questionnaires with lay health workers. Communities approved of the community case management programme, but expressed concern about other general barriers to care, particularly transportation challenges. Most lay health workers acquired important skills, but a sizeable minority did not understand the rapid diagnostic test algorithm and were not able to correctly prescribe arteminisin-based combination therapy soon after the training. Further, few women lay health workers participated in the programme. Finally, the study identified stock-outs of rapid tests and anti-malaria medication products in over half of the programme sites two months after the start of the programme, thought due to a regional shortage. This study identified barriers to implementation of the community case management of malaria programme in Saraya that include lay health worker training, low numbers of women participants, and generalized stock-outs. These barriers warrant investigation into possible solutions of relevance to community case management generally.
Schnall, Rebecca; Smith, Ann B; Sikka, Manik; Gordon, Peter; Camhi, Eli; Kanter, Timothy; Bakken, Suzanne
2012-10-01
Case managers facilitate continuity of care for persons living with HIV (PLWH) by coordination of resources and referrals to social services and medical care. The complexity of HIV care and associated comorbidities drives the need for medical and psychosocial care coordination, which may be achieved through health information exchange (HIE) systems. However, the use of HIE has not been well studied in the context of HIV services. The purpose of this descriptive qualitative study is to explore factors influencing case managers' adoption of electronic clinical data (ECD) summaries as an HIE strategy in HIV care through application of the "fit between individuals, task and technology" (FITT) framework. Focus group methodology was used to gather perceptions from 48 participants who provided direct case management services for PLWH in New York City. Questions addressed current quality and efficiency challenges to HIE utilization in the context of case management of PLWH as well as barriers and enablers to use of an ECD summary. Analysis of the data was guided by the FITT framework. Major themes by interaction type were: (1) task-technology fit - resources, time and workflow; (2) individual-task fit - training and technical support; and 3) individual-technology fit - ECD summary functionality, technical difficulties and the need of a computer for each end-user. Our findings provide evidence for the applicability of the FITT framework to explore case managers' perceptions of factors influencing the adoption of ECD summary systems for HIV care prior to actual implementation. Assessment of fit among individual, task, and technology and addressing the concerns identified prior to implementation is critical to successful adoption of health information technology as a strategy to improve quality and efficiency in health care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Tai, Alex Y C; Easton, Marion; Encena, Jess; Rotty, Jessica; Valcanis, Mary; Howden, Benjamin P; Slota-Kan, Simon; Gregory, Joy
2016-12-01
To review the national case definition for shigellosis following the introduction of culture independent diagnostic testing by clinical laboratories and provide evidence to reform jurisdictional public health practices for the management shigellosis., . A review of all Australian jurisdictional public health guidelines for shigellosis was conducted. Victorian 2014 shigellosis data were analysed: demographics and risk factors for cases identified by conventional culture or culture-independent diagnostic methods were described. There was considerable variation in reporting of cases to the National Notifiable Disease Surveillance System (NNDSS) by the eight Australian jurisdictions, with an array of classifications based on diagnostic testing methodologies. Analysis of Victorian 2014 shigellosis data found that culture positive cases were more likely to have reported men who have sex with men (MSM) as a risk factor than PCR positive only cases (p<0.0001) and less likely to have reported overseas travel during their incubation period (p<0.0001). Over a 10-year period (2005 to 2014), only two of 86 cases who were employed in high-risk occupations had ongoing positive faecal cultures after appropriate treatment. The national surveillance case definition for shigellosis should be reviewed to facilitate standardised reporting across Australia. All jurisdictions must consider the public health significance of PCR positive only results in their surveillance risk assessments to inform management of shigellosis cases. © 2016 Public Health Association of Australia.
Pransky, Glenn; Shaw, William; Franche, Renee-Louise; Clarke, Andrew
2004-06-03
To review prevailing models of disability management and prevention with respect to communication, and to suggest alternative approaches. Review of selected articles. Effective disability management and return to work strategies have been the focus of an increasing number of intervention programmes and associated research studies, spanning a variety of worker populations and provider and business perspectives. Although primary and secondary disability prevention approaches have addressed theoretical basis, methods and costs, few identify communication as a key factor influencing disability outcomes. Four prevailing models of disability management and prevention (medical model, physical rehabilitation model, job-match model, and managed care model) are identified. The medical model emphasizes the physician's role to define functional limitations and job restrictions. In the physical rehabilitation model, rehabilitation professionals communicate the importance of exercise and muscle reconditioning for resuming normal work activities. The job-match model relies on the ability of employers to accurately communicate physical job requirements. The managed care model focuses on dissemination of acceptable standards for medical treatment and duration of work absence, and interventions by case managers when these standards are exceeded. Despite contrary evidence for many health impairments, these models share a common assumption that medical disability outcomes are highly predictable and unaffected by either individual or contextual factors. As a result, communication is often authoritative and unidirectional, with workers and employers in a passive role. Improvements in communication may be responsible for successes across a variety of new interventions. Communication-based interventions may further improve disability outcomes, reduce adversarial relationships, and prove cost-effective; however, controlled trials are needed.
NASA Astrophysics Data System (ADS)
Ssegawa, Joseph K.; Kasule, Daniel
2017-09-01
The article provides a self-assessment by final-year engineering students at the University of Botswana regarding the propensity to get employment. Students rated which employability attributes are important, the level of attainment and the sources that have facilitated the development of the attributes. Results indicated that students identified the most important attributes as management of time; possessing a high level of technical skills, meeting deadlines and creating viable solutions for solving a problem. They also indicated that they have weaknesses in managing time, meeting deadlines and creating viable solutions (attributes critical to the engineering profession). Students reported that their strengths were in having a positive attitude, orderly physical presentation, adaptation to new environments and willingness to learn new ideas. Students further noted that they developed the attributes from the university academic system followed by their own private activities. The study concludes that students lacked some of the critical attributes of engineering. They therefore, need to be explicitly and holistically sensitised as to how the attributes relate to their profession, employment and career development. As part of the review of the engineering programmes, sensitisation could be included in the induction process at enrolment.
Liu, Wen-I; Rong, Jiin-Ru; Liu, Chieh-Yu
2014-11-01
E-learning is a flexible strategy to improve nurses' knowledge of case management, but there are methodological limitations in previous research into the effectiveness of such programs. To describe the development and effectiveness of an evidence-integrated e-learning program in case management continuing education for Taiwanese psychiatric nurses. Multiple methods were adopted to develop the program and a randomised controlled trial with repeated measures was employed to evaluate it. The e-learning program was developed in four stages: (1) systematic review of literature; (2) needs assessment through a national survey and focus group; (3) development of learning materials; and (4) pilot test. Following program development, psychiatric nurses were recruited and randomly allocated into an experimental or comparison group. The experimental group participated in an e-learning continuing education program. The case management knowledge index with sufficient reliability and validity and a satisfaction survey were used to determine the outcomes. A generalised estimating equation was used to assess the difference between the 2 groups before, after, and at 3 months follow-up. The learning material comprised 5 simulated learning modules, self-assessment questions, learning cases, sharing experiences, and learning resources. A total of 200 participants completed the 3 measurements. Knowledge scores in the experimental group significantly exceeded those in the comparison group after the program and at the 3-month follow-up. Participants reported positive learning perceptions. The program provides an evidence-based educational resource for nursing continuing education in case management. Copyright © 2014 Elsevier Ltd. All rights reserved.
Code of Federal Regulations, 2010 CFR
2010-07-01
... Employment (VR&E) Officer's review of program costs. The VR&E Officer will review the program costs for the... for a calendar year exceeds $25,000. The VR&E Officer may not delegate this responsibility. The case manager will neither sign a rehabilitation plan nor authorize expenditures before the VR&E Officer...
Managing Heuristics as a Method of Inquiry in Autobiographical Graphic Design Theses
ERIC Educational Resources Information Center
Ings, Welby
2011-01-01
This article draws on case studies undertaken in postgraduate research at AUT University, Auckland. It seeks to address a number of issues related to heuristic inquiries employed by graphic design students who use autobiographical approaches when developing research-based theses. For this type of thesis, heuristics as a system of inquiry may…
A Case Study to Explore the Impact of Knowledge Management Systems on Workplace Diversity Programs
ERIC Educational Resources Information Center
Gautier, Michael
2012-01-01
The ongoing debate over the definition and application of workplace diversity policies results in a wide range of viewpoints. There are a number of theoreticians who feel that if diversity is more than avoidance of discrimination, that the traditional body of anti-discrimination programs such as the Equal Employment Opportunity (EEO) efforts…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-29
... for Children and Families. SUMMARY: The Office of Refugee Resettlement (ORR) announces the award of a... grantee to provide cash and medical assistance to arriving refugees and others who are also eligible for... medical) and services (employment, case- management, ESL and other social services) to refugees, asylees...
Code of Federal Regulations, 2014 CFR
2014-07-01
... Employment (VR&E) Officer's review of program costs. The VR&E Officer will review the program costs for the... for a calendar year exceeds $25,000. The VR&E Officer may not delegate this responsibility. The case manager will neither sign a rehabilitation plan nor authorize expenditures before the VR&E Officer...
Code of Federal Regulations, 2012 CFR
2012-07-01
... Employment (VR&E) Officer's review of program costs. The VR&E Officer will review the program costs for the... for a calendar year exceeds $25,000. The VR&E Officer may not delegate this responsibility. The case manager will neither sign a rehabilitation plan nor authorize expenditures before the VR&E Officer...
Code of Federal Regulations, 2013 CFR
2013-07-01
... Employment (VR&E) Officer's review of program costs. The VR&E Officer will review the program costs for the... for a calendar year exceeds $25,000. The VR&E Officer may not delegate this responsibility. The case manager will neither sign a rehabilitation plan nor authorize expenditures before the VR&E Officer...
Silviculture and multi-resource management case studies for southwestern pinyon-juniper woodlands
Gerald J. Gottfried
2008-01-01
Southwestern pinyon-juniper and juniper woodlands cover large areas of the Western United States. The woodlands are heterogeneous, consisting of numerous combinations of tree, shrub, and herbaceous species and stand densities that are representative of the wide range of sites and habitat types they occupy. Silvicultural methods can be employed on better sites to meet...
States Facing Fiscal Strain of Pensions: Obligations to Teachers May Outpace Assets
ERIC Educational Resources Information Center
Hoff, David J.
2005-01-01
Although the rules for public-employee pension funds vary, they operate under the same guidelines. Throughout their careers, teachers and other state and local employees contribute portions of their salaries into retirement funds managed by states and municipalities. In almost all cases, the employers also pitch in a percentage of the employees'…
ERIC Educational Resources Information Center
Gross, Jeff; Ntagengwa, Christine
2016-01-01
For refugee households, stable child-care arrangements are a key underpinning of working parents' employment success and family self-sufficiency, and thus an important goal of refugee case management. Given the well-documented impact of early learning services on children's school readiness and long-term cognitive, socioemotional, and educational…
ERIC Educational Resources Information Center
Rocha, Magda
2015-01-01
The basis for this longitudinal study was to find the predictors of transferable skills acquisition and portability among university sophomore students. The method employed was the path analysis using as variables: (1) the theoretical framework of transferable skills representations (Evers and Rush in "Manag Learn" 27(4):275-300, 1996;…
Snakebites in Africa and Europe: a military perspective and update for contemporary operations.
Wilkins, Daniel; Burns, D S; Wilson, D; Warrell, D A; Lamb, L E M
2018-04-05
Snakebite envenoming is rare among military patients, with few cases reported in recent years. Increasingly, however, military operations are taking place in remote parts of Africa, which are inhabited by numerous species of venomous snake, and in Europe, where dangerous species exist but are less common. Bites from a venomous snake may prove fatal, and therefore military medics must be adequately prepared to manage them. This paper reviews the most medically significant species of venomous snake present in Africa and Europe, before suggesting an evidence-based approach to snakebite prevention and management, including possible changes to the UK's Clinical Guidelines for Operations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
[The role of percutaneous renal biopsy in kidney transplant].
Manfro, R C; Lee, J Y; Lewgoy, J; Edelweiss, M I; Gonçalves, L F; Prompt, C A
1994-01-01
Percutaneous renal biopsy (PRB) is an useful tool for diagnostic and therapeutic orientation in renal transplantation. PURPOSE--To evaluate the current role of PRB in post-transplant acute renal dysfunction (ARD) of renal allografts. METHODS--Sixty-five renal transplant patients were submitted to 95 valid renal biopsies with no major complications. RESULTS--There was disagreement between the clinical and the pathological diagnosis in 28 occasions (29.5%). In 36 cases (37.9%) the results of the pathological examination led to a modification in patient's management. These modifications were most commonly the avoidance or witholding of a steroid pulse (8 cases); nephrectomy of the renal allograft (8 cases); witholding or decrease of cyclosporine dosage (6 cases); giving a steroid pulse (5 cases) and giving antibiotics to treat acute pyelonephritis in 4 cases. The use of kidneys from cadaveric donors was significantly associated with an increased number of biopsies (p < 0.05). CONCLUSION--These results demonstrate that even though several less invasive procedures are currently employed, renal biopsy is still an indispensable method to the management of ARD in renal transplant patients.
Attitudes of US neurologists concerning the ethical dimensions of managed care.
Bernat, J L; Ringel, S P; Vickrey, B G; Keran, C
1997-07-01
We surveyed attitudes of US neurologists about the ethical dimensions of managed care by administering a written instrument containing paradigmatic cases portraying conflicts of physicians, patients, and managed care organizations (MCOs). After each case, we assessed neurologists' attitudes by asking them their degree of agreement with a series of statements. We found that neurologists (1) generally were willing to follow clinical practice guidelines if they were created by medical societies; (2) experienced frequent conflicts of interest or conflicts of obligation in the care of their MCO patients; (3) feared legal ramifications of their clinical decisions on MCO patients; (4) were unwilling to employ deception or gaming to achieve what they perceived to be good patient care; (5) believed that their professional prerogatives and autonomy were under attack by MCOs; and (6) felt that the good of their patients should not be sacrificed for the good of society.
Implementation of behavioral health interventions in real world scenarios: Managing complex change.
Clark, Khaya D; Miller, Benjamin F; Green, Larry A; de Gruy, Frank V; Davis, Melinda; Cohen, Deborah J
2017-03-01
A practice embarks on a radical reformulation of how care is designed and delivered when it decides to integrate medical and behavioral health care for its patients and success depends on managing complex change in a complex system. We examined the ways change is managed when integrating behavioral health and medical care. Observational cross-case comparative study of 19 primary care and community mental health practices. We collected mixed methods data through practice surveys, observation, and semistructured interviews. We analyzed data using a data-driven, emergent approach. The change management strategies that leadership employed to manage the changes of integrating behavioral health and medical care included: (a) advocating for a mission and vision focused on integrated care; (b) fostering collaboration, with a focus on population care and a team-based approaches; (c) attending to learning, which includes viewing the change process as continuous, and creating a culture that promoted reflection and continual improvement; (d) using data to manage change, and (e) developing approaches to finance integration. This paper reports the change management strategies employed by practice leaders making changes to integrate care, as observed by independent investigators. We offer an empirically based set of actionable recommendations that are relevant to a range of leaders (policymakers, medical directors) and practice members who wish to effectively manage the complex changes associated with integrated primary care. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
The role of rural nurse managers in supporting new graduate nurses in rural practice.
Lea, Jackie; Cruickshank, Mary
2017-04-01
To investigate the nature and timing of support available to new graduate nurses within a rural transition to practice programme. For new graduates in rural practice successful transition is complicated by the unique role of the rural nurse, staff ratios and resources within rural environments. Little is known about the support needs of graduates working in rural health services, or who is best placed to provide support during their transition. This was a qualitative case study, using individual interviews with new graduate nurses at 3, 6 and 9 months milestones during a 12-month rural transition to practice programme plus interviews with experienced rural nurses who were employed in rural health agencies where the new graduate nurses were employed. Graduates in rural health services rely on nurse unit managers and nurse managers for feedback, support and debriefing, provision of emotional support, advocacy, openness, encouragement and protection from organisational requests and demands during the transition to rural nursing practice. Nurse managers play an important role in rural health services in the provision of support for new graduate nurses. As clinical leaders rural nurse managers and nurse unit managers, have an important role in facilitating the successful entry and retention of new graduate nurses into the rural nursing workforce. © 2016 John Wiley & Sons Ltd.
The making of an immigrant niche.
Waldinger, R
1994-01-01
"This article speaks to the conceptual and methodological issues in research on the making of an immigrant niche through a case study of immigrant professionals in New York City government." The author argues that "the growth of this immigrant niche resulted from changes in the relative supply of native workers and in the structure of employment, which opened the bureaucracy to immigrants and reduced native/immigrant competition. These shifts opened hiring portals; given the advantages of network hiring for workers and managers, and an immigrant propensity for government employment, network recruitment led to a rapid buildup in immigrant ranks." excerpt
Birch, G F; Gunns, T J; Chapman, D; Harrison, D
2016-05-01
As coastal populations increase, considerable pressures are exerted on estuarine environments. Recently, there has been a trend towards the development and use of estuarine assessment schemes as a decision support tool in the management of these environments. These schemes offer a method by which complex environmental data is converted into a readily understandable and communicable format for informed decision making and effective distribution of limited management resources. Reliability and effectiveness of these schemes are often limited due to a complex assessment framework, poor data management and use of ineffective environmental indicators. The current scheme aims to improve reliability in the reporting of estuarine condition by including a concise assessment framework, employing high-value indicators and, in a unique approach, employing fuzzy logic in indicator evaluation. Using Sydney estuary as a case study, each of the 15 sub-catchment/sub-estuary systems were assessed using the current scheme. Results identified that poor sediment quality was a significant issue in Blackwattle/Rozelle Bay, Iron Cove and Hen and Chicken Bay while poor water quality was of particular concern in Duck River, Homebush Bay and the Parramatta River. Overall results of the assessment scheme were used to prioritise the management of each sub-catchment/sub-estuary assessed with Blackwattle/Rozelle Bay, Homebush Bay, Iron Cove and Duck River considered to be in need of a high priority management response. A report card format, using letter grades, was employed to convey the results of the assessment in a readily understood manner to estuarine managers and members of the public. Letter grades also provide benchmarking and performance monitoring ability, allowing estuarine managers to set improvement targets and assesses the effectiveness of management strategies. The current assessment scheme provides an effective, integrated and consistent assessment of estuarine health and provides an effective decision support tool to maximise the efficient distribution of limited management resources.
Spontaneous resolution of postoperative lumbar pseudomeningoceles: A report of four cases.
Solomon, Prince; Sekharappa, Vijay; Krishnan, Venkatesh; David, Kenny Samuel
2013-07-01
Pseudomeningocele is an extradural cerebrospinal fluid collection arising from a dural defect, that may be congenital, traumatic, or more commonly as a result of postoperative complication. Majority of the postoperative pseudomeningoceles occurring after lumbar spine surgeries are small and resolve spontaneously. However, large pseudomeningoceles are rare and spontaneous resolution of such pseudomeningoceles has not been described. We report four cases of postoperative large lumbar pseudomeningoceles that presented as asymptomatic soft fluctuant swelling over the back which resolved spontaneously. We also reviewed the related literatures and operative records of these patients to find the possible mechanism of occurrence, their management, prevention, and reasons for spontaneous resolution. We conclude that nonoperative management under close observation can be employed for asymptomatic postoperative large lumbar pseudomeningoceles. Surgical exploration and repair should be reserved for symptomatic cases presenting with clinical features of intracranial hypotension, worsening neurology, external fistula or infection, thereby avoiding morbidity and potential complications associated with surgical treatment.
Active listening: The key of successful communication in hospital managers.
Jahromi, Vahid Kohpeima; Tabatabaee, Seyed Saeed; Abdar, Zahra Esmaeili; Rajabi, Mahboobeh
2016-03-01
One of the important causes of medical errors and unintentional harm to patients is ineffective communication. The important part of this skill, in case it has been forgotten, is listening. The objective of this study was to determine whether managers in hospitals listen actively. This study was conducted between May and June 2014 among three levels of managers at teaching hospitals in Kerman, Iran. Active Listening skill among hospital managers was measured by self-made Active Listening Skill Scale (ALSS), which consists of the key elements of active listening and has five subscales, i.e., Avoiding Interruption, Maintaining Interest, Postponing Evaluation, Organizing Information, and Showing Interest. The data were analyzed by IBM-SPSS software, version 20, and the Pearson product-moment correlation coefficient, the chi-squared test, and multiple linear regressions. The mean score of active listening in hospital managers was 2.32 out of 3.The highest score (2.27) was obtained by the first-level managers, and the top managers got the lowest score (2.16). Hospital mangers were best in showing interest and worst in avoiding interruptions. The area of employment was a significant predictor of avoiding interruption and the managers' gender was a strong predictor of skill in maintaining interest (p < 0.05). The type of management and education can predict postponing evaluation, and the length of employment can predict showing interest (p < 0.05). There is a necessity for the development of strategies to create more awareness among the hospital managers concerning their active listening skills.
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.
A business case evaluation of workplace engineering noise control: a net-cost model.
Lahiri, Supriya; Low, Colleen; Barry, Michael
2011-03-01
This article provides a convenient tool for companies to determine the costs and benefits of alternative interventions to prevent noise-induced hearing loss (NIHL). Contextualized for Singapore and in collaboration with Singapore's Ministry of Manpower, the Net-Cost model evaluates costs of intervention for equipment and labor, avoided costs of productivity losses and medical care, and productivity gains from the employer's economic perspective. To pilot this approach, four case studies are presented, with varying degrees of economic benefits to the employer, including one in which multifactor productivity is the main driver. Although compliance agencies may not require economic analysis of NIHL, given scarce resources in a market-driven economy, this tool enables stakeholders to understand and compare the costs and benefits of NIHL interventions comprehensively and helps in determining risk management strategies.
Kennedy, Margaret Q; Badger, Elizabeth; Pompeii, Lisa; Lipscomb, Hester J
2003-05-01
1. Through a community based program, nurses were hired by a rural medical center to facilitate care for injured workers in the community. This placed the nurses outside the industrial and insurance arenas. 2. Rapid access to care and expedited return to work were made possible largely through improved communication, facilitated by the nurse case coordinators, among all involved parties (i.e., workers, employers, health care providers, insurance carriers). 3. The program provides access to occupational health nurses, or case managers, to a large number of rural workers--many of whom work for small employers and would not have these services otherwise. 4. The simple administrative model has resulted in increased numbers of workers returning to work with decreasing numbers of transitional or modified duty days.
The pattern of acute poisoning in a teaching hospital, north-west Ethiopia.
Abula, Teferra; Wondmikun, Yared
2006-04-01
Poisoning by means of hazardous chemicals through ignorance, mishap or intentionally is becoming a serious health problem worldwide. Epidemiological data on this important health issue are, however, scarce in Ethiopia. The purpose of this study is to assess the pattern of acute poisonings and determine the approaches employed for the management of poisoning. The medical records of patients with acute poisonings presented to the Gondar University hospital between July 2001 and June 2004 were reviewed retrospectively. One hundred and two patients presenting to the emergency department of the hospital were due to acute poisoning; accounting for about 0.45% of emergency room admissions. Organophosphates, rat poison and alcohol were the commonly encountered poisoning agents (in about 70% of cases) mainly in adults possibly with suicidal or para-suicidal intention. The approaches employed in the management of poisoning mainly involved gastrointestinal decontamination procedures. Specific antidotes were used in a substantial number of patients. The fatality rate was 2.4%. Poisoning with suicidal intention is becoming a serious health problem particularly in adults. Pesticides are commonly used toxicants. The approaches in the management of poisoning are justifiable in some cases. However, much is to be done to improve the recording of patient-related information and record-keeping processes. Further large scale studies are required to investigate national trends of poisoning and factors associated with poisoning.
Building a Consensus on Community Health Workers’ Scope of Practice: Lessons From New York
Matos, Sergio; Hicks, April L.; Campbell, Ayanna; Moore, Addison; Diaz, Diurka
2012-01-01
Objectives. We evaluated efforts in New York to build a consensus between community health workers (CHWs) and employers on CHWs’ scope of practice, training standards, and certification procedures. Methods. We conducted multiple-choice surveys in 2008 and 2010 with 226 CHWs and 44 employers. We compared CHWs’ and employers’ recommendations regarding 28 scope of practice elements. The participatory ranking method was used to identify consensus scope of practice recommendations. Results. There was consensus on 5 scope of practice elements: outreach and community organizing, case management and care coordination, home visits, health education and coaching, and system navigation. For each element, 3 to 4 essential skills were identified, giving a total of 27 skills. These included all skills recommended in national CHW studies, along with 3 unique to New York: computer skills, participatory research methods, and time management. Conclusions. CHWs and employers in New York were in consensus on CHWs’ scope of practice on virtually all of the detailed core competency skills. The CHW scope of practice recommendations of these groups can help other states refine their scope of practice elements. PMID:22897548
ERIC Educational Resources Information Center
Machart, Régis
2017-01-01
The large range of jobs that Malaysian undergraduates of foreign languages are often employed in after completion of their studies (education, tourism, banking, business, management, etc.) is not necessarily related to their major field of study. This situation often makes it difficult for lecturers to develop a comprehensive professional training…
ERIC Educational Resources Information Center
Alfred, Mary V.; Martin, Larry G.
2007-01-01
In 1996, the US Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act, changing the culture of welfare from a system of dependency to one of personal responsibility and economic self-sufficiency through workplace participation. Through the expert views of case managers and area employers of Wisconsin, this research…
ERIC Educational Resources Information Center
Leberman, Sarah; Shaw, Sally
2015-01-01
The business case for diversity is increasingly being recognised. However, worldwide women are still under-represented at the executive level. The notions of employability and career adaptability are examined in the context of female sport management graduates, to better understand why they are not attaining leadership positions in New Zealand…
ERIC Educational Resources Information Center
Jowallah, Rohan
2014-01-01
This research evaluates the strategies implemented to support the research activities of postgraduate students pursuing online master's programs in the University of the West Indies Open Campus, as well as the activities of their supervisors. The three main strategies employed were (1) the use of a web-based "teaching-learning space" to…
Demou, Evangelia; Brown, Judith; Sanati, Kaveh; Kennedy, Mark; Murray, Keith; Macdonald, Ewan B.
2015-01-01
BACKGROUND: Sickness absence (SA) is multi-causal and remains a significant problem for employees, employers and society. This makes it necessary to concurrently manage a particular disabling condition and consider the working environment and employee-employer relationship. OBJECTIVE: To describe and examine the components of a novel SA management service Early Access to Support for You (EASY) and discuss their potential influence on the intervention. METHODS: A new sickness absence model, starting from day one of absence, was created called EASY. EASY is planned to support both employees and managers and comprises elements already found to be associated with reduction of SA, such as maintaining regular contact; early biopsychosocial case-management; physiotherapy; mental-health counselling; work modification; phased return-to-work; and health promotion activities. RESULTS: During the EASY implementation period, the SA rate at a health board reversed its trend of being one of the highest rates in the Scottish National Health Service (NHS) and EASY was considered helpful by both managers and employees. CONCLUSIONS: This paper describes an innovative occupational health intervention to sickness absence management based on the bio-psychosocial model to provide early intervention, and discusses the pros and cons of applying cognitive behavioural principles at an early stage in sickness-absence events, in order to improve return-to-work outcomes. PMID:26409380
Biswas, Shampa; Vacik, Harald; Swanson, Mark E; Haque, S M Sirajul
2012-05-01
Criteria and indicators assessment is one of the ways to evaluate management strategies for mountain watersheds. One framework for this, Integrated Watershed Management (IWM), was employed at Chittagong Hill Tracts region of Bangladesh using a multi-criteria analysis approach. The IWM framework, consisting of the design and application of principles, criteria, indicators, and verifiers (PCIV), facilitates active participation by diverse professionals, experts, and interest groups in watershed management, to explicitly address the demands and problems to measure the complexity of problems in a transparent and understandable way. Management alternatives are developed to fulfill every key component of IWM considering the developed PCIV set and current situation of the study area. Different management strategies, each focusing on a different approach (biodiversity conservation, flood control, soil and water quality conservation, indigenous knowledge conservation, income generation, watershed conservation, and landscape conservation) were assessed qualitatively on their potential to improve the current situation according to each verifier of the criteria and indicator set. Analytic Hierarchy Process (AHP), including sensitivity analysis, was employed to identify an appropriate management strategy according to overall priorities (i.e., different weights of each principle) of key informants. The AHP process indicated that a strategy focused on conservation of biodiversity provided the best option to address watershed-related challenges in the Chittagong Hill Tracts, Bangladesh.
Hypnosis and cognitive-behavioral therapy during breast cancer radiotherapy: a case report.
Schnur, Julie B; Montgomery, Guy H
2008-01-01
This case report describes an effort to control two primary side-effects of breast cancer radiotherapy (fatigue and skin discomfort) that used a combination of cognitive-behavioral therapy with hypnosis (CBTH). Two patients, matched on demographic and medical variables (marital status, employment status, number of children, cancer diagnosis, surgical history, radiation dose), were compared: one who received a CBTH intervention and one who received standard care. Results were consistent with the view that CBTH was effective in managing fatigue and skin discomfort, and increasing relaxation.
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.
Sexual harassment in the workplace: guidelines for educating healthcare managers.
Robinson, Robert K; Franklin, Geralyn Mcclure; Tinney, Cathie H; Crow, Stephen M; Hartman, Sandra J
2005-01-01
Actionable sexual harassment is defined as a violation of Title VII of the Civil Rights Act of 1964. In recent years, there have been a number of significant developments in sexual harassment case law and litigation including: (1) nationwide legal recognition for same-sex sexual harassment; (2) increased standards on employer liability for sexual harassment perpetrated by supervisory and managerial personnel; and (3) guidelines for mitigating damages when employers are found liable. These developments are of particular concern in those professions such as healthcare in which women historically have been represented as a significant portion of the workforce. Moreover, because management and supervisory relationships in healthcare are often cloudy, harassment by "supervisors" in healthcare settings can be an issue of special concern. In this article, we review relevant issues related to sexual harassment and provide guidance in dealing with the issue in the workplace.
Zulman, Donna M; Ezeji-Okoye, Stephen C; Shaw, Jonathan G; Hummel, Debra L; Holloway, Katie S; Smither, Sasha F; Breland, Jessica Y; Chardos, John F; Kirsh, Susan; Kahn, James S; Asch, Steven M
2014-12-01
We employed a partnered research healthcare delivery redesign process to improve care for high-need, high-cost (HNHC) patients within the Veterans Affairs (VA) healthcare system. Health services researchers partnered with VA national and Palo Alto facility leadership and clinicians to: 1) analyze characteristics and utilization patterns of HNHC patients, 2) synthesize evidence about intensive management programs for HNHC patients, 3) conduct needs-assessment interviews with HNHC patients (n = 17) across medical, access, social, and mental health domains, 4) survey providers (n = 8) about care challenges for HNHC patients, and 5) design, implement, and evaluate a pilot Intensive Management Patient-Aligned Care Team (ImPACT) for a random sample of 150 patients. HNHC patients accounted for over half (52 %) of VA facility patient costs. Most (94 %) had three or more chronic conditions, and 60 % had a mental health diagnosis. Formative data analyses and qualitative assessments revealed a need for intensive case management, care coordination, transitions navigation, and social support and services. The ImPACT multidisciplinary team developed care processes to meet these needs, including direct access to team members (including after-hours), chronic disease management protocols, case management, and rapid interventions in response to health changes or acute service use. Two-thirds of invited patients (n = 101) enrolled in ImPACT, 87 % of whom remained actively engaged at 9 months. ImPACT is now serving as a model for a national VA intensive management demonstration project. Partnered research that incorporated population data analysis, evidence synthesis, and stakeholder needs assessments led to the successful redesign and implementation of services for HNHC patients. The rigorous design process and evaluation facilitated dissemination of the intervention within the VA healthcare system. Employing partnered research to redesign care for high-need, high-cost patients may expedite development and dissemination of high-value, cost-saving interventions.
ERIC Educational Resources Information Center
DeSensi, Joy T.; And Others
The report consists of a series of studies designed to assess the needs of sport management positions and evaluate sport management programs/curricula in institutions of higher education. Three surveys were conducted to determine: (1) employer expectations of sport managers; (2) employer evaluation of educational sport management…
Iles, Ross Anthony; Wyatt, M; Pransky, G
2012-12-01
This study aimed to determine whether a multi-faceted model of management of work related musculoskeletal disorders reduced compensation claim costs and days of compensation for injured workers. An intervention including early reporting, employee centred case management and removal of barriers to return to work was instituted in 16 selected companies with a combined remuneration over $337 million. Outcomes were evaluated by an administrative dataset from the Victorian WorkCover Authority database. A 'quasi experimental' pre-post design was employed with 492 matched companies without the intervention used as a control group and an average of 21 months of post-intervention follow-up. Primary outcomes were average number of days of compensation and average cost of claims. Secondary outcomes were total medical costs and weekly benefits paid. Information on 3,312 claims was analysed. In companies where the intervention was introduced the average cost of claims was reduced from $6,019 to $3,913 (estimated difference $2,329, 95 % CI $1,318-$3,340) and the number of days of compensation decreased from 33.5 to 14.1 (HR 0.77, 95 % CI 0.67-0.88). Medical costs and weekly benefits costs were also lower after the intervention (p < 0.05). Reduction in claims costs were noted across industry types, injury location and most employer sizes. The model of claims management investigated was effective in reducing the number of days of compensation, total claim costs, total medical costs and the amount paid in weekly benefits. Further research should investigate whether the intervention improves non-financial outcomes in the return to work process.
Employing a Modified Diffuser Momentum Model to Simulate Ventilation of the Orion CEV
NASA Technical Reports Server (NTRS)
Straus, John; Lewis, John F.
2011-01-01
The Ansys CFX CFD modeling tool was used to support the design efforts of the ventilation system for the Orion CEV. CFD modeling was used to establish the flow field within the cabin for several supply configurations. A mesh and turbulence model sensitivity study was performed before the design studies. Results were post-processed for comparison with performance requirements. Most configurations employed straight vaned diffusers to direct and throw the flow. To manage the size of the models, the diffuser vanes were not resolved. Instead, a momentum model was employed to account for the effect of the diffusers. The momentum model was tested against a separate, vane-resolved side study. Results are presented for a single diffuser configuration for a low supply flow case.
Saal, Susanne; Forschner, Lukas; Kemmann, Dietmar; Zlatosch, Jacqueline; Kallert, Thomas W
2016-08-05
Substance use disorders are associated with unemployment. An employment-focused case management (CMRE) has been conceptualised as a specific intervention to help substance use disorder patients return to competitive employment immediately after inpatient rehabilitation. This study investigated the effect of the intervention on return to work of persons with substance use disorders. The study was conducted in four German inpatient rehabilitation departments, and included unemployed patients (aged between 18 and 63 years) with a main clinical diagnosis of ICD-10 F10-19 disorders. Six weeks before discharge, patients were randomly allocated to CMRE or standard care (SC) using a quasi-randomised approach. The primary outcome measure was integration into competitive employment 24 months after discharge from rehabilitation. Secondary outcome domains were abstinence, duration of employment, proportion of publicly funded employment, satisfaction with life, precarious housing situation and precarious financial situation, and use of follow-up services. Outcome measures were assessed 6 weeks and 1-2 days prior to discharge, and 12 and 24 months after discharge from rehabilitation. One hundred sixty patients were allocated into the CMRE group and 160 patients into the control group. 267 resp. 179 participants could be included in the analyses performed for the 12-, and the 24-months follow-up assessments. At the study endpoint the rate of integration into the primary labour market was 35.6 % in the CMRE group and 41.2 % in the control group, respectively (Relative Risk 0.92, 95 % CI, 0.47; 1.79). There was a significantly higher proportion in the CMRE group, however, which immediately after discharge linked with services of the Federal Employment Agency or Job Centres. There were no statistically significant differences in other outcomes between the groups. Compared to SC, the additional specific CMRE intervention did not result in superior effects on return to work rates, abstinence, satisfaction with life, and housing and precarious financial situation. But CMRE was more effective on linking substance use disorder patients with services of the Federal Employment Agency or Job Centres. Reasons for the finding that such close linking does not have an impact on return to work rates are discussed in detail. Identifier: DRKS00003574 ; March 12, 2012. The trial was retrospectively registered.
Transitions of Care Model Inclusive of Unplanned Care Improves the Patient Experience
Cox, Jon; Teague, Stephanie; Beck, Eric
2016-01-01
A major emphasis in health care is creating an experience whereby patients receive the right care at the right time from the right provider in the right setting at the right cost. Over the past several decades, there has been considerable effort in the area of medical management, with prior authorization, gatekeeper utilization management regimens, and other techniques designed to guide patients and caregivers into desired treatment pathways. Alternatively, the concept of demand management may be employed to achieve these desired outcomes by giving patients meaningful, expanded choices beyond traditional acute-care settings. The implementation of a novel, patient-centered, unplanned care delivery model is described along with illustrative case studies. PMID:28725828
Principles and guidelines for good practice in Indigenous engagement in water planning
NASA Astrophysics Data System (ADS)
Jackson, Sue; Tan, Poh-Ling; Mooney, Carla; Hoverman, Suzanne; White, Ian
2012-12-01
SummaryIndigenous rights, values and interests relating to water have been identified by Australia's National Water Commission as a national priority area, requiring greater understanding, research attention and government action. Yet Indigenous water values are rarely addressed in water planning, despite objectives in national policy requiring Indigenous participation and the identification of Indigenous social, spiritual and customary values in water plans. Water planners are presently equipped with a very limited number of engagement tools tailored to the water resource management context to redress the historical neglect of Indigenous interests. In an Australian research project focused on water planning, seven participatory planning tools were employed in three Australian case studies with different social and hydrological characteristics to improve the way in which Indigenous values are elicited and incorporated and to enhance the status of Indigenous knowledge in water planning. The results from the two Murray Darling Basin (MDB) case studies reveal the many ways in which Indigenous values have been adversely affected by recent water resource developments and concomitant water scarcity. In the third case on the Tiwi Islands in the Northern Territory, where land title to the entire water planning area is vested in Indigenous traditional owners, methods were refined to ensure engagement and generate capacity to manage the development of a solely Indigenous-owned, first-generation Water Management Strategy, in collaboration with a range of stakeholders. This paper describes the needs and aspirations of Indigenous people, the engagement strategies employed to elicit Indigenous knowledge, assess Indigenous values, and incorporate the results into three developing water plans. In addition, it outlines a set of general principles to guide water planning in other regions and thereby to improve Indigenous access to water.
Muir, Carlyn; Johnston, Ian R; Howard, Eric
2018-06-01
The Victorian Safe System approach to road safety slowly evolved from a combination of the Swedish Vision Zero philosophy and the Sustainable Safety model developed by the Dutch. The Safe System approach reframes the way in which road safety is viewed and managed. This paper presents a case study of the institutional change required to underpin the transformation to a holistic approach to planning and managing road safety in Victoria, Australia. The adoption and implementation of a Safe System approach require strong institutional leadership and close cooperation among all the key agencies involved, and Victoria was fortunate in that it had a long history of strong interagency mechanisms in place. However, the challenges in the implementation of the Safe System strategy in Victoria are generally neither technical nor scientific; they are predominantly social and political. While many governments purport to develop strategies based on Safe System thinking, on-the-ground action still very much depends on what politicians perceive to be publicly acceptable, and Victoria is no exception. This is a case study of the complexity of institutional change and is presented in the hope that the lessons may prove useful for others seeking to adopt more holistic planning and management of road safety. There is still much work to be done in Victoria, but the institutional cultural shift has taken root. Ongoing efforts must be continued to achieve alert and compliant road users; however, major underpinning benefits will be achieved through focusing on road network safety improvements (achieving forgiving infrastructure, such as wire rope barriers) in conjunction with reviews of posted speed limits (to be set in response to the level of protection offered by the road infrastructure) and by the progressive introduction into the fleet of modern vehicle safety features. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Jacobs, Sally; Johnson, Sheena; Hassell, Karen
2018-02-01
Workplace stress in community pharmacy is increasing internationally due, in part, to pharmacists' expanding roles and escalating workloads. Whilst the business case for preventing and managing workplace stress by employers is strong, there is little evidence for the effectiveness of organisational stress management interventions in community pharmacy settings. To identify and synthesise existing evidence for the effectiveness of organisational solutions to workplace stress from the wider organisational literature which may be adaptable to community pharmacies. A secondary synthesis of existing reviews. Publications were identified through keyword searches of electronic databases and the internet; inclusion and exclusion criteria were applied; data about setting, intervention, method of evaluation, effectiveness and conclusions (including factors for success) were extracted and synthesised. Eighteen reviews of the stress management and prevention literature were identified. A comprehensive list of organisational interventions to prevent or manage workplace stress, ordered by prevalence of evidence of effectiveness, was produced, together with an ordered list of the benefits both to the individual and employing organisation. An evidence-based model of best practice was derived specifying eight factors for success: top management support, context-specific interventions, combined organisational and individual interventions, a participative approach, clearly delineated tasks and responsibilities, buy-in from middle management, change agents as facilitators and change in organisational culture. This literature review provides community pharmacy organisations with evidence from which to develop effective and successful stress management strategies to support pharmacists and pharmacy staff. Well-designed trials of stress management interventions in community pharmacy organisations are still required. © 2017 Royal Pharmaceutical Society.
The Management Issues of Implementing Telecommuting: A Case Study
1993-09-01
telecommuting ; benefits for both the employers and employees. These benefits include: (JALA (b) 1990) * Significantly increased productivity (10 to 20% on...1992 to April 1993. B. RESEARCH QUESTIONS Prior research reveals that a successful telecommuting program has the following benefits : "* Flexibility...State, Jack Nilles outlines a different set of important factors and points out that: While telecommuting has many benefits , there also are potential
1994-04-01
focus of this thesis. The Supreme Court articulated an analytical framework for Title VII disparate treatment cases principally in McDonald Douglas Corp...a footnote. Roush v. KFC National Management Co., 10 F.3d 392, 396 n.5 (6th Cir. 1993). 276. Bodenheimer v. PPG Industries, Inc., 5 F.3d 955, 957
Nuclear Deterrence in Cyber-ia: Challenges and Controversies
2016-09-01
acceptance of possible opponents. In short, the task of managing a nuclear crisis demands clear thinking and good information. But the employment of...economy, and social infrastructure. (Stuxnet was an exceptional, purpose-built destroyer of targeted nuclear facilities.) Failure of deterrence can...lead to historically unprecedented and socially catastrophic damage even in the case of a “limited” nuclear war by Cold War standards. 58 | Air
ERIC Educational Resources Information Center
Baba, Pauline A.; Odiba, Isaac A.
2015-01-01
This research paper examines the effects of Information and Communication Technology (ICT) on Nigerian educational system with a focus on Kogi State University (KSU), Anyigba. The study employed the survey method, choosing 40 academic staff, five library staff, 5 management staff and 250 students randomly from the seven (7) faculties at KSU. A…
Maraba, Noriah; Chihota, Violet; McCarthy, Kerrigan; Churchyard, Gavin J; Grant, Alison D
2018-05-24
We piloted an intervention to determine if support from a case manager would assist adults being investigated for tuberculosis (TB) to link into TB and HIV care. Pilot interventional cohort study. Patients identified by primary healthcare clinic staff in South Africa as needing TB investigations were enrolled. Participants were supported for 3 months by case managers who facilitated the care pathway by promoting HIV testing, getting laboratory results, calling patients to return for results and facilitating treatment initiation. Linkage to TB care was defined as starting TB treatment within 28 days in those with a positive test result; linkage to HIV care, for HIV-positive people, was defined as having blood taken for CD4 count and, for those eligible, starting antiretroviral therapy within 3 months. Intervention implementation was measured by number of attempts to contact participants. Among 562 participants (307 (54.6%) female, median age: 36 years (IQR 29-44)), most 477 (84.8%) had previously tested for HIV; of these, 328/475 (69.1%) self-reported being HIV-positive. Overall, 189/562 (33.6%) participants needed linkage to care (132 HIV care linkage only; 35 TB treatment linkage only; 22 both). Of 555 attempts to contact these 189 participants, 407 were to facilitate HIV care linkage, 78 for TB treatment linkage and 70 for both. At the end of 3-month follow-up, 40 participants had not linked to care (29 of the 132 (22.0%) participants needing linkage to HIV care only, 4 of the 35 (11.4%) needing to start on TB treatment only and 7 of the 22 (31.8%) needing both). Many people testing for TB need linkage to care. Despite case manager support, non-linkage into HIV care remained higher than desirable, suggesting a need to modify this intervention before implementation. Innovative strategies to enable linkage to care are needed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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.
Howard, Rachel; Rodgers, Sarah; Avery, Anthony J; Sheikh, Aziz
2014-02-01
To undertake a process evaluation of pharmacists' recommendations arising in the context of a complex IT-enabled pharmacist-delivered randomised controlled trial (PINCER trial) to reduce the risk of hazardous medicines management in general practices. PINCER pharmacists manually recorded patients' demographics, details of interventions recommended, actions undertaken by practice staff and time taken to manage individual cases of hazardous medicines management. Data were coded, double-entered into SPSS version 15 and then summarised using percentages for categorical data (with 95% confidence interval (CI)) and, as appropriate, means (± standard deviation) or medians (interquartile range) for continuous data. Pharmacists spent a median of 20 min (interquartile range 10, 30) reviewing medical records, recommending interventions and completing actions in each case of hazardous medicines management. Pharmacists judged 72% (95% CI 70, 74; 1463/2026) of cases of hazardous medicines management to be clinically relevant. Pharmacists recommended 2105 interventions in 74% (95% CI 73, 76; 1516/2038) of cases and 1685 actions were taken in 61% (95% CI 59, 63; 1246/2038) of cases; 66% (95% CI 64, 68; 1383/2105) of interventions recommended by pharmacists were completed and 5% (95% CI 4, 6; 104/2105) of recommendations were accepted by general practitioners (GPs), but not completed at the end of the pharmacists' placement; the remaining recommendations were rejected or considered not relevant by GPs. The outcome measures were used to target pharmacist activity in general practice towards patients at risk from hazardous medicines management. Recommendations from trained PINCER pharmacists were found to be broadly acceptable to GPs and led to ameliorative action in the majority of cases. It seems likely that the approach used by the PINCER pharmacists could be employed by other practice pharmacists following appropriate training. © 2013 The Authors. International Journal of Pharmacy Practice published by John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.
Reasonable Accommodation Information Tracking System
The Reasonable Accommodation Information Tracking System (RAITS) is a case management system that allows the National Reasonable Accommodation Coordinator (NRAC) and the Local Reasonable Accommodation Coordinators (LORAC) to manage information related to Reasonable Accommodation (RA) requests. It provides a data base system in compliance with Executive Order 13164 and required by the Equal Employment Opportunity Commission (EEOC) Regulations and American Federation of Government Employees (AFGE) Bargaining Unit as described in the AFGE National Reasonable Accommodation Procedures. It is a tool that was internally developed in Lotus Notes to track requests for reasonable accommodation and was custom-configured to meet EPA's specific needs and infrastructure.
Implementing graduate entry registration for nursing in England: a scope review.
DeBell, Diane; Branson, Kathy
2009-07-01
A graduate entry workforce for nurse registration has been approved for England by 2010/11. The aim of this research was to discover the immediate tasks facing nurse managers in implementing that change. Previous research has focused on making the case for change rather than on implementation. Similar to the implementation of Project 2000, this change in nurse education and employment will raise questions for employers and for higher education institutions. It will also raise questions about nurse recruitment numbers, workforce development, and the profiles of entrants to a changing workforce. In preparation for these changes, we conducted a scope review of published and grey literature in the English language. We also reviewed the earlier experiences of transfer to graduate status amongst other workforces such as teaching and social work and we investigated reported practice in other industrialised countries. The education provider changes necessary for such a large professional workforce will need considerable leadership skills from within nursing and nurse management. At present, there are too many employers and education providers in England who appear to be relatively unaware of the changes facing nurse education and professional practice and the urgency needed to lead that change. Education, training and development as well as employer/commissioner practice will rely on leadership from within the nurse profession itself. For nurse managers, this requires a rapid planning process in order to ensure smooth implementation. The danger is that either education providers or commissioners of nursing services will react rather than proactively plan for the changes that are already in progress.
NASA Astrophysics Data System (ADS)
Lührs, Nikolas; Jager, Nicolas W.; Challies, Edward; Newig, Jens
2018-02-01
Public participation is potentially useful to improve public environmental decision-making and management processes. In corporate management, the Vroom-Yetton-Jago normative decision-making model has served as a tool to help managers choose appropriate degrees of subordinate participation for effective decision-making given varying decision-making contexts. But does the model recommend participatory mechanisms that would actually benefit environmental management? This study empirically tests the improved Vroom-Jago version of the model in the public environmental decision-making context. To this end, the key variables of the Vroom-Jago model are operationalized and adapted to a public environmental governance context. The model is tested using data from a meta-analysis of 241 published cases of public environmental decision-making, yielding three main sets of findings: (1) The Vroom-Jago model proves limited in its applicability to public environmental governance due to limited variance in its recommendations. We show that adjustments to key model equations make it more likely to produce meaningful recommendations. (2) We find that in most of the studied cases, public environmental managers (implicitly) employ levels of participation close to those that would have been recommended by the model. (3) An ANOVA revealed that such cases, which conform to model recommendations, generally perform better on stakeholder acceptance and environmental standards of outputs than those that diverge from the model. Public environmental management thus benefits from carefully selected and context-sensitive modes of participation.
Lührs, Nikolas; Jager, Nicolas W; Challies, Edward; Newig, Jens
2018-02-01
Public participation is potentially useful to improve public environmental decision-making and management processes. In corporate management, the Vroom-Yetton-Jago normative decision-making model has served as a tool to help managers choose appropriate degrees of subordinate participation for effective decision-making given varying decision-making contexts. But does the model recommend participatory mechanisms that would actually benefit environmental management? This study empirically tests the improved Vroom-Jago version of the model in the public environmental decision-making context. To this end, the key variables of the Vroom-Jago model are operationalized and adapted to a public environmental governance context. The model is tested using data from a meta-analysis of 241 published cases of public environmental decision-making, yielding three main sets of findings: (1) The Vroom-Jago model proves limited in its applicability to public environmental governance due to limited variance in its recommendations. We show that adjustments to key model equations make it more likely to produce meaningful recommendations. (2) We find that in most of the studied cases, public environmental managers (implicitly) employ levels of participation close to those that would have been recommended by the model. (3) An ANOVA revealed that such cases, which conform to model recommendations, generally perform better on stakeholder acceptance and environmental standards of outputs than those that diverge from the model. Public environmental management thus benefits from carefully selected and context-sensitive modes of participation.
The costs and benefits of enhanced depression care to employers.
Wang, Philip S; Patrick, Amanda; Avorn, Jerry; Azocar, Francisca; Ludman, Evette; McCulloch, Joyce; Simon, Gregory; Kessler, Ronald
2006-12-01
Although outreach and enhanced treatment interventions improve depression outcomes, uptake has been poor in part because purchasers lack information on their return on investment. To estimate the costs and benefits of enhanced depression care for workers from the societal and employer-purchaser perspectives. Cost-effectiveness and cost-benefit analyses using state-transition Markov models. Simulated movements between health states were based on probabilities drawn from the clinical literature. Hypothetical cohort of 40-year-old workers. Intervention Enhanced depression care consisting of a depression screen and care management for those depressed vs usual care. Our base-case cost-effectiveness analysis was from the societal perspective; costs and quality-adjusted life-years were used to compute the incremental cost-effectiveness of the intervention relative to usual care. A secondary cost-benefit analysis from the employer's perspective tracked monetary costs and monetary benefits accruing to employers during a 5-year time horizon. From the societal perspective, screening and depression care management for workers result in an incremental cost-effectiveness ratio of $19 976 per quality-adjusted life-year relative to usual care. These results are consistent with recent primary care effectiveness trials and within the range for medical interventions usually covered by employer-sponsored insurance. From the employer's perspective, enhanced depression care yields a net cumulative benefit of $2895 after 5 years. In 1-way and probabilistic sensitivity analyses, these findings were robust to a variety of assumptions. If these results can be replicated in effectiveness trials directly assessing effects on work outcomes, they suggest that enhanced treatment quality programs for depression are cost-beneficial to purchasers.
Active listening: The key of successful communication in hospital managers
Jahromi, Vahid Kohpeima; Tabatabaee, Seyed Saeed; Abdar, Zahra Esmaeili; Rajabi, Mahboobeh
2016-01-01
Introduction One of the important causes of medical errors and unintentional harm to patients is ineffective communication. The important part of this skill, in case it has been forgotten, is listening. The objective of this study was to determine whether managers in hospitals listen actively. Methods This study was conducted between May and June 2014 among three levels of managers at teaching hospitals in Kerman, Iran. Active Listening skill among hospital managers was measured by self-made Active Listening Skill Scale (ALSS), which consists of the key elements of active listening and has five subscales, i.e., Avoiding Interruption, Maintaining Interest, Postponing Evaluation, Organizing Information, and Showing Interest. The data were analyzed by IBM-SPSS software, version 20, and the Pearson product-moment correlation coefficient, the chi-squared test, and multiple linear regressions. Results The mean score of active listening in hospital managers was 2.32 out of 3.The highest score (2.27) was obtained by the first-level managers, and the top managers got the lowest score (2.16). Hospital mangers were best in showing interest and worst in avoiding interruptions. The area of employment was a significant predictor of avoiding interruption and the managers’ gender was a strong predictor of skill in maintaining interest (p < 0.05). The type of management and education can predict postponing evaluation, and the length of employment can predict showing interest (p < 0.05). Conclusion There is a necessity for the development of strategies to create more awareness among the hospital managers concerning their active listening skills. PMID:27123221
78 FR 12107 - Hispanic Council on Federal Employment
Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-21
... OFFICE OF PERSONNEL MANAGEMENT Hispanic Council on Federal Employment AGENCY: Office of Personnel Management. ACTION: Scheduling of Council Meetings. SUMMARY: The Hispanic Council on Federal Employment will... Management on matters involving the recruitment, hiring, and advancement of Hispanics in the Federal...
Concerns About Lung Cancer Among Prisoners.
Renault, Luc; Perrot, Emmanuel; Pradat, Eric; Bartoli, Christophe; Greillier, Laurent; Remacle-Bonnet, Anne; Telmon, Norbert; Mazières, Julien; Molinier, Laurent; Couraud, Sébastien
2018-02-01
Few studies have looked at lung cancer in prisoners, despite this population is possibly at increased risk of malignancy. In a previous study, we found an early onset of lung cancer in prisoners. Thus, the present CARCAN study was aimed at assessing the epidemiological characteristics, management, prognosis, and incidence of lung cancer in prisoners compared to a sample of non-prisoner patients. We performed a multi-center observational case-control study. Cases were prisoners diagnosed with lung cancer from 2005 to 2013. Controls were non-prisoner lung cancer patients selected from hospital databases and randomly matched to cases (targeted case-control ratio: 1:3). Incidence rates in both groups were calculated using national statistics. Seventy-two cases and 170 controls met inclusion criteria. Cases were mainly men (99%). Mean age at diagnosis was 52.9 (± 11.0) in cases and 64.3 (± 10.1) in controls (p < 0.0001). More case patients were current smokers compared to control patients (83% vs 53%; p < 0.0001). We found no significant differences between the two groups as concerns histologic types, TNM stages at diagnosis, initially-employed treatments, times to management or survival. Incidence rates (2008-2012) in male prisoners were higher than those in the general population in all concerned age groups. There is a shift of lung cancer toward young people in prisons. However, the presentation, management, and prognosis of lung cancer are similar between prisoners and non-prisoners. These finding could justify a specific screening policy for the incarcerated populations.
Plant invasions in mountains: Global lessons for better management
McDougall, K.L.; Khuroo, A.A.; Loope, L.L.; Parks, C.G.; Pauchard, A.; Reshi, Z.A.; Rushworth, I.; Kueffer, C.
2011-01-01
Mountains are one of few ecosystems little affected by plant invasions. However, the threat of invasion is likely to increase because of climate change, greater anthropogenic land use, and continuing novel introductions. Preventive management, therefore, will be crucial but can be difficult to promote when more pressing problems are unresolved and predictions are uncertain. In this essay, we use management case studies from 7 mountain regions to identify common lessons for effective preventive action. The degree of plant invasion in mountains was variable in the 7 regions as was the response to invasion, which ranged from lack of awareness by land managers of the potential impact in Chile and Kashmir to well-organized programs of prevention and containment in the United States (Hawaii and the Pacific Northwest), including prevention at low altitude. In Australia, awareness of the threat grew only after disruptive invasions. In South Africa, the economic benefits of removing alien plants are well recognized and funded in the form of employment programs. In the European Alps, there is little need for active management because no invasive species pose an immediate threat. From these case studies, we identify lessons for management of plant invasions in mountain ecosystems: (i) prevention is especially important in mountains because of their rugged terrain, where invasions can quickly become unmanageable; (ii) networks at local to global levels can assist with awareness raising and better prioritization of management actions; (iii) the economic importance of management should be identified and articulated; (iv) public acceptance of management programs will make them more effective; and (v) climate change needs to be considered. We suggest that comparisons of local case studies, such as those we have presented, have a pivotal place in the proactive solution of global change issues. ?? International Mountain Society.
[Management of opioid maintenance treatments when analgesic treatments are required].
Laprevote, Vincent; Geoffroy, Pierre A; Rolland, Benjamin; Leheup, Benoît F; Di Patrizio, Paolo; Cottencin, Olivier; Schwan, Raymund
2013-01-01
Opioid maintenance treatments (OMT) reduce illicit opiate use and its associated risks. They are often prescribed on a long-term basis. Physiological changes induced by long-term OMT may cause hyperalgesia and cross-tolerance to opioid agonists, which suggests that the dosage of analgesic treatment should be modified in cases of acute pain, especially when an opioid-based analgesia is required. When treatment with analgesics is necessary, OMT must be maintained, except in exceptional cases. If a split-dosing schedule is temporarily employed during OMT, the daily dosage should not be increased for analgesic purposes. Analgesic treatment must be managed differently in case of treatment with buprenorphine or methadone. With buprenorphine, non-opioid analgesics should be introduced first, if possible. If this strategy is inefficient or contraindicated, a temporary or definitive switch to methadone should be considered. In the case of methadone-based OMT, opioid analgesics should be added directly and the dosage should be adapted according to the level of pain reported by the patient. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Missing persons-missing data: the need to collect antemortem dental records of missing persons.
Blau, Soren; Hill, Anthony; Briggs, Christopher A; Cordner, Stephen M
2006-03-01
The subject of missing persons is of great concern to the community with numerous associated emotional, financial, and health costs. This paper examines the forensic medical issues raised by the delayed identification of individuals classified as "missing" and highlights the importance of including dental data in the investigation of missing persons. Focusing on Australia, the current approaches employed in missing persons investigations are outlined. Of particular significance is the fact that each of the eight Australian states and territories has its own Missing Persons Unit that operates within distinct state and territory legislation. Consequently, there is a lack of uniformity within Australia about the legal and procedural framework within which investigations of missing persons are conducted, and the interaction of that framework with coronial law procedures. One of the main investigative problems in missing persons investigations is the lack of forensic medical, particularly, odontological input. Forensic odontology has been employed in numerous cases in Australia where identity is unknown or uncertain because of remains being skeletonized, incinerated, or partly burnt. The routine employment of the forensic odontologist to assist in missing person inquiries, has however, been ignored. The failure to routinely employ forensic odontology in missing persons inquiries has resulted in numerous delays in identification. Three Australian cases are presented where the investigation of individuals whose identity was uncertain or unknown was prolonged due to the failure to utilize the appropriate (and available) dental resources. In light of the outcomes of these cases, we suggest that a national missing persons dental records database be established for future missing persons investigations. Such a database could be easily managed between a coronial system and a forensic medical institute. In Australia, a national missing persons dental records database could be incorporated into the National Coroners Information System (NCIS) managed, on behalf of Australia's Coroners, by the Victorian Institute of Forensic Medicine. The existence of the NCIS would ensure operational collaboration in the implementation of the system and cost savings to Australian policing agencies involved in missing person inquiries. The implementation of such a database would facilitate timely and efficient reconciliation of clinical and postmortem dental records and have subsequent social and financial benefits.
Strategy in the Surgical Treatment of Primary Spinal Tumors
Williams, Richard; Foote, Matthew; Deverall, Hamish
2012-01-01
Primary spine tumors are rare, accounting for only 4% of all tumors of the spine. A minority of the more common primary benign lesions will require surgical treatment, and most amenable malignant lesions will proceed to attempted resection. The rarity of malignant primary lesions has resulted in a paucity of historical data regarding optimal surgical and adjuvant treatment and, although we now derive benefit from standardized guidelines of overall care, management of each neoplasm often proceeds on a case-by-case basis, taking into account the individual characteristics of patient operability, tumor resectability, and biological potential. This article aims to provide an overview of diagnostic techniques, staging algorithms and the authors' experience of surgical treatment alternatives that have been employed in the care of selected benign and malignant lesions. Although broadly a review of contemporary management, it is hoped that the case illustrations given will serve as additional “arrows in the quiver” of the treating surgeon. PMID:24353976
Reducing suboptimal employee decisions can build the business case for employee benefits.
Goldsmith, Christopher; Cyboran, Steven F
2013-01-01
Suboptimal employee decisions are prevalent in employee benefit plans. Poor decisions have significant consequences for employees and employers. Improving participant decisions produces beneficial outcomes such as lower labor costs, higher productivity and better workforce management. The business case for employee benefits can be strengthened by applying lessons learned from the field of behavioral economics to employee benefit plan design and to workforce communication. This article explains the types of behavioral biases that influence suboptimal decisions and explores how enlightened employee benefit plan choice architecture and vivid behavioral messaging contribute to human and better organizational outcomes.
Comprehensive managed care evaluation.
Bushick, B
1992-01-01
To optimize the benefits of managed care delivery systems, employers must identify and reward those systems that are most efficient and effective. At the same time, their deeper involvement in system design and management exposes employers to greater potential liability. Employers thus need to better evaluate their managed care programs in order to enhance the benefits and minimize the risks.
44 CFR 19.130 - Effect of employment opportunities.
Code of Federal Regulations, 2010 CFR
2010-10-01
... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 19.130 Effect of employment opportunities... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Effect of employment opportunities. 19.130 Section 19.130 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY...
Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review.
Kaplan, Nathan B; Molinari, Christine; Molinari, Robert W
2015-12-01
Study Design Literature review and case report. Objective Review the existing literature and report the successful nonoperative management of a two-level craniocervical ligamentous distraction injury. Methods A PubMed and Medline review revealed only three limited reports involving the nonoperative management of patients with craniocervical distraction injury. This article reviews the existing literature and reports the case of a 27-year-old man who was involved in a motorcycle accident and sustained multiple systemic injuries and ligamentous distraction injuries to both occipitocervical joints and both C1-C2 joints. The patient's traumatic brain injury and bilateral pulmonary contusions precluded safe operative management of the two-level craniocervical distraction injury. Therefore, the patient was placed in a halo immobilization device. Results The literature remains unclear as to the specific indications for nonoperative management of ligamentous craniocervical injuries. Nonoperative management was associated with poor outcomes in the majority of reported patients. We report a patient who was managed for 6 months in a halo device. Posttreatment computed tomography and flexion-extension radiographs demonstrated stable occipitocervical and C1-C2 joints bilaterally. The patient reported minimal neck pain and had excellent functional outcome with a Neck Disability Index score of 2 points at 41 months postoperatively. He returned to preinjury level of employment without restriction. Conclusions Further study is needed to determine which craniocervical injuries may be managed successfully with nonoperative measures.
Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review
Kaplan, Nathan B.; Molinari, Christine; Molinari, Robert W.
2015-01-01
Study Design Literature review and case report. Objective Review the existing literature and report the successful nonoperative management of a two-level craniocervical ligamentous distraction injury. Methods A PubMed and Medline review revealed only three limited reports involving the nonoperative management of patients with craniocervical distraction injury. This article reviews the existing literature and reports the case of a 27-year-old man who was involved in a motorcycle accident and sustained multiple systemic injuries and ligamentous distraction injuries to both occipitocervical joints and both C1–C2 joints. The patient's traumatic brain injury and bilateral pulmonary contusions precluded safe operative management of the two-level craniocervical distraction injury. Therefore, the patient was placed in a halo immobilization device. Results The literature remains unclear as to the specific indications for nonoperative management of ligamentous craniocervical injuries. Nonoperative management was associated with poor outcomes in the majority of reported patients. We report a patient who was managed for 6 months in a halo device. Posttreatment computed tomography and flexion–extension radiographs demonstrated stable occipitocervical and C1–C2 joints bilaterally. The patient reported minimal neck pain and had excellent functional outcome with a Neck Disability Index score of 2 points at 41 months postoperatively. He returned to preinjury level of employment without restriction. Conclusions Further study is needed to determine which craniocervical injuries may be managed successfully with nonoperative measures. PMID:26682101
Caldon, L J M; Walters, S J; Reed, J A; Murphy, A; Worley, A; Reed, M W R
2004-01-01
Wide variation in the surgical management of breast cancer exists at hospital, regional, national and international level. To demonstrate whether variation in surgical practice observed at aggregate level between breast units persists following adjustment for case-mix, individual patient-level data from the Trent Breast Screening Programme Quality Assurance database (1997–2003) was analysed. Expected case-mix adjusted mastectomy rates were derived by logistic regression using the variables tumour size, site and grade, patient age and year of presentation, employing the region's overall case-mix adjusted practice as the reference population. The region's 11 breast screening units detected 5109 (3989 invasive) surgically managed primary breast cancers over the 6-year period. A total of 1828 mastectomies (Mx) were performed (Mx rate 35.8%, 95% confidence interval: 34.5–37.1%). Significant variation in mastectomy rates were observed between units (range 25–45%, P<0.0001), and persists following case-mix adjustment (P<0.0001). Two-fold variation in observed to expected unit mastectomy rate coefficient is demonstrated overall (range 0.66–1.36), increasing to almost four-fold variation in cancers less than 15 mm diameter (range 0.55–1.95). Significant variation in surgery for screen-detected primary breast cancer is not explained by case-mix. Further research is required to investigate potential patient and professional causative factors. PMID:15611797
The surveillance of nursing standards: an organisational case study.
Cooke, Hannah
2006-11-01
Quality assurance has acquired increasing prominence in contemporary healthcare systems and there has been an 'explosion' of audit activity. Some authors have begun to investigate the impact of audit activity on organisational and professional cultures. This paper considers data from a wider study of the management of the 'problem' nurse. Nurses and managers had contrasting perceptions of the value of different methods of assessing ward standards and their views are presented here. The study involved organisational case studies in three healthcare Trusts in the north of England. The fieldwork for this study was funded by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting under their research scholarship programme. Multiple methods were employed including observation, interviewing and documentary analysis. A total of 144 informal interviews were carried out with ward nurses and their managers. The study demonstrated different viewpoints regarding the surveillance of nursing standards at top management, middle management and ward levels. The paper considers the discrepancies between these different viewpoints. None of the participants placed a high value on audit as a method of assessing ward standards. Complaints data and informal methods were more highly valued by managers. Ward nurses stressed the importance of presence and vigilance in assuring high standards of nursing care.
Arnold-Reed, Diane E; Brett, Tom; Troeung, Lakkhina; Vickery, Alistair; Garton-Smith, Jacquie; Bell, Damon; Pang, Jing; Grace, Tegan; Bulsara, Caroline; Li, Ian; Bulsara, Max; Watts, Gerald F
2017-10-22
Familial hypercholesterolaemia (FH), an autosomal dominant disorder of lipid metabolism, results in accelerated onset of atherosclerosis if left untreated. Lifelong treatment with diet, lifestyle modifications and statins enable a normal lifespan for most patients. Early diagnosis is critical. This protocol trials a primary care-based model of care (MoC) to improve detection and management of FH. Pragmatic cluster intervention study with pre-post intervention comparisons in Australian general practices. At study baseline, current FH detection practice is assessed. Medical records over 2 years are electronically scanned using a data extraction tool (TARB-Ex) to identify patients at increased risk. High-risk patients are clinically reviewed to provide definitive, phenotypic diagnosis using Dutch Lipid Clinic Network Criteria. Once an index family member with FH is identified, the primary care team undertake cascade testing of first-degree relatives to identify other patients with FH. Management guidance based on disease complexity is provided to the primary care team. Study follow-up to 12 months with TARB-Ex rerun to identify total number of new FH cases diagnosed over study period (via TARB-Ex, cascade testing and new cases presenting). At study conclusion, patient and clinical staff perceptions of enablers/barriers and suggested improvements to the approach will be examined. Resources at each stage will be traced to determine the economic implications of implementing the MoC and costed from health system perspective. Primary outcomes: increase in number of index cases clinically identified; reduction in low-density lipoprotein cholesterol of treated cases. increase in the number of family cases detected/contacted; cost implications of the MoC. Study approval by The University of Notre Dame Australia Human Research Ethics Committee Protocol ID: 0 16 067F. Registration: Australian New Zealand Clinical Trials Registry ID: 12616000630415. Information will be disseminated via research seminars, conference presentations, journal articles, media releases and community forums. Australian New Zealand Clinical Trials Registry ID 12616000630415; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
[Return to Work and Stay at Work - The Question of Successful Operational Integration Management].
Ohlbrecht, Heike; Detka, Carsten; Kuczyk, Susanne; Lange, Bianca
2018-06-01
The study focuses on the question of how the design of operational integration management (OIM) can be optimized, especially in small and medium-sized enterprises (SMEs), and how previous experience with operational integration management can be used to develop preventive measures to ensure employability. The study follows a multi-perspective qualitative research design. It focused on the survey of 40 retrospective interviews with employees who have undergone different variants of the OIM. In addition, company and inter-company actors were examined through expert surveys. The evaluation of the interviews followed the heuristics of case reconstruction and the research strategy of Grounded Theory. Various influencing factors for the design of a operational integration management can be identified - the biographically anchored attitudes of employers and employees, the corporate culture as well as (company-specific) structural factors - which can become successful conditions and inhibitors of OIM processes in SMEs. Dilemmas that can hinder OIM processes are also evident. OIM processes can also have effects that go beyond the OIM objectives in a narrower sense. The reintegration and retention of the employability of employees can be successful above all if there is a trust-based corporate culture of mindfulness, appreciation and openness. This depends in particular on the attitudes of all those involved. But even in such a corporate culture, dilemmas and conflict potential have an influence on the success of the OIM process. Each company also needs internal and/or external actors with sufficient knowledge and skills to carry out an OIM. © Georg Thieme Verlag KG Stuttgart · New York.
Temporary Employment and Perceived Employability: Mediation by Impression Management
ERIC Educational Resources Information Center
De Cuyper, Nele; De Witte, Hans
2010-01-01
Perceived employability (PE) has been advanced as the upcoming resource for career development, particularly for temporary workers. The question is how temporary workers become employable. Our hypothesis is that temporary workers more than permanent workers use impression management to become employable, both on the internal and the external labor…
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 1 2010-10-01 2010-10-01 false What form must an employer use to report Management Information System (MIS) data to a DOT agency? 40.26 Section 40.26 Transportation Office of the... Employer Responsibilities § 40.26 What form must an employer use to report Management Information System...
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 1 2011-10-01 2011-10-01 false What form must an employer use to report Management Information System (MIS) data to a DOT agency? 40.26 Section 40.26 Transportation Office of the... Employer Responsibilities § 40.26 What form must an employer use to report Management Information System...
Code of Federal Regulations, 2014 CFR
2014-10-01
... 49 Transportation 1 2014-10-01 2014-10-01 false What form must an employer use to report Management Information System (MIS) data to a DOT agency? 40.26 Section 40.26 Transportation Office of the... Employer Responsibilities § 40.26 What form must an employer use to report Management Information System...
Code of Federal Regulations, 2013 CFR
2013-10-01
... 49 Transportation 1 2013-10-01 2013-10-01 false What form must an employer use to report Management Information System (MIS) data to a DOT agency? 40.26 Section 40.26 Transportation Office of the... Employer Responsibilities § 40.26 What form must an employer use to report Management Information System...
Code of Federal Regulations, 2012 CFR
2012-10-01
... 49 Transportation 1 2012-10-01 2012-10-01 false What form must an employer use to report Management Information System (MIS) data to a DOT agency? 40.26 Section 40.26 Transportation Office of the... Employer Responsibilities § 40.26 What form must an employer use to report Management Information System...
Lindberg, Arley
2012-01-01
While effective knowledge management practices are commonly sought by organizations, facilitating the use and ongoing engagement in these practices can be challenging. To this end, one agency developed a strategy for institutionalizing their knowledge management functions by appointing a team responsible for monitoring and implementing knowledge management functions, and creating a report for use as a tool by departments agency-wide. Aimed at increasing transparency both within the agency and with the surrounding community, the report provides an overview of individual departments' programs, goals, recent caseload trends, and latest achievements. The report is made available online and accessible by the general public. This case study describes the development of this team and report, as well as lessons learned and future knowledge management goals for the agency. Copyright © Taylor & Francis Group, LLC
Bhesania, Dhvani; Arora, Ankit; Kapoor, Sonali
2015-09-01
Numerous cases of enamel renal syndrome have been previously reported. Various terms, such as enamel renal syndrome, amelogenesis imperfecta and gingival fibromatosis syndrome, and enamel-renal-gingival syndrome, have been used for patients presenting with the dental phenotype characteristic of this condition, nephrocalcinosis or nephrolithiasis, and gingival findings. This report describes a case of amelogenesis imperfecta of the enamel agenesis variety with nephrolithiasis in a 21-year-old male patient who complained of small teeth. The imaging modalities employed were conventional radiography, cone-beam computed tomography, and renal sonography. Such cases are first encountered by dentists, as other organ or metabolic diseases are generally hidden. Hence, cases of amelogenesis imperfecta should be subjected to advanced diagnostic modalities, incorporating both dental and medical criteria, in order to facilitate comprehensive long-term management.
Managing Liability. Employment Discrimination: A Risk Management Strategy.
ERIC Educational Resources Information Center
McMullan, Sandra H.
This booklet discusses the risks that educational institutions face in regard to employment discrimination litigation and outlines a program to effectively manage such risks. Institutions need to address three main types of employment discrimination issues: sexual harassment, disability-based discrimination, and age discrimination. To deal with…
The perils of healthcare workforce forecasting: a case study of the Philadelphia metropolitan area.
Smith, David Barton; Aaronson, William
2003-01-01
In 1996, a widely circulated and influential forecast for the Philadelphia Metropolitan Area stated that a decline in hospital and healthcare employment in the region would occur over the next five years. It also suggested that this decline would exacerbate the problem of an oversupply of nurses seeking hospital employment. The forecast reflected a regional leadership and expert consensus on the impact of the managed care transformation on workforce needs and was supported by short-term statistical trends in regional utilization and employment. Confounding these predictions was the fact that hospital and healthcare employment actually grew. By the end of 2001, hospitals in the region were experiencing problems in recruiting sufficient numbers of nurses, pharmacists, and technicians. The forecast failed to anticipate the impact of a strong regional economy on supply and underestimated the resilience of underlying forces that have driven the long-term growth in healthcare workforce demand. More effective ongoing monitoring can help moderate the fluctuation of workforce shortages and surpluses.
Self-Management: Facilitating Employee Independence in Supported Employment Settings. Volume 4.
ERIC Educational Resources Information Center
Lagomarcino, Thomas R.; And Others
Seven papers address the teaching of self-management skills to disabled persons in supported employment settings. In "Competitive Employment: Teaching Mentally Retarded Employees to Maintain Their Work Behavior," (Frank Rusch and others), external cues managed by job coaches are contrasted to self-generated cues leading to employee self…
Human Resource Management: Accountability, Reciprocity and the Nexus between Employer and Employee
ERIC Educational Resources Information Center
Charlton, Donna; Kritsonis, William Allan
2009-01-01
The article addresses teacher retention challenges employers are experiencing in the quest to effectively meet standard human resource management practices. The quality of the employer-employee relationship forms the foundation upon which effective management practices thrive. Teachers who remain in education value students and their personal…
Medication management strategies used by older adults with heart failure: A systems-based analysis.
Mickelson, Robin S; Holden, Richard J
2017-09-01
Older adults with heart failure use strategies to cope with the constraining barriers impeding medication management. Strategies are behavioral adaptations that allow goal achievement despite these constraining conditions. When strategies do not exist, are ineffective or maladaptive, medication performance and health outcomes are at risk. While constraints to medication adherence are described in literature, strategies used by patients to manage medications are less well-described or understood. Guided by cognitive engineering concepts, the aim of this study was to describe and analyze the strategies used by older adults with heart failure to achieve their medication management goals. This mixed methods study employed an empirical strategies analysis method to elicit medication management strategies used by older adults with heart failure. Observation and interview data collected from 61 older adults with heart failure and 31 caregivers were analyzed using qualitative content analysis to derive categories, patterns and themes within and across cases. Data derived thematic sub-categories described planned and ad hoc methods of strategic adaptations. Stable strategies proactively adjusted the medication management process, environment, or the patients themselves. Patients applied situational strategies (planned or ad hoc) to irregular or unexpected situations. Medication non-adherence was a strategy employed when life goals conflicted with medication adherence. The health system was a source of constraints without providing commensurate strategies. Patients strived to control their medication system and achieve goals using adaptive strategies. Future patient self-mangement research can benefit from methods and theories used to study professional work, such as strategies analysis.
Brain drain and health workforce distortions in Mozambique.
Sherr, Kenneth; Mussa, Antonio; Chilundo, Baltazar; Gimbel, Sarah; Pfeiffer, James; Hagopian, Amy; Gloyd, Stephen
2012-01-01
Trained human resources are fundamental for well-functioning health systems, and the lack of health workers undermines public sector capacity to meet population health needs. While external brain drain from low and middle-income countries is well described, there is little understanding of the degree of internal brain drain, and how increases in health sector funding through global health initiatives may contribute to the outflow of health workers from the public sector to donor agencies, non-governmental organisations (NGOs), and the private sector. An observational study was conducted to estimate the degree of internal and external brain drain among Mozambican nationals qualifying from domestic and foreign medical schools between 1980-2006. Data were collected 26-months apart in 2008 and 2010, and included current employment status, employer, geographic location of employment, and main work duties. Of 723 qualifying physicians between 1980-2006, 95.9% (693) were working full-time, including 71.1% (493) as clinicians, 20.5% (142) as health system managers, and 6.9% (48) as researchers/professors. 25.5% (181) of the sample had left the public sector, of which 62.4% (113) continued working in-country and 37.6% (68) emigrated from Mozambique. Of those cases of internal migration, 66.4% (75) worked for NGOs, 21.2% (24) for donor agencies, and 12.4% (14) in the private sector. Annual incidence of physician migration was estimated to be 3.7%, predominately to work in the growing NGO sector. An estimated 36.3% (41/113) of internal migration cases had previously held senior-level management positions in the public sector. Internal migration is an important contributor to capital flight from the public sector, accounting for more cases of physician loss than external migration in Mozambique. Given the urgent need to strengthen public sector health systems, frank reflection by donors and NGOs is needed to assess how hiring practices may undermine the very systems they seek to strengthen.
Brain Drain and Health Workforce Distortions in Mozambique
Sherr, Kenneth; Mussa, Antonio; Chilundo, Baltazar; Gimbel, Sarah; Pfeiffer, James; Hagopian, Amy; Gloyd, Stephen
2012-01-01
Introduction Trained human resources are fundamental for well-functioning health systems, and the lack of health workers undermines public sector capacity to meet population health needs. While external brain drain from low and middle-income countries is well described, there is little understanding of the degree of internal brain drain, and how increases in health sector funding through global health initiatives may contribute to the outflow of health workers from the public sector to donor agencies, non-governmental organisations (NGOs), and the private sector. Methods An observational study was conducted to estimate the degree of internal and external brain drain among Mozambican nationals qualifying from domestic and foreign medical schools between 1980–2006. Data were collected 26-months apart in 2008 and 2010, and included current employment status, employer, geographic location of employment, and main work duties. Results Of 723 qualifying physicians between 1980–2006, 95.9% (693) were working full-time, including 71.1% (493) as clinicians, 20.5% (142) as health system managers, and 6.9% (48) as researchers/professors. 25.5% (181) of the sample had left the public sector, of which 62.4% (113) continued working in-country and 37.6% (68) emigrated from Mozambique. Of those cases of internal migration, 66.4% (75) worked for NGOs, 21.2% (24) for donor agencies, and 12.4% (14) in the private sector. Annual incidence of physician migration was estimated to be 3.7%, predominately to work in the growing NGO sector. An estimated 36.3% (41/113) of internal migration cases had previously held senior-level management positions in the public sector. Discussion Internal migration is an important contributor to capital flight from the public sector, accounting for more cases of physician loss than external migration in Mozambique. Given the urgent need to strengthen public sector health systems, frank reflection by donors and NGOs is needed to assess how hiring practices may undermine the very systems they seek to strengthen. PMID:22558237
Minimally Invasive Surgery (MIS) Approaches to Thoracolumbar Trauma.
Kaye, Ian David; Passias, Peter
2018-03-01
Minimally invasive surgical (MIS) techniques offer promising improvements in the management of thoracolumbar trauma. Recent advances in MIS techniques and instrumentation for degenerative conditions have heralded a growing interest in employing these techniques for thoracolumbar trauma. Specifically, surgeons have applied these techniques to help manage flexion- and extension-distraction injuries, neurologically intact burst fractures, and cases of damage control. Minimally invasive surgical techniques offer a means to decrease blood loss, shorten operative time, reduce infection risk, and shorten hospital stays. Herein, we review thoracolumbar minimally invasive surgery with an emphasis on thoracolumbar trauma classification, minimally invasive spinal stabilization, surgical indications, patient outcomes, technical considerations, and potential complications.
A Risk Radar driven by Internet of intelligences serving for emergency management in community.
Huang, Chongfu; Wu, Tong; Renn, Ortwin
2016-07-01
Today, most of the commercial risk radars only have the function to show risks, as same as a set of risk matrixes. In this paper, we develop the Internet of intelligences (IOI) to drive a risk radar monitoring dynamic risks for emergency management in community. An IOI scans risks in a community by 4 stages: collecting information and experience about risks; evaluating risk incidents; verifying; and showing risks. Employing the information diffusion method, we optimized to deal with the effective information for calculating risk value. Also, a specific case demonstrates the reliability and practicability of risk radar. Copyright © 2016 Elsevier Inc. All rights reserved.
38 CFR 21.194 - “Employment services” status.
Code of Federal Regulations, 2010 CFR
2010-07-01
.... Chapter 31 Case Status § 21.194 “Employment services” status. (a) Purpose. The status employment services... veteran's case may be assigned or reassigned to employment services status under the provisions of §§ 21.84, 21.88, 21.94 and 21.98. (c) Continuation in employment services status. A case will remain in...
Update on the Management of High-Risk Penetrating Keratoplasty.
Jabbehdari, Sayena; Rafii, Alireza Baradaran; Yazdanpanah, Ghasem; Hamrah, Pedram; Holland, Edward J; Djalilian, Ali R
2017-03-01
In this article, we review the indications and latest management of high-risk penetrating keratoplasty. Despite the immune-privilege status of the cornea, immune-mediated graft rejection still remains the leading cause of corneal graft failure. This is particularly a problem in the high-risk graft recipients, namely patients with previous graft failure due to rejection and those with inflamed and vascularized corneal beds. A number of strategies including both local and systemic immunosuppression are currently used to increase the success rate of high-risk corneal grafts. Moreover, in cases of limbal stem cell deficiency, limbal stem cells transplantation is employed. Corticosteroids are still the top medication for prevention and treatment in cases of corneal graft rejection. Single and combined administration of immunosuppressive agents e.g. tacrolimus, cyclosporine and mycophenolate are promising adjunctive therapies for prolonging graft survival. In the future, cellular and molecular therapies should allow us to achieve immunologic tolerance even in high-risk grafts.
Giorgini, Giulia; Mesto, Anna; Soardo, Vincenzo
2013-01-01
Tuberculosis (TB) affects more than two billion people worldwide. In hospitals, the presence of suspect cases of infectious TB should be reported as quickly as possible. An anonymous questionnaire was administered to a sample of radiology technicians employed by several local health departments in Italy. The questionnaire contained questions regarding workplace characteristics, knowledge about precautions for preventing disease transmission, degree of collaboration between health professionals and departments regarding communicable diseases. Study results point to the presence of structural and organizational weaknesses as well as inadequate communication between healthcare workers and units. Eighty percent of surveyed technicians stated that patients with suspected TB may arrive in diagnostic radiology wards devoid of surgical mask. The authors suggest the adoption of a checklist to aid healthcare professionals and specifically X-Ray technicians in adopting a behavioral model for the management of patients with infectious TB.
Simma, Leopold; Cincotta, Domenic; Sabato, Stefan; Long, Elliot
2017-09-01
Airway emergencies presenting to the emergency department (ED) are usually managed with conventional equipment and techniques. The patient group managed urgently in the operating room (OR) has not been described. This study aims to describe a case series of children presenting to the ED with airway emergencies managed urgently in the OR, particularly the anaesthetic equipment and techniques used and airway findings. A retrospective cohort study undertaken at The Royal Children's Hospital, Melbourne, Australia. All patients presenting to the ED between 1 January 2012 and 30 July 2015 (42 months) with an airway emergency who were subsequently managed in the OR were included. Patient characteristics, anaesthetic equipment and technique and airway findings were recorded. Twenty-two airway emergencies in 21 patients were included over the study period, on average one every 2 months. Median age was 18 months and 43% were male. Inhalational induction was used in 77.3%, combined inhalational and intravenous induction in 9.1%, and intravenous induction alone in 13.6%. The most commonly used inhalational induction agent was sevoflurane, and the most commonly used intravenous induction agents were ketamine and propofol. Ten airway emergencies did not require intubation, seven for removal of inhaled foreign body, two with progressive tracheal stenosis requiring emergent dilatation and one examination under anaesthesia to rule out inhaled foreign body. Of the 12 airway emergencies that required immediate intubation, direct laryngoscopy was used in 9 and fibre-optic intubating bronchoscopy in 3. For intubations performed by direct laryngoscopy, one was difficult (Cormack and Lehane grade 3). First pass success was 83.3%. Adverse events occurred in 3/22 (13.6%) cases. Advanced airway techniques, including inhalational induction and intubation via fibre-optic intubating bronchoscope, are rarely but predictably required in the management of patients presenting to the ED. Institutions caring for children should prepare in advance where such patients should be managed, by whom, and provide equipment and training for their care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Cecal volvulus as a complication of gastric banding.
Fakhro, Abdulla; O'Riordan, James M; Lawler, Leo P; O'Connell, P Ronan
2009-12-01
Surgery is an increasingly important management option for patients with obesity. Laparoscopic adjustable gastric banding is a procedure employed to treat morbid obesity refractory to medical therapy. It works by reducing the capacity of the stomach and promoting early satiety. We report the unusual case of a 33-year-old female who presented acutely 2 years following laparoscopic adjustable gastric banding with cecal volvulus and closed loop obstruction caused by displacement of the connecting tube.
2001-08-01
Benefit the Direct and Indirect Methods 16 Figure Figure 1: Military Exchanges’ Food Sales for Fiscal Year 1999 6 Abbreviations AAFES Army and Air Force...military installation. As the franchisee , the exchange service builds and operates the restaurants and directly employs and trains the personnel. In...they do not routinely develop a business case analysis, which would include weighing financial benefits with other factors, when determining which
Management in general practice: the challenge of the new General Medical Services contract.
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
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
Cocker, Fiona; Martin, Angela; Scott, Jenn; Venn, Alison; Otahal, Petr; Sanderson, Kristy
2011-12-01
Employees experiencing depression can take a sickness absence or continue working ('presenteeism'). However, little is known about the factors associated with these behaviors within this population. This study aimed to determine the relative importance of socio-demographic, financial, work and health-related factors associated with presenteeism. The 2007 Australian National Survey of Mental Health and Wellbeing provided data from employed individuals reporting lifetime major depression with 12-month symptoms (N=320). Survey adjusted multivariable logistic regression assessed classification of 12-month, depression-related presenteeism on the basis of socio-demographic, financial, work and health factors. Acceptable classification of cases was 70% or greater. Classification of cases based on socio-demographic factors, age, sex and marital status, was reasonable (62%). Adding work factors (work hours and occupation type) produced a 1% increase in successfully classified cases (63%). Health factors further increased correctly classified cases (67%). Marital status, housing tenure and co-morbid mental disorders were important indicators of presenteeism behavior. Work-related variables were restricted to available measures. Potentially important psychosocial work environment factors were unavailable. Cross-sectional data precluded causal inference. Using available factors, model discrimination did not reach an acceptable level i.e. 70% of presenteeism cases successfully classified. This highlighted the contribution of unmeasured factors to presenteeism behavior. Future research should explore the relative importance of psychosocial work environment and personality factors such as work demands, effort/reward imbalance and conscientiousness. The identified associations between socio-demographic, financial and health factors on work attendance behaviors could inform disease management guidelines for employers via recognition of employees at risk of presenteeism. Copyright © 2011 Elsevier B.V. All rights reserved.
Consumers as mental health providers: first-person accounts of benefits and limitations.
Mowbray, C T; Moxley, D P; Collins, M E
1998-11-01
Community support programs are increasingly establishing paid service positions designated exclusively for consumers. Project WINS (Work Incentives and Needs Study), a hybrid case management-vocational program for individuals with severe mental illness, used consumers as peer support specialists (PSSs) to supplement professional roles. Semistructured interviews were conducted with PSSs about 12 months after their employment ended. They identified substantial personal benefits specific to consumer-designated roles (e.g., a "safe" employment setting with accommodations) and general benefits from employment. Problems described were just as numerous, encompassing attitudes toward assigned peers and costs to their own well-being. Critical commentary addressed program operations (structure, supervision, and training needs) and problems in the mental health system. The authors discuss the changed sense of self that service provider roles can create for consumers and suggest that mental health administrators provide anticipatory socialization for this service innovation throughout their agencies and ongoing supports for consumers in their new roles.
Tudor, Terry L; Woolridge, Anne C; Bates, Margaret P; Phillips, Paul S; Butler, Sharon; Jones, Keith
2008-06-01
Changes in environmental legislation and standards governing healthcare waste, such as the Hazardous Waste Regulations are expected to have a significant impact on healthcare waste quantities and costs in England and Wales. This paper presents findings from two award winning case study organizations, the Cardiff and Vale NHS Trust and the Cornwall NHS Trust on 'systems' they have employed for minimizing waste. The results suggest the need for the development and implementation of a holistic range of systems in order to develop best practice, including waste minimization strategies, key performance indicators, and staff training and awareness. The implications for the sharing of best practice from the two case studies are also discussed.
Molecular subtype shift in breast cancer upon trastuzumab treatment: a case report.
