5 CFR 511.612 - Finality of decision.

Code of Federal Regulations, 2011 CFR

2011-01-01

....612 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CLASSIFICATION UNDER THE GENERAL SCHEDULE Classification Appeals § 511.612 Finality of decision. An appellate decision made by the Office is final unless reconsidered by the Office. There is no further right of appeal. The...

7 CFR 3560.102 - Housing project management.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Housing project management. 3560.102 Section 3560.102... § 3560.102 Housing project management. (a) General. Borrowers hold final responsibility for housing project management and must ensure that operations comply with the terms of all loan or grant documents...

75 FR 47826 - Final General Management Plan/Environmental Impact Statement, Cumberland Gap National Historical...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

..., regulations, and policies and the purpose of the Cumberland Gap National Historical Park, the Final GMP/EIS... prescriptions to ensure protection, access and enjoyment of the park's resources. The Final GMP/EIS describes... Final GMP/EIS contains NPS responses to public comments on the Draft GMP/EIS, and copies of agency...

77 FR 132 - General Management Plan and Environmental Impact Statement for Lincoln Home National Historic Site

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-03

...: The Abbreviated Final General Management Plan and Environmental Impact Statement (GMP/EIS) will remain... Site. SUPPLEMENTARY INFORMATION: We, the National Park Service, prepared a draft GMP/EIS for the park... summaries of the draft GMP/EIS. In addition to the distribution, the draft GMP/EIS was also made available...

15 CFR 921.50 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT NATIONAL... high quality research within designated National Estuarine Research Reserves, NOAA may provide... with approved final management plans. Although research may be conducted within the immediate watershed...

15 CFR 921.50 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT NATIONAL... high quality research within designated National Estuarine Research Reserves, NOAA may provide... with approved final management plans. Although research may be conducted within the immediate watershed...

Controls Over Project Management Oversight Program

DOT National Transportation Integrated Search

1997-12-08

This is the final report on Federal Transit Administration's (FTA) controls over its Project Management Oversight (PMO) Program. This report reflects Office of Inspector General's (OIG) consideration of information provided in FTA's May 29, 1997, rep...

78 FR 760 - Notice of Availability of the Final General Management Plan/Final Environmental Impact Statement...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-04

... document is available on the internet at the NPS Planning, Environment, and Public Comment Web site at http.../EIS assesses impacts to soil resources, water quality, soundscapes, vegetation and wildlife...

76 FR 59159 - Record of Decision; Apostle Islands National Lakeshore, WI

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-23

... Impact Statement (EIS) for the General Management Plan (GMP)/Wilderness Management Plan for Apostle... approved the ROD for the Final GMP/EIS. As soon as practicable, the NPS will begin to implement the...

76 FR 81962 - Final Environmental Impact Statement for General Management Plan, Ross Lake National Recreation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-29

... soundscapes, and scenery through traditional outdoor activities. The NPS would actively manage to reduce... Ross Lake NRA in order to protect and enhance soundscapes and wilderness character, experience, and...

76 FR 9596 - General Management Plan, Final Environmental Impact Statement, Cedar Creek and Belle Grove...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-18

... will provide guidance to park management for administration, development, and interpretation of park... request, and on the NPS Planning, Environment, and Public Comment Web site ( http://parkplanning.nps.gov... development and future management of the National Historical Park. Alternative A (Continuation of Current...

75 FR 71730 - General Management Plan/Wilderness Study/Off-Road Vehicle Management Plan, Final Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... Planning, Environmental Impact Analysis, and Decision- making), the NPS announces the availability of a... National Park Service will execute a Record of Decision (ROD) no sooner than 30 days following publication...

75 FR 17756 - Availability of the Final General Management Plan and Environmental Impact Statement (GMP/EIS...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-07

... and Environmental Impact Statement (GMP/EIS) for Chattahoochee River National Recreation Area (CRNRA...) announces the availability of a Final GMP/EIS for the CRNRA, Georgia. Consistent with NPS laws, regulations, and policies, and the purpose of the CRNRA, the Final GMP/EIS describes Alternative F at the NPS...

A Multivariate Model of Stakeholder Preference for Lethal Cat Management

PubMed Central

Wald, Dara M.; Jacobson, Susan K.

2014-01-01

Identifying stakeholder beliefs and attitudes is critical for resolving management conflicts. Debate over outdoor cat management is often described as a conflict between two groups, environmental advocates and animal welfare advocates, but little is known about the variables predicting differences among these critical stakeholder groups. We administered a mail survey to randomly selected stakeholders representing both of these groups (n = 1,596) in Florida, where contention over the management of outdoor cats has been widespread. We used a structural equation model to evaluate stakeholder intention to support non-lethal management. The cognitive hierarchy model predicted that values influenced beliefs, which predicted general and specific attitudes, which in turn, influenced behavioral intentions. We posited that specific attitudes would mediate the effect of general attitudes, beliefs, and values on management support. Model fit statistics suggested that the final model fit the data well (CFI = 0.94, RMSEA = 0.062). The final model explained 74% of the variance in management support, and positive attitudes toward lethal management (humaneness) had the largest direct effect on management support. Specific attitudes toward lethal management and general attitudes toward outdoor cats mediated the relationship between positive (p<0.05) and negative cat-related impact beliefs (p<0.05) and support for management. These results supported the specificity hypothesis and the use of the cognitive hierarchy to assess stakeholder intention to support non-lethal cat management. Our findings suggest that stakeholders can simultaneously perceive both positive and negative beliefs about outdoor cats, which influence attitudes toward and support for non-lethal management. PMID:24736744

A multivariate model of stakeholder preference for lethal cat management.

PubMed

Wald, Dara M; Jacobson, Susan K

2014-01-01

Identifying stakeholder beliefs and attitudes is critical for resolving management conflicts. Debate over outdoor cat management is often described as a conflict between two groups, environmental advocates and animal welfare advocates, but little is known about the variables predicting differences among these critical stakeholder groups. We administered a mail survey to randomly selected stakeholders representing both of these groups (n=1,596) in Florida, where contention over the management of outdoor cats has been widespread. We used a structural equation model to evaluate stakeholder intention to support non-lethal management. The cognitive hierarchy model predicted that values influenced beliefs, which predicted general and specific attitudes, which in turn, influenced behavioral intentions. We posited that specific attitudes would mediate the effect of general attitudes, beliefs, and values on management support. Model fit statistics suggested that the final model fit the data well (CFI=0.94, RMSEA=0.062). The final model explained 74% of the variance in management support, and positive attitudes toward lethal management (humaneness) had the largest direct effect on management support. Specific attitudes toward lethal management and general attitudes toward outdoor cats mediated the relationship between positive (p<0.05) and negative cat-related impact beliefs (p<0.05) and support for management. These results supported the specificity hypothesis and the use of the cognitive hierarchy to assess stakeholder intention to support non-lethal cat management. Our findings suggest that stakeholders can simultaneously perceive both positive and negative beliefs about outdoor cats, which influence attitudes toward and support for non-lethal management.

Ocean and coastal data management

USGS Publications Warehouse

de La Beaujardière, Jeff; Beegle-Krause, C; Bermudez, Luis; Hankin, Steven C.; Hazard, Lisa; Howlett, Eoin; Le, Steven; Proctor, Roger; Signell, Richard P.; Snowden, Derrick P.; Thomas, Julie

2010-01-01

We introduce data management concepts, including what we mean by "data" and its "management," sources of data, interoperability, and data geometry. We then discuss various components of a data management system. Finally, we summarize some existing ocean and coastal data management efforts. We make specific recommendations throughout the paper. We are generally optimistic that ocean and coastal data management is an interesting and solvable challenge that will provide great benefit to society.

Climate Change and Aquatic Invasive Species (Final Report) ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, Climate Change and Aquatic Invasive Species. This report reviews available literature on climate-change effects on aquatic invasive species (AIS) and examines state-level AIS management activities. Data on management activities came from publicly available information, was analyzed with respect to climate-change effects, and was reviewed by managers. This report also analyzes state and regional AIS management plans to determine their capacity to incorporate information on changing conditions generally, and climate change specifically. The report is intended for managers and scientists working with AIS to provide them with information on the potential effects of climate change on AIS, strategies for adapting their management to accomodate these environmental changes, and highlight further research needs and gaps.

77 FR 47302 - South Dakota: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-08

... Attorney General regarding Indian country language. No further opportunity for comment will be provided... the rule in accordance with the ``Attorney General's Supplemental Guidelines for the Evaluation of... House of the Congress and to the Comptroller General of the United States. EPA will submit a report...

29 CFR 1952.104 - Final approval determination.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OSHA through participation in the Federal-state Integrated Management Information System, the Assistant... exception of temporary labor camps in agriculture, general industry, construction and logging) is at least... covered by the plan (with the exception of temporary labor camps in agriculture, general industry...

77 FR 77076 - Environmental Impacts Statements; Notice of Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

...-557-5107. EIS No. 20120397, Final EIS, BLM, AK, National Petroleum Reserve-- Alaska (NPR-A) Integrated.... EIS No. 20120398, Final EIS, NPS, WI, Ice Age Complex at Cross Plains General Management Plan... Flood Risk in the Sutter Basin, Sutter and Butte Counties, CA, Comment Period Ends: 02/13/2013, Contact...

Michigan Physicians' Conference on Elder Abuse. Final Report.

ERIC Educational Resources Information Center

Sengstock, Mary C.; O'Brien, James G.

The final report describes the Michigan Physicians' Conference on Elder Abuse project. The project conference had four major content areas, including: a general introduction to the problem of elder abuse; clinical symptoms of abuse; legal issues; and referral and case management techniques. Training techniques included lectures, group discussion,…

78 FR 68858 - Seal Beach National Wildlife Refuge, Orange County, CA; Final Comprehensive Conservation Plan and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... mission; and is consistent with principles of sound fish and wildlife management. Based on the associated...-acre Refuge was officially established on July 11, 1974, following approval of a general management plan for the Refuge by the Service and the Navy. Refuge purposes include preservation and management of...

78 FR 48048 - Student Assistance General Provisions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-07

... DEPARTMENT OF EDUCATION 34 CFR Part 668 RIN 1880-AA87 Student Assistance General Provisions AGENCY: Office of Hearings & Appeals, Office of Management, Department of Education. ACTION: Final regulations... participation in the student financial assistance programs authorized under Title IV of the Higher Education Act...

EPA Region 10 Climate Change and TMDL Pilot – South Fork Nooksack River, Washington Final Report

EPA Science Inventory

This final report provides an overarching summary of the pilot research project, including the methods used in and the findings of the quantitative and qualitative assessments. It is written to appeal to a wide audience of policy makers, managers, agency staff and the general pub...

Leadership and management for quality.

PubMed

Gillam, Steve; Siriwardena, A Niroshan

2013-01-01

This is the third in a series of articles about the science of quality improvement. Leadership and management are required for change and are therefore important for all quality improvement initiatives. We describe the differences between and features of each, and how they support change in individuals, groups and organisations according to the culture and characteristics of the latter. Finally, we see that leadership competencies are conceptualised in the NHS Leadership Framework and how this can be applied to quality improvement in general practice and healthcare more generally.

Radioactive Wastes.

