A Risk Management Framework to Characterize Black Swan Risks: A Case Study of Lightning Effects on Insensitive High Explosives

NASA Astrophysics Data System (ADS)

Sanders, Gary A.

Effective and efficient risk management processes include the use of high fidelity modeling and simulation during the concept exploration phase as part of the technology and risk assessment activities, with testing and evaluation tasks occurring in later design development phases. However, some safety requirements and design architectures may be dominated by the low probability/high consequence "Black Swan" vulnerabilities that require very early testing to characterize and efficiently mitigate. Failure to address these unique risks has led to catastrophic systems failures including the space shuttle Challenger, Deepwater Horizon, Fukushima nuclear reactor, and Katrina dike failures. Discovering and addressing these risks later in the design and development process can be very costly or even lead to project cancellation. This paper examines the need for risk management process adoption of early hazard phenomenology testing to inform the technical risk assessment, requirements definition and conceptual design. A case study of the lightning design vulnerability of the insensitive high explosives being used in construction, mining, demolition, and defense industries will be presented to examine the impact of this vulnerability testing during the concept exploration phase of the design effort. While these insensitive high explosives are far less sensitive to accidental initiation by fire, impact, friction or even electrical stimuli, their full range of sensitivities have not been characterized and ensuring safe engineering design and operations during events such as lightning storms requires vulnerability testing during the risk assessment phase.

49 CFR 195.452 - Pipeline integrity management in high consequence areas.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Pipeline integrity management in high consequence... Management § 195.452 Pipeline integrity management in high consequence areas. (a) Which pipelines are covered... by this section must: (1) Develop a written integrity management program that addresses the risks on...

49 CFR 195.452 - Pipeline integrity management in high consequence areas.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Pipeline integrity management in high consequence... Management § 195.452 Pipeline integrity management in high consequence areas. (a) Which pipelines are covered... by this section must: (1) Develop a written integrity management program that addresses the risks on...

49 CFR 195.452 - Pipeline integrity management in high consequence areas.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Pipeline integrity management in high consequence... Management § 195.452 Pipeline integrity management in high consequence areas. (a) Which pipelines are covered... by this section must: (1) Develop a written integrity management program that addresses the risks on...

Initiatives and Challenges in Consequence Management after a WMD Attack

DTIC Science & Technology

2004-08-01

Challenges in Consequence Management people to seek shelter or other protection when possible, to avoid exposure to weapons of mass destruction effects . The...Potential Effects .........................................9 V. Methods for Managing the Consequences of WMD Use.................14 VI. Toward a...mass destruction (WMD). Consequence management1 is a process to mitigate the effects of the use of weapons of mass destruction, including

Homeland Biological Warfare Consequence Management: Capabilities and Needs Assessment

DTIC Science & Technology

2001-04-01

AU/ACSC/105/2001-04 AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY HOMELAND BIOLOGICAL WARFARE CONSEQUENCE MANAGEMENT: CAPABILITIES AND NEEDS...Dates Covered (from... to) - Title and Subtitle Homeland biological Warfare Consequence Management: Capabilities and Needs Assessment Contract...FEMA, DoJ, DoD, HHS, etc.) make a comprehensive, organized solution to the problem difficult. Focusing on the consequence management functions

Use of a systematic risk analysis method (FMECA) to improve quality in a clinical laboratory procedure.

PubMed

Serafini, A; Troiano, G; Franceschini, E; Calzoni, P; Nante, N; Scapellato, C

2016-01-01

Risk management is a set of actions to recognize or identify risks, errors and their consequences and to take the steps to counter it. The aim of our study was to apply FMECA (Failure Mode, Effects and Criticality Analysis) to the Activated Protein C resistance (APCR) test in order to detect and avoid mistakes in this process. We created a team and the process was divided in phases and sub phases. For each phase we calculated the probability of occurrence (O) of an error, the detectability score (D) and the severity (S). The product of these three indexes yields the RPN (Risk Priority Number). Phases with a higher RPN need corrective actions with a higher priority. The calculation of RPN showed that more than 20 activities have a score higher than 150 and need important preventive actions; 8 have a score between 100 and 150. Only 23 actions obtained an acceptable score lower than 100. This was one of the first experience of application of FMECA analysis to a laboratory process, and the first one which applies this technique to the identification of the factor V Leiden, and our results confirm that FMECA could be a simple, powerful and useful tool in risk management and helps to identify quickly the criticality in a laboratory process.

Using task analysis to improve the requirements elicitation in health information system.

PubMed

Teixeira, Leonor; Ferreira, Carlos; Santos, Beatriz Sousa

2007-01-01

This paper describes the application of task analysis within the design process of a Web-based information system for managing clinical information in hemophilia care, in order to improve the requirements elicitation and, consequently, to validate the domain model obtained in a previous phase of the design process (system analysis). The use of task analysis in this case proved to be a practical and efficient way to improve the requirements engineering process by involving users in the design process.

Assessing assessment: Can the expected effects of the St. Marys River sea lamprey control strategy be detected?

USGS Publications Warehouse

Adams, Jean V.; Bergstedt, Roger A.; Christie, Gavin C.; Cuddy, Douglas W.; Fodale, Michael F.; Heinrich, John W.; Jones, Michael L.; McDonald, Rodney B.; Mullett, Katherine M.; Young, Robert J.

2003-01-01

In 1997 the Great Lakes Fishery Commission approved a 5-year (1998 to 2002) control strategy to reduce sea lamprey (Petromyzon marinus) production in the St. Marys River, the primary source of parasitic sea lampreys in northern Lake Huron. An assessment plan was developed to measure the success of the control strategy and decide on subsequent control efforts. The expected effects of the St. Marys River control strategy are described, the assessments in place to measure these effects are outlined, and the ability of these assessments to detect the expected effects are quantified. Several expected changes were predicted to be detectable: abundance of parasitic-phase sea lampreys and annual mortality of lake trout (Salvelinus namaycush) by 2001, abundance of spawning-phase sea lampreys by 2002, and relative return rates of lake trout and sea lamprey wounding rates on lake trout by 2005. Designing an effective assessment program to quantify the consequences of fishery management actions is a critical, but often overlooked ingredient of sound fisheries management.

Resilience, Integrity and Ecosystem Dynamics: Bridging Ecosystem Theory and Management

NASA Astrophysics Data System (ADS)

Müller, Felix; Burkhard, Benjamin; Kroll, Franziska

In this paper different approaches to elucidate ecosystem dynamics are described, illustrated and interrelated. Ecosystem development is distinguished into two separate sequences, a complexifying phase which is characterized by orientor optimization and a destruction based phase which follows disturbances. The two developmental pathways are integrated in a modified illustration of the “adaptive cycle”. Based on these fundamentals, the recent definitions of resilience, adaptability and vulnerability are discussed and a modified comprehension is proposed. Thereafter, two case studies about wetland dynamics are presented to demonstrate both, the consequences of disturbance and the potential of ecosystem recovery. In both examples ecosystem integrity is used as a key indicator variable. Based on the presented results the relativity and the normative loading of resilience quantification is worked out. The paper ends with the suggestion that the features of adaptability could be used as an integrative guideline for the analysis of ecosystem dynamics and as a well-suited concept for ecosystem management.

Seeing the Elephant -- Consequence Management Policy for the Department of Defense

DTIC Science & Technology

2001-05-01

required for effective Consequence Management. The three response tiers allows the DoD to provide a predesignated level of support to the appropriate Federal...recommendation is the creation of a tiered response capability that balances time and tasks required for effective Consequence Management. The three...the response required for toxic chemical events. The third tier is reserved for the actions required for the Consequence Management for a biological

A psychosocial risk assessment and management framework to enhance response to CBRN terrorism threats and attacks.

PubMed

Lemyre, Louise; Clément, Mélanie; Corneil, Wayne; Craig, Lorraine; Boutette, Paul; Tyshenko, Michael; Karyakina, Nataliya; Clarke, Robert; Krewski, Daniel

2005-01-01

Evidence in the disaster mental health literature indicates that psychosocial consequences of terrorism are a critical component of chemical, biological, radiological, and nuclear (CBRN) events, both at the clinical level and the normal behavioral and emotional levels. Planning for such psychosocial aspects should be an integral part of emergency preparedness. As Canada and other countries build the capacity to prevent, mitigate, and manage CBRN threats and events, it is important to recognize the range of social, psychological, emotional, spiritual, behavioral, and cognitive factors that may affect victims and their families, communities, children, the elderly, responders, decision makers, and others at all phases of terrorism, from threat to post-impact recovery. A structured process to assist CBRN emergency planners, decision makers, and responders in identifying psychosocial risks, vulnerable populations, resources, and interventions at various phases of a CBRN event to limit negative psychosocial impacts and promote resilience and adaptive responses is the essence of our psychosocial risk assessment and management (P-RAM) framework. This article presents the evidence base and conceptual underpinnings of the framework, the principles underlying its design, its key elements, and its use in the development of decision tools for responders, planners, decision makers, and the general public to better assess and manage psychosocial aspects of CBRN threats or attacks.

Consequence Management - Ready or Not?

DTIC Science & Technology

2003-04-07

Defense will have sufficient capability and be ready to respond to a Weapons of Mass Destruction/ Effects attack. An effective consequence management...Defense adopts the National Military Strategy and its consequence management approach, it must identify Weapons of Mass Destruction/ Effects threats...that the Department of Defense: develop Weapons of Mass Destruction/ Effects performance standards for response assets; implement a consequence

Satellite Systems Design/Simulation Environment: A Systems Approach to Pre-Phase A Design

NASA Technical Reports Server (NTRS)

Ferebee, Melvin J., Jr.; Troutman, Patrick A.; Monell, Donald W.

1997-01-01

A toolset for the rapid development of small satellite systems has been created. The objective of this tool is to support the definition of spacecraft mission concepts to satisfy a given set of mission and instrument requirements. The objective of this report is to provide an introduction to understanding and using the SMALLSAT Model. SMALLSAT is a computer-aided Phase A design and technology evaluation tool for small satellites. SMALLSAT enables satellite designers, mission planners, and technology program managers to observe the likely consequences of their decisions in terms of satellite configuration, non-recurring and recurring cost, and mission life cycle costs and availability statistics. It was developed by Princeton Synergetic, Inc. and User Systems, Inc. as a revision of the previous TECHSAT Phase A design tool, which modeled medium-sized Earth observation satellites. Both TECHSAT and SMALLSAT were developed for NASA.

[Management of patients with simple cervical distortions].

PubMed

Foletti, G; Regli, F

1995-11-11

Common distortion of the cervical spine without evidence of neurological or osteoligamentary damage is a frequent consequence of indirect head and neck trauma. The mechanism of the injury (called "whiplash", "coup de lapin", or "Schleudertrauma") does not imply direct trauma to the head or neck. In the acute phase, common distortion of the cervical spine requires treatment. Rapid management may avoid or considerably reduce the chronic pain syndrome with the characteristic chronic tension-like headache. The chronic pain and the numerous associated functional disorders are not well understood: certain factors favour central and peripheral dysfunction and others emphasize the importance of extra-trauma phenomena. In our opinion, extra-trauma phenomena would explain the invalidating nature of pain in a small number of patients. Management of these chronic patients requires a multidisciplinary approach aimed at helping the patient overcome the inconveniences of this condition.

Management of patients during hunger strike and refeeding phase.

PubMed

Eichelberger, M; Joray, M L; Perrig, M; Bodmer, M; Stanga, Z

2014-01-01

Hunger strikers resuming nutritional intake may develop a life-threatening refeeding syndrome (RFS). Consequently, hunger strikers represent a core challenge for the medical staff. The objective of the study was to test the effectiveness and safety of evidence-based recommendations for prevention and management of RFS during the refeeding phase. This was a retrospective, observational data analysis of 37 consecutive, unselected cases of prisoners on a hunger strike during a 5-y period. The sample consisted of 37 cases representing 33 individual patients. In seven cases (18.9%), the hunger strike was continued during the hospital stay, in 16 episodes (43.2%) cessation of the hunger strike occurred immediately after admission to the security ward, and in 14 episodes (37.9%) during hospital stay. In the refeed cases (n = 30), nutritional replenishment occurred orally, and in 25 (83.3%) micronutrients substitutions were made based on the recommendations. The gradual refeeding with fluid restriction occurred over 10 d. Uncomplicated dyselectrolytemia was documented in 12 cases (40%) within the refeeding phase. One case (3.3%) presented bilateral ankle edemas as a clinical manifestation of moderate RFS. Intensive medical treatment was not necessary and none of the patients died. Seven episodes of continued hunger strike were observed during the entire hospital stay without medical complications. Our data suggested that seriousness and rate of medical complications during the refeeding phase can be kept at a minimum in a hunger strike population. This study supported use of recommendations to optimize risk management and to improve treatment quality and patient safety in this vulnerable population. Copyright © 2014 Elsevier Inc. All rights reserved.

Cascading disasters in the huge coastal aquifer of Salento (Apulia region, Southern Italy) ensuing droughts

NASA Astrophysics Data System (ADS)

Parisi, Alessandro; Fidelibus, Maria Dolores

2017-04-01

Physical extremes can be distinguished in "sudden physical extremes" (e.g. earthquakes, tsunami) and "progressive physical extremes" (e.g. drought, desertification, landslides). They differ for frequency, intensity, spatial extent, duration and timing of occurrence. If a physical extreme, by interacting with human systems, induces negative consequences, its outcome can be a "disaster". The disasters are, in both above cases, characterized by a few phases: physical extreme occurrence, emergency, response, and recovery. However, in the case of a progressive physical extreme, the disaster develops with an overlap in the time of the above-mentioned phases. When the events are repetitive, the emergency planning (which follows a cycle) succeeds with preparedness and mitigation with the intent of reducing the risk. Both the sudden and progressive physical extremes produce cascading effects of consequences on social, environmental and economic systems. Disasters consequent to sudden and progressive extremes show, however, some differences, mainly attributable to the "visibility" of the effects and to their time scale of evolution. As matter of fact, a disaster consequent to a progressive physical extreme produces "emerging signals" that are often invisible. Moreover, the emergency phase can arise with a time delay compared to the occurrence of the physical extreme, depending on the spatial scale of impacted system. The above differences allow defining "creeping disasters" the potential disasters related to progressive physical extremes. This study deals with some peculiar "cascading disasters" consequent to drought, which is the main "creeping disaster", namely the groundwater drought and the consequent salinization of coastal aquifers. In regional flow systems, their effects are invisible in the immediate to common people (and often even to managers) because of the concealed nature of groundwater; moreover, they are difficult to assess because of the shift over time of their evolution compared to the promptness of surface effects. The study area is the Salento coastal karstic aquifer (Apulia region, Southern Italy), where the groundwater flows according to a regional flow system. It has been subject to successive meteorological droughts between 1960 and 2010. The groundwater monitoring performed during this period, even with some gaps, allows identifying time lags between superficial effects and underground system response, potential tipping points, and emerging signals of the cascading disasters.

The preanalytic phase in veterinary clinical pathology.

PubMed

Braun, Jean-Pierre; Bourgès-Abella, Nathalie; Geffré, Anne; Concordet, Didier; Trumel, Cathy

2015-03-01

This article presents the general causes of preanalytic variability with a few examples showing specialists and practitioners that special and improved care should be given to this too often neglected phase. The preanalytic phase of clinical pathology includes all the steps from specimen collection to analysis. It is the phase where most laboratory errors occur in human, and probably also in veterinary clinical pathology. Numerous causes may affect the validity of the results, including technical factors, such as the choice of anticoagulant, the blood vessel sampled, and the duration and conditions of specimen handling. While the latter factors can be defined, influence of biologic and physiologic factors such as feeding and fasting, stress, and biologic and endocrine rhythms can often not be controlled. Nevertheless, as many factors as possible should at least be documented. The importance of the preanalytic phase is often not given the necessary attention, although the validity of the results and consequent clinical decision making and medical management of animal patients would likely be improved if the quality of specimens submitted to the laboratory was optimized. © 2014 American Society for Veterinary Clinical Pathology.

Using the theoretical domains framework to identify barriers and enablers to pediatric asthma management in primary care settings.

PubMed

Yamada, Janet; Potestio, Melissa L; Cave, Andrew J; Sharpe, Heather; Johnson, David W; Patey, Andrea M; Presseau, Justin; Grimshaw, Jeremy M

2017-12-20

This study aimed to apply a theory-based approach to identify barriers and enablers to implementing the Alberta Primary Care Asthma Pediatric Pathway (PCAPP) into clinical practice. Phase 1 included an assessment of assumptions underlying the intervention from the perspectives of the developers. Phase 2 determined the perceived barriers and enablers for: 1) primary care physicians' prescribing practices, 2) allied health care professionals' provision of asthma education to parents, and 3) children and parents' adherence to their treatment plans. Interviews were conducted with 35 individuals who reside in Alberta, Canada. Phase 1 included three developers. Phase 2 included 11 primary care physicians, 10 allied health care professionals, and 11 parents of children with asthma. Phase 2 interviews were based on the 14 domains of the Theoretical Domains Framework (TDF). Transcribed interviews were analyzed using a directed content analysis. Key assumptions by the developers about the intervention, and beliefs by others about the barriers and enablers of the targeted behaviors were identified. Eight TDF domains mapped onto the assumptions of the pathway as described by the intervention developers. Interviews with health care professionals and parents identified nine TDF domains that influenced the targeted behaviors: knowledge, skills, beliefs about capabilities, social/professional role and identity, beliefs about consequences, environmental context and resources, behavioral regulation, social influences, and emotions. Barriers and enablers perceived by health care professionals and parents that influenced asthma management will inform the optimization of the PCAPP prior to its evaluation.

Sleep in children with autism spectrum disorder.

PubMed

Kotagal, Suresh; Broomall, Eileen

2012-10-01

Children with autism spectrum disorder demonstrate an increased prevalence of difficulties with sleep initiation and maintenance. The consequences may include alterations in daytime behavior, memory, and learning in patients, and significant stress in caretakers. The dysregulation of melatonin synthesis, sensitization to environmental stimuli, behavioral insomnia syndromes, delayed sleep phase syndrome, rapid eye movement sleep behavior disorder, and comorbid anxiety, depression, and epilepsy comprise common etiologic factors. The clinical assessment of sleep problems in this population and a management algorithm are presented. Copyright © 2012 Elsevier Inc. All rights reserved.

THE ROLE OF THE CONSEQUENCE MANAGEMENT HOME TEAM IN THE FUKUSHIMA DAIICHI RESPONSE

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

Pemberton, Wendy; Mena, RaJah; Beal, William

The Consequence Management Home Team is a U.S. Department of Energy/National Nuclear Security Administration asset. It assists a variety of response organizations with modeling; radiological operations planning; field monitoring techniques; and the analysis, interpretation, and distribution of radiological data. These reach-back capabilities are activated quickly to support public safety and minimize the social and economic impact of a nuclear or radiological incident. In the Fukushima Daiichi response, the Consequence Management Home Team grew to include a more broad range of support than was historically planned. From the early days of the response to the continuing involvement in supporting late phasemore » efforts, each stage of the Consequence Management Home Team support had distinct characteristics in terms of management of incoming data streams as well as creation of products. Regardless of stage, the Consequence Management Home Team played a critical role in the Fukushima Daiichi response effort.« less

41 CFR 302-15.13 - What are the income tax consequences when my agency pays for my property management services?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What are the income tax consequences when my agency pays for my property management services? 302-15.13 Section 302-15.13 Public....13 What are the income tax consequences when my agency pays for my property management services? When...

41 CFR 302-3.421 - What are the income tax consequences when my agency pays for property management services?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What are the income tax consequences when my agency pays for property management services? 302-3.421 Section 302-3.421 Public Contracts... § 302-3.421 What are the income tax consequences when my agency pays for property management services...

A new service support tool for COSMO-SkyMed: civil user coordination service and civil request management optimization

NASA Astrophysics Data System (ADS)

Daraio, M. G.; Battagliere, M. L.; Sacco, P.; Fasano, L.; Coletta, A.

2015-10-01

COSMO-SkyMed is a dual-use program for both civilian and defense provides user community (institutional and commercial) with SAR data in several environmental applications. In the context of COSMO-SkyMed data and User management, one of the aspects carefully monitored is the user satisfaction level, it is links to satisfaction of submitted user requests. The operational experience of the first years of operational phase, and the consequent lessons learnt by the COSMO-SkyMed data and user management, have demonstrated that a lot of acquisition rejections are due to conflicts (time conflicts or system conflicts) among two or more civilian user requests, and they can be managed and solved implementing an improved coordination of users and their requests on a daily basis. With this aim a new Service Support Tool (SST) has been designed and developed to support the operators in the User Request coordination. The Tool allow to analyze conflicts among Acquisition Requests (ARs) before the National Rankization phase and to elaborate proposals for conflict resolution. In this paper the most common causes of the occurred rejections will be showed, for example as the impossibility to aggregate different orders, and the SST functionalities will be described, in particular how it works to remove or minimize the conflicts among different orders.

IS-ENES project management - lessons learnt

NASA Astrophysics Data System (ADS)

Parinet, Marie; Guglielmo, Francesca; Joussaume, Sylvie

2017-04-01

IS-ENES is the distributed e-infrastructure of models, model data and metadata of the European Network for Earth System Modelling (ENES). It has benefitted from two EC FP7 grants and aims towards further European and national funding to achieve sustainability. We highlight here several challenges related to project management that have risen in the course of these two project-phases spanning 8 years. Some challenges are related to the heterogeneity of the activities within IS-ENES, with different groups working on very diverse activities, not necessarily strictly interdependent. An immediate consequence is the need of implementing and setting up in early phases of the project efficient collection and circulation of information to preserve and reinforce the systemic view of the infrastructure as a whole and the pursuit of common goals, including coordinated provision of services. Toward and beyond such common goals, managing IS-ENES, covering both scientific and more strictly management-related aspects, implies a double-paced approach: besides setting up efficient project workflow, there is the need of setting up longer term objectives. This implies, within the project lifetime, to elaborate and implement a coherent organizational (consistent with scientific goals, funding schemes, research and technology landscape) strategy to pursue these goals beyond the project itself. Furthermore, a series of more generic project management challenges will also be listed and can be gathered around 3 main objectives: ease the internal processes in order to optimize the work, anticipate delays and budget issues, and motivate the project teams by ensuring an efficient internal and external communication.

A key to success: optimizing the planning process

NASA Astrophysics Data System (ADS)

Turk, Huseyin; Karakaya, Kamil

2014-05-01

By adopting The NATO Strategic Concept Document in 2010, some important changes in the perception of threat and management of crisis were introduced. This new concept, named ''Comprehensive Approach'', includes the precautions of pre-crisis management, applications of crisis-duration management and reconstruction phase of post-intervention management. NATO will be interested in not only the political and military options , but also social, economical and informational aspects of crisis. NATO will take place in all phases of conflict. The conflicts which occur outside the borders of NATO's nations and terrorism are perceived as threat sources for peace and stability. In addition to conventional threats, cyber attacks which threaten network-supported communication systems, preventing applications from accessing to space that will be used in different fields of life. On the other hand, electronic warfare capabilities which can effect us negatively are added to threat list as new threats. In the process in which military is thought as option, a harder planning phase is waiting for NATO's decision makers who struggle for keeping peace and security. Operation planning process which depends on comprehensive approach, contains these steps: Situational awareness of battlefield, evaluation of the military intervention options, orientation, developing an operation plan, reviewing the plan and transition phases.1 To be successful in theater which is always changing with the technological advances, there has to be an accurate and timely planning on the table. So, spending time for planning can be shown as one of the biggest problem. In addition, sustaining situational awareness which is important for the whole operation planning process, technical command and control hitches, human factor, inability to determine the center of gravity of opponent in asymmetrical threat situations can be described as some of the difficulties in operation planning. In this study, a possible air operation planning process is analyzed according to a comprehensive approach. The difficulties of planning are identified. Consequently, for optimizing a decisionmaking process of an air operation, a planning process is identified in a virtual command and control structure.

12 CFR 225.83 - What are the consequences of failing to continue to meet applicable capital and management...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 3 2012-01-01 2012-01-01 false What are the consequences of failing to continue to meet applicable capital and management requirements? 225.83 Section 225.83 Banks and Banking... the consequences of failing to continue to meet applicable capital and management requirements? (a...

12 CFR 225.83 - What are the consequences of failing to continue to meet applicable capital and management...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 3 2010-01-01 2010-01-01 false What are the consequences of failing to continue to meet applicable capital and management requirements? 225.83 Section 225.83 Banks and Banking... the consequences of failing to continue to meet applicable capital and management requirements? (a...

Salem 98: A post-plume phase, federal participation exercise

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

NONE

Salem 98 was the largest nuclear power plant post-plume phase exercise since the 1993 FRMAC-93 exercise at the Fort Calhoun Nuclear Power Plant in Nebraska. Salem 98 was a 3 Day exercise, held on May 5--7, 1998, involving participation by the States of New Jersey and Delaware and associated State and county agencies. Public Service Electric and Gas was the host utility and Salem County the host county. Federal participation included the Nuclear Regulatory Commission, Federal Emergency Management Agency, Department of Energy, Environmental Protection Agency, US department of Agriculture and Department of Health and Human Services. In addition, the Americanmore » Nuclear Insurers participated, adding a dimension to the exercise not experienced often enough. This was a stand-alone post-plume phase exercise, which took place 2 months after the evaluated plume phase exercise held on March 3, 1998, also including participation by various Federal agencies. This exercise demonstrated the positive working relationship among utility, State, county, and Federal responders in response to a postulated major nuclear power plant emergency with significant offsite consequences.« less

Towards responsible system development in health services: a discourse analysis study of design conflict resolution tactics.

PubMed

Irestig, Magnus; Timpka, Toomas

2010-02-01

We set out to examine design conflict resolution tactics used in development of large information systems for health services and to outline the design consequences for these tactics. Discourse analysis methods were applied to data collected from meetings conducted during the development of a web-based system in a public health context. We found that low risk tactics were characterized by design issues being managed within the formal mandate and competences of the design group. In comparison, high risk tactics were associated with irresponsible compromises, i.e. decisions being passed on to others or to later phases of the design process. The consequence of this collective disregard of issues such as responsibility and legitimacy is that the system design will be impossible to implement in factual health service contexts. The results imply that downstream responsibility issues have to be continuously dealt with in system development in health services.

Disappearance of a stutter shortly before death.

PubMed

Duong, Phuc H; Zulian, Gilbert B

2007-01-01

A patient with a stutter caused by the trauma of the death of a loved one was able to recover normal speech 1 week before her death, which resulted from intestinal obstruction caused by ovarian cancer. The stutter appeared to have been overcome using a combination therapy of sophrology, self-regulation, and drug therapy. During a genuine resilience process, the patient was able to overcome an earlier existential fracture. In this final phase of life, health professionals and the family fully respected the patient's independence to remain in control of events. She repeatedly refused to have a nasogastric tube inserted to extract fecal matter from the stomach. This patient consequently repossessed her own language of expression in a body that was shattered by cancerous illness and the consequences of treatments. She thus managed to find a successful balance between the body, the spirit, and the brain.

Emerging Technologies: Biosecurity and Consequence Management Implications

NASA Astrophysics Data System (ADS)

Perkins, Dana; Nordmann, Brian

The natural outbreaks of disease and pandemics are transnational threats that create international challenges when detection and containment are not timely due to scarce human and material resources. Whether the cause of those outbreaks is natural or intentional in origin, the main goal of consequence management operations is to save lives. The consequence management process is a continuum of inter-connected phases such as planning, preparation, response, and recovery. The rapid advances of life sciences and the emergence of dual-use technologies such as synthetic biology and nanotechnology pose additional challenges in terms of planning for the unknown potential threats whether they may be synthetic microorganisms with unpredictable dissemination patterns or nanoscale-manipulated biological agents evading current detection capabilities. The US National Strategy for Countering Biological Threats is emphasizing prevention while continuing to support the national preparedness goals and response/recovery capabilities. The recent policies, guidelines, and recommendations on overhauling the biological risk management in the United States are a proactive stance to a rapidly changing global environment. They include optimization of the current oversight frameworks and active engagement of the industry and academia in order to reduce the risk that individuals with ill intent may exploit the commercial application of nucleic acid synthesis technology to access genetic material derived from or by encoding Biological Select Agents or Toxins. We are also actively seeking to increase our knowledge of health effects of various types of nanomaterials, and how to assess, control, and prevent harmful exposure, taking into consideration the numerous gaps that currently exist with regard to the distinct behavior of nanoparticles compared to the same chemical or material at "macro-scale". Fundamentally, a biological incident, whether it is of natural, accidental, or deliberate origin, constitutes a public health problem and the United States is engaged with the international community to enhance our collective capability to address emerging health security threats.

T7 phage factor required for managing RpoS in Escherichia coli.

PubMed

Tabib-Salazar, Aline; Liu, Bing; Barker, Declan; Burchell, Lynn; Qimron, Udi; Matthews, Steve J; Wigneshweraraj, Sivaramesh

2018-06-05

T7 development in Escherichia coli requires the inhibition of the housekeeping form of the bacterial RNA polymerase (RNAP), Eσ 70 , by two T7 proteins: Gp2 and Gp5.7. Although the biological role of Gp2 is well understood, that of Gp5.7 remains to be fully deciphered. Here, we present results from functional and structural analyses to reveal that Gp5.7 primarily serves to inhibit Eσ S , the predominant form of the RNAP in the stationary phase of growth, which accumulates in exponentially growing E. coli as a consequence of the buildup of guanosine pentaphosphate [(p)ppGpp] during T7 development. We further demonstrate a requirement of Gp5.7 for T7 development in E. coli cells in the stationary phase of growth. Our finding represents a paradigm for how some lytic phages have evolved distinct mechanisms to inhibit the bacterial transcription machinery to facilitate phage development in bacteria in the exponential and stationary phases of growth.

12 CFR 225.83 - What are the consequences of failing to continue to meet applicable capital and management...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 3 2014-01-01 2014-01-01 false What are the consequences of failing to continue to meet applicable capital and management requirements? 225.83 Section 225.83 Banks and Banking....83 What are the consequences of failing to continue to meet applicable capital and management...

Counter-Chemical, Biological, Radiological, and Nuclear Operations

DTIC Science & Technology

2007-01-26

environment. (Page 10) Consequence management activities serve to reduce the effects of a CBRN attack or event, and assist in the restoration of...can be used quite effectively as attack agents. Toxic Industrial Chemicals (TICs), Toxic Industrial Materials (TIMs), and other potentially...CBRN pillars. Consequence Management Consequence management (CM) activities serve to reduce the effects of a CBRN attack or event, and assist in

From industry to academia: Benefits of integrating a professional project management standard into (geo)science research

NASA Astrophysics Data System (ADS)

Cristini, Luisa

2017-04-01

Scientific and technological research carried out within universities and public research institutions often involves large collaborations across several countries. Despite the considerable budget (typically millions of Euros), the high expectations (high impact scientific findings, new technological developments and links with policy makers, industry and civil society) and the length of the project over several years, these international projects often rely heavily on the personal skills of the management team (project coordinator, project manager, principal investigators) without a structured, transferable framework. While this approach has become an established practice, it's not ideal and can jeopardise the success of the entire effort with consequences ranging from schedule delays, loss of templates/systems, financial charges and ultimately project failure. In this presentation I will show the advantages of integrating a globally recognised standard for professional project management, such as the PMP® by the Project Management Institute, into academic research. I will cover the project management knowledge areas (integration management, scope management, time management, cost management, quality management, human resources management, risk management, procurement management, and stakeholder management) and the processes within these throughout the phases of the project lifetime (project initiation, planning, executing, monitoring and controlling, and closure). I will show how application of standardised, transferable procedures, developed within the business & administration sector, can benefit academia and more generally scientific research.

Capacity Management and Walkdown During LEO Cycling of Nickel-Hydrogen Cells and Batteries

NASA Technical Reports Server (NTRS)

Thaller, Lawrence H.; Zimmerman, Albert H.; To, Gloria

2001-01-01

This viewgraph presentation discusses the following topics: 1) Capacity walkdown defined and illustrated; 2) Importance of capacity walkdown: 3) Four approaches to understanding the phenomenon - Pressure Trend, Charging Curve, Electrochemical Voltage Spectroscopy, and Destructive Physical Analysis Studies; 4) Results of the interrelated studies; 5) Suggested mechanism for capacity walkdown; and 6) Charging protocols to avoid the problem. In summary: 1) capacity walkdown is a consequence of the inability to maintain a high state of charge; 2) Capacity loss is typically 35% which would be expected by the valence difference between gamma and beta nickel oxyhydroxide; 3) Cycling at -5 degrees facilitates the formation of the gamma phase; 4) Excessive overcharge can also facilitate gamma phase formation at the expense of cycle life; and 5) Conditions can now be suggested to help minimize capacity walkdown.

REASONS AND CONSEQUENCES OF APPLIED LEADERSHIP STYLES IN ETHICAL DILEMMAS WHEN NURSE MANAGERS MAKE DECISIONS.

PubMed

Zydziunaite, V; Suominen, T

2014-09-21

Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. Purpose: To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. Methods: The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (n=278) were nurse managers. The data were analyzed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. Results: The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients', relatives' and nurse managers' needs. Conclusions: Nurse managers exhibited leadership styles oriented to maintenance, focusing more on the "doing the job" than on managing the decision-making in ethical dilemmas.

Leadership styles of nurse managers in ethical dilemmas: Reasons and consequences.

PubMed

Zydziunaite, Vilma; Suominen, Tarja

2014-01-01

Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (N = 278) were nurse managers. The data were analysed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients,' relatives' and nurse managers' needs. Nurse managers exhibited leadership styles oriented to maintenance, focussing more on the 'doing the job' than on managing the decision-making in ethical dilemmas.

Detecting the Benefits of Shade Management in the Thermal Regime of an Upland River Under Positive and Negative Phases of the NAO

NASA Astrophysics Data System (ADS)

Wilby, R.; Johnson, M. F.

2017-12-01

Water temperature is an important determinant of river ecosystem function and health. Hence, there is growing concern about rising surface water temperatures as a consequence of global warming and human modifications to river regimes. Some agencies are advocating riparian shade management as a means of `keeping rivers cool'. As appealing as this policy might seem, there are a host of practical considerations such as which species to plant, where to plant, and how much to plant? Moreover, there can be unintended consequences for groundwater recharge, flood risk and nutrient fluxes through the buffer zone. The thermal benefits of tree-planting may also be hard to detect amidst the integrated, downstream effects of landscape shade and flows from springs. Yet, to truly evaluate shade management as an adaptation to climate change, clear evidence is needed of the costs and benefits of this local intervention. What has this got to do with natural modes of climate variability? Continental scale, hydrological impacts of ENSO, the PDO and NAO have been widely reported - these periodic variations in ocean-atmosphere circulations are often blamed for floods, droughts, wildfire, crop failures, and the like. But there is emerging evidence that such phenomena also drive inter-annual variations in the heat flux of rivers. This matters because the underlying signal can confound field and model experiments intended to test adaptation options. Here, we present evidence of NAO signatures in the water temperature regime of the River Dove, UK. We compare the amplitude of these thermal variations with the expected benefit of tree planting. We demonstrate that the difference in maximum summer water temperature between strongly positive and strongly negative NAO phases can be about 2.5°C. This is equivalent to the thermal benefit of more than 2 km of riparian shade for the river studied. So, whilst modes of climate variability undoubtedly have a global footprint, let us not forget that river management literally begins at the grass-root level.

Advanced consequence management program: challenges and recent real-world implementations

NASA Astrophysics Data System (ADS)

Graser, Tom; Barber, K. S.; Williams, Bob; Saghir, Feras; Henry, Kurt A.

2002-08-01

The Enhanced Consequence Management, Planning and Support System (ENCOMPASS) was developed under DARPA's Advanced Consequence Management program to assist decision-makers operating in crisis situations such as terrorist attacks using conventional and unconventional weapons and natural disasters. ENCOMPASS provides the tools for first responders, incident commanders, and officials at all levels to share vital information and consequently, plan and execute a coordinated response to incidents of varying complexity and size. ENCOMPASS offers custom configuration of components with capabilities ranging from map-based situation assessment, situation-based response checklists, casualty tracking, and epidemiological surveillance. Developing and deploying such a comprehensive system posed significant challenges for DARPA program management, due to an inherently complex domain, a broad spectrum of customer sites and skill sets, an often inhospitable runtime environment, demanding development-to-deployment transition requirements, and a technically diverse and geographically distributed development team. This paper introduces ENCOMPASS and explores these challenges, followed by an outline of selected ENCOMPASS deployments, demonstrating how ENCOMPASS can enhance consequence management in a variety real world contexts.

Managing fatigue after cancer treatment: development of RESTORE, a web-based resource to support self-management.

PubMed

Foster, C; Calman, L; Grimmett, C; Breckons, M; Cotterell, P; Yardley, L; Joseph, J; Hughes, S; Jones, R; Leonidou, C; Armes, J; Batehup, L; Corner, J; Fenlon, D; Lennan, E; Morris, C; Neylon, A; Ream, E; Turner, L; Richardson, A

2015-08-01

The aim of this study is to co-create an evidence-based and theoretically informed web-based intervention (RESTORE) designed to enhance self-efficacy to live with cancer-related fatigue (CRF) following primary cancer treatment. A nine-step process informed the development of the intervention: (1) review of empirical literature; (2) review of existing patient resources; (3) establish theoretical framework; (4) establish design team with expertise in web-based interventions, CRF and people affected by cancer; (5) develop prototype intervention; (6) user testing phase 1; (7) refinement of prototype; (8) user testing phase 2; and (9) develop final intervention. Key stakeholders made a critical contribution at every step of intervention development, and user testing, which involved an iterative process and resulted in the final intervention. The RESTORE intervention has five sessions; sessions 1 and 2 include an introduction to CRF and goal setting. Sessions 3-5 can be tailored to user preference and are designed to cover areas of life where CRF may have an impact: home and work life, personal relationships and emotional adjustment. It is feasible to systematically 'co-create' an evidence-based and theory-driven web-based self-management intervention to support cancer survivors living with the consequences of cancer and its treatment. This is the first account of the development of a web-based intervention to support self-efficacy to manage CRF. An exploratory trial to test the feasibility and acceptability of RESTORE is now warranted. Copyright © 2015 John Wiley & Sons, Ltd.

Management of crizotinib therapy for ALK-rearranged non-small cell lung carcinoma: an expert consensus.

PubMed

Cappuzzo, Federico; Moro-Sibilot, Denis; Gautschi, Oliver; Boleti, Ekaterini; Felip, Enriqueta; Groen, Harry J M; Germonpré, Paul; Meldgaard, Peter; Arriola, Edurne; Steele, Nicola; Fox, Jesme; Schnell, Patrick; Engelsberg, Arne; Wolf, Jürgen

2015-02-01

Within 4 years of the discovery of anaplastic lymphoma kinase (ALK) rearrangements in non-small cell lung cancer (NSCLC), the ALK inhibitor crizotinib gained US and European approval for the treatment of advanced ALK-positive NSCLC. This was due to the striking response data observed with crizotinib in phase I and II trials in patients with ALK-positive NSCLC, as well as the favorable tolerability and safety profile observed. Recently published phase III data established crizotinib as a new standard of care for this NSCLC molecular subset. A consequence of such rapid approval, however, is the limited clinical experience and relative paucity of information concerning optimal therapy management. In this review, we discuss the development of crizotinib and the clinical relevance of its safety profile, examining crizotinib-associated adverse events in detail and making specific management recommendations. Crizotinib-associated adverse events were mostly mild to moderate in severity in clinical studies, and appropriate monitoring and supportive therapies are considered effective in avoiding the need for dose interruption or reduction in most cases. Therapy management of patients following disease progression on crizotinib is also discussed. Based on available clinical data, it is evident that patients may have prolonged benefit from crizotinib after Response Evaluation Criteria in Solid Tumors-defined disease progression, and crizotinib should be continued for as long as the patient derives benefit. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Effect of Phase Shift from Corals to Zoantharia on Reef Fish Assemblages

PubMed Central

Cruz, Igor C. S.; Loiola, Miguel; Albuquerque, Tiago; Reis, Rodrigo; de Anchieta C. C. Nunes, José; Reimer, James D.; Mizuyama, Masaru; Kikuchi, Ruy K. P.; Creed, Joel C.

2015-01-01

Consequences of reef phase shifts on fish communities remain poorly understood. Studies on the causes, effects and consequences of phase shifts on reef fish communities have only been considered for coral-to-macroalgae shifts. Therefore, there is a large information gap regarding the consequences of novel phase shifts and how these kinds of phase shifts impact on fish assemblages. This study aimed to compare the fish assemblages on reefs under normal conditions (relatively high cover of corals) to those which have shifted to a dominance of the zoantharian Palythoa cf. variabilis on coral reefs in Todos os Santos Bay (TSB), Brazilian eastern coast. We examined eight reefs, where we estimated cover of corals and P. cf. variabilis and coral reef fish richness, abundance and body size. Fish richness differed significantly between normal reefs (48 species) and phase-shift reefs (38 species), a 20% reduction in species. However there was no difference in fish abundance between normal and phase shift reefs. One fish species, Chaetodon striatus, was significantly less abundant on normal reefs. The differences in fish assemblages between different reef phases was due to differences in trophic groups of fish; on normal reefs carnivorous fishes were more abundant, while on phase shift reefs mobile invertivores dominated. PMID:25629532

Common ground: an investigation of environmental management alcohol prevention initiatives in a college community.

PubMed

Wood, Mark D; Dejong, William; Fairlie, Anne M; Lawson, Doreen; Lavigne, Andrea M; Cohen, Fran

2009-07-01

This article presents an evaluation of Common Ground, a media campaign-supported prevention program featuring increased enforcement, decreased alcohol access, and other environmental management initiatives targeting college student drinking. Phase 1 of the media campaign addressed student resistance to environmentally focused prevention by reporting majority student support for alcohol policy and enforcement initiatives. Phase 2 informed students about state laws, university policies, and environmental initiatives. We conducted student telephone surveys, with samples stratified by gender and year in school, for 4 consecutive years at the intervention campus and 3 years at a comparison campus. We did a series of one-way between-subjects analyses of variance and analyses of covariance, followed by tests of linear trend and planned comparisons. Targeted outcomes included perceptions of enforcement and alcohol availability, alcohol use, and alcohol-impaired driving. We examined archived police reports for student incidents, primarily those resulting from loud parties. There were increases at the intervention campus in students' awareness of formal alcohol-control efforts and perceptions of the alcohol environment, likelihood of apprehension for underage drinking, consequences for alcohol-impaired driving, and responsible alcohol service practices. There were decreases in the perceived likelihood of other students' negative behavior at off-campus parties. Police-reported incidents decreased over time; however, perceived consequences for off-campus parties decreased. No changes were observed for difficulty finding an off-campus party, self-reported alcohol use, or alcohol-impaired driving. The intervention successfully altered perceptions of alcohol enforcement, alcohol access, and the local alcohol environment. This study provides important preliminary information to researchers and practitioners engaged in collaborative prevention efforts in campus communities.

Common Ground: An Investigation of Environmental Management Alcohol Prevention Initiatives in a College Community*

PubMed Central

Wood, Mark D.; DeJong, William; Fairlie, Anne M.; Lawson, Doreen; Lavigne, Andrea M.; Cohen, Fran

2009-01-01

Objective: This article presents an evaluation of Common Ground, a media campaign-supported prevention program featuring increased enforcement, decreased alcohol access, and other environmental management initiatives targeting college student drinking. Method: Phase 1 of the media campaign addressed student resistance to environmentally focused prevention by reporting majority student support for alcohol policy and enforcement initiatives. Phase 2 informed students about state laws, university policies, and environmental initiatives. We conducted student telephone surveys, with samples stratified by gender and year in school, for 4 consecutive years at the intervention campus and 3 years at a comparison campus. We did a series of one-way between-subjects analyses of variance and analyses of covariance, followed by tests of linear trend and planned comparisons. Targeted outcomes included perceptions of enforcement and alcohol availability, alcohol use, and alcohol-impaired driving. We examined archived police reports for student incidents, primarily those resulting from loud parties. Results: There were increases at the intervention campus in students' awareness of formal alcohol-control efforts and perceptions of the alcohol environment, likelihood of apprehension for underage drinking, consequences for alcohol-impaired driving, and responsible alcohol service practices. There were decreases in the perceived likelihood of other students' negative behavior at off-campus parties. Police-reported incidents decreased over time; however, perceived consequences for off-campus parties decreased. No changes were observed for difficulty finding an off-campus party, self-reported alcohol use, or alcohol-impaired driving. Conclusions: The intervention successfully altered perceptions of alcohol enforcement, alcohol access, and the local alcohol environment. This study provides important preliminary information to researchers and practitioners engaged in collaborative prevention efforts in campus communities. PMID:19538917

Combating Terrorism: Issues in Managing Counterterrorist Programs

DTIC Science & Technology

2000-04-06

major effort to develop a national strategy, to date the strategy does not include a clear desired outcome to be achieved. Resources to combat...Federal exercises, in contrast to earlier years, are now practicing crisis and consequence management simultaneously and including state and local...categories—crisis management and consequence management. Crisis management includes efforts to stop a terrorist attack, arrest terrorists, and gather

Environmental Security Cooperation USARPAC’s: Defense Environmental and International Cooperation (DEIC) Conference (Center of Strategic Leadeship Issue Paper, Volume 07-03, September 2003)

DTIC Science & Technology

2003-09-01

infrastructure, and providing consequence management and mitigation of man-made and natural disasters. The United States Army, Pacifi c (USARPAC), the Offi...Terrorism, Disaster Response and Consequence Management , and Medical Aspects of Environmental Security. The conference brought together military and...consequence management in maintaining governmental legitimacy, and examine salient military roles in preventing, responding to, and mitigating natural

Croatian Society of Medical Biochemistry and Laboratory Medicine: national recommendations for venous blood sampling

PubMed Central

Nikolac, Nora; Šupak-Smolčić, Vesna; Šimundić, Ana-Maria; Ćelap, Ivana

2013-01-01

Phlebotomy is one of the most complex medical procedures in the diagnosis, management and treatment of patients in healthcare. Since laboratory test results are the basis for a large proportion (60–80%) of medical decisions, any error in the phlebotomy process could have serious consequences. In order to minimize the possibility of errors, phlebotomy procedures should be standardised, well-documented and written instructions should be available at every workstation. Croatia is one of the few European countries that have national guidelines for phlebotomy, besides the universally used CLSI (Clinical Laboratory Standards Institute) H3-A6 Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; approved Standard-Sixth Edition (CLSI, 2007) and WHO (World Health Organization) guidelines on drawing blood: best practices in phlebotomy (WHO, 2010). However, the growing body of evidence in importance of preanalytical phase management resulted in a need for evidence based revision and expansion of existing recommendations. The Croatian Society for Medical Biochemistry and Laboratory Medicine, Working Group for the Preanalytical Phase issued this recommendation. This document is based on the CLSI guideline H3-A6, with significant differences and additional information. PMID:24266294

Croatian Society of Medical Biochemistry and Laboratory Medicine: national recommendations for venous blood sampling.

PubMed

Nikolac, Nora; Supak-Smolcić, Vesna; Simundić, Ana-Maria; Celap, Ivana

2013-01-01

Phlebotomy is one of the most complex medical procedures in the diagnosis, management and treatment of patients in healthcare. Since laboratory test results are the basis for a large proportion (60-80%) of medical decisions, any error in the phlebotomy process could have serious consequences. In order to minimize the possibility of errors, phlebotomy procedures should be standardised, well-documented and written instructions should be available at every workstation. Croatia is one of the few European countries that have national guidelines for phlebotomy, besides the universally used CLSI (Clinical Laboratory Standards Institute) H3-A6 Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; approved Standard-Sixth Edition (CLSI, 2007) and WHO (World Health Organization) guidelines on drawing blood: best practices in phlebotomy (WHO, 2010). However, the growing body of evidence in importance of preanalytical phase management resulted in a need for evidence based revision and expansion of existing recommendations. The Croatian Society for Medical Biochemistry and Laboratory Medicine, Working Group for the Preanalytical Phase issued this recommendation. This document is based on the CLSI guideline H3-A6, with significant differences and additional information.

Moving forward in uveitis therapy: preclinical to phase II clinical trial drug development.

PubMed

Salazar-Méndez, Raquel; Yilmaz, Taygan; Cordero-Coma, Miguel

2016-01-01

Several advances have been made in the diagnostic approach and therapeutic management of patients with immune-mediated uveitis over the last few decades, which have to lead to an improvement in the visual prognosis of patients. However, the use of available therapies, including steroids and immunosuppressive drugs, is still associated with limited efficacy and potentially serious side effects. Consequently, efforts have been made to develop novel therapeutic alternatives including new molecules and innovative therapeutic approaches. Herein, the authors provide an updated review of those drugs in the initial phases of evaluation for the treatment of immune-mediated uveitides as well as the latest evidence from basic research. Enhanced understanding of the pathogenic mechanisms leading to immune-mediated uveitis has led to the identification of new therapeutic targets and thus to the development of more specific drugs. In addition, considering that the eye is a semi-enclosed chamber and that local therapy has the benefit of sparing the rest of the body from potentially toxic exposure, several attempts of establishing direct ophthalmologic avenues for delivery of the established and emerging drugs have also been made. All these advances have been an unquestionable step forward in the challenging management of uveitis patients.

Single-Axis Three-Beam Amplitude Monopulse Antenna-Signal Processing Issues

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

Doerry, Armin W.; Bickel, Douglas L.

2015-05-01

Typically, when three or more antenna beams along a single axis are required, the answer has been multiple antenna phase-centers, essentially a phase-monopulse system. Such systems and their design parameters are well-reported in the literature. Less appreciated is that three or more antenna beams can also be generated in an amplitude-monopulse fashion. Consequently, design guidelines and performance analysis of such antennas is somewhat under-reported in the literature. We provide discussion herein of three beams arrayed in a single axis with an amplitude-monopulse configuration. Acknowledgements The preparation of this report is the result of an unfunded research and development activity. Sandiamore » National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administ ration under contract DE-AC04-94AL85000.« less

Integration of social dimension in an index oriented methodology for consequence analysis of natural hazards: application to the Upper Guil Catchment (Southern French Alps)

NASA Astrophysics Data System (ADS)

Carlier, Benoit; Puissant, Anne; Dujarric, Constance

2017-04-01

Vulnerability assessment together with hazard exposure is generally accepted as the two main steps of risk analysis. If quantitative methods to estimate hazard exposure are now well-defined, it is not the case regarding vulnerability assessment. Vulnerability is a complex concept involving a variety of disciplines from physical and socio-economic sciences (i.e. engineering, economics, social and health sciences etc.). Currently, two opposite trends exist: the 'physical' approach in which vulnerability is analysed as potential impacts (i.e. structural and functional) on the elements at risk (building, network, land cover); and the 'social' approach in which vulnerability is a combination of socio-economic variables determining people's ability to anticipate before a catastrophic event, to react during it, and to recover after it. For a complete analysis of vulnerability it is essential to combine these two approaches but in reality few works exists. The objective of this research is to improve the Potential Damage Index (PDI), detailed in Puissant el al. (2013), originally developed to assess physical injury, structural and functional consequences of landslide hazard, by including socio-economic characteristics of population information. Data from the French Census data (INSEE, 2012) and a survey on risk perception (100 questionnaires obtained between 2014 and 2015/16) were used to propose an overall index taking into account the three main phases of risk management: preparedness, crisis management and recovery. This new index called Global Potential Damage Index (GPDI) is applied on the Upper Guil Catchment to assess potential torrential floods hazard in the context of the French funded project SAMCO (Society Adaptation for coping with Mountain risks in a global change Context). Results of the PDI are compared with the GPDI and show significant differences. GPDI scores mapping are lower than PDI scores indicating that resilient population may qualify results obtained for physical consequences. In GPDI the social and institutional component is expressed by a unique value applied for the overall stakes of a same community. Consequently, socio-economics differences between Upper Guil catchments communities are highlighted and make results easily understandable for local manager.

Exploring patient perception of success and benefit in self-management of breast cancer-related arm lymphoedema.

PubMed

Jeffs, Eunice; Ream, Emma; Shewbridge, Amanda; Cowan-Dickie, Siobhan; Crawshaw, Diana; Huit, Martine; Wiseman, Theresa

2016-02-01

The aim of this study was to identify factors influencing patient perception of success and benefit with self-management of breast cancer-related lymphoedema (BCRL) and explore how patients decide whether their swollen limb has improved or deteriorated. This qualitative study used a Grounded Theory approach. Twenty-one women in the BCRL self-management phase participated in one in-depth interview exploring their experience and perspective on self-managing their BCRL. Seven enablers and blocks to self-management were identified: routine, recognising benefit of self-management and consequences of non-treatment, owning treatment, knowledge and understanding, problem-solving, time required for treatment and aesthetics of hosiery. Women determined treatment outcome by monitoring size, appearance, texture and internal sensations within the affected arm. Women who participated in this study showed varying degrees of acceptance and adjustment to life with lymphoedema. This appears to directly impact their ability to self-manage lymphoedema. Lymphoedema practitioners and oncology nurses have a valuable role providing knowledge and support to patients transitioning to independent self-care. A better understanding of factors facilitating patients to become experts in their condition may improve longer term outcomes and reduce cost pressures on lymphoedema services. Copyright © 2015 Elsevier Ltd. All rights reserved.

Coordination of short-term and long-term mitigation measures of hydro-meteorological risks: the importance of establishing a link between emergency management and spatial planning

NASA Astrophysics Data System (ADS)

Prenger-Berninghoff, Kathrin; Cortes, V. Juliette; Aye, Zar Chi; Sprague, Teresa

2013-04-01

The management of natural hazards involves, as generally known, the four stages of the risk management cycle: Prevention, preparedness, response and recovery. Accordingly, the mitigation of disasters can be performed in terms of short-term and long-term purposes. Whereas emergency management or civil protection helps to strengthen a community's capacity to be better prepared for natural hazards and to better respond in case a disaster strikes, thus addressing the short-term perspective, spatial planning serves long-term planning goals and can therefore implement long-term prevention measures. A purposefully applied risk mitigation strategy requires coordination of short-term and long-term mitigation measures and thus an effective coordination of emergency management and spatial planning. Several actors are involved in risk management and should consequently be linked throughout the whole risk management cycle. However, these actors, partly because of a historically fragmented administrative system, are hardly connected to each other, with spatial planning only having a negligible role compared to other actors1, a problem to which Young (2002) referred to as the "problem of interplay". In contrast, information transfer and decision-taking happen at the same time and are not coordinated among different actors. This applies to the prevention and preparedness phase as well as to the recovery phase, which basically constitutes the prevention phase for the next disaster2. Since investments in both risk prevention and emergency preparedness and response are considered necessary, a better coordination of the two approaches is required. In this regard, Decision Support Systems (DSS) can be useful in order to provide support in the decision-making aspect of risk management. The research work currently undertaken examines the problem of interplay in the four case study areas of the Marie Curie ITN, CHANGES3. The link between different risk management actors will be explored by means of exploratory questionnaires and interviews with government agencies, local administrations, community and research organizations on each study site. First results provided will address the general role of spatial planning in risk management. Additionally, preliminary observations are made in regard to the coordination of emergency preparedness and long-term spatial planning activities. The observations consider that integration facilitates proactive strategies that aim at preventing disaster occurrence and promote interaction between involved parties. Finally, consideration is given to the potential use of a DSS tool to cover both aspects of spatial planning and emergency management in the risk management cycle.

Cognitive Learning Theory Takes a Backseat: Consequences of a Management Development Program for Work Practice

ERIC Educational Resources Information Center

Moesby-Jensen, Cecilie K.

2008-01-01

This paper describes the consequences of a cognitive management development program for middle managers in a public organization. The objective was to teach transformational leadership and teamwork but it occasioned a very limited improved articulation of transformational leadership and teamwork and only a modest change in the managers' actions in…

Managing nuclear power plant induced disasters.

PubMed

Kyne, Dean

2015-01-01

To understand the management process of nuclear power plant (NPP) induced disasters. The study shields light on phases and issues associated with the NPP induced disaster management. This study uses Palo Verde Nuclear Generation Station as study subject and Arizona State as study area. This study uses the Radiological Assessment System for Consequence Analysis (RASCAL) Source Term to Dose (STDose) of the Nuclear Regulatory Commission, a computer software to project and assess the source term dose and release pathway. This study also uses ArcGIS, a geographic information system to analyze geospatial data. A detailed case study of Palo Verde Nuclear Power Generation (PVNPG) Plant was conducted. The findings reveal that the NPP induced disaster management process is conducted by various stakeholders. To save lives and to minimize the impacts, it is vital to relate planning and process of the disaster management. Number of people who expose to the radioactive plume pathway and level of radioactivity could vary depending on the speed and direction of wind on the day the event takes place. This study findings show that there is a need to address the burning issue of different racial and ethnic groups' unequal exposure and unequal protection to potential risks associated with the NPPs.

The toxicology and immunology of detergent enzymes.

PubMed

Basketter, David; Berg, Ninna; Kruszewski, Francis H; Sarlo, Katherine; Concoby, Beth

2012-01-01

Detergent enzymes have a very good safety profile, with almost no capacity to generate adverse acute or chronic responses in humans. The exceptions are the limited ability of some proteases to produce irritating effects at high concentrations, and the intrinsic potential of these bacterial and fungal proteins to act as respiratory sensitizers, demonstrated in humans during the early phase of the industrial use of enzymes during the 1960s and 1970s. How enzymes generate these responses are beginning to become a little clearer, with a developing appreciation of the cell surface mechanism(s) by which the enzymatic activity promotes the T-helper (T(H))-2 cell responses, leading to the generation of IgE. It is a reasonable assumption that the majority of enzyme proteins possess this intrinsic hazard. However, toxicological methods for characterizing further the respiratory sensitization hazard of individual enzymes remains a problematic area, with the consequence that the information feeding into risk assessment/management, although sufficient, is limited. Most of this information was in the past generated in animal models and in vitro immunoassays that assess immunological cross-reactivity. Ultimately, by understanding more fully the mechanisms which drive the IgE response to enzymes, it will be possible to develop better methods for hazard characterization and consequently for risk assessment and management.

Biochar from Biosolids Pyrolysis: A Review.

PubMed

Paz-Ferreiro, Jorge; Nieto, Aurora; Méndez, Ana; Askeland, Matthew Peter James; Gascó, Gabriel

2018-05-10

Ever increasing volumes of biosolids (treated sewage sludge) are being produced by municipal wastewater facilities. This is a consequence of the continued expansion of urban areas, which in turn require the commissioning of new treatment plants or upgrades to existing facilities. Biosolids contain nutrients and energy which can be used in agriculture or waste-to-energy processes. Biosolids have been disposed of in landfills, but there is an increasing pressure from regulators to phase out landfilling. This article performs a critical review on options for the management of biosolids with a focus on pyrolysis and the application of the solid fraction of pyrolysis (biochar) into soil.

Biochar from Biosolids Pyrolysis: A Review

PubMed Central

Nieto, Aurora; Méndez, Ana; Askeland, Matthew Peter James; Gascó, Gabriel

2018-01-01

Ever increasing volumes of biosolids (treated sewage sludge) are being produced by municipal wastewater facilities. This is a consequence of the continued expansion of urban areas, which in turn require the commissioning of new treatment plants or upgrades to existing facilities. Biosolids contain nutrients and energy which can be used in agriculture or waste-to-energy processes. Biosolids have been disposed of in landfills, but there is an increasing pressure from regulators to phase out landfilling. This article performs a critical review on options for the management of biosolids with a focus on pyrolysis and the application of the solid fraction of pyrolysis (biochar) into soil. PMID:29748488

Hunger strike among detainees: guidance for good medical practice.

PubMed

Gétaz, Laurent; Rieder, Jean-Pierre; Nyffenegger, Laurent; Eytan, Ariel; Gaspoz, Jean-Michel; Wolff, Hans

2012-09-17

Hunger strike is a regularly reported problem in prison. Although clinical situations are rarely severe, hospitalisation is often considered. In consequence, it is not only physicians working in prisons, but also hospital medical teams who face challenges related to hunger strike, involving somatic, psychological, legal and human rights aspects. Furthermore, deontological rules must be strictly respected when delivering care, particularly in prison setting. Starvation involves metabolic changes and can cause severe, and sometimes even irreversible or fatal complications. Moreover, the phase of re-alimentation should not be trivialised, as re-feeding syndrome is a potentially fatal phenomenon. This article provides guidance for monitoring and management of patients on hunger strike.

Automated Platform Management System Scheduling

NASA Technical Reports Server (NTRS)

Hull, Larry G.

1990-01-01

The Platform Management System was established to coordinate the operation of platform systems and instruments. The management functions are split between ground and space components. Since platforms are to be out of contact with the ground more than the manned base, the on-board functions are required to be more autonomous than those of the manned base. Under this concept, automated replanning and rescheduling, including on-board real-time schedule maintenance and schedule repair, are required to effectively and efficiently meet Space Station Freedom mission goals. In a FY88 study, we developed several promising alternatives for automated platform planning and scheduling. We recommended both a specific alternative and a phased approach to automated platform resource scheduling. Our recommended alternative was based upon use of exactly the same scheduling engine in both ground and space components of the platform management system. Our phased approach recommendation was based upon evolutionary development of the platform. In the past year, we developed platform scheduler requirements and implemented a rapid prototype of a baseline platform scheduler. Presently we are rehosting this platform scheduler rapid prototype and integrating the scheduler prototype into two Goddard Space Flight Center testbeds, as the ground scheduler in the Scheduling Concepts, Architectures, and Networks Testbed and as the on-board scheduler in the Platform Management System Testbed. Using these testbeds, we will investigate rescheduling issues, evaluate operational performance and enhance the platform scheduler prototype to demonstrate our evolutionary approach to automated platform scheduling. The work described in this paper was performed prior to Space Station Freedom rephasing, transfer of platform responsibility to Code E, and other recently discussed changes. We neither speculate on these changes nor attempt to predict the impact of the final decisions. As a consequence some of our work and results may be outdated when this paper is published.

Risk management in waste water treatment.

PubMed

Wagner, M; Strube, I

2005-01-01

With the continuous restructuring of the water market due to liberalisation, privatisation and internationalisation processes, the requirements on waste water disposal companies have grown. Increasing competition requires a target-oriented and clearly structured procedure. At the same time it is necessary to meet the environment-relevant legal requirements and to design the processes to be environment-oriented. The implementation of risk management and the integration of such a management instrument in an existing system in addition to the use of modern technologies and procedures can help to make the operation of the waste water treatment safer and consequently strengthen market position. The risk management process consists of three phases, risk identification, risk analysis/risk assessment and risk handling, which are based on each other, as well as of the risk managing. To achieve an identification of the risks as complete as possible, a subdivision of the kind of risks (e.g. legal, financial, market, operational) is suggested. One possibility to assess risks is the portfolio method which offers clear representation. It allows a division of the risks into classes showing which areas need handling. The determination of the appropriate measures to handle a risk (e.g. avoidance, reduction, shift) is included in the concluding third phase. Different strategies can be applied here. On the one hand, the cause-oriented strategy, aiming at preventive measures which aim to reduce the probability of occurrence of a risk (e.g. creation of redundancy, systems with low susceptibility to malfunction). On the other hand, the effect-oriented strategy, aiming to minimise the level of damage in case of an undesired occurrence (e.g. use of alarm systems, insurance cover).

Exercise and reproductive dysfunction.

PubMed

Chen, E C; Brzyski, R G

1999-01-01

To provide an overview of our current understanding of exercise-induced reproductive dysfunction and an approach to its evaluation and management. A MEDLINE search was performed to review all articles with title words related to menstrual dysfunction, amenorrhea, oligomenorrhea, exercise, and athletic activities from 1966 to 1998. The pathophysiology, proposed mechanisms, clinical manifestations, evaluation, and management of exercise-associated reproductive dysfunction were compiled. Exercise-induced menstrual irregularity appears to be multifactorial in origin and remains a diagnosis of exclusion. The underlying mechanisms are mainly speculative. Clinical manifestations range from luteal phase deficiency to anovulation, amenorrhea, and even delayed menarche. Evaluation should include a thorough history and a complete physical plus pelvic examination. Most cases are reversible with dietary and exercise modifications. Hormonal replacement in cases of a prolonged hypoestrogenic state with evidence of increased bone loss is recommended, although the long-term consequences of prolonged hormonal deficiency are ill-defined.

Spontaneously regulated vs. controlled ventilation of acute lung injury/acute respiratory distress syndrome.

PubMed

Marini, John J

2011-02-01

To present an updated discussion of those aspects of controlled positive pressure breathing and retained spontaneous regulation of breathing that impact the management of patients whose tissue oxygenation is compromised by acute lung injury. The recent introduction of ventilation techniques geared toward integrating natural breathing rhythms into even the earliest phase of acute respiratory distress syndrome support (e.g., airway pressure release, proportional assist ventilation, and neurally adjusted ventilatory assist), has stimulated a burst of new investigations. Optimizing gas exchange, avoiding lung injury, and preserving respiratory muscle strength and endurance are vital therapeutic objectives for managing acute lung injury. Accordingly, comparing the physiology and consequences of breathing patterns that preserve and eliminate breathing effort has been a theme of persisting investigative interest throughout the several decades over which it has been possible to sustain cardiopulmonary life support outside the operating theater.

Parental management of adrenal crisis in children with congenital adrenal hyperplasia

PubMed Central

Fleming, Louise; Knafl, Kathleen; Knafl, George; Van Riper, Marcia

2018-01-01

Purpose Congenital adrenal hyperplasia (CAH) requires parents to inject their child with hydro-cortisone intramuscularly during times of illness and adrenal crisis. The purpose of this study was to describe circumstances surrounding adrenal crisis events in children with CAH; to explore parents’ perceptions of the consequences of having a child with a life-threatening condition; and to examine a relationship between parents’ perceived management ability and the impact CAH has on the family. Methods In Phase 1 of this mixed-methods, cross-sectional study, 77 parents were asked to complete questionnaires comprising measures of family life in the context of childhood illness. Descriptive statistics were computed with four separate analyses using linear mixed models allowing for correlation between responses from parents of the same family and for the variance to be different for fathers and mothers. The following relationships were examined: (1) parental management ability and type of provider instruction on how to manage adrenal crises; (2) parental management ability and child age; (3) the perceived impact of the condition on the family and management ability; and (4) the age of the child and number of adrenal crisis events. In Phase 2, 16 semi-structured interviews were conducted to elicit detailed descriptions of parents’ experiences in managing crises. Results There was a significant, positive relationship between detailed provider instruction to parents on adrenal crisis management and perceived management ability (p = .02), additionally the stronger the perceived management ability, the less impact CAH had on the family (p < .001). From birth to age 5, parents reported more frequent crisis events and less perceived ability to manage the condition when compared with parents of older children (p = .009). The threat of an adrenal crisis event is a pervasive concern for parents, especially when they are not being properly prepared by providers. Practice Implications Provider support is needed for these parents throughout childhood, but especially in the first 5 years of life when parents are adjusting to having a child with a life-threatening condition. Identifying gaps in parent education by healthcare providers is necessary to promote positive family outcomes. PMID:28771930

Parental management of adrenal crisis in children with congenital adrenal hyperplasia.

PubMed

Fleming, Louise; Knafl, Kathleen; Knafl, George; Van Riper, Marcia

2017-10-01

Congenital adrenal hyperplasia (CAH) requires parents to inject their child with hydrocortisone intramuscularly during times of illness and adrenal crisis. The purpose of this study was to describe circumstances surrounding adrenal crisis events in children with CAH; to explore parents' perceptions of the consequences of having a child with a life-threatening condition; and to examine a relationship between parents' perceived management ability and the impact CAH has on the family. In Phase 1 of this mixed-methods, cross-sectional study, 77 parents were asked to complete questionnaires comprising measures of family life in the context of childhood illness. Descriptive statistics were computed with four separate analyses using linear mixed models allowing for correlation between responses from parents of the same family and for the variance to be different for fathers and mothers. The following relationships were examined: (1) parental management ability and type of provider instruction on how to manage adrenal crises; (2) parental management ability and child age; (3) the perceived impact of the condition on the family and management ability; and (4) the age of the child and number of adrenal crisis events. In Phase 2, 16 semi-structured interviews were conducted to elicit detailed descriptions of parents' experiences in managing crises. There was a significant, positive relationship between detailed provider instruction to parents on adrenal crisis management and perceived management ability (p = .02), additionally the stronger the perceived management ability, the less impact CAH had on the family (p < .001). From birth to age 5, parents reported more frequent crisis events and less perceived ability to manage the condition when compared with parents of older children (p = .009). The threat of an adrenal crisis event is a pervasive concern for parents, especially when they are not being properly prepared by providers. Provider support is needed for these parents throughout childhood, but especially in the first 5 years of life when parents are adjusting to having a child with a life-threatening condition. Identifying gaps in parent education by healthcare providers is necessary to promote positive family outcomes. © 2017 Wiley Periodicals, Inc.

The Efficacy of All-Positive Management as a Function of the Prior Use of Negative Consequences.

ERIC Educational Resources Information Center

Pfiffner, Linda J.; O'Leary, Susan G.

1987-01-01

The study found that in the absence of a history of negative consequences, an all-positive management system for eight first- through third-grade children with academic and/or classroom behavioral problems was not sufficient to maintain on-task rates of academic accuracy. The addition of negative consequences immediately improved on-task behavior…

Waste flow analysis and life cycle assessment of integrated waste management systems as planning tools: Application to optimise the system of the City of Bologna.

PubMed

Tunesi, Simonetta; Baroni, Sergio; Boarini, Sandro

2016-09-01

The results of this case study are used to argue that waste management planning should follow a detailed process, adequately confronting the complexity of the waste management problems and the specificity of each urban area and of regional/national situations. To support the development or completion of integrated waste management systems, this article proposes a planning method based on: (1) the detailed analysis of waste flows and (2) the application of a life cycle assessment to compare alternative scenarios and optimise solutions. The evolution of the City of Bologna waste management system is used to show how this approach can be applied to assess which elements improve environmental performance. The assessment of the contribution of each waste management phase in the Bologna integrated waste management system has proven that the changes applied from 2013 to 2017 result in a significant improvement of the environmental performance mainly as a consequence of the optimised integration between materials and energy recovery: Global Warming Potential at 100 years (GWP100) diminishes from 21,949 to -11,169 t CO2-eq y(-1) and abiotic resources depletion from -403 to -520 t antimony-eq. y(-1) This study analyses at great detail the collection phase. Outcomes provide specific operational recommendations to policy makers, showing the: (a) relevance of the choice of the materials forming the bags for 'door to door' collection (for non-recycled low-density polyethylene bags 22 kg CO2-eq (tonne of waste)(-1)); (b) relatively low environmental impacts associated with underground tanks (3.9 kg CO2-eq (tonne of waste)(-1)); (c) relatively low impact of big street containers with respect to plastic bags (2.6 kg CO2-eq. (tonne of waste)(-1)). © The Author(s) 2016.

Hong Kong Hospital Authority resource efficiency evaluation: Via a novel DEA-Malmquist model and Tobit regression model.

PubMed

Guo, Hainan; Zhao, Yang; Niu, Tie; Tsui, Kwok-Leung

2017-01-01

The Hospital Authority (HA) is a statutory body managing all the public hospitals and institutes in Hong Kong (HK). In recent decades, Hong Kong Hospital Authority (HKHA) has been making efforts to improve the healthcare services, but there still exist some problems like unfair resource allocation and poor management, as reported by the Hong Kong medical legislative committee. One critical consequence of these problems is low healthcare efficiency of hospitals, leading to low satisfaction among patients. Moreover, HKHA also suffers from the conflict between limited resource and growing demand. An effective evaluation of HA is important for resource planning and healthcare decision making. In this paper, we propose a two-phase method to evaluate HA efficiency for reducing healthcare expenditure and improving healthcare service. Specifically, in Phase I, we measure the HKHA efficiency changes from 2000 to 2013 by applying a novel DEA-Malmquist index with undesirable factors. In Phase II, we further explore the impact of some exogenous factors (e.g., population density) on HKHA efficiency by Tobit regression model. Empirical results show that there are significant differences between the efficiencies of different hospitals and clusters. In particular, it is found that the public hospital serving in a richer district has a relatively lower efficiency. To a certain extent, this reflects the socioeconomic reality in HK that people with better economic condition prefers receiving higher quality service from the private hospitals.

Hong Kong Hospital Authority resource efficiency evaluation: Via a novel DEA-Malmquist model and Tobit regression model

PubMed Central

Guo, Hainan; Zhao, Yang; Niu, Tie; Tsui, Kwok-Leung

2017-01-01

The Hospital Authority (HA) is a statutory body managing all the public hospitals and institutes in Hong Kong (HK). In recent decades, Hong Kong Hospital Authority (HKHA) has been making efforts to improve the healthcare services, but there still exist some problems like unfair resource allocation and poor management, as reported by the Hong Kong medical legislative committee. One critical consequence of these problems is low healthcare efficiency of hospitals, leading to low satisfaction among patients. Moreover, HKHA also suffers from the conflict between limited resource and growing demand. An effective evaluation of HA is important for resource planning and healthcare decision making. In this paper, we propose a two-phase method to evaluate HA efficiency for reducing healthcare expenditure and improving healthcare service. Specifically, in Phase I, we measure the HKHA efficiency changes from 2000 to 2013 by applying a novel DEA-Malmquist index with undesirable factors. In Phase II, we further explore the impact of some exogenous factors (e.g., population density) on HKHA efficiency by Tobit regression model. Empirical results show that there are significant differences between the efficiencies of different hospitals and clusters. In particular, it is found that the public hospital serving in a richer district has a relatively lower efficiency. To a certain extent, this reflects the socioeconomic reality in HK that people with better economic condition prefers receiving higher quality service from the private hospitals. PMID:28886087

A strategic plan for the second phase (2013-2015) of the Korea biobank project.

PubMed

Park, Ok; Cho, Sang Yun; Shin, So Youn; Park, Jae-Sun; Kim, Jun Woo; Han, Bok-Ghee

2013-04-01

The Korea Biobank Project (KBP) was led by the Ministry of Health and Welfare to establish a network between the National Biobank of Korea and biobanks run by university-affiliated general hospitals (regional biobanks). The Ministry of Health and Welfare started the project to enhance medical and health technology by collecting, managing, and providing researchers with high-quality human bioresources. The National Biobank of Korea, under the leadership of the Ministry of Health and Welfare, collects specimens through various cohorts and regional biobanks within university hospitals gather specimens from patients. The project began in 2008, and the first phase ended in 2012, which meant that there needed to be a plan for the second phase that begins in 2013. Consequently, professionals from within and outside the project were gathered to develop a plan for the second phase. Under the leadership of the planning committee, six working groups were formed to formulate a practical plan. By conducting two workshops with experts in the six working groups and the planning committee and three forums in 2011 and 2012, they have developed a strategic plan for the second phase of the KBP. This document presents a brief report of the second phase of the project based on a discussion with them. During the first phase of the project (2008-2012), a network was set up between the National Biobank of Korea and 17 biobanks at university-affiliated hospitals in an effort to unify informatics and governance among the participating biobanks. The biobanks within the network manage data on their biospecimens with a unified Biobank Information Management System. Continuous efforts are being made to develop a common standard operating procedure for resource collection, management, distribution, and personal information security, and currently, management of these data is carried out in a somewhat unified manner. In addition, the KBP has trained and educated professionals to work within the biobanks, and has also carried out various publicity promotions to the public and researchers. During the first phase, biospecimens from more than 300,000 participants through various cohorts and biospecimens from more than 200,000 patients from hospitals were collected, which were distributed to approximately 600 research projects. The planning committee for the second phase evaluated that the first phase of the KBP was successful. However, the first phase of the project was meant to allow autonomy to the individual biobanks. The biobanks were able to choose the kind of specimens they were going to collect and the amount of specimen they would set as a goal, as well as being allowed to choose their own methods to manage their biobanks (autonomy). Therefore, some biobanks collected resources that were easy to collect and the resources needed by researchers were not strategically collected. In addition, there was also a low distribution rate to researchers outside of hospitals, who do not have as much access to specimens and cases as those in hospitals. There were also many cases in which researchers were not aware of the KBP, and the distribution processes were not set up to be convenient to the demands of researchers. Accordingly, the second phase of the KBP will be focused on increasing the integration and cooperation between the biobanks within the network. The KBP plans to set goals for the strategic collection of the needed human bioresources. Although the main principle of the first phase was to establish infrastructure and resource collection, the key objective of the second phase is the efficient utilization of gathered resources. In order to fully utilize the gathered resources in an efficient way, distribution systems and policies must be improved. Vitalization of distribution, securing of high-value resource and related clinical and laboratory information, international standardization of resource management systems, and establishment of a virtuous cycle between research and development (R&D) and biobanks are the four main strategies. Based on these strategies, 12 related objectives have been set and are planned to be executed.

General RMP Guidance - Chapter 7: Prevention Program (Program 3)

EPA Pesticide Factsheets

Many Program 3 processes are already addressed by the OSHA Process Safety Management Program, which covers on-site consequences. So for compliance with the risk management program, process hazard analysis teams must consider potential offsite consequences.

Consequence Maps: A Novel Behavior Management Tool for Educators

ERIC Educational Resources Information Center

Tobin, Catherine E.; Simpson, Richard

2012-01-01

Behavior management remains one of the most significant challenges faced by classroom personnel. One relatively novel and promising management approach involves the use of "Consequence Maps". In this article we discuss the use of this method, including its application and evaluation. A case study of a six-year-old boy in a self-contained special…

Assessing the Potential Environmental Consequences of a New Energetic Material: A Phased Approach

DTIC Science & Technology

2007-12-01

Melting point • Ionization potential (2) QSAR approaches can also be used to estimate toxicological impact. Toxicity QSAR models can often... TOXICOLOGY STUDY NO. 87-XE-03N3-05 ASSESSING THE POTENTIAL ENVIRONMENTAL CONSEQUENCES OF A NEW ENERGETIC MATERIAL: A PHASED APPROACH...SEPTEMBER 2005 Published: December 2007 Approved for public release; distribution unlimited. Toxicology Study No. 87-XE-03N3-05

A Decision Support System for Concrete Bridge Maintenance

NASA Astrophysics Data System (ADS)

Rashidi, Maria; Lemass, Brett; Gibson, Peter

2010-05-01

The maintenance of bridges as a key element in transportation infrastructure has become a major concern for asset managers and society due to increasing traffic volumes, deterioration of existing bridges and well-publicised bridge failures. A pivotal responsibility for asset managers in charge of bridge remediation is to identify the risks and assess the consequences of remediation programs to ensure that the decisions are transparent and lead to the lowest predicted losses in recognized constraint areas. The ranking of bridge remediation treatments can be quantitatively assessed using a weighted constraint approach to structure the otherwise ill-structured phases of problem definition, conceptualization and embodiment [1]. This Decision Support System helps asset managers in making the best decision with regards to financial limitations and other dominant constraints imposed upon the problem at hand. The risk management framework in this paper deals with the development of a quantitative intelligent decision support system for bridge maintenance which has the ability to provide a source for consistent decisions through selecting appropriate remediation treatments based upon cost, service life, product durability/sustainability, client preferences, legal and environmental constraints. Model verification and validation through industry case studies is ongoing.

[Improving blood safety: errors management in transfusion medicine].

PubMed

Bujandrić, Nevenka; Grujić, Jasmina; Krga-Milanović, Mirjana

2014-01-01

The concept of blood safety includes the entire transfusion chain starting with the collection of blood from the blood donor, and ending with blood transfusion to the patient. The concept involves quality management system as the systematic monitoring of adverse reactions and incidents regarding the blood donor or patient. Monitoring of near-miss errors show the critical points in the working process and increase transfusion safety. The aim of the study was to present the analysis results of adverse and unexpected events in transfusion practice with a potential risk to the health of blood donors and patients. One-year retrospective study was based on the collection, analysis and interpretation of written reports on medical errors in the Blood Transfusion Institute of Vojvodina. Errors were distributed according to the type, frequency and part of the working process where they occurred. Possible causes and corrective actions were described for each error. The study showed that there were not errors with potential health consequences for the blood donor/patient. Errors with potentially damaging consequences for patients were detected throughout the entire transfusion chain. Most of the errors were identified in the preanalytical phase. The human factor was responsible for the largest number of errors. Error reporting system has an important role in the error management and the reduction of transfusion-related risk of adverse events and incidents. The ongoing analysis reveals the strengths and weaknesses of the entire process and indicates the necessary changes. Errors in transfusion medicine can be avoided in a large percentage and prevention is cost-effective, systematic and applicable.

Cryptococcal meningitis: epidemiology and therapeutic options

PubMed Central

Sloan, Derek J; Parris, Victoria

2014-01-01

Cryptococcal meningitis causes morbidity and mortality worldwide. The burden of disease is greatest in middle- and low-income countries with a high incidence of human immunodeficiency virus (HIV) infection. Patients taking immunosuppressive drugs and some immunocompetent hosts are also at risk. Treatment of cryptococcal meningitis consists of three phases: induction, consolidation, and maintenance. Effective induction therapy requires potent fungicidal drugs (amphotericin B and flucytosine), which are often unavailable in low-resource, high-endemicity settings. As a consequence, mortality is unacceptably high. Wider access to effective treatment is urgently required to improve outcomes. For human immunodeficiency virus-infected patients, judicious management of asymptomatic cryptococcal antigenemia and appropriately timed introduction of antiretroviral therapy are important. PMID:24872723

Biophysical Approaches for Oral Wound Healing: Emphasis on Photobiomodulation

PubMed Central

Khan, Imran; Arany, Praveen

2015-01-01

Significance: Oral wounds can lead to significant pain and discomfort as well as affect overall general health due to poor diet and inadequate nutrition. Besides many biological and pharmaceutical methods being investigated, there is growing interest in exploring various biophysical devices that utilize electric, magnetic, ultrasound, pressure, and light energy. Recent Advances: Significant insight into mechanisms of these biophysical devices could provide a clear rationale for their clinical use. Preclinical studies are essential precursors in determining physiological mechanisms and elucidation of causal pathways. This will lead to development of safe and effective therapeutic protocols for clinical wound management. Critical Issues: Identification of precise events initiated by biophysical devices, specifically photobiomodulation—the major focus of this review, offers promising avenues in improving oral wound management. The primary phase responses initiated by the interventions that distinctly contribute to the therapeutic response must be clearly delineated from secondary phase responses. The latter events are a consequence of the wound healing process and must not be confused with causal mechanisms. Future Direction: Clinical adoption of these biophysical devices needs robust and efficacious protocols that can be developed by well-designed preclinical and clinical studies. Elucidation of the precise molecular mechanisms of these biophysical approaches could determine optimization of their applications for predictive oral wound care. PMID:26634185

Stability of cosmological deflagration fronts

NASA Astrophysics Data System (ADS)

Mégevand, Ariel; Membiela, Federico Agustín

2014-05-01

In a cosmological first-order phase transition, bubbles of the stable phase nucleate and expand in the supercooled metastable phase. In many cases, the growth of bubbles reaches a stationary state, with bubble walls propagating as detonations or deflagrations. However, these hydrodynamical solutions may be unstable under corrugation of the interface. Such instability may drastically alter some of the cosmological consequences of the phase transition. Here, we study the hydrodynamical stability of deflagration fronts. We improve upon previous studies by making a more careful and detailed analysis. In particular, we take into account the fact that the equation of motion for the phase interface depends separately on the temperature and fluid velocity on each side of the wall. Fluid variables on each side of the wall are similar for weakly first-order phase transitions, but differ significantly for stronger phase transitions. As a consequence, we find that, for large enough supercooling, any subsonic wall velocity becomes unstable. Moreover, as the velocity approaches the speed of sound, perturbations become unstable on all wavelengths. For smaller supercooling and small wall velocities, our results agree with those of previous works. Essentially, perturbations on large wavelengths are unstable, unless the wall velocity is higher than a critical value. We also find a previously unobserved range of marginally unstable wavelengths. We analyze the dynamical relevance of the instabilities, and we estimate the characteristic time and length scales associated with their growth. We discuss the implications for the electroweak phase transition and its cosmological consequences.

Observable consequences of zero-point energy

NASA Astrophysics Data System (ADS)

Sen, Siddhartha; Gupta, Kumar S.

2017-12-01

Spectral line widths, the Lamb shift and the Casimir effect are generally accepted to be observable consequences of the zero-point electromagnetic (ZPEM) fields. A new class of observable consequences of ZPEM field at the mesoscopic scale were recently proposed and observed. Here, we extend this class of observable effects and predict that mesoscopic water layers should have a high value for its solid-liquid phase transition temperature, as illustrated by water inside a single-walled carbon nanotube (CNT). For this case, our analysis predicts that the phase transition temperature scales inversely with the square of the effective radius available for the water flow within the CNT.

Exploring how nurses assess, monitor and manage acute pain for adult critically ill patients in the emergency department: protocol for a mixed methods study.

PubMed

Varndell, Wayne; Fry, Margaret; Elliott, Doug

2017-08-01

Many critically ill patients experience moderate to severe acute pain that is frequently undetected and/or undertreated. Acute pain in this patient cohort not only derives from their injury and/or illness, but also as a consequence of delivering care whilst stabilising the patient. Emergency nurses are increasingly responsible for the safety and wellbeing of critically ill patients, which includes assessing, monitoring and managing acute pain. How emergency nurses manage acute pain in critically ill adult patients is unknown. The objective of this study is to explore how emergency nurses manage acute pain in critically ill patients in the Emergency Department. In this paper, we provide a detailed description of the methods and protocol for a multiphase sequential mixed methods study, exploring how emergency nurses assess, monitor and manage acute pain in critically ill adult patients. The objective, method, data collection and analysis of each phase are explained. Justification of each method and data integration is described. Synthesis of findings will generate a comprehensive picture of how emergency nurses' perceive and manage acute pain in critically ill adult patients. The results of this study will form a knowledge base to expand theory and inform research and practice.

Disordered Phase of the 3x3 Pb/Ge(111) structure at low temperature

NASA Astrophysics Data System (ADS)

Guo, Jiandong; Bolorizadeh, Mehdi; Plummer, E. W.

2003-03-01

* Dept. of Phys., Univ. of Tenn., Knoxville, TN 37996. ** Condensed Matter Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831. At a metal surface or a thin metallic film on a semiconductor there is a competition between the long-range adatom-adatom interactions and the local stress fields imposed by the substrate bulk structure. In interesting cases this leads to a structural phase transition. In this talk we present a STM investigation of the two-dimensional structure at different temperatures for the 1/3 monolayer of Pb on Ge(111) system. When the temperature is lowered the interface undergoes a (3x3)R30^o to (3x3) phase transition at roughly 110 K. Substitutional Ge defects play a crucial role in the phase transition as has been reported for the isoelectronic Sn/Ge system. However, unlike Sn/Ge, as the temperature is lowed below 80 K the (3x3) structure in Pb/Ge is broken and a disordered glassy-like structure is observed. This is very similar to the glassy phase predicted by Shi et al. in a model calculation for the Sn/Ge system. The question we address is, is this disordered low temperature phase inherent to the ideal Pb/Ge system or a consequence of the Ge substitutional defects? This work was funded by NSF DMR-0105232 and Oak Ridge National Laboratory, managed by UT-Battelle, LLC, for the U.S. Dept. of Energy under contract DE-AC05-00OR22725.

Online information seeking practices of biology teachers and the perceived influences on instructional planning

NASA Astrophysics Data System (ADS)

Perrault, Anne Marie

The purpose of this study was to examine biology teachers' perceptions of how their online information seeking practices influence their instructional planning. When teachers engage in activities to locate, evaluate, and use online information and resources, a myriad of inter-related and often inseparable consequences follows. These influences may be any combination of direct/indirect, desirable/undesirable, or anticipated/unanticipated (Rogers, 2003). This exploratory study collected baseline data regarding teachers' online practices and its influence on their practice. There were two phases of data collection in this study. Phase I was an online survey of more than seventy New York State biology teachers. The survey was intended to capture (1) a snapshot of the biology teachers' online information seeking practices during the summer and fall 2004, and (2) their perceptions regarding how their online practices influenced their instructional planning. In Phase II, ten study participants were interviewed in order to explore in greater detail the consequences of their online information seeking practices on their instructional planning. Four themes reflecting the consequences of teachers' information seeking practices emerged from the data analysis: Currency of Information; Sparking of Ideas and Gaining Personal Knowledge; Resource Management and the Role of Time; and Webs of Sharing. Each theme encompassed both the purposeful and the indirect actions by teachers to access knowledge and resources to refine and improve their instructional planning. This study's findings show that teachers are using a greater number and wider range of current and multi-modal resources than pre-Internet and they perceive this as an advantage in creating authentic, inquiry-based learning experiences. A notable discovery was of the under-use by teachers of educational online resources specifically designed to support teaching and learning activities (e.g., digital libraries, online databases, and listservs). This study's findings point to a recursive process in which teachers are engaged in ongoing online information seeking practices; continually learning and fostering new knowledge; integrating the learning into their instructional planning practices; changing their teaching strategies; and going back online to search for information and resources and begin the cycle again.

Assessing the Potential Environmental Consequences of a New Energetic Material: A Phased Approach, September 2005

DTIC Science & Technology

2007-12-01

there are no reliable alternatives to animal testing in the determination of toxicity. QSARs are only as reliable as the corroborating toxicological ...2) QSAR approaches can also be used to estimate toxicological impact. Toxicity QSAR models can often predict many toxicity parameters without... Toxicology Study No. 87-XE-03N3-05, Assessing the Potential Environmental Consequences of a New Energetic Material: A Phased Approach, September 2005 1

Storm surge evolution and its relationship to climate oscillations at Duck, NC

NASA Astrophysics Data System (ADS)

Munroe, Robert; Curtis, Scott

2017-07-01

Coastal communities experience increased vulnerability during storm surge events through the risk of damage to coastal infrastructure, erosion/deposition, and the endangerment of human life. Policy and planning measures attempt to avoid or mitigate storm surge consequences through building codes and setbacks, beach stabilization, insurance rates, and coastal zoning. The coastal emergency management community and public react and respond on shorter time scales, through temporary protection, emergency stockpiling, and evacuation. This study utilizes time series analysis, the Kolmogorov-Smirnov (K-S) test, Pearson's correlation, and the generalized extreme value (GEV) theorem to make the connection between climate oscillation indices and storm surge characteristics intra-seasonally to inter-annually. Results indicate that an El Niño (+ENSO), negative phase of the NAO, and positive phase of the PNA pattern all support longer duration and hence more powerful surge events, especially in winter. Increased surge duration increases the likelihood of extensive erosion, inland inundation, among other undesirable effects of the surge hazard.

Probing concept of critical thinking in nursing education in Iran: a concept analysis.

PubMed

Tajvidi, Mansooreh; Ghiyasvandian, Shahrzad; Salsali, Mahvash

2014-06-01

Given the wide disagreement over the definition of critical thinking in different disciplines, defining and standardizing the concept according to the discipline of nursing is essential. Moreover, there is limited scientific evidence regarding critical thinking in the context of nursing in Iran. The aim of this study was to analyze and clarify the concept of critical thinking in nursing education in Iran. We employed the hybrid model to define the concept of critical thinking. The hybrid model has three interconnected phases--the theoretical phase, the fieldwork phase, and the final analytic phase. In the theoretical phase, we searched the online scientific databases (such as Elsevier, Wiley, CINAHL, Proquest, Ovid, and Springer as well as Iranian databases such as SID, Magiran, and Iranmedex). In the fieldwork phase, a purposive sample of 17 nursing faculties, PhD students, clinical instructors, and clinical nurses was recruited. Participants were interviewed by using an interview guide. In the analytical phase we compared the data from the theoretical and the fieldwork phases. The concept of critical thinking had many different antecedents, attributes, and consequences. Antecedents, attributes, and consequences of critical thinking concept identified in the theoretical phase were in some ways different and in some way similar to antecedents, attributes, and consequences identified in the fieldwork phase. Finally critical thinking in nursing education in Iran was clarified. Critical thinking is a logical, situational, purposive, and outcome-oriented thinking process. It is an acquired and evolving ability which develops individually. Such thinking process could lead to the professional accountability, personal development, God's consent, conscience appeasement, and personality development. Copyright © 2014. Published by Elsevier B.V.

Simulation of the consequences of different fire regimes to support wildland fire use decisions

Treesearch

Carol Miller

2007-01-01

The strategy known as wildland fire use, in which lightning-ignited fires are allowed to burn, is rapidly gaining momentum in the fire management community. Managers need to know the consequences of an increase in area burned that might result from an increase in wildland fire use. One concern of land managers as they consider implementing wildland fire use is whether...

5 CFR 250.103 - Consequences of improper agency actions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Consequences of improper agency actions. 250.103 Section 250.103 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL MANAGEMENT IN AGENCIES Authority for Personnel Actions in Agencies § 250.103...

Using total quality management approach to improve patient safety by preventing medication error incidences*.

PubMed

Yousef, Nadin; Yousef, Farah

2017-09-04

Whereas one of the predominant causes of medication errors is a drug administration error, a previous study related to our investigations and reviews estimated that the incidences of medication errors constituted 6.7 out of 100 administrated medication doses. Therefore, we aimed by using six sigma approach to propose a way that reduces these errors to become less than 1 out of 100 administrated medication doses by improving healthcare professional education and clearer handwritten prescriptions. The study was held in a General Government Hospital. First, we systematically studied the current medication use process. Second, we used six sigma approach by utilizing the five-step DMAIC process (Define, Measure, Analyze, Implement, Control) to find out the real reasons behind such errors. This was to figure out a useful solution to avoid medication error incidences in daily healthcare professional practice. Data sheet was used in Data tool and Pareto diagrams were used in Analyzing tool. In our investigation, we reached out the real cause behind administrated medication errors. As Pareto diagrams used in our study showed that the fault percentage in administrated phase was 24.8%, while the percentage of errors related to prescribing phase was 42.8%, 1.7 folds. This means that the mistakes in prescribing phase, especially because of the poor handwritten prescriptions whose percentage in this phase was 17.6%, are responsible for the consequent) mistakes in this treatment process later on. Therefore, we proposed in this study an effective low cost strategy based on the behavior of healthcare workers as Guideline Recommendations to be followed by the physicians. This method can be a prior caution to decrease errors in prescribing phase which may lead to decrease the administrated medication error incidences to less than 1%. This improvement way of behavior can be efficient to improve hand written prescriptions and decrease the consequent errors related to administrated medication doses to less than the global standard; as a result, it enhances patient safety. However, we hope other studies will be made later in hospitals to practically evaluate how much effective our proposed systematic strategy really is in comparison with other suggested remedies in this field.

40 CFR 1400.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OFF-SITE CONSEQUENCE ANALYSIS INFORMATION DISTRIBUTION OF OFF-SITE CONSEQUENCE ANALYSIS INFORMATION... analysis (OCA) information means sections 2 through 5 of a risk management plan (consisting of an... consequence analysis (OCA) data elements means the results of the off-site consequence analysis conducted by a...

40 CFR 1400.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OFF-SITE CONSEQUENCE ANALYSIS INFORMATION DISTRIBUTION OF OFF-SITE CONSEQUENCE ANALYSIS INFORMATION... analysis (OCA) information means sections 2 through 5 of a risk management plan (consisting of an... consequence analysis (OCA) data elements means the results of the off-site consequence analysis conducted by a...

40 CFR 1400.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... OFF-SITE CONSEQUENCE ANALYSIS INFORMATION DISTRIBUTION OF OFF-SITE CONSEQUENCE ANALYSIS INFORMATION... analysis (OCA) information means sections 2 through 5 of a risk management plan (consisting of an... consequence analysis (OCA) data elements means the results of the off-site consequence analysis conducted by a...

40 CFR 1400.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OFF-SITE CONSEQUENCE ANALYSIS INFORMATION DISTRIBUTION OF OFF-SITE CONSEQUENCE ANALYSIS INFORMATION... analysis (OCA) information means sections 2 through 5 of a risk management plan (consisting of an... consequence analysis (OCA) data elements means the results of the off-site consequence analysis conducted by a...

Legal Aspects: Civilians/Contractors in the War Zone And Disaster Relief Support Joint Center for Operational Analysis Journal, Volume 10, Issue 2, June 2008

DTIC Science & Technology

2008-06-01

operations . The JSC, however, has analyzed the new legislation and their JCOA Journal, June 2008 13 recommendations for managing how these cases are...CBRNE) consequence management operations . 4 While the Department of Homeland Security’s (DHS) Federal Emergency Management Agency (FEMA) 5 is...affect the Department of Defense’s consequence management operations in support of a primary federal agency. Although the U.S. Constitution’s Supremacy

A matter of life or limb? A review of traumatic injury patterns and anesthesia techniques for disaster relief after major earthquakes.

PubMed

Missair, Andres; Pretto, Ernesto A; Visan, Alexandru; Lobo, Laila; Paula, Frank; Castillo-Pedraza, Catalina; Cooper, Lebron; Gebhard, Ralf E

2013-10-01

All modalities of anesthetic care, including conscious sedation, general, and regional anesthesia, have been used to manage earthquake survivors who require urgent surgical intervention during the acute phase of medical relief. Consequently, we felt that a review of epidemiologic data from major earthquakes in the context of urgent intraoperative management was warranted to optimize anesthesia disaster preparedness for future medical relief operations. The primary outcome measure of this study was to identify the predominant preoperative injury pattern (anatomic location and pathology) of survivors presenting for surgical care immediately after major earthquakes during the acute phase of medical relief (0-15 days after disaster). The injury pattern is of significant relevance because it closely relates to the anesthetic techniques available for patient management. We discuss our findings in the context of evidence-based strategies for anesthetic management during the acute phase of medical relief after major earthquakes and the associated obstacles of devastated medical infrastructure. To identify reports on acute medical care in the aftermath of natural disasters, a query was conducted using MEDLINE/PubMed, Embase, CINAHL, as well as an online search engine (Google Scholar). The search terms were "disaster" and "earthquake" in combination with "injury," "trauma," "surgery," "anesthesia," and "wounds." Our investigation focused only on studies of acute traumatic injury that specified surgical intervention among survivors in the acute phase of medical relief. A total of 31 articles reporting on 15 major earthquakes (between 1980 and 2010) and the treatment of more than 33,410 patients met our specific inclusion criteria. The mean incidence of traumatic limb injury per major earthquake was 68.0%. The global incidence of traumatic limb injury was 54.3% (18,144/33,410 patients). The pooled estimate of the proportion of limb injuries was calculated to be 67.95%, with a 95% confidence interval of 62.32% to 73.58%. Based on this analysis, early disaster surgical intervention will focus on surviving patients with limb injury. All anesthetic techniques have been safely used for medical relief. While regional anesthesia may be an intuitive choice based on these findings, in the context of collapsed medical infrastructure, provider experience may dictate the available anesthetic techniques for earthquake survivors requiring urgent surgery.

Consequence Management: A Disconnect Between National Security Policy and Force Structure?

DTIC Science & Technology

2001-03-15

effects or the consequences of a detonated and/or released weapon(s) has only recently been given much attention. Despite several warnings of the...with the exposure ? Second, the time required to establish and field a regional JTF would prevent the force from having a strong positive effect on the... outcome of the situation. One of the critical missions of a successful consequence management force is its ability to provide a strong deterrent

Transcriptional Characterization of Salmonella TAl00 in Growth and Stationary Phase: Mutagenesis of MX in Both Types of Cells

EPA Science Inventory

The Salmonella (Ames) mutagenicity assay can be performed using cells that are in different growth phases. Thus, the plate-incorporation assay involves plating stationary-phase cells with the mutagen, after which the cells undergo a brief lag phase and, consequently, are exposed ...

Consequences of increased longevity for wealth, fertility, and population growth

NASA Astrophysics Data System (ADS)

Bogojević, A.; Balaž, A.; Karapandža, R.

2008-01-01

We present, solve and numerically simulate a simple model that describes the consequences of increased longevity for fertility rates, population growth and the distribution of wealth in developed societies. We look at the consequences of the repeated use of life extension techniques and show that they represent a novel commodity whose introduction will profoundly influence key aspects of the economy and society in general. In particular, we uncover two phases within our simplified model, labeled as ‘mortal’ and ‘immortal’. Within the life extension scenario it is possible to have sustainable economic growth in a population of stable size, as a result of dynamical equilibrium between the two phases.

Geothermal space heating for the Senior Citizens Center at Truth or Consequences, New Mexico. Final report

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

Mancini, T.R.; Chaturvedi, L.N.; Gebhard, T.G.

A demonstration project to heat the Senior Citizens Center at Truth or Consequences, New Mexico with geothermal waters is described. There were three phases to the project: Phase I - design and permitting; Phase II - installation of the heating system and well drilling; and Phase III - operation of the system. All three phases went well and there was only one major problem encountered. This was that the well which was drilled to serve as the geothermal source was dry. This could not have been anticipated and there was, as a contingency plan, the option of using an existingmore » sump in the Teen Center adjacent to the Senior Citizens Center as the geothermal source. The system was made operational in August of 1981 and has virtually supplied all of the heat to the Senior Citizens Center during this winter.« less

Behavior Management: Examining the Functions of Behavior

ERIC Educational Resources Information Center

Alstot, Andrew E.; Alstot, Crystal D.

2015-01-01

Appropriate student behavior is essential for the success of a physical education lesson. Despite using effective proactive management strategies, teachers may need to also use reactive techniques to reduce problem behaviors by applying suitable consequences. For these consequences to be effective, they must be aligned with the function, or cause,…

Cyber-Victimization and Its Psychosocial Consequences: Relationships with Behavior Management and Traditional Bullying

ERIC Educational Resources Information Center

Mindrila, Diana; Moore, Lori; Davis, Pamela

2015-01-01

The current study investigated the relationship between behavior management, traditional bullying, cyber-victimization, and several psychosocial consequences of cyber-victimization. Findings from previous research were used to specify a complex path model, which allowed the simultaneous estimation of multiple direct and indirect effects. Data were…

Space-inhomogeneous phase modulation of laser radiation in an electro-optical ferroelectric liquid crystal cell for suppressing speckle noise.

PubMed

Andreev, Alexander L; Andreeva, Tatiana B; Kompanets, Igor N; Zalyapin, Nikolay V

2018-02-20

Spatially inhomogeneous modulation of a phase delay with the depth of the order π or more makes it possible to destroy phase relations in a laser beam passing through an electro-optical cell with the ferroelectric liquid crystal (FLC) and, as a consequence, to suppress speckle noise in images formed by this beam. Such a modulation is a consequence of chaotic changes in the position of the scattering indicatrix of helix-free FLC, when an electro-optical cell is simultaneously supplied with a low-frequency and high-frequency bipolar control voltage. In this work, the phase modulation and effective suppressing of the speckles are realized using a new type of helix-free FLC material with periodic deformations of smectic layers.

Effects of previous grazing nutrition and management on feedlot performance of cattle.

PubMed

Drouillard, J S; Kuhl, G L

1999-01-01

Management strategies designed to improve grazing animal performance can influence feedlot performance and carcass traits both positively and negatively. In spite of the economic relevance of potential interactions between grazing and finishing performance, controlled experiments evaluating integrated production systems are limited in number. Effects of grazing treatments can result from, or be overshadowed by, changes in gut fill, thus making it difficult to assign precise costs to different phases of production. Published reports have considered the effects of stocking rate, duration of grazing, forage characteristics, supplementation, and growth-promoting implants on subsequent finishing performance. Improvements in cattle performance attributed to changes in stocking rate generally have been neutral to positive with respect to effects on finishing performance. Comparisons among forages have led to the suggestion that forage species may contribute to differences in gastrointestinal fill of grazing cattle, thereby influencing gain and efficiency during the subsequent finishing phase. Creep-feeding suckling calves generally has increased preweaning performance but has had relatively little influence on performance during the subsequent finishing phase. Grain supplementation of stocker cattle during the grazing period has improved grazing performance, but effects on subsequent feedlot performance have been inconsistent. Potential carryover effects from protein and mineral supplementation also have been inconclusive. Lack of congruence among studies is puzzling but may be the consequence of highly varied production systems, differences in experimental procedures, and changes in gut fill or mass of internal organs. Based on the studies reviewed, the expression or absence of compensatory growth during the finishing phase appears to be related to the nutritional quality of forages utilized in the grazing period, with higher quality forages tending to yield greater compensatory effects. The bulk of evidence with suckling cattle and stocker implants suggests that effects on subsequent finishing performance are minimal. Attention is drawn to the noticeable lack of research pertaining to integrated production systems. A more thorough understanding of the interactions among grazing nutrition and management, finishing performance, and carcass traits is needed to facilitate greater economic exploitation of these relationships.

The Systematic Use of Positive and Negative Consequences in Managing Classroom Encopresis

ERIC Educational Resources Information Center

George, Thomas W.; And Others

1977-01-01

This study reports a successful classroom intervention program which was designed to curb encopresis. It used positive consequences in combination with negative consequences, rather than negative consequences alone. Also it utilized a reversal strategy to evalulate the efficacy of the treatment variables. (Author)

Recognising sleep apnoea.

PubMed

How, C H; Hsu, P P; Tan, K L

2015-03-01

Most people spend a third of their lives sleeping, and thus, sleep has a major impact on all of us. As sleep is a function and not a structure, it is challenging to treat and prevent its complications. Sleep apnoea is one such complication, with serious and potentially life-threatening consequences. Local studies estimate that about 15% of Singapore's population is afflicted with sleep apnoea. The resulting sleep fragmentation may result in poor quality of sleep, leading to daytime sleepiness. Sleep apnoea may also be the underlying cause of high blood pressure, memory loss, poor concentration and work performance, motor vehicle accidents, and marital problems. Evaluation involves a sleep study, followed by patient education, and an individualised step-wise management approach should be explored. Many patients will require follow-up for a long period of time, as management options may not offer a permanent cure; other contributory causes may arise at different phases of their lives, compounded by genetic and hormonal issues, ethnicity and the modern hazards of a fast-paced society.

Team building: electronic management-clinical translational research (eM-CTR) systems.

PubMed

Cecchetti, Alfred A; Parmanto, Bambang; Vecchio, Marcella L; Ahmad, Sjarif; Buch, Shama; Zgheib, Nathalie K; Groark, Stephen J; Vemuganti, Anupama; Romkes, Marjorie; Sciurba, Frank; Donahoe, Michael P; Branch, Robert A

2009-12-01

Classical drug exposure: response studies in clinical pharmacology represent the quintessential prototype for Bench to Bedside-Clinical Translational Research. A fundamental premise of this approach is for a multidisciplinary team of researchers to design and execute complex, in-depth mechanistic studies conducted in relatively small groups of subjects. The infrastructure support for this genre of clinical research is not well-handled by scaling down of infrastructure used for large Phase III clinical trials. We describe a novel, integrated strategy, whose focus is to support and manage a study using an Information Hub, Communication Hub, and Data Hub design. This design is illustrated by an application to a series of varied projects sponsored by Special Clinical Centers of Research in chronic obstructive pulmonary disease at the University of Pittsburgh. In contrast to classical informatics support, it is readily scalable to large studies. Our experience suggests the culture consequences of research group self-empowerment is not only economically efficient but transformative to the research process.

Is the great attractor really a great wall

NASA Technical Reports Server (NTRS)

Stebbins, Albert; Turner, Michael S.

1988-01-01

Some of the cosmological consequences are discussed of a late time phase transition which produces light domain walls. The observed peculiar velocity field of the Universe and the observed isotropy of the microwave background radiation severely constrain the wall surface density in such a scenario. The most interesting consequence of such a phase transition is the possibility that the local, coherent streaming motion reported by the Seven Samurai could be explained by the repulsive effect of a relic domain wall with the Hubble volume (the Great Wall).

Checkpoints: it takes more than time to heal some wounds.

PubMed

Rhind, N; Russell, P

The S-phase DNA damage checkpoint seems to provide a twist on the checkpoint theme. Instead of delaying replication and allowing repair as a consequence, it may activate repair and delay replication as a consequence.

Taking out violence.

PubMed

Loafmann, B

2001-01-01

An analysis of how consequences impact your company from inside or outside will enable you to prevent the situations that can build up until they explode into violence. Specific skill enhancement on the use of feedback and consequences will broaden the base of involvement and foster early intervention opportunities before things get out of control. Understanding how consequences influence behavior also can improve self-management efforts. When these strategies are coupled with security hardware and appropriate policies, we can once again help our managers and employees work without fear of violence.

Optimizing the care model for an uncomplicated acute pain episode in sickle cell disease.

PubMed

Telfer, Paul; Kaya, Banu

2017-12-08

The pathophysiology, clinical presentation, and natural history of acute pain in sickle cell disease are unique and require a disease-centered approach that also applies general principles of acute and chronic pain management. The majority of acute pain episodes are managed at home without the need to access health care. The long-term consequences of poorly treated acute pain include chronic pain, adverse effects of chronic opioid usage, psychological maladjustment, poor quality of life, and excessive health care utilization. There is no standard protocol for management of an acute pain crisis in either the hospital or the community. The assumptions that severe acute pain must be managed in the hospital with parenteral opioids and that strong opioids are needed for home management of pain need to be questioned. Pain management in the emergency department often does not meet acceptable standards, while chronic use of strong opioids is likely to result in opioid-induced hyperalgesia, exacerbation of chronic pain symptoms, and opioid dependency. We suggest that an integrated approach is needed to control the underlying condition, modify psychological responses, optimize social support, and ensure that health care services provide safe, effective, and prompt treatment of acute pain and appropriate management of chronic pain. This integrated approach should begin at an early age and continue through the adolescent, transition, and adult phases of the care model. © 2016 by The American Society of Hematology. All rights reserved.

Wind disasters: A comprehensive review of current management strategies

PubMed Central

Marchigiani, Raffaele; Gordy, Stephanie; Cipolla, James; Adams, Raeanna C; Evans, David C; Stehly, Christy; Galwankar, Sagar; Russell, Sarah; Marco, Alan P; Kman, Nicholas; Bhoi, Sanjeev; Stawicki, Stanislaw P A; Papadimos, Thomas J

2013-01-01

Wind disasters are responsible for tremendous physical destruction, injury, loss of life and economic damage. In this review, we discuss disaster preparedness and effective medical response to wind disasters. The epidemiology of disease and injury patterns observed in the early and late phases of wind disasters are reviewed. The authors highlight the importance of advance planning and adequate preparation as well as prompt and well-organized response to potential damage involving healthcare infrastructure and the associated consequences to the medical response system. Ways to minimize both the extent of infrastructure damage and its effects on the healthcare system are discussed, focusing on lessons learned from recent major wind disasters around the globe. Finally, aspects of healthcare delivery in disaster zones are reviewed. PMID:23961458

Changes in groundwater recharge under projected climate in the upper Colorado River basin

USGS Publications Warehouse

Tillman, Fred; Gangopadhyay, Subhrendu; Pruitt, Tom

2016-01-01

Understanding groundwater-budget components, particularly groundwater recharge, is important to sustainably manage both groundwater and surface water supplies in the Colorado River basin now and in the future. This study quantifies projected changes in upper Colorado River basin (UCRB) groundwater recharge from recent historical (1950–2015) through future (2016–2099) time periods, using a distributed-parameter groundwater recharge model with downscaled climate data from 97 Coupled Model Intercomparison Project Phase 5 climate projections. Simulated future groundwater recharge in the UCRB is generally expected to be greater than the historical average in most decades. Increases in groundwater recharge in the UCRB are a consequence of projected increases in precipitation, offsetting reductions in recharge that would result from projected increased temperatures.

SLURM: Simple Linux Utility for Resource Management

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

Jette, M; Dunlap, C; Garlick, J

2002-04-24

Simple Linux Utility for Resource Management (SLURM) is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for Linux clusters of thousands of nodes. Components include machine status, partition management, job management, and scheduling modules. The design also includes a scalable, general-purpose communication infrastructure. Development will take place in four phases: Phase I results in a solid infrastructure; Phase II produces a functional but limited interactive job initiation capability without use of the interconnect/switch; Phase III provides switch support and documentation; Phase IV provides job status, fault-tolerance, and job queuing and control through Livermore's Distributed Productionmore » Control System (DPCS), a meta-batch and resource management system.« less

[Surgical management of animal bites in children].

PubMed

Touzet-Roumazeille, S; Jayyosi, L; Plenier, Y; Guyot, E; Guillard, T; François, C

2016-10-01

Children represent a population at risk, because of their short size, their naivety and their attraction to animals. The face and hands are the most specific locations in young children. Wounds are often multiple. In more than half the cases, the child knows the animal, which are dogs and cats by frequency argument. The bite episode occurs mostly when the child is alone with the pet without direct supervision, while playing or stroking the animal. As in all bites, pediatric lesions are infectious, functional and aesthetic emergencies, but the goal of this work was primarily to make a point on principles of surgical management of animal bites in children, highlighting pediatric specificities. Animal bites require psychological, anesthetic and surgical treatment, adapted to the child, in a specialized structure. Hospitalization and general anesthesia are more frequent in children. Any suspicion of mistreatment (and/or abuse) should lead to the child's hospitalization, even if wounds do not justify monitoring in a surgical environment. Emergency surgery is essential to limit functional and aesthetic consequences. The healing capacities of the child and the frequent lack of co-morbidity allow a conservative surgical treatment with suture, repositioning skin flaps and controlled healing in the first place. Immobilization, drainage, and antibiotics will complete the surgery. The healing process, however, leads to a specific management during scar remodeling phase and growth. Psychological care of the child and parents should not be forgotten, and has to start at the same time as surgical treatment at in acute phase. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

User Experience Evaluation Methods in Product Development (UXEM'09)

NASA Astrophysics Data System (ADS)

Roto, Virpi; Väänänen-Vainio-Mattila, Kaisa; Law, Effie; Vermeeren, Arnold

High quality user experience (UX) has become a central competitive factor of product development in mature consumer markets [1]. Although the term UX originated from industry and is a widely used term also in academia, the tools for managing UX in product development are still inadequate. A prerequisite for designing delightful UX in an industrial setting is to understand both the requirements tied to the pragmatic level of functionality and interaction and the requirements pertaining to the hedonic level of personal human needs, which motivate product use [2]. Understanding these requirements helps managers set UX targets for product development. The next phase in a good user-centered design process is to iteratively design and evaluate prototypes [3]. Evaluation is critical for systematically improving UX. In many approaches to UX, evaluation basically needs to be postponed until the product is fully or at least almost fully functional. However, in an industrial setting, it is very expensive to find the UX failures only at this phase of product development. Thus, product development managers and developers have a strong need to conduct UX evaluation as early as possible, well before all the parts affecting the holistic experience are available. Different types of products require evaluation on different granularity and maturity levels of a prototype. For example, due to its multi-user characteristic, a community service or an enterprise resource planning system requires a broader scope of UX evaluation than a microwave oven or a word processor that is meant for a single user at a time. Before systematic UX evaluation can be taken into practice, practical, lightweight UX evaluation methods suitable for different types of products and different phases of product readiness are needed. A considerable amount of UX research is still about the conceptual frameworks and models for user experience [4]. Besides, applying existing usability evaluation methods (UEMs) without adaptation to evaluate UX may lead to some scoping issues. Consequently, there is a strong need to put UX evaluation from research into practice.

Integrated therapy for HIV and cryptococcosis.

PubMed

Srichatrapimuk, Sirawat; Sungkanuparph, Somnuek

2016-11-29

Cryptococcosis has been one of the most common opportunistic infections and causes of mortality among HIV-infected patients, especially in resource-limited countries. Cryptococcal meningitis is the most common form of cryptococcosis. Laboratory diagnosis of cryptococcosis includes direct microscopic examination, isolation of Cryptococcus from a clinical specimen, and detection of cryptococcal antigen. Without appropriate treatment, cryptococcosis is fatal. Early diagnosis and treatment is the key to treatment success. Treatment of cryptococcosis consists of three main aspects: antifungal therapy, intracranial pressure management for cryptococcal meningitis, and restoration of immune function with antiretroviral therapy (ART). Optimal integration of these three aspects is crucial to achieving successful treatment and reducing the mortality. Antifungal therapy consists of three phases: induction, consolidation, and maintenance. A combination of two drugs, i.e. amphotericin B plus flucytosine or fluconazole, is preferred in the induction phase. Fluconazole monotherapy is recommended during consolidation and maintenance phases. In cryptococcal meningitis, intracranial pressure rises along with CSF fungal burden and is associated with morbidity and mortality. Aggressive control of intracranial pressure should be done. Management options include therapeutic lumbar puncture, lumbar drain insertion, ventriculostomy, or ventriculoperitoneal shunt. Medical treatment such as corticosteroids, mannitol, and acetazolamide are ineffective and should not be used. ART has proven to have a great impact on survival rates among HIV-infected patients with cryptococcosis. The time to start ART in HIV-infected patients with cryptococcosis has to be deferred until 5 weeks after the start of antifungal therapy. In general, any effective ART regimen is acceptable. Potential drug interactions between antiretroviral agents and amphotericin B, flucytosine, and fluconazole are minimal. Of most potential clinical relevance is the concomitant use of fluconazole and nevirapine. Concomitant use of these two drugs should be cautious, and patients should be monitored closely for nevirapine-associated adverse events, including hepatotoxicity. Overlapping toxicities of antifungal and antiretroviral drugs and immune reconstitution inflammatory syndrome are not uncommon. Early recognition and appropriate management of these consequences can reinforce the successful integrated therapy in HIV-infected patients with cryptococcosis.

Electrical, Electronic, and Electromechanical (EEE) parts management and control requirements for NASA space flight programs

NASA Technical Reports Server (NTRS)

1989-01-01

This document establishes electrical, electronic, and electromechanical (EEE) parts management and control requirements for contractors providing and maintaining space flight and mission-essential or critical ground support equipment for NASA space flight programs. Although the text is worded 'the contractor shall,' the requirements are also to be used by NASA Headquarters and field installations for developing program/project parts management and control requirements for in-house and contracted efforts. This document places increased emphasis on parts programs to ensure that reliability and quality are considered through adequate consideration of the selection, control, and application of parts. It is the intent of this document to identify disciplines that can be implemented to obtain reliable parts which meet mission needs. The parts management and control requirements described in this document are to be selectively applied, based on equipment class and mission needs. Individual equipment needs should be evaluated to determine the extent to which each requirement should be implemented on a procurement. Utilization of this document does not preclude the usage of other documents. The entire process of developing and implementing requirements is referred to as 'tailoring' the program for a specific project. Some factors that should be considered in this tailoring process include program phase, equipment category and criticality, equipment complexity, and mission requirements. Parts management and control requirements advocated by this document directly support the concept of 'reliability by design' and are an integral part of system reliability and maintainability. Achieving the required availability and mission success objectives during operation depends on the attention given reliability and maintainability in the design phase. Consequently, it is intended that the requirements described in this document are consistent with those of NASA publications, 'Reliability Program Requirements for Aeronautical and Space System Contractors,' NHB 5300.4(1A-l); 'Maintainability Program Requirements for Space Systems,' NHB 5300.4(1E); and 'Quality Program Provisions for Aeronautical and Space System Contractors,' NHB 5300.4(1B).

Consequence Management Symposium

DTIC Science & Technology

2001-09-01

AND SUBTITLE Consequence Management Symposium 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e...log i cal agents and their effects was deemed essen tial for “first respond ers,” includ ing emer gency medi cal and hospi tal prac ti tio ners

Checkpoints: It takes more than time to heal some wounds

PubMed Central

Rhind, Nicholas; Russell, Paul

2010-01-01

The S-phase DNA damage checkpoint seems to provide a twist on the checkpoint theme. Instead of delaying replication and allowing repair as a consequence, it may activate repair and delay replication as a consequence. PMID:11137027

Wait time management strategies for total joint replacement surgery: sustainability and unintended consequences.

PubMed

Pomey, Marie-Pascale; Clavel, Nathalie; Amar, Claudia; Sabogale-Olarte, Juan Carlos; Sanmartin, Claudia; De Coster, Carolyn; Noseworthy, Tom

2017-09-07

In Canada, long waiting times for core specialized services have consistently been identified as a key barrier to access. Governments and organizations have responded with strategies for better access management, notably for total joint replacement (TJR) of the hip and knee. While wait time management strategies (WTMS) are promising, the factors which influence their sustainable implementation at the organizational level are understudied. Consequently, this study examined organizational and systemic factors that made it possible to sustain waiting times for TJR within federally established limits and for at least 18 months or more. The research design is a multiple case study of WTMS implementation. Five cases were selected across five Canadian provinces. Three success levels were pre-defined: 1) the WTMS maintained compliance with requirements for more than 18 months; 2) the WTMS met requirements for 18 months but could not sustain the level thereafter; 3) the WTMS never met requirements. For each case, we collected documents and interviewed key informants. We analyzed systemic and organizational factors, with particular attention to governance and leadership, culture, resources, methods, and tools. We found that successful organizations had specific characteristics: 1) management of the whole care continuum, 2) strong clinical leadership; 3) dedicated committees to coordinate and sustain strategy; 4) a culture based on trust and innovation. All strategies led to relatively similar unintended consequences. The main negative consequence was an initial increase in waiting times for TJR and the main positive consequence was operational enhancement of other areas of specialization based on the TJR model. This study highlights important differences in factors which help to achieve and sustain waiting times. To be sustainable, a WTMS needs to generate greater synergies between contextual-level strategy (provincial or regional) and organizational objectives and constraints. Managers at the organizational level should be vigilant with regard to unintended consequences that a WTMS in one area can have for other areas of care. A more systemic approach to sustainability can help avoid or mitigate undesirable unintended consequences.

Earthworks logistics in the high density urban development conditions - case study

NASA Astrophysics Data System (ADS)

Sobotka, A.; Blajer, M.

2017-10-01

Realisation of the construction projects on highly urbanised areas carries many difficulties and logistic problems. Earthworks conducted in such conditions constitute a good example of how important it is to properly plan the works and use the technical means of the logistics infrastructure. The construction processes on the observed construction site, in combination with their external logistics service are a complex system, difficult for mathematical modelling and achievement of appropriate data for planning the works. The paper shows describe and analysis of earthworks during construction of the Centre of Power Engineering of AGH in Krakow for two stages of a construction project. At the planning stage in the preparatory phase (before realization) and in the implementation phase of construction works (foundation). In the first case, an example of the use of queuing theory for prediction of excavation time under random work conditions of the excavator and the associated trucks is provided. In the second case there is a change of foundation works technology resulting as a consequence of changes in logistics earthworks. Observation of the construction has confirmed that the use of appropriate methods of construction works management, and in this case agile management, the time and cost of the project have not been exceeded. The success of a project depends on the ability of the contractor to react quickly when changes occur in the design, technology, environment, etc.

Integrated Risk Management Within NASA Programs/Projects

NASA Technical Reports Server (NTRS)

Connley, Warren; Rad, Adrian; Botzum, Stephen

2004-01-01

As NASA Project Risk Management activities continue to evolve, the need to successfully integrate risk management processes across the life cycle, between functional disciplines, stakeholders, various management policies, and within cost, schedule and performance requirements/constraints become more evident and important. Today's programs and projects are complex undertakings that include a myriad of processes, tools, techniques, management arrangements and other variables all of which must function together in order to achieve mission success. The perception and impact of risk may vary significantly among stakeholders and may influence decisions that may have unintended consequences on the project during a future phase of the life cycle. In these cases, risks may be unintentionally and/or arbitrarily transferred to others without the benefit of a comprehensive systemic risk assessment. Integrating risk across people, processes, and project requirements/constraints serves to enhance decisions, strengthen communication pathways, and reinforce the ability of the project team to identify and manage risks across the broad spectrum of project management responsibilities. The ability to identify risks in all areas of project management increases the likelihood a project will identify significant issues before they become problems and allows projects to make effective and efficient use of shrinking resources. By getting a total team integrated risk effort, applying a disciplined and rigorous process, along with understanding project requirements/constraints provides the opportunity for more effective risk management. Applying an integrated approach to risk management makes it possible to do a better job at balancing safety, cost, schedule, operational performance and other elements of risk. This paper will examine how people, processes, and project requirements/constraints can be integrated across the project lifecycle for better risk management and ultimately improve the chances for mission success.

A risk-based approach to sanitary sewer pipe asset management.

PubMed

Baah, Kelly; Dubey, Brajesh; Harvey, Richard; McBean, Edward

2015-02-01

Wastewater collection systems are an important component of proper management of wastewater to prevent environmental and human health implications from mismanagement of anthropogenic waste. Due to aging and inadequate asset management practices, the wastewater collection assets of many cities around the globe are in a state of rapid decline and in need of urgent attention. Risk management is a tool which can help prioritize resources to better manage and rehabilitate wastewater collection systems. In this study, a risk matrix and a weighted sum multi-criteria decision-matrix are used to assess the consequence and risk of sewer pipe failure for a mid-sized city, using ArcGIS. The methodology shows that six percent of the uninspected sewer pipe assets of the case study have a high consequence of failure while four percent of the assets have a high risk of failure and hence provide priorities for inspection. A map incorporating risk of sewer pipe failure and consequence is developed to facilitate future planning, rehabilitation and maintenance programs. The consequence of failure assessment also includes a novel failure impact factor which captures the effect of structurally defective stormwater pipes on the failure assessment. The methodology recommended in this study can serve as a basis for future planning and decision making and has the potential to be universally applied by municipal sewer pipe asset managers globally to effectively manage the sanitary sewer pipe infrastructure within their jurisdiction. Copyright © 2014 Elsevier B.V. All rights reserved.

Burn Injuries: Causes, Consequences, Knowledge, Behaviors.

ERIC Educational Resources Information Center

Healer, Cheryl V.; And Others

This report covers Phase I of the Burn Injury Education Demonstration Project, a four-phased project designed to explore the feasibility of using educational intervention strategies to increase knowledge and appropriate behaviors and attitudes to reduce the number and severity of burns. Phase I involved a comprehensive needs assessment conducted…

Congenital hypogonadotropic hypogonadism: implications of absent mini-puberty.

PubMed

Dwyer, Andrew A; Jayasena, Channa N; Quinton, Richard

2016-06-01

The phenomenon known as "mini-puberty" refers to activation of the neonatal hypothalamo-pituitary axis causing serum concentrations of gonadotrophins and testosterone (T) to approach adult male levels. This early neonatal period is a key proliferative window for testicular germ cells and immature Sertoli cells. Although failure to spontaneously initiate (adolescent) puberty is the most evident consequence of a defective gonadotropin-releasing hormone (GnRH) neurosecretory network, absent mini-puberty is also likely to have a major impact on the reproductive phenotype of men with congenital hypogonadotrophic hypogonadism (CHH). Furthermore, the phase of male mini-puberty represents a key window-of-opportunity to identify congenital GnRH deficiency (either isolated CHH, or as part of combined pituitary hormone deficiency) in childhood. Among male neonates exhibiting "red flag" indicators for CHH (i.e. maldescended testes with or without cryptorchidism) a single serum sample (between 4-8 weeks of life) can pinpoint congenital GnRH deficiency far more rapidly and with much greater accuracy than dynamic tests performed in later childhood or adolescence. Potential consequences for missing absent mini-puberty in a male neonate include the lack of monitoring of pubertal progression/lack of progression, and the missed opportunity for early therapeutic intervention. This article will review our current understanding of the mechanisms and clinical consequences of mini-puberty. Furthermore, evidence for the optimal clinical management of patients with absent mini-puberty will be discussed.

41 CFR 105-55.024 - Consideration of tax consequences to the Government.

Code of Federal Regulations, 2010 CFR

2010-07-01

... consequences to the Government. 105-55.024 Section 105-55.024 Public Contracts and Property Management Federal... consequences to the Government. In negotiating a compromise, the General Services Administration (GSA) may consider the tax consequences to the Government. In particular, GSA may consider requiring a waiver of tax...

Electrophoretic serum protein fraction profile during the different physiological phases in Comisana ewes.

PubMed

Piccione, G; Alberghina, D; Marafioti, S; Giannetto, C; Casella, S; Assenza, A; Fazio, F

2012-08-01

The aim of this study was to evaluate the influence of different physiological phases on serum total proteins and their fractions of ten Comisana ewes housed in Mediterranean area. From each animal, blood samples were collected at different physiological phases: late pregnancy, post-partum, early, mid-, end lactation and dry period. On all samples serum total proteins were determined by the biuret method, and albumin, α-globulins, β(1) -globulins, β(2) -globulins and γ-globulins concentrations were assessed using an automated system. One-way repeated measures analysis of variance was applied to determine the significant effect of different physiological phases on the parameters studied. During the late pregnancy and post-partum, total proteins, β1- and β2-globulins and γ-globulins showed the highest values. Starting from post-partum, α-globulins increased to reach their peaks in mid-lactation. Early lactation was characterized by low γ-globulins values. The increase in serum albumin concentration and the drop in some globulin fractions determined the significant increase in albumin/globulin ratio. The obtained results contributed to improve the knowledge on electrophoretic profile during the different physiological phases in ewes, confirming that pregnancy and lactation periods affect the protein metabolism. Particularly, serum protein fractions pattern could give information about dehydration, plasma volume expansion and hepatic function, which occur during the different physiological phases. Dynamics of the protein profile - from pregnancy to dry period - which are provided by our results, could be considered as guidelines for the management strategies to guarantee the nutritional needs of these animals during the different physiological phases and to avoid a decline of productive performance and consequently an economic loss. © 2011 Blackwell Verlag GmbH.

Management of government quality assurance functions for NASA contracts

NASA Technical Reports Server (NTRS)

1993-01-01

This handbook sets forth requirements for NASA direction and management of government quality assurance functions performed for NASA contracts and is applicable to all NASA installations. These requirements will standardize management to provide the minimum oversight and effective use of resources. This handbook implements Federal Acquisition Regulation (FAR) Part 46, NASA FAR Supplement 18-46, Quality Assurance, and NMI 7410.1. Achievement of established quality and reliability goals at all levels is essential to the success of NASA programs. Active participation by NASA and other agency quality assurance personnel in all phases of contract operations, including precontract activity, will assist in the economic and timely achievement of program results. This involves broad participation in design, development, procurement, inspection, testing, and preventive and corrective actions. Consequently, government, as well as industry, must place strong emphasis on the accomplishment of all functions having a significant bearing on quality and reliability from program initiation through end-use of supplies and services produced. For purposes of implementing NASA and other agency agreements, and to provide for uniformity and consistency, the terminology and definitions prescribed herein and in a future handbook shall be utilized for all NASA quality assurance delegations and subsequent redelegations.

Management of government quality assurance functions for NASA contracts

NASA Astrophysics Data System (ADS)

1993-04-01

This handbook sets forth requirements for NASA direction and management of government quality assurance functions performed for NASA contracts and is applicable to all NASA installations. These requirements will standardize management to provide the minimum oversight and effective use of resources. This handbook implements Federal Acquisition Regulation (FAR) Part 46, NASA FAR Supplement 18-46, Quality Assurance, and NMI 7410.1. Achievement of established quality and reliability goals at all levels is essential to the success of NASA programs. Active participation by NASA and other agency quality assurance personnel in all phases of contract operations, including precontract activity, will assist in the economic and timely achievement of program results. This involves broad participation in design, development, procurement, inspection, testing, and preventive and corrective actions. Consequently, government, as well as industry, must place strong emphasis on the accomplishment of all functions having a significant bearing on quality and reliability from program initiation through end-use of supplies and services produced. For purposes of implementing NASA and other agency agreements, and to provide for uniformity and consistency, the terminology and definitions prescribed herein and in a future handbook shall be utilized for all NASA quality assurance delegations and subsequent redelegations.

41 CFR 302-14.7 - Are there tax consequences when I receive a home marketing incentive payment?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false Are there tax consequences when I receive a home marketing incentive payment? 302-14.7 Section 302-14.7 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES...

Action errors, error management, and learning in organizations.

PubMed

Frese, Michael; Keith, Nina

2015-01-03

Every organization is confronted with errors. Most errors are corrected easily, but some may lead to negative consequences. Organizations often focus on error prevention as a single strategy for dealing with errors. Our review suggests that error prevention needs to be supplemented by error management--an approach directed at effectively dealing with errors after they have occurred, with the goal of minimizing negative and maximizing positive error consequences (examples of the latter are learning and innovations). After defining errors and related concepts, we review research on error-related processes affected by error management (error detection, damage control). Empirical evidence on positive effects of error management in individuals and organizations is then discussed, along with emotional, motivational, cognitive, and behavioral pathways of these effects. Learning from errors is central, but like other positive consequences, learning occurs under certain circumstances--one being the development of a mind-set of acceptance of human error.

40 CFR 68.165 - Offsite consequence analysis.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Offsite consequence analysis. 68.165 Section 68.165 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.165 Offsite consequence...

40 CFR 68.165 - Offsite consequence analysis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Offsite consequence analysis. 68.165 Section 68.165 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.165 Offsite consequence...

Sundstrand’s Precision Metal Forming Cell. Industrial Modernization Incentive Program (IMIP). Phase 2

DTIC Science & Technology

1991-03-01

1-2 1.4 CONCLUSIONS AND RECOMMENDATIONS ....................... 1-2 20. PHASE II MANAGEMENT PLAN...2-1 2.1 PROGRAM MANAGEMENT ................................... 2-1 2.2 IM IP TEAM...Barbier, reference Section 2.0 (Phase II Management Plan), is complete and this report provides the results of the Phase II study. 1.2 OBJECTIVES The

The multiuniverse transition in superfluid 3He

NASA Astrophysics Data System (ADS)

Bunkov, Yury

2013-10-01

The symmetry-breaking phase transitions of the universe and of superfluid 3He may lead to the formation of different states with different order parameters. In both cases the energy potential below the transition temperature has a complicated multidimensional profile with many local minima and saddle points, which correspond to different states. Consequently, not only topological defects, but also islands of different metastable states can be created. Using 3He we can analyse the properties and experimental consequences of such transitions and, in particular, the first-order phase transition between the two low symmetry states.

The multiuniverse transition in superfluid 3He.

PubMed

Bunkov, Yury

2013-10-09

The symmetry-breaking phase transitions of the universe and of superfluid (3)He may lead to the formation of different states with different order parameters. In both cases the energy potential below the transition temperature has a complicated multidimensional profile with many local minima and saddle points, which correspond to different states. Consequently, not only topological defects, but also islands of different metastable states can be created. Using (3)He we can analyse the properties and experimental consequences of such transitions and, in particular, the first-order phase transition between the two low symmetry states.

Isothermal lipid phase transitions.

PubMed

Cevc, G

1991-03-01

In liotropic lipid systems phase transitions can be induced isothermally by changing the solvent concentration or composition; alternatively, lipid composition can be modified by (bio)chemical means. The probability for isothermal phase transitions increases with the decreasing transition entropy; it is proportional to the magnitude of the transition temperature shift caused by transformation-inducing system variation. Manipulations causing large thermodynamic effects, such as lipid (de)hydration, binding of protons or divalent ions and macromolecular adsorption, but also close bilayer approach are, therefore, likely to cause structural lipid change(s) at a constant temperature. Net lipid charges enhance the membrane susceptibility to salt-induced isothermal phase transitions; a large proportion of this effect is due to the bilayer dehydration, however, rather than being a consequence of the decreased Coulombic electrostatic interactions. Membrane propensity for isothermal phase transitions, consequently, always increases with the hydrophilicity of the lipid heads, as well as with the desaturation and shortening of the lipid chains. Upon a phase change at a constant temperature, some of the interfacially bound solutes (e.g. protons or calcium) are released in the solution. Membrane permeability and fusogenicity simultaneously increase. In mixed systems, isothermal phase transitions, moreover, may result in lateral phase separation. All this opens up ways for the involvement of isothermal phase transitions in the regulation of biological processes.

A new methodology to identify surface water bodies at risk by using pesticide monitoring data: The glyphosate case study in Lombardy Region (Italy).

PubMed

Di Guardo, Andrea; Finizio, Antonio

2018-01-01

In the last decades, several monitoring programs were established as an effect of EU Directives addressing the quality of water resources (drinking water, groundwater and surface water). Plant Protection Products (PPPs) are an obvious target of monitoring activities, since they are directly released into the environment. One of the challenges in managing the risk of pesticides at the territorial scale is identifying the locations in water bodies needing implementation of risk mitigation measures. In this, the national pesticides monitoring plans could be very helpful. However, monitoring of pesticides is a challenging task because of the high number of registered pesticides, cost of analyses, and the periodicity of sampling related to pesticide application and use. Extensive high-quality data-sets are consequently often missing. More in general, the information that can be obtained from monitoring studies are frequently undervalued by risk managers. In this study, we propose a new methodology providing indications about the need to implement mitigation measures in stretches of surface water bodies on a territory by combining historical series of monitoring data and GIS. The methodology is articulated in two distinct phases: a) acquisition of monitoring data and setting-up of informative layers of georeferenced data (phase 1) and b) statistical and expert analysis for the identification of areas where implementation of limitation or mitigation measures are suggested (phase 2). Our methodology identifies potentially vulnerable water bodies, considering temporal contamination trends and relative risk levels at selected monitoring stations. A case study is presented considering glyphosate monitoring data in Lombardy Region (Northern of Italy) for the 2008-2014 period. Copyright © 2017 Elsevier B.V. All rights reserved.

Protocol for the ProCare Trial: a phase II randomised controlled trial of shared care for follow-up of men with prostate cancer

PubMed Central

Emery, Jon; Doorey, Juanita; Jefford, Michael; King, Madeleine; Pirotta, Marie; Hayne, Dickon; Martin, Andrew; Trevena, Lyndal; Lim, Tee; Constable, Roger; Hawks, Cynthia; Hyatt, Amelia; Hamid, Akhlil; Violet, John; Gill, Suki; Frydenberg, Mark; Schofield, Penelope

2014-01-01

Introduction Men with prostate cancer require long-term follow-up to monitor disease progression and manage common adverse physical and psychosocial consequences of treatment. There is growing recognition of the potential role of primary care in cancer follow-up. This paper describes the protocol for a phase II multisite randomised controlled trial of a novel model of shared care for the follow-up of men after completing treatment for low-moderate risk prostate cancer. Methods and analysis The intervention is a shared care model of follow-up visits in the first 12 months after completing treatment for prostate cancer with the following specific components: a survivorship care plan, general practitioner (GP) management guidelines, register and recall systems, screening for distress and unmet needs and patient information resources. Eligible men will have completed surgery and/or radiotherapy for low-moderate risk prostate cancer within the previous 8 weeks and have a GP who consents to participate. Ninety men will be randomised to the intervention or current hospital follow-up care. Study outcome measures will be collected at baseline, 3, 6 and 12 months and include anxiety, depression, unmet needs, prostate cancer-specific quality of life and satisfaction with care. Clinical processes and healthcare resource usage will also be measured. The principal emphasis of the analysis will be on obtaining estimates of the treatment effect size and assessing feasibility in order to inform the design of a subsequent phase III trial. Ethics and dissemination Ethics approval has been granted by the University of Western Australia and from all hospital recruitment sites in Western Australia and Victoria. Results of this phase II trial will be reported in peer-reviewed publications and in conference presentations. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12610000938000 PMID:24604487

Mission Analysis for Using Preventive Radiological/Nuclear Detection Equipment for Consequence Management

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

Buddemeier, Brooke R.; Wood-Zika, Annmarie R.; Haynes, Daniel

The overall objective of this project is to research, evaluate, and test first responder preventive radiological/nuclear detection (PRND) equipment to provide state and local agencies with scientific guidance on how to effectively use this equipment for response after a radiological/nuclear release or detonation. While the equipment being tested in this effort has been specifically designed by technology manufacturers and purchased by responders for preventive detection and source interdiction operations, the fleet of PRND equipment can help fill critical needs for radiological instrumentation should a consequence management (CM) response take place, as it is currently the most widely available and fieldedmore » radiological instrumentation by state and local agencies. This effort will provide scientific guidance on the most effective way to utilize this class of equipment for consequence management missions. Gaining a better understanding of how PRND equipment can operate and perform for these missions will allow for recommendations on the tactical approach responders can use for consequence management operations. PRND equipment has been placed into service by federal, state, and local agencies throughout the nation. If the equipment capability and limitations are taken into account, this large inventory can be leveraged to support the emergency response in the aftermath of a radiological or nuclear event. With several hundred makes and models of PRND equipment, often with significantly different detection capabilities that do not align with their nominal PRND equipment type, development of a streamlined categorization scheme with respect to consequence management missions was the first step to identifying safe and effective uses of PRND equipment for radiological/nuclear incident response.« less

Occupational Stress in Secondary Education in Cyprus: Causes, Symptoms, Consequences and Stress Management

ERIC Educational Resources Information Center

Hadjisymeou, Georgia

2010-01-01

The survey attempted to look into the causes, symptoms and consequences that occupational stress has on teachers in Secondary Education in Cyprus and find ways to manage it. Thirty eight schools with 553 teachers participated in the survey. The sample chosen is a result of a simple random sampling and it is representative of the country's…

Effective Risk Management in Innovative Projects: A Case Study of the Construction of Energy-efficient, Sustainable Building of the Laboratory of Intelligent Building in Cracow

NASA Astrophysics Data System (ADS)

Krechowicz, Maria

2017-10-01

Many construction projects fail to meet deadlines or they exceed the assumed budget. This scenario is particularly common in the case of innovative projects, in which too late identification of a high risk of delays and exceeding the assumed costs makes a potentially profitable project untenable. A high risk level, far exceeding the level of risk in standard non-innovative projects, is a characteristic feature of the realization phase of innovative projects. This is associated not only with greater complexity of the design and construction phases, but also with the problems with application of new technologies and prototype solutions, lack of qualified personnel with suitable expertise in specialized areas, and with the ability to properly identify the gaps between available and required knowledge and skills. This paper discusses the process of effective risk management in innovative projects on the example of the realization phase of an innovative, energy-efficient and sustainable building of the Laboratory of Intelligent Building in Cracow - DLJM Lab, from the point of view of DORBUD S.A., its general contractor. In this paper, a new approach to risk management process for innovative construction projects is proposed. Risk management process was divided into five stages: gathering information, identification of the important unwanted events, first risk assessment, development and choice of risk reaction strategies, assessment of the residual risk after introducing risk reactions. 18 unwanted events in an innovative construction project were identified. The first risk assessment was carried out using two-parametric risk matrix, in which the probability of unwanted event occurrence and its consequences were analysed. Three levels of risks were defined: tolerable, controlled and uncontrolled. Risk reactions to each defined unwanted event were developed. The following risk reaction types were considered: risk retention, risk reduction, risk transfer and risk elimination. Three-parametric risk matrix was developed to make it possible to assess risk after implementing risk reactions. The possibility of implementing risk management was inversely proportional to the probability of unwanted event occurrence and its contribution to the project outcome. Introducing this risk management strategy allowed to significantly reduce the risk of the innovative construction project. It proved to be an effective tool to reduce risk to an acceptable level. It had a significant contribution to carrying out the project within the assumed time, budget and quality standards.

EMP/GMD Phase 0 Report, A Review of EMP Hazard Environments and Impacts

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

Rivera, Michael Kelly; Backhaus, Scott N.; Woodroffe, Jesse Richard

The purpose of this study is to determine methods to analyze the hazard environments, impacts, and consequences of different sources of electromagnetic pulse (EMP), including nuclear electromagnetic pulse (NEMP) and geomagnetic disturbance (GMD) on the U.S. electric power infrastructures and to use those methods to determine EMP and GMD events of concern. The study will be carried out in four phases, each of which will provide higher levels of analytic fidelity that focuses on those EMP/GMD sources and events that create significant consequences, or whose consequences are sufficiently uncertain, to require more in-depth study. This study will leverage the bestmore » experimental data; device, equipment and system models; and simulation tools currently available. This study focuses primarily on the bulk electric system (BES) including large generating stations, large power transformers, the transmission network, and transmission system protection. Electrical distribution systems may potentially be included, if warranted, after consideration of the consequences for the bulk power system.« less

[Abnormal hepatic function tests in pregnancy: causes and consequences].

PubMed

Nemesánszky, Elemér

2013-07-21

The well-known normal ranges of laboratory parameters are altered due to the broad spectrum of physiological changes as well as proinflammatory and procoagulant effects of pregnancy. Hepatic disorders of any aetiology can cause potential problems during gravidity. Most frequently toxic-effects, hepatotrop viruses (such as hepatitis B and C), metabolic syndrome and diseases with autoimmune background can be observed. When dealing with "pregnancy-specific hepatic syndromes", it is very important to consider the "timing-factors" of pathologic changes and deterioration of clinical pictures as well. Due to the progress in cholestasis management, early termination of pregnancy can be avoided in many cases. As the overlap is really broad between various hepatic disorders, a multidisciplinary cooperation of different sub-disciplines is emphasized in order to achieve proper diagnosis and curative measures at early phase.

Healthcare managers in negative media focus: a qualitative study of personification processes and their personal consequences

PubMed Central

2014-01-01

Background Over the last decade healthcare management and managers have increasingly been in focus in public debate. The purpose of the present study was to gain a deeper understanding of how prolonged, unfavorable media focus can influence both the individual as a person and his or her managerial practice in the healthcare organization. Methods In-depth interviews (n = 49) with 24 managers and their superiors, or subordinate human resources/information professionals, and partners were analyzed using a grounded theory approach. Results The conceptual model explains how perceived uncertainties related to the managerial role influence personification and its negative consequences. The role ambiguities comprised challenges regarding the separation of individual identity from the professional function, the interaction with intra-organizational support and political play, and the understanding and acceptance of roles in society. A higher degree of uncertainty in role ambiguity increased both personification and the personal reaction to intense media pressure. Three types of reactions were related to the feeling of being infringed: avoidance and narrow-mindedness; being hard on self, on subordinates, and/or family members; and resignation and dejection. The results are discussed so as to elucidate the importance of support from others within the organization when under media scrutiny. Conclusions The degree of personification seems to determine the personal consequences as well as the consequences for their managerial practice. Organizational support for managers appearing in the media would probably be beneficial for both the manager and the organization. PMID:24397306

A Method for Dynamic Risk Assessment and Management of Rockbursts in Drill and Blast Tunnels

NASA Astrophysics Data System (ADS)

Liu, Guo-Feng; Feng, Xia-Ting; Feng, Guang-Liang; Chen, Bing-Rui; Chen, Dong-Fang; Duan, Shu-Qian

2016-08-01

Focusing on the problems caused by rockburst hazards in deep tunnels, such as casualties, damage to construction equipment and facilities, construction schedule delays, and project cost increase, this research attempts to present a methodology for dynamic risk assessment and management of rockbursts in D&B tunnels. The basic idea of dynamic risk assessment and management of rockbursts is determined, and methods associated with each step in the rockburst risk assessment and management process are given, respectively. Among them, the main parts include a microseismic method for early warning the occurrence probability of rockburst risk, an estimation method that aims to assess potential consequences of rockburst risk, an evaluation method that utilizes a new quantitative index considering both occurrence probability and consequences for determining the level of rockburst risk, and the dynamic updating. Specifically, this research briefly describes the referenced microseismic method of warning rockburst, but focuses on the analysis of consequences and associated risk assessment and management of rockburst. Using the proposed method of risk assessment and management of rockburst, the occurrence probability, potential consequences, and the level of rockburst risk can be obtained in real-time during tunnel excavation, which contributes to the dynamic optimisation of risk mitigation measures and their application. The applicability of the proposed method has been verified by those cases from the Jinping II deep headrace and water drainage tunnels at depths of 1900-2525 m (with a length of 11.6 km in total for D&B tunnels).

Medication Incidents Related to Automated Dose Dispensing in Community Pharmacies and Hospitals - A Reporting System Study

PubMed Central

Cheung, Ka-Chun; van den Bemt, Patricia M. L. A.; Bouvy, Marcel L.; Wensing, Michel; De Smet, Peter A. G. M.

2014-01-01

Introduction Automated dose dispensing (ADD) is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may introduce new safety issues. This descriptive study provides insight into the nature and consequences of medication incidents related to ADD, as reported by healthcare professionals in community pharmacies and hospitals. Methods The medication incidents that were submitted to the Dutch Central Medication incidents Registration (CMR) reporting system were selected and characterized independently by two researchers. Main Outcome Measures Person discovering the incident, phase of the medication process in which the incident occurred, immediate cause of the incident, nature of incident from the healthcare provider's perspective, nature of incident from the patient's perspective, and consequent harm to the patient caused by the incident. Results From January 2012 to February 2013 the CMR received 15,113 incidents: 3,685 (24.4%) incidents from community pharmacies and 11,428 (75.6%) incidents from hospitals. Eventually 1 of 50 reported incidents (268/15,113 = 1.8%) were related to ADD; in community pharmacies more incidents (227/3,685 = 6.2%) were related to ADD than in hospitals (41/11,428 = 0.4%). The immediate cause of an incident was often a change in the patient's medicine regimen or relocation. Most reported incidents occurred in two phases: entering the prescription into the pharmacy information system and filling the ADD bag. Conclusion A proportion of incidents was related to ADD and is reported regularly, especially by community pharmacies. In two phases, entering the prescription into the pharmacy information system and filling the ADD bag, most incidents occurred. A change in the patient's medicine regimen or relocation was the immediate causes of an incident. PMID:25058321

Medication incidents related to automated dose dispensing in community pharmacies and hospitals--a reporting system study.

PubMed

Cheung, Ka-Chun; van den Bemt, Patricia M L A; Bouvy, Marcel L; Wensing, Michel; De Smet, Peter A G M

2014-01-01

Automated dose dispensing (ADD) is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may introduce new safety issues. This descriptive study provides insight into the nature and consequences of medication incidents related to ADD, as reported by healthcare professionals in community pharmacies and hospitals. The medication incidents that were submitted to the Dutch Central Medication incidents Registration (CMR) reporting system were selected and characterized independently by two researchers. Person discovering the incident, phase of the medication process in which the incident occurred, immediate cause of the incident, nature of incident from the healthcare provider's perspective, nature of incident from the patient's perspective, and consequent harm to the patient caused by the incident. From January 2012 to February 2013 the CMR received 15,113 incidents: 3,685 (24.4%) incidents from community pharmacies and 11,428 (75.6%) incidents from hospitals. Eventually 1 of 50 reported incidents (268/15,113 = 1.8%) were related to ADD; in community pharmacies more incidents (227/3,685 = 6.2%) were related to ADD than in hospitals (41/11,428 = 0.4%). The immediate cause of an incident was often a change in the patient's medicine regimen or relocation. Most reported incidents occurred in two phases: entering the prescription into the pharmacy information system and filling the ADD bag. A proportion of incidents was related to ADD and is reported regularly, especially by community pharmacies. In two phases, entering the prescription into the pharmacy information system and filling the ADD bag, most incidents occurred. A change in the patient's medicine regimen or relocation was the immediate causes of an incident.

Landscape history improves detection of marginal habitats on semi-natural grasslands.

PubMed

Pitkänen, Timo P; Kumpulainen, J; Lehtinen, J; Sihvonen, M; Käyhkö, N

2016-01-01

Semi-natural grassland habitats have markedly declined from their historical coverage, thus causing substantial losses for agricultural biodiversity and establishing a consequent need to spot the remaining habitat patches. These patches are generally remnants of once larger habitat areas, formed by uninterrupted and low-intensity management for centuries, but then later being isolated and fragmented into smaller pieces. In the light of this development, past landscape phases have a crucial role for the present existence of semi-natural grasslands. The importance of historical factors has been indicated in many studies but evaluation of their added value, or actual site-specific effects compared to observations of only the present landscape characteristics, is not generally provided. As data related to the past is often difficult to obtain, tedious to process and challenging to interpret, assessment of its advantages and related effects - or consequences of potential exclusion - would be needed. In this study, we used maximum entropy approach to model the distribution of Fumewort (Corydalis solida) which in the study area is a good indicator of valuable semi-natural habitats. We constructed three different models - one based on only the contemporary environment with expected indicators of habitat stability, one solely on the historical landscape phases and long-term dynamics, and one combining variables from the past and the present. Predictions of the three models were validated and compared with each other, followed by an analysis indicating the similarity of model results with known Fumewort occurrences. Our results indicate that present landscapes may provide workable surrogates to delineate larger core habitats, but utilization of historical data markedly improves the detection of small outlying patches. These conclusions emphasize the importance of previous landscape phases particularly in detecting marginal semi-natural grassland habitats, existing in contemporarily suboptimal conditions and being prone to disappear if no further actions are taken. Copyright © 2015 Elsevier B.V. All rights reserved.

Water Availability for the Western United States - Key Scientific Challenges

USGS Publications Warehouse

Anderson, Mark Theodore; Woosley, Lloyd H.

2005-01-01

In the Western United States, the availability of water has become a serious concern for many communities and rural areas. Near population centers, surface-water supplies are fully appropriated, and many communities are dependent upon ground water drawn from storage, which is an unsustainable strategy. Water of acceptable quality is increasingly hard to find because local sources are allocated to prior uses, depleted by overpumping, or diminished by drought stress. Some of the inherent characteristics of the West add complexity to the task of securing water supplies. The Western States, including the arid Southwest, have the most rapid population growth in the United States. The climate varies widely in the West, but it is best known for its low precipitation, aridity, and drought. There is evidence that the climate is warming, which will have consequences for Western water supplies, such as increased minimum streamflow and earlier snowmelt events in snow-dominated basins. The potential for departures from average climatic conditions threatens to disrupt society and local to regional economies. The appropriative rights doctrine governs the management of water in most Western States, although some aspects of the riparian doctrine are being incorporated. The 'use it or lose it' provisions of Western water law discourage conservation and make the reallocation of water to instream environmental uses more difficult. The hydrologic sciences have defined the interconnectedness of ground water and surface water, yet these resources are still administered separately by most States. The definition of water availability has been expanded to include sustaining riparian ecosystems and individual endangered species, which are disproportionately represented in the Western States. Federal reserved rights, common in the West because of the large amount of Federal land, exist with quite senior priority dates whether or not water is currently being used. A major challenge for water users in the West is that these reserved rights may supersede other existing users. The minimum amount of water required, however, to sustain native peoples, a riparian system, or an endangered species eventually will need to be known in order to manage the available water supply. Periodic inventory and assessment of the amounts and trends of water available in surface water and ground water are needed to support water management. There is a widespread perception that the amount of available water is diminishing with time. This and other perceptions about water availability should be replaced by objective data and analysis. Some data are presented here for the major Western rivers that show that flows are not decreasing in most streams and rivers in the West. Systematic information is lacking to make broad assessments of ground-water availability, but available data for specific aquifers indicate that these aquifers are being depleted, especially near population centers. The complexity added to the issue of Western water availability by these and other factors gives rise to a significant role of science. Science has played a role in support of Western water development from the beginning, and the role has evolved and changed over time as society's values have changed. In this report, the role of science is discussed in three phases: (1) development and construction, (2) consequences and environmental awareness, and (3) sustainability. The development and construction phase includes some historical accounting of water development in the West and shows how some precedents set in those early days are still applied today. Science has played an important role in the second phase by objectively pointing out the consequences of this development and construction phase, such as the effects from converting rivers to reservoirs, the effects of ground-water pumping on surface water in streams, land-surface subsidence, and the changes in water quality brought about by the dispo

Characterization and Consequences of Estrogen Receptor Exon Five Deletion.

DTIC Science & Technology

1997-08-01

physiology: the follicular or proliferative phase (beginning with the first day of menstruation and ending with ovulation), and the luteal or secretory...biosynthesis during the luteal phase (estrogen production remains elevated through most of the luteal phase, 250ug/day, and progesterone production peaks...in the mid- luteal phase, 10-40mg/day) [7]. If implantation does not occur gonadotropin secretion goes down, resulting in a drop of steroid hormone

Paper 8775 - Integrating Natural Resources and Ecological Science into the Disaster Risk CYCLE: Lessons Learned and Future Directions

NASA Astrophysics Data System (ADS)

Brosnan, D. M.

2014-12-01

Familiar to disaster risk reduction (DRR) scientists and professionals, the disaster cycle is an adaptive approach that involves planning, response and learning for the next event. It has proven effective in saving lives and helping communities around the world deal with natural and other hazards. But it has rarely been applied to natural resource and ecological science, despite the fact that many communities are dependent on these resources. This presentation will include lessons learned from applying science to tackle ecological consequences in several disasters in the US and globally, including the Colorado Floods, the SE Asia tsunami, the Montserrat volcanic eruption, and US SAFRR tsunami scenario. The presentation discusses the role that science and scientists can play at each phase of the disaster cycle. The consequences of not including disaster cycles in the management of natural systems leaves these resources and the huge investments made to protect highly vulnerable. The presentation discusses how The presentation discusses how science can help government and communities in planning and responding to these events. It concludes with a set of lessons learned and guidlines for moving forward.

Preparing for the Unthinkable: DOD Support to Foreign Consequence Management

DTIC Science & Technology

2010-05-03

Nuclear Disaster ” (research paper, Maxwell Air Force Base, AL: Air University, 2001), 23. 17 Department of Defense Consequence Management...States Government Response to an Overseas Chemical, Biological, Radiological, or Nuclear Disaster ” (research paper, Maxwell Air Force Base, AL: Air...Government Response to an Overseas Chemical, Biological, Radiological, or Nuclear Disaster .” Research paper, Maxwell Air Force Base, AL: Air University

Simultaneous Chiral Symmetry Restoration and Deconfinement Consequences for the QCD Phase Diagram

NASA Astrophysics Data System (ADS)

Klähn, Thomas; Fischer, Tobias; Hempel, Matthias

2017-02-01

For studies of quark matter in astrophysical scenarios, the thermodynamic bag model is commonly employed. Although successful, it does not account for dynamical chiral symmetry breaking and repulsions due to the vector interaction which is crucial to explain recent observations of massive, two solar mass neutron stars. In Klähn & Fischer we developed the novel vBag quark matter model which takes these effects into account. This article extends vBag to finite temperatures and isospin asymmetry. Another particular feature of vBag is the determination of the deconfinement bag constant {B}{dc} from a given hadronic equation of state in order to ensure that chiral and deconfinement transitions coincide. We discuss consequences of this novel approach for the phase transition construction, the phase diagram, and implications for protoneutron stars.

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

PubMed

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

2013-11-30

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

5 CFR 250.103 - Consequences of improper agency actions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Consequences of improper agency actions. 250.103 Section 250.103 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE... Consequences of improper agency actions. If OPM finds that an agency has taken an action contrary to a law...

Theories of lean management: an empirical evaluation.

PubMed

Handel, Michael J

2014-03-01

Debates within organization theory traditionally argued the relative merits of bureaucracy but today there is broad agreement across different perspectives that bureaucratic organization is inefficient and outmoded. Despite their differences, post-bureaucratic and neo-liberal theories argue that organizations with relatively flat hierarchies and low management overhead are better adapted to current market requirements. Post-bureaucratic theory also argues that employees, as well as firms, benefit from leaner management structures. This paper investigates trends in managerial leanness, proposed explanations for such trends, and the consequences of leanness for firms and employees. Although there is a trend toward flatter management hierarchies, there is only weak support for current claims regarding both the causes and consequences of lean management. Copyright © 2013 Elsevier Inc. All rights reserved.

Consequences of insecurity in emergency telephone consultations: an experimental study in medical students.

PubMed

Barth, J; Ahrens, R; Schaufelberger, M

2014-01-01

Handling emergency telephone consultations (ETCs) is a challenging and very important task for doctors. The aims of the study were to document insecurity in medical students during ETCs and to identify the reasons for that insecurity. We hypothesised that insecurity is associated with advising more urgent action (e.g. advice to call for an ambulance) in ETCs. We used ETCs with simulated patients (SPs), with each student randomly allocated two of four possible cases. After the training, 137 students reported on any insecurity that they had in the various ETC phases. We analysed the reasons for insecurity using descriptive statistics. The association between the students' advice that urgent action was needed and their insecurity was analysed with Spearman rank correlation. Overall, 95% of the students felt insecure in at least one phase of their ETC. History taking was the phase in which students felt most insecure (63.1%), followed by the phase of analysing the information given by the patient (44.9%). Perceived insecurity was associated with more urgent advice in one case scenario (abdominal pain; correlation r = 0.46; p <0.01). The other two cases (child with fever; chest pain) also had a positive, but not statistically significant, correlation trend (p <0.12; p <0.08). Insecurity is highly prevalent among medical students in their ETC decision-making. ETC training in medical schools, with a focus on structured history taking and formulating discriminating questions, might help decrease insecurity in ETCs. Medical education should also teach management of insecurity.

Assessment of a Bayesian Belief Network-GIS framework as a practical tool to support marine planning.

PubMed

Stelzenmüller, V; Lee, J; Garnacho, E; Rogers, S I

2010-10-01

For the UK continental shelf we developed a Bayesian Belief Network-GIS framework to visualise relationships between cumulative human pressures, sensitive marine landscapes and landscape vulnerability, to assess the consequences of potential marine planning objectives, and to map uncertainty-related changes in management measures. Results revealed that the spatial assessment of footprints and intensities of human activities had more influence on landscape vulnerabilities than the type of landscape sensitivity measure used. We addressed questions regarding consequences of potential planning targets, and necessary management measures with spatially-explicit assessment of their consequences. We conclude that the BN-GIS framework is a practical tool allowing for the visualisation of relationships, the spatial assessment of uncertainty related to spatial management scenarios, the engagement of different stakeholder views, and enables a quick update of new spatial data and relationships. Ultimately, such BN-GIS based tools can support the decision-making process used in adaptive marine management. Copyright © 2010 Elsevier Ltd. All rights reserved.

Integrated System Health Management: Pilot Operational Implementation in a Rocket Engine Test Stand

NASA Technical Reports Server (NTRS)

Figueroa, Fernando; Schmalzel, John L.; Morris, Jonathan A.; Turowski, Mark P.; Franzl, Richard

2010-01-01

This paper describes a credible implementation of integrated system health management (ISHM) capability, as a pilot operational system. Important core elements that make possible fielding and evolution of ISHM capability have been validated in a rocket engine test stand, encompassing all phases of operation: stand-by, pre-test, test, and post-test. The core elements include an architecture (hardware/software) for ISHM, gateways for streaming real-time data from the data acquisition system into the ISHM system, automated configuration management employing transducer electronic data sheets (TEDS?s) adhering to the IEEE 1451.4 Standard for Smart Sensors and Actuators, broadcasting and capture of sensor measurements and health information adhering to the IEEE 1451.1 Standard for Smart Sensors and Actuators, user interfaces for management of redlines/bluelines, and establishment of a health assessment database system (HADS) and browser for extensive post-test analysis. The ISHM system was installed in the Test Control Room, where test operators were exposed to the capability. All functionalities of the pilot implementation were validated during testing and in post-test data streaming through the ISHM system. The implementation enabled significant improvements in awareness about the status of the test stand, and events and their causes/consequences. The architecture and software elements embody a systems engineering, knowledge-based approach; in conjunction with object-oriented environments. These qualities are permitting systematic augmentation of the capability and scaling to encompass other subsystems.

A three-step approach to minimise the impact of a mining site on vicuña (Vicugna vicugna) and to restore landscape connectivity.

PubMed

Mata, Cristina; Malo, Juan E; Galaz, José Luis; Cadorzo, César; Lagunas, Héctor

2016-07-01

Resource extraction projects generate a diversity of negative effects on the environment that are difficult to predict and mitigate. Consequently, adaptive management approaches have been advocated to develop effective responses to impacts that were not predicted. Mammal populations living in or around mine sites are frequently of management concern; yet, there is a dearth of published information on how to minimise the negative effects of different phases of mining operations on them. Here, we present the case study of a copper mine in the Chilean Altiplano, which caused roadkills of the protected vicuña (Vicugna vicugna). This issue led to a three-step solution being implemented: (1) the initial identification of the problem and implementation of an emergency response, (2) the scientific analysis for decision making and (3) the planning and informed implementation of responses for different future scenarios and timescales. The measures taken under each of these steps provide examples of environmental management approaches that make use of scientific information to develop integrated management responses. In brief, our case study showed how (1) the timescale and the necessity/urgency of the case were addressed, (2) the various stakeholders involved were taken into account and (3) changes were included into the physical, human and organisational elements of the company to achieve the stated objectives.

40 CFR 68.165 - Offsite consequence analysis.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.165 Offsite consequence... released in pounds; (7) Release rate; (8) Release duration; (9) Wind speed and atmospheric stability class...

40 CFR 68.165 - Offsite consequence analysis.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.165 Offsite consequence... released in pounds; (7) Release rate; (8) Release duration; (9) Wind speed and atmospheric stability class...

40 CFR 68.165 - Offsite consequence analysis.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.165 Offsite consequence... released in pounds; (7) Release rate; (8) Release duration; (9) Wind speed and atmospheric stability class...

Botulinum toxin in the management of facial paralysis.

PubMed

Cabin, Jonathan A; Massry, Guy G; Azizzadeh, Babak

2015-08-01

Complete flaccid facial paralysis, as well as the synkinetic and hyperkinetic sequelae of partial recovery, has significant impact on quality of life. Patients suffer from functional deficiencies, cosmetic deformity, discomfort and social consequences leading to emotional distress. Despite an extensive and sophisticated array of available interventions for facial reanimation, most patients have persistent issues that require consistent follow-up. In long-term management, botulinum toxin (BT) injection remains a critical tool in the treatment of the facial paralysis patient, particularly in the case of synkinesis, hyperkinesis and imbalance. We review the recent scientific literature and highlight key principles and developments in the use of BT in the management of facial paralysis, including less common applications for acute facial paralysis, hyperlacrimation and pseudoptosis. We reviewed the literature for the latest advances in the use of BT in facial paralysis, including applications and technique, as well as measurement tools and adjunct exercises. We also share our experience in treating our own patient population. BT continues to be a well tolerated and effective tool in the long-term management of facial paralysis, specifically in treating synkinesis, imbalance and hyperkinesis, as well as hyperlacrimation and pseudoptosis. Consistent measurement tools and adjunct neuromuscular retraining are crucial in the successful deployment of BT. Controversy exists as to whether BT should be used to manage facial paralysis during the acute phase, and whether BT application to the nonparalyzed face can improve long-term recovery in the paralyzed side.

Environmental Studies at the Guiana Space Centre

NASA Astrophysics Data System (ADS)

Richard, Sandrine

2013-09-01

The Environmental Commitment of the French Space Agency at the Guiana Space Centre (CNES / CSG) specifies that the environmental protection is a major stake. Consequently, CNES participates in numerous space programs that contribute significantly to a better knowledge, management and protection of our environment at a global scale.The studies and researches that are done at CNES / CSG meet several objectives:* Assessment of safety and environmental effects and risk related to the effects overflowing due to a pollution caused by ground and flight activities* Improvement of the studies related to the knowledge of the environment (flora and fauna monitoring).* Risk assessment and management which may affect the safety of people , property, and protection of public health and environment * Verification of the compliance of the results of impact studies of launch vehicle in flight phase provided by the launch operator (Technical Regulation) with the French Safety Operational Acts.In this note, study and research programs are presented. They allow a better knowledge of the surrounding environment and of impacts caused by the industrial activities done in Guiana Space Center.

Integrated Management of European Cherry Fruit Fly Rhagoletis cerasi (L.): Situation in Switzerland and Europe.

PubMed

Daniel, Claudia; Grunder, Jürg

2012-10-16

The European cherry fruit fly, Rhagoletis cerasi (L.) (Diptera: Tephritidae), is a highly destructive pest. The low tolerance for damaged fruit requires preventive insecticide treatments for a marketable crop. The phase-out of old insecticides threatens cherry production throughout the European Union (EU). Consequently, new management techniques and tools are needed. With the increasing number of dwarf tree orchards covered against rain to avoid fruit splitting, crop netting has become a viable, cost-effective method of cherry fruit fly control. Recently, a biocontrol method using the entomopathogenic fungus Beauveria bassiana has been developed for organic agriculture. However, for most situations, there is still a lack of efficient and environmentally sound insecticides to control this pest. This review summarizes the literature from over one hundred years of research on R. cerasi with focus on the biology and history of cherry fruit fly control as well as on antagonists and potential biocontrol organisms. We will present the situation of cherry fruit fly regulation in different European countries, give recommendations for cherry fruit fly control, show gaps in knowledge and identify future research opportunities.

Kynurenine Pathway Pathologies: do Nicotinamide and Other Pathway Co-Factors have a Therapeutic Role in Reduction of Symptom Severity, Including Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM)

PubMed Central

Blankfield, Adele

2013-01-01

The definition of dual tryptophan pathways has increased the understanding of the mind-body, body-mind dichotomy. The serotonergic pathway highlights the primary (endogenous) psychiatric disorders. The up-regulation of the kynurenine pathway by physical illnesses can cause neuropathic and immunological disorders1 associated with secondary neuropsychiatric symptoms. Tryptophan and nicotinamide deficiencies fall within the protein energy malnutrition (PEM) spectrum. They can arise if the kynurenine pathway is stressed by primary or secondary inflammatory conditions and the consequent imbalance of available catabolic/anabolic substrates may adversely influence convalescent phase efficiency. The replacement of depleted or reduced NAD+ levels and other cofactors can perhaps improve the clinical management of these disorders. Chronic fatigue syndrome (CFS) and fibromyalgia (FM) appear to meet the criteria of a tryptophan-kynurenine pathway disorder with potential neuroimmunological sequelae. Aspects of some of the putative precipitating factors have been previously outlined.2,3 An analysis of the areas of metabolic dysfunction will focus on future directions for research and management. PMID:23922501

Integrated Management of European Cherry Fruit Fly Rhagoletis cerasi (L.): Situation in Switzerland and Europe

PubMed Central

Daniel, Claudia; Grunder, Jürg

2012-01-01

The European cherry fruit fly, Rhagoletis cerasi (L.) (Diptera: Tephritidae), is a highly destructive pest. The low tolerance for damaged fruit requires preventive insecticide treatments for a marketable crop. The phase-out of old insecticides threatens cherry production throughout the European Union (EU). Consequently, new management techniques and tools are needed. With the increasing number of dwarf tree orchards covered against rain to avoid fruit splitting, crop netting has become a viable, cost-effective method of cherry fruit fly control. Recently, a biocontrol method using the entomopathogenic fungus Beauveria bassiana has been developed for organic agriculture. However, for most situations, there is still a lack of efficient and environmentally sound insecticides to control this pest. This review summarizes the literature from over one hundred years of research on R. cerasi with focus on the biology and history of cherry fruit fly control as well as on antagonists and potential biocontrol organisms. We will present the situation of cherry fruit fly regulation in different European countries, give recommendations for cherry fruit fly control, show gaps in knowledge and identify future research opportunities. PMID:26466721

Addressing overtreatment of screen detected DCIS; the LORIS trial.

PubMed

Francis, Adele; Thomas, Jeremy; Fallowfield, Lesley; Wallis, Matthew; Bartlett, John M S; Brookes, Cassandra; Roberts, Tracy; Pirrie, Sarah; Gaunt, Claire; Young, Jennie; Billingham, Lucinda; Dodwell, David; Hanby, Andrew; Pinder, Sarah E; Evans, Andrew; Reed, Malcolm; Jenkins, Valerie; Matthews, Lucy; Wilcox, Maggie; Fairbrother, Patricia; Bowden, Sarah; Rea, Daniel

2015-11-01

Overdiagnosis, and thus overtreatment, are inevitable consequences of most screening programmes; identification of ways of minimising the impact of overdiagnosis demands new prospective research, in particular the need to separate clinically relevant lesions that require active treatment from those that can be safely left alone or monitored and only need treated if they change characteristics. Breast cancer screening has led to a large increase in ductal carcinoma in situ (DCIS) diagnoses. This is a widely heterogeneous disease and most DCIS detected through screening is of high cytonuclear grade and therefore likely to be important clinically. However, the historic practice of surgical treatment for all DCIS is unlikely to be optimal for lower risk patients. A clearer understanding of how to manage DCIS is required. This article describes the background and development of 'The low risk' DCIS trial (LORIS), a phase III trial of surgery versus active monitoring. LORIS will determine if it is appropriate to manage women with screen detected or asymptomatic, low grade and intermediate grade DCIS with low grade features, by active monitoring rather than by surgical treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Towards Application of NASA Standard for Models and Simulations in Aeronautical Design Process

NASA Astrophysics Data System (ADS)

Vincent, Luc; Dunyach, Jean-Claude; Huet, Sandrine; Pelissier, Guillaume; Merlet, Joseph

2012-08-01

Even powerful computational techniques like simulation endure limitations in their validity domain. Consequently using simulation models requires cautions to avoid making biased design decisions for new aeronautical products on the basis of inadequate simulation results. Thus the fidelity, accuracy and validity of simulation models shall be monitored in context all along the design phases to build confidence in achievement of the goals of modelling and simulation.In the CRESCENDO project, we adapt the Credibility Assessment Scale method from NASA standard for models and simulations from space programme to the aircraft design in order to assess the quality of simulations. The proposed eight quality assurance metrics aggregate information to indicate the levels of confidence in results. They are displayed in management dashboard and can secure design trade-off decisions at programme milestones.The application of this technique is illustrated in aircraft design context with specific thermal Finite Elements Analysis. This use case shows how to judge the fitness- for-purpose of simulation as Virtual testing means and then green-light the continuation of Simulation Lifecycle Management (SLM) process.

Beliefs About Dysmenorrhea and Their Relationship to Self-Management.

PubMed

Chen, Chen X; Kwekkeboom, Kristine L; Ward, Sandra E

2016-08-01

Dysmenorrhea is highly prevalent and is the leading cause of work and school absences among women of reproductive age. However, self-management of dysmenorrhea is not well understood in the US, and little evidence is available on factors that influence dysmenorrhea self-management. Guided by the Common Sense Model, we examined women's representations of dysmenorrhea (beliefs about causes, symptoms, consequences, timeline, controllability, coherence, and emotional responses), described their dysmenorrhea self-management behaviors, and investigated the relationship between representations and self-management behaviors. We conducted a cross-sectional, web-based survey of 762 adult women who had dysmenorrhea symptoms in the last six months. Participants had varied beliefs about the causes of their dysmenorrhea symptoms, which were perceived as a normal part of life. Dysmenorrhea symptoms were reported as moderately severe, with consequences that moderately affected daily life. Women believed they understood their symptoms moderately well and perceived them as moderately controllable but them to continue through menopause. Most women did not seek professional care but rather used a variety of pharmacologic and complementary health approaches. Care-seeking and use of self-management strategies were associated with common sense beliefs about dysmenorrhea cause, consequences, timeline, and controllability. The findings may inform development and testing of self-management interventions that address dysmenorrhea representations and facilitate evidence-based management. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Characterization and Consequences of Estrogen Receptor Exon Five Deletion.

DTIC Science & Technology

1998-08-01

and ending with ovulation), and the luteal or secretory phase (beginning with ovulation and ending with the onset of menses) (7). Early in the...7), the primary site of both progesterone and estrogen biosynthesis during the luteal phase 3 (estrogen production remains elevated through most of...the luteal phase, 250ug/day, and progesterone production peaks in the mid- luteal phase, 10-40mg/day) (7). If implantation does not occur gonadotropin

Modulated phase matching and high-order harmonic enhancement mediated by the carrier-envelope phase

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

Faccio, Daniele; CNISM and Department of Physics and Mathematics, Universita dell'Insubria, Via Valleggio 11, I-22100 Como; Serrat, Carles

2010-01-15

The process of high-order harmonic generation in gases is numerically investigated in the presence of a few-cycle pulsed-Bessel-beam pump, featuring a periodic modulation in the peak intensity due to large carrier-envelope-phase mismatch. A two-decade enhancement in the conversion efficiency is observed and interpreted as the consequence of a mechanism known as a nonlinearly induced modulation in the phase mismatch.

Design participation as an insurance: risk-management and end-user participation in the development of information systems in healthcare organizations.

PubMed

Vimarlund, V; Timpka, T

2002-01-01

The aim of this paper is to build a theoretical framework for analysis of when decision-makers should use end-user participation as a form of insurance for unforeseen consequences of implementing information systems in healthcare organizations. Data were collected in a case study of an information system development project in a small clinical setting. During the initial phase, the future end-users of the system were allowed to actively influence the system design and test every new tool that was considered for implementation. The results of the case study suggest that when time and effort are invested in allowing healthcare staff to participate in information system development processes, the benefits can well exceed the costs throughout the life cycle of the project. Risk-averse decision-makers fearing negative secondary consequences of a HIS, with regard to clinical work flow, will always adopt measures to prevent future failures, if they can find a possibility of shifting these risks. Therefore, they calculate the present discounted value of the effects accrued over time to the unit and predict the amount of resources they are willing to pay to acquire on insurance (such as design participation) that will protect the organization from future losses. End-user participation in the design process can be the key positive influence on the quality of the service and, thereby, organizational effectiveness. Investments in broad design participation can, consequently, be a productive activity that transforms potential current income into future benefits.

78 FR 37676 - Federal Acquisition Regulation; System for Award Management Name Change, Phase 1 Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-21

....204-13 System for Award Management Maintenance. * * * * * System for Award Management Maintenance (Jul...; System for Award Management Name Change, Phase 1 Implementation AGENCY: Department of Defense (DoD... System for Award Management (SAM) database. DATES: Effective Date: July 22, 2013. FOR FURTHER INFORMATION...

Conceptual Model of Weight Management in Overweight and Obese African-American Females.

PubMed

Sutton, Suzanne M; Magwood, Gayenell S; Nemeth, Lynne S; Jenkins, Carolyn M

2017-04-01

Weight management of overweight and obese (OWO) African-American females (AAFs) is a poorly defined concept, leading to ineffective treatment of overweight and obesity, prevention of health sequelae, and risk reduction. A conceptual model of the phenomenon of weight management in OWO AAFs was developed through dimensional analysis of the literature. Constructs were identified and sorted into the dimensions of perspective, context, conditions, process, and consequences and integrated into an explanatory matrix. Through dimensional analysis, weight management in OWO AAFs was characterized as a multidimensional concept, defined from the perspective of weight loss in community-dwelling AAFs. Behaviors associated with weight management are strongly influenced by intrinsic factors and extrinsic conditions, which influence engagement in the processes and consequences of weight management. The resulting conceptual model of weight management in OWO AAFs provides a framework for research interventions applicable in a variety of settings. © 2016 Wiley Periodicals, Inc.

Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

ERIC Educational Resources Information Center

Naradko, Anthony M.

2017-01-01

The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

Phase polyphenism and preventative locust management.

PubMed

Sword, Gregory A; Lecoq, Michel; Simpson, Stephen J

2010-08-01

The ecology of phase polyphenism plays a major role in locust swarm formation. We describe how recent advances in the understanding of phase polyphenism can be combined with existing management approaches as part of a preventative Desert locust management strategy. We start with a brief overview of phase polyphenism with particular emphasis on the role that resource distribution patterns play in the process of locust phase change. We then review current perspective on preventative locust management, and conclude by proposing a framework for quantitatively assessing the risk that phase change will occur in local locust populations. Importantly, the data required to implement this framework can be readily collected with little additional effort or cost just by slightly modifying locust habitat survey protocols that are already in operation. Incorporating gregarization risk assessment into existing preventative management strategies stands to make a considerable contribution toward realizing sustainable goals of reductions in the pesticide, manpower and financial support necessary to combat Desert locust upsurges, outbreaks and ultimately plagues. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Diagnostic and therapeutic yield of a patient-controlled portable EEG device with dry electrodes for home-monitoring neurological outpatients-rationale and protocol of the HOMEONE pilot study.

PubMed

Neumann, Thomas; Baum, Anne Katrin; Baum, Ulrike; Deike, Renate; Feistner, Helmut; Hinrichs, Hermann; Stokes, Joseph; Robra, Bernt-Peter

2018-01-01

The HOME ONE study is part of the larger HOME project, which aims to provide evidence of diagnostic and therapeutic yield ("change of management") of a patient-controlled portable EEG device with dry electrodes for the purposes of EEG home-monitoring neurological outpatients. The HOME ONE study is the first step in the process of investigating whether outpatient EEG home-monitoring changes the diagnosis and treatment of patients in comparison to conventional EEG ("change of management"). Both EEG devices (conventional and portable) will be systematically compared via a two-phase intra-individual assessment.In the first phase (pilot study phase), both EEG devices will be used within neurologist practices (all other things being equal). This pilot study (involving 130 patients) will evaluate the technical usability and efficacy of the new portable dry electrode EEG recorder in comparison to conventional EEG devices. Judgements will be based on technical assessments and EEG record examinations of private practitioners and two experienced neurologists (percent of concordant readings and kappa values).The second phase (feasibility study phase) aims to assess patients' acceptability and feasibility of the EEG home-monitoring and will provide insights into the extent diagnostic and therapeutic yields can be expected.For this purpose, a conventional EEG will be recorded in neurologist practices. Thereafter, the practice staff will instruct the patients on how the portable EEG device functions. The patients will subsequently use the devices in their home environment.The evaluation will compare the before and after documented diagnostic findings and the therapeutic consequences of the private practitioners with those of two experienced neurologists. To the best of our knowledge, this will be the first study of its kind to examine new approaches to diagnosing unclear consciousness disorders or other disorders of the CNS or the cardiovascular system through the use of a patient-controlled portable EEG device with dry electrodes for the purpose of home-monitoring neurological outpatients. If the two phases of the HOME ONE study provide sufficient evidence of diagnostic and therapeutic yields, this would justify (indication-specific) full-scale randomized controlled trials or observational studies. DRKS DRKS00012685. Registered 9 August 2017, retrospectively registered.

Joint Base Langley-Eustis

Science.gov Websites

Advanced Environmental Management Training (AEM) Advanced Environmental Management Phase I Training (AEM Phase I) Leadership Environmental Management and Competency Training (LEMAC) Basic Environmental Management Training (BEMA) Environmental Training Information Fort Eustis Chapel Fort Eustis Command Judge

Participatory modeling and structured decision making

USGS Publications Warehouse

Robinson, Kelly F.; Fuller, Angela K.

2016-01-01

Structured decision making (SDM) provides a framework for making sound decisions even when faced with uncertainty, and is a transparent, defensible, and replicable method used to understand complex problems. A hallmark of SDM is the explicit incorporation of values and science, which often includes participation from multiple stakeholders, helping to garner trust and ultimately result in a decision that is more likely to be implemented. The core steps in the SDM process are used to structure thinking about natural resources management choices, and include: (1) properly defining the problem and the decision context, (2) determining the objectives that help describe the aspirations of the decision maker, (3) devising management actions or alternatives that can achieve those objectives, (4) evaluating the outcomes or consequences of each alternative on each of the objectives, (5) evaluating trade-offs, and (6) implementing the decision. Participatory modeling for SDM includes engaging stakeholders in some or all of the steps of the SDM process listed above. In addition, participatory modeling often is crucial for creating qualitative and quantitative models of how the system works, providing data for these models, and eliciting expert opinion when data are unavailable. In these ways, SDM provides a framework for decision making in natural resources management that includes participation from stakeholder groups throughout the process, including the modeling phase.

The Phase Rule in a System Subject to a Pressure Gradient

NASA Astrophysics Data System (ADS)

Podladchikov, Yuri; Connolly, James; Powell, Roger; Aardvark, Alberto

2015-04-01

It can be shown by diligent application of Lagrange's method of undetermined multipliers that the phase rule in a system subject to a pressure gradient is: � + 赑 ≥ ρ. We explore the consequence of this important relationship for natural systems.

Positive Reinforcement and Logical Consequences in the Treatment of Classroom Encopresis.

ERIC Educational Resources Information Center

Lyon, Mark A.

1984-01-01

A child with a diagnosis of mild mental retardation was treated for encopresis. Positive reinforcement procedures for continence and logical consequences for soiling were effective in accomplishing complete continence during the final phase of treatment. An ABCDA design with a decelerating rate of reinforcement was utilized to assess treatment…

[Drug shortage: determinants, consequences and management].

PubMed

Reis, Adriano Max Moreira; Perini, Edson

2008-04-01

The present study analyzes drug shortage as a problem reaching beyond the logistic aspect of the health field and discusses its consequences with respect to quality, safety and cost of health care delivery. The pharmaceutical supply chain and the factors that determine the distribution and availability of drugs are discussed. The contribution of the Pharmacy and Therapeutics Committee in preventing and managing drug shortage in health institutions is stressed and measures for drug shortage management are suggested. Finally it is emphasized that drugs should be considered health products rather than consumer goods and as such be given a different treatment by the supply chain.

Supported self-management for cancer survivors to address long-term biopsychosocial consequences of cancer and treatment to optimize living well.

PubMed

Howell, Doris D

2018-03-01

As individuals are living longer with cancer as a chronic disease, they face new health challenges that require the application of self-management behaviors and skills that may not be in their usual repertoire of self-regulatory health behaviors. Increasing attention is focused on supported self-management (SSM) programs to enable survivors in managing the long-term biopsychosocial consequences and health challenges of survivorship. This review explores current directions and evidence for SSM programs that enable survivors to manage these consequences and optimize health. Cancer survivors face complex health challenges that affect daily functioning and well being. Multiple systematic reviews show that SSM programs have positive effects on health outcomes in typical chronic diseases. However, the efficacy of these approaches in cancer survivors are in their infancy; and the 'one-size' fits all approach for chronic disease self-management may not be adequate for cancer as a complex chronic illness. This review suggests that SSM has promising potential for improving health and well being of cancer survivors, but there is a need for standardizing SSM for future research. Although there is increasing enthusiasm for SSM programs tailored to cancer survivors, there is a need for further research of their efficacy on long-term health outcomes.

High risk of hypogonadism after traumatic brain injury: clinical implications.

PubMed

Agha, Amar; Thompson, Christopher J

2005-01-01

Several recent studies have convincingly documented a close association between traumatic brain injury (TBI) and pituitary dysfunction. Post-traumatic hypogonadism is very common in the acute post-TBI phase, though most cases recover within six to twelve months following trauma. The functional significance of early hypogonadism, which may reflect adaptation to acute illness, is not known. Hypogonadism persists, however, in 10-17% of long-term survivors. Sex steroid deficiency has implications beyond psychosexual function and fertility for survivors of TBI. Muscle weakness may impair functional recovery from trauma and osteoporosis may be exacerbated by immobility secondary to trauma. Identification and appropriate and timely management of post-traumatic hypogonadism is important in order to optimise patient recovery from head trauma, improve quality of life and avoid the long-term adverse consequences of untreated sex steroid deficiency.

Preeclampsia; short and long-term consequences for mother and neonate.

PubMed

Bokslag, Anouk; van Weissenbruch, Mirjam; Mol, Ben Willem; de Groot, Christianne J M

2016-11-01

Preeclampsia is a common pregnancy specific disease, that presents with hypertension and a variety of organ failures, including malfunction of kidneys, liver and lungs. At present, the only definitive treatment of preeclampsia is end the pregnancy and deliver the neonate and placenta. For women with mild preeclampsia in the preterm phase of pregnancy, expectant management is generally indicated to improve fetal maturity, often requiring maternal medical treatment. Last decades, more evidence is available that the underlying mechanism of preeclampsia, endothelial disease, is not limited to pregnancy but increases cardiovascular risk in later life. In this review, we present the most recent insight in preeclampsia with focus on impact on the fetus, short and long-term outcome of offspring's, and long-term outcome of women with a history of preeclampsia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Physical activity during the transition period between occupation and retirement].

PubMed

Strobl, H; Brehm, W; Tittlbach, S

2010-10-01

During the transition period between occupation and retirement, different mental challenges may arise as a consequence of the numerous changes and necessary reorientation to the following phase of life. Personal well-being is a precondition to cope with these challenges. Interviews with physically active people in the transition period between occupation and retirement, concerning the importance of physical activity in coping with mental challenges, were conducted. Physical activity is meant to affect well-being and the physical condition in a positive way. In addition, it should foster social contacts and make it easier to manage everyday life. Moreover, it is a measure of personal success during advanced age. Because of its influence on various physical, mental, and social aspects, physical activity can help a person to cope with mental challenges in the transition period between occupation and retirement.

Spatiotemporal hazard mapping of a flood event "migration" in a transboundary river basin as an operational tool in flood risk management

NASA Astrophysics Data System (ADS)

Perrou, Theodora; Papastergios, Asterios; Parcharidis, Issaak; Chini, Marco

2017-10-01

Flood disaster is one of the heaviest disasters in the world. It is necessary to monitor and evaluate the flood disaster in order to mitigate the consequences. As floods do not recognize borders, transboundary flood risk management is imperative in shared river basins. Disaster management is highly dependent on early information and requires data from the whole river basin. Based on the hypothesis that the flood events over the same area with same magnitude have almost identical evolution, it is crucial to develop a repository database of historical flood events. This tool, in the case of extended transboundary river basins, could constitute an operational warning system for the downstream area. The utility of SAR images for flood mapping, was demonstrated by previous studies but the SAR systems in orbit were not characterized by high operational capacity. Copernicus system will fill this gap in operational service for risk management, especially during emergency phase. The operational capabilities have been significantly improved by newly available satellite constellation, such as the Sentinel-1A AB mission, which is able to provide systematic acquisitions with a very high temporal resolution in a wide swath coverage. The present study deals with the monitoring of a transboundary flood event in Evros basin. The objective of the study is to create the "migration story" of the flooded areas on the basis of the evolution in time for the event occurred from October 2014 till May 2015. Flood hazard maps will be created, using SAR-based semi-automatic algorithms and then through the synthesis of the related maps in a GIS-system, a spatiotemporal thematic map of the event will be produced. The thematic map combined with TanDEM-X DEM, 12m/pixel spatial resolution, will define the non- affected areas which is a very useful information for the emergency planning and emergency response phases. The Sentinels meet the main requirements to be an effective and suitable operational tool in transboundary flood risk management.

VLBI Phase-Referenced Observations on Southern Hemisphere HIPPARCOS Radio Start

NASA Technical Reports Server (NTRS)

Guirado, J. C.; Preston, R. A.; Jones, D. L.; Lestrade, J. F.; Reynolds, J. E.; Jauncey, D. L.; Tzioumis, A. K.; Ferris, R. H.; King, E. A.; Lovell, J. E. J.;

Evaluation of volcanic risk management in Merapi and Bromo Volcanoes

NASA Astrophysics Data System (ADS)

Bachri, S.; Stöetter, J.; Sartohadi, J.; Setiawan, M. A.

2012-04-01

Merapi (Central Java Province) and Bromo (East Java Province) volcanoes have human-environmental systems with unique characteristics, thus causing specific consequences on their risk management. Various efforts have been carried out by many parties (institutional government, scientists, and non-governmental organizations) to reduce the risk in these areas. However, it is likely that most of the actions have been done for temporary and partial purposes, leading to overlapping work and finally to a non-integrated scheme of volcanic risk management. This study, therefore, aims to identify and evaluate actions of risk and disaster reduction in Merapi and Bromo Volcanoes. To achieve this aims, a thorough literature review was carried out to identify earlier studies in both areas. Afterward, the basic concept of risk management cycle, consisting of risk assessment, risk reduction, event management and regeneration, is used to map those earlier studies and already implemented risk management actions in Merapi and Bromo. The results show that risk studies in Merapi have been developed predominantly on physical aspects of volcanic eruptions, i.e. models of lahar flows, hazard maps as well as other geophysical modeling. Furthermore, after the 2006 eruption of Merapi, research such on risk communication, social vulnerability, cultural vulnerability have appeared on the social side of risk management research. Apart from that, disaster risk management activities in the Bromo area were emphasizing on physical process and historical religious aspects. This overview of both study areas provides information on how risk studies have been used for managing the volcano disaster. This result confirms that most of earlier studies emphasize on the risk assessment and only few of them consider the risk reduction phase. Further investigation in this field work in the near future will accomplish the findings and contribute to formulate integrated volcanic risk management cycles for both Merapi and Bromo. Keywords: Risk management, volcanoes hazard, Merapi and Bromo Volcano Indonesia

Statistical Tools for Fitting Models of the Population Consequences of Acoustic Disturbance to Data from Marine Mammal Populations (PCAD Tools II)

DTIC Science & Technology

2014-09-30

Consequences of Acoustic Disturbance to Data from Marine Mammal Populations (PCAD Tools II) Len Thomas, John Harwood, Catriona Harris, and Robert S... mammals changes over time. This project will develop statistical tools to allow mathematical models of the population consequences of acoustic...disturbance to be fitted to data from marine mammal populations. We will work closely with Phase II of the ONR PCAD Working Group, and will provide

Contingency Management for Adolescent Smokers: An Exploratory Study

ERIC Educational Resources Information Center

Tevyaw, Tracy O'Leary; Gwaltney, Chad; Tidey, Jennifer W.; Colby, Suzanne M.; Kahler, Christopher W.; Miranda, Robert; Barnett, Nancy P.; Rohsenow, Damaris J.; Monti, Peter M.

2007-01-01

This exploratory study investigated the efficacy and feasibility of a contingency management (CM) protocol for adolescent smokers that included use of a reduction phase. Using a within-participants design, 19 adolescents completed three 7-day phases: (1) reinforcement for attendance and provision of breath samples (RA) phase, (2) a washout phase,…

A Threshold Concept in Managing: What Students in Introductory Management Courses Must Know

ERIC Educational Resources Information Center

Donovan, Paul

2017-01-01

In the field of management, a practice--theory gap has developed and consequently, management education has been criticized for being irrelevant to the needs of stakeholders. This article argues that introduction to management courses in higher education perpetuate this gap by not teaching what managers do. These courses fail to communicate well…

Management approach recommendations. Earth Observatory Satellite system definition study (EOS)

NASA Technical Reports Server (NTRS)

1974-01-01

Management analyses and tradeoffs were performed to determine the most cost effective management approach for the Earth Observatory Satellite (EOS) Phase C/D. The basic objectives of the management approach are identified. Some of the subjects considered are as follows: (1) contract startup phase, (2) project management control system, (3) configuration management, (4) quality control and reliability engineering requirements, and (5) the parts procurement program.

Clinical Characteristics of Dysphagia in Children with Down Syndrome.

PubMed

Jackson, Arwen; Maybee, Jennifer; Moran, Maura K; Wolter-Warmerdam, Kristine; Hickey, Francis

2016-10-01

Aspiration is an often unrecognized comorbidity in children with Down syndrome with serious medical consequences. This retrospective chart review of swallow study reports characterizes oral and pharyngeal phase dysphagia and diet modifications on videofluoroscopic swallow studies (VFSS) in a large cohort of children with Down syndrome. A total of 158 pediatric patients (male = 95; female = 63; mean age 2.10 years, SD 3.17 years) received an initial VFSS at a pediatric teaching hospital as part of their medical care. A total of 56.3 % (n = 89) children had pharyngeal phase dysphagia with aspiration and deep laryngeal penetration occurring most frequently. Of the 61 patients who aspirated, 90.2 % (n = 55) did so silently with no cough or overt clinical symptoms. In 76.7 % of cases of pharyngeal phase dysphagia, a functional feeding plan, with use of thickened liquids or change in feeding system to control flow rate and/or bolus size, was able to be established, which allowed children to continue eating by mouth. Thickened liquids (76.7 %, n = 46) were the most effective adaptation, with change in feeding system alone effective in only 8.3 % (n = 5) cases. Oral phase dysphagia was reported in the majority of patients (63.8 %, n = 88/138); however, this was not predictive of pharyngeal phase dysphagia. Age, sex, and reason for referral, including prior clinical symptoms, did not have a statistically significant impact on the presence of dysphagia. This comprehensive review has application to clinical understanding and management of dysphagia in children with Down syndrome.

A Data Management System for Multi-Phase Case-Control Studies

PubMed Central

Gibeau, Joanne M.; Steinfeldt, Lois C.; Stine, Mark J.; Tullis, Katherine V.; Lynch, H. Keith

1983-01-01

The design of a computerized system for the management of data in multi-phase epidemiologic case-control studies is described. Typical study phases include case-control selection, abstracting of data from medical records, and interview of study subjects or next of kin. In consultation with project personnel, requirements for the system were established: integration of data from all study phases into one data base, accurate follow-up of subjects through the study, sophisticated data editing capabilities, ready accessibility of specified programs to project personnel, and generation of current status and exception reports for project managment. SIR (Scientific Information Retrieval), a commercially available data base management system, was selected as the foundation of this system. The system forms a comprehensive data management system applicable to many types of public health research studies.

Management of Pregnant Women with Type 2 Diabetes Mellitus and the Consequences of Fetal Programming in Their Offspring.

PubMed

Berry, Diane C; Boggess, Kim; Johnson, Quinetta B

2016-05-01

The obesity epidemic has fueled an epidemic of prediabetes and type 2 diabetes mellitus in women of childbearing age. This paper examines the state of the science on preconception and pregnancy management of women with type 2 diabetes to optimize outcomes for the women and their infants. In addition, the consequence of fetal programming as a result of suboptimal maternal glycemic control is discussed. The paper focuses on type 2 diabetes, not type 1 diabetes or gestational diabetes. Management of women with type 2 diabetes includes preconception counseling, preconception weight management and weight loss, proper weight gain during pregnancy, self-monitoring of blood glucose levels, medication, medical nutrition therapy, and exercise.

UK report on waste management

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

Ferguson, J.

1995-09-01

Arising jointly from the National and European Union requirements for more intensive attention to be paid to the environment, the United Kingdom (UK) has taken many strides forward in protecting the environment from pollution and preventing harm to human health arising from the handling, transport and disposal of wastes. Major adjustments are taking place in Europe following the opening up of the Eastern European countries. The consequences of the illegal movement of wastes and its mistreatment and disposal are now recognised within the European Union. The UK as a member State is well aware of the consequences which arise frommore » the lack of proper waste management. This paper discusses waste management and legislation pertaining to waste management in the United Kingdom.« less

[Principles of management of All-Russia Disaster Medicine Services].

PubMed

Sakhno, I I

2000-11-01

Experience of liquidation of earthquake consequences in Armenia (1988) has shown that it is extremely necessary to create the system of management in regions of natural disaster, large accident or catastrophe before arrival of main forces in order to provide reconnaissance, to receive the arriving units. It will help to make well-grounded decisions, to set tasks in time, to organize and conduct emergency-and-rescue works. The article contains general material concerning the structure of All-Russia service of disaster medicine (ARSDM), organization of management at all levels and interaction between the components of ARSDM and other subsystems of Russian Service of Extreme Situations. It is recommended how to organize management of ARSDM during liquidation of medical-and-sanitary consequences of large-scale extreme situations.

Chief Executive Officers: Academic Leaders or Business Managers?

ERIC Educational Resources Information Center

Doring, Allan

This paper explores the role and preparation of academics for senior management and executive positions in colleges and universities, particularly in Australia. A background section cites trends in higher education management and recent critiques of that management and the consequent scrutiny of leadership effectiveness. There follows an…

Phase diagrams of flux lattices with disorder

NASA Astrophysics Data System (ADS)

Giamarchi, T.; Le Doussal, P.

1997-03-01

We review the prediction, made in a previous work [T. Giamarchi and P. Le Doussal, Phys. Rev. B 52, 1242 (1995)], that the phase diagram of type-II superconductors consists of a topologically ordered Bragg glass phase at low fields undergoing a transition at higher fields into a vortex glass or a liquid. We estimate the position of the phase boundary using a Lindemann criterion. We find that the proposed theory is compatible with recent experiments on superconductors. Further experimental consequences are investigated.

A Primer on Risks, Issues and Opportunities

DTIC Science & Technology

2016-08-01

likelihood or consequence. A risk has three main parts: a future root cause, a likelihood and a consequence. The future root cause is determined...through root cause analysis, which is the most important part of any risk management effort. SPECIAL SECTION: RISK MANAGEMENT Defense AT&L: July-August...2016 10 Root cause analysis gets to the heart of the risk. Why does the risk exist? What is its nature? How will the risk occur? What should be

Risk Management and Critical Infrastructure Protection: Assessing, Integrating, and Managing Threats, Vulnerabilities and Consequences

DTIC Science & Technology

2004-09-02

Consequences 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7...OSLGCP now administers the grants programs. 30According to the guidance, threat assessment determines the relative likelihood of a known potential...information on critical infrastructure assets. The Office of State and Local Government Coordination and Preparedness (OSLGCP) administers two grant

Risk Management and Critical Infrastructure Protection: Assessing, Integrating, and Managing Threats, Vulnerabilities and Consequences

DTIC Science & Technology

2005-02-04

Consequences 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7...OSLGCP). The OSLGCP now administers the grants programs. 37 According to the guidance, threat assessment determines the relative likelihood of a...Preparedness (OSLGCP) administers two grant programs that give states the opportunity to identify critical infrastructure assets: the State Homeland Security

Portfolio management in early stage drug discovery - a traveler's guide through uncharted territory.

PubMed

Betz, Ulrich A K

2011-07-01

Portfolio management in drug development has become a best practice in the pharmaceutical industry. By contrast, early on in the value chain - the discovery phase - portfolio management is still in its infancy. Nevertheless, owing to the attrition of R&D projects from phase to phase and the cost of capital involved, these early phases of drug discovery play a significant part for the overall cost of bringing new, innovative drugs to the market. This paper describes various approaches to manage a portfolio of projects in early-stage drug discovery and provides crucial factors that determine the success of such an approach. Copyright © 2011 Elsevier Ltd. All rights reserved.

40 CFR 1400.8 - Access to off-site consequence analysis information by Federal government officials.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ENVIRONMENTAL PROTECTION AGENCY AND DEPARTMENT OF JUSTICE ACCIDENTAL RELEASE PREVENTION REQUIREMENTS; RISK MANAGEMENT PROGRAMS UNDER THE CLEAN AIR ACT SECTION 112(r)(7); DISTRIBUTION OF OFF-SITE CONSEQUENCE ANALYSIS...

The management of acute adverse effects of breast cancer treatment in general practice: a video-vignette study.

PubMed

Jiwa, Moyez; Long, Anne; Shaw, Tim; Pagey, Georgina; Halkett, Georgia; Pillai, Vinita; Meng, Xingqiong

2014-09-03

There has been a focus recently on the use of the Internet and email to deliver education interventions to general practitioners (GPs). The treatment of breast cancer may include surgery, radiotherapy, chemotherapy, and/or hormone treatment. These treatments may have acute adverse effects. GPs need more information on the diagnosis and management of specific adverse effects encountered immediately after cancer treatment. The goal was to evaluate an Internet-based educational program developed for GPs to advise patients with acute adverse effects following breast cancer treatment. During phase 1, participants viewed 6 video vignettes of actor-patients reporting 1 of 6 acute symptoms following surgery and chemotherapy and/or radiotherapy treatment. GPs indicated their diagnosis and proposed management through an online survey program. They received feedback about each scenario in the form of a specialist clinic letter, as if the patient had been seen at a specialist clinic after they had attended the GP. This letter incorporated extracts from local guidelines on the management of the symptoms presented. This feedback was sent to the GPs electronically on the same survey platform. In phase 2, all GPs were invited to manage similar cases as phase 1. Their proposed management was compared to the guidelines. McNemar test was used to compare data from phases 1 and 2, and logistic regression was used to explore the GP characteristics that were associated with inappropriate case management. A total of 50 GPs participated. Participants were younger and more likely to be female than other GPs in Australia. For 5 of 6 vignettes in phase 1, management was consistent with expert opinion in the minority of cases (6%-46%). Participant demographic characteristics had a variable effect on different management decisions in phase 1. The variables modeled explained 15%-28% of the differences observed. Diagnosis and management improved significantly in phase 2, especially for diarrhea, neutropenia, and seroma sample cases. The proportion of incorrect management responses was reduced to a minimum (25.3%-49.3%) in phase 2. There was evidence that providing feedback by experts on specific cases had an impact on GPs' knowledge about how to appropriately manage acute treatment adverse effects. This educational intervention could be targeted to support the implementation of shared care during cancer treatment.

The Management of Acute Adverse Effects of Breast Cancer Treatment in General Practice: A Video-Vignette Study

PubMed Central

Pagey, Georgina; Halkett, Georgia; Pillai, Vinita; Meng, Xingqiong

2014-01-01

Background There has been a focus recently on the use of the Internet and email to deliver education interventions to general practitioners (GPs). The treatment of breast cancer may include surgery, radiotherapy, chemotherapy, and/or hormone treatment. These treatments may have acute adverse effects. GPs need more information on the diagnosis and management of specific adverse effects encountered immediately after cancer treatment. Objective The goal was to evaluate an Internet-based educational program developed for GPs to advise patients with acute adverse effects following breast cancer treatment. Methods During phase 1, participants viewed 6 video vignettes of actor-patients reporting 1 of 6 acute symptoms following surgery and chemotherapy and/or radiotherapy treatment. GPs indicated their diagnosis and proposed management through an online survey program. They received feedback about each scenario in the form of a specialist clinic letter, as if the patient had been seen at a specialist clinic after they had attended the GP. This letter incorporated extracts from local guidelines on the management of the symptoms presented. This feedback was sent to the GPs electronically on the same survey platform. In phase 2, all GPs were invited to manage similar cases as phase 1. Their proposed management was compared to the guidelines. McNemar test was used to compare data from phases 1 and 2, and logistic regression was used to explore the GP characteristics that were associated with inappropriate case management. Results A total of 50 GPs participated. Participants were younger and more likely to be female than other GPs in Australia. For 5 of 6 vignettes in phase 1, management was consistent with expert opinion in the minority of cases (6%-46%). Participant demographic characteristics had a variable effect on different management decisions in phase 1. The variables modeled explained 15%-28% of the differences observed. Diagnosis and management improved significantly in phase 2, especially for diarrhea, neutropenia, and seroma sample cases. The proportion of incorrect management responses was reduced to a minimum (25.3%-49.3%) in phase 2. Conclusions There was evidence that providing feedback by experts on specific cases had an impact on GPs’ knowledge about how to appropriately manage acute treatment adverse effects. This educational intervention could be targeted to support the implementation of shared care during cancer treatment. PMID:25274131

Unintended consequences and trade-offs of fish passage

USGS Publications Warehouse

McLaughlin, Robert L.; Smyth, Eric R.; Castro-Santos, Theodore; Jones, Michael L.; Koops, Marten A.; Pratt, Thomas C.; Vélez-Espino, Luis-Antonio

2012-01-01

We synthesized evidence for unintended consequences and trade-offs associated with the passage of fishes. Provisioning of fish passageways at dams and dam removals are being carried out increasingly as resource managers seek ways to reduce fragmentation of migratory fish populations and restore biodiversity and nature-like ecosystem services in tributaries altered by dams. The benefits of provisioning upstream passage are highlighted widely. Possible unwanted consequences and trade-offs of upstream passage are coming to light, but remain poorly examined and underappreciated. Unintended consequences arise when passage of native and desirable introduced fishes is delayed, undone (fallback), results in patterns of movement and habitat use that reduce Darwinian fitness (e.g. ecological traps), or is highly selective taxonomically and numerically. Trade-offs arise when passage decisions intended to benefit native species interfere with management decisions intended to control the unwanted spread of non-native fishes and aquatic invertebrates, or genes, diseases and contaminants carried by hatchery and wild fishes. These consequences and trade-offs will vary in importance from system to system and can result in large economic and environmental costs. For some river systems, decisions about how to manage fish passage involve substantial risks and could benefit from use of a formal, structured process that allows transparent, objective and, where possible, quantitative evaluation of these risks. Such a process can also facilitate the design of an adaptive framework that provides valuable insights into future decisions.

Patch burn grazing management in a semiarid grassland: Consequences for pronghorn, plains pricklypear and wind erosion

USDA-ARS?s Scientific Manuscript database

Rangeland management strategies that allow for spatial and temporal interactions between fire and herbivores can achieve multiple management goals related to livestock production and wildlife conservation in mesic grasslands and savannas. Less is known about integrated management of herbivores and f...

[Incidence and preventability of adverse events in patients hospitalised in three Colombian hospitals during 2006].

PubMed

Gaitán-Duarte, Hernando; Eslava-Schmalbach, Javier; Rodríguez-Malagon, Nelcy; Forero-Supelano, Víctor; Santofimio-Sierra, Dagoberto; Altahona, Hernando

2008-01-01

Determining adverse event (AE) incidence, preventability, classification and impact for establishing their importance as a public health problem within the Colombian Social Security System. This was a study of a prospective inpatient cohort from three Colombian general-practice institutions. at least 12 hours' length of hospital stay during 2006. suffering psychiatric disorders and AE which had occurred before hospitalisation indexing. The sample consisted of 6 557 patients. clinical charts. Being a three-phase design, the first phase consisted of translating and standardising screening and causation formats, phase II of actively monitoring screening criteria and phase III of evaluating causation regarding the care being provided, based on specialist committee concept on a 0-6 scale. The variables measured were age, gender, social security affiliation, cumulative AE incidence, temporality, preventability of AE and disability resulting from them. 6,688 patients were evaluated; 505 of them fulfilled positive screening criteria (95 % CI=7,9;7,3-8,6), 310 presented at least one AE during their hospitalisation (95 %CI for accumulated incidence=4,6; 4,1-5,1). AE were considered to have been preventable in 189 cases (95 % CI=61;55-66) and permanent disability occurred in 1,3 % of them. AE-associated mortality was 6,4 % (20/310). Hospitalisation became increased to 1 072 days as a direct consequence of AE. This study revealed an important incidence of AE in three Colombian hospitals, these being mainly preventable. Their ongoing monitoring as a part of risk management systems could reduce costs and AE-associated morbidity and mortality.

Manual editing of automatically recorded data in an anesthesia information management system.

PubMed

Wax, David B; Beilin, Yaakov; Hossain, Sabera; Lin, Hung-Mo; Reich, David L

2008-11-01

Anesthesia information management systems allow automatic recording of physiologic and anesthetic data. The authors investigated the prevalence of such data modification in an academic medical center. The authors queried their anesthesia information management system database of anesthetics performed in 2006 and tabulated the counts of data points for automatically recorded physiologic and anesthetic parameters as well as the subset of those data that were manually invalidated by clinicians (both with and without alternate values manually appended). Patient, practitioner, data source, and timing characteristics of recorded values were also extracted to determine their associations with editing of various parameters in the anesthesia information management system record. A total of 29,491 cases were analyzed, 19% of which had one or more data points manually invalidated. Among 58 attending anesthesiologists, each invalidated data in a median of 7% of their cases when working as a sole practitioner. A minority of invalidated values were manually appended with alternate values. Pulse rate, blood pressure, and pulse oximetry were the most commonly invalidated parameters. Data invalidation usually resulted in a decrease in parameter variance. Factors independently associated with invalidation included extreme physiologic values, American Society of Anesthesiologists physical status classification, emergency status, timing (phase of the procedure/anesthetic), presence of an intraarterial catheter, resident or certified registered nurse anesthetist involvement, and procedure duration. Editing of physiologic data automatically recorded in an anesthesia information management system is a common practice and results in decreased variability of intraoperative data. Further investigation may clarify the reasons for and consequences of this behavior.

Implications of male circumcision for women in Papua New Guinea: a transformational grounded theory study.

PubMed

Redman-MacLaren, Michelle; Mills, Jane; Tommbe, Rachael; MacLaren, David; Speare, Rick; McBride, William J H

2017-07-27

Male circumcision reduces the risk of female-to-male transmission of human immunodeficiency virus (HIV) and is being explored for HIV prevention in Papua New Guinea (PNG). PNG has a concentrated HIV epidemic which is largely heterosexually transmitted. There are a diverse range of male circumcision and penile modification practices across PNG. Exploring the implications of male circumcision for women in PNG is important to inform evidence-based health policy that will result in positive, intended consequences. The transformational grounded theory study incorporated participatory action research and decolonizing methodologies. In Phase One, an existing data set from a male circumcision study of 861 male and 519 female participants was theoretically sampled and analyzed for women's understanding and experience of male circumcision. In Phase Two of the study, primary data were co-generated with 64 women in seven interpretive focus group discussions and 11 semi-structured interviews to develop a theoretical model of the processes used by women to manage the outcomes of male circumcision. In Phase Three participants assisted to refine the developing transformational grounded theory and identify actions required to improve health. Many women know a lot about male circumcision and penile modification and the consequences for themselves, their families and communities. Their ability to act on this knowledge is determined by numerous social, cultural and economic factors. A transformational grounded theory was developed with connecting categories of: Women Know a Lot, Increasing Knowledge; Increasing Options; and Acting on Choices. Properties and dimensions of each category are represented in the model, along with the intervening condition of Safety. The condition of Safety contextualises the overarching lived realty for women in PNG, enables the inclusion of men in the transformational grounded theory model, and helps to explain relationships between men and women. The theory presents the core category as Power of Choice. This transformational grounded theory provides a means to explore how women experience male circumcision and penile modification in PNG, including for HIV prevention. Women who have had opportunities for education have a greater range of choices and an increased opportunity to act upon these choices. However, women can only exercise their power of choice in the context of safety. The concept of Peace drawn from the Social Determinants of Health is applied in order to extend the explanatory power of the transformational grounded theory. This study shows that women's ambivalence about male circumcision is often related to lack of safety, a consequence of gender inequality in PNG.

Self-Management Patient Education and Weight Loss

ERIC Educational Resources Information Center

Stombaugh, Angela M.

2010-01-01

Self-management of a disease is defined as "having or being able to obtain, the skills and resources necessary to best accommodate to the chronic disease and its consequences" (Holman & Lorig, 1992, p. 309). Self-management has been used in the management of several chronic conditions and this model may be useful in the management of weight loss.…

Increasing the visibility of watershed management as a land management profession

Treesearch

Daniel G. Neary; Peter F. Ffolliott; Kenneth N. Brooks

2000-01-01

Population increases will continue to severely pressure water resources in the 21st century. Consequently, the importance of watershed management will increase. The potential demand in the next century for information on, and individuals skilled in, watershed management raises several important issues: the need for watershed management to have a central voice to gain...

Large-scale interdisciplinary experiments inform current and future forestry management options in the U.S

Treesearch

C.E. Peterson; P.D. Anderson

2009-01-01

Over the last 20 years, changing public values and increased ecological understanding have led to a paradigm shift in forestry from timber management to sustainable ecosystem management on U.S. federal lands. Forest managers are now seeking alternative management approaches that simultaneously meet socio-cultural, ecological and economic goals. Consequently, many field...

Evaluation of fleet management techniques for timber highway bridges

Treesearch

Brent M. Phares; Travis K. Hosteng; Justin Dahlberg; Michael A. Ritter

2011-01-01

The general condition of the nation's bridges presents a complex management issue when considering cost, safety, and time. Consequently, the management of those bridges can become an overwhelming task. The need for a management system that is specific to rural systems may help to improve the management of this significant number of bridges. Although individual...

41 CFR 302-12.108 - What are the income tax consequences that we must consider when offering relocation services?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE... Constitution Avenue, NW., Room 5501, Washington, DC 20224, for information on the income tax consequences of...

41 CFR 302-12.115 - What are the income tax consequences that we must consider when offering relocation services?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE... Constitution Avenue, NW., Room 5501, Washington, DC 20224, for information on the income tax consequences of...

41 CFR 302-12.115 - What are the income tax consequences that we must consider when offering relocation services?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE... Constitution Avenue, NW., Room 5501, Washington, DC 20224, for information on the income tax consequences of...

New England Cod Collapse and the Climate.

PubMed

Meng, Kyle C; Oremus, Kimberly L; Gaines, Steven D

2016-01-01

To improve fishery management, there is an increasing need to understand the long-term consequences of natural and anthropogenic climate variability for ecological systems. New England's iconic cod populations have been in decline for several decades and have recently reached unprecedented lows. We find that 17% of the overall decline in Gulf of Maine cod biomass since 1980 can be attributed to positive phases of the North Atlantic Oscillation (NAO). This is a consequence of three results: i) a 1-unit increase in the NAO winter index is associated with a 17% decrease in the spring biomass of age-1 cod the following year; ii) this NAO-driven decrease persists as the affected cohort matures; iii) fishing practices appear to exacerbate NAO's direct biological effect such that, since 1913, a 1-unit increase in the NAO index lowers subsequent cod catch for up to 19 years. The Georges Bank cod stock displays similar patterns. Because we statistically detect a delay between the NAO and subsequent declines in adult biomass, our findings imply that observed current NAO conditions can be used in stock forecasts, providing lead time for adaptive policy. More broadly, our approach can inform forecasting efforts for other fish populations strongly affected by natural and anthropogenic climatic variation.

New England Cod Collapse and the Climate

PubMed Central

Meng, Kyle C.; Oremus, Kimberly L.; Gaines, Steven D.

2016-01-01

To improve fishery management, there is an increasing need to understand the long-term consequences of natural and anthropogenic climate variability for ecological systems. New England’s iconic cod populations have been in decline for several decades and have recently reached unprecedented lows. We find that 17% of the overall decline in Gulf of Maine cod biomass since 1980 can be attributed to positive phases of the North Atlantic Oscillation (NAO). This is a consequence of three results: i) a 1-unit increase in the NAO winter index is associated with a 17% decrease in the spring biomass of age-1 cod the following year; ii) this NAO-driven decrease persists as the affected cohort matures; iii) fishing practices appear to exacerbate NAO’s direct biological effect such that, since 1913, a 1-unit increase in the NAO index lowers subsequent cod catch for up to 19 years. The Georges Bank cod stock displays similar patterns. Because we statistically detect a delay between the NAO and subsequent declines in adult biomass, our findings imply that observed current NAO conditions can be used in stock forecasts, providing lead time for adaptive policy. More broadly, our approach can inform forecasting efforts for other fish populations strongly affected by natural and anthropogenic climatic variation. PMID:27463967

Fostering food security in areas of extreme poverty through Integrated Farm Management: the case of Burundi

NASA Astrophysics Data System (ADS)

Kessler, Aad; van Duivenbooden, Niek; van Beek, Christy

2014-05-01

Extreme poverty in Burundi's rural area and tensions between families with limited access to arable land hinder development towards a more stable and peaceful society. Due to these tensions and a rapid population growth, agricultural land is currently subject to increased degradation and low agricultural productivity. A whole range of other limiting factors contributes to this, such as: poor seed quality, poor nutrient management combined with low soil fertility, inadequate agronomic practices, pests and crop diseases, poorly developed supply chains, health problems, difficult access to credit, and insecurity. Solving one of these problems will not solve the chain that eventually leads to low food production; it will simply move the emphasis to the next constraining factor. An integrated rural development approach is therefore required to break this vicious circle. The project Fanning the Spark, a Public-Private-Partnership between Achmea Foundation, Alterra of Wageningen University and Research Centre, and HealthNet-TPO in Burundi started in September 2013 with an intervention in several rural villages in Gitega. The project's objective is to increase food production at village level, by means of investments in crop production, a family (income) insurance package that protects rural families against the financial consequences of catastrophic events (natural and health) and making micro-credits available. This will enhance farmers' workability and generate income from agricultural activities in order to break the poverty cycle and enhance food security. The insurance package comprises agricultural and health insurances, and will be jointly implemented with the sustainable agriculture component. The latter component focuses on Integrated Farm Management and the use of innovative soil management practices. Farmer-to-farmer training and scaling-up are crucial components, and in the first phase of the project "innovative farmer groups" have a central role in the project. Each innovative farmer formulates and implements an Integrated Farm Management plan. This is a tool for farmers to plan, reflect and learn about sustainable land management, and particularly about the integration of all farm activities and how these contribute together to enhanced food security. Activities considered in these Integrated Farm Management plans are related to agriculture, livestock, infrastructure, agroforestry, soil conservation and training. The first results of the acceptance and impact of the strategy are now available, and in the next phase all innovative farmers will implement their plans and train fellow farmers to start planning their own Integrated Farm Management.

Delta ferrite is ubiquitous in type 304 stainless steel: Consequences for magnetic characterization

NASA Astrophysics Data System (ADS)

Graham, C. D.; Lorenz, B. E.

2018-07-01

Using a vibrating-sample magnetometer with a maximum field of 20.5 kOe, we have measured over 50 samples of annealed 304 stainless steel, which is usually considered to be non-magnetic. In almost every case, we observe the presence of a small, usually less than 0.01, fraction of a ferromagnetic phase, which we believe to be equilibrium bcc delta ferrite. The consequences of this observation for the measurement and specification of the magnetic properties of annealed 304 stainless are discussed. Our measurements also establish the most likely value for the magnetic permeability of the fcc austenitic phase in 304 stainless steel austenite as 1.0033 ± 0.0003.

The Ice Line in Pre-Solar Protoplanetary Disks

NASA Technical Reports Server (NTRS)

Davis, Sanford S.

2012-01-01

Protoplanetary disks contain abundant quantities of water molecules in both gas and solid phases. The distribution of these two phases in an evolving protoplanetary disk will have important consequences regarding water sequestration in planetary embryos. The boundary between gaseous and solid water is the "ice line" or "snow line" A simplified model that captures the complicated two-branched structure of the ice line is developed and compared with recent investigations. The effect of an evolving Sun is also included for the first time. This latter parameter could have important consequences regarding the thermodynamic state and the surface reaction environment for the time-dependent chemical reactions occurring during the 1- to 10-million-year lifetime of the pre-solar disk.

'Seeking authorization': a grounded theory exploration of mentors' experiences of assessing nursing students on the borderline of achievement of competence in clinical practice.

PubMed

Cassidy, Simon; Coffey, Michael; Murphy, Fiona

2017-09-01

To develop a substantive theoretical explanation of how mentors make sense of their experiences where nursing students are on the borderline of achievement of competence in clinical practice. The reluctance of Registered Nurse mentors to fail nursing students in clinical practice despite concerns about competence remains a contemporary issue in international healthcare education. Mentors' assessment decisions have considerable impact for a variety of key stakeholders, not least for students in these circumstances. Grounded theory qualitative study. Phase one involved 20 individual semi-structured interviews with nurse mentors in one United Kingdom National Health Service Health Board (July-October 2009). Phase two included eight individual semi-structured interviews and seven focus groups with mentors and practice educators (n = 38) in four further Health Boards (June 2011-February 2012). Data were analysed using open, axial and selective coding consistent with grounded theory method. Three categories 'the conundrum of practice competence,' 'the intensity of nurturing hopefulness,' and 'managing assessment impasse,' led to the study's substantive theoretical explanation - 'Seeking authorization: Establishing collective accountability for mentorship.' This demonstrates how mentors are dependent on key sources of support and feedback to validate their assessment decision-making, notwithstanding substantial personal, professional and organizational pressures. We conclude that management of borderline assessment situations is considerably developed by recognition of the authorizing effects of a wider community of assessors. Consequently, we identify the personal, professional and organizational implications involved in the preparation, support and regulation of mentors specifically during borderline assessment circumstances. © 2017 John Wiley & Sons Ltd.

Scientific management of Space Telescope

NASA Technical Reports Server (NTRS)

Odell, C. R.

1981-01-01

A historical summay is given on the science management of the Space Telescope, the inception of which began in 1962, when scientists and engineers first recommended the development of a nearly diffraction limited substantial-size optical telescope. Phase A, the feasibility requirements generation phase, began in 1971 and consisted largely of NASA scientists and a NASA design. Phase B, the preliminary design phase, established a tiered structure of scientists, led by the Large Space Telescope operations and Management Work Group. A Mission Operations Working Group headed six instrument definition teams to develop the essential instrument definitions. Many changes took place during Phase B, before design and development, which began in 1978 and still continues today.

A GIS-based model to estimate flood consequences and the degree of accessibility and operability of strategic emergency response structures in urban areas

NASA Astrophysics Data System (ADS)

Albano, R.; Sole, A.; Adamowski, J.; Mancusi, L.

2014-11-01

Efficient decision-making regarding flood risk reduction has become a priority for authorities and stakeholders in many European countries. Risk analysis methods and techniques are a useful tool for evaluating costs and benefits of possible interventions. Within this context, a methodology to estimate flood consequences was developed in this paper that is based on GIS, and integrated with a model that estimates the degree of accessibility and operability of strategic emergency response structures in an urban area. The majority of the currently available approaches do not properly analyse road network connections and dependencies within systems, and as such a loss of roads could cause significant damages and problems to emergency services in cases of flooding. The proposed model is unique in that it provides a maximum-impact estimation of flood consequences on the basis of the operability of the strategic emergency structures in an urban area, their accessibility, and connection within the urban system of a city (i.e. connection between aid centres and buildings at risk), in the emergency phase. The results of a case study in the Puglia region in southern Italy are described to illustrate the practical applications of this newly proposed approach. The main advantage of the proposed approach is that it allows for defining a hierarchy between different infrastructure in the urban area through the identification of particular components whose operation and efficiency are critical for emergency management. This information can be used by decision-makers to prioritize risk reduction interventions in flood emergencies in urban areas, given limited financial resources.

The severe hypercholesterolemia phenotype: clinical diagnosis, management, and emerging therapies.

PubMed

Sniderman, Allan D; Tsimikas, Sotirios; Fazio, Sergio

2014-05-20

The severe hypercholesterolemia phenotype includes all patients with marked elevation of low-density lipoprotein cholesterol (LDL-C) levels. The most common cause is autosomal dominant hypercholesterolemia, an inherited disorder caused by mutations either in LDL receptor, apolipoprotein B (APOB), or proprotein convertase subtilisin kexin type 9 (PCSK9) genes. However, it is now known that many subjects with severe inherited hypercholesterolemia have no defects in these genes. These cases are caused either by mutations in genes yet to be identified or are consequences of polygenic, epigenetic, or acquired defects. Because the clinical consequences of extreme hypercholesterolemia are the same no matter the cause, the focus should be on the identification of subjects with severe hypercholesterolemia, followed by phenotypic screening of family members. Genetic screening is not necessary to diagnose or initiate treatment for the severe hypercholesterolemia phenotype. Management of severe hypercholesterolemia is based on risk factor modification and use of multiple lipid-lowering medications. Lipoprotein apheresis is indicated for coronary artery disease (CAD) patients taking maximally tolerated therapy and with LDL-C levels >200 mg/dl (>300 mg/dl if without CAD). A microsomal triglyceride transfer protein inhibitor and an antisense oligonucleotide against APOB have recently been approved for use in subjects with clinically diagnosed homozygous familial hypercholesterolemia. PCSK9 inhibitors, currently in phase II and III trials, lower LDL-C up to an additional 70% in the setting of maximally tolerated medical therapy and have the potential to reduce LDL-C to <70 mg/dl in most patients. Early identification of affected individuals and aggressive treatment should significantly reduce the burden of cardiovascular disease in society. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Directive and incentive functions of affective action consequences: an ideomotor approach.

PubMed

Eder, Andreas B; Rothermund, Klaus; De Houwer, Jan; Hommel, Bernhard

2015-07-01

Five experiments examined whether affective consequences become associated with the responses producing them and whether anticipations of positive and negative action outcomes influence action control differently. In a learning phase, one response produced pleasant and another response unpleasant visual effects. In a subsequent test phase, the same actions were carried out in response to a neutral feature of affective stimuli. Results showed that responses were faster when the irrelevant valence of the response cue matched the valence of the response outcome, but only when the responses still produced outcomes. These results suggest that affective action consequences have a directive function in that they facilitate the selection of the associated response over other responses, even when the response outcome is unpleasant (Experiment 4A). Results of another experiment showed that affective action consequences can also have an incentive function in that responses with pleasant outcomes are generally facilitated relative to responses with unpleasant outcomes. However, this motivational effect was seen only in a free-choice test (Experiment 5). The results suggest that behavioral impulses induced by ideomotor processes are constrained by the motivational evaluation of the anticipated action outcome. A model that integrates motivational factors into ideomotor theory is presented.

Monolithic carrier-envelope phase-stabilization scheme.

PubMed

Fuji, Takao; Rauschenberger, Jens; Apolonski, Alexander; Yakovlev, Vladislav S; Tempea, Gabriel; Udem, Thomas; Gohle, Christoph; Hänsch, Theodor W; Lehnert, Walter; Scherer, Michael; Krausz, Ferenc

2005-02-01

A new scheme for stabilizing the carrier-envelope (CE) phase of a few-cycle laser pulse train is demonstrated. Self-phase modulation and difference-frequency generation in a single periodically poled lithium niobate crystal that transmits the main laser beam allows CE phase locking directly in the usable output. The monolithic scheme obviates the need for splitting off a fraction of the laser output for CE phase control, coupling into microstructured fiber, and separation and recombination of spectral components. As a consequence, the output yields 6-fs, 800-nm pulses with an unprecedented degree of short- and long-term reproducibility of the electric field waveform.

Decision-making process related to treatment and management in Korean women with breast cancer: Finding the right individualized healthcare trajectory.

PubMed

Kim, Kkotbong; Yang, Jinhyang

2017-06-01

After being diagnosed with breast cancer, women must make a number of decisions about their treatment and management. When the decision-making process among breast cancer patients is ineffective, it results in harm to their health. Little is known about the decision-making process of breast cancer patients during the entire course of treatment and management. We investigated women with breast cancer to explore the decision-making processes related to treatment and management. Eleven women participated, all of whom were receiving treatment or management in Korea. The average participant age was 43.5years. For data collection and analysis, a grounded theory methodology was used. Through constant comparative analyses, a core category emerged that we referred to as "finding the right individualized healthcare trajectory." The decision-making process occurred in four phases: turmoil, exploration, balance, and control. The turmoil phase included weighing the credibility of information and lowering the anxiety level. The exploration phase included assessing the expertise/promptness of medical treatment and evaluating the effectiveness of follow-up management. The balance phase included performing analyses from multiple angles and rediscovering value as a human being. The control phase included constructing an individualized management system and following prescribed and other management options. It is important to provide patients with accurate information related to the treatment and management of breast cancer so that they can make effective decisions. Healthcare providers should engage with patients on issues related to their disease, understand the burden placed on patients because of issues related to their sex, and ensure that the patient has a sufficient support system. The results of this study can be used to develop phase-specific, patient-centered, and tailored interventions for breast cancer patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Balanced Depth and Breadth in a New Interdisciplinary Nanotechnology Course

ERIC Educational Resources Information Center

Jiao, Lihong; Barakat, Nael

2012-01-01

The field of nanotechnology has outgrown the discovery phase into the application and even commercial production phases. Consequently, the need for a workforce capable of supporting this growth is more than ever. However, because of the different challenges associated with nanotechnology education, specific courses are required to be developed and…

Influence of Motivating Operations and Discriminative Stimuli on Challenging Behavior Maintained by Positive Reinforcement

ERIC Educational Resources Information Center

Edrisinha, Chaturi; O'Reilly, Mark; Sigafoos, Jeff; Lancioni, Giulio; Choi, Ha Young

2011-01-01

We examined the effects of an establishing operation (EO) and abolishing operation (AO) on stimulus control of challenging behavior. Two participants with developmental disabilities and challenging behavior participated. In Phase I, a functional analysis was conducted to identify the consequences maintaining challenging behavior. In Phase II, a…

Phase space deformations in phantom cosmology

NASA Astrophysics Data System (ADS)

López, J. L.; Sabido, M.; Yee-Romero, C.

2018-03-01

We discuss the physical consequences of general phase space deformations on the minisuperspace of phantom cosmology. Based on the principle of physically equivalent descriptions in the deformed theory, we investigate for what values of the deformation parameters the arising descriptions are physically equivalent. We also construct and solve the quantum model and derive the semiclassical dynamics.

Risk analysis of urban gas pipeline network based on improved bow-tie model

NASA Astrophysics Data System (ADS)

Hao, M. J.; You, Q. J.; Yue, Z.

2017-11-01

Gas pipeline network is a major hazard source in urban areas. In the event of an accident, there could be grave consequences. In order to understand more clearly the causes and consequences of gas pipeline network accidents, and to develop prevention and mitigation measures, the author puts forward the application of improved bow-tie model to analyze risks of urban gas pipeline network. The improved bow-tie model analyzes accident causes from four aspects: human, materials, environment and management; it also analyzes the consequences from four aspects: casualty, property loss, environment and society. Then it quantifies the causes and consequences. Risk identification, risk analysis, risk assessment, risk control, and risk management will be clearly shown in the model figures. Then it can suggest prevention and mitigation measures accordingly to help reduce accident rate of gas pipeline network. The results show that the whole process of an accident can be visually investigated using the bow-tie model. It can also provide reasons for and predict consequences of an unfortunate event. It is of great significance in order to analyze leakage failure of gas pipeline network.

RMP Guidance for Chemical Distributors - Chapter 7: Prevention Program (Program 3)

EPA Pesticide Factsheets

The OSHA Process Safety Management program has legal authority for on-site consequences, EPA's Prevention Program for offsite consequences, so your process hazard analysis (PHA) team may have to assess new hazards to the public and offsite environment.

40 CFR 1400.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OFF-SITE CONSEQUENCE ANALYSIS INFORMATION DISTRIBUTION OF OFF-SITE CONSEQUENCE ANALYSIS INFORMATION... chemical accidents and submit the results of their analyses to the U.S. Environmental Protection Agency as... the portions of risk management plans containing the results of those analyses and certain related...

40 CFR 1400.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... OFF-SITE CONSEQUENCE ANALYSIS INFORMATION DISTRIBUTION OF OFF-SITE CONSEQUENCE ANALYSIS INFORMATION... chemical accidents and submit the results of their analyses to the U.S. Environmental Protection Agency as... the portions of risk management plans containing the results of those analyses and certain related...

40 CFR 1400.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OFF-SITE CONSEQUENCE ANALYSIS INFORMATION DISTRIBUTION OF OFF-SITE CONSEQUENCE ANALYSIS INFORMATION... chemical accidents and submit the results of their analyses to the U.S. Environmental Protection Agency as... the portions of risk management plans containing the results of those analyses and certain related...

40 CFR 1400.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OFF-SITE CONSEQUENCE ANALYSIS INFORMATION DISTRIBUTION OF OFF-SITE CONSEQUENCE ANALYSIS INFORMATION... chemical accidents and submit the results of their analyses to the U.S. Environmental Protection Agency as... the portions of risk management plans containing the results of those analyses and certain related...

49 CFR 831.8 - Investigator-in-charge.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-charge (IIC) organizes, conducts, controls, and manages the field phase of the investigation, regardless... to have considerable organizational and management responsibilities throughout later phases of the...

Verification and Implementation of Operations Safety Controls for Flight Missions

NASA Technical Reports Server (NTRS)

Smalls, James R.; Jones, Cheryl L.; Carrier, Alicia S.

2010-01-01

There are several engineering disciplines, such as reliability, supportability, quality assurance, human factors, risk management, safety, etc. Safety is an extremely important engineering specialty within NASA, and the consequence involving a loss of crew is considered a catastrophic event. Safety is not difficult to achieve when properly integrated at the beginning of each space systems project/start of mission planning. The key is to ensure proper handling of safety verification throughout each flight/mission phase. Today, Safety and Mission Assurance (S&MA) operations engineers continue to conduct these flight product reviews across all open flight products. As such, these reviews help ensure that each mission is accomplished with safety requirements along with controls heavily embedded in applicable flight products. Most importantly, the S&MA operations engineers are required to look for important design and operations controls so that safety is strictly adhered to as well as reflected in the final flight product.

Reversible Holmes' tremor due to spontaneous intracranial hypotension.

PubMed

Iyer, Rajesh Shankar; Wattamwar, Pandurang; Thomas, Bejoy

2017-07-27

Holmes' tremor is a low-frequency hand tremor and has varying amplitude at different phases of motion. It is usually unilateral and does not respond satisfactorily to drugs and thus considered irreversible. Structural lesions in the thalamus and brainstem or cerebellum are usually responsible for Holmes' tremor. We present a 23-year-old woman who presented with unilateral Holmes' tremor. She also had hypersomnolence and headache in the sitting posture. Her brain imaging showed brain sagging and deep brain swelling due to spontaneous intracranial hypotension (SIH). She was managed conservatively and had a total clinical and radiological recovery. The brain sagging with the consequent distortion of the midbrain and diencephalon was responsible for this clinical presentation. SIH may be considered as one of the reversible causes of Holmes' tremor. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Management of thinned Emory oak coppice for multiple resource benefits

Treesearch

D. Catlow Shipek; Peter F. Ffolliott

2005-01-01

Managers are increasingly moving toward an ecosystem-based, multiple-use approach in managing Emory oak woodlands in the Southwestern United States. Often of particular interest is managing the coppice that evolves from earlier fuelwood harvesting activities. Emory oak (Quercus emoryi) is a prolific sprouting species and, as a consequence, post-...

41 CFR 302-12.9 - What are the income tax consequences if I use a relocation services company?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What are the income tax consequences if I use a relocation services company? 302-12.9 Section 302-12.9 Public Contracts and Property... the income tax consequences if I use a relocation services company? You may incur income taxes on...

Managing Field Evacuations.

ERIC Educational Resources Information Center

Satz, Jay A.; McEvoy, David; Merrill, Kurt

In the event of a debilitating injury or illness, outdoor leaders should consider four critical phases in successfully managing backcountry field evaluations. The first phase, managing the immediate scene, involves assuring scene safety, medical care of the patient, instituting the emergency response plan, and providing for the needs of uninjured…

Time management displays for shuttle countdown

NASA Technical Reports Server (NTRS)

Beller, Arthur E.; Hadaller, H. Greg; Ricci, Mark J.

1992-01-01

The Intelligent Launch Decision Support System project is developing a Time Management System (TMS) for the NASA Test Director (NTD) to use for time management during Shuttle terminal countdown. TMS is being developed in three phases: an information phase; a tool phase; and an advisor phase. The information phase is an integrated display (TMID) of firing room clocks, of graphic timelines with Ground Launch Sequencer events, and of constraints. The tool phase is a what-if spreadsheet (TMWI) for devising plans for resuming from unplanned hold situations. It is tied to information in TMID, propagates constraints forward and backward to complete unspecified values, and checks the plan against constraints. The advisor phase is a situation advisor (TMSA), which proactively suggests tactics. A concept prototype for TMSA is under development. The TMID is currently undergoing field testing. Displays for TMID and TMWI are described. Descriptions include organization, rationale for organization, implementation choices and constraints, and use by NTD.

Adaptive social impact management for conservation and environmental management.

PubMed

Kaplan-Hallam, Maery; Bennett, Nathan J

2018-04-01

Concerns about the social consequences of conservation have spurred increased attention the monitoring and evaluation of the social impacts of conservation projects. This has resulted in a growing body of research that demonstrates how conservation can produce both positive and negative social, economic, cultural, health, and governance consequences for local communities. Yet, the results of social monitoring efforts are seldom applied to adaptively manage conservation projects. Greater attention is needed to incorporating the results of social impact assessments in long-term conservation management to minimize negative social consequences and maximize social benefits. We bring together insights from social impact assessment, adaptive management, social learning, knowledge coproduction, cross-scale governance, and environmental planning to propose a definition and framework for adaptive social impact management (ASIM). We define ASIM as the cyclical process of monitoring and adaptively managing social impacts over the life-span of an initiative through the 4 stages of profiling, learning, planning, and implementing. We outline 14 steps associated with the 4 stages of the ASIM cycle and provide guidance and potential methods for social-indicator development, predictive assessments of social impacts, monitoring and evaluation, communication of results, and identification and prioritization of management responses. Successful ASIM will be aided by engaging with best practices - including local engagement and collaboration in the process, transparent communication of results to stakeholders, collective deliberation on and choice of interventions, documentation of shared learning at the site level, and the scaling up of insights to inform higher-level conservation policies-to increase accountability, trust, and perceived legitimacy among stakeholders. The ASIM process is broadly applicable to conservation, environmental management, and development initiatives at various scales and in different contexts. © 2017 Society for Conservation Biology.

Mapping the phase inhomogeneity across first order spin flop transition

NASA Astrophysics Data System (ADS)

Tripathi, Malvika; Majumder, Supriyo; Choudhary, R. J.; Phase, D. M.

2018-04-01

As a consequence of spin reorientation phase transition (SRPT, TSRPT = 34K) in SmCrO3, the two phases, high temperature uncompensated anti-ferromagnetic Γ4 configuration and low temperature collinear anti-ferromagnetic phase Γ1 coexist in the vicinity of transition. The observed unexpectedly huge coercivity (Hc ˜2T) below SRPT at 25K questions on the behavior of two co-existing phases. In the present study, we have used the FORC diagrams to monitor the distribution of clusters related to different phases and to understand the nature of interaction among the clusters of distinct phases. We observed that the nature of interaction has indeed magnetic effect and the pining across phase boundaries may cause the enhancement of coercivity at 25K.

Large-scale interdisciplinary experiments inform current and future forestry management options in the U.S. Pacific Northwest

Treesearch

Charles E. Peterson; Paul D. Anderson

2009-01-01

Over the last 20 years, changing public values and increased ecological understanding have led to a paradigm shift in forestry from timber management to sustainable ecosystem management on U.S. federal lands. Forest managers are now seeking alternative management approaches that simultaneously meet socio-cultural, ecological and economic goals. Consequently, many field...

[Drug utilization and pharmaceutical cost-containment in germany-perspectives 1 year after enactment of the GMG].

PubMed

Schlander, Michael

2005-06-15

After 3 decades of health care cost containment in Germany, enactment of the most recent reform (Health Insurance Modernization Act, GMG) marks a watershed insofar as, apparently, the potential has been largely exhausted for further savings in pharmaceutical spending. Yet the new drugs segment maintains its role as a growth driver, owing to the continuing shift from older to new, and frequently more expensive, products. This observation holds true even after introducing phase 2 reference pricing, covering so-called me too products. Health economic analyses would be required to better differentiate pharmaceutical products based on their incremental cost-effectiveness ratio. However, the opportunity was missed with the GMG to introduce formal health-economic evaluations and thus overcome the counterproductive silo mentality associated with traditional German component management. International experience from Australia, Canada, and the United Kingdom suggests that economic evaluations, while informing rational reimbursement decisions, may in fact contribute to increasing pharmaceutical expenditures. Further tightening of pharmaceutical component management in Germany may result in increasing inefficiencies due to underuse of effective products; furthermore, it appears conceivable that ("second order") dynamic inefficiencies and, hence, social costs might be the consequence of reduced pharmaceutical research and development expenditures.

[Introduction of disease management programmes in Germany as reflected by differing interests of health insurance companies and the federal association of statutory health insurance physicians].

PubMed

Erler, A

2002-11-01

On 1st January 2002 a law was enacted by the German Federal Government reorganising the reinsurance pool known as the "risk compensation scheme" (RSA) of the German health insurance system. This enactment contemplates a gradual restructuring of the RSA to shift from a system that considered only certain demographic criteria to one that reflects actual morbidity rates, with the shift to be phased in before full implementation by 2007. The enactment also introduced disease management programmes (DMP) for patients with certain chronic illnesses. Insurance companies will now receive additional payments from the RSA for patients with a chronic condition who are enrolled in a DMP. The intent is to improve the poor medical care for chronically ill patients in Germany - as had been stated by the advisory council of the Concerted Action in Health Care - and to reduce the natural tendency of insurance companies to prefer young healthy members over chronically ill patients. Possible consequences of the legal changes are discussed from the point of view of the various insurance companies as well as the Federal Association of Statutory Health Insurance Physicians.

Role of vaptans in the management of hydroelectrolytic imbalance in liver cirrhosis.

PubMed

Facciorusso, Antonio; Amoruso, Annabianca; Neve, Viviana; Antonino, Matteo; Prete, Valentina Del; Barone, Michele

2014-11-27

Ascites and hyponatremia are the most common complications in patients with liver cirrhosis and develop as a consequence of a severe impairment of liver function and portal hypertension. Increasing evidences support the central role of renal function alterations in the pathogenesis of hydroelectrolytic imbalances in cirrhotic patients, thus implying a dense cross-talk between liver and kidney in the systemic and splanchnic vascular homeostasis in such subjects. Since Arginin Vasopressin (AVP) hyperincretion occurs at late stage of cirrhosis and plays an important role in the development of refractory ascites, dilutional hyponatremia and finally hepato-renal syndrome, selective antagonists of AVP receptors V2 (vaptans) have been recently introduced in the therapeutic algorithm of advanced cirrhotic patients. Despite the promising results of earlier phase-two studies, randomized controlled trials failed to find significant results in terms of efficacy of such drugs both in refractory ascites and hyponatremia. Moreover, concerns on their safety profile arise, due to the number of potentially severe side effects of vaptans in the clinical setting, such as hypernatremia, dehydration, renal impairment, and osmotic demyelination syndrome. More robust data from randomized controlled trials are needed in order to confirm the potential role of vaptans in the management of advanced cirrhotic patients.

I used to cry every day: a model of the family process of managing displacement.

PubMed

Greene, Danielle; Tehranifar, Parisa; Hernandez-Cordero, Lourdes J; Fullilove, Mindy Thompson

2011-06-01

Community displacing events, natural or human made, are increasing in frequency. By the end of 2009, over 36 million people were known to be displaced worldwide. Displacement is a traumatic experience with significant short- and long-term health consequences. The losses and costs associated with displacement-social connections, employment, property, and economic capital-are felt not only by the displaced individuals but also the communities they have left behind, and the communities that receive displaced individuals. Many researchers have explored the link between health and reduced social, cultural, and economic capital. Most of the displacement literature focuses on the effect of displacement on the displaced individual; however, many families move as a group. In this study, we examined the family process of managing displacement and its associated capital losses by conducting interviews with 20 families. We found that families undergo a four-phase process of displacement: antecedent, uprooting, transition, and resettlement. The losses families experience impact the health and well-being of individuals, families, and communities. The degree to which the displacement process ends successfully, or ends at all, can be affected by efforts to both create connections within the new communities and rebuild economic and social capital.

Exploratory study on the effect of discount pricing strategies for new product introduction

NASA Astrophysics Data System (ADS)

Mat Zaib, Nurul Afiqah; Bazin, Nor Erne Nazira; Mustaffa, Noorfa Haszlinna

2013-04-01

Rapid introduction of new product into the market has resulted in growing competition between retailers. Nowadays, retailers compete with one another in order to increase revenue and to maintain their position in the marketplace. This situation has forced the retailers to enhance their strategic management as well as creating competitive advantages. Generally, this situation can be observed in highly demanded product such as fashion goods and high technology electronic devices (smart phone, notebook). The consequence from the intense competition and new product introduction is difficulties in retailers pricing management. Retailers are now facing with complexity in making decisions on suitable pricing strategies and discount level for new product in association with the product life cycle. Thus, this research aims to investigate the suitable discount pricing strategies that can be integrated in every phase of product life cycle. This paper presents relationships between the discount pricing and the stages in the product life cycle in the form of conceptual diagram and mathematical expression. A system dynamic approach is used for developing the conceptual diagram and formulating the mathematical expression for the discount pricing strategies to visualize the relationship between discount pricing and product life cycle.

Diffuse pollution of soil and water: Long term trends at large scales?

NASA Astrophysics Data System (ADS)

Grathwohl, P.

2012-04-01

Industrialization and urbanization, which consequently increased pressure on the environment to cause degradation of soil and water quality over more than a century, is still ongoing. The number of potential environmental contaminants detected in surface and groundwater is continuously increasing; from classical industrial and agricultural chemicals, to flame retardants, pharmaceuticals, and personal care products. While point sources of pollution can be managed in principle, diffuse pollution is only reversible at very long time scales if at all. Compounds which were phased out many decades ago such as PCBs or DDT are still abundant in soils, sediments and biota. How diffuse pollution is processed at large scales in space (e.g. catchments) and time (centuries) is unknown. The relevance to the field of processes well investigated at the laboratory scale (e.g. sorption/desorption and (bio)degradation kinetics) is not clear. Transport of compounds is often coupled to the water cycle and in order to assess trends in diffuse pollution, detailed knowledge about the hydrology and the solute fluxes at the catchment scale is required (e.g. input/output fluxes, transformation rates at the field scale). This is also a prerequisite in assessing management options for reversal of adverse trends.

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

DTIC Science & Technology

1980-02-26

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

Critical Essay: Building new management theories on sound data? The case of neuroscience

PubMed Central

Lindebaum, Dirk

2015-01-01

In this critical essay, I contend that accelerating demands for novel theories in management studies imply that new methodologies and data are sometimes accepted prematurely as supply of these novel theories. This point is illustrated with reference to how neuroscience can inform management research. I propose two demand forces that foster the increased focus on neuroscience in management studies, these being (i) the direction of public research funding, and (ii) publication bias as a boost for journal impact factor. Looking at the supply side, I note that (i) the statistical power of studies using functional magnetic resonance imaging (or fMRI, the ‘gold’ standard) is unacceptably low, (ii) the use of imprecise ‘motherhood’ statements, and (iii) the dismissal of ethical concerns in the formulation of management theories and practice informed by neuroscience. I then briefly outline the bad consequences of this for management theory and practice, emphasize why it is important to prevent these consequences, and offer some methodological suggestions for future research. PMID:27041766

Accuracy and impact of Xpert MTB/RIF for the diagnosis of smear-negative or sputum-scarce tuberculosis using bronchoalveolar lavage fluid.

PubMed

Theron, Grant; Peter, Jonny; Meldau, Richard; Khalfey, Hoosain; Gina, Phindile; Matinyena, Brian; Lenders, Laura; Calligaro, Gregory; Allwood, Brian; Symons, Gregory; Govender, Ureshnie; Setshedi, Mashiko; Dheda, Keertan

2013-11-01

The accuracy and impact of new tuberculosis (TB) tests, such as Xpert MTB/RIF, when performed on bronchoalveolar lavage fluid (BALF) obtained from patients with sputum-scarce or smear-negative TB is unclear. South African patients with suspected pulmonary TB (n=160) who were sputum-scarce or smear-negative underwent bronchoscopy. MTB/RIF was performed on uncentrifuged BALF (1 ml) and/or a resuspended pellet of centrifuged BALF (∼10 ml). Time to TB detection and anti-TB treatment initiation were compared between phase one, when MTB/RIF was performed as a research tool, and phase two, when it was used for patient management. 27 of 154 patients with complete data had culture-confirmed TB. Of these, a significantly lower proportion were detected by smear microscopy compared with MTB/RIF (58%, 95% CI 39% to 75% versus 93%, 77% to 98%; p<0.001). Of the 127 patients who were culture negative, 96% (91% to 98%) were MTB/RIF negative. When phase two was compared with phase one, MTB/RIF reduced the median days to TB detection (29 (18-41) to 0 (0-0); p<0.001). However, more patients initiated empirical therapy (absence of a positive test in those commencing treatment) in phase one versus phase two (79% (11/14) versus 28% (10/25); p=0.026). Consequently, there was no detectable difference in the overall proportion of patients initiating treatment (26% (17/67; 17% to 37%) versus 36% (26/73; 26% to 47%); p=0.196) or the days to treatment initiation (10 (1-49) versus 7 (0-21); p=0.330). BALF centrifugation, HIV coinfection and a second MTB/RIF did not result in detectable changes in accuracy. MTB/RIF detected TB cases more accurately and more rapidly than smear microscopy and significantly reduced the rate of empirical treatment.

Accuracy and impact of Xpert MTB/RIF for the diagnosis of smear-negative or sputum-scarce tuberculosis using bronchoalveolar lavage fluid

PubMed Central

Theron, Grant; Peter, Jonny; Meldau, Richard; Khalfey, Hoosain; Gina, Phindile; Matinyena, Brian; Lenders, Laura; Calligaro, Gregory; Allwood, Brian; Symons, Gregory; Govender, Ureshnie; Setshedi, Mashiko; Dheda, Keertan

2017-01-01

Rationale The accuracy and impact of new tuberculosis (TB) tests, such as Xpert MTB/RIF, when performed on bronchoalveolar lavage fluid (BALF) obtained from patients with sputum-scarce or smear-negative TB is unclear. Methods South African patients with suspected pulmonary TB (n=160) who were sputum-scarce or smear-negative underwent bronchoscopy. MTB/RIF was performed on uncentrifuged BALF (1 ml) and/or a resuspended pellet of centrifuged BALF (~10 ml). Time to TB detection and anti-TB treatment initiation were compared between phase one, when MTB/RIF was performed as a research tool, and phase two, when it was used for patient management. Results 27 of 154 patients with complete data had culture-confirmed TB. Of these, a significantly lower proportion were detected by smear microscopy compared with MTB/RIF (58%, 95% CI 39% to 75% versus 93%, 77% to 98%; p<0.001). Of the 127 patients who were culture negative, 96% (91% to 98%) were MTB/RIF negative. When phase two was compared with phase one, MTB/RIF reduced the median days to TB detection (29 (18–41) to 0 (0–0); p<0.001). However, more patients initiated empirical therapy (absence of a positive test in those commencing treatment) in phase one versus phase two (79% (11/14) versus 28% (10/25); p=0.026). Consequently, there was no detectable difference in the overall proportion of patients initiating treatment (26% (17/67; 17% to 37%) versus 36% (26/73; 26% to 47%); p=0.196) or the days to treatment initiation (10 (1–49) versus 7 (0–21); p=0.330). BALF centrifugation, HIV coinfection and a second MTB/RIF did not result in detectable changes in accuracy. Conclusions MTB/RIF detected TB cases more accurately and more rapidly than smear microscopy and significantly reduced the rate of empirical treatment. PMID:23811536

Linking Indicators: Key Research Questions to Guide Decisions on What to Measure, Map and Model

EPA Science Inventory

Public policy increasingly demands insight into the social consequences of environmental policy and drivers of human behaviors that affect the environment. Social consequences can provide potent justifications for environmental protection and management, and human preferences and...

Sexual Difficulties after Pelvic Radiotherapy: Improving Clinical Management.

PubMed

White, I D

2015-11-01

Modern multimodality cancer treatment has led to more than 2 million people living with and beyond cancer in the UK, an impressive survival statistic on which clinicians and services continue to build. However, what is less readily acknowledged by health professionals and patients alike are the 500,000 people whose daily lives are adversely affected by the longer term consequences of cancer treatment. Macmillan Cancer Support estimate as many as 350,000 people in the UK experience sexual consequences of cancer and its treatment, an aspect of survivorship and rehabilitation that receives relatively scant attention in service provision, policy development and research terms. This overview addresses the sexual impact of radical pelvic radiotherapy for the more common (prostate, ano-rectal, cervical and endometrial) adult malignancies. Through discussion of the clinical assessment and management of desire, arousal, orgasmic and sexual pain difficulties that arise after pelvic radiotherapy, this overview offers an integrated biopsychosocial model of practice that incorporates the physical, psychological and relationship elements of these treatment sequelae. It is important that clinicians raise the profile of the sexual consequences of cancer treatment as a legitimate aspect of survivorship and service provision. Only in this way can the identification and management of treatment-induced sexual difficulties, frequently experienced by patients and their partners, be better understood and managed. Increased focus on the sexual consequences of treatment and cancer survivorship more broadly may, in time, lead to greater clinical recognition, service development and, most importantly, increased research devoted to the effective management of what remains a neglected aspect of cancer care. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

The second generation intelligent user interface for the crustal dynamics data information system. [for nasa space missions

NASA Technical Reports Server (NTRS)

Short, Nicholas, Jr.; Wattawa, Scott L.

1988-01-01

For the past decade, operations and research projects that support a major portion of NASA's overall mission have experienced a dramatic increase in the volume of generated data and resultant information that is unparalleled in the history of the agency. The effect of such an increase is that most of the science and engineering disciplines are undergoing an information glut, which has occurred, not only because of the amount, but also because of the type of data being collected. This information glut is growing exponentially and is expected to grow for the foreseeable future. Consequently, it is becoming physically and intellectually impossible to identify, access, modify, and analyze the most suitable information. Thus, the dilemma arises that the amount and complexity of information has exceeded and will continue to exceed, using present information systems, the ability of all the scientists and engineers to understand and take advantage of this information. As a result of this information problem, NASA has initiated the Intelligent Data Management (IDM) project to design and develop Advanced Information Management (IDM) project to design and develop Advanced Information Management Systems (AIMS). The first effort of the Project was the prototyping of an Intelligent User Interface (IUI) to an operational scientific database using expert systems, natural language processing, and graphics technologies. An overview of the IUI formulation and development for the second phase is presented.

Surgical errors and risks – the head and neck cancer patient

PubMed Central

Harréus, Ulrich

2013-01-01

Head and neck surgery is one of the basic principles of head and neck cancer therapy. Surgical errors and malpractice can have fatal consequences for the treated patients. It can lead to functional impairment and has impact in future chances for disease related survival. There are many risks for head and neck surgeons that can cause errors and malpractice. To avoid surgical mistakes, thorough preoperative management of patients is mandatory. As there are ensuring operability, cautious evaluation of preoperative diagnostics and operative planning. Moreover knowledge of anatomical structures of the head and neck, of the medical studies and data as well as qualification in modern surgical techniques and the surgeons ability for critical self assessment are basic and important prerequisites for head and neck surgeons in order to make out risks and to prevent from mistakes. Additionally it is important to have profound knowledge in nutrition management of cancer patients, wound healing and to realize and to be able to deal with complications, when they occur. Despite all precaution and surgical care, errors and mistakes cannot always be avoided. For that it is important to be able to deal with mistakes and to establish an appropriate and clear communication and management for such events. The manuscript comments on recognition and prevention of risks and mistakes in the preoperative, operative and postoperative phase of head and neck cancer surgery. PMID:24403972

Cost effective management of space venture risks

NASA Technical Reports Server (NTRS)

Giuntini, Ronald E.; Storm, Richard E.

1986-01-01

The development of a model for the cost-effective management of space venture risks is discussed. The risk assessment and control program of insurance companies is examined. A simplified system development cycle which consists of a conceptual design phase, a preliminary design phase, a final design phase, a construction phase, and a system operations and maintenance phase is described. The model incorporates insurance safety risk methods and reliability engineering, and testing practices used in the development of large aerospace and defense systems.

Acta Oncologica Lecture. Gastrointestinal consequences of cancer treatment and the wider context: a bad gut feeling.

PubMed

Muls, Ann Cecile

2014-03-01

The percentage of people living with a diagnosis of cancer is rising globally. Between 20% and 25% of people treated for cancer experience a consequence of cancer which has an adverse impact on the quality of their life. Gastrointestinal (GI) symptoms are the most common of all consequences of cancer treatment and have the greatest impact on daily activity. PATHOPHYSIOLOGY OF LONG-TERM BOWEL DAMAGE AFTER PELVIC RADIOTHERAPY: Long-term damage to the bowel after radiotherapy is mediated by ischaemic changes and fibrosis. Each fraction of radiotherapy causes a series of repetitive injuries to the intestinal tissue resulting in an altered healing process, which affects the integrity of the repair and changes the architecture of the bowel wall. THE NATURE OF GI SYMPTOMS THAT DEVELOP: Patient-reported outcome measures show that diarrhoea, urgency, increased bowel frequency, tenesmus and flatulence are the five most prevalent GI symptoms with a moderate or severe impact on patients' daily lives after treatment with pelvic radiotherapy. Many patients also experience fatigue, urinary problems and have sexual concerns. SYSTEMATIC ASSESSMENT AND MANAGEMENT: The complex nature of those symptoms warrants systematic assessment and management. The use of a tested algorithm can assist in achieving this. The most common contributing factors to ongoing bowel problems after pelvic radiotherapy are small intestinal bacterial overgrowth, bile acid malabsorption, pancreatic insufficiency, rectal bleeding and its impact on bone health. Symptom burden, socio-psychosocial impact, memory and cognitive function, fatigue, urinary problems and sexual concerns need to be taken into account when thinking about consequences of cancer treatment. As our understanding of consequences of cancer treatments continues to emerge and encompass a wide variety of specialties, a holistic, multifaceted and multidisciplinary approach is required to manage those consequences long-term.

Phase segregation due to simultaneous migration and coalescence

NASA Technical Reports Server (NTRS)

Davis, Robert H.; Wang, Hua; Hawker, Debra

1994-01-01

Ground-based modeling and experiments have been performed on the interaction and coalescence of drops leading to macroscopic phase separation. The focus has been on gravity-induced motion, with research also initiated on thermocapillary motion of drops. The drop size distribution initially shifts toward larger drops with time due to coalescence, and then a back towards smaller drops due to the larger preferentially settling out. As a consequence, the phase separation rate initially increases with time and then decreases.

Coexistence of Phases in a Protein Heterodimer

PubMed Central

Krokhotin, Andrey; Liwo, Adam; Niemi, Antti J.; Scheraga, Harold A.

2012-01-01

A heterodimer consisting of two or more different kinds of proteins can display an enormous number of distinct molecular architectures. The conformational entropy is an essential ingredient in the Helmholtz free energy and, consequently, these heterodimers can have a very complex phase structure. Here, it is proposed that there is a state of proteins, in which the different components of a heterodimer exist in different phases. For this purpose, the structures in the protein data bank (PDB) have been analyzed, with radius of gyration as the order parameter. Two major classes of heterodimers with their protein components coexisting in different phases have been identified. An example is the PDB structure 3DXC. This is a transcriptionally active dimer. One of the components is an isoform of the intra-cellular domain of the Alzheimer-disease related amyloid precursor protein (AICD), and the other is a nuclear multidomain adaptor protein in the Fe65 family. It is concluded from the radius of gyration that neither of the two components in this dimer is in its own collapsed phase, corresponding to a biologically active protein. The UNRES energy function has been utilized to confirm that, if the two components are separated from each other, each of them collapses. The results presented in this work show that heterodimers whose protein components coexist in different phases, can have intriguing physical properties with potentially important biological consequences. PMID:22830730

Governing University Strategy: Perceptions and Practice of Governance and Management Roles

ERIC Educational Resources Information Center

Rytmeister, Catherine

2009-01-01

Intertwined trends of massification, internationalisation and marketisation constitute and drive change in higher education at all levels. Consequences at the institutional level include: increased competition, adoption of corporate management forms, accrual of power to executive management, and greater emphasis on strategy. As Government policy…

Rationalizing Management Information System Costs.

ERIC Educational Resources Information Center

Parden, Robert J.

This paper examines the proposition that management information systems (MIS) for colleges and universities are not achieving their original objectives of supporting better management decisions by providing more and better information in a more timely manner. As a consequence, the MIS activity should be reduced in scope, and standardized to…

Complexities of One-Component Phase Diagrams

ERIC Educational Resources Information Center

Ciccioli, Andrea; Glasser, Leslie

2011-01-01

For most materials, the solid at and near the triple-point temperature is denser than the liquid with which it is in equilibrium. However, for water and certain other materials, the densities of the phases are reversed, with the solid being less dense. The profound consequences for the appearance of the "pVT" diagram of one-component materials…

Experienced dilemmas of everyday life in chronic neuropathic pain patients--results from a critical incident study.

PubMed

Hensing, Gunnel K E; Sverker, Annette M; Leijon, Göran S

2007-06-01

Neuropathic pain is a disabling chronic condition with limited therapeutic options. Few studies have addressed patient's experience and strategies. The aim of this study was to explore dilemmas experienced in order to improve care and rehabilitation. An interview study with 39 patients suffering from neuropathic pain of different origin was performed. We used the critical incident technique to collect data. Questions on occasions when patients had been hindered by or reminded of their neuropathic pain were included, and the self-perceived consequences and management of such occasions. The interviews were transcribed verbatim and analysed qualitatively. A broad range of experiences categorised into dilemmas, disturbances, consequences and managements from most parts of everyday life was identified. The dilemmas were 'housework', 'sitting', 'physical activity', 'personal hygiene', 'sleeping difficulties', 'hypersensitivity to external stimuli', 'social relationships', 'transportation' and 'leisure time'. Disturbances were 'failures', 'inabilities' and 'restrictions'. Consequences were 'increased pain', 'psychological reactions' and 'physical symptoms'. The majority of the patients used activity-oriented strategies to manage their pain such as alternative ways of performing the task, a cognitive approach or simply ignoring the pain. This is one of the first studies presenting detailed data on everyday dilemmas, disturbances and consequences of patients with chronic neuropathic pain. Such information is important in clinical settings to improve care and rehabilitation.

Design of Training Systems Phase I Summary Report.

ERIC Educational Resources Information Center

Lindahl, William H.; And Others

A summary is provided of the status of Phase I of the three-stage project, "Design of Training Systems" (DOTS). The purpose of the overall project is described as being to introduce the technologies of education, psychology, management and operations research into the management of Navy training. Phase I of the effort is designed to…

Devolved School Management in Tayside Region. Research Report Series.

ERIC Educational Resources Information Center

Wilson, Valerie; And Others

This report contains findings of an evaluation of the first phase of Tayside Region's (Scotland) Devolved School Management (DSM) scheme. The evaluation sought to evaluate the first phase of implementation and to suggest ways in which the scheme and accompanying training might be improved. Sixty schools chose to participate in the first phase,…

Clinical operations management in radiology.

PubMed

Ondategui-Parra, Silvia; Gill, Ileana E; Bhagwat, Jui G; Intrieri, Lisa A; Gogate, Adheet; Zou, Kelly H; Nathanson, Eric; Seltzer, Steven E; Ros, Pablo R

2004-09-01

Providing radiology services is a complex and technically demanding enterprise in which the application of operations management (OM) tools can play a substantial role in process management and improvement. This paper considers the benefits of an OM process in a radiology setting. Available techniques and concepts of OM are addressed, along with gains and benefits that can be derived from these processes. A reference framework for the radiology processes is described, distinguishing two phases in the initial assessment of a unit: the diagnostic phase and the redesign phase.

Harnessing landscape heterogeneity for managing future disturbance risks in forest ecosystems.

PubMed

Seidl, Rupert; Albrich, Katharina; Thom, Dominik; Rammer, Werner

2018-03-01

In order to prevent irreversible impacts of climate change on the biosphere it is imperative to phase out the use of fossil fuels. Consequently, the provisioning of renewable resources such as timber and biomass from forests is an ecosystem service of increasing importance. However, risk factors such as changing disturbance regimes are challenging the continuous provisioning of ecosystem services, and are thus a key concern in forest management. We here used simulation modeling to study different risk management strategies in the context of timber production under changing climate and disturbance regimes, focusing on a 8127 ha forest landscape in the Northern Front Range of the Alps in Austria. We show that under a continuation of historical management, disturbances from wind and bark beetles increase by +39.5% on average over 200 years in response to future climate change. Promoting mixed forests and climate-adapted tree species as well as increasing management intensity effectively reduced future disturbance risk. Analyzing the spatial patterns of disturbance on the landscape, we found a highly uneven distribution of risk among stands (Gini coefficients up to 0.466), but also a spatially variable effectiveness of silvicultural risk reduction measures. This spatial variability in the contribution to and control of risk can be used to inform disturbance management: Stands which have a high leverage on overall risk and for which risks can effectively be reduced (24.4% of the stands in our simulations) should be a priority for risk mitigation measures. In contrast, management should embrace natural disturbances for their beneficial effects on biodiversity in areas which neither contribute strongly to landscape-scale risk nor respond positively to risk mitigation measures (16.9% of stands). We here illustrate how spatial heterogeneity in forest landscapes can be harnessed to address both positive and negative effects of changing natural disturbance regimes in ecosystem management. Copyright © 2017 Elsevier Ltd. All rights reserved.

Harnessing landscape heterogeneity for managing future disturbance risks in forest ecosystems

PubMed Central

Seidl, Rupert; Albrich, Katharina; Thom, Dominik; Rammer, Werner

2018-01-01

In order to prevent irreversible impacts of climate change on the biosphere it is imperative to phase out the use of fossil fuels. Consequently, the provisioning of renewable resources such as timber and biomass from forests is an ecosystem service of increasing importance. However, risk factors such as changing disturbance regimes are challenging the continuous provisioning of ecosystem services, and are thus a key concern in forest management. We here used simulation modeling to study different risk management strategies in the context of timber production under changing climate and disturbance regimes, focusing on a 8127 ha forest landscape in the Northern Front Range of the Alps in Austria. We show that under a continuation of historical management, disturbances from wind and bark beetles increase by +39.5% on average over 200 years in response to future climate change. Promoting mixed forests and climate-adapted tree species as well as increasing management intensity effectively reduced future disturbance risk. Analyzing the spatial patterns of disturbance on the landscape, we found a highly uneven distribution of risk among stands (Gini coefficients up to 0.466), but also a spatially variable effectiveness of silvicultural risk reduction measures. This spatial variability in the contribution to and control of risk can be used to inform disturbance management: Stands which have a high leverage on overall risk and for which risks can effectively be reduced (24.4% of the stands in our simulations) should be a priority for risk mitigation measures. In contrast, management should embrace natural disturbances for their beneficial effects on biodiversity in areas which neither contribute strongly to landscape-scale risk nor respond positively to risk mitigation measures (16.9% of stands). We here illustrate how spatial heterogeneity in forest landscapes can be harnessed to address both positive and negative effects of changing natural disturbance regimes in ecosystem management. PMID:29275284

Urban Flood Risk Insurance Models as a Strategy for Proactive Water Management Policies

NASA Astrophysics Data System (ADS)

Graciosa, M. C.; Mendiondo, E. M.

2006-12-01

To improve the water management through hydrological sciences, novel integration strategies could be underpinned to bridge up both engineering and economics. This is especially significant in developing nations where hydrologic extremes are expressive while the financial resources to mitigate that variability are scarce. One example of this problem is related to floods and their global and regional consequences. Floods mainly cause disasters in terms of human and material losses. In 2002, more than 30% of extreme climatic events occurred worldwide were floods, representing 42% of fatalities and 66% of material losses, mostly related to reactive policies. Throughout the last century, hydrological variability and rapidly growing of urban areas have developed new environmental problems in Brazilian cities, such as inundation occurrences on non-planned river basins. One of the causes of flood impacts is that public funds (national, state or municipal) have barely introduced wise proactive polices to follow up rapidly growing urban areas. Inexistent flood-risk-transfer mechanisms have caused the so-called `flood poverty cycle' due to reactive polices that have been increasing flood losses and, sometimes, became flood disasters. Flood risk management (FRM) is part of pro-active policies to mitigate inundation losses, in order to sustain environmental, social and economic aspects. Concepts and principles of FRM are part of a process that encompasses three phases: (1) preparedness stage, that consists in structural and non-structural actions to prevent and protect potential risk areas, such as early warning systems and scenarios development; (2) control stage, that refers to help actions and protection facilities during the event, and (3) restoration stage, that is related to rebuild affected areas, restore the river dynamics and transfer the socio-economic risks through flood insurances. Flood risk insurances agree to the goals of losses mitigation programs. Their use is more common in basins affected by alluvial floods. However, most of losses occur in urban areas, as a consequence of flash floods. Quantification of losses is an important basis of flood mitigation programs. It is also a complex task, which involves setting values on not easily quantifiable goods and determining risk and damage curves. This work proposes a flood insurance risk model coupled with a hydrological model as an incentive-based mechanism for achieving economically efficient flood management to be applied in Brazilian urban basins. It consists of integrating an insurance model and hydrological modeling of peak discharge warnings. It sets up curves, such as: water level versus discharge, water level versus inundation areas, and inundation area versus damage. It considers the prediction of future scenarios in order to evaluate the behavior of the insurance fund under climate variability. By using different probability distribution is compared the solvency and efficiency of the flood insurance fund for each premium-covered situation. The methodology is outlined to provide resources for the FRM restoration phase. Results are depicted from an experimental river basin sited on a rapid growing urban area, with some lessons learned valid to approach in other urban basins. This example is envisaged to foster resilience in the integration of hydrological science with policy and economic approaches. KEY WORDS: Flood risks management; flood insurance; hydrological modeling.

Adolescent and parent diabetes distress in type 1 diabetes: the role of self-efficacy, perceived consequences, family responsibility and adolescent-parent discrepancies.

PubMed

Law, G Urquhart; Walsh, Jennifer; Queralt, Victoria; Nouwen, Arie

2013-04-01

To examine the association of adolescent and parent diabetes distress with perceived consequences, dietary self-efficacy, and discrepancies in diabetes family responsibility, in type 1 diabetes (T1D). 203 adolescents with T1D, aged 12-18, and their parents completed self-report questionnaires cross-sectionally. Higher HbA1c, greater perceived negative consequences of diabetes, and reduced self-efficacy predicted adolescent diabetes distress. Higher HbA1c predicted parental diabetes distress, as did diabetes family responsibility disagreements when both family members claimed responsibility, and parents' perception of reduced adolescent self-efficacy. Dietary self-efficacy and perceived negative consequences of diabetes are important factors to consider in assessing and managing adolescent diabetes distress. Perceptions of family responsibility for self-care tasks and parental confidence in adolescents' self-management have implications for parental diabetes distress. Clinical implications support long-held recommendations of taking a family-perspective of T1D care. Copyright © 2012 Elsevier Inc. All rights reserved.

Five potential consequences of climate change for invasive species.

PubMed

Hellmann, Jessica J; Byers, James E; Bierwagen, Britta G; Dukes, Jeffrey S

2008-06-01

Scientific and societal unknowns make it difficult to predict how global environmental changes such as climate change and biological invasions will affect ecological systems. In the long term, these changes may have interacting effects and compound the uncertainty associated with each individual driver. Nonetheless, invasive species are likely to respond in ways that should be qualitatively predictable, and some of these responses will be distinct from those of native counterparts. We used the stages of invasion known as the "invasion pathway" to identify 5 nonexclusive consequences of climate change for invasive species: (1) altered transport and introduction mechanisms, (2) establishment of new invasive species, (3) altered impact of existing invasive species, (4) altered distribution of existing invasive species, and (5) altered effectiveness of control strategies. We then used these consequences to identify testable hypotheses about the responses of invasive species to climate change and provide suggestions for invasive-species management plans. The 5 consequences also emphasize the need for enhanced environmental monitoring and expanded coordination among entities involved in invasive-species management.

Defence Capability Plan 2006-2016

DTIC Science & Technology

2006-06-14

and supply chain management ; and • developing strategies focussing on critical industry capabilities and Defence’s ability to manage supply and... managers undertake pre-approval study activity and prepare the necessary departmental documentation. More formal industry solicitation would continue...Defence Management Systems Improvement Less than $10m JP 2085 Phase 1B Explosive Ordnance Warstock $150m to $200m JP 2090 Phase 1B Combined Information

CAD/CAM and scientific data management at Dassault

NASA Technical Reports Server (NTRS)

Bohn, P.

1984-01-01

The history of CAD/CAM and scientific data management at Dassault are presented. Emphasis is put on the targets of the now commercially available software CATIA. The links with scientific computations such as aerodynamics and structural analysis are presented. Comments are made on the principles followed within the company. The consequences of the approximative nature of scientific data are examined. Consequence of the new history function is mainly its protection against copy or alteration. Future plans at Dassault for scientific data appear to be in opposite directions compared to some general tendencies.

Uncertainty Analysis of Consequence Management (CM) Data Products.

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

Hunt, Brian D.; Eckert-Gallup, Aubrey Celia; Cochran, Lainy Dromgoole

The goal of this project is to develop and execute methods for characterizing uncertainty in data products that are deve loped and distributed by the DOE Consequence Management (CM) Program. A global approach to this problem is necessary because multiple sources of error and uncertainty from across the CM skill sets contribute to the ultimate p roduction of CM data products. This report presents the methods used to develop a probabilistic framework to characterize this uncertainty and provides results for an uncertainty analysis for a study scenario analyzed using this framework.

A fuzzy model for assessing risk of occupational safety in the processing industry.

PubMed

Tadic, Danijela; Djapan, Marko; Misita, Mirjana; Stefanovic, Miladin; Milanovic, Dragan D

2012-01-01

Managing occupational safety in any kind of industry, especially in processing, is very important and complex. This paper develops a new method for occupational risk assessment in the presence of uncertainties. Uncertain values of hazardous factors and consequence frequencies are described with linguistic expressions defined by a safety management team. They are modeled with fuzzy sets. Consequence severities depend on current hazardous factors, and their values are calculated with the proposed procedure. The proposed model is tested with real-life data from fruit processing firms in Central Serbia.

Communication management between architects and clients

NASA Astrophysics Data System (ADS)

Taleb, Hala; Ismail, Syuhaida; Wahab, Mohammad Hussaini; Rani, Wan Nurul Mardiah Wan Mohd.

2017-10-01

Architectural projects are initiated with the designing phase, that tends to translate and materialize the client's requirements and needs. This phase is highly and directly affected by the exchanged information and communication between architects with their clients. Nevertheless, despite of its importance, studies have proven that communication management, being a significant field of project management, is distinctly overlooked by architects in the architectural industry. Thus, this paper highlights the current practices and attributes of communication management in the context of architectural design phase. It outlines the different aspects' definitions of communication, as well as communication management standards and practices. By the end of this paper, the findings are expected to increase the communication management knowledge amongst architects to achieve success in projects by promoting the relationships between them and their clients. Finally, this paper uncover the architects' need for significant improvement of communication management as an insistent matter to ultimately fulfill project success.

Alabama Coronary Artery Bypass Grafting Project

PubMed Central

Holman, William L.; Sansom, Monique; Kiefe, Catarina I.; Peterson, Eric D.; Hubbard, Steve G.; Delong, James F.; Allman, Richard M.

2004-01-01

Objective/Background: This report describes the first round of results for Phase II of the Alabama CABG Project, a regional quality improvement initiative. Methods: Charts submitted by all hospitals in Alabama performing CABG (ICD-9 codes 36.10–36.20) were reviewed by a Clinical Data Abstraction Center (CDAC) (preintervention 1999–2000; postintervention 2000–2001). Variables that described quality in Phase I were abstracted for Phase II and data describing the new variables of β-blocker use and lipid management were collected. Data samples collected onsite by participating hospitals were used for rapid cycle improvement in Phase II. Results: CDAC data (n = 1927 cases in 1999; n = 2001 cases in 2000) showed that improvements from Phase I in aspirin prescription, internal mammary artery use, and duration of intubation persisted in Phase II. During Phase II, use of β-blockers before, during, or after CABG increased from 65% to 76% of patients (P < 0.05). Appropriate lipid management, an aggregate variable, occurred in 91% of patients before and 91% after the educational intervention. However, there were improvements in 3 of 5 subcategories for lipid management (documenting a lipid disorder [52%–57%], initiating drug therapy [45%–53%], and dietary counseling [74%–91%]; P < 0.05). Conclusions: In Phase II, this statewide process-oriented quality improvement program added two new measures of quality. Achievements of quality improvement from Phase I persisted in Phase II, and improvements were seen in the new variables of lipid management and perioperative use of β-blockers. PMID:14685107

The valence bond glass phase

NASA Astrophysics Data System (ADS)

Tarzia, M.; Biroli, G.

2008-06-01

We show that a new glassy phase can emerge in the presence of strong magnetic frustration and quantum fluctuations. It is a valence bond glass (VBG). We study its properties solving the Hubbard-Heisenberg model on a Bethe lattice within the large-N limit introduced by Affleck and Marston. We work out the phase diagram that contains Fermi liquid, dimer and valence bond glass phases. This new glassy phase has no electronic or spin gap (although a pseudo-gap is observed), it is characterized by long-range critical valence bond correlations and is not related to any magnetic ordering. As a consequence, it is quite different from both valence bond crystals and spin glasses.

Risk and resilience in the shale gas context: a nexus perspective

NASA Astrophysics Data System (ADS)

Rosales, T. Y.; Notte, C. A.; Allen, D. M.; Kirste, D. M.

2014-12-01

The accelerated exploration for and development of unconventional gas plays around the world has raised public concern about potential risks to human health and the environment. In this study, a risk assessment framework specific to shale gas development is proposed. The framework aims to quantify and/or qualify both risk and resilience within a water-energy nexus context, using a comprehensive approach that considers environment, health and policy. The risk assessment framework is intended to be flexible so that it can be used in different regions, but will be tested in North East British Columbia, Canada where shale gas development is rapidly expanding. The main components of risk include hazards, susceptibility and potential consequences, which will be evaluated in space and time using ArcGIS software. The hazards are associated with all phases of shale gas development and include: water, air, and soil contamination; water use (surface and groundwater), and land use disturbance, and their assessment will take into account where they may occur, their frequency, duration and magnitude. Hazard-specific susceptibility maps will be generated based on the physical characteristics of the environment (e.g. soil, geology, hydrology, topography) as well as water source information (e.g. well locations), community footprints, etc. When combined with an evaluation of potential consequences, the resulting set of spatial risk maps can then be used for water resource management, land use planning, and industry permitting. Resilience, which buffers risk, here considers the existing regulatory framework and whether or not existing regulations can mitigate risk by reducing the hazard potential or consequences. The study considers how regulations may fully, partially, or inadequately mitigate the consequences of a given hazard. If development is to continue at its current pace in North East BC, it is imperative that decision-makers recognize the changing risk and resilience profiles and respond with appropriate policy. A critical component of the study comprises a gap analysis of current regulation and a possible path forward.

In-phased second harmonic wave array generation with intra-Talbot-cavity frequency-doubling.

PubMed

Hirosawa, Kenichi; Shohda, Fumio; Yanagisawa, Takayuki; Kannari, Fumihiko

2015-03-23

The Talbot cavity is one promising method to synchronize the phase of a laser array. However, it does not achieve the lowest array mode with the same phase but the highest array mode with the anti-phase between every two adjacent lasers, which is called out-phase locking. Consequently, their far-field images exhibit 2-peak profiles. We propose intra-Talbot-cavity frequency-doubling. By placing a nonlinear crystal in a Talbot cavity, the Talbot cavity generates an out-phased fundamental wave array, which is converted into an in-phase-locked second harmonic wave array at the nonlinear crystal. We demonstrate numerical calculations and experiments on intra-Talbot-cavity frequency-doubling and obtain an in-phase-locked second harmonic wave array for a Nd:YVO₄ array laser.

The neglected role of distress in pain management: qualitative research on a gastrointestinal ward.

PubMed

Drake, Gareth; Williams, Amanda C de C

2018-05-09

Pain management for hospital inpatients remains suboptimal. Previously identified barriers to optimal pain management include staff communication difficulties, confusion around pain management roles and a lack of suitable resources for clinical staff. The emotional, relational and contextual complexities of gastrointestinal (GI) pain create particular challenges for frontline clinical staff attempting to implement a biopsychosocial approach to its management. The current study took place over 2 years, comprised an ethnographic and a feedback phase, and aimed to examine pain management processes with clinical staff in order to generate hypotheses and initiatives for improvement. This paper focuses on two overarching themes identified in the ethnographic phase of the study, centred on the neglected role of both staff and patient distress in GI pain management. Grounded theory and thematic analysis methods were used as part of action research, which involves collaborative working with clinical staff. The study took place on a 60 bed GI ward in a university hospital in London. Participants were clinical staff who were either ward-based or involved in the care of particular patients. This latter group included doctors, nurses, psychologists and physiotherapists from the Acute and Complex Pain Teams. Qualitative data on pain management processes was gathered from staff interviews, consultation groups, and observations of patient-staff interactions. Recruitment was purposive and collaborative in that early participants suggested targets and staff groups for subsequent enquiry. Following the identification of initial ethnographic themes, further analysis and the use of existing literature led to the identification of two overarching pain management processes. As such the results are divided into three sections: (i) illustration of initial ethnographic themes, (ii) summary of relevant theory used, (iii) exploration of hypothesised overarching processes. Initially, two consultation groups, five nursing staff and five junior doctors, provided key issues that were included in subsequent interviews (n=18) and observations (n=5). Initial ethnographic themes were divided into challenges and resources, reflecting the emergent structure of interviews and observations. Drawing on attachment, psychodynamic and evolutionary theories, themes were then regrouped around two overarching processes, centred on the neglected role of distress in pain management. The first process elucidates the lack of recognition during pain assessment of the emotional impact of patient distress on staff decision-making and pain management practice. The second process demonstrates that, as a consequence of resultant staff distress, communication between staff groups was fraught and resources, such as expert team referral and pharmacotherapy, appeared to function, at times, to protect staff rather than to help patients. Interpersonal skills used by staff to relieve patient distress were largely outside systems for pain care. Findings suggest that identified "barriers" to optimal pain management likely serve an important defensive function for staff and organisations. Unless the impact of patient distress on staff is recognised and addressed within the system, these barriers will persist.

Beyond wilderness: Broadening the applicability of limits of acceptable change

Treesearch

Mark W. Brunson

1977-01-01

The Limits of Acceptable Change (LAC) process helps managers preserve wilderness attributes along with recreation opportunities. Ecosystem management likewise requires managers to balance societal and ecosystem needs. Both are more likely to succeed through collaborative planning. Consequently, LAC can offer a conceptual framework for achieving sustainable solutions...

77 FR 30320 - General Management Plan/Environmental Impact Statement, Ross Lake National Recreation Area, North...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-22

... Management Plan/Environmental Impact Statement, Ross Lake National Recreation Area, North Cascades National... Impact Statement for the new General Management Plan (GMP) for Ross Lake National Recreation Area, part... Wilderness Act of 1988. The full range of foreseeable environmental consequences from implementing the...

Congruent Knowledge Management Behaviors as Discriminate Sources of Competitive Advantage

ERIC Educational Resources Information Center

Magnier-Watanabe, Remy; Senoo, Dai

2009-01-01

Purpose: While knowledge management has been shown to be a strategic source of competitive advantage, processes designed to enhance the productivity of knowledge do not, however, equally contribute to the organization's capabilities. Consequently, this research aims to focus on the relationship between each mode of the knowledge management process…

Broad-scale consequences of land management: Columbia basin example.

Treesearch

Richard W. Haynes; Thomas M. Quigley

2001-01-01

Integrating management actions to consistently achieve broad ecological and socioeconomic goals is a challenge largely unmet. The presumed or real conflict between these goals establishes a forum for debate. Broad measures are needed to describe tradeoffs, trends in conditions under varying management scenarios, and a transparent science underpinning. The Interior...

[Case management process identified from experience of nurse case managers].

PubMed

Park, Eun-Jun; Kim, Chunmi

2008-12-01

The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

Cancer as quasi-attractor in the gene expression phase space

NASA Astrophysics Data System (ADS)

Giuliani, A.

2017-09-01

It takes no more than 250 tissue types to build up a metazoan, and each tissue has a specific and largely invariant gene expression signature. This implies the `viable configurations' correspondent to a given activated/inactivated expression pattern over the entire genome are very few. This points to the presence of few `low energy deep valleys' correspondent to the allowed states of the system and is a direct consequence of the fact genes do not work by alone but embedded into genetic expression networks. Statistical thermodynamics formalism focusing on the changes in the degree of correlation of the studied systems allows to detect transition behavior in gene expression phase space resembling the phase transition of physical-chemistry studies. In this realm cancer can be intended as a sort of `parasite' sub-attractor of the corresponding healthy tissue that, in the case of disease, is `kinetically entrapped' into a sub-optimal solution. The consequences of such a state of affair for cancer therapies are potentially huge.

Characterization of a cold-rolled 2101 lean duplex stainless steel.

PubMed

Bassani, Paola; Breda, Marco; Brunelli, Katya; Mészáros, Istvan; Passaretti, Francesca; Zanellato, Michela; Calliari, Irene

2013-08-01

Duplex stainless steels (DSS) may be defined as a category of steels with a two-phase ferritic-austenitic microstructure, which combines good mechanical and corrosion properties. However, these steels can undergo significant microstructural modification as a consequence of either thermo-mechanical treatments (ferrite decomposition, which causes σ- and χ-phase formation and nitride precipitation) or plastic deformation at room temperature [austenite transformation into strain-induced martensite (SIM)]. These secondary phases noticeably affect the properties of DSS, and therefore are of huge industrial interest. In the present work, SIM formation was investigated in a 2101 lean DSS. The material was subjected to cold rolling at various degrees of deformation (from 10 to 80% thickness reduction) and the microstructure developed after plastic deformation was investigated by electron backscattered diffraction, X-ray diffraction measurements, and hardness and magnetic tests. It was observed that SIM formed as a consequence of deformations higher than ~20% and residual austenite was still observed at 80% of thickness reduction. Furthermore, a direct relationship was found between microstructure and magnetic properties.

Reduced vibration motor winding arrangement

DOEpatents

Slavik, C.J.; Rhudy, R.G.; Bushman, R.E.

1997-11-11

An individual phase winding arrangement having a sixty electrical degree phase belt width for use with a three phase motor armature includes a delta connected phase winding portion and a wye connected phase winding portion. Both the delta and wye connected phase winding portions have a thirty electrical degree phase belt width. The delta and wye connected phase winding portions are each formed from a preselected number of individual coils each formed, in turn, from an unequal number of electrical conductor turns in the approximate ratio of {radical}3. The individual coils of the delta and wye connected phase winding portions may either be connected in series or parallel. This arrangement provides an armature winding for a three phase motor which retains the benefits of the widely known and utilized thirty degree phase belt concept, including improved mmf waveform and fundamental distribution factor, with consequent reduced vibrations and improved efficiency. 4 figs.

Application of phase-change materials in memory taxonomy.

PubMed

Wang, Lei; Tu, Liang; Wen, Jing

2017-01-01

Phase-change materials are suitable for data storage because they exhibit reversible transitions between crystalline and amorphous states that have distinguishable electrical and optical properties. Consequently, these materials find applications in diverse memory devices ranging from conventional optical discs to emerging nanophotonic devices. Current research efforts are mostly devoted to phase-change random access memory, whereas the applications of phase-change materials in other types of memory devices are rarely reported. Here we review the physical principles of phase-change materials and devices aiming to help researchers understand the concept of phase-change memory. We classify phase-change memory devices into phase-change optical disc, phase-change scanning probe memory, phase-change random access memory, and phase-change nanophotonic device, according to their locations in memory hierarchy. For each device type we discuss the physical principles in conjunction with merits and weakness for data storage applications. We also outline state-of-the-art technologies and future prospects.

Reduced vibration motor winding arrangement

DOEpatents

Slavik, Charles J.; Rhudy, Ralph G.; Bushman, Ralph E.

1997-01-01

An individual phase winding arrangement having a sixty electrical degree phase belt width for use with a three phase motor armature includes a delta connected phase winding portion and a wye connected phase winding portion. Both the delta and wye connected phase winding portions have a thirty electrical degree phase belt width. The delta and wye connected phase winding portions are each formed from a preselected number of individual coils each formed, in turn, from an unequal number of electrical conductor turns in the approximate ratio of .sqroot.3. The individual coils of the delta and wye connected phase winding portions may either be connected in series or parallel. This arrangement provides an armature winding for a three phase motor which retains the benefits of the widely known and utilized thirty degree phase belt concept, including improved mmf waveform and fundamental distribution factor, with consequent reduced vibrations and improved efficiency.

49 CFR 192.905 - How does an operator identify a high consequence area?

Code of Federal Regulations, 2010 CFR

2010-10-01

...) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Gas Transmission Pipeline Integrity Management § 192.905 How does an operator identify a high consequence area? (a...

40 CFR 1400.5 - Internet access to certain off-site consequence analysis data elements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AGENCY AND DEPARTMENT OF JUSTICE ACCIDENTAL RELEASE PREVENTION REQUIREMENTS; RISK MANAGEMENT PROGRAMS... elements in the risk management plan database available on the Internet: (a) The concentration of the...

41 CFR 301-73.105 - What are the consequences of an employee not using the E-Gov Travel Service or the TMS?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 41 Public Contracts and Property Management 4 2014-07-01 2014-07-01 false What are the consequences of an employee not using the E-Gov Travel Service or the TMS? 301-73.105 Section 301-73.105 Public... What are the consequences of an employee not using the E-Gov Travel Service or the TMS? If an employee...

41 CFR 301-73.105 - What are the consequences of an employee not using the E-Gov Travel Service or the TMS?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 4 2013-07-01 2012-07-01 true What are the consequences of an employee not using the E-Gov Travel Service or the TMS? 301-73.105 Section 301-73.105 Public... What are the consequences of an employee not using the E-Gov Travel Service or the TMS? If an employee...

41 CFR 301-73.105 - What are the consequences of an employee not using the E-Gov Travel Service or the TMS?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 41 Public Contracts and Property Management 4 2012-07-01 2012-07-01 false What are the consequences of an employee not using the E-Gov Travel Service or the TMS? 301-73.105 Section 301-73.105 Public... What are the consequences of an employee not using the E-Gov Travel Service or the TMS? If an employee...

41 CFR 301-73.105 - What are the consequences of an employee not using the E-Gov Travel Service or the TMS?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What are the consequences of an employee not using the E-Gov Travel Service or the TMS? 301-73.105 Section 301-73.105 Public... What are the consequences of an employee not using the E-Gov Travel Service or the TMS? If an employee...

41 CFR 301-73.105 - What are the consequences of an employee not using the E-Gov Travel Service or the TMS?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 4 2011-07-01 2011-07-01 false What are the consequences of an employee not using the E-Gov Travel Service or the TMS? 301-73.105 Section 301-73.105 Public... What are the consequences of an employee not using the E-Gov Travel Service or the TMS? If an employee...

Theory of disordered unconventional superconductors

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

Keles, A.; Andreev, A. V.; Spivak, B. Z., E-mail: spivak@uw.edu

In contrast to conventional s-wave superconductivity, unconventional (e.g., p- or d-wave) superconductivity is strongly suppressed even by relatively weak disorder. Upon approaching the superconductormetal transition, the order parameter amplitude becomes increasingly inhomogeneous, leading to effective granularity and a phase ordering transition described by the Mattis model of spin glasses. One consequence of this is that at sufficiently low temperatures, between the clean unconventional superconducting and the diffusive metallic phases, there is necessarily an intermediate superconducting phase that exhibits s-wave symmetry on macroscopic scales.

Phase Memory Preserving Harmonics from Abruptly Autofocusing Beams.

PubMed

Koulouklidis, Anastasios D; Papazoglou, Dimitris G; Fedorov, Vladimir Yu; Tzortzakis, Stelios

2017-12-01

We demonstrate both theoretically and experimentally that the harmonics from abruptly autofocusing ring-Airy beams present a surprising property: They preserve the phase distribution of the fundamental beam. Consequently, this "phase memory" imparts to the harmonics the abrupt autofocusing behavior, while, under certain conditions, their foci coincide in space with the one of the fundamental. Experiments agree well with our theoretical estimates and detailed numerical calculations. Our findings open the way for the use of such beams and their harmonics in strong field science.

Exploring staff diabetes medication knowledge and practices in regional residential care: triangulation study.

PubMed

Wellard, Sally Jane; Rasmussen, Bodil; Savage, Sally; Dunning, Trisha

2013-07-01

This study is drawn from a larger project that aimed to identify the staffing and organisational factors influencing the quality of diabetes care for older people living in residential care in regional Victoria, Australia. The focus of the current study is on medication management for residents with diabetes. With a continuous rise in diabetes in the population, there is an associated increase in the prevalence of diabetes in aged care residential settings. However, there is little specific guidance on how to manage diabetes in older people living in institutional settings who experience multiple concurrent chronic conditions. A triangulation strategy consisting of three phases. A one-shot cross-sectional survey (n = 68) focus group interviews and a case file audit (n = 20). Data were collected between May 2009-January 2010. Staff knowledge of diabetes and its contemporary medication management was found to be suboptimal. Challenges to managing residents with diabetes included limited time, resident characteristics and communication systems. Additionally, the variability in medical support available to residents and a high level of polypharmacy added to the complexity of medication management of resident. The current study suggests administering medicine to residents in aged care settings is difficult and has potentially serious medical, professional and economic consequences. Limitations to staff knowledge of contemporary diabetes care and medications potentially place residents with diabetes at risk of receiving less than optimal diabetes care. Providing evidence-based guidelines about diabetes care in residential care settings is essential to achieve acceptable outcomes and increase the quality of life for residents in public aged care. Continuing education programs in diabetes care specifically related to medication must be provided to all health professionals and encompass scope of practice. © 2013 John Wiley & Sons Ltd.

A randomized controlled trial to evaluate the effectiveness of a cognitive behavioural group approach to improve patient adherence to peritoneal dialysis fluid restrictions: a pilot study.

PubMed

Hare, Jennifer; Clark-Carter, David; Forshaw, Mark

2014-03-01

Peritoneal dialysis (PD) requires patients to take an active role in their adherence to fluid restrictions. Although fluid non-adherence had been identified among this patient group, no specific interventions have been researched or published with in the PD population. The current study sought to investigate whether an applied cognitive behavioural therapy (CBT-based intervention) used among haemodialysis patients would improve fluid adherence among PD patients; utilizing clinical indicators used in practice. Fifteen PD patients identified as fluid non-adherent were randomly assigned to an intervention group (IG) or a deferred-entry control group (CG). The study ran for a total of 21 weeks, with five data collection points; at baseline, post-intervention and at three follow-up points; providing a RCT phase and a combined longitudinal analysis phase. The content of the group intervention encompassed educational, cognitive and behavioural components, aimed to assist patients' self-management of fluid. No significant differences in weight (kg) reduction were found in either phase and undesirable changes in blood pressure (BP) were observed. However, in the longitudinal phase, a statistically significant difference in oedematous status was observed at 6-week follow-up; which may be indicative of fluid adherence. Positive and significant differences were observed in the desired direction for measures of psychological well-being, quality of life and health beliefs; areas correlated with enhanced fluid adherence in other research. This study reveals encouraging and significant changes in predictors of fluid adherence. Although there were no significant changes in weight as a crude clinical measure of fluid intake, significant reductions in oedematous status were observed as a consequence of this CBT-based group intervention.

Specific CDK4/6 inhibition in breast cancer: a systematic review of current clinical evidence

PubMed Central

Polk, Anne; Kolmos, Ida Lykke; Kümler, Iben; Nielsen, Dorte Lisbeth

2016-01-01

Background Loss of cell cycle control is a hallmark of cancer, and aberrations in the cyclin-dependent kinase-retinoblastoma (CDK-Rb) pathway are common in breast cancer (BC). Consequently, inhibition of this pathway is an attractive therapeutic strategy. The present review addresses efficacy and toxicity of CDK4/6 inhibition in BC. Methods A literature search was carried out using PubMed and EMBASE; data reported at international meetings and clinicaltrials.gov were included. Results Three specific CDK4/6 inhibitors palbociclib, abemaciclib and ribociclib are tested in clinical trials. A randomised phase II trial of palbociclib plus letrozole versus letrozole and a phase III of palbociclib plus fulvestrant versus fulvestrant showed significantly increased progression-free survival when compared with endocrine therapy alone in first-line and second-line treatment for advanced hormone receptor-positive HER2-negative BC. At the moment several phase III studies are ongoing with all three CDK4/6 inhibitors in hormone receptor-positive HER2-negative BC as well as other subtypes of BC. The predominant toxicity of agents was limited neutropenia. Other common adverse events were infections, fatigue and gastrointestinal toxicity. The toxicities seemed manageable. Yet data are too limited to differentiate between the compounds. Retinoblastoma protein (Rb) is considered a promising biomarker. Conclusion CDK4/6 inhibition might represent a substantial advance for patients with hormone receptor-positive HER2-negative BC. Results must be confirmed in phase III trials before any firm conclusions can be made regarding the future influence of CDK4/6 inhibition. There is an urgent need for prospective biomarker-driven trials to identify patients for whom CDK4/6 inhibition is cost-effective. PMID:28848657

[Carbetocin use to prevent obstetric hemorrhage].

PubMed

Posadas Robledo, Francisco Javier

2011-07-01

in Mexico, obstetric hemorrhage and its complications are the second leading cause of maternal death and is the origin of irreversible functional consequences. Carbetocin is a synthetic analogue of oxytocin with an average lifespan four times that of oxytocin and pharmacological effects of 120 minutes produces a tonic contraction which reduces postpartum blood loss. To evaluate the usefulness of carbetocin to prevent uterine bleeding complications and maternal deaths and assess the benefits, effectiveness and side effects. Prospective, observational clinical research in two phases, the first from May 2005 to January 2006 with a sample of 40 patients and the second from January to December of 2008 with a sample of 72 patients conducted at the Hospital Materno Infantil Dr. Alberto López Hermosa, San Luis Potosi. All were high-risk pregnancies and medical complications that warranted specialty hospital management. The intervention consisted of applying undiluted single dose of 100 micrograms of intravenous carbetocin at the time of delivery, as prophylaxis in patients with uterine overdistention in the first phase of the study and complicated pregnancies in the second phase. Were born by caesarean section over 60%. Initially, the hemoglobin showed a reduction of 17% after delivery. Seven patients required blood transfusion (17.5%). In the second phase, 65 patients (90%) did not require transfusion, only 6 patients (8%) required transfusion. No side effects were documented. Uterine overdistension was the main risk factor for bleeding and transfusion. Carbetocin combines the safety of oxytocin and the strength of the ergonovine preparations. To determine where carbetocin will be situated in the future as an useful oxytocic, it requires more than a simple demonstration of its effectiveness. This should be determined in each clinical situation, with factors such as overdistended uterus, indicating the convenience and economic constraints.

Development of Novel PEM Membrane and Multiphase CD Modeling of PEM Fuel Cell

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

K. J. Berry; Susanta Das

2009-12-30

To understand heat and water management phenomena better within an operational proton exchange membrane fuel cell's (PEMFC) conditions, a three-dimensional, two-phase computational fluid dynamic (CFD) flow model has been developed and simulated for a complete PEMFC. Both liquid and gas phases are considered in the model by taking into account the gas flow, diffusion, charge transfer, change of phase, electro-osmosis, and electrochemical reactions to understand the overall dynamic behaviors of species within an operating PEMFC. The CFD model is solved numerically under different parametric conditions in terms of water management issues in order to improve cell performance. The results obtainedmore » from the CFD two-phase flow model simulations show improvement in cell performance as well as water management under PEMFCs operational conditions as compared to the results of a single phase flow model available in the literature. The quantitative information obtained from the two-phase model simulation results helped to develop a CFD control algorithm for low temperature PEM fuel cell stacks which opens up a route in designing improvement of PEMFC for better operational efficiency and performance. To understand heat and water management phenomena better within an operational proton exchange membrane fuel cell's (PEMFC) conditions, a three-dimensional, two-phase computational fluid dynamic (CFD) flow model has been developed and simulated for a complete PEMFC. Both liquid and gas phases are considered in the model by taking into account the gas flow, diffusion, charge transfer, change of phase, electro-osmosis, and electrochemical reactions to understand the overall dynamic behaviors of species within an operating PEMFC. The CFD model is solved numerically under different parametric conditions in terms of water management issues in order to improve cell performance. The results obtained from the CFD two-phase flow model simulations show improvement in cell performance as well as water management under PEMFCs operational conditions as compared to the results of a single phase flow model available in the literature. The quantitative information obtained from the two-phase model simulation results helped to develop a CFD control algorithm for low temperature PEM fuel cell stacks which opens up a route in designing improvement of PEMFC for better operational efficiency and performance.« less

Projecting Forest Policy and Management Effects across Ownerships in Coastal Oregon

Treesearch

Thomas A. Spies; K. Norman Johnson

2007-01-01

Two of the most fundamental questions in forest ecosystem management are: (1) What are the consequences of different forest management practices? and (2) How do they vary with spatial and temporal scale? The forest management controversies of the 1990s in the Pacific Northwest revolved around these questions and led to major new forest polices in the region for federal...

Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction

PubMed Central

Pedraza, Rodrigo; Nieto, Javier; Ibarra, Sergio; Haas, Eric M.

2014-01-01

Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR) is a noninvasive modality involving cognitive reeducation, modification, and retraining of the pelvic floor and associated musculature. We describe our standardized PMR protocol for the management of pelvic floor dysfunction syndromes. Pelvic Muscle Rehabilitation Program. The diagnostic assessment includes electromyography and manometry analyzed in 4 phases: (1) initial baseline phase; (2) rapid contraction phase; (3) tonic contraction and endurance phase; and (4) late baseline phase. This evaluation is performed at the onset of every session. PMR management consists of 6 possible therapeutic modalities, employed depending on the diagnostic evaluation: (1) down-training; (2) accessory muscle isolation; (3) discrimination training; (4) muscle strengthening; (5) endurance training; and (6) electrical stimulation. Eight to ten sessions are performed at one-week intervals with integration of home exercises and lifestyle modifications. Conclusions. The PMR protocol offers a standardized approach to diagnose and manage pelvic floor dysfunction syndromes with potential advantages over traditional biofeedback, involving additional interventions and a continuous pelvic floor assessment with management modifications over the clinical course. PMID:25006337

Managed care. Shifts health care from an altruistic model to a business framework.

PubMed

Kersbergen, A L

2000-01-01

The term managed care, as used throughout the scientific and lay literature, has become a generic label without a clear, universally accepted definition. The many definitions and descriptions of managed care are usually directly related to the model under discussion. Nevertheless, as nurse educators attempt to align curricula with the evolving health care environment, it is imperative that students gain an understanding of the concept of managed care and the skills needed to practice in the managed care environment. Schools of nursing must prepare students to deal with the consequences of managed care, namely, the changing base of power, conflicts, and ethical dilemmas across settings. The drive to control health care costs in the 1990s brought about unprecedented change for nurses. Regardless of the strategies implemented in the name of managing care, the evolving health care environment has changed where and how nurses practice. To aid faculty in the revision of the nursing curriculum, an attempt was made to arrive at an empirically based definition of managed care that will provide a conceptual foundation for future research and theoretical discussions. Other goals were to identify consequences of managed care across disciplines and models implemented in the name of managing care, and to identify skills needed by nurses today.

Transdermal Alcohol Concentration Data Collected During a Contingency Management Program to Reduce At-Risk Drinking

PubMed Central

Dougherty, Donald M.; Karns, Tara E.; Mullen, Jillian; Liang, Yuanyuan; Lake, Sarah L.; Roache, John D.; Hill-Kapturczak, Nathalie

2017-01-01

Background Recently, we demonstrated that transdermal alcohol monitors could be used in a contingency management procedure to reduce problematic drinking; the frequency of self-reported heavy/moderate drinking days decreased and days of no to low drinking increased. These effects persisted for three months after intervention. In the current report, we used the transdermal alcohol concentration (TAC) data collected prior to and during the contingency management procedure to provide a detailed characterization of objectively measured alcohol use. Methods Drinkers (n = 80) who frequently engaged in risky drinking behaviors were recruited and participated in three study phases: a 4-week Observation phase where participants drank as usual; a 12-week Contingency Management phase where participants received $50 each week when TAC did not exceed 0.03 g/dl; and a 3-month Follow-up phase where self-reported alcohol consumption was monitored. Transdermal monitors were worn during the first two phases, where each week they recived $105 for visiting the clinic and wearing the monitor. Outcomes focused on using TAC data to objectively characterize drinking and were used to classify drinking levels as either no, low, moderate, or heavy drinking as a function of weeks and day of week. Results Compared to the Observation phase, TAC data indicated that episodes of heavy drinking days during the Contingency Management phase were reduced and episodes of no drinking and low to moderate drinking increased. Conclusions These results lend further support for linking transdermal alcohol monitoring with contingency management interventions. Collectively, studies to date indicate that interventions like these may be useful for both abstinence and moderation-based programs. PMID:25582388

Transdermal alcohol concentration data collected during a contingency management program to reduce at-risk drinking.

PubMed

Dougherty, Donald M; Karns, Tara E; Mullen, Jillian; Liang, Yuanyuan; Lake, Sarah L; Roache, John D; Hill-Kapturczak, Nathalie

2015-03-01

Recently, we demonstrated that transdermal alcohol monitors could be used in a contingency management procedure to reduce problematic drinking; the frequency of self-reported heavy/moderate drinking days decreased and days of no to low drinking increased. These effects persisted for three months after intervention. In the current report, we used the transdermal alcohol concentration (TAC) data collected prior to and during the contingency management procedure to provide a detailed characterization of objectively measured alcohol use. Drinkers (n=80) who frequently engaged in risky drinking behaviors were recruited and participated in three study phases: a 4-week Observation phase where participants drank as usual; a 12-week Contingency Management phase where participants received $50 each week when TAC did not exceed 0.03g/dl; and a 3-month Follow-up phase where self-reported alcohol consumption was monitored. Transdermal monitors were worn during the first two phases, where each week they recived $105 for visiting the clinic and wearing the monitor. Outcomes focused on using TAC data to objectively characterize drinking and were used to classify drinking levels as either no, low, moderate, or heavy drinking as a function of weeks and day of week. Compared to the Observation phase, TAC data indicated that episodes of heavy drinking days during the Contingency Management phase were reduced and episodes of no drinking and low to moderate drinking increased. These results lend further support for linking transdermal alcohol monitoring with contingency management interventions. Collectively, studies to date indicate that interventions like these may be useful for both abstinence and moderation-based programs. Copyright © 2015. Published by Elsevier Ireland Ltd.

The Laureate English Program: Taking a Research Informed Approach to Blended Learning

ERIC Educational Resources Information Center

Johnson, Christopher; Marsh, Debra

2013-01-01

The aim of this case study is to describe the implementation of the Laureate English Program (LEP), the consequent decision to roll out blended learning across the network, and the Laureate-Cambridge University Press research partnership. Phase 1 of the research was completed in September 2012. The goal of this first phase was to gain a general…

The Foundation Phase in Wales--A Play-Based Curriculum That Supports the Development of Physical Literacy

ERIC Educational Resources Information Center

Wainwright, N.; Goodway, J.; Whitehed, M.; Williams, A.; Kirk, D.

2016-01-01

In 2008, the Welsh Assembly Government began the implementation of a new holistic play-based learning continuum for children aged three to seven called the Foundation Phase. Areas of learning replaced subjects and consequently pupils in Wales under the age of seven no longer study Physical Education in its traditional form. With growing…

Pilgrims: A Simulation of the First Year at Plymouth Colony.

ERIC Educational Resources Information Center

Flint, Myron

This simulation allows students to learn about the struggle of daily life in Plymouth Colony. Students experience the hardships of life in the New World as they make decisions and face consequences as the Pilgrims did nearly 400 years ago. The unit is divided into nine phases with each phase taking approximately one hour of class time. Students…

Using Lean Management to Reduce Emergency Department Length of Stay for Medicine Admissions.

PubMed

Allaudeen, Nazima; Vashi, Anita; Breckenridge, Julia S; Haji-Sheikhi, Farnoosh; Wagner, Sarah; Posley, Keith A; Asch, Steven M

The practice of boarding admitted patients in the emergency department (ED) carries negative operational, clinical, and patient satisfaction consequences. Lean tools have been used to improve ED workflow. Interventions focused on reducing ED length of stay (LOS) for admitted patients are less explored. To evaluate a Lean-based initiative to reduce ED LOS for medicine admissions. Prospective quality improvement initiative performed at a single university-affiliated Department of Veterans Affairs (VA) medical center from February 2013 to February 2016. We performed a Lean-based multidisciplinary initiative beginning with a rapid process improvement workshop to evaluate current processes, identify root causes of delays, and develop countermeasures. Frontline staff developed standard work for each phase of the ED stay. Units developed a daily management system to reinforce, evaluate, and refine standard work. The primary outcome was the change in ED LOS for medicine admissions pre- and postintervention. ED LOS at the intervention site was compared with other similar VA facilities as controls over the same time period using a difference-in-differences approach. ED LOS for medicine admissions reduced 26.4%, from 8.7 to 6.4 hours. Difference-in-differences analysis showed that ED LOS for combined medicine and surgical admissions decreased from 6.7 to 6.0 hours (-0.7 hours, P = .003) at the intervention site compared with no change (5.6 hours, P = .2) at the control sites. We utilized Lean management to significantly reduce ED LOS for medicine admissions. Specifically, the development and management of standard work were key to sustaining these results.

Climate Change, Carbon Dioxide, and Pest Biology: Monitor, Mitigate, Manage.

PubMed

Ziska, Lewis H; McConnell, Laura L

2016-01-13

Rising concentrations of atmospheric carbon dioxide ([CO2]) and subsequent changes in climate, including temperature and precipitation extremes, are very likely to alter pest pressures in both managed and unmanaged plant communities. Such changes in pest pressures can be positive (migration from a region) or negative (new introductions), but are likely to be accompanied by significant economic and environmental consequences. Recent studies indicate the range of invasive weeds such as kudzu and insects such as mountain pine beetle have already expanded to more northern regions as temperatures have risen. To reduce these consequences, a better understanding of the link between CO2/climate and pest biology is needed in the context of existing and new strategies for pest management. This paper provides an overview of the probable biological links and the vulnerabilities of existing pest management (especially chemical control) and provides a preliminary synthesis of research needs that could potentially improve the ability to monitor, mitigate, and manage pest impacts.

Alcohol Use Disorders in Pregnancy

PubMed Central

DeVido, Jeffrey; Bogunovic, Olivera; Weiss, Roger D.

2015-01-01

Alcohol use disorders (AUD) during pregnancy are less prevalent than in non-pregnant women, but they can create a host of clinical challenges when encountered. Unfortunately, there is little research information available to guide clinical decision-making in this population. Drinking alcohol during pregnancy can have negative consequences on both fetus and mother, but there is controversy regarding the volume of alcohol consumption that correlates with these consequences. There is little evidence to support the use of pharmacologic interventions for AUD during pregnancy. Similarly, there are few data to guide management of alcohol detoxification in pregnant women, and the use of benzodiazepines (the mainstay of most alcohol detoxification protocols) in pregnant women is controversial. Despite a lack of robust data to guide management of AUDs in pregnancy, clinicians must nonetheless make management decisions when confronted with these challenging situations. Therefore, this paper reviews the epidemiology of AUDs in pregnancy, and the pharmacologic management of both AUDs and alcohol withdrawal in pregnant women, to better inform clinicians about what is known about managing these co-occurring conditions. PMID:25747924

The Social Consequences of Disability: An Experiential Approach.

ERIC Educational Resources Information Center

Brooks, Nancy A.

1980-01-01

Reports on the application of experiential learning to a college level sociology course on the social consequences of disability. The course involves traditional methods such as reading/lecture/examination and more innovative approaches such as experiential learning and directing students to manage their own learning processes. (Author/DB)

SCENARIO ANALYSIS FOR THE SAN PEDRO RIVER, ANALYZING HYDROLOGICAL CONSEQUENCES FOR A FUTURE ENVIRONMENT

EPA Science Inventory

Studies of future management and policy options based on different assumptions provide a mechanism to examine possible outcomes and especially their likely benefits and consequences. The San Pedro River in Arizona and Sonora, Mexico is an area that has undergone rapid changes in ...

40 CFR 1400.3 - Public access to paper copies of off-site consequence analysis information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Public access to paper copies of off-site consequence analysis information. 1400.3 Section 1400.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY AND DEPARTMENT OF JUSTICE ACCIDENTAL RELEASE PREVENTION REQUIREMENTS; RISK MANAGEMENT...

Filling in the gaps: reporting of concurrent supportive care therapies in breast cancer chemotherapy trials.

PubMed

Freedman, Orit; Amir, Eitan; Zimmermann, Camilla; Clemons, Mark

2011-03-01

Supportive care interventions can have a substantial impact on side effects of chemotherapy. Consequently, accurate reporting of such interventions is essential when interpreting clinical trial results. This study determined the prevalence and quality of reporting of supportive care treatment for common chemotherapy-induced toxicities in phase III, breast cancer chemotherapy trials. A systematic review of phase III trials of breast cancer trials incorporating chemotherapy published in the last 5 years was undertaken. Trials were identified through MEDLINE, EMBASE, BIOSIS, and the Cochrane Library. Supportive treatments evaluated were use of antiemetics, colony-stimulating growth factors, and antibiotics. Reporting quality was rated as "good", "fair", "poor", or "absent" using predetermined criteria. Sixty-two trials met inclusion criteria. In 41 studies (66%), details regarding prophylactic antiemetic treatment were not provided. Growth factor use was not reported in 20 trials (32%). Instructions for the use of prophylactic antibiotics were absent in 45 trials (72%). There are significant deficiencies in reporting of use of prophylactic supportive care agents in breast cancer trials. Omission of supportive care instructions may impact substantially on patient management and health care system expenditure. Recommendations for the type, dose, and frequency of supportive care drugs should be provided and reported on in trials.

Order Batching in Warehouses by Minimizing Total Tardiness: A Hybrid Approach of Weighted Association Rule Mining and Genetic Algorithms

PubMed Central

Taheri, Shahrooz; Mat Saman, Muhamad Zameri; Wong, Kuan Yew

2013-01-01

One of the cost-intensive issues in managing warehouses is the order picking problem which deals with the retrieval of items from their storage locations in order to meet customer requests. Many solution approaches have been proposed in order to minimize traveling distance in the process of order picking. However, in practice, customer orders have to be completed by certain due dates in order to avoid tardiness which is neglected in most of the related scientific papers. Consequently, we proposed a novel solution approach in order to minimize tardiness which consists of four phases. First of all, weighted association rule mining has been used to calculate associations between orders with respect to their due date. Next, a batching model based on binary integer programming has been formulated to maximize the associations between orders within each batch. Subsequently, the order picking phase will come up which used a Genetic Algorithm integrated with the Traveling Salesman Problem in order to identify the most suitable travel path. Finally, the Genetic Algorithm has been applied for sequencing the constructed batches in order to minimize tardiness. Illustrative examples and comparisons are presented to demonstrate the proficiency and solution quality of the proposed approach. PMID:23864823

Order batching in warehouses by minimizing total tardiness: a hybrid approach of weighted association rule mining and genetic algorithms.

PubMed

Azadnia, Amir Hossein; Taheri, Shahrooz; Ghadimi, Pezhman; Saman, Muhamad Zameri Mat; Wong, Kuan Yew

2013-01-01

One of the cost-intensive issues in managing warehouses is the order picking problem which deals with the retrieval of items from their storage locations in order to meet customer requests. Many solution approaches have been proposed in order to minimize traveling distance in the process of order picking. However, in practice, customer orders have to be completed by certain due dates in order to avoid tardiness which is neglected in most of the related scientific papers. Consequently, we proposed a novel solution approach in order to minimize tardiness which consists of four phases. First of all, weighted association rule mining has been used to calculate associations between orders with respect to their due date. Next, a batching model based on binary integer programming has been formulated to maximize the associations between orders within each batch. Subsequently, the order picking phase will come up which used a Genetic Algorithm integrated with the Traveling Salesman Problem in order to identify the most suitable travel path. Finally, the Genetic Algorithm has been applied for sequencing the constructed batches in order to minimize tardiness. Illustrative examples and comparisons are presented to demonstrate the proficiency and solution quality of the proposed approach.

The Effect of Lycopene Preexposure on UV-B-Irradiated Human Keratinocytes

PubMed Central

Ascenso, Andreia; Pedrosa, Tiago; Pinho, Sónia; Pinho, Francisco; de Oliveira, José Miguel P. Ferreira; Cabral Marques, Helena; Oliveira, Helena; Simões, Sandra; Santos, Conceição

2016-01-01

Lycopene has been reported as the antioxidant most quickly depleted in skin upon UV irradiation, and thus it might play a protective role. Our goal was to investigate the effects of preexposure to lycopene on UV-B-irradiated skin cells. Cells were exposed for 24 h to 10 M lycopene, and subsequently irradiated and left to recover for another 24 h period. Thereafter, several parameters were analyzed by FCM and RT-PCR: genotoxicity/clastogenicity by assessing the cell cycle distribution; apoptosis by performing the Annexin-V assay and analyzing gene expression of apoptosis biomarkers; and oxidative stress by ROS quantification. Lycopene did not significantly affect the profile of apoptotic, necrotic and viable cells in nonirradiated cells neither showed cytostatic effects. However, irradiated cells previously treated with lycopene showed an increase in both dead and viable subpopulations compared to nonexposed irradiated cells. In irradiated cells, lycopene preexposure resulted in overexpression of BAX gene compared to nonexposed irradiated cells. This was accompanied by a cell cycle delay at S-phase transition and consequent decrease of cells in G0/G1 phase. Thus, lycopene seems to play a corrective role in irradiated cells depending on the level of photodamage. Thus, our findings may have implications for the management of skin cancer. PMID:26664697

A Digital App to Aid Detection, Monitoring, and Management of Dyslexia in Young Children (DIMMAND): Protocol for a Digital Health and Education Solution.

PubMed

Sood, Mariam R; Toornstra, Annet; Sereno, Martin I; Boland, Mark; Filaretti, Daniele; Sood, Anuj

2018-05-17

Dyslexia, a specific learning difficulty and a disability as defined in the Equality Act 2010, is a lifelong condition that affects a child from the start of education. Dyslexia is characterized by difficulties in language processing (reading, spelling, and writing) which do not correspond with the child's general intellectual abilities. Although dyslexia cannot be cured, there is a consensus that interventions are more effective and have greater impact the earlier they are administered. Effective interventions start with diagnosis. Currently, formal diagnosis requires an assessment by a dyslexia specialist or educational psychologist. These assessments are expensive and are not easy for a non-specialist teacher or parent to interpret. Consequently, formal assessments are normally performed at a much later age, when interventions are less likely to be effective. Combining the latest in scientific research, expertise of dyslexia practitioners and real-time interactivity facilitated by digital technologies, we aim to provide a cost-effective and convenient solution that focuses on early dyslexia detection and management. We discuss the rationale and protocol for the design and development of a digital health solution aimed at improving the early detection, monitoring and management of dyslexia (DIMMAND) in young children (4-8 years). The primary objective is to create a game-based digital solution aimed at children, parents, and teachers that firstly assesses, then monitors and manages progress in a convenient, cost-effective and private environment. The proposed solution will be designed and developed in phases. In the initial phase, the full functional specification of the games that constitute the app will be designed, together with the overall architecture of the solution. Prototype proof-of-concept implementation for few of these games, and commercialization strategies will also be developed. The follow-on phases will see the design implemented into a validated solution. In the initial phase, we worked closely with dyslexia specialists, adult dyslexics, teachers of special-needs children, parents of dyslexic children, and senior dyslexia representatives for large organizations. These interactions provided insights into the range of language difficulties faced by dyslexics, which solutions are used by teachers and professionals, and an overall understanding of the market. We comprehensively defined the ethical, privacy, and data security issues. The detailed design spec of the games, the methodology to be followed to interpret the results, and flow diagrams illustrating how the game screens will be presented was completed. As proof of concept, a few reading, visual, and auditory games were developed and successfully tested by stakeholders on different digital devices. The stakeholders provided regular feedback and confirmed the viability of our game-based solution. DIMMAND has the potential to provide significant positive health care and economic impact. It is expected to reduce intervention costs, improve dyslexia detection at an early age and aid self-management. RR1-10.2196/9583. ©Mariam R Sood, Annet Toornstra, Martin I Sereno, Mark Boland, Daniele Filaretti, Anuj Sood. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 17.05.2018.

Investigating the consequences of urban volcanism using a scenario approach II: Insights into transportation network damage and functionality

NASA Astrophysics Data System (ADS)

Blake, Daniel M.; Deligne, Natalia I.; Wilson, Thomas M.; Lindsay, Jan M.; Woods, Richard

2017-06-01

Transportation networks are critical infrastructure in urban environments. Before, during and following volcanic activity, these networks can incur direct and indirect impacts, which subsequently reduces the Level-of-Service available to transportation end-users. Additionally, reductions in service can arise from management strategies including evacuation zoning, causing additional complications for transportation end-users and operators. Here, we develop metrics that incorporate Level-of-Service for transportation end-users as the key measure of vulnerability for multi-hazard volcanic impact and risk assessments. A hypothetical eruption scenario recently developed for the Auckland Volcanic Field, New Zealand, is applied to describe potential impacts of a small basaltic eruption on different transportation modes, namely road, rail, and activities at airports and ports. We demonstrate how the new metrics can be applied at specific locations worldwide by considering the geophysical hazard sequence and evacuation zones in this scenario, a process that was strongly informed by consultation with transportation infrastructure providers and emergency management officials. We also discuss the potential implications of modified hazard sequences (e.g. different wind profiles during the scenario, and unrest with no resulting eruption) on transportation vulnerability and population displacement. The vent area of the eruption scenario used in our study is located north of the Māngere Bridge suburb of Auckland. The volcanic activity in the scenario progresses from seismic unrest, through phreatomagmatic explosions generating pyroclastic surges to a magmatic phase generating a scoria cone and lava flows. We find that most physical damage to transportation networks occurs from pyroclastic surges during the initial stages of the eruption. However, the most extensive service reduction across all networks occurs 6 days prior to the eruption onset, largely attributed to the implementation of evacuation zones; these disrupt crucial north-south links through the south eastern Auckland isthmus, and at times cause up to 435,000 residents and many businesses to be displaced. Ash deposition on road and rail following tephra-producing eruptive phases causes widespread Level-of-Service reduction, and some disruption continues for > 1 month following the end of the eruption until clean-up and re-entry to most evacuated zones is completed. Different tephra dispersal and deposition patterns can result in substantial variations to Level-of-Service and consequences for transportation management. Additional complexities may also arise during times of unrest with no eruption, particularly as residents are potentially displaced for longer periods of time due to extended uncertainties on potential vent location. The Level-of-Service metrics developed here effectively highlight the importance of considering transportation end-users when developing volcanic impact and risk assessments. We suggest that the metrics are universally applicable in other urban environments.

Landslides affecting critical infrastructures: the use of a GB-InSAR based warning system in Calatabiano (Southern Italy).

NASA Astrophysics Data System (ADS)

Nolesini, Teresa; Frodella, William; Bardi, Federica; Intrieri, Emanuele; Carlà, Tommaso; Solari, Lorenzo; Dotta, Giulia; Ferrigno, Federica; Casagli, Nicola

2017-04-01

Landslides represent one of the most frequent geo-hazard, not only causing a serious threat to human lives, but also determining socio-economic losses, countable in billions of Euros and expressed in terms of damage to property, infrastructures and environmental degradation. Recent events show a significant increase in the number of disasters with natural and/or technological causes, which could have potentially serious consequences for Critical Infrastructures (CI). Where these infrastructures tend to fail or to be destroyed, the resulting cascade effect (chain of accidents) could lead to catastrophic damage and affect people, the environment and the economy. In the field of landslide detection, mapping, monitoring and management, the availability of advanced remote sensing technologies, which allow systematic and easily updatable acquisitions of data, may enhance the implementation of near real time monitoring activity and the production of landslide maps, optimizing field work. This work aims at presenting an example of the advantages given by the combined use of advanced remote sensing techniques, such as Ground-Based Interferometric Synthetic Aperture Radar (GB-InSAR), Terrestrial Laser Scanning (TLS) and Infrared Thermography (IRT), in order to monitor and map the Calatabiano landslide, located in the Catania Province (Sicily Island, Southern Italy). The landslide occurred on October 24th 2015, after a period of heavy rainfall, causing the rupture of a water pipeline transect of the aqueduct supplying water to the city of Messina. As a consequence of this event a considerable lack in water resources occurred for a large number of the city inhabitants. A provisional by-pass, consisting of three 350 m long pipes passing through the landslide area, was implemented in order to restore the city water supplies during the emergency management phase. In this framework an integrated monitoring network was implemented, in order to assess the residual risk by analyzing the landslide geomorphological and kinematic features, and to support the early warning procedures needed to ensure the safety of the personnel involved in the by-pass realization and the long term landslide stabilization works. The intrinsic characteristics of the abovementioned techniques, such as the capability of: i) producing near-real time displacement maps without physical access to the analysed area; ii) observing the investigated scenario 24 hours per day and in all-weather conditions; iii) generating high-resolution images, especially for local scale phenomena analysis; iv) providing high versatility and transportability; represent consistent advantages with respect to the traditional methods. The preliminary monitoring results and a 3D landslide mapping have shown its effectiveness during the emergency and the post emergency management phase.

Antecedents, consequences and interventions for workplace bullying.

PubMed

Kemp, Vivien

2014-09-01

The issue of workplace bullying has become an area of research interest in the last 3 decades. Much of the extant literature is published in the business management journals. This is problematic as the targets of workplace bullying may need psychiatric treatment; as a discipline, therefore psychiatrists may benefit from a deeper understanding of the nature of workplace bullying and its sequelae. There is still no agreed upon definition, although most definitions include similar criteria. Managers and human resources personnel frequently have difficulty identifying and effectively managing workplace bullying. The consequences for the targets of bullying can be severe; they may need psychiatric treatment and it can have a lifelong impact. There is a paucity of research into effective prevention and intervention programs. Preventive measures that focus on the whole workplace culture or on targets alone have mixed results. Workplace policies and procedures may lessen the prevalence and incidence of bullying, but often competing interests of senior management, human resources personnel, supervisors and workers may mitigate any antibullying interventions. Although psychiatrists are likely to treat the targets of bullying, bullying has yet to attract much attention as a research topic in psychiatry. Although the consequences of bullying can be severe for both targets and workplaces, prevention strategies are hampered by competing interests.

Fringe pattern demodulation with a two-dimensional digital phase-locked loop algorithm.

PubMed

Gdeisat, Munther A; Burton, David R; Lalor, Michael J

2002-09-10

A novel technique called a two-dimensional digital phase-locked loop (DPLL) for fringe pattern demodulation is presented. This algorithm is more suitable for demodulation of fringe patterns with varying phase in two directions than the existing DPLL techniques that assume that the phase of the fringe patterns varies only in one direction. The two-dimensional DPLL technique assumes that the phase of a fringe pattern is continuous in both directions and takes advantage of the phase continuity; consequently, the algorithm has better noise performance than the existing DPLL schemes. The two-dimensional DPLL algorithm is also suitable for demodulation of fringe patterns with low sampling rates, and it outperforms the Fourier fringe analysis technique in this aspect.

Organisational Barriers for Women in Senior Management: A Comparison of Turkish and New Zealand Universities

ERIC Educational Resources Information Center

Neale, Jenny; Ozkanli, Ozlem

2010-01-01

This paper reports on the second phase of a multi-country study examining cross-cultural perspectives of gender and management in universities. The first phase of this research with eight countries found that the representation of women was consistently low, especially at Rector/Vice Chancellor level. In the second phase interviews were conducted…

Making a model meaningful to coral reef managers in a developing nation: a case study of overfishing and rock anchoring in Indonesia.

PubMed

Maynard, Jeffrey A; Anthony, Kenneth R N; Afatta, Siham; Dahl-Tacconi, Nancy; Hoegh-Guldberg, Ove

2010-10-01

Most of the world's coral reefs line the coasts of developing nations, where impacts from intense and destructive fishing practices form critical conservation issues for managers. Overfishing of herbivorous fishes can cause phase shifts to macroalgal dominance, and fishers' use of rocks as anchors lowers coral cover, giving further competitive advantage to macroalgae. Overfishing and anchoring have been studied extensively, but the role of their interaction in lowering coral reef resilience has not been quantified formally. We analyzed the combined effects of overfishing and rock anchoring on a range of reef habitat types--varying from high coral and low macroalgae cover to low coral and high macroalgae cover--in a marine park in Indonesia. We parameterized a model of coral and algal dynamics with three intensities of anchoring and fishing pressure. Results of the model indicated that damage caused by rock anchoring was equal to or possibly more devastating to coral reefs in the area than the impact of overfishing. This is an important outcome for local managers, who usually have the funds to distribute less-damaging anchors, but normally are unable to patrol regularly and effectively enough to reduce the impact of overfishing. We translated model results into an interactive visual tool that allows managers to explore the benefits of reducing anchoring frequency and fishing pressure. The potential consequences of inaction were made clear: the likelihood that any of the reef habitats will be dominated in the future by macroalgae rather than corals depends on reducing anchoring frequency, fishing pressure, or both. The tool provides a platform for strengthened relationships between managers and conservationists and can facilitate the uptake of recommendations regarding resource allocation and management actions. Conservation efforts for coral reefs in developing nations are likely to benefit from transforming model projections of habitat condition into tools local managers can understand and interact with. © 2010 Society for Conservation Biology.

Compulsive methamphetamine taking under punishment is associated with greater cue-induced drug seeking in rats.

PubMed

Torres, Oscar V; Jayanthi, Subramanian; Ladenheim, Bruce; McCoy, Michael T; Krasnova, Irina N; Cadet, Jean Lud

2017-05-30

Methamphetamine (METH) addicts lose control over drug consumption despite suffering multiple adverse medicolegal consequences. To mimic the negative events associated with drug addiction in humans, we recently introduced a rat model of self-administration (SA) with response-contingent punishment on METH intake. These procedures allowed us to distinguish between two addiction-like phenotypes in rats, those that sustained METH taking despite negative consequences (shock-resistant, SR) and rats that significantly reduced their METH intake (shock-sensitive, SS). Here, we further developed our adverse consequence model and examined incubation of METH craving by measuring cue-induced drug seeking in SR and SS rats. Male Sprague-Dawley rats were trained to self-administer METH (0.1mg/kg/injection) or saline intravenously (i.v.) during twenty-two 9-h sessions that consisted of 3 separate 3-h sessions separated by 30min. Subsequently, rats were subjected to incremental footshocks during thirteen additional 9-h METH SA sessions performed in a fashion identical to the training phase. Cue-induced drug craving was then assessed at 2 and 21days after the footshock phase. All rats escalated their intake of METH, with both phenotypes showing similar drug taking patterns during SA training. In addition, rats that continued their METH intake despite negative consequences showed even greater cue-induced drug craving following withdrawal than the rats that reduced METH intake following negative consequences. Taken together, our adverse consequence-based model highlights the possibility of identifying rats by addiction-like phenotypes and subsequent vulnerability to relapse-like behaviors. The use of similar SA models should help in the development of better therapeutic approaches to treat different stages of METH addiction. Published by Elsevier B.V.

EVALUATION OF THE FARM MANAGEMENT PHASE OF THE FARM AND HOME MANAGEMENT PROGRAM IN NEW YORK STATE. EXTENSION STUDY, NUMBER 1.

ERIC Educational Resources Information Center

ALEXANDER, FRANK D.; LONGEST, JAMES W.

THE MAIN PURPOSE OF THIS 1956-60 LONGITUDINAL STUDY WAS TO COMPARE CHANGES IN FARM PRACTICES AND RELATED KNOWLEDGE AND IN INCOME AND RELATED BUSINESS FACTORS AMONG 87 PARTICIPANTS (DAIRYMEN) IN THE FARM MANAGEMENT PHASE OF THE NEW YORK STATE FARM AHD HOME MANAGEMENT PROGRAM, WITH THOSE OF A CONTROL GROUP OF 87 WHO DID NOT PARTICIPATE. IN 1956, THE…

Strategic planning, implementation, and evaluation processes in hospital systems: a survey from Iran.

PubMed

Sadeghifar, Jamil; Jafari, Mehdi; Tofighi, Shahram; Ravaghi, Hamid; Maleki, Mohammad Reza

2014-09-28

Strategic planning has been presented as an important management practice. However, evidence of its deployment in healthcare systems in low-income and middle-income countries (LMICs) is limited. This study investigated the strategic management process in Iranian hospitals. The present study was accomplished in 24 teaching hospitals in Tehran, Iran from September 2012 to March 2013. The data collection instrument was a questionnaire including 130 items. This questionnaire measured the situation of formulation, implementation, and evaluation of strategic plan as well as the requirements, facilitators, and its benefits in the studied hospitals. All the investigated hospitals had a strategic plan. The obtained percentages for the items "the rate of the compliance to requirements" and "the quantity of planning facilitators" (68.75%), attention to the stakeholder participation in the planning (55.74%), attention to the planning components (62.22%), the status of evaluating strategic plan (59.94%) and the benefits of strategic planning for hospitals (65.15%) were in the medium limit. However, the status of implementation of the strategic plan (53.71%) was found to be weak. Significant statistical correlations were observed between the incentive for developing strategic plan and status of evaluating phase (P=0.04), and between status of implementation phase and having a documented strategic plan (P=0.03). According to the results, it seems that absence of appropriate internal incentive for formulating and implementing strategies led more hospitals to start formulation strategic planning in accordance with the legal requirements of Ministry of Health. Consequently, even though all the investigated hospital had the documented strategic plan, the plan has not been implemented efficiently and valid evaluation of results is yet to be achieved.

Strategic Planning, Implementation, and Evaluation Processes in Hospital Systems: A Survey From Iran

PubMed Central

Sadeghifar, Jamil; Jafari, Mehdi; Tofighi, Shahram; Ravaghi, Hamid; Maleki, Mohammad Reza

2015-01-01

Aim & Background: Strategic planning has been presented as an important management practice. However, evidence of its deployment in healthcare systems in low-income and middle-income countries (LMICs) is limited. This study investigated the strategic management process in Iranian hospitals. Methods: The present study was accomplished in 24 teaching hospitals in Tehran, Iran from September 2012 to March 2013. The data collection instrument was a questionnaire including 130 items. This questionnaire measured the situation of formulation, implementation, and evaluation of strategic plan as well as the requirements, facilitators, and its benefits in the studied hospitals. Results: All the investigated hospitals had a strategic plan. The obtained percentages for the items “the rate of the compliance to requirements” and “the quantity of planning facilitators” (68.75%), attention to the stakeholder participation in the planning (55.74%), attention to the planning components (62.22%), the status of evaluating strategic plan (59.94%) and the benefits of strategic planning for hospitals (65.15%) were in the medium limit. However, the status of implementation of the strategic plan (53.71%) was found to be weak. Significant statistical correlations were observed between the incentive for developing strategic plan and status of evaluating phase (P=0.04), and between status of implementation phase and having a documented strategic plan (P=0.03). Conclusion: According to the results, it seems that absence of appropriate internal incentive for formulating and implementing strategies led more hospitals to start formulation strategic planning in accordance with the legal requirements of Ministry of Health. Consequently, even though all the investigated hospital had the documented strategic plan, the plan has not been implemented efficiently and valid evaluation of results is yet to be achieved. PMID:25716385

Employment and weight status: The extreme case of body concern in South Korea.

PubMed

Han, Seung-Yong; Brewis, Alexandra A; SturtzSreetharan, Cindi

2018-05-01

For an industrialized nation, obesity rates in South Korea are extremely low. Yet, reflecting an extremely fat-averse, thin-positive society, efforts to lose weight are now reportedly very common. Since the 1980s, South Korea has experienced an increasingly flexible and insecure labor market which was exacerbated by the 1997 economic recession. In this social and economic setting, body shape and weight status, as human capital, may have gained significant bargaining power in the labor market. Consequently, we propose that Koreans, particularly those who are employed in "stable" jobs (i.e., non-manual and regular jobs), would increasingly engage in intense weight management and reduction activities even when not technically overweight or obese as a means to job security and upward mobility. Using nationally-representative data from the Korean Nutrition and Health Examination Survey (KNHANES), we identify the changing role of weight concerns versus actual body weight in predicting South Korean efforts to lose weight between 2001 (KNHANES-phase 1) and 2007-2009 (phase 4). The patterns were examined by occupation type (manual and non-manual jobs) and status (regular and non-regular jobs). Oaxaca decomposition analysis supported that people's perception of being "fat," rather than actual weight status, was crucial to explaining accelerated weight management efforts in South Korea over the decade (coef. = 0.062 and p-value < .0001 for male with regular work; coef. = 0.031 and p-value = .002 for female with regular work). Occupation status, rather than employment in itself, mattered. Job stability predicted increased effort; the pattern of change through time suggests efforts to invest high levels of effort in appearance positively impacts both employment opportunity and stability. Copyright © 2018 Elsevier B.V. All rights reserved.

Recent advances in pharmacological treatments of hyperkalemia: focus on patiromer.

PubMed

Epstein, Murray; Pitt, Bertram

2016-07-01

Hyperkalemia is a common electrolyte disorder, especially among patients with chronic kidney disease (CKD), diabetes mellitus, or heart failure, and is associated with a significantly increased risk for all-cause mortality. Hyperkalemia remains a vexing and challenging problem for clinicians, particularly in the management of patients with chronic kidney disease and congestive heart failure. Several observational and retrospective studies have reported a large gap between recommendations in guidelines and real-world practice in the implementation of RAASi therapies. RAASi treatment regimens are frequently down-titrated or discontinued following hyperkalemia events, with consequent worse outcomes than patients who remain on maximum doses. This review covers the preclinical and clinical studies that led to the approval of patiromer for the treatment of hyperkalemia. A literature search on patiromer was carried out using the PubMed database up to December 2015. Recently, patiromer was approved by the FDA as the first new potassium binder for the treatment of hyperkalemia in over 50 years. Based on the results of phase II and phase III studies, we conclude that patiromer is a well-tolerated and predictable medication to consistently and safely reduce serum potassium levels and to sustain normokalemia for periods up to 52 weeks in patients with diverse underlying diseases including congestive heart failure, and chronic kidney disease. Future research questions that should be evaluated are: the role of patiromer in treating hyperkalemia and the potential to thereby allow the optimal management of resistant hypertension and the use of high dose MRAs in patients with acute decompensated heart failure. Additional research is also warranted in the potential safety benefits of reducing potassium fluctuations in patients on hemodialysis as a result of treatment of hyperkalemia with patiromer.

Three Insights About Change

NASA Technical Reports Server (NTRS)

Little, Terry

2002-01-01

Managers need to develop credibility, and need to base it upon new managerial accomplishments rather than previous ones. New and exciting jobs in management are challenging, but can lead to personal growth. Personnel who are afraid of potential negative consequences resulting from administrative changes are a hindrance to projects. An approval-seeking management style almost always fails.

Manipulation of density of Pseudotsuga menziesii canopies: preliminary effects on understory vegetation.

Treesearch

D.R. Thysell; A.B. Carey

2001-01-01

Managing second-growth forests to conserve biodiversity has been proposed by both foresters and conservation biologists. Management, however, can have unintended consequences, including reduction in native species diversity and increased invasion by exotic species. Our goal was to determine if inducing heterogeneity in managed forest canopies could promote a diversity...

Ecological consequences of the MPB epidemic for habitats and populations of wildlife [Chapter 5

Treesearch

Beth Hahn; Vicki Saab; Barbara Bentz; Rachel Loehman; Bob Keane

2014-01-01

Wildlife biologists must balance a diverse array of ecological and social considerations in managing species and habitats. The challenges of managing species and habitats in dynamic landscapes are influenced by diverse factors, including natural disturbances, vegetation development, and anthropogenic-mediated changes, such as climate change, management activities, and...

Simulating the Effects of Alternative Forest Management Strategies on Landscape Structure

Treesearch

Eric J. Gustafson; Thomas Crow

1996-01-01

Quantitative, spatial tools are needed to assess the long-term spatial consequences of alternative management strategies for land use planning and resource management. We constructed a timber harvest allocation model (HARVEST) that provides a visual and quantitative means to predict the spatial pattern of forest openings produced by alternative harvest strategies....

Career Self-Management: Its Nature, Causes and Consequences

ERIC Educational Resources Information Center

King, Zella

2004-01-01

In a recent special issue [Journal of Vocational Behavior 59 (2001) 284], scholars noted that the field of vocational psychology needs a better understanding of career self-management. This article proposes a conceptual framework of career self-management, based on Crites' [Vocational Psychology, McGraw-Hill, New York, 1969] model of vocational…

The Manager of Academic Outreach: A Role of Consequence to University Survival and Growth

ERIC Educational Resources Information Center

Miller, Lawrence R.

1977-01-01

University managers of academic outreach need outstanding skills in communication, persuasion, and negotiation to win and maintain active faculty/administrator support for outreach activities. Failure to generate such support will make it impossible for outreach managers to deliver on the promise of the outreach concept. (Editor/LBH)

41 CFR 105-74.500 - How are violations of this part determined for recipients other than individuals?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false How are violations of... Contracts and Property Management Federal Property Management Regulations System (Continued) GENERAL... DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Violations of this Part and Consequences § 105-74.500 How...

Educators' Self-Reported Training, Use, and Perceived Effectiveness of Evidence-Based Classroom Management Practices

ERIC Educational Resources Information Center

Cooper, Justin T.; Gage, Nicholas A.; Alter, Peter J.; LaPolla, Stefanie; MacSuga-Gage, Ashley S.; Scott, Terrance M.

2018-01-01

A survey study of 248 educators in four states was conducted to identify respondents' formal training, use, and perceived effectiveness of 37 evidence-based classroom management practices within four general categories: (a) antecedent-based, (b) instructionally based, (c) consequence-based, and (d) self-management. Results indicated that, on…

Organizational learning contributes to guidance for managing wildland fires for multiple objectives

Treesearch

Tom Zimmerman; Tim Sexton

2010-01-01

Since the inception of organized fire suppression in the early 1900s, wildland fire management has dramatically evolved in operational complexity; ecological significance; social, economic, and political magnitude; areas and timing of application; and recognition of potentially serious consequences. Throughout the past 100 years, fire management has matured from a...

Space Matters: Experiences of Managing Static Formal Learning Spaces

ERIC Educational Resources Information Center

Montgomery, Tim

2008-01-01

Managing the space in which learning takes place is subject to ongoing debate. Spatial management and movement can impact upon the construction of meaning within education and upon the dynamic of learning. It is suggested that there are now different learning goals and expectations and consequently a need for different learning environments. We…

The Importance of Training in Operationalising HR Policy

ERIC Educational Resources Information Center

Bond, Sue; McCracken, Martin

2005-01-01

Purpose: To understand how line managers make decisions about employee requests for time off at short notice and to consider the consequences for management training. Design/methodology/approach: Based on evidence from case studies carried out in four financial sector companies in Scotland, this paper illustrates a model of line manager decision…

PRISM: Priority Symptom Management Project phase I: assessment.

PubMed

Ropka, M E; Spencer-Cisek, P

2001-01-01

To provide an overview of the process, goals, and outcome recommendations from the assessment phase of the Oncology Nursing Society's Priority Symptom Management (PRISM) project and to provide the foundation for a series of evidence-based practice and qualitative systematic review articles generated from the first phase of PRISM. Published articles, abstracts, and books; computerized databases; nonpublished research; personal communications; and proceedings of the PRISM summit meeting. Symptom management is a key component in quality cancer care. The assessment phase of PRISM yielded systematic reviews with an evidence-based framework to evaluate key symptoms, developed a framework for teaching and evaluating other symptoms, and recommended future ONS initiatives. Outcome recommendations from the PRISM summit targeted practice; professional and public education; research; and health policy. These activities provide background for subsequent evidence-based practice and qualitative systematic review articles that will focus on cancer symptom management.

Healthcare managers' decision making: findings of a small scale exploratory study.

PubMed

Macdonald, Jackie; Bath, Peter A; Booth, Andrew

2008-12-01

Managers who work in publicly funded healthcare organizations are an understudied group. Some of the influences on their decisions may be unique to healthcare. This study considers how to integrate research knowledge effectively into healthcare managers' decision making, and how to manage and integrate information that will include community data. This first phase in a two-phase mixed methods research study used a qualitative, multiple case studies design. Nineteen semi-structured interviews were undertaken using the critical incident technique. Interview transcripts were analysed using the NatCen Framework. One theme represented ;information and decisions'. Cases were determined to involve complex multi-level, multi-situational decisions with participants in practical rather than ceremonial work roles. Most considered organizational knowledge in the first two decision phases and external knowledge, including research, in the third phase. All participants engaged in satisficing to some degree.

Correlated topographic and structural modification on Si surface during multi-shot femtosecond laser exposures: Si nanopolymorphs as potential local structural nanomarkers

NASA Astrophysics Data System (ADS)

Ionin, A. A.; Kudryashov, S. I.; Levchenko, A. O.; Nguyen, L. V.; Saraeva, I. N.; Rudenko, A. A.; Ageev, E. I.; Potorochin, D. V.; Veiko, V. P.; Borisov, E. V.; Pankin, D. V.; Kirilenko, D. A.; Brunkov, P. N.

2017-09-01

High-pressure Si-XII and Si-III nanocrystalline polymorphs, as well as amorphous Si phase, appear consequently during multi-shot femtosecond-laser exposure of crystalline Si wafer surface above its spallation threshold along with permanently developing quasi-regular surface texture (ripples, microcones), residual hydrostatic stresses and subsurface damage, which are characterized by scanning and transmission electron microscopy, as well as by Raman micro-spectroscopy. The consequent yields of these structural Si phases indicate not only their spatially different appearance, but also potentially enable to track nanoscale, transient laser-induced high-pressure, high-temperature physical processes - local variation of ablation mechanism and rate, pressurization/pressure release, melting/resolidification, amorphization, annealing - versus cumulative laser exposure and the related development of the surface topography.

Development of the EORTC QLQ-CAX24, A Questionnaire for Cancer Patients With Cachexia.

PubMed

Wheelwright, Sally J; Hopkinson, Jane B; Darlington, Anne-Sophie; Fitzsimmons, Deborah F; Fayers, Peter; Balstad, Trude R; Bredart, Anne; Hammerlid, Eva; Kaasa, Stein; Nicolatou-Galitis, Ourania; Pinto, Monica; Schmidt, Heike; Solheim, Tora S; Strasser, Florian; Tomaszewska, Iwona M; Johnson, Colin D

2017-02-01

Cachexia is commonly found in cancer patients and has profound consequences; yet there is only one questionnaire that examines the patient's perspective. To report a rigorously developed module for patient self-reported impact of cancer cachexia. Module development followed published guidelines. Patients from across the cancer cachexia trajectory were included. In Phase 1, health-related quality of life (HRQOL) issues were generated from a literature review and interviews with patients in four countries. The issues were revised based on patient and health care professional (HCP) input. In Phase 2, questionnaire items were formulated and translated into the languages required for Phase 3, the pilot phase, in which patients from eight countries scored the relevance and importance of each item, and provided qualitative feedback. A total of 39 patients and 12 HCPs took part in Phase 1. The literature review produced 68 HRQOL issues, with 22 new issues arising from the patient interviews. After patient and HCP input, 44 issues were formulated into questionnaire items in Phase 2. One hundred ten patients took part in Phase 3. One item was reworded, and 20 items were deleted as a consequence of patient feedback. The QLQ-CAX24 is a cancer cachexia-specific questionnaire, comprising 24 items, for HRQOL assessment in clinical trials and practice. It contains five multi-item scales (food aversion, eating and weight-loss worry, eating difficulties, loss of control, and physical decline) and four single items. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

The Consequences of Employee Commitment, Turnover, and Absenteeism: An Exploratory Analysis.

DTIC Science & Technology

1981-08-01

and Absenteeism : An Exploratory Analysis Gt. PERFORMING ORG. REPORT NUMBER 7. AUTHOR(a) S. CONTRACT OR GRANT NUMBER(e) Richard T. Mowday N00014-81-K... Absenteeism therefore provides organizations with the opportunity to train employees to perform a number of different tasks. -35- Negative consequences...AD-A103 359 OREGON UNIV EUGENE GRADUATE SCHOOL OF MANAGEMENT AND-ETC Ft6 S/1 THE CONSEQUENCES OF EMPLOYEE COMMITMENT, TURNOVER, AND ABSENTEE -ETC(U

Housing preferences of young adults in Indonesia: housing attributes and consequences

NASA Astrophysics Data System (ADS)

Farasa, N.; Kusuma, H. E.

2018-03-01

Nowadays, the housing demand of young adults in Indonesia is important issues for the sustainable development of the market. Facing differences of life phases, such as marriage, leaving home after graduation, and new job positioning, young adults become the main segment facing constant housing choice decisions in the housing market. In their particular phase of life, young adults have distinct preferences for housing attributes which bring a great influence on their lives in the future. Data was gathered from a survey questionnaire that was answered by 180 young adults in Indonesia, ranging from age 22-33 years. The findings suggest that the green area and view, location, simplicity, home design, and accessibility are the significant parts as housing attributes for young adults’ housing preferences in Indonesia. The effect of these attributes has many consequences such as security, personalization, mood/ambiance, maintenance, interaction, image, flexibility, environmental, economy, durability, convenience, comfort, and circulation. The biggest group of young adults who prefer comfort as their wanted consequences tend to have high preferences on housing attributes of the green area and view, and simplicity.

Nuclear risk analysis of the Ulysses mission

NASA Astrophysics Data System (ADS)

Bartram, Bart W.; Vaughan, Frank R.; Englehart, Richard W., Dr.

1991-01-01

The use of a radioisotope thermoelectric generator fueled with plutonium-238 dioxide on the Space Shuttle-launched Ulysses mission implies some level of risk due to potential accidents. This paper describes the method used to quantify risks in the Ulysses mission Final Safety Analysis Report prepared for the U.S. Department of Energy. The starting point for the analysis described herein is following input of source term probability distributions from the General Electric Company. A Monte Carlo technique is used to develop probability distributions of radiological consequences for a range of accident scenarios thoughout the mission. Factors affecting radiological consequences are identified, the probability distribution of the effect of each factor determined, and the functional relationship among all the factors established. The probability distributions of all the factor effects are then combined using a Monte Carlo technique. The results of the analysis are presented in terms of complementary cumulative distribution functions (CCDF) by mission sub-phase, phase, and the overall mission. The CCDFs show the total probability that consequences (calculated health effects) would be equal to or greater than a given value.

Nuclear Dynamics Consequence Analysis (NDCA) for the Disposal of Spent Nuclear Fuel in an Underground Geologic Repository--Volume 2: Methodology and Results

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

Taylor, L.L.; Wilson, J.R.; Sanchez, L.C.

1998-10-01

The US Department of Energy Office of Environmental Management's (DOE/EM's) National Spent Nuclear Fuel Program (NSNFP), through a collaboration between Sandia National Laboratories (SNL) and Idaho National Engineering and Environmental Laboratory (INEEL), is conducting a systematic Nuclear Dynamics Consequence Analysis (NDCA) of the disposal of SNFs in an underground geologic repository sited in unsaturated tuff. This analysis is intended to provide interim guidance to the DOE for the management of the SNF while they prepare for final compliance evaluation. This report presents results from a Nuclear Dynamics Consequence Analysis (NDCA) that examined the potential consequences and risks of criticality duringmore » the long-term disposal of spent nuclear fuel owned by DOE-EM. This analysis investigated the potential of post-closure criticality, the consequences of a criticality excursion, and the probability frequency for post-closure criticality. The results of the NDCA are intended to provide the DOE-EM with a technical basis for measuring risk which can be used for screening arguments to eliminate post-closure criticality FEPs (features, events and processes) from consideration in the compliance assessment because of either low probability or low consequences. This report is composed of an executive summary (Volume 1), the methodology and results of the NDCA (Volume 2), and the applicable appendices (Volume 3).« less

Pressure Monitoring to Detect Fault Rupture Due to CO 2 Injection

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

Keating, Elizabeth; Dempsey, David; Pawar, Rajesh

The capacity for fault systems to be reactivated by fluid injection is well-known. In the context of CO 2 sequestration, however, the consequence of reactivated faults with respect to leakage and monitoring is poorly understood. Using multi-phase fluid flow simulations, this study addresses key questions concerning the likelihood of ruptures, the timing of consequent upward leakage of CO 2, and the effectiveness of pressure monitoring in the reservoir and overlying zones for rupture detection. A range of injection scenarios was simulated using random sampling of uncertain parameters. These include the assumed distance between the injector and the vulnerable fault zone,more » the critical overpressure required for the fault to rupture, reservoir permeability, and the CO 2 injection rate. We assumed a conservative scenario, in which if at any time during the five-year simulations the critical fault overpressure is exceeded, the fault permeability is assumed to instantaneously increase. For the purposes of conservatism we assume that CO 2 injection continues ‘blindly’ after fault rupture. We show that, despite this assumption, in most cases the CO 2 plume does not reach the base of the ruptured fault after 5 years. As a result, one possible implication of this result is that leak mitigation strategies such as pressure management have a reasonable chance of preventing a CO 2 leak.« less

Pressure Monitoring to Detect Fault Rupture Due to CO 2 Injection

DOE PAGES

Keating, Elizabeth; Dempsey, David; Pawar, Rajesh

2017-08-18

The capacity for fault systems to be reactivated by fluid injection is well-known. In the context of CO 2 sequestration, however, the consequence of reactivated faults with respect to leakage and monitoring is poorly understood. Using multi-phase fluid flow simulations, this study addresses key questions concerning the likelihood of ruptures, the timing of consequent upward leakage of CO 2, and the effectiveness of pressure monitoring in the reservoir and overlying zones for rupture detection. A range of injection scenarios was simulated using random sampling of uncertain parameters. These include the assumed distance between the injector and the vulnerable fault zone,more » the critical overpressure required for the fault to rupture, reservoir permeability, and the CO 2 injection rate. We assumed a conservative scenario, in which if at any time during the five-year simulations the critical fault overpressure is exceeded, the fault permeability is assumed to instantaneously increase. For the purposes of conservatism we assume that CO 2 injection continues ‘blindly’ after fault rupture. We show that, despite this assumption, in most cases the CO 2 plume does not reach the base of the ruptured fault after 5 years. As a result, one possible implication of this result is that leak mitigation strategies such as pressure management have a reasonable chance of preventing a CO 2 leak.« less

Choice of phase in the CS and IOS approximation

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

Snider, R.F.

1982-04-01

With the recognition that the angular momentum representations of unit position and momentum directional states must have different but uniquely related phases, the previously presented expression of scattering amplitude in terms of IOS angle dependent phase shifts must be modified. This resolves a major disagreement between IOS and close coupled degeneracy averaged differential cross sections. It is found that the phase factors appearing in the differential cross section have nothing to do with any particular choice of decoupling parameter. As a consequence, the differential cross section is relatively insensitive to the choice of CS decoupling parameter. The phase relations obtainedmore » are also in agreement with those deduced from the Born approximation.« less

Biological Implications of Dynamical Phases in Non-equilibrium Networks

NASA Astrophysics Data System (ADS)

Murugan, Arvind; Vaikuntanathan, Suriyanarayanan

2016-03-01

Biology achieves novel functions like error correction, ultra-sensitivity and accurate concentration measurement at the expense of free energy through Maxwell Demon-like mechanisms. The design principles and free energy trade-offs have been studied for a variety of such mechanisms. In this review, we emphasize a perspective based on dynamical phases that can explain commonalities shared by these mechanisms. Dynamical phases are defined by typical trajectories executed by non-equilibrium systems in the space of internal states. We find that coexistence of dynamical phases can have dramatic consequences for function vs free energy cost trade-offs. Dynamical phases can also provide an intuitive picture of the design principles behind such biological Maxwell Demons.

Phase diagram and magnetic relaxation phenomena in Cu2OSeO3

NASA Astrophysics Data System (ADS)

Qian, F.; Wilhelm, H.; Aqeel, A.; Palstra, T. T. M.; Lefering, A. J. E.; Brück, E. H.; Pappas, C.

2016-08-01

We present an investigation of the magnetic-field-temperature phase diagram of Cu2OSeO3 based on dc magnetization and ac susceptibility measurements covering a broad frequency range of four orders of magnitude, from very low frequencies reaching 0.1 Hz up to 1 kHz. The experiments were performed in the vicinity of Tc=58.2 K and around the skyrmion lattice A phase. At the borders between the different phases the characteristic relaxation times reach several milliseconds and the relaxation is nonexponential. Consequently the borders between the different phases depend on the specific criteria and frequency used and an unambiguous determination is not possible.

Dynamism or Disorder at High Pressures?

NASA Astrophysics Data System (ADS)

Angel, R. J.; Bismayer, U.; Marshall, W. G.

2002-12-01

Phase transitions in minerals at elevated temperatures typically involve dynamics as a natural consequence of the increase in thermal energy available to the system. Classic examples include quartz, cristobalite, and carbonates in which the high-temperature, high symmetry phase is dynamically disordered. This disorder has important thermodynamic consequences, including displacement and curvature of phase boundaries (e.g. calcite-aragonite). In other minerals such as clinopyroxenes and anorthite feldspar, the dynamic behaviour is restricted to the neighbourhood of the phase transition. The fundamental question is whether increasing pressure generally suppresses such dynamic behaviour (as in anorthite; Angel, 1988), or not. In the latter case it must be included in thermodynamic models of high-pressure phase equilibria and seismological modelling of the mantle; the potential dynamics and softening in stishovite may provide the critical observational constraint on the presence or otherwise of free silica in the lower mantle. We have continued to use the lead phosphate as a prototype ferroelastic in which to understand dynamic behaviour, simply because its dynamics and transition behaviour is far better characterised than any mineral. Furthermore, the phase transition is at a pressure where experimental difficulties do not dominate the experimental results. Our previous neutron diffraction study (Angel et al., 2001) revealed that some disorder, either dynamic or static, is retained in the high-symmetry, high-pressure phase just above the phase transition. New neutron diffraction data on the pure material now suggests that this disorder slowly decreases with increasing pressure until at twice the transition pressure it is ordered. Further data for doped material provides insights into the nature of this disorder. Angel (1988) Amer. Mineral. 73:1114. Angel et al (2001) J PhysC 13: 5353.

Mobile, stationary and mixed phase tracers: consequences to sea ice biogeochemistry

NASA Astrophysics Data System (ADS)

Jeffery, N.; Elliott, S.; Hunke, E. C.; Deal, C.; Jin, M.

2016-02-01

Models of brine motion in sea ice have offered mechanisms for transporting biogeochemical compounds vertically within the ice and between the ice-ocean interface. In these models, sea ice microstructure and/or gross physical properties determine the resupply of nitrate, for example, to sympagic algae and that resupply, in large part, constrains sea ice primary production. The assumption of brine transport models is that the transported matter exists in a purely mobile phase within the ice brine channels. As a result, non-reacting, mobile phase tracers evolve like salinity in dynamic sea ice. Field and laboratory observations indicate that this is a good approximation for the primary algal macronutrients - nitrate, silicate and phosphate, but clear deviations are evident for ammonium, micronutrients such as iron, humic substances, algal bi-products such as gels and extracellular polysaccharides, and the algae themselves. This wide range of biogeochemical matter resists brine motion and is present in both the mobile and stationary phases, i.e. these tracers are "mixed" with respect to their transport phases. Although the precise mechanism for this resistance may be due to attachment by frustules, "stickiness" of the material surface, adsorption, or, in the case of microorganisms, active motility, a key common element in all cases is the presence of the ice matrix. In this presentation we investigate the consequences of mixed phase tracers in sea ice on algal concentrations, vertical distributions, and the potential accumulation of biogeochemical matter within the ice. We assume that sea ice growth promotes retention to the stationary phase, while melt and the disintegration of the ice matrix promotes release into the mobile phase. By varying the retention and release timescales of this formulation, we retrieve the purely mobile and maximal accumulation limits.

Endogenous Delta/Theta Sound-Brain Phase Entrainment Accelerates the Buildup of Auditory Streaming.

PubMed

Riecke, Lars; Sack, Alexander T; Schroeder, Charles E

2015-12-21

In many natural listening situations, meaningful sounds (e.g., speech) fluctuate in slow rhythms among other sounds. When a slow rhythmic auditory stream is selectively attended, endogenous delta (1‒4 Hz) oscillations in auditory cortex may shift their timing so that higher-excitability neuronal phases become aligned with salient events in that stream [1, 2]. As a consequence of this stream-brain phase entrainment [3], these events are processed and perceived more readily than temporally non-overlapping events [4-11], essentially enhancing the neural segregation between the attended stream and temporally noncoherent streams [12]. Stream-brain phase entrainment is robust to acoustic interference [13-20] provided that target stream-evoked rhythmic activity can be segregated from noncoherent activity evoked by other sounds [21], a process that usually builds up over time [22-27]. However, it has remained unclear whether stream-brain phase entrainment functionally contributes to this buildup of rhythmic streams or whether it is merely an epiphenomenon of it. Here, we addressed this issue directly by experimentally manipulating endogenous stream-brain phase entrainment in human auditory cortex with non-invasive transcranial alternating current stimulation (TACS) [28-30]. We assessed the consequences of these manipulations on the perceptual buildup of the target stream (the time required to recognize its presence in a noisy background), using behavioral measures in 20 healthy listeners performing a naturalistic listening task. Experimentally induced cyclic 4-Hz variations in stream-brain phase entrainment reliably caused a cyclic 4-Hz pattern in perceptual buildup time. Our findings demonstrate that strong endogenous delta/theta stream-brain phase entrainment accelerates the perceptual emergence of task-relevant rhythmic streams in noisy environments. Copyright © 2015 Elsevier Ltd. All rights reserved.

Perspective on pain management in the 21st century.

PubMed

Polomano, Rosemary C; Dunwoody, Colleen J; Krenzischek, Dina A; Rathmell, James P

2008-02-01

Pain is a predictable consequence of surgery or trauma. Untreated, it is associated with significant physiological, emotional, mental, and economic consequences. Despite the vast amount of current knowledge, uncontrolled postoperative pain is reported by approximately 50% of patients. Thus, techniques for effective acute pain management (APM) represent unmet educational needs. The significance of these unmet needs is reflected in the number of journal and textbook publications dedicated to disseminating research, evidence-based guidelines, and clinical information. Acknowledging the importance of APM, health care accrediting agencies and professional societies have become increasingly focused on ensuring that patients receive prompt and acceptable pain relief.

U.S. Geological Survey Science Strategy for the Wyoming Landscape Conservation Initiative

USGS Publications Warehouse

Bowen, Zachary H.; Aldridge, Cameron L.; Anderson, Patrick J.; Chong, Geneva W.; Drummond, Mark A.; Homer, Collin G.; Johnson, Ronald C.; Kauffman, Matthew J.; Knick, Steven T.; Kosovich, John J.; Miller, Kirk A.; Owens, Tom; Shafer, Sarah L.; Sweat, Michael J.

2009-01-01

Southwest Wyoming's wildlife and habitat resources are increasingly affected by energy and urban/exurban development, climate change, and other key drivers of ecosystem change. To ensure that southwest Wyoming's wildlife populations and habitats persist in the face of development and other changes, a consortium of public resource-management agencies proposed the Wyoming Landscape Conservation Initiative (WLCI), the overall goal of which is to implement conservation actions. As the principal agency charged with conducting WLCI science, the U.S. Geological Survey (USGS) has developed a Science Strategy for the WLCI. Workshops were held for all interested parties to identify and refine the most pressing management needs for achieving WLCI goals. Research approaches for addressing those needs include developing conceptual models for understanding ecosystem function, identifying key drivers of change affecting WLCI ecosystems, and conducting scientific monitoring and experimental studies to better understand ecosystems processes, cumulative effects of change, and effectiveness of habitat treatments. The management needs drive an iterative, three-phase framework developed for structuring and growing WLCI science efforts: Phase I entails synthesizing existing information to assess current conditions, determining what is already known about WLCI ecosystems, and providing a foundation for future work; Phase II entails conducting targeted research and monitoring to address gaps in data and knowledge during Phase I; and Phase III entails integrating new knowledge into WLCI activities and coordinating WLCI partners and collaborators. Throughout all three phases, information is managed and made accessible to interested parties and used to guide and improve management and conservation actions, future habitat treatments, best management practices, and other conservation activities.

The role of silviculture in the active management of riparian zone vegetation in the Oregon Coast Range: a partnership between researchers and managers

Treesearch

Samuel S. Chan; Margaret David Bailey; Daniel Karnes; Robert Metzger; Walter W., Jr. Kastner

1997-01-01

Riparian plant communities are extremely diverse. Their structure and composition can affect fish and wildlife habitat, while trees and associated vegetation can provide sustainable sources of forest products. Management of riparian vegetation can greatly affect these values. Little information exists however, about the consequences of actively managing riparians to...

Taking Risk Assessment and Management to the Next Level: Program-Level Risk Analysis to Enable Solid Decision-Making on Priorities and Funding

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

Nelson, J. G.; Morton, R. L.; Castillo, C.

2011-02-01

A multi-level (facility and programmatic) risk assessment was conducted for the facilities in the Nevada National Security Site (NNSS) Readiness in Technical Base and Facilities (RTBF) Program and results were included in a new Risk Management Plan (RMP), which was incorporated into the fiscal year (FY) 2010 Integrated Plans. Risks, risk events, probability, consequence(s), and mitigation strategies were identified and captured, for most scope areas (i.e., risk categories) during the facilitated risk workshops. Risk mitigations (i.e., efforts in addition to existing controls) were identified during the facilitated risk workshops when the risk event was identified. Risk mitigation strategies fell intomore » two broad categories: threats or opportunities. Improvement projects were identified and linked to specific risks they mitigate, making the connection of risk reduction through investments for the annual Site Execution Plan. Due to the amount of that was collected, analysis to be performed, and reports to be generated, a Risk Assessment/ Management Tool (RAMtool) database was developed to analyze the risks in real-time, at multiple levels, which reinforced the site-level risk management process and procedures. The RAMtool database was developed and designed to assist in the capturing and analysis of the key elements of risk: probability, consequence, and impact. The RAMtool calculates the facility-level and programmatic-level risk factors to enable a side-by-side comparison to see where the facility manager and program manager should focus their risk reduction efforts and funding. This enables them to make solid decisions on priorities and funding to maximize the risk reduction. A more active risk management process was developed where risks and opportunities are actively managed, monitored, and controlled by each facility more aggressively and frequently. risk owners have the responsibility and accountability to manage their assigned risk in real-time, using the RAMtool database.« less

Topical Backgrounder: Evaluating Chemical Hazards in the Community: Using RMP's Offsite Consequence Analysis

EPA Pesticide Factsheets

Part of a May 1999 series on the Risk Management Program Rule and issues related to chemical emergency management. Explains hazard versus risk, worst-case and alternative release scenarios, flammable endpoints and toxic endpoints.

77 FR 27279 - Pipeline Safety: Information Collection Activities

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-09

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No... collections relate to the pipeline integrity management requirements for gas transmission pipeline operators... Management in High Consequence Areas Gas Transmission Pipeline Operators. OMB Control Number: 2137-0610...

77 FR 46155 - Pipeline Safety: Information Collection Activities

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-02

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No... collections relate to the pipeline integrity management requirements for gas transmission pipeline operators... Management in High Consequence Areas Gas Transmission Pipeline Operators. OMB Control Number: 2137-0610...

Integrated corridor management initiative : demonstration phase evaluation - final national evaluation framework.

DOT National Transportation Integrated Search

2012-05-01

This report provides an analytical framework for evaluating the two field deployments under the United States Department of Transportation (U.S. DOT) Integrated Corridor Management (ICM) Initiative Demonstration Phase. The San Diego Interstate 15 cor...

TxDOT's pavement management information system : current status and future directions

DOT National Transportation Integrated Search

1997-12-01

Phase 2 focuses on improving The Texas Pavement Management Information System (PMIS) implementation at the district level, the goal being to provide sufficient information to move from network to project level decision making. Phase 2 implementation ...

Weather information integration in transportation management center (TMC) operations.

DOT National Transportation Integrated Search

2011-01-02

This report presents the results of the third phase of an on-going FHWA study on weather integration in Transportation Management Center (TMC) operations. The report briefly describes the earlier phases of the integration study, summarizes the findin...

Migrating a lecture in nursing informatics to a blended learning format--A bottom-up approach to implement an open-source web-based learning management system.

PubMed

Schrader, Ulrich

2006-01-01

At the university of applied sciences in Germany a learning management system has been implemented. The migration of classic courses to a web-enhances curriculum can be categorized into three phases independent of the technology used. The first two phases "dedicated website" and "database supported content management system" are mainly concerned with bringing the learning material and current information online and making it available to the students. The goal is here to make the maintenance of the learning material easier. The third phase characterized by the use of a learning management system offers the support of more modern didactic principles like social constructionism or problem-oriented learning. In this papers the phases as they occurred with the migration of a course of nursing informatics are described and experiences discussed.. The absence of institutional goals associated with the use of a learning management system led to a bottom-up approach triggered by faculty activities that can be described by a promoter model rather than by a process management model. The use of an open source learning management systems made this process easier to realize since no financial commitment is required up front.

Engineering the Business of Defense Acquisition: An Analysis of Program Office Processes

DTIC Science & Technology

2015-05-01

Information Technology and Business Process Redesign | MIT Sloan Management Review . MIT Sloan Management Review . Retrieved from http://sloanreview.mit.edu...links systems management to process execution Three Phases/ Multi-Year Effort (This Phase) Literature review Model development— Formal and...estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining

Behavioral Impulsivity Does Not Predict Naturalistic Alcohol Consumption or Treatment Outcomes

PubMed Central

Mullen, Jillian; Mathias, Charles W.; Karns, Tara E.; Liang, Yuanyuan; Hill-Kapturczak, Nathalie; Roache, John D.; Lamb, Richard J.; Dougherty, Donald M.

2016-01-01

Objective The purpose of this study was to determine if behavioral impulsivity under multiple conditions (baseline, after alcohol consumption or after serotonin depletion) predicted naturalistic alcohol use or treatment outcomes from a moderation-based contingency management intervention. Method The current data analysis pulls information from three phases of a large study: 1) Phase 1 examined baseline and the effects of alcohol use and serotonin depletion on three types of behavioral impulsivity: response initiation (IMT task), response inhibition (GoStop task), and delay discounting (SKIP task); 2) Phase 2 involved 28 days of naturalistic drinking; and 3) Phase 3 involved 3 months of contingency management. During phases 2 and 3 alcohol use was measured objectively using transdermal alcohol monitors. The results of each individual phase has been previously published showing that at a group level the effects of alcohol consumption on impulsivity were dependent on the component of impulsivity being measured and the dose of alcohol consumed but serotonin depletion had no effect on impulsivity, and that a moderation-based contingency management intervention reduced heavy drinking. Results The current analysis combining data from those who completed all three phases (n = 67) showed that impulsivity measured at baseline, after alcohol consumption, or after serotonin depletion did not predict naturalistic drinking or treatment outcomes from a moderation-based CM treatment. Conclusions Contingency management interventions may prove to be an effective intervention for impulsive individuals, however, normal variations in measured impulsivity do not seem to relate to normal variations in drinking pattern or response to moderation-based contingency management. PMID:27746702

Disaster Medical Assistance Teams After Earthquakes in Iran: Propose a Localized Model

PubMed Central

Abbasi, Mohsen; Salehnia, M Hossein

2013-01-01

Background In the past 10 years, 13 fatal earthquakes have occurred in Iran and led to death of 30,000 people whom most of them were killed in the earlier hours of the disaster. Disaster Medical Assistance Teams are groups of trained medical and non-medical personnel with various combinations that on the optimal conditions are deployed just within 8 hours of notification and are able to work self-sufficiently for at least 72 hours without any outside help and can treat up to 250 patients per day. Currently there are no such rapid-response teams in case of unexpected events in Iran, which causes the responses to such disasters, not to be organized or practiced. For instance, there were many rescue forces in 2003 Bam earthquake but not enough skilled ones to cope with; consequently they themselves became a problem in crisis management instead of solving the problem. Objectives In this study, we have investigated which of the following is more efficient: changing the size and combination of the team depending on the type of disaster and environmental conditions or, determine a fixed combination team. Materials and Methods Totally, several reasons for dynamic combination and size of the teams are presented. later, earthquake disaster is divided into 3 phases in terms of time including the acute phase (1st to 4th day after disaster), the sub-acute phase (5th to 14thday) and the recovery phase (after the 14th day), and finally the appropriate team combinations in every phases are offered. Results Regarding to introduction and considering the existing statistics in different legal Iranian resources and by division of the earthquake disaster to three phases including acute phase (1st to the 4th day after disaster), sub-acute phase (5th to 14th day) and recovery phase (after the 14th day) Conclusions The countries pioneer in disaster medical assistance teams, now are inclined to deploy different teams consistent with each kind of disasters or with other effective components on the combination of system. Every disaster has its own condition and would require different combination of relief and medical forces. For example, people’s health needs in flood is different from the earthquake PMID:24616795

The providers' profile of the disability support workforce in New Zealand.

PubMed

Jorgensen, Diane; Parsons, Matthew; Reid, Michelle Gundersen; Weidenbohm, Kate; Parsons, John; Jacobs, Stephen

2009-07-01

To understand one of the predominant groups supporting people with disabilities and illness, this study examined the profile of New Zealand paid caregivers, including their training needs. Paid caregivers, also known as healthcare assistants, caregivers and home health aides, work across several long-term care settings, such as residential homes, continuing-care hospitals and also private homes. Their roles include assisting with personal care and household management. New Zealand, similar to other countries, is facing a health workforce shortage. A three-phased design was used: phase I, a survey of all home-based and residential care providers (N = 942, response rate = 45%); phase II, a targeted survey of training needs (n = 107, response = 100%); phase III, four focus groups and 14 interviews with 36 providers, exploring themes arising from phases I and II. Findings on 17,910 paid caregivers revealed a workforce predominantly female (94%), aged between 40 and 50, with 6% over the age of 60. Mean hourly pay NZ$10.90 (minimum wage NZ$10.00 approx. UK3.00 at time of study) and 24 hours per week. The national paid caregiver turnover was 29% residential care and 39% community. Most providers recognised the importance of training, but felt their paid caregivers were not adequately trained. Training was poorly attended; reasons cited were funding, family, secondary employment, staff turnover, low pay and few incentives. The paid caregiver profile described reflects trends also observed in other countries. There is a clear policy direction in New Zealand and other countries to support people with a disability at home, and yet the workforce which is facilitating this vision is itself highly vulnerable. Paid caregivers have minimum pay, are female, work part-time and although it is recognised that training is important for them, they do not attend, so consequently remain untrained.

Household costs of illness during different phases of tuberculosis treatment in Central Asia: a patient survey in Tajikistan

PubMed Central

2010-01-01

Background Illness-related costs incurred by patients constitute a severe economic burden for households especially in low-income countries. High household costs of illness lead to impoverishment; they impair affordability and equitable access to health care and consequently hamper tuberculosis (TB) control. So far, no study has investigated patient costs of TB in the former Soviet Union. Methods All adult new pulmonary TB cases enrolled into the DOTS program in 12 study districts during the study period were enrolled. Medical and non-medical expenditure as well as loss of income were quantified in two interviews covering separate time periods. Costs of different items were summed up to calculate total costs. For missing values, multiple imputation was applied. Results A cohort of 204 patients under DOTS, 114 men and 90 women, participated in the questionnaire survey. Total illness costs of a TB episode averaged $1053 (c. $4900 purchasing power parity, PPP), of which $292, $338 and $422 were encountered before the start of treatment, during intensive phase and in continuation phase, respectively. Costs per month were highest before the start of treatment ($145) and during intensive phase ($153) and lower during continuation phase ($95). These differences were highly significant (paired t-test, p < 0.0005 for both comparisons). Conclusions The illness-related costs of an episode of TB exceed the per capita GDP of $1600 PPP about two-and-a-half times. Hence, these costs are catastrophic for concerned households and suggest a high risk for impoverishment. Costs are not equally spread over time, but peak in early stages of treatment, exacerbating the problem of affordability. Mitigation strategies are needed in order to control TB in Tajikistan and may include social support to the patients as well as changes in the management of TB cases. These mitigation strategies should be timed early in treatment when the cost burden is highest. PMID:20078897

Shift Work and Cognitive Flexibility: Decomposing Task Performance.

PubMed

Cheng, Philip; Tallent, Gabriel; Bender, Thomas John; Tran, Kieulinh Michelle; Drake, Christopher L

2017-04-01

Deficits in cognitive functioning associated with shift work are particularly relevant to occupational performance; however, few studies have examined how cognitive functioning is associated with specific components of shift work. This observational study examined how circadian phase, nocturnal sleepiness, and daytime insomnia in a sample of shift workers ( N = 30) were associated with cognitive flexibility during the night shift. Cognitive flexibility was measured using a computerized task-switching paradigm, which produces 2 indexes of flexibility: switch cost and set inhibition. Switch cost represents the additional cognitive effort required in switching to a different task and can impact performance when multitasking is involved. Set inhibition is the efficiency in returning to previously completed tasks and represents the degree of cognitive perseveration, which can lead to reduced accuracy. Circadian phase was measured via melatonin assays, nocturnal sleepiness was assessed using the Multiple Sleep Latency Test, and daytime insomnia was assessed using the Insomnia Severity Index. Results indicated that those with an earlier circadian phase, insomnia, and sleepiness exhibited reduced cognitive flexibility; however, specific components of cognitive flexibility were differentially associated with circadian phase, insomnia, and sleepiness. Individuals with an earlier circadian phase (thus more misaligned to the night shift) exhibited larger switch costs, which was also associated with reduced task efficiency. Shift workers with more daytime insomnia demonstrated difficulties with cognitive inhibition, whereas nocturnal sleepiness was associated with difficulties in reactivating previous tasks. Deficits in set inhibition were also related to reduced accuracy and increased perseverative errors. Together, this study indicates that task performance deficits in shift work are complex and are variably impacted by different mechanisms. Future research may examine phenotypic differences in shift work and the associated consequences. Results also suggest that fatigue risk management strategies may benefit from increased scope and specificity in assessment of sleep, sleepiness, and circadian rhythms in shift workers.

Iron metabolism and oxidative profile of dogs naturally infected by Ehrlichia canis: Acute and subclinical disease.

PubMed

Bottari, Nathieli B; Crivellenti, Leandro Z; Borin-Crivellenti, Sofia; Oliveira, Jéssica R; Coelho, Stefanie B; Contin, Catarina M; Tatsch, Etiane; Moresco, Rafael N; Santana, Aureo E; Tonin, Alexandre A; Tinucci-Costa, Mirela; Da Silva, Aleksandro S

2016-03-01

The aim of this study was to evaluate the oxidant profile and iron metabolism in serum of dogs infected by Ehrlichia canis. Banked sera samples of dogs were divided into two groups: negative control (n = 17) and infected by E. canis on acute (n = 24), and subclinical (n = 18) phases of the disease. The eritrogram, leucogram, and platelet counts were evaluate as well as iron, ferritin, and transferrin levels, latent iron binding capacity (LIBC), and transferrin saturation index (TSI) concentration. In addition, the advanced oxidation protein products (AOPP) and ferric reducing ability of plasma (FRAP) in sera were also analyzed. Blood samples were examined for the presence of E. canis by PCR techniques. History and clinical signals were recorded for each dog. During the acute phase of the disease, infected animals showed thrombocytopenia and anemia when compared to healthy animals (P < 0.05) as a consequence of lower iron levels. Ferritin and transferrin levels were higher in both phases (acute and subclinical) of the disease. The AOPP and FRAP levels increased in infected animals on the acute phase; however, the opposite occurred in the subclinical phase. We concluded that dogs naturally infected by E. canis showed changes in the iron metabolism and developed an oxidant status in consequence of disease pathophysiology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Elastic Properties and Enhanced Piezoelectric Response at Morphotropic Phase Boundaries

PubMed Central

Cordero, Francesco

2015-01-01

The search for improved piezoelectric materials is based on the morphotropic phase boundaries (MPB) between ferroelectric phases with different crystal symmetry and available directions for the spontaneous polarization. Such regions of the composition x−T phase diagrams provide the conditions for minimal anisotropy with respect to the direction of the polarization, so that the polarization can easily rotate maintaining a substantial magnitude, while the near verticality of the TMPBx boundary extends the temperature range of the resulting enhanced piezoelectricity. Another consequence of the quasi-isotropy of the free energy is a reduction of the domain walls energies, with consequent formation of domain structures down to nanoscale. Disentangling the extrinsic and intrinsic contributions to the piezoelectricity in such conditions requires a high level of sophistication from the techniques and analyses for studying the structural, ferroelectric and dielectric properties. The elastic characterization is extremely useful in clarifying the phenomenology and mechanisms related to ferroelectric MPBs. The relationship between dielectric, elastic and piezoelectric responses is introduced in terms of relaxation of defects with electric dipole and elastic quadrupole, and extended to the response near phase transitions in the framework of the Landau theory. An account is provided of the anelastic experiments, from torsional pendulum to Brillouin scattering, that provided new important information on ferroelectric MPBs, including PZT, PMN-PT, NBT-BT, BCTZ, and KNN-based systems. PMID:28793707

The impact of the great recession on community-based mental health organizations: an analysis of top managers' perceptions of the economic downturn's effects and adaptive strategies used to manage the consequences in Ohio.

PubMed

Sweeney, Helen Anne; Knudsen, Kraig

2014-04-01

The Great Recession of 2007-2009 adversely affected the financial stability of the community-based mental health infrastructure in Ohio. This paper presents survey results of the type of adaptive strategies used by Ohio community-based mental health organizations to manage the consequences of the economic downturn. Results were aggregated into geographical classifications of rural, mid-sized urban, and urban. Across all groups, respondents perceived, to varying degrees, that the Great Recession posed a threat to their organization's survival. Urban organizations were more likely to implement adaptive strategies to expand operations while rural and midsized urban organizations implemented strategies to enhance internal efficiencies.

Klamath Basin: A Watershed Approach to Support Habitat Restoration, Species Recovery, and Water Resource Planning

USGS Publications Warehouse

VanderKooi, S.P.; Thorsteinson, L.

2007-01-01

Water allocation among human and natural resource uses in the American West is challenging. Western rivers have been largely managed for hydropower, irrigation, drinking water, and navigation. Today land and water use practices have gained importance, particularly as aging dams are faced with re-licensing requirements and provisions of the Endangered Species and Clean Water Acts. Rising demand for scarce water heightens the need for scientific research to predict consequences of management actions on habitats, human resource use, and fish and wildlife. Climate change, introduction of invasive species, or restoration of fish passage can have large, landscape-scaled consequences - research must expand to encompass the appropriate scale and by applying multiple scientific disciplines to complex ecosystem challenges improve the adaptive management framework for decision-making.

Risk management and post-marketing surveillance of CNS drugs.

PubMed

Henningfield, Jack E; Schuster, Charles R

2009-12-01

Drugs affecting the central nervous system span a broad range of chemical entities, dosage forms, indications, and risks. Unintended consequences include potential abuse and overdose in non-patient drug abusers, deliberate tampering of drug dosage forms, and criminal behavior associated with diversion. Regulators must consider diverse factors to find the appropriate conditions of approval to minimize unintended consequences while enabling a level of access desired by health care providers and patients. This commentary appears as part of a special issue of Drug and Alcohol Dependence that focuses on risk management and post-marketing surveillance and addresses key issues that pose real-world challenges to pharmaceutical sponsors and regulators in particular. For example, in the U.S., Controlled Substances Act drug scheduling can be considered a risk management strategy but its legal authorities and administrative processes are independent from those of risk management (including Risk Evaluation and Mitigation Strategies or REMS); better harmonization of these approaches is vital from drug development and regulatory perspectives. Risk management would ideally be implemented on a strong science foundation demonstrating that the tools employed to mitigate risks and ensure safe use are effective. In reality, research and evaluation of tools in this area is in its infancy and will necessarily be an evolutionary process; furthermore, there is little precedent for linking interventions and program evolution to unintended consequences such as regional outbreaks of abuse and diversion. How such issues are resolved has the potential to stimulate or stifle innovations in drug development and advance or imperil health care.

Development of the young spine questionnaire.

PubMed

Lauridsen, Henrik Hein; Hestbaek, Lise

2013-06-12

Back pain in children is common and early onset of back pain has been shown to increase the risk of back pain significantly in adulthood. Consequently, preventive efforts must be targeted the young population but research relating to spinal problems in this age group is scarce. Focus has primarily been on the working age population, and therefore specific questionnaires to measure spinal pain and its consequences, specifically aimed at children and adolescents are absent. The purpose of this study was to develop a questionnaire for schoolchildren filling this gap. The Young Spine Questionnaire (YSQ) was developed in three phases--a conceptualisation, development and testing phase. The conceptualisation phase followed the Wilson and Cleary model and included questions regarding spinal prevalence estimates, pain frequency and intensity, activity restrictions, care seeking behaviour and influence of parental back trouble. Items from existing questionnaires and the "Revised Faces Pain Scale" (rFPS) were included during the development phase. The testing phase consisted of a mixed quantitative and qualitative iterative method carried out in two pilot tests using 4th grade children and focusing on assessment of spinal area location and item validity. The testing phase resulted in omission of the pain drawings and the questions and answer categories were simplified in several questions. Agreement between the questionnaire prevalence estimates and the interviews ranged between 83.7% (cervical pain today) and 97.9% (thoracic pain today). To improve the understanding of the spinal boundaries we added bony landmarks to the spinal drawings after pilot test I. This resulted in an improved sense of spinal boundary location in pilot test II. Correlations between the rFPS and the interview pain score ranged between 0.67 (cervical spine) and 0.79 (lumbar spine). The Young Spine Questionnaire contains questions that assess spinal pain and its consequences. The items have been tested for content understanding and agreement between questionnaire scores and interview findings among target respondents. These preliminary results suggest that the YSQ is feasible, has content validity and is a well understood questionnaire to be used in studies of children aged 9 to 11 years.

Integrated Computer System of Management in Logistics

NASA Astrophysics Data System (ADS)

Chwesiuk, Krzysztof

2011-06-01

This paper aims at presenting a concept of an integrated computer system of management in logistics, particularly in supply and distribution chains. Consequently, the paper includes the basic idea of the concept of computer-based management in logistics and components of the system, such as CAM and CIM systems in production processes, and management systems for storage, materials flow, and for managing transport, forwarding and logistics companies. The platform which integrates computer-aided management systems is that of electronic data interchange.

Secure SCADA communication by using a modified key management scheme.

PubMed

Rezai, Abdalhossein; Keshavarzi, Parviz; Moravej, Zahra

2013-07-01

This paper presents and evaluates a new cryptographic key management scheme which increases the efficiency and security of the Supervisory Control And Data Acquisition (SCADA) communication. In the proposed key management scheme, two key update phases are used: session key update and master key update. In the session key update phase, session keys are generated in the master station. In the master key update phase, the Elliptic Curve Diffie-Hellman (ECDH) protocol is used. The Poisson process is also used to model the Security Index (SI) and Quality of Service (QoS). Our analysis shows that the proposed key management not only supports the required speed in the MODBUS implementation but also has several advantages compared to other key management schemes for secure communication in SCADA networks. Copyright © 2013 ISA. Published by Elsevier Ltd. All rights reserved.

78 FR 26775 - Information Collection Request Submitted to OMB for Review and Approval; Comment Request...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-08

...), Distribution of Offsite Consequence Analysis Information under Section 112(r)(7)(H) of the Clean Air Act (CAA... a risk management plan (RMP) to EPA. The RMP includes information on offsite consequence analyses... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OAR-2003-0073; FRL-9530-6] Information Collection Request...

The hidden consequences of fire suppression

Treesearch

Carol Miller

2012-01-01

Wilderness managers need a way to quantify and monitor the effects of suppressing lightning-caused wildfires, which can alter natural fire regimes, vegetation, and habitat. Using computerized models of fire spread, weather, and fuels, it is now possible to quantify many of the hidden consequences of fire suppression. Case study watersheds in Yosemite and Sequoia-Kings...

Why do infants begin to talk? Language as an unintended consequence.

PubMed

Locke, J L

1996-06-01

Scholars have addressed a range of questions about language development, but for some reason have neglected to ask why infants begin to talk. Biologists often prefer 'how' to 'why' questions, but it is possible to ask about the immediate consequences of developing behaviours--an acceptable strategy for attacking causation--and psycholinguists can study the immediate consequences to the infant of behaviours that lead to linguistic competence. This process is demonstrated with a series of illustrative proposals as to the short- and long-term consequences of vocal learning and utterance storage, two developmental phases that lead to talking, as well as the act of talking itself. The goal is to encourage investigation of behavioural dispositions that nudge the child, by degrees, towards proficiency in the use of spoken language.

Cost effectiveness of adopted quality requirements in hospital laboratories.

PubMed

Hamza, Alneil; Ahmed-Abakur, Eltayib; Abugroun, Elsir; Bakhit, Siham; Holi, Mohamed

2013-01-01

The present study was designed in quasi-experiment to assess adoption of the essential clauses of particular clinical laboratory quality management requirements based on international organization for standardization (ISO 15189) in hospital laboratories and to evaluate the cost effectiveness of compliance to ISO 15189. The quality management intervention based on ISO 15189 was conceded through three phases; pre - intervention phase, Intervention phase and Post-intervention phase. In pre-intervention phase the compliance to ISO 15189 was 49% for study group vs. 47% for control group with P value 0.48, while the post intervention results displayed 54% vs. 79% for study group and control group respectively in compliance to ISO 15189 and statistically significant difference (P value 0.00) with effect size (Cohen's d) of (0.00) in pre-intervention phase and (0.99) in post - intervention phase. The annual average cost per-test for the study group and control group was 1.80 ± 0.25 vs. 1.97 ± 0.39, respectively with P value 0.39 whereas the post-intervention results showed that the annual average total costs per-test for study group and control group was 1.57 ± 0.23 vs 2.08 ± 0.38, P value 0.019 respectively, with cost-effectiveness ratio of (0.88) in pre -intervention phase and (0.52) in post-intervention phase. The planned adoption of quality management requirements (QMS) in clinical laboratories had great effect to increase the compliance percent with quality management system requirement, raise the average total cost effectiveness, and improve the analytical process capability of the testing procedure.

Fluvial biogeomorphology in the Anthropocene: Managing rivers and managing landscapes.

NASA Astrophysics Data System (ADS)

Viles, Heather

2015-04-01

Biogeomorphology considers the many, and often complex, interactions between ecological and geomorphological processes. The concept of the Anthropocene deserves greater attention by scientists working on biogeomorphology, as will be demonstrated in this talk though a focus on fluvial environments. Rivers and river systems have been the subject of long-term human interference and management across the world, often in the form of direct manipulation of biogeomorphic interactions. Up to the present three broadly-defined phases of the Anthropocene can be identified - the Palaeoanthropocene, the Industrial Revolution and the Great Acceleration. Each of these broad phases of the Anthropocene has different implications for fluvial biogeomorphology and river management. The nature and dynamics of tufa-depositing systems provide good examples of the differing Anthropocene situations and will be focused on in this talk. We may now be entering a fourth phase of the Anthropocene called 'Earth system stewardship'. In terms of better understanding and managing the biogeomorphic interactions within rivers in such a phase, an improved conceptualisation of the Anthropocene and the complex web of interactions between human, ecological and geomorphological processes is needed.

Motivational interviewing and cognitive behaviour therapy in the treatment of adolescent overweight and obesity: study design and methodology.

PubMed

Brennan, Leah; Walkley, Jeff; Fraser, Steve F; Greenway, Kate; Wilks, Ray

2008-05-01

Despite the high prevalence and negative physical and psychosocial consequences of overweight and obesity in adolescents, very little research has evaluated treatment in this population. Consequently, clinicians working with overweight and obese adolescents have little empirical research on which to base their practise. Cognitive behavioural therapy has demonstrated efficacy in promoting behaviour change in many treatment resistant disorders. Motivational interviewing has been used to increase motivation for change and improve treatment outcomes. In this paper we describe the rationale and design of a randomised controlled trial testing the efficacy of motivational interviewing and cognitive behaviour therapy in the treatment of overweight and obese adolescents. Participants took part in a motivational interview or a standard semi-structured assessment interview and were then randomly allocated to a cognitive behavioural intervention or a wait-list control condition. The cognitive behavioural intervention, the CHOOSE HEALTH Program, consisted of 13 individual treatment sessions (12 face-to-face, 1 phone call) followed by 9 maintenance sessions (7 phone calls, 2 face-to-face). Assessments were conducted prior to participation, after the treatment phase and after the maintenance phase of intervention. Improvement in body composition was the primary outcome; secondary outcomes included improved cardiovascular fitness, eating and physical activity habits, family and psychosocial functioning. Despite the demonstrated effectiveness of motivational interviewing and cognitive behavioural therapy in the long-term management of many treatment resistant disorders, these approaches have been under-utilised in adolescent overweight and obesity treatment. This study provides baseline data and a thorough review of the study design and treatment approach to allow for the assessment of the efficacy of motivational interviewing and cognitive behavioural therapy in the treatment of adolescent overweight and obesity. Data obtained in this study will also provide much needed information about the behavioural and psychosocial factors associated with adolescent overweight and obesity.

Statement on Intellectual Property

ERIC Educational Resources Information Center

American Association of University Professors, 2014

2014-01-01

The management of university-generated intellectual property is complex and carries significant consequences for those involved in direct negotiations (faculty inventors, companies, university administrators, attorneys, and invention-management agents) as well as those who may be affected (competing companies, the public, patients, and the wider…

The proactive management of rumor and gossip.

PubMed

Ribeiro, V E; Blakeley, J A

1995-06-01

Gossip and rumor are common forms of communication in the workplace. Consequently, nursing administrators are challenged to find ways to manage these grapevine activities. The authors present an analysis of gossip and rumor and discuss strategies for their prevention and control.

User's Guide for SeedCalc: A Decision-Support System for Integrated Pest Management in Slash Pine Seed Orchards

Treesearch

Carl W. Fatzinger; Wayne N. Dixon

1996-01-01

SeedCalc, a decision-support system designed for use on personal computers, evaluates the consequences of different pest management strategies in slash pine (Pinus ellliottii Engelm. var. elliottii) seed orchards.

Topological Weyl superconductor to diffusive thermal Hall metal crossover in the B phase of UPt3

NASA Astrophysics Data System (ADS)

Goswami, Pallab; Nevidomskyy, Andriy H.

2015-12-01

The recent phase-sensitive measurements in the superconducting B phase of UPt3 provide strong evidence for the triplet, chiral kz(kx±i ky) 2 pairing symmetries, which endow the Cooper pairs with orbital angular momentum projections Lz=±2 along the c axis. In the absence of disorder such pairing can support both line and point nodes, and both types of nodal quasiparticles exhibit nontrivial topology in the momentum space. The point nodes, located at the intersections of the closed Fermi surfaces with the c axis, act as the double monopoles and the antimonopoles of the Berry curvature, and generalize the notion of Weyl quasiparticles. Consequently, the B phase should support an anomalous thermal Hall effect, the polar Kerr effect, in addition to the protected Fermi arcs on the (1 ,0 ,0 ) and the (0 ,1 ,0 ) surfaces. The line node at the Fermi surface equator acts as a vortex loop in the momentum space and gives rise to the zero-energy, dispersionless Andreev bound states on the (0 ,0 ,1 ) surface. At the transition from the B phase to the A phase, the time-reversal symmetry is restored, and only the line node survives inside the A phase. As both line and double-Weyl point nodes possess linearly vanishing density of states, we show that weak disorder acts as a marginally relevant perturbation. Consequently, an infinitesimal amount of disorder destroys the ballistic quasiparticle pole, while giving rise to a diffusive phase with a finite density of states at the zero energy. The resulting diffusive phase exhibits T -linear specific heat, and an anomalous thermal Hall effect. We predict that the low-temperature thermodynamic and transport properties display a crossover between a ballistic thermal Hall semimetal and a diffusive thermal Hall metal. By contrast, the diffusive phase obtained from a time-reversal-invariant pairing exhibits only the T -linear specific heat without any anomalous thermal Hall effect.

Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy.

PubMed

Malbrain, Manu L N G; Van Regenmortel, Niels; Saugel, Bernd; De Tavernier, Brecht; Van Gaal, Pieter-Jan; Joannes-Boyau, Olivier; Teboul, Jean-Louis; Rice, Todd W; Mythen, Monty; Monnet, Xavier

2018-05-22

In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition. In this paradigm-shifting review, we discuss different fluid management strategies including early adequate goal-directed fluid management, late conservative fluid management and late goal-directed fluid removal. In addition, we expand on the concept of the "four D's" of fluid therapy, namely drug, dosing, duration and de-escalation. During the treatment of patients with septic shock, four phases of fluid therapy should be considered in order to provide answers to four basic questions. These four phases are the resuscitation phase, the optimization phase, the stabilization phase and the evacuation phase. The four questions are "When to start intravenous fluids?", "When to stop intravenous fluids?", "When to start de-resuscitation or active fluid removal?" and finally "When to stop de-resuscitation?" In analogy to the way we handle antibiotics in critically ill patients, it is time for fluid stewardship.

Performance Management as a Means of Teacher Evaluation: A South Australian Perspective

ERIC Educational Resources Information Center

Naidu, Sham

2011-01-01

The introduction of performance management in South Australian public schools raises a number of issues regarding the structure, purpose and control of the process itself and the consequences of teacher evaluation. Performance management has the potential to shape teaching and the culture of schools according to what it values and what it ignores.…

Paradigms and problems: The practice of social science in natural resource management

Treesearch

Michael E. Patterson; Daniel R. Williams

1998-01-01

Increasingly, natural resource management is seeing calls for new paradigms. These calls pose challenges that have implications not only for planning and management, but also for the practice of science. As a consequence, the profession needs to deepen its understanding of the nature of science by exploring recent advances in the philosophy of science....

Biodiversity in Finnish wilderness areas: Historical and cultural constraints to preserve species and habitats

Treesearch

Anna-Liisa Sippola

2002-01-01

The present status of species and habitats in Finnish wilderness areas is largely a consequence of past administrative, use, and management traditions in northern Finland. The existing wilderness legislation sets a framework for management, but historical uses and administrative decisions have influenced many prevailing practices. In addition, management of many uses...

Fuels planning: science synthesis and integration; environmental consequences fact sheet 08: Evaluating sedimentation risks associated with fuel management

Treesearch

William Elliot; Pete Robichaud

2005-01-01

This fact sheet describes the sources of sediment in upland forest watersheds in the context of fuel management activities. It presents the dominant forest soil erosion processes, and the principles behind the new sediment delivery interface developed to aid in erosion analysis of fuel management projects.

Evaluating management risks using landscape trajectory analysis: a case study of California fisher

Treesearch

Craig M. Thompson; William J. Zielinski; Kathryn L. Purcell

2011-01-01

Ecosystem management requires an understanding of how landscapes vary in space and time, how this variation can be affected by management decisions or stochastic events, and the potential consequences for species. Landscape trajectory analysis, coupled with a basic knowledge of species habitat selection, offers a straightforward approach to ecological risk analysis and...

Evaluating the habitat capability model for Merriam's turkeys

Treesearch

Mark A. Rumble; Stanley H. Anderson

1995-01-01

Habitat capability (HABCAP) models for wildlife assist land managers in predicting the consequences of their management decisions. Models must be tested and refined prior to using them in management planning. We tested the predicted patterns of habitat selection of the R2 HABCAP model using observed patterns of habitats selected by radio-marked Merriam’s turkey (

University Governance, Leadership and Management in a Decade of Diversification and Uncertainty

ERIC Educational Resources Information Center

Shattock, Michael

2013-01-01

The last decade has seen an acceleration of change in the way British universities have been governed, led and managed. This has substantially been driven by the instability of the external environment, which has encouraged a greater centralisation of decision-making leading to less governance and more management, but it is also a consequence of…

Foraging plasticity by a keystone excavator, the white-headed woodpecker, in managed forests: Are there consequences for productivity?

Treesearch

Teresa J. Lorenz; Kerri T. Vierling; Jeffrey M. Kozma; Janet E. Millard

2016-01-01

Information on the foraging ecology of animals is important for conservation and management, particularly for keystone species whose presence affects ecosystem health. We examined foraging by an at-risk cavity excavator, the white-headed woodpecker (Picoides albolarvatus). The foraging needs of this species are used to inform management of...

Auditory closed-loop stimulation of the sleep slow oscillation enhances memory.

PubMed

Ngo, Hong-Viet V; Martinetz, Thomas; Born, Jan; Mölle, Matthias

2013-05-08

Brain rhythms regulate information processing in different states to enable learning and memory formation. The <1 Hz sleep slow oscillation hallmarks slow-wave sleep and is critical to memory consolidation. Here we show in sleeping humans that auditory stimulation in phase with the ongoing rhythmic occurrence of slow oscillation up states profoundly enhances the slow oscillation rhythm, phase-coupled spindle activity, and, consequently, the consolidation of declarative memory. Stimulation out of phase with the ongoing slow oscillation rhythm remained ineffective. Closed-loop in-phase stimulation provides a straight-forward tool to enhance sleep rhythms and their functional efficacy. Copyright © 2013 Elsevier Inc. All rights reserved.

Frequency-domain phase fluorometry in the presence of dark states: A numerical study

NASA Astrophysics Data System (ADS)

Zhu, Xinxin; Min, Wei

2011-11-01

Fluorescence anomalous phase advance (FAPA) is a newly discovered spectroscopy phenomenon: instead of lagging behind the modulated light, fluorescence signal can exhibit FAPA as if it precedes the excitation source in time. While FAPA offers a promising technique for probing dark state lifetime, the underlying mechanism is not fully elucidated. Herein we investigate frequency-domain phase fluorometry as a result of intricate interplay between a short-lived fluorescent state and a long-lived dark state. In particular, the quantitative dependence on modulation frequency, excitation intensity, nonradiative decay, intersystem crossing and dark-state lifetime are explored respectively. A comprehensive view of phase fluorometry emerges consequently.

Rate-induced solubility and suppression of the first-order phase transition in olivine LiFePO4.

PubMed

Zhang, Xiaoyu; van Hulzen, Martijn; Singh, Deepak P; Brownrigg, Alex; Wright, Jonathan P; van Dijk, Niels H; Wagemaker, Marnix

2014-05-14

The impact of ultrahigh (dis)charge rates on the phase transition mechanism in LiFePO4 Li-ion electrodes is revealed by in situ synchrotron diffraction. At high rates the solubility limits in both phases increase dramatically, causing a fraction of the electrode to bypass the first-order phase transition. The small transforming fraction demonstrates that nucleation rates are consequently not limiting the transformation rate. In combination with the small fraction of the electrode that transforms at high rates, this indicates that higher performances may be achieved by further optimizing the ionic/electronic transport in LiFePO4 electrodes.

Towards an integrated AlGaAs waveguide platform for phase and polarisation shaping

NASA Astrophysics Data System (ADS)

Maltese, G.; Halioua, Y.; Lemaître, A.; Gomez-Carbonell, C.; Karimi, E.; Banzer, P.; Ducci, S.

2018-05-01

We propose, design and fabricate an on-chip AlGaAs waveguide capable of generating a controlled phase delay of π/2 between the guided transverse electric and magnetic modes. These modes possess significantly strong longitudinal field components as a direct consequence of their strong lateral confinement in the waveguide. We demonstrate that the effect of the device on a linearly polarised input beam is the generation of a field, which is circularly polarised in its transverse components and carries a phase vortex in its longitudinal component. We believe that the discussed integrated platform enables the generation of light beams with tailored phase and polarisation distributions.

Carrier-envelope phase-stabilized attosecond pulses from asymmetric molecules

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

Lan Pengfei; Lu Peixiang; Cao Wei

2007-08-15

High-order harmonic generation from asymmetric molecules is investigated, and the concept of phase-stabilized infrared ultrashort laser pulses is extended to the extreme ultraviolet regime. It is shown that the ionization symmetry in consecutive half optical cycles is broken for asymmetric molecules, and both even and odd harmonics with comparable intensity are produced. In the time domain, only one attosecond pulse is generated in each cycle of the driving field, and the carrier-envelope phases of the attosecond pulses are equal. Consequently, a clean attosecond pulse train with the same carrier-envelope phase from pulse to pulse is obtained in the extreme ultravioletmore » regime.« less

[Changing economic environment of hospitals: management challenges of the 1990s].

PubMed

Rotstein, Z; Noy, S; Goldman, B; Shani, M

1990-12-16

The modern hospital is an organization which is influenced by the external environment in which it functions. A major relevant area is the economic environment. In recent years the western world has been facing the challenge of rising costs of health care and an increase in their proportion to the gross national product of most countries. Consequently, hospitals as major providers of health care are under pressure from governments and health insurance companies to cut costs and to "produce" more efficiently. Since hospitals worldwide are finding it hard and painful to function in the new environment in which attitudes to hospitals are changing, a potential managerial-economic crisis may be the next phase. How can the hospital adapt to these changes? First, by adopting managerial attitudes and the tools of the business sector. These include: the strategic planning process, hospital operative autonomy, creating medical-economic responsibility centers as departments, cost-accounting for medical procedures, and case-mix budgeting. Management information systems are necessary during the transition. The hospital information system should include functions at the operative level, such as outpatient visits, and admissions and discharges of patients; and also clinical, diagnostic and laboratory procedures related to the patient case-mix. The second level is a management information system which includes salaries of personnel, case-mix budgeting with variance analysis, prices of procedures and epidemiological data. The authors believe that only the managerial approach combining medical and economic disciplines can meet the challenges of the changing modern economic environment.

Integrating Water Quality and River Rehabilitation Management - A Decision-Analytical Perspective

NASA Astrophysics Data System (ADS)

Reichert, P.; Langhans, S.; Lienert, J.; Schuwirth, N.

2009-04-01

Integrative river management involves difficult decisions about alternative measures to improve their ecological state. For this reason, it seems useful to apply knowledge from the decision sciences to support river management. We discuss how decision-analytical elements can be employed for designing an integrated river management procedure. An important aspect of this procedure is to clearly separate scientific predictions of the consequences of alternatives from objectives to be achieved by river management. The key elements of the suggested procedure are (i) the quantitative elicitation of the objectives from different stakeholder groups, (ii) the compilation of the current scientific knowledge about the consequences of the effects resulting from suggested measures in the form of a probabilistic mathematical model, and (iii) the use of these predictions and valuations to prioritize alternatives, to uncover conflicting objectives, to support the design of better alternatives, and to improve the transparency of communication about the chosen management strategy. The development of this procedure led to insights regarding necessary steps to be taken for rational decision-making in river management, to guidelines about the use of decision-analytical techniques for performing these steps, but also to new insights about the application of decision-analytical techniques in general. In particular, the consideration of the spatial distribution of the effects of measures and the potential added value of connected rehabilitated river reaches leads to favoring measures that have a positive effect beyond a single river reach. As these effects only propagate within the river network, this results in a river basin oriented management concept as a consequence of a rational decision support procedure, rather than as an a priori management paradigm. There are also limitations to the support that can be expected from the decision-analytical perspective. It will not provide the societal values that are driving prioritization in river management, it will only support their elicitation and rational use. This is particularly important for the assessment of micro-pollutants because of severe limitations in scientific knowledge of their effects on river ecosystems. This makes the influence of pollution by micro-pollutants on prioritization of measures strongly dependent on the weight of the precautionary principle relative to other societal objectives of river management.

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

Taylor, L.L.; Wilson, J.R.; Sanchez, L.C.

The United States Department of Energy Office of Environmental Management's (DOE/EM's) National Spent Nuclear Fuel Program (NSNFP), through a collaboration between Sandia National Laboratories (SNL) and Idaho National Engineering and Environmental Laboratory (INEEL), is conducting a systematic Nuclear Dynamics Consequence Analysis (NDCA) of the disposal of SNFs in an underground geologic repository sited in unsaturated tuff. This analysis is intended to provide interim guidance to the DOE for the management of the SNF while they prepare for final compliance evaluation. This report presents results from a Nuclear Dynamics Consequence Analysis (NDCA) that examined the potential consequences and risks of criticalitymore » during the long-term disposal of spent nuclear fuel owned by DOE-EM. This analysis investigated the potential of post-closure criticality, the consequences of a criticality excursion, and the probability frequency for post-closure criticality. The results of the NDCA are intended to provide the DOE-EM with a technical basis for measuring risk which can be used for screening arguments to eliminate post-closure criticality FEPs (features, events and processes) from consideration in the compliance assessment because of either low probability or low consequences. This report is composed of an executive summary (Volume 1), the methodology and results of the NDCA (Volume 2), and the applicable appendices (Volume 3).« less

Towards a practical framework for managing the risks of selecting technology to support independent living.

PubMed

Monk, Andrew; Hone, Kate; Lines, Lorna; Dowdall, Alan; Baxter, Gordon; Blythe, Mark; Wright, Peter

2006-09-01

Information and communication technology applications can help increase the independence and quality of life of older people, or people with disabilities who live in their own homes. A risk management framework is proposed to assist in selecting applications that match the needs and wishes of particular individuals. Risk comprises two components: the likelihood of the occurrence of harm and the consequences of that harm. In the home, the social and psychological harms are as important as the physical ones. The importance of the harm (e.g., injury) is conditioned by its consequences (e.g., distress, costly medical treatment). We identify six generic types of harm (including dependency, loneliness, fear and debt) and four generic consequences (including distress and loss of confidence in ability to live independently). The resultant client-centred framework offers a systematic basis for selecting and evaluating technology for independent living.

The siting of UK nuclear reactors.

PubMed

Grimston, Malcolm; Nuttall, William J; Vaughan, Geoff

2014-06-01

Choosing a suitable site for a nuclear power station requires the consideration and balancing of several factors. Some 'physical' site characteristics, such as the local climate and the potential for seismic activity, will be generic to all reactors designs, while others, such as the availability of cooling water, the area of land required and geological conditions capable of sustaining the weight of the reactor and other buildings will to an extent be dependent on the particular design of reactor chosen (or alternatively the reactor design chosen may to an extent be dependent on the characteristics of an available site). However, one particularly interesting tension is a human and demographic one. On the one hand it is beneficial to place nuclear stations close to centres of population, to reduce transmission losses and other costs (including to the local environment) of transporting electricity over large distances from generator to consumer. On the other it is advantageous to place nuclear stations some distance away from such population centres in order to minimise the potential human consequences of a major release of radioactive materials in the (extremely unlikely) event of a major nuclear accident, not only in terms of direct exposure but also concerning the management of emergency planning, notably evacuation.This paper considers the emergence of policies aimed at managing this tension in the UK. In the first phase of nuclear development (roughly speaking 1945-1965) there was a highly cautious attitude, with installations being placed in remote rural locations with very low population density. The second phase (1965-1985) saw a more relaxed approach, allowing the development of AGR nuclear power stations (which with concrete pressure vessels were regarded as significantly safer) closer to population centres (in 'semi-urban' locations, notably at Hartlepool and Heysham). In the third phase (1985-2005) there was very little new nuclear development, Sizewell B (the first and so far only PWR power reactor in the UK) being colocated with an early Magnox station on the rural Suffolk coast. Renewed interest in nuclear new build from 2005 onward led to a number of sites being identified for new reactors before 2025, all having previously hosted nuclear stations and including the semi-urban locations of the 1960s and 1970s. Finally, some speculative comments are made as to what a 'fifth phase' starting in 2025 might look like.

Application of phase-change materials in memory taxonomy

PubMed Central

Wang, Lei; Tu, Liang; Wen, Jing

2017-01-01

Abstract Phase-change materials are suitable for data storage because they exhibit reversible transitions between crystalline and amorphous states that have distinguishable electrical and optical properties. Consequently, these materials find applications in diverse memory devices ranging from conventional optical discs to emerging nanophotonic devices. Current research efforts are mostly devoted to phase-change random access memory, whereas the applications of phase-change materials in other types of memory devices are rarely reported. Here we review the physical principles of phase-change materials and devices aiming to help researchers understand the concept of phase-change memory. We classify phase-change memory devices into phase-change optical disc, phase-change scanning probe memory, phase-change random access memory, and phase-change nanophotonic device, according to their locations in memory hierarchy. For each device type we discuss the physical principles in conjunction with merits and weakness for data storage applications. We also outline state-of-the-art technologies and future prospects. PMID:28740557

The Effect of Water Management and Land Use Practices on the Restoration of Lee Vining and Rush Creeks

Treesearch

Peter Vorster; G. Mathias Kondolf

1989-01-01

This paper describes water management and land use practices in the Rush and Lee Vining Creek watersheds and evaluates the effect they have had on the stream environment. The management practices will continue to have effects on the flow regime and consequently habitat conditions on lower Lee Vining and Rush Creeks. The implications of existing and potential management...

State-and-transition models: Conceptual versus simulation perspectives, usefulness and breadth of use, and land management applications

USGS Publications Warehouse

Provencher, Louis; Frid, Leonardo; Czembor, Christina; Morisette, Jeffrey T.

2016-01-01

State-and-Transition Simulation Modeling (STSM) is a quantitative analysis method that can consolidate a wide array of resource management issues under a “what-if” scenario exercise. STSM can be seen as an ensemble of models, such as climate models, ecological models, and economic models that incorporate human dimensions and management options. This chapter presents STSM as a tool to help synthesize information on social–ecological systems and to investigate some of the management issues associated with exotic annual Bromus species, which have been described elsewhere in this book. Definitions, terminology, and perspectives on conceptual and computer-simulated stochastic state-and-transition models are given first, followed by a brief review of past STSM studies relevant to the management of Bromus species. A detailed case study illustrates the usefulness of STSM for land management. As a whole, this chapter is intended to demonstrate how STSM can help both managers and scientists: (a) determine efficient resource allocation for monitoring nonnative grasses; (b) evaluate sources of uncertainty in model simulation results involving expert opinion, and their consequences for management decisions; and (c) provide insight into the consequences of predicted local climate change effects on ecological systems invaded by exotic annual Bromus species.

[Who is suited as operation room manager? Evaluation process for hospitals and candidates].

PubMed

Schüpfer, G; Bauer, M

2011-03-01

Operation room (OR) management is not an end in itself. The challenge is more to organize the complex, inhomogeneous and interference-prone machinery of intraoperative service provision according to business objectives. Although business objectives may differ in some details the ultimate consequence is always to assure the quality of medical care along with adhering to the general economic conditions. The narrower the economic framework the smaller the company's tolerance to unprofessional OR management. Consequently, it can be noticed that OR management has become of age. An internal socialization as frontline leader is no longer sufficient for taking over a job profile which, regarding the risks of revenues and costs belongs to the top management of a company. Prior to looking for a future OR manager it is mandatory to develop a profile of qualifications tailored to the company. In the following selection process the important thing is to identify the candidate who fits best to the developed profile. This paper sees itself as an assistance in the development of such a company-specific qualification profile for an OR manager. On the basis of knowledge, skills and characteristics, different manager typologies are developed, facilitating the successful evaluation in a selection process for both the company and the candidate.

Instructional System Design for Executive Orientation and Project Management Training Packages, Technical Memorandum No. 3. Interim Report. RF Project No. 3131-A1.

ERIC Educational Resources Information Center

Cook, Desmond L.; And Others

This memorandum reports on the third phase, the design, of a four-phase project to design project management training materials for local educational agencies. The first section of the memorandum explains some considerations regarding management education and the organization of the report. Section 2 presents the design specifications for the…

Device for limiting single phase ground fault of mining machines

NASA Astrophysics Data System (ADS)

Fediuk, R. S.; Stoyushko, N. Yu; Yevdokimova, Yu G.; Smoliakov, A. K.; Batarshin, V. O.; Timokhin, R. A.

2017-10-01

The paper shows the reasons and consequences of the single-phase ground fault. With all the variety of devices for limiting the current single-phase ground fault, it was found that the most effective are Peterson coils having different switching circuits. Measuring of the capacity of the network is of great importance in this case, a number of options capacitance measurement are presented. A closer look is taken at the device for limiting the current of single-phase short circuit, developed in the Far Eastern Federal University under the direction of Dr. G.E. Kuvshinov. The calculation of single-phase short-circuit currents in the electrical network, without compensation and with compensation of capacitive current is carried out. Simulation of a single-phase circuit in a network with the proposed device is conducted.

The second generation intelligent user interface for the crustal dynamics data information system

NASA Technical Reports Server (NTRS)

Short, Nicholas, Jr.; Wattawa, Scott L.

1988-01-01

For the past decade, operations and research projects that support a major portion of NASA's overall mission have experienced a dramatic increase in the volume of generated data and resultant information that is unparalleled in the history of the agency. The effect of such an increase is that most of the science and engineering disciplines are undergoing an information glut, which has occurred, not only because of the amount, but also because of the type of data being collected. This information glut is growing exponentially and is expected to grow for the foreseeable future. Consequently, it is becoming physically and intellectually impossible to identify, access, modify, and analyze the most suitable information. Thus, the dilemma arises that the amount and complexity of information has exceeded and will continue to exceed, using present information systems, the ability of all the scientists and engineers to understand and take advantage of this information. As a result of this information problem, NASA has initiated the Intelligent Data Management (IDM) project to design and develop Advanced Information Management Systems (AIMS). The first effort of the Project was the prototyping of an Intelligent User Interface (IUI) to an operational scientific database using expert systems, natural language processing, and graphics technologies. An overview of the IUI formulation and development for the second phase is presented.

Role of vaptans in the management of hydroelectrolytic imbalance in liver cirrhosis

PubMed Central

Facciorusso, Antonio; Amoruso, Annabianca; Neve, Viviana; Antonino, Matteo; Prete, Valentina Del; Barone, Michele

2014-01-01

Ascites and hyponatremia are the most common complications in patients with liver cirrhosis and develop as a consequence of a severe impairment of liver function and portal hypertension. Increasing evidences support the central role of renal function alterations in the pathogenesis of hydroelectrolytic imbalances in cirrhotic patients, thus implying a dense cross-talk between liver and kidney in the systemic and splanchnic vascular homeostasis in such subjects. Since Arginin Vasopressin (AVP) hyperincretion occurs at late stage of cirrhosis and plays an important role in the development of refractory ascites, dilutional hyponatremia and finally hepato-renal syndrome, selective antagonists of AVP receptors V2 (vaptans) have been recently introduced in the therapeutic algorithm of advanced cirrhotic patients. Despite the promising results of earlier phase-two studies, randomized controlled trials failed to find significant results in terms of efficacy of such drugs both in refractory ascites and hyponatremia. Moreover, concerns on their safety profile arise, due to the number of potentially severe side effects of vaptans in the clinical setting, such as hypernatremia, dehydration, renal impairment, and osmotic demyelination syndrome. More robust data from randomized controlled trials are needed in order to confirm the potential role of vaptans in the management of advanced cirrhotic patients. PMID:25429317

NHEXAS PHASE I MARYLAND STUDY--QUALITY SYSTEMS AND IMPLEMENTATION PLAN (HSPH QSIP)

EPA Science Inventory

This document describes the project design and quality systems used by the Maryland Study for NHEXAS Phase 1. It contains the following sections: Project Planning and Organization, Project Implementation Plan, Data Acquisition and Management, Records Usage and Management, Routin...

Potential roles of past, present, and future urbanization characteristics in producing varied stream responses

EPA Science Inventory

Urban wastewater and stormwater management practices are one of the primary pathways through which urbanization degrades streams. In particular the long-term development and management phases create a complex spatiotemporal layering of infrastructure technologies. These phases re...

Efficient modeling of phase jitter in dispersion-managed soliton systems.

PubMed

McKinstrie, C J; Xie, C; Lakoba, T I

2002-11-01

The variational method is used to derive correlation equations that model phase jitter in dispersion-managed soliton systems. The predictions of these correlation equations are consistent with numerical solutions of the nonlinear Schrödinger equation on which they are based.

Preventive Rad/Nuc Detection Equipment Categorization for Consequence Management

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

Buddemeier, B. R.; Musolino, S. V.; Klemic, G.

The overall objective of this project is to research, evaluate, and test first responder preventive radiological/nuclear detection equipment (PRND) to provide state and local agencies with guidance on how to best use this equipment for response after a radiological/nuclear release or detonation. While the equipment being tested in this effort has been specifically designed for detection and interdiction operations, the fleet of PRND equipment can help fill critical needs for radiological instrumentation should a consequence management response take place. This effort will provide scientific guidance on the best way to deploy and operate this class of equipment for consequence managementmore » missions. With the support of the US Department of Homeland Security’s (DHS) Domestic Nuclear Detection Office (DNDO), PRND equipment has been placed into service at federal, state, and local agencies throughout the nation. If the equipment capability and limitations are taken into account, this large inventory can be repurposed to support the emergency response in the aftermath of a radiological of nuclear event. This report evaluates PRND equipment to define key categories of equipment and the types of missions they can be used for. This is important because there are over 100 different types of PRND equipment, often with significantly different capabilities with respect to the consequence management mission. The current DNDO draft NIMS PRND equipment types were used as a foundation and expanded, when necessary, to address key characteristics important for the consequence mission. Table 1 provides a summary of the PRND instrument categories developed for this effort. Also included on the table are some common response mission detection equipment categories that will be used for capability comparisons.« less

Perceived consequences of ageing with late effects of polio and strategies for managing daily life: a qualitative study.

PubMed

Sjödahl Hammarlund, Catharina; Lexell, Jan; Brogårdh, Christina

2017-08-09

New or increased impairments may develop several decades after an acute poliomyelitis infection. These new symptoms, commonly referred to as late effects of polio (LEoP), are characterised by muscular weakness and fatigue, generalised fatigue, pain at rest or during activities and cold intolerance. Growing older with LEoP may lead to increased activity limitations and participation restrictions, but there is limited knowledge of how these persons perceive the practical and psychological consequences of ageing with LEoP and what strategies they use in daily life. The aim of this qualitative study was therefore to explore how ageing people with LEoP perceive the their situation and what strategies they use for managing daily life. Seven women and seven men (mean age 70 years) were interviewed. They all had a confirmed history of acute poliomyelitis and new impairments after a stable period of at least 15 years. Data were transcribed verbatim and analysed using systematic text condensation. The latent analysis resulted in three categories 'Various consequences of ageing with LEoP', 'Limitations in everyday activities and participation restrictions', and 'Strategies for managing daily life when ageing with LEoP' and 12 subcategories. The new impairments led to decreased physical and mental health. The participants perceived difficulties in performing everyday activities such as managing work, doing chores, partaking in recreational activities and participating in social events, thereby experiencing emotional and psychological distress. They managed to find strategies that mitigated their worries and upheld their self-confidence, for example finding practical solutions, making social comparisons, minimising, and avoidance. Ageing with LEoP affected daily life to a great extent. The participants experienced considerable impact of the new and increased impairments on their life situation. Consequently, their ability to participate in various social activities also became restricted. Social comparisons and practical solutions are strategies that facilitate adaptation and acceptance of the new situation due to LEoP. This emphasises the need to design rehabilitation interventions that focus on coping, empowerment and self-management for people ageing with LEoP.

Department of the Interior metadata implementation guide—Framework for developing the metadata component for data resource management

USGS Publications Warehouse

Obuch, Raymond C.; Carlino, Jennifer; Zhang, Lin; Blythe, Jonathan; Dietrich, Christopher; Hawkinson, Christine

2018-04-12

The Department of the Interior (DOI) is a Federal agency with over 90,000 employees across 10 bureaus and 8 agency offices. Its primary mission is to protect and manage the Nation’s natural resources and cultural heritage; provide scientific and other information about those resources; and honor its trust responsibilities or special commitments to American Indians, Alaska Natives, and affiliated island communities. Data and information are critical in day-to-day operational decision making and scientific research. DOI is committed to creating, documenting, managing, and sharing high-quality data and metadata in and across its various programs that support its mission. Documenting data through metadata is essential in realizing the value of data as an enterprise asset. The completeness, consistency, and timeliness of metadata affect users’ ability to search for and discover the most relevant data for the intended purpose; and facilitates the interoperability and usability of these data among DOI bureaus and offices. Fully documented metadata describe data usability, quality, accuracy, provenance, and meaning.Across DOI, there are different maturity levels and phases of information and metadata management implementations. The Department has organized a committee consisting of bureau-level points-of-contacts to collaborate on the development of more consistent, standardized, and more effective metadata management practices and guidance to support this shared mission and the information needs of the Department. DOI’s metadata implementation plans establish key roles and responsibilities associated with metadata management processes, procedures, and a series of actions defined in three major metadata implementation phases including: (1) Getting started—Planning Phase, (2) Implementing and Maintaining Operational Metadata Management Phase, and (3) the Next Steps towards Improving Metadata Management Phase. DOI’s phased approach for metadata management addresses some of the major data and metadata management challenges that exist across the diverse missions of the bureaus and offices. All employees who create, modify, or use data are involved with data and metadata management. Identifying, establishing, and formalizing the roles and responsibilities associated with metadata management are key to institutionalizing a framework of best practices, methodologies, processes, and common approaches throughout all levels of the organization; these are the foundation for effective data resource management. For executives and managers, metadata management strengthens their overarching views of data assets, holdings, and data interoperability; and clarifies how metadata management can help accelerate the compliance of multiple policy mandates. For employees, data stewards, and data professionals, formalized metadata management will help with the consistency of definitions, and approaches addressing data discoverability, data quality,  and data lineage. In addition to data professionals and others  associated with information technology; data stewards and program subject matter experts take on important metadata management roles and responsibilities as data flow through their respective business and science-related workflows.  The responsibilities of establishing, practicing, and  governing the actions associated with their specific metadata management roles are critical to successful metadata implementation.

The Folly of Consequence-free Budget Scoring

DTIC Science & Technology

2007-04-30

çÑ=íÜÉ= clroqe=^ååì~ä=^Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã== qÜìêëÇ~ó=ëÉëëáçåë= The Folly of Consequence -free Budget Scoring Published: 30 April 2007... Consequence -free Budget Scoring 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER...Folly of Consequence -free Budget Scoring Presenter: Gerald S. Koenig is Managing Director of Hannon Armstrong Advisory Services, a firm that advises

Designing a model for trauma system management using public health approach: the case of Iran.

PubMed

Tarighi, Payam; Tabibi, Seyed Jamaledin; Motevalian, Seyed Abbas; Tofighi, Shahram; Maleki, Mohammad Reza; Delgoshaei, Bahram; Panahi, Farzad; Masoomi, Gholam Reza

2012-01-01

Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring (BIS) to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level.

The STRIDE (Strategies to Increase confidence, InDependence and Energy) study: cognitive behavioural therapy-based intervention to reduce fear of falling in older fallers living in the community - study protocol for a randomised controlled trial.

PubMed

Parry, Steve W; Deary, Vincent; Finch, Tracy; Bamford, Claire; Sabin, Neil; McMeekin, Peter; O'Brien, John; Caldwell, Alma; Steen, Nick; Whitney, Susan L; Macdonald, Claire; McColl, Elaine

2014-06-06

Around 30% to 62% of older individuals fall each year, with adverse consequences of falls being by no means limited to physical injury and escalating levels of dependence. Many older individuals suffer from a variety of adverse psychosocial difficulties related to falling including fear, anxiety, loss of confidence and subsequent increasing activity avoidance, social isolation and frailty. Such 'fear of falling' is common and disabling, but definitive studies examining the effective management of the syndrome are lacking. Cognitive behavioural therapy has been trialed with some success in a group setting, but there is no adequately powered randomised controlled study of an individually based cognitive behavioural therapy intervention, and none using non-mental health professionals to deliver the intervention. We are conducting a two-phase study examining the role of individual cognitive behavioural therapy delivered by healthcare assistants in improving fear of falling in older adults. In Phase I, the intervention was developed and taught to healthcare assistants, while Phase II is the pragmatic randomised controlled study examining the efficacy of the intervention in improving fear of falling in community-dwelling elders attending falls services. A qualitative process evaluation study informed by Normalization Process Theory is being conducted throughout to examine the potential promoters and inhibitors of introducing such an intervention into routine clinical practice, while a health economic sub-study running alongside the trial is examining the costs and benefits of such an approach to the wider health economy. Current Controlled Trials ISRCTN78396615.

A Coastal Risk Assessment Framework Tool to Identify Hotspots at the Regional Scale

NASA Astrophysics Data System (ADS)

Van Dongeren, A.; Viavattene, C.; Jimenez, J. A.; Ferreira, O.; Bolle, A.; Owen, D.; Priest, S.

2016-02-01

Extreme events in combination with an increasing population on the coast, future sea level rise and the deterioration of coastal defences can lead to catastrophic consequences for coastal communities and their activities. The Resilience-Increasing Strategies for Coasts - toolkit (RISC-KIT) FP7 EU project is producing a set of EU-coherent open-source and open-access tools in support of coastal managers and decision-makers. This paper presents one of these tools, the Coastal Risk Assessment Framework (CRAF) which assesses coastal risk at a regional scale to identify potential impact hotspots for more detailed assessment. Applying a suite of complex models at a full and detailed regional scale remains difficult and may not be efficient, therefore a 2-phase approach is adopted. CRAF Phase 1 is a screening process based on a coastal-index approach delimiting several hotspots in alongshore length by assessing the potential exposure for every kilometre along the coast. CRAF Phase 2 uses a suite of more complex modelling process (including X-beach 1D, inundation model, impact assessment and Multi-Criteria Analysis approach) to analyse and compare the risks between the aforementioned identified hotspots. Results of its application are compared on 3 European Case Studies, the Flemish highly protected low-lying coastal plain with important urbanization and harbors, a Portuguese coastal lagoon protected by a multi-inlet barrier system, the highly urbanized Catalonian coast with touristic activities at threat. The flexibility of the tool allows tailoring the comparative analysis to these different contexts and to adapt to the quality of resources and data available. Key lessons will be presented.

Incident management in Virginia : a state of the practice report : final report.

DOT National Transportation Integrated Search

1991-01-01

Because of the number of incidents and the magnitude of their consequences, the Virginia Department of transportation made a concerted effort to ensure that incident management became a top priority and spearheaded an effort to start a statewide inci...

Evaluating Web accessibility at different processing phases

NASA Astrophysics Data System (ADS)

Fernandes, N.; Lopes, R.; Carriço, L.

2012-09-01

Modern Web sites use several techniques (e.g. DOM manipulation) that allow for the injection of new content into their Web pages (e.g. AJAX), as well as manipulation of the HTML DOM tree. This has the consequence that the Web pages that are presented to users (i.e. after browser processing) are different from the original structure and content that is transmitted through HTTP communication (i.e. after browser processing). This poses a series of challenges for Web accessibility evaluation, especially on automated evaluation software. This article details an experimental study designed to understand the differences posed by accessibility evaluation after Web browser processing. We implemented a Javascript-based evaluator, QualWeb, that can perform WCAG 2.0 based accessibility evaluations in the two phases of browser processing. Our study shows that, in fact, there are considerable differences between the HTML DOM trees in both phases, which have the consequence of having distinct evaluation results. We discuss the impact of these results in the light of the potential problems that these differences can pose to designers and developers that use accessibility evaluators that function before browser processing.

Principles of Micellar Electrokinetic Capillary Chromatography Applied in Pharmaceutical Analysis

PubMed Central

Hancu, Gabriel; Simon, Brigitta; Rusu, Aura; Mircia, Eleonora; Gyéresi, Árpád

2013-01-01

Since its introduction capillary electrophoresis has shown great potential in areas where electrophoretic techniques have rarely been used before, including here the analysis of pharmaceutical substances. The large majority of pharmaceutical substances are neutral from electrophoretic point of view, consequently separations by the classic capillary zone electrophoresis; where separation is based on the differences between the own electrophoretic mobilities of the analytes; are hard to achieve. Micellar electrokinetic capillary chromatography, a hybrid method that combines chromatographic and electrophoretic separation principles, extends the applicability of capillary electrophoretic methods to neutral analytes. In micellar electrokinetic capillary chromatography, surfactants are added to the buffer solution in concentration above their critical micellar concentrations, consequently micelles are formed; micelles that undergo electrophoretic migration like any other charged particle. The separation is based on the differential partitioning of an analyte between the two-phase system: the mobile aqueous phase and micellar pseudostationary phase. The present paper aims to summarize the basic aspects regarding separation principles and practical applications of micellar electrokinetic capillary chromatography, with particular attention to those relevant in pharmaceutical analysis. PMID:24312804

Consequences of Fire: The Killing Fumes

MedlinePlus

... Electric Vehicles Fire Fighter Safety and Response for Solar Power Systems Fire Fighting Tactics Under Wind Driven ... Protection Devices Development of Fire Mitigations Solutions for PV Systems Installed on Building Roofs - Phase 1 Electric/ ...

Solidification of carbon-oxygen white dwarfs

NASA Technical Reports Server (NTRS)

Schatzman, E.

1982-01-01

The internal structure of white dwarfs is discussed. Highly correlated plasmas are reviewed. Implications for phase separation in the core of cooling white dwarfs are considered. The consequences for evolution of white dwarfs are addressed.

Advanced Software Techniques for Data Management Systems. Volume 2: Space Shuttle Flight Executive System: Functional Design

NASA Technical Reports Server (NTRS)

Pepe, J. T.

1972-01-01

A functional design of software executive system for the space shuttle avionics computer is presented. Three primary functions of the executive are emphasized in the design: task management, I/O management, and configuration management. The executive system organization is based on the applications software and configuration requirements established during the Phase B definition of the Space Shuttle program. Although the primary features of the executive system architecture were derived from Phase B requirements, it was specified for implementation with the IBM 4 Pi EP aerospace computer and is expected to be incorporated into a breadboard data management computer system at NASA Manned Spacecraft Center's Information system division. The executive system was structured for internal operation on the IBM 4 Pi EP system with its external configuration and applications software assumed to the characteristic of the centralized quad-redundant avionics systems defined in Phase B.

Unintended adverse consequences of introducing electronic health records in residential aged care homes.

PubMed

Yu, Ping; Zhang, Yiting; Gong, Yang; Zhang, Jiajie

2013-09-01

The aim of this study was to investigate the unintended adverse consequences of introducing electronic health records (EHR) in residential aged care homes (RACHs) and to examine the causes of these unintended adverse consequences. A qualitative interview study was conducted in nine RACHs belonging to three organisations in the Australian Capital Territory (ACT), New South Wales (NSW) and Queensland, Australia. A longitudinal investigation after the implementation of the aged care EHR systems was conducted at two data points: January 2009 to December 2009 and December 2010 to February 2011. Semi-structured interviews were conducted with 110 care staff members identified through convenience sampling, representing all levels of care staff who worked in these facilities. Data analysis was guided by DeLone and McLean Information Systems Success Model, in reference with the previous studies of unintended consequences for the introduction of computerised provider order entry systems in hospitals. Eight categories of unintended adverse consequences emerged from 266 data items mentioned by the interviewees. In descending order of the number and percentage of staff mentioning them, they are: inability/difficulty in data entry and information retrieval, end user resistance to using the system, increased complexity of information management, end user concerns about access, increased documentation burden, the reduction of communication, lack of space to place enough computers in the work place and increasing difficulties in delivering care services. The unintended consequences were caused by the initial conditions, the nature of the EHR system and the way the system was implemented and used by nursing staff members. Although the benefits of the EHR systems were obvious, as found by our previous study, introducing EHR systems in RACH can also cause adverse consequences of EHR avoidance, difficulty in access, increased complexity in information management, increased documentation burden, reduction of communication and the risks of lacking care follow-up, which may cause negative effects on aged care services. Further research can focus on investigating how the unintended adverse consequences can be mitigated or eliminated by understanding more about nursing staff's work as well as the information flow in RACH. This will help to improve the design, introduction and management of EHR systems in this setting. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A comparative study of the metabolic profile, insulin sensitivity and inflammatory response between organically and conventionally managed dairy cattle during the periparturient period.

PubMed

Abuelo, A; Hernández, J; Benedito, J L; Castillo, C

2014-09-01

The number of organically managed cattle (OMC) within the European Union has increased tremendously in the last decade. However, there are still some concerns about animals under this farming system meeting their dietary requirements for milk production. The aim of this study was to compare the metabolic adaptations to the onset of lactation in three different herds, one conventional and two organic ones. Twenty-two conventionally managed cattle (CMC) and 20 from each organic farm were sampled throughout the periparturient period. These samplings were grouped into four different stages: (i) far-off dry, (ii) close-up dry, (iii) fresh and (iv) peak of lactation and compared among them. In addition, the results of periparturient animals were also compared within each management type with a control group (animals between the 4th and 5th months of pregnancy). Metabolic profiles were used to assess the health status of the herds, along with the quantification of the acute phase proteins haptoglobin and serum amyloid A, insulin and the calculation of different surrogate indices of insulin sensitivity. Generalised linear mixed models with repeated measurements were used to study the effect of the stage, management type or their interaction on the serum variables studied. The prevalence of subclinical ketosis was higher in OMC, although they showed better insulin sensitivity, a lower degree of inflammation and less liver injury, without a higher risk of macromineral deficiencies. Therefore, attention should be paid on organic farms to the nutritional management of cows around the time of calving in order to prevent the harmful consequences of excessive negative energy balance. Moreover, it must be taken into account that most of the common practices used to treat this condition in CMC are not allowed on a systematic basis in OMC.

Dysphagia in Duchenne muscular dystrophy: practical recommendations to guide management.

PubMed

Toussaint, Michel; Davidson, Zoe; Bouvoie, Veronique; Evenepoel, Nathalie; Haan, Jurn; Soudon, Philippe

2016-10-01

Duchenne muscular dystrophy (DMD) is a rapidly progressive neuromuscular disorder causing weakness of the skeletal, respiratory, cardiac and oropharyngeal muscles with up to one third of young men reporting difficulty swallowing (dysphagia). Recent studies on dysphagia in DMD clarify the pathophysiology of swallowing disorders and offer new tools for its assessment but little guidance is available for its management. This paper aims to provide a step-by-step algorithm to facilitate clinical decisions regarding dysphagia management in this patient population. This algorithm is based on 30 years of clinical experience with DMD in a specialised Centre for Neuromuscular Disorders (Inkendaal Rehabilitation Hospital, Belgium) and is supported by literature where available. Dysphagia can worsen the condition of ageing patients with DMD. Apart from the difficulties of chewing and oral fragmentation of the food bolus, dysphagia is rather a consequence of an impairment in the pharyngeal phase of swallowing. By contrast with central neurologic disorders, dysphagia in DMD accompanies solid rather than liquid intake. Symptoms of dysphagia may not be clinically evident; however laryngeal food penetration, accumulation of food residue in the pharynx and/or true laryngeal food aspiration may occur. The prevalence of these issues in DMD is likely underestimated. There is little guidance available for clinicians to manage dysphagia and improve feeding for young men with DMD. This report aims to provide a clinical algorithm to facilitate the diagnosis of dysphagia, to identify the symptoms and to propose practical recommendations to treat dysphagia in the adult DMD population. Implications for Rehabilitation Little guidance is available for the management of dysphagia in Duchenne dystrophy. Food can penetrate the vestibule, accumulate as residue or cause aspiration. We propose recommendations and an algorithm to guide management of dysphagia. Penetration/residue accumulation: prohibit solid food and promote intake of fluids. Aspiration: if cough augmentation techniques are ineffective, consider tracheostomy.

Dysphagia in Duchenne muscular dystrophy: practical recommendations to guide management

PubMed Central

Toussaint, Michel; Davidson, Zoe; Bouvoie, Veronique; Evenepoel, Nathalie; Haan, Jurn; Soudon, Philippe

2016-01-01

Abstract Purpose: Duchenne muscular dystrophy (DMD) is a rapidly progressive neuromuscular disorder causing weakness of the skeletal, respiratory, cardiac and oropharyngeal muscles with up to one third of young men reporting difficulty swallowing (dysphagia). Recent studies on dysphagia in DMD clarify the pathophysiology of swallowing disorders and offer new tools for its assessment but little guidance is available for its management. This paper aims to provide a step-by-step algorithm to facilitate clinical decisions regarding dysphagia management in this patient population. Methods: This algorithm is based on 30 years of clinical experience with DMD in a specialised Centre for Neuromuscular Disorders (Inkendaal Rehabilitation Hospital, Belgium) and is supported by literature where available. Results: Dysphagia can worsen the condition of ageing patients with DMD. Apart from the difficulties of chewing and oral fragmentation of the food bolus, dysphagia is rather a consequence of an impairment in the pharyngeal phase of swallowing. By contrast with central neurologic disorders, dysphagia in DMD accompanies solid rather than liquid intake. Symptoms of dysphagia may not be clinically evident; however laryngeal food penetration, accumulation of food residue in the pharynx and/or true laryngeal food aspiration may occur. The prevalence of these issues in DMD is likely underestimated. Conclusions: There is little guidance available for clinicians to manage dysphagia and improve feeding for young men with DMD. This report aims to provide a clinical algorithm to facilitate the diagnosis of dysphagia, to identify the symptoms and to propose practical recommendations to treat dysphagia in the adult DMD population.Implications for RehabilitationLittle guidance is available for the management of dysphagia in Duchenne dystrophy.Food can penetrate the vestibule, accumulate as residue or cause aspiration.We propose recommendations and an algorithm to guide management of dysphagia.Penetration/residue accumulation: prohibit solid food and promote intake of fluids.Aspiration: if cough augmentation techniques are ineffective, consider tracheostomy. PMID:26728920

Greening academia: Developing sustainable waste management at Higher Education Institutions

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

Zhang, N.; Williams, I.D., E-mail: idw@soton.ac.uk; Kemp, S.

Higher Education Institutions (HEIs) are often the size of small municipalities. Worldwide, the higher education (HE) sector has expanded phenomenally; for example, since the 1960s, the United Kingdom (UK) HE system has expanded sixfold to >2.4 million students. As a consequence, the overall production of waste at HEIs throughout the world is very large and presents significant challenges as the associated legislative, economic and environmental pressures can be difficult to control and manage. This paper critically reviews why sustainable waste management has become a key issue for the worldwide HE sector to address and describes some of the benefits, barriers,more » practical and logistical problems. As a practical illustration of some of the issues and problems, the four-phase waste management strategy developed over 15 years by one of the largest universities in Southern England - the University of Southampton (UoS) - is outlined as a case study. The UoS is committed to protecting the environment by developing practices that are safe, sustainable and environmentally friendly and has developed a practical, staged approach to manage waste in an increasingly sustainable fashion. At each stage, the approach taken to the development of infrastructure (I), service provision (S) and behavior change (B) is explained, taking into account the Political, Economic, Social, Technological, Legal and Environmental (PESTLE) factors. Signposts to lessons learned, good practice and useful resources that other institutions - both nationally and internationally - can access are provided. As a result of the strategy developed at the UoS, from 2004 to 2008 waste costs fell by around Pounds 125k and a recycling rate of 72% was achieved. The holistic approach taken - recognizing the PESTLE factors and the importance of a concerted ISB approach - provides a realistic, successful and practical example for other institutions wishing to effectively and sustainably manage their waste.« less

Greening academia: developing sustainable waste management at Higher Education Institutions.

PubMed

Zhang, N; Williams, I D; Kemp, S; Smith, N F

2011-07-01

Higher Education Institutions (HEIs) are often the size of small municipalities. Worldwide, the higher education (HE) sector has expanded phenomenally; for example, since the 1960s, the United Kingdom (UK) HE system has expanded sixfold to >2.4 million students. As a consequence, the overall production of waste at HEIs throughout the world is very large and presents significant challenges as the associated legislative, economic and environmental pressures can be difficult to control and manage. This paper critically reviews why sustainable waste management has become a key issue for the worldwide HE sector to address and describes some of the benefits, barriers, practical and logistical problems. As a practical illustration of some of the issues and problems, the four-phase waste management strategy developed over 15 years by one of the largest universities in Southern England--the University of Southampton (UoS)--is outlined as a case study. The UoS is committed to protecting the environment by developing practices that are safe, sustainable and environmentally friendly and has developed a practical, staged approach to manage waste in an increasingly sustainable fashion. At each stage, the approach taken to the development of infrastructure (I), service provision (S) and behavior change (B) is explained, taking into account the Political, Economic, Social, Technological, Legal and Environmental (PESTLE) factors. Signposts to lessons learned, good practice and useful resources that other institutions--both nationally and internationally--can access are provided. As a result of the strategy developed at the UoS, from 2004 to 2008 waste costs fell by around £125k and a recycling rate of 72% was achieved. The holistic approach taken--recognizing the PESTLE factors and the importance of a concerted ISB approach--provides a realistic, successful and practical example for other institutions wishing to effectively and sustainably manage their waste. Copyright © 2011 Elsevier Ltd. All rights reserved.

RCRA facility investigation and risk assessment, McAlester Army Ammunition Plant, McAlester, Oklahoma. Supplemental phase 2 RFI report, Solid Waste Management Units 32 and 33

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

NONE

1994-11-30

This report presents the results of the Supplemental Phase 2 Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) conducted for Solid Waste Management Units (SWMU) Number 32 and Number 33 at McAlester Army Ammunition Plant (MCAAP). The supplemental action of the RFI was conducted as part of the actions required in connection with the application for a RCRA permit for the management of hazardous waste at MCAAP. The objective of this Supplemental Phase 2 RFI is to collect and analyze soil samples from Solid Waste Management Unit (SWMU) 32 and SWMU 33 for dioxins/dibenzofurans. The purpose of this reportmore » is to describe the procedures used to perform the Supplemental Phase 2 RFI to present and assess the results obtained in terms of the nature and extent of any contamination found, to present the results of human health and ecological risk assessments, and to recommend future actions.« less

Consequences of transition from liquid chromatography to supercritical fluid chromatography on the overall performance of a chiral zwitterionic ion-exchanger.

PubMed

Wolrab, Denise; Frühauf, Peter; Gerner, Christopher; Kohout, Michal; Lindner, Wolfgang

2017-09-29

Major differences in the chromatographic performance of a zwitterion ion-exchange type (ZWIX) chiral stationary phase (CSP) in supercritical fluid chromatography (SFC) and high-performance liquid chromatography (HPLC) have been observed. To explain these differences, transition from HPLC to SFC conditions has been performed. The amount of a protic organic modifier in supercritical carbon dioxide (scCO 2 ) was stepwise increased and the effect of this change studied using acidic, basic and ampholytic analytes. At the same time, the effect of various basic additives to the mobile phase and transient acidic buffer species, formed by the reaction of scCO 2 with the organic modifier and additives, was assessed. Evidence is provided that a transient acid together with the intrinsic counter-ions present in the ZWIX selector structure drive the elution of analytes even when no buffer is employed. We show that the tested analytes can be enantioseparated under both SFC and HPLC conditions; the best conditions for the resolution of ampholytes are in the so-called enhanced-fluidity mobile phase region. As a consequence, subcritical fluid and enhanced-fluidity mobile phase regions seem to be chromatographic modes with a high potential for operating ZWIX CSPs. Copyright © 2017 Elsevier B.V. All rights reserved.

Fitness cost of incubation in great tits (Parus major) is related to clutch size

PubMed Central

de Heij, Maaike E; van den Hout, Piet J; Tinbergen, Joost M

2006-01-01

Life-history theory predicts that parents produce the number of offspring that maximizes their fitness. In birds, natural selection on parental decisions regarding clutch size may act during egg laying, incubation or nestling phase. To study the fitness consequences of clutch size during the incubation phase, we manipulated the clutch sizes during this phase only in three breeding seasons and measured the fitness consequences on the short and the long term. Clutch enlargement did not affect the offspring fitness of the manipulated first clutches, but fledging probability of the subsequent clutch in the same season was reduced. Parents incubating enlarged first clutches provided adequate care for the offspring of their first clutches during the nestling phase, but paid the price when caring for the offspring of their second clutch. Parents that incubated enlarged first clutches had lower local survival in the 2 years when the population had a relatively high production of second clutches, but not in the third year when there was a very low production of second clutches. During these 2 years, the costs of incubation were strong enough to change positive selection, as established by brood size manipulations in this study population, into stabilizing selection through the negative effect of incubation on parental fitness. PMID:16928638

Why do large and small scales couple in a turbulent boundary layer?

NASA Astrophysics Data System (ADS)

Bandyopadhyay, Promode R.

2011-11-01

Correlation measurement, which is not definitive, suggests that large and small scales in a turbulent boundary layer (TBL) couple. A TBL is modeled as a jungle of interacting nonlinear oscillators to explore the origin of the coupling. These oscillators have the inherent property of self-sustainability, disturbance rejection, and of self-referential phase reset whereby several oscillators can phase align (or have constant phase difference between them) when an ``external'' impulse is applied. Consequently, these properties of a TBL are accounted for: self-sustainability, return of the wake component after a disturbance is removed, and the formation of the 18o large structures, which are composed of a sequential train of hairpin vortices. The nonlinear ordinary differential equations of the oscillators are solved using an analog circuit for rapid solution. The post-bifurcation limit cycles are determined. A small scale and a large scale are akin to two different oscillators. The state variables from the two disparate interacting oscillators are shown to couple and the small scales appear at certain regions of the phase of the large scale. The coupling is a consequence of the nonlinear oscillatory behavior. Although state planes exist where the disparate scales appear de-superposed, all scales in a TBL are in fact coupled and they cannot be monochromatically isolated.

Detecting local heterogeneity and ionization ability in the head group region of different lipidic phases using modified fluorescent probes

NASA Astrophysics Data System (ADS)

Abou-Zied, Osama K.; Zahid, N. Idayu; Khyasudeen, M. Faisal; Giera, David S.; Thimm, Julian C.; Hashim, Rauzah

2015-03-01

Local heterogeneity in lipid self-assembly is important for executing the cellular membrane functions. In this work, we chemically modified 2-(2'-hydroxyphenyl)benzoxazole (HBO) and attached a C8 alkyl chain in two different locations to probe the microscopic environment of four lipidic phases of dodecyl β-maltoside. The fluorescence change in HBO and the new probes (HBO-1 and HBO-2) shows that in all phases (micellar, hexagonal, cubic and lamellar) three HBO tautomeric species (solvated syn-enol, anionic, and closed syn-keto) are stable. The formation of multi tautomers reflects the heterogeneity of the lipidic phases. The results indicate that HBO and HBO-1 reside in a similar location within the head group region, whereas HBO-2 is slightly pushed away from the sugar-dominated area. The stability of the solvated syn-enol tautomer is due to the formation of a hydrogen bond between the OH group of the HBO moiety and an adjacent oxygen atom of a sugar unit. The detected HBO anions was proposed to be a consequence of this solvation effect where a hydrogen ion abstraction by the sugar units is enhanced. Our results point to a degree of local heterogeneity and ionization ability in the head group region as a consequence of the sugar amphoterism.

Modelling marine community responses to climate-driven species redistribution to guide monitoring and adaptive ecosystem-based management.

PubMed

Marzloff, Martin Pierre; Melbourne-Thomas, Jessica; Hamon, Katell G; Hoshino, Eriko; Jennings, Sarah; van Putten, Ingrid E; Pecl, Gretta T

2016-07-01

As a consequence of global climate-driven changes, marine ecosystems are experiencing polewards redistributions of species - or range shifts - across taxa and throughout latitudes worldwide. Research on these range shifts largely focuses on understanding and predicting changes in the distribution of individual species. The ecological effects of marine range shifts on ecosystem structure and functioning, as well as human coastal communities, can be large, yet remain difficult to anticipate and manage. Here, we use qualitative modelling of system feedback to understand the cumulative impacts of multiple species shifts in south-eastern Australia, a global hotspot for ocean warming. We identify range-shifting species that can induce trophic cascades and affect ecosystem dynamics and productivity, and evaluate the potential effectiveness of alternative management interventions to mitigate these impacts. Our results suggest that the negative ecological impacts of multiple simultaneous range shifts generally add up. Thus, implementing whole-of-ecosystem management strategies and regular monitoring of range-shifting species of ecological concern are necessary to effectively intervene against undesirable consequences of marine range shifts at the regional scale. Our study illustrates how modelling system feedback with only limited qualitative information about ecosystem structure and range-shifting species can predict ecological consequences of multiple co-occurring range shifts, guide ecosystem-based adaptation to climate change and help prioritise future research and monitoring. © 2016 John Wiley & Sons Ltd.

A support architecture for reliable distributed computing systems

NASA Technical Reports Server (NTRS)

Mckendry, Martin S.

1986-01-01

The Clouds kernel design was through several design phases and is nearly complete. The object manager, the process manager, the storage manager, the communications manager, and the actions manager are examined.

40 CFR 1400.5 - Internet access to certain off-site consequence analysis data elements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Internet access to certain off-site... DISTRIBUTION OF OFF-SITE CONSEQUENCE ANALYSIS INFORMATION Public Access § 1400.5 Internet access to certain off... elements in the risk management plan database available on the Internet: (a) The concentration of the...

Conserving genetic diversity in the honeybee: comments on Harpur et al. (2012).

PubMed

De la Rúa, Pilar; Jaffé, Rodolfo; Muñoz, Irene; Serrano, José; Moritz, Robin F A; Kraus, F Bernhard

2013-06-01

The article by Harpur et al. (2012) 'Management increases genetic diversity of honey bees via admixture' concludes that '…honey bees do not suffer from reduced genetic diversity caused by management and, consequently, that reduced genetic diversity is probably not contributing to declines of managed Apis mellifera populations'. In the light of current honeybee and beekeeping declines and their consequences for honeybee conservation and the pollination services they provide, we would like to express our concern about the conclusions drawn from the results of Harpur et al. (2012). While many honeybee management practices do not imply admixture, we are convinced that the large-scale genetic homogenization of admixed populations could drive the loss of valuable local adaptations. We also point out that the authors did not account for the extensive gene flow that occurs between managed and wild/feral honeybee populations and raise concerns about the data set used. Finally, we caution against underestimating the importance of genetic diversity for honeybee colonies and highlight the importance of promoting the use of endemic honeybee subspecies in apiculture. © 2013 John Wiley & Sons Ltd.

Do competition and managed care improve quality?

PubMed

Sari, Nazmi

2002-10-01

In recent years, the US health care industry has experienced a rapid growth of managed care, formation of networks, and an integration of hospitals. This paper provides new insights about the quality consequences of this dynamic in US hospital markets. I empirically investigate the impact of managed care and hospital competition on quality using in-hospital complications as quality measures. I use random and fixed effects, and instrumental variable fixed effect models using hospital panel data from up to 16 states in the 1992-1997 period. The paper has two important findings: First, higher managed care penetration increases the quality, when inappropriate utilization, wound infections and adverse/iatrogenic complications are used as quality indicators. For other complication categories, coefficient estimates are statistically insignificant. These findings do not support the straightforward view that increases in managed care penetration are associated with decreases in quality. Second, both higher hospital market share and market concentration are associated with lower quality of care. Hospital mergers have undesirable quality consequences. Appropriate antitrust policies towards mergers should consider not only price and cost but also quality impacts. Copyright 2002 John Wiley & Sons, Ltd.

Alcohol use disorders in pregnancy.

PubMed

DeVido, Jeffrey; Bogunovic, Olivera; Weiss, Roger D

2015-01-01

Alcohol use disorders (AUDs) are less prevalent in pregnant women than in nonpregnant women, but these disorders can create a host of clinical challenges when encountered. Unfortunately, little evidence is available to guide clinical decision making in this population. Drinking alcohol during pregnancy can have negative consequences on both fetus and mother, but it remains controversial as to the volume of alcohol consumption that correlates with these consequences. Likewise, little evidence is available to support the use of particular pharmacologic interventions for AUDs during pregnancy or to guide the management of alcohol detoxification in pregnant women. The use of benzodiazepines (the mainstay of most alcohol detoxification protocols) in pregnant women is controversial. Nevertheless, despite the lack of robust data to guide management of AUDs in pregnancy, clinicians need to make management decisions when confronted with these challenging situations. In that context, this article reviews the epidemiology of AUDs in pregnancy and the pharmacologic management of both AUDs and alcohol withdrawal in pregnant women, with the goal of informing clinicians about what is known about managing these co-occurring conditions.

Stroke rehabilitation. 4. Stroke outcome and psychosocial consequences.

PubMed

Flick, C L

1999-05-01

This self-directed learning module highlights recent research in assessment of stroke outcomes and management of the psychosocial consequences of stroke. It is a part of the chapter on stroke rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses predictive factors for mortality and functional recovery; proposed case mix adjustment and prospective payment systems for stroke rehabilitation; continuum of care and utilization of acute, nursing home, outpatient and home health rehabilitation programs; reintegration and socialization after stroke; vocational rehabilitation of stroke patients; and management of the psychosocial effects of stroke on patients and families.

A Framework for Modeling Human-Machine Interactions

NASA Technical Reports Server (NTRS)

Shafto, Michael G.; Rosekind, Mark R. (Technical Monitor)

1996-01-01

Modern automated flight-control systems employ a variety of different behaviors, or modes, for managing the flight. While developments in cockpit automation have resulted in workload reduction and economical advantages, they have also given rise to an ill-defined class of human-machine problems, sometimes referred to as 'automation surprises'. Our interest in applying formal methods for describing human-computer interaction stems from our ongoing research on cockpit automation. In this area of aeronautical human factors, there is much concern about how flight crews interact with automated flight-control systems, so that the likelihood of making errors, in particular mode-errors, is minimized and the consequences of such errors are contained. The goal of the ongoing research on formal methods in this context is: (1) to develop a framework for describing human interaction with control systems; (2) to formally categorize such automation surprises; and (3) to develop tests for identification of these categories early in the specification phase of a new human-machine system.

Structured methods for identifying and correcting potential human errors in aviation operations

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

Nelson, W.R.

1997-10-01

Human errors have been identified as the source of approximately 60% of the incidents and accidents that occur in commercial aviation. It can be assumed that a very large number of human errors occur in aviation operations, even though in most cases the redundancies and diversities built into the design of aircraft systems prevent the errors from leading to serious consequences. In addition, when it is acknowledged that many system failures have their roots in human errors that occur in the design phase, it becomes apparent that the identification and elimination of potential human errors could significantly decrease the risksmore » of aviation operations. This will become even more critical during the design of advanced automation-based aircraft systems as well as next-generation systems for air traffic management. Structured methods to identify and correct potential human errors in aviation operations have been developed and are currently undergoing testing at the Idaho National Engineering and Environmental Laboratory (INEEL).« less

An HDF5-based framework for the distribution and analysis of ultrasonic concrete data

NASA Astrophysics Data System (ADS)

Prince, Luke; Clayton, Dwight; Santos-Villalobos, Hector

2017-02-01

There are many commercial ultrasonic tomography devices (UTDs) available for use in nondestructive evaluation (NDE) of reinforced concrete structures. These devices emit, measure, and store ultrasonic signals typically in the 25 kHz to 5 MHz frequency range. UTDs are characterized by a composition of multiple transducers, also known as a transducer array or phased array. Often, UTDs data are in a proprietary format. Consequently, NDE research data is limited to those who have prior non-disclosure agreements or the appropriate licenses. Thus, there is a need for a proper universal data framework to exist such that proprietary file datasets for different concrete specimens can be converted, organized, and stored with relative metadata for individual or collaborative NDE research. Building upon the Hierarchical Data Format (HDF5) model, we have developed a UTD data management framework and Graphic User Interface (GUI) to promote the algorithmic reconstruction of ultrasonic data in a controlled environment for easily reproducible and publishable results.

An HDF5-Based Framework for the Distribution and Analysis of Ultrasonic Concrete Data

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

Prince, Luke J; Clayton, Dwight A; Santos-Villalobos, Hector J

There are many commercial ultrasonic tomography devices (UTDs) available for use in nondestructive evaluation (NDE) of reinforced concrete structures. These devices emit, measure, and store ultrasonic signals typically in the 25 kHz to 5 MHz frequency range. UTDs are characterized by a composition of multiple transducers, also known as a transducer array or phased array. Often, UTDs data are in a proprietary format. Consequently, NDE research data is limited to those who have prior non-disclosure agreements or the appropriate licenses. Thus, there is a need for a proper universal data framework to exist such that proprietary file datasets for differentmore » concrete specimens can be converted, organized, and stored with relative metadata for individual or collaborative NDE research. Building upon the Hierarchical Data Format (HDF5) model, we have developed a UTD data management framework and Graphic User Interface (GUI) to promote the algorithmic reconstruction of ultrasonic data in a controlled environment for easily reproducible and publishable results.« less

Club drugs: review of the ‘rave’ with a note of concern for the Indian scenario

PubMed Central

Chakraborty, Kaustav; Neogi, Rajarshi; Basu, Debasish

2011-01-01

‘Club drugs’ which include Ecstasy, gamma-hydroxybutyrate (GHB), ketamine, and Rohypnol (flunitrazepam) have become popular with participants in ‘raves’, because they are perceived to enhance energy, endurance, sociability and sexual arousal. These drugs vary in their pharmacologic properties, physiological and psychological effects, and potential consequences. The use of club drugs by young people has increased in the last decade, and continue to get modified and evolve, making them very difficult to monitor. Further, these drugs are not picked up by routine drugs screening procedures, thereby making these popular with the criminals. India, which is in a phase of social transition, also faces this rising menace. Despite the nature and extent of this problem, this area has been under-researched. Data from India are sparse barring a few newspaper and police reports. Keeping abreast of current trends in club drug use prepares the clinician to recognize the clinical effects of club drug use, to manage club drug related emergencies, and to generate social awareness. PMID:21727657

Soaking it up: new lipid sponge phases and their applications

NASA Astrophysics Data System (ADS)

Brasnett, Christopher; Seddon, Annela

Recent work has demonstrated that cubic lipid systems may be doped with charged lipids, with important consequences for their physical properties. Among others, Tyler et al. have reported some of the largest lipid cubic phases seen to date using this technique. The sponge phase is a disordered bicontinuous phase, formed when the membrane curvature of a cubic phase is reduced through the addition of butane diol. Additionally, it is known that sponge phases may be converted back into highly ordered cubic ones. Whilst past work has concentrated on sponge phases formed from monoolein, we have investigated the properties and behaviour of a bipartite sponge phase formed of monoolein and DOPG, and their conversion to cubic phases using shear. Furthermore, as both the sponge and cubic phase are of interest with respect to their applications in protein crystallography, we have explored the interaction of the protein light-harvesting complex with the lipid system. CB is supported by a University of Bristol EPSRC funded studentship.

48 CFR 36.303-2 - Phase Two.

Code of Federal Regulations, 2010 CFR

2010-10-01

... potential phase-two technical evaluation factors include design concepts, management approach, key personnel... OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Two-Phase Design-Build Selection...

Can we manage for biological diversity in the absence of science?

USGS Publications Warehouse

Trauger, D.L.; Hall, R.J.

1995-01-01

Conservation of biological diversity is dependent on sound scientific information about underlying ecological processes. Current knowledge of the composition, distribution, abundance and life cycles of most species of plants and animals is incomplete, insufficient, unreliable, or nonexistent. Contemporary managers are also confronted with additional levels of complexity related to varying degrees of knowledge and understanding about interactions of species and ecosystems. Consequently, traditional species-oriented management schemes may have unintended consequences and ecosystem-oriented management initiatives may fail in the face of inadequate or fragmentary information on the structure, function, and dynamics of biotic communities and ecological systems. Nevertheless, resource managers must make decisions and manage based on the best biological information currently available. Adaptive resource management may represent a management paradigm that allows managers to learn something about the species or systems that they are managing while they are managing, but potential pitfalls lurk for such approaches. In addition to lack of control over the primary physical, chemical, and ecological processes, managers also lack control over social, economic, and political parameters affecting resource management options. Moreover, appropriate goals may be difficult to identify and criteria for determining success may be elusive. Some management responsibilities do not lend themselves to adaptive strategies. Finally, the lessons learned from adaptive management are usually obtained from a highly situational context that may limit applicability in a wider range of situations or undermine confidence that problems and solutions were properly diagnosed and addressed. Several scenarios are critically examined where adaptive management approaches may be inappropriate or ineffective and where management for biological diversity may be infeasible or inefficient without a sound scientific basis. Whereas some level of management must exist to meet agency responsibilities, more research is needed to conserve biological diversity.