Āboliņš, Arnis; Vanags, Andrejs; Trofimovičs, Genadijs; Miklaševičs, Edvīns; Gardovskis, Jānis; Štrumfa, Ilze
2011-01-01
Breast cancer is the most common cancer in women. The mortality remains significant despite advanced treatment possibilities. The management of breast cancer is guided by immunohistochemical data that are summarized into molecular subtypes, namely, luminal A, luminal B, HER2 positive and triple negative. HER2 positive and triple negative subtypes of breast cancer are considered to be biologically distinct. We present a case of clinically aggressive breast cancer in a 58-year-old female. Along the course of the disease, the molecular type switched from HER2 positive to triple negative. The patient deteriorated despite combined therapy. We recommend making a possible change of the molecular subtype and employing repeated immunohistochemical investigation in case of relapse.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Employment. 16.140 Section 16... CONDUCTED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY § 16.140 Employment. No qualified individual with handicaps shall, on the basis of handicap, be subject to discrimination in employment under any program or...
Barnett, Scott D.; Goetz, Lance L.; Toscano, Richard
2015-01-01
Background: Designing effective vocational programs for persons with spinal cord injury (SCI) is essential for improving return to work outcome following injury. The relationship between specific vocational services and positive employment outcome has not been empirically studied. Objective: To examine the association of specific vocational service activities as predictors of employment. Method: Secondary analysis of a randomized, controlled trial of evidence-based supported employment (EBSE) with 12-month follow-up data among 81 Veteran participants with SCI. Results: Primary activities recorded were vocational counseling (23.9%) and vocational case management (23.8%). As expected, job development and employment supports were the most time-consuming activities per appointment. Though the amount of time spent in weekly appointments did not differ by employment outcome, participants obtaining competitive employment averaged significantly more individual activities per appointment. Further, for these participants, job development or placement and employment follow-along or supports were more likely to occur and vocational counseling was less likely to occur. Community-based employment services, including job development or placement and employment follow-along or supports as part of a supported employment model, were associated with competitive employment outcomes. Office-based vocational counseling services, which are common to general models of vocational rehabilitation, were associated with a lack of employment. Conclusions: Vocational services that actively engage Veterans with SCI in job seeking and acquisition and that provide on-the-job support are more likely to lead to employment than general vocational counseling that involves only job preparation. PMID:25762858
Management of organisational changes in a case of de-institutionalisation.
Parlalis, Stavros K
2011-01-01
This paper seeks to explore the development of a discharge programme in one learning disability hospital in Scotland. The study aims to concentrate on organisational developmental changes in that institution. The model of the management during the discharge programme was investigated. The aim of the study is to explore how the discharge programme developed, as seen under the lens of organisational change, in order to find out what kind of model of management is more suitable in similar programmes. A case study was employed. Data were collected by means of interviews. The interviews followed a structured format. The sample of the study had to be a purposive sample and the method of snowball sampling was used; finally, 28 interviews were conducted. A grounded approach was adopted for the data analysis. The software program QSR "NUD*IST" (version "N6") was used as a technical tool, in order to facilitate the data analysis. The findings of this study show that various management models were adopted in the four phases of the discharge programme. These different models represent a "quest" by the institution's management regarding the most appropriate model for managing the discharge programme. This study shows that this goes on continuously in organisations under transition until they settle down to a more permanent state. It was concluded that management models, which are composed of characteristics from the organic theory of organisational management, could apply in discharge programmes. The data gathered enabled the researcher to arrive at a model of management which is suitable for managing organisational changes in discharge programmes, the named "stakeholder management model".
Eliason, Michael J; Melzer, Jonathan M; Winters, Jessica R; Gallagher, Thomas Q
2016-08-01
To complement a case series review of button battery impactions managed at our single military tertiary care center with a thorough literature review of laboratory research and clinical cases to develop a protocol to optimize patient care. Specifically, to identify predictive factors of long-term complications which can be used by the pediatric otolaryngologist to guide patient management after button battery impactions. A retrospective review of the Department of Defense's electronic medical record systems was conducted to identify patients with button battery ingestions and then characterize their treatment course. A thorough literature review complemented the lessons learned to identify potentially predictive clinical measures for long-term complications. Eight patients were identified as being treated for button battery impaction in the aerodigestive tract with two sustaining long-term complications. The median age of the patients treated was 33 months old and the median estimated time of impaction in the aerodigestive tract prior to removal was 10.5 h. Time of impaction, anatomic direction of the battery's negative pole, and identifying specific battery parameters were identified as factors that may be employed to predict sequelae. Based on case reviews, advancements in battery manufacturing, and laboratory research, there are distinct clinical factors that should be assessed at the time of initial therapy to guide follow-up management to minimize potential catastrophic sequelae of button battery ingestion. Published by Elsevier Ireland Ltd.
Viability and Management Targets of Mediterranean Demersal Fisheries: The Case of the Aegean Sea.
Tserpes, George; Nikolioudakis, Nikolaos; Maravelias, Christos; Carvalho, Natacha; Merino, Gorka
2016-01-01
Management of the Mediterranean demersal stocks has proven challenging mainly due to the multi-species character of the fisheries. In the present work, we focus on the multi-species demersal fisheries of the Aegean Sea (eastern Mediterranean) aiming to study the effects of different management measures on the main commercial stocks, as well as to explore the economic viability of the fisheries depending upon these resources, by means of simulated projections. Utilizing the limited available data, our results demonstrated that, under the current exploitation pattern, the economic viability of the fleets is threatened, particularly if fuel prices increase. Additionally, the biological targets set for the most exploited species, such as hake, will not be met under the current management regime. The projections also showed that the only management scenario under which both resource sustainability and economic viability of the fisheries are ensured is the decrease of fleet capacity in terms of vessel numbers. In this case, however, measures to support the fisheries-dependent communities need to be implemented to prevent the collapse of local economies due to employment decrease. Scenarios assuming selectivity improvements would be also beneficial for the stocks but they showed low economic performance and their application would threaten the viability of the fleets, particularly that of the trawlers.
The doctor in claims for work injuries and ill health--legal pitfalls.
Lee, See-Muah; Sng, Judy; Koh, David
2009-08-01
Occupational health work is currently undertaken by the specialist and the non-specialist physician alike. The work scope can vary from medical assessments of individual workers to health risk assessment at the workplace. The scope of the latter will include evaluation of exposures, hazards, risks and its management to control these risks. Much of the case law governing legal disputes over industrial safety and health have involved the employers. Over the years, the actions brought forth by workers have resulted in a formidable volume of case law based on statutes and on the common law of negligence in tort. Disputes over the assessment of workers' health or workplace health risks to the extent that it is a failure to discharge a reasonable standard of care, may result in the doctor being a defendant. Measures to prevent these legal pitfalls include communication with employers about the causative link of the illness suffered to workplace factors and the clarity of contractual obligations undertaken with regard to workplace health risk assessment.
Haynie, J Michael; Shepherd, Dean
2011-05-01
Career researchers have focused on the mechanisms related to career progression. Although less studied, situations in which traumatic life events necessitate a discontinuous career transition are becoming increasingly prevalent. Employing a multiple case study method, we offer a deeper understanding of such transitions by studying an extreme case: soldiers and Marines disabled by wartime combat. Our study highlights obstacles to future employment that are counterintuitive and stem from the discontinuous and traumatic nature of job loss. Effective management of this type of transitioning appears to stem from efforts positioned to formulate a coherent narrative of the traumatic experience and thus to reconstruct foundational assumptions about the world, humanity, and self. These foundational assumptions form the basis for enacting future-orientated career strategies, such that progress toward establishing a new career path is greatest for those who can orientate themselves away from the past (trauma), away from the present (obstacles to a new career), and toward an envisioned future career positioned to confer meaning and purpose through work.
Transcriptomic resources for environmental risk assessment: a case study in the Venice lagoon.
Milan, M; Pauletto, M; Boffo, L; Carrer, C; Sorrentino, F; Ferrari, G; Pavan, L; Patarnello, T; Bargelloni, L
2015-02-01
The development of new resources to evaluate the environmental status is becoming increasingly important representing a key challenge for ocean and coastal management. Recently, the employment of transcriptomics in aquatic toxicology has led to increasing initiatives proposing to integrate eco-toxicogenomics in the evaluation of marine ecosystem health. However, several technical issues need to be addressed before introducing genomics as a reliable tool in regulatory ecotoxicology. The Venice lagoon constitutes an excellent case, in which the assessment of environmental risks derived from the nearby industrial activities represents a crucial task. In this context, the potential role of genomics to assist environmental monitoring was investigated through the definition of reliable gene expression markers associated to chemical contamination in Manila clams, and their subsequent employment for the classification of Venice lagoon areas. Overall, the present study addresses key issues to evaluate the future outlooks of genomics in the environmental monitoring and risk assessment. Copyright © 2014 Elsevier Ltd. All rights reserved.
NASA Astrophysics Data System (ADS)
Ren, Lixia; He, Li; Lu, Hongwei; Chen, Yizhong
2016-08-01
A new Monte Carlo-based interval transformation analysis (MCITA) is used in this study for multi-criteria decision analysis (MCDA) of naphthalene-contaminated groundwater management strategies. The analysis can be conducted when input data such as total cost, contaminant concentration and health risk are represented as intervals. Compared to traditional MCDA methods, MCITA-MCDA has the advantages of (1) dealing with inexactness of input data represented as intervals, (2) mitigating computational time due to the introduction of Monte Carlo sampling method, (3) identifying the most desirable management strategies under data uncertainty. A real-world case study is employed to demonstrate the performance of this method. A set of inexact management alternatives are considered in each duration on the basis of four criteria. Results indicated that the most desirable management strategy lied in action 15 for the 5-year, action 8 for the 10-year, action 12 for the 15-year, and action 2 for the 20-year management.
Management and outcome of infective prepatellar bursitis.
Wilson-MacDonald, J.
1987-01-01
Forty seven cases of prepatellar bursitis are reported. Twenty one patients had sustained a recent injury with a break in the skin which had caused the infection and seventeen patients were employed in jobs which involved kneeling. Oral antibiotics proved to be inadequate treatment in many cases. Splintage and intravenous antibiotics with or without aspiration of the bursa were usually successful in treating the condition, although nine patients required surgical drainage of the bursa. Twelve patients continued to have symptoms months or years after the infection, particularly those with preexisting chronic bursitis, or those who kneeled at work. There was little difference in the results between the different treatment groups. PMID:3447109
An unusual case of intraorbital foreign body and its management
Mukherjee, Bipasha; Goel, Shubhra; Subramanian, Nirmala
2011-01-01
Intraorbital foreign bodies are usually the result of accidental trauma and can lead to considerable morbidity. We report an unusual case of an industrial injury in a plastic manufacuring unit wherein hot molten plastic splashed and solidified inside the orbit. The resultant increased intraorbital pressure led to loss of vision in that eye. The extreme temperature of the foreign body caused extensive thermal damage to the surrounding adnexal structures. Staged reconstructive surgery was undertaken to repair the damage, with an acceptable final cosmetic outcome. Employment of protective eye wear to prevent such accidents in high-risk occupations should be made mandatory. PMID:21157077
Conservative management of uncomplicated mechanical neck pain in a military aviator
Green, Bart N.; Dunn, Andrew S.; Pearce, Solomon M.; Johnson, Claire D.
2010-01-01
Non-radicular neck pain arising from local musculoskeletal structures, known as mechanical neck pain or somatic dysfunction, is highly prevalent in the fighter jet aviator population. The management of this problem includes both therapeutic and aeromedical decisions. In addition to non-steroidal anti-inflammatory medications, waiver guides recommend therapeutic exercise and manipulative therapy as treatments for somatic spine pain in aviators, and such treatments are employed in many military locations. However, there are currently no published studies that describe the use of manipulative therapy for fighter jet aviators. We report the case of an F/A-18 instructor pilot who experienced long-term relief of uncomplicated mechanical neck pain following interdisciplinary management that included manipulation and a home exercise program. Diagnostic considerations, conservative treatment options, and aeromedical concerns are discussed. PMID:20520753
Facial Nerve Trauma: Evaluation and Considerations in Management
Gordin, Eli; Lee, Thomas S.; Ducic, Yadranko; Arnaoutakis, Demetri
2014-01-01
The management of facial paralysis continues to evolve. Understanding the facial nerve anatomy and the different methods of evaluating the degree of facial nerve injury are crucial for successful management. When the facial nerve is transected, direct coaptation leads to the best outcome, followed by interpositional nerve grafting. In cases where motor end plates are still intact but a primary repair or graft is not feasible, a nerve transfer should be employed. When complete muscle atrophy has occurred, regional muscle transfer or free flap reconstruction is an option. When dynamic reanimation cannot be undertaken, static procedures offer some benefit. Adjunctive tools such as botulinum toxin injection and biofeedback can be helpful. Several new treatment modalities lie on the horizon which hold potential to alter the current treatment algorithm. PMID:25709748
Can job sharing work for nurse managers?
Dubourg, Laurence; Ahmling, Janette A; Bujas, Lenka
2006-02-01
Addressing employer reluctance to employ nurse managers in a job-sharing capacity, the aim of this paper is to explore job sharing among nurse managers. The literature highlighted potential fragmentation of leadership, breakdown of communication and higher costs as issues, with the retention of experienced highly motivated managers identified as an advantage. A staff survey explored whether the job-sharing arrangement trialled in a day surgery setting by two nurse managers was successful compared with similar roles held by full-time managers. This paper suggests that nurse managers can successfully job share. Overall, this paper recommends that employers consider a job-sharing arrangement when they wish to retain experienced nurse managers, and highlights aspects that can enhance a successful outcome.
Strategies for the Management of SVC Stent Migration into the Right Atrium
DOE Office of Scientific and Technical Information (OSTI.GOV)
Taylor, J. D., E-mail: drjeremytaylor@yahoo.co.uk; Lehmann, E. D.; Belli, A.-M.
Purpose. Stent migration into the right atrium is a potentially fatal complication of stenting in the venous system and is most likely to occur during the treatment of superior vena cava obstruction. Endovascular approaches that can salvage this hazardous situation are described and the keys to successful treatment are highlighted. Materials and Methods. Four different strategies are reviewed: (1) snaring the stent directly, (2) angioplasty balloon-assisted snaring of the stent, (3) guide wire-assisted snaring of the stent, and (4) superior vena cava-to-inferior vena cava bridging stent. Results. These techniques have been employed in the successful management of four cases. Nomore » short- or long-term complications as a result of these maneuvers have been identified. Additional treatment of the underlying disease was possible at the same time in each case. Conclusion. We conclude that prompt management of right atrial stent migration is essential and can be successfully achieved by a variety of 'bale-out' techniques which are within the technical range of most interventional radiologists.« less
Yuki, Tomoshi; Hakozaki, Yukiya; Yoshinaga, Takeo; Koizumi, Akio
2004-09-01
In present day Japan, when a crisis like the Bhopal accident occurs, due to defects in the current of industrial health law, effective crisis management cannot be taken to minimize health damage in both workers and residents. The current law characterizes industrial health as a part of the welfare service provided by employers for employees. Nevertheless, the company should be liable for all failure and damage including health impairment as a primary party. Moreover, in an emergency crisis, unlike the case of reparations, it is not accepted to argue whether the company should take absolute liability or not. Accordingly, in such cases, we consider it more appropriate to apply the "Polluter Pays Principle" and the principle of "Liability without Fault" to the company's responsibility. By these rules, the company should mobilize their own professionals, who are experts of managing crises, such as occupational physicians and/or industrial health professionals to minimize health damages among citizens in general. The company should take such a social responsibility in a crisis when it is the primary responsible party to the crisis.
2011-01-01
Background Employment rates of long-term ill and disabled people in the UK are low and 2.63 million are on disability-related state benefits. Since the mid-1990 s, UK governments have experimented with a range of active labour market policies aimed to move disabled people off benefits and into work to reduce the risk of poverty and social exclusion. This systematic review asks what employment impact have these interventions had and how might they work better? Methods A systematic review of observational and qualitative empirical studies and systematic reviews published between 2002 and mid-2008 reporting employment effects and/or process evaluations of national UK government interventions focused on helping long-term sick or disabled people (aged 16-64) into the open labour market. This built on our previous systematic review which covered the years 1970 to 2001. Results Searches identified 42 studies, 31 of which evaluated initiatives with an individual focus (improving an individual's employability or providing financial support in returning to work) while 11 evaluated initiatives with an environmental focus (directed at the employment environment or changing the behaviour of employers). This paper synthesises evidence from the 31 studies with an individual focus. The use of personal advisors and individual case management in these schemes helped some participants back to work. Qualitative studies, however, revealed that time pressures and job outcome targets influenced advisors to select 'easier-to-place' claimants into programmes and also inhibited the development of mutual trust, which was needed for individual case management to work effectively. Financial incentives can help with lasting transitions into work, but the incentives were often set too low or were too short-term to have an effect. Many of the studies suffered from selection bias into these programmes of more work-ready claimants. Even though these were national programmes, they had very low awareness and take-up rates, making it unlikely that a population-level impact would be achieved even if effective for participants. Conclusions The evidence reveals barriers and facilitators for the effective implementation of these types of interventions that could inform the continuing welfare reforms. The evidence points towards the need for more long-term, sustained and staged support for those furthest from the labour market. PMID:21418621
Zhu, Min; Liu, Chao; Ren, Shuangshuang; Lin, Zintong; Miao, Leiying; Sun, Weibin
2015-01-01
Gemination or fusion is a rare occurrence in the mandibular posterior teeth. The aim of this article is to describe the problems encountered and the strategy employed in treating such cases. A 34 years old patient came with the complaint of spontaneous and radiating pain in the right mandibular posterior region. The tooth in concern was an anomalous 'double' second mandibular molar diagnosed as having necrotic pulp with chronic apical abscess of endodontic origin. The present case emphasizes the importance of identifying anatomical anomalies during treatment of fused teeth with supernumerary tooth, and the need for the use of advanced imaging modalities like CBCT which is a critical aid in the diagnosis of such cases. Fused teeth can be managed quite efficiently by an overall combined treatment including both endodontic and periodontal therapy.
Okike, Ifeanyichukwu O; Ladhani, Shamez N; Anthony, Mark; Ninis, Nelly; Heath, Paul T
2017-08-21
To define early presenting features of bacterial meningitis in young infants in England and to review the adequacy of individual case management as compared with relevant national guidelines and an expert panel review. Retrospective medical case note review and parental recall using standardised questionnaires. England and Wales. Infants aged <90 days with bacterial meningitis diagnosed between July 2010 and July 2013. Of the 97 cases recruited across England and Wales, 66 (68%) were admitted from home and 31 (32%) were in hospital prior to disease onset. Almost all symptoms reported by parents appeared at the onset of the illness, with very few new symptoms appearing subsequently. Overall, 20/66 (30%) infants were assessed to have received inappropriate prehospital management. The median time from onset of first symptoms to first help was 5 hours (IQR: 2-12) and from triage to receipt of first antibiotic dose was 2.0 hours (IQR: 1.0-3.3), significantly shorter in infants with fever or seizures at presentation compared with those without (1.7 (IQR: 1.0-3.0) vs 4.2 (IQR: 1.8-6.3) hours, p=0.02). Overall, 26 (39%) infants had a poor outcome in terms of death or neurological complication; seizures at presentation was the only significant independent risk factor (OR, 7.9; 95% CI 2.3 to 207.0). For cases in hospital already, the median time from onset to first dose of antibiotics was 2.6 (IQR: 1.3-9.8) hours, and 12/31 (39%) of infants had serious neurological sequelae at hospital discharge. Hearing test was not performed in 23% and when performed delayed by ≥4 weeks in 41%. In young infants, the non-specific features associated with bacterial meningitis appear to show no progression from onset to admission, whereas there were small but significant differences in the proportion of infants with more specific symptoms at hospital admission compared with at the onset of the illness, highlighting the difficulties in early recognition by parents and healthcare professionals alike. A substantial proportion of infants received inappropriate prehospital and posthospital management. We propose a targeted campaign for education and harmonisation of practice with evidence-based management algorithms. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Consolidation of medical groups into physician practice management organizations.
Robinson, J C
1998-01-14
Medical groups are growing and merging to improve efficiency and bargaining leverage in the competitive managed care environment. An increasing number are affiliating with physician practice management (PPM) firms that offer capital financing, expertise in utilization management, and global capitation contracts with health insurance entities. These physician organizations provide an alternative to affiliation with a hospital system and to individual physician contracting with health plans. To describe the growth, structure, and strategy of PPM organizations that coordinate medical groups in multiple markets and contract with health maintenance organizations (HMOs). Case studies, including interviews with administrative and clinical leaders, review of company documents, and analysis of documents from investment bankers, the Securities and Exchange Commission, and industry observers. Medical groups and independent practice associations (IPAs) in California and New Jersey affiliated with MedPartners, FPA Medical Management, and UniMed. Growth in number of primary care and specialty care physicians employed by and contracting with affiliated medical groups; growth in patient enrollment from commercial, Medicare, and Medicaid HMOs; growth in capitation and noncapitation revenues; structure and governance of affiliated management service organizations and professional corporations; and contracting strategies with HMOs. Between 1994 and 1996, medical groups and IPAs affiliated with 3 PPMs grew from 3787 to 25763 physicians; 65% of employed physicians provide primary care, while the majority of contracting physicians provide specialty care. Patient enrollment in HMOs grew from 285503 to 3028881. Annual capitation revenues grew from $190 million to $2.1 billion. Medical groups affiliated with PPMs are capitated for most professional, hospital, and ancillary clinical services and are increasingly delegated responsibility by HMOs for utilization management and quality assurance. Physician practice management organizations and their affiliated medical groups face the challenge of continuing rapid growth, sustaining stock values, and improving practice efficiencies while maintaining the loyalty of physicians and patients.
Carboni, Fabio; Valle, Mario; Federici, Orietta; Levi Sandri, Giovanni Battista; Camperchioli, Ida; Lapenta, Rocco; Assisi, Daniela; Garofalo, Alfredo
2016-08-01
Esophagojejunal anastomosis leakage after total gastrectomy (TG) for esophagogastric junction (EGJ) adenocarcinoma (ADC) constitutes one of the most serious and sometimes life-threatening complications. Management remains controversial and still challenging. A total of 198 patients operated for type I and II EGJ ADC were reviewed. Diagnosis of leakage was based on a combination of clinical and radiological findings. It was classified including objective endoscopic and clinical parameters requiring different type of treatment. Anastomotic leakage was diagnosed in 14 patients (7%). Two cases recovered with conservative therapy. Six cases underwent endoscopy with clips placement in 2 and partially covered self-expandable metal stent placement in 4. Other two cases underwent reoperation with reconstruction of anastomosis and primary repair respectively. In the last four cases emergency surgery with total esophagectomy and diversion was required. Mortality occurred only in 3 of these patients and overall treatment was successful in 11 patients (78.5%). No consensus has been reached on the best method of esophagojejunal anastomosis leakage management and the rate of failure remains significant. Different options of treatment are available but early detection and multidisciplinary approaches are the keys to obtain successful results irrespective of the employed strategy.
Vergara, Franz H; Sheridan, Daniel J; Sullivan, Nancy J; Budhathoki, Chakra
The purpose of this study was to determine whether a face-to-face meeting with patients by a telephonic case manager prehospital discharge would result in increased telephone follow-up (TFU) reach rates posthospital discharge. Acute care adult medicine inpatient units. A quasiexperimental design was utilized. Two adult inpatient medicine units were selected as the intervention and comparison groups. The framework of the study is the transitions theory. A convenience sampling technique was used, whereby 88 eligible patients on the intervention unit received face-to-face meetings prehospital discharge whereas 123 patients on the comparison unit received standard care (no face-to-face meetings). Cross-tabulation and chi-square tests were employed to examine the association of face-to-face meeting intervention and TFU reach rates. Implementing brief (<10 min) face-to-face meetings by a telephonic case manager prehospital discharge resulted in a TFU reach rate of 87% on the intervention unit, whereas the comparison unit only had a 58% TFU reach rate (p < .001). Increasing reach rates by a telephonic case manager facilitates communication with more patients posthospital discharge. A brief prehospital discharge face-to-face meeting with patients assisted them to understand the reasons for a posthospital discharge telephone call, identified the best times to call using accurate telephone numbers, and taught patients how best to prepare for the call. In addition, by meeting patients face-to-face, the telephonic case manager was no longer an unknown person on the telephone asking them questions about their medical condition. These factors combined may have significantly helped to increase TFU reach rates.
NASA Astrophysics Data System (ADS)
Xiao, Jian; Zhang, Mingqiang; Tian, Haiping; Huang, Bo; Fu, Wenlong
2018-02-01
In this paper, a novel prognostics and health management system architecture for hydropower plant equipment was proposed based on fog computing and Docker container. We employed the fog node to improve the real-time processing ability of improving the cloud architecture-based prognostics and health management system and overcome the problems of long delay time, network congestion and so on. Then Storm-based stream processing of fog node was present and could calculate the health index in the edge of network. Moreover, the distributed micros-service and Docker container architecture of hydropower plants equipment prognostics and health management was also proposed. Using the micro service architecture proposed in this paper, the hydropower unit can achieve the goal of the business intercommunication and seamless integration of different equipment and different manufacturers. Finally a real application case is given in this paper.
NASA Astrophysics Data System (ADS)
Mesick, S.; Weathers, K. W.
2017-12-01
Data complexity can be seen as a continuum from complex to simple. The term data complexity refers to data collections that are disorganized, poorly documented, and generally do not follow best data management practices. Complex data collections are challenging and expensive to manage. Simplified collections readily support automated archival processes, enhanced discovery and data access, as well as production of services that make data easier to reuse. In this session, NOAA NCEI scientific data stewards will discuss the data complexity continuum. This talk will explore data simplification concepts, methods, and tools that data managers can employ which may offer more control over data management costs and processes, while achieving policy goals for open data access and ready reuse. Topics will include guidance for data managers on best allocation of limited data management resources; models for partnering with NCEI to accomplish shared data management goals; and will demonstrate through case studies the benefits of investing in documentation, accessibility, and services to increase data value and return on investment.
[Standard of integration management at company level and its auditing].
Flach, T; Hetzel, C; Mozdzanowski, M; Schian, H-M
2006-10-01
Responsibility at company level for the employment of workers with health-related problems or disabilities has increased, inter alia because of integration management at company level according to section 84 (2) of the German Social Code Book IX. Although several recommendations exist, no standard is available for auditing and certification. Such a standard could be a basis for granting premiums according to section 84 (3) of Book IX of the German Social Code. AUDIT AND CERTIFICATION: One product of the international "disability management" movement is the "Consensus Based Disability Management Audit" (CBDMA). The Audit is a systematic and independent measurement of the effectiveness of integration management at company level. CBDMA goals are to give evidence of the quality of the integration management implemented, to identify opportunities for improvement and recommend appropriate corrective and preventive action. In May 2006, the integration management of Ford-Werke GmbH Germany with about 23 900 employees was audited and certified as the first company in Europe. STANDARD OF INTEGRATION MANAGEMENT AT COMPANY LEVEL: In dialogue with corporate practitioners, the international standard of CBDMA has been adapted, completed and verified concerning its practicability. Process orientation is the key approach, and the structure is similar to DIN EN ISO 9001:2000. Its structure is as follows: (1) management-labour responsibility (goals and objectives, program planning, management-labour review), (2) management of resources (disability manager and DM team, employees' participation, cooperation with external partners, infrastructure), (3) communication (internal and external public relations), (4) case management (identifying cases, contact, situation analysis, planning actions, implementing actions and monitoring, process and outcome evaluation), (5) analysis and improvement (analysis and program evaluation), (6) documentation (manual, records).
Moving from full-time healing work to paid employment: challenges and celebrations.
Bergmans, Yvonne; Carruthers, Anne; Ewanchuk, Elizabeth; James, Judy; Wren, Kate; Yager, Christina
2009-01-01
The experiences and barriers associated with the return to paid employment following healing from recurrent suicide attempts related to mental illness have not been addressed in the literature to date. This paper is a collaborative case study between graduates (experts by experience) and facilitators of a psychosocial/psychoeducational group for people with recurrent suicide attempts. The journeys taken by the experts by experience are explored through thematic narrative analysis. Issues of stigma, disclosure, accommodations, maintaining wellness and coming to re-define a sense of self were consistent themes found throughout all narratives. The paper identified key areas of challenge and celebration, suggesting the need for enhanced support from health care providers, workplace managers, supervisors and colleagues for successful transitions into the workplace.
Employer Engagement Practices of UK Business Schools and Departments: An Empirical Investigation
ERIC Educational Resources Information Center
Bennett, Roger; Kane, Suzanne
2009-01-01
A survey of managers in charge of employer engagement activities in UK business schools and departments was completed to ascertain: (1) the employer engagement methods that were most commonly used by institutions; (2) business school managers' attitudes towards employers' involvement in course design; and (3) the respondents' perceptions of the…
Sritharan, Jeavana; Demers, Paul A; Harris, Shelley A; Cole, Donald C; Peters, Cheryl E; Villeneuve, Paul J
2017-06-01
The etiology of prostate cancer continues to be poorly understood, including the role of occupation. Past Canadian studies have not been able to thoroughly examine prostate cancer by occupation with detailed information on individual level factors. Occupation, industry and prostate cancer were examined using data from the National Enhanced Cancer Surveillance System, a large population-based case-control study conducted across eight Canadian provinces from 1994 to 1997. This analysis included 1737 incident cases and 1803 controls aged 50 to 79 years. Lifetime occupational histories were used to group individuals by occupation and industry employment. Odds ratios and 95% confidence intervals were calculated and adjustments were made for known and possible risk factors. By occupation, elevated risks were observed in farming and farm management (OR=1.37, 95% CI 1.02-1.84), armed forces (OR=1.33, 95% CI 1.06-1.65) and legal work (OR=2.58, 95% CI 1.05-6.35). Elevated risks were also observed in office work (OR=1.20, 95% CI 1.00-1.43) and plumbing (OR=1.77, 95% CI 1.07-2.93) and with ≥10 years duration of employment. Decreased risks were observed in senior management (OR=0.65, 95% CI 0.46-0.91), construction management (OR=0.69, 95% CI 0.50-0.94) and travel work (OR=0.37, 95% CI 0.16-0.88). Industry results were similar to occupation results, except for an elevated risk in forestry/logging (OR=1.54, 95% CI 1.06-2.25) and a decreased risk in primary metal products (OR=0.70, 95% CI 0.51-0.96). This study presents associations between occupation, industry and prostate cancer, while accounting for individual level factors. Further research is needed on potential job-specific exposures and screening behaviours. Copyright © 2017 Elsevier Ltd. All rights reserved.
[New analgesics in paediatrics].
Avez-Couturier, Justine; Wood, Chantal
2016-01-01
There are a number of different types of analgesics in paediatrics. They must be used in accordance with the situation, the type of pain and the characteristics of the child. In all cases, strict compliance with the posology and the instructions for use is essential to avoid any risk of error. Finally, pharmacological, physical and psychological treatments are employed in a complementary manner, for the biopsychosocial management of the child's care. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Argon plasma coagulation in the management of uncovered tracheal stent fracture
Ching, Yiu-Hei; Geck, Robert D.; Andrews, Arthur D.; Rumbak, Mark J.; Camporesi, Enrico M.
2014-01-01
Endotracheal and endobronchial stenting, particularly with uncovered stents, can be complicated by stent fracture, granulation tissue formation, direct airway injury, and airway obstruction. While stent removal is possible, it can result in significant complications and long-term benefit is not guaranteed. Argon plasma coagulation can be employed to trim fractured stent fragments and remove granulation tissue simultaneously. In this manuscript, we report a case and describe our experience with using this technique. PMID:26029557
Allocation of health resources according to the type and size of Iranian governmental hospitals.
Hassani, Sa; Abolhallaje, M; Inanlo, S; Hosseini, H; Pourmohammadi, K; Bastani, P; Ramezanian, M; Marnani, A Barati
2013-01-01
Due to consuming about 50%-80% of health resources, hospitals are the greatest and costly operational units in Iranian Health system. so allocation of resources specially human and space resources as the most expensive ones is really important for further controlling of costs, analysis of costs and making suitable policies for increasing the profitability and allocation of resources and improvement of quality. This paper intends to describe and analyze any allocation of resources in 530 university hospitals in Iran. The final goal of this research is to provide a data bank according which there is a basis for more scientific budget allocation of state's hospitals from the size and type of application points of view. The relevant index of person to bed was 2.04 for human resources. All hospitals more than 300 beds are located in benefiting areas from which 17 cases are educational and 2 cases are therapeutic. This is necessary to mention that the rate of management group forces to total personnel at deprived areas is about 2.5% more than benefiting areas. Because 60-80% of hospital costs are applied for human forces, all managers of hospitals are obliged to revise their policies in attraction and employment of human force in order to benefit from such a valuable resource and prevent from expensive costs. So any employment of personnel should be based upon real needs of hospital.
Coe, Taylor M.; Chang, David C.; Sicklick, Jason K.
2015-01-01
Background Small bowel volvulus is a rare entity in Western adults. Greater insight into epidemiology and outcomes may be gained from a national database inquiry. Methods The Nationwide Inpatient Sample (1998–2010), a 20% stratified sample of United States hospitals, was retrospectively reviewed for small bowel volvulus cases (ICD-9 560.2 excluding gastric/colonic procedures) in patients ≥18-years old. Results There were 2,065,599 hospitalizations for bowel obstruction (ICD-9 560.x). Of those, there were 20,680 (1.00%) small bowel volvulus cases; 169 were attributable to intestinal malrotation. Most cases presented emergently (89.24%) and operative management was employed more frequently than non-operative (65.21% vs. 34.79%, P<0.0001). Predictors of mortality included age >50-years, Charlson comorbidity index ≥1, emergent admission, peritonitis, acute vascular insufficiency, coagulopathy, and non-operative management (P<0.0001). Conclusions As the first population-based epidemiological study of small bowel volvulus, our findings provide a robust representation of this rare cause of small bowel obstruction in American adults. PMID:26002189
41 CFR 101-4.505 - Employment criteria.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Employment criteria. 101-4.505 Section 101-4.505 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 4-NONDISCRIMINATION ON THE BASIS OF SEX IN...
Pinto, Sharrel L; Kumar, Jinender; Partha, Gautam; Bechtol, Robert A
2013-01-01
Background The purpose of this study was to determine the cost savings of a pharmacist-led, employer-sponsored medication therapy management (MTM) program for diabetic patients and to assess for any changes in patient satisfaction and self-reported medication adherence for enrollees. Methods Participants in this study were enrollees of an employer-sponsored MTM program. They were included if their primary medical insurance and prescription coverage was from the City of Toledo, they had a diagnosis of type 2 diabetes, and whether or not they had been on medication or had been given a new prescription for diabetes treatment. The data were analyzed on a prospective, pre-post longitudinal basis, and tracked for one year following enrollment. Outcomes included economic costs, patient satisfaction, and self-reported patient adherence. Descriptive statistics were used to characterize the population, calculate the number of visits, and determine the mean costs for each visit. Friedman’s test was used to determine changes in outcomes due to the nonparametric nature of the data. Results The mean number of visits to a physician’s office decreased from 10.22 to 7.07. The mean cost of these visits for patients increased from $47.70 to $66.41, but use of the emergency room and inpatient visits decreased by at least 50%. Employer spending on emergency room visits decreased by $24,214.17 and inpatient visit costs decreased by $166,610.84. Office visit spending increased by $11,776.41. A total cost savings of $179,047.80 was realized by the employer at the end of the program. Significant improvements in patient satisfaction and adherence were observed. Conclusion Pharmacist interventions provided through the employer-sponsored MTM program led to substantial cost savings to the employer with improved patient satisfaction and adherence on the part of employees at the conclusion of the program. PMID:23610526
Tucker, P; Gaertner, J; Mason, C
2001-12-01
As with many forms of flexible working, Annualized Hours (AH) systems offer potential benefits to both the employer and the employee. However, the flexibility requirements of employers and employees often conflict. Therefore, when a large food manufacturing organization decided to redesign its AH system, it employed an independent consultancy to act as neutral third party. The consultancy provided technical expertise and assistance in developing an AH system that optimised productivity and was acceptable to the workforce. Data are presented, obtained from focus groups conducted throughout the organization, describing some of the potential difficulties of implementing an AH system. Drawing upon these data, a number of new AH systems were proposed and modelled using specialist software tools. The design process is described, together with the advantages and difficulties associated with use of the software tools. It is concluded that the key elements in the process of designing AH systems are centred around issues of trust and communication; the involvement of a broad range of interested parties, through a process of carefully managed group facilitation; and the need for adequate technical support in the development and evaluation of AH systems.
41 CFR 301-75.101 - What pre-employment interview travel expenses may we pay?
Code of Federal Regulations, 2010 CFR
2010-07-01
... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What pre-employment interview travel expenses may we pay? 301-75.101 Section 301-75.101 Public Contracts and Property Management...-EMPLOYMENT INTERVIEW TRAVEL Travel Expenses § 301-75.101 What pre-employment interview travel expenses may we...
41 CFR 301-75.2 - May we pay pre-employment interview travel expenses?
Code of Federal Regulations, 2010 CFR
2010-07-01
... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false May we pay pre-employment interview travel expenses? 301-75.2 Section 301-75.2 Public Contracts and Property Management...-EMPLOYMENT INTERVIEW TRAVEL General Rules § 301-75.2 May we pay pre-employment interview travel expenses? Yes...
2013-01-01
Background Effective human resources management plays a vital role in the success of health-care sector reform. Leaders are selected for their clinical expertise and not their management skills, which is often the case at the middle-management level. The purpose of this study was to examine the situation in some fields that involve working with people in health-care organizations at middle-management level. Methods The study included eight state-owned hospitals in Slovenia. A cross-sectional study included 119 middle managers and 778 employees. Quota sampling was used for the subgroups. Structured survey questionnaires were administered to leaders and employees, each consisting of 24 statements in four content sets evaluated on a 5-point Likert-type scale. Respondents were also asked about the type and number of training or education programmes they had participated in over the last three years. Descriptive statistics, two-way analysis of variance, Pearson’s correlation coefficient and multiple linear regression were used. The study was conducted from March to December 2008. Results Statistically significant differences were established between leaders and employees in all content sets; no significant differences were found when comparing health-care providers and health-administration workers. Employment position was found to be a significant predictor for employee development (β = 0.273, P < 0.001), the leader–employee relationship (β = 0.291, P < 0.001) and organizational motivation (β = 0.258, P < 0.001). Area of work (β = 0.113, P = 0.010) and employment position (β = 0.389, P < 0.001) were significant predictors for personal involvement. Level of education correlated negatively with total scores for organizational motivation: respondents with a higher level of education were rated with a lower score (β = -0.117, P = 0.024). Health-care providers participate in management programmes less frequently than do health-administration workers. Conclusion Employee participation in change-implementation processes was low, as was awareness of the importance of employee development. Education of employees in Slovenian hospitals for leadership roles is still not perceived as a necessary investment for improving work processes. Hospitals are state owned and a national strategy should be developed on how to improve leadership and management in Slovenian hospitals. PMID:23663315
Skull base bony lesions: Management nuances; a retrospective analysis from a Tertiary Care Centre
Singh, Amit Kumar; Srivastava, Arun Kumar; Sardhara, Jayesh; Bhaisora, Kamlesh Singh; Das, Kuntal Kanti; Mehrotra, Anant; Sahu, Rabi Narayan; Jaiswal, Awadhesh Kumar; Behari, Sanjay
2017-01-01
Background: Skull base lesions are not uncommon, but their management has been challenging for surgeons. There is large no of bony tumors at the skull base which has not been studied in detail as a group. These tumors are difficult not only because of their location but also due to their variability in the involvement of important local structure. Through this retrospective analysis from a Tertiary Care Centre, we are summarizing the details of skull base bony lesions and its management nuances. Materials and Methods: The histopathologically, radiologically, and surgically proven cases of skull base bony tumors or lesions involving bone were analyzed from the neurosurgery, neuropathology record of our Tertiary Care Institute from January 2009 to January 2014. All available preoperative and postoperative details were noted from their case files. The extent of excision was ascertained from operation records and postoperative magnetic resonance imaging if available. Results: We have surgically managed 41 cases of skull base bony tumors. It includes 11 patients of anterior skull base, 13 middle skull base, and 17 posterior skull base bony tumors. The most common bony tumor was chordoma 15 (36.6%), followed by fibrous dysplasia 5 (12.2%), chondrosarcoma (12.2%), and ewings sarcoma-peripheral primitive neuroectodermal tumor (EWS-pPNET) five cases (12.2%) each. There were more malignant lesions (n = 29, 70.7%) at skull base than benign (n = 12, 29.3%) lesions. The surgical approach employed depended on location of tumor and pathology. Total mortality was 8 (20%) of whom 5 patients were of histological proven EWS-pPNET. Conclusions: Bony skull base lesion consists of wide variety of lesions, and requires multispecialty management. The complex lesions required tailored approaches surgery of these lesions. With the advent of microsurgical and endoscopic techniques, and use of navigation better outcomes are being seen, but these lesions require further study for development of proper management plan. PMID:28761532
ERIC Educational Resources Information Center
Fonseca, Linda Lafferty
Developed in Illinois, this document contains three components. The first component consists of employability task lists for the business, marketing, and management occupations of first-line supervisors and manager/supervisors; file clerks; traffic, shipping, and receiving clerks; records management analysts; adjustment clerks; and customer…
Mitchell, Michael S; Koen, Clifford M; Darden, Stephen M
2014-01-01
As more and more individuals express themselves with tattoos and body piercings and push the envelope on what is deemed appropriate in the workplace, employers have an increased need for creation and enforcement of reasonable dress codes and appearance policies. As with any employment policy or practice, an appearance policy must be implemented and enforced without regard to an individual's race, color, gender, national origin, religion, disability, age, or other protected status. A policy governing dress and appearance based on the business needs of an employer that is applied fairly and consistently and does not have a disproportionate effect on any protected class will generally be upheld if challenged in court. By examining some of the more common legal challenges to dress codes and how courts have resolved the disputes, health care managers can avoid many potential problems. This article, the second part of a 3-part examination of dress codes and appearance policies, focuses on the issue of gender under the Civil Rights Act of 1964. Pertinent court cases that provide guidance for employers are addressed.
Mitchell, Michael S; Koen, Clifford M; Moore, Thomas W
2013-01-01
As more and more individuals choose to express themselves and their religious beliefs with headwear, jewelry, dress, tattoos, and body piercings and push the envelope on what is deemed appropriate in the workplace, employers have an increased need for creation and enforcement of reasonable dress codes and appearance policies. As with any employment policy or practice, an appearance policy must be implemented and enforced without regard to an individual's race, color, sex, national origin, religion, disability, age, or any other protected status. A policy governing dress and appearance based on the business needs of an employer that is applied fairly and consistently and does not have a disproportionate effect on any protected class will generally be upheld if challenged in court. By examining some of the more common legal challenges to dress codes and how courts have resolved the disputes, health care managers can avoid many potential problems. This article addresses the issue of religious discrimination focusing on dress and appearance and some of the court cases that provide guidance for employers.
Lafreniere, Katherine C; Deshpande, Sameer; Bjornlund, Henning; Hunter, M Gordon
2013-11-15
Many attempts to implement resource management initiatives in Canadian and international communities have been resisted by stakeholders despite inclusion of their representatives in the decision-making process. Managers' failure to understand stakeholders' perspectives when proposing initiatives is a potential cause of this resistance. Our study uses marketing thought to enhance stakeholder theory by bringing in an audience-centric perspective. We attempt to understand how stakeholders perceive their interests in an organization and consequently decide how to influence that organization. By doing so, we investigate whether a disconnect exists between the perceptions of managers and those of stakeholders. Natural resource managers can utilize this knowledge to garner stakeholder support for the organization and its activities. We support this claim with findings from a water transfer plebiscite held in the Canadian province of Alberta. Sixteen personal interviews employing narrative inquiry were conducted to document voters' (i.e., irrigators') interpretations. Copyright © 2013 Elsevier Ltd. All rights reserved.
Hardy, Claire; Griffiths, Amanda; Hunter, Myra S
2017-07-01
To explore women's perspectives on what employers and managers should and should not do in relation to women going through the menopause. An online questionnaire was used to collect qualitative data in a cross-sectional study of working women. Three open-ended questions asked peri- and post-menopausal women, aged 45-65 years: (i) what they thought employers could do, or should do, to help menopausal women who may be experiencing difficult menopausal symptoms at work; (ii) how managers should behave; and (iii) how managers should not behave towards women going through the menopause. 137 women responded to the open questions in the survey. An inductive thematic analysis was conducted and three overarching themes emerged. Theme 1 related to employer/manager awareness, specifically to knowledge about the menopause and awareness of how the physical work environment might impact on menopausal women. Theme 2 related to employer/manager communication skills and behaviors, specifically those considered helpful and desired and those considered unhelpful and undesired. Theme 3 described employer actions, involving staff training and raising awareness, and supportive policies such as those relating to sickness absence and flexible working hours. The menopause can be difficult for some women to deal with at work, partly due to the working environment. To our knowledge, this is the first study to explore women's descriptions of how they would like to be treated by employers/managers, and what would be helpful and unhelpful. The results have clear implications for communication about menopause at work and for employer-level policy and practice. Copyright © 2017. Published by Elsevier B.V.
Dengue fever in patients admitted in tertiary care hospitals in Pakistan.
Munir, Muhammad Arif; Alam, Syed Ejaz; Khan, Zareef Uddin; Saeed, Quaid; Arif, Ambreen; Iqbal, Rizwan; Saqib, Muhammad Arif Nadeem; Qureshi, Huma
2014-05-01
To assess the gaps in the diagnosis and management of dengue fever cases. The retrospective descriptive analytical study was done with a case record analysis of patients with dengue fever admitted from January to December 2010 at five tertiary care hospitals in different Pakistani cities. Using a questionnaire, information was gathered on demography, haematological profile, management, use of blood and platelet transfusions and the outcome. For comparison, data of serologically-confirmed dengue patients from a private laboratory in Islamabad was collected to see the age, gender and month-wise distribution of cases tested over the same period. SPSS 16 was used for statistical analysis. Out of the 841 confirmed dengue cases, 514 (79%) were males and 139 (21%) females. The overall mean age was 31.3 +/- 14.0 years. Dengue fever was seen in 653 (78%) and dengue haemorrhagic fever (DHF) in 188 (22%) patients. Most cases were between 20 and 49 years of age. A gradual increase in dengue fever and dengue haemorrhagic fever was seen from August, with a peak in October/November. Tourniquet test was done only in 20 (2.3%) cases, out of which 11 (55%) were positive and 9 (45%) were negative. Serial haematocrit was not done in any case. Total deaths were 5 (0.6%). Most cases were seen in October/November with the majority being in the 20-39 age group. Tourniquet test and serial haematocrit were infrequently used. No standard national guidelines were employed.
Poremski, Daniel; Stergiopoulos, Vicky; Braithwaite, Erika; Distasio, Jino; Nisenbaum, Rosane; Latimer, Eric
2016-06-01
Housing First is emerging as an evidence-based practice for housing and supporting people who are homeless and have a mental illness. The objective of this study was to determine whether Housing First increases the odds of obtaining competitive employment in this population and affects income, including income from informal and illegal sources. A total of 2,148 people with a mental illness were recruited from five Canadian cities while they were homeless, classified as having moderate or high needs, and randomly assigned to Housing First or usual care. Housing First participants with high needs received assertive community treatment (ACT), and those with moderate needs received intensive case management (ICM). Every three months, participants were interviewed about employment and earnings in the previous months (median follow-up=745 days). Regression models were estimated via generalized estimating equations. ICM recipients had lower odds of obtaining employment compared with the control group with moderate needs. The odds of obtaining employment among ICM recipients increased but their employment rate never exceeded that of the control group. For ACT recipients, the odds of obtaining employment were not significantly different from those of the control group. Among Housing First participants, persons employed at baseline, men, and younger participants had greater odds of employment compared with control participants. Housing First did not appear to significantly increase income. This was the first large-scale randomized controlled study of Housing First's effects on employment. Further research is needed to determine how Housing First may be enhanced to increase odds of obtaining employment.
41 CFR 101-4.435 - Employment assistance to students.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Employment assistance to students. 101-4.435 Section 101-4.435 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 4-NONDISCRIMINATION ON THE BASIS OF SEX IN...
41 CFR 101-4.130 - Effect of employment opportunities.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Effect of employment opportunities. 101-4.130 Section 101-4.130 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 4-NONDISCRIMINATION ON THE BASIS OF SEX IN...
(OAR) EEO/Diversity Program provides services to OAR employees, managers and applicants for employment for employment and management about Equal Employment Opportunity/Diversity through the following , DOC, EEOC and OPM. ANNOUNCEMENTS 2018 EEO/Diversity Calendar of Events Nicole photo Nicole Mason EEO
Bowser, Benjamin P; Jenkins-Barnes, Tazima; Dillard-Smith, Carla; Lockett, Gloria
2010-01-01
MORE was a mobile outreach drug abuse prevention and HIV harm reduction program primarily for ex-offenders who are active drug users. Through case management, clients were provided substance abuse education, counseling, and referral. Long term goals of these services were to reduce their drug use and re-incarceration for drug related crimes. From January 2002 to May 2006, 487 unduplicated clients were recruited in year long cohorts and offered services. The program evaluation tool was the Federal Office of Budget and Management Government Performance and Results Act questionnaire. Government Performance and Results Act interviews were conducted at in-take into the program, approximately six months later and again approximately 12 months after their initial in-take. By the six and 12 month follow-up interviews, active drug using clients reported significant reductions in their use of alcohol, cocaine/crack, heroin, and fewer sex partners and crimes. Program completers reported significantly reduced cocaine/crack and heroin use as well as fewer days in jail and crimes than non-completers (p < .01 to .001). Six program components account for these reductions: case management, day-treatment, outpatient services, outreach, HIV/AIDS, and substance abuse education. The differences in program service intensity, income, and employment for program completers and non-completers were analyzed using logistic regression. The intensity of case management and all services received along with having higher income by month six were the most significant predictors of program completion.
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.
Munro, Kathleen M
2008-11-01
This paper aims to highlight some issues and tensions that currently challenge the profession, individual nurses and their employers when considering the need for continuing professional development. The Nursing and Midwifery Council states the professional requirements for continuing professional development. However the nature and type required seems to be determined by the individual on the one hand and the organisation on the other, rather than an integral part of professional activity within the context of work. This can lead to a mismatch between personal and organisational goals. Views emerged from participants in a previous case study that focused on learning through work, about support available to nurses for professional development. The perceptions of nurses and their managers about learning through work were explored, using semi structured interviews, picture mapping and structured interviews. The 'Charity Paradigm' is presented as an outcome of major issues within an organisation. It underpins negative perceptions of individuals about employer support of continuing professional development. It is suggested that there is a need for collaborative collective approaches to structured development in order to meet both individual and organisational needs. This is also advocated in order to achieve life long learning and transformational learning within an organisation. The tension between individual personal ambitions and employer demands can adversely affect the professional development of the practitioner and the organisation that employs them. The personal perspectives of nurses and managers about learning within their organisation are therefore important to acknowledge in terms of positive and negative influences. It is also necessary to recognise the contribution of the employer as well as the identifiable charitable contribution of individual practitioners and the input from external contributors to the organisation.
Identifying and Tracing User Needs
NASA Astrophysics Data System (ADS)
To, C.; Tauer, E.
2017-12-01
Providing adequate tools to the user community hinges on reaching the specific goals and needs behind the intended application of the tool. While the approach of leveraging user-supplied inputs and use cases to identify those goals is not new, there frequently remains the challenge of tracing those use cases through to implementation in an efficient and manageable fashion. Processes can become overcomplicated very quickly, and additionally, explicitly mapping progress towards the achievement of the user demands can become overwhelming when hundreds of use-cases are at play. This presentation will discuss a demonstrated use-case approach that has achieved an initial success with a tool re-design and deployment, the means to apply use cases in the generation of a roadmap for future releases over time, and the ability to include and adjust to new user requirements and suggestions with minimal disruption to the traceability. It is hoped that the findings and lessons learned will help make use case employment easier for others seeking to create user-targeted capabilities.
[Analysis of a case series of workers with mobbing syndrome].
Marinoni, B; Minelli, C M; Franzina, B; Martellosio, V; Scafa, F; Giorgi, I; Mazzacane, F; Stancanelli, M; Mennoia, N V; Candura, S M
2007-01-01
Mobbing represents nowadays a major challenge for Occupational Medicine. We examined, during the last seven years, 253 patients who asked medical assistance for psychopathological problems by them ascribed to mobbing in the working environment. All patients underwent occupational health visit, psychological counselling (including personality tests administration), and psychiatric evaluation. A clinical picture probably due to mobbing was diagnosed in 37 workers: 2 cases of Post-Traumatic Stress Disorder (PTSD), 33 of Adjustment Disorder (AD), and 2 of anxiety disorder. Regarding mobbing typology, we found 19 cases of vertical mobbing (by an employer/manager to employees), 14 cases of strategic mobbing, 3 cases of horizontal mobbing (among colleagues), and one non intentional mobbing. In conclusion, a pure mobbing syndrome was diagnosed in a lower proportion than that reported by other investigators. The described interdisciplinary approach appears useful for the diagnostic assessment of suspect mobbing cases, that in turn is crucial for prognosis and treatment, as well as in relation to medico-legal issues and work-related compensation claims.
Do rheumatologists recognize their patients' work-related problems?
Gilworth, G; Haigh, R; Tennant, A; Chamberlain, M A; Harvey, A R
2001-11-01
The question addressed in this pilot study was 'Does the addition of an occupational health physiotherapist offering early vocational assessment influence the management of rheumatology patients (clinically and related to the workplace)?' Sequential vocational assessments were offered to 78 subjects with rheumatological complaints of more than 1 yr duration experiencing difficulties in working. The findings from the vocational assessments were fed back to rheumatologists. Where necessary and acceptable, workplace interventions were made and the Employment Service's Access to Work scheme was utilized to address the employment problems found. The intervention vocational assessments trebled the number of subjects seeing a Disability Employment Adviser (17% before the study, a further 37% during it). High levels of satisfaction were reported for interventions made at work. Some important changes to the management of some patients by a few doctors were made, but information from the vocational assessments did not reach them reliably in a number of cases. An unmet need for advice and workplace aids and equipment was identified. Vocational assessment by a practitioner with clinical knowledge, ergonomic and workplace experience proved helpful to patients in this pilot study. Without vocational assessment, the hospital-based team rarely identified what were often remediable, work problems and appeared unaware of the appropriate referral route for this group of patients. Rheumatologists may need to expand their management to include consideration of work issues to ensure that their patients are referred early for appropriate ergonomic intervention when required. Further study is required to help facilitate easy identification in the clinical setting of patients with problems at work.
43 CFR 3861.5 - Appointment and employment of mineral surveyors.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Appointment and employment of mineral...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.5 Appointment and employment of mineral surveyors. ...
43 CFR 3861.5 - Appointment and employment of mineral surveyors.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Appointment and employment of mineral...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.5 Appointment and employment of mineral surveyors. ...
43 CFR 3861.5 - Appointment and employment of mineral surveyors.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Appointment and employment of mineral...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.5 Appointment and employment of mineral surveyors. ...
43 CFR 3861.5 - Appointment and employment of mineral surveyors.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Appointment and employment of mineral...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.5 Appointment and employment of mineral surveyors. ...
International management platform for children's interstitial lung disease (chILD-EU).
Griese, Matthias; Seidl, Elias; Hengst, Meike; Reu, Simone; Rock, Hans; Anthony, Gisela; Kiper, Nural; Emiralioğlu, Nagehan; Snijders, Deborah; Goldbeck, Lutz; Leidl, Reiner; Ley-Zaporozhan, Julia; Krüger-Stollfuss, Ingrid; Kammer, Birgit; Wesselak, Traudl; Eismann, Claudia; Schams, Andrea; Neuner, Doerthe; MacLean, Morag; Nicholson, Andrew G; Lauren, McCann; Clement, Annick; Epaud, Ralph; de Blic, Jacques; Ashworth, Michael; Aurora, Paul; Calder, Alistair; Wetzke, Martin; Kappler, Matthias; Cunningham, Steve; Schwerk, Nicolaus; Bush, Andy
2018-03-01
Children's interstitial lung diseases (chILD) cover many rare entities, frequently not diagnosed or studied in detail. There is a great need for specialised advice and for internationally agreed subclassification of entities collected in a register.Our objective was to implement an international management platform with independent multidisciplinary review of cases at presentation for long-term follow-up and to test if this would allow for more accurate diagnosis. Also, quality and reproducibility of a diagnostic subclassification system were assessed using a collection of 25 complex chILD cases. A web-based chILD management platform with a registry and biobank was successfully designed and implemented. Over a 3-year period, 575 patients were included for observation spanning a wide spectrum of chILD. In 346 patients, multidisciplinary reviews were completed by teams at five international sites (Munich 51%, London 12%, Hannover 31%, Ankara 1% and Paris 5%). In 13%, the diagnosis reached by the referring team was not confirmed by peer review. Among these, the diagnosis initially given was wrong (27%), imprecise (50%) or significant information was added (23%).The ability of nine expert clinicians to subcategorise the final diagnosis into the chILD-EU register classification had an overall exact inter-rater agreement of 59% on first assessment and after training, 64%. Only 10% of the 'wrong' answers resulted in allocation to an incorrect category. Subcategorisation proved useful but training is needed for optimal implementation. We have shown that chILD-EU has generated a platform to help the clinical assessment of chILD. Results, NCT02852928. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
A study on building data warehouse of hospital information system.
Li, Ping; Wu, Tao; Chen, Mu; Zhou, Bin; Xu, Wei-guo
2011-08-01
Existing hospital information systems with simple statistical functions cannot meet current management needs. It is well known that hospital resources are distributed with private property rights among hospitals, such as in the case of the regional coordination of medical services. In this study, to integrate and make full use of medical data effectively, we propose a data warehouse modeling method for the hospital information system. The method can also be employed for a distributed-hospital medical service system. To ensure that hospital information supports the diverse needs of health care, the framework of the hospital information system has three layers: datacenter layer, system-function layer, and user-interface layer. This paper discusses the role of a data warehouse management system in handling hospital information from the establishment of the data theme to the design of a data model to the establishment of a data warehouse. Online analytical processing tools assist user-friendly multidimensional analysis from a number of different angles to extract the required data and information. Use of the data warehouse improves online analytical processing and mitigates deficiencies in the decision support system. The hospital information system based on a data warehouse effectively employs statistical analysis and data mining technology to handle massive quantities of historical data, and summarizes from clinical and hospital information for decision making. This paper proposes the use of a data warehouse for a hospital information system, specifically a data warehouse for the theme of hospital information to determine latitude, modeling and so on. The processing of patient information is given as an example that demonstrates the usefulness of this method in the case of hospital information management. Data warehouse technology is an evolving technology, and more and more decision support information extracted by data mining and with decision-making technology is required for further research.
The role of the occupational therapist in the care of people living with lung cancer.
White, Kahren M
2016-06-01
This paper aims to explore the vital role occupational therapists play in enabling people living with lung cancer to continue to actively live. Core assessments and interventions employed by occupational therapists are described in a case study. It will demonstrate how people living with lung cancer can continue to participate in meaningful and chosen life roles, even in the face of functional decline. Skilled management by the occupational therapist of the refractory symptoms of advanced lung cancer supports this participation.
Intrathecal Analgesia and Palliative Care: A Case Study
Salins, Naveen S; Crawford, Gregory B
2010-01-01
Intrathecal analgesia is an interventional form of pain relief with definite advantages and multiple complications. Administration of intrathecal analgesia needs a good resource setting and expertise. Early complications of intrathecal analgesia can be very distressing and managing these complications will need a high degree of knowledge, technical expertise and level of experience. Pain control alone cannot be the marker of quality in palliative care. A holistic approach may need to be employed that is more person and family oriented. PMID:20859471
Rocca-Serra, Philippe; Brandizi, Marco; Maguire, Eamonn; Sklyar, Nataliya; Taylor, Chris; Begley, Kimberly; Field, Dawn; Harris, Stephen; Hide, Winston; Hofmann, Oliver; Neumann, Steffen; Sterk, Peter; Tong, Weida; Sansone, Susanna-Assunta
2010-01-01
Summary: The first open source software suite for experimentalists and curators that (i) assists in the annotation and local management of experimental metadata from high-throughput studies employing one or a combination of omics and other technologies; (ii) empowers users to uptake community-defined checklists and ontologies; and (iii) facilitates submission to international public repositories. Availability and Implementation: Software, documentation, case studies and implementations at http://www.isa-tools.org Contact: isatools@googlegroups.com PMID:20679334
A new frontier: applying comprehensive DM strategies to healthy members.
2001-02-01
Extend disease management services to 'healthy' members. Why? Because with all the emphasis on high-cost, chronically ill patients, a health plan's most valuable asset is being ignored. At least that's the case being made by Nashville, TN-based American Healthways, which has rolled out a new program designed to put health plans in touch with all their members, not just the chronically ill. Through the use of predictive modeling, the program is designed to target higher risk members so preventive strategies can be employed.
Segmenting hospitals for improved management strategy.
Malhotra, N K
1989-09-01
The author presents a conceptual framework for the a priori and clustering-based approaches to segmentation and evaluates them in the context of segmenting institutional health care markets. An empirical study is reported in which the hospital market is segmented on three state-of-being variables. The segmentation approach also takes into account important organizational decision-making variables. The sophisticated Thurstone Case V procedure is employed. Several marketing implications for hospitals, other health care organizations, hospital suppliers, and donor publics are identified.
Xingjun, Guo; Feng, Zhu; Min, Wang; Renyi, Qin
2016-08-01
Crohn's disease of the duodenum is an uncommon condition. Our case was an extremely rare manifestation of Crohn's disease, who presented with obstruction of the pylorus and the first and the second parts of the duodenum. Because of the severity of the obstruction, he underwent laparoscopic pancreaticoduodenectomy. Postoperative pancreatic leakage and bowel fistula were not observed, and there was no morbidity during the follow-up period. There was also no disturbance in digestive function, postoperatively. This is the first case employing laparoscopic pancreaticoduodenectomy to cure benign lesions leading to duodenal obstruction. Minimally invasive laparoscopic pancreaticoduodenectomy technology shows a very big advantage in treating this rare benign Crohn's disease.
THE MANAGEMENT OF ABSCESS OF THE LUNG
Byron, Francis X.
1952-01-01
A review of the literature raises considerable doubt as to the advisability of surgical drainage of lung abscess as a definitive procedure. The mortality rate with use of this procedure and other hazards associated with it, must now be viewed in the light of improved methods of conservative therapy — involving the use of penicillin, bronchoscopic treatment and postural drainage—by which cure can be obtained in more than 80 per cent of cases of acute abscess and in a smaller proportion of cases of chronic abscess. Another factor to be considered is the better chance for diagnosis and effective resection of associated carcinoma when conservative treatment is employed. ImagesFigure 1. PMID:14935878
[Emergency eye care in French university hospitals].
Bourges, J-L
2018-03-01
The patient's request for urgent care in ophthalmology (PRUCO) at health care centers is constantly growing. In France, university hospitals are managing 75% of these cases. We sought to quantify PRUCO referred to French university hospital emergency units as well as to approach the structure and the territorial distribution of emergency eye care provided by French university hospitals. We conducted a quick cross-sectional survey sent to the 32 metropolitan and overseas French university hospitals. It inquired for each hospital whether emergency eye care units were available, whether ophthalmologists were on duty or on call overnight and how many PRUCO were managed in 2016. The 32 university hospitals completed the survey. A total of 398650 PRUCO were managed in French university hospitals in 2016. The emergency unit was exclusively dedicated to eye care for 70% of the hospitals, with 47% (15/32) of them employing an ophthalmologist on duty overnight. Every hospital but one had at least one ophthalmologist on call. The city of Paris set aside, university hospitals took care of an annual mean of 9000 PRUCO (min=500; max=32,250). The 32 French university hospitals are actively responding to patient's requests for urgent care in ophthalmology with very heterogeneous patient volumes and organizational systems. Half of them employ ophthalmologists on duty. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Disability management: organizational diversity and Dutch employment policy.
Kopnina, Helen; Haafkens, Joke A
2010-06-01
While Human Resource Managers (HRM) and line managers could play a significant role in the prevention of job-related problems and in promotion of early job-continuation, it is not clear wether the chronically ill workers are recognized as a group. Unlike some other groups, distinguished by gender, age or ethnicity, those with chronic illness are less distinct and may not be included in diversity management programs. The aim of this research is to address theory and evidence in literature about the topic, as well as to inquire whether chronic illness of the employees is 'visible' in practice. For desk research, we used a systematic search strategy involving medical, statistical, management, and social science databases (Web of Science, MedLine, Pub Med, Psych Info, etc.). Research results are based on case studies conducted with the managers and HRM of government and commercial organizations between March 2007 and October 2008 and between October 2008 and April 2009. These case studies were based on open interviews and focus group sessions (for human resource departments) which were consequently analyzed using thematical analysis. For group sessions, we used concept mapping to collect information from two groups of HRM professionals and managers. Secondary analysis included thematic and content analysis of 'best practice' organizations carried out by the Dutch organization Gatekeeper. We have discovered that the chronically ill employees are largely invisible to HRM practitioners, line managers who do not always have the right instruments for implementation of the European or national frameworks. Most practitioners are unaware of the impact of chronic illness in their organizations and in employees work life.
Population-based medical and disease management: an evaluation of cost and quality.
Wise, Christopher G; Bahl, Vinita; Mitchell, Rita; West, Brady T; Carli, Thomas
2006-02-01
Reports by the Institute of Medicine and the Health Care Financing Administration have emphasized that the integration of medical care delivery, evidence-based medicine, and chronic care disease management may play a significant role in improving the quality of care and reducing medical care costs. The specific aim of this project is to assess the impact of an integrated set of care coordination tools and chronic disease management interventions on utilization, cost, and quality of care for a population of beneficiaries who have complementary health coverage through a plan designed to apply proactive medical and disease management processes. The utilization of health care services by the study population was compared to another population from the same geographic service area and covered by a traditional fee-for-service indemnity insurance plan that provided few medical or disease management services. Evaluation of the difference in utilization was based on the difference in the cost per-member-per-month (PMPM) in a 1-year measurement period, after adjusting for differences in fee schedules, case-mix and healthcare benefit design. After adjustments for both case-mix and benefit differences, the study group is $63 PMPM less costly than the comparison population for all members. Cost differences are largest in the 55-64 and 65 and above age groups. The study group is $115 PMPM lower than the comparison population for the age category of 65 years and older, after adjustments for case-mix and benefits. Health Plan Employer and Data Information Set (HEDIS)-based quality outcomes are near the 90th percentile for most indications. The cost outcomes of a population served by proactive, population-based disease management and complex care management, compared to an unmanaged population, demonstrates the potential of coordinated medical and disease management programs. Further studies utilizing appropriate methodologies would be beneficial.
49 CFR 655.72 - Reporting of results in a management information system.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 7 2010-10-01 2010-10-01 false Reporting of results in a management information... management information system. (a) Each recipient shall annually prepare and maintain a summary of the... recipient's or employer's behalf. (d) As an employer, you must use the Management Information System (MIS...
49 CFR 382.403 - Reporting of results in a management information system.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 5 2010-10-01 2010-10-01 false Reporting of results in a management information... Confidentiality § 382.403 Reporting of results in a management information system. (a) An employer shall prepare... that the FMCSA specifies in its request. The employer must use the Management Information System (MIS...
29 CFR 541.201 - Directly related to management or general business operations.
Code of Federal Regulations, 2010 CFR
2010-07-01
... management or general business operations. (a) To qualify for the administrative exemption, an employee's... operations of the employer or the employer's customers. The phrase “directly related to the management or... 29 Labor 3 2010-07-01 2010-07-01 false Directly related to management or general business...
49 CFR 382.403 - Reporting of results in a management information system.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 5 2011-10-01 2011-10-01 false Reporting of results in a management information... Confidentiality § 382.403 Reporting of results in a management information system. (a) An employer shall prepare... that the FMCSA specifies in its request. The employer must use the Management Information System (MIS...
49 CFR 382.403 - Reporting of results in a management information system.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 49 Transportation 5 2012-10-01 2012-10-01 false Reporting of results in a management information... Confidentiality § 382.403 Reporting of results in a management information system. (a) An employer shall prepare... that the FMCSA specifies in its request. The employer must use the Management Information System (MIS...
49 CFR 382.403 - Reporting of results in a management information system.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 49 Transportation 5 2013-10-01 2013-10-01 false Reporting of results in a management information... Confidentiality § 382.403 Reporting of results in a management information system. (a) An employer shall prepare... that the FMCSA specifies in its request. The employer must use the Management Information System (MIS...
49 CFR 655.72 - Reporting of results in a management information system.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 7 2011-10-01 2011-10-01 false Reporting of results in a management information... management information system. (a) Each recipient shall annually prepare and maintain a summary of the... recipient's or employer's behalf. (d) As an employer, you must use the Management Information System (MIS...
49 CFR 655.72 - Reporting of results in a management information system.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 49 Transportation 7 2014-10-01 2014-10-01 false Reporting of results in a management information... management information system. (a) Each recipient shall annually prepare and maintain a summary of the... recipient's or employer's behalf. (d) As an employer, you must use the Management Information System (MIS...
49 CFR 382.403 - Reporting of results in a management information system.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 49 Transportation 5 2014-10-01 2014-10-01 false Reporting of results in a management information... Confidentiality § 382.403 Reporting of results in a management information system. (a) An employer shall prepare... that the FMCSA specifies in its request. The employer must use the Management Information System (MIS...
49 CFR 655.72 - Reporting of results in a management information system.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 49 Transportation 7 2012-10-01 2012-10-01 false Reporting of results in a management information... management information system. (a) Each recipient shall annually prepare and maintain a summary of the... recipient's or employer's behalf. (d) As an employer, you must use the Management Information System (MIS...
49 CFR 655.72 - Reporting of results in a management information system.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 49 Transportation 7 2013-10-01 2013-10-01 false Reporting of results in a management information... management information system. (a) Each recipient shall annually prepare and maintain a summary of the... recipient's or employer's behalf. (d) As an employer, you must use the Management Information System (MIS...
77 FR 77121 - Hispanic Council on Federal Employment
Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-31
.... Reviewing leading practices in strategic human resources management planning; b. Providing advice on ways to... technical expertise regarding strategic human resources management planning and the merit systems principles... OFFICE OF PERSONNEL MANAGEMENT Hispanic Council on Federal Employment AGENCY: Office of Personnel...
Ulhassan, Waqar; von Thiele Schwarz, Ulrica; Westerlund, Hugo; Sandahl, Christer; Thor, Johan
2015-01-01
Visual management (VM) tools such as whiteboards, often employed in Lean thinking applications, are intended to be helpful in improving work processes in different industries including health care. It remains unclear, however, how VM is actually applied in health care Lean interventions and how it might influence the clinical staff. We therefore examined how Lean-inspired VM using whiteboards for continuous improvement efforts related to the hospital staff's work and collaboration. Within a case study design, we combined semistructured interviews, nonparticipant observations, and photography on 2 cardiology wards. The fate of VM differed between the 2 wards; in one, it was well received by the staff and enhanced continuous improvement efforts, whereas in the other ward, it was not perceived to fit in the work flow or to make enough sense in order to be sustained. Visual management may enable the staff and managers to allow communication across time and facilitate teamwork by enabling the inclusion of team members who are not present simultaneously; however, its adoption and value seem contingent on finding a good fit with the local context. A combination of continuous improvement and VM may be helpful in keeping the staff engaged in the change process in the long run.
Factors associated with unreported tuberculosis cases in Spanish hospitals.
Morales-García, Concepción; Rodrigo, Teresa; García-Clemente, Marta M; Muñoz, Ana; Bermúdez, Pilar; Casas, Francisco; Somoza, María; Milá, Celia; Penas, Antón; Hidalgo, Carmen; Casals, Martí; Caylá, Joan A
2015-07-29
Under-reporting of tuberculosis (TB) cases complicates disease control, hinders contact tracing and alters the accuracy of epidemiological data, including disease burden. The objective of the present study is to evaluate the proportion of unreported TB cases in Spanish healthcare facilities and to identify the associated factors. A multi-center retrospective study design was employed. The study included TB cases diagnosed in 16 facilities during 2011-2012. These cases were compared to those reported to the corresponding public health departments. Demographic, microbiological and clinical data were analyzed to determine the factors associated with unreported cases. Associated factors were analyzed on a bivariate level using the x(2) test and on a multivariate level using a logistic regression. Odds ratios (OR) and 95 % confidence intervals (CI) were calculated. Of the 592 TB cases included in the study, 85 (14.4 %) were not reported. The percentage of unreported cases per healthcare center ranged from 0-45.2 %. The following variables were associated to under-reporting at a multivariate level: smear-negative TB (OR = 1.87; CI:1.07-3.28), extrapulmonary disease (OR = 2.07; CI:1.05-4.09) and retired patients (OR = 3.04; CI:1.29-7.18). A nurse case manager was present in all of the centers with 100 % reporting. The percentage of reported cases among the smear-positive cases was 9.4 % and 19.4 % (p = 0.001) among the rest of the study population. Smear-positive TB was no associated to under-reporting. It is important that TB Control Programs encourage thorough case reporting to improve disease control, contact tracing and accuracy of epidemiological data. The help from a TB nurse case manager could improve the rate of under-reporting.
NASA Schedule Management Handbook
NASA Technical Reports Server (NTRS)
2011-01-01
The purpose of schedule management is to provide the framework for time-phasing, resource planning, coordination, and communicating the necessary tasks within a work effort. The intent is to improve schedule management by providing recommended concepts, processes, and techniques used within the Agency and private industry. The intended function of this handbook is two-fold: first, to provide guidance for meeting the scheduling requirements contained in NPR 7120.5, NASA Space Flight Program and Project Management Requirements, NPR 7120.7, NASA Information Technology and Institutional Infrastructure Program and Project Requirements, NPR 7120.8, NASA Research and Technology Program and Project Management Requirements, and NPD 1000.5, Policy for NASA Acquisition. The second function is to describe the schedule management approach and the recommended best practices for carrying out this project control function. With regards to the above project management requirements documents, it should be noted that those space flight projects previously established and approved under the guidance of prior versions of NPR 7120.5 will continue to comply with those requirements until project completion has been achieved. This handbook will be updated as needed, to enhance efficient and effective schedule management across the Agency. It is acknowledged that most, if not all, external organizations participating in NASA programs/projects will have their own internal schedule management documents. Issues that arise from conflicting schedule guidance will be resolved on a case by case basis as contracts and partnering relationships are established. It is also acknowledged and understood that all projects are not the same and may require different levels of schedule visibility, scrutiny and control. Project type, value, and complexity are factors that typically dictate which schedule management practices should be employed.
The Trouble with Applicant Impression Management.
ERIC Educational Resources Information Center
Ralston, Steven M.; Kirkwood, William G.
1999-01-01
Suggests that applicant impression management (AIM) is more harmful to employment interviewing than is currently suspected. Offers a conceptual model of AIM that is consistent with employment interviewing practice. Presents and critiques three arguments used to defend AIM. Examines a model for helping employers conduct interviews that minimize the…
41 CFR 60-250.20 - Covered employment activities.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Covered employment activities. 60-250.20 Section 60-250.20 Public Contracts and Property Management Other Provisions Relating to... PROTECTED VETERANS Discrimination Prohibited § 60-250.20 Covered employment activities. The prohibition...
41 CFR 60-250.20 - Covered employment activities.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Covered employment activities. 60-250.20 Section 60-250.20 Public Contracts and Property Management Other Provisions Relating to... PROTECTED VETERANS Discrimination Prohibited § 60-250.20 Covered employment activities. The prohibition...
41 CFR 60-250.20 - Covered employment activities.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Covered employment activities. 60-250.20 Section 60-250.20 Public Contracts and Property Management Other Provisions Relating to... PROTECTED VETERANS Discrimination Prohibited § 60-250.20 Covered employment activities. The prohibition...
NASA Astrophysics Data System (ADS)
Coughlan, Michael R.
2016-05-01
Forest managers are increasingly recognizing the value of disturbance-based land management techniques such as prescribed burning. Unauthorized, "arson" fires are common in the southeastern United States where a legacy of agrarian cultural heritage persists amidst an increasingly forest-dominated landscape. This paper reexamines unauthorized fire-setting in the state of Georgia, USA from a historical ecology perspective that aims to contribute to historically informed, disturbance-based land management. A space-time permutation analysis is employed to discriminate systematic, management-oriented unauthorized fires from more arbitrary or socially deviant fire-setting behaviors. This paper argues that statistically significant space-time clusters of unauthorized fire occurrence represent informal management regimes linked to the legacy of traditional land management practices. Recent scholarship has pointed out that traditional management has actively promoted sustainable resource use and, in some cases, enhanced biodiversity often through the use of fire. Despite broad-scale displacement of traditional management during the 20th century, informal management practices may locally circumvent more formal and regionally dominant management regimes. Space-time permutation analysis identified 29 statistically significant fire regimes for the state of Georgia. The identified regimes are classified by region and land cover type and their implications for historically informed disturbance-based resource management are discussed.
Coughlan, Michael R
2016-05-01
Forest managers are increasingly recognizing the value of disturbance-based land management techniques such as prescribed burning. Unauthorized, "arson" fires are common in the southeastern United States where a legacy of agrarian cultural heritage persists amidst an increasingly forest-dominated landscape. This paper reexamines unauthorized fire-setting in the state of Georgia, USA from a historical ecology perspective that aims to contribute to historically informed, disturbance-based land management. A space-time permutation analysis is employed to discriminate systematic, management-oriented unauthorized fires from more arbitrary or socially deviant fire-setting behaviors. This paper argues that statistically significant space-time clusters of unauthorized fire occurrence represent informal management regimes linked to the legacy of traditional land management practices. Recent scholarship has pointed out that traditional management has actively promoted sustainable resource use and, in some cases, enhanced biodiversity often through the use of fire. Despite broad-scale displacement of traditional management during the 20th century, informal management practices may locally circumvent more formal and regionally dominant management regimes. Space-time permutation analysis identified 29 statistically significant fire regimes for the state of Georgia. The identified regimes are classified by region and land cover type and their implications for historically informed disturbance-based resource management are discussed.
[Stress management for office workers].
Hayashi, Takeshi
2002-09-01
The environment which surrounds office workers has undergone a big transformation with the collapse of lifetime employment, the shift from the long employment principle to meritocracy, the results principle, the introduction of flexible work hours, outsourcing and dispatch work. Today's office worker stressor include 1. VDT work, 2. meritocracy, 3. management by objective, 4. excessive load on the middle and advanced age generations, 5. the collapse of the lifetime employment system and 6. non-employee changes. (1) VDT work management, (2) the use of Information technology, (3) Improvement of office environments, (4) Management of long overtime work and (5) Support of superiors and colleagues are thought as stress management.
Assessment of need of patients with schizophrenia: a study in Vellore, India.
Ernest, Sharmila; Nagarajan, Guru; Jacob, K S
2013-12-01
and aims: There is a dearth of studies investigating the prevalence and factors associated with unmet needs in people with schizophrenia from low- and middle-income countries. We aimed to study prevalence and risk factors for unmet need. A case-control study design was employed. One hundred and one (101) consecutive patients attending a psychiatric hospital were assessed using Camberwell Assessment of Need Short version (CANSAS) and Positive and Negative Syndrome Scale (PANSS). Multivariate analysis was employed to adjust for confounders. The majority of patients had many unmet needs. These unmet needs were significantly associated with lower education, poverty and persistent psychopathology on multivariate analysis. Unmet needs are associated with poverty, lower education and persistent psychopathology. There is a need to manage unmet needs, in addition to addressing psychopathology and poverty.
Managing age discrimination: an examination of the techniques used when seeking employment.
Berger, Ellie D
2009-06-01
This article examines the age-related management techniques used by older workers in their search for employment. Data are drawn from interviews with individuals aged 45-65 years (N = 30). Findings indicate that participants develop "counteractions" and "concealments" to manage perceived age discrimination. Individuals counteract employers' ageist stereotypes by maintaining their skills and changing their work-related expectations and conceal age by altering their résumés, physical appearance, and language used. This research suggests that there is a need to reexamine the hiring practices of employers and to improve legislation in relation to their accountability.
78 FR 45580 - Hispanic Council on Federal Employment
Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-29
... OFFICE OF PERSONNEL MANAGEMENT Hispanic Council on Federal Employment AGENCY: Office of Personnel Management. ACTION: Cancelling and re-scheduling of Council meetings. SUMMARY: The Hispanic Council on... other responsibilities, the Council shall advise the Director of the Office of Personnel Management on...
78 FR 65010 - Hispanic Council on Federal Employment
Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-30
... OFFICE OF PERSONNEL MANAGEMENT Hispanic Council on Federal Employment AGENCY: Office of Personnel Management. ACTION: Cancelling and Re-Scheduling of Council Meetings. SUMMARY: The Hispanic Council on... other responsibilities, the Council shall advise the Director of the Office of Personnel Management on...
Disability Management in Small Firms.
ERIC Educational Resources Information Center
Drury, David
1991-01-01
Notes that American research has paid relatively little attention to prospects for adapting disability management practices to financial and management environment of smaller employers. Compares large and small firms in terms of employer disability practices and characteristics of disabled workers; discusses barriers to rehabilitation and…
Update on the Management of High-Risk Penetrating Keratoplasty
Jabbehdari, Sayena; Rafii, Alireza Baradaran; Yazdanpanah, Ghasem; Hamrah, Pedram; Holland, Edward J.; Djalilian, Ali R
2017-01-01
Purpose of review In this article, we review the indications and latest management of high-risk penetrating keratoplasty. Recent findings Despite the immune-privilege status of the cornea, immune-mediated graft rejection still remains the leading cause of corneal graft failure. This is particularly a problem in the high-risk graft recipients, namely patients with previous graft failure due to rejection and those with inflamed and vascularized corneal beds. A number of strategies including both local and systemic immunosuppression are currently used to increase the success rate of high-risk corneal grafts. Moreover, in cases of limbal stem cell deficiency, limbal stem cells transplantation is employed. Summary Corticosteroids are still the top medication for prevention and treatment in cases of corneal graft rejection. Single and combined administration of immunosuppressive agents e.g. tacrolimus, cyclosporine and mycophenolate are promising adjunctive therapies for prolonging graft survival. In the future, cellular and molecular therapies should allow us to achieve immunologic tolerance even in high-risk grafts. PMID:28959505
Learning Strategy in Class Management: A Reflection from Manado Case
NASA Astrophysics Data System (ADS)
Suardi Wekke, Ismail; Yandra, Alexander; Hamuddin, Budianto
2017-12-01
This article is a research conducted with qualitative approach with various case studies underlining a strategy that becomes the basis for classroom management. The article discusses and links to the learning revolution that becomes today’s demands, including a discussion that analyses the condition of learners. The article based its data preliminary study conducted in Manado in the province of North Sulawesi in Indonesia. This region has its own characteristics with the encounter of Muslims and the Protestant community for century. Due to its uniqueness 3 Moslem schools and 3 Protestant schools in Manado were selected to study. Data collection was conducted for a year, from May 2016 to April 2017. The study employ four stages research steps: identification, data collection, data validity checking, and directed discussion. The stages include observation and in-depth interviews and conducting focus group discussions. Two important thought about the essence of learning strategy and learning revolution in class were shared briefly within this article.
Environmental impacts and benefits of state-of-the-art technologies for E-waste management.
Ikhlayel, Mahdi
2017-10-01
This study aims to evaluate the environmental impacts and benefits of state-of-the-art technologies for proper e-waste handling using Jordan as a case study. Life Cycle Assessment (LCA) was employed to evaluate five advanced management systems represent state-of-the-art treatment technologies, including sanitary landfilling; proper recycling of metals, materials, and precious metals (PMs); and incineration of plastic and the hazardous portion of printed circuit boards (PCBs). Six e-waste products that contribute the most to the e-waste in Jordan were included in the assessment of each scenario, which resulted in 30 total cases of e-waste management. The findings indicated that landfills for the entire components of the e-waste stream are the worst option and should be avoided. The most promising e-waste management scenario features integrated e-waste processes based on the concept of Integrated Waste Management (IWM), including recycling materials such as non-PMs and PMs, incinerating plastic and the hazardous content of PCBs using the energy recovered from incineration, and using sanitary landfills of residues. For this scenario, the best environmental performance was obtained for the treatment of mobile phones. Incineration of the portion of hazardous waste using energy recovery is an option that deserves attention. Because scenario implementation depends on more than just the environmental benefits (e.g., economic cost and technical aspects), the study proposes a systematic approach founded on the IWM concept for e-waste management scenario selection. Copyright © 2017 Elsevier Ltd. All rights reserved.
41 CFR 60-250.84 - Responsibilities of local employment service offices.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Responsibilities of local employment service offices. 60-250.84 Section 60-250.84 Public Contracts and Property Management Other... OTHER PROTECTED VETERANS Ancillary Matters § 60-250.84 Responsibilities of local employment service...
41 CFR 60-250.84 - Responsibilities of local employment service offices.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Responsibilities of local employment service offices. 60-250.84 Section 60-250.84 Public Contracts and Property Management Other... OTHER PROTECTED VETERANS Ancillary Matters § 60-250.84 Responsibilities of local employment service...
41 CFR 60-250.84 - Responsibilities of local employment service offices.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Responsibilities of local employment service offices. 60-250.84 Section 60-250.84 Public Contracts and Property Management Other... OTHER PROTECTED VETERANS Ancillary Matters § 60-250.84 Responsibilities of local employment service...
Employablity Skills among Graduates of Estate Management in Nigeria
ERIC Educational Resources Information Center
Egbenta, Idu Robert
2015-01-01
There is wide claim that employers have a high level of dissatisfaction associated with graduates from Nigeria higher institutions of learning. This paper examines whether graduates of estate management in Nigeria higher institutions have employability skills for productive employment. The study randomly sampled 59 principal partners or heads of…
Konstantinidis, Evdokimos I; Frantzidis, Christos A; Pappas, Costas; Bamidis, Panagiotis D
2012-07-01
In this paper the feasibility of adopting Graphic Processor Units towards real-time emotion aware computing is investigated for boosting the time consuming computations employed in such applications. The proposed methodology was employed in analysis of encephalographic and electrodermal data gathered when participants passively viewed emotional evocative stimuli. The GPU effectiveness when processing electroencephalographic and electrodermal recordings is demonstrated by comparing the execution time of chaos/complexity analysis through nonlinear dynamics (multi-channel correlation dimension/D2) and signal processing algorithms (computation of skin conductance level/SCL) into various popular programming environments. Apart from the beneficial role of parallel programming, the adoption of special design techniques regarding memory management may further enhance the time minimization which approximates a factor of 30 in comparison with ANSI C language (single-core sequential execution). Therefore, the use of GPU parallel capabilities offers a reliable and robust solution for real-time sensing the user's affective state. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Philippou, Julia
2015-01-01
To examine nurse employees' and employers' views about responsibilities for managing nurses' careers. Career management policies are associated with cost savings, in terms of workforce recruitment and retention and an increase in job and career satisfaction. In nursing, responsibility for career management remains relatively unexplored. A multicenter, cross-sectional questionnaire survey. Data were collected from 871 nurse employees and employers in the British National Health Service. The study was conducted in 2008, a period when policy reforms aimed at modernizing the healthcare workforce in England. In the current discussions in Europe and the USA about the future of nursing, these data reveal insights not previously reported. Exploratory analyses were undertaken using descriptive and inferential statistics. The analysis indicated a temporal dimension to career management responsibilities. Short-term responsibilities for securing funding and time for development lay more with employers. Medium-term responsibilities for assessing nurses' strengths and weakness, determining job-related knowledge and skills and identifying education and training needs appeared to be shared. Long-term responsibilities for developing individual careers and future development plans lay primarily with employees. New ways of managing nurses' career development that lead to greater independence for employees and greater flexibility for employers, while retaining a high-calibre and competent workforce, are needed. Ultimately, career management responsibilities should not tilt to either side but rather be shared to benefit both parties. Clarifying employers' and employees' responsibilities for career management may help both parties to develop a common understanding of each other's role and to meet their obligations in a constructive dialogue. © 2014 John Wiley & Sons Ltd.
Reed, Karla S; Meade, Michelle A; Krause, James S
2016-01-01
Objective: The purpose of this study was to examine the relationship between employment and psychological health and health management as described by individuals with spinal cord injury (SCI) who were employed at least once following injury. Methods: A qualitative approach used 6 focus groups at 2 sites with 44 participants who were at least 10 years post SCI. All had been employed at some point since injury. Heterogeneous and homogeneous groups were delineated based on specific characteristics, such as education, gender, or race. Group sessions followed a semi-structured interview format with questions about personal, environmental, and policy related factors influencing employment following SCI. All group sessions were recorded, transcribed, and coded into conceptual categories to identify topics, themes, and patterns. Inferences were drawn about their meaning. NVivo 10 software using the constant comparative method was used for data analysis. Results: Narratives discussed the relationship between employment and psychological and emotional health and health management. Four themes were identified: (1) adjustment and dealing with emotional reactions, (2) gaining self-confidence, (3) preventing burnout, and (4) attitudes and perspectives. Most themes reflected issues that varied based on severity of injury as well as stage of employment. Conclusions: Individuals with SCI who are successful in working following injury must determine how to perform the behaviors necessary to manage their health and prevent emotional or physical complications. The emotional consequences of SCI must be recognized and addressed and specific behaviors enacted in order to optimize employment outcomes.
Kordi, Masoumeh; Erfanian, Fatemeh; Fakari, Farzaneh Rashidi; Dastfan, Fatemeh; Nejad, Keivan Shariati
2017-01-01
INTRODUCTION: Shoulder dystocia is one of the obstetric emergencies that are accompanied to serious risks for mother and fetus. It necessitates making the method of training of shoulder dystocia management more efficient, i.e., better management and giving services with higher quality. Thus, this study was carried out to compare the impact of training by simulation and oral technique on the skill of the employed midwives in obstetric clinics at Mashhad city (Iran) in shoulder dystocia management during 2012. METHODS: The current research is a double-group clinical trial that was conducted on 51 members of the employed midwives in the obstetric clinic at Mashhad city in 2012. The questionnaire of personal specification and awareness about shoulder dystocia and practical examination (objective-structured clinical examination) were employed as tools for data collection. The learners were divided into two groups by randomized allocation. Training was done by the presentation of lecture in the oral content group and a short movie was displayed at the end of it. The shoulder dystocia management technique was simulated in another group and through role-playing of instructor application of moulage (station) training was conducted. The period of the training course (4 h) and content of the educational workshop was identical for both groups. The practical examination was held for the learners before and immediately after training course. The given data were analyzed by means of statistical descriptive tests including Mann–Whitney U-test and Wilcoxon test via SPSS software (version 16). The significance level was considered as (P < 0.05) in all cases. RESULTS: The total mean score was significantly increased for the variable of shoulder dystocia management skill after intervention in both groups (P < 0.0001). Similarly, the results of Mann–Whitney U-test statistical tests indicated that total mean score for the variable of shoulder dystocia management skill after the intervention was significantly greater in simulation group than in an oral group (P = 0.040). CONCLUSION: Training in simulated delivery room by means of role-playing is an efficient method for training shoulder dystocia management skill, so it is recommended to use this program in the training of this skill. PMID:28616417
ERIC Educational Resources Information Center
Messum, Diana; Wilkes, Lesly; Peters, Cath; Jackson, Debra
2017-01-01
If work-integrated learning (WIL) is intended by universities to meet the demand for work-ready graduates, identification of skill requirements for development on placements is a critical part of the learning process. Health services management specific employability skills perceived to be important by managers and recent graduates working in the…
41 CFR 101-8.307 - Employment criteria.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Employment criteria. 101-8.307 Section 101-8.307 Public Contracts and Property Management Federal Property Management... speaking skills except where those skills are the factors that the test purports to measure. ...
41 CFR 101-8.307 - Employment criteria.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Employment criteria. 101-8.307 Section 101-8.307 Public Contracts and Property Management Federal Property Management... speaking skills except where those skills are the factors that the test purports to measure. ...
When does a worker's death become murder?
Rosner, D
2000-01-01
During the past 2 decades, a growing number of manslaughter and even murder charges have been brought against employers in cases involving the death of workers on the job. In this commentary, the author reviews some of these recent cases and looks at other periods in American history when workers' deaths were considered a form of homicide. He examines the social forces that shape how we define a worker's death: as an accidental, chance occurrence for which no individual is responsible, or as a predictable result of gross indifference to human life for which management bears criminal responsibility. He asks whether there is a parallel between the conditions of 19th-century laissez-faire capitalism that led to popular movements promoting workplace safety and the move in recent decades toward deregulation and fewer restraints on industry that has led state and local prosecutors to criminalize some workplace accidents. Despite an increased federal presence, the activities of state and local district attorneys perhaps signal a redefinition of the popular understanding of employers' responsibility in maintaining a safe workplace. PMID:10754966
Agricultural reuse of municipal wastewater through an integral water reclamation management.
Intriago, Juan Carlo; López-Gálvez, Francisco; Allende, Ana; Vivaldi, Gaetano Alessandro; Camposeo, Salvatore; Nicolás Nicolás, Emilio; Alarcón, Juan José; Pedrero Salcedo, Francisco
2018-05-01
The DESERT-prototype, a state-of-the-art compact combination of water treatment technologies based on filtration and solar-based renewable energy, was employed to reclaim water for agricultural irrigation. Water reclaimed through the DESERT-prototype (PW) from a secondary effluent of a wastewater treatment plant, as well as conventional irrigation water (CW) and the secondary effluent (SW) itself, were employed to cultivate baby romaine lettuces in a greenhouse in Murcia (Spain), by means of drip and sprinkler irrigation methods, thus establishing six treatments. Assessments of physicochemical and microbiological quality of irrigation water, as well as agronomic and microbiological quality of crops from all treatments, showed that results associated to PW complied in all cases with relevant standards and guidelines. In contrast, results linked to SW and CW presented certain non-compliance cases of water and crop microbiological quality. These assessments lead to conclude that the DESERT-prototype is an appropriate technology for safe water reclamation oriented to agricultural production, that can be complemented by a proper irrigation method in reaching safety targets. Copyright © 2018 Elsevier Ltd. All rights reserved.
Durso, Francis T; Ferguson, Ashley N; Kazi, Sadaf; Cunningham, Charlene; Ryan, Christina
2015-03-01
Part of the work of a critical care nurse is to manage the threats that arise that could impede efficient and effective job performance. Nurses manage threats by employing various strategies to keep performance high and workload manageable. We investigated strategic threat management by using the Threat-Strategy Interview. Threats frequently involved technology, staff, or organizational components. The threats were managed by a toolbox of multifaceted strategies, the most frequent of which involved staff-, treatment- (patient + technology), examination- (patient + clinician), and patient-oriented strategies. The profile of strategies for a particular threat often leveraged work facets similar to the work facet that characterized the threat. In such cases, the nurse's strategy was directed at eliminating the threat (not working around it). A description at both a domain invariant level - useful for understanding strategic threat management generally - and a description at an operational, specific level - useful for guiding interventions-- are presented. A structural description of the relationship among threats, strategies, and the cues that trigger them is presented in the form of an evidence accumulation framework of strategic threat management. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.
A Reporting System to Protect the Human Rights of People Living with HIV and Key Populations.
Williamson, R Taylor; Fiscian, Vivian; Olson, Ryan Ubuntu; Poku, Fred Nana; Whittal, Joseph
2017-12-01
People living with HIV and key populations face human rights violations that affect their access to health services, relationships in their communities, housing options, and employment. To address these violations, government and civil society organizations in Ghana developed a discrimination reporting system managed by the Commission on Human Rights and Administrative Justice that links people living with HIV and key populations to legal services. This article presents findings on how Ghanaian stakeholders built this reporting system and discusses preliminary data on its impact. To organize our analysis, we used a conceptual framework that outlines the legal frameworks that protect human rights, the institutions that promote access to justice, and the mechanisms that link people living with HIV and key populations to legal services. Using in-depth interviews, we show that targeted technical assistance increased stakeholders' knowledge of issues that affect people living with HIV and key populations, strengthened these stakeholders' commitment to address discrimination, streamlined case management systems, and improved relationships between civil society and the government. Through case review, we find that most discrimination happens when accessing government services, inside communities and families, and in the workplace. Finally, we describe implications for other human rights commissions that are considering using a reporting system to protect human rights, including using legal frameworks, developing case management systems, and working with civil society.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-04
...The Department of Labor proposes to revise and reorganize the Rules of Practice and Procedure for Administrative Hearings Before the Office of Administrative Law Judges, from our regulations, which provide procedural guidance to administrative law judges, claimants, employers, and Department of Labor representatives seeking to resolve disputes under a variety of employment and labor laws. The Office of Administrative Law Judges promulgated these regulations in 1983. The regulations were modeled on the Federal Rules of Civil Procedure (FRCP) and have proved extraordinarily helpful in providing litigants with familiar rules governing hearing procedure. Since 1983, the FRCP have been amended many times. Moreover, in 2007 the FRCP were given a complete revision to improve style and clarity. The nature of litigation has also changed in the past 28 years, particularly in the areas of discovery and electronic records. Thus, OALJ has revised its regulations to make the rules more accessible and useful to parties, and to harmonize administrative hearing procedures with the current FRCP. The goal in amending the regulations is to provide clarity through the use of consistent terminology, structure and formatting so that parties have clear direction when pursuing or defending against a claim. In addition to revising the regulations to conform to modern legal procedure, the rules need to be modified to reflect the types of claims now heard by OALJ. When the rules were promulgated in 1983, OALJ primarily adjudicated occupational disease and injury cases. Presently, and looking ahead to the future, OALJ is and will be increasingly tasked with hearing whistleblower and other workplace retaliation claims, in addition to the occupational disease and injury cases. These types of cases require more structured management and oversight by the presiding administrative law judge and more sophisticated motions and discovery procedures than the current regulations provide. In order to best manage the complexities of whistleblower and discrimination claims, OALJ needs to update its rules to address the procedural questions that arise in these cases.
Nemeth, Endre; Szigeti, Szabolcs; Varga, Tamas; Daroczi, Laszlo; Barati, Zoltan; Merkely, Bela; Gal, Janos
2018-05-01
The acute surgical treatment of infective endocarditis (IE) carries a high risk of postoperative mortality. Most complications are linked to uncontrolled sepsis and inflammatory processes. Cytokine haemoadsorption is an extracorporeal technique which has benefits reported in haemodynamic stability and inflammatory response. A 46-year-old male patient underwent emergency cardiac surgery due to progressive IE. Postcardiotomy cardiogenic shock associated with cardiac surgery required the implantation of venoarterial (VA)-ECMO. Three days later, the patient developed secondary septic shock. The novel application of continuous CytoSorb TM treatment installed in the VA-ECMO circuit is demonstrated in this case during the management of simultaneous shocks. Advanced intensive care led to an improvement in the patient's condition, which facilitated successful weaning from mechanical ventilation. However, the patient died from a new onset fulminant septic shock two months after his initial cardiac surgery. VA-ECMO is suitable for installation of the CytoSorb TM cartridge. This modality could be an option for high-volume, continuous cytokine haemoadsorption when VA-ECMO is employed without renal replacement therapy. This specific application of CytoSorb TM was safe, feasible and contributed to the optimal management of simultaneous shocks.
NASA Technical Reports Server (NTRS)
Mercer, Joey; Callantine, Todd; Martin, Lynne
2012-01-01
A recent human-in-the-loop simulation in the Airspace Operations Laboratory (AOL) at NASA's Ames Research Center investigated the robustness of Controller-Managed Spacing (CMS) operations. CMS refers to AOL-developed controller tools and procedures for enabling arrivals to conduct efficient Optimized Profile Descents with sustained high throughput. The simulation provided a rich data set for examining how a traffic management supervisor and terminal-area controller participants used the CMS tools and coordinated to respond to off-nominal events. This paper proposes quantitative measures for characterizing the participants responses. Case studies of go-around events, replicated during the simulation, provide insights into the strategies employed and the role the CMS tools played in supporting them.
Strain-Based Damage Determination Using Finite Element Analysis for Structural Health Management
NASA Technical Reports Server (NTRS)
Hochhalter, Jacob D.; Krishnamurthy, Thiagaraja; Aguilo, Miguel A.
2016-01-01
A damage determination method is presented that relies on in-service strain sensor measurements. The method employs a gradient-based optimization procedure combined with the finite element method for solution to the forward problem. It is demonstrated that strains, measured at a limited number of sensors, can be used to accurately determine the location, size, and orientation of damage. Numerical examples are presented to demonstrate the general procedure. This work is motivated by the need to provide structural health management systems with a real-time damage characterization. The damage cases investigated herein are characteristic of point-source damage, which can attain critical size during flight. The procedure described can be used to provide prognosis tools with the current damage configuration.
Bellinger, Goli Amin
2013-06-01
Being uprooted, displaced, and resettled can produce great tension in refugee marriages. This paper details a technique to help refugees recognize and manage changes and threats to traditional gender roles after resettlement to western countries. A case study from a multisite psycho-educational marriage project illustrates the application of the Relationship Enhancement model with a Bhutanese couple. Through empathy and structured dialogue, the couple is coached to identify their core concerns about the changes in their lives and come up with mutually beneficial solutions. Focusing on the redistribution of each gender's prescribed responsibilities allows the clinician to respond to the cultural structuring of equitable division of labor while helping families to address new responsibilities in managing household duties, parenting, employment, and finances.
Allocation of Health Resources According To the Type and Size of Iranian Governmental Hospitals
Hassani, SA; Abolhallaje, M; Inanlo, S; Hosseini, H; Pourmohammadi, K; Bastani, P; Ramezanian, M; Marnani, A Barati
2013-01-01
Background: Due to consuming about 50%–80% of health resources, hospitals are the greatest and costly operational units in Iranian Health system. so allocation of resources specially human and space resources as the most expensive ones is really important for further controlling of costs, analysis of costs and making suitable policies for increasing the profitability and allocation of resources and improvement of quality. Method: This paper intends to describe and analyze any allocation of resources in 530 university hospitals in Iran. The final goal of this research is to provide a data bank according which there is a basis for more scientific budget allocation of state’s hospitals from the size and type of application points of view. Results: The relevant index of person to bed was 2.04 for human resources. All hospitals more than 300 beds are located in benefiting areas from which 17 cases are educational and 2 cases are therapeutic. This is necessary to mention that the rate of management group forces to total personnel at deprived areas is about 2.5% more than benefiting areas. Conclusion: Because 60–80% of hospital costs are applied for human forces, all managers of hospitals are obliged to revise their policies in attraction and employment of human force in order to benefit from such a valuable resource and prevent from expensive costs. So any employment of personnel should be based upon real needs of hospital. PMID:23865036
Adverse drug reactions in patients with phaeochromocytoma: incidence, prevention and management.
Eisenhofer, Graeme; Rivers, Graham; Rosas, Alejandro L; Quezado, Zena; Manger, William M; Pacak, Karel
2007-01-01
The dangers of phaeochromocytomas are mainly due to the capability of these neuroendocrine tumours to secrete large quantities of vasoactive catecholamines, thereby increasing blood pressure and causing other related adverse events or complications. Phaeochromocytomas are often missed, sometimes only becoming apparent during therapeutic interventions that provoke release or interfere with the disposition of catecholamines produced by the tumours. Because phaeochromocytomas are rare, evidence contraindicating use of specific drugs is largely anecdotal or based on case reports. The heterogeneous nature of the tumours also makes adverse reactions highly variable among patients. Some drugs, such as dopamine D(2) receptor antagonists (e.g. metoclopramide, veralipride) and beta-adrenergic receptor antagonists (beta-blockers) clearly carry high potential for adverse reactions, while others such as tricyclic antidepressants seem more inconsistent in producing complications. Other drugs capable of causing adverse reactions include monoamine oxidase inhibitors, sympathomimetics (e.g. ephedrine) and certain peptide and corticosteroid hormones (e.g. corticotropin, glucagon and glucocorticoids). Risks associated with contraindicated medications are easily minimised by adoption of appropriate safeguards (e.g. adrenoceptor blockade). Without such precautions, the state of cardiovascular vulnerability makes some drugs and manipulations employed during surgical anaesthesia particularly dangerous. Problems arise most often when drugs or therapeutic procedures are employed in patients in whom the tumour is not suspected. In such cases, it is extremely important for the clinician to recognise the possibility of an underlying catecholamine-producing tumour and to take the most appropriate steps to manage and treat adverse events and clinical complications.
Qiu, Meiguang; Shi, Zhanjun; Xiao, Jun; Zhang, Xuming; Ling, Shishui; Ling, Hao
2016-12-01
The purpose of this study is to evaluate the potential benefits of rib fracture fixation in patients with flail chest and multiple non-flail rib fractures versus conventional treatment modalities. A retrospective reviewed study compared 86 cases which received surgical treatment between June 2009 and May 2013 to 76 cases which received conservative treatment between January 2006 and May 2009. The patients were divided into the flail chest ( n = 38) and multiple non-flail rib fracture groups ( n = 124). In the flail chest group, the mechanical ventilation time, ICU monitoring time, tracheostomies, thoracic deformity, and impaired pulmonary function and return to full-time employment were compared. In the multiple non-flail rib fracture group, fracture healing, visual analog scale (VAS) pain score, inpatient length of stay, atelectatic, pulmonary complications, and normal activity-returning time were compared. Patients in the flail chest operative fixation group had significantly shorter ICU stay, decreased ventilator requirements, fewer tracheostomies, less thoracic deformity and impaired pulmonary function, and more returned to full-time employment. Patients in the multiple non-flail rib fracture operative fixation had shorter hospital stay, less pain, earlier return to normal activity, more fracture healing, less atelectasis, and fewer pulmonary infections. This study demonstrates the potential benefits of surgical stabilization of flail chest and multiple non-flail rib fractures with plate fixation. When compared with conventional conservative management, operatively managed patients demonstrated improved clinical outcomes.
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.
48 CFR 970.0371-7 - Outside employment of contractor employees.
Code of Federal Regulations, 2010 CFR
2010-10-01
... ENERGY AGENCY SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Improper Business.... Employees of a management and operating contractor are entitled to the same rights and privileges with... full or part-time basis under a DOE management and operating contract may engage in employment outside...
76 FR 75567 - Hispanic Council on Federal Employment
Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-02
... Office of Personnel Management and the Assistant Secretary for Human Resources and Administration at the... Diversity and Inclusion, Office of Personnel Management, 1900 E St. NW., Suite 5H35, Washington, DC 20415... OFFICE OF PERSONNEL MANAGEMENT Hispanic Council on Federal Employment AGENCY: Office of Personnel...
A Conceptual Model for Employer Training to Manage Employee Counter-Productive Behaviors
ERIC Educational Resources Information Center
Rock, Naomi Spickard
2011-01-01
The purpose of this study was to develop a model for employer training to manage employees who possess counter-productive behaviors. With the increasing encouragement for employers to hire without discriminating, the number of individuals with disabilities in the workforce will rise. There is limited training in universities and businesses to…
Competence and Employment Forum: Linking HRD and HRM
ERIC Educational Resources Information Center
Siikaniemi, Lena
2009-01-01
Purpose: The purpose of this paper is to find a model for the individual employee, the employer, the supervisors and the personnel at HR to manage organizational and individual changes. The objective of the model is to manage the changes in parallel with the competence (HRD) and employment (HRM) aspects. Design/methodology/approach: The research…
Mackenzie, Catherine R; Keuskamp, Dominic; Ziersch, Anna M; Baum, Fran E; Popay, Jennie
2013-09-03
The psychosocial work environment can benefit and harm mental health. Poor psychosocial work environments and high level work-family conflict are both associated with poor mental health, yet little is known about how people with poor mental health manage the interactions among multiple life domains. This study explores the interfaces among paid work, family, community and support services and their combined effects on mental health. We conducted 21 in-depth semi-structured interviews with people identified as having poor mental health to examine their experiences of paid employment and mental health and wellbeing in the context of their daily lives. The employment-related psychosocial work environment, particularly workplace relationships, employment security and degree of control over hours, strongly affected participants' mental health. The interfaces among the life domains of family, community and access to support services suggest that effects on mental health differ according to: time spent in each domain, the social, psychological and physical spaces where domain activities take place, life stage and the power available to participants in their multiple domains. This paper is based on a framework analysis of all the interviews, and vignettes of four cases. Cases were selected to represent different types of relationships among the domains and how interactions among them either mitigated and/or exacerbated mental health effects of psychosocial work environments. Examining domain interactions provides greater explanatory capacity for understanding how people with low mental health manage their lives than restricting the research to the separate impacts of the psychosocial work environment or work-family conflict. The extent to which people can change the conditions under which they engage in paid work and participate in family and social life is significantly affected by the extent to which their employment position affords them latitude. Policies that provide psychosocial protections to workers that enable them to make changes or complaints without detrimental repercussions (such as vilification or job loss) and increase access to welfare benefits and support services could improve mental health among people with paid work. These policies would have particularly important effects for those in lower socioeconomic status positions.
2013-01-01
Background The psychosocial work environment can benefit and harm mental health. Poor psychosocial work environments and high level work-family conflict are both associated with poor mental health, yet little is known about how people with poor mental health manage the interactions among multiple life domains. This study explores the interfaces among paid work, family, community and support services and their combined effects on mental health. Methods We conducted 21 in-depth semi-structured interviews with people identified as having poor mental health to examine their experiences of paid employment and mental health and wellbeing in the context of their daily lives. Results The employment-related psychosocial work environment, particularly workplace relationships, employment security and degree of control over hours, strongly affected participants’ mental health. The interfaces among the life domains of family, community and access to support services suggest that effects on mental health differ according to: time spent in each domain, the social, psychological and physical spaces where domain activities take place, life stage and the power available to participants in their multiple domains. This paper is based on a framework analysis of all the interviews, and vignettes of four cases. Cases were selected to represent different types of relationships among the domains and how interactions among them either mitigated and/or exacerbated mental health effects of psychosocial work environments. Conclusions Examining domain interactions provides greater explanatory capacity for understanding how people with low mental health manage their lives than restricting the research to the separate impacts of the psychosocial work environment or work-family conflict. The extent to which people can change the conditions under which they engage in paid work and participate in family and social life is significantly affected by the extent to which their employment position affords them latitude. Policies that provide psychosocial protections to workers that enable them to make changes or complaints without detrimental repercussions (such as vilification or job loss) and increase access to welfare benefits and support services could improve mental health among people with paid work. These policies would have particularly important effects for those in lower socioeconomic status positions. PMID:24004446
Salivary Secretory Disorders, Inducing Drugs, and Clinical Management
Miranda-Rius, Jaume; Brunet-Llobet, Lluís; Lahor-Soler, Eduard; Farré, Magí
2015-01-01
Background: Salivary secretory disorders can be the result of a wide range of factors. Their prevalence and negative effects on the patient's quality of life oblige the clinician to confront the issue. Aim: To review the salivary secretory disorders, inducing drugs and their clinical management. Methods: In this article, a literature search of these dysfunctions was conducted with the assistance of a research librarian in the MEDLINE/PubMed Database. Results: Xerostomia, or dry mouth syndrome, can be caused by medication, systemic diseases such as Sjögren's Syndrome, glandular pathologies, and radiotherapy of the head and neck. Treatment of dry mouth is aimed at both minimizing its symptoms and preventing oral complications with the employment of sialogogues and topical acting substances. Sialorrhea and drooling, are mainly due to medication or neurological systemic disease. There are various therapeutic, pharmacologic, and surgical alternatives for its management. The pharmacology of most of the substances employed for the treatment of salivary disorders is well-known. Nevertheless, in some cases a significant improvement in salivary function has not been observed after their administration. Conclusion: At present, there are numerous frequently prescribed drugs whose unwanted effects include some kind of salivary disorder. In addition, the differing pathologic mechanisms, and the great variety of existing treatments hinder the clinical management of these patients. The authors have designed an algorithm to facilitate the decision making process when physicians, oral surgeons, or dentists face these salivary dysfunctions. PMID:26516310
Coe, Taylor M; Chang, David C; Sicklick, Jason K
2015-08-01
Small bowel volvulus is a rare entity in Western adults. Greater insight into epidemiology and outcomes may be gained from a national database inquiry. The Nationwide Inpatient Sample (1998 to 2010), a 20% stratified sample of United States hospitals, was retrospectively reviewed for small bowel volvulus cases (International Classification of Diseases, 9th Edition [ICD-9] code 560.2 excluding gastric/colonic procedures) in patients greater than or equal to 18 years old. There were 2,065,599 hospitalizations for bowel obstruction (ICD-9 560.x). Of those, there were 20,680 (1.00%) small bowel volvulus cases; 169 were attributable to intestinal malrotation. Most cases presented emergently (89.24%) and operative management was employed more frequently than nonoperative (65.21% vs 34.79%, P < .0001). Predictors of mortality included age greater than 50 years, Charlson comorbidity index greater than or equal to 1, emergent admission, peritonitis, acute vascular insufficiency, coagulopathy, and nonoperative management (P < .0001). As the first population-based epidemiological study of small bowel volvulus, our findings provide a robust representation of this rare cause of small bowel obstruction in American adults. Copyright © 2015 Elsevier Inc. All rights reserved.
Closed Loop Requirements and Analysis Management
NASA Technical Reports Server (NTRS)
Lamoreaux, Michael; Verhoef, Brett
2015-01-01
Effective systems engineering involves the use of analysis in the derivation of requirements and verification of designs against those requirements. The initial development of requirements often depends on analysis for the technical definition of specific aspects of a product. Following the allocation of system-level requirements to a product's components, the closure of those requirements often involves analytical approaches to verify that the requirement criteria have been satisfied. Meanwhile, changes that occur in between these two processes need to be managed in order to achieve a closed-loop requirement derivation/verification process. Herein are presented concepts for employing emerging Team center capabilities to jointly manage requirements and analysis data such that analytical techniques are utilized to effectively derive and allocate requirements, analyses are consulted and updated during the change evaluation processes, and analyses are leveraged during the design verification process. Recommendations on concept validation case studies are also discussed.
Economic credentialing: the propriety of managing physician costs through privileging.
Dahl, B A
1999-01-01
Hospital executives face the unique task of managing the costs of an institution in which they have no direct managerial authority over the primary cost drivers, namely, the physicians who practice in the hospital. Perhaps the most controversial method of controlling physician costs consists of the application of economic factors to the credentialing process. Using the credentialing process as a technique to exert fiscal control over physicians affords hospital executives and their governing boards a tremendous cost-management opportunity. The legal propriety of economic credentialing remains unsettled. Many commentators, relying on limited case law, conclude that hospitals can engage in economic credentialing. Nevertheless, hospitals should exercise care when employing an economic rationale to restrict privileges lest they stir up legal challenges. Moreover, if hospitals use economic credentialing to limit medicaid patients' access to hospitals by excluding these patients' physicians from the hospital, the federal government may have the last word on the propriety of the practice.
Vecchio, Jennifer; Kearney, Christopher A
2009-12-01
Selective mutism is a severe childhood disorder involving failure to speak in public situations in which speaking is expected. The present study examined 9 youths with selective mutism treated with child-focused, exposure-based practices and parent-focused contingency management via an alternating treatments design. Broadband measures of functioning were employed, but particular focus was made on behavioral assessment of words spoken audibly and daily in public situations. Treatment ranged from 8 to 32 sessions and resulted in positive end-state functioning for 8 of 9 participants. Broader analyses indicated greater effectiveness for exposure-based practice than contingency management. The results support recent case reports of behavioral treatment for this population but in more rigorous fashion. Clinical and research challenges are discussed, including caveats about length and intensity of treatment for this population and need to develop standardized daily measures.
Epidemiology and Management of the 2013-16 West African Ebola Outbreak.
Boisen, M L; Hartnett, J N; Goba, A; Vandi, M A; Grant, D S; Schieffelin, J S; Garry, R F; Branco, L M
2016-09-29
The 2013-16 West African Ebola outbreak is the largest, most geographically dispersed, and deadliest on record, with 28,616 suspected cases and 11,310 deaths recorded to date in Guinea, Liberia, and Sierra Leone. We provide a review of the epidemiology and management of the 2013-16 Ebola outbreak in West Africa aimed at stimulating reflection on lessons learned that may improve the response to the next international health crisis caused by a pathogen that emerges in a region of the world with a severely limited health care infrastructure. Surveillance efforts employing rapid and effective point-of-care diagnostics designed for environments that lack advanced laboratory infrastructure will greatly aid in early detection and containment efforts during future outbreaks. Introduction of effective therapeutics and vaccines against Ebola into the public health system and the biodefense armamentarium is of the highest priority if future outbreaks are to be adequately managed and contained in a timely manner.
Determining if disease management saves money: an introduction to meta-analysis.
Linden, Ariel; Adams, John L
2007-06-01
Disease management (DM) programmes have long been promoted as a major medical cost-saving mechanism, even though the scant research that exists on the topic has provided conflicting results. In a 2004 literature review, the Congressional Budget Office stated that 'there is insufficient evidence to conclude that disease management programs can generally reduce the overall cost of health care services'. To address this question more accurately, a meta-analysis was warranted. Meta-analysis is the quantitative technique used to pool the results of many studies on the same topic and summarize them statistically. This method is also quite suitable for individual DM firms to assess whether their programmes are effective at the aggregate level. This paper describes the elements of a rigorous meta-analytic process and discusses potential biases. A hypothetical DM organization is then evaluated with a specific emphasis on medical cost-savings, simulating a case in which different populations are served, evaluation methodologies are employed, and diseases are managed.
Barriers to vocational effectiveness in ACT: staff perspectives.
Waynor, William R; Pratt, Carlos W
2011-01-01
Assertive community treatment (ACT), for persons with serious mental illness, includes a vocational focus as an important aspect of community integration. Nevertheless, research suggests that ACT does not assist significant numbers of consumers in achieving employment goals. A two-step survey of New Jersey ACT team members was designed to identify the key issues that hinder ACT staff members in assisting consumers with obtaining employment. Survey items were categorized into three sections: (a) staff attitudes, (b) consumer barriers, and (c) staff barriers to working on employment. The initial survey asked staff members to rate items in each of these categories. Highly rated items were used in a subsequent paired comparison survey to determine the relative importance of each. This method highlighted the following issues: four staff attitude items-(a) returning to work is positive, (b) employment is key to recovery, (c) abstinence from substance abuse is needed to work, and (d) consumers are too ill to work; four consumer barrier items-(a) fear of loss of Social Security Administration benefits, (b) symptoms related to the illness, (c) lack of motivation, and (d) poor social skills; and three barriers to working on employment issues items-(a) clinical issues take priority, (b) other case management issues takes priority, and (c) too many emergencies. The implications for staff training are discussed.
Quinlan, M; Mayhew, C; Bohle, P
2001-01-01
In this review of a range of studies on the health and safety effects of precarious employment in industrialized societies published since 1984, the authors examine the overall findings and methodological issues and identify areas in need of further research. Of the 93 published journal articles and monographs/book chapters reviewed, 76 studies found precarious employment was associated with a deterioration in occupational health and safety (OHS) in terms of injury rates, disease risk, hazard exposures, or worker (and manager) knowledge of OHS and regulatory responsibilities. Of the more than 25 studies each on outsourcing and organizational restructuring/downsizing, well over 90 percent find a negative association with OHS. The evidence is fairly persuasive for temporary workers, with 14 of 24 studies finding a negative association with OHS. The evidence is less strong for small business, and a handful of studies on part-time workers found no clear association with negative OHS outcomes (in some cases the reverse). Further research is needed to more clearly link health effects to particular business practices and neoliberal policies and to explore the regulatory implications of the growth of precarious employment. The authors suggest some ways to conceptualize the association between precarious employment and occupational health.
Can managed care reduce employers' retiree medical liability?
Taylor, R S; Newton, B
1991-01-01
The Financial Accounting Standards Board (FASB) has forced U.S. companies to look squarely at their current retiree health obligations and their future commitments. Accounting Statement No. 106 (FAS 106) requires employers to accrue liabilities for retiree health benefits during employees' active service, rather than record the costs as benefits are paid. Employers are scrambling to find ways to reduce the statement's effect on corporate balance sheets. While managed health care has been increasingly employed to control benefit costs in active employee health plans, it has not been as popular in retiree plans. This article reviews important demographic and health trends in the retiree population and summarizes employers' early responses to FAS 106. It explores why managed health care has thus far played a limited role in reducing employers' postretirement medical liability, and offers insight into how that role could be increased in the future.
41 CFR 101-4.130 - Effect of employment opportunities.
Code of Federal Regulations, 2010 CFR
2010-07-01
... EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 101-4.130 Effect of... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Effect of employment opportunities. 101-4.130 Section 101-4.130 Public Contracts and Property Management Federal Property Management...
29 CFR 405.4 - Terminal report.
Code of Federal Regulations, 2010 CFR
2010-07-01
... Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT STANDARDS... of this part, who during its fiscal year loses its identity as a reporting employer through merger... employer report, and one copy, with the Office of Labor-Management Standards on Form LM-10 signed by the...
76 FR 35483 - Hispanic Council on Federal Employment; Cancellation of Upcoming Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-17
... OFFICE OF PERSONNEL MANAGEMENT Hispanic Council on Federal Employment; Cancellation of Upcoming Meeting AGENCY: U. S. Office of Personnel Management. ACTION: Notice. SUMMARY: The Hispanic Council on..., Office of Personnel Management, 1900 E. St., NW., Suite 5305, Washington, DC 20415. Phone (202) 606- 2984...
Managing and Creating an Image in the Interview: The Role of Interviewee Initial Impressions
ERIC Educational Resources Information Center
Swider, Brian W.; Barrick, Murray R.; Harris, T. Brad; Stoverink, Adam C.
2011-01-01
In employment interviews, individuals use impression management tactics to present themselves as suitable candidates to interviewers. However, not all impression management tactics, or the interviewees who employ them, are effective at positively influencing interview scores. Results of this study indicate that the relationship between impression…
ERIC Educational Resources Information Center
LaPrince, Shelly L.
2013-01-01
The exploratory qualitative research study explored management education business school offerings in comparison to employer expectations. Through the lens of alumni and human-resources personnel participants, the research examined the skills deemed as transferrable to the workplace and competencies that undergraduate-management education alumni…
Taylor, Kathryn A; Durrheim, David N; Merritt, Tony; Massey, Peter; Ferguson, John; Ryan, Nick; Hullick, Carolyn
2018-01-01
Background System factors in a regional Australian health district contributed to avoidable care deviations from invasive meningococcal disease (IMD) management guidelines. Traditional root cause analysis (RCA) is not well-suited to IMD, focusing on individual cases rather than system improvements. As IMD requires complex care across healthcare silos, it presents an opportunity to explore and address system-based patient safety issues. Context Baseline assessment of IMD cases (2005–2006) identified inadequate triage, lack of senior clinician review, inconsistent vital sign recording and laboratory delays as common issues, resulting in antibiotic administration delays and inappropriate or premature discharge. Methods Clinical governance, in partnership with clinical and public health services, established a multidisciplinary Meningococcal Reference Group (MRG) to routinely review management of all IMD cases. The MRG comprised representatives from primary care, acute care, public health, laboratory medicine and clinical governance. Baseline data were compared with two subsequent evaluation points (2011–2012 and 2013–2015). Interventions Phase I involved multidisciplinary process mapping and development of a standardised audit tool from national IMD management guidelines. Phase II involved formalisation of group processes and advocacy for operational change. Phase III focused on dissemination of findings to clinicians and managers. Results Greatest care improvements were observed in the final evaluation. Median antibiotic delay decreased from 72 to 42 min and proportion of cases triaged appropriately improved from 38% to 75% between 2013 and 2015. Increasing fatal outcomes were attributed to the emergence of more virulent meningococcal serotypes. Conclusions The MRG was a key mechanism for identifying system gaps, advocating for change and enhancing communication and coordination across services. Employing IMD case review as a focus for district-level process reflection presents an innovative patient safety approach, combining the strengths of prospective hazard analysis with more traditional RCA methodologies. PMID:29527576
Court Cases Alleging Employment Discrimination in Public Schools
ERIC Educational Resources Information Center
Speers, Gary M.
2014-01-01
The purpose of this research was to examine Court Cases Alleging Employment Discrimination in Public Schools by analyzing 115 law based court cases ranging during 1980-2012, through the most available publication of "West's Educational Law Digest" of 2012. Employment is a means to provide sustainable income to support the individual(s)…
Employment-based health insurance is failing: now what?
Enthoven, Alain C
2003-01-01
Employment-based health insurance is failing. Costs are out of control. Employers have no effective strategy to deal with this. They must think strategically about fundamental change. This analysis explains how employers' purchasing policies contribute to rising costs and block growth of economical care. Single-source managed care is ineffective, and effective managed care cannot be a single source. Employers should create exchanges through which they can offer employees wide, responsible, individual, multiple choices among health care delivery systems and create serious competition based on value for money. Recently introduced technology can assist this process.
Hypothenar hammer syndrome: a case and brief review.
Swanson, Keith E; Bartholomew, John R; Paulson, Rolf
2012-04-01
Hypothenar hammer syndrome is an uncommon cause of upper-extremity ischemia that is often overlooked in the absence of a thorough occupational and recreational history. Importantly, it is a reversible cause of hand ischemia that, if missed, can lead to significant morbidity and even amputation. The occupational ramifications and quality of life of those affected can be significant. Its relative rarity, set against the ubiquitous use of the hand as a 'hammer' is noteworthy. Several other causes of hand ischemia can present similarly; therefore, consideration of other etiologies must be thoroughly investigated. Key distinguishing clinical features, in addition to a detailed occupational and recreational history, may include characteristic sparing of the thumb, the absence of a hyperemic phase in 'Raynaud's phenomenon', and a positive Allen's sign. Both non-invasive and invasive diagnostic studies, including bilateral upper-limb segmental pulse volume recordings (PVR), arterial duplex examination, and upper-extremity angiography, are complementary to a thorough history and physical examination. Optimal management strategies are not well defined because of its rarity and resultant lack of quality, evidence-based data. Though most cases can be successfully managed non-operatively, micrographic arterial reconstruction may be limb saving in severe or recalcitrant cases. Newer, experimental strategies including selective sympathetic blockage using botulinum toxin A have been reported in a few recalcitrant cases. The brief case description illustrates the typical presentation and potential treatment strategies employed in a difficult case. A review of relevant literature is also presented.
Case-specific colleague guidance for general practitioners' management of sickness absence.
Nordhagen, H P; Harvey, S B; Rosvold, E O; Bruusgaard, D; Blonk, R; Mykletun, A
2017-12-02
General practitioners (GPs) report sickness absence certification as challenging. They express need for support with functional assessment beyond guidelines and reforms. Case-specific collegial one-to-one guidance for other clinical topics has proved popular with GPs and may be an acceptable and effective way to improve GPs skills and competence in sickness absence certification. To present a new model of case-specific colleague guidance focusing on the management of long-term sickness absence and to describe its feasibility in terms of application and reception among GPs, and also GPs' self-reports of effects on their practice. Randomly selected GPs received case-specific collegial guidance over a 12-month period, in two Norwegian trials, delivered by former GPs employed by the social security administration. We measured reception and perceived effects by GPs' self-report and registered participation and withdrawal rates. The participation rate (n = 165) was 94%, and no GPs withdrew during training. Among the 116 GPs responding to the survey (70%), 112 (97%; 95% CI 92-99) stated they would recommend it to their colleagues. Considerable benefit from the guidance was reported by 68 (59%; 95% CI 50-68). The GPs self-reported other effects on their sickness absence certification, specifically an increased use of part-time sickness absence (Fit-Note equivalent). This model of case-specific colleague guidance to aid GPs' management of long-term sickness absence is feasible and was popular. This type of guidance was perceived by GPs to be somewhat beneficial and to alter their sickness absence certification behaviour, though the true impact requires further testing in controlled trials. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com
28 CFR 68.15 - Intervenor in unfair immigration-related employment cases.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Intervenor in unfair immigration-related... ALLEGATIONS OF UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR IMMIGRATION-RELATED EMPLOYMENT PRACTICES, AND DOCUMENT FRAUD § 68.15 Intervenor in unfair immigration-related employment cases. The Special Counsel, or any...
HRD Practices and Talent Management in the Companies with the Employer Brand
ERIC Educational Resources Information Center
Kucherov, Dmitry; Zavyalova, Elena
2012-01-01
Purpose: The employer brand could be a key factor of competitiveness for a company in a contemporary labour market. The purpose of this paper is to identify the features of human resource development (HRD) practices and talent management in companies with employer brand (CEBs). Design/methodology/approach: The authors examined three economic…
The Use of Marking Rubrics in Management Education: Issues of Deconstruction and Andragogy
ERIC Educational Resources Information Center
Cohen, Michael; Billsberry, Jon
2014-01-01
Advocates of rubrics have claimed that the inclusion of employers in the shaping of management education rubrics can help students demonstrate to employers that they have relevant managerial skills. There is an inevitable logic to this argument. Let employers determine what they want from graduates, and academics can then design programs to…
[Intraoperative frozen sections of the thyroid gland].
Synoracki, S; Ting, S; Siebolts, U; Dralle, H; Koperek, O; Schmid, K W
2015-07-01
The goal of evaluation of intraoperative frozen sections of the thyroid gland is to achieve a definitive diagnosis which determines the subsequent surgical management as fast as possible; however, due to the specific methodological situation of thyroid frozen sections evaluation a conclusive diagnosis can be made in only some of the cases. If no conclusive histological diagnosis is possible during the operation, subsequent privileged processing of the specimen allows a final diagnosis at the latest within 48 h in almost all remaining cases. Applying this strategy, both pathologists and surgeons require a high level of communication and knowledge regarding the specific diagnostic and therapeutic peculiarities of thyroid malignancies because different surgical strategies must be employed depending on the histological tumor subtype.
Treatment of Adult Insomnia With Cognitive–Behavioral Therapy
Pigeon, Wilfred R.
2015-01-01
Insomnia is a highly prevalent disorder that occurs frequently in its acute form and at a rate of approximately 10% in its chronic form. There is a high prevalence of insomnia in a variety of medical and psychiatric conditions. Cognitive–behavioral therapy (CBT) may be employed for chronic insomnia as well as for insomnia in the context of other conditions such as chronic pain conditions. In such cases, some simple adaptations to standard CBT for insomnia are useful. This article reviews the typical assessment and CBT for adult insomnia, which have substantial empirical support for its efficacy. A case illustrates the core treatment processes and demonstrates that improving sleep in the context of conditions like chronic pain can lead to better management of such conditions. PMID:20853442
Managing prescription drug costs: a case study.
DuBois, R W; Feinberg, P E
1994-06-01
Pharmacy costs in most private insurance companies and public concerns have risen over the past several years. To address the problem of increased expenditures in its government employee pharmacy program, the State of New York sought bids from outside vendors to help it control pharmaceutical costs. The following is a case study of the tools the state employed in that effort. Over time, both prescription drug coverage and mental health and substance abuse benefits were carved out of the medical plan and are now provided under free-standing programs. In order to participate, an independent pharmacy must accept a discount of 10% off the average wholesale price of brand name drugs and 25% off the average generic price of generic drugs.
Disability Management: Organizational Diversity and Dutch Employment Policy
Haafkens, Joke A.
2010-01-01
Introduction While Human Resource Managers (HRM) and line managers could play a significant role in the prevention of job-related problems and in promotion of early job-continuation, it is not clear wether the chronically ill workers are recognized as a group. Unlike some other groups, distinguished by gender, age or ethnicity, those with chronic illness are less distinct and may not be included in diversity management programs. The aim of this research is to address theory and evidence in literature about the topic, as well as to inquire whether chronic illness of the employees is ‘visible’ in practice. Methods For desk research, we used a systematic search strategy involving medical, statistical, management, and social science databases (Web of Science, MedLine, Pub Med, Psych Info, etc.). Research results are based on case studies conducted with the managers and HRM of government and commercial organizations between March 2007 and October 2008 and between October 2008 and April 2009. These case studies were based on open interviews and focus group sessions (for human resource departments) which were consequently analyzed using thematical analysis. For group sessions, we used concept mapping to collect information from two groups of HRM professionals and managers. Secondary analysis included thematic and content analysis of ‘best practice’ organizations carried out by the Dutch organization Gatekeeper. Conclusions We have discovered that the chronically ill employees are largely invisible to HRM practitioners, line managers who do not always have the right instruments for implementation of the European or national frameworks. Most practitioners are unaware of the impact of chronic illness in their organizations and in employees work life. PMID:20383740
Minton, Deborah; Elias, Eileen; Rumrill, Phillip; Hendricks, Deborah J; Jacobs, Karen; Leopold, Anne; Nardone, Amanda; Sampson, Elaine; Scherer, Marcia; Gee Cormier, Aundrea; Taylor, Aiyana; DeLatte, Caitlin
2017-09-14
Project Career is a five-year interdisciplinary demonstration project funded by NIDILRR. It provides technology-driven supports, merging Cognitive Support Technology (CST) evidence-based practices and rehabilitation counseling, to improve postsecondary and employment outcomes for veteran and civilian undergraduate students with traumatic brain injury (TBI). Provide a technology-driven individualized support program to improve career and employment outcomes for students with TBI. Project staff provide assessments of students' needs relative to assistive technology, academic achievement, and career preparation; provide CST training to 150 students; match students with mentors; provide vocational case management; deliver job development and placement assistance; and maintain an electronic portal regarding accommodation and career resources. Participating students receive cognitive support technology training, academic enrichment, and career preparatory assistance from trained professionals at three implementation sites. Staff address cognitive challenges using the 'Matching Person with Technology' assessment to accommodate CST use (iPad and selected applications (apps)). JBS International (JBS) provides the project's evaluation. To date, 117 students participate with 63% report improved life quality and 75% report improved academic performance. Project Career provides a national model based on best practices for enabling postsecondary students with TBI to attain academic, employment, and career goals.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false May I use a Government motor vehicle for transportation between places of employment and mass transit facilities? 102-34.210 Section 102-34.210 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION...
An employee total health management-based survey of Iowa employers.
Merchant, James A; Lind, David P; Kelly, Kevin M; Hall, Jennifer L
2013-12-01
To implement an Employee Total Health Management (ETHM) model-based questionnaire and provide estimates of model program elements among a statewide sample of Iowa employers. Survey a stratified random sample of Iowa employers, and characterize and estimate employer participation in ETHM program elements. Iowa employers are implementing less than 30% of all 12 components of ETHM, with the exception of occupational safety and health (46.6%) and workers' compensation insurance coverage (89.2%), but intend modest expansion of all components in the coming year. The ETHM questionnaire-based survey provides estimates of progress Iowa employers are making toward implementing components of Total Worker Health programs.
Guanidinoacetate methyltransferase (GAMT) deficiency: a rare but treatable epilepsy.
Stern, William M; Winston, Joel S; Murphy, Elaine; Cross, J Helen; Sander, Josemir W
2017-06-01
Epilepsy commonly presents in childhood as part of a syndrome, and some such children may reach adult services without an underlying syndromic diagnosis. For adult neurologists taking over their care, it is often unclear how hard to search for an underlying diagnosis. The diagnostic yield may be small and such a diagnosis may not change management. Young adults with learning difficulties are also challenging to investigate, as they may not tolerate standard epilepsy tests.We present such a case in which simple tests identified a unifying diagnosis. With the new diagnosis came a new treatment that had a significant impact on seizures and quality of life. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Okahara, Shintaro; Lee, Byeong-Woo; Ogasawara, Takayuki; Mori, Koji
2014-09-01
The Korean Occupational Safety and Health Act requires an employer with more than 50 employees to assign a health manager or an occupational physician. However, there are many cases where it is difficult for medium-scale enterprises to perform occupational health practices autonomously because their financial base is weaker than that of large-scale enterprises. The Korean Occupational Safety and Health Act was amended in 1990 so that medium-scale enterprises could entrust a health management service institution with their health management tasks. This system is similar to the outsourcing of medical examinations, occupational physicians, or the measurement of the working environment in Japan, but its legal background and actual activities are korea-specific, and it has some different points. In particular, the quality control of health management service institutions by legal and administrative regulations, and the multidisciplinary provision of services contribute to the development of occupational health in medium-scale enterprises. This will be a good reference for occupational health services in small- and medium-scale enterprises in the future in Japan.
ERIC Educational Resources Information Center
Spraakman, Gary; O'Grady, Winifred; Askarany, Davood; Akroyd, Chris
2015-01-01
Management accountants work in a computerized workplace with information technology (IT) for producing financial ledgers and for reporting. Thus, the role of the management accountant has shifted from capturing and recording transactions to analyzing business issues. The research question is: what IT knowledge and skills do employers require of…
20 CFR 670.515 - What responsibilities do the center operators have in managing work-based learning?
Code of Federal Regulations, 2012 CFR
2012-04-01
... have in managing work-based learning? 670.515 Section 670.515 Employees' Benefits EMPLOYMENT AND... operators have in managing work-based learning? (a) The center operator must emphasize and implement work... training, and through arrangements with employers. Work-based learning must be under actual working...
20 CFR 670.515 - What responsibilities do the center operators have in managing work-based learning?
Code of Federal Regulations, 2013 CFR
2013-04-01
... have in managing work-based learning? 670.515 Section 670.515 Employees' Benefits EMPLOYMENT AND... operators have in managing work-based learning? (a) The center operator must emphasize and implement work... training, and through arrangements with employers. Work-based learning must be under actual working...
20 CFR 670.515 - What responsibilities do the center operators have in managing work-based learning?
Code of Federal Regulations, 2014 CFR
2014-04-01
... have in managing work-based learning? 670.515 Section 670.515 Employees' Benefits EMPLOYMENT AND... operators have in managing work-based learning? (a) The center operator must emphasize and implement work... training, and through arrangements with employers. Work-based learning must be under actual working...
Operations Management: Is There a Disconnect between Journal Article Content and Employer Needs?
ERIC Educational Resources Information Center
Singer, Marc G.; Welborn, Cliff A.
2014-01-01
The authors sought to determine whether topics researched by academicians in the field of operations management were aligned with the knowledge, skills, and abilities (KSAs) employers were seeking from potential employees. Twenty-eight research topics were identified in the operations management literature and were compared to the KSAs derived…
20 CFR 670.515 - What responsibilities do the center operators have in managing work-based learning?
Code of Federal Regulations, 2010 CFR
2010-04-01
... have in managing work-based learning? 670.515 Section 670.515 Employees' Benefits EMPLOYMENT AND... managing work-based learning? (a) The center operator must emphasize and implement work-based learning... arrangements with employers. Work-based learning must be under actual working conditions and must be designed...
Managing Age Discrimination: An Examination of the Techniques Used when Seeking Employment
ERIC Educational Resources Information Center
Berger, Ellie D.
2009-01-01
Purpose: This article examines the age-related management techniques used by older workers in their search for employment. Design and Methods: Data are drawn from interviews with individuals aged 45-65 years (N = 30). Results: Findings indicate that participants develop "counteractions" and "concealments" to manage perceived age discrimination.…
20 CFR 670.515 - What responsibilities do the center operators have in managing work-based learning?
Code of Federal Regulations, 2011 CFR
2011-04-01
... have in managing work-based learning? 670.515 Section 670.515 Employees' Benefits EMPLOYMENT AND... managing work-based learning? (a) The center operator must emphasize and implement work-based learning... arrangements with employers. Work-based learning must be under actual working conditions and must be designed...
Surviving self-employment: a personal case history.
Kasnot, K
1993-01-01
In the popular perception of what determines one's success as a free-lance illustrator, issues other than natural talent or artistic ability are seldom emphasized. In addition to a firm philosophical foundation and a good work ethic, the organization and management of practical concerns play significant roles in the successful operation of any free-lance business. Presented as a personal history, this article discusses some of the most important, yet most neglected, issues that are essential to the economic security and survival of anyone considering a career as a free-lance illustrator.
Sa, Young Jo; Song, Dae Heon; Kim, Jae Jun; Kim, Young Du; Kim, Chi Kyung; Moon, Seok Whan
2015-11-01
Intractable or persistent hiccups require intensive or invasive treatments. The use of a phrenic nerve block or destructive treatment for intractable hiccups has been reported to be a useful and discrete method that might be valuable to patients with this distressing problem and for whom diverse management efforts have failed. We herein report a successful treatment using a removable and adjustable ligature for the phrenic nerve in a patient with recurrent and intractable hiccups, which was employed under the guidance of electromyography.
Contoured technique for lentigo maligna*
Mateus, Monica Jidid; Tortelly, Violeta Duarte; Barcaui, Carlos Baptista; Jourdan, Carla Araujo; Simão, Tassiana; Maceira, Juan Manuel Piñeiro
2015-01-01
The surgical approach to lentigo maligna is a challenge to dermatologists, given the difficulty of clinical delimitation of borders. We report here a case of a 69-year-old female patient presenting with brownish macules on her face, since 10 years ago, with histopathological diagnosis of lentigo maligna. The surgical management employed was excision of visible borders with the contoured technique and immediate submission of these borders for histopathological analysis before complete excision of the tumor. This technique is a variant of staged excision, with lower rates of recurrence and acceptable aesthetic results. PMID:25672308
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
This publication is one in an ongoing series of case studies for "Laboratories for the 21st Century," a joint program of the U.S. Environmental Protection Agency and the U.S. Department of Energy Federal Energy Management Program. It is intended for all those who plan, design, and construct public and private-sector laboratory buildings. This study describes how the Nidus Center, a nonprofit incubator for life sciences and plan biotechnology established by Monsanto Company, employs daylighting, an energy-efficient mechanical system featuring energy recovery, and water conservation practices, among others, to save energy and money and help conserve natural resources.
Combating employee benefit cost and control issues: the case for coalition purchasing.
Anastasio, Louis N
2005-01-01
Growing in popularity, employee benefit coalitions can impact an employer's bottom line and are becoming a market factor to be dealt with in every industry and business setting. This article examines how modern-day coalitions are bringing classic aggregation theory into the 21st century and the reasons behind the growing popularity of employee benefit coalitions. It also suggests several strategic initiatives that human resource (HR) and benefit managers can take within their own organization to unlock the power of the coalition movement toward a better, more efficient buying model.
Hanlon, Peter; Yeoman, Lynsey; Gibson, Lauren; Esiovwa, Regina; Williamson, Andrea E; Mair, Frances S; Lowrie, Richard
2018-04-07
Identify, describe and appraise trials of interventions delivered by healthcare professionals to manage non-communicable diseases (NCDs) and communicable diseases that require long-term care or treatment (LT-CDs), excluding mental health and substance use disorders, in homeless adults. Systematic review of randomised controlled trials (RCTs), non-RCTs and controlled before-after studies. Interventions characterised using Effective Practice and Organisation of Care (EPOC) taxonomy. Quality assessed using EPOC risk of bias criteria. Database searches (MEDLINE, Embase, PsycINFO, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Applied Social Sciences Index and Abstracts (ASSIA) and Cochrane Central Register of Controlled Trials), hand searching reference lists, citation searches, grey literature and contact with study authors. Community. Adults (≥18 years) fulfilling European Typology of Homelessness criteria. Delivered by healthcare professionals managing NCD and LT-CDs. Primary outcome: unscheduled healthcare utilisation. mortality, biological markers of disease control, adherence to treatment, engagement in care, patient satisfaction, knowledge, self-efficacy, quality of life and cost-effectiveness. 11 studies were included (8 RCTs, 2 quasi-experimental and 1 feasibility) involving 9-520 participants (67%-94% male, median age 37-49 years). Ten from USA and one from UK. Studies included various NCDs (n=3); or focused on latent tuberculosis (n=4); HIV (n=2); hepatitis C (n=1) or type 2 diabetes (n=1). All interventions were complex with multiple components. Four described theories underpinning intervention. Three assessed unscheduled healthcare utilisation: none showed consistent reduction in hospitalisation or emergency department attendance. Six assessed adherence to specific treatments, of which four showed improved adherence to latent tuberculosis therapy. Three concerned education case management, all of which improved disease-specific knowledge. No improvements in biological markers of disease (two studies) and none assessed mortality. Evidence for management of NCD and LT-CDs in homeless adults is sparse. Educational case-management interventions may improve knowledge and medication adherence. Large trials of theory-based interventions are needed, assessing healthcare utilisation and outcomes as well as assessment of biological outcomes and cost-effectiveness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Topp, Stephanie M; Chipukuma, Julien M
2016-03-01
Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers' organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers' clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients' trust in health workers' service values and professionalism. Lack of patient-provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Lack of resourcing and poor leadership were key factors leading to providers' weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient-provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational management to strengthen providers' trust in their employer(s) and colleagues, as an entry-point for developing both the capacity and a work culture oriented towards respectful and patient-centred care. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
Addressing Obesity in the Workplace: The Role of Employers
Heinen, Luann; Darling, Helen
2009-01-01
Context: Employers have pursued many strategies over the years to control health care costs and improve care. Disappointed by efforts to manage costs through the use of insurance-related techniques (e.g., prior authorization, restricted provider networks), employers have also begun to try to manage health by addressing their employees' key lifestyle risks. Reducing obesity (along with tobacco use and inactivity) is a priority for employers seeking to lower the incidence and severity of chronic illness and the associated demand for health services. Methods: This article describes the employer's perspective on the cost impact of obesity, discusses current practices in employer-sponsored wellness and weight management programs, provides examples from U.S. companies illustrating key points of employers' leverage and opportunities, and suggests policy directions to support the expansion of employers' initiatives, especially for smaller employers. Findings: Researchers and policymakers often overlook the extensive efforts and considerable impact of employer-sponsored wellness and health improvement programs. Greater focus on opportunities in the workplace is merited, however, for the evidence base supporting the economic and health impacts of employer-sponsored health promotion and wellness is growing, although not as quickly as the experience base of large employers. Conclusions: Public and private employers can serve their own economic interests by addressing obesity. Health care organizations, particularly hospitals, as well as public employers can be important role models. Policy development is needed to accelerate change, especially for smaller employers (those with fewer than 500 employees), which represent the majority of U.S. employers and are far less likely to offer health promotion programs. PMID:19298417
Addressing obesity in the workplace: the role of employers.
Heinen, LuAnn; Darling, Helen
2009-03-01
Employers have pursued many strategies over the years to control health care costs and improve care. Disappointed by efforts to manage costs through the use of insurance-related techniques (e.g., prior authorization, restricted provider networks), employers have also begun to try to manage health by addressing their employees' key lifestyle risks. Reducing obesity (along with tobacco use and inactivity) is a priority for employers seeking to lower the incidence and severity of chronic illness and the associated demand for health services. This article describes the employer's perspective on the cost impact of obesity, discusses current practices in employer-sponsored wellness and weight management programs, provides examples from U.S. companies illustrating key points of employers' leverage and opportunities, and suggests policy directions to support the expansion of employers' initiatives, especially for smaller employers. Researchers and policymakers often overlook the extensive efforts and considerable impact of employer-sponsored wellness and health improvement programs. Greater focus on opportunities in the workplace is merited, however, for the evidence base supporting the economic and health impacts of employer-sponsored health promotion and wellness is growing, although not as quickly as the experience base of large employers. Public and private employers can serve their own economic interests by addressing obesity. Health care organizations, particularly hospitals, as well as public employers can be important role models. Policy development is needed to accelerate change, especially for smaller employers (those with fewer than 500 employees), which represent the majority of U.S. employers and are far less likely to offer health promotion programs.
Employment of Young Adults with Disabilities in Dubai--A Case Study
ERIC Educational Resources Information Center
Alborno, Nadera; Gaad, Eman
2012-01-01
The authors investigated the implementation of the United Arab Emirates Federal Law regarding the employment of people with disabilities. They used a case study evaluation of an employment program initiated by a private national landscaping company in Dubai providing training and employment opportunities for young adults with varied physical and…
ERIC Educational Resources Information Center
Rebell, Michael A.
Title VII and Equal Employment Opportunity Commission (EEOC) guidelines on discrimination in employment are not always the basis for court decisions in individual cases where intent to discriminate is challenged. A number of employment discrimination cases over the last decade have invalidated employee selection practices of local school boards…
ERIC Educational Resources Information Center
Schaller, James; Yang, Nancy K.
2005-01-01
Differences in rates of case closure, case service cost, hours worked per week, and weekly wage between customers with autism closed successfully in competitive employment and supported employment were found using the Rehabilitation Service Administration national database of 2001. Using logistic regression, customer demographic variables related…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Davis, G., E-mail: gudavis@cytanet.com.cy
2012-10-15
Highlights: Black-Right-Pointing-Pointer Existing qualifications do not meet the needs of the sector in Queensland. Black-Right-Pointing-Pointer Businesses may not be best positioned to identify training needs. Black-Right-Pointing-Pointer Companies are developing training internally to meet their own specific needs. Black-Right-Pointing-Pointer Smaller companies lack the resources to develop internal training are disadvantaged. Black-Right-Pointing-Pointer There is industry support for an entry-level, minimum industry qualification. - Abstract: Vocational Education and Training (VET) is an essential tool for providing waste management and recycling workers with the necessary skills and knowledge needed to beneficially influence their own employment and career development; and to also ensure productivity andmore » safe working conditions within the organisations in which they are employed. Current training opportunities within Queensland for the sector are limited and not widely communicated or marketed; with other States, particularly Victoria and New South Wales, realising higher numbers of VET enrollments for waste management courses. This paper presents current VET opportunities and trends for the Queensland waste management sector. Results from a facilitated workshop to identify workforce requirements and future training needs organised by the Waste Contractors and Recyclers Association of Queensland (WCRAQ) are also presented and discussion follows on the future training needs of the industry within Queensland.« less
Malacarne, Mara; Lesma, Alessandro; Madera, Angelo; Malfatti, Eugenio; Castelli, Alberto; Lucini, Daniela; Pizzinelli, Paolo; Pagani, Massimo
2004-01-01
This paper describes preliminary experience in shared clinical management of patients located in Pointe Noire, Africa, and a referral center, Sacco University Hospital, located in Milan, Italy. The employed infrastructure INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS) jointly developed by CEFRIEL (Center of Excellence For Research, Innovation, Education & Industrial Labs partnership) and ENI (Ente Nazionale Idrocarburi) is based on commercial off-the-shelf technology. This minimizes maintenance problems, while permitting a simple and friendly sharing of data using the telephone and e-mail for store-and-forward applications. The critical aspect of the flow of events comprising the exchange of information is discussed. In 60% of cases, only one telemedicine consultation was required. In the remainder 40%, a number of telemedicine consultations were required for appropriate management of clinical cases. The project demonstrated flexibility as documented by the wide range of pathologies that can be dealt with it. Finally the possibility of using shared clinical management as a learning tool is highlighted by the steep and rising learning curve. We conclude, however, that the patient, although handled in a "virtual" manner, should be viewed as very "real," as some of them elected to close the gap physically between Pointe Noire and Milan, and chose to be treated at the referral site.
ERIC Educational Resources Information Center
Yopp, Martha C.
State employment service managers in the Pacific Northwest, secondary principals in the Pacific Northwest, chief state school officers throughout the United States, and state directors of employment and training throughout the United States were asked to rate students on a list of 15 attributes seen as key to performance on the job. Their…
29 CFR 1614.302 - Mixed case complaints.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 29 Labor 4 2012-07-01 2012-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...
29 CFR 1614.302 - Mixed case complaints.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 29 Labor 4 2014-07-01 2014-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...
29 CFR 1614.302 - Mixed case complaints.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 29 Labor 4 2013-07-01 2013-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...
29 CFR 1614.302 - Mixed case complaints.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 29 Labor 4 2011-07-01 2011-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...
29 CFR 1614.302 - Mixed case complaints.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 29 Labor 4 2010-07-01 2010-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...