PubMed

Choudri, B S; Charabi, Yassine; Baawain, Mahad; Ahmed, Mushtaque

2017-10-01

Papers reviewed herein present a general overview of radioactive waste related activities around the world in 2016. The current reveiw include studies related to safety assessments, decommission and decontamination of nuclear facilities, fusion facilities, transportation. Further, the review highlights on management solutions for the final disposal of low and high level radioactive wastes (LLW and HLW), interim storage and final disposal options for spent fuel (SF), and tritiated wastes, with a focus on environmental impacts due to the mobility of radionuclides in ecosystem, water and soil alongwith other progress made in the management of radioactive wastes.

Fault management for data systems

NASA Technical Reports Server (NTRS)

Boyd, Mark A.; Iverson, David L.; Patterson-Hine, F. Ann

1993-01-01

Issues related to automating the process of fault management (fault diagnosis and response) for data management systems are considered. Substantial benefits are to be gained by successful automation of this process, particularly for large, complex systems. The use of graph-based models to develop a computer assisted fault management system is advocated. The general problem is described and the motivation behind choosing graph-based models over other approaches for developing fault diagnosis computer programs is outlined. Some existing work in the area of graph-based fault diagnosis is reviewed, and a new fault management method which was developed from existing methods is offered. Our method is applied to an automatic telescope system intended as a prototype for future lunar telescope programs. Finally, an application of our method to general data management systems is described.

Final Department of Defense - State Memorandum of Agreement (DSMOA)

EPA Pesticide Factsheets

This page contains the final version of the model Department of Defense - State Memorandum of Agreement (DSMOA), developed by the Association of State and Territorial Solid Waste Management Officials (ASTSWMO) and the Department of Defense (DoD) with assistance from representatives of the National Association of Attorneys General (NAAG) and the National Governors' Association (NGA).

41 CFR 101-6.205-3 - Elementary and secondary schools.

Code of Federal Regulations, 2010 CFR

2010-07-01

... final order of a court of the United States for the desegregation of such school or school system, and... order of a court of the United States for the desegregation of such school or school system is entered... Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 6-MISCELLANEOUS REGULATIONS 6.2...

48 CFR 1842.7201 - General.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Management Reports, the NASA form 533 series, is required on cost-type, price redetermination, and fixed... implemented in the contract based on the estimated final contract value at the time of award. [62 FR 14017...

Joint Operations 2030 - Final Report (Operations interarmees 2030 - Rapport final)

DTIC Science & Technology

2011-04-01

case of crisis : • Technologies to support emergency management operations, inter-organisational coordination and communication , distributed...are made up of national representatives as well as generally recognised ‘world class’ scientists. They also provide a communication link to military...Other Entities H.4 Capable of Establishing and Maintaining Communication Channels and Liaison Relationships H-7 with Potential Service Providers

76 FR 42727 - Notice of Availability of a Record of Decision on the Final Environmental Impact Statement for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... of Decision for the Final Environmental Impact Statement for the General Management Plan (FEIS/GMP... Alternative contained in the FEIS/GMP issued on September 19, 2008. The following course of action will occur... events. This alternative has been modified from the Alternative B presented in the FEIS/GMP as discussed...

43 CFR 2522.1 - General acts authorizing extensions of time.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES... of time for the submission of final proof by a desert-land claimant. Said Acts are the following... making desert-land proofs were authorized by the Acts of June 16, 1933 (48 Stat. 274; 43 U.S.C. 256a...

43 CFR 2522.1 - General acts authorizing extensions of time.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES... of time for the submission of final proof by a desert-land claimant. Said Acts are the following... making desert-land proofs were authorized by the Acts of June 16, 1933 (48 Stat. 274; 43 U.S.C. 256a...

43 CFR 2522.1 - General acts authorizing extensions of time.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES... of time for the submission of final proof by a desert-land claimant. Said Acts are the following... making desert-land proofs were authorized by the Acts of June 16, 1933 (48 Stat. 274; 43 U.S.C. 256a...

43 CFR 2522.1 - General acts authorizing extensions of time.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES... of time for the submission of final proof by a desert-land claimant. Said Acts are the following... making desert-land proofs were authorized by the Acts of June 16, 1933 (48 Stat. 274; 43 U.S.C. 256a...

78 FR 3028 - Final Environmental Impact Statement for General Management Plan, Blue Ridge Parkway, Virginia...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-15

... (GMP) for Blue Ridge Parkway (parkway). Consistent with NPS laws, regulations, and policies and the purpose of the parkway, the FEIS/GMP will guide the management of the parkway over the next 20+ years... the Environmental Protection Agency of its Notice of Availability of the FEIS/GMP in the Federal...

75 FR 76984 - Notice Regarding National Pollutant Discharge Elimination System (NPDES); General Permit for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-10

... certification pursuant to section 401 of the Clean Water Act (CWA) from Hawaii and a final response on the... Robin Danesi at EPA Headquarters, Office of Water, Office of Wastewater Management, Mail Code 4203M... Headquarters, Office of Water, Office of Wastewater Management, Mail Code 4203M, 1200 Pennsylvania Ave., NW...

Self-management support by final year nursing students: A correlational study of performance and person-related associated factors.

PubMed

Duprez, Veerle; Beeckman, Dimitri; Verhaeghe, Sofie; Van Hecke, Ann

2017-09-01

Chronic conditions put a heavy burden on healthcare in every country. Supporting persons with a chronic illness to take an active role in the management of their condition is a core component in the Chronic Care Model. It implies confidence and good skills from professionals. To date, there is no evidence on final year nursing students' performance in supporting patients' self-management, nor on factors associated with this performance. To explore self-reported performance of supporting patients' self-management by final year nursing students, and person-related factors associated with this performance. A correlational multi-centre study of final year nursing students (N=256) from eight nursing schools. Students were recruited from a convenience sample of eight nursing schools. All final year students were invited to participate. Data were collected between January 2015 and May 2016 using self-administered validated questionnaires. Theoretical behavioural frameworks were used to select hypothesized associated factors for self-management support: self-efficacy to perform self-management support and socio-structural factors (Social Cognitive Theory); needs for autonomy, competence and relatedness, and patient-invested contingent self-esteem (Self-Determination Theory); and attitudes towards supporting patients' self-management (Theory of Planned Behaviour). Final year nursing students (N=256) reported an overall low level of performance in delivering self-management support during internship. Students lacked mainly competencies in collaborative goal setting and shared decision making. Students reported a significant gap between their confidence and their actual performance in self-management support (p<0.001). About 33% of the variance in students' performance is predicted by four person-related factors, i.e. self-efficacy to perform self-management support, general feeling of competency on internship, belief on patients' knowledge about condition management, and contingency of a student's professional self-esteem upon patients' achievements. Final year nursing students are actually not ready to support patients' self-management even though they will soon be in practice as qualified nurses. Nursing curricula should be further attuned to the complex competencies of self-management support. Special attention is needed to broaden the perspective on self-management support. Learning opportunities can be introduced in classroom activities and on internship. Copyright © 2017 Elsevier Ltd. All rights reserved.

Final Independent External Peer Review Report, Cache la Poudre at Greeley, Colorado General Investigation Feasibility Study

DTIC Science & Technology

2014-06-06

Adaptive Management Plan NED national economic development NEPA National Environmental Policy Act NER National Ecosystem Restoration NFIP... management and flow maintenance (e.g., flood water height, channel and culvert sizing) are based on high water events (i.e., FEMA base flood – 1% or 100...Minimum 15 years of experience in economics X Minimum 15 years of experience in flood risk management analysis and benefits calculations X Direct

An Assessment of the Factors in Office Automation Systems Affecting Air Force Middle Managers and Clerical Workers in the Information Management Career Field

DTIC Science & Technology

1990-12-01

Implementation..........14 Advantages of OA ............... 20 Social Impact of CA. ........... Effect of OA on Users ............. 25 Conclusion...discussed include social impacts , specific Air Force studies, job skills, supervision, and changes in employment. 10 Chapter III contains the... social impact of OA on managers and clerical workers. The final area examined effects of OA on users in their environments. General Review Review of

An Analysis of the Balance of Management, Technical and Leadership Progression through the Three USAF Officer Tiers

DTIC Science & Technology

2007-03-01

schools of thought on the relationship between management and leadership traits among successful CEO’s, Generals, politicians, entrepreneurs, etc… First...al. 2005:6). Finally, there is a school of thought that management and leadership are two distinct entities, but extremely successful people happen...doesn’t mean they can play basketball and a person having basketball skills doesn’t make them tall. However, the NBA is predominantly filled with

Project PEGS! Practices in Effective Guidance Strategies: Interactive CD-ROM Series for Educators To Practice Positive Behavior Management Skills, October 1, 1999-December 30, 2002. Final Performance Report.

ERIC Educational Resources Information Center

Quirk, Constance A.

This final report describes the activities and outcomes of a federally funded project designed to produce and field-test two computer-based interactive CD-ROMs: "PEGS! for Preschool" and "PEGS! for Secondary School". These programs, in a game format, provide beginning general and special educators with independent practice in…

Air traffic control by distributed management in a MLS environment

NASA Technical Reports Server (NTRS)

Kreifeldt, J. G.; Parkin, L.; Hart, S.

1977-01-01

The microwave landing system (MLS) is a technically feasible means for increasing runway capacity since it could support curved approaches to a short final. The shorter the final segment of the approach, the wider the variety of speed mixes possible so that theoretically, capacity would ultimately be limited by runway occupance time only. An experiment contrasted air traffic control in a MLS environment under a centralized form of management and under distributed management which was supported by a traffic situation display in each of the 3 piloted simulators. Objective flight data, verbal communication and subjective responses were recorded on 18 trial runs lasting about 20 minutes each. The results were in general agreement with previous distributed management research. In particular, distributed management permitted a smaller spread of intercrossing times and both pilots and controllers perceived distributed management as the more 'ideal' system in this task. It is concluded from this and previous research that distributed management offers a viable alternative to centralized management with definite potential for dealing with dense traffic in a safe, orderly and expeditious manner.

A Survey of Knowledge Management Research & Development at NASA Ames Research Center

NASA Technical Reports Server (NTRS)

Keller, Richard M.; Clancy, Daniel (Technical Monitor)

2002-01-01

This chapter catalogs knowledge management research and development activities at NASA Ames Research Center as of April 2002. A general categorization scheme for knowledge management systems is first introduced. This categorization scheme divides knowledge management capabilities into five broad categories: knowledge capture, knowledge preservation, knowledge augmentation, knowledge dissemination, and knowledge infrastructure. Each of nearly 30 knowledge management systems developed at Ames is then classified according to this system. Finally, a capsule description of each system is presented along with information on deployment status, funding sources, contact information, and both published and internet-based references.

Mulch evaluation and managing vegetation in medians : final report.

DOT National Transportation Integrated Search

1980-01-01

Experiments show best erosion control and vegetation with straw mulch, all wood or paper fiber mulches being suitable tacking agents at rates of 750 lb/A. When used alone, standard woodfiber generally gave better vegetative cover than paperfiber; how...

Combating information overload: a six-month pilot evaluation of a knowledge management system in general practice.

PubMed Central

O'Brien, C; Cambouropoulos, P

2000-01-01

A six-month prospective study was conducted on the usefulness and usability of a representative electronic knowledge management tool, the WAX Active Library, for 19 general practitioners (GPs) evaluated using questionnaires and audit trail data. The number of pages accessed was highest in the final two months, when over half of the access trails were completed within 40 seconds. Most GPs rated the system as easy to learn, fast to use, and preferable to paper for providing information during consultations. Such tools could provide a medium for the activities of knowledge officers, help demand management, and promote sharing of information within primary care groups and across NHSnet or the Internet. PMID:10962792

76 FR 81359 - National Security Personnel System

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-28

... contains regulatory documents #0;having general applicability and legal effect, most of which are keyed #0... Security Personnel System AGENCY: Department of Defense; Office of Personnel Management. ACTION: Final rule... concerning the National Security Personnel System (NSPS). Section 1113 of the National Defense Authorization...

Surgical Practical Skills Learning Curriculum: Implementation and Interns' Confidence Perceptions.

PubMed

Acosta, Danilo; Castillo-Angeles, Manuel; Garces-Descovich, Alejandro; Watkins, Ammara A; Gupta, Alok; Critchlow, Jonathan F; Kent, Tara S

To provide an overview of the practical skills learning curriculum and assess its effects over time on the surgical interns' perceptions of their technical skills, patient management, administrative tasks, and knowledge. An 84-hour practical skills curriculum composed of didactic, simulation, and practical sessions was implemented during the 2015 to 2016 academic year for general surgery interns. Totally, 40% of the sessions were held during orientation, whereas the remainder sessions were held throughout the academic year. Interns' perceptions of their technical skills, administrative tasks, patient management, and knowledge were assessed by the practical skills curriculum residents' perception survey at various time points during their intern year (baseline, midpoint, and final). Interns were also asked to fill out an evaluation survey at the completion of each session to obtain feedback on the curriculum. General Surgery Residency program at a tertiary care academic institution. 20 General Surgery categorical and preliminary interns. Significant differences were found over time in interns' perceptions on their technical skills, patient management, administrative tasks, and knowledge (p < 0.001 for all). The results were also statistically significant when accounting for a prior boot camp course in medical school, intern status (categorical or preliminary), and gender (p < 0.05 for all). Differences in interns' perceptions occurred both from baseline to midpoint, and from midpoint to final time point evaluations (p < 0.001 for all). Prior surgical boot camp in medical school status, intern status (categorical vs. preliminary), and gender did not differ in the interns' baseline perceptions of their technical skills, patient management, administrative tasks, and knowledge (p > 0.05 for all). Implementation of a Practical Skills Curriculum in surgical internships can improve interns' confidence perception on their technical skills, patient management skills, administrative tasks, and knowledge. Copyright © 2018. Published by Elsevier Inc.

The Dilemma of Decline.

ERIC Educational Resources Information Center

Abramowitz, Susan

This paper, one of two related documents, examines the impact of declining enrollments on educational expenditures. It highlights population and social changes that have contributed to the decline and discusses the general financing of schools. Finally, the paper discusses strategies state policymakers can use to manage decline, including…

Mississippi Department of Transportation Research Division peer exchange II final report : September 24-26, 2002.

DOT National Transportation Integrated Search

2009-01-01

A peer exchange can discuss general research management, or the agency can focus on certain parts of the research process. MDOT chose to focus on four themes: 1) Current Research Organization, 2) Identifying improvements That Streamline the Research ...

Potable Water Treatment Facility General Permit (PWTF GP) ...

EPA Pesticide Factsheets

2017-08-28

The Final PWTF GP establishes permit eligibility conditions, Notice of Intent (NOI) requirements, effluent limitations, standards, prohibitions, and best management practices for facilities that discharge to waters in the Commonwealth of Massachusetts (including both Commonwealth and Indian country lands) and the State of New Hampshire.

Final Oahe Dam/Lake Oahe Master Plan Missouri River, South Dakota and North Dakota

DTIC Science & Technology

2010-09-01

STUDY Recreation Management Opportunities, Inc. "Market Analysis & Feasibility of Recreation & Tourism Development of the Missouri River Basin in...Missouri River between Sioux City, Iowa and the mouth near St. Louis. One of Lake Oahe’s primary water management functions is to provide the extra...slopes tend to flatten toward the stream’s mouth . Generally, the right-bank tributaries have comparatively narrow valleys and are entrenched roughly 100

5 CFR 890.107 - Court review.

Code of Federal Regulations, 2010 CFR

2010-01-01

... EMPLOYEES HEALTH BENEFITS PROGRAM Administration and General Provisions § 890.107 Court review. (a) A suit... against the Office of Personnel Management. (c) Federal Employees Health Benefits (FEHB) carriers resolve... judicial review of OPM's final action on the denial of a health benefits claim. A legal action to review...

76 FR 58330 - Shipping Coordinating Committee; Notice of Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-20

... for 2013 --Any other business --Report to the Maritime Safety Committee Finally, an open meeting will... agenda --Report of the Secretary-General on credentials --Strategy and planning --Organizational reforms --Resource management --Results-based budget for 2012-2013 --Consideration of the report of the Marine...

Hazardous Waste Management System - General - Identification and Listing of Hazardous Waste - Used Oil - Federal Register Notice, May 20, 1992

EPA Pesticide Factsheets

EPA is today promulgating a final listing decision for used oils based upon the technical criteria provided in the Resource Conservation and Recovery Act (RCRA) sections 1004 and 3001 and in 40 CFR 261.11 (a)(1) and (a)(3).

GENERAL CH4 OXIDATION MODEL AND COMPARISONS OF CH4 OXIDATION IN NATURAL AND MANAGED SYSTEMS. (R824993)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Evaluation of techniques for ocular measurement as an index of fatigue and as the basis for alertness management

DOT National Transportation Integrated Search

1998-04-01

This final report establishes the scientific validity of the ocular measure "Perclose" as a generally useful and reliable index of lapses in visual attention, i.e. the percentage of eyelid closure over the pupil. Perclose was previously specified as ...

Army Strategic Plan for Civilian Personnel Management Research: A Roadmap for the Future.

DTIC Science & Technology

1986-10-01

Development Center. Ronen , Simcha , and Primps, Sophia (1980). "The impact of flextime on performance and attitudes in 25 public agencies," Pul" Personnel...net savings. Finally, Ronen and Primps (1980) survey of 25 public agencies showed that flex- time generally improved productivity through better

41 CFR 60-40.2 - Information available on request.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Information available on... OF LABOR 40-EXAMINATION AND COPYING OF OFCCP DOCUMENTS General § 60-40.2 Information available on..., pending or approved. (3) Text of final conciliation agreements. (4) Validation studies of tests or other...

History of Physicists in Industry. Final Report

ERIC Educational Resources Information Center

Anderson, R. Joseph; Butler, Orville R.

2008-01-01

This project is the first systematic study of the organizational structure, communications patterns, and archival records of industrial physicists in the U.S., and it provides general guidelines for understanding and documenting their work. The study confirms that the organization and management of industrial R&D is volatile, changing in response…

Data management and language enhancement for generalized set theory computer language for operation of large relational databases

NASA Technical Reports Server (NTRS)

Finley, Gail T.

1988-01-01

This report covers the study of the relational database implementation in the NASCAD computer program system. The existing system is used primarily for computer aided design. Attention is also directed to a hidden-surface algorithm for final drawing output.

The Management of Patients With Diverticulosis and Diverticular Disease in Primary Care: An Online Survey Among Italian General Pratictioners.

PubMed

De Bastiani, Rudi; Sanna, Guido; Fracasso, Pierluigi; D'Urso, Maurizio; Benedetto, Edoardo; Tursi, Antonio

2016-10-01

To investigate the current opinion of Italian general practitioners (GPs) on the management of patients with diverticular disease (DD) of the colon. The management of DD remains a point of debate, and guidelines are not uniform in their advice. A web-based survey was conducted among Italian GPs. Twelve questions were aimed at the diagnosis, treatment, and management options for diverticulosis and symptomatic DD. In total, 245 surveys were filled out. A high-fiber diet was prescribed widely in diverticulosis (44%), together with advice to allow seeds (30%). Rifaximin (26%) and probiotics (25%) were the most frequently prescribed drugs in this population. Colonoscopy was the most prescribed instrumental tool in the diagnosis (77%) and follow-up (21%) of symptomatic uncomplicated diverticular disease patients. Rifaximin, probiotics, and mesalazine were the most frequently prescribed drugs in symptomatic uncomplicated diverticular disease patients (82.8, 59.5%, and 36.3%, respectively). Finally, 77% of the Italian GPs prescribed laboratory exams in the follow-up of these patients. The vast majority of the Italian GPs (83%) managed suspected acute diverticulitis at home, and did not consider two episodes of acute diverticulitis as a strict surgical indication (86%). Rifaximin, probiotics, and mesalazine were the most frequently prescribed drugs to prevent recurrence of the disease (42.5%, 28.2%, and 12.4%, respectively). Finally, 87% of the Italian GPs prescribed laboratory examinations in the follow-up of these patients. This survey shows that the current management of DD in primary care by Italian GPs is not fully in line with current guidelines and more recent literature data.

A new framework for assessing hospital crisis management based on resilience engineering approach.

PubMed

Shirali, Gh A; Azadian, Sh; Saki, A

2016-06-14

In recent years, an increasing number of natural and man-made disasters have exposed many people and properties to various disasters. This has resulted in approximately 75,000 deaths worldwide every year due to disasters. Crisis management is becoming increasingly important to cope effectively with the magnitude and potential damage resulting from disasters. Hospitals, as the final point in the rescue chain, have a key role in the crisis management and need to be resilient against disasters. The purpose of this paper is to present a new framework for assessing the crisis management based on resilience principles in hospital infrastructure of a developing country. A questionnaire was developed and completed by 310 staff (nurses and managers) of eight hospitals in Iran. The findings indicate that the eight hospitals included in the study have moderate conditions in general, while hospitals X3, X4, and X7 have poor conditions in the crisis management. Consequently, it seems that the crisis management system was not resilient in all these hospitals in general. Using resilience engineering in assessing crisis management can improve and develop the ability of the hospitals' management to cope with any type of disaster.

Visibility and coping with minority stress: a gender-specific analysis among lesbians, gay men, and bisexuals in Flanders.

PubMed

Dewaele, Alexis; Van Houtte, Mieke; Vincke, John

2014-11-01

The role of visibility management strategies, as an extended measure of outness related to sexual orientation, has been rarely studied with the aim of explaining the experience of external stressors (i.e., experiences of everyday discrimination and perceived sanctioning of cross-gender behavior) and internal stressors (i.e., internalized homonegativity and general mental distress). In this study, we examined gender differences within these relationships. A non-representative sample of 2,378 lesbians, gay men, and bisexuals was recruited. We found that lesbian and bisexual women scored significantly higher on perceived cross-gender sanctioning and general mental distress compared to gay and bisexual men. Multivariate analysis showed that visibility management was significantly related to the experience of internalized homonegativity in both men and women. Visibility management mediated the relationship between experiences of every day discrimination on the one hand and internalized homonegativity and general mental distress on the other. Finally, we found that compared to gay and bisexual men, lesbian and bisexual women who maintained relatively closed visibility management strategies, reported lower scores on internalized homonegativity but higher scores on general mental distress. We found fewer gender differences related to visibility management than expected and those that we did find were relatively small. Flemish lesbian and bisexual women and gay and bisexual men appear to more alike than different.

Sex offender polygraph examination: an evidence-based case management tool for social workers.

PubMed

Levenson, Jill S

2009-10-01

This article will review the use of polygraphy in the assessment and treatment of sexual perpetrators. Such information can be utilized by social workers who are involved in the treatment and case management of child sexual abuse cases. First, the controversial literature regarding the validity and reliability of polygraph examination in general will be reviewed. Next, an emerging body of evidence supporting the utility of polygraph testing with sex offenders will be discussed. Finally, ways that social workers can incorporate this knowledge into their case management and clinical roles will be offered.

Final Environmental Assessment for Implementation of Proposed Actions in the Moody Air Force Base Integrated Natural Resources Management Plan (INRMP)

DTIC Science & Technology

2015-09-01

e.g., white-tailed deer, eastern wild turkey, small game) and game fish , and generally consists of activities related to consumptive uses of these...Grassy Pond Lake for eagles, including the control of invasive aquatic species and periodic restocking of forage fish . The overall effect of this...management concerns obtained from cooperating agencies· (i.e., the U.S. Fish and Wildlife Service and Georgia Deparbnent of Natural Resources), the military

75 FR 19939 - Magnuson-Stevens Act Provisions; General Provisions for Domestic Fisheries; Application for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... consistent with the goals and objectives of the Monkfish Fishery Management Plan (FMP). However, further review and consultation may be necessary before a final determination is made to issue an EFP. The EFP would allow commercial fishing vessels to conduct research and compensation fishing operations that are...

Library Information System Time-Sharing (LISTS) Project. Final Report.

ERIC Educational Resources Information Center

Black, Donald V.

The Library Information System Time-Sharing (LISTS) experiment was based on three innovations in data processing technology: (1) the advent of computer time-sharing on third-generation machines, (2) the development of general-purpose file-management software and (3) the introduction of large, library-oriented data bases. The main body of the…

78 FR 15738 - Notice of Availability of Final General Management Plan/Environmental Impact Statement for Effigy...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-12

... Planning, Environment, and Public Comment Web site at http://www.parkplanning.nps.gov/indu.efmo . FOR... resources, and museum collections), to natural resources (soils, wild and scenic rivers, vegetation, fish..., to the socioeconomic environment, and to EFMO operations and facilities. The preferred alternative in...

Final Environmental Assessment, Assured Aerospace Fuels Research Facility, Wright-Patterson Air Force Base, Ohio

DTIC Science & Technology

2008-09-01

Fish and Wildlife Services Amir Mott Program Manager 88 ABW/CECW Zachary Olds WPAFB Air and Water Program Technician 88 ABW/CEV Warren Richardson...Building 22 Wright Patterson AFB, OH 45433-5209 Dear Mr. Baker: BOARD OF DIRECTORS William E. Lukens Gayle B. Price, Jr. Thomas B. Rentschler GENERAL

Rehabilitation of Executive Functions in a Real-Life Setting: Goal Management Training Applied to a Person with Schizophrenia

PubMed Central

Levaux, M.-N.; Larøi, F.; Malmedier, M.; Offerlin-Meyer, I.; Danion, J.-M.; Van der Linden, M.

2012-01-01

The aim was to assess the efficacy of a modified version of Goal Management Training (GMT) in a person with schizophrenia who had difficulties in attaining the final goal for new and multitasking daily-life situations. GMT is designed to improve abilities in establishing goal-directed plans and carrying them out effectively. Beneficial effects of GMT were measured for several clinical questionnaires, laboratory tasks, and three real-life situations: meal preparation (trained, familiar); washing (nontrained, familiar); meeting preparation (nontrained, unfamiliar). The results revealed improvement in planning and on trained laboratory and meal preparation tasks and a generalization of GMT effects on nontrained laboratory and everyday tasks. Self-esteem also improved. Finally, a two-year followup indicated the durability of the beneficial effects. PMID:23094177

Controversies in perioperative anesthetic management of the morbidly obese: I am a surgeon, why should I care?

PubMed

Sinha, Ashish C; Singh, Preet Mohinder

2015-05-01

Over the last four decades, as the rates of obesity have increased, so have the challenges associated with its anesthetic management. In the present review, we discuss perioperative anesthesia management issues that are modifiable by the early involvement of the surgical team. We sum up available evidence or expert opinion on issues like patient positioning, postoperative analgesia, and the effect of continuous positive airway pressure (CPAP) ventilation on surgical anastomosis. We also address established predictors of higher perioperative risk and suggest possible management strategies and concerns of obese patients undergoing same day procedures. Finally, a generalized pharmacological model relevant to altered pharmacokinetics in these patients is presented.

Short communication: survey of fresh cow management practices of dairy cattle on small and large commercial farms.

PubMed

Heuwieser, W; Iwersen, M; Gossellin, J; Drillich, M

2010-03-01

The objective was to conduct a survey of current fresh cow management practices that have an effect on health and diseases postpartum considering different herd sizes of commercial dairy farms. A mail survey regarding aspects of the fresh cow program including general management issues, calving, diseases, and veterinary service was conducted utilizing a convenience sample. A total of 429 survey forms were returned (12.0% response rate) and could be used for final analysis. Only 21.6% of the farms had a designated fresh cow pen. Almost every farm executed some type of fresh cow examination. Only 18.5% of farm managers documented the observations. Most of the dairy managers used more or less subjective criteria such as general appearance (97.0%) and appetite (69.7%). Only a minority of the responding dairy managers monitored their fresh cows using objective (fever 33.6%) or semiquantitative measures (subclinical ketosis 2.8%; body condition score 36.4%). On most farms, the veterinarian visited the herd only if needed (72.6%). Most cases of retained fetal membranes were treated by manual removal (72.3%) and antibiotic pills (89.5%). Several challenges and opportunities were identified to improve cow management practices.

The Use of Management Games for Developing Army Officers in Administrative and Staff Jobs. [Final Report.

ERIC Educational Resources Information Center

Olmstead, Joseph A.; Elder, B. Leon

A research project was undertaken to provide a foundation for future research on the efficacy of games and simulations for use in training and assessing junior company-grade officers working in administrative, nontactical support, and staff jobs. Based on survey interviews with nineteen incumbents of Finance, Adjutant General, and Quartermaster…

Guide on Data Models in the Selection and Use of Database Management Systems. Final Report.

ERIC Educational Resources Information Center

Gallagher, Leonard J.; Draper, Jesse M.

A tutorial introduction to data models in general is provided, with particular emphasis on the relational and network models defined by the two proposed ANSI (American National Standards Institute) database language standards. Examples based on the network and relational models include specific syntax and semantics, while examples from the other…

75 FR 9345 - Michigan: Final Authorization of State Hazardous Waste Management Program Revision

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

....9109(q) ``Water 6/21/1994, Word ``which'' (bulk shipment)''. renumbered as changed to ``that.'' (jj... authority it is using, HSWA or non-HSWA, in each rulemaking. That explanation is generally found in the... requirement initiated Description of change modification MAC R 299.9101(a) 10/15/1996....... Words ``is able...

75 FR 11002 - Hazardous Waste Management System; Identification and Listing of Hazardous Waste; Final Rule

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-10

... effect in the State. A dual system (that is, both Federal (RCRA) and State (non-RCRA) programs) may... does not have federalism implications. It will not have substantial direct effects on the States, on... Act of 1996, generally provides that before a rule may take effect, the agency promulgating the rule...

Diagnosis and management of deep venous thrombosis and pulmonary embolism in neonates and children.

PubMed

Monagle, Paul

2012-10-01

Neonates and children represent a specific population that can suffer from deep venous thrombosis (DVT) and pulmonary embolism (PE). In considering how the diagnosis and management of DVT/PE in neonates and children differs from adults, one has to consider the fundamental differences in the general characteristics of the patient population, the specific differences in the disease entity, the differences in sensitivity or specificity of diagnostic strategies and risk/benefit profile of therapeutic options available, and then finally the practical applications of therapies, using an evidence-based approach. This review will articulate the key differences in the patient population, disease entity, diagnostic strategies, and drug therapies that must be understood to apply a rigorous evidence-based approach to diagnosis and management of DVT and PE in neonates and children. Finally, there will be a brief discussion of the latest American College of Chest Physician guidelines for antithrombotic treatment in neonates and children. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

IWRM Policy in Colombia, drawbacks and strategies towards integration

NASA Astrophysics Data System (ADS)

Cardona, C. A.

2016-12-01

Since the establishment of the Integrated Water Resource Management National Policy in Colombia in 2010- IWRMNP, several initiatives has been developed in order to understand and manage water within the integration perspective. However, the Colombian institutional and legal frameworks do not favor the implementation of integrated management exercises, and many efforts have been fruitless in recent years. Additionally, there is an avalanche of techniques and available technologies to develop integrated models, analysis or assessments, which frequently are interpreted as the same tool. An analysis of the Colombian context in regulatory terms and institutions involved is carried out, as a prelude to address the topic of analysis modeling and integrated management. Moreover, in Colombian legislation there exists policies regarding integrated soil management, integrated biodiversity management, as well as several current international trends such as integrated landscape planning, integrated urban areas management etc. Therefore, and in light of the initial analysis, a discussion of redundancy or complementarity of such management it is carried out. Finally, a strategy is proposed for decision makers of local and regional level, trying to overcome technical gaps left by national policy and regulations. This is done from a discussion of the various anthropic damages to water resources systems. Also a classification of integrated models is proposed and a general approach to systems integrated resource management to finally present a state- management matrix methodology applicable to different cases and management requirements. The results of its implementation in a small basin is presented.

The Greening Role of Tour Operators

NASA Astrophysics Data System (ADS)

Lozano, Javier; Arbulú, Italo; Rey-Maquieira, Javier

2016-01-01

This paper shows that the tour operators (TOs) can play a coordinating role in the adoption of environmental management upstream the tourism supply chain. This is done using a dynamic model to analyze the environmental management adoption by hotels in a tourism destination induced by a TO. The TO can create incentives to greening hotels' management through the sharing of an environmental price premium. We show that the extent of green management adoption depends on interest rate, the willingness to pay for environmental quality, and hotels' organizational inertia. We also show how the financial yields from green management are shared between TOs and hotels. Finally, we consider a destination manager that subsidizes hotels' green management. If the destination manager does not take the greening role of TOs into account, she could mistake the true trade-off that she faces between the destination's economic and environmental outcomes for the win-win setting that characterizes the general problem.

The Greening Role of Tour Operators.

PubMed

Lozano, Javier; Arbulú, Italo; Rey-Maquieira, Javier

2016-01-01

This paper shows that the tour operators (TOs) can play a coordinating role in the adoption of environmental management upstream the tourism supply chain. This is done using a dynamic model to analyze the environmental management adoption by hotels in a tourism destination induced by a TO. The TO can create incentives to greening hotels' management through the sharing of an environmental price premium. We show that the extent of green management adoption depends on interest rate, the willingness to pay for environmental quality, and hotels' organizational inertia. We also show how the financial yields from green management are shared between TOs and hotels. Finally, we consider a destination manager that subsidizes hotels' green management. If the destination manager does not take the greening role of TOs into account, she could mistake the true trade-off that she faces between the destination's economic and environmental outcomes for the win-win setting that characterizes the general problem.

The M68HC11 gripper controller software. Thesis

NASA Technical Reports Server (NTRS)

Tsai, Jodi Wei-Duk

1991-01-01

This thesis discusses the development of firmware for the 68HC11 gripper controller. A general description of the software and hardware interfaces is given. The C library interface for the gripper is then described and followed by a detailed discussion of the software architecture of the firmware. A procedure to assemble and download 68HC11 programs is presented in the form of a tutorial. The tools used to implement this environment are then described. Finally, the implementation of the configuration management scheme used to manage all CIRSSE software is presented.

[The German Program for Disease Management Guidelines: COPD Guideline 2006. Short review].

PubMed

Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika

2007-01-15

In Germany, the first national consensus on evidence-based recommendations for COPD prevention and disease management was reached in spring 2006. After a development period of 9 months, the National Disease Management Guideline COPD was finalized by nominal group process under the authorship of the scientific societies for pneumology (DGP and Atemwegsliga), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the NICE COPD Guideline 2004, the GOLD Recommendations as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline COPD 2006 (www.copd.versorgungsleitlinien.de).

Quantifying risk and accuracy in cancer risk assessment: the process and its role in risk management problem-solving.

PubMed

Turturro, A; Hart, R W

1987-01-01

A better understanding of chemical-induced cancer has led to appreciation of similarities to problems addressed by risk management of radiation-induced toxicity. Techniques developed for cancer risk assessment of toxic substances can be generalized to toxic agents. A recent problem-solving approach for risk management of toxic substances developed for the U.S. Department of Health and Human Services, and the role of risk assessment and how uncertainty should be treated within the context of this approach, is discussed. Finally, two different methods, research into the assumptions underlying risk assessment and the modification of risk assessment/risk management documents, are used to illustrate how the technique can be applied.

78 FR 38359 - Notice of Availability of a Record of Decision on the Final General Management Plan/Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... alternative, a large portion of the Monument would be zoned as backcountry, a virtual research center would be created to collect and share information on mound research and preservation, and access to the South Unit..., and other laws and policies that apply to lands within the Monument. The NPS also carefully considered...

Timing and Planning for Hardwood Regeneration in the Coastal Plains

Treesearch

Robert L. Johnson

1971-01-01

Foresters generally do a good job of managing hardwood overstories; they upgrade the stand by deadening or cutting decadent and undesirable trees. But eventually they have to cut the overstory,and if they wait until after final harvesting to plan for reproduction, it is too late. Where the overstory has been removed and reproduction is unacceptable, as it is on many...

75 FR 19422 - Availability of a Final Environmental Impact Statement for the General Management Plan (FEIS/GMP...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-14

..., use, and development options for the historic site by the NPS for the next 15 to 20 years. It... no major changes in direction. Alternative B emphasizes the natural environment by keeping the site... emphasis on the natural environment outside of the core historic and visitor areas. Alternative D is the...

A New Clinical Pain Knowledge Test for Nurses: Development and Psychometric Evaluation.

PubMed

Bernhofer, Esther I; St Marie, Barbara; Bena, James F

2017-08-01

All nurses care for patients with pain, and pain management knowledge and attitude surveys for nurses have been around since 1987. However, no validated knowledge test exists to measure postlicensure clinicians' knowledge of the core competencies of pain management in current complex patient populations. To develop and test the psychometric properties of an instrument designed to measure pain management knowledge of postlicensure nurses. Psychometric instrument validation. Four large Midwestern U.S. hospitals. Registered nurses employed full time and part time August 2015 to April 2016, aged M = 43.25 years; time as RN, M = 16.13 years. Prospective survey design using e-mail to invite nurses to take an electronic multiple choice pain knowledge test. Content validity of initial 36-item test "very good" (95.1% agreement). Completed tests that met analysis criteria, N = 747. Mean initial test score, 69.4% correct (range 27.8-97.2). After revision/removal of 13 unacceptable questions, mean test score was 50.4% correct (range 8.7-82.6). Initial test item percent difficulty range was 15.2%-98.1%; discrimination values range, 0.03-0.50; final test item percent difficulty range, 17.6%-91.1%, discrimination values range, -0.04 to 1.04. Split-half reliability final test was 0.66. A high decision consistency reliability was identified, with test cut-score of 75%. The final 23-item Clinical Pain Knowledge Test has acceptable discrimination, difficulty, decision consistency, reliability, and validity in the general clinical inpatient nurse population. This instrument will be useful in assessing pain management knowledge of clinical nurses to determine gaps in education, evaluate knowledge after pain management education, and measure research outcomes. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Patient safety in external beam radiotherapy, results of the ACCIRAD project: Recommendations for radiotherapy institutions and national authorities on assessing risks and analysing adverse error-events and near misses.

PubMed

Malicki, Julian; Bly, Ritva; Bulot, Mireille; Godet, Jean-Luc; Jahnen, Andreas; Krengli, Marco; Maingon, Philippe; Prieto Martin, Carlos; Skrobala, Agnieszka; Valero, Marc; Jarvinen, Hannu

2018-05-02

The ACCIRAD project, commissioned by the European Commission (EC) to develop guidelines for risk analysis of accidental and unintended exposures in external beam radiotherapy (EBRT), was completed in the year 2014. In 2015, the "General guidelines on risk management in external beam radiotherapy" were published as EC report Radiation Protection (RP)-181. The present document is the third and final report of the findings from the ACCIRAD project. The main aim of this paper is to describe the key features of the risk management process and to provide general guidelines for radiotherapy departments and national authorities on risk assessment and analysis of adverse error-events and near misses. The recommendations provided here and in EC report RP-181 are aimed at promoting the harmonisation of risk management systems across Europe, improving patient safety, and enabling more reliable inter-country comparisons. Copyright © 2018 Elsevier B.V. All rights reserved.

Municipal solid waste management in Malaysia: practices and challenges.

PubMed

Manaf, Latifah Abd; Samah, Mohd Armi Abu; Zukki, Nur Ilyana Mohd

2009-11-01

Rapid economic development and population growth, inadequate infrastructure and expertise, and land scarcity make the management of municipal solid waste become one of Malaysia's most critical environmental issues. The study is aimed at evaluating the generation, characteristics, and management of solid waste in Malaysia based on published information. In general, the per capita generation rate is about 0.5-0.8 kg/person/day in which domestic waste is the primary source. Currently, solid waste is managed by the Ministry of Housing and Local Government, with the participation of the private sector. A new institutional and legislation framework has been structured with the objectives to establish a holistic, integrated, and cost-effective solid waste management system, with an emphasis on environmental protection and public health. Therefore, the hierarchy of solid waste management has given the highest priority to source reduction through 3R, intermediate treatment and final disposal.

Financial Analysis of National University Hospitals in Korea.

PubMed

Lee, Munjae

2015-10-01

This paper provides information for decision making of the managers and the staff of national university hospitals. In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry.

Financial Analysis of National University Hospitals in Korea

PubMed Central

Lee, Munjae

2015-01-01

Objectives This paper provides information for decision making of the managers and the staff of national university hospitals. Methods In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. Results The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. Conclusion These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry. PMID:26730356

[The German Program for Disease Management Guidelines: CHD Guideline 2006. Short review].

PubMed

Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

2006-12-15

In Germany, the first national consensus on evidence-based recommendations for disease management in patients with chronic coronary heart disease was reached in summer 2006. After a development period of 4 years, the National Disease Management Guideline Chronic Coronary Heart Disease was finalized by nominal group process under the authorship of the scientific associations for cardiac rehabilitation (DGPR), cardiac surgery (DGTHG), cardiology (DGK), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the ACC/AHA guidelines 2002 updates as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Chronic Coronary Heart Disease 2006 (www.khk.versorgungsleitlinie.de).

Return on Investment Analysis for the Almond Board of California

DTIC Science & Technology

2004-06-01

general approach for the analysis is first to identify relevant factors concerning consumer behavior using exploratory factor analysis (EFA) and...That completed the intermediate stage of the conceptual model below, referring to the latent drivers of consumer behavior that affect the almond... consumer behavior remains a challenge that will have to be continuously addressed by the ABC management. Finally, to improve the methodology for

Developing the Potential of Low Ability Personnel. Final Report for Period 15 June 1974 to 15 June 1975.

ERIC Educational Resources Information Center

Jealous, Fred S.; And Others

The project was an empirical exploration to determine the scope of the learning capacity of marginal Army personnel (those with low scores on Army general ability and aptitude tests), to observe the longitudinal effects of long term, self-managed learning strategies, and to determine the proficiency levels that these men could reach as a result of…

Acute generalized, widespread bleeding. Diagnosis and management.

PubMed

Rocha, E; Páramo, J A; Montes, R; Panizo, C

1998-11-01

Acute generalized, widespread bleeding is often related to disseminated intravascular coagulation (DIC), a pathologic process which complicates the clinical course of many diseases and is characterized by huge amounts of thrombin and plasmin within the circulation. The final result is the consumption of platelets, coagulation factors and inhibitors, as well as secondary hyperfibrinolysis, all leading to diffuse hemorrhage and microthromboses. This review article examines the present attitudes to the diagnosis and treatment of overt DIC in clinical practice, emphasizing the importance of an accurate differential diagnosis from some other processes characterized by acute generalized, widespread bleeding. The authors have been working in this field, both at experimental and clinical levels, contributing original papers for many years. In addition, material examined in this review includes articles published in journals covered by MedLine, recent reviews in journals with high impact factor and in relevant books on hemostasis and thrombosis. DIC is an intermediary mechanism of disease which complicates the clinical course of many well-known disorders. Although the systemic hemorrhagic syndrome is the predominant clinical manifestation, massive intravascular thrombosis frequently occurs contributing to ischemia and associated organ damage, making the mortality rate of this condition high. Current concepts on the pathophysiology, laboratory diagnosis and management of DIC are presented. Complex pathophysiological interrelations make the diagnosis of the etiology of the DIC difficult in clinical practice, although simple tests are useful for identification of patients with the process. Laboratory diagnosis of DIC is mainly based on screening assays, which allow a rapid diagnosis, whereas some other highly sensitive but more complex assays are not always available to routine clinical laboratories. The management of DIC is based on the treatment of the underlying disease, supportive and replacement therapies and the control of the coagulation mechanisms. Although some advances have been achieved, management decisions are still controversial, so that therapy should be highly individualized depending on the nature of the DIC and severity of clinical symptoms. Many syndromes sharing common findings with DIC, such as primary hyperfibrinolysis or thrombotic thrombocytopenic purpura, should be excluded. Finally, new therapeutic approaches to the management of this potentially catastrophic syndrome are required.

A General Water Resources Regulation Software System in China

NASA Astrophysics Data System (ADS)

LEI, X.

2017-12-01

To avoid iterative development of core modules in water resource normal regulation and emergency regulation and improve the capability of maintenance and optimization upgrading of regulation models and business logics, a general water resources regulation software framework was developed based on the collection and analysis of common demands for water resources regulation and emergency management. It can provide a customizable, secondary developed and extensible software framework for the three-level platform "MWR-Basin-Province". Meanwhile, this general software system can realize business collaboration and information sharing of water resources regulation schemes among the three-level platforms, so as to improve the decision-making ability of national water resources regulation. There are four main modules involved in the general software system: 1) A complete set of general water resources regulation modules allows secondary developer to custom-develop water resources regulation decision-making systems; 2) A complete set of model base and model computing software released in the form of Cloud services; 3) A complete set of tools to build the concept map and model system of basin water resources regulation, as well as a model management system to calibrate and configure model parameters; 4) A database which satisfies business functions and functional requirements of general water resources regulation software can finally provide technical support for building basin or regional water resources regulation models.

Barriers to community case management of malaria in Saraya, Senegal: training, and supply-chains.

PubMed

Blanas, Demetri A; Ndiaye, Youssoupha; Nichols, Kim; Jensen, Andrew; Siddiqui, Ammar; Hennig, Nils

2013-03-14

Health workers in sub-Saharan Africa can now diagnose and treat malaria in the field, using rapid diagnostic tests and artemisinin-based combination therapy in areas without microscopy and widespread resistance to previously effective drugs. This study evaluates communities' perceptions of a new community case management of malaria programme in the district of Saraya, south-eastern Senegal, the effectiveness of lay health worker trainings, and the availability of rapid diagnostic tests and artemisinin-based combination therapy in the field. The study employed qualitative and quantitative methods including focus groups with villagers, and pre- and post-training questionnaires with lay health workers. Communities approved of the community case management programme, but expressed concern about other general barriers to care, particularly transportation challenges. Most lay health workers acquired important skills, but a sizeable minority did not understand the rapid diagnostic test algorithm and were not able to correctly prescribe arteminisin-based combination therapy soon after the training. Further, few women lay health workers participated in the programme. Finally, the study identified stock-outs of rapid tests and anti-malaria medication products in over half of the programme sites two months after the start of the programme, thought due to a regional shortage. This study identified barriers to implementation of the community case management of malaria programme in Saraya that include lay health worker training, low numbers of women participants, and generalized stock-outs. These barriers warrant investigation into possible solutions of relevance to community case management generally.

Financial management challenges for general hospital psychiatry 2001.

PubMed

Goldberg, R J

2001-01-01

Psychiatry programs are facing significant business and financial challenges. This paper provides an overview of these management challenges in five areas: departmental, hospital, payment system, general finance, and policy. Psychiatric leaders will require skills in a variety of business management areas to ensure their program success. Many programs will need to develop new compensation models with more of an emphasis on revenue collection and overhead management. Programs which cannot master these areas are likely to go out of business. For academic programs, incentive systems must address not only clinical productivity, but academic and teaching output as well. General hospital programs will need to develop increased sophistication in differential cost accounting in order to be able to advocate for their patients and program in the current management climate. Clinical leaders will need the skills (ranging from actuarial to negotiations) to be at the table with contract development, since those decisions are inseparable from clinical care issues. Strategic planning needs to consider the value of improving integration with primary care, along with the ability to understand the advantages and disadvantages of risk-sharing models. Psychiatry leaders need to define and develop useful reports shared with clinical division leadership to track progress and identify problems and opportunities. Leaders should be responsible for a strategy for developing appropriate information system architecture and infrastructure. Finally, it is hoped that some leaders will emerge who can further our needs to address inequities in mental health fee schedules and parity issues which affect our program viability.

Ulcerative colitis outpatient management: development and evaluation of tools to support primary care practitioners.

PubMed

Bennett, A L; Buckton, S; Lawrance, I; Leong, R W; Moore, G; Andrews, J M

2015-12-01

Current models of care for ulcerative colitis (UC) across healthcare systems are inconsistent with a paucity of existing guidelines or supportive tools for outpatient management. This study aimed to produce and evaluate evidence-based outpatient management tools for UC to guide primary care practitioners and patients in clinical decision-making. Three tools were developed after identifying current gaps in the provision of healthcare services for patients with UC at a Clinical Insights Meeting in 2013. Draft designs were further refined through consultation and consolidation of feedback by the steering committee. Final drafts were developed following feasibility testing in three key stakeholder groups (gastroenterologists, general practitioners and patients) by questionnaire. The tools were officially launched into mainstream use in Australia in 2014. Three quarters of all respondents liked the layout and content of each tool. Minimal safety concerns were aired and those, along with pieces of information that were felt to be omitted, that were reviewed by the steering committee and incorporated into the final documents. The majority (over 80%) of respondents felt that the tools would be useful and would improve outpatient management of UC. Evidence-based outpatient clinical management tools for UC can be developed. The concept and end-product have been well received by all stakeholder groups. These tools should support non-specialist clinicians to optimise UC management and empower patients by facilitating them to safely self-manage and identify when medical support is needed. © 2015 Royal Australasian College of Physicians.

A 3-year prospective study on ocular injuries with tennis or cricket ball while playing cricket: A case series.

PubMed

Mahapatra, Santosh Kumar; Malhotra, Kundan; Mendke, Rohit Ganapatrao

2018-02-01

The purpose of this study is to study the clinical features, visual outcome, management, and ocular complications of ocular injury, following trauma with tennis or cricket ball. A prospective, noncomparative case study of patients having injury with tennis/cricket ball while playing cricket was conducted between January 2013 and April 2016. Seventy-six eyes of 76 patients were studied. Presenting vision, age, gender, time since injury, general and ocular examination, intraocular pressure, indirect ophthalmoscopy, B scan, and X-ray/computed tomography scan findings were noted. Patients were managed medically or surgically as per the need and followed up at least for 6 months. Seventy-six eyes of 76 patients were studied. All cases were male, except two. Majority (80.2%) were <25 years. Median presenting visual acuity (VA) was 6/36 and median final VA was 6/18. Significant findings in the decreasing order of frequency were sphincter tear (26.3%), retinal detachment (23.6%), angle recession (18.4%), choroidal rupture (17.1%), and Berlin's edema (15.7%). Most of the cases (69.7%) were managed medically. Only 30.2% cases needed surgical intervention. Final visual outcome in our study was depended on initial VA (P = 0.000). It was also correlating with presenting clinical feature (P = 0.010) and type of intervention (medical/surgical) (P = 0.001). Cricket-related ocular injury generally has a poor prognosis with most cases being closed globe injury; retinal detachment is the most common vision-threatening presentation. In spite of being a common event, cricket-related injury is sparingly documented and hence needs further studies for proper documentation, prognostication, and formulation of definitive management plan.

Beyond feedback control: the interactive use of performance management systems. Implications for process innovation in Italian healthcare organizations.

PubMed

Demartini, Chiara; Mella, Piero

2014-01-01

This paper shows how the use of performance management systems affects managers' perception of satisfaction, the effectiveness of the control system and the performance related to process innovation. An exploratory empirical research has been conducted on 85 managers operating in Italian healthcare organizations. Empirical findings put forward that the interactive--as opposed to diagnostic--use of performance management systems enhances managerial satisfaction with the control system and managerial perception of effectiveness. The present study then showed that it is not the control itself that is an obstacle to innovation in organizations in general (and in health organizations in particular) but the diagnostic use of the control mechanisms, which impedes the interaction between the control personnel and those subject to the control. Finally, this paper addresses managerial implications and further research avenues. Copyright © 2013 John Wiley & Sons, Ltd.

Infrastructure support for a waste management institute. Final project report, September 12, 1994--September 11, 1997

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

NONE

1997-11-01

North Carolina A and T State University has completed the development of an infrastructure for the interdisciplinary Waste Management Institute (WMI). The Interdisciplinary Waste Management Institute (WMI) was approved in June, 1994 by the General Administration of the University of North Carolina as an academic support unit with research and public service functions. The mission of the WMI is to enhance awareness and understanding of waste management issues and to provide instructional support including research and outreach. The goals of WMI are as follows: increase the number of minority professionals who will work in waste management fields; develop cooperative andmore » exchange programs involving faculty, students, government, and industry; serve as institutional sponsor of public awareness workshops and lecture series; and support interdisciplinary research programs. The vision of the WMI is to provide continued state-of-the art environmental educational programs, research, and outreach.« less

The Effectiveness of Group Training of CBT-Based Stress Management on Anxiety, Psychological Hardiness and General Self-Efficacy Among University Students.

PubMed

Molla Jafar, Hamdam; Salabifard, Seddigheh; Mousavi, Seyedeh Maryam; Sobhani, Zahra

2015-09-28

Admission to university is a very sensitive period of life for efficient, active, and young workforces in any country, and it is mostly associated with many changes in social and human relationships. These changes lead to anxiety in students. Moreover, humans need certain functions in order to adaptively deal with different life situations and challenges. By training stress management, these functions can help human acquire the required abilities. The present study was aimed at investigating the effectiveness of stress management training in anxiety, psychological hardiness, and general self-efficacy among university students. The study was a quasi-experimental intervention (pretest-posttest-follow-up) including a control group, it was a fundamental applied study. The statistical population consisted of all students of Islamic Azad University, Karaj, Iran. Convenient sampling was employed to select 30 students who were divided into an experimental group (n=15) and a control group (n=15). Before stress management training, both groups filled out Beck Anxiety Inventory, Long and Goulet scale of psychological hardiness, and General Self-efficacy Scale (GSE-10). Afterwards, the experimental group was provided with stress management training. And after the experiment, the abovementioned questionnaires and scales were responded by the two groups. Finally the collected data were analyzed and compared using one-way MANOVA. The results of MANOVA indicated that there was a significant difference between the two groups in terms of anxiety, hardiness, and general self-efficacy (p<0.001). According to the results of the present study and those of previous investigations that are in agreement with those of the present study, it can be concluded that stress management among university students cause anxiety to drop; moreover, it enhances their psychological hardiness and self-efficacy. In regard with the role and importance of stress management, training this skill should be included in educational plans of university.

The Effectiveness of Group Training of CBT-Based Stress Management on Anxiety, Psychological Hardiness and General Self-Efficacy among University Students

PubMed Central

Jafar, Hamdam Molla; Salabifard, Seddigheh; Mousavi, Seyedeh Maryam; Sobhani, Zahra

2016-01-01

Background: Admission to university is a very sensitive period of life for efficient, active, and young workforces in any country, and it is mostly associated with many changes in social and human relationships. These changes lead to anxiety in students. Moreover, humans need certain functions in order to adaptively deal with different life situations and challenges. By training stress management, these functions can help human acquire the required abilities. Objective: The present study was aimed at investigating the effectiveness of stress management training in anxiety, psychological hardiness, and general self-efficacy among university students. Method: The study was a quasi-experimental intervention (pretest-posttest-follow-up) including a control group, it was a fundamental applied study. The statistical population consisted of all students of Islamic Azad University, Karaj, Iran. Convenient sampling was employed to select 30 students who were divided into an experimental group (n=15) and a control group (n=15). Before stress management training, both groups filled out Beck Anxiety Inventory, Long and Goulet scale of psychological hardiness, and General Self-efficacy Scale (GSE-10). Afterwards, the experimental group was provided with stress management training. And after the experiment, the abovementioned questionnaires and scales were responded by the two groups. Finally the collected data were analyzed and compared using one-way MANOVA. Results: The results of MANOVA indicated that there was a significant difference between the two groups in terms of anxiety, hardiness, and general self-efficacy (p<0.001). Conclusion: According to the results of the present study and those of previous investigations that are in agreement with those of the present study, it can be concluded that stress management among university students cause anxiety to drop; moreover, it enhances their psychological hardiness and self-efficacy. In regard with the role and importance of stress management, training this skill should be included in educational plans of university. PMID:26755483

Investigation of the conditions affecting the joining of Hungarian hospitals to an accreditation programme: a cross-sectional study

PubMed Central

Margitai, Barnabás; Dózsa, Csaba; Bárdos-Csenteri, Orsolya Karola; Sándor, János; Gáll, Tibor; Gődény, Sándor

2018-01-01

Objective Quantitative studies have shown the various benefits for having accreditation in hospitals. However, neither of these explored the general conditions before applying for an accreditation. To close this gap, this study aimed to investigate the possible association between joining an accreditation programme with various hospital characteristics. Design A cross-sectional study was implemented using the databases of the 2013 Hungarian hospital survey and of the Hungarian State Treasury. Setting Public general hospitals in Hungary. Participants The analysis involved 44 public general hospitals, 14 of which joined the preparatory project for a newly developed accreditation programme. Main outcome measures The outcomes included the percentage of compliance in quality management, patient information and identification, internal professional regulation, safe surgery, pressure sore prevention, infection control, the opinions of the heads of quality management regarding the usefulness of quality management and clinical audits, and finally, the total debt of the hospital per bed and per discharged patient. Results According to our findings, the general hospitals joining the preparatory project of the accreditation programme performed better in four of the six investigated activities, the head of quality management had a better opinion on the usefulness of quality management, and both the debt per bed number and the debt per discharged patient were lower than those who did not join. However, no statistically significant differences between the two groups were found in any of the examined outcomes. Conclusions The findings suggest that hospitals applying for an accreditation programme do not differ significantly in characteristics from those which did not apply. This means that if in the future the accredited hospitals become better than other hospitals, then the improvement could be solely contributed to the accreditation. PMID:29391381

Taxonomy Working Group Final Report

NASA Technical Reports Server (NTRS)

Parsons, Vickie S.; Beil, Robert J.; Terrone, Mark; Barth, Timothy S.; Panontin, Tina L.; Wales, Roxana; Rackley, Michael W.; Milne, James S.; McPherson, John W.; Dutra, Jayne E.;

Depiction of Trends in Administrative Healthcare Data from Hospital Information System.

PubMed

Kalankesh, Leila R; Pourasghar, Faramarz; Jafarabadi, Mohammad Asghari; Khanehdan, Negar

2015-06-01

administrative healthcare data are among main components of hospital information system. Such data can be analyzed and deployed for a variety of purposes. The principal aim of this research was to depict trends of administrative healthcare data from HIS in a general hospital from March 2011 to March 2014. data set used for this research was extracted from the SQL database of the hospital information system in Razi general hospital located in Marand. The data were saved as CSV (Comma Separated Values) in order to facilitate data cleaning and analysis. The variables of data set included patient's age, gender, final diagnosis, final diagnosis code based on ICD-10 classification system, date of hospitalization, date of discharge, LOS(Length of Stay), ward, and survival status of the patient. Data were analyzed and visualized after applying appropriate cleansing and preparing techniques. morbidity showed a constant trend over three years. Pregnancy, childbirth and the puerperium were the leading category of final diagnosis (about 32.8 %). The diseases of the circulatory system were the second class accounting for 13 percent of the hospitalization cases. The diseases of the digestive system had the third rank (10%). Patients aged between 14 and 44 constituted a higher proportion of total cases. Diseases of the circulatory system was the most common class of diseases among elderly patients (age≥65). The highest rate of mortality was observed among patients with final diagnosis of the circulatory system diseases followed by those with diseases of the respiratory system, and neoplasms. Mortality rate for the ICU and the CCU patients were 62% and 33% respectively. The longest average of LOS (7.3 days) was observed among patients hospitalized in the ICU while patients in the Obstetrics and Gynecology ward had the shortest average of LOS (2.4 days). Multiple regression analysis revealed that LOS was correlated with variables of surgery, gender, and type of payment, ward, the class of final diagnosis and age. this study presents trends in administrative health care data residing in hospital information system of a general public hospital. Patterns in morbidity, mortality and length of stay can inform decision making in health care management. Mining trends in administrative healthcare data can add value to the health care management.

Management of radioactive material safety programs at medical facilities. Final report

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

Camper, L.W.; Schlueter, J.; Woods, S.

A Task Force, comprising eight US Nuclear Regulatory Commission and two Agreement State program staff members, developed the guidance contained in this report. This report describes a systematic approach for effectively managing radiation safety programs at medical facilities. This is accomplished by defining and emphasizing the roles of an institution`s executive management, radiation safety committee, and radiation safety officer. Various aspects of program management are discussed and guidance is offered on selecting the radiation safety officer, determining adequate resources for the program, using such contractual services as consultants and service companies, conducting audits, and establishing the roles of authorized usersmore » and supervised individuals; NRC`s reporting and notification requirements are discussed, and a general description is given of how NRC`s licensing, inspection and enforcement programs work.« less

Treatment outcomes in 4 modes of orthodontic practice.

PubMed

Poulton, Donald; Vlaskalic, Vicki; Baumrind, Sheldon

2005-03-01

This study is a continuation of a previously published report on the outcome of orthodontic treatment provided in offices representing different modes of practice. The sample consisted of duplicate pretreatment (T1) and posttreatment (T2) dental casts of 348 patients from traditional private orthodontic practices (5 offices, 134 patients), company-owned practices (5 offices, 107 patients), offices associated with practice-management organizations (2 offices, 60 patients), and general dental practices (2 offices, 47 patients). Methods were used to obtain random, representative samples from each office, starting with lists of patients who were treated consecutively with full fixed orthodontic appliances. The dental casts were measured by 2 independent judges who used the unweighted PAR score. Good interjudge agreement was shown on the initial casts, but the agreement was not as strong on the final casts. The measurements showed that treatment outcomes were generally satisfactory, although some significant differences between offices and management modes were shown.

76 FR 58492 - Agency Information Collection Activities; Proposed Collection; Comment Request; Final...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-21

... Activities; Proposed Collection; Comment Request; Final Authorization for Hazardous Waste Management Programs... Request (ICR) concerning final authorization for State Hazardous Waste Management Programs. This ICR is... potentially affected by this action are States. Title: Final Authorization for Hazardous Waste Management...

76 FR 33342 - Final Supplementary Rules for Public Lands Managed by the California Desert District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [L12200000.NO0000.LLCAD00000] Final Supplementary Rules for Public Lands Managed by the California Desert District AGENCY: Bureau of Land Management... Land Management (BLM), CDD office and the five field offices within the CDD, are issuing Final...

Life cycle management of analytical methods.

PubMed

Parr, Maria Kristina; Schmidt, Alexander H

2018-01-05

In modern process management, the life cycle concept gains more and more importance. It focusses on the total costs of the process from invest to operation and finally retirement. Also for analytical procedures an increasing interest for this concept exists in the recent years. The life cycle of an analytical method consists of design, development, validation (including instrumental qualification, continuous method performance verification and method transfer) and finally retirement of the method. It appears, that also regulatory bodies have increased their awareness on life cycle management for analytical methods. Thus, the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH), as well as the United States Pharmacopeial Forum discuss the enrollment of new guidelines that include life cycle management of analytical methods. The US Pharmacopeia (USP) Validation and Verification expert panel already proposed a new General Chapter 〈1220〉 "The Analytical Procedure Lifecycle" for integration into USP. Furthermore, also in the non-regulated environment a growing interest on life cycle management is seen. Quality-by-design based method development results in increased method robustness. Thereby a decreased effort is needed for method performance verification, and post-approval changes as well as minimized risk of method related out-of-specification results. This strongly contributes to reduced costs of the method during its life cycle. Copyright © 2017 Elsevier B.V. All rights reserved.

A Method for Making Cross-Comparable Estimates of the Benefits of Decision Support Technologies for Air Traffic Management

NASA Technical Reports Server (NTRS)

Lee, David; Long, Dou; Etheridge, Mel; Plugge, Joana; Johnson, Jesse; Kostiuk, Peter

1998-01-01

We present a general method for making cross comparable estimates of the benefits of NASA-developed decision support technologies for air traffic management, and we apply a specific implementation of the method to estimate benefits of three decision support tools (DSTs) under development in NASA's advanced Air Transportation Technologies Program: Active Final Approach Spacing Tool (A-FAST), Expedite Departure Path (EDP), and Conflict Probe and Trial Planning Tool (CPTP). The report also reviews data about the present operation of the national airspace system (NAS) to identify opportunities for DST's to reduce delays and inefficiencies.

The Spanish General Radioactive Waste Management Plan

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

Espejo, J.M.; Abreu, A.

This paper mainly describes the strategies, the necessary actions and the technical solutions to be developed by ENRESA in the short, medium and long term, aimed at ensuring the adequate management of radioactive waste, the dismantling and decommissioning of nuclear and radioactive facilities and other activities, including economic and financial measures required to carry them out. Starting with the Spanish administrative organization in this field, which identifies the different agents involved and their roles, and after referring to the waste generation, the activities to be performed in the areas of LILW, SF and HLW management, decommissioning of installations and othersmore » are summarized. Finally, the future management costs are estimated and the financing system currently in force is explained. The so-called Sixth General Radioactive Waste Plan (6. GRWP), approved by the Spanish Government, is the 'master document' of reference where all the above mentioned issues are contemplated. In summary: The 6. GRWP includes the strategies and actions to be performed by Enresa in the coming years. The document, revised by the Government and subject to a process of public information, underlines the fact that Spain possesses an excellent infrastructure for the safe and efficient management of radioactive waste, from the administrative, technical and economic-financial points of view. From the administrative point of view there is an organisation, supported by ample legislative developments, that contemplates and governs the main responsibilities of the parties involved in the process (Government, CSN, ENRESA and waste producers). As regards the technical aspect, the experience accumulated to date by Enresa is particularly significant, as are the technologies now available in the field of management and for dismantling processes. As regards the economic-financial basis, a system is in place that guarantees the financing of radioactive waste management costs. This system is based on the generation of funds up front, during the operating lifetime of the facilities, through the application of fees established by Statutory provisions. Finally, a mandatory mechanism of annual revision for both technical issues and economic and financial aspects, allows to have updated all the courses of action. (authors)« less

[A brief review of research on chronic disease management based on collaborative care model in China].

PubMed

Li, Huayan; Fuller, Jeffrey; Sun, Mei; Wang, Yong; Xu, Shuang; Feng, Hui

2014-11-01

To evaluate the situation for chronic disease management in China, and to seek the method for improving the collaborative management for chronic diseases in community. We searched literature between January 2008 and November 2013 from the Database, such as China Academic Journal Full-Text Database, and PubMed. The screening was strictly in accordance with the inclusion and exclusion criteria and a summary was made among the selected literature based on a collaboration model. We got 698 articles after rough screen and finally selected 33. All studies were involved in patient's self-management support, but only 9 studies mentioned the communication within the team, and 11 showed a clear team division of labor. Chronic disease community management in China displays some disadvantages. It really needs a general service team with clear roles and responsibilities for team members to improve the service ability of team members and provide patients with various forms of self management services.

Performance Management in Healthcare Organizations: Concept and Practicum.

PubMed

Dimitropoulos, Panagiotis E

2017-01-01

Organizational performance can create and sustain competitive advantages for corporations and even improve their sustainability and future prospects. Health care organizations present a sector where performance management is structured by multiple dimensions. The scope of this study is to analyze the issue of performance management in healthcare organizations and specifically the implementation of the Balanced Scorecard (BSC) methodology on organizations providing health services. The study provides a discussion on the BSC development process, the steps that management has to take in order to prepare the implementation of the BSC and finally discusses a practical example of a scorecard with specific strategic goals and performance indicators. Managers of healthcare organizations and specifically those providing services to the elderly and the general population could use the propositions of the study as a roadmap for processing, analyzing, evaluating and implementing the balanced scorecard approach in their organizations' daily operations. BSC methodology can give an advantage in terms of enhanced stakeholder management and preservation within a highly volatile and competitive economic environment.

Dynamic bin packing problem

NASA Technical Reports Server (NTRS)

Dikshit, Piyush; Guimaraes, Katia; Ramamurthy, Maya; Agrawala, Ashok K.; Larsen, Ronald L.

1989-01-01

In a previous work we have defined a general architecture model for autonomous systems, which can be mapped easily to describe the functions of any automated system (SDAG-86-01). In this note, we use the model to describe the problem of thermal management in space stations. First we briefly review the architecture, then we present the environment of our application, and finally we detail the specific function for each functional block of the architecture for that environment.

NRC comprehensive records disposition schedule. Revision 3

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

NONE

1998-02-01

Title 44 US Code, ``Public Printing and Documents,`` regulations issued by the General Service Administration (GSA) in 41 CFR Chapter 101, Subchapter B, ``Management and Use of Information and Records,`` and regulations issued by the National Archives and Records Administration (NARA) in 36 CFR Chapter 12, Subchapter B, ``Records Management,`` require each agency to prepare and issue a comprehensive records disposition schedule that contains the NARA approved records disposition schedules for records unique to the agency and contains the NARA`s General Records Schedules for records common to several or all agencies. The approved records disposition schedules specify the appropriate durationmore » of retention and the final disposition for records created or maintained by the NRC. NUREG-0910, Rev. 3, contains ``NRC`s Comprehensive Records Disposition Schedule,`` and the original authorized approved citation numbers issued by NARA. Rev. 3 incorporates NARA approved changes and additions to the NRC schedules that have been implemented since the last revision dated March, 1992, reflects recent organizational changes implemented at the NRC, and includes the latest version of NARA`s General Records Schedule (dated August 1995).« less

Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report

PubMed Central

Clavien, Pierre-Alain; Lesurtel, Mickael; Bossuyt, Patrick M M; Gores, Gregory J; Langer, Bernard; Perrier, Arnaud

2012-01-01

Although liver transplantation is a widely accepted treatment for hepatocellular carcinoma (HCC), much controversy remains and there is no generally accepted set of guidelines. An international consensus conference was held on Dec 2–4, 2010, in Zurich, Switzerland, with the aim of reviewing current practice regarding liver transplantation in patients with HCC and to develop internationally accepted statements and guidelines. The format of the conference was based on the Danish model. 19 working groups of experts prepared evidence-based reviews according to the Oxford classification, and drafted recommendations answering 19 specific questions. An independent jury of nine members was appointed to review these submissions and make final recommendations, after debates with the experts and audience at the conference. This report presents the final 37 statements and recommendations, covering assessment of candidates for liver transplantation, criteria for listing in cirrhotic and non-cirrhotic patients, role of tumour downstaging, management of patients on the waiting list, role of living donation, and post-transplant management. PMID:22047762

Remembering the Important Things: Semantic Importance in Stream Reasoning

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

Yan, Rui; Greaves, Mark T.; Smith, William P.

Reasoning and querying over data streams rely on the abil- ity to deliver a sequence of stream snapshots to the processing algo- rithms. These snapshots are typically provided using windows as views into streams and associated window management strategies. Generally, the goal of any window management strategy is to preserve the most im- portant data in the current window and preferentially evict the rest, so that the retained data can continue to be exploited. A simple timestamp- based strategy is rst-in-rst-out (FIFO), in which items are replaced in strict order of arrival. All timestamp-based strategies implicitly assume that a temporalmore » ordering reliably re ects importance to the processing task at hand, and thus that window management using timestamps will maximize the ability of the processing algorithms to deliver accurate interpretations of the stream. In this work, we explore a general no- tion of semantic importance that can be used for window management for streams of RDF data using semantically-aware processing algorithms like deduction or semantic query. Semantic importance exploits the infor- mation carried in RDF and surrounding ontologies for ranking window data in terms of its likely contribution to the processing algorithms. We explore the general semantic categories of query contribution, prove- nance, and trustworthiness, as well as the contribution of domain-specic ontologies. We describe how these categories behave using several con- crete examples. Finally, we consider how a stream window management strategy based on semantic importance could improve overall processing performance, especially as available window sizes decrease.« less

Towards Excellence in Asthma Management: final report of an eight-year program aimed at reducing care gaps in asthma management in Quebec.

PubMed

Boulet, Louis-Philippe; Dorval, E; Labrecque, M; Turgeon, M; Montague, T; Thivierge, R L

2008-09-01

Asthma care in Canada and around the world persistently falls short of optimal treatment. To optimize care, a systematic approach to identifying such shortfalls or 'care gaps', in which all stakeholders of the health care system (including patients) are involved, was proposed. Several projects of a multipartner, multidisciplinary disease management program, developed to optimize asthma care in Quebec, was conducted in a period of eight years. First, two population maps were produced to identify regional variations in asthma-related morbidity and to prioritize interventions for improving treatment. Second, current care was evaluated in a physician-patient cohort, confirming the many care gaps in asthma management. Third, two series of peer-reviewed outcome studies, targeting high-risk populations and specific asthma care gaps, were conducted. Finally, a process to integrate the best interventions into the health care system and an agenda for further research on optimal asthma management were proposed. Key observations from these studies included the identification of specific patterns of noncompliance in using inhaled corticosteroids, the failure of increased access to spirometry in asthma education centres to increase the number of education referrals, the transient improvement in educational abilities of nurses involved with an asthma hotline telephone service, and the beneficial effects of practice tools aimed at facilitating the assessment of asthma control and treatment needs by general practitioners. Disease management programs such as Towards Excellence in Asthma Management can provide valuable information on optimal strategies for improving treatment of asthma and other chronic diseases by identifying care gaps, improving guidelines implementation and optimizing care.

76 FR 61756 - Final Guidance on Appointment of Lobbyists to Federal Boards and Commissions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-05

... OFFICE OF MANAGEMENT AND BUDGET Final Guidance on Appointment of Lobbyists to Federal Boards and Commissions AGENCY: Office of Management and Budget. ACTION: Notice of Final Guidance. SUMMARY: The Office of Management and Budget (OMB) is issuing final guidance to Executive Departments and agencies concerning the...

10 CFR 51.90 - Final environmental impact statement-general.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Final environmental impact statement-general. 51.90... Implementing Section 102(2) Final Environmental Impact Statements-General Requirements § 51.90 Final environmental impact statement—general. After receipt and consideration of comments requested pursuant to §§ 51...

Applying Graph Theory to Problems in Air Traffic Management

NASA Technical Reports Server (NTRS)

Farrahi, Amir Hossein; Goldbert, Alan; Bagasol, Leonard Neil; Jung, Jaewoo

2017-01-01

Graph theory is used to investigate three different problems arising in air traffic management. First, using a polynomial reduction from a graph partitioning problem, it is shown that both the airspace sectorization problem and its incremental counterpart, the sector combination problem are NP-hard, in general, under several simple workload models. Second, using a polynomial time reduction from maximum independent set in graphs, it is shown that for any fixed e, the problem of finding a solution to the minimum delay scheduling problem in traffic flow management that is guaranteed to be within n1-e of the optimal, where n is the number of aircraft in the problem instance, is NP-hard. Finally, a problem arising in precision arrival scheduling is formulated and solved using graph reachability. These results demonstrate that graph theory provides a powerful framework for modeling, reasoning about, and devising algorithmic solutions to diverse problems arising in air traffic management.

Applying Graph Theory to Problems in Air Traffic Management

NASA Technical Reports Server (NTRS)

Farrahi, Amir H.; Goldberg, Alan T.; Bagasol, Leonard N.; Jung, Jaewoo

2017-01-01

Graph theory is used to investigate three different problems arising in air traffic management. First, using a polynomial reduction from a graph partitioning problem, it isshown that both the airspace sectorization problem and its incremental counterpart, the sector combination problem are NP-hard, in general, under several simple workload models. Second, using a polynomial time reduction from maximum independent set in graphs, it is shown that for any fixed e, the problem of finding a solution to the minimum delay scheduling problem in traffic flow management that is guaranteed to be within n1-e of the optimal, where n is the number of aircraft in the problem instance, is NP-hard. Finally, a problem arising in precision arrival scheduling is formulated and solved using graph reachability. These results demonstrate that graph theory provides a powerful framework for modeling, reasoning about, and devising algorithmic solutions to diverse problems arising in air traffic management.

(Low-level waste disposal facility siting and site characterization)

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

Mezga, L.J.; Ketelle, R.H.; Pin, F.G.

A US team consisting of representatives of Oak Ridge National Laboratory (ORNL), Savannah River Plant (SRP), Savannah river Laboratory (SRL), and the Department of Energy Office of Defense Waste and Byproducts Management participated in the fourth meeting held under the US/French Radioactive Waste Management Agreement between the US Department of Energy and the Commissariat a l'Energie Atomique. This meeting, held at Agence Nationale pour les Gestion des Dechets Radioactifs' (ANDRA's) Headquarters in Paris, was a detailed, technical topical workshop focusing on Low-Level Waste Disposal Facility Siting and Site Characterization.'' The meeting also included a visit to the Centre de lamore » Manche waste management facility operated by ANDRA to discuss and observe the French approach to low-level waste management. The final day of the meeting was spent at the offices of Societe Generale pour les Techniques Nouvelles (SGN) discussing potential areas of future cooperation and exchange. 20 figs.« less

77 FR 52054 - Notice of Availability of the Proposed Bakersfield Resource Management Plan and Final...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-28

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCAC06000.L16100000.DQ0000.LXSS095B0000] Notice of Availability of the Proposed Bakersfield Resource Management Plan and Final Environmental... prepared the Proposed Resource Management Plan (RMP) and Final Environmental Impact Statement (EIS) for the...

Why are there gaps in our management of those with high cardiovascular risk?

PubMed

Doolan-Noble, Fiona; Tracey, Jocelyn; Mann, Stewart

2012-03-01

Multiple New Zealand and other international studies have identified gaps in the management of those identified at high risk of a future cardiovascular (CV) event. This study sought to explore the views of health professionals about the barriers and facilitators present within the current primary health care system to the optimal management of those at high CV risk. This qualitative study utilised a focus group methