Sample records for factor issue management

  1. Reflections: Management Morphology--How We Got To Be Who We Are.

    ERIC Educational Resources Information Center

    Hoadley, Irene B.

    1999-01-01

    Reviews library management issues over the past 25 years. Highlights include library education for managerial skills; on the job training; gender issues; societal factors; Total Quality Management; management changes; and future possibilities, including managerial roles, management models, and organizational structure. (LRW)

  2. A life cycle model of public policy issues in health care: the importance of strategic issues management.

    PubMed

    Rakich, J S; Feit, M D

    2001-01-01

    Public policy affects health and social services organizations. Senior management has a responsibility to prevent inappropriate demands of stakeholders from predominating and to influence the outcome of public policy to the benefit of their organization through the strategic issues management process. This article presents a public policy issue life cycle model, life-cycle stages and suggested strategies, paths issues can take in the life cycle, and factors that affect issue paths. An understanding of these dynamics can aid senior managers in shaping and changing public policy issues and lessening external environment threats to their organization.

  3. Ethical issues in the diagnosis and management of fetal disorders.

    PubMed

    Chadwick, Ruth; Childs, Richardo

    2012-10-01

    The ethics of diagnosis and management of fetal genetic disorders are particularly controversial because of the contested status of the fetus and perceptions of genetics. An additional complicating factor is the potential conflict between mother and fetus. Ethical issues in diagnosis include the nature and purpose of the diagnosis itself, and management of the information. Management of the disorder includes issues of termination as an option, and the emerging field of fetal gene therapy with associated issues of somatic versus germ-line interventions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Managing the Pediatric Facial Fracture

    PubMed Central

    Cole, Patrick; Kaufman, Yoav; Hollier, Larry H.

    2009-01-01

    Facial fracture management is often complex and demanding, particularly within the pediatric population. Although facial fractures in this group are uncommon relative to their incidence in adult counterparts, a thorough understanding of issues relevant to pediatric facial fracture management is critical to optimal long-term success. Here, we discuss several issues germane to pediatric facial fractures and review significant factors in their evaluation, diagnosis, and management. PMID:22110800

  5. Structural marsh management research priorities

    USGS Publications Warehouse

    Cahoon, Donald R.; Groat, Charles G.

    1989-01-01

    The paper presents a prioritized list of research issues related to structural marsh management developed by a multidisciplinary panel of regulatory agency representatives, landowners, and scientists. More than 75 issues were identified concerning landscape changes, influence on ecological processes (i.e., hydrologic, biologic, and edaphic factors), habitat quality, cumulative impacts, and management approach. These issues were prioritized and organized around six basic questions regulatory personnel must try to answer for each marsh management plan application. The six questions deal with the influence of marsh management on, in order of most immediate need, marsh loss and health, fisheries, wildlife, habitat change, water quality, and cumulative effects.

  6. Understanding safety and production risks in rail engineering planning and protection.

    PubMed

    Wilson, John R; Ryan, Brendan; Schock, Alex; Ferreira, Pedro; Smith, Stuart; Pitsopoulos, Julia

    2009-07-01

    Much of the published human factors work on risk is to do with safety and within this is concerned with prediction and analysis of human error and with human reliability assessment. Less has been published on human factors contributions to understanding and managing project, business, engineering and other forms of risk and still less jointly assessing risk to do with broad issues of 'safety' and broad issues of 'production' or 'performance'. This paper contains a general commentary on human factors and assessment of risk of various kinds, in the context of the aims of ergonomics and concerns about being too risk averse. The paper then describes a specific project, in rail engineering, where the notion of a human factors case has been employed to analyse engineering functions and related human factors issues. A human factors issues register for potential system disturbances has been developed, prior to a human factors risk assessment, which jointly covers safety and production (engineering delivery) concerns. The paper concludes with a commentary on the potential relevance of a resilience engineering perspective to understanding rail engineering systems risk. Design, planning and management of complex systems will increasingly have to address the issue of making trade-offs between safety and production, and ergonomics should be central to this. The paper addresses the relevant issues and does so in an under-published domain - rail systems engineering work.

  7. An integrated GIS/remote sensing data base in North Cache soil conservation district, Utah: A pilot project for the Utah Department of Agriculture's RIMS (Resource Inventory and Monitoring System)

    NASA Technical Reports Server (NTRS)

    Wheeler, D. J.; Ridd, M. K.; Merola, J. A.

    1984-01-01

    A basic geographic information system (GIS) for the North Cache Soil Conservation District (SCD) was sought for selected resource problems. Since the resource management issues in the North Cache SCD are very complex, it is not feasible in the initial phase to generate all the physical, socioeconomic, and political baseline data needed for resolving all management issues. A selection of critical varables becomes essential. Thus, there are foud specific objectives: (1) assess resource management needs and determine which resource factors ae most fundamental for building a beginning data base; (2) evaluate the variety of data gathering and analysis techniques for the resource factors selected; (3) incorporate the resulting data into a useful and efficient digital data base; and (4) demonstrate the application of the data base to selected real world resoource management issues.

  8. Clinical management issues vary by specialty in the Victorian Audit of Surgical Mortality: a retrospective observational study

    PubMed Central

    Vinluan, Jessele; Retegan, Claudia; Chen, Andrew; Beiles, Charles Barry

    2014-01-01

    Objective Clinical management issues are contributory factors to mortality. The aim of this study was to use data from the Victorian Audit of Surgical Mortality (VASM), an educational peer-review process for surgeons, to discover differences in the incidence of these issues between surgical specialties in order to focus attention to areas of care that might be improved. Design This study used retrospectively analysed observational data from VASM. Clinical management issues between eight specialties were assessed using χ2 analysis. Data sources VASM data were reported by participating public and private health services, the Coroner and self-reporting surgeons across Victoria. Results A total of 2946 specific clinical issues as deficiencies of care were reported. 15% of cases had significant issues of care. The most common clinical management issue was the delay in delivery of treatment. Other clinical issues included the quality of communication and documentation, preoperative and postoperative care, adverse events and protocol issues. There were significant differences in issues between specialties. Conclusions The clinical management issues presented across surgical specialties were similar; however, five issues of clinical care differed significantly in frequency across surgical specialties. The three main issues varying among specialties were complications after operation, communication and postoperative care. Addressing these clinical management issues via the peer-review process may impact positively on patient care. PMID:24980043

  9. Pharmacologic issues in management of chronic disease.

    PubMed

    DeSevo, Gina; Klootwyk, Jacqueline

    2012-06-01

    A significant portion of the adult population uses one or more medications on a regular basis to manage chronic conditions. As the number of medications that patients are prescribed increases, an increase in pharmacologic-related issues and complications may occur, such as polypharmacy, inappropriate prescribing, medication nonadherence and nonpersistence, and adverse drug reactions and events. Risk factors and consequences of these issues have been identified and are discussed in this article. In addition, a review is presented of the numerous methods that have been evaluated to help prevent and minimize these pharmacologic issues in the management of chronic disease. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Making Informed Decisions: Management Issues Influencing Computers in the Classroom.

    ERIC Educational Resources Information Center

    Strickland, James

    A number of noninstructional factors appear to determine the extent to which computers make a difference in writing instruction. Once computers have been purchased and installed, it is generally school administrators who make management decisions, often from an uninformed pedagogical orientation. Issues such as what hardware and software to buy,…

  11. The interface of legal and esthetic considerations

    Treesearch

    Richard C. Smardon

    1979-01-01

    This paper is an overview of development of legal/policy factors affecting visual resource management. Review of major legal issues, court cases, laws and administrative decisionmaking reveals that the "action" regarding legal and aesthetic issues is currently in the public arena as managed by administrative agencies. Analysis of key court cases reveals that...

  12. Human factors integration challenges in the traffic flow management (TFM) environment

    DOT National Transportation Integrated Search

    2005-08-01

    This report discusses a high level examination that was conducted to identify human factors issues in the integration of future traffic flow management (TFM) tools. The focus of the examination is on the integration of future systems and was driven b...

  13. Interactions of water quality and integrated groundwater management: Examples from the United States and Europe: Chapter 14

    USGS Publications Warehouse

    Warner, Kelly L.; Barataud, Fabienne; Hunt, Randall J.; Benoit, Marc; Anglade, Juliette; Borchardt, Mark A.

    2015-01-01

    Groundwater is available in many parts of the world, but the quality of the water may limit its use. Contaminants can limit the use of groundwater through concerns associated with human health, aquatic health, economic costs, or even societal perception. Given this broad range of concerns, this chapter focuses on examples of how water quality issues influence integrated groundwater management. One example evaluates the importance of a naturally occurring contaminant Arsenic (As) for drinking water supply, one explores issues resulting from agricultural activities on the land surface and factors that influence related groundwater management, and the last examines unique issues that result from human-introduced viral pathogens for groundwater-derived drinking water vulnerability. The examples underscore how integrated groundwater management lies at the intersections of environmental characterization, engineering constraints, societal needs, and human perception of acceptable water quality. As such, water quality factors can be a key driver for societal decision making.

  14. Relationship between time management in construction industry and project management performance

    NASA Astrophysics Data System (ADS)

    Nasir, Najuwa; Nawi, Mohd Nasrun Mohd; Radzuan, Kamaruddin

    2016-08-01

    Nowadays, construction industry particularly in Malaysia struggle in achieving status of eminent time management for construction project. Project managers have a great responsibility to keep the project success under time of project completion. However, studies shows that delays especially in Malaysian construction industry still unresolved due to weakness in managing the project. In addition, quality of time management on construction projects is generally poor. Due to the progressively extended delays issue, time performance becomes an important subject to be explored to investigate delay factors. The method of this study is review of literature towards issues in construction industry which affecting time performance of project in general by focusing towards process involved for project management. Based on study, it was found that knowledge, commitment, cooperation are the main criteria as an overall to manage the project into a smooth process during project execution until completion. It can be concluded that, the strength between project manager and team members in these main criteria while conducting the project towards good time performance is highly needed. However, there is lack of establishment towards factors of poor time performance which strongly related with project management. Hence, this study has been conducted to establish factors of poor time performance and its relations with project management.

  15. Ethical questions for resource managers.

    Treesearch

    G.H. Reeves; D.L. Bottom; M.H. Brookes

    1992-01-01

    The decisions of natural resource managers are not simply scientific issues but involve fundamental questions of ethics. Conflicts in fisheries management, forestry, and other applied sciences arise from social and economic factors that affect natural resource values. Administrative processes, cost-benefit analyses, and various management "myths" have been...

  16. The impact and control of major southern forest diseases

    Treesearch

    A. Dan Wilson; Theodor D. Leininger; William J. Otrosina; L. David Dwinell; Nathan M. Schiff

    2004-01-01

    A variety of forest health issues, concerns, and events have rapidly changed southern forests and plantations in the past two decades. These factors have strongly impacted the ways we manage forest pests in the Southern United States. This trend will no doubt continue to shape forest pest management in the future. The major issues and events of concern include changing...

  17. Dimensions of Culturally Sensitive Factors in the Design and Development of Learning Objects

    ERIC Educational Resources Information Center

    Qi, Mei; Boyle, Tom

    2010-01-01

    Open educational resources (OERs) are designed to be globally reusable. Yet comparatively little attention has been given to the cultural issues. This paper addresses the issue of culturally sensitive factors that may influence the design of reusable learning objects. These influences are often subtle and hard to manage. The paper proposes a…

  18. [Success factors in hospital management].

    PubMed

    Heberer, M

    1998-12-01

    The hospital environment of most Western countries is currently undergoing dramatic changes. Competition among hospitals is increasing, and economic issues have become decisive factors for the allocation of medical care. Hospitals therefore require management tools to respond to these changes adequately. The balanced scorecard is a method of enabling development and implementation of a business strategy that equally respects the financial requirements, the needs of the customers, process development, and organizational learning. This method was used to derive generally valid success factors for hospital management based on an analysis of an academic hospital in Switzerland. Strategic management, the focus of medical services, customer orientation, and integration of professional groups across the hospital value chain were identified as success factors for hospital management.

  19. Issues, benefits, and problems associated with fishing tournaments in inland waters of the United States: A survey of fishery agency administrators

    USGS Publications Warehouse

    Schramm, H.L.; Hunt, K.M.

    2007-01-01

    A web-based survey was administered to state fisheries agency administrators in 2005 to assess and prioritize the impacts of tournament fishing on management of inland fishery resources. Surveys were completed by fishery administrators of 48 state agencies and the District of Columbia. Respondents rated tournaments as neither strongly benefiting nor adversely affecting fishery management. Benefits of tournaments to fishery management grouped into four factors (in order of decreasing impact) characterized as enhancing fishery management agency effectiveness, stimulating interest in fishing and fishery resources, measuring economic value, and collecting biological information. Adverse impacts grouped into six factors (in order of decreasing impact), characterized as resource crowding, user-group conflicts, costs of tournaments to fishery agencies, non-traditional uses of fisheries resources, fish introductions, and adverse affects on fish populations. Tournament issues and impacts generally did not differ regionally and suggested the effects of tournaments do not vary among different fisheries. Comparison with previous surveys indicates that the prevalence of some benefits and problems have changed since 1989. Social issues remained paramount problems, but biological impacts were considered a lesser problem. Agencies recognized that tournaments can benefit fisheries management efforts and angler recruitment. Future management of tournaments should consider a management team approach.

  20. Training Manual for Human Service Risk Managers. Final Report.

    ERIC Educational Resources Information Center

    Davis, Frank W.; And Others

    This manual is designed to educate human service agency management personnel involved in transportation about basic risk management principles and insurance issues. Chapter I illustrates the liability factors that create the insurance and risk management needs. Both legal and humanitarian obligations of human service agencies involved in…

  1. Use of Health Information and Communication Technologies to Promote Health and Manage Behavioral Risk Factors Associated with Chronic Disease: Applications in the Field of Health Education

    ERIC Educational Resources Information Center

    Stellefson, Michael; Alber, Julia M.; Wang, Min Qi; Eddy, James M.; Chaney, Beth H.; Chaney, J. Don

    2015-01-01

    This special issue provides real-world examples of the diverse methods health education researchers are using to expand existing applications of information and communication technologies (ICTs) for health promotion and chronic disease management. The original and review articles presented in this special issue investigate eHealth, mHealth, and…

  2. Leveraging Commercially Issued Multi-Factor Identification Credentials

    NASA Technical Reports Server (NTRS)

    Baldridge, Tim W.

    2010-01-01

    This slide presentation reviews the Identity, Credential and Access Management (ICAM) system. This system is a complete system of identity management, access to desktops and applications, use of smartcards, and building access throughout NASA.

  3. Alternative management structures for municipal waste collection services: the influence of economic and political factors.

    PubMed

    Plata-Díaz, Ana María; Zafra-Gómez, José Luis; Pérez-López, Gemma; López-Hernández, Antonio Manuel

    2014-11-01

    Identifying and characterising the factors that determine why a local authority opts for a particular way of managing its waste collection service is an important issue, warranting research interest in the field of municipal solid waste (MSW) management. This paper presents empirical evidence spanning a broad time horizon (2002-2010) showing that economic and political factors impact in different ways on the provision of waste management services. We examine five alternatives in this area, including public and private service delivery formulas and, within each field, individual and joint options. Our findings highlight the importance of the service cost and that of the various indicators of fiscal stress as determinant factors of management decisions regarding the provision of MSW management services. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. New perspectives in forest management: background, science issues, and research agenda.

    Treesearch

    David J. Brooks; Gordon E. Grant

    1992-01-01

    Scientific, management, and social factors that have contributed to changes in United States forest management are examined. Principles underlying new approaches are developed and implications are considered at various spatial and temporal scales. A general framework for a research program is outlined.

  5. Paving the Way for the 21st Century: The Human Factor in Higher Education Financial Management.

    ERIC Educational Resources Information Center

    Ginsburg, Sigmund G., Ed.

    This book presents human resources issues that will affect the financial management of colleges and universities as they move into the 21st century. It examines how business managers and human resources managers must balance human resources management policies and practices against the financial demands on the institution. It discusses the…

  6. An examination on the influence of small and medium enterprise (SME) stakeholder on green supply chain management practices

    NASA Astrophysics Data System (ADS)

    Shahlan, M. Z.; Sidek, A. A.; Suffian, S. A.; Hazza, M. H. F. A.; Daud, M. R. C.

    2018-01-01

    In this paper, climate change and global warming are the biggest current issues in the industrial sectors. The green supply chain managements (GSCM) is one of the crucial input to these issues. Effective GSCM can potentially secure the organization’s competitive advantage and improve the environmental performance of the network activities. In this study, the aim is to investigate and examine how a small and medium enterprises (SMEs) stakeholder pressure and top management influence green supply chain management practices. The study is further advance green supply chain management research in Malaysia focusing on SMEs manufacturing sector using structural equation modelling. Structural equation modelling is a multivariate statistical analysis technique used to examine structural relationship. It is the combination of factor analysis and multi regression analysis and used to analyse structural relationship between measure variable and latent factor. This research found that top management support and stakeholder pressure is the major influence for SMEs to adopt green supply chain management. The research also found that top management is fully mediate with the relationship between stakeholder pressure and monitoring supplier environmental performance.

  7. An Exploratory Study of Alpha Contracting: Antecedents, Processes, Issues, Success Factors and Consequences

    DTIC Science & Technology

    2009-09-01

    ABSTRACT (maximum 200 words) Alpha contracting is a collaborative effort between a buyer and supplier during contract formation to maximize efficiency...experienced Alpha contracting teams, to include contracting officers, DCAA, DCMA, end users/ customers , program managers and acquisition directors to better...PROCESSES, ISSUES, SUCCESS FACTORS AND CONSEQUENCES ABSTRACT Alpha contracting is a collaborative effort between a buyer and supplier

  8. Management challenges faced by managers of New Zealand long-term care facilities.

    PubMed

    Madas, E; North, N

    2000-01-01

    This article reports on a postal survey of 78 long-term care managers in one region of New Zealand, of whom 45 (58%) responded. Most long-term care managers (73.2%) were middle-aged females holding nursing but not management qualifications. Most long-term care facilities (69%) tended to be stand-alone facilities providing a single type of care (rest home or continuing care hospital). The most prominent issues facing managers were considered to be inadequate funding to match the growing costs of providing long-term care and occupancy levels. Managers believed that political/regulatory, economic and social factors influenced these issues. Despite a turbulent health care environment and the challenges facing managers, long-term care managers reported they were coping well and valued networking.

  9. Design of a Model-Based Online Management Information System for Interlibrary Loan Networks.

    ERIC Educational Resources Information Center

    Rouse, Sandra H.; Rouse, William B.

    1979-01-01

    Discusses the design of a model-based management information system in terms of mathematical/statistical, information processing, and human factors issues and presents a prototype system for interlibrary loan networks. (Author/CWM)

  10. Assessment of public perception of radioactive waste management in Korea.

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

    Trone, Janis R.; Cho, SeongKyung; Whang, Jooho

    2011-11-01

    The essential characteristics of the issue of radioactive waste management can be conceptualized as complex, with a variety of facets and uncertainty. These characteristics tend to cause people to perceive the issue of radioactive waste management as a 'risk'. This study was initiated in response to a desire to understand the perceptions of risk that the Korean public holds towards radioactive waste and the relevant policies and policy-making processes. The study further attempts to identify the factors influencing risk perceptions and the relationships between risk perception and social acceptance.

  11. A data-driven approach to quality risk management.

    PubMed

    Alemayehu, Demissie; Alvir, Jose; Levenstein, Marcia; Nickerson, David

    2013-10-01

    An effective clinical trial strategy to ensure patient safety as well as trial quality and efficiency involves an integrated approach, including prospective identification of risk factors, mitigation of the risks through proper study design and execution, and assessment of quality metrics in real-time. Such an integrated quality management plan may also be enhanced by using data-driven techniques to identify risk factors that are most relevant in predicting quality issues associated with a trial. In this paper, we illustrate such an approach using data collected from actual clinical trials. Several statistical methods were employed, including the Wilcoxon rank-sum test and logistic regression, to identify the presence of association between risk factors and the occurrence of quality issues, applied to data on quality of clinical trials sponsored by Pfizer. ONLY A SUBSET OF THE RISK FACTORS HAD A SIGNIFICANT ASSOCIATION WITH QUALITY ISSUES, AND INCLUDED: Whether study used Placebo, whether an agent was a biologic, unusual packaging label, complex dosing, and over 25 planned procedures. Proper implementation of the strategy can help to optimize resource utilization without compromising trial integrity and patient safety.

  12. International Nursing: How Much Power Do Nurse Managers Have?

    PubMed

    Trus, Marija; Martinkenas, Arvydas; Suominen, Tarja

    This study was conducted to explore issues of nurse managers' power and empowerment. Data were collected from nurse managers by way of a questionnaire consisting of background factors, work-related questions, and power-related questions at the unit and organization levels. The degree of empowerment was evaluated using 2 established instruments (CWEQ-II and Work Empowerment Questionnaire). The overall level of managers' personal power within their own units was relatively high. Nurse managers' perception of their power at an organizational level was found to be at a moderate level. Several factors related to an individual's professional background were correlated to power issues, both at the unit and organizational levels. Structural and psychological empowerment correlated with the overall level of power at a unit level and the overall level of power at an organizational level. Nurse managers self-reported their own general power at a unit level as high, which offers them possibilities to lead the development of nursing care in their units. Organizations may benefit more from nurse managers' leadership by more fully integrating them in the development processes of the entire organization.

  13. 75 FR 44313 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-28

    ... care issues. Frank Szeflinski, (303) 844-7119, Medicare Advantage issues. SUPPLEMENTARY INFORMATION... MCO Managed Care Organization MITA Medicaid Information Technology Architecture MMIS Medicaid... Payment Calculation for Eligible Hospitals c. Medicare Share d. Charity Care e. Transition Factor f...

  14. Challenges and issues in moving towards sustainable landfilling in a transitory country - Malaysia.

    PubMed

    Agamuthu, P; Fauziah, S H

    2011-01-01

    Malaysia disposes of 28,500 tonnes of municipal solid waste directly into landfills daily. This fact alone necessitates sustainable landfills to avoid adverse impacts on the population and the environment. The aim of the present study was to elucidate the issues and challenges faced by waste managers in moving towards sustainable landfilling in Malaysia. Various factors influence the management of a landfill. Among them is the human factor, which includes attitude and public participation. Although Malaysia's economy is developing rapidly, public concern and awareness are not evolving in parallel and therefore participation towards sustainable waste management through the 'reduce, reuse and recycle' approach (3Rs) is severely lacking. Consequently, landfill space is exhausted earlier than scheduled and this is no longer sustainable in terms of security of disposal. Challenges also arise from the lack of funding and the increase in the price of land. Thus, most waste managers normally aim for 'just enough' to comply with the regulations. Investment for the establishment of landfills generally is minimized since landfilling operations are considered uneconomical after closure. Institutional factors also hamper the practice of sustainable landfilling in the country where 3Rs is not mandatory and waste separation is totally absent. Although there are huge obstacles to be dealt with in moving towards sustainable landfilling in Malaysia, recent developments in waste management policy and regulations have indicated that positive changes are possible in the near future. Consequently, with the issues solved and challenges tackled, landfills in Malaysia can then be managed effectively in a more sustainable manner.

  15. Evaluating the underlying factors behind variable rate debt.

    PubMed

    McCue, Michael J; Kim, Tae Hyun Tanny

    2007-01-01

    Recent trends show a greater usage of variable rate debt among health care bond issues. In 2004, 63.4% of the total health care bonds issued were variable rate compared with 30.6% in 1995 (Fitch Ratings, 2005). The purpose of this study is to gain a better understanding of the underlying factors, credit spread, issue characteristics, and issuer factors behind why hospitals and health system borrowers select variable rate debt compared with fixed rate debt. From 2000 to 2004, this study sampled 230 newly issued tax-exempt bonds issued by acute care hospitals and health care systems that included both variable and fixed rate debt issues. Using a logistic regression model, hospitals with variable rate debt issues were assigned a value of 1, whereas hospitals with fixed rate debt issues were assigned a value of 0. This study found a positive association between bond insurance and variable rate debt and a negative association between callable feature and variable rate debt. Facilities located in certificate-of-need states that possessed higher case mix acuity, earned higher profit margins, generated higher debt service coverage, and held less debt were more likely to issue variable rate debt. Overall, hospital managers and board members of hospitals possessing a strong financial performance have an interest in utilizing variable rate debt to lower their cost of capital. In addition, this outcome may also reflect that investment bankers are doing a better job in educating senior hospital management about the interest rate savings benefit of variable rate compared with fixed rate debt.

  16. FAA airborne data link human factors research plan

    DOT National Transportation Integrated Search

    1993-07-01

    This report contains a five-year plan to perform research of human factors issues and topics : related to Data Link implementations in general aviation and transport category aircraft. : Elements such as resource allocation and management and coordin...

  17. Invasive meningococcal disease--improving management through structured review of cases in the Hunter New England area, Australia.

    PubMed

    Guimont, Chantal; Hullick, Carolyn; Durrheim, David; Ryan, Nick; Ferguson, John; Massey, Peter

    2010-03-01

    Invasive meningococcal disease (IMD) is the most common infectious cause of death in childhood in developed countries. This disease may cause severe disability or death if a patient is sub-optimally managed. An audit was performed in Australia of all 2005-06 notified IMD cases to elicit correctable issues. Over the 2 year period, 24 cases were notified in the Hunter New England Health area. These cases were reviewed by an expert panel to highlight key correctable issues in recognition and management of IMD. The 24 patients were aged between 1 month and 70 years. Thirteen (54%) were children and 14 (58%) were women. Six (25%) cases developed complications, two being severe (one death, one limb amputations). These patients had risk factors for IMD. The emergency department average delay between assessment and administration of antibiotics was 57.8 min. There were avoidable factors identified in both patients with a poor outcome. Length of delay in initiating antibiotic therapy has been associated with poor outcome, thus the delay in our series is of concern. The audit highlighted many potentially correctable issues in the medical, laboratory and public health management of IMD cases.

  18. Examining the Impact of Non-Technical Security Management Factors on Information Security Management in Health Informatics

    ERIC Educational Resources Information Center

    Imam, Abbas H.

    2013-01-01

    Complexity of information security has become a major issue for organizations due to incessant threats to information assets. Healthcare organizations are particularly concerned with security owing to the inherent vulnerability of sensitive information assets in health informatics. While the non-technical security management elements have been at…

  19. China's water scarcity.

    PubMed

    Jiang, Yong

    2009-08-01

    China has been facing increasingly severe water scarcity, especially in the northern part of the country. China's water scarcity is characterized by insufficient local water resources as well as reduced water quality due to increasing pollution, both of which have caused serious impacts on society and the environment. Three factors contribute to China's water scarcity: uneven spatial distribution of water resources; rapid economic development and urbanization with a large and growing population; and poor water resource management. While it is nearly impossible to adjust the first two factors, improving water resource management represents a cost-effective option that can alleviate China's vulnerability to the issue. Improving water resource management is a long-term task requiring a holistic approach with constant effort. Water right institutions, market-based approaches, and capacity building should be the government's top priority to address the water scarcity issue.

  20. Impact of age on cardiovascular risk: implications for cardiovascular disease management.

    PubMed

    Tuomilehto, Jaakko

    2004-05-01

    Cardiovascular disease (CVD) represents a major global healthcare problem. The prevalence of this condition increases with age. As many countries around the world are experiencing an increase in the proportion of elderly people in the population, this raises serious issues for cardiac and cerebrovascular disease prevention and management. A wealth of data has established smoking, dyslipidemia, hypertension and type 2 diabetes as major risk factors for cardiac and cerebrovascular events. This article reviews the evidence that links these metabolic risk factors with an increased risk of complications, and assesses the data concerning how risk changes with age. This review also focuses on how these conditions can be optimally managed and whether treatment outcomes are affected by age. The current status of research is assessed and issues which remain to be resolved are highlighted.

  1. Transitional Patterns of Adolescent Females in Non-Traditional Career Paths.

    ERIC Educational Resources Information Center

    Ciccocioppo, Anna-Lisa; Stewin, Leonard L.; Madill, Helen M.; Montgomerie, T. Craig; Tovell, Dorothy R.; Armour, Margaret-Ann; Fitzsimmons, George W.

    2002-01-01

    Examines the factors that affected the career decision-making of adolescent females and young women in undergraduate science, engineering, and technology programs. Qualitative analysis was used to uncover seven themes: transition from high school, educational influences, family influences, academic issues, coursework management, gender issues, and…

  2. Advances in Library Administration and Organization. Volume 16.

    ERIC Educational Resources Information Center

    Williams, Delmus E., Ed.; Garten, Edward D., Ed.

    This book presents the following papers on library organizational and management issues: (1) "Knowledge Management: An Essential Framework for Corporate Library Leadership" (Deanna J. Streng); (2) "Critical Factors for Collaboration in an Academic Library Setting" (Charlotte M. Knoche); (3) "Salaries of Academic Librarians…

  3. A data-driven approach to quality risk management

    PubMed Central

    Alemayehu, Demissie; Alvir, Jose; Levenstein, Marcia; Nickerson, David

    2013-01-01

    Aim: An effective clinical trial strategy to ensure patient safety as well as trial quality and efficiency involves an integrated approach, including prospective identification of risk factors, mitigation of the risks through proper study design and execution, and assessment of quality metrics in real-time. Such an integrated quality management plan may also be enhanced by using data-driven techniques to identify risk factors that are most relevant in predicting quality issues associated with a trial. In this paper, we illustrate such an approach using data collected from actual clinical trials. Materials and Methods: Several statistical methods were employed, including the Wilcoxon rank-sum test and logistic regression, to identify the presence of association between risk factors and the occurrence of quality issues, applied to data on quality of clinical trials sponsored by Pfizer. Results: Only a subset of the risk factors had a significant association with quality issues, and included: Whether study used Placebo, whether an agent was a biologic, unusual packaging label, complex dosing, and over 25 planned procedures. Conclusion: Proper implementation of the strategy can help to optimize resource utilization without compromising trial integrity and patient safety. PMID:24312890

  4. Marketing the mental health care hospital: identification of communication factors.

    PubMed

    Patzer, G L; Rawwas, M Y

    1994-01-01

    The current study provides guidance to hospital administrators in their effort to develop more effective marketing communication strategies. Two types of communication factors are revealed: primary and secondary. Marketers of psychiatric hospitals may use the primary factors as basic issues for their communication campaign, while secondary factors may be used for segmentation or positioning purposes. The primary factors are open wards, special treatment for adolescents, temporary absence, while patient, in-patient care, and visitation management. The secondary factors are temporary absence while a patient, voluntary consent to admit oneself, visitation management, health insurance, open staff, accreditation, physical plant, and credentials of psychiatrists.

  5. Management: A bibliography for NASA managers (supplement 21)

    NASA Technical Reports Server (NTRS)

    1987-01-01

    This bibliography lists 664 reports, articles and other documents introduced into the NASA scientific and technical information system in 1986. Items are selected and grouped according to their usefulness to the manager as manager. Citations are grouped into ten subject categories: human factors and personnel issues; management theory and techniques; industrial management and manufacturing; robotics and expert systems; computers and information management; research and development; economics, costs, and markets; logistics and operations management; reliability and quality control; and legality, legislation, and policy.

  6. Management: A bibliography for NASA Managers

    NASA Technical Reports Server (NTRS)

    1986-01-01

    This bibliography lists 707 reports, articles and other documents introduced into the NASA scientific and technology information system in 1985. Items are selected and grouped according to their usefulness to the manager as manager. Citations are grouped into ten subject categories: human factors and personnel issues; management theory and techniques; industrial management and manufacturing; robotics and expert systems; computers and information management; research and development; economics, costs, and markets; logistics and operations management; reliability and quality control; and legality, legislation, and policy.

  7. Management: A bibliography for NASA managers

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This bibliography lists 731 reports, articles and other documents introduced into the NASA Scientific and Technical Information System in 1990. Items are selected and grouped according to their usefulness to the manager as manager. Citations are grouped into ten subject categories: human factors and personnel issues; management theory and techniques; industrial management and manufacturing; robotics and expert systems; computers and information management; research and development; economics, costs and markets; logistics and operations management; reliability and quality control; and legality, legislation, and policy.

  8. Management: A bibliography for NASA managers

    NASA Technical Reports Server (NTRS)

    1990-01-01

    This bibliography lists 755 reports, articles and other documents introduced into the NASA Scientific and Technical Information System in 1989. Items are selected and grouped according to their usefulness to the manager as manager. Citations are grouped into ten subject categories: human factors and personnel issues; management theory and techniques; industrial management and manufacturing; robotics and expert systems; computers and information management; research and development; economics, costs and markets; logistics and operations management; reliability and quality control; and legality, legislation, and policy.

  9. Management: A bibliography for NASA managers

    NASA Technical Reports Server (NTRS)

    1989-01-01

    This bibliography lists 822 reports, articles and other documents introduced into the NASA Scientific and Technical Information System in 1988. Items are selected and grouped according to their usefulness to the manager as manager. Citations are grouped into ten subject categories: human factors and personnel issues; management theory and techniques; industrial management and manufacturing; robotics and expert systems; computers and information management; research and development; economics, costs and markets; logistics and operations management; reliability and quality control; and legality, legislation, and policy.

  10. Management: A bibliography for NASA managers

    NASA Technical Reports Server (NTRS)

    1992-01-01

    This bibliography lists 630 reports, articles and other documents introduced into the NASA Scientific and Technical Information System in 1991. Items are selected and grouped according to their usefulness to the manager as manager. Citations are grouped into ten subject categories: human factors and personnel issues; management theory and techniques; industrial management and manufacturing; robotics and expert systems; computers and information management; research and development; economics, costs and markets; logistics and operations management; reliability and quality control; and legality, legislation, and policy.

  11. Management: A bibliography for NASA managers

    NASA Technical Reports Server (NTRS)

    1988-01-01

    This bibliography lists 653 reports, articles and other documents introduced into the NASA scientific and technical information system in 1987. Items are selected and grouped according to their usefulness to the manager as manager. Citiations are grouped into ten subject categories; human factors and personnel issues; management theory and techniques; industrial management and manufacturing; robotics and expert systems; computers and information management; research and development; economics, costs and markets; logistics and operations management, reliability and quality control; and legality, legislation, and policy.

  12. Geographic variation in social acceptability of wildland fuels management in the western United States

    USGS Publications Warehouse

    Brunson, M.; Schindler, Bruce A.

    2004-01-01

    Contemporary natural resource management requires consideration of the social acceptability of management practices and conditions. Agencies wishing to measure, respond to, and influence social acceptability must understand the nuances of public perception regarding controversial issues. This study explores social acceptability judgments about one such issue: reduction of wildland fuel hazards on federal lands in the western United States. Citizens were surveyed in four locations where fire has been a significant ecological disturbance agent and public land agencies propose to reduce wildland fuel levels and wildfire hazards via prescribed burning, thinning, brush removal, and/or livestock grazing. Respondents in different locations differed in their knowledge about fire and fuel issues as well in their acceptability judgments. Differences are associated with location-specific social and environmental factors as well as individual beliefs. Results argue against using a??one-size-fits-alla?? policies or information strategies about fuels management.

  13. An integrated operational definition and conceptual model of asthma self-management in teens.

    PubMed

    Mammen, Jennifer; Rhee, Hyekyun; Norton, Sally A; Butz, Arlene M; Halterman, Jill S; Arcoleo, Kimberly

    2018-01-19

    A previous definition of adolescent asthma self-management was derived from interviews with clinicians/researchers and published literature; however, it did not incorporate perspectives of teens or parents. Therefore, we conducted in-depth interviews with teens and parents and synthesized present findings with the prior analysis to develop a more encompassing definition and model. Focal concepts were qualitatively extracted from 14-day self-management voice-diaries (n = 14) and 1-hour interviews (n = 42) with teens and parents (28 individuals) along with concepts found in the previous clinical/research oriented analysis. Conceptual structure and relationships were identified and key findings synthesized to develop a revised definition and model of adolescent asthma self-management. There were two primary self-management constructs: processes of self-management and tasks of self-management. Self-management was defined as the iterative process of assessing, deciding, and responding to specific situations in order to achieve personally important outcomes. Clinically relevant asthma self-management tasks included monitoring asthma, managing active issues through pharmacologic and non-pharmacologic strategies, preventing future issues, and communicating with others as needed. Self-management processes were reciprocally influenced by intrapersonal factors (both cognitive and physical), interpersonal factors (family, social and physical environments), and personally relevant asthma and non-asthma outcomes. This is the first definition of asthma self-management incorporating teen, parent, clinician, and researcher perspectives, which suggests that self-management processes and behaviors are influenced by individually variable personal and interpersonal factors, and are driven by personally important outcomes. Clinicians and researchers should investigate teens' symptom perceptions, medication beliefs, current approaches to symptom management, relevant outcomes, and personal priorities.

  14. [Tenure--a Management Problem.

    ERIC Educational Resources Information Center

    Brassie, Stan

    Tenure saturation coupled with declining enrollments, abolishment of general university requirements, program diversity, and affirmative action programs make tenure an issue. These factors are representative of many facing university management today. Serious examination of the concept of tenure reveals that 85 percent of all colleges have tenure,…

  15. An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study

    PubMed Central

    Laws, Rachel A; Kemp, Lynn A; Harris, Mark F; Davies, Gawaine Powell; Williams, Anna M; Eames-Brown, Rosslyn

    2009-01-01

    Background Despite the effectiveness of brief lifestyle intervention delivered in primary healthcare (PHC), implementation in routine practice remains suboptimal. Beliefs and attitudes have been shown to be associated with risk factor management practices, but little is known about the process by which clinicians' perceptions shape implementation. This study aims to describe a theoretical model to understand how clinicians' perceptions shape the implementation of lifestyle risk factor management in routine practice. The implications of the model for enhancing practices will also be discussed. Methods The study analysed data collected as part of a larger feasibility project of risk factor management in three community health teams in New South Wales (NSW), Australia. This included journal notes kept through the implementation of the project, and interviews with 48 participants comprising 23 clinicians (including community nurses, allied health practitioners and an Aboriginal health worker), five managers, and two project officers. Data were analysed using grounded theory principles of open, focused, and theoretical coding and constant comparative techniques to construct a model grounded in the data. Results The model suggests that implementation reflects both clinician beliefs about whether they should (commitment) and can (capacity) address lifestyle issues. Commitment represents the priority placed on risk factor management and reflects beliefs about role responsibility congruence, client receptiveness, and the likely impact of intervening. Clinician beliefs about their capacity for risk factor management reflect their views about self-efficacy, role support, and the fit between risk factor management ways of working. The model suggests that clinicians formulate different expectations and intentions about how they will intervene based on these beliefs about commitment and capacity and their philosophical views about appropriate ways to intervene. These expectations then provide a cognitive framework guiding their risk factor management practices. Finally, clinicians' appraisal of the overall benefits versus costs of addressing lifestyle issues acts to positively or negatively reinforce their commitment to implementing these practices. Conclusion The model extends previous research by outlining a process by which clinicians' perceptions shape implementation of lifestyle risk factor management in routine practice. This provides new insights to inform the development of effective strategies to improve such practices. PMID:19825189

  16. Psychosocial and nonclinical factors predicting hospital utilization in patients of a chronic disease management program: a prospective observational study.

    PubMed

    Tran, Mark W; Weiland, Tracey J; Phillips, Georgina A

    2015-01-01

    Psychosocial factors such as marital status (odds ratio, 3.52; 95% confidence interval, 1.43-8.69; P = .006) and nonclinical factors such as outpatient nonattendances (odds ratio, 2.52; 95% confidence interval, 1.22-5.23; P = .013) and referrals made (odds ratio, 1.20; 95% confidence interval, 1.06-1.35; P = .003) predict hospital utilization for patients in a chronic disease management program. Along with optimizing patients' clinical condition by prescribed medical guidelines and supporting patient self-management, addressing psychosocial and nonclinical issues are important in attempting to avoid hospital utilization for people with chronic illnesses.

  17. Contributing factors in construction accidents.

    PubMed

    Haslam, R A; Hide, S A; Gibb, A G F; Gyi, D E; Pavitt, T; Atkinson, S; Duff, A R

    2005-07-01

    This overview paper draws together findings from previous focus group research and studies of 100 individual construction accidents. Pursuing issues raised by the focus groups, the accident studies collected qualitative information on the circumstances of each incident and the causal influences involved. Site based data collection entailed interviews with accident-involved personnel and their supervisor or manager, inspection of the accident location, and review of appropriate documentation. Relevant issues from the site investigations were then followed up with off-site stakeholders, including designers, manufacturers and suppliers. Levels of involvement of key factors in the accidents were: problems arising from workers or the work team (70% of accidents), workplace issues (49%), shortcomings with equipment (including PPE) (56%), problems with suitability and condition of materials (27%), and deficiencies with risk management (84%). Employing an ergonomics systems approach, a model is proposed, indicating the manner in which originating managerial, design and cultural factors shape the circumstances found in the work place, giving rise to the acts and conditions which, in turn, lead to accidents. It is argued that attention to the originating influences will be necessary for sustained improvement in construction safety to be achieved.

  18. Environmental problem-solving: Psychosocial factors

    NASA Astrophysics Data System (ADS)

    Miller, Alan

    1982-11-01

    This is a study of individual differences in environmental problem-solving, the probable roots of these differences, and their implications for the education of resource professionals. A group of student Resource Managers were required to elaborate their conception of a complex resource issue (Spruce Budworm management) and to generate some ideas on management policy. Of particular interest was the way in which subjects dealt with the psychosocial aspects of the problem. A structural and content analysis of responses indicated a predominance of relatively compartmentalized styles, a technological orientation, and a tendency to ignore psychosocial issues. A relationship between problem-solving behavior and personal (psychosocial) style was established which, in the context of other evidence, suggests that problem-solving behavior is influenced by more deep seated personality factors. The educational implication drawn was that problem-solving cannot be viewed simply as an intellectual-technical activity but one that involves, and requires the education of, the whole person.

  19. Managing Multiple Risk Factors.

    DTIC Science & Technology

    1998-09-01

    to the racial differences in cardiovascular risk and events among women. High levels of socioeconomic stress, higher dietary fat intake and sedentary ... lifestyle are more prevalent among black than white women. The proposed study will address the issue of whether the cluster of risk factors for

  20. An Assessment of Air Force Development Portfolio Management Practices

    DTIC Science & Technology

    2002-01-01

    of Product Innovation Management , 12, 235–246. Cooper, R. G., & Kleinschmidt, E. J. (1995). Benchmarking the firm’s criti- cal success factors in new...product development. Journal of Product Innovation Management , 12, 374– 391. Cooper, R. G., Edgett, S. J., & Klein- schmidt, E. J. (1998a). Best...Scott, G. M. (2000). Critical technology management issues of new product development in high-tech companies. Journal of Product Innovation Management , 17

  1. The Life-and-Death Factor: Focus on Healthcare Facilities

    ERIC Educational Resources Information Center

    Dessoff, Alan

    2009-01-01

    With economic pressures restricting campus budgets and healthcare policy issues capturing national attention, facilities managers at university-affiliated hospitals and other healthcare entities say they feel more urgency than ever to provide cost-effective services to patients, providers, medical researchers, and students. Managing facilities at…

  2. Integrated Information Centers within Academic Environments: Introduction and Overview.

    ERIC Educational Resources Information Center

    Lunin, Luis F., Ed.; D'Elia, George, Ed.

    1991-01-01

    Introduces eight articles on the Integrated Information Center (IIC) Project, which investigated significant behavioral, technological, organizational, financial, and legal factors involved in the management of IICs. Four articles address design and management issues of general interest, and four focus on specific design considerations and a…

  3. Human Factors Society, Annual Meeting, 35th, San Francisco, CA, Sept. 2-6, 1991, Proceedings. Vols. 1 2

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

    Not Available

    These proceedings discuss human factor issues related to aerospace systems, aging, communications, computer systems, consumer products, education and forensic topics, environmental design, industrial ergonomics, international technology transfer, organizational design and management, personality and individual differences in human performance, safety, system development, test and evaluation, training, and visual performance. Particular attention is given to HUDs, attitude indicators, and sensor displays; human factors of space exploration; behavior and aging; the design and evaluation of phone-based interfaces; knowledge acquisition and expert systems; handwriting, speech, and other input techniques; interface design for text, numerics, and speech; and human factor issues in medicine. Also discussedmore » are cumulative trauma disorders, industrial safety, evaluative techniques for automation impacts on the human operators, visual issues in training, and interpreting and organizing human factor concepts and information.« less

  4. Challenges Associated With Managing Suicide Risk in Long-Term Care Facilities.

    PubMed

    O'Riley, Alisa; Nadorff, Michael R; Conwell, Yeates; Edelstein, Barry

    2013-06-01

    Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents' responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting.

  5. Old age and frailty in the dialysis population.

    PubMed

    Brown, Edwina A; Johansson, Lina

    2010-01-01

    Dialysis management is changing over time due to the changing dialysis population, with many overlapping issues between gerontological and nephrological care. The conditions that are focused on in this review are frailty, cognitive impairment, depression and changes in body composition. These factors should be considered when managing older patients on dialysis.

  6. Flight Training Technology for Regional/Commuter Airline Operations: Regional Airline Association/NASA Workshop Proceedings

    NASA Technical Reports Server (NTRS)

    Lee, A. T. (Editor); Lauber, J. K. (Editor)

    1984-01-01

    Programs which have been developed for training commercial airline pilots and flight crews are discussed. The concept of cockpit resource management and the concomitant issues of management techniques, interpersonal communication, psychological factors, and flight stress are addressed. Training devices and simulation techniques are reported.

  7. Emotion Management in Online Groupwork Reported by Chinese Students

    ERIC Educational Resources Information Center

    Xu, Jianzhong; Du, Jianxia; Fan, Xitao

    2014-01-01

    Emotion and emotion regulation are increasingly viewed as critical issues in online learning environments. Online collaborative environments in particular create novel challenges for emotion regulation. Few studies, however, have focused on a range of factors that may influence students' efforts to manage their emotion in online collaborative…

  8. Management: A bibliography for NASA managers

    NASA Technical Reports Server (NTRS)

    1985-01-01

    This bibliography lists 706 reports, articles, and other documents introduced into the NASA scientific and technical information system in 1984. Entries, which include abstracts, are arranged in the following categories: human factors and personnel issues; management theory and techniques; industrial management and manufacturing; robotics and expert systems; computers and information management; research and development; economics, costs, and markets; logistics and operations management; reliability and quality control; and legality, legislation, and policy. Subject, personal author, corporate source, contract number, report number, and accession number indexes are included.

  9. Challenging issues of urban biodiversity related to ecohydrology.

    PubMed

    Mendiondo, E M

    2008-11-01

    This paper aims to outline challenging issues of urban biodiversity in order to address yardsticks related to ecohydrology, and with a complementary approach to eutrophication impacts. The vision of environmental services, urbanization's consequences and management aspects of water governance are also depicted. Factors of river restoration, environmental tradeoffs and socio-cultural constrains are envisaged through concept questions towards emerging aspects that figure out methodological guides, strategic challenges for stakeholders and inter-disciplinary opportunities. Examples from case studies on restoration and management, from experiences and lessons learned, are enclosed, with brief discussions and literature citation.

  10. Factors influencing intentions to stay and retention of nurse managers: a systematic review.

    PubMed

    Brown, Pamela; Fraser, Kimberly; Wong, Carol A; Muise, Melanie; Cummings, Greta

    2013-04-01

    This systematic review aimed to explore factors known to influence intentions to stay and retention of nurse managers in their current position. Retaining staff nurses and recruiting nurses to management positions are well documented; however, there is sparse research examining factors that influence retention of nurse managers. Thirteen studies were identified through a systematic search of the literature. Eligibility criteria included both qualitative and quantitative studies that examined factors related to nurse manager intentions to stay and retention. Quality assessments, data extraction and analysis were completed on all studies included. Twenty-one factors were categorized into three major categories: organizational, role and personal. Job satisfaction, organizational commitment, organizational culture and values, feelings of being valued and lack of time to complete tasks leading to work/life imbalance, were prominent across all categories. These findings suggest that intentions to stay and retention of nurse managers are multifactoral. However, lack of robust literature highlights the need for further research to develop strategies to retain nurse managers. ImplICATIONS FOR NURSE MANAGEMENT: Health-care organizations and senior decision-makers should feel a responsibility to support front-line managers in relation to workload and span of control, and in understanding work/life balance issues faced by managers. © 2012 Blackwell Publishing Ltd.

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

    PubMed Central

    Moise, Imelda K.; Mulhall, Peter F.

    2016-01-01

    Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking clients to adequate services rather than reporting performance. Case managers favored measurable deliverables rather than operational work products. A proposed solution to current challenges emphasizes and encourages the iterative learning process and shared decision making between program targets, funders and providers. Case managers are aware of the challenging environment in which they operate for their clients and for themselves. However, future interventions will require clearly identified performance measures and increased systems support. PMID:27149061

  12. Challenges of Managing Animals in Disasters in the U.S.

    PubMed Central

    Heath, Sebastian E.; Linnabary, Robert D.

    2015-01-01

    Simple Summary This article describes common challenges to managing animals in disasters in the US, summarizes how some of these challenges are being met and makes recommendations on how to overcome others. Many predictable adverse situations affecting animals and their owners can be prevented when communities develop a comprehensive emergency management strategy that integrates animal care into planning, preparedness, mitigation, and recovery activities, as well as response. Abstract Common to many of the repeated issues surrounding animals in disasters in the U.S. is a pre-existing weak animal health infrastructure that is under constant pressure resulting from pet overpopulation. Unless this root cause is addressed, communities remain vulnerable to similar issues with animals they and others have faced in past disasters. In the US the plight of animals in disasters is frequently viewed primarily as a response issue and frequently handled by groups that are not integrated with the affected community’s emergency management. In contrast, animals, their owners, and communities would greatly benefit from integrating animal issues into an overall emergency management strategy for the community. There is no other factor contributing as much to human evacuation failure in disasters that is under the control of emergency management when a threat is imminent as pet ownership. Emergency managers can take advantage of the bond people have with their animals to instill appropriate behavior amongst pet owners in disasters. PMID:26479228

  13. The Hazardous-Drums Project: A Multiweek Laboratory Exercise for General Chemistry Involving Environmental, Quality Control, and Cost Evaluation

    ERIC Educational Resources Information Center

    Hayes, David; Widanski, Bozena

    2013-01-01

    A laboratory experiment is described that introduces students to "real-world" hazardous waste management issues chemists face. The students are required to define an analytical problem, choose a laboratory analysis method, investigate cost factors, consider quality-control issues, interpret the meaning of results, and provide management…

  14. The critical success factor approach to strategic alignment: seeking a trail from a health organization's goals to its management information infrastructure.

    PubMed

    Tan, J K

    1999-11-01

    The critical success factor (CSF) approach is a technique that will aid health administrators, planners and managers to identify, specify and sort among the most relevant and critical factors determining an organization's survival and success. Following a top-down management perspective, this paper discusses the CSF methodology as a strategic information management process comprising several important phases: (i) understanding the external factors such as the organization's industry, market and environment; (ii) achieving strong support and championship from top management; (iii) encouraging the proactive involvement of management and staff in generic CSF identification; (iv) educating and directing the participation of staff members in CSF verification and further refinement of generic CSFs into specific CSFs; and (v) aggregating, prioritizing and translating activity-related CSFs into organizational information requirements for the design of the organization's management information infrastructure. The implementation of this CSF approach is illustrated in the context of a British Columbia community hospital, with insights provided into key issues for future health researchers and practitioners.

  15. Women in Higher Education: Exploring Stressful Workplace Factors and Coping Strategies

    ERIC Educational Resources Information Center

    Kersh, Renique

    2018-01-01

    For women administrators in higher education, workplace factors like managing multiple roles; work bleeding into personal life; issues with leadership; discrimination and marginalization; and role insufficiency (i.e., ambiguity in work roles and reduced sense of control) contribute to increased workplace stress. Individual coping responses are…

  16. Space Station Human Factors Research Review. Volume 4: Inhouse Advanced Development and Research

    NASA Technical Reports Server (NTRS)

    Tanner, Trieve (Editor); Clearwater, Yvonne A. (Editor); Cohen, Marc M. (Editor)

    1988-01-01

    A variety of human factors studies related to space station design are presented. Subjects include proximity operations and window design, spatial perceptual issues regarding displays, image management, workload research, spatial cognition, virtual interface, fault diagnosis in orbital refueling, and error tolerance and procedure aids.

  17. Constructing Ability Groups in the Secondary School: Issues in Practice.

    ERIC Educational Resources Information Center

    Ireson, Judith; Clark, Helen; Hallam, Susan

    2002-01-01

    Examines grouping practices in 45 secondary schools in England based on information provided by curriculum managers and department heads about allocation procedures, factors affecting the size and number of student groups, movement between groups, pressures and constraints on movement, and behavioral and motivational factors. Finds wide variety of…

  18. Research on Influencing Factors of Salespeople's Empowerment Readiness in Green Energy Enterprise

    NASA Astrophysics Data System (ADS)

    Dong, Yuan; Liu, Xiaohui

    As market competition in green energy enterprises continues to intensify, marketing activities are enlarging and customer demand is increasingly growing and diversifying. More and more green energy enterprises have empowered their own salespeople. And managers in green energy enterprises are more concerned with the issues which employees suit to be empowered and which factors will influence employee empowerment readiness. This paper proposes the definition of salespeople's empowerment readiness, analyzes influencing factors of salespeople's empowerment readiness, discusses the effect mechanism of influencing factors of salespeople's empowerment readiness, finally, and puts forward some suggestions to enhance salespeople's empowerment readiness from the perspective of human resource management practice.

  19. Access to laboratory testing: the impact of managed care in the Pacific Northwest.

    PubMed

    LaBeau, K M; Simon, M; Steindel, S J

    1999-01-01

    Patient access to health-care services has become an important issue owing to the growth of managed care organizations and the number of patients enrolled. To better understand the current issues related to access to laboratory testing, with a particular focus on the impact of managed care, we gathered information from a network of clinical laboratories in the Pacific Northwest. Two questionnaires were sent to the 257 Laboratory Medicine Sentinel Monitoring Network participants in November 1995 and March 1996 to investigate trends in the availability and utilization of laboratory testing services and changes in onsite testing menus. Although laboratories reported that managed care was a factor in their decisions about laboratory practices, testing decisions were more likely made for business reasons, based on medical practice changes and marketplace influences not associated with managed care.

  20. Automated Management Of Documents

    NASA Technical Reports Server (NTRS)

    Boy, Guy

    1995-01-01

    Report presents main technical issues involved in computer-integrated documentation. Problems associated with automation of management and maintenance of documents analyzed from perspectives of artificial intelligence and human factors. Technologies that may prove useful in computer-integrated documentation reviewed: these include conventional approaches to indexing and retrieval of information, use of hypertext, and knowledge-based artificial-intelligence systems.

  1. Ecosystem management issues

    Treesearch

    Jim Boynton

    1995-01-01

    Although recognized as an important tool for ecosystem maintenance, fuels management, and a variety of other purposes, the prescribed fire program in the Pacific Southwest Region of the USDA Forest Service has been constrained by several factors. These range from funding availability, to debates on the effect of fire on the habitat of sensitive species, to competition...

  2. Business Candidate Reactions to Community College Recruitment Practices: Effects of Instructional Programs and Job Attributes.

    ERIC Educational Resources Information Center

    Winter, Paul A.

    This paper draws on the literatures of educational administration, management, and marketing to address, empirically, two issues related to community college faculty recruitment: (a) factors influencing faculty application decisions, and (b) the utility of an existing model for recruiting community college faculty. It examines factors influencing…

  3. Collaborative Network Management for Enhancing Quality Education of Primary Schools

    ERIC Educational Resources Information Center

    Chaikoed, Wisithsak; Sirisuthi, Chaiyuth; Numnaphol, Kochaporn

    2017-01-01

    This research aims to study the network and collaborative factors that enhance quality education of primary schools. Different methods were used in this research work: (1) Related approaches, theories, and research literatures and (2) Scholars were interviewed on 871 issues in the form of questionnaire, and the collaborative network factors were…

  4. Reshaping the electric utility industry: Competitive implications for Illinois

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

    Maschoff, D.C.

    1995-12-31

    This paper briefly outlines some of the issues in the electric power industry restructuring. In addition, the impacts of these changes on the energy marketplace are discussed. Federal policy initiatives, state regulatory response, and utility management response are each described. Management skills are identified as the critical success factor for competition in the utility market.

  5. Transitioning issues in adolescent to young adult hemophilia patients with inhibitors: an approach for a growing population.

    PubMed

    Young, Guy

    2010-09-01

    The major adverse effect of factor replacement therapy in patients with hemophilia is the development of neutralizing antibodies termed inhibitors. This complication renders standard factor replacement therapy ineffective resulting in increased morbidity and mortality. Until recently, the population of adults with inhibitors was relatively small due to the death of many of the patients from HIV that they contracted from contaminated factor in the early 1980s. With the advent of factor products with reduced risks for deadly infections in the mid-1980s to early 1990s, a cohort of inhibitor patients is now beginning to enter adulthood thus raising the issues regarding the transition of these patients into adulthood. It is, therefore, expected that adult hematologists will be seeing more inhibitor patients and that pediatric hematologists will be faced with managing this transition process, which may not necessarily include transition to an adult facility or adult hematologist. This review will discuss the various issues ranging from choice of medical provider to a discussion of psychosocial and financial issues facing this specific patient population.

  6. Alternative management structures for municipal waste collection services: The influence of economic and political factors

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

    Plata-Díaz, Ana María, E-mail: amplata@ugr.es; Zafra-Gómez, José Luis, E-mail: jlzafra@ugr.es; Pérez-López, Gemma, E-mail: gemmapl@ugr.es

    2014-11-15

    Highlights: • We analyzed the factors that influence on the restructuring of MSW services. • We evaluated five different alternatives for public and private service. • Our analysis covers a broad time horizon, 2002–2010. • We used a conditional fixed-effects logistic regression as the evaluation method. • Municipalities tend to contract out the MSW service in the presence of high costs and fiscal stress. - Abstract: Identifying and characterising the factors that determine why a local authority opts for a particular way of managing its waste collection service is an important issue, warranting research interest in the field of municipalmore » solid waste (MSW) management. This paper presents empirical evidence spanning a broad time horizon (2002–2010) showing that economic and political factors impact in different ways on the provision of waste management services. We examine five alternatives in this area, including public and private service delivery formulas and, within each field, individual and joint options. Our findings highlight the importance of the service cost and that of the various indicators of fiscal stress as determinant factors of management decisions regarding the provision of MSW management services.« less

  7. Solid Waste Management in Nigeria: Problems and Issues.

    PubMed

    AGUNWAMBA

    1998-11-01

    / This paper is a presentation of the problems of solid waste management in Nigeria and certain important issues that must be addressed in order to achieve success. At the core of the problems of solid waste management are the absence of adequate policies, enabling legislation, and an environmentally stimulated and enlightened public. Government policies on the environment are piecemeal where they exist and are poorly implemented. Public enlightenment programs lacked the needed coverage, intensity, and continuity to correct the apathetic public attitude towards the environment. Up to now the activities of the state environmental agencies have been hampered by poor funding, inadequate facilities and human resources, inappropriate technology, and an inequitable taxation system. Successful solid waste management in Nigeria will require a holistic program that will integrate all the technical, economic, social, cultural, and psychological factors that are often ignored in solid waste programs.KEY WORDS: Solid waste; Management; Problems; Solutions; Nigeria

  8. Management challenges in children with both epilepsy and intellectual disability.

    PubMed

    Buelow, Janice M; Shore, Cheryl P

    2010-01-01

    People who have both epilepsy and intellectual disability have significant problems requiring skilled health care management. Clinical nurse specialists have the unique opportunity to work with these people and their families to help them develop self-management and family management skills. In this article, we describe some factors associated with intellectual disability and epilepsy. In addition, we address the management challenges associated with this dual diagnoses in 3 areas: (1) problems associated with the management of seizure and prescription management, (2) problems associated with the seizure management other than prescriptions, and (3) life management issues. Finally, we suggest ways that clinical nurse specialists can foster development of management skills.

  9. Ecological Knowledge Among Communities, Managers and Scientists: Bridging Divergent Perspectives to Improve Forest Management Outcomes

    NASA Astrophysics Data System (ADS)

    Rist, Lucy; Shackleton, Charlie; Gadamus, Lily; Chapin, F. Stuart; Gowda, C. Made; Setty, Siddappa; Kannan, Ramesh; Shaanker, R. Uma

    2016-04-01

    Multiple actors are typically involved in forest management, namely communities, managers and researchers. In such cases, suboptimal management outcomes may, in addition to other factors, be symptomatic of a divergence in perspectives among these actors driven by fundamental differences in ecological knowledge. We examine the degree of congruence between the understandings of actors surrounding key issues of management concern in three case studies from tropical, subtropical and boreal forests. We identify commonly encountered points of divergence in ecological knowledge relating to key management processes and issues. We use these to formulate seven hypotheses about differences in the bodies of knowledge that frequently underlie communication and learning failures in forest management contexts where multiple actors are involved and outcomes are judged to be suboptimal. Finally, we present a set of propositions to acknowledge and narrow these differences. A more complete recognition of the full triangulation between all actors involved, and of the influence that fundamental differences in ecological knowledge can exert, may help lead to a more fruitful integration between local knowledge and practice, manager knowledge and practice, and contemporary science in forest management.

  10. Organizational factors related to low levels of sickness absence in a representative set of Swedish companies.

    PubMed

    Stoetzer, Ulrich; Bergman, Peter; Aborg, Carl; Johansson, Gun; Ahlberg, Gunnel; Parmsund, Marianne; Svartengren, Magnus

    2014-01-01

    The aim of this qualitative study was to identify manageable organizational factors that could explain why some companies have low levels of sickness absence. There may be factors at company level that can be managed to influence levels of sickness absence, and promote health and a prosperous organization. 38 representative Swedish companies. The study included a total of 204 semi-structured interviews at 38 representative Swedish companies. Qualitative thematic analysis was applied to the interviews, primarily with managers, to indicate the organizational factors that characterize companies with low levels of sickness absence. The factors that were found to characterize companies with low levels of sickness absence concerned strategies and procedures for managing leadership, employee development, communication, employee participation and involvement, corporate values and visions, and employee health. The results may be useful in finding strategies and procedures to reduce levels of sickness absence and promote health. There is research at individual level on the reasons for sickness absence. This study tries to elevate the issue to an organizational level. The findings suggest that explicit strategies for managing certain organizational factors can reduce sickness absence and help companies to develop more health-promoting strategies.

  11. Clinical ethics issues in HIV care in Canada: an institutional ethnographic study.

    PubMed

    Kaposy, Chris; Greenspan, Nicole R; Marshall, Zack; Allison, Jill; Marshall, Shelley; Kitson, Cynthia

    2017-02-06

    This is a study involving three HIV clinics in the Canadian provinces of Newfoundland and Labrador, and Manitoba. We sought to identify ethical issues involving health care providers and clinic clients in these settings, and to gain an understanding of how different ethical issues are managed by these groups. We used an institutional ethnographic method to investigate ethical issues in HIV clinics. Our researcher conducted in-depth semi-structured interviews, compiled participant observation notes, and studied health records in order to document ethical issues in the clinics, and to understand how health care providers and clinic clients manage and resolve these issues. We found that health care providers and clinic clients have developed work processes for managing ethical issues of various types: conflicts between client-autonomy and public health priorities ("treatment as prevention"), difficulties associated with the criminalization of nondisclosure of HIV positive status, challenges with non-adherence to HIV treatment, the protection of confidentiality, barriers to treatment access, and negative social determinants of health and well-being. Some ethical issues resulted from structural disadvantages experienced by clinic clients. The most striking findings in our study were the negative social determinants of health and well-being experienced by some clinic clients - such as experiences of violence and trauma, poverty, racism, colonization, homelessness, and other factors affecting well-being such as problematic substance use. These negative determinants were at the root of other ethical issues, and are themselves of ethical concern.

  12. Health assessments for Indigenous Australians at Orange Aboriginal Medical Service: health problems identified and subsequent follow up.

    PubMed

    Dutton, Tegan; Stevens, Wendy; Newman, Jamie

    2016-01-01

    This study aimed to document the types, management and follow up of health issues identified by all Aboriginal Health Assessments (AHA) performed at Orange Aboriginal Medical Service from 1 January 2011 to 31 December 2012. This was done with a retrospective audit of clinical records. In total, 1169 AHAs were performed: 41% child, 53% adult and 6% older person AHAs. Newly identified health issues were documented in 85% (984). Being overweight (41%; 476) and smoking (26%; 301) were the common risk factors identified. As a result of the AHA, most children who were not up-to-date with their vaccinations received catch-up immunisations; 11% (36) of adult women (n=314) received a Pap smear, although Pap smear status was unknown or not up-to-date for 61% (192); 27% (311) of cases were prescribed new medication; and 1239 referrals were made but only 40% were attended. At 6 months following the AHA, 26% (240) of cases with newly identified health issues were completely managed and followed up, whereas 25% (226) received no follow up. The AHAs are useful for identifying new health issues; however, follow up of the identified health issues should be improved. If AHAs are to improve health outcomes, appropriate management and follow up of the identified health issues are essential.

  13. Ethical decision making in pain management: a conceptual framework.

    PubMed

    Carvalho, Ana Sofia; Martins Pereira, Sandra; Jácomo, António; Magalhães, Susana; Araújo, Joana; Hernández-Marrero, Pablo; Costa Gomes, Carlos; Schatman, Michael E

    2018-01-01

    The practice and study of pain management pose myriad ethical challenges. There is a consensual opinion that adequate management of pain is a medical obligation rooted in classical Greek practice. However, there is evidence that patients often suffer from uncontrolled and unnecessary pain. This is inconsistent with the leges artis, and its practical implications merit a bioethical analysis. Several factors have been identified as causes of uncontrolled and unnecessary pain, which deprive patients from receiving appropriate treatments that theoretically they have the right to access. Important factors include (with considerable regional, financial, and cultural differences) the following: 1) failure to identify pain as a priority in patient care; 2) failure to establish an adequate physician-patient relationship; 3) insufficient knowledge regarding adequate prescription of analgesics; 4) conflicting notions associated with drug-induced risk of tolerance and fear of addiction; 5) concerns regarding "last-ditch" treatments of severe pain; and 6) failure to be accountable and equitable. The aim of this article was to establish that bioethics can serve as a framework for addressing these challenging issues and, from theoretical to practical approaches, bioethical reflection can contextualize the problem of unrelieved pain. This article is organized into three parts. First, we illustrate that pain management and its undertreatment are indeed ethical issues. The second part describes possible ethical frameworks that can be combined and integrated to better define the ethical issues in pain management. Finally, we discuss possible directions forward to improve ethical decision making in pain management. We argue that 1) the treatment of pain is an ethical obligation, 2) health science schools, especially medical training institutions, have the duty to teach pain management in a comprehensive fashion, and 3) regulatory measures, which prevent patients from access to opioid treatment as indicated in their cases, are unethical and should be reconsidered. Developing an ethical framework for pain management will result in enhanced quality of care, linking the epistemic domains of pain management to their anthropological foundations, thereby making them ethically sound.

  14. Maximizing Your Investment in Building Automation System Technology.

    ERIC Educational Resources Information Center

    Darnell, Charles

    2001-01-01

    Discusses how organizational issues and system standardization can be important factors that determine an institution's ability to fully exploit contemporary building automation systems (BAS). Further presented is management strategy for maximizing BAS investments. (GR)

  15. What nurses and midwives want: Findings from the national survey on workplace climate and well-being.

    PubMed

    Holland, Peter J; Tham, Tse Leng; Gill, Fenella J

    2018-06-01

    A discussion of the findings from a nationwide study of workplace and well-being issues of Australian nurses and midwives. Current discourse only provides a fragmented understanding of a multifaceted nature of working conditions and well-being, necessitating a more holistic investigation to identify critical workplace issues within these professions. Discussion paper. A national survey conducted in July 2016 involving Australian Nursing and Midwifery Federation members. The literature supporting this paper focuses on the nursing and midwifery workforce and studies on attraction and retention issues. Workplace policies and practices in place in health care organizations that are within the control of management are key factors in the negative issues associated with the profession from the survey. Proactive and targeted interventions particularly aimed at salient issues of work intensification, declining engagement, and effective voice mechanisms are needed to address these crucial issues if the attrition of individuals from nursing and midwifery occupations is going to be ameliorated. To alleviate workforce issues pushing nurses and midwives to the tipping point of exiting the professions, health care organizations need to take a proactive stance in addressing issues under the control of management. © 2018 John Wiley & Sons Australia, Ltd.

  16. Nurse manager perceptions of role satisfaction and retention at an academic medical center.

    PubMed

    Zwink, Jennifer E; Dzialo, Maureen; Fink, Regina M; Oman, Kathleen S; Shiskowsky, Kaycee; Waite, Kathi; DeVine, Deborah; Sanders, Carolyn L; Le-Lazar, Jamie T T

    2013-03-01

    The aim of this study was to explore the perceptions of inpatient acute care nurse managers (NM) employed at an academic Magnet® hospital about factors that influence NM retention, including current work environment, satisfaction, work-life balance, sucssful NM traits, and personal development and educational needs. Nurse managers are challenged with increased workloads impacting their ability to implement all role components. A qualitative descriptive study design used focus group methodology to explore perceptions of the NM role. Nurse managers identified staff recognition, support, peer relationships, collaboration, and ability to make positive change as factors influencing their decision to remain in the role. Burnout factors included workload issues, work-life imbalance, and difficulty sustaining positive relationships. Traits supporting success were communication, resiliency, integrity, and a visionary outlook. Suggestions for NM development and education were identified. Findings can be used to improve NM satisfaction, work-life balance, recruitment, retention, and succession planning.

  17. Managing incidentally diagnosed isolated factor VII deficiency perioperatively: a brief expert consensus report.

    PubMed

    Sheth, Sujit; Soff, Gerald; Mitchell, Beau; Green, David; Kaicker, Shipra; Fireman, Fernando; Tugal, Oya; Guarini, Ludovico; Giardina, Patricia; Aledort, Louis

    2012-02-01

    While isolated factor VII (FVII) deficiency is being more frequently diagnosed owing to improved preoperative screening procedures, there is no specific guideline for perioperative management of such patients. To complicate the issue, FVII activity levels seem to correlate less well with the risk of hemorrhage than the patient's past and family bleeding history do. We have devised expert consensus recommendations for managing such patients perioperatively, taking into consideration the personal and family bleeding history, the FVII activity level and the inherent bleeding risk of the procedure itself. We hope that clinicians will find this a useful tool in the decision-making process, thereby limiting the use of recombinant factor VIIa to those who need it most, and preventing possible thrombotic complications in those without a strong indication for its use.

  18. Quality of Project Management Education and Training Programmes

    NASA Astrophysics Data System (ADS)

    Bodea, Constanta-Nicoleta; Dascalu, Maria; Coman, Melania

    The paper refers to the factors which influence the quality of training and education on project management. A survey was made and the main results are presented. 81 % of the responses came from China. The rest were professionals of different EU nationalities. The percentage of Project Managers who answered the questions is rather low - 8%. In the "Others" category, we have software developers, financial managers and professors, who are involved in both training on project management, but also as team members or team managers in projects, thus ensuring a balanced overview of both theory and practical issues.

  19. Increasing the relevance of research to health care managers: hospital CEO imperatives for improving quality and lowering costs.

    PubMed

    Alexander, Jeffrey A; Hearld, Larry R; Jiang, H Joanna; Fraser, Irene

    2007-01-01

    Evidence-based management assumes that available research evidence is consistent with the problems and decision-making conditions faced by those who will utilize this evidence in practice. This article attempts to identify how hospital leaders view key determinants of hospital quality and costs, as well as the fundamental ways these leaders "think" about solutions to quality and cost issues in their organizations. The objective of this analysis is to better inform the research agenda and approaches pursued by health services research so that this research reflects the "realities" of practice in hospitals. We conducted a series of semistructured interviews with a convenience sample of eight hospital and three health system leaders. Questions focused on current and future challenges facing hospitals as they relate to hospital quality, costs, and efficiency, and potential solutions to those challenges. Nine major organizational and managerial factors emerged from the interviews, including staffing, evidence-based practice, information technology, data availability and benchmarking, and leadership. Hospital leaders tend to think about these factors systemically and consider process-related factors as the important drivers of cost and quality. The results suggest a need to expand the methods utilized by health services researchers to make their research more relevant to health care managers. Expanding research methods to reflect the systemic way that managers view the challenges and solutions facing their organizations may enhance the application of research findings into management practice. Finally, better communication is needed between the research and practice communities. Researchers must learn to think more like managers if their research is to be relevant, and managers must learn to more effectively communicate their issues with the research community and frame their problems in researchable terms.

  20. Enhancing Knowledge Sharing and Research Collaboration among Academics: The Role of Knowledge Management

    ERIC Educational Resources Information Center

    Tan, Christine Nya-Ling

    2016-01-01

    Although knowledge sharing (KS) has been acknowledged as important, universities face issues that may hinder active sharing among its faculty members such as the absence of trust among its members or insufficient incentives rewarded to those who deserved it. The aim of this research is to focus on the impact of knowledge management (KM) factors in…

  1. Analysis of Causes of Major Environmental Issues Occurring on Sea Coastlines of the Peter the Great Bay

    NASA Astrophysics Data System (ADS)

    Golikov, S. Yu; Dulepov, V. I.; Maiorov, I. S.

    2017-11-01

    The geoecological assessment of any territory or aquatic area is based on the evaluation of the natural resource potential, conditions and factors influencing its development as well as the analysis of major environmental issues that characterize the current regional state. The monitoring of water ecosystems under the conditions of anthropogenic impact on coastal areas is of significant importance within the study of the conservation and restoration of biodiversity, in the assessment of the dynamics of various environmental factors and their effects on ecosystems and on the bioresources management planning.

  2. Evaluation and review of the safety management system implementation in the Royal Thai Air Force

    NASA Astrophysics Data System (ADS)

    Chaiwan, Sakkarin

    This study was designed to determine situation and effectiveness of the safety management system currently implemented in the Royal Thai Air Force. Reviewing the ICAO's SMS and the RTAF's SMS was conducted to identify similarities and differences between the two safety management systems. Later, the researcher acquired safety statistics from the RTAF Safety Center to investigate effectiveness of its safety system. The researcher also collected data to identify other factors affecting effectiveness of the safety system during conducting in-depth interviews. Findings and Conclusions: The study shows that the Royal Thai Air Force has never applied the International Civil Aviation Organization's Safety management System to its safety system. However, the RTAF's SMS and the ICAO's SMS have been developed based on the same concepts. These concepts are from Richard H. Woods's book, Aviation safety programs: A management handbook. However, the effectiveness of the Royal Thai Air Force's safety system is in good stance. An accident rate has been decreasing regularly but there are no known factors to describe the increasing rate, according to the participants' opinion. The participants have informed that there are many issues to be resolved to improve the RTAF's safety system. Those issues are cooperation among safety center's staffs, attitude toward safety of the RTAF senior commanders, and safety standards.

  3. NGO management and health care financing approaches in the Eastern Democratic Republic of the Congo.

    PubMed

    Dijkzeul, D; Lynch, C A

    2006-01-01

    The role of cost-sharing in health care is a crucial, yet contentious issue. In conflict situations, cost-sharing becomes even more controversial as health and other institutions are failing. In such situations, NGOs manage health programmes which aim to aid populations in crisis and improve or at least sustain a deteriorating health system. This study looks at the issue of cost-sharing in the wider context of utilization rates and management approaches of three NGOs in the chronic, high-mortality crisis of the eastern DRC. Approaches to increase access to health care were found to exist, yet cost-recovery, even on the basis of maximum utilization rates, would only partially sustain the health system in the eastern DRC. Factors external to the direct management of NGO health programs, such as the wider economic and security situation, local management structures, and international donor policies, need to be taken into account for establishing more integrated management and financing approaches.

  4. Obesity Prevention for Individuals with Spina Bifida.

    PubMed

    Polfuss, Michele; Bandini, Linda G; Sawin, Kathleen J

    2017-06-01

    Obesity is a common comorbidity in individuals with spina bifida. Carrying excess weight exacerbates the inherent health challenges associated with spina bifida, impedes the individual's ability to self-manage their condition, and creates further challenges for family members and caregivers. This manuscript provides a narrative review of key issues for understanding and prevention of obesity in persons with spina bifida within the context of the social ecological model. Specific variables related to obesity and spina bifida include individual factors (i.e., body composition and measurement issues, energy needs, eating patterns, physical activity, and sedentary activity) family factors (i.e., parenting/family, peers), community factors (i.e., culture, built environment, healthcare and healthcare providers, and school), and societal factors (i.e., policy issues). Due to the complex etiology of obesity and its increased prevalence in individuals with spina bifida, it is critical to initiate prevention efforts early with a multifactorial approach for this at-risk population. Increased research is warranted to support these efforts.

  5. Proceedings of the Human Factors Society 35th annual meeting

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

    Not Available

    1991-01-01

    These volumes cover the proceedings of the 35th annual meeting of the Human Factors Society. Topics include: designing for the future of nuclear power plants international perspectives on advanced control room design; human performance assessment in the nuclear power industry; validity of strength tests for predicting endurance of coal miners, psychosocial issues in hazard management and nuclear power plants; and human factors at the DOE's national laboratories.

  6. The impact of prescription charges on asthma patients is uneven and unpredictable: evidence from qualitative interviews.

    PubMed

    Schafheutle, Ellen I

    2009-12-01

    To explore whether, and how, prescription charges affect asthma patients' disease management behaviour. Thirty qualitative interviews. Interviewees were aged between 21 and 59, 21 were women, 24 were paying individual prescription charges, and six had prepayment certificates (PPCs). Most had a beta2-agonist 'reliever' and a steroid 'preventer' inhaler. Prescription charges posed affordability issues for some, and for two patients cost-related reduction in 'preventer' use affected asthma control negatively. Many described various ways of keeping medication cost down. Affordability issues, negative views on paying charges, and whether interviewees viewed their asthma medication as essential, were influential factors. Steroid inhalers were viewed more commonly as being less essential and affected by cost. The episodic nature of asthma meant that predicting benefit from PPCs was difficult. This study strengthens existing evidence that medication cost is a factor in asthma patients' management decisions, with a potential cost-related impact on asthma control.

  7. Strategies for individualizing management of patients with metastatic melanoma: a managed care perspective.

    PubMed

    Goldstein, Daniel A; Zeichner, Simon B

    2015-09-01

    The management of metastatic melanoma has been revolutionized in recent years with the development of both targeted therapy and immunotherapy. Although potentially extending the life expectancy for patients, these therapies also significantly increase the healthcare expenditure. In this paper, we review the monthly costs for drugs approved by the FDA since 2011. Additionally, factors that affect the cost, such as dosing strategies, biomarkers, combination therapies, and political/legislative issues, will be discussed.

  8. Risks and Protective Factors for Stress Self-Management in Parents of Children With Autism Spectrum Disorder: An Integrated Review of the Literature.

    PubMed

    Bonis, Susan A; Sawin, Kathleen J

    Stress in parents of children with autism spectrum disorder (ASD) has been reported to be very high. However, little is known about what risk and protective factors influence parental stress self-management in this population. Accordingly, this manuscript is a synthesis of the risk and protective factors that impact self-management of stress in these parents. The concepts in the individual and family self-management theory context domain were used as a framework to guide data collection and analysis. Searches were conducted using CINAHL, MedLine and PsychInfo. Studies were included if they addressed context factors in parents of children with ASD and were written in English. Ninety-eight studies met review criteria. This review highlighted risk factors to parental stress self-management within the context of condition-specific factors, physical and social environment, and individual and family. The most concerning of these findings is that parents struggle accessing a diagnosis and services for their child and are frustrated with health care providers' knowledge of ASD and lack of communication. The risks parents experience as they care for their child with ASD far outweigh the protective factors for self-management of parental stress. Nurses who are aware of these issues can make important changes to their practice and have a significant impact on parental stress self-management and the care of children with ASD. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Nutritional issues in heart transplant candidates and recipients.

    PubMed

    Amarelli, Cristiano; Buonocore, Marianna; Romano, Gianpaolo; Maiello, Ciro; De Santo, Luca Salvatore

    2012-01-01

    Heart transplant is the golden standard in the management of end-stage heart failure. Recent studies have pointed out the role of nutritional issues in patients evaluated for heart transplant listing. In particular, extremes in body habitus, cachexia and obesity, have been characterized and identified as independent prognostic factors and clinically relevant target for therapeutic interventions. Effects of such conditions exert a prognostic implication well beyond waiting time up to early post transplant setting. Changes in posttransplant clinical conditions and nutritional status have been recently described in their pattern of presentation and implications on weight gain, reversal of preoperative cachexia and early and late morbidity and mortality. New onset diabetes mellitus and metabolic syndrome have been disclosed as relevant clinical conditions in this setting. Implications for tailoring of immunosuppressive therapy and dietary prescription emerged as main stem of long term recipient management. All this issues have been reviewed focusing on the clinical relevance of this growing body of knowledge and emphasizing the role of a multidisciplinary approach for selection and management of heart transplant recipients.

  10. Evidence-based disease management: its role in cardiovascular risk reduction.

    PubMed

    Fanning, Etta L

    2004-01-01

    Cardiovascular disease remains the most pressing healthcare problem in the United States. Traditional risk factors--hypertension, obesity, and diabetes-are still unresolved issues; and new risk factors--pre-diabetes, insulin resistance, and pediatric and adolescent diabetes-have emerged. There is an urgent need to identify the risk factors for cardiovascular disease, and address risk reduction with disease management and treatment for each factor, based on qualitative and quantitative approaches for developing the evidence base for public health action. The objectives of this paper are to review (i) the burden of cardiovascular illness-morbidity, mortality, and cost; (ii) risk factors and the emerging epidemic of adolescent obesity; (iii) the challenges of attaining target endpoints; and (iv) the attributes of a successful programmatic healthcare initiative for potential impact on cardiovascular care and, eventually, public health.

  11. Overview of Contemporary Issues of Forest Research and Management in China

    NASA Astrophysics Data System (ADS)

    He, Hong S.; Shifley, Stephen R.; Thompson, Frank R.

    2011-12-01

    With 207 million ha of forest covering 22% of its land area, China ranks fifth in the world in forest area. Rapid economic growth, climate change, and forest disturbances pose new, complex challenges for forest research and management. Progress in meeting these challenges is relevant beyond China, because China's forests represent 34% of Asia's forests and 5% of the worlds' forests. To provide a broader understanding of these management challenges and of research and policies that address them, we organized this special issue on contemporary forest research and management issues in China. At the national level, papers review major forest types and the evolution of sustainable forestry, the development of China's forest-certification efforts, the establishment of a forest inventory system, and achievements and challenges in insect pest control in China. Papers focused on Northern China address historical, social, and political factors that have shaped the region's forests; the use of forest landscape models to assess how forest management can achieve multiple objectives; and analysis and modeling of fuels and fire behavior. Papers addressing Central and South China describe the "Grain for Green" program, which converts low productivity cropland to grassland and woodland to address erosion and soil carbon sequestration; the potential effects of climate change on CO2 efflux and soil respiration; and relationships between climate and net primary productivity. China shares many forest management and research issues with other countries, but in other cases China's capacity to respond to forest management challenges is unique and bears watching by the rest of the world.

  12. Breaking the glass ceiling.

    PubMed

    Lazarus, A

    1997-03-01

    The glass ceiling is a form of organizational bias and discrimination that prevents qualified professionals from achieving positions of top governance and leadership. This article examines glass ceiling barriers that keep physicians from the upper reaches of management. While these factors apply mainly to women and minority physicians in academia, and are attributable to sexual harassment and discrimination, physicians as a class are frequently denied executive management positions. Such denial results from inadequate preparation for a career in health care administration. Important issues in the professional development of physician executives include mentoring, training and education, administrative experience, and cultural and personality factors. All of those must be considered when making the transition from medicine to management.

  13. Veterinary teaching hospitals: current challenges and pathways for the future.

    PubMed

    Hubbell, John A E

    2008-01-01

    University-based veterinary teaching hospitals must change to maintain their viability. A number of factors both internal and external to universities and the veterinary profession have contributed to the need for change. A task force formed by the Association of American Veterinary Medical Colleges and the American Association of Veterinary Clinicians was convened to identify the issues and propose individual and collective strategies for the future. Primary issues include a shortage of faculty and staff, the nature of the case load, the need for fiscal management strategies, and the need to manage stakeholder expectations. The majority of the proposed strategies for the future will be managed individually by the colleges. Proposed collective strategies center on increasing the number of specialists and improving recruitment and retention of faculty and staff.

  14. Towards an evaluation framework for information quality management (IQM) practices for health information systems--evaluation criteria for effective IQM practices.

    PubMed

    Mohammed, Siti Asma; Yusof, Maryati Mohd

    2013-04-01

    Poor information quality (IQ) must be understood as a business problem rather than systems problem. In health care organization, what is required is an effective quality management that continuously manages and reviews the factors influencing IQ in health information systems (HIS) so as to achieve the desired outcomes. Hence, in order to understand the issues of information quality management (IQM) practices in health care organizations, a more holistic evaluation study should be undertaken to investigate the IQM practices in health care organizations. It is the aim of this paper to identify the significant evaluation criteria that influence the production of good IQ in HIS. Six selected frameworks and best practices both from health informatics and information systems literature have been reviewed to identify the evaluation criteria from the perspective of human, organizational and technological factors. From the review, it was found that human and organization factors are of greater significance in influencing HIS IQ. Our review depicts that there is still shortage in finding a comprehensive IQM evaluation framework. Thus, the criteria from the frameworks reviewed can be used in combination for more comprehensive evaluation criteria. Integrated IQM evaluation criteria for HIS are then proposed in this study. Poor IQ is the result of complex interdependency within sociotechnical factors in health care organization and lack of formal and structured IQM practices. Thus, a feedback mechanism such as evaluation is needed to understand the issues in depth in the future. © 2012 Blackwell Publishing Ltd.

  15. SAFE FOOD

    EPA Science Inventory

    NHEERL research is providing the scientific basis for policy decisions regarding the need for an additional safety factor for children, the need to assess cumulative exposures, and the best way to deal with risk management issues related to common mode of action. Research can be ...

  16. Final Environmental Impact Statement. Disposal and Reuse of Norton Air Force Base, California

    DTIC Science & Technology

    1993-06-01

    transportation, utilities, hazardous materials/wastes, soils and geology, water resources, air quality, noise, biological resources, and cultural resources...as project-related influencing factors. Issues related to current and future management of hazardous materials and wastes are also discussed...34 Hazardous Materials/ Hazardous Waste Management (Sections 3.3 and 4.3) includes expanded discussions on the following: - FFA schedule moved from

  17. Does Management Really Matter? And If so, to Who?: Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

    PubMed

    Dovlo, Delanyo

    2015-12-03

    The editorial is commendable and I agree with many of the points raised. Management is an important aspect of health system strengthening which is often overlooked. In order to build the capacity of management, we need to consider other factors such as, the environment within which managers work, their numbers, support systems and distribution. Effective leadership is an issue which cannot be overemphasized as part of management capacity in resource deprived settings as difficult settings require leadership skills in order to achieve managerial success. A primary issue of importance highlighted in the editorial is country ownership of management effectiveness initiatives, which may be very difficult when the health sector is dependent on support and funding from donors and influential partners, who drive change often without a good understanding of the context. How partners finance health programmes is another dilemma as it can distract from locally determined priorities. Further research should help us to understand better what works and under different settings. © 2016 by Kerman University of Medical Sciences.

  18. Exploring parental factors related to weight management in survivors of childhood central nervous system tumors.

    PubMed

    Santa Maria, Diane; Swartz, Maria C; Markham, Christine; Chandra, Joya; McCurdy, Sheryl; Basen-Engquist, Karen

    2014-01-01

    Childhood central nervous system tumor survivors (CCNSTS) are at risk for adverse health issues. Little research has been conducted to explore the role of parental factors in weight management to mitigate adverse health outcomes. We conducted 9 group interviews (n=20) with CCNSTS, their parents, and health care providers to ascertain parental factors that may influence weight management practices in CCNSTS. Three main themes were identified: parenting style, parent-child connectedness, and food and physical activity (PA) environment. Although most parents adopted an authoritative parenting style related to diet and PA practices, some adopted a permissive parenting style. Participants expressed high levels of connection that may hinder the development of peer relationships and described the food and PA environments that promote or hinder weight management through parental modeling of healthy eating and PA and access to healthy food and activities. Weight management interventions for CCNSTS may experience greater benefit from using a family-focused approach, promoting positive food and PA environments, parental modeling of healthy eating and exercise, and partnering with youth to adopt weight management behaviors.

  19. Innovative solutions for intractable water problems in the face of climate change in southern and East African sub regions

    NASA Astrophysics Data System (ADS)

    Mapani, Benjamin; Makurira, Hodson; Magole, Lapologang; Meck, Maideyi; Mkandawire, Theresa; Mul, Marloes; Ngongondo, Cosmo

    2018-06-01

    This issue has a total of thirty-two (32) papers; and covers the IWRM sub themes of Hydrology, Land and People, Water Resources Management, Water and Environment and Wastewater and Sanitation. Water issues have become more and more complex as the supply side is affected by issues of quantity, availability and vulnerability due to natural factors such as climate change and urbanization. These challenges call for new management strategies and governance styles. Access to clean freshwater is a basic requirement for enhanced quality of life and development by all. However, this access has three main components that must be met adequately as this issue illustrates. These components are firstly, the quantity of water available; secondly, the quality and thirdly supply and appropriate delivery of this precious resource to domestic, commercial and industrial users. The demand side has also become more challenging, especially in urban areas as more and more people move from the rural areas to the cities. It has become a daily challenge in many African cities to supply water to these new urban dwellers and more so in unplanned settlements. These issues require a way and manner of delivering solutions and new innovative ideas. The topics in this issue vary from climate variability and how we are to improve our management strategies to mitigation, through to vulnerability of water resources and how to strengthen governance issues that plague some institutions in our region.

  20. Psychosocial Issues in Geriatric Rehabilitation.

    PubMed

    Rodriguez, Ricardo M

    2017-11-01

    Geriatric patients present multiple age-related challenges and needs that must be taken into account during the rehabilitation process to achieve expected goals. This article examines the importance of identifying and managing psychosocial issues commonly observed in older adults and presents strategies to optimize their rehabilitation process. Depression, anxiety, fear of falling, adjustment issues, neurocognitive disorders, and caregiver support are discussed as a selection of factors that are relevant for geriatric patients undergoing rehabilitation. An argument is made for the importance of comprehensive geriatric assessment in older adults to identify salient issues that may impact rehabilitation and quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Principles of disaster management lesson. 12: structuring organizations.

    PubMed

    Cuny, F C

    2001-01-01

    This lesson discusses various structures for organizations that have functional roles in disaster responses, relief, and/or management activities. It distinguishes between pyramidal and matrix structures, and notes the advantages and disadvantages of each in relation to disasters. Span of control issues are dissected including the impact of the "P" factor on the performance of disaster managers and workers including its relationship to the coordination and control function. The development of a Table of Organization and how it relates to departmentalization within an organization also is provided.

  2. Knowledge management and informatics considerations for comparative effectiveness research: a case-driven exploration.

    PubMed

    Embi, Peter J; Hebert, Courtney; Gordillo, Gayle; Kelleher, Kelly; Payne, Philip R O

    2013-08-01

    As clinical data are increasingly collected and stored electronically, their potential use for comparative effectiveness research (CER) grows. Despite this promise, challenges face those wishing to leverage such data. In this paper we aim to enumerate some of the knowledge management and informatics issues common to such data reuse. After reviewing the current state of knowledge regarding biomedical informatics challenges and best practices related to CER, we then present 2 research projects at our institution. We analyze these and highlight several common themes and challenges related to the conduct of CER studies. Finally, we represent these emergent themes. The informatics challenges commonly encountered by those conducting CER studies include issues related to data information and knowledge management (eg, data reuse, data preparation) as well as those related to people and organizational issues (eg, sociotechnical factors and organizational factors). Examples of these are described in further detail and a formal framework for describing these findings is presented. Significant challenges face researchers attempting to use often diverse and heterogeneous datasets for CER. These challenges must be understood in order to be dealt with successfully and can often be overcome with the appropriate use of informatics best practices. Many research and policy questions remain to be answered in order to realize the full potential of the increasingly electronic clinical data available for such research.

  3. Methods for assessment of keel bone damage in poultry.

    PubMed

    Casey-Trott, T; Heerkens, J L T; Petrik, M; Regmi, P; Schrader, L; Toscano, M J; Widowski, T

    2015-10-01

    Keel bone damage (KBD) is a critical issue facing the laying hen industry today as a result of the likely pain leading to compromised welfare and the potential for reduced productivity. Recent reports suggest that damage, while highly variable and likely dependent on a host of factors, extends to all systems (including battery cages, furnished cages, and non-cage systems), genetic lines, and management styles. Despite the extent of the problem, the research community remains uncertain as to the causes and influencing factors of KBD. Although progress has been made investigating these factors, the overall effort is hindered by several issues related to the assessment of KBD, including quality and variation in the methods used between research groups. These issues prevent effective comparison of studies, as well as difficulties in identifying the presence of damage leading to poor accuracy and reliability. The current manuscript seeks to resolve these issues by offering precise definitions for types of KBD, reviewing methods for assessment, and providing recommendations that can improve the accuracy and reliability of those assessments. © 2015 Poultry Science Association Inc.

  4. End-User Imaging DISKussions.

    ERIC Educational Resources Information Center

    McConnell, Pamela Jean

    1993-01-01

    This third in a series of articles on EDIS (Electronic Document Imaging System) technology focuses on organizational issues. Highlights include computer platforms; management information systems; computer-based skills of staff; new technology and change; time factors; financial considerations; document conversion costs; the benefits of EDIS…

  5. Fiscal Issues in Higher Education.

    ERIC Educational Resources Information Center

    Rigolot, Carol, Ed.

    Forty colleges and life insurance presidents met to discuss key historical and contemporary factors influencing fiscal management in higher education, including inflation, salaries, diminishing enrollment figures, energy costs, federal regulations and the increasing cost of research. Differences and similarities between business and academia were…

  6. Business continuity management in emerging markets: the case of Jordan.

    PubMed

    Sawalha, Ihab H; Anchor, John R

    2012-01-01

    Despite their considerable growth in last few decades, emerging markets (EM) face numerous risks that have the potential to slow down or obstruct their development. Three main issues are discussed in this paper: first, the risks facing organisations operating in emerging markets and Jordan in particular; secondly, the role of business continuity management (BCM) in emerging markets; and thirdly, potential factors that underpin the role of BCM in emerging markets. These issues are significant, as they represent the role of BCM in highly dynamic and fast changing business environments. The paper provides a discussion of the significance of BCM in reducing or preventing risks facing organisations operating in emerging markets, especially those in Jordan.

  7. Ethical decision making in pain management: a conceptual framework

    PubMed Central

    Carvalho, Ana Sofia; Martins Pereira, Sandra; Jácomo, António; Magalhães, Susana; Araújo, Joana; Hernández-Marrero, Pablo; Costa Gomes, Carlos; Schatman, Michael E

    2018-01-01

    Introduction The practice and study of pain management pose myriad ethical challenges. There is a consensual opinion that adequate management of pain is a medical obligation rooted in classical Greek practice. However, there is evidence that patients often suffer from uncontrolled and unnecessary pain. This is inconsistent with the leges artis, and its practical implications merit a bioethical analysis. Several factors have been identified as causes of uncontrolled and unnecessary pain, which deprive patients from receiving appropriate treatments that theoretically they have the right to access. Important factors include (with considerable regional, financial, and cultural differences) the following: 1) failure to identify pain as a priority in patient care; 2) failure to establish an adequate physician–patient relationship; 3) insufficient knowledge regarding adequate prescription of analgesics; 4) conflicting notions associated with drug-induced risk of tolerance and fear of addiction; 5) concerns regarding “last-ditch” treatments of severe pain; and 6) failure to be accountable and equitable. Objective The aim of this article was to establish that bioethics can serve as a framework for addressing these challenging issues and, from theoretical to practical approaches, bioethical reflection can contextualize the problem of unrelieved pain. Methods This article is organized into three parts. First, we illustrate that pain management and its undertreatment are indeed ethical issues. The second part describes possible ethical frameworks that can be combined and integrated to better define the ethical issues in pain management. Finally, we discuss possible directions forward to improve ethical decision making in pain management. Discussion We argue that 1) the treatment of pain is an ethical obligation, 2) health science schools, especially medical training institutions, have the duty to teach pain management in a comprehensive fashion, and 3) regulatory measures, which prevent patients from access to opioid treatment as indicated in their cases, are unethical and should be reconsidered. Conclusion Developing an ethical framework for pain management will result in enhanced quality of care, linking the epistemic domains of pain management to their anthropological foundations, thereby making them ethically sound. PMID:29844699

  8. Management of processes of electrochemical dimensional processing

    NASA Astrophysics Data System (ADS)

    Akhmetov, I. D.; Zakirova, A. R.; Sadykov, Z. B.

    2017-09-01

    In different industries a lot high-precision parts are produced from hard-processed scarce materials. Forming such details can only be acting during non-contact processing, or a minimum of effort, and doable by the use, for example, of electro-chemical processing. At the present stage of development of metal working processes are important management issues electrochemical machining and its automation. This article provides some indicators and factors of electrochemical machining process.

  9. Time to get serious about assessing - and managing - psychosocial issues associated with chronic wounds.

    PubMed

    Alexander, Susan J

    2013-03-01

    This article comprises a review of the literature published during the period January 2011 to June 2012 on the topic of the psychosocial impact of wounds and strategies to manage them. There is a growing discussion of the reciprocal link between psychological influences and wound healing. Although the mechanisms underlying these influences are not well understood, evidence from the reviewed literature adds to the existing body of evidence demonstrating that negative psychological states can impair immune function and wound healing. Despite this recognition, there are still few studies that provide strategies to address the identified psychosocial issues associated with wounds, particularly those of chronic duration. A wide range of psychosocial factors likely to be associated with a wound have been identified. The importance of understanding the nature and extent of their impact is illustrated by the patients' experiences of living with a chronic wound which they rate as serious as cancer or myocardial infarction. Although there is currently limited evidence on which to base management strategies, it is recommended that interventions should commence with a comprehensive individualized assessment which can then inform the development of an appropriate management plan that includes the identified psychosocial issues.

  10. Hyperpigmentation therapy: a review.

    PubMed

    Desai, Seemal R

    2014-08-01

    With an increasing number of multicultural patients and those of different backgrounds presenting in dermatology clinics, issues facing patients with higher Fitzpatrick skin classifications, often referred to as skin of color patients, are on the rise. Knowledge of the diagnostic dilemmas, cutting edge treatment options, and latest clinical research in the diagnosis and management of cutaneous anomalies in skin of color patients is of paramount importance. Of the most common complaints in patients with skin of color is hyperpigmentation. Despite the availability of multiple treatments for the condition, hyperpigmentation continues to present clinical management challenges for dermatologists. Difficulty may be traced to physician or patient reluctance to use certain agents or interventions, failure to identify and avoid contributing factors, and insufficient attention paid to the psychosocial aspects of the disease. This review addresses a variety of issues including the diagnosis and management of hyperpigmentation.

  11. Individual patient's preferences for hypertension management: a Q-methodological approach.

    PubMed

    Morecroft, Charles; Cantrill, Judy; Tully, Mary P

    2006-06-01

    To systematically explore and elicit individual patient's preferences in the management of their hypertension using Q-methodology. Using Q-methodology, 120 patients ranking 42 statements according to their agreement or disagreement when considering appropriate hypertension management. The statements were derived from an earlier qualitative study. Factor analysis of the data was undertaken using PQMethod software to determine if any patterns were discernible. Ninety-two patients clustered to five factors, which all varied in the degree of involvement patients had, or wished to have, in their hypertension management. The 42 patients who loaded to factor 1 considered that appropriate antihypertensive treatment involved leaving medical decisions to their GPs and trusting their judgement in such matters. The patients (n = 31) who positively loaded to factor 2 suggested that an autonomous relationship with their healthcare professional(s) was an important issue when considering treatment. It is concluded that this study has successfully used Q-methodology to systematically investigate people's subjectivity and developed a novel approach to elicit the views of individual patients, as well as explore and differentiate between groups of patients. The formation of true partnerships between patients and healthcare professionals which will enhance individual patients' ability to self-manage chronic disease.

  12. Identification and Characterization of Key Human Performance Issues and Research in the Next Generation Air Transportation System (NextGen)

    NASA Technical Reports Server (NTRS)

    Lee, Paul U.; Sheridan, Tom; Poage, james L.; Martin, Lynne Hazel; Jobe, Kimberly K.

    2010-01-01

    This report identifies key human-performance-related issues associated with Next Generation Air Transportation System (NextGen) research in the NASA NextGen-Airspace Project. Four Research Focus Areas (RFAs) in the NextGen-Airspace Project - namely Separation Assurance (SA), Airspace Super Density Operations (ASDO), Traffic Flow Management (TFM), and Dynamic Airspace Configuration (DAC) - were examined closely. In the course of the research, it was determined that the identified human performance issues needed to be analyzed in the context of NextGen operations rather than through basic human factors research. The main gaps in human factors research in NextGen were found in the need for accurate identification of key human-systems related issues within the context of specific NextGen concepts and better design of the operational requirements for those concepts. By focusing on human-system related issues for individual concepts, key human performance issues for the four RFAs were identified and described in this report. In addition, mixed equipage airspace with components of two RFAs were characterized to illustrate potential human performance issues that arise from the integration of multiple concepts.

  13. 14 CFR 91.1017 - Amending program manager's management specifications.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... proposed amendment. (2) The Flight Standards District Office that issued the program manager's management... presented, the Flight Standards District Office that issued the program manager's management specifications... Standards District Office that issued the program manager's management specifications issues an amendment of...

  14. 14 CFR 91.1017 - Amending program manager's management specifications.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... proposed amendment. (2) The Flight Standards District Office that issued the program manager's management... presented, the Flight Standards District Office that issued the program manager's management specifications... Standards District Office that issued the program manager's management specifications issues an amendment of...

  15. Contemporary Issues of Occupational Education in Finland.

    ERIC Educational Resources Information Center

    Lasonen, Johanna, Ed.; Stenstrom, Marja-Leena, Ed.

    This book contains 28 papers about the current status of occupational education in Finland, with special emphasis on context factors, structural and pedagogical reform, and quality management. The following papers are included: "Introduction of Educational Structure in Finland" (Johanna Lasonen, Marja-Leena Stenstrom); "Vocational…

  16. 77 FR 65372 - Agency Information Collection Activities; Submission to the Office of Management and Budget for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... System. OMB Control Number: Pending. Type of Review: New collection, request for a new OMB Control Number... been issued the required two factor authentication tokens can access the FS SAS. The FS SAS allows...

  17. The drivers of sea lice management policies and how best to integrate them into a risk management strategy: An ecosystem approach to sea lice management.

    PubMed

    Jackson, D; Moberg, O; Stenevik Djupevåg, E M; Kane, F; Hareide, H

    2018-06-01

    The control of sea lice infestations on cultivated Atlantic salmon is a major issue in many regions of the world. The numerous drivers which shape the priorities and objectives of the control strategies vary for different regions/jurisdictions. These range from the animal welfare and economic priorities of the producers, to the mitigation of any potential impacts on wild stocks. Veterinary ethics, environmental impacts of therapeutants, and impacts for organic certification of the produce are, amongst others, additional sets of factors which should be considered. Current best practice in both EU and international environmental law advocates a holistic ecosystem approach to assessment of impacts and risks. The issues of biosecurity and ethics, including the impacts on the stocks of species used as cleaner fish, are areas for inclusion in such a holistic ecosystem assessment. The Drivers, Pressures, State, Impacts, Responses (DPSIR) process is examined as a decision-making framework and potential applications to sea lice management are outlined. It is argued that this is required to underpin any integrated sea lice management (ISLM) strategy to balance pressures and outcomes and ensure a holistic approach to managing the issue of sea lice infestations on farmed stock on a medium to long-term basis. © 2017 The Authors. Journal of Fish Diseases Published by John Wiley & Sons Ltd.

  18. Investigating motivating factors for sound hospital waste management.

    PubMed

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz

    2016-08-01

    Sustainable management of hospital waste requires an active involvement of all key players. This study aims to test the hypothesis that three motivating factors, namely, Reputation, Liability, and Expense, influence hospital waste management. The survey for this study was conducted in two phases, with the pilot study used for exploratory factor analysis and the subsequent main survey used for cross-validation using confirmatory factor analysis. The hypotheses were validated through one-sample t tests. Correlations were established between the three motivating factors and organizational characteristics of hospital type, location, category, and size. The hypotheses were validated, and it was found that the factors of Liability and Expense varied considerably with respect to location and size of a hospital. The factor of Reputation, however, did not exhibit significant variation. In conclusion, concerns about the reputation of a facility and an apprehension of liability act as incentives for sound hospital waste management, whereas concerns about financial costs and perceived overburden on staff act as disincentives. This paper identifies the non economic motivating factors that can be used to encourage behavioral changes regarding waste management at hospitals in resource constrained environments. This study discovered that organizational characteristics such as hospital size and location cause the responses to vary among the subjects. Hence a policy maker must take into account the institutional setting before introducing a change geared towards better waste management outcomes across hospitals. This study covers a topic that has hitherto been neglected in resource constrained countries. Thus it can be used as one of the first steps to highlight and tackle the issue.

  19. Contrasting Eutrophication Risks and Countermeasures in Different Water Bodies: Assessments to Support Targeted Watershed Management.

    PubMed

    Li, Tong; Chu, Chunli; Zhang, Yinan; Ju, Meiting; Wang, Yuqiu

    2017-06-29

    Eutrophication is a major problem in China. To combat this issue, the country needs to establish water quality targets, monitoring systems, and intelligent watershed management. This study explores a new watershed management method. Water quality is first assessed using a single factor index method. Then, changes in total nitrogen/total phosphorus (TN/TP) are analyzed to determine the limiting factor. Next, the study compares the eutrophication status of two water function districts, using a comprehensive nutritional state index method and geographic information system (GIS) visualization. Finally, nutrient sources are qualitatively analyzed. Two functional water areas in Tianjin, China were selected and analyzed: Qilihai National Wetland Nature Reserve and Yuqiao Reservoir. The reservoir is a drinking water source. Results indicate that total nitrogen (TN) and total phosphorus (TP) pollution are the main factors driving eutrophication in the Qilihai Wetland and Yuqiao Reservoir. Phosphorus was the limiting factor in the Yuqiao Reservoir; nitrogen was the limiting factor in the Qilihai Wetland. Pollution in Qilihai Wetland is more serious than in Yuqiao Reservoir. The study found that external sources are the main source of pollution. These two functional water areas are vital for Tianjin; as such, the study proposes targeted management measures.

  20. Spirituality and Religion in Pain and Pain Management

    PubMed Central

    Dedeli, Ozden; Kaptan, Gulten

    2013-01-01

    Pain relief is a management problem for many patients, their families, and the medical professionals caring for them. Although everyone experiences pain to some degree, responses to it vary from one person to another. Recognizing and specifying someone else’s pain is clinically a well know challenge. Research on the biology and neurobiology of pain has given us a relationship between spirituality and pain. There is growing recognition that persistent pain is a complex and multidimensional experience stemming from the interrelations among biological, psychological, social, and spiritual factors. Patients with pain use a number of cognitive and behavioral strategies to cope with their pain, including religious/spiritual factors, such as prayers, and seeking spiritual support to manage their pain. This article provides an overview of the complex phenomenon of pain, with a focus on spiritual and religious issues in pain management. PMID:26973914

  1. Approaches to acceptable risk

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

    Whipple, C

    Several alternative approaches to address the question {open_quotes}How safe is safe enough?{close_quotes} are reviewed and an attempt is made to apply the reasoning behind these approaches to the issue of acceptability of radiation exposures received in space. The approaches to the issue of the acceptability of technological risk described here are primarily analytical, and are drawn from examples in the management of environmental health risks. These include risk-based approaches, in which specific quantitative risk targets determine the acceptability of an activity, and cost-benefit and decision analysis, which generally focus on the estimation and evaluation of risks, benefits and costs, inmore » a framework that balances these factors against each other. These analytical methods tend by their quantitative nature to emphasize the magnitude of risks, costs and alternatives, and to downplay other factors, especially those that are not easily expressed in quantitative terms, that affect acceptance or rejection of risk. Such other factors include the issues of risk perceptions and how and by whom risk decisions are made.« less

  2. Psychosocial and Behavioral Factors Associated with Bowel and Bladder Management after SCI

    DTIC Science & Technology

    2013-10-01

    feelings of shame , lack of intimacy and sexuality are just some of the issues associated with neurogenic bladder and bowel. Adjusting to losses related...independence, community participation, respect, feelings of shame , lack of intimacy and sexuality are just some of the issues associated with neurogenic...Always Cardiovascular 1. I avoid smoking cigarettes. 0 1 2 3 4 2. I limit the amount of fat and cholesterol in my diet (for example, I limit red

  3. The leadership/management role: a differentiating factor for ADN/BSN programs?

    PubMed

    Schank, M J; Stollenwerk, R

    1988-06-01

    The resurgence of the ADN/BSN issue relative to educational preparation and roles and the concomitant development of positions taken by the professional associations and National Commission on Nursing pointed to the need for study of current ADN/BSN curricula and utilization of graduates. Based upon a brief historical literature review and ADN/BSN competency statements, the leadership/management role was selected for study as a possible differentiating factor between these programs. Findings from a statewide study of ADN and BSN programs and a representative sample of nurse executives indicated that an education and service dilemma exists relative to this role. The majority of ADN program directors noted that a leadership/management component should be part of ADN curricula, whereas BSN program directors did not concur. Nurse executives utilized ADN graduates in leadership/management positions and stated that length of experience was an influencing factor in selection. Numerous other findings showed a discrepancy in beliefs and practices among educators and nurse executives. This survey demonstrates the need for curriculum changes and role clarification. The leadership/management role may be a viable area for consideration.

  4. Human risk factors associated with pilots in runway excursions.

    PubMed

    Chang, Yu-Hern; Yang, Hui-Hua; Hsiao, Yu-Jung

    2016-09-01

    A breakdown analysis of civil aviation accidents worldwide indicates that the occurrence of runway excursions represents the largest portion among all aviation occurrence categories. This study examines the human risk factors associated with pilots in runway excursions, by applying a SHELLO model to categorize the human risk factors and to evaluate the importance based on the opinions of 145 airline pilots. This study integrates aviation management level expert opinions on relative weighting and improvement-achievability in order to develop four kinds of priority risk management strategies for airline pilots to reduce runway excursions. The empirical study based on experts' evaluation suggests that the most important dimension is the liveware/pilot's core ability. From the perspective of front-line pilots, the most important risk factors are the environment, wet/containment runways, and weather issues like rain/thunderstorms. Finally, this study develops practical strategies for helping management authorities to improve major operational and managerial weaknesses so as to reduce the human risks related to runway excursions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Consideration of Environmental Factors in Planning and Development of Urban Areas

    NASA Astrophysics Data System (ADS)

    Kustysheva, I.

    2017-11-01

    Environmental factors, in varying degrees, always have a direct influence on the urban environment formation and the provision of favorable and safe conditions for the life of the population. Their role in the planning and development of urban areas remains an integral part of the management of such areas. Management should be aimed at improving the efficiency of use of the territories and ecological environment improvement. Planning must be done with the consideration of identified ecological processes in cities on the basis of the information about their occurrence in the past and present. Currently, cities face a multitude of problems that require urgent and immediate solutions. One of the most important issues is the poor state of the urban environment, so the environmental factors remain one of the most critical problems that should be considered by the authorities while implementing the urban areas’ development plans. The article discusses the role of environmental factors in the management and planning of urban territories by the example of the city of Tobolsk.

  6. Evolution of China's water issues as framed in Chinese mainstream newspaper.

    PubMed

    Xiong, Yonglan; Wei, Yongping; Zhang, Zhiqiang; Wei, Jing

    2016-03-01

    There is an urgent need globally to trigger fundamental societal changes in water management away from existing unsustainable paradigms. This paper attempts to understand the evolution of newspaper coverage of water issues in China by analyzing water-related articles in a major national newspaper, the People's Daily, over the period 1946-2012 using a content analysis approach. The major findings include the following: (1) water issues were in relatively prominent positions in the newspaper; (2) the reporting of water issues in China experienced three stages: 1946 to the middle of 1980s-flood and drought control and water for food production, the middle of 1980s to 1997-water for economic development, and 1998 to the present-water for the environmental sustainability and economic development; (3) the reporting of water issues in the People's Daily clearly reflected China's top-down water resources management system, and no "real" public opinions on water were reported during the study period; and (4) the People's Daily is just a wind vane of Chinese mainstream values and policies on water. The findings supported the realist assumption that the societal value changes on water issues in China were triggered by a range of factors including biophysical pressure (floods and droughts), political campaign (the Cultural Revolution), macro-economic reform (Reform and Opening-up), water institutional arrangement (the Water Law), and water management reform (the No. 1 Central Document on water reform). While there are similarities and differences between this study and other studies, important implications for more sustainable water management are a need to strengthen academic specialists' and NGO's voices in the newspaper to create a better informed public, and to stimulate practices toward sustainable water use.

  7. North America Wound, Ostomy, and Continence and Enterostomal Therapy Nurses Current Ostomy Care Practice Related to Peristomal Skin Issues.

    PubMed

    Colwell, Janice C; McNichol, Laurie; Boarini, Joy

    The purpose of this study was to describe the practice of 796 ostomy nurses in North America in 2014 related to peristomal skin issues. Descriptive study. Participants were 796 wound, ostomy, and continence (WOC) and enterostomal therapy (ET) nurses currently practicing in the United States or Canada and caring for patients with ostomies. The collection of data occurred in conjunction with an educational program on peristomal skin complications and practice issues and solicited the participant's perception on the incidence and frequency of peristomal skin issues as well as on practice patterns. Participants attended an educational program. They were also asked to anonymously respond to multiple-choice questions on ostomy care management via an audience response system followed by discussion of each item and their responses. This descriptive study reports on the answers to the questions as well as the pertinent discussion points. Participants estimated that approximately 77.70% of their patients developed peristomal skin issues. The most commonly encountered problem was irritant contact dermatitis (peristomal moisture-associated skin damage). Contributing factors were inappropriate use of a pouching system owing to lack of follow-up after hospital discharge. Reported interventions for the prevention and management of peristomal skin issues included preoperative stoma site marking, use of a convex pouching system, and barrier rings. However, subsequent discussion revealed that the frequency of use of these products varied considerably. Participants identified shortened hospital stays, absence of preoperative stoma marking, and limited outpatient follow-up as contributing to development of peristomal skin problems. WOC and ET nurses estimate that more than three-quarters of persons living with an ostomy develop peristomal skin problems. Multiple interventions for managing these problems were identified, but some variability in management approaches emerged.

  8. Road safety issues for bus transport management.

    PubMed

    Cafiso, Salvatore; Di Graziano, Alessandro; Pappalardo, Giuseppina

    2013-11-01

    Because of the low percentage of crashes involving buses and the assumption that public transport improves road safety by reducing vehicular traffic, public interest in bus safety is not as great as that in the safety of other types of vehicles. It is possible that less attention is paid to the significance of crashes involving buses because the safety level of bus systems is considered to be adequate. The purpose of this study was to evaluate the knowledge and perceptions of bus managers with respect to safety issues and the potential effectiveness of various technologies in achieving higher safety standards. Bus managers were asked to give their opinions on safety issues related to drivers (training, skills, performance evaluation and behaviour), vehicles (maintenance and advanced devices) and roads (road and traffic safety issues) in response to a research survey. Kendall's algorithm was used to evaluate the level of concordance. The results showed that the majority of the proposed items were considered to have great potential for improving bus safety. The data indicated that in the experience of the participants, passenger unloading and pedestrians crossing near bus stops are the most dangerous actions with respect to vulnerable users. The final results of the investigation showed that start inhibition, automatic door opening, and the materials and internal architecture of buses were considered the items most strongly related to bus passenger safety. Brake assistance and vehicle monitoring systems were also considered to be very effective. With the exception of driver assistance systems for passenger and pedestrian safety, the perceptions of the importance of other driver assistance systems for vehicle monitoring and bus safety were not unanimous among the bus company managers who participated in this survey. The study results showed that the introduction of new technologies is perceived as an important factor in improving bus safety, but a better understanding of their actual effectiveness and related risk factor avoidance must be developed to permit their useful implementation in bus fleets. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. The University as a Land Developer.

    ERIC Educational Resources Information Center

    Fink, Ira

    1983-01-01

    To assist universities in developing or redeveloping surplus campus or endowment property, these factors in the process are outlined and discussed: development decisions, working with a developer, ground leasing, unrelated taxable income issues, creating a university land management office, some recent experiences, and research and development…

  10. CD-ROM: Potential and Pitfalls.

    ERIC Educational Resources Information Center

    Dreiss, L. Jack; Bashir, Shahzad

    1990-01-01

    Examines issues surrounding CD-ROM as an organizational information management tool: (1) the CD-ROM market; (2) pitfalls, including compatibility, effect on existing information systems, fear of obsolescence, protection of sensitive information, and lack of successful role models; and (3) factors that will fuel growth, including greater…

  11. Factors influencing the development and implementation of advanced radiographer practice in Australia – a qualitative study using an interpretative phenomenological approach

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

    Page, Barbara A, E-mail: barbpage09@gmail.com; Bernoth, Maree; Davidson, Rob

    2014-09-15

    The purpose of this study was to explore the factors influencing the implementation or the lack of implementation of advanced practitioner role in Australia. This study uses an interpretative phenomenological approach to explore the in-depth real life issues, which surround the advanced practitioner as a solution to radiologist workforce shortages in Australia. Research participants are radiographers, radiation therapists and health managers registered with the Australian Institute of Radiography (AIR) and holding senior professional and AIR Board positions with knowledge of current advanced practice. In total, seven interviews were conducted revealing education, governance, technical, people issues, change management, government, costs andmore » timing as critical factors influencing advanced practice in Australia. Seven participants in this study perceived an advanced practice role might have major benefits and a positive impact on the immediate and long-term management of patients. Another finding is the greater respect and appreciation of each other's roles and expertise within the multidisciplinary healthcare team. Engagement is required of the critical stakeholders that have been identified as ‘blockers’ (radiologists, health departments) as well as identified allies (e.g. emergency clinicians, supportive radiologists, patient advocacy groups). The research supports that the AIR has a role to play for the professional identity of radiographers and shaping the advanced practice role in Australia.« less

  12. Workload management and geographic disorientation in aviation incidents: A review of the ASRS data base

    NASA Technical Reports Server (NTRS)

    Williams, Henry P.; Tham, Mingpo; Wickens, Christopher D.

    1993-01-01

    NASA's Aviation Safety Reporting System (ASRS) incident reports are reviewed in two related areas: pilots' failures to appropriately manage tasks, and breakdowns in geographic orientation. Examination of 51 relevant reports on task management breakdowns revealed that altitude busts and inappropriate runway usee were the most frequently reported consequences. Task management breakdowns appeared to occur at all levels of expertise, and prominent causal factors were related to breakdowns in crew communications, over-involvement with the flight management system and, for small (general aviation) aircraft, preoccupation with weather. Analysis of the 83 cases of geographic disorientation suggested that these too occurred at all levels of pilot experience. With regard to causal factors, a majority was related to poor cockpit resource management, in which inattention led to a loss of geographic awareness. Other leading causes were related to poor weather and poor decision making. The potential of the ASRS database for contributing to research and design issues is addressed.

  13. Public relations effectiveness in public health institutions.

    PubMed

    Springston, Jeffrey K; Weaver Lariscy, Ruth Ann

    2005-01-01

    This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

  14. Confirmatory Factor Analysis of Burnout Dimensions: Correlations with Job Stressors and Aspects of Social Support and Job Satisfaction

    DTIC Science & Technology

    1992-02-01

    1986) revision of the Maslach and Jackson (1981) Maslach Burnout Inventory (MBI). Results of confirmatory factor analyses conducted on data... Maslach organizational issues: depersonalization was and Jackson (1981) Maslach Burnout Inventory related to decision-making policies, personal (MBI). The...manage- (1989). The dimensionality of a modified ment interventions to respond to different mani- form of the Maslach Burnout Inventory for festations

  15. Holistic Management of Schizophrenia Symptoms Using Pharmacological and Non-pharmacological Treatment.

    PubMed

    Ganguly, Pronab; Soliman, Abdrabo; Moustafa, Ahmed A

    2018-01-01

    Individuals with schizophrenia lead a poor quality of life, due to poor medical attention, homelessness, unemployment, financial constraints, lack of education, and poor social skills. Thus, a review of factors associated with the holistic management of schizophrenia is of paramount importance. The objective of this review is to improve the quality of life of individuals with schizophrenia, by addressing the factors related to the needs of the patients and present them in a unified manner. Although medications play a role, other factors that lead to a successful holistic management of schizophrenia include addressing the following: financial management, independent community living, independent living skill, relationship, friendship, entertainment, regular exercise for weight gained due to medication administration, co-morbid health issues, and day-care programmes for independent living. This review discusses the relationship between different symptoms and problems individuals with schizophrenia face (e.g., homelessness and unemployment), and how these can be managed using pharmacological and non-pharmacological methods. Thus, the target of this review is the carers of individuals with schizophrenia, public health managers, counselors, case workers, psychiatrists, and clinical psychologists aiming to enhance the quality of life of individuals with schizophrenia.

  16. [Women's health in violent situations: municipal administrative roles and decision-making in the Brazilian public health system].

    PubMed

    Porto, Madge; McCallum, Cecilia; Scott, Russell Parry; de Morais, Heloísa M Mendonça

    2003-01-01

    The aim of this study was to investigate the role of health management staff concerning the health of women facing violent situations and the impact these roles have on decisions concerning health measures targeting these women. The study employed a qualitative, descriptive methodology including 18 health management staff members from three municipalities classified as having fully autonomous municipal management systems under the Unified National Health System (SUS) in Greater Metropolitan Recife, Pernambuco State, Brazil. Staff members were divided into three distinct groups according to their opinions on women in violent situations and women's health interventions. However, the three groups were convergent with respect to their roles in determining decisions on health actions for these women. The health management staff's commitment to the feminist movement proved to be the most relevant factor. Common issues among staff members, such as the problem of public health and quality of living, or more technically, the cost-benefit issue, did appear as key arguments.

  17. Technology to optimize pediatric diabetes management and outcomes.

    PubMed

    Markowitz, Jessica T; Harrington, Kara R; Laffel, Lori M B

    2013-12-01

    Technology for diabetes management is rapidly developing and changing. With each new development, there are numerous factors to consider, including medical benefits, impact on quality of life, ease of use, and barriers to use. It is also important to consider the interaction between developmental stage and technology. This review considers a number of newer diabetes-related technologies and explores issues related to their use in the pediatric diabetes population (including young adults), with a focus on psychosocial factors. Areas include trend technology in blood glucose monitoring, continuous glucose monitoring, sensor-augmented insulin pumps and low glucose suspend functions, internet applications including videoconferencing, mobile applications (apps), text messaging, and online gaming.

  18. College Psychiatry 2006: Challenges and Opportunities

    ERIC Educational Resources Information Center

    Kadison, Richard

    2006-01-01

    This article discusses some of the dramatic changes seen in college mental health issues over the past 2 decades. These modifications are a consequence of many factors: changes in our health care system (managed care), new effective biological treatments (medications), the focus of psychiatric training (biologic focus), technology advances…

  19. "Sustaining the Shrinking City: Concepts, Dynamics and Management" (A special issue of Sustainability) (ISSN 2071-1050).

    EPA Science Inventory

    Sustainability can be broadly defined as the resilient outcome of the interaction among social equity, economic stability, and environmental quality factors. For example, the utilization of natural resource capitals are constrained by economic forces, and further modulated by soc...

  20. 50 CFR 648.206 - Framework provisions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... management measures are recommended, an analysis of impacts and a recommendation to NMFS on whether to issue... support and analysis for each factor considered: (i) Whether the availability of data on which the... vessels, gear location reporting by fixed gear fishermen, mandatory plotting of gear by mobile fishermen...

  1. Theory underlying CRM training: Psychological issues in flight crew performance and crew coordination

    NASA Technical Reports Server (NTRS)

    Helmreich, Robert L.

    1987-01-01

    What psychological theory and research can reveal about training in Cockpit Resource Management (CRM) is summarized. A framework is provided for the critical analysis of current approaches to CRM training. Background factors and definitions critical to evaluating CRM are reviewed, followed by a discussion of issues directly related to CRM training effectiveness. Some of the things not known about the optimization of crew performance and the research needed to make these efforts as effective as possible are described.

  2. The occupational safety and health scorecard--a business case example for strategic management.

    PubMed

    Köper, Birgit; Möller, Klaus; Zwetsloot, Gerard

    2009-12-01

    Human resources and health issues are crucial in terms of corporate competitiveness. However, systematic, continuous and strategically aligned occupational safety and health (OSH) management is scarcely applied in companies. One major reason for this could be the lack of generally accepted and standardised OSH control methods. Our objective was thus to conceptualize a method by which qualitative factors such as human resources and OSH aspects contribute to the performance or value-added layer of an organization. We developed a business case based on the well-known and accepted Balanced Scorecard approach, which we adapted and applied to the management of OSH issues. The concept was implemented in the course of a comprehensive case study at a German automobile manufacturer. We gathered health as well as finance data in order to test which health-related indicators had an impact on financial performance. The demonstration of, and reporting on, how the promotion of workplace health contributes strategically to the organization is crucial for both health and human resource managers. Based on multivariate regression analyses, our main finding was that the Balanced Scorecard approach is an adequate means to control OSH issues in terms of strategic health management. Our analyses demonstrated that health-related interventions contribute significantly to performance aspects such as quality, productivity, absenteeism, and cost reduction. Therefore, the financial impact of health-related aspects / interventions could be demonstrated by means of the OSH scorecard. The availability and quality of health data within the context of overall corporate performance data needs to be improved in order to bridge OSH-related and performance issues of an organization.

  3. Pregnancy and autoimmune connective tissue diseases

    PubMed Central

    Marder, Wendy; Littlejohn, Emily A

    2016-01-01

    The autoimmune connective tissue diseases predominantly affect women and often occur during the reproductive years. Thus, specialized issues in pregnancy planning and management are commonly encountered in this patient population. This chapter provides a current overview of pregnancy as a risk factor for onset of autoimmune disease, considerations related to the course of pregnancy in several autoimmune connective tissue diseases, and disease management and medication issues before and during pregnancy and the postpartum period. A major theme that has emerged across these inflammatory diseases is that active maternal disease during pregnancy is associated with adverse pregnancy outcomes, and that maternal and fetal health can be optimized when conception is planned during times of inactive disease and through maintaining treatment regimens compatible with pregnancy. PMID:27421217

  4. The role of mutation analysis of the APC gene in the management of FAP patients. A controversial issue.

    PubMed

    Dodaro, Concetta; Grifasi, Carlo; Florio, Jole; Santangelo, Michele L; Duraturo, Francesca; De Rosa, Marina; Izzo, Paola; Renda, Andrea

    A correlation between the location of mutation in the adenomatous polyposis coli (APC) gene and clinical manifestations of familial adenomatous polyposis (FAP) has repeatedly been reported. Some Authors suggest the use of mutational analysis as a guide to select the best surgical option in FAP patients. However, data coming from studies on large series have raised questions on this issue. The aim of this study is to discuss the role of the genetic tests in the management of FAP. A literature review was performed considering only peer-reviewed articles published between 1991-2015. All the studies examined the role of genetic as a guide for surgical management of FAP. Of 363 articles identified, 21 were selected for full-text review. We found different positions with regard the use of genetic tests to determine surgical management of FAP. In particular, while consistent correlations between the APC mutation site and FAP phenotype were observed in large series, 8 studies reported a wide variation of genotypephenotype correlation in patients with the same mutation and they recommended that decisions regarding surgical strategy should be based not only on genotype but also on the clinical factors and the will of the patient who must be fully informed. The decision on the type and the timing of surgery should be based on the assessment of many factors and genotype assessment should be used in combination with clinical data. Disease severity, Familial adenomatous polyposis, Genetic tests, Genotype-phenotype correlations, Surgical management.

  5. Adoption of Smart Structures for Prevention of Health Hazards in Buildings

    NASA Astrophysics Data System (ADS)

    Oke, Ayodeji; Aigbavboa, Clinton; Ngema, Wiseman

    2017-11-01

    The importance of building quality to the health and well-being of occupants and surrounding neighbors cannot be overemphasized. Smart structures were construed to proffer solution to various issues of sustainable development including social factors that is concerned with health and safety of people. Based on existing literature materials on building quality, smart structures and general aspect of sustainable developments, this study examined the benefits of smart structures in the prevention of various health issues in infrastructural buildings, which has been a concern for stakeholders in the architecture, engineering and construction industry. The criterion for indoor environmental quality was adopted and various health and bodily issues related to building quality were explained. The adoption of smart structure concept will help to manage physical, chemical, biological and psychological factors of building with a view to enhancing better quality of life of occupants.

  6. Project delivery in HIV/AIDS and TB in Southern Africa: the cross-cultural management imperative.

    PubMed

    Claeyé, Frederik; Jackson, Terence

    2011-01-01

    The purpose of this paper is to report the findings of a broad-based study that initially investigated a possible gap in global inputs into the fight against HIV/AIDS and TB co-infection, and outputs in terms of results achieved. It is proposed that such a gap may be hypothesized to be due, at least in part, to inappropriate management regimes within the global health governance structure. The research does not simply question the effectiveness of the management of programs and projects, but rather the inappropriateness resulting from the lack of addressing cross-cultural issues. The factors facilitating or hampering project service delivery were examined, by looking at 12 case studies in Botswana and South Africa. These data were complemented with seven semi-structured interviews with donor organizations and NGOs, conducted in the North. Cultural interactions were investigated by using the concept of "interfaces". The results suggest that there is a disjuncture between the global and local level that affects project delivery. The main issues hampering project outcomes can be summarized as systemic, structural and cultural. The article's main contributions are both theoretical, looking at global project delivery from a cross-cultural management perspective, as well as to development praxis by highlighting the need to focus more critically on cross-cultural management issues within the global health governance structure, and indeed within international development as a whole.

  7. Managing problematic severe asthma: beyond the guidelines.

    PubMed

    Pike, Katharine C; Levy, Mark L; Moreiras, John; Fleming, Louise

    2018-04-01

    This review discusses issues related to managing problematic severe asthma in children and young people. A small minority of children have genuinely severe asthma symptoms which are difficult to control. Children with genuinely severe asthma need investigations and treatments beyond those described within conventional guidelines. However, the majority of children with poor symptom control despite high-intensity treatment achieve improvement in their asthma control once attention has been paid to the basics of asthma management. Basic asthma management requires optimisation of inhaler technique and treatment adherence, avoidance of environmental triggers and self-management education. It is also important that clinicians recognise risk factors that predispose patients to asthma exacerbations and potentially life-threatening attacks. These correctable issues need to be tackled in partnership with children and young people and their families. This requires a coordinated approach between professionals across healthcare settings. Establishing appropriate infrastructure for coordinated asthma care benefits not only those with problematic severe asthma, but also the wider asthma population as similar correctable issues exist for children with asthma of all severities. Investigation and management of genuine severe asthma requires specialist multidisciplinary expertise and a systematic approach to characterising patients' asthma phenotypes and delivering individualised care. While inhaled corticosteroids continue to play a leading role in asthma therapy, new treatments on the horizon might further support phenotype-specific therapy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Mental health issues in the workplace: a case for a new managerial approach.

    PubMed

    Dunnagan, T; Peterson, M; Haynes, G

    2001-12-01

    Anger, stress, and depression in the workplace are growing concerns among management. Traditionally, health outcomes have functioned under the realm of workplace health professionals. This study assessed whether a traditional worksite health promotion program had an impact on mental health factors. The results suggested that worksite health promotion programs play a limited role in ameliorating work-related mental health outcomes. Rather, management must play a greater role in addressing workplace stress, anger, and depression.

  9. The role of behavioral decision theory for cockpit information management

    NASA Technical Reports Server (NTRS)

    Jonsson, Jon E.

    1991-01-01

    The focus of this report is the consideration of one form of cognition, judgment and decision making, while examining some information management issues associated with the implementation of new forms of automation. As technology matures and more tasks become suitable to automation, human factors researchers will have to consider the effect that increasing automation will have on operator performance. Current technology allows flight deck designers the opportunity to automate activities involving substantially more cognitive processing.

  10. Latest Developments and Future Perspectives in the Field Of Obesity.

    PubMed

    Pérez-Pevida, Belén; Miras, Alexander D

    2017-04-01

    The prevalence of obesity is increasing exponentially worldwide, becoming an international public health issue that affects quality of life, increases the risk of illness and raises healthcare costs in countries in all parts of the world. In this editorial, we analyse the latest progress in the management of obesity and associated cardiovascular risk factors, and summarise the latest randomised controlled trials that have had the biggest influence on the current changes we are experiencing in obesity management.

  11. Using PRECEDE to develop a weight management program for disadvantaged young adults.

    PubMed

    Walsh, Jennifer R; White, Adrienne A; Kattelmann, Kendra K

    2014-01-01

    To conduct a needs assessment using the PRECEDE model for the development of a weight management program for low-income young adults. Four phases were implemented using qualitative (focus groups and interviews) and quantitative (survey) methodologies, with steering committee guidance. Northeastern residential vocational center. Convenience sample of low-income young adults, 18-24 years old (total n = 203), who were attending a job training vocational center. General themes of life satisfaction determinants and issues related to weight, self-reported weight and related behavior, existing environmental supports, and desired changes of behavioral and environmental influences of weight. Content analysis of qualitative data; descriptive analysis and Student t test. Self-image and discrimination were themes for weight issues. More than half of participants were overweight or obese (57%) and had low levels of physical activity (58%). Self-reported fruit and vegetable intake was inadequate (<2.5 cups/d). Identified environmental factors most needing improvement were accessibility for walking and biking and availability of healthful food. Participants reported exercising, getting adequate sleep, eating healthful snacks, and effectively managing stress as behavior they were willing to change. The PRECEDE model was useful to identify concerns, priorities, and modifiable factors among a young adult community that can increase the relevancy of a weight management program. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  12. 75 FR 65645 - Notice Reopening the Call for Nominations for the New Mexico Resource Advisory Councils

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-26

    ... INFORMATION CONTACT: Allison Sandoval, Bureau of Land Management, Correspondence, International, and Advisory... variety of factors, including training, experience, and knowledge of the geographical area of the RAC... Office will issue a press release simultaneously with this notice, providing additional information for...

  13. Consultation Stressors and Stress Management.

    ERIC Educational Resources Information Center

    Portman, Sandy Kosub

    A high incidence of occupational stress has been demonstrated in the mental health and social service professions and appears to be a major factor contributing to low worker morale, absenteeism, high job turnover, and other indices of job stress. A study was conducted to examine the issue of occupational stress among psychological consultants.…

  14. ISSUES AND RECCOMMENDATIONS FOR POREWATER TOXCITY TESTING: METHODOLOGICAL UNCERTAINTIES, CONFOUNDING FACTORS AND TOXCITY IDENTIFICATION EVALUATION PROCEDURES

    EPA Science Inventory

    During the last decade porewater toxicity tests have gained popularity among researchers and managers as tools for the assessment of the presence and biological effects of bioavailable contaminants in aquatic sediments. However, there are a number of information gaps in our know...

  15. Providing for Student Voice in Classroom Management: Teachers' Views

    ERIC Educational Resources Information Center

    Lewis, Ramon; Burman, Eva

    2008-01-01

    Recent research indicates that teachers would prefer to allow for more student voice in classroom discipline decision-making than is currently the case. This paper identifies factors that teachers suggest inhibit them from implementing their ideas of best disciplinary practice. It also examines which classroom discipline issues teachers are…

  16. Creating a Healthy Camp Community: A Nurse's Role.

    ERIC Educational Resources Information Center

    Lishner, Kris Miller; Bruya, Margaret Auld

    This book provides an organized, systematic overview of the basic aspects of health program management, nursing practice, and human relations issues in camp nursing. A foremost assumption is that health care in most camps needs improvement. Good health is dependent upon interventions involving social, environmental, and lifestyle factors that…

  17. Common diseases of black bass: implications for conservation and management

    USDA-ARS?s Scientific Manuscript database

    Disease issues relevant to black bass populations arise from infectious as well as noninfectious etiologies. While disease outbreaks can occur via direct means, as is the case with primary pathogens, mortality events can also be linked to factors that disrupt the delicate balance between the enviro...

  18. Dryland ecohydrology and climate change: critical issues and technical advances

    NASA Astrophysics Data System (ADS)

    Wang, L.; D'Odorico, P.; Evans, J. P.; Eldridge, D.; McCabe, M. F.; Caylor, K. K.; King, E. G.

    2012-04-01

    Drylands cover about 40% of the terrestrial land surface and account for approximately 40% of global net primary productivity. Water is fundamental to the biophysical processes that sustain ecosystem function and food production, particularly in drylands, where a tight coupling exists between water resource availability and ecosystem productivity, surface energy balance, and biogeochemical cycles. Currently, drylands support at least 2 billion people and comprise both natural and managed ecosystems. In this synthesis, we identify some current critical issues in the understanding of dryland systems and discuss how arid and semiarid environments are responding to the changes in climate and land use. Specifically, we focus on dryland agriculture and food security, dryland population growth, desertification, shrub encroachment and dryland development issues as factors of change requiring increased understanding and management. We also review recent technical advances in the quantitative assessment of human versus climate change related drivers of desertification, evapotranspiration partitioning using field deployable stable water isotope systems and the remote sensing of key ecohydrological processes. These technological advances provide new tools that assist in addressing major critical issues in dryland ecohydrology under climate change

  19. Occupational therapists' experience of workplace fatigue: Issues and action.

    PubMed

    Brown, Cary A; Schell, Jennifer; Pashniak, Lisa M

    2017-01-01

    Occupational therapists (OTs) work in all areas of health and wellbeing. The work is physically and psychologically demanding, but OTs are often not diligent about recognizing and attending to the workplace health and safety issue of fatigue in their own work settings. The purpose of this paper is to determine current issues and the evidence-base as presented in the literature so as to develop awareness and best practice interventions for fatigue reduction and management in occupational therapists' workplace. A comprehensive search strategy was carried out by the medical librarian on the study team and themes were extracted from the relevant literature by the study team. The literature revealed little research directly addressing occupational therapy workplace fatigue and we expanded our review of the evidence-base across all healthcare workers to identify publications of particular relevance to occupational therapists. This background paper is an important first step to raising awareness among OTs, guide key stakeholders regarding contributing factors to, and consequences of, OTs' workplace fatigue, and set research direction. Knowing which factors influencing workplace fatigue are shared across healthcare professionals and which are unique to OTs can also help organizations develop more tailored workplace fatigue risk reduction programs. This review concludes with a list of existing guidelines and tools for developing workplace fatigue risk assessment and management programs relevant to occupational therapists.

  20. Rheumatoid Arthritis and Cardiovascular Disease: Update on Treatment Issues

    PubMed Central

    Barbhaiya, Medha; Solomon, Daniel H.

    2016-01-01

    Purpose of review This review examines thresholds for treatment of traditional cardiovascular disease (CVD) risk factors among RA patients and whether RA-specific treatment modulates cardiovascular risk. Recent findings There are substantial data demonstrating an increased CVD risk among patients with RA. Both traditional CVD risk factors and inflammation contribute to this risk. Recent epidemiologic studies strengthen the case that aggressive immunosuppression with biologic DMARDs, such as TNF antagonists, is associated with a reduced risk of CVD events. However, to data, there are no randomized controlled trials published regarding the management of CVD in RA. Summary Epidemiologic evidence continues to accumulate regarding the relationship between the effects of traditional CVD risk factors and RA-specific treatments on CV outcomes in RA. The field needs randomized controlled trials to better guide management. PMID:23466960

  1. A Multicultural Competencies Approach to Developing Human Capital Management

    NASA Astrophysics Data System (ADS)

    Woolliscroft, Paul; Cagáňová, Dagmar; Čambál, Miloš; Šefčíková, Miriam; Kamenova, Joana Valery

    2012-12-01

    The globalisation phenomenon has been prevalent since the last decade of 20th century and remains a significant factor influencing both organisations and individuals today. Within a globalised business environment the effective management of multicultural aspects and differences has become imperative to ensure success. It is increasingly evident there is a need to develop a clear understanding of multicultural competencies in order to fully develop a strategic approach to human capital management (HCM). The adoption of a strategic approach is necessary to ensure a focus on the issues critical to success and competitive advantage including multicultural management, professional skills and knowledge management. This paper aims to identify the importance of intercultural management and the impact of globalisation upon international business.

  2. Contrasting Eutrophication Risks and Countermeasures in Different Water Bodies: Assessments to Support Targeted Watershed Management

    PubMed Central

    Li, Tong; Chu, Chunli; Zhang, Yinan; Ju, Meiting; Wang, Yuqiu

    2017-01-01

    Eutrophication is a major problem in China. To combat this issue, the country needs to establish water quality targets, monitoring systems, and intelligent watershed management. This study explores a new watershed management method. Water quality is first assessed using a single factor index method. Then, changes in total nitrogen/total phosphorus (TN/TP) are analyzed to determine the limiting factor. Next, the study compares the eutrophication status of two water function districts, using a comprehensive nutritional state index method and geographic information system (GIS) visualization. Finally, nutrient sources are qualitatively analyzed. Two functional water areas in Tianjin, China were selected and analyzed: Qilihai National Wetland Nature Reserve and Yuqiao Reservoir. The reservoir is a drinking water source. Results indicate that total nitrogen (TN) and total phosphorus (TP) pollution are the main factors driving eutrophication in the Qilihai Wetland and Yuqiao Reservoir. Phosphorus was the limiting factor in the Yuqiao Reservoir; nitrogen was the limiting factor in the Qilihai Wetland. Pollution in Qilihai Wetland is more serious than in Yuqiao Reservoir. The study found that external sources are the main source of pollution. These two functional water areas are vital for Tianjin; as such, the study proposes targeted management measures. PMID:28661417

  3. A social–ecological perspective for riverscape management in the Columbia River Basin

    USGS Publications Warehouse

    Hand, Brian K.; Flint, Courtney G.; Frissell, Chris A.; Muhlfeld, Clint C.; Devlin, Shawn P.; Kennedy, Brian P.; Crabtree, Robert L.; McKee, W. Arthur; Luikart, Gordon; Stanford, Jack A.

    2018-01-01

    Riverscapes are complex, landscape-scale mosaics of connected river and stream habitats embedded in diverse ecological and socioeconomic settings. Social–ecological interactions among stakeholders often complicate natural-resource conservation and management of riverscapes. The management challenges posed by the conservation and restoration of wild salmonid populations in the Columbia River Basin (CRB) of western North America are one such example. Because of their ecological, cultural, and socioeconomic importance, salmonids present a complex management landscape due to interacting environmental factors (eg climate change, invasive species) as well as socioeconomic and political factors (eg dams, hatcheries, land-use change, transboundary agreements). Many of the problems in the CRB can be linked to social–ecological interactions occurring within integrated ecological, human–social, and regional–climatic spheres. Future management and conservation of salmonid populations therefore depends on how well the issues are understood and whether they can be resolved through effective communication and collaboration among ecologists, social scientists, stakeholders, and policy makers.

  4. Factors Influencing Implementation of OHSAS 18001 in Indian Construction Organizations: Interpretive Structural Modeling Approach

    PubMed Central

    Rajaprasad, Sunku Venkata Siva; Chalapathi, Pasupulati Venkata

    2015-01-01

    Background Construction activity has made considerable breakthroughs in the past two decades on the back of increases in development activities, government policies, and public demand. At the same time, occupational health and safety issues have become a major concern to construction organizations. The unsatisfactory safety performance of the construction industry has always been highlighted since the safety management system is neglected area and not implemented systematically in Indian construction organizations. Due to a lack of enforcement of the applicable legislation, most of the construction organizations are forced to opt for the implementation of Occupational Health Safety Assessment Series (OHSAS) 18001 to improve safety performance. Methods In order to better understand factors influencing the implementation of OHSAS 18001, an interpretive structural modeling approach has been applied and the factors have been classified using matrice d'impacts croises-multiplication appliqué a un classement (MICMAC) analysis. The study proposes the underlying theoretical framework to identify factors and to help management of Indian construction organizations to understand the interaction among factors influencing in implementation of OHSAS 18001. Results Safety culture, continual improvement, morale of employees, and safety training have been identified as dependent variables. Safety performance, sustainable construction, and conducive working environment have been identified as linkage variables. Management commitment and safety policy have been identified as the driver variables. Conclusion Management commitment has the maximum driving power and the most influential factor is safety policy, which states clearly the commitment of top management towards occupational safety and health. PMID:26929828

  5. Waste-to-energy: What are the issues?

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

    Merritt, J.A.

    1995-09-01

    It is very difficult to have been associated with the Waste-to-Energy ({open_quotes}WTE{close_quotes}) Industry during the past twelve months without feeling a profound sense of being under attack and more than a little shell shocked. That is not to say that scrutiny and regulation haven`t been an important factor for WTE from its inception, only that it seems that certain difficult issues have been thrust to the fore through the recent actions of the courts and regulatory agencies. While ash management and flow control hit center stage with a flourish in a one-two punch last Spring with the Supreme Court inmore » the City of Chicago and Carbone decisions, significant compliance issues still remain with respect to implementing the Clean Air Act Amendments of 1990 ({open_quotes}CAAA{close_quotes}). In my state, the long term plans for waste management have WTE facilities responsible for turning 50% of the total waste stream into electricity, with other recycling accounting for all but 4% of the rest. With similar reliance upon WTE facilities elsewhere, it is critical that cost effective ways of managing these issues be found. Beyond these primarily regulatory and legal issues, there are also numerous challenges in the marketplace with increased reliance on recycling and the normal ebb and flow of the business cycle. Finally, there are always issues, including those already mentioned, which are best addressed in the political arena. Working together as an industry and regulated community will be essential if we are to make progress in addressing many of our challenges.« less

  6. Clinical assessment and crisis intervention for the suicidal bipolar disorder patient.

    PubMed

    Saunders, Kate E A; Hawton, Keith

    2013-08-01

    Suicidal behaviour is common in people suffering with bipolar disorder, and suicide is a leading cause of death in this group. Our aim in this review is to provide an overview of key assessment and management strategies, highlight research findings relevant to suicide prevention, and identify important areas for future research. We reviewed the published literature regarding the risk factors for and management of suicida\\l behaviour in individuals with bipolar disorder using the Pubmed and PsychINFO databases. Where available, we focused our search on systematic reviews. Suicide is usually associated with a depressive phase, although mixed affective states also convey increased risk. All individuals with bipolar disorder should have an up-to-date crisis management plan which outlines the action to be taken should suicidal behaviour emerge. Timely clinical assessment is essential in ensuring that those at high risk are identified. This should include mental state examination, consideration of risk factors, and evaluation of issues such as access to means, preparatory acts before suicide, and also protective factors. While pharmacological approaches are the mainstay of management, less specific measures, such as the removal of access to means, are also important in ensuring safety in the acute situation. Intensifying the clinical support of both patients and relatives, and the sharing of risk information with other health agencies are essential in management. Specific psychological treatments are likely to be helpful in preventing crises, although the evidence base is limited. The aetiology of suicidal behaviour in bipolar disorder is multifactorial and requires proactive crisis planning and management. A range of issues need to be addressed in the assessment of at-risk patients. Determining the efficacy of interventions specific to reducing suicidality in bipolar disorder should be a research priority. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Categorization of potential project cost overrun factors in construction industry

    NASA Astrophysics Data System (ADS)

    Karunakaran, P.; Abdullah, A. H.; Nagapan, S.; Sohu, S.; Kasvar, K. K.

    2018-04-01

    Cost overrun has been severely hit down the economy and reputations for many construction industry around the world. Many project management tools developed to control the budget of a project. However, the cost management is still considered poor as there are many cost overrun issues occurred in the construction industry. Thus, this paper aims to identify and cluster the potential construction project cost overrun factors according to their originating groups using the thematic approach. Basically, through literature review, all the potential factors that may cause cost overrun were screened thoroughly before they were clustered into seven (7) groups of the originating factors, namely project, contract, client, contractor, consultant, labour and external. Each potential factor was explained clearly with some examples based on the Malaysian case studies to illustrate the cost overrun scenario. These findings may aid in the future to highlight on how to mitigate the critical potential factors of cost overrun to reduce or overcome its impact on all the stakeholders involved.

  8. Sexual and reproductive issues and inflammatory bowel disease: a neglected topic in men.

    PubMed

    Allocca, Mariangela; Gilardi, Daniela; Fiorino, Gionata; Furfaro, Federica; Peyrin-Biroulet, Laurent; Danese, Silvio

    2018-03-01

    There has been considerable literature on sexual issues in women with inflammatory bowel disease (IBD), but relatively little attention has been paid to these aspects in men. To review the available literature and to provide the best management of sexual and reproductive issues in male patients with IBD. The scientific literature on sexual and reproductive issues in men with IBD was reviewed. Several factors, including surgical and medication treatments, disease activity, lifestyle, and psychological factors, may play a role in the development of infertility and sexual dysfunction and may negatively impact pregnancy outcomes. Proctocolectomy with ileal pouch-anal anastomosis increases the risk of erectile and ejaculatory dysfunction by up to 26%. A treatment with sildenafil can be effective. Sperm banking should be advised to young men with IBD before surgery. Both sulfasalazine and methotrexate may be responsible for reversible sexual dysfunction and infertility. Furthermore, sulfasalazine should be switched to mesalazine at least 4 months before conception because of a higher risk of congenital malformations in pregnancies fathered by men treated with this drug. Psychotropic drugs, frequently used in IBD, may cause sexual dysfunction up to 80%. Last but not the least, voluntary childlessness occurs frequently, mainly because of concerns about medication safety in pregnancy and fear of transmitting disease. Accurate counseling, and where necessary, psychological support can decrease any misperceptions and fears. Close collaboration between the gastroenterologist and the patient is recommended for the best management of these relevant, neglected aspects in men with IBD.

  9. Conflict management styles among Iranian critical care nursing staff: a cross-sectional study.

    PubMed

    Ahanchian, Mohammad Reza; Emami Zeydi, Amir; Armat, Mohammad Reza

    2015-01-01

    Conflict among nurses has been recognized as an extremely important issue within health care settings throughout the world. Identifying the conflict management style would be a key strategy for conflict management. The aim of this study was to evaluate the prevalence of conflict management styles and its related factors among Iranian critical care nursing staff. In a descriptive cross-sectional study, a total of 149 critical care nurses who worked in the critical care units of 4 teaching hospitals in Sari (Iran) were evaluated. A 2-part self-reported questionnaire including personal information and Rahim Organizational Conflict Inventory II was used for data collection. Although Iranian critical care nurses used all 5 conflict management styles to manage conflict with their peers, the collaborating style was the most prevalent conflict management style used by them, followed by compromising, accommodating, avoiding, and competing. Male gender was a predictor for both compromising and competing styles, whereas position and shift time were significant predictors for compromising and competing styles, respectively. Based on the results of this study, nurse managers need to take these factors into account in designing programs to help nurses constructively manage unavoidable conflicts in health care setting.

  10. Introduction to the special issue: Tree invasions: towards a better understanding of their complex evolutionary dynamics.

    PubMed

    Hirsch, Heidi; Richardson, David M; Le Roux, Johannes J

    2017-05-01

    Many invasive plants show evidence of trait-based evolutionary change, but these remain largely unexplored for invasive trees. The increasing number of invasive trees and their tremendous impacts worldwide, however, illustrates the urgent need to bridge this knowledge gap to apply efficient management. Consequently, an interdisciplinary workshop, held in 2015 at Stellenbosch University in Stellenbosch, South Africa, brought together international researchers to discuss our understanding of evolutionary dynamics in invasive trees. The main outcome of this workshop is this Special Issue of AoB PLANTS . The collection of papers in this issue has helped to identify and assess the evolutionary mechanisms that are likely to influence tree invasions. It also facilitated expansion of the unified framework for biological invasions to incorporate key evolutionary processes. The papers cover a wide range of evolutionary mechanisms in tree genomes (adaptation), epigenomes (phenotypic plasticity) and their second genomes (mutualists), and show how such mechanisms can impact tree invasion processes and management. The special issue provides a comprehensive overview of the factors that promote and mitigate the invasive success of tree species in many parts of the world. It also shows that incorporating evolutionary concepts is crucial for understanding the complex drivers of tree invasions and has much potential to improve management. The contributions of the special issue also highlight many priorities for further work in the face of ever-increasing tree invasions; the complexity of this research needs calls for expanded interdisciplinary research collaborations.

  11. Issues Management and the Role of Strategic Planning. AIR 1985 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Lozier, G. Gregory; Chittipeddi, Kumar

    The integration of issues management into the institutional strategic planning process at Pennsylvania State University is discussed. The significance of issues management as an organizational process is also considered. Stages of the issues management process are: (1) scanning the external environment to identify strategic issues; (2) analyzing…

  12. The background and theory of integrated risk management

    NASA Technical Reports Server (NTRS)

    Hunsucker, John L.

    1995-01-01

    While all good managers have always considered risk in their decision making, only recently have formal programs to do so been introduced. This report covers the logical structure behind the formulation of an integrated risk management plan (IRM). Included in the report are factors forcing the development of a formal plan to consider risk, the basic objective or purpose of an IRM, and desirable traits of such a plan. The report moves on to a discussion of background issues, seeks to formalize some definitions, and then discusses required information on threats. The report concludes with the steps for an IRM.

  13. [Modern nursing work management trends: the case of cooperative companies].

    PubMed

    Guimarães, Raphael Mendonça; Muzi, Camila Drumond; Mauro, Maria Yvone Chaves

    2004-01-01

    This article introduces the issue of nursing work management from a theoretical and conceptual perspective by raising some implications for the management of organizations, as well as its impact on work relationships and, consequently, on the worker's health. The main results about ways and modalities of cooperative companies bring about the consideration that proposals of positive changes in the category run contrary to progress. Indecent work conditions, poor quality assistance and low compensation make up the main negative factors in this work process. Therefore, it is urgent to resume the discussion of what one expects from nursing for the future.

  14. Quality of Diabetes Management in Saudi Arabia: A Review of Existing Barriers.

    PubMed

    Almutairi, Khalid M

    2015-12-01

    Diabetes mellitus is a complex disorder that requires continuous management and medical care. The purpose of this review is to identify and summarize the barriers that affect diabetes management in Saudi Arabia. Studies that have examined the quality of diabetes management in Saudi Arabia were identified through online and manual literature searches. Two researchers independently searched and assessed for inclusion/exclusion criteria. All studies were screened by a specialist for the significance of the review. Studies that were included were evaluated for relevance, methodological rigor, and credibility by giving a quality score based on Russell and Gregory's criteria. This review presents an overview of the quality of diabetes management and issues and barriers concerning the improvement of diabetes care in Saudi Arabia. The online literature search yielded 11 studies which met the inclusion criteria. Factors affecting the quality of diabetes care can be categorized into patient factors (such as adherence, compliance, attitudes, beliefs, knowledge, financial resources and co-morbidities) and healthcare providers' factors (including beliefs, attitudes and knowledge, patient - provider interaction and communication). The identified barriers, both from patients and healthcare providers, will help healthcare authorities to improve diabetes management in Saudi Arabia. Improvement of health awareness about disease and disease management should be tailored through continuous patient education. Continuous training and seminars will also expand providers' knowledge that will ensure quality and effective diabetes management.

  15. Technology to Optimize Pediatric Diabetes Management and Outcomes

    PubMed Central

    Harrington, Kara R.; Laffel, Lori M. B.

    2013-01-01

    Technology for diabetes management is rapidly developing and changing. With each new development, there are numerous factors to consider, including medical benefits, impact on quality of life, ease of use, and barriers to use. It is also important to consider the interaction between developmental stage and technology. This review considers a number of newer diabetes-related technologies and explores issues related to their use in the pediatric diabetes population (including young adults), with a focus on psychosocial factors. Areas include trend technology in blood glucose monitoring, continuous glucose monitoring, sensor-augmented insulin pumps and low glucose suspend functions, internet applications including videoconferencing, mobile applications (apps), including text messaging, and online gaming. PMID:24046146

  16. Public-private delivery of insecticide-treated nets: a voucher scheme in Volta Region, Ghana

    PubMed Central

    Kweku, Margaret; Webster, Jayne; Taylor, Ian; Burns, Susan; Dedzo, McDamien

    2007-01-01

    Background Coverage of vulnerable groups with insecticide-treated nets (ITNs) in Ghana, as in the majority of countries of sub-Saharan Africa is currently low. A voucher scheme was introduced in Volta Region as a possible sustainable delivery system for increasing this coverage through scale-up to other regions. Successful scale-up of public health interventions depends upon optimal delivery processes but operational research for delivery processes in large-scale implementation has been inadequate. Methods A simple tool was developed to monitor numbers of vouchers given to each health facility, numbers issued to pregnant women by the health staff, and numbers redeemed by the distributors back to the management agent. Three rounds of interviews were undertaken with health facility staff, retailers and pregnant women who had attended antenatal clinic (ANC). Results During the one year pilot 25,926 vouchers were issued to eligible women from clinics, which equates to 50.7% of the 51,658 ANC registrants during this time period. Of the vouchers issued 66.7% were redeemed by distributors back to the management agent. Initially, non-issuing of vouchers to pregnant women was mainly due to eligibility criteria imposed by the midwives; later in the year it was due to decisions of the pregnant women, and supply constraints. These in turn were heavily influenced by factors external to the programme: current household ownership of nets, competing ITN delivery strategies, and competition for the limited number of ITNs available in the country from major urban areas of other regions. Conclusion Both issuing and redemption of vouchers should be monitored as factors assumed to influence voucher redemption had an influence on issuing, and vice versa. More evidence is needed on how specific contextual factors influence the success of voucher schemes and other models of delivery of ITNs. Such an evidence base will facilitate optimal strategic decision making so that the delivery model with the best probability of success within a given context is implemented. Rigorous monitoring has an important role to play in the successful scaling-up of delivery of effective public health interventions. PMID:17274810

  17. Distributed Information System Development: Review of Some Management Issues

    NASA Astrophysics Data System (ADS)

    Mishra, Deepti; Mishra, Alok

    Due to the proliferation of the Internet and globalization, distributed information system development is becoming popular. In this paper we have reviewed some significant management issues like process management, project management, requirements management and knowledge management issues which have received much attention in distributed development perspective. In this literature review we found that areas like quality and risk management issues could get only scant attention in distributed information system development.

  18. Analysis of Factors Influencing Building Refurbishment Project Performance

    NASA Astrophysics Data System (ADS)

    Ishak, Nurfadzillah; Aswad Ibrahim, Fazdliel; Azizi Azizan, Muhammad

    2018-03-01

    Presently, the refurbishment approach becomes favourable as it creates opportunities to incorporate sustainable value with other building improvement. In this regard, this approach needs to be implemented due to the issues on overwhelming ratio of existing building to new construction, which also can contribute to the environmental problem. Refurbishment principles imply to minimize the environmental impact and upgrading the performance of an existing building to meet new requirements. In theoretically, building project's performance has a direct bearing on related to its potential for project success. However, in refurbishment building projects, the criteria for measure are become wider because the projects are a complex and multi-dimensional which encompassing many factors which reflect to the nature of works. Therefore, this impetus could be achieve by examine the direct empirical relationship between critical success factors (CSFs) and complexity factors (CFs) during managing the project in relation to delivering success on project performance. The research findings will be expected as the basis of future research in establish appropriate framework that provides information on managing refurbishment building projects and enhancing the project management competency for a better-built environment.

  19. Management of bone disease in women after breast cancer.

    PubMed

    Milat, F; Vincent, A J

    2015-01-01

    Breast cancer and osteoporosis are common conditions affecting women, particularly following menopause. With increasing breast cancer incidence, effects of therapies and decreasing mortality, issues relating to the preservation of bone health with breast cancer therapy have become a priority. Contributing factors to bone loss and fractures in women with breast cancer include tumor effects, estrogen deprivation secondary to breast cancer therapies (chemotherapy, ovarian ablation or aromatase inhibitors), natural menopause and secondary causes of bone loss, typically from concurrently prescribed medications. Management of osteoporosis and other survivorship care is complex, and a multi-disciplinary approach is recommended with assessment of risk factors for bone loss, optimization of bone health through lifestyle approaches and pharmacological interventions based on evidence-based algorithms. This review examines the pathophysiology of bone loss and gives guidelines for the management of bone disease in women with breast cancer.

  20. Workplace in fluency management: factoring the workplace into fluency management.

    PubMed

    Cassar, M C; Neilson, M D

    1997-01-01

    This article addresses competency-based standards and guidelines for the involvement of speech-language pathologists in the workplace of clients who stutter. It advocates broadening customary practices in stuttering treatment and suggests that speech-language pathologists should extend their scope of service delivery to the workplace. It presents a sequence for the collaborative involvement of the employer and other workplace members and proposes strategies for evaluating workplace based fluency programs. Issues of fluency management, transfer, maintenance, and efficacy are discussed in the workplace context. Also addressed is workplace communication as well as such factors as stereotypes, discrimination, and resistance to change which may impinge on workplace intervention. It is argued that structured intervention, transfer, and generalization within a collaborative workplace framework facilitates best practice for the fluency clinician and more appropriate outcomes for the diversity of clients who stutter.

  1. Perceptions of prominent neighborhood individuals regarding neighborhood factors and intimate partner violence.

    PubMed

    Yonas, Michael; Akers, Aletha Y; Burke, Jessica G; Chang, Judy C; Thomas, Alicia L; Thomas, Aletha L; O'Campo, Patricia

    2011-04-01

    Research addressing the impact of neighborhood factors on intimate partner violence (IPV) often lacks discussion of how and why such factors impact IPV. In order to address this gap, 16 prominent neighborhood individuals (PNI) from 4 low-income urban neighborhoods were asked to share through in-depth interviews their insights and perceptions of IPV as an issue in their neighborhoods, and the relationship between social and structural neighborhood-level factors and IPV. PNIs most often associated IPV with only physical violence. Several did not feel IPV was a significant issue in their neighborhood, confirming a lack of awareness and underreporting of IPV. However, other PNIs were able to speak of the relationship between IPV and neighborhood factors, including lack of opportunities for employment, vacant housing, trash management, lack of community awareness, and social capacity to act to address IPV. Results provide unique insights regarding the mechanisms linking neighborhood factors to IPV outcomes. These results contribute to a deeper understanding of contextual influences upon IPV, the development of tailored quantitative research and to the design of local multi-level public health IPV intervention and prevention efforts.

  2. Before the experts arrive.

    PubMed

    Chandley, M

    2001-06-01

    This article addresses the rare event of the hostage situation in a forensic psychiatric nursing setting. It has a specific focus on the initial response and the accompanying issues for nurses at the clinical interface as the situation emerges. The intention of this article is to both offer guidance and raise the profile of this unique management issue because little attention is drawn to early-stage hostage situations at an organizational level. When a hostage situation occurs, inadequate preparation can mean the difference between life and death for the hostage, negotiator, or hostage taker. This article provides an overview of the relevant literature and offers guidance about the actions required when a nurse suddenly becomes responsible for managing the early stages of such a traumatic event. Responses, safety, and communication factors concerning the hostage taker are covered.

  3. Management and design of long-life systems; Proceedings of the Symposium, Denver, Colo., April 24-26, 1973

    NASA Technical Reports Server (NTRS)

    Schurmeier, H. M.

    1974-01-01

    The long life of Pioneer interplanetary spacecraft is considered along with a general accelerated methodology for long-life mechanical components, dependable long-lived household appliances, and the design and development philosophy to achieve reliability and long life in large turbine generators. Other topics discussed include an integrated management approach to long life in space, artificial heart reliability factors, and architectural concepts and redundancy techniques in fault-tolerant computers. Individual items are announced in this issue.

  4. Evaluating Parents' Self-Efficacy for Diabetes Management in Pediatric Type 1 Diabetes.

    PubMed

    Noser, Amy E; Patton, Susana R; Van Allen, Jason; Nelson, Michael B; Clements, Mark A

    2017-04-01

    To examine the factor structure and construct validity of the Maternal Self-Efficacy for Diabetes Management Scale (MSED) in 135 youth ( Mage  = 13.50  ±  1.83 years), with type 1 diabetes mellitus. The study used exploratory factor analysis (EFA) to examine the factor structure and correlations to examine relationships among MSED factors and select parent and child diabetes-related health behaviors and outcomes. EFA identified an 11-item three-factor solution (χ 2 (25, n  = 133)  = 40.22, p  < .03, RMSEA = 0.07, CFI = 0.98, TLI = 0.97), with factors corresponding to parents' perceived ability to manage their child's diabetes (MSED-M), problem-solve issues surrounding glycemic control (MSED-P), and teach their child about diabetes care (MSED-T). Correlational analyses revealed significant associations between the MSED-M and MSED-T and parent-reported optimism and youth's diabetes-specific self-efficacy. The MSED-T was also associated with glycated hemoglobin and self-monitoring blood glucose. Results provide preliminary evidence for the reliability and validity of a three-factor solution of the MSED. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  5. Classifying nursing errors in clinical management within an Australian hospital.

    PubMed

    Tran, D T; Johnson, M

    2010-12-01

    Although many classification systems relating to patient safety exist, no taxonomy was identified that classified nursing errors in clinical management. To develop a classification system for nursing errors relating to clinical management (NECM taxonomy) and to describe contributing factors and patient consequences. We analysed 241 (11%) self-reported incidents relating to clinical management in nursing in a metropolitan hospital. Descriptive analysis of numeric data and content analysis of text data were undertaken to derive the NECM taxonomy, contributing factors and consequences for patients. Clinical management incidents represented 1.63 incidents per 1000 occupied bed days. The four themes of the NECM taxonomy were nursing care process (67%), communication (22%), administrative process (5%), and knowledge and skill (6%). Half of the incidents did not cause any patient harm. Contributing factors (n=111) included the following: patient clinical, social conditions and behaviours (27%); resources (22%); environment and workload (18%); other health professionals (15%); communication (13%); and nurse's knowledge and experience (5%). The NECM taxonomy provides direction to clinicians and managers on areas in clinical management that are most vulnerable to error, and therefore, priorities for system change management. Any nurses who wish to classify nursing errors relating to clinical management could use these types of errors. This study informs further research into risk management behaviour, and self-assessment tools for clinicians. Globally, nurses need to continue to monitor and act upon patient safety issues. © 2010 The Authors. International Nursing Review © 2010 International Council of Nurses.

  6. The Organizational Decision Making Climate of Issues Management Programs: A Case Study.

    ERIC Educational Resources Information Center

    Wills, Sandra

    A study examined the decision making climate of organizations that are using issues management and what type of model of issues management is followed--theorists have been attempting to define issues management since it began appearing 20 year ago. Subjects, 112 males and 30 females who were professionals working in the area of issues management…

  7. Late whiplash syndrome: a clinical science approach to evidence-based diagnosis and management.

    PubMed

    Poorbaugh, Keith; Brismée, Jean-Michel; Phelps, Valerie; Sizer, Phillip S

    2008-01-01

    The purpose of this article is to narrow the gap that exists in the clinical application of scientific research and empiric evidence for the evaluation and management of late whiplash. Considering that 14% to 42% of patients are left with chronic symptoms following whiplash injury, it is unlikely that only minor self-limiting injuries result from the typical rear-end impact. As psychosocial issues play a role in the development of persistent whiplash symptoms, discerning the organic conditions from the biopsychosocial factors remains a challenge to clinicians. The term "whiplash" represents the multiple factors associated with the event, injury, and clinical syndrome that are the end-result of a sudden acceleration-deceleration trauma to the head and neck. However, contentions surround the nature of soft-tissue injuries that occur with most motor vehicle accidents and whether these injuries are significant enough to result in chronic pain and limitations. The stark contrast in litigation for whiplash that exists among industrialized nations and less developed countries suggests another factor that could influence one's interpretation of symptoms' chronicity associated with Late Whiplash Syndrome. There are no gold standard tests or imaging techniques that can objectify whiplash-associated disorders. A lack of supporting evidence and disparity in medico-legal issues have created distinct camps in the scientific interpretations and clinical management of late whiplash. It is likely that efforts in research and/or clinical practice will begin to explain the disparity between acute and chronic whiplash syndrome. Recent evidence suggests that Late Whiplash Syndrome should be considered from a different context. The purpose of this article is to expound on several of the significant findings in the literature and offer clinical applications for evaluation and management of Late Whiplash Syndrome.

  8. [Chewing on bruxism. Diagnosis, imaging, epidemiology and aetiology].

    PubMed

    Lobbezoo, F; Jacobs, R; De Laat, A; Aarab, G; Wetselaar, P; Manfredini, D

    2017-06-01

    Since the publication of a special issue on bruxism of the NTvT in July 2000, consensus has been reached on bruxism's definition as a repetitive masticatory muscle activity that is characterised by clenching and/or grinding while awake (awake bruxism) or during sleep (sleep bruxism). As yet, however, no consensus exists about the diagnosis of bruxism: sufficient evidence to establish the reliability and validity of the commonly used techniques (self-report, clinical examination, imaging, electromyography, polysomnography) has not yet been produced. Morphological factors are no longer considered important aetiological factors, while increasing evidence suggests aetiological roles for psychosocial, physiological, biological, and exogenous factors. This review paper is the first part of a diptych and is concerned with the definition, diagnostics, epidemiology and possible causes of this disorder. In the second part, that will be published in the next issue, associations of bruxism with other conditions will be discussed, along with its (purported) consequences and its management.

  9. Human Factors Considerations for Performance-Based Navigation

    NASA Technical Reports Server (NTRS)

    Barhydt, Richard; Adams, Catherine A.

    2006-01-01

    A transition toward a performance-based navigation system is currently underway in both the United States and around the world. Performance-based navigation incorporates Area Navigation (RNAV) and Required Navigation Performance (RNP) procedures that do not rely on the location of ground-based navigation aids. These procedures offer significant benefits to both operators and air traffic managers. Under sponsorship from the Federal Aviation Administration (FAA), the National Aeronautics and Space Administration (NASA) has undertaken a project to document human factors issues that have emerged during RNAV and RNP operations and propose areas for further consideration. Issues were found to include aspects of air traffic control and airline procedures, aircraft systems, and procedure design. Major findings suggest the need for human factors-specific instrument procedure design guidelines. Ongoing industry and government activities to address air-ground communication terminology, procedure design improvements, and chart-database commonality are strongly encouraged.

  10. Managing United States public lands in response to climate change: a view from the ground up.

    PubMed

    Ellenwood, Mikaela S; Dilling, Lisa; Milford, Jana B

    2012-05-01

    Federal land managers are faced with the task of balancing multiple uses and goals when making decisions about land use and the activities that occur on public lands. Though climate change is now well recognized by federal agencies and their local land and resource managers, it is not yet clear how issues related to climate change will be incorporated into on-the-ground decision making within the framework of multiple use objectives. We conducted a case study of a federal land management agency field office, the San Juan Public Lands Center in Durango, CO, U.S.A., to understand from their perspective how decisions are currently made, and how climate change and carbon management are being factored into decision making. We evaluated three major management sectors in which climate change or carbon management may intersect other use goals: forests, biofuels, and grazing. While land managers are aware of climate change and eager to understand more about how it might affect land resources, the incorporation of climate change considerations into everyday decision making is currently quite limited. Climate change is therefore on the radar screen, but remains a lower priority than other issues. To assist the office in making decisions that are based on sound scientific information, further research is needed into how management activities influence carbon storage and resilience of the landscape under climate change.

  11. Environmental Education, Drought and the Rural Man: Implications for Policy-Makers and Farmers in Sub-Saharan Africa.

    ERIC Educational Resources Information Center

    Ladele, Ademola A.

    2001-01-01

    Examines issues related to the nexus of some factors affecting the environment, specifically drought. Suggests that because small farmers are usually at the mercy of unpredictable weather, even simple tips on resource management, when properly packaged, could make tremendous change. (Contains 27 references.) (Author/YDS)

  12. Factors affecting potential for Palmer amaranth (Amaranthus palmeri) suppression by winter rye in Georgia, USA

    USDA-ARS?s Scientific Manuscript database

    Herbicide resistant Palmer amaranth (Amaranthus palmeri) has rapidly become a dominant weed management issue in agronomic crops of the Southeast US. The small size of Palmer amaranth seeds, relative to other common weeds, provides an opportunity to use physical weed control through high-residue, ro...

  13. A Study of the Predictability of School District Bond Ratings.

    ERIC Educational Resources Information Center

    Vedra, Kenneth David

    School district bond ratings, issued on request by Standard and Poor's Corporation or Moody's Investors Service, hold implications for school districts' financial management. Ultimately, the bond rating assigned is a factor affecting the total cost of the bond issuance, related to the principal and interest payments over the life of the debt. A…

  14. Carbon and nitrogen pools in oak-hickory forests of varying productivity

    Treesearch

    Donald J. Kaczmarek; Karyn S. Rodkey; Robert T. Reber; Phillip E. Pope; Felix, Jr. Ponder

    1995-01-01

    Carbon (C) and nitrogen (N) storage capacities are critical issues facing forest ecosystem management in the face of potential global climate change. The amount of C sequestered by forest ecosystems can be a significant sink for increasing atmospheric CO2 levels. N availability can interact with other environmental factors such as water...

  15. Women: Managers Stuck in the Middle?

    ERIC Educational Resources Information Center

    O'Leary, Virginia E.

    Promoting women into higher level organizational positions is vital as a social issue and a subject for organizational theory and research. Recently, Henning and Jardin have identified an internal factor that poses a problem to women and their job-related aspirations. The absence of long-term career commitment has been found to inhibit the…

  16. Factors affecting potential for Palmer amaranth (Amaranthus palmeri) suppression by winter rye in Georgia, USA

    USDA-ARS?s Scientific Manuscript database

    Herbicide resistant Palmer amaranth has rapidly become a dominant weed management issue in agronomic crops of the Southeast U. S. The small size of Palmer amaranth seeds, relative to other common weeds, provides an opportunity to use physical weed control through high-biomass, rolled cover crop mul...

  17. A Study of Suicide and Socioeconomic Factors

    ERIC Educational Resources Information Center

    Ying, Yung-hsiang; Chang, Koyin

    2009-01-01

    The topic of suicide has long been an important socioeconomic issue studied in many countries. Suicides inject an atmosphere of unrest into society, and media attention furthers that social uneasiness. From the viewpoint of economics and management, suicide is a waste of human resource: it decreases the labor force in society and deteriorates…

  18. Modelling Student Satisfaction and Motivation in the Integrated Educational Environment: An Empirical study

    ERIC Educational Resources Information Center

    Stukalina, Yulia

    2016-01-01

    Purpose: The purpose of this paper is to explore some issues related to enhancing the quality of educational services provided by a university in the agenda of integrating quality assurance activities and strategic management procedures. Design/methodology/approach: Employing multiple regression analysis the author has examined some factors that…

  19. Motivational Issues of Faculty in Saudi Arabia

    ERIC Educational Resources Information Center

    Abdul-Cader, Akram; Anthony, Peter John

    2014-01-01

    This study focused on the factors that affect motivation of faculty in Saudi Arabia. It included two surveys and open-ended queries to a focus group of five academic managers and 25 faculty members of varying nationalities, rank, and institutes in Saudi Arabia. The research showed that the faculties in Saudi Arabia's highest education industry…

  20. Management of Children Using Cochlear Implants and Hearing Aids.

    ERIC Educational Resources Information Center

    Ching, Teresa Y. C.; Psarros, Colleen; Incerti, Paula; Hill, Mandy

    2001-01-01

    Four case studies identify six factors affecting successful use of a hearing aid with a cochlear implant: duration of hearing aid use prior to implantation, amount of residual hearing in the non-implanted ear, educational and listening demands, cosmetic issues, hearing aid rejection, and extended period of non-use of hearing aid. (Contains…

  1. Managerial process improvement: a lean approach to eliminating medication delivery.

    PubMed

    Hussain, Aftab; Stewart, LaShonda M; Rivers, Patrick A; Munchus, George

    2015-01-01

    Statistical evidence shows that medication errors are a major cause of injuries that concerns all health care oganizations. Despite all the efforts to improve the quality of care, the lack of understanding and inability of management to design a robust system that will strategically target those factors is a major cause of distress. The paper aims to discuss these issues. Achieving optimum organizational performance requires two key variables; work process factors and human performance factors. The approach is that healthcare administrators must take in account both variables in designing a strategy to reduce medication errors. However, strategies that will combat such phenomena require that managers and administrators understand the key factors that are causing medication delivery errors. The authors recommend that healthcare organizations implement the Toyota Production System (TPS) combined with human performance improvement (HPI) methodologies to eliminate medication delivery errors in hospitals. Despite all the efforts to improve the quality of care, there continues to be a lack of understanding and the ability of management to design a robust system that will strategically target those factors associated with medication errors. This paper proposes a solution to an ambiguous workflow process using the TPS combined with the HPI system.

  2. Earnings Management before Rights Issues and the Subsequent Cash Transfer in Chinese Firms

    NASA Astrophysics Data System (ADS)

    Tsai, Bi-Huei

    2009-08-01

    Unlike private enterprises in developed markets, political influence is profound upon Chinese state-dominated firms. Under this consideration, this paper demonstrates how political impact interferes in Chinese managers' decisions. State-assigned managers were found to deliberately transfer cash raised via rights issues from the public shareholders to the state by cash dividends in order to please Chinese politicians. Especially, to meet the regulatory requirement of rights issues, managers from firms which distributed more cash dividends in the same year of rights issues were more likely to inflate earnings before rights issues. The earnings inflation which managers use to boost firm's incomes is defined as "earnings management." Furthermore, the empirical results also exhibit that firm's close relationship with the state enables managers to obtain approvals of rights issues easily, which reduces the firm's earnings management tendency. The manager's incentives of earnings management is closely attributed to the political intervention.

  3. The changing training needs of clinical nurse managers: exploring issues for continuing professional development.

    PubMed

    Gould, D; Kelly, D; Goldstone, L; Maidwell, A

    2001-04-01

    To identify areas where clinical nurse managers perceived that they would benefit from further training and to make recommendations for planning future programmes to meet their needs. The effectiveness of the clinical nurse manager has traditionally been associated with maintaining standards of care. Continuing professional development (CPD) is essential to ensure this important group feel adequately prepared to perform their role and has been recognized as an important factor in maintaining job satisfaction and reducing wasteful staff turnover. A review of the literature indicated that since the 1980s the CPD needs of clinical nurse managers have tended to be overlooked despite increasing complexity of the tasks expected of them. Thus it appeared that a fresh study to address these needs would be justified and should take into account sources of work-related stress and variables relating to job satisfaction. The study involved clinical nurse managers employed in all four acute hospital National Health Service (NHS) trusts where training needs were served by a major inner city educational consortium. Data collection proceeded in two stages. Initially interviews were undertaken with a random sample of 15 clinical nurse managers to provide in-depth, qualitative data. This information was used to develop a survey questionnaire distributed to the remaining 182 clinical nurse managers in each of the trusts. Data from the interviews indicated that clinical nurse managers appeared to feel clinically competent but generally experienced lack of confidence when dealing with a range of issues, in particular; human resources, managing budgets, deputizing for senior colleagues across the trust ('acting up') and using information technology in everyday practice. Response rate to the survey was good (65%). The results corroborated the interview findings, indicating a need for updating in the same wide range of topics. There were few differences in training needs across all four trusts. Clinical nurse managers who perceived that they had been well-prepared for their role demonstrated higher levels of job satisfaction. Perceived preparation for clinical leadership was the same irrespective of the employing trust, length of time in post and other sociodemographic variables. The study findings confirm that CPD remains a major issue for clinical nurse managers in the United Kingdom (UK) and that providing opportunities for such development may be an important factor in enhancing job satisfaction. The study findings should help those providing CPD to plan more effectively for this group and have implications for staff recruitment and retention.

  4. North America Wound, Ostomy, and Continence and Enterostomal Therapy Nurses Current Ostomy Care Practice Related to Peristomal Skin Issues

    PubMed Central

    McNichol, Laurie; Boarini, Joy

    2017-01-01

    PURPOSE: The purpose of this study was to describe the practice of 796 ostomy nurses in North America in 2014 related to peristomal skin issues. DESIGN: Descriptive study. SUBJECTS AND SETTING: Participants were 796 wound, ostomy, and continence (WOC) and enterostomal therapy (ET) nurses currently practicing in the United States or Canada and caring for patients with ostomies. The collection of data occurred in conjunction with an educational program on peristomal skin complications and practice issues and solicited the participant's perception on the incidence and frequency of peristomal skin issues as well as on practice patterns. METHODS: Participants attended an educational program. They were also asked to anonymously respond to multiple-choice questions on ostomy care management via an audience response system followed by discussion of each item and their responses. This descriptive study reports on the answers to the questions as well as the pertinent discussion points. RESULTS: Participants estimated that approximately 77.70% of their patients developed peristomal skin issues. The most commonly encountered problem was irritant contact dermatitis (peristomal moisture-associated skin damage). Contributing factors were inappropriate use of a pouching system owing to lack of follow-up after hospital discharge. Reported interventions for the prevention and management of peristomal skin issues included preoperative stoma site marking, use of a convex pouching system, and barrier rings. However, subsequent discussion revealed that the frequency of use of these products varied considerably. Participants identified shortened hospital stays, absence of preoperative stoma marking, and limited outpatient follow-up as contributing to development of peristomal skin problems. CONCLUSION: WOC and ET nurses estimate that more than three-quarters of persons living with an ostomy develop peristomal skin problems. Multiple interventions for managing these problems were identified, but some variability in management approaches emerged. PMID:28362656

  5. [Facilitating the diagnosis of depression and burnout by identifying demographic and work-related risk and protective factors among nurses].

    PubMed

    Ádám, Szilvia; Nistor, Anikó; Nistor, Katalin; Cserháti, Zoltán; Mészáros, Veronika

    2015-08-09

    Depression and burnout are frequent comorbidities among nurses. Despite similar symptoms, their management differ. Therefore, their timely diagnosis is essential. To identify demographic and work-related risk and protective factors of burnout and depression, and facilitate their diagnosis. A cross-sectional study among 1,713 nurses was carried out. Depression and burnout were assessed by the shortened Beck Depression Questionnaire and Maclach Burnout Inventory, respectively. Risk and protective factors were explored using t-tests and analysis of variance. The prevalence of depression and moderate-to-high burnout was 35.1% and 34-74%, respectively. Having a partner/child and longer employment in the outpatient setting protected from burnout. Lack of a partner and male sex emerged as risk factors of depression and depersonalisation, respectively. High prevalence of depression and burnout among nurses poses a significant public health issue. Familiarity with the disease-specific risk and protective factors identified in this research may facilitate timely diagnosis and effective disease management.

  6. 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.

  7. Organizational factors related to the confidence of workers in working with residents with dementia or depression in aged care facilities.

    PubMed

    McCabe, Marita P; Mellor, David; Karantzas, Gery; Von Treuer, Kathryn; Davison, Tanya E; O'Connor, Daniel

    2017-05-01

    There has been limited research examining how organizational factors are associated with the level of confidence of residential aged care staff in managing both residents' depression and the behavioural and psychological symptoms of residents with dementia (BPSD). This study investigated this issue. A cross-sectional study design was employed. In total, 255 aged care staff (131 senior staff, 124 junior staff) from 21 residential care facilities participated in the study. All staff completed measures of self-efficacy in managing BPSD as well as confidence in working with older people with depression. They also completed measures of organizational climate (autonomy, cohesion, trust, pressure, support, recognition, fairness and encouragement of innovation) and measures of workplace experience (job role, number of years working in aged care facilities), job stress and satisfaction, and knowledge of depression. The results demonstrated that autonomy, trust, support, and job stress were associated with confidence in managing BPSD, while the factors related to confidence in managing depression were autonomy, support, job stress, job satisfaction, and knowledge of depression. These findings highlight that organizational climate factors need to be addressed in order to increase staff confidence in managing BPSD and depression. In particular, the findings demonstrate the importance of fostering organizational environments in which autonomy is promoted and there is support and cooperation among aged care staff. Attention to these factors is likely to increase the confidence of staff as they carry out their carer role.

  8. Dietitian-general practitioner interface: a pilot study on what influences the provision of effective nutrition management.

    PubMed

    Nicholas, Lisa G; Pond, C Dimity; Roberts, David C K

    2003-04-01

    Effective patient nutrition management can both improve people's health and reduce the cost of health care. In Australia, general practitioners (GPs) and dietitians are in a position to provide this service. However, there is a lack of information available on what influences the provision of the service. The objective was to determine qualitative factors that influence nutrition management by GPs and dietitians. A convenience sample of GPs and dietitians was surveyed using a qualitative questionnaire. The questionnaire related to issues including influences on the GP's decision to initiate nutrition management, barriers to providing nutrition counseling, influences on the GP's decision to refer to a dietitian, and barriers to referral. Fourteen of 20 GPs and 15 of 30 dietitians responded with usable data. The primary influence on a GP's decision to initiate nutrition management (GPs' and dietitians' responses) was the presentation of a patient who required nutrition advice. Barriers to providing nutrition counseling were time and knowledge (GP response), whereas dietitians saw time and lack of patient interest as issues. The primary influence on the GP's decision to refer to a dietitian was a patient presenting with complicated nutrition requirements (GP response), whereas dietitians considered a patient seeking nutrition knowledge as the key influencer. GPs identified cost to the patient as the main barrier to referring to a dietitian, whereas dietitians saw lack of knowledge of where to refer as the key issue. The differing responses suggest that more research is required to understand what influences patient nutrition management by GPs and dietitians in Australia.

  9. Constraint and Flight Rule Management for Space Mission Operations

    NASA Technical Reports Server (NTRS)

    Barreiro, J.; Chachere, J.; Frank, J.; Bertels, C.; Crocker, A.

    2010-01-01

    The exploration of space is one of the most fascinating domains to study from a human factors perspective. Like other complex work domains such as aviation (Pritchett and Kim, 2008), air traffic management (Durso and Manning, 2008), health care (Morrow, North, and Wickens, 2006), homeland security (Cooke and Winner, 2008), and vehicle control (Lee, 2006), space exploration is a large-scale sociotechnical work domain characterized by complexity, dynamism, uncertainty, and risk in real-time operational contexts (Perrow, 1999; Woods et al, 1994). Nearly the entire gamut of human factors issues - for example, human-automation interaction (Sheridan and Parasuraman, 2006), telerobotics, display and control design (Smith, Bennett, and Stone, 2006), usability, anthropometry (Chaffin, 2008), biomechanics (Marras and Radwin, 2006), safety engineering, emergency operations, maintenance human factors, situation awareness (Tenney and Pew, 2006), crew resource management (Salas et al., 2006), methods for cognitive work analysis (Bisantz and Roth, 2008) and the like -- are applicable to astronauts, mission control, operational medicine, Space Shuttle manufacturing and assembly operations, and space suit designers as they are in other work domains (e.g., Bloomberg, 2003; Bos et al, 2006; Brooks and Ince, 1992; Casler and Cook, 1999; Jones, 1994; McCurdy et al, 2006; Neerincx et aI., 2006; Olofinboba and Dorneich, 2005; Patterson, Watts-Perotti and Woods, 1999; Patterson and Woods, 2001; Seagull et ai, 2007; Sierhuis, Clancey and Sims, 2002). The human exploration of space also has unique challenges of particular interest to human factors research and practice. This chapter provides an overview of those issues and reports on some of the latest research results as well as the latest challenges still facing the field.

  10. Alaska Humans Factors Safety Study: The Southern Coastal Area

    NASA Technical Reports Server (NTRS)

    Chappell, Sheryl L.; Reynard, William (Technical Monitor)

    1995-01-01

    At the request of the Alaska Air Carriers Association, researchers from the NASA Aviation Safety Reporting System, at NASA Ames Research Center, conducted a study on aspects of safety in Alaskan Part 135 air taxi operations. An interview form on human factors safety issues was created by a representative team from the FAA-Alaska, NTSB-Alaska, NASA-ASRS, and representatives of the Alaska Air Carriers Association which was subsequently used in the interviews of pilots and managers. Because of the climate and operational differences, the study was broken into two geographical areas, the southern coastal areas and the northern portion of the state. This presentation addresses the southern coastal areas, specifically: Anchorage, Dillingham, King Salmon, Kodiak, Cold Bay, Juneau, and Ketchikan. The interview questions dealt with many of the potential pressures on pilots and managers associated with the daily air taxi operations in Alaska. The impact of the environmental factors such as the lack of available communication, navigation and weather information systems was evaluated. The results of this study will be used by government and industry working in Alaska. These findings will contribute important information on specific Alaska safety issues for eventual incorporation into training materials and policies that will help to assure the safe conduct of air taxi flights in Alaska.

  11. Health of adolescent refugees resettling in high-income countries.

    PubMed

    Hirani, Kajal; Payne, Donald; Mutch, Raewyn; Cherian, Sarah

    2016-07-01

    Adolescent refugees are a vulnerable population with complex healthcare needs that are distinct from younger and older age groups. Physical health problems are common in this cohort with communicable diseases being the focus of attention followed by an emphasis on nutritional deficiencies and other chronic disorders. Adolescent refugees have also often experienced multiple traumatic stressors and are at a heightened risk of developing mental health problems. Navigating these problems at the time of pubertal development adds further challenges and can exacerbate or lead to the emergence of health risk behaviours. Educational difficulties and acculturation issues further compound these issues. Adolescents who have had experiences in detention or are unaccompanied by parents are particularly at risk. Despite a constantly growing number of adolescent refugees resettling in high-income countries, knowledge regarding their specific healthcare needs is limited. Research data are largely extrapolated from studies conducted within paediatric and adult cohorts. Holistic management of the medical and psychological issues faced by this group is challenging and requires an awareness of the socioeconomic factors that can have an impact on effective healthcare delivery. Legal and ethical issues can further complicate their management and addressing these in a culturally appropriate manner is essential. Early identification and management of the healthcare issues faced by adolescent refugees resettling in high-income countries are key to improving long-term health outcomes and future healthcare burden. This review article aims to increase knowledge and awareness of these issues among paediatricians and other health professionals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Evolution of China's water issues as framed in Chinese mainstream media

    NASA Astrophysics Data System (ADS)

    Wei, Y.; Xiong, Y.; Zhang, Z.

    2016-12-01

    There is an urgent need globally to trigger fundamental societal changes in water use away from existing unsustainable paradigms. This paper attempts to understand the evolution of newspaper coverage of water issues in China by analyzing water-related articles in a major national newspaper People's Daily during 1946-2012 using a content analysis approach. The major findings include: 1) water issues have been in relatively important positions in the newspaper; 2) water issues reporting in China has experienced three stages: 1946- the middle of 1980s: flood and drought control and water for food; the middle of 1980s to 1997: water for economic development; and 1998 to the present: water for the environmental sustainability and economic development; 3) water issue reporting in the People's Daily clearly reflected China's top-down water resources management system, no "real" public opinions on water were reported during the study period; 4) The People's Daily is just a wind vane of Chinese mainstream values and policies on water. These findings supported the realist assumption that the societal changes on water issues in China were triggered by a multitude of factors including the biophysical pressure (floods and droughts), political campaign (the Cultural Revolution), macro-economic reform (Reform and Opening-up), water institutional arrangement (the Water Law) and water management reform (the No. 1 Central Document on water reform).

  13. Alternative approaches to pollution control and waste management: Regulatory and economic instruments. Planteamientos alternos para el control de la contaminacion y el manejo de desechos: instrumentos regulatorios y economicos

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

    Bernstein, J.D.

    1993-01-01

    The paper examines ways in which developed and developing countries control pollution and manage urban wastes. It addresses pollution issues of concern to local, provincial, and national governments, as well as nongovernmental organizations. Two approaches to pollution management are discussed: direct regulation and economic incentives. Direct regulation sets standards and enforces them through permits, licenses, and controls on land or water use. Economic incentives encourage polluters to adopt control measures and are more flexible and cost effective. Such incentives include charging fees to enterprises for pollution discharges or providing government subsidies for pollution control technology. The author tells how economicmore » incentives can supplement direct regulation and why such incentives, when properly used, offer advantages over direct regulation. The author discusses how governments have used economic incentives to deal with specific environmental issues and what factors policymakers must address when they plan pollution controls.« less

  14. Identifying emerging issues in forestry as a tool for research planning.

    Treesearch

    Hans M. Gregersen; Allen L. Lundgren; Pamela J. Jakes; David N. Bengston

    1989-01-01

    A Delphi exercise is used to identify emerging issues in National Forest management and use, the relative importance of the issues, and barriers to resolving issues. USDA Forest Service managers agree on the importance of the 11 issues identified; however, researchers and National Forest managers do not always agree on the importance of issues or barriers.

  15. Healthy Coping: Issues and Implications in Diabetes Education and Care

    PubMed Central

    Kent, Dan; Haas, Linda; Randal, David; Lin, Elizabeth; Thorpe, Carolyn T.; Boren, Suzanne A.; Fisher, Jan; Heins, Joan; Lustman, Patrick; Nelson, Joe; Ruggiero, Laurie; Wysocki, Tim; Sherr, Dawn; Martin, Annette Lenzi

    2010-01-01

    Abstract Psychological, emotional, and social factors not only impact quality of life, but also often play a role in chronic illness outcomes. Diabetes care, in particular, is greatly influenced by psychosocial factors when they hinder a person's ability to manage the disease and achieve metabolic control. Healthy coping, defined as responding to a psychological and physical challenge by recruiting available resources to increase the probability of favorable outcomes in the future, is essential to effective self-management by people with diabetes. In June 2009, the American Association of Diabetes Educators convened a multidisciplinary expert panel to discuss healthy coping in diabetes. The panel included diabetes educators and behavioral science and mental health professionals. Drawing on their knowledge and experiences, as well as information presented at the symposium, the panel probed several aspects of healthy coping including what it entails, common barriers, assessment, population diversity, and clinical applications. A team approach to addressing the patient's coping is critical. Team involvement relieves the diabetes educator of the entire burden of supporting the patient in this regard. The team should be broadly defined and include those who are formally and informally involved. Healthy coping is a complex, qualitative behavior that cannot be easily quantified. Future efforts to address the issue of healthy coping should add to the body of literature regarding diabetes self-management at the individual and population-based levels. (Population Health Management 2010;13:227–233) PMID:20879903

  16. Saving the superstar: a review of the social factors affecting tiger conservation in India.

    PubMed

    Rastogi, Archi; Hickey, Gordon M; Badola, Ruchi; Hussain, Syed Ainul

    2012-12-30

    Tiger conservation in India represents an excellent case study of the many challenges facing conservation programs internationally. It is well understood that tigers are sensitive to human disturbances and large areas of habitat need to be protected for their conservation. Such protected areas in India are managed by the governments using an exclusionary approach. However, this approach is known to create several issues with local communities, including historical, legal, livelihood and management issues; with a volume of literature suggesting the inclusion of local communities in management. Yet, other evidence suggests that inclusion of communities in tiger conservation may lead to anthropogenic disturbances that can jeopardize tigers. The gravity of the situation is reflected in the recent disappearance of tigers from two key protected areas in India, the Sariska and Panna Tiger Reserves. This review paper connects the key literature from conservation biology, environmental history, management sciences, policy and political sciences to underline the gridlock of tiger conservation: it needs exclusive protected areas that antagonize communities, and it depends on the support of the same communities for success. We examine the possibility of reconciliation between these disciplines, and assert that research on tiger conservation needs to allow for an increasingly interdisciplinary approach. We call for a more integrated approach to tiger conservation, to examine the values inherent in conservation and to shed more light on the social factors that affect tiger conservation schemes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Nurse managers' experience with ethical issues in six government hospitals in Malaysia: a cross-sectional study.

    PubMed

    Musa, Maizura binti; Harun-Or-Rashid, M D; Sakamoto, Junichi

    2011-11-16

    Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues. A cross-sectional study was conducted in August-September, 2010 involving 417 (69.2%) of total 603 nurse managers in the six Malaysian government hospitals. Data were collected using three-part self-administered questionnaire. Part I was regarding participants' demographics. Part II was about the frequency and areas of management where ethical issues were experienced, and scoring of the importance of 11 pre-identified ethical issues. Part III asked how they dealt with ethical issues in general; ways to deal with the 11 pre-identified ethical issues, and perceived stress level. Data were analyzed using descriptive statistics, cross-tabulations and Pearson's Chi-square. A total of 397 (95.2%) participants experienced ethical issues and 47.2% experienced them on weekly to daily basis. Experiencing ethical issues were not associated with areas of practice. Top area of management where ethical issues were encountered was "staff management", but "patient care" related ethical issues were rated as most important. Majority would "discuss with other nurses" in dealing generally with the issues. For pre-identified ethical issues regarding "patient care", "discuss with doctors" was preferred. Only 18.1% referred issues to "ethics committees" and 53.0% to the code of ethics. Nurse managers, regardless of their areas of practice, frequently experienced ethical issues. For dealing with these, team-approach needs to be emphasized. Proper understanding of the code of ethics is needed to provide basis for reasoning.

  18. Managing the transcription revolution. Industry forces shape future of field.

    PubMed

    Faulkner, Scott D

    2003-01-01

    You may be struggling with contract issues with a vendor. Or maybe you're contemplating the pros and cons of working with outsource, at-home, or overseas transcriptionists. It's a fact: if transcription processes aren't working efficiently, the entire HIM department may be adversely affected. Factor in additional concerns such as data capture for electronic health records, compliance, and patient safety, and the importance of ensuring quality and cost-efficient transcription becomes even more apparent. To help you answer some of these questions, the Journal of AHIMA is launching a four-part series dedicated to transcription issues from the HIM professional's point of view. In this issue, we begin with MTIA president Scott Faulkner's overview of the industry and where it's going next. In upcoming issues, other experts will look at controlling cost and monitoring quality, navigating new technologies, and dealing with contract-related issues.

  19. Time Overrun in Construction Project

    NASA Astrophysics Data System (ADS)

    Othman, I.; Shafiq, Nasir; Nuruddin, M. F.

    2017-12-01

    Timely completion is the key criteria to achieve success in any project despite the industry. Unfortunately construction industry in Malaysia has been labelled as industry facing poor performance leading to failure in achieving effective time management. As the consequence most of the project face huge amount of time overrun. This study assesses the causes of construction projects time overrun in Malaysia using structured questionnaire survey. Each respondent is asked to assign a one-to-five rating for each of the 18 time factors identified from literature review. Out of the 50 questionnaires sent out, 33 were received back representing 68% of the response rate. Data received from the questionnaires were analysed and processed using the descriptive statistics procedures. Findings from the study revealed that design and documentation issues, project management and contract administration, ineffective project planning and scheduling, contractor’s site management, financial resource management were the major factors that cause the time overrun. This study is hoped to help the practitioners to implement the mitigation measure at planning stage in order to achieve successful construction projects.

  20. Patients' Perspective on the Value of Medication Management Appointments.

    PubMed

    Cruz, Mario; Cruz, Robyn Flaum; Pincus, Harold Alan

    2015-05-20

    There is ongoing concern that psychiatric medication management appointments add little value to care. The present study attempted to address this concern by capturing depressed patients' views and opinions about the value of psychiatric medication management appointments. Seventy-eight semi-structured interviews were performed with white and African American depressed patients post medication management appointments. These interviews tapped patients' views and opinions about the value of attending medication management appointments. An iterative thematic analysis was performed. Patients reported greater appointment value when appointments included obtaining medications, discussing the need for medication changes or dose adjustments, and discussing the impact of medications on their illness. Additionally, greater appointment value was perceived by patients when there were non-medical conversations about life issues, immediate outcomes from the appointment such as motivation to continue in care, and specific qualities of providers that were appealing to patients. Patients' perceived value of psychiatric medication management appointments is complex. Though important patient outcomes are obtaining medicine and perceiving improvement in their mental health, there are other valued appointment and provider factors. Some of these other valued factors embedded within medication management appointments could have therapeutic properties. These findings have implications for future clinical research and service delivery.

  1. The Insertion of Human Factors Concerns into NextGen Programmatic Decisions

    NASA Technical Reports Server (NTRS)

    Beard, Bettina L.; Holbrook, Jon Brian; Seely, Rachel

    2013-01-01

    Since the costs of proposed improvements in air traffic management exceed available funding, FAA decision makers must select and prioritize what actually gets implemented. We discuss a set of methods to help forecast operational and human performance issues and benefits before new automation is introduced. This strategy could minimize the impact of politics, assist decision makers in selecting and prioritizing potential improvements, make the process more transparent and strengthen the link between the engineering and human factors domains.

  2. Research on the Hotel Image Based on the Detail Service

    NASA Astrophysics Data System (ADS)

    Li, Ban; Shenghua, Zheng; He, Yi

    Detail service management, initially developed as marketing programs to enhance customer loyalty, has now become an important part of customer relation strategy. This paper analyzes the critical factors of detail service and its influence on the hotel image. We establish the theoretical model of influencing factors on hotel image and propose corresponding hypotheses. We use applying statistical method to test and verify the above-mentioned hypotheses. This paper provides a foundation for further study of detail service design and planning issues.

  3. Factors Influencing Diabetes Self-Management Among Medically Underserved Patients With Type II Diabetes

    PubMed Central

    Reyes, Jimmy; Tripp-Reimer, Toni; Parker, Edith; Muller, Brandi; Laroche, Helena

    2017-01-01

    In this study, researchers compare and contrast issues regarding diabetes self-management between persons in good versus poor glycemic control. The sample comprises low-income racially diverse adults with diabetes from four mid-western community health centers; 44 patients participated in eight focus groups divided by control status (HbA1c of > 9 [uncontrolled] or < 7 [controlled]). Themes common to both groups included the impact of dietary restrictions on social interactions, food cravings, the impact of mental health on self-management, and the importance of formal and informal (friends and family) support. Those in the uncontrolled groups described fear about being able to control their diabetes, confusion about self-management, and difficulty managing their diabetes while caring for family members. Although those in the controlled groups acknowledged difficulties, they discussed resisting cravings, making improvements with small changes, positive feelings about their ability to control their diabetes, and enjoying new foods and exercise. Interventions should include mental health support, incorporate formal and informal patient support structures, and address literacy issues. Health care providers and intervention personnel should be very concrete about how to do self-management tasks and guide patients on how to alter their diabetes regimens for social and other important life events. PMID:28660239

  4. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review

    PubMed Central

    Hudon, Catherine; Chouinard, Maud-Christine; Lambert, Mireille; Diadiou, Fatoumata; Bouliane, Danielle; Beaudin, Jérémie

    2017-01-01

    Objective The aim of this paper was to identify the key factors of case management (CM) interventions among frequent users of healthcare services found in empirical studies of effectiveness. Design Thematic analysis review of CM studies. Methods We built on a previously published review that aimed to report the effectiveness of CM interventions for frequent users of healthcare services, using the Medline, Scopus and CINAHL databases covering the January 2004–December 2015 period, then updated to July 2017, with the keywords ‘CM’ and ‘frequent use’. We extracted factors of successful (n=7) and unsuccessful (n=6) CM interventions and conducted a mixed thematic analysis to synthesise findings. Chaudoir’s implementation of health innovations framework was used to organise results into four broad levels of factors: (1) environmental/organisational level, (2) practitioner level, (3) patient level and (4) programme level. Results Access to, and close partnerships with, healthcare providers and community services resources were key factors of successful CM interventions that should target patients with the greatest needs and promote frequent contacts with the healthcare team. The selection and training of the case manager was also an important factor to foster patient engagement in CM. Coordination of care, self-management support and assistance with care navigation were key CM activities. The main issues reported by unsuccessful CM interventions were problems with case finding or lack of care integration. Conclusions CM interventions for frequent users of healthcare services should ensure adequate case finding processes, rigorous selection and training of the case manager, sufficient intensity of the intervention, as well as good care integration among all partners. Other studies could further evaluate the influence of contextual factors on intervention impacts. PMID:29061623

  5. Drivers of Continuing Education Learning Preferences for Veterans Affairs Women's Health Primary Care Providers.

    PubMed

    Zuchowski, Jessica L; Hamilton, Alison B; Washington, Donna L; Gomez, Arthur G; Veet, Laure; Cordasco, Kristina M

    2017-01-01

    Documented gaps in health professionals' training in women's health are a special concern for continuing education (CE). In the Veterans Affairs (VA) health care system, women veterans are a numerical minority, preferably assigned to designated women's health primary care providers (DWHPs). DWHPs need to maintain their knowledge and skills in women's health topics, in addition to general internal medicine topics. We explored drivers of VA DWHPs' learning preferences for women's health topics-ie, factors which influence greater and lesser learning interest. We conducted semistructured telephone interviews with DWHPs across six VA health care systems. Interviews were audio recorded, transcribed, and coded in ATLAS.ti. We synthesized results by grouping relevant coded sections of text to form emergent themes. Among the 31 DWHPs interviewed, reported drivers of learning interests among women's health topics were (1) high frequency of clinical incidence of particular issues; (2) perceived appropriateness of particular issues for management in primary care settings; and (3) perceived appropriateness of particular issues for partial management in primary care. Lower interest in particular women's health topics was associated with (1) perceived existing competency or recent training in an issue and (2) perceived need for specialty care management of an issue. Understanding drivers of DWHPs' CE learning priorities lays a foundation for developing CE programming that will be of interest to women's health primary care providers. Attention to drivers of learning interests may have applicability beyond women's health, suggesting a general approach for CE programming that prioritizes high-volume topics within the practice scope of target providers.

  6. Why issues emerge

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

    Coates, J.F.; Jarrett, J.; Decker, C.

    1989-10-01

    For those analysts and managers responsible for anticipating issues that may become important to their organizations, the origin of such issues is an important question. This study looks at how, and why, an issue may emerge from a situation, or an event. The full development of an issue, and its resolution may take from five to 30 years or more. The earlier it can be anticipated, the more opportunity for its stakeholders to develop positions and options for addressing it. Three approaches to examining the origins of issues are employed; the invention of ten models as metaphors for the formationmore » and growth of issues; the test of these models against 12 well-known, and fully developed issues; and the analysis of three case studies of issue development. This analysis assesses the readiness at different times for cultural, institutional and situational factors to allow or promote a situation to transition into an issue. Six of the ten conceptual models prove to be more powerful metaphors of issue development than the others. Analysis of the case studies shows that a readiness assessment of an unfolding situation may yield clues to a new issue. A readiness checklist is provided. 6 figs., 4 tabs.« less

  7. The successful management of programs for human factors certification of advanced aviation technologies

    NASA Technical Reports Server (NTRS)

    Baldwin, Rod

    1994-01-01

    In recent years there have been immense pressures to enact changes on the air traffic control organizations of most states. In addition, many of these states are or have been subject to great political, sociological and economic changes. Consequently, any new schemes must be considered within the context of national or even international changes. Europe has its own special problems, and many of these are particularly pertinent when considering human factors certification programs. Although these problems must also be considered in the wider context of change, it is usually very difficult to identify which forces are pressing in support of human factors aspects and which forces are resisting change. There are a large number of aspects which must be taken into account if human factors certification programs are to be successfully implemented. Certification programs would be new ventures, and like many new ventures it will be essential to ensure that managers have the skills, commitment and experience to manage the programs effectively. However, they must always be aware of the content and the degree of certainty to which the human factors principles can be applied - as Debons and Horne have carefully described. It will be essential to avoid the well known pitfalls which occur in the implementation of performance appraisal schemes. While most appraisal schemes are usually extremely well thought out, they often do not produce good results because they are not implemented properly and staff therefore do not have faith in them. If the manager does not have the commitment and interest in his/her staff as human beings, then the schemes will not be effective. Thus, one aspect of considering human factors certification schemes is within the context of a managed organization. This paper outlines some of the management factors which need to be considered for the air traffic control services. Many of the points received attention during the plenary sessions while others were covered by the working groups when the question arose of how various aspects of human factors certification programs would be managed. Management and organizational issues will certainly need to be included in any frame of reference by those who may be involved in developing certification programs.

  8. Urban hydrology—Science capabilities of the U.S. Geological Survey

    USGS Publications Warehouse

    Bell, Joseph M.; Simonson, Amy E.; Fisher, Irene J.

    2016-04-29

    Urbanization affects streamflow characteristics, coastal flooding, and groundwater recharge. Increasing impervious areas, streamflow diversions, and groundwater pumpage are some of the ways that the natural water cycle is affected by urbanization. Assessment of the relations among these factors and changes in land use helps water-resource managers with issues such as stormwater management and vulnerability to flood and drought. Scientists with the U.S. Geological Survey (USGS) have the expertise to monitor and model urban hydrologic systems. Streamflow and groundwater data are available in national databases, and analyses of these data, including identification of long-term streamflow trends and the efficacy of management practices, are published in USGS reports.

  9. Enrolment Management in Graduate Business Programs: Predicting Student Retention

    ERIC Educational Resources Information Center

    Eshghi, Abdoloreza; Haughton, Dominique; Li, Mingfei; Senne, Linda; Skaletsky, Maria; Woolford, Sam

    2011-01-01

    The increasing competition for graduate students among business schools has resulted in a greater emphasis on graduate business student retention. In an effort to address this issue, the current article uses survival analysis, decision trees and TreeNet® to identify factors that can be used to identify students who are at risk of dropping out of a…

  10. Do School-Level Factors Influence the Educational Benefits of Digital Technology? A Critical Analysis of Teachers' Perceptions

    ERIC Educational Resources Information Center

    Perrotta, Carlo

    2013-01-01

    The supposed benefits of teachers' use of information and communications technology (digital technology) are well reported throughout the academic literature--most often involving issues of enhanced learning outcomes, increased pupil engagement and more efficient management and organisation of learning. This paper uses survey data from 683…

  11. REPORT ON THE PANEL SESSION: EMERGING ELECTRONICS ISSUES - HOW CAN WE MINIMIZE THE HEALTH AND ENVIRONMENTAL IMPACTS OF ELECTRONICS RECYCLING?

    EPA Science Inventory

    The production and use of electronic products is growing and the rapid pace at which the technology advances means that many electronic products become obsolete in a relatively short period of time. These factors are contributing to a growing challenge for waste management becaus...

  12. Health of eastern North American sugar maple forests and factors affecting decline

    Treesearch

    Stephen B. Horsley; Robert P. Long; Scott W. Bailey; Richard A. Hallett; Philip M. Wargo

    2002-01-01

    Sugar maple (Acer saccharum) is a keystone species in the forests of the northeastern and Midwestern United States and eastern Canada. Its sustained health is an important issue in both managed and unmanaged forests. While sugar maple generally is healthy throughout its range, decline disease of sugar maple has occurred sporadically during the past...

  13. Mixed-Methods Analysis of Rural Special Educators' Role Stressors, Behavior Management, and Burnout

    ERIC Educational Resources Information Center

    Garwood, Justin D.; Werts, Margaret G.; Varghese, Cheryl; Gosey, Leanne

    2018-01-01

    The researchers of this study used a mixed-methods approach to understand issues of rural special education teacher burnout. Results of survey responses (n = 64) and follow-up focus group interviews (n = 12) from rural special education teachers indicated several factors contributing to stress and burnout. Teachers noted that lack of clarity in…

  14. Predicting Personal Healthcare Management: Impact of Individual Characteristics on Patient Use of Health Information Technology

    ERIC Educational Resources Information Center

    Sandefer, Ryan Heath

    2017-01-01

    The use of health information and health information technology by consumers is a major factor in the current healthcare systems' effort to address issues related to quality, cost, and access. Patient engagement in the healthcare process through access to information related to diagnoses, procedures, and treatment has the potential to improve…

  15. Genome-based approach to discover new livestock pest control technologies: The horn fly (Haematobia irritans) genome sequencing project

    USDA-ARS?s Scientific Manuscript database

    Invasion of the Americas by the horn fly, H. irritans, has resulted in control issues throughout the continent. Insecticide resistance is a major complicating factor with efforts to manage this pest. Stakeholder focus groups identified the horn fly as the top priority arthropod pest affecting cattle...

  16. Examining the Factors, Which Compel Online Graduate Students to Seek Academic Assistance

    ERIC Educational Resources Information Center

    Daines, Ramon

    2017-01-01

    The number of graduate level students who do not complete their degree has been an ongoing issue in higher education and has increased with the growth of online education. Research demonstrates that online learners who have already achieved their degree could manage their learning experience, understood the importance of seeking help when…

  17. Carbon sequestration potential of poplar energy crops in the Midwest, USA

    Treesearch

    R.S. Jr. Zalesny; W.L. Headlee; R.B. Hall; D.R. Coyle

    2010-01-01

    Energy use and climate change mitigation are closely linked via ecological, social, and economic factors, including carbon management. Energy supply is a key 21st century National security issue for the United States; identifying and developing woody feedstocks for transportation fuels and combined heat and power operations are a crucial component of the future...

  18. Whose Evidence Base? The Dynamic Effects of Ownership, Receptivity and Values on Collaborative Evidence-Informed Policy Making

    ERIC Educational Resources Information Center

    Shine, Kasey Treadwell; Bartley, Brendan

    2011-01-01

    This paper explores questions of ownership of and receptivity to research-based evidence and, in combination with often competing values, their effect on collaborative evidence-informed policy making (EIPM). We propose that these issues generate a "dynamo" of push-pull factors for policy makers, researchers and research managers. Through…

  19. Diagnosis and management of people with venous thromboembolism and advanced cancer: how do doctors decide? A qualitative study.

    PubMed

    Johnson, Miriam J; Sheard, Laura; Maraveyas, Anthony; Noble, Simon; Prout, Hayley; Watt, Ian; Dowding, Dawn

    2012-07-20

    The treatment of cancer associated thrombosis (CAT) is well established, with level 1A evidence to support the recommendation of a low molecular weight heparin (LMWH) by daily injection for 3-6 months. However, registry data suggest compliance to clinical guidelines is poor. Clinicians face particular challenges in treating CAT in advanced cancer patients due to shorter life expectancy, increased bleeding risk and concerns that self injection may be too burdensome. For these reasons decision making around the diagnosis and management of CAT in people with advanced cancer, can be complex, and should focus on its likely net benefit for the patient. We explored factors that influence doctors' decision making in this situation and sought to gain an understanding of the barriers and facilitators to the application of best practice. Think aloud exercises using standardised case scenarios, and individual in depth interviews were conducted. All were transcribed. The think aloud exercises were analysed using Protocol Analysis and the interviews using Framework Analysis. 46 participants took part in the think aloud exercises and 45 participants were interviewed in depth. Each group included oncologists, palliative physicians and general practitioners and included both senior doctors and those in training. Two Strategic Health Authority regions, one in the north of England and one in Wales. The following key issues arose from the data synthesis: the importance of patient prognosis; the concept of "appropriateness"; "benefits and burdens" of diagnosis and treatment; LMWH or warfarin for treatment and sources of information which changed practice. Although interlinked, they do describe distinct aspects of the factors that influence doctors in their decisions in this area. The above factors are issues doctors take into account when deciding whether to send a patient to hospital for investigation or to anticoagulate a patient with confirmed or suspected VTE. Many factors interweave and are themselves influenced by and dependent on each other. It is only after all are taken into account that the doctor arrives at the point of referring the patient for investigation. Some factors including logistic and organisational issues appeared to influence whether a patient would be investigated or treated with LMWH for a confirmed VTE. It is important that services are optimised to ensure that these do not hinder the appropriate investigation and management of individual patients.

  20. The Current Working Conditions in Ugandan Apparel Assembly Plants.

    PubMed

    Tebyetekerwa, Mike; Akankwasa, Nicholus Tayari; Marriam, Ifra

    2017-12-01

    The present rapid shift of industrialization from developed to developing countries requires developing countries to understand issues related to work organization, management, and working conditions. There are many factors slackening production, of which working conditions is part. A complete inquiry into the workers' working conditions can enable managements to reduce risks in the workplaces and improve productivity. Understanding and awareness of the benefits of workplace research and a probe into the working conditions in the Ugandan apparel assembly plants are urgently required. A total of 103 (70 women and 33 men) workers from five different plants were interviewed. Together with the top management of various plants, questionnaires about the workers' opinions of their physical working conditions were prepared. Data was collected using two methods: (1) questionnaire; and (2) observation of the workers during their work. The results indicated that poor plant working conditions were mainly contributed by the workers' social factors and the management policies. The government, together with the management, should work to improve the working conditions in the apparel assembly plants, as it greatly affects both.

  1. Understanding the contribution of environmental factors in the spread of antimicrobial resistance.

    PubMed

    Fletcher, Stephanie

    2015-07-01

    The overuse and abuse of antibiotics have contributed to the global epidemic of antibiotic resistance. Current evidence suggests that widespread dependency on antibiotics and complex interactions between human health, animal husbandry and veterinary medicine, have contributed to the propagation and spread of resistant organisms. The lack of information on pathogens of major public health importance, limited surveillance, and paucity of standards for a harmonised and coordinated approach, further complicates the issue. Despite the widespread nature of antimicrobial resistance, limited focus has been placed on the role of environmental factors in propagating resistance. There are limited studies that examine the role of the environment, specifically water, sanitation and hygiene factors that contribute to the development of resistant pathogens. Understanding these elements is necessary to identify any modifiable interactions to reduce or interrupt the spread of resistance from the environment into clinical settings. This paper discusses some environmental issues that contribute to antimicrobial resistance, including soil related factors, animal husbandry and waste management, potable and wastewater, and food safety, with examples drawn mainly from the Asian region. The discussion concludes that some of the common issues are often overlooked and whilst there are numerous opportunities for environmental factors to contribute to the growing burden of antimicrobial resistance, a renewed focus on innovative and traditional environmental approaches is needed to tackle the problem.

  2. Handball Coaches’ Perceptions About the Value of Working Competences According to Their Coaching Background

    PubMed Central

    Mesquita, Isabel; Borges, Mario; Rosado, Antonio; Souza, Adriano De

    2011-01-01

    The purpose of this study was to analyze the value attributed to given working competences, by Portuguese handball coaches according to their coaching background, certification level, coaching experience, and level of education. A sample of 207 handball coaches responded to a questionnaire which included demographic characteristics and a scale focused on perceptions of the level of importance attributed to working competences. Data analysis included an exploratory factorial analysis applying Maximum Likelihood Factoring (MLF) and Oblimin rotation. These factors were submitted to a One-way ANOVA and Tukey’s post hoc multiple comparisons to analyse coaches’ perceptions according to their coaching background. A six factor solution was found where three major domains of competences were highlighted; the first one related to training and competition (e.g. planning and conducting the training, team administration in competition, annual and multi-annual planning, and coaching methodology); the second one related to social and cultural issues and management (e.g. implementation of youth sport development projects, team leadership and coach education) and the third one related to the cognitive background (meta-cognitive competences). The importance ascribed to some working competences was influenced by their coaching experience and certification level. Highly experienced and qualified coaches perceived competences of everyday practice, social, cultural and management issues related to training and competition as more important than the other coaches. This study suggests the need to consider some working competences, until now not explicitly present in the Portuguese coaching education curriculum which could enable coaches to choose the best way to practice/work in a manner that will foster and support their professional development. Key points Three major domains of competences were highlighted by Portuguese handball coaches. The first one related to training and competition, the second one related to social and cultural issues and management and the third one related to the cognitive background. The importance ascribed by Portuguese handball coaches to some working competences was influenced by their coaching experience and certification level, as high experienced coaches and coaches with higher certification levels perceived competences related to training and competition of the everyday practice and social, cultural issues and management as more important. The value attributed by Portuguese handball coaches to working competences did not vary according to the coaches’ academic education level. Portuguese handball coaches valued the meta-cognitive competences, the competences to implement sport development project and related to annual and multi-annual planning independently of their coaching background. PMID:24149314

  3. Handball coaches' perceptions about the value of working competences according to their coaching background.

    PubMed

    Mesquita, Isabel; Borges, Mario; Rosado, Antonio; Souza, Adriano De

    2011-01-01

    The purpose of this study was to analyze the value attributed to given working competences, by Portuguese handball coaches according to their coaching background, certification level, coaching experience, and level of education. A sample of 207 handball coaches responded to a questionnaire which included demographic characteristics and a scale focused on perceptions of the level of importance attributed to working competences. Data analysis included an exploratory factorial analysis applying Maximum Likelihood Factoring (MLF) and Oblimin rotation. These factors were submitted to a One-way ANOVA and Tukey's post hoc multiple comparisons to analyse coaches' perceptions according to their coaching background. A six factor solution was found where three major domains of competences were highlighted; the first one related to training and competition (e.g. planning and conducting the training, team administration in competition, annual and multi-annual planning, and coaching methodology); the second one related to social and cultural issues and management (e.g. implementation of youth sport development projects, team leadership and coach education) and the third one related to the cognitive background (meta-cognitive competences). The importance ascribed to some working competences was influenced by their coaching experience and certification level. Highly experienced and qualified coaches perceived competences of everyday practice, social, cultural and management issues related to training and competition as more important than the other coaches. This study suggests the need to consider some working competences, until now not explicitly present in the Portuguese coaching education curriculum which could enable coaches to choose the best way to practice/work in a manner that will foster and support their professional development. Key pointsThree major domains of competences were highlighted by Portuguese handball coaches. The first one related to training and competition, the second one related to social and cultural issues and management and the third one related to the cognitive background.The importance ascribed by Portuguese handball coaches to some working competences was influenced by their coaching experience and certification level, as high experienced coaches and coaches with higher certification levels perceived competences related to training and competition of the everyday practice and social, cultural issues and management as more important.The value attributed by Portuguese handball coaches to working competences did not vary according to the coaches' academic education level.Portuguese handball coaches valued the meta-cognitive competences, the competences to implement sport development project and related to annual and multi-annual planning independently of their coaching background.

  4. The motivations to nurse: an exploration of factors amongst undergraduate students, registered nurses and nurse managers.

    PubMed

    Newton, Jennifer M; Kelly, Cherene M; Kremser, Anne K; Jolly, Brian; Billett, Stephen

    2009-04-01

    To identify what motivates individuals to engage in a nursing career. Recruitment and retention of nurses is a worldwide concern that is associated with several compounding factors, primarily the high attrition of its new graduates and an ageing workforce. Given these factors, it is necessary to understand why individuals choose to nurse, what keeps them engaged in nursing, and in what ways healthcare systems can support career development and retention. This paper presents initial interview data from a longitudinal multi method study with 29 undergraduate student nurses, 25 registered nurses (RNs), six Nurse Unit Managers (NUMs) and four Directors of Nursing (DoNs) from four hospitals across a healthcare organization in Australia. Thematic analysis yielded four key themes that were common to all participants: (1) a desire to help, (2) caring, (3) sense of achievement and (4) self-validation. These themes represented individuals' motivation to enter nursing and sustain them in their careers as either nurses or managers. Managers need to be cognisant of nurses underlying values and motivators in addressing recruitment and retention issues. Strategies need to be considered at both unit and organizational levels to ensure that the 'desire to care' does not become lost.

  5. Supporting cancer patients in illness management: usability evaluation of a mobile app.

    PubMed

    Mirkovic, Jelena; Kaufman, David R; Ruland, Cornelia M

    2014-08-13

    Mobile phones and tablets currently represent a significant presence in people's everyday lives. They enable access to different information and services independent of current place and time. Such widespread connectivity offers significant potential in different app areas including health care. Our goal was to evaluate the usability of the Connect Mobile app. The mobile app enables mobile access to the Connect system, an online system that supports cancer patients in managing health-related issues. Along with symptom management, the system promotes better patient-provider communication, collaboration, and shared decision making. The Connect Mobile app enables access to the Connect system over both mobile phones and tablets. The study consisted of usability tests of a high fidelity prototype with 7 cancer patients where the objectives were to identify existing design and functionality issues and to provide patients with a real look-and-feel of the mobile system. In addition, we conducted semistructured interviews to obtain participants' feedback about app usefulness, identify the need for new system features and design requirements, and measure the acceptance of the mobile app and its features within everyday health management. The study revealed a total of 27 design issues (13 for mobile apps and 14 for tablet apps), which were mapped to source events (ie, errors, requests for help, participants' concurrent feedback, and moderator observation). We also applied usability heuristics to identify violations of usability principles. The majority of violations were related to enabling ease of input, screen readability, and glanceability (15 issues), as well as supporting an appropriate match between systems and the real world (7 issues) and consistent mapping of system functions and interactions (4 issues). Feedback from participants also showed the cancer patients' requirements for support systems and how these needs are influenced by different context-related factors, such as type of access terminal (eg, desktop computer, tablet, mobile phone) and phases of illness. Based on the observed results, we proposed design and functionality recommendations that can be used for the development of mobile apps for cancer patients to support their health management process. Understanding and addressing users' requirements is one of the main prerequisites for developing useful and effective technology-based health interventions. The results of this study outline different user requirements related to the design of the mobile patient support app for cancer patients. The results will be used in the iterative development of the Connect Mobile app and can also inform other developers and researchers in development, integration, and evaluation of mobile health apps and services that support cancer patients in managing their health-related issues.

  6. On the relation between trust and fairness in environmental risk management.

    PubMed

    Earle, Timothy C; Siegrist, Michael

    2008-10-01

    In this study, we empirically examine the relations between trust, fairness, and cooperation within two environmental risk management contexts, one in which the focal issue is of high personal moral importance and the other in which the focal issue is of low moral importance. Using an experimental design embedded in two parallel survey questionnaires, one mailed to residents of Washington State, the other to German-speaking residents of Switzerland, we either manipulated or constructed three factors, issue importance (high/low), procedural fairness (fair/unfair), and policy outcome (risk averse/risk accepting). This design enabled us to compare the predictions of the standard account of procedural fairness, that trust and cooperation are determined by judgments of fairness, with the predictions of an alternative account, that trust and cooperation will be determined by judgments of procedural fairness only when the issue involved is not morally important. Results for the American case showed that under conditions of high issue importance, policy outcome affected judged fairness, trust, and cooperation. Under conditions of low issue importance, policy outcome had no effect on judged fairness or trust but did have a moderate impact on cooperation. Analyses also showed that when issue importance was high, procedural fairness had no effects. When issue importance was low, procedural fairness had moderate effects on judged fairness and trust. Results for the Swiss case replicated the main findings for the American case. Together, these results support the alternative model of the relation between trust and fairness, suggesting that the efficacy of fair procedures is strictly limited.

  7. Lessons to learn from epidemiologic studies in ARDS.

    PubMed

    McNicholas, Bairbre A; Rooney, Grainne M; Laffey, John G

    2018-02-01

    Recent advances in our understanding of the epidemiology of ARDS has generated key insights into the incidence, risk factors, demographics, management and outcomes from this devastating clinical syndrome. ARDS occurs in 10% of all ICU patients, in 23% of all mechanically ventilated patients, with 5.5 cases per ICU bed each year. Although some regional variation exists regarding ARDS incidence, this may be less than previously thought. Subphenotypes are increasingly identified within the ARDS cohort, with studies identifying a 'hyperinflammatory' or 'reactive' subgroup that has a higher mortality, and may respond differently to therapeutic interventions. Demographic factors, such as race, may also affect the therapeutic response. Although mortality in ARDS is decreasing in clinical trials, it remains unchanged at approximately 40% in major observational studies. Modifiable ventilatory management factors, including PEEP, airway pressures, and respiratory rate are associated with mortality in ARDS. Hospital and ICU organizational factors play a role in outcome, whereas socioeconomic status is independently associated with survival in patients with ARDS. The Kigali adaptation of the Berlin ARDS definition may provide useful insights into the burden of ARDS in the developing world. ARDS exerts a substantial disease burden, with 40% of patients dying in hospital. Diverse factors, including patient-related factors such as age and illness severity, country level socioeconomic status, and ventilator management and ICU organizational factors each contribute to outcome from ARDS. Addressing these issues provides opportunities to improve outcome in patients with ARDS.

  8. Management of health care expenditure by soft computing methodology

    NASA Astrophysics Data System (ADS)

    Maksimović, Goran; Jović, Srđan; Jovanović, Radomir; Aničić, Obrad

    2017-01-01

    In this study was managed the health care expenditure by soft computing methodology. The main goal was to predict the gross domestic product (GDP) according to several factors of health care expenditure. Soft computing methodologies were applied since GDP prediction is very complex task. The performances of the proposed predictors were confirmed with the simulation results. According to the results, support vector regression (SVR) has better prediction accuracy compared to other soft computing methodologies. The soft computing methods benefit from the soft computing capabilities of global optimization in order to avoid local minimum issues.

  9. Observations of elk movement patterns on Fossil Butte National Monument

    USGS Publications Warehouse

    Olexa, Edward M.; Soileau, Suzanna Carrithers.; Allen, Leslie A.

    2014-01-01

    The elk herd that frequents Fossil Butte National Monument, a subset of the West Green River elk population, provides visitors with seasonal opportunities to view an iconic species of the western United States. Throughout the year, these elk range across a variety of private, State, and Federal lands within close proximity to the Monument. These lands are managed differently for various uses which can create challenging wildlife-management issues and influence the herd’s seasonal movements and distribution. Research lead by the USGS investigates some of the factors associated with these seasonal changes.

  10. [Crises of trust].

    PubMed

    Chen, Thai-Form; Tseng, Hsing-Chau

    2006-02-01

    Extensive media coverage is warning of a crisis of trust that has emerged as a serious issue in our society. This article explores the meaning of "crisis," concepts of crisis management, mechanisms for building trust, and the underlying significance of trust and distrust. Evidence is adduced to testify to the erosion of trust and factors in our society that reflect the potential for crises of trust. Organizational decision makers, including hospital managers, are urged to identify and reflect upon weaknesses in their organizations in order that remedial action can be taken to preempt such crises.

  11. Using a Prediction Model to Manage Cyber Security Threats.

    PubMed

    Jaganathan, Venkatesh; Cherurveettil, Priyesh; Muthu Sivashanmugam, Premapriya

    2015-01-01

    Cyber-attacks are an important issue faced by all organizations. Securing information systems is critical. Organizations should be able to understand the ecosystem and predict attacks. Predicting attacks quantitatively should be part of risk management. The cost impact due to worms, viruses, or other malicious software is significant. This paper proposes a mathematical model to predict the impact of an attack based on significant factors that influence cyber security. This model also considers the environmental information required. It is generalized and can be customized to the needs of the individual organization.

  12. Using a Prediction Model to Manage Cyber Security Threats

    PubMed Central

    Muthu Sivashanmugam, Premapriya

    2015-01-01

    Cyber-attacks are an important issue faced by all organizations. Securing information systems is critical. Organizations should be able to understand the ecosystem and predict attacks. Predicting attacks quantitatively should be part of risk management. The cost impact due to worms, viruses, or other malicious software is significant. This paper proposes a mathematical model to predict the impact of an attack based on significant factors that influence cyber security. This model also considers the environmental information required. It is generalized and can be customized to the needs of the individual organization. PMID:26065024

  13. Occupational stress in nursing: a review of the literature.

    PubMed

    Clegg, A

    2001-03-01

    The management and reduction of occupational stress are recognized as key factors in promoting employee well-being. Nursing is one of the many disciplines contributing to a huge body of research into the causes and effect of the ill-defined phenomenon of occupational stress. This literature review considers the ontological contribution of a number of disciplines to a growing body of knowledge on the subject of stress. The paper examines the complex issue of stress management, highlighting the impact of organizational culture and transformational leadership style on staff satisfaction levels.

  14. Risky business: Preventing skin breakdown in children with spina bifida.

    PubMed

    Ekmark, Elaine McGarr

    2009-01-01

    The purpose of this article is to provide an overview of skin issues in children with spina bifida. Included in the discussion below is a review of the etiology of pressure ulcers and the updated 2007 pressure ulcer definition and pressure ulcer staging system as defined by the National Pressure Ulcer Advisory Panel (NPUAP). Pediatric risk factors for skin breakdown are presented including risk factors unique to children with spina bifida. Pediatric pressure ulcer risk assessment scales are described. The 5 Million Lives Kids' Campaign which has a focus on preventing hospital-acquired pressure ulcers in children is also reviewed along with evidence based prevention strategies. The key to preventing skin breakdown and pressure ulcers in children with spina bifida is early identification of the child's individual risk factors so that a prevention protocol can be implemented in all settings: hospital, home and the community. Options for wound management, dressing selection and pain management are included.

  15. Framework for continuous assessment and improvement of occupational health and safety issues in construction companies.

    PubMed

    Mahmoudi, Shahram; Ghasemi, Fakhradin; Mohammadfam, Iraj; Soleimani, Esmaeil

    2014-09-01

    Construction industry is among the most hazardous industries, and needs a comprehensive and simple-to-administer tool to continuously assess and promote its health and safety performance. Through the study of various standard systems (mainly Health, Safety, and Environment Management System; Occupational Health and Safety Assessment Series 180001; and British Standard, occupational health and safety management systems-Guide 8800), seven main elements were determined for the desired framework, and then, by reviewing literature, factors affecting these main elements were determined. The relative importance of each element and its related factors was calculated at organizational and project levels. The provided framework was then implemented in three construction companies, and results were compared together. THE RESULTS OF THE STUDY SHOW THAT THE RELATIVE IMPORTANCE OF THE MAIN ELEMENTS AND THEIR RELATED FACTORS DIFFER BETWEEN ORGANIZATIONAL AND PROJECT LEVELS: leadership and commitment are the most important elements at the organization level, whereas risk assessment and management are most important at the project level. The present study demonstrated that the framework is easy to administer, and by interpreting the results, the main factors leading to the present condition of companies can be determined.

  16. Human Factors in Space Exploration

    NASA Technical Reports Server (NTRS)

    Jones, Patricia M.; Fiedler, Edna

    2010-01-01

    The exploration of space is one of the most fascinating domains to study from a human factors perspective. Like other complex work domains such as aviation (Pritchett and Kim, 2008), air traffic management (Durso and Manning, 2008), health care (Morrow, North, and Wickens, 2006), homeland security (Cooke and Winner, 2008), and vehicle control (Lee, 2006), space exploration is a large-scale sociotechnical work domain characterized by complexity, dynamism, uncertainty, and risk in real-time operational contexts (Perrow, 1999; Woods et ai, 1994). Nearly the entire gamut of human factors issues - for example, human-automation interaction (Sheridan and Parasuraman, 2006), telerobotics, display and control design (Smith, Bennett, and Stone, 2006), usability, anthropometry (Chaffin, 2008), biomechanics (Marras and Radwin, 2006), safety engineering, emergency operations, maintenance human factors, situation awareness (Tenney and Pew, 2006), crew resource management (Salas et aI., 2006), methods for cognitive work analysis (Bisantz and Roth, 2008) and the like -- are applicable to astronauts, mission control, operational medicine, Space Shuttle manufacturing and assembly operations, and space suit designers as they are in other work domains (e.g., Bloomberg, 2003; Bos et al, 2006; Brooks and Ince, 1992; Casler and Cook, 1999; Jones, 1994; McCurdy et ai, 2006; Neerincx et aI., 2006; Olofinboba and Dorneich, 2005; Patterson, Watts-Perotti and Woods, 1999; Patterson and Woods, 2001; Seagull et ai, 2007; Sierhuis, Clancey and Sims, 2002). The human exploration of space also has unique challenges of particular interest to human factors research and practice. This chapter provides an overview of those issues and reports on sorne of the latest research results as well as the latest challenges still facing the field.

  17. Weight gain as a consequence of living a modern lifestyle: a discussion of barriers to effective weight control and how to overcome them

    PubMed Central

    Seaman, David R.

    2013-01-01

    Objective The purpose of this commentary is to discuss modern lifestyle factors that promote weight gain and to suggest methods for clinicians to more effectively educate patients about weight management. Discussion Most adults in the United States are overweight or obese. Multiple factors related to the modern lifestyle appear to play causal roles. In general, the population maintains sedentary lives and overconsumes calorie-dense foods. In particular, refined carbohydrates negatively impact metabolism and stimulate neural addiction mechanisms, which facilitate weight gain. As adipose tissue mass accumulates, satiation centers in the hypothalamus become resistant to insulin and leptin, which leads to increased caloric consumption. Several behavior issues further augment weight gain, such as eating too quickly, a lack of sleep, high stress levels, and a lack of exercise. Finally, adipose tissue accumulation alters the body weight set point, which leads to metabolic changes that function to resist weight loss efforts. Each of these factors may work together to augment weight gain and promote obesity. Health care providers, such as chiropractic physicians, who educate patients on wellness, prevention, and lifestyle changes are well positioned to address these issues. Conclusion People need to be educated about the modern lifestyle factors that prevent effective weight management. Without this knowledge and the associated practical application of lifestyle choices that prevent weight gain, becoming overweight or obese appears to be an unavoidable consequence of living a modern lifestyle. PMID:25067929

  18. The effectiveness of risk communication regarding drug safety information: a nationwide survey by the Japanese public health insurance claims data.

    PubMed

    Hagiwara, Hiromi; Nakano, Shun; Ogawa, Yoshihiro; Tohkin, Masahiro

    2015-06-01

    We evaluated the effectiveness of warning letters published by the pharmaceutical regulatory agency in Japan on communication of drug safety and risk by quantitative analysis of the national health insurance claims database (NHICD). We then explored what factors may have affected risk communication. We measured the implementation rate of the hepatitis virus-monitoring test among methotrexate (MTX)-treated patients; a warning letter had been issued regarding the use of MTX, as it apparently activates the hepatitis virus. Data from the NHICD, which include 99·3% of Japanese residents, were used. A total of 4,933,481 patients with rheumatoid arthritis (RA) (January-June, 2010) were the focus of this study. The implementation rate of the hepatitis virus-monitoring test increased from 1·4% before to 1·8% after the warning letter announcement. Logistic regression analysis suggested that the installation of a drug information management room is one of the important factors affecting risk communication. Further analysis revealed that the hepatitis virus monitoring rates in hospitals without drug information management rooms increased from 2·3% to 4·1% due to the issue of the warning letter. The warning letter from the regulatory agency plays an important role in risk communication in hospitals without drug information management rooms. © 2015 John Wiley & Sons Ltd.

  19. Initial development of the Systems Approach to Home Medication Management (SAHMM) model.

    PubMed

    Doucette, William R; Vinel, Shanrae'l; Pennathur, Priyadarshini

    Adverse drug events and medication nonadherence are two problems associated with prescription medication use for chronic conditions. These issues often develop because patients have difficulty managing their medications at home. To guide patients and providers for achieving safe and effective medication use at home, the Systems Approach to Home Medication Management (SAHMM) model was derived from a systems engineering model for health care workplace safety. To explore how well concepts from the SAHMM model can represent home medication management by using patient descriptions of how they take prescription medications at home. Twelve patients were interviewed about home medication management using an interview guide based on the factors of the SAHMM model. Each interview was audio-taped and then transcribed verbatim. Interviews were coded to identify themes for home medication management using MAXQDA for Windows. SAHMM concepts extracted from the coded interview transcripts included work system components of person, tasks, tools & technology, internal environment, external environment, and household. Concepts also addressed work processes and work outcomes for home medication management. Using the SAHMM model for studying patients' home medication management is a promising approach to improving our understanding of the factors that influence patient adherence to medication and the development of adverse drug events. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Economic Techniques of Occupational Health and Safety Management

    NASA Astrophysics Data System (ADS)

    Sidorov, Aleksandr I.; Beregovaya, Irina B.; Khanzhina, Olga A.

    2016-10-01

    The article deals with the issues on economic techniques of occupational health and safety management. Authors’ definition of safety management is given. It is represented as a task-oriented process to identify, establish and maintain such a state of work environment in which there are no possible effects of hazardous and harmful factors, or their influence does not go beyond certain limits. It was noted that management techniques that are the part of the control mechanism, are divided into administrative, organizational and administrative, social and psychological and economic. The economic management techniques are proposed to be classified depending on the management subject, management object, in relation to an enterprise environment, depending on a control action. Technoeconomic study, feasibility study, planning, financial incentives, preferential crediting of enterprises, pricing, profit sharing and equity, preferential tax treatment for enterprises, economic regulations and standards setting have been distinguished as economic techniques.

  1. Nurse managers' experience with ethical issues in six government hospitals in Malaysia: A cross-sectional study

    PubMed Central

    2011-01-01

    Background Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues. Methods A cross-sectional study was conducted in August-September, 2010 involving 417 (69.2%) of total 603 nurse managers in the six Malaysian government hospitals. Data were collected using three-part self-administered questionnaire. Part I was regarding participants' demographics. Part II was about the frequency and areas of management where ethical issues were experienced, and scoring of the importance of 11 pre-identified ethical issues. Part III asked how they dealt with ethical issues in general; ways to deal with the 11 pre-identified ethical issues, and perceived stress level. Data were analyzed using descriptive statistics, cross-tabulations and Pearson's Chi-square. Results A total of 397 (95.2%) participants experienced ethical issues and 47.2% experienced them on weekly to daily basis. Experiencing ethical issues were not associated with areas of practice. Top area of management where ethical issues were encountered was "staff management", but "patient care" related ethical issues were rated as most important. Majority would "discuss with other nurses" in dealing generally with the issues. For pre-identified ethical issues regarding "patient care", "discuss with doctors" was preferred. Only 18.1% referred issues to "ethics committees" and 53.0% to the code of ethics. Conclusions Nurse managers, regardless of their areas of practice, frequently experienced ethical issues. For dealing with these, team-approach needs to be emphasized. Proper understanding of the code of ethics is needed to provide basis for reasoning. PMID:22085735

  2. Natural resource manager perceptions of agency performance on climate change.

    PubMed

    Lemieux, Christopher J; Thompson, Jessica L; Dawson, Jackie; Schuster, Rudy M

    2013-01-15

    An important precursor to the adoption of climate change adaptation strategies is to understand the perceived capacity to implement and operationalize such strategies. Utilizing an importance-performance analysis (IPA) evaluation framework, this article presents a comparative case study of federal and state land and natural resource manager perceptions of agency performance on factors influencing adaptive capacity in two U.S. regions (northern Colorado and southwestern South Dakota). Results revealed several important findings with substantial management implications. First, none of the managers ranked the adaptive capacity factors as a low priority. Second, managers held the perception that their agencies were performing either neutrally or poorly on most factors influencing adaptive capacity. Third, gap analysis revealed that significant improvements are required to facilitate optimal agency functioning when dealing with climate change-related management issues. Overall, results suggest that a host of institutional and policy-oriented (e.g., lack of clear mandate to adapt to climate change), financial and human resource (e.g., inadequate staff and financial resources), informational (e.g., inadequate research and monitoring programs) and contextual barriers (e.g., sufficient regional networks to mitigate potential transboundary impacts) currently challenge the efficient and effective integration of climate change into decision-making and management within agencies working in these regions. The IPA framework proved to be an effective tool to help managers identify and understand agency strengths, areas of concern, redundancies, and areas that warrant the use of limited funds and/or resource re-allocation in order to enhance adaptive capacity and maximize management effectiveness with respect to climate change. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Confirmatory Factor Analysis of a Questionnaire Measure of Managerial Stigma Towards Employee Depression.

    PubMed

    Martin, Angela J; Giallo, Rebecca

    2016-12-01

    Managers' attitudes play a key role in how organizations respond to employees with depression. We examine the measurement properties of a questionnaire designed to assess managerial stigma towards employees with depression. Using data from a sample of 469 Australian managers representing a wide range of industries and work settings, we conducted a confirmatory factor analysis to assess three proposed subscales representing affective, cognitive and behavioural forms of stigma. Results were equivocal indicating acceptable fit for two-factor (affective and cognitive + behavioural), three-factor (affective, cognitive and behavioural) and higher order models. Failure to demonstrate the discriminant validity of the cognitive and behavioural dimensions, even though they are theoretically distinct, suggests that further work on the scale is warranted. These results provide an extension to the psychometric profile of this measure (exploratory factor analysis; Martin, ). Development of strategies to operationalize this construct will benefit occupational health research and practice, particularly in interventions that aim to reduce the stigma of mental health issues in the workplace or where managers' attitudes are a key mechanism in intervention efficacy. We encourage future research on this measure pertaining in particular to further enhancing all aspects of its construct validity. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  4. Factors of accepting pain management decision support systems by nurse anesthetists

    PubMed Central

    2013-01-01

    Background Pain management is a critical but complex issue for the relief of acute pain, particularly for postoperative pain and severe pain in cancer patients. It also plays important roles in promoting quality of care. The introduction of pain management decision support systems (PM-DSS) is considered a potential solution for addressing the complex problems encountered in pain management. This study aims to investigate factors affecting acceptance of PM-DSS from a nurse anesthetist perspective. Methods A questionnaire survey was conducted to collect data from nurse anesthetists in a case hospital. A total of 113 questionnaires were distributed, and 101 complete copies were returned, indicating a valid response rate of 89.3%. Collected data were analyzed by structure equation modeling using the partial least square tool. Results The results show that perceived information quality (γ=.451, p<.001), computer self-efficacy (γ=.315, p<.01), and organizational structure (γ=.210, p<.05), both significantly impact nurse anesthetists’ perceived usefulness of PM-DSS. Information quality (γ=.267, p<.05) significantly impacts nurse anesthetists’ perceptions of PM-DSS ease of use. Furthermore, both perceived ease of use (β=.436, p<.001, R2=.487) and perceived usefulness (β=.443, p<.001, R2=.646) significantly affected nurse anesthetists’ PM-DSS acceptance (R2=.640). Thus, the critical role of information quality in the development of clinical decision support system is demonstrated. Conclusions The findings of this study enable hospital managers to understand the important considerations for nurse anesthetists in accepting PM-DSS, particularly for the issues related to the improvement of information quality, perceived usefulness and perceived ease of use of the system. In addition, the results also provide useful suggestions for designers and implementers of PM-DSS in improving system development. PMID:23360305

  5. Management of ErbB2-positive Breast Cancer: Insights from Preclinical and Clinical Studies with Lapatinib

    PubMed Central

    Vogel, Charles; Chan, Arlene; Gril, Brunilde; Kim, Sung-Bae; Kurebayashi, Junichi; Liu, Li; Lu, Yen-Shen; Moon, Hanlim

    2010-01-01

    The management of human epidermal growth factor receptor 2-positive (ErbB2+) breast cancer is challenging; patients with ErbB2+ breast tumors have more aggressive disease and a poor prognosis. The increasing incidence of breast cancer in Asia and the limitations of existing treatments pose additional challenges. In this review, we summarize the preclinical and clinical evidence that indicates how lapatinib, a novel inhibitor that targets the human epidermal growth factor receptor (ErbB1) and ErbB2 may help clinicians address four particularly challenging issues in the management of ErbB2+ breast cancer. These issues are: (i) trastuzumab therapy failure, (ii) development of central nervous system metastases, (iii) minimizing toxicity and (iv) selecting the most appropriate partners (chemotherapy and non-chemotherapy) for combination therapy with lapatinib. Lapatinib, in combination with chemotherapeutic agents, such as capecitabine, provides clinical benefits to patients with ErbB2+ breast cancer, including patients who develop progressive disease on trastuzumab. Lapatinib, in combination with non-chemotherapeutic agents, such as letrozole, may also provide a chemotherapy-free treatment option for postmenopausal patients with estrogen receptor-positive/ErbB2+ metastatic breast cancer. Encouraging results have also emerged regarding the synergistic effects of lapatinib in combination with other agents for the treatment of ErbB2+ breast cancer. Promising findings have also been reported for the use of lapatinib to prevent and treat central nervous system metastases. Collectively, these results indicate that the judicious use of lapatinib, an effective oral therapy with a manageable toxicity profile, can enhance the management of patients with ErbB2+ breast cancer. PMID:20542996

  6. Management of ErbB2-positive breast cancer: insights from preclinical and clinical studies with lapatinib.

    PubMed

    Vogel, Charles; Chan, Arlene; Gril, Brunilde; Kim, Sung-Bae; Kurebayashi, Junichi; Liu, Li; Lu, Yen-Shen; Moon, Hanlim

    2010-11-01

    The management of human epidermal growth factor receptor 2-positive (ErbB2+) breast cancer is challenging; patients with ErbB2+ breast tumors have more aggressive disease and a poor prognosis. The increasing incidence of breast cancer in Asia and the limitations of existing treatments pose additional challenges. In this review, we summarize the preclinical and clinical evidence that indicates how lapatinib, a novel inhibitor that targets the human epidermal growth factor receptor (ErbB1) and ErbB2 may help clinicians address four particularly challenging issues in the management of ErbB2+ breast cancer. These issues are: (i) trastuzumab therapy failure, (ii) development of central nervous system metastases, (iii) minimizing toxicity and (iv) selecting the most appropriate partners (chemotherapy and non-chemotherapy) for combination therapy with lapatinib. Lapatinib, in combination with chemotherapeutic agents, such as capecitabine, provides clinical benefits to patients with ErbB2+ breast cancer, including patients who develop progressive disease on trastuzumab. Lapatinib, in combination with non-chemotherapeutic agents, such as letrozole, may also provide a chemotherapy-free treatment option for postmenopausal patients with estrogen receptor-positive/ErbB2+ metastatic breast cancer. Encouraging results have also emerged regarding the synergistic effects of lapatinib in combination with other agents for the treatment of ErbB2+ breast cancer. Promising findings have also been reported for the use of lapatinib to prevent and treat central nervous system metastases. Collectively, these results indicate that the judicious use of lapatinib, an effective oral therapy with a manageable toxicity profile, can enhance the management of patients with ErbB2+ breast cancer.

  7. Psychosocial Modeling of Insider Threat Risk Based on Behavioral and Word Use Analysis

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

    Greitzer, Frank L.; Kangas, Lars J.; Noonan, Christine F.

    In many insider crimes, managers and other coworkers observed that the offenders had exhibited signs of stress, disgruntlement, or other issues, but no alarms were raised. Barriers to using such psychosocial indicators include the inability to recognize the signs and the failure to record the behaviors so that they can be assessed. A psychosocial model was developed to assess an employee’s behavior associated with an increased risk of insider abuse. The model is based on case studies and research literature on factors/correlates associated with precursor behavioral manifestations of individuals committing insider crimes. A complementary Personality Factor modeling approach was developedmore » based on analysis to derive relevant personality characteristics from word use. Several implementations of the psychosocial model were evaluated by comparing their agreement with judgments of human resources and management professionals; the personality factor modeling approach was examined using email samples. If implemented in an operational setting, these models should be part of a set of management tools for employee assessment to identify employees who pose a greater insider threat.« less

  8. A qualitative study explaining nurses' perceptions of quality care for older people in long-term care settings in Ireland.

    PubMed

    Murphy, Kathy

    2007-03-01

    The aim of this research was to explore nurses' perceptions of the attributes of quality care and the factors that facilitate or hinder high-quality nursing care in long-term care. The quality of care for older people living in long-term care has been identified as an issue of concern in many nursing research studies. While many factors have been identified, it is difficult to determine key factors from current research. The study was a qualitative exploration of nurses' perceptions of quality care for older people and the factors that facilitate or hinder quality care. It involved 20 interviews with nurses. Respondents were asked to illustrate their accounts with examples from practice. This phase of the research was guided by the principles of hermeneutic phenomenology and the analysis process by Van Manen. The findings indicated that nurses perceived quality care for older people in Ireland as holistic, individualized and focused on promoting independence and choice. The research revealed, however, that care in many practice areas was not individualized, patient choice and involvement in decision making was limited and some areas engendered dependency. While staffing was identified as a factor which had an impact on the provision of patient choice, other issues, such as the motivation of staff, the role of the ward manager and the dominance of routine were also highlighted. There is a need to review organizational approaches to care, develop patient centred approaches to care and provide educational support for managers. This research focuses on care for older people; it helps practitioners identify key factors in the provision of quality care for older people living in long-term care.

  9. Demographic, genetic, and environmental factors that modify disease course.

    PubMed

    Marrie, Ruth Ann

    2011-05-01

    As with susceptibility to disease, it is likely that multiple factors interact to influence the phenotype of multiple sclerosis and long-term disease outcomes. Such factors may include genetic factors, socioeconomic status, comorbid diseases, and health behaviors, as well as environmental exposures. An improved understanding of the influence of these factors on disease course may reap several benefits, such as improved prognostication, allowing us to tailor disease management with respect to intensity of disease-modifying therapies and changes in specific health behaviors, in the broad context of coexisting health issues. Such information can facilitate appropriately adjusted comparisons within and between populations. Elucidation of these factors will require careful study of well-characterized populations in which the roles of multiple factors are considered simultaneously. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Group Work and the Impact, if Any, of the Use of Google Applications for Education

    ERIC Educational Resources Information Center

    Maqbool, Jannat

    2016-01-01

    The use of group work in teaching practices has been well supported in educational theories however the researcher has experienced a number of issues or areas of concern in having students work in groups to complete a major assessment for a second year Project Management course at a leading polytechnic in New Zealand. Factors potentially…

  11. Electronic Information Systems and User Contexts; Emerging Social Science Issues,

    DTIC Science & Technology

    1981-09-01

    long-term national significance. Clearly alternative choices in the management of that process can have substantially different economic and social...systems, reflecting primarily an intersection of eco- nomic needs and technological opportunities. Among the economic factors behind the drive to automate...productivity improvements have lagged far behind industrial and manufacturing growth ( Keating , 1980; Bennis, 1980). These problems are exacerbated by

  12. Forest operations, extreme flooding events, and considerations for hydrologic modeling in the Appalachians--A review

    Treesearch

    M.A. Eisenbies; W.M. Aust; J.A. Burger; M.B. Adams

    2007-01-01

    The connection between forests and water resources is well established, but the relationships among controlling factors are only partly understood. Concern over the effects of forestry operations, particularly harvesting, on extreme flooding events is a recurrent issue in forest and watershed management. Due to the complexity of the system, and the cost of installing...

  13. A View from the Principal's Office: A Grounded-Theory Exploration of Principals' Perceptions of Non-Academic Barriers to Learning--Implications for School Social Work

    ERIC Educational Resources Information Center

    Prather, JoNataye Arnitra

    2010-01-01

    The importance of the principal has been found to be a critical factor in student and school success. School principal responsibilities traditionally encompass operations and management. However, many principals are unable to fulfill these expectations because of students' social and behavioral issues. Consequently, this qualitative study explored…

  14. A STELLA model to estimate soil CO2 emissions from a short-rotation woody crop

    Treesearch

    Ying Ouyang; Theodor D. Leininger; Jeff Hatten; Prem B. Parajuli

    2012-01-01

    The potential for climatic factors as well as soil–plant–climate interactions to change as a result of rising levels of atmospheric CO2 concentration is an issue of increasing international environmental concern. Agricultural and forest practices and managements may be important contributors to mitigating elevated atmospheric CO2...

  15. Factors influencing loblolly pine stand health in Fort Benning, Georgia, USA

    Treesearch

    Soung Ryoul Ryu; G. Geoff Wang; Joan L. Walker

    2013-01-01

    Loblolly pine (LBP; Pinus taeda L.) stands provide two-thirds of the existing federally protected red-cockaded woodpecker (RCW; Picoides borealis) habitat in Fort Benning, Georgia, USA. However, LBP in this area is suspected to face a forest decline issue, which may risk the sustainability of the RCW population. Land managers are attempting to convert LBP stands to...

  16. Problems associated with noise measurements in the mining industry

    NASA Astrophysics Data System (ADS)

    Bauer, Eric R.; Vipperman, Jeffrey S.

    2002-05-01

    In response to the continuing problem of noise-induced hearing loss (NIHL) among mine workers, the National Institute for Occupational Safety and Health (NIOSH) has been conducting numerous noise- and hearing-loss research efforts in the mining industry. Research is underway to determine worker noise exposure, equipment noise, hearing loss and hearing protection use, and to evaluate engineering controls. Issues that are peculiar to the mining industry have complicated these efforts. A few of the issues that must be overcome to conduct meaningful research include constantly moving equipment, changing work environments, confined space, varying production rates, multiple noise sources, and electronic permissibility of instrumentation. This presentation will address the factors that affect the measurement and analysis of noise in the mining industry and how these factors are managed. In addition, some examples of research results will be included.

  17. Research Initiatives and Preliminary Results In Automation Design In Airspace Management in Free Flight

    NASA Technical Reports Server (NTRS)

    Corker, Kevin; Lebacqz, J. Victor (Technical Monitor)

    1997-01-01

    The NASA and the FAA have entered into a joint venture to explore, define, design and implement a new airspace management operating concept. The fundamental premise of that concept is that technologies and procedures need to be developed for flight deck and ground operations to improve the efficiency, the predictability, the flexibility and the safety of airspace management and operations. To that end NASA Ames has undertaken an initial development and exploration of "key concepts" in the free flight airspace management technology development. Human Factors issues in automation aiding design, coupled aiding systems between air and ground, communication protocols in distributed decision making, and analytic techniques for definition of concepts of airspace density and operator cognitive load have been undertaken. This paper reports the progress of these efforts, which are not intended to definitively solve the many evolving issues of design for future ATM systems, but to provide preliminary results to chart the parameters of performance and the topology of the analytic effort required. The preliminary research in provision of cockpit display of traffic information, dynamic density definition, distributed decision making, situation awareness models and human performance models is discussed as they focus on the theme of "design requirements".

  18. Beyond job security and money: driving factors of motivation for government doctors in India.

    PubMed

    Purohit, Bhaskar; Bandyopadhyay, Tathagata

    2014-02-21

    Despite many efforts from government to address the shortage of medical officers (MOs) in rural areas, rural health centres continue to suffer from severe shortage of MOs. Lack of motivation to join and continue service in rural areas is a major reason for such shortage. In the present study, we aimed to assess and rank the driving factors of motivation important for in-service MOs in their current job. The study participants included ninety two in-service government MOs from three states in India. The study participants were required to rank 14 factors of motivation important for them in their current job. The factors for the study were selected using Herzberg's two-factor theory of motivation and the data were collected using an instrument that has an established reliability and validity. Test of Kendall's coefficient of concordance (W) was carried out to assess the agreement in ranks assigned by participants to various motivation factors. Next, we studied the distributions of ranks of different motivating factors using standard descriptive statistics and box plots, which gave us interesting insights into the strength of agreement of the MOs in assigning ranks to various factors. And finally to assess whether MOs are more intrinsically motivated or extrinsically motivated, we used Kolmogorov-Smirnov test. The (W) test indicated statistically significant (P < 0.01) agreement of the participants in assigning ranks. The Kolmogorov-Smirnov test indicated that from policy perspectives, MOs place significantly more motivational importance to intrinsic factors than to extrinsic factors. The study results indicate that job security was the most important factor related to motivation, closely followed by interesting work and respect and recognition. Among the top five preferred factors, three were intrinsic factors indicating a great importance given by MOs to factors beyond money and job security. To address the issue of motivation, the health departments need to pay close attention to devising management strategies that address not only extrinsic but also intrinsic factors of motivation. The study results may be useful to understand the complicated issue of work motivation and can give some useful insights to design comprehensive management strategies that are based on motivational needs of MOs.

  19. Coral reefs in the Gulf are mostly dead now, but can we do anything about it?

    PubMed

    Sheppard, Charles

    2016-04-30

    This article discusses two key issues: firstly, the demise of reefs in the Gulf which is happening probably more rapidly than elsewhere; and secondly, the reasons why this remains such an intractable problem. Most reasons for this decline are scientifically well understood, though clearly not by the region's managers. Several factors may cause people to ignore the problem, even though habitat loss is vastly costly to the region. About 70% of the Gulf's reefs have essentially disappeared in a few decades, and although scientific indicators confirm that this is happening, it is commonly discounted as even being a possibility. Management of human interactions with the Gulf's marine systems remains very inadequate, to the detriment of the Gulf's marine systems and its people. It is clear that this not a scientific issue any longer but rather it is a political problem and failure. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Financial and risk considerations for successful disease management programs.

    PubMed

    Baldwin, A L

    1999-11-01

    Results for disease management [DM] programs have not been as positive as hoped because of clinical issues, lack of access to capital, and administrative issues. The financial experience of DM programs can be quite volatile. Financial projections that are protocol-based, rather than experience-based, may understate the revenue required and the range of possible costs for a DM program by understating the impact of complicating conditions and comorbidities. Actuarial tools (risk analysis and risk projection models) support better understanding of DM contracts. In particular, these models can provide the ability to quantify the impact of the factors that drive costs of a contract and the volatility of those costs. This analysis can assist DM companies in setting appropriate revenue and capital targets. Similar analysis by health plans can identify diseases that are good candidates for DM programs and can provide the basis for performance targets.

  1. Psychosocial and environmental factors in the prognosis of individuals with chronic pain and comorbid mental health.

    PubMed

    Hruschak, Valerie; Cochran, Gerald

    2017-08-01

    Chronic pain has considerable medical, social, and economic implications as its high prevalence rate and negative societal burden provides justification that it is a major health issue. The value of understanding psychological, social, and environmental factors in chronic pain has become widely recognized and accepted as a biopsychosocial phenomenon in which the social work perspective offers a valuable lens. Through the critical application of systems theory and ecological perspective, accompanied with the diathesis stress model, this article examines psychosocial and environmental influences as being contributory factors in the prognosis of individuals with chronic pain and comorbid mental health disorders. The social work profession will also be explored as playing a definite role in addressing elements pertaining to pain management depicted from these theories. Lastly, implications for research, policy, and practice will be reviewed to better understand the association between psychosocial and environmental influences of individuals with chronic pain and comorbid mental health issues.

  2. “I Need my Own Place to get Better”: Patient Perspectives on the Role of Housing in Potentially Preventable Hospitalizations

    PubMed Central

    Quensell, Michelle L.; Taira, Deborah A.; Seto, Todd B.; Braun, Kathryn L.; Sentell, Tetine L.

    2017-01-01

    Objective To analyze patient perspectives on the role of housing in their potentially preventable hospitalization. Methods Individuals admitted with cardiovascular-or diabetes-related diagnoses (n = 90) in a major medical center in Hawai‘i completed an in-person interview eliciting patient perspectives on key factors leading to hospitalization. Using the framework approach, two independent coders identified themes. This study focused on housing-related findings. Results Overall, 23% of participants reported housing as a precipitating factor to their hospitalization, including 12 with no regular place to stay. Four housing-related themes emerged: challenges meeting basic needs, complex chronic care management difficulties, stigma and relationship with provider, and stress and other mental health issues. Discussion Almost 25% of patients identified housing as a key factor to their hospital stay. Patient-reported themes highlight specific mechanisms by which housing challenges may lead to hospitalization. Addressing housing issues could help reduce the number and associated cost burden of preventable hospitalizations. PMID:28529224

  3. Managing IT service management implementation complexity: from the perspective of the Warfield Version of systems science

    NASA Astrophysics Data System (ADS)

    Wan, Jiangping; Jones, James D.

    2013-11-01

    The Warfield version of systems science supports a wide variety of application areas, and is useful to practitioners who use the work program of complexity (WPOC) tool. In this article, WPOC is applied to information technology service management (ITSM) for managing the complexity of projects. In discussing the application of WPOC to ITSM, we discuss several steps of WPOC. The discovery step of WPOC consists of a description process and a diagnosis process. During the description process, 52 risk factors are identified, which are then narrowed to 20 key risk factors. All of this is done by interviews and surveys. Root risk factors (the most basic risk factors) consist of 11 kinds of common 'mindbugs' which are selected from an interpretive structural model. This is achieved by empirical analysis of 25 kinds of mindbugs. (A lesser aim of this research is to affirm that these mindbugs developed from a Western mindset have corresponding relevance in a completely different culture: the Peoples Republic of China.) During the diagnosis process, the relationships among the root risk factors in the implementation of the ITSM project are identified. The resolution step of WPOC consists of a design process and an implementation process. During the design process, issues related to the ITSM application are compared to both e-Government operation and maintenance, and software process improvement. The ITSM knowledge support structure is also designed at this time. During the implementation process, 10 keys to the successful implementation of ITSM projects are identified.

  4. Factors impacting on psychological wellbeing of international students in the health professions: A scoping review.

    PubMed

    McKenna, Lisa; Robinson, Eddie; Penman, Joy; Hills, Danny

    2017-09-01

    There are increasing numbers of international students undertaking health professional courses, particularly in Western countries. These courses not only expose students to the usual stresses and strains of academic learning, but also require students to undertake clinical placements and practice-based learning. While much is known about general issues facing international students, less is known about factors that impact on those studying in the health professions. To explore what is known about factors that influence the psychological wellbeing of international students in the health professions. A scoping review. A range of databases were searched, including CINAHL, Medline, Scopus, Proquest and ERIC, as well as grey literature, reference lists and Google Scholar. The review included qualitative or quantitative primary peer reviewed research studies that focused on international undergraduate or postgraduate students in the health professions. The core concept underpinning the review was psychological issues, with the outcome being psychological and/or social wellbeing. Thematic analysis across studies was used to identify key themes emerging. A total of 13 studies were included in the review, from the disciplines of nursing, medicine and speech-language pathology. Four key factor groups emerged from the review: negotiating structures and systems, communication and learning, quality of life and self-care, and facing discrimination and social isolation. International health professional students face similar issues to other international students. The nature of their courses, however, also requires negotiating different health care systems, and managing a range of clinical practice issues including with communication, and isolation and discrimination from clinical staff and patients. Further research is needed to specifically explore factors impacting on student well-being and how international students can be appropriately prepared and supported for their encounters. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Organ procurement: Spanish transplant procurement management.

    PubMed

    Manyalich, Martí; Mestres, Carlos A; Ballesté, Chloë; Páez, Gloria; Valero, Ricard; Gómez, María Paula

    2011-06-01

    Transplantation is an accepted therapeutic option to save or improve the quality of life when organ failure occurs or tissue replacements are needed. However, the lack of organs is the major limitation. The deceased organ procurement organization and professionals provide the solution to this international problem. In this review, we identify the elements involved in the organ procurement management process to analyze the possibility of implementation of deceased organ procurement for a transplantation program. While the donation rates are subject to several negative factors including religious, economic, cultural, and legal issues, the existence of well-trained professionals may considerably increase them. Professional training in organ donation along with the establishment of a solid organizational system has been identified as the crucial factor in developing efficient organ donation and transplantation programs.

  6. Defining snow drought and why it matters

    USGS Publications Warehouse

    Harpold, Adrian; Dettinger, Michael; Rajagopal, Seshadri

    2017-01-01

    On 12 February, water resource managers at the Oroville Dam issued an evacuation warning that forced some 180,000 Californians to relocate to higher ground. The story of how conditions got to this point involves several factors, but two clearly stand out: the need to prevent water shortages during a record drought, followed by one of the wettest October–February periods in California history.The situation at Oroville Dam highlights difficulties that many reservoir managers face in managing flood risks while simultaneously storing water to mitigate severe droughts and smaller snowpacks. Central to this difficulty is the idea of “snow drought,” a term that’s gaining traction in both scientific and lay literature.

  7. Software development environments: Status and trends

    NASA Technical Reports Server (NTRS)

    Duffel, Larry E.

    1988-01-01

    Currently software engineers are the essential integrating factors tying several components together. The components consist of process, methods, computers, tools, support environments, and software engineers. The engineers today empower the tools versus the tools empowering the engineers. Some of the issues in software engineering are quality, managing the software engineering process, and productivity. A strategy to accomplish this is to promote the evolution of software engineering from an ad hoc, labor intensive activity to a managed, technology supported discipline. This strategy may be implemented by putting the process under management control, adopting appropriate methods, inserting the technology that provides automated support for the process and methods, collecting automated tools into an integrated environment and educating the personnel.

  8. Workplace Violence: Practical Considerations for Mental Health Professionals in Consultation, Assessment, and Management of Risk.

    PubMed

    Saragoza, Philip; White, Stephen G

    2016-12-01

    Workplace predatory violence has been the focus of increased study over the past 30 years, leading to a more sophisticated understanding of the factors that contribute to it, and important considerations for its assessment and management. Risk assessment professionals involved in workplace violence consultations should be mindful of issues specific to the workplace context and the principles of threat assessment to provide a more precise opinion of risk, to inform and enhance critical decisions regarding the employment status of the individual of concern, security measures, possible treatment options, and other management responses, while being mindful of the employee's certain rights. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Disturbance, life history, and optimal management for biodiversity

    USGS Publications Warehouse

    Guo, Q.

    2003-01-01

    Both frequency and intensity of disturbances in many ecosystems have been greatly enhanced by increasing human activities. As a consequence, the short-lived plant species including many exotics might have been dramatically increased in term of both richness and abundance on our planet while many long-lived species might have been lost. Such conclusions can be drawn from broadly observed successional cycles in both theoretical and empirical studies. This article discusses two major issues that have been largely overlooked in current ecosystem management policies and conservation efforts, i.e., life history constraints and future global warming trends. It also addresses the importance of these two factors in balancing disturbance frequency and intensity for optimal biodiversity maintenance and ecosystem management.

  10. Developing leadership in nursing: exploring core factors.

    PubMed

    Curtis, Elizabeth A; de Vries, Jan; Sheerin, Fintan K

    This article provides an introduction to the issue of nursing leadership, addressing definitions and theories underpinning leadership, factors that enhance leadership in nursing, and the nature of leadership content taught in undergraduate programmes. Highlighted are differences between leadership and management, and the notion that leadership can be 'learned'. The authors also point out that there is a discrepancy between how leading undergraduate nursing programmes prepare students primarily in the transition of education to practice, and the suggestion from a number of nursing publications that leadership in nurses should be fostered throughout their education.

  11. Prevention of MSD within OHSMS/IMS: a systematic review of risk assessment strategies.

    PubMed

    Yazdani, Amin; Wells, Richard

    2012-01-01

    The purpose of this systematic review was to identify and summarize the research evidence on prevention of Musculoskeletal Disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS) and Integrated Management Systems (IMS). Databases in business, management, engineering and health and safety were systematically searched and relevant publications were synthesized. The number of papers that could address the research questions was small. However, the review revealed that many of the techniques to address MSD hazards require substantial background knowledge and training. This may limit employees' involvement in the technical aspects of the risk assessment process. Also these techniques did not usually fit into techniques used by companies to address other risk factors within their management systems. This could result in MSD prevention becoming a separate issue that cannot be managed with company-wide tools. In addition, this review also suggested that there is a research gap concerning the MSD prevention within companies' management systems.

  12. [Effective delegation].

    PubMed

    Fang, Li; Hung, Chich-Hsiu

    2008-12-01

    Ninety-seven percent of middle level managers feel they face work overload. The source of this problem may lie in a failure to delegate tasks effectively. If a manager does not effectively delegate, he/she is more likely to report fatigue, stress and depression. Conversely, effectively delegating tasks will improve overall job quality, professional growth in subordinates and cooperation within the team. While it is necessary for managers to delegate tasks effectively, few can be considered to be good natural 'delegators'. Learning and training is necessary for managers to develop the necessary confidence and maturity. This article describes the definitions, purpose and benefits of delegation; factors related to effective delegation; strategies related to successful delegation and skills related to performing cross-cultural delegations. Such issues have seldom been addressed in previous articles. Moreover, nursing implications and suggested applications in nursing practice, education, management and research are mentioned. This article is intended to provide directions to nursing managers and subordinates to promote delegation knowledge and skills.

  13. Environmental audit: III. Improving the management of environmental information for toxic substances

    NASA Astrophysics Data System (ADS)

    Sokolik, Stanley L.; Schaeffer, David J.

    1986-05-01

    Environmental programs have been commonly driven by a preoccupation with the collection of data in the mistaken belief that data is synonymous with information. The distinction between data (that is, the quantified and qualitative attributes of a particular environment) and information (specifically, data processed so as to focus upon a particular environmental problem) will become far more important to environmental managers. They will increasingly manage their information through use of what has become known as information resource management (IRM) and the attendant use of critical success factors methodology. Environmental managers will thereby move away from concerns about data and specific EDP hardware and applications toward managing information as a valuable agency resource. In applying IRM, they will find it helpful to include a number of planning elements and to resolve early a number of issues critical to its successful use.

  14. Toward the development of a motivational model of pain self-management.

    PubMed

    Jensen, Mark P; Nielson, Warren R; Kerns, Robert D

    2003-11-01

    Adaptive management of chronic pain depends to a large degree on how patients choose to cope with pain and its impact. Consequently, patient motivation is an important factor in determining how well patients learn to manage pain. However, the role of patient motivation in altering coping behavior and maintaining those changes is seldom discussed, and theoretically based research on motivation for pain treatment is lacking. This article reviews theories that have a direct application to understanding motivational issues in pain coping and presents a preliminary motivational model of pain self-management. The implications of this model for enhancing engagement in and adherence to chronic pain treatment programs are then discussed. The article ends with a call for research to better understand motivation as it applies to chronic pain self-management. In particular, there is a need to determine whether (and which) motivation enhancement interventions increase active participation in self-management treatment programs for chronic pain.

  15. How Have States Used Executive Orders to Address Public Health?

    PubMed

    Gakh, Maxim; Callahan, Karen; Goodie, Aaliyah; Rutkow, Lainie

    2018-06-07

    Gubernatorial executive orders (GEOs) are important, yet poorly understood, public health tools. We analyzed health-related GEOs nationwide using a modified legal mapping approach. We searched Westlaw's Netscan Executive Orders database for orders issued between 2008 and 2014. Search terms were generated from the Healthy People 2020 Leading Health Indicators (LHIs). GEOs were screened with data abstracted and analyzed on the basis of LHIs, states, years, and characteristics identified in previous literature. We found differences in GEOs issued per LHI. Of the 303 unique orders, they ranged from 32 to 53 issued per year and 0 to 45 issued per state. Most GEOs managed governmental public health functions, required collaboration, and mandated studying problems. Fewer directly addressed health equity, chronic disease, and resource deployment. Gubernatorial authority and political and institutional factors appear relevant to GEO issuance. GEOs offer means to institute public health policies and should be considered by public health professionals.

  16. Description and Application of a Mathematical Method for the Analysis of Harmony

    PubMed Central

    Zuo, Qiting; Jin, Runfang; Ma, Junxia

    2015-01-01

    Harmony issues are widespread in human society and nature. To analyze these issues, harmony theory has been proposed as the main theoretical approach for the study of interpersonal relationships and relationships between humans and nature. Therefore, it is of great importance to study harmony theory. After briefly introducing the basic concepts of harmony theory, this paper expounds the five elements that are essential for the quantitative description of harmony issues in water resources management: harmony participant, harmony objective, harmony regulation, harmony factor, and harmony action. A basic mathematical equation for the harmony degree, that is, a quantitative expression of harmony issues, is introduced in the paper: HD = ai − bj, where a is the uniform degree, b is the difference degree, i is the harmony coefficient, and j is the disharmony coefficient. This paper also discusses harmony assessment and harmony regulation and introduces some application examples. PMID:26167535

  17. Another decade of social scientific work on sex work: a review of research 1990-2000.

    PubMed

    Vanwesenbeeck, I

    2001-01-01

    The international, psychological and sociological research literature on prostitution from 1990 through 2000 is reviewed. The stage is set by scanning topics and perspectives in earlier writings. Then the research is discussed under the following headings: (a) HIV related research (HIV prevalence studies, factors in condom use, and prevention program evaluation); (b) workers' background and motivational issues (early victimization and connected factors, economic motives and connected factors); (c) work related issues (working routines, risks and stresses, and managing risk, work and identity); (d) research on clients, and (e) issues related to social and legal status. The literature is still much more about sex than it is about work. In addition, although an increasing number of authors have criticized the dominance of a deviance perspective over work perspectives on prostitution, the literature still reveals many features of stigmatization. For instance, the wrongs associated with sex work are all too often attributed to the nature of sex work itself instead of to the stigma attached to it or to specific negative circumstances. Likewise, the association between prostitution and negative features (in particular HIV and early victimization) is overwhelming, despite evidence that, for large groups of sex workers, these issues are of limited relevance. Generally, writers fail to adequately differentiate among types of sex workers. In particular, in relation to issues of health and well-being, differentiation among sex workers on the basis of specific features of their working situation (e.g., contexts, routines, relations, conditions) has hardly been studied and is recommended for the future.

  18. The relationship between energy information management and energy management performance in higher education sector in Thailand, considering from resource and process based views

    NASA Astrophysics Data System (ADS)

    Mongkolsawat, Darunee

    The performance of energy management is usually considered through the energy reduction result however this does not sufficient for managing facility's energy in the long term. In combination to that, this study decides to investigate the relationship between the effectiveness of energy information management and the energy management performance. The interested sector is higher education institutions in Thailand due to their complex organisation both in management and property aspects. By not focusing on quantitative energy reduction as centre, the study seeks to establish a framework or tool in helping to understand such relationship qualitatively through organisation resource and process based view. Additionally, energy management structure is also accounted as initial factor. In relation to such framework, the performance of energy management is considered on its primary results concerning the issues of the data available, analysis results, and energy action. After the investigation, it is found that between the concerned factors and primary performance there are various specific relationships. For example, some tend to have direct connections as relations between the energy management structure and implemented actions, and between the investment in organisation resources and data available. While some have flexible relations as between data collection and results of analysed data. Furthermore, the load of energy management has been found influencing on organisation's motivation to invest in energy management. At the end of the paper, further application to the study is also proposed.

  19. Fatigue factors affecting metropolitan bus drivers: a qualitative investigation.

    PubMed

    Biggs, Herbert; Dingsdag, Donald; Stenson, Nick

    2009-01-01

    Metropolitan bus drivers daily face work in a stressful and draining work environment, exposing them to the serious risk of driver fatigue. However, there has been a dearth of information exploring the unique antecedents and effects of such fatigue. To date, much of the research into metropolitan bus drivers has been under the umbrella of large heavy vehicle driving studies, which include a disproportionally large population of long-haul drivers, who are likely to face a significantly different set of fatigue factors [1]. The present study aimed to investigate which work and environmental factors may cause fatigue in metropolitan bus drivers by seeking drivers' own perspectives on the issues. To this end, focus groups were held at five bus depots in Sydney and Newcastle, with an effort made to include a stratified sample of drivers at each. Each of the groups were invited to nominate what factors they felt were most salient, with a number of common factors emerging across the depots. Key themes identified were: support from management; ticketing and related issues; interaction with passengers; cabin ergonomics; tight route schedules; turn-around and shift irregularity; extended shift cycles; interactions with other road users; and extended commute times.

  20. An overlooked alliance: using human factors engineering to reduce patient harm.

    PubMed

    Perry, Shawna J

    2004-08-01

    Although human factors engineering (HFE) is considered only in relationship to the design of medical devices or information systems technology, human factors issues arise in many aspects of work in health care organizations. In one scenario, the resuscitation stretcher would not pass through the ED door closest to radiology. Many clinical work spaces were never formally designed for the work currently being performed in them; instead, they were adapted from existing space originally designed for a different use. In a second scenario, infusion pump malfunction was not apparent. The patient experienced a near miss secondary to poor design; users thought that the infusion pump had been turned off when it was not. Health care can significantly benefit from the incorporation of HFE into the workplace. Introductory classes in medical and nursing schools on HFE will assist students in detecting HFE-related issues, making them less likely to suffer with them or overlook them once in clinical practice. More extensive training for patient safety and risk managers, that is, at a minimum, a certificate-level course from an HFE program, would enhance case and root cause analyses since these issues are rarely factored in. Collaboration with HFE experts and use of HFE principles may not make health care fool-proof, but it will make it less dependent on improvisation and ingenuity to protect patients from the system's vulnerabilities.

  1. ERCMExpress. Volume 3, Issue 4

    ERIC Educational Resources Information Center

    Taymans, Mary Frances; McDonald, Dale

    2007-01-01

    The Emergency Response and Crisis Management (ERCM) Technical Assistance Center's "ERCMExpress" is a newsletter that provides comprehensive information on key issues in school emergency management. This issue, entitled "Emergency Management Opportunities and Challenges for Non-Public Schools," examines integrating non-public…

  2. Climate change collaboration among natural resource management agencies: lessons learned from two US regions

    USGS Publications Warehouse

    Lemieux, Christopher J.; Thompson, Jessica; Slocombe, D. Scott; Schuster, Rudy

    2015-01-01

    It has been argued that regional collaboration can facilitate adaptation to climate change impacts through integrated planning and management. In an attempt to understand the underlying institutional factors that either support or contest this assumption, this paper explores the institutional factors influencing adaptation to climate change at the regional scale, where multiple public land and natural resource management jurisdictions are involved. Insights from two mid-western US case studies reveal that several challenges to collaboration persist and prevent fully integrative multi-jurisdictional adaptation planning at a regional scale. We propose that some of these challenges, such as lack of adequate time, funding and communication channels, be reframed as opportunities to build interdependence, identify issue-linkages and collaboratively explore the nature and extent of organisational trade-offs with respect to regional climate change adaptation efforts. Such a reframing can better facilitate multi-jurisdictional adaptation planning and management of shared biophysical resources generally while simultaneously enhancing organisational capacity to mitigate negative effects and take advantage of potentially favourable future conditions in an era characterised by rapid climate change.

  3. Hospital ergonomics: a qualitative study to explore the organizational and cultural factors.

    PubMed

    Hignett, Sue

    2003-07-15

    The primary objective was to identify the characteristics of the health care industry with respect to organizational and cultural factors and consider how these might impact on the practice of ergonomics. Qualitative methodology was chosen as a suitable approach. This was supported by a middle ground philosophical position. Twenty-one interviews were carried out with academics and practitioners using a questionnaire proforma which developed iteratively over the 18 months of the project. A progressive four stage sampling strategy was used starting with purposive sampling to spread the net. Suggested contacts were then followed up (snowball sampling), before the third stage of intensity sampling to focus on participants with specific experience in hospital ergonomics. A final strategy of analysis sampling sought extreme and deviant cases to achieve theoretical saturation. The analysis resulted in three categories: organizational, staff and patient issues. The organizational issues included both the size and complexity of the National Health Service. For example, three hierarchical lines were identified in the management structure: an administrative line, a professional line and a patient-focused clinical management line. One of the surprising findings for the staff issues was the perceived lack of ergonomic information about female workers as a population group and traditional female employment sectors. The patient issues incorporated three dimensions associated with the caring role: the type of work; expectations; and possible outcomes. The work tends to be dirty and emotional, with a professional subculture to allow the handling of other peoples' bodies. This subculture was linked to a 'coping' attitude where staff put the patients' needs and well-being before their own. The change in patient expectations (from being apologetic through to demanding their rights) is mirrored in a changing model of care from paternalism to partnership. A lack of ergonomic research was identified for female workers in the health care industry relating to both the type of work and gender issues.

  4. Biomarkers of susceptibility: State of the art and implications for occupational exposure to engineered nanomaterials

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

    Iavicoli, Ivo, E-mail: ivo.iavicoli@unina.it

    Rapid advances and applications in nanotechnology are expected to result in increasing occupational exposure to nano-sized materials whose health impacts are still not completely understood. Scientific efforts are required to identify hazards from nanomaterials and define risks and precautionary management strategies for exposed workers. In this scenario, the definition of susceptible populations, which may be at increased risk of adverse effects may be important for risk assessment and management. The aim of this review is to critically examine available literature to provide a comprehensive overview on susceptibility aspects potentially affecting heterogeneous responses to nanomaterials workplace exposure. Genetic, genotoxic and epigeneticmore » alterations induced by nanomaterials in experimental studies were assessed with respect to their possible function as determinants of susceptibility. Additionally, the role of host factors, i.e. age, gender, and pathological conditions, potentially affecting nanomaterial toxicokinetic and health impacts, were also analysed. Overall, this review provides useful information to obtain insights into the nanomaterial mode of action in order to identify potentially sensitive, specific susceptibility biomarkers to be validated in occupational settings and addressed in risk assessment processes. The findings of this review are also important to guide future research into a deeper characterization of nanomaterial susceptibility in order to define adequate risk communication strategies. Ultimately, identification and use of susceptibility factors in workplace settings has both scientific and ethical issues that need addressing. - Highlights: • To define susceptible populations is important for risk assessment and management; • Genetic susceptibility may influence the individual response to nanomaterial exposure; • Susceptibility factors in workplace settings have both scientific and ethical issues.« less

  5. Human factors evaluations of Free Flight Issues solved and issues remaining.

    PubMed

    Ruigrok, Rob C J; Hoekstra, Jacco M

    2007-07-01

    The Dutch National Aerospace Laboratory (NLR) has conducted extensive human-in-the-loop simulation experiments in NLR's Research Flight Simulator (RFS), focussed on human factors evaluation of Free Flight. Eight years of research, in co-operation with partners in the United States and Europe, has shown that Free Flight has the potential to increase airspace capacity by at least a factor of 3. Expected traffic loads and conflict rates for the year 2020 appear to be no major problem for professional airline crews participating in flight simulation experiments. Flight efficiency is significantly improved by user-preferred routings, including cruise climbs, while pilot workload is only slightly increased compared to today's reference. Detailed results from three projects and six human-in-the-loop experiments in NLR's Research Flight Simulator are reported. The main focus of these results is on human factors issues and particularly workload, measured both subjectively and objectively. An extensive discussion is included on many human factors issues resolved during the experiments, but also open issues are identified. An intent-based Conflict Detection and Resolution (CD&R) system provides "benefits" in terms of reduced pilot workload, but also "costs" in terms of complexity, need for priority rules, potential compatibility problems between different brands of Flight Management Systems and large bandwidth. Moreover, the intent-based system is not effective at solving multi-aircraft conflicts. A state-based CD&R system also provides "benefits" and "costs". Benefits compared to the full intent-based system are simplicity, low bandwidth requirements, easy to retrofit (no requirements to change avionics infrastructure) and the ability to solve multi-aircraft conflicts in parallel. The "costs" involve a somewhat higher pilot workload in similar circumstances, the smaller look-ahead time which results in less efficient resolution manoeuvres and the sometimes false/nuisance alerts due to missing intent information. The optimal CD&R system (in terms of costs versus benefits) has been suggested to be state-based CD&R with the addition of intended or target flight level. This combination of state-based CD&R with a limited amount of intent provides "the best of both worlds". Studying this CD&R system is still an open issue.

  6. HIV/AIDS issues in the workplace of nurses.

    PubMed

    Minnaar, A

    2005-08-01

    HIV/AIDS is a global problem with an estimated 40 million infected people. In less than two years, this figure will leap to 100 million according to the World Health Organisation (WHO). By 2005, 65 million people will be infected. Half of the number of people in this group will be under 25 years old, and will die before they reach the age of 35. In a South African study done by the Human Science Research Council and published in 2003, regarding the impact of HIV/AIDS on the health sector, the findings were that 15% of health workers in public and private hospitals tested positive for HIV antibodies. Together with these facts above it was found that 46.2 percent of patients served in medical and paediatric wards tested positive for HIV. These factors have major implication for staffing in the future and the role of the nurse manager in South Africa. To explore the management of HIV/AIDS in the workplace of nurses in selected health services in KwaZulu-Natal. This research was part of a greater study on the exploration of the presence of caring as part of nursing management. THE METHODOLOGY: The qualitative research approach was used with a phenomenological design, which ensured that the richness and the complexities are reflected in the study. The data was collected by means of an open-ended question to nurse managers during an interview. The first question posed was; How do you or your services care for nurses in this hospital? Secondly nurse managers were asked, To explain their role in caring for HIV/AIDS positive nurses on their staff establishment. A qualitative analysis of the interviews with nurse managers indicated that they rate HIV/AIDS issues as an important part of their management task. Four main themes were identified, namely HIV/AIDS, counselling, dying of AIDS and funerals. Rich descriptions of these themes are given in this paper. Nurse managers in the health services are managing HIV/AIDS affected nurses, but are doing so without any formal policy on HIV/AIDS in the workplace. It is recommended that nurse managers deal with HIV/AIDS issues in the workplace by raising HIV/AIDS awareness regarding HIV/AIDS issues and HIV/AIDS in the workplace. Nurse managers saw their role regarding nurses with HIV/AIDS mainly as supportive--being involved in family problems and counselling and guiding nurses that live with HIV/AIDS. The health services in KwaZulu-Natal, and especially nurses, are currently affected by HIV/AIDS in a significant way.

  7. Feasibility of Large High-Powered Solar Electric Propulsion Vehicles: Issues and Solutions

    NASA Technical Reports Server (NTRS)

    Capadona, Lynn A.; Woytach, Jeffrey M.; Kerslake, Thomas W.; Manzella, David H.; Christie, Robert J.; Hickman, Tyler A.; Schneidegger, Robert J.; Hoffman, David J.; Klem, Mark D.

    2012-01-01

    Human exploration beyond low Earth orbit will require the use of enabling technologies that are efficient, affordable, and reliable. Solar electric propulsion (SEP) has been proposed by NASA s Human Exploration Framework Team as an option to achieve human exploration missions to near Earth objects (NEOs) because of its favorable mass efficiency as compared to traditional chemical systems. This paper describes the unique challenges and technology hurdles associated with developing a large high-power SEP vehicle. A subsystem level breakdown of factors contributing to the feasibility of SEP as a platform for future exploration missions to NEOs is presented including overall mission feasibility, trip time variables, propellant management issues, solar array power generation, array structure issues, and other areas that warrant investment in additional technology or engineering development.

  8. Web-Based Self-Service Systems for Managed IT Support: Service Provider Perspectives of Stakeholder-Based Issues

    NASA Astrophysics Data System (ADS)

    Cooper, Vanessa A.; Lichtenstein, Sharman; Smith, Ross

    This chapter explores the provision of after-sales information technology (IT) support services using Web-based self-service systems (WSSs) in a business-to-business (B2B) context. A recent study conducted at six large multi-national IT support organisations revealed a number of critical success factors (CSFs) and stakeholder-based issues. To better identify and understand these important enablers and barriers, we explain how WSSs should be considered within a complex network of service providers, business partners and customer firms. The CSFs and stakeholder-based issues are discussed. The chapter highlights that for more successful service provision using WSSs, IT service providers should collaborate more effectively with enterprise customers and business partners and should better integrate their WSSs.

  9. Chronic diseases are not being managed effectively in either high-risk or low-risk populations in South Africa.

    PubMed

    Brand, Martin; Woodiwiss, Angela J; Michel, Frederic; Booysens, Hendrik L; Majane, Olebogeng H I; Maseko, Muzi J; Veller, Martin G; Norton, Gavin R

    2013-07-29

    Primary healthcare is the foundation of a country's healthcare system. Without an efficient and cost-effective programme, the level of healthcare offered across all levels of health management is adversely affected. To analyse the effectiveness of the management of hypertension and diabetes mellitus (DM) among two distinct patient populations, one with significant cardiovascular risk factors and the other without. We performed a case control study of a high-risk group of patients presenting with chronic critical limb ischaemia (CLI) to the Divisions of Vascular Surgery at Charlotte Maxeke Johannesburg Academic Hospital and Chris Hani Baragwanath Academic Hospital, and a randomly selected group of 'healthy' community participants from Johannesburg's South Western Townships (Soweto). We assessed 217 patients with CLI and 1 030 participants from the community. We assessed the number of patients who were not achieving their therapeuatic targets, among those known to be hypertensive (CLI: 44.7%; community: 59.9%) and diabetic (CLI: 83.5%; community: 66%). Undiagnosed diabetes affected 10.8% of patients with CLI and 11% of the community sample. Traditional vascular risk factors are managed poorly at both primary healthcare and at tertiary care levels. There is a need to identify factors that will address this issue.

  10. Management of radon: a review of ICRP recommendations.

    PubMed

    Vaillant, Ludovic; Bataille, Céline

    2012-09-01

    This article proposes a review of past and current ICRP publications dealing with the management of radon exposures. Its main objective is to identify and discuss the driving factors that have been used by the Commission during the last 50 years so as to better appreciate current issues regarding radon exposure management. The analysis shows that major evolutions took place in very recent years. As far as the management of radon exposures is concerned, ICRP recommended, until ICRP Publication 103 (ICRP 2007 ICRP Publication 103; Ann. ICRP 37), to use action levels and to consider only exposures above these levels. The Commission has reviewed its approach and now proposes to manage any radon exposure through the application of the optimisation principle and associated reference levels. As far as the assessment of the radon risk is concerned, it appears that the successive changes made by ICRP did not have a strong impact on the values of radon gas concentration recommended as action levels either in dwellings or in workplaces. The major change occurred in late 2009 with the publication of the ICRP Statement on Radon, which acknowledged that the radon risk has been underestimated by a factor of 2, thus inducing a major revision of radon reference levels.

  11. Goal setting education and counseling practices of diabetes educators.

    PubMed

    Malemute, Charlene L; Shultz, Jill Armstrong; Ballejos, Miriam; Butkus, Sue; Early, Kathaleen Briggs

    2011-01-01

    The purpose of this study was to identify goal setting education practices used by diabetes educators working with type 2 diabetes patients. Data were collected by a mail questionnaire with 179 diabetes educators purposively selected from the 2008 American Association of Diabetes Educators membership listing. Many diabetes educators (52%) reported that more than 75% of their patients set goals for diabetes control. Independent factor patterns for the frequency of information collected from the patient for the first diabetes education session showed that educators either focused on patients' self-management practices (exercise and dietary practices, knowledge, and social impacts of diabetes) or issues with learning about self-management, such as understanding the patient's learning style and motivation for managing diabetes. Factor patterns overall showed diverse approaches to working with patients, including strategies used with patients struggling with dietary goals and the importance of tasks to complete during the first patient session. Although most educators reported practices that were largely patient centered as promoted by the American Diabetes Association (ADA) and models of chronic disease management, patterns of practice suggest that diabetes educators vary considerably in how they apply education practices, especially with dietary self-management education.

  12. Multilevel and Hybrid Architecture for Device Abstraction and Context Information Management in Smart Home Environments

    NASA Astrophysics Data System (ADS)

    Peláez, Víctor; González, Roberto; San Martín, Luis Ángel; Campos, Antonio; Lobato, Vanesa

    Hardware device management, and context information acquisition and abstraction are key factors to develop the ambient intelligent paradigm in smart homes. This work presents an architecture that addresses these two problems and provides a usable framework to develop applications easily. In contrast to other proposals, this work addresses performance issues specifically. Results show that the execution performance of the developed prototype is suitable for deployment in a real environment. In addition, the modular design of the system allows the user to develop applications using different techniques and different levels of abstraction.

  13. Supporting Cancer Patients in Illness Management: Usability Evaluation of a Mobile App

    PubMed Central

    Kaufman, David R; Ruland, Cornelia M

    2014-01-01

    Background Mobile phones and tablets currently represent a significant presence in people’s everyday lives. They enable access to different information and services independent of current place and time. Such widespread connectivity offers significant potential in different app areas including health care. Objective Our goal was to evaluate the usability of the Connect Mobile app. The mobile app enables mobile access to the Connect system, an online system that supports cancer patients in managing health-related issues. Along with symptom management, the system promotes better patient-provider communication, collaboration, and shared decision making. The Connect Mobile app enables access to the Connect system over both mobile phones and tablets. Methods The study consisted of usability tests of a high fidelity prototype with 7 cancer patients where the objectives were to identify existing design and functionality issues and to provide patients with a real look-and-feel of the mobile system. In addition, we conducted semistructured interviews to obtain participants’ feedback about app usefulness, identify the need for new system features and design requirements, and measure the acceptance of the mobile app and its features within everyday health management. Results The study revealed a total of 27 design issues (13 for mobile apps and 14 for tablet apps), which were mapped to source events (ie, errors, requests for help, participants' concurrent feedback, and moderator observation). We also applied usability heuristics to identify violations of usability principles. The majority of violations were related to enabling ease of input, screen readability, and glanceability (15 issues), as well as supporting an appropriate match between systems and the real world (7 issues) and consistent mapping of system functions and interactions (4 issues). Feedback from participants also showed the cancer patients’ requirements for support systems and how these needs are influenced by different context-related factors, such as type of access terminal (eg, desktop computer, tablet, mobile phone) and phases of illness. Based on the observed results, we proposed design and functionality recommendations that can be used for the development of mobile apps for cancer patients to support their health management process. Conclusions Understanding and addressing users’ requirements is one of the main prerequisites for developing useful and effective technology-based health interventions. The results of this study outline different user requirements related to the design of the mobile patient support app for cancer patients. The results will be used in the iterative development of the Connect Mobile app and can also inform other developers and researchers in development, integration, and evaluation of mobile health apps and services that support cancer patients in managing their health-related issues. PMID:25119490

  14. The Management Issues of Implementing Telecommuting: A Case Study

    DTIC Science & Technology

    1993-09-01

    telecommuting ; benefits for both the employers and employees. These benefits include: (JALA (b) 1990) * Significantly increased productivity (10 to 20% on...1992 to April 1993. B. RESEARCH QUESTIONS Prior research reveals that a successful telecommuting program has the following benefits : "* Flexibility...State, Jack Nilles outlines a different set of important factors and points out that: While telecommuting has many benefits , there also are potential

  15. Urban phosphorus sustainability: Systemically incorporating social, ecological, and technological factors into phosphorus flow analysis

    Treesearch

    Genevieve S. Metson; David M. Iwaniec; Lawrence A. Baker; Elena M. Bennett; Daniel L. Childers; Dana Cordell; Nancy B. Grimm; J. Morgan Grove; Daniel A. Nidzgorski; Stuart White

    2015-01-01

    Phosphorus (P) is an essential fertilizer for agricultural production but is also a potent aquatic pollutant. Current P management fails to adequately address both the issue of food security due to P scarcity and P pollution threats to water bodies. As centers of food consumption and waste production, cities transport and store much P and thus provide important...

  16. Metastatic basal cell carcinoma: case series and review of the literature.

    PubMed

    Tang, Simon; Thompson, Stephen; Smee, Robert

    2017-05-01

    Metastatic basal cell carcinoma is exceedingly uncommon, with a poorly defined natural history, and its incidence, risk factors, patterns of spread, prognosis and potential treatment options are not well understood. This retrospective single institution case series aims to shed light on these issues. Aggressive local management in patients with locoregional disease may result in long-term survivors. © 2016 The Australasian College of Dermatologists.

  17. Management of work-related stress by Finnish occupational physicians.

    PubMed

    Kinnunen-Amoroso, M; Liira, J

    2013-07-01

    Occupational stress is a serious threat to the well-being of employees and organizations and may cause ill-health and loss of productivity. Determining the methods that occupational health (OH) services and employers use to manage work-related stress can help to detect both barriers and facilitating factors for effective stress management. To examine stress management methods used by OH physicians in Finland. Anonymous, self-administered e-mail questionnaire to Finnish OH physicians. A total of 222 OH physicians responded. Neither OH services nor their client organizations used standardized tools to assess or manage work-related stress. Work-related stress was assessed using patient interviews. Physicians reported that the main method used to manage occupational stress was supporting the individual employee. Half of the physicians attempted to involve workplaces in stress management by asking their patients to contact their supervisors regarding stress issues. In order to tackle work-related stress consistently and effectively employers and OH services should have agreed standardized protocols for managing stress in the workplace.

  18. 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

  19. 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.

  20. Caring for women living with HIV: gaps in the evidence

    PubMed Central

    Loutfy, Mona R; Sherr, Lorraine; Sonnenberg-Schwan, Ulrike; Walmsley, Sharon L; Johnson, Margaret; d'Arminio Monforte, Antonella

    2013-01-01

    Introduction In the management of HIV, women and men generally undergo the same treatment pathway, with gender differences being given limited consideration. This is in spite of accumulating evidence that there are a number of potential differences between women and men which may affect response to treatment, pharmacokinetics, toxicities and coping. There are also notable psychological, behavioural, social and structural factors that may have a unique impact on women living with HIV (WLWH). Despite our increasing knowledge of HIV and advances in treatment, there are significant gaps in the data relating specifically to women. One of the factors contributing to this situation is the under-representation of women in all aspects of HIV clinical research. Furthermore, there are clinical issues unique to women, including gynaecologic and breast diseases, menopause-related factors, contraception and other topics related to women's and sexual health. Methods Using scoping review methodology, articles from the literature from 1980 to 2012 were identified using appropriate MeSH headings reflecting the clinical status of WLWH, particularly in the areas of clinical management, sexual health, emotional wellbeing and treatment access. Titles and abstracts were scanned to determine whether they were relevant to non-reproductive health in WLWH, and papers meeting inclusion criteria were reviewed. Results This review summarizes our current knowledge of the clinical status of WLWH, particularly in the areas of clinical management, sexual health, emotional wellbeing and treatment access. It suggests that there are a number of gender differences in disease and treatment outcomes, and distinct women-specific issues, such as menopause and co-morbidities, that pose significant challenges to the care of WLWH. Conclusions Based on a review of this evidence, outstanding questions and areas where further studies are required to determine gender differences in the efficacy and safety of treatment and other clinical and psychological issues specifically affecting WLWH have been identified. Well-controlled and adequately powered clinical studies are essential to help provide answers to these questions and to contribute to activities aimed at improving the health and wellbeing of WLWH. PMID:24088395

  1. Declines of greater and lesser scaup populations: issues, hypotheses, and research needs

    USGS Publications Warehouse

    Austin, J.E.; Afton, A.D.; Anderson, M.G.; Clark, R.G.; Custer, Christine M.; Lawrence, J.; Pollard, J.B.; Ringelman, J.K.

    2000-01-01

    The population estimate for greater (Aythya marila) and lesser (Aythya affinis) scaup (combined) has declined dramatically since the early 1980s to record lows in 1998. The 1998 estimate of 3.47 million scaup is far below the goal of 6.3 million set in the North American Waterfowl Management Plan (NAWMP), causing concern among biologists and hunters. We summarize issues of concern, hypotheses for factors contributing to the population decline, and research and management needs recommended by participants of the Scaup Workshop, held in September 1999. We believe that contaminants, lower female survival, and reduced recruitment due to changes in food resources or breeding-ground habitats are primary factors contributing to the decline. These factors are not mutually exclusive but likely interact across seasons. Workshop participants identified seven action items. We need to further delineate where declines in breeding populations have occurred, with a primary focus on the western Canadian boreal forest, where declines appear to be most pronounced. Productivity in various areas and habitats throughout the breeding range needs to be assessed by conducting retrospective analyses of existing data and by intensive field studies at broad and local scales. Annual and seasonal survival rates need to be determined in order to assess the role of harvest or natural mortality. Effects of contaminants on reproduction, female body condition, and behavior must be investigated. Use, distribution, and role of food resources relative to body condition and reproduction need to be examined to better understand seasonal dynamics of nutrient reserves and the role in reproductive success. Affiliations among breeding, migration, and wintering areas must be assessed in order to understand differential exposure to harvest or contaminants, and differential reproductive success and recruitment. Biologists and agencies need to gather and improve information needed to manage greater and lesser scaup separately; this includes monitoring the breeding populations of each species separately, closer examination of existing data to improve surveys and data collection, and re-evaluation of the NAWMP population goal. These complex issues will require extensive cooperation and communication among many agencies and organizations in North America.

  2. Women, work and health: issues and implications for worksite health promotion.

    PubMed

    Collins, B S; Hollander, R B; Koffman, D M; Reeve, R; Seidler, S

    1997-01-01

    This paper identifies issues related to worksite health promotion programs for women by examining ways that work factors, health behaviors, family roles and responsibilities, and women's health are linked. Work conditions may affect women uniquely, as in the case of chemical exposure affecting reproductive health; disproportionately, such as the interaction between work and family roles; or differently from men, as in women's experience of stress in the workplace. The focus is on the differences and uniqueness of working women's health. Drawing on a public health perspective, implications for consideration by worksite health promotion programs specialist, human resource managers, and researchers are presented.

  3. DOT's Budget: Safety, Management, and Other Issues Facing the Department in Fiscal Year 1998 and Beyond

    DOT National Transportation Integrated Search

    1997-03-06

    This testimony discusses key resource management issues and performance challenges facing the Department of Transportation in 1998 and beyond. 1. Increased safety and security concerns prompted by accidents and maintenance issues. 2. Important manage...

  4. Multidisciplinary study on anthropogenic landslides in Nepal

    NASA Astrophysics Data System (ADS)

    Puglia, Christopher; Derron, Marc-Henri; Nicolet, Pierrick; Sudmeier-Rieux, Karen; Jaboyedoff, Michel; Devkota, Sanjay

    2013-04-01

    Nepal is a country in which shallow landslide is a frequent phenomenon. Monsoon is the main triggering factor but anthropogenic influence is often significant too. Indeed, many infrastructures, such as roads or water pipes, are not built in a rigorous way because of a lack of funds and knowledge. In the present study we examine the technical, social and economic issues of landslide management for two sites in Nepal. The first site is located in Sanusiruwari VDC (Sindhupalchock district, central Nepal) and the second one in Namadi VDC (Ramecchap district, central Nepal). Both sites are affected by landslides induced by the construction of hydropower plants. These landslides may threaten the viability of the hydropower plants. At both sites the problems are quite similar, but the first site project is a private one and the second one is a public one implemented by the United Nations Development Programme (UNDP). For both sites, bioengineering methods using Vetiver (Vetyveria zizanioides) plantations is the main stabilization measure. To follow the progression of both landslides, fieldwork observations were conducted before and after the 2012 rainy season, including photogrammetric and distancemeter acquisitions. Main issues were discussed with communities and stakeholders of the hydropower projects through interviews and participatory risk mapping. Main issues include: lack of communication between the project managers and communities leading to conflict and the lack of maintenance of the bio-engineering sites, leading to less effective Vetiver growth and slope stabilization. Comparing the landslide management (technical, social and economic) of the two projects allows to point out some specific issues within an integrated risk perspective.

  5. Communicating Medical Needs to Non-Medical Managers

    NASA Technical Reports Server (NTRS)

    Bacal, Kira; Miller, Robert; Doerr, Harold

    2004-01-01

    Differences in communication styles and languages between groups often lead to miscommunication, confusion, and/or frustration. Engineers, computer specialists, clinicians, and managers often utilize the English language in very different ways, with different groups using the same words to represent different concepts ("complaint" is a typical example). In addition, medical issues are often perceived as "off-nominal" and not "primary mission tasks" by managers, which can cause them to assign lower priorities to medical training time and resources. Knowledge bases differ due to variations in training and skill sets, and the goals (both immediate and long-term) of the communicators may also vary, with managers being primarily concerned with overall mission objectives, while clinicians focus on individual or group health issues. Furthermore, true communication is only possible when clinicians possess a deep understanding of mission requirements as well as the ability to communicate medical requirements on a priority basis using risk assessment, added value, and cost benefit analysis. These understandable differences may contribute to difficulties in expressing concerns and ideas in an efficient manner, particularly in projects, such as the space program or many military operations, where these varied groups must collaborate, and where the final decisions must be made by fully informed mission commanders. Methods: Three scenario-based approaches were developed utilizing decision trees and problem based learning, to help define and integrate these concepts. Results: Use of these techniques by NASA and military personnel will be presented. Discussion: To enhance communication, particularly of medical needs, one must identify the concerns and motivating factors for the other groups; for example, members of management may focus on financial concerns, a desire for risk mitigation, public perceptions, mission objectives, etc. Training clinicians to frame issues in these terms may lead to better understanding of the medical concerns by other groups.

  6. Managing Senegalese water resources: Definition and relative importance of information needs

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

    Engi, D.

    1998-09-01

    This report provides an overview of the results of the Vital Issues process as implemented for the Senegal Water Resources Management Initiative, a collaborative effort between the Senegalese Ministry of Water Resources and Sandia National Laboratories. This Initiative is being developed to assist in the development of an efficient and sustainable water resources management system for Senegal. The Vital Issues process was used to provide information for the development of a proposal that will recommend actions to address the key management issues and establish a state-of-the-art decision support system (DSS) for managing Senegal`s water resources. Three Vital Issues panel meetingsmore » were convened to (1) develop a goal statement and criteria for identifying and ranking the issues vital to water resources management in Senegal; (2) define and rank the issues, and (3) identify and prioritize a preliminary list of information needed to address the vital issues. The selection of panelists from the four basic institutional perspectives (government, industry, academe, and citizens` interest groups) ensured a high level of stakeholder representation on the panels.« less

  7. [Detection of intimate partner violence in primary care and related factors].

    PubMed

    Rodríguez-Blanes, Gloria M; Vives-Cases, Carmen; Miralles-Bueno, Juan José; San Sebastián, Miguel; Goicolea, Isabel

    Intimate partner violence (IPV) against women is a significant public health and human rights problem. Primary care professionals play a key role in detecting and addressing this issue. The aim of this study is to determine the frequency of IPV and its associated factors in primary care by means of a screening questionnaire and to describe the main actions taken in identified cases. Cross-sectional study in 15 health centres in four autonomous regions of Spain with a total of 265 health professionals. The information was collected through the self-administered PREMIS questionnaire (Physician Readiness to Manage Intimate Partner Violence Survey), which includes variables concerning screening questions, sociodemographic factors, level of training/knowledge about IPV, perceptions and actions. A descriptive and analytical study was conducted. 67.2% of participants said they ask about IPV during consultations. The most frequent actions were: referring patients to other departments, individual counselling and information delivery. ≥21hours of training, an advanced training level, knowledge of policies and programmes and the implementation of an appropriate protocol and reference resources were all factors that increased the likelihood of investigating IPV. The asking of questions increases in line with professionals' perceived level of training in IPV and the provision of a case management protocol. Two thirds of health professional respondents said they inquire about IPV. Given the influence of training in IPV and awareness of the resources to address the issue, it is essential to continue investing in the IPV training of healthcare personnel. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Impact of managed care on healthcare delivery practices: the perception of healthcare administrators and clinical practitioners.

    PubMed

    Tietze, Mari F

    2003-01-01

    Managed care has introduced changes, such as cost effectiveness, access to care, and quality of care, to many components of the U.S. healthcare delivery system. These changes have affected how healthcare administrators and clinical practitioners perceive the impact of managed care on healthcare delivery practices. A survey was initiated to explore whether the perceptions of administrators differed from those of practitioners and to discover which organizational variables could explain the difference. A descriptive, cross-sectional survey design was used for the target population of administrators and practitioners in high, moderate, and low managed-care-penetration markets. Two investigator-developed instruments--the Managed Care Perceptions Inventory (MCPI) and the MCPI-Demographic--and an intact centralization of decision-making assessment subscale were used for data collection. Administrators had a statistically significant, more positive perception of the impact of managed care on healthcare delivery than did practitioners. When the distinction between administrator and practitioner was not used as a grouping factor, managed care market penetration, nonprofit status, and years in current employment position were factors that had statistically significant associations with a more positive perception of managed care. Based on these findings, both administrators and practitioners have a role in maintaining awareness regarding their perceptions and should work collaboratively to address issues of concern. Similarly, promoting trust and commitment at the organizational level is important. Recommendations for further research are also provided.

  9. Supports and Concerns for Teacher Professional Growth During the Implementation of a Science Curriculum Innovation

    NASA Astrophysics Data System (ADS)

    Peers, Cheryl (Shelley) E.; Diezmann, Carmel M.; Watters, James J.

    2003-02-01

    Internationally, considerable reform in science education is occurring which promotes constructivist philosophies and advocates constructivist-inspired pedagogical strategies that are new to many teachers. This paper reports on the supporting factors necessary for teacher professional growth and the issues of concern that were evident during one primary teacher''s successful implementation of a unit of work based on a draft of a new state-wide science syllabus which proposes such approaches. One researcher (CEP) provided guidance during the writing and implementation of the unit through professional development workshops complemented by ongoing collegial support. The analysis of the teacher''s practice reveals that professional growth required a willingness of the teacher to engage with change and modify his professional practice. The support factors for teacher growth consisted of an appropriate program of professional development, teacher understanding of the elements of the curriculum innovation, and successful experiences in implementing new approaches. In contrast, the issues of concern were: the adequacy of support for planning including the time required to understand the innovation and make changes to teaching practice; science equipment; teacher knowledge; classroom management strategies; and ways to cope with change. Understanding of these support factors and issues of concern is vital for the successful implementation of science curriculum innovations.

  10. Scaling issues in sustainable river basin management

    NASA Astrophysics Data System (ADS)

    Timmerman, Jos; Froebich, Jochen

    2014-05-01

    Sustainable river basin management implies considering the whole river basin when managing the water resources. Management measures target at dividing the water over different uses (nature, agriculture, industry, households) thereby avoiding calamities like having too much, too little or bad quality water. Water management measures are taken at the local level, usually considering the sub-national and sometimes national effects of such measures. A large part of the world's freshwater resources, however, is contained in river basins and groundwater systems that are shared by two or more countries. Sustainable river basin management consequently has to encompass local, regional, national and international scales. This requires coordination over and cooperation between these levels that is currently compressed into the term 'water governance' . Governance takes into account that a large number of stakeholders in different regimes (the principles, rules and procedures that steer management) contribute to policy and management of a resource. Governance includes the increasing importance of basically non-hierarchical modes of governing, where non-state actors (formal organizations like NGOs, private companies, consumer associations, etc.) participate in the formulation and implementation of public policy. Land use determines the run-off generation and use of irrigation water. Land use is increasingly determined by private sector initiatives at local scale. This is a complicating factor in the governance issue, as in comparison to former developments of large scale irrigation systems, planning institutions at state level have then less insight on actual water consumption. The water management regime of a basin consequently has to account for the different scales of water management and within these different scales with both state and non-state actors. The central elements of regimes include the policy setting (the policies and water management strategies), legal setting (national and international laws and agreements), the institutional setting (the formal networks), information management (the information collection and dissemination system), and financing systems (the public and private sources that cover the water management costs). These elements are usually designed for a specific level and are ideally aligned with the other levels. The presentation will go into detail on connecting the different elements of the water management regime between different levels as well as on the overarching governance issues that play a role and will present opportunities and limitations of the linking options.

  11. The significance of cell-related challenges in the clinical application of tissue engineering.

    PubMed

    Almela, Thafar; Brook, Ian M; Moharamzadeh, Keyvan

    2016-12-01

    Tissue engineering is increasingly being recognized as a new approach that could alleviate the burden of tissue damage currently managed with transplants or synthetic devices. Making this novel approach available in the future for patients who would potentially benefit is largely dependent on understanding and addressing all those factors that impede the translation of this technology to the clinic. Cell-associated factors in particular raise many challenges, including those related to cell sources, up- and downstream techniques, preservation, and the creation of in vitro microenvironments that enable cells to grow and function as far as possible as they would in vivo. This article highlights the main confounding issues associated with cells in tissue engineering and how these issues may hinder the advancement of therapeutic tissue engineering. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 3157-3163, 2016. © 2016 Wiley Periodicals, Inc.

  12. Job satisfaction among public health nurses: a national survey.

    PubMed

    Curtis, Elizabeth A; Glacken, Michele

    2014-07-01

    Despite increasing interest in nurses' job satisfaction relatively few studies have investigated job satisfaction among public health nurses. To establish current level of job satisfaction among public health nurses and identify the main contributing variables/factors to job satisfaction among this population. Quantitative descriptive design. A simple random sample of 1000 public health nurses was conducted yielding a response rate of 35.1% (n = 351). Data was collected using the Index of Work Satisfaction Questionnaire. Descriptive and inferential statistics were deployed. Low levels of job satisfaction among public health nurses emerged. Professional status, interaction and autonomy contributed most to job satisfaction while pay and task-related activities contributed least. Age and tenure were the only biographic factors that correlated significantly with job satisfaction. Public health nurse managers/leaders need to find creative ways of improving the factors that contribute to job satisfaction and address robustly those factors that result in low job satisfaction. The critical issue for public health nurse managers is to determine how job satisfaction can be improved. Greater collaboration and consultation between managers and public health nurses can be regarded as a useful way to begin this process, especially if contemporary nursing is to embrace a responsive approach within the profession. © 2012 John Wiley & Sons Ltd.

  13. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review.

    PubMed

    Hudon, Catherine; Chouinard, Maud-Christine; Lambert, Mireille; Diadiou, Fatoumata; Bouliane, Danielle; Beaudin, Jérémie

    2017-10-22

    The aim of this paper was to identify the key factors of case management (CM) interventions among frequent users of healthcare services found in empirical studies of effectiveness. Thematic analysis review of CM studies. We built on a previously published review that aimed to report the effectiveness of CM interventions for frequent users of healthcare services, using the Medline, Scopus and CINAHL databases covering the January 2004-December 2015 period, then updated to July 2017, with the keywords 'CM' and 'frequent use'. We extracted factors of successful (n=7) and unsuccessful (n=6) CM interventions and conducted a mixed thematic analysis to synthesise findings. Chaudoir's implementation of health innovations framework was used to organise results into four broad levels of factors: (1) ,environmental/organisational level, (2) practitioner level, (3) patient level and (4) programme level. Access to, and close partnerships with, healthcare providers and community services resources were key factors of successful CM interventions that should target patients with the greatest needs and promote frequent contacts with the healthcare team. The selection and training of the case manager was also an important factor to foster patient engagement in CM. Coordination of care, self-management support and assistance with care navigation were key CM activities. The main issues reported by unsuccessful CM interventions were problems with case finding or lack of care integration. CM interventions for frequent users of healthcare services should ensure adequate case finding processes, rigorous selection and training of the case manager, sufficient intensity of the intervention, as well as good care integration among all partners. Other studies could further evaluate the influence of contextual factors on intervention impacts. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Quantifying climate change impacts emphasises the importance of managing regional threats in the endangered Yellow-eyed penguin.

    PubMed

    Mattern, Thomas; Meyer, Stefan; Ellenberg, Ursula; Houston, David M; Darby, John T; Young, Melanie; van Heezik, Yolanda; Seddon, Philip J

    2017-01-01

    Climate change is a global issue with effects that are difficult to manage at a regional scale. Yet more often than not climate factors are just some of multiple stressors affecting species on a population level. Non-climatic factors-especially those of anthropogenic origins-may play equally important roles with regard to impacts on species and are often more feasible to address. Here we assess the influence of climate change on population trends of the endangered Yellow-eyed penguin ( Megadyptes antipodes ) over the last 30 years, using a Bayesian model. Sea surface temperature (SST) proved to be the dominating factor influencing survival of both adult birds and fledglings. Increasing SST since the mid-1990s was accompanied by a reduction in survival rates and population decline. The population model showed that 33% of the variation in population numbers could be explained by SST alone, significantly increasing pressure on the penguin population. Consequently, the population becomes less resilient to non-climate related impacts, such as fisheries interactions, habitat degradation and human disturbance. However, the extent of the contribution of these factors to declining population trends is extremely difficult to assess principally due to the absence of quantifiable data, creating a discussion bias towards climate variables, and effectively distracting from non-climate factors that can be managed on a regional scale to ensure the viability of the population.

  15. Cultural issues and other factors that affect self-management of Type 2 Diabetes Mellitus (T2D) by Chinese immigrants in Australia.

    PubMed

    Eh, Kexin; McGill, Margaret; Wong, Jencia; Krass, Ines

    2016-09-01

    To investigate the influence of cultural and other factors on diabetes self-management behaviors among Australian Chinese immigrants with T2D. A cross-sectional survey was conducted between June and October 2015. The questionnaire comprised several validated scales examining aspects of self-management practice including medication adherence, acculturation and demographics. Participants were recruited from the community and Diabetes Center of the Royal Prince Alfred Hospital (RPAH), Sydney, Australia. Of the 139 participants, a majority were female, from mainland China, with high school level education and a mean age of 64 (SD±12) years. Participants were found to have poor self-management practices generally but moderate medication adherence. 13.7% of participants reported incorporating TCM into their diabetes treatment and 24% reported a cultural shame surrounding a diabetes diagnosis. Higher levels of acculturation predicted better medication adherence, whereas stronger beliefs in TCM predicted poorer medication adherence. Gender, education level and duration of diabetes were also predictors of diabetes self-management behaviors. This study provided insight into cultural influences on diabetes self-management and medication taking among Chinese immigrants in Australia. Health care providers should take these into account in delivering culturally sensitive care and advice to achieve better health outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Men's mobility into management from blue collar and white collar jobs: race differences across the early work-career.

    PubMed

    Wilson, George; Maume, David

    2014-07-01

    Within the context of the "particularistic mobility thesis" we examine racial differences in the incidence, and determinants of, as well as timing to, mobility into management across the critical early career years at a refined level, namely, when groups share similar white collar and blue collar jobs. Findings from a Panel Study of Income Dynamics sample of men support theory and indicate that from both job levels a racial hierarchy exists: African Americans have the lowest rate of mobility, reach management through a route that is relatively formal and structured by a traditional range of stratification-based causal factors and take longest to reach management. Whites, in contrast, have the highest mobility rate, reach management through a relatively informal path that is less structured by traditional stratification-based factors, and reach management the quickest, and, across all three issues Latinos occupy an intermediate ground between African Americans and Latinos. Further, as predicted by theory, racial differences, particularly, relative to whites, are greater among those tracked from blue collar jobs than white collar jobs. Discussed are implications of the findings for understanding racial disadvantage in the American labor market across the work-career and on an inter-generational basis. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Progress with anti-tumor necrosis factor therapeutics for the treatment of inflammatory bowel disease.

    PubMed

    Fernandes, Carlos; Allocca, Mariangela; Danese, Silvio; Fiorino, Gionata

    2015-01-01

    Anti-tumor necrosis factor (TNF) therapy is a valid, effective and increasingly used option in inflammatory bowel disease management. Nevertheless, further knowledge and therapeutic indications regarding these drugs are still evolving. Anti-TNF therapy may be essential to achieve recently proposed end points, namely mucosal healing, prevention of bowel damage and prevention of patient's disability. Anti-TNF drugs are also suggested to be more effective in early disease, particularly in early Crohn's disease. Moreover, its efficacy for prevention of postoperative recurrence in Crohn's disease is still debated. Costs and adverse effects, the relevance of drug monitoring and the possibility of anti-TNF therapy withdrawal in selected patients are still debated issues. This review aimed to describe and discuss the most relevant data about the progress with anti-TNF therapy for the management of inflammatory bowel disease.

  18. A Chronic Disease Prevention and Management Corridor© to Supporting System-Level Transformations for Chronic Conditions.

    PubMed

    Sampalli, Tara; Christian, Erin; Edwards, Lynn; Ryer, Ashley

    2015-01-01

    Improving care for chronic conditions requires system-level transformations to ensure multiple levels of adoption and sustainability of the implemented improvements. These comprehensive solutions require transformations and supports at various levels, leadership and process changes at service/program level. Recognizing the importance of an organization-wide strategy to mitigate the growing issue of chronic disease prevention and management, a novel system-level approach has been developed in a district health authority in Nova Scotia, Canada. In this paper, the contextual factors and efforts that led to the conceptual framework of the Chronic Disease Prevention and Management (CDPM) "Corridor©" to management of chronic conditions are discussed. The CDPM Corridor© essentially constitutes a system-level redesign process; common elements, tools and resources; and a hub of supports for chronic disease prevention and management. The CDPM Corridor © will include a toolkit to guide the implementation of the proposed transformations.

  19. Using Online Databases in Corporate Issues Management.

    ERIC Educational Resources Information Center

    Thomsen, Steven R.

    1995-01-01

    Finds that corporate public relations practitioners felt they were able, using online database and information services, to intercept issues earlier in the "issue cycle" and thus enable their organizations to develop more "proactionary" or "catalytic" issues management repose strategies. (SR)

  20. Introduction

    Treesearch

    Sheila E. Ward; David Boshier; James Grogan

    2008-01-01

    This special issue of Forest Ecology and Management addresses management issues for the tropical timber species of the Meliaceae. The concept for this issue originated from a technical session entitled ..Sustainable management of highvalue timber species of the Meliaceae: a global perspective.., held at the 2005 World Congress of the International Union of Forest...

  1. Issues in NASA Program and Project Management:: A Collection of Papers on Aerospace Management Issues (Supplement 11)

    NASA Technical Reports Server (NTRS)

    Hoffman, Edward J. (Editor); Lawbaugh, William M. (Editor)

    1996-01-01

    Papers address the following topics: NASA's project management development process; Better decisions through structural analysis; NASA's commercial technology management system; Today's management techniques and tools; Program control in NASA - needs and opportunities; and Resources for NASA managers.

  2. Large reservoirs: Chapter 17

    USGS Publications Warehouse

    Miranda, Leandro E.; Bettoli, Phillip William

    2010-01-01

    Large impoundments, defined as those with surface area of 200 ha or greater, are relatively new aquatic ecosystems in the global landscape. They represent important economic and environmental resources that provide benefits such as flood control, hydropower generation, navigation, water supply, commercial and recreational fisheries, and various other recreational and esthetic values. Construction of large impoundments was initially driven by economic needs, and ecological consequences received little consideration. However, in recent decades environmental issues have come to the forefront. In the closing decades of the 20th century societal values began to shift, especially in the developed world. Society is no longer willing to accept environmental damage as an inevitable consequence of human development, and it is now recognized that continued environmental degradation is unsustainable. Consequently, construction of large reservoirs has virtually stopped in North America. Nevertheless, in other parts of the world construction of large reservoirs continues. The emergence of systematic reservoir management in the early 20th century was guided by concepts developed for natural lakes (Miranda 1996). However, we now recognize that reservoirs are different and that reservoirs are not independent aquatic systems inasmuch as they are connected to upstream rivers and streams, the downstream river, other reservoirs in the basin, and the watershed. Reservoir systems exhibit longitudinal patterns both within and among reservoirs. Reservoirs are typically arranged sequentially as elements of an interacting network, filter water collected throughout their watersheds, and form a mosaic of predictable patterns. Traditional approaches to fisheries management such as stocking, regulating harvest, and in-lake habitat management do not always produce desired effects in reservoirs. As a result, managers may expend resources with little benefit to either fish or fishing. Some locally expressed effects, such as turbidity and water quality, zooplankton density and size composition, or fish growth rates and assemblage composition, are the upshot of large-scale factors operating outside reservoirs and not under the direct control of reservoir managers. Realistically, abiotic and biotic conditions in reservoirs are shaped by factors working inside and outside reservoirs, with the relative importance of external factors differing among reservoirs. With this perspective, large reservoirs are viewed from a habitat standpoint within the framework of a conceptual model in which individual reservoir characteristics are influenced by both local- and landscape-scale factors (Figure 17.1). In the sections that follow, how each element of this hierarchical model influences habitat and fish assemblages in reservoirs is considered. Important in-reservoir habitat issues and reservoirs as part of larger systems, where reservoir management requires looking for real solutions outside individual reservoirs are described.

  3. Attitudes towards establishing a daily supervised school-based toothbrushing programme--determined by Q-sort methodology.

    PubMed

    Trubey, R J; Chestnutt, I G

    2013-03-01

    This study used Q-sort methodology to determine the views of staff involved in a national school-based daily toothbrushing programme. Q-methodology is a mixed-method approach in which participants are asked to sort a collection of statements according to degree of agreement with them. Factor analysis identified subgroups of like-minded participants and revealed areas of consensus and disagreement. 24 Community Dental Service staff managing or delivering the toothbrushing programme were asked to rank 49 statements derived from previous qualitative interviews. Varimax rotation produced a three-factor solution with five/six participants loading significantly into each group. Groups divided largely according to staff role: Factor 1, mainly support workers (assistants with no oral-health background); Factor 2, managers; and factor 3, oral health educators (dental nurses with teaching qualifications). As staff new to the area of oral-health, the views of support workers were of particular interest. Unlike others, this group saw Designed to Smile as a unique health promotion scheme and wanted to involve as many children as possible, regardless of oral-disease risk. Managers' perceptions of issues affecting the establishment of the programme differed from those staff in day-to-day contact with the 515 schools in which the toothbrushing took place. This study used a long established but little used technique to ascertain the commonality of views of staff These data may be of value not only in managing the current programme, but for anyone who may be considering developing such a toothbrushing scheme.

  4. Safety climate in university and college laboratories: impact of organizational and individual factors.

    PubMed

    Wu, Tsung-Chih; Liu, Chi-Wei; Lu, Mu-Chen

    2007-01-01

    Universities and colleges serve to be institutions of education excellence; however, problems in the areas of occupational safety may undermine such goals. Occupational safety must be the concern of every employee in the organization, regardless of job position. Safety climate surveys have been suggested as important tools for measuring the effectiveness and improvement direction of safety programs. Thus, this study aims to investigate the influence of organizational and individual factors on safety climate in university and college laboratories. Employees at 100 universities and colleges in Taiwan were mailed a self-administered questionnaire survey; the response rate was 78%. Multivariate analysis of variance revealed that organizational category of ownership, the presence of a safety manager and safety committee, gender, age, title, accident experience, and safety training significantly affected the climate. Among them, accident experience and safety training affected the climate with practical significance. The authors recommend that managers should address important factors affecting safety issues and then create a positive climate by enforcing continuous improvements.

  5. Towards an organization with a memory: exploring the organizational generation of adverse events in health care.

    PubMed

    Smith, Denis; Toft, Brian

    2005-05-01

    The role of organizational factors in the generation of adverse events, and the manner in which such factors can also inhibit an organization's abilities to learn, have become important agenda items within health care. The government report 'An organization with a memory' highlighted many of the problems facing health care and suggested changes that need to be made if the sector is to learn effective lessons and prevent adverse events from occurring. This paper seeks to examine some of these organizational factors in more detail and suggests issues that managers need to consider as part of their wider strategies for the prevention and management of risk. The paper sets out five core elements that are held to be importance in shaping the manner in which the potential for risk is incubated within organizations. Although the paper focuses its attention on health care, the points made have validity across the public sector and into private sector organizations.

  6. Cross-cultural and psychological issues in irritable bowel syndrome.

    PubMed

    Sahoo, Swapnajeet; Padhy, Susanta Kumar

    2017-10-01

    Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders encountered by gastroenterologists worldwide. Of all the etiological factors that had been postulated to explain the pathophysiology of IBS, cultural and psychological factors are unique and difficult to understand. Culture plays an important role in coloring the presentation of IBS, and many a times, it has a significant role in several treatment aspects too. Psychological aspects like personality profiles, family relationships, societal myths, and abuse in any form are equally important in the management perspectives of IBS. In this brief review, we had tried to specifically focus on these aspects in IBS and have explained the evidences in favor of these factors. Knowledge about various cross-cultural aspects and psychological factors in patients with IBS is essential for taking an appropriate history and for undertaking a holistic approach for the management of the same. A collaborative team effort by psychiatrists and gastroenterologists could help in reducing the burden of this difficult to treat functional bowel disorder. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  7. Culture shock and synergy. Academic/managed care/corporate alliances in outcomes management.

    PubMed

    Berman, W H; Darling, H; Hurt, S W; Hunkeler, E M

    1994-01-01

    The Behavioral Health Outcomes Study is a partnership in conducting outcomes measurement involving a corporate healthcare purchaser, five managed behavioral healthcare organizations and academic researchers. The goals of this study are to: evaluate the feasibility of incorporating patient self-reported data in outcomes research; identify factors that may be predictors of outcome; and evaluate the effectiveness of an employee-sponsored aftercare program. The differing perspectives and needs of the three partners have created a number of challenges in the areas of goals, confidentiality, proprietary vs. open access issues and methodology. However, after the study's first year, it is clear not only that outcomes research can be conducted under such a partnership, but that the partnership generates a kind of synergy in problem-solving.

  8. To Issue of Mathematical Management Methods Applied for Investment-Building Complex under Conditions of Economic Crisis

    NASA Astrophysics Data System (ADS)

    Novikova, V.; Nikolaeva, O.

    2017-11-01

    In the article the authors consider a cognitive management method of the investment-building complex in the crisis conditions. The factors influencing the choice of an investment strategy are studied, the basic lines of the activity in the field of crisis-management from a position of mathematical modelling are defined. The general approach to decision-making on investment in real assets on the basis of the discrete systems based on the optimum control theory is offered. With the use of a discrete maximum principle the task in view of the decision is found. The numerical algorithm to define the optimum control is formulated by investments. Analytical decisions for the case of constant profitability of the basic means are obtained.

  9. Below-cost timber sales and the political marketplace

    NASA Astrophysics Data System (ADS)

    Cortner, Hanna J.; Schweitzer, Dennis L.

    1993-01-01

    Political pressures exist to increase the economic efficiency of timber management and production on the national forests managed by the USDA Forest Service. There is growing belief both outside and within the Forest Service that current levels of timber production, and most particularly uneconomic timber production, should be reduced. Many argue that eliminating uneconomic timber management programs will both save money and reduce environmental degradation. This article traces the political evolution of the focus on economic efficiency in timber production and explores the political-institutional factors that are shaping the current policy debate. The below-cost issue is less about economic efficiency than it is about political advantage and alternative political visions of the societal role of the nation's national forests now and in the future.

  10. When snakes bite: the management of North American Crotalinae snake envenomation.

    PubMed

    Ashton, Jenny; Baker, Stephanie N; Weant, Kyle A

    2011-01-01

    There are more than 120 species of snakes indigenous to the United States, 25 of which are venomous. Although snake envenomation carries a relatively low risk of mortality in the United States, it can result in significant morbidity if left untreated. The venom of Crotalinae snakes contains a complex mixture of enzymatic proteins with various clinical implications. Of these complications, the most significant are consumptive coagulopathy, compartment syndrome, and hypovolemic shock. The development of ovine Crotalidae polyvalent immune Fab antivenin (CroFab) has greatly changed the approach to snake envenomation. Nevertheless, multiple factors complicate its use and the overall management of this clinical presentation. The intent of this review is to discuss relevant management issues associated with Crotalinae envenomation in the emergency department.

  11. Survey of public perceptions of prion disease risks in Canada: what does the public care about?

    PubMed

    Lemyre, L; Gibson, S; Markon, M P L; Lee, J E C; Brazeau, I; Carroll, A; Boutette, P; Krewski, D

    2009-01-01

    A national public survey on public perceptions of prion disease risk in Canada was conducted from October to December 2007. The survey aimed at documenting the public's perceptions of prion diseases, within the broader context of food safety, in establishing parameters of risk acceptability. It also documented the public's perceptions of prion diseases in delineating social values and ethics that can guide Canada's future policies on prion disease risk management. In addition, the survey served to establish baseline data against which to monitor the evolution of the public's views on and understanding of this important risk issue. In total, 1517 Canadians were randomly selected to be representative of the adult population by region, age, and gender, as per the 2001 Census. This study presents descriptive findings from the survey regarding perceived risk, perceived control, uncertainty, sources of information, trust and knowledge, and beliefs pertaining to bovine spongiform encephalopathy (BSE). The survey data reveal that Canadians do not perceive mad cow disease as a salient risk but consider it more of an economic, political, social, and foreign trade issue than a public health one. Canadians are somewhat prepared to pay a premium to have a safer food supply, but not to the same extent that they desire extra measures pertaining to BSE risk management. In the context of increasing accountability in risk management decisions about food safety and population health issues, it is important to understand the way Canadians perceive such matters and identify their information needs and the factors that influence the acceptability of risks and of risk management policies.

  12. Nursing implications: symptom presentation and quality of life in rectal cancer patients.

    PubMed

    O'Gorman, Claire; Barry, Amanda; Denieffe, Suzanne; Sasiadek, Wojciech; Gooney, Martina

    2016-05-01

    To determine the changes in symptoms experienced by rectal cancer patients during preoperative chemoradiotherapy, with a specific focus on fatigue and to explore how symptoms impact the quality of life. Rectal cancer continues to be a healthcare issue internationally, despite advances in management strategies, which includes the administration of preoperative chemoradiotherapy to improve locoregional control. It is known that this treatment may cause adverse effects; however, there is a paucity of literature that specifically examines fatigue, symptoms and quality of life in this patient cohort. A prospective, quantitative correlational design using purposive sampling was adopted. Symptoms and quality of life were measured with validated questionnaires in 35 patients at four time points. Symptoms that changed significantly over time as examined using rm-anova include fatigue, bowel function issues, nutritional issues, pain, dermatological issues and urinary function issues. Findings indicate that fatigue leads to poorer quality of life, with constipation, bloating, stool frequency, appetite loss, weight worry, nausea and vomiting, dry mouth and pain also identified as influencing factors on quality of life. Findings have highlighted the importance of thorough symptom assessment and management of patients receiving preoperative chemoradiotherapy, particularly midway through treatment, in order to optimise quality of life and minimise interruptions to treatment. Close monitoring of symptoms during preoperative chemoradiotherapy, particularly at week 4, will enable the implementation of timely interventions so that interruptions to treatment are prevented and the quality of life is optimised, which may hasten postoperative recovery times. © 2016 John Wiley & Sons Ltd.

  13. Toward fisheries sustainability in North America: Issues, challenges, and strategies for action

    USGS Publications Warehouse

    MacDonald, D.D.; Knudsen, E.E.

    2004-01-01

    Many fisheries in North America are severely depleted and trending downwards. In an effort to find ways of reversing this disturbing situation, the American Fisheries Society and the Sustainable Fisheries Foundation invited leading experts in fisheries science and aquatic resource management to share their thoughts and insights in this book. These experts were asked to identify the factors that are currently impairing our ability to effectively manage fisheries resources and propose creative solutions for addressing the most challenging issues affecting fisheries sustainability. Based on the information that was provided by the experts (i.e., as presented in the earlier chapters of this book), it is apparent that a wide range of human activities are adversely affecting our shared fisheries resources and the aquatic habitats upon which they depend. The most challenging problems stem from causes that are largely beyond the scope of traditional fisheries management (e.g., human population growth, resource consumption patterns, global climate change, broad land-use patterns). It is also apparent that resolution of these challenges will require a new approach to fisheries management - one that effectively integrates economic, social, and environmental interests into a decision-making framework that supports fisheries sustainability. The key strategies for supporting such a transition toward a more holistic and comprehensive approach to managing the human activities that influence fisheries and aquatic resources are summarized in this chapter. ?? 2004 by the American Fisheries Society.

  14. Incentive Issues in Information Security Management

    ERIC Educational Resources Information Center

    Lee, Chul Ho

    2012-01-01

    This dissertation studies three incentive issues in information security management. The first essay studies contract issues between a firm that outsources security functions and a managed security service provider (MSSP) that provides security functions to the firm. Since MSSP and firms cannot observe each other's actions, both can suffer…

  15. Opioid addiction and misuse in adult and adolescent patients with cancer.

    PubMed

    Pinkerton, Ross; Hardy, Janet R

    2017-06-01

    In the context of a therapeutic opioid epidemic, particularly in the USA, where increasingly stringent screening for 'at risk' individuals and close monitoring of opioid prescription and use is strongly recommended, the issue of misuse within the cancer population must be addressed. Most patients with advanced cancer will have pain requiring opioid therapy at some stage during their disease course. In the majority, this will provide good pain relief with no short- or longer-term adverse sequelae. A subset will present with substance misuse issues that will influence management and prescribing practice. The potential ethical issues of limiting effective analgesia on the basis of addiction risk or history must be acknowledged. Both a judgemental or 'relaxed' approach to such patients is problematic. Ignoring the situation will not be in the patient's best interest, but an undue focus on this aspect may damage therapeutic relationships with clinicians and adversely affect a holistic approach to care. Clinical practitioners must be aware of the risk factors for opioid misuse and in patients who are not under palliative care consider screening prior to commencing opioids. Clinicians must be able to manage and monitor those identified as having an opioid misuse problem. © 2017 Royal Australasian College of Physicians.

  16. Knowledge and pharmacological management of Alzheimer's disease by managing community pharmacists: a nationwide study.

    PubMed

    Zerafa, Natalie; Scerri, Charles

    2016-12-01

    Background Managing community pharmacists can play a leading role in supporting community dwelling individuals with Alzheimer's disease and their caregivers. Objective The main purpose of this study was to assess knowledge of managing community pharmacists towards Alzheimer's disease and its pharmacological management. Setting Community pharmacies in the Maltese islands. Method A nationwide survey was conducted with full-time managing community pharmacists in possession of a tertiary education degree in pharmacy studies. The level of knowledge was investigated using the Alzheimer's Disease Knowledge Scale and the Alzheimer's Disease Pharmacotherapy Measure. Participants were also asked to rate a number of statements related to disease management. Results Maltese managing community pharmacists (57 % response rate) had inadequate knowledge on risk factors, caregiving issues and pharmacological management of Alzheimer's disease. Age and number of years working in a community pharmacy setting were found to be negatively correlated with increased knowledge. Conclusion The findings highlight the need of providing training and continued educational support to managing community pharmacists in order to provide quality advice to individuals with dementia and their caregivers in the community.

  17. Integration of human factors principles in LARG organizations--a conceptual model.

    PubMed

    Figueira, Sara; Machado, V Cruz; Nunes, Isabel L

    2012-01-01

    Nowadays many companies are undergoing organizational transformations in order to meet the changing market demands. Thus, in order to become more competitive, supply chains (SC) are adopting new management paradigms to improve SC performance: lean, agile, resilient and green (LARG paradigms). The implementation of new production paradigms demands particular care with the issues related with Human Factors to avoid health and safety problems to workers and losses to companies. Thus, the successful introduction of these new production paradigms depends among others on a Human Factors oriented approach. This work presents a conceptual framework that allows integrating ergonomic and safety design principles during the different implementation phases of lean, agile, resilient and green practices.

  18. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017.

    PubMed

    MacMahon, Heber; Naidich, David P; Goo, Jin Mo; Lee, Kyung Soo; Leung, Ann N C; Mayo, John R; Mehta, Atul C; Ohno, Yoshiharu; Powell, Charles A; Prokop, Mathias; Rubin, Geoffrey D; Schaefer-Prokop, Cornelia M; Travis, William D; Van Schil, Paul E; Bankier, Alexander A

    2017-07-01

    The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013. Since then, new information has become available; therefore, the guidelines have been revised to reflect current thinking on nodule management. The revised guidelines incorporate several substantive changes that reflect current thinking on the management of small nodules. The minimum threshold size for routine follow-up has been increased, and recommended follow-up intervals are now given as a range rather than as a precise time period to give radiologists, clinicians, and patients greater discretion to accommodate individual risk factors and preferences. The guidelines for solid and subsolid nodules have been combined in one simplified table, and specific recommendations have been included for multiple nodules. These guidelines represent the consensus of the Fleischner Society, and as such, they incorporate the opinions of a multidisciplinary international group of thoracic radiologists, pulmonologists, surgeons, pathologists, and other specialists. Changes from the previous guidelines issued by the Fleischner Society are based on new data and accumulated experience. © RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on March 13, 2017.

  19. CKD screening and management in the Veterans Health Administration: the impact of system organization and an innovative electronic record.

    PubMed

    Patel, Thakor G; Pogach, Leonard M; Barth, Robert H

    2009-03-01

    At the beginning of this decade, Healthy People 2010 issued a series of objectives to "reduce the incidence, morbidity, mortality and health care costs of chronic kidney disease." A necessary feature of any program to reduce the burden of kidney disease in the US population must include mechanisms to screen populations at risk and institute early the aspects of management, such as control of blood pressure, management of diabetes, and, in patients with advanced chronic kidney disease (CKD), preparation for dialysis therapy and proper vascular access management, that can retard CKD progression and improve long-term outcome. The Department of Veterans Affairs and the Veterans Health Administration is a broad-based national health care system that is almost uniquely situated to address these issues and has developed a number of effective approaches using evidence-based clinical practice guidelines, performance measures, innovative use of a robust electronic medical record system, and system oversight during the past decade. In this report, we describe the application of this systems approach to the prevention of CKD in veterans through the treatment of risk factors, identification of CKD in veterans, and oversight of predialysis and dialysis care. The lessons learned and applicability to the private sector are discussed.

  20. Contributing factors of elective surgical case cancellation: a retrospective cross-sectional study at a single-site hospital.

    PubMed

    Yu, Kaiye; Xie, Xiaolei; Luo, Li; Gong, Renrong

    2017-09-11

    Case cancellation (CC) has significant impact on the efficiency of operating room (OR) management, which can be mitigated by taking preventive measures. In this study, using the data of the West China Hospital (WCH), we identified the effect of contributing factors and recommended hospital interventions to facilitate CC prevention. We conducted a retrospective review of 11,331 elective surgical cases from January 1 to December 31, 2014. CC reasons were grouped into six categories. The methods of descriptive statistics and hypothesis test were used to identify the effect of factors. CC reasons (746) were divided into six broad categories: workup related (preoperative diagnostic assessment issues or sudden medical condition changes) (25.8%), non-specified reasons (25.8%), coordination issues (15.1%), patient related (13.0%), support system issues (11.8%), and doctor related (8.5%). The types of the most frequently performed operations are identified, as well as their CRs. The cancellation rate (CR) of males was lower than that of females (16.7% to 18.3%). A large difference in the CRs existed among doctors. The CR on Monday was significantly higher than the other four weekdays. Workup related issues, the types of procedures, the menstrual cycle of females, highly imbalanced CRs among doctors, and tendency of cancellation on Monday are the major identified factors, which account for a significant amount of preventable cancellations. It is suggested that corresponding hospital interventions can reduce CR and improve OR efficiency, including maintaining effective coordination, good communication and well-designed preoperative assessment processes, focusing on the type of procedures which are more time-consuming and complex, paying special attention to the physiology of females during surgery planning, taking measures to reduce CR of top eight doctors, and improving surgery scheduling on Monday.

  1. Examining the macroergonomics and safety factors among teleworkers: development of a conceptual model.

    PubMed

    Robertson, Michelle M; Schleifer, Lawrence M; Huang, Yueng-hsiang

    2012-01-01

    With the rising number of teleworkers who are working in non-traditional work locations, health and safety issues are even more critical. While telework offers attractive alternatives to traditional work locations, it is not without challenges for employers and workers. A macroergonomics approach or work system design for telework programs is proposed to address these new challenges. This approach explains the impact of organizational, psychosocial and workplace risk factors on teleworker's health and safety. A process for managing the health and safety of teleworkers is presented along with preventive strategies to provide an injury-free working environment.

  2. Understanding the Context of Learning in an Online Social Network for Health Professionals' Informal Learning.

    PubMed

    Li, Xin; Gray, Kathleen; Verspoor, Karin; Barnett, Stephen

    2017-01-01

    Online social networks (OSN) enable health professionals to learn informally, for example by sharing medical knowledge, or discussing practice management challenges and clinical issues. Understanding the learning context in OSN is necessary to get a complete picture of the learning process, in order to better support this type of learning. This study proposes critical contextual factors for understanding the learning context in OSN for health professionals, and demonstrates how these contextual factors can be used to analyse the learning context in a designated online learning environment for health professionals.

  3. Controlled ecological life support system - biological problems

    NASA Technical Reports Server (NTRS)

    Moore, B., III (Editor); Macelroy, R. D. (Editor)

    1982-01-01

    The general processes and controls associated with two distinct experimental paradigms are examined. Specific areas for research related to biotic production (food production) and biotic decomposition (waste management) are explored. The workshop discussions were directed toward Elemental cycles and the biological factors that affect the transformations of nutrients into food, of food material into waste, and of waste into nutrients were discussed. To focus on biological issues, the discussion assumed that (1) food production would be by biological means (thus excluding chemical synthesis), (2) energy would not be a limiting factor, and (3) engineering capacity for composition and leak rate would be adequate.

  4. Combating WMD Journal. Issue 1

    DTIC Science & Technology

    2007-01-01

    Design /Layout CW5 Stephen A. Gomes Ms. Helen M. Stewart DISTRIBUTION STATEMENtI A Approved for Public Release Distribution Unlimited FRO THE DIECO...forming to assist Echelon Above Corps Army elements NBC Defence Factors in the Design , Testing and Accep- with CWMD planning capability. Their initial...Counterproliferation (CP) and Con- with smaller number of officers (-160 designers of the current Officer Pro- sequence Management (CM) arenas FA52s and 275 EOD

  5. Market value: an underused financial planning tool.

    PubMed

    Harris, J P; Schimmel, V E

    1987-04-01

    Two issues facing CFOs are capital formation and the long-range financial impact of strategic planning decisions. For not-for-profit organizations, debt capacity is the main determining factor of capital formation while investment analysis is the key to the financial evaluation of strategic planning options. And, the market, or sale, value of the organization can serve as an effective tool to manage current debt capacity and future investment decisions.

  6. Results of SEI Independent Research and Development Projects

    DTIC Science & Technology

    2008-07-01

    and the processes being followed. The coordination occurs uti- lizing one or more different media types. Figure 2-2: Factors Impacting Coordination...use of one media and be continued using another. Table 2-2: Styles of Coordination and Type of Tool Used for Each Style Teleconference E-mail... social and legal issues, stakeholder management, and training and education. These relationships are shown in Figure 4-1. 19 | CMU/SEI-2008-TR

  7. Women's Health at Work Program: musculoskeletal pain experienced by women of Chinese background working on market gardens in the Sydney Basin.

    PubMed

    Innes, Ev; Crowther, Amber; Fonti, Fiona; Quayle, Leonie

    2010-01-01

    OBJECTIVE/PARTICIPANTS: This report describes a project undertaken by three final (4th) year occupational therapy undergraduate students from the University of Sydney, Australia, in their final fieldwork placement. The project involved women from a Chinese background who worked on market gardens across the Sydney Basin. Its purpose was to identify musculoskeletal risks in the work environment and work practices of a selected group of seven Cantonese-speaking women working on market gardens in the Western Sydney region. The approaches used in the project reflected a risk management approach, and involved background research, initial interviews, task analysis, hazard identification, risk assessment, data analysis, identification of key issues, and developing recommendations, in collaboration with participants and consultation with professionals. The key issues identified as contributing factors to musculoskeletal pain and injuries were: (1) work practices (long work hours, repetitive work); (2) biomechanical factors (repetitive and sustained work postures, poor manual handling practices) and limited training; (3) ergonomics of the equipment used; (4) fatigue. Two priority areas for intervention were identified: (1) pain management, and (2) preventative strategies (improving both the work environment and work practices). Recommendations were made in collaboration with the women, and in consultation with health professionals.

  8. Relevance of multidrug-resistant Pseudomonas aeruginosa infections in cystic fibrosis.

    PubMed

    Stefani, S; Campana, S; Cariani, L; Carnovale, V; Colombo, C; Lleo, M M; Iula, V D; Minicucci, L; Morelli, P; Pizzamiglio, G; Taccetti, G

    2017-09-01

    Multidrug-resistant (MDR) Pseudomonas aeruginosa is an important issue for physicians who take care of patients with cystic fibrosis (CF). Here, we review the latest research on how P. aeruginosa infection causes lung function to decline and how several factors contribute to the emergence of antibiotic resistance in P. aeruginosa strains and influence the course of the infection course. However, many aspects of the practical management of patients with CF infected with MDR P. aeruginosa are still to be established. Less is known about the exact role of susceptibility testing in clinical strategies for dealing with resistant infections, and there is an urgent need to find a tool to assist in choosing the best therapeutic strategy for MDR P. aeruginosa infection. One current perception is that the selection of antibiotic therapy according to antibiogram results is an important component of the decision-making process, but other patient factors, such as previous infection history and antibiotic courses, also need to be evaluated. On the basis of the known issues and the best current data on respiratory infections caused by MDR P. aeruginosa, this review provides practical suggestions to optimize the diagnostic and therapeutic management of patients with CF who are infected with these pathogens. Copyright © 2017 Elsevier GmbH. All rights reserved.

  9. Understanding cultural issues in the diabetes self-management behaviors of Korean immigrants.

    PubMed

    Cha, EunSeok; Yang, Kyeongra; Lee, Jia; Min, Jiwon; Kim, Kevin H; Dunbar, Sandra B; Jennings, Bonnie Mowinski

    2012-01-01

    The purpose of this study was to explore potential factors affecting the self-management behaviors of Korean immigrants with type 2 diabetes mellitus (KIT2Ds). A qualitative descriptive design guided this study. Semistructured interviews lasting 45 to 60 minutes were conducted with 20 KIT2Ds in the participants' preferred language; in all cases, this was Korean. Each interview was audiotaped, transcribed, and analyzed using conventional content analysis. Data analysis was performed in two steps. The data written in Korean were initially analyzed by 3 bilingual researchers. A qualitative researcher then participated in the analysis to refine the findings for presentation to an English-speaking audience while staying true to the data and preserving the nuanced Korean meanings. The mean age of the sample was 64. 5 ± 11.6 years (9 men and 11 women). The mean years of staying in the United States and age at diabetes mellitus diagnosis were 23.6 ± 9.7 years and 52.5 ± 12.3 years, respectively. Three major ideas were identified: (1) issues on treatment regimen related to medications and diet, (2) resources that helped or hindered ability to manage diabetes, and (3) the physician-patient relationship. Important cultural nuances need to be addressed to better prepare KIT2Ds to manage their diabetes more effectively. A culture-specific program should extend beyond a diabetes self-management education delivered in Korean language. Rather, content and education methods need to consider acculturation effects on diabetes management behaviors.

  10. Colorectal cancer: complexities and challenges in managed care.

    PubMed

    Minkoff, Neil B

    2007-08-01

    Managed care weighs advances and associated costs to determine whether the combination of longer life at sometimes significantly increased cost represents value. The price of treatment is only 1 factor. To review treatment decision processes for oncologic agents in managed care environments. Price can be exceptionally high for individuals. But if the population size is low, the per-member-per-month (PMPM) impact can be almost negligible, unlike treatments that have moderate costs but are used ubiquitously. Cancer therapies have, for the most part, escaped managed care's notice. For 2007, the national Cancer Institute projects that antineoplastic agents will consume almost a quarter of the overall drug spend. The Medicare population is a unique concern with regard to cancer. Traditionally, Medicare reimbursement of chemotherapeutic agents was based on average wholesale price (AWP) discounting, not the oncologist's purchasing cost. This allowed oncologists to use reimbursement for infusions to support their medical practices. The proposed plan of the Center for Medicare & Medicaid Services (CMS) to use average sales price (ASP) plus 6% to reimburse for drugs used in the office setting leads to significant problems. Pharmacy and therapeutics committees will also face challenges: fewer data are available for some agents because they have become available through the U.S. Food and drug administration's Fast Track, Priority review, or accelerated approval processes. Oncology disease management programs must reach out to patients and not necessarily deal with oncology issues directly, but address tangential issues that impact care, especially depression and pain management.

  11. Labor force planning issues for allied health in Australia.

    PubMed

    Smith, C S; Crowley, S

    1995-01-01

    The aim of this paper is to discuss labor force planning issues for allied health professionals in Australia. Health system reform and changes in the demand for health labor, combined with key characteristics of the professions, will have a profound influence on future needs for career development of allied health professionals. Key issues include the increasing need for allied health professionals to undertake business management and public health training, the growing trend of multiskilling versus specialization, and the need for the professions to diversify their skill base to ensure a range of career options in a changing health care system. The challenge for allied health professions is to improve tools of analysis in relation to labor force planning and to systematically investigate various factors influencing labor force supply and demand, on both a short-term and long-term basis.

  12. A systematic review of explanatory factors of barriers and facilitators to improving asthma management in South Asian children

    PubMed Central

    2014-01-01

    Background South Asian children with asthma are less likely to receive prescriptions and more likely to suffer uncontrolled symptoms and acute asthma admissions compared with White British children. Understanding barriers are therefore vital in addressing health inequalities. We undertook a systematic review identifying explanatory factors for barriers and facilitators to asthma management in South Asian children. South Asians were defined as individuals of Indian, Pakistani or Bangladeshi descent. Methods Data Sources - Medline, HMIC, EMBASE, ASSIA, Web of Science, BNI, CINAHL, PsycINFO, OpenSIGLE, CRD, Scopus, NHS Evidence, Cochrane Library, Campbell Collaboration, RCPCH, ATS, ERS, Asthma UK, Google Scholar & Asthma Guidelines (BTS, GINA, ATS, Monash, NAEPP, Singapore & New Zealand) to August 2013. Inclusion Criteria – Qualitative, quantitative or mixed methods research with primary focus on identifying explanations for barriers and/or facilitators to asthma management in South Asian children aged 0–18 years with diagnosed/suspected asthma and/or carers and/or healthcare professionals. Data Extraction – Three authors independently reviewed, selected & extracted eligible articles with disagreements resolved by research team discussion. Results 15 studies encompassing 25,755 children, 18,483 parents/carers and 239 healthcare professionals were included. Barriers and explanatory factors identified were: 1. Lack of asthma knowledge in families and healthcare professionals. 2. Under-use of preventer medications. 3. Non-acceptance/denial of asthma. 4. Over-reliance on Emergency Department management. 5. Communication problems. 6. Non-adherence to medication. 7. Use of complementary therapies. Little facilitators regarding asthma management were identified. Conclusions Several key issues were identified as likely to be ethnic-specific to South Asian families, rather than a reflection of minority status: impact of parental and professional knowledge and beliefs, health service utilisation pattern explanations and the impact of prejudice and stigmatisation. Other explanations such as language barriers are not strictly ethnic specific but instead reflect a minority position. Further research is required to identify why barriers exist, the mechanisms by which they impact on asthma management and how they can be overcome. Furthermore, understanding the difference between barriers and explanations that are ethnic-specific and those that are related to being a minority will enable the application of generic system-wide interventions where ethnicity is not the issue and ethnically-tailored interventions where needed. PMID:24767303

  13. Strategic Issues for Training.

    ERIC Educational Resources Information Center

    Pollitt, David, Ed.

    1999-01-01

    Contains precis of 18 articles on strategic management issues, including management development, on-the-job training, corporate scholarship, educational technology, coaching, investing in intellectual capital, and knowledge management. (SK)

  14. Skin problems and EGFR-tyrosine kinase inhibitor

    PubMed Central

    Kozuki, Toshiyuki

    2016-01-01

    Epidermal growth factor receptor inhibition is a good target for the treatment of lung, colon, pancreatic and head and neck cancers. Epidermal growth factor receptor-tyrosine kinase inhibitor was first approved for the treatment of advanced lung cancer in 2002. Epidermal growth factor receptor-tyrosine kinase inhibitor plays an essential role in the treatment of cancer, especially for patients harbouring epidermal growth factor receptor activating mutation. Hence, skin toxicity is the most concerning issue for the epidermal growth factor receptor-tyrosine kinase inhibitor treatment. Skin toxicity is bothersome and sometimes affects the quality of life and treatment compliance. Thus, it is important for physicians to understand the background and how to manage epidermal growth factor receptor-tyrosine kinase inhibitor-associated skin toxicity. Here, the author reviewed the mechanism and upfront preventive and reactive treatments for epidermal growth factor receptor inhibitor-associated skin toxicities. PMID:26826719

  15. What factors determine academic achievement in high achieving undergraduate medical students? A qualitative study.

    PubMed

    Abdulghani, Hamza M; Al-Drees, Abdulmajeed A; Khalil, Mahmood S; Ahmad, Farah; Ponnamperuma, Gominda G; Amin, Zubair

    2014-04-01

    Medical students' academic achievement is affected by many factors such as motivational beliefs and emotions. Although students with high intellectual capacity are selected to study medicine, their academic performance varies widely. The aim of this study is to explore the high achieving students' perceptions of factors contributing to academic achievement. Focus group discussions (FGD) were carried out with 10 male and 9 female high achieving (scores more than 85% in all tests) students, from the second, third, fourth and fifth academic years. During the FGDs, the students were encouraged to reflect on their learning strategies and activities. The discussion was audio-recorded, transcribed and analysed qualitatively. Factors influencing high academic achievement include: attendance to lectures, early revision, prioritization of learning needs, deep learning, learning in small groups, mind mapping, learning in skills lab, learning with patients, learning from mistakes, time management, and family support. Internal motivation and expected examination results are important drivers of high academic performance. Management of non-academic issues like sleep deprivation, homesickness, language barriers, and stress is also important for academic success. Addressing these factors, which might be unique for a given student community, in a systematic manner would be helpful to improve students' performance.

  16. Optimization of healthcare supply chain in context of macro-ergonomics factors by a unique mathematical programming approach.

    PubMed

    Azadeh, A; Motevali Haghighi, S; Gaeini, Z; Shabanpour, N

    2016-07-01

    This study presents an integrated approach for analyzing the impact of macro-ergonomics factors in healthcare supply chain (HCSC) by data envelopment analysis (DEA). The case of this study is the supply chain (SC) of a real hospital. Thus, healthcare standards and macro-ergonomics factors are considered to be modeled by the mathematical programming approach. Over 28 subsidiary SC divisions with parallel missions and objectives are evaluated by analyzing inputs and outputs through DEA. Each division in this HCSC is considered as decision making unit (DMU). This approach can analyze the impact of macro-ergonomics factors on supply chain management (SCM) in healthcare sector. Also, this method ranks the relevant performance efficiencies of each HCSC. In this study by using proposed method, the most effective macro-ergonomics factor on HCSC is identified as "teamwork" issue. Also, this study would help managers to identify the areas of weaknesses in their SCM system and set improvement target plan for the related SCM system in healthcare industry. To the best of our knowledge, this is the first study for macro-ergonomics optimization of HCSC. Copyright © 2016 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  17. A perspective study on green cleaning for Malaysian public hospital

    NASA Astrophysics Data System (ADS)

    Ramli, N. A.; Zawawi, E. M.; Arif, N. R. M.; Mahbob, N. S.; Sulaiman, Z.; Zainol, N. N.

    2018-02-01

    Cleaning being a major contributor to the operations and maintenance expenditure and also Indoor Environmental Quality (IEQ) issues. Improper and ineffective cleaning can harm the environment and poses greatest risk to health. The use of traditional cleaning products presents a variety of human health and ecological concerns; and may contribute to poor IEQ. As an effort to reduce the issue of operations and maintenance costs and IEQ issues in a building, it is important to establish a green cleaning programme to ensure that the buildings are cleaned in a green way. Numbers of scholars has pointed out the factors which had prevented the green cleaning implementation in hospital buildings. Nonetheless, the significance of these factors has yet to be practically explored in the Malaysian context. Hence, the aim of the paper is to identify the most critical factor that prevents the implementation of green cleaning in Malaysian hospital building. A questionnaire survey and personal communication (i.e. interview) was conducted which involved two groups of respondents. They are the hospital maintenance staff (Cleansing Service Department) and cleaning contractors. Frequency and criticality index calculations have been used to rank these factors according to the level of importance. The result showed that an “unclear components and requirements of green cleaning” indicated as the most critical factor that prevent the implementation of green cleaning in Malaysian hospital building. In the concern for a successful implementation of green cleaning, it is hope that the findings of these studies can be enlightenment to the cleaning contractors as well as the hospital maintenance management team in Malaysia.

  18. U.S. News Media Coverage of Pharmaceutical Pollution in the Aquatic Environment: A Content Analysis of the Problems and Solutions Presented by Actors.

    PubMed

    Blair, Benjamin; Zimny-Schmitt, Daniel; Rudd, Murray A

    2017-08-01

    Pharmaceutical pollution in the aquatic environment is an issue of concern that has attracted attention by the news media. Understanding the factors that contribute to media framing of pharmaceutical pollution may lead to a better understanding of the management and governance of this issue, including why these pollutants are generally unregulated at this time. This study conducted a content analysis of 405 newspaper articles (81 had substantive information on the topic) from 2007 to 2014, using the search terms "water" and "pharmaceuticals" in the Chicago Tribune, Denver Post, Los Angeles Times, New York Daily News, New York Times, USA Today, Wall Street Journal, and Washington Post. We sought to analyze the factors that contributed to the news media presentation of pharmaceutical pollution in the United States, including the presentation of the risks/safety and solutions by various actors. We found that the primary issues in the news media were uncertainty regarding public health and harm to the environment. The primary solutions recommended within the news media were implementing additional water treatment technologies, taking unused pharmaceuticals to predetermined sites for disposal (take-back programs), and trash disposal of unused pharmaceuticals. Water utilities and scientists presented improved water treatment technology, government actors presented take-back programs, and pharmaceutical representatives, while sparsely involved in the news media, presented trash disposal as their primary solutions. To advance the understanding of the management of pharmaceutical pollution, this article offers further insight into the debate and potential solutions within the news media presentation of this complex scientific topic.

  19. U.S. News Media Coverage of Pharmaceutical Pollution in the Aquatic Environment: A Content Analysis of the Problems and Solutions Presented by Actors

    NASA Astrophysics Data System (ADS)

    Blair, Benjamin; Zimny-Schmitt, Daniel; Rudd, Murray A.

    2017-08-01

    Pharmaceutical pollution in the aquatic environment is an issue of concern that has attracted attention by the news media. Understanding the factors that contribute to media framing of pharmaceutical pollution may lead to a better understanding of the management and governance of this issue, including why these pollutants are generally unregulated at this time. This study conducted a content analysis of 405 newspaper articles (81 had substantive information on the topic) from 2007 to 2014, using the search terms "water" and "pharmaceuticals" in the Chicago Tribune, Denver Post, Los Angeles Times, New York Daily News, New York Times, USA Today, Wall Street Journal, and Washington Post. We sought to analyze the factors that contributed to the news media presentation of pharmaceutical pollution in the United States, including the presentation of the risks/safety and solutions by various actors. We found that the primary issues in the news media were uncertainty regarding public health and harm to the environment. The primary solutions recommended within the news media were implementing additional water treatment technologies, taking unused pharmaceuticals to predetermined sites for disposal (take-back programs), and trash disposal of unused pharmaceuticals. Water utilities and scientists presented improved water treatment technology, government actors presented take-back programs, and pharmaceutical representatives, while sparsely involved in the news media, presented trash disposal as their primary solutions. To advance the understanding of the management of pharmaceutical pollution, this article offers further insight into the debate and potential solutions within the news media presentation of this complex scientific topic.

  20. Prescription opioid abuse, pain and addiction: Clinical issues and implications

    PubMed Central

    LING, WALTER; MOONEY, LARISSA; HILLHOUSE, MAUREEN

    2014-01-01

    Issues Prescription opioid misuse in the USA has increased over threefold since 1990 to epidemic proportions, with substantial increases in prescription opioid use also reported in other countries, such as Australia and New Zealand. The broad availability of prescription pain medications, coupled with public misconceptions about their safety and addictive potential, have contributed to the recent surge in non-medical use of prescription opioids and corresponding increases in treatment admissions for problems related to opioid misuse. Given competing pressures faced by physicians to both diagnose and treat pain syndromes and identify individuals at risk for addictive disorders, the use of opioids in the treatment of pain poses a significant clinical challenge. Approach This paper reviews the interaction between pain and opioid addiction with a focus on clinical management issues, including risk factors for opioid dependence in patients with chronic pain and the use of assessment tools to identify and monitor at-risk individuals. Treatment options for opioid dependence and pain are reviewed, including the use of the partial μ agonist buprenorphine in the management of concurrent pain and opioid addiction. Implications Physicians should strive to find a reasonable balance between minimising potential adverse effects of opioid medications without diminishing legitimate access to opioids for analgesia. Conclusions The article discusses the need to identify methods for minimising risks and negative consequences associated with opioid analgesics and poses research directions, including the development of abuse-deterrent opioid formulations, genetic risk factors for opioid dependence and opioid-induced hyperalgesia as a potential target for medication therapy. PMID:21545561

  1. System Wide Information Management (SWIM)

    NASA Technical Reports Server (NTRS)

    Hritz, Mike; McGowan, Shirley; Ramos, Cal

    2004-01-01

    This viewgraph presentation lists questions regarding the implementation of System Wide Information Management (SWIM). Some of the questions concern policy issues and strategies, technology issues and strategies, or transition issues and strategies.

  2. Principles and practices board. Issue Analysis 98-1. Compliance with laws and regulations for healthcare organizations. Healthcare Financial Management Association.

    PubMed

    1998-09-01

    This is the third Issue Analysis of HFMA's Principles and Practices (P&P) Board. The P&P Board writes an Issue Analysis in response to the need for practical information on emerging issues in healthcare financial management. An Issue Analysis is factual but not authoritative. It is not sent out for public comment and provides the healthcare industry short-term assistance on emerging issues. The purpose of P&P Board Issue Analysis 98-1, Compliance with Laws and Regulations for Healthcare Organizations, is to help healthcare financial managers understand their responsibility to implement and maintain an effective internal control system to ensure compliance with laws and regulations.

  3. Fuzzy Multicriteria Decision Analysis for Adaptive Watershed Management

    NASA Astrophysics Data System (ADS)

    Chang, N.

    2006-12-01

    The dramatic changes of societal complexity due to intensive interactions among agricultural, industrial, and municipal sectors have resulted in acute issues of water resources redistribution and water quality management in many river basins. Given the fact that integrated watershed management is more a political and societal than a technical challenge, there is a need for developing a compelling method leading to justify a water-based land use program in some critical regions. Adaptive watershed management is viewed as an indispensable tool nowadays for providing step-wise constructive decision support that is concerned with all related aspects of the water consumption cycle and those facilities affecting water quality and quantity temporally and spatially. Yet the greatest challenge that decision makers face today is to consider how to leverage ambiguity, paradox, and uncertainty to their competitive advantage of management policy quantitatively. This paper explores a fuzzy multicriteria evaluation method for water resources redistribution and subsequent water quality management with respect to a multipurpose channel-reservoir system--the Tseng- Wen River Basin, South Taiwan. Four fuzzy operators tailored for this fuzzy multicriteria decision analysis depict greater flexibility in representing the complexity of various possible trade-offs among management alternatives constrained by physical, economic, and technical factors essential for adaptive watershed management. The management strategies derived may enable decision makers to integrate a vast number of internal weirs, water intakes, reservoirs, drainage ditches, transfer pipelines, and wastewater treatment facilities within the basin and bring up the permitting issue for transboundary diversion from a neighboring river basin. Experience gained indicates that the use of different types of fuzzy operators is highly instructive, which also provide unique guidance collectively for achieving the overarching goals of sustainable development on a regional scale.

  4. 13 CFR 107.250 - Exclusion of stock options issued by Licensee from Management Expenses.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Sbic § 107.250 Exclusion of stock options issued by Licensee from Management Expenses. Stock options... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Exclusion of stock options issued by Licensee from Management Expenses. 107.250 Section 107.250 Business Credit and Assistance SMALL...

  5. 77 FR 59221 - Information Collection Activities: Timpanogos Cave National Monument Visitor and Community Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-26

    ... of how each of the above management issue affects their overall quality of visit experience. Visitors... collect visitors and local community members' perceptions and evaluations of four management issues (1... management issues: (1) Cave tour size and frequency. (2) Ticketing process and fees. (3) Concession service...

  6. The Corporate Library and Issues Management.

    ERIC Educational Resources Information Center

    Lancaster, F. W.; Loescher, Jane

    1994-01-01

    Discussion of corporate library services and the role of the librarian focuses on the recognition and tracking of issues of potential significance to the corporation, or issues management. Topics addressed include environmental scanning of relevant literature, and the use of databases to track issues. (16 references) (LRW)

  7. Issues Management and the Use of Technologies in Public Relations.

    ERIC Educational Resources Information Center

    Ramsey, Shirley A.

    1993-01-01

    Finds that members of the Issues Management Association were more positively involved with two procedures--"environmental scanning for emerging issues" and "developing communication plans about the issues"--than were other public relations practitioners. Finds that respondents were highly likely to use advanced communication…

  8. Beyond job security and money: driving factors of motivation for government doctors in India

    PubMed Central

    2014-01-01

    Background Despite many efforts from government to address the shortage of medical officers (MOs) in rural areas, rural health centres continue to suffer from severe shortage of MOs. Lack of motivation to join and continue service in rural areas is a major reason for such shortage. In the present study, we aimed to assess and rank the driving factors of motivation important for in-service MOs in their current job. Methods The study participants included ninety two in-service government MOs from three states in India. The study participants were required to rank 14 factors of motivation important for them in their current job. The factors for the study were selected using Herzberg’s two-factor theory of motivation and the data were collected using an instrument that has an established reliability and validity. Test of Kendall’s coefficient of concordance (W) was carried out to assess the agreement in ranks assigned by participants to various motivation factors. Next, we studied the distributions of ranks of different motivating factors using standard descriptive statistics and box plots, which gave us interesting insights into the strength of agreement of the MOs in assigning ranks to various factors. And finally to assess whether MOs are more intrinsically motivated or extrinsically motivated, we used Kolmogorov-Smirnov test. Results The (W) test indicated statistically significant (P < 0.01) agreement of the participants in assigning ranks. The Kolmogorov-Smirnov test indicated that from policy perspectives, MOs place significantly more motivational importance to intrinsic factors than to extrinsic factors. The study results indicate that job security was the most important factor related to motivation, closely followed by interesting work and respect and recognition. Among the top five preferred factors, three were intrinsic factors indicating a great importance given by MOs to factors beyond money and job security. Conclusion To address the issue of motivation, the health departments need to pay close attention to devising management strategies that address not only extrinsic but also intrinsic factors of motivation. The study results may be useful to understand the complicated issue of work motivation and can give some useful insights to design comprehensive management strategies that are based on motivational needs of MOs. PMID:24555787

  9. EVALUATION AND MANAGEMENT OF ANEMIA IN THE ELDERLY

    PubMed Central

    Goodnough, Lawrence Tim; Schrier, Stanley L.

    2015-01-01

    Anemia is now recognized as a risk factor for a number of adverse outcomes in the elderly, including hospitalization, morbidity, and mortality. What constitutes appropriate evaluation and management for an elderly patient with anemia, and when to initiate a referral to a hematologist, are significant issues. Attempts to identify suggested hemoglobin levels for blood transfusion therapy have been confounded for elderly patients with their co-morbidities. Since no specific recommended hemoglobin threshold has stood the test of time, prudent transfusion practices to maintain hemoglobin thresholds of 9–10 g/dl in the elderly are indicated, unless or until evidence emerges to indicate otherwise. PMID:24122955

  10. Report of the workshop on Aviation Safety/Automation Program

    NASA Technical Reports Server (NTRS)

    Morello, Samuel A. (Editor)

    1990-01-01

    As part of NASA's responsibility to encourage and facilitate active exchange of information and ideas among members of the aviation community, an Aviation Safety/Automation workshop was organized and sponsored by the Flight Management Division of NASA Langley Research Center. The one-day workshop was held on October 10, 1989, at the Sheraton Beach Inn and Conference Center in Virginia Beach, Virginia. Participants were invited from industry, government, and universities to discuss critical questions and issues concerning the rapid introduction and utilization of advanced computer-based technology into the flight deck and air traffic controller workstation environments. The workshop was attended by approximately 30 discipline experts, automation and human factors researchers, and research and development managers. The goal of the workshop was to address major issues identified by the NASA Aviation Safety/Automation Program. Here, the results of the workshop are documented. The ideas, thoughts, and concepts were developed by the workshop participants. The findings, however, have been synthesized into a final report primarily by the NASA researchers.

  11. Managerial implications of medical sales representative perceptions of job duties, job qualifications, and other performance-related issues.

    PubMed

    Tengilimoğlu, Dilaver; Korkmaz, Sezer; Akinci, Fevzi; Parsons, Amy L

    2004-01-01

    This study examined the perceptions of medical sales representatives of job related duties, job qualifications needed, and motivating factors and tested for differences based on gender, age, years of experience and education using prior research as a base. This study also explored issues that may arise between sales people and physicians. The authors surveyed 132 medical sales representatives from pharmaceutical firms located in Ankara, Turkey. The authors' findings highlight the need in Turkey for developing in-service training programs for medical sales representatives, especially in the areas related to technical aspects of the product, effective marketing and personal selling strategies, and consumer relations. Training in these areas will help salespeople to better manage the problems typically encountered in physician-sales representative relations. While the study was conducted in Turkey, the results are similar to findings in prior research conducted in other countries and therefore may be of interest to all sales managers.

  12. Evidence-based treatment of attention deficit/hyperactivity disorder in a preschool-age child: a case study.

    PubMed

    Verduin, Timothy L; Abikoff, Howard; Kurtz, Steven M S

    2008-04-01

    This case study illustrates a behavioral treatment of "Peter," a 4-year-old male with attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder. Multiple evidence-based treatment procedures were implemented, affording the opportunity to explore issues common to the clinical application of empirically supported interventions. Among the strategies utilized were behavioral parent training, school consultation and behavioral training of educators, school-based contingency management, and a behavioral daily report card. Numerous issues are discussed, including the limited evidence regarding interventions for preschool-age children with ADHD, factors influencing treatment planning and sequencing, collaboration with schools and parents, and evidence-based assessment of treatment gains.

  13. Determinants of individual and group performance

    NASA Technical Reports Server (NTRS)

    Helmreich, Robert L.

    1986-01-01

    A broad exploration of individual and group/organizational factors that influence performance in demanding environments such as space and air transport was undertaken. Primary efforts were directed toward defining critical issues, developing new methodologies for the assessment of performance in such environments, and developing new measures of personality and attitudes as predictors of performance. Substantial clarification of relevant issues for research and validation was achieved. A reliable instrument to assess crewmembers' attitudes regarding crew coordination and flightdeck management was validated. Major efforts in data collection to validate concepts were initiated. The results suggest that substantial improvements can be made in the prediction of performance and in the selection of crewmembers for aviation and space.

  14. Personality Assessment of Global Talent: Conceptual and Methodological Issues

    ERIC Educational Resources Information Center

    van de Vijver, Fons J. R.

    2008-01-01

    The recruitment of managers who will operate in a culturally heterogeneous context (as expatriate managers, managers in a global company, or managers of a multicultural workforce) is increasingly important in an age of globalization. This article describes conceptual and methodological issues in the assessment of such managers, notably in the…

  15. Approaches of Improving University Assets Management Efficiency

    ERIC Educational Resources Information Center

    Wang, Jingliang

    2015-01-01

    University assets management, as an important content of modern university management, is generally confronted with the issue of low efficiency. Currently, to address the problems exposed in university assets management and take appropriate modification measures is an urgent issue in front of Chinese university assets management sectors. In this…

  16. Managing length of stay using patient flow--part 1.

    PubMed

    Cesta, Toni

    2013-02-01

    This month we have discussed the fundamentals of patient flow and its related theories. We reviewed the concepts of demand and capacity management as they apply to the hospital setting. Patient flow requires daily diligence and attention. It should not be something focused on only on busy days, but should be managed each and every day. By taking a proactive approach to patient flow, the number of days your hospital will be bottlenecked can be reduced. Patient flow needs to be part of the daily activities of every case management department and should be factored in as a core role and function in a contemporary case management department. Patient flow needs to be addressed at the patient, departmental, and hospital level. In next month's issue we will continue our discussion on patient flow with a detailed review of specific examples that any case management department can use. We will also review all the departments and disciplines that contribute to patient flow and their role in it.

  17. Manager support for work/family issues and its impact on employee-reported pain in the extended care setting

    PubMed Central

    O’Donnell, Emily M.; Berkman, Lisa F.; Subramanian, Sv

    2012-01-01

    Objective Supervisor-level policies and the presence of a manager engaged in an employee’s need to achieve work/family balance, or “supervisory support,” may benefit employee health, including self-reported pain. Methods We conducted a census of employees at four selected extended-care facilities in the Boston metropolitan region (n= 368). Supervisory support was assessed through interviews with managers and pain was employee-reported. Results Our multilevel logistic models indicate that employees with managers who report the lowest levels of support for work/family balance experience twice as much overall pain as employees with managers who report high levels of support. Conclusions Low supervisory support for work/family balance is associated with an increased prevalence of employee-reported pain in extended-care facilities. We recommend that manager-level policies and practices receive additional attention as a potential risk factor for poor health in this setting. PMID:22892547

  18. A proactive approach for managing indoor air quality

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

    Greene, R.E.; Casey, J.M.; Williams, P.L.

    1997-11-01

    Ventilation and maintenance, followed by psychosocial issues, are the factors most often implicated in indoor air quality (IAQ) investigations. The absence of accepted exposure standards and the presence of a wide variety of building designs, ages, ventilation systems, and usages often make IAQ complaint investigations ineffective. Thus, the best approach to achieving IAQ is to prevent problems from occurring. This paper presents the framework for a proactive approach to managing the causes most often implicated in IAQ investigations. It is the aim of this proactive protocol to provide a cost-effective guide for preventing IAQ problems in nonindustrial settings and inmore » buildings for which there are no current IAQ complaints. The proposed protocol focuses on heating, ventilation, and air-conditioning (HVAC) system maintenance and operation; psychosocial factors; and the handling and investigation of complaints. An IAQ manager is designated to implement and manage the protocol. The HVAC system portion of the protocol focuses on proper maintenance of the components often identified as sources of problems in IAQ studies, documentation of the maintenance procedures, and training of individuals responsible for building maintenance. The protocol addresses the psychosocial factors with an environmental survey that rates the occupants` perceptions of the indoor air to identify potential IAQ problems. The psychosocial portion of the protocol also incorporates occupant education and awareness. Finally, a three-step initial investigation procedure for addressing IAQ problems is presented.« less

  19. Opportunity to discuss ethical issues during clinical learning experience.

    PubMed

    Palese, Alvisa; Gonella, Silvia; Destrebecq, Anne; Mansutti, Irene; Terzoni, Stefano; Morsanutto, Michela; Altini, Pietro; Bevilacqua, Anita; Brugnolli, Anna; Canzan, Federica; Ponte, Adriana Dal; De Biasio, Laura; Fascì, Adriana; Grosso, Silvia; Mantovan, Franco; Marognolli, Oliva; Nicotera, Raffaela; Randon, Giulia; Tollini, Morena; Saiani, Luisa; Grassetti, Luca; Dimonte, Valerio

    2018-01-01

    Undergraduate nursing students have been documented to experience ethical distress during their clinical training and felt poorly supported in discussing the ethical issues they encountered. Research aims: This study was aimed at exploring nursing students' perceived opportunity to discuss ethical issues that emerged during their clinical learning experience and associated factors. An Italian national cross-sectional study design was performed in 2015-2016. Participants were invited to answer a questionnaire composed of four sections regarding: (1) socio-demographic data, (2) previous clinical learning experiences, (3) current clinical learning experience quality and outcomes, and (4) the opportunity to discuss ethical issues with nurses in the last clinical learning experience (from 0 - 'never' to 3 - 'very much'). Participants and research context: Participants were 9607 undergraduate nursing students who were attending 95 different three-year Italian baccalaureate nursing programmes, located at 27 universities in 15 Italian regions. Ethical considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after the research protocol was approved by an ethics committee. Overall, 4707 (49%) perceived to have discussed ethical issues 'much' or 'very much'; among the remaining, 3683 (38.3%) and 1217 (12.7%) students reported the perception of having discussed, respectively, 'enough' or 'never' ethical issues emerged in the clinical practice. At the multivariate logistic regression analysis explaining 38.1% of the overall variance, the factors promoting ethical discussion were mainly set at the clinical learning environment levels (i.e. increased learning opportunities, self-directed learning, safety and nursing care quality, quality of the tutorial strategies, competences learned and supervision by a clinical nurse). In contrast, being male was associated with a perception of less opportunity to discuss ethical issues. Nursing faculties should assess the clinical environment prerequisites of the settings as a context of student experience before deciding on their accreditation. Moreover, the nursing faculty and nurse managers should also enhance competence with regard to discussing ethical issues with students among clinical nurses by identifying factors that hinder this learning opportunity in daily practice.

  20. General principles of institutional risks influence on pension systems

    NASA Astrophysics Data System (ADS)

    Nepp, A. N.; Shilkov, A. A.; Sheveleva, A. Y.; Mamedbakov, M. R.

    2016-12-01

    This paper examines the tools used to study the influence of institutional factors on investment returns. The research object are the tools used in the evaluation of institutional risks in the pension system, in particular, the correlation model of factors impacting on the `anti-director' index, econometric estimates combining the different determinants of savings, the model of endogenous institutional change, etc. Research work focusing on issues of institutional factors affecting pension systems (authored by La Porta, Guiso, Gianetti, El-Mekkaouide Freitas, Neyapti B., and others) is reviewed. The model is examined in terms of the impact of institutional risks on pension systems, especially with regard to the funded part. The study identified the following factors that affect financial institutions, including pension institutions: management quality, regulation quality, rule of law, political stability, and corruption control.

  1. Through the Eyes of Higher Education Attorneys: How Department Chairs Are Navigating the Waters of Legal Issues and Risk Management

    ERIC Educational Resources Information Center

    Hustoles, Carol L. J.

    2012-01-01

    Legal and risk management issues substantially impact the operations of colleges and universities, which face escalating compliance requirements in an increasingly litigious environment. Failing to assess legal liability issues and to constructively address them with risk management processes create vulnerability to claims and litigation,…

  2. Treating cardiovascular disease in women.

    PubMed

    Taggu, Wasing; Lloyd, Guy

    2007-12-01

    Cardiovascular disease (CVD) is the most common cause of death in women but some of the challenges of management differ from those in men. This article addresses the gender-specific issues of cardiovascular management, with emphasis on ischaemic heart disease and modification of coronary risk factors. Women with ischaemic heart disease present later than men, and are therefore older and more likely to suffer from co-morbidities such as diabetes and hypertension. Proven CVD risk factors in women can be divided into those that are modifiable and those that are non-modifiable. The former include diabetes, dyslipidaemia, hypertension, smoking, obesity, sedentary lifestyle and poor nutrition; the latter include family history of heart disease and older age at presentation. It is this difference in age and general health that explains much of the variability in response to treatment. Pharmacotherapy, percutaneous intervention, surgical revascularization, and cardiac rehabilitation and disease prevention are discussed.

  3. Cross-cultural organizational behavior.

    PubMed

    Gelfand, Michele J; Erez, Miriam; Aycan, Zeynep

    2007-01-01

    This article reviews research on cross-cultural organizational behavior (OB). After a brief review of the history of cross-cultural OB, we review research on work motivation, or the factors that energize, direct, and sustain effort across cultures. We next consider the relationship between the individual and the organization, and review research on culture and organizational commitment, psychological contracts, justice, citizenship behavior, and person-environment fit. Thereafter, we consider how individuals manage their interdependence in organizations, and review research on culture and negotiation and disputing, teams, and leadership, followed by research on managing across borders and expatriation. The review shows that developmentally, cross-cultural research in OB is coming of age. Yet we also highlight critical challenges for future research, including moving beyond values to explain cultural differences, attending to levels of analysis issues, incorporating social and organizational context factors into cross-cultural research, taking indigenous perspectives seriously, and moving beyond intracultural comparisons to understand the dynamics of cross-cultural interfaces.

  4. Psychological and psychosexual aspects of vulvar vestibulitis.

    PubMed Central

    Nunns, D; Mandal, D

    1997-01-01

    AIMS: To objectively assess the psychological and psychosexual morbidity of patients with vulvar vestibulitis. METHODS: 30 patients with variable degrees of vulvar vestibulitis were recruited from a vulval clinic. Each patient underwent a detailed history and clinical examination. Friedrich's criteria were used for the diagnosis of vulvar vestibulitis. Standardised questionnaires to assess psychological and psychosexual function were completed by the patient before review. These questionnaires were the STAI and a modified psychosexual questionnaire introduced by Campion. RESULTS: Patients experienced considerable psychological dysfunction compared with controls. All aspects of psychosexual dysfunction were affected. CONCLUSIONS: When managing patients, psychosexual and psychological issues must be considered in addition to other conventional types of therapy. Vulvar vestibulitis may be a risk factor for developing psychosexual complications including vaginismus, low libido, and orgasmic dysfunction. Consideration of these factors must be an integral part of the management of patients with all chronic vulval conditions. PMID:9582478

  5. Negotiating the maze: risk factors for suicidal behavior in chronic pain patients.

    PubMed

    Newton-John, Toby R O

    2014-09-01

    Chronic pain disorders can exert major negative effects on virtually every aspect of an individual's life. It is not surprising then that many chronic pain sufferers find themselves at a point of emotional fragility where they experience thoughts of ending their life. Suicidal behavior encompasses a spectrum of experience, from "life weariness" or passive suicidal ideation, to more active suicidal intent and suicide completion. A range of risk factors for suicidal behavior in the general population have been identified, and these apply equally to the chronic pain population: a family history of mental illness, past history of suicide attempts, and the presence of comorbid depression. With regard specifically to chronic pain patients, elevated suicide risk is also associated with severe or recurrent headache, ambiguous diagnoses (psychogenic pain, abdominal pain), and medicolegal issues related to the pain. A number of suggestions for clinicians managing chronic pain patients with regards to managing suicide risk are given.

  6. Environmental and socio-economic methodologies and solutions towards integrated water resources management.

    PubMed

    Friesen, Jan; Rodriguez Sinobas, Leonor; Foglia, Laura; Ludwig, Ralf

    2017-03-01

    Semi-arid regions are facing the challenge of managing water resources under conditions of increasing scarcity and drought. These are recently pressured by the impact of climate change favoring the shifting from using surface water to groundwater without taking sustainability issues into account. Likewise, water scarcity raises the competition for water among users, increasing the risk of social conflicts, as the availability of fresh water in sufficient quality and quantity is already one of the major factors limiting socio-economic development. In terms of hydrology, semi-arid regions are characterized by very complex hydro- and hydrogeological systems. The complexity of the water cycle contrasts strongly with the poor data availability, (1) which limits the number of analysis techniques and methods available to researchers, (2) limits the accuracy of models and predictions, and (3) consequently challenges the capabilities to develop appropriate management measures to mitigate or adapt the environment to scarcity and drought conditions. Integrated water resources management is a holistic approach to focus on both environmental as well as on socio-economic factors influencing water availability and supply. The management approaches and solutions adopted, e.g. in form of decision support for specific water resources systems, are often highly specific for individual case studies. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. 76 FR 53414 - Pacific Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... Trailing Actions 7. Consider Inseason Adjustments--Part I 8. Emerging Issues Under Trawl Rationalization... Run Chinook Management Issues 2. 2011 Methodology Review I. Pacific Halibut Management 1. 2012 Pacific...

  8. Prioritizing critical success factors for reverse logistics implementation using fuzzy-TOPSIS methodology

    NASA Astrophysics Data System (ADS)

    Agrawal, Saurabh; Singh, Rajesh K.; Murtaza, Qasim

    2016-03-01

    Electronics industry is one of the fastest growing industries in the world. In India also, there are high turnovers and growing demand of electronics product especially after post liberalization in early nineties. These products generate e-waste which has become big environmental issue. Industries can handle these e-waste and product returns efficiently by developing reverse logistics (RL) system. A thorough study of critical success factors (CSFs) and their ordered implementation is essential for successful RL implementation. The aim of the study is to review the CSFs, and to prioritize them for RL implementation in Indian electronics industry. Twelve CSFs were identified through literature review, and discussion with the experts from the Indian electronics industry. Fuzzy-Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach is proposed for prioritizing these CSFs. Perusal of literature indicates that fuzzy-TOPSIS has not been applied earlier for prioritization of CSFs in Indian electronics industry. Five Indian electronics companies were selected for evaluation of this methodology. Results indicate that most of the identified factors are crucial for the RL implementation. Top management awareness, resource management, economic factors, and contracts terms and conditions are top four prioritized factor, and process capabilities and skilled workers is the least prioritized factor. The findings will be useful for successful RL implementation in Indian electronics industry.

  9. Situational variables and institutional violence: a systematic review of the literature.

    PubMed

    Gadon, Lisa; Johnstone, Lorraine; Cooke, David

    2006-09-01

    The impact of violence on institutions is not hard to discern: staff and patients are physically injured and may become psychologically disturbed, property is destroyed, and regimes and programs are disrupted and thereby impoverished. Furthermore, violent individuals are not only incarcerated for longer but are held in more expensive and more restrictive conditions. In order to manage institutional violence, risk factors need to be identified. Research directed at understanding institutional violence has tended to focus on person-centered explanations. However, human behavior does not occur in a vacuum of internal drives and motivations; situational factors are also relevant. A focus on situational risk factors may provide an additional means for managing institutional violence. The primary aim of this systematic review was to examine research that measured the impact of situational factors on institutional violence. The relationships among physical, verbal and/or sexual face-to-face violence and situational factors in prisons and closed psychiatric settings were reviewed. A descriptive and in-depth analysis of previous research findings was carried out. Findings indicated that a range of situational factors may impact on institutional violence. Methodological issues that influence the confidence that can be placed on these findings are considered. The implications of the findings are outlined.

  10. Human Factors in Cabin Accident Investigations

    NASA Technical Reports Server (NTRS)

    Chute, Rebecca D.; Rosekind, Mark R. (Technical Monitor)

    1996-01-01

    Human factors has become an integral part of the accident investigation protocol. However, much of the investigative process remains focussed on the flight deck, airframe, and power plant systems. As a consequence, little data has been collected regarding the human factors issues within and involving the cabin during an accident. Therefore, the possibility exists that contributing factors that lie within that domain may be overlooked. The FAA Office of Accident Investigation is sponsoring a two-day workshop on cabin safety accident investigation. This course, within the workshop, will be of two hours duration and will explore relevant areas of human factors research. Specifically, the three areas of discussion are: Information transfer and resource management, fatigue and other physical stressors, and the human/machine interface. Integration of these areas will be accomplished by providing a suggested checklist of specific cabin-related human factors questions for investigators to probe following an accident.

  11. 77 FR 40817 - Low-Level Radioactive Waste Regulatory Management Issues

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-11

    ...-2011-0012] RIN-3150-AI92 Low-Level Radioactive Waste Regulatory Management Issues AGENCY: Nuclear... Materials and Environmental Management Programs, U.S. Nuclear Regulatory Commission, Washington, DC 20555... State Materials and Environmental Management Programs, U.S. Nuclear Regulatory Commission, Washington...

  12. Telemental Health for Children and Adolescents: An Overview of Legal, Regulatory, and Risk Management Issues.

    PubMed

    Kramer, Gregory M; Luxton, David D

    2016-04-01

    The use of technology to provide telemental healthcare continues to increase; however, little has been written about the legal and regulatory issues involved in providing this form of care to children and adolescents. This article reviews existing laws and regulations to summarize the risk management issues relevant to providing telemental healthcare to children and adolescents. There are several legal and regulatory areas in which telemental health clinicians need to have awareness. These areas include: 1) Licensure, 2) malpractice liability, 3) credentialing and privileging, 4) informed consent, 5) security and privacy, and 6) emergency management. Although legal and regulatory challenges remain in providing telemental healthcare to children and adolescents, it is possible to overcome these challenges with knowledge of the issues and appropriate risk management strategies. We provide general knowledge of these key legal and regulatory issues, along with some risk management recommendations.

  13. Importance x dissatisfaction = a formula for managerial action.

    PubMed

    Carson, Kerry D; Carson, Paula Phillips; Fontenot, Gwen; Toma, Alfred G

    2005-01-01

    Management should not only survey employees about their satisfaction with an issue but should also inquire about how important that issue is to them. If the issue is very important to employees and they are very dissatisfied, then management action may be urgent. However, if staff members are dissatisfied with an issue that is unimportant to them, then no management action may be required. Rank ordering the items by importance and then subtracting satisfaction from importance to get a performance-gap score is insufficient. The decision maker still may have to use intuition to determine which items have priority. Rather than gap analysis, it is better to multiply the importance score by the dissatisfaction score. This will yield a clear rank order of the issues to which the management must attend. The authors used the multiplicative method with a health care organization. These results are analyzed, and management actions are recommended.

  14. Failure to engage the public in issues related to inland fishes and fisheries: strategies for building public and political will to promote meaningful conservation.

    PubMed

    Cooke, S J; Lapointe, N W R; Martins, E G; Thiem, J D; Raby, G D; Taylor, M K; Beard, T D; Cowx, I G

    2013-10-01

    Generating awareness of environmental conservation issues among the public is essential if there is an expectation of them to alter their behaviour, facilitate informed decisions and engage governments or regulatory authorities to take action. There are, however, exceedingly few public engagement success stories related to inland fishes and fisheries policy and resource allocation decisions. Inland aquatic resources and their associated fisheries provide employment, recreation, culture and, in developing regions, a considerable proportion of human nutrition and food security. Freshwater fishes are incredibly diverse but are among the most endangered organisms globally. Many threats to inland fisheries are driven largely by externalities to inland fisheries. The purpose of this paper is to draw attention to the role and plight of inland fishes and fisheries, and the need to generate the public and political will necessary to promote meaningful conservation. With this paper, the extent to which the scientific and environmental management communities have failed to engage the public in issues related to inland fishes and fisheries is characterized. Next, the barriers or factors that serve as the basis for the problem with public engagement are identified. The paper concludes by identifying strategies, including those focused on environmental education initiatives, for building the public and political will necessary to promote meaningful conservation of inland fishes and fisheries in developed and developing countries. Scientists, environmental managers, non-governmental organizations, politicians, regulatory authorities and the media all have important roles to play in overcoming challenges to inland fisheries. Failure to engage the public in freshwater conservation and management issues will impede efforts to stem the loss of freshwater habitats, fisheries and aquatic biodiversity. Thankfully, there are opportunities to learn from success stories related to other environmental issues and initiatives that have been successful in marine fish conservation. © 2013 The Fisheries Society of the British Isles.

  15. Conflict management in public hospitals: the Cyprus case.

    PubMed

    Pavlakis, A; Kaitelidou, D; Theodorou, M; Galanis, P; Sourtzi, P; Siskou, O

    2011-06-01

    Conflict among health-care personnel has been identified as an issue within health-care settings around the world. To investigate the existence and management of conflict among health-care personnel in public hospitals in Cyprus; to assess the factors leading to conflict among staff members; to evaluate the consequences of conflict arising; and to consider the management strategies. A self-administered questionnaire was completed by a random sample of 1037 health-care professionals in all (seven) state-run hospitals in Cyprus in 2008. Mean age of respondents was 41 years, and 75% were female. Sixty-four per cent of respondents reported that they had never been informed about conflict management strategies, with physicians being the least informed as the relative percentage was 79.8% (χ(2) = 33, P < 0.001). Sixty per cent of health-care professionals reported conflict at work with other health-care personnel one to five times per week, and 37% of the respondents stated that they devote 90 min (mean value) from work during their shift in conflict resolution, meaning that managing conflicts may absorb 19% of working time daily. The majority of respondents agreed that organizational problems and communication gaps were the main issues creating conflict. Avoidance and collaboration were the preferable strategies for conflict resolution, used by 36.6% and 37.5% of the respondents, respectively.   Better communication, fair management practices and clear job descriptions and expectations may be needed in order to facilitate change and reverse the negative atmosphere that exists. Further education in conflict management for physicians, nurses and their managers may also be needed. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

  16. Local Government Capacity to Respond to Environmental Change: Insights from Towns in New York State.

    PubMed

    Larson, Lincoln R; Lauber, T Bruce; Kay, David L; Cutts, Bethany B

    2017-07-01

    Local governments attempting to respond to environmental change face an array of challenges. To better understand policy responses and factors influencing local government capacity to respond to environmental change, we studied three environmental issues affecting rural or peri-urban towns in different regions of New York State: climate change in the Adirondacks (n = 63 towns), loss of open space due to residential/commercial development in the Hudson Valley (n = 50), and natural gas development in the Southern Tier (n = 62). Our analysis focused on towns' progression through three key stages of the environmental policy process (issue awareness and salience, common goals and agenda setting, policy development and implementation) and the factors that affect this progression and overall capacity for environmental governance. We found that-when compared to towns addressing open space development and natural gas development-towns confronted with climate change were at a much earlier stage in the policy process and were generally less likely to display the essential resources, social support, and political legitimacy needed for an effective policy response. Social capital cultivated through collaboration and networking was strongly associated with towns' policy response across all regions and could help municipalities overcome omnipresent resource constraints. By comparing and contrasting municipal responses to each issue, this study highlights the processes and factors influencing local government capacity to address a range of environmental changes across diverse management contexts.

  17. Third International Symposium on Space Mission Operations and Ground Data Systems, part 2

    NASA Technical Reports Server (NTRS)

    Rash, James L. (Editor)

    1994-01-01

    Under the theme of 'Opportunities in Ground Data Systems for High Efficiency Operations of Space Missions,' the SpaceOps '94 symposium included presentations of more than 150 technical papers spanning five topic areas: Mission Management, Operations, Data Management, System Development, and Systems Engineering. The symposium papers focus on improvements in the efficiency, effectiveness, and quality of data acquisition, ground systems, and mission operations. New technology, methods, and human systems are discussed. Accomplishments are also reported in the application of information systems to improve data retrieval, reporting, and archiving; the management of human factors; the use of telescience and teleoperations; and the design and implementation of logistics support for mission operations. This volume covers expert systems, systems development tools and approaches, and systems engineering issues.

  18. Management of the assaultive adolescent.

    PubMed

    Marohn, R C

    1992-06-01

    Evaluation and treatment of the assaultive adolescent is an important but difficult process. From a psychodynamic perspective, the author reviews factors associated with adolescent violence, including alcohol and substance use, depression and suicidality, overstimulation, sociocultural and family ambience, property damage, threats of violence, and alexythymia. Management and treatment issues are surveyed, such as the necessity to recognize that in some adolescents violence erupts not from narcissitic rage but from strong wishes for affectionate contact. Violent adolescents have little awareness of an inner psychological world, cannot name affects or differentiate one from another, and often confuse thought, feeling, and deed. In psychodynamic treatment, adolescents are helped to experience affect as part of themselves and to develop the capacity to manage affect and use it as a basis for communication and self-understanding.

  19. Nontechnical issues in waste management: ethical, institutional, and political concerns

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

    Hebert, J.A.; Rankin, W.L.; Brown, P.G.

    1978-05-01

    The report consists of a presentation and distillation of major nontechnical issues surrounding commercial waste management, followed by ethical, institutional, and political analyses of these issues. The ethical analysis consists of a discusson of what is meant by ''ethics'' and ''morality'' in the waste management context and an illustrative attempt at an ethical analysis of the commercial nuclear waste problem. Two institutional analyses are presented: one is an analysis of the possible problems of long-term human institutions in waste management; the other is a presentation of institutional arrangements for the short term. A final chapter discusses issues and concerns involvingmore » intergovernmental relations--that is, local, state, and federal interface problems in waste management.« less

  20. Does the Department of Defense Possess Solutions for the Department of Homeland Security’s Personnel Management Issues?

    DTIC Science & Technology

    2015-12-01

    DEPARTMENT OF DEFENSE POSSESS SOLUTIONS FOR THE DEPARTMENT OF HOMELAND SECURITY’S PERSONNEL MANAGEMENT ISSUES? by Joshua D. Frizzell December 2015...22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. 1. AGENCY USE ONLY (Leave blank...SOLUTIONS FOR THE DEPARTMENT OF HOMELAND SECURITY’S PERSONNEL MANAGEMENT ISSUES? 5. FUNDING NUMBERS 6. AUTHOR(S) Joshua D. Frizzell 7

  1. Attrition, burnout, job dissatisfaction and occupational therapy managers.

    PubMed

    Kraeger, M M; Walker, K F

    1992-01-01

    At a time when there is growing concern about the person-power shortages in occupational therapy, there is a need to address reasons why therapists leave the job market. Two job-related reasons for attrition are burnout and job dissatisfaction. The burnout phenomenon occurs as a result of personnel shortages, high-stress demands on therapists, the severity and complexity of client's problems, and the therapist's own ''worker personality.'' Bureaucratic constraints, limited advancement, issues related to a profession which is made up predominantly of women, lack of autonomy, and type of management and supervision are factors that contribute to job dissatisfaction. Occupational therapy managers can consider the causes of burnout and job dissatisfaction and initiate resources to retain therapists. Managers can increase the job benefits, such as flexible working hours, take steps to reduce stress in the workplace, offer career laddering opportunities, and promote staff development. By identifying the causes for attrition and by addressing those causes, the threat of losing therapists from the work force may be averted. Respondents (n = 106) to a survey of occupational therapy managers indicated that job dissatisfaction, burnout, and attrition of registered occupational therapists were not major problems in their settings. They reported a variety of strategies to reduce job dissatisfaction, burnout, and attrition. When these problems were present, managers cited bureaucratic red tape, lack of opportunity for advancement, and increasing role demands as contributing factors.

  2. Identification of Crew-Systems Interactions and Decision Related Trends

    NASA Technical Reports Server (NTRS)

    Jones, Sharon Monica; Evans, Joni K.; Reveley, Mary S.; Withrow, Colleen A.; Ancel, Ersin; Barr, Lawrence

    2013-01-01

    NASA Vehicle System Safety Technology (VSST) project management uses systems analysis to identify key issues and maintain a portfolio of research leading to potential solutions to its three identified technical challenges. Statistical data and published safety priority lists from academic, industry and other government agencies were reviewed and analyzed by NASA Aviation Safety Program (AvSP) systems analysis personnel to identify issues and future research needs related to one of VSST's technical challenges, Crew Decision Making (CDM). The data examined in the study were obtained from the National Transportation Safety Board (NTSB) Aviation Accident and Incident Data System, Federal Aviation Administration (FAA) Accident/Incident Data System and the NASA Aviation Safety Reporting System (ASRS). In addition, this report contains the results of a review of safety priority lists, information databases and other documented references pertaining to aviation crew systems issues and future research needs. The specific sources examined were: Commercial Aviation Safety Team (CAST) Safety Enhancements Reserved for Future Implementation (SERFIs), Flight Deck Automation Issues (FDAI) and NTSB Most Wanted List and Open Recommendations. Various automation issues taxonomies and priority lists pertaining to human factors, automation and flight design were combined to create a list of automation issues related to CDM.

  3. Managing changes in distributed biomedical ontologies using hierarchical distributed graph transformation.

    PubMed

    Shaban-Nejad, Arash; Haarslev, Volker

    2015-01-01

    The issue of ontology evolution and change management is inadequately addressed by available tools and algorithms, mostly due to the lack of suitable knowledge representation formalisms to deal with temporal abstract notations and the overreliance on human factors. Also most of the current approaches have been focused on changes within the internal structure of ontologies and interactions with other existing ontologies have been widely neglected. In our research, after revealing and classifying some of the common alterations in a number of popular biomedical ontologies, we present a novel agent-based framework, Represent, Legitimate and Reproduce (RLR), to semi-automatically manage the evolution of bio-ontologies, with emphasis on the FungalWeb Ontology, with minimal human intervention. RLR assists and guides ontology engineers through the change management process in general and aids in tracking and representing the changes, particularly through the use of category theory and hierarchical graph transformation.

  4. Elements affecting food waste in the food service sector.

    PubMed

    Heikkilä, Lotta; Reinikainen, Anu; Katajajuuri, Juha-Matti; Silvennoinen, Kirsi; Hartikainen, Hanna

    2016-10-01

    Avoidable food waste is produced in the food service sector, with significant ecological and economical impacts. In order to understand and explain better the complex issue of food waste a qualitative study was conducted on the reasons for its generation in restaurants and catering businesses. Research data were collected during three participatory workshops for personnel from three different catering sector companies in Finland. Based on synthesized qualitative content analysis, eight elements influencing production and reduction of food waste were identified. Results revealed the diversity of managing food waste in the food service sector and how a holistic approach is required to prevent and reduce it. It is crucial to understand that food waste is manageable and should be an integral component of the management system. The model of eight factors provides a framework for recognition and management of food waste in the food service sector. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Challenges of managing child behavior in the 21st century dental setting.

    PubMed

    Sheller, Barbara

    2004-01-01

    This paper discussed factors influencing behavior management of the child dental patient. Pediatric dentists are affected by changes in: (1) society; (2) marketing and media; (3) communications and technology; and (4) parenting practices. Behavior of pediatric patients reflects fewer boundaries, less discipline and self-control, and lowered behavioral expectations by parents and contemporary culture. The insurance industry, regulatory bodies, legal system, dental staff, and pediatric dentist education are other influences on behavior management. Responses of the American Academy of Pediatric Dentistry (AAPD), which could support the pediatric dentist in the changing environment, include: (1) research; (2) continuing education for staff and dentists; (3) development of Internet accessible materials for the public; (4) legislative activity; (5) partnering with pediatric medicine to develop new behavior management strategies; (6) establishment of an AAPD Council on Child Behavior; and (7) ongoing critical reassessment of behavior issues by the AAPD.

  6. Transition to management -- A personal perspective

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

    Williams, J.L.

    1998-02-01

    This paper explores one woman`s journey through her recent promotion into management, and will identify key factors that helped prepare and position her to be ready to exercise leadership through a formal management role. It discusses assessment of qualifications and skills, acquisition of needed skills, the influence of luck and timing, and the use of mentors and delegation as survival skills to get through the transition period and become fully functional as a manager. It also includes insights into sensitive issues such as how to relate to former peers, how to gain credibility as the junior member of the managementmore » team, and how to juggle family responsibilities with increased time commitments at work. It emphasizes the importance of acknowledging the help the authors receive in reaching their own career goals and offering the same kind of help and support to those in the early stages of their careers.« less

  7. Traffic Management for Satellite-ATM Networks

    NASA Technical Reports Server (NTRS)

    Goyal, Rohit; Jain, Raj; Fahmy, Sonia; Vandalore, Bobby; Goyal, Mukul

    1998-01-01

    Various issues associated with "Traffic Management for Satellite-ATM Networks" are presented in viewgraph form. Specific topics include: 1) Traffic management issues for TCP/IP based data services over satellite-ATM networks; 2) Design issues for TCP/IP over ATM; 3) Optimization of the performance of TCP/IP over ATM for long delay networks; and 4) Evaluation of ATM service categories for TCP/IP traffic.

  8. The middle manager role in energy company environmental efforts

    NASA Astrophysics Data System (ADS)

    Fischhoff, Maya E.

    2005-12-01

    This research examines the internal organizational processes determining corporate environmental action. Corporations have a tremendous environmental impact, yet relatively little is known about how employees within them view and work on these issues. The research focused on middle managers, a level of the company whose value is often questioned. Interviews were conducted with 70 middle managers at two energy companies (comprising utilities and unregulated businesses). Interviews examined the shape and significance of middle manager involvement in environmental issues, looking specifically at what issues middle managers deal with, what goals they pursue, and what approaches they use. The research finds middle managers' roles with respect to environmental issues to be far-reaching and complex. Much of their effort is focused on meeting regulatory requirements ("complying"). They are committed to compliance, in part for ethical reasons, but often find regulations frustrating and costly. Compliance is more challenging than commonly thought; it demands time, knowledge, and substantial creativity. In pursuing it, interviewees work with employees throughout the organization. This research shows middle managers interacting with those hierarchically above and below them in ways that greatly modify earlier portrayals of middle managers. Earlier portrayals often emphasized struggles for power within the organization. Here, middle managers work in ways best characterized as collaborative and supportive. Middle managers also have extensive involvement laterally within the company and with groups outside the company. These links have received modest attention in literature, yet are found to be terribly important. Middle managers' lateral efforts inside the company, often on teams, allow diverse expertise (e.g., from people in different functions) to be applied to environmental issues. Documenting middle managers' involvement externally, with governmental officials and sectors of the public, illuminates areas of very visible corporate impact. External interactions are also settings in which middle managers encounter alternative views about environmental issues. The study reveals the importance of middle managers in the challenge of environmental compliance. It provides knowledge that can be used by external entities seeking to connect with companies, and by companies seeking to address environmental issues better. It thus aids understanding of a critical societal challenge and opportunity.

  9. Human resource processes and the role of the human resources function during mergers and acquisitions in the electricity industry

    NASA Astrophysics Data System (ADS)

    Dass, Ted K.

    Mergers and acquisitions (M&A) have been a popular strategy for organizations to consolidate and grow for more than a century. However, research in this field indicates that M&A are more likely to fail than succeed, with failure rates estimated to be as high as 75%. People-related issues have been identified as important causes for the high failure rate, but these issues are largely neglected until after the deal is closed. One explanation for this neglect is the low involvement of human resource (HR) professionals and the HR function during the M&A process. The strategic HR management literature suggests that a larger role for HR professionals in the M&A process would enable organizations to identify potential problems early and devise appropriate solutions. However, empirical research from an HR perspective has been scarce in this area. This dissertation examines the role of the HR function and the HR processes followed in organizations during M&A. Employing a case-study research design, this study examines M&A undertaken by two large organizations in the electricity industry through the lens of a "process" perspective. Based on converging evidence, the case studies address three sets of related issues: (1) how do organizations undertake and manage M&A; (2) what is the extent of HR involvement in M&A and what role does it play in the M&A process; and (3) what factors explain HR involvement in the M&A process and, more generally, in the formulation of corporate goals and strategies. Results reveal the complexity of issues faced by organizations in undertaking M&A, the variety of roles played by HR professionals, and the importance of several key contextual factors---internal and external to the organization---that influence HR involvement in the M&A process. Further, several implications for practice and future research are explored.

  10. Managing the integration and harmonization of national airspace for unmanned and manned systems

    NASA Astrophysics Data System (ADS)

    Mumm, Hans

    This dissertation examines the leadership challenge created by the requirement to integrate unmanned aerial vehicles (UAVs) into the national airspace system (NAS). The lack of UAV-related federal rules and regulations is a primary factor prolonging this integration. This effort focuses primarily on the leadership portion of the solution and not the technological requirements. The research explores an adaptation of the complexity theory that offers a potential leadership framework for the government, industry, and academia to use for achieving the full integration of UAVs into the NAS. Due to the large number of stakeholders and the multitude of interrelated issues, a complexity-theory-leadership methodology was created and examined as a potential way to help the FAA accelerate their rule-making efforts. This dissertation focuses on United States UAV issues. The United States is one of the leaders in the unmanned systems arena, to include the first significant use of recoverable autonomous weaponized systems in combat. Issues such as airspace, airworthiness, social issues, privacy issues, regulations, and the lack of policies, procedures, or governance are universal for all countries that are active in this technology area. This qualitative dissertation makes use of the grounded theory methodology as it combines a literature review and research along with interviews with subject matter experts, and information gained from attending UAV related gatherings/discussions. The investigation uncovered significant FAA process impediments as well as some possible break through concepts that could work well with the complexity-theory-leadership methodology. Keywords: Complexity theory, leadership, change management, UAV, unmanned aerial vehicle, National Airspace, NAS, FAA, Federal Aviation Administration.

  11. Comparative Study On The Ethical Perceptions Of Contractors And Designers In The China Construction Industry

    NASA Astrophysics Data System (ADS)

    Kang, Byung Gyoo; Long, Kaiwen; Zhang, Cheng; Li Hao, Jian

    2017-12-01

    Ethics is becoming one of the most important requirements for successful business in the 21st century. The construction industry cannot be exceptional from this trend. However construction ethics management requires different approaches from other industries, as the products of the industry are construction projects which are completely different from mass production. Contractors and designers are two major participants in construction projects. The roles and responsibilities of these two project stakeholders decisively influence all aspects of construction project. Practically ethical perceptions of contractors and designers are one of main aspects to be considered for the effective and efficient management of ethics for the construction industry. This research has investigated the ethical perceptions of contractors and designers in the China construction industry. A questionnaire survey which contains 15 ethical issues and 6 demographic factors has been conducted. 170 construction professionals from construction companies and consulting companies have been participated in this survey. These 15 ethical issues are ranked in terms of seriousness, frequency and importance for both contractors and designers as a single group to understand the overall perceptions in the industry. The analysis has also been conducted for contractors and designers respectively to make comparisons between them. The top three serious ethical issues in the industry are ‘Bribery and corruption’, ‘Failure to practice whistle-blowing’ and ‘Improper bidding practices’. Contractors and designers showed similar outcomes for the top five important ethical issues. But for the middle ranged ethical issues, they showed some differences. Further researches are required to identify the causes of the similarity and differences.

  12. Do we really understand how to retain nurses?

    PubMed

    O'Brien-Pallas, Linda; Duffield, Christine; Hayes, Laureen

    2006-05-01

    To compare views of nurse executives with those of nurses who have left the profession on the importance of retention strategies. Although much has been written about nursing turnover, there continues to be dissonance among decision makers as to why nurses leave the profession and what the most crucial issues are for retention. Factor analysis was undertaken to compare responses of nurse executives with those of nurses employed outside of nursing. Contract requirements represented the greatest discrepancy, 1.07, followed by legal and employer issues, 1.02; worklife/homelife balance, 0.91; external values and beliefs about nursing, 0.75; and professional practice, 0.29. A disparity exists between perceptions of nurse executives and those of nurses who have left the profession as to which issues are most critical in retention. We suggest that nurse executives ensure sufficient organizational support for nursing unit managers who are more likely to understand methods of retaining nurses at the clinical interface.

  13. Optimal Subdivision for Treatment and Management of Catastrophic Landslides in a Watershed Using Topographic Factors.

    PubMed

    Lin, Chao-Yuan; Fu, Kuei-Lin; Lin, Cheng-Yu

    2016-11-01

    Recent extreme rainfall events led to many landslides due to climate changes in Taiwan. How to effectively promote post-disaster treatment and/or management works in a watershed/drainage basin is a crucial issue. Regarding the processes of watershed treatment and/or management works, disaster hotspot scanning and treatment priority setup should be carried out in advance. A scanning method using landslide ratio to determine the appropriate outlet of an interested watershed, and an optimal subdivision system with better homogeneity and accuracy in landslide ratio estimation were developed to help efficient executions of treatment and/or management works. Topography is a key factor affecting watershed landslide ratio. Considering the complexity and uncertainty of the natural phenomenon, multivariate analysis was applied to understand the relationship between topographic factors and landslide ratio in the interested watershed. The concept of species-area curve, which is usually adopted at on-site vegetation investigation to determinate the suitable quadrate size, was used to derive the optimal threshold in subdivisions. Results show that three main component axes including factors of scale, network and shape extracted from Digital Terrain Model coupled with areas of landslide can effectively explain the characteristics of landslide ratio in the interested watershed, and a relation curve obtained from the accuracy of landslide ratio classification and number of subdivisions could be established to derive optimal subdivision of the watershed. The subdivision method promoted in this study could be further used for priority rank and benefit assessment of landslide treatment in a watershed.

  14. Optimal Subdivision for Treatment and Management of Catastrophic Landslides in a Watershed Using Topographic Factors

    NASA Astrophysics Data System (ADS)

    Lin, Chao-Yuan; Fu, Kuei-Lin; Lin, Cheng-Yu

    2016-11-01

    Recent extreme rainfall events led to many landslides due to climate changes in Taiwan. How to effectively promote post-disaster treatment and/or management works in a watershed/drainage basin is a crucial issue. Regarding the processes of watershed treatment and/or management works, disaster hotspot scanning and treatment priority setup should be carried out in advance. A scanning method using landslide ratio to determine the appropriate outlet of an interested watershed, and an optimal subdivision system with better homogeneity and accuracy in landslide ratio estimation were developed to help efficient executions of treatment and/or management works. Topography is a key factor affecting watershed landslide ratio. Considering the complexity and uncertainty of the natural phenomenon, multivariate analysis was applied to understand the relationship between topographic factors and landslide ratio in the interested watershed. The concept of species-area curve, which is usually adopted at on-site vegetation investigation to determinate the suitable quadrate size, was used to derive the optimal threshold in subdivisions. Results show that three main component axes including factors of scale, network and shape extracted from Digital Terrain Model coupled with areas of landslide can effectively explain the characteristics of landslide ratio in the interested watershed, and a relation curve obtained from the accuracy of landslide ratio classification and number of subdivisions could be established to derive optimal subdivision of the watershed. The subdivision method promoted in this study could be further used for priority rank and benefit assessment of landslide treatment in a watershed.

  15. Factors influencing workplace health promotion intervention: a qualitative systematic review.

    PubMed

    Rojatz, Daniela; Merchant, Almas; Nitsch, Martina

    2017-10-01

    Although workplace health promotion (WHP) has evolved over the last 40 years, systematically collected knowledge on factors influencing the functioning of WHP is scarce. Therefore, a qualitative systematic literature review was carried out to systematically identify and synthesize factors influencing the phases of WHP interventions: needs assessment, planning, implementation and evaluation. Research evidence was identified by searching electronic databases (Scopus, PubMed, Social Sciences Citation Index, ASSIA, ERIC, IBBS and PsycINFO) from 1998 to 2013, as well as by cross-checking reference lists of included peer-reviewed articles. The inclusion criteria were: original empirical research, description of WHP, description of barriers to and/or facilitators of the planning, implementation and/or evaluation of WHP. Finally, 54 full texts were included. From these, influencing factors were extracted and summarized using thematic analysis. The majority of influencing factors referred to the implementation phase, few dealt with planning and/or evaluation and none with needs assessment. The influencing factors were condensed into topics with respect to factors at contextual level (e.g. economic crisis); factors at organizational level (e.g. management support); factors at intervention level (e.g. quality of intervention concept); factors at implementer level (e.g. resources); factors at participant level (e.g. commitment to intervention) and factors referring to methodological and data aspects (e.g. data-collection issues). Factors regarding contextual issues and organizational aspects were identified across three phases. Therefore, future research and practice should consider not only the influencing factors at different levels, but also at different phases of WHP interventions. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Management of ethical issues related to care of seriously ill dialysis patients in free-standing facilities.

    PubMed

    Song, Mi-Kyung; Hanson, Laura C; Gilet, Constance A; Jo, Minjeong; Reed, Teresa J; Hladik, Gerald A

    2014-09-01

    There are few data on the frequency and current management of clinical ethical issues related to care of seriously ill dialysis patients in free-standing dialysis facilities. To examine the extent of clinical ethical challenges experienced by care providers in free-standing facilities and their perceptions about how those issues are managed. A total of 183 care providers recruited from 15 facilities in North Carolina completed a survey regarding the occurrence and management of ethical issues in the past year. Care plan meetings were observed at four of the facilities for three consecutive months. Also, current policies and procedures at each of the facilities were reviewed. The two most frequently experienced challenges involved dialyzing frail patients with multiple comorbidities and caring for disruptive/difficult patients. The most common ways of managing ethical issues were discussions in care plan meetings (n = 47) or discussions with the clinic manager (n = 47). Although policies were in place to guide management of some of the challenges, respondents were often not aware of those policies. Also, although participants reported that ethical issues related to dialyzing undocumented immigrants were fairly common, no facility had a policy for managing this challenge. Participants suggested that all staff obtain training in clinical ethics and communication skills, facilities develop ethics teams, and there be clear policies to guide management of ethical challenges. The scope of ethical challenges was extensive, how these challenges were managed varied widely, and there were limited resources for assistance. Multifaceted efforts, encompassing endeavors at the individual, facility, organization, and national levels, are needed to support staff in improving the management of ethical challenges in dialysis facilities. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  17. Team-based efforts to improve quality of care, the fundamental role of ethics, and the responsibility of health managers: monitoring and management strategies to enhance teamwork.

    PubMed

    Kossaify, A; Hleihel, W; Lahoud, J-C

    2017-12-01

    Highlight the importance of teamwork in health care institutions by performing a review and discussion of the relevant literature. Review paper. A MEDLINE/Pubmed search was performed starting from 1990, and the terms 'team, teamwork, managers, healthcare, and cooperation' were searched in titles, abstracts, keywords, and conclusions; other terms 'patient safety, ethics, audits and quality of care' were specifically searched in abstracts and were used as additional filters criteria to select relevant articles. Thirty-three papers were found relevant; factors affecting the quality of care in health care institutions are multiple and varied, including issues related to individual profile, to administrative structure and to team-based effort. Issues affecting teamwork include mainly self-awareness, work environment, leadership, ethics, cooperation, communication, and competition. Moreover, quality improvement plans aiming to enhance and expand teams are essential in this context. Team monitoring and management are vital to achieve efficient teamwork with all the required qualities for a safer health system. In all cases, health managers' responsibility plays a fundamental role in creating and sustaining a teamwork atmosphere. Teamwork is known to improve outcomes in medicine, whether at the clinical, organizational, or scientific level. Teamwork in health care institutions must increasingly be encouraged, given that individual effort is often insufficient for optimal clinical outcome. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. Greenhouse gas accounting and waste management.

    PubMed

    Gentil, Emmanuel; Christensen, Thomas H; Aoustin, Emmanuelle

    2009-11-01

    Accounting of emissions of greenhouse gas (GHG) is a major focus within waste management. This paper analyses and compares the four main types of GHG accounting in waste management including their special features and approaches: the national accounting, with reference to the Intergovernmental Panel on Climate Change (IPCC), the corporate level, as part of the annual reporting on environmental issues and social responsibility, life-cycle assessment (LCA), as an environmental basis for assessing waste management systems and technologies, and finally, the carbon trading methodology, and more specifically, the clean development mechanism (CDM) methodology, introduced to support cost-effective reduction in GHG emissions. These types of GHG accounting, in principle, have a common starting point in technical data on GHG emissions from specific waste technologies and plants, but the limited availability of data and, moreover, the different scopes of the accounting lead to many ways of quantifying emissions and producing the accounts. The importance of transparency in GHG accounting is emphasised regarding waste type, waste composition, time period considered, GHGs included, global warming potential (GWP) assigned to the GHGs, counting of biogenic carbon dioxide, choice of system boundaries, interactions with the energy system, and generic emissions factors. In order to enhance transparency and consistency, a format called the upstream-operating-downstream framework (UOD) is proposed for reporting basic technology-related data regarding GHG issues including a clear distinction between direct emissions from waste management technologies, indirect upstream (use of energy and materials) and indirect downstream (production of energy, delivery of secondary materials) activities.

  19. A STUDY ON THE HIERARCHY OF MANAGEMENT ELEMENTS

    NASA Astrophysics Data System (ADS)

    Suzuki, Nobuyuki; Watanabe, Tadashi

    Compared to the late 20th century, the Japanese construction industry has drastically changed its business methodology, outlook and approach in response to global issues and the incredible advances in technology. Such influences, non-exhaustively include the; WTO Government procurement agreement, updating conditions of tendering and contracting, client demands for cost reduction and the rapid penetration of ICT (Information and Communication Technology) into modern society. These days, the significance of controlling Quality, Cost and Time (the so-called QCT) has been recognized as an eternal-triangle by almost all countries, Government organizations and the private sector. However, as the construction industry is exposed to , and influenced by, more and more internal and external dynamic factors, continued reliance on managing and controlling QCT elements on their own is no longer adequate in meeting the growing demands and expectations, and as such control of additional management elements is now essential to avoid problems, or minimize their potential impacts should they occur. This paper utilizes the results of a survey carried out amongst construction managers and consultants in Japan and overseas to develop a spatial network that defines the interaction of management factors as a weighted graphical model. The calculated closeness centrality index of the developed management network model is adopted to identify the initialelement hierarchy, which is then further analyzed using the minimum distance of independent relationships of management elements (Warshall-Floyd algorism methodology), to identify the optimum potential hierarchy for effective construction management. A key result of the analysis is the significance of "Human Resource" in the construction industry management element hierarchy alongside the traditional QCT elements.

  20. An Evaluation and Redesign of the Conflict Prediction and Trial Planning Planview Graphical User Interface

    NASA Technical Reports Server (NTRS)

    Laudeman, Irene V.; Brasil, Connie L.; Stassart, Philippe

    1998-01-01

    The Planview Graphical User Interface (PGUI) is the primary display of air traffic for the Conflict Prediction and Trial Planning, function of the Center TRACON Automation System. The PGUI displays air traffic information that assists the user in making decisions related to conflict detection, conflict resolution, and traffic flow management. The intent of this document is to outline the human factors issues related to the design of the conflict prediction and trial planning portions of the PGUI, document all human factors related design changes made to the PGUI from December 1996 to September 1997, and outline future plans for the ongoing PGUI design.

  1. Issues in Hypertriglyceridemic Pancreatitis - An Update

    PubMed Central

    Scherer, John; Singh, Vijay; Pitchumoni, C. S; Yadav, Dhiraj

    2014-01-01

    Hypertriglyceridemia (HTG) is a well established but underestimated cause of acute (AP) and recurrent AP (RAP). The clinical presentation of HTG-induced pancreatitis (HTG pancreatitis) is similar to other causes. Pancreatitis secondary to HTG is typically seen in the presence of one or more secondary factors (uncontrolled diabetes, alcoholism, medications, pregnancy) in a patient with an underlying common genetic abnormality of lipoprotein metabolism (Familial combined hyperlipidemia or Familial HTG). Less commonly, a patient with rare genetic abnormality (Familial chylomicronemic syndrome) with or without an additional secondary factor is encountered. The risk of AP in patients with serum triglycerides >1000 mg/dl and >2000 mg/dl is ∼5% and 10-20% respectively. It is not clear whether HTG pancreatitis is more severe than when it is due to other causes. Clinical management of HTG pancreatitis is similar to that of other causes. Insulin infusion in diabetic patients with HTG can rapidly reduce triglyceride levels. Use of apheresis is still experimental and better designed studies are needed to clarify its role in management of HTG pancreatitis. Diet, lifestyle changes, control of secondary factors are key to the treatment and medications are useful adjuncts to long term management of triglyceride levels. Control of triglyceride levels to well below 500 mg/dl can effectively prevent recurrences of pancreatitis. PMID:24172179

  2. Understanding Cultural Issues in Diabetes Self-Management Behaviors of Korean Immigrants

    PubMed Central

    Cha, Eun Seok; Yang, Kyeongra; Lee, Jia; Min, Jiwon; Kim, Kevin H.; Dunbar, Sandra B.; Jennings, Bonnie Mowinski

    2013-01-01

    Purpose The purpose of this study was to explore potential factors affecting self-management behaviors in Korean immigrants with type 2 diabetes mellitus (KIT2Ds). Methods A qualitative descriptive design guided this study. Semi-structured interviews lasting 45-60 minutes were conducted with 20 KIT2Ds in the participant’s preferred language; in all cases this was Korean. Each interview was audio-taped, transcribed, and analyzed using conventional content analysis. Data analysis was performed in two steps. The data written in Korean were initially analyzed by three bilingual researchers. A qualitative researcher then participated in the analysis to refine the findings for presentation to an English speaking audience while staying true to the data and preserving the nuanced Korean meanings. Results The mean age of the sample was 64. 5 ± 11.6 years (9 men and 11 women). The mean years of staying in the U. S. and age at diabetes mellitus diagnosis were 23.6 ± 9.7 years and 52.5 ± 12.3 years, respectively. Three major ideas were identified: (a) issues on treatment regimen related to both medications and diet, (b) resources that helped or hindered their ability to manage diabetes, and (c) the physician/patient relationship. Conclusions There were important cultural nuances that need to be addressed to better prepare KIT2Ds to manage their diabetes more effectively. A culture specific program should extend beyond a diabetes self-management education delivered in Korean language. Rather, content and education methods need to consider acculturation effects on diabetes management behaviors. PMID:23019236

  3. Issues for small businesses with waste management.

    PubMed

    Redmond, Janice; Walker, Elizabeth; Wang, Calvin

    2008-07-01

    Participation by small and medium enterprise (SME) in corporate social responsibility issues has been found to be lacking. This is a critical issue, as individually SMEs may have little impact on the environment but their collective footprint is significant. The management style and ethical stance of the owner-manager affects business decision making and therefore has a direct impact on the environmental actions of the business. Although adoption of environmental practices to create competitive advantage has been advocated, many businesses see implementation as a cost which cannot be transferred to their customers. After a brief review of pertinent literature this paper reports on an exploratory investigation into the issue. Results show that whereas owner-managers of small enterprises express concern regarding the environment, this does not then translate into better waste management practices.

  4. Redefining diabetes and the concept of self-management from a patient's perspective: implications for disease risk factor management.

    PubMed

    Masupe, T K; Ndayi, K; Tsolekile, L; Delobelle, P; Puoane, T

    2018-02-01

    The colliding epidemics of non-communicable diseases including diabetes with chronic infectious diseases in Sub-Saharan Africa requires contextualized innovative disease management strategies. This qualitative study conducted in a peri-urban township near Cape Town, South Africa aimed to identify and gain in-depth understanding of contextual and environmental issues pertinent to the patient that could influence Type 2-diabetes mellitus (T2DM) care and self-management. Participants included purposively sampled diabetics or pre-diabetics from the community, PURE study database, facility health club and health care providers. Data collection employed in-depth interviews, focus group discussions (FGDs) using structured interviews and FGD topic guides. Thematic data analysis was done to identify recurrent themes. Themes identified: knowledge and awareness about T2DM; health-seeking behaviour; weight perceptions; healthy lifestyles; self-management; health education needs and health care provider experiences. Patients defined T2DM as a physically and emotionally dangerous disease caused by socio-cultural factors, influenced by the sufferers' food and socio-cultural environment with significance placed on physical, social and emotional effects of T2DM diagnosis. Patient-centred definition of T2DM is key to enhancing T2DM self-management. Patients suggested that personally rewarding benefits of physical activity and healthy diet such as anti-ageing, brain boosting, energy boosting which are commonly harnessed by food, tobacco and beauty industry should be considered in T2DM self-management strategies.

  5. 41 CFR 109-27.5104-5 - Control and issue of stock.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Control and issue of stock. 109-27.5104-5 Section 109-27.5104-5 Public Contracts and Property Management Federal Property Management Regulations System (Continued) DEPARTMENT OF ENERGY PROPERTY MANAGEMENT REGULATIONS SUPPLY AND...

  6. 17 CFR 274.13 - Form N-8B-3, registration statement of unincorporated management investment companies currently...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... statement of unincorporated management investment companies currently issuing periodic payment plan...-8B-3, registration statement of unincorporated management investment companies currently issuing..., pursuant to section 8(b) of the Investment Company Act of 1940, by unincorporated management investment...

  7. University Management Education and Research in Canada: Some Unresolved Issues.

    ERIC Educational Resources Information Center

    von Zur-Muehlen, Max

    An historical overview of university management education and research in Canada is presented and issues relevant to the present status of management education and research opportunities are discussed. Management and administrative studies schools in Canada receive, on the average, about four percent of the operating budget of the university…

  8. Disturbance, scale, and boundary in wilderness management

    Treesearch

    Peter S. White; Jonathan Harrod; Joan L. Walker; Anke Jentsch

    2000-01-01

    Natural disturbances are critical to wilderness management. This paper reviews recent research on natural disturbance and addresses the problem of managing for disturbances in a world of human-imposed scales and boundaries. The dominant scale issue in disturbance management is the question of patch dynamic equilibrium. The dominant boundary issue in disturbance...

  9. 41 CFR 101-39.208 - Vehicles removed from defined areas.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VEHICLES 39-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.2-GSA Interagency Fleet Management System Services... operated outside the geographical area served by the issuing GSA IFMS fleet management center. However... shall notify the issuing GSA IFMS fleet management center of the following: (1) The location at which...

  10. Disturbance, Scale, and Boundary in Wilderness Management

    Treesearch

    Peter S. White; Jonathan Harrod; Joan L. Walker; Anke Jentsch

    2000-01-01

    Natural disturbances are critical to wilderness management. This paper reviews recent research on natural disturbance and addresses the problem of managing for disturbances in a world of human-imposed scales and boundaries. The dominant scale issue in disturbance management is the question of patch dynamic equilibrium. The dominant boundary issue in disturbance...

  11. Drivers of cost system development in hospitals: results of a survey.

    PubMed

    Cardinaels, Eddy; Roodhooft, Filip; van Herck, Gustaaf

    2004-08-01

    While many hospitals are under pressure to become more cost efficient, new costing systems such as activity-based costing (ABC) may form a solution. However, the factors that may facilitate (or inhibit) cost system changes towards ABC have not yet been disentangled in a specific hospital context. Via a survey study of hospitals, we discovered that cost system development in hospitals could largely be explained by hospital specific factors. Issues such as the support of the medical parties towards cost system use, the awareness of problems with the existing legal cost system, the type of contract for the physician's internal financial agreement, should be considered if hospitals refine their cost system. Conversely, ABC-adoption issues that were found to be crucial in other industries are less important. Apparently, installing a cost system requires a different approach in hospital settings. Especially, results suggest that hospital management should not underestimate the interest of the physician in the process of redesigning cost systems.

  12. Systems Perspective of Amazon Mechanical Turk for Organizational Research: Review and Recommendations

    PubMed Central

    Keith, Melissa G.; Tay, Louis; Harms, Peter D.

    2017-01-01

    Amazon Mechanical Turk (MTurk) is becoming a prevalent source of quick and cost effective data for organizational research, but there are questions about the appropriateness of the platform for organizational research. To answer these questions, we conducted an integrative review based on 75 papers evaluating the MTurk platform and 250 MTurk samples used in organizational research. This integrative review provides four contributions: (1) we analyze the trends associated with the use of MTurk samples in organizational research; (2) we develop a systems perspective (recruitment system, selection system, and work management system) to synthesize and organize the key factors influencing data collected on MTurk that may affect generalizability and data quality; (3) within each factor, we also use available MTurk samples from the organizational literature to analyze key issues (e.g., sample characteristics, use of attention checks, payment); and (4) based on our review, we provide specific recommendations and a checklist for data reporting in order to improve data transparency and enable further research on this issue. PMID:28848474

  13. E-Prescribing: History, Issues, and Potentials

    PubMed Central

    Salmon, J. Warren; Jiang, Ruixuan

    2012-01-01

    Electronic-Prescribing, Computerized Prescribing, or E-RX has increased dramatically of late in the American health care system, a long overdue alternative to the written form for the almost five billion drug treatments annually. This paper examines the history and selected issues in the rise of E-RX by a review of salient literature, interviews, and field observations in Pharmacy. Pharmacies were early adopters of computerization for a variety of factors. The profession in its new corporate forms of chain drug stores and pharmacy benefits firms has sought efficiencies, profit enhancements, and clinical improvements through managed care strategies that rely upon data automation. E-RX seems to be a leading factor in overall physician acceptance of Electronic Medical Records (EMRs), although the Centers for Medicare and Medicaid (CMS) incentives seem to be the propelling force in acceptance. We conclude that greater research should be conducted by public health professionals to focus on resolutions to pharmaceutical use, safety, and cost escalation, which persist and remain dire following health reform. PMID:23569654

  14. The multidimensional causal factors of 'wet litter' in chicken-meat production.

    PubMed

    Dunlop, Mark W; Moss, Amy F; Groves, Peter J; Wilkinson, Stuart J; Stuetz, Richard M; Selle, Peter H

    2016-08-15

    The problem of 'wet litter', which occurs primarily in grow-out sheds for meat chickens (broilers), has been recognised for nearly a century. Nevertheless, it is an increasingly important problem in contemporary chicken-meat production as wet litter and associated conditions, especially footpad dermatitis, have developed into tangible welfare issues. This is only compounded by the market demand for chicken paws and compromised bird performance. This review considers the multidimensional causal factors of wet litter. While many causal factors can be listed it is evident that the critical ones could be described as micro-environmental factors and chief amongst them is proper management of drinking systems and adequate shed ventilation. Thus, this review focuses on these environmental factors and pays less attention to issues stemming from health and nutrition. Clearly, there are times when related avian health issues of coccidiosis and necrotic enteritis cannot be overlooked and the development of efficacious vaccines for the latter disease would be advantageous. Presently, the inclusion of phytate-degrading enzymes in meat chicken diets is routine and, therefore, the implication that exogenous phytases may contribute to wet litter is given consideration. Opinion is somewhat divided as how best to counter the problem of wet litter as some see education and extension as being more beneficial than furthering research efforts. However, it may prove instructive to assess the practice of whole grain feeding in relation to litter quality and the incidence of footpad dermatitis. Additional research could investigate the relationships between dietary concentrations of key minerals and the application of exogenous enzymes with litter quality. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  15. A qualitative study of work-life balance amongst specialist orthodontists in the United Kingdom.

    PubMed

    Bateman, Lindsey E; Collins, Joanne M; Cunningham, Susan J

    2016-12-01

    To identify factors affecting work-life balance amongst male and female orthodontists in the UK. A qualitative interview-based study with a cross-sectional design. Specialist orthodontists working in specialist practice and the hospital service in the UK were selected by purposive sampling. In-depth semi-structured interviews were conducted with 18 orthodontic specialists. Interview transcripts were analyzed using Framework Analysis. Four main themes pertaining to work-life balance in orthodontics were identified: work factors affecting work-life balance, life factors affecting work-life balance, perception and effects of work-life balance and suggestions for managing work-life balance within the profession. There was substantial variation in the work-life balance of the orthodontists interviewed in this study; however the majority reported high levels of career satisfaction despite difficulties maintaining a good work-life balance. Whilst there were some clear distinctions in the factors affecting work-life balance between the hospital environment and specialist practice (including additional professional commitments and teaching/training-related issues), there were also a number of similarities. These included, the lack of flexibility in the working day, managing patient expectations, taking time off work at short notice and the ability to work part-time.

  16. Change in Level of Service Inventory-Ontario Revised (LSI-OR) Risk Scores Over Time: An Examination of Overall Growth Curves and Subscale-Dependent Growth Curves.

    PubMed

    Day, David M; Wilson, Holly A; Bodwin, Kelly; Monson, Candice M

    2017-10-01

    The dynamic nature of risk to re-offend is an important issue in the management of offenders and has stimulated extensive research into dynamic risk factors that can alter an individual's overall risk to re-offend if addressed. However, few studies have examined the relative importance of these dynamic risk factors, complicating the task of developing case management and treatment plans that will effect the most change. Using a large, high-risk sample and multi-wave data of a common risk assessment tool, the Level of Service Inventory-Ontario Revised (LSI-OR), the current study investigated the relationship among criminogenic risk factors and their role in influencing the overall risk score. Results indicated a diverse pattern of effects on the eight subscale scores, specifically suggesting that changes on Procriminal Attitude/Orientation, Criminal History, and Leisure/Recreation subscales resulted in a quicker rate of change to the overall risk score over time. These results suggest that some factors may be driving the change in overall risk and could potentially effect the most change if prioritized for intervention. Practical implications and implications for further research are discussed.

  17. Single-entry models (SEMs) for scheduled services: Towards a roadmap for the implementation of recommended practices.

    PubMed

    Lopatina, Elena; Damani, Zaheed; Bohm, Eric; Noseworthy, Tom W; Conner-Spady, Barbara; MacKean, Gail; Simpson, Chris S; Marshall, Deborah A

    2017-09-01

    Long waiting times for elective services continue to be a challenging issue. Single-entry models (SEMs) are used to increase access to and flow through the healthcare system. This paper provides a roadmap for healthcare decision-makers, managers, physicians, and researchers to guide implementation and management of successful and sustainable SEMs. The roadmap was informed by an inductive qualitative synthesis of the findings from a deliberative process (a symposium on SEMs, with clinicians, researchers, senior policy-makers, healthcare managers, and patient representatives) and focus groups with the symposium participants. SEMs are a promising strategy to improve the management of referrals and represent one approach to reduce waiting times. The SEMs roadmap outlines current knowledge about SEMs and critical success factors for SEMs' implementation and management. This SEM roadmap is intended to help clinicians, decision-makers, managers, and researchers interested in developing new or strengthening existing SEMs. We consider this roadmap to be a living document that will continue to evolve as we learn more about implementing and managing sustainable SEMs. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Applying business management models in health care.

    PubMed

    Trisolini, Michael G

    2002-01-01

    Most health care management training programmes and textbooks focus on only one or two models or conceptual frameworks, but the increasing complexity of health care organizations and their environments worldwide means that a broader perspective is needed. This paper reviews five management models developed for business organizations and analyses issues related to their application in health care. Three older, more 'traditional' models are first presented. These include the functional areas model, the tasks model and the roles model. Each is shown to provide a valuable perspective, but to have limitations if used in isolation. Two newer, more 'innovative' models are next discussed. These include total quality management (TQM) and reengineering. They have shown potential for enabling dramatic improvements in quality and cost, but have also been found to be more difficult to implement. A series of 'lessons learned' are presented to illustrate key success factors for applying them in health care organizations. In sum, each of the five models is shown to provide a useful perspective for health care management. Health care managers should gain experience and training with a broader set of business management models.

  19. Factors affecting ethical behavior in pediatric occupational therapy: A qualitative study

    PubMed Central

    Kalantari, Minoo; Kamali, Mohammad; Joolaee, Soodabeh; Shafarodi, Narges; Rassafiani, Mehdi

    2015-01-01

    Background: It is the responsibility of each occupational therapist to always act ethically and professionally in a clinical setting. However, there is little information available concerning the factors influencing ethical behavior of occupational therapists at work. Since no study has been conducted in Iran on this topic, this qualitative study aimed to identify the factors influencing ethical behavior of pediatric occupational therapists. Methods: Twelve pediatric occupational therapists participated in this study. The sampling was purposeful, and the interviews continued until reaching data saturation. All interviews were recorded and transcribed. The data were analyzed by qualitative content analysis, and the ethics of qualitative research was considered. Results: The factors influencing ethical behavior were classified into four main categories including organizational factors, therapist related factors, client’s family issues, and social factors. Conclusion: This study identified numerous factors influencing the ethical behavior of pediatric occupational therapists that could be used to train occupational therapists, human resources managers, professional policy makers, and could also be used to conduct future researches, and produce tools. PMID:26913245

  20. Integrated watershed approach in controlling point and non-point source pollution within Zelivka drinking water reservoir.

    PubMed

    Holas, J; Hrncir, M

    2002-01-01

    An agricultural watershed involves manipulation of soil, water and other natural resources and it has profound impacts on ecosystems. To manage these complex issues, we must understand causes and consequences and interactions-related transport of pollutants, quality of the environment, mitigation measures and policy measures. A ten year period of economic changes has been analysed with respect to sustainable development concerning Zelivka drinking water reservoir and its watershed, where agriculture and forestry are the main human activities. It is recommended that all land users within a catchment area should receive payments for their contribution to water cycle management. Setting up the prevention principles and best management practices financially subsidized by a local water company has been found very effective in both point and non-point source pollution abatement, and the newly prepared Clean Water Programme actively involves local municipal authorities as well. The first step based on systems analysis was to propose effective strategies and select alternative measures and ways for their financing. Long term monitoring of nutrient loads entering the reservoir and hazardous events statistics resulted in maps characterising the territory including vulnerable zones and risk factors. Financing involves providing annual payments to farmers, who undertake to manage specified areas of their land in a particular way and one-off payments to realise proposed issues ensuring soil conservation and watershed ecosystem benefits.

  1. Need of risk management practice amongst bumiputera contractors in Malaysia construction industries

    NASA Astrophysics Data System (ADS)

    Syuhada Fadzil, Nur; Noor, Nurazuwa Md; Rahman, Ismail Abdul

    2017-11-01

    Malaysia construction industry has been growing continuously with double-digit growth for the past two decades. There are many issues surrounded the industry such as delay in delivery, cost overrun, quality and safety. In bumiputera contractor’s context, the literature review found that 32 issues were encountered in the construction project. These issues can be handled properly with the application of risk management. According to previous researchers, application of risk management in Malaysia construction industry is at the low level where it is implemented in traditional ways that are brainstorming and checklist. These were due to lack of knowledge, the high cost of hiring experts and avoiding extra cost. Besides that, this study also intentions to analyse the risk categories in the construction industry as well as identify risk management process to resolve the construction issues. Hence, this paper presents issues engulfed by Bumiputera contractors which can partly be resolved by applying risk management practice in carrying out the construction activity. This may inspire the contractors to apply the risk management practice in ensuring the success of their construction project.

  2. The importance of manager support for the mental health and well-being of ambulance personnel.

    PubMed

    Petrie, Katherine; Gayed, Aimée; Bryan, Bridget T; Deady, Mark; Madan, Ira; Savic, Anita; Wooldridge, Zoe; Counson, Isabelle; Calvo, Rafael A; Glozier, Nicholas; Harvey, Samuel B

    2018-01-01

    Interventions to enhance mental health and well-being within high risk industries such as the emergency services have typically focused on individual-level factors, though there is increasing interest in the role of organisational-level interventions. The aim of this study was to examine the importance of different aspects of manager support in determining the mental health of ambulance personnel. A cross-sectional survey was completed by ambulance personnel across two Australian states (N = 1,622). Demographics, manager support and mental health measures were assessed. Hierarchical multiple linear regressions were conducted to determine the explanatory influence of the employee's perception of the priority management places upon mental health issues (manager psychosocial safety climate) and managers' observed behaviours (manager behaviour) on employee common mental disorder and well-being within ambulance personnel. Of the 1,622 participants, 123 (7.6%) were found to be suffering from a likely mental disorder. Manager psychosocial safety climate accounted for a significant amount of the variance in levels of employee common mental health disorder symptoms (13%, p<0.01) and well-being (13%, p<0.01). Manager behaviour had a lesser, but still statistically significant influence upon symptoms of common mental disorder (7% of variance, p<0.01) and well-being (10% of variance, p<0.05). The perceived importance management places on mental health and managers' actual behaviour are related but distinct concepts, and each appears to impact employee mental health. While the overall variance explained by each factor was limited, the fact that each is potentially modifiable makes this finding important and highlights the significance of organisational and team-level interventions to promote employee well-being within emergency services and other high-risk occupations.

  3. Factors influencing Macao nurses' intention to leave current employment.

    PubMed

    Chan, Moon Fai; Luk, Andrew Leung; Leong, Sok Man; Yeung, Siu Ming; Van, Iat Kio

    2009-03-01

    To investigate factors associated with nurses' intention to leave current employment in Macao. The shortage of nursing staff and nurses voluntarily leaving their jobs has continued to be a problem affecting the delivery of health care all over the world. One way to alleviate this shortfall is via recruitment, but this is not always successful. Another way is to reduce the rate at which nurses voluntarily leave their work places. A descriptive survey was conducted and data were collected using a self-reported structured questionnaire. Nurses were recruited in the Health Bureau and one private hospital in Macao. The status of nurses' intention to leave current employment (yes vs. no) was the dependent variable and nurses' predisposing characteristics, organisational environments and five components on job satisfaction outcomes were independent variables. Of 426 nurses, 166 (39.0%) indicated an intention to leave current employment. The results showed that age (p < 0.001), work experience (p < 0.001), workplace (p = 0.015) and job satisfaction: pay and benefits (p < 0.001) were significant risk factors to predict nurses' intention to leave current employment. More than one-third of the nurses in Macao indicated an intention to leave current employment. This figure may be a cause of concern for the hospital management and highlights the need to implement strategies to improve the communication between nurses and the organisation, to enhance nurse job satisfaction and commitment to the organisation. Our findings outline some issues contributing to this problem and provide the nurse manager with information regarding specific influences on nurses' turnover in Macao. Given the complexity of issues outlined in this analysis, nurse managers should assist their nursing staff to deal with those influences, make efforts to address the nursing shortage that will require additional communications and recognise the needs and values of their staff and empower them to create a better work environment. As a consequence, their commitment to the organisation can be fostered.

  4. AANA Journal course: update for nurse anesthetists--ERR WATCH: anesthesia crisis resource management from the nurse anesthetist's perspective.

    PubMed

    Fletcher, J L

    1998-12-01

    Anesthesia crisis resource management (ACRM) was developed by David Gaba, MD, and colleagues at Stanford University in the early 1990s. Derived from cockpit resource management of the aviation industry, ACRM addresses the issues of human performance and patient safety in anesthesia. Due to the inherent complexity of our dynamic work environment, we are frequently faced with situations that could escalate into critical incidents. ACRM explains the role of personal and environmental factors that can contribute to the evolution of critical incidents and provides the practitioner with some behavioral and intellectual guidelines to manage the risks more effectively. ERR WATCH is an acronym I developed to interpret the principles of ACRM from the nurse anesthetist's perspective. It provides a quick review of the major principles of ACRM, which are Environment, Resources, Reevaluation, Workload, Attention, Teamwork, Communication, and Help. Used together with good clinical management, these principles may provide an edge in solving complex problems and improving performance.

  5. Security, safety, and related technology - the triangle of eHealth service provision.

    PubMed

    Savastano, Mario; Hovsto, Asbjorn; Pharow, Peter; Blobel, Bernd

    2008-01-01

    The developing of innovative solutions in the emerging eHealth market requires strong economic efforts which may be justified only in presence of particularly suitable boundary conditions. Among the factors retained of primary importance for the development of eHealth, a correct approach to id-management is unanimously considered fundamental. Three keywords in the id-management context appear particularly important: standardization, security and safety. Standardization may contribute to increase the size and duration of the eHealth market, while security and safety may encourage all the stakeholders to trust in a appropriate and safe management of all the very sensitive personal data involved in the eHealth applications. The aim of the present paper is analyzing some security and safety issues in eHealth from the particular prospective of the identity management and standardization. The paper highlights the mission of the EU funded "BioHealth" project whose mission is to increase the stakeholders' knowledge about existing and emerging standards in eHealth with particular reference to identity management.

  6. Stakeholder Perceptions of Welfare Issues and Indicators for Extensively Managed Sheep in Australia

    PubMed Central

    Doughty, Amanda K.; Coleman, Grahame J.; Hinch, Geoff N.; Doyle, Rebecca E.

    2017-01-01

    Simple Summary This survey was designed as the first step in the development of a welfare assessment framework with the aim of identifying potential causes of welfare compromise and useful indicators for sheep in extensive Australian production systems. We asked the general public, sheep producers, service providers and sheep industry related scientists to provide their thoughts on the importance of a range of sheep welfare issues and possible key indicators. All respondents thought sheep welfare was adequate but that improvement was desired. Issues perceived to cause the most risk to sheep related to factors influenced by the environment (i.e., nutrition and food supply), heat stress and lameness while key indicators useful to assess welfare were nutrition and food availability, mortality/management issues, pain and fear related indicators, and numbers of illness/injuries. Women and the general public perceived all issues and indicators to be more important than other groups of respondents. These results highlight the need to consult a wide range of stakeholders in order to develop a broadly acceptable assessment system. Abstract An online survey was designed to form the basis of a framework for the welfare assessment of extensively managed sheep in Australia. The survey focused on welfare compromise and useful welfare indicators. A total of 952 people completed the survey in its entirety, representing four stakeholder groups: Public (53.6%), Producer (27.4%), Scientist (9.9%), and Service provider (9.1%). Animal welfare was considered to be important by all participating groups in this survey (average score of 3.78/4). Respondents felt the welfare of grazing sheep was generally adequate but improvement was desired (2.98/5), with female members of the public rating sheep welfare significantly worse than other respondents (p < 0.05). Environmental issues were considered to pose the greatest risk to welfare (3.87/5), followed by heat stress (3.79), lameness (3.57) and husbandry practices (3.37). Key indicators recognised by all respondents were those associated with pain and fear (3.98/5), nutrition (4.23), mortality/management (4.27), food on offer (4.41) and number of illness/injures in a flock (4.33). There were gender and stakeholder differences in the perceived importance of both welfare issues and indicators with women and the public consistently rating issues (all p < 0.01) and indicators (all p < 0.05) to be of greater significance than other respondents. These results highlight the importance of including all stakeholders and an even balance of genders when developing a welfare framework that can address both practical and societal concerns. PMID:28333110

  7. The effect of water regime and soil management on methane (CH4) emission of rice field

    NASA Astrophysics Data System (ADS)

    Naharia, O.; Setyanto, P.; Arsyad, M.; Burhan, H.; Aswad, M.

    2018-05-01

    Mitigation of CH4 emission of rice field is becoming a serious issue. The Agricultural Environment Preservation Research Station in Central Java conducted a field study to investigate the effect of water regime and soil tillage on CH4 emission from paddy fields. Treatments consisted of two factors. The first factor was water regime, e.g., 1) continuously flooded 5 cm, 2) intermittent irrigation and 3) saturated water condition at 0-1 cm water level. The second factor was soil management, e.g., 1) normal tillage, 2) zero tillage + 3 sulfosate ha-1 and 3) zero tillage + 3 L paraquat ha-1. Most of treatments gave a significant reduction of total CH4 emission between 34 – 85% during the wet season crop as compared to normal rice cropping practice, while in the dry season the CH4 reduction ranged between 16 – 92%. No-tillage with non-selective herbicides combined with intermittent/saturated irrigation system significantly reduced methane emission without significantly affecting rice productivity as compared to normal tillage with continuous flooding (farmers practice)

  8. Venous thromboembolism: role of pharmacists and managed care considerations.

    PubMed

    Horner, Tuesdy; Mahan, Charles E

    2017-12-01

    Venous thromboembolism (VTE) includes deep vein thrombosis and pulmonary embolism. Anticoagulation is used in patients with VTE to reduce the risk of recurrent VTE and VTE-related death. The overall incidence of VTE is 1 to 2 per 1000 person-years. Long-term mortality for patients with VTE is poor, with 25% of patients not surviving 7 days and nearly 40% not surviving the first year. Coagulation disorders demand effective anticoagulant therapy to avoid complications, especially recurrent VTE and VTE-related death. For more than 60 years, warfarin has been the cornerstone of therapy for patients requiring anticoagulation and was the sole oral anticoagulant available in the United States until 2010. Since then, the FDA has approved 5 direct-acting oral anticoagulants (DOACs) that inhibit single coagulation factors (factor Xa and thrombin). DOACs provide predictable anticoagulation with fixed dosing, easier perioperative management, no routine laboratory monitoring, and fewer food-drug interactions. However, when choosing DOACs, clinicians must consider several issues in addition to efficacy and safety before employing these therapies, including patient-specific factors, adherence and persistence with therapy, and their cost-effectiveness for clinical use.

  9. Commuter migration: work environment factors influencing nurses' decisions regarding choice of employment.

    PubMed

    Rajacich, D; Freeman, M; Armstrong-Stassen, M; Cameron, S; Wolfe, B

    2014-06-01

    Nurse migration is of global concern for every country, and study of migration can provide critical information for managers concerned with nurse recruitment and retention. This mixed-methods research examined factors influencing registered nurses' (RNs') decisions to work in their home country, Canada, or to commute daily to a nursing position in the United States. Measures included nurses' feelings about their work environment conditions, work status congruence (the goodness of fit between employer expectations and their own regarding hours and times worked), professional development opportunities, and their perceptions of organizational support and autonomy (freedom and independence) in the workplace. All work environment variables were significantly higher for nurses working in Michigan. Qualitative results supported these survey findings, providing additional information about nurses' satisfaction. Nurses in our sample were more satisfied with all the work environment factors examined, even when stress from commuting out of country was experienced. The environmental issues examined in this study should be considered by nurse managers concerned with recruitment and retention of nurses. Copyright © 2014 Longwoods Publishing.

  10. How to Identify Success Among Networks That Promote Active Living.

    PubMed

    Litt, Jill; Varda, Danielle; Reed, Hannah; Retrum, Jessica; Tabak, Rachel; Gustat, Jeanette; O'Hara Tompkins, Nancy

    2015-11-01

    We evaluated organization- and network-level factors that influence organizations' perceived success. This is important for managing interorganizational networks, which can mobilize communities to address complex health issues such as physical activity, and for achieving change. In 2011, we used structured interview and network survey data from 22 states in the United States to estimate multilevel random-intercept models to understand organization- and network-level factors that explain perceived network success. A total of 53 of 59 "whole networks" met the criteria for inclusion in the analysis (89.8%). Coordinators identified 559 organizations, with 3 to 12 organizations from each network taking the online survey (response rate = 69.7%; range = 33%-100%). Occupying a leadership position (P < .01), the amount of time with the network (P < .05), and support from community leaders (P < .05) emerged as correlates of perceived success. Organizations' perceptions of success can influence decisions about continuing involvement and investment in networks designed to promote environment and policy change for active living. Understanding these factors can help leaders manage complex networks that involve diverse memberships, varied interests, and competing community-level priorities.

  11. Defining physicians' readiness to screen and manage intimate partner violence in Greek primary care settings.

    PubMed

    Papadakaki, Maria; Prokopiadou, Dimitra; Petridou, Eleni; Kogevinas, Manolis; Lionis, Christos

    2012-06-01

    The current article aims to translate the PREMIS (Physician Readiness to Manage Intimate Partner Violence) survey into the Greek language and test its validity and reliability in a sample of primary care physicians. The validation study was conducted in 2010 and involved all the general practitioners serving two adjacent prefectures of Greece (n = 80). Maximum-likelihood factor analysis (MLF) was used to extract key survey factors. The instrument was further assessed for the following psychometric properties: (a) scale reliability, (b) item-specific reliability, (c) test-retest reliability, (d) scale construct validity, and (e) internal predictive validity. The MLF analysis of 23 opinion items revealed a seven-factor solution (preparation, constraint, workplace issues, screening, self-efficacy, alcohol/drugs, victim understanding), which was statistically sound (p = .293). Most of the newly derived scales displayed satisfactory internal consistency (α ≥ .60), high item-specific reliability, strong construct, and internal predictive validity (F = 2.82; p = .004), and high repeatability when retested with 20 individuals (intraclass correlation coefficient [ICC] > .70). The tool was found appropriate to facilitate the identification of competence deficits and the evaluation of training initiatives.

  12. Facilitators and Barriers to the Achievement of Healthy Lifestyle Goals: Qualitative Findings From Australian Parents Enrolled in the PEACH Child Weight Management Program.

    PubMed

    Perry, Rebecca Anne; Daniels, Lynne Anne; Bell, Lucinda; Magarey, Anthea Margaret

    2017-01-01

    To describe the qualitative research methods used in the Parenting Eating and Activity for Child Health (PEACH) randomized controlled trial and to examine parent-reported facilitators and barriers to the achievement of program goals. Qualitative study using semistructured interviews. Parents enrolled in the Australian PEACH randomized controlled trial, a family-focused child weight management program conducted blinded for review. A total of 95 parents of overweight children aged 5-10 years participated in face-to-face semistructured interviews. Factors external to the PEACH intervention that facilitated or inhibited their success. Interviews were recorded, transcribed, and analyzed using thematic analysis techniques. Three facilitator themes were identified: (1) internal locus of parental control, (2) external locus of parental control, and (3) child factors. Six barrier themes were identified: (1) internal locus of parental control, (2) external locus of parental control, and (3) child factors; (4) maintenance and managing special occasions; (5) time management challenges; and (6) inconsistencies or lack of support. The social and environmental barriers and time pressures identified by parents are a common feature of Western family life such that many parents are raising families in stressful situations. Insights provided by this qualitative research provide an important understanding of these experiences. Consideration of such issues in the design and implementation of future child weight management interventions may help to increase the acceptability and effectiveness of such programs. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  13. Data management issues in mobile ad hoc networks

    PubMed Central

    HARA, Takahiro

    2017-01-01

    Research on mobile ad hoc networks (MANETs) has become a hot research topic since the middle 1990’s. Over the first decade, most research focused on networking techniques, ignoring data management issues. We, however, realized early the importance of data management in MANETs, and have been conducting studies in this area for 15 years. In this review, we summarize some key technical issues related to data management in MANETs, and the studies we have done in addressing these issues, which include placement of data replicas, update management, and query processing with security management. The techniques proposed in our studies have been designed with deep considerations of MANET features including network partitioning, node participation/disappearance, limited network bandwidth, and energy efficiency. Our studies published in early 2000’s have developed a new research field as data management in MANETs. Also, our recent studies are expected to be significant guidelines of new research directions. We conclude the review by discussing some future directions for research. PMID:28496052

  14. Data management issues in mobile ad hoc networks.

    PubMed

    Hara, Takahiro

    2017-01-01

    Research on mobile ad hoc networks (MANETs) has become a hot research topic since the middle 1990's. Over the first decade, most research focused on networking techniques, ignoring data management issues. We, however, realized early the importance of data management in MANETs, and have been conducting studies in this area for 15 years. In this review, we summarize some key technical issues related to data management in MANETs, and the studies we have done in addressing these issues, which include placement of data replicas, update management, and query processing with security management. The techniques proposed in our studies have been designed with deep considerations of MANET features including network partitioning, node participation/disappearance, limited network bandwidth, and energy efficiency. Our studies published in early 2000's have developed a new research field as data management in MANETs. Also, our recent studies are expected to be significant guidelines of new research directions. We conclude the review by discussing some future directions for research.

  15. The disaster prevention awareness of foreign residents and disaster management of organizations for foreign employees

    NASA Astrophysics Data System (ADS)

    Xin, Tan Yen; Sugiki, Nao; Matsuo, Kojiro

    2017-10-01

    Japan is known to have many natural disasters occurrences, especially in recent years, the seismic hazard named "Nankai-trough Disastrous Earthquake" of magnitude 9(M) was predicted and will have caused huge damages. Therefore, disaster management should be well planned and executed to ensure minimal amount of victims and damages from disaster. However, foreign residents are mostly vulnerable and ill-equipped to face such consequences compared to Japanese residents, especially when there is limited information available for foreigners presently. As the influx of foreigner migration has been steadily increasing annually, it is vital for disaster management to be compulsively planned to cope up with the great variety of foreigners' needs from diverse backgrounds accordingly. The purpose of this study is to comprehend foreign residents' disaster prevention awareness, in order to provide a more effective information provision on disaster management, so as to help improve their disaster prevention awareness. Thus, this study is set in Toyohashi city, and the methodology used is by conducting two questionnaires. Firstly, to have an accurate understanding on the awareness of foreign residents towards disasters prevention, the questionnaire is conducted towards foreign university students, on pertinent issues such as on the degree of preparedness and their matters of concern of which is related to natural disasters. Secondly, to comprehend disaster management of organizations, the other focuses on preventive measures adopted by manufacturing industry organizations, such as types of preventive measures as a whole and on the issues and challenges encountered during foreign employee-related enforcement of disaster management. Finally, based both results of the questionnaire, the key factors on effective information provision of disaster management is considered.

  16. Issues in Coastal Zone Management.

    ERIC Educational Resources Information Center

    Davis, Derrin

    1992-01-01

    Addresses the following issues relevant to coastal zone management: overcrowding, resource exploitation, pollution, agriculture, fisheries, industrial, and other uses. Describes conflicts and trade-offs in management typified by fragmented agency decision making. Discusses implications of the greenhouse effect, sustainable development, and the…

  17. Special Issue: Book Reviews 2002-2003.

    ERIC Educational Resources Information Center

    Grauer, Barbara Ellman, Ed.

    2003-01-01

    This special issue reviews 71 books on the following topics: career management; career opportunities for people with disabilities; federal government career information; college career development/counseling; job search strategies, tools, methods; coaching; retirement issues; strategies for managers; women and careers; general career books; and…

  18. Building on common ground to address biodiversity conflicts and foster collaboration in environmental management.

    PubMed

    Lecuyer, Lou; White, Rehema M; Schmook, Birgit; Calmé, Sophie

    2018-08-15

    Conservation biology faces critical challenges that require collaborative approaches, including novel strategies to support interactions among actors in biodiversity conflicts. The goals of this study were to investigate the concept of common ground across multiple issues and to explore its practical application for the support of environmental management. We conceptually defined common ground as the areas of relevance underlying the suite of issues expressed by people regarding environmental management in a particular context. We then empirically tested this in the Calakmul region of Mexico, where the complex socio-historical context and high biodiversity have created environmental management challenges that are now being addressed by a local, multi-stakeholder management board. We conducted 26 open interviews with members of the board and a further round of quantitative prioritisation of issues raised. Using a coding process designed to reveal common ground, we categorized the issues at four levels ranging from coarse to fine (themes, topics, sub-topics and perspectives). We then analysed two levels, topics (n = 14 issues) and sub-topics (n = 51 issues). To do so, we built common ground matrices to identify and analyze common ground among actors and across issues. First, cluster and non-metrical data analyses revealed the diversity of actor positions and the lack of consistent grouping among actors by occupational activity. This demonstrated that focusing on actors' differences might be misleading, and that actors' views were not closely aligned with their roles. Second, we located issues according to their levels of common ground and importance among actors. We showed that by not focusing on single issue conflicts, the identification of common ground across multiple issues can pinpoint synergies. We then proposed a framework for collaboration that prioritizes issues of high importance with greater common ground (e.g. sustainable resource use activities), to support the development of trust and norms of reciprocity among actors, strengthening the potential for future cooperation. By adopting this approach, environmental managers could support the initial stages of collaborative conservation strategies, engaging with other actors to seek common ground, avoid the creation of polarised groups and help effectively manage biodiversity conflicts. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Issues in NASA program and project management

    NASA Technical Reports Server (NTRS)

    Hoban, Francis T. (Editor)

    1989-01-01

    This new collection of papers on aerospace management issues contains a history of NASA program and project management, some lessons learned in the areas of management and budget from the Space Shuttle Program, an analysis of tools needed to keep large multilayer programs organized and on track, and an update of resources for NASA managers. A wide variety of opinions and techniques are presented.

  20. Mountain biking: issues and actions for USDA Forest Service managers

    Treesearch

    Deborah J. Chavez

    1996-01-01

    Managers of National Forests are faced with many challenges related to the growing use of mountain bikes. To determine the issues and management actions associated with this growth, USDA Forest Service managers from across the United States were surveyed. Managers from at least two National Forests from every Region (except Alaska) reported annual use of trails by 10,...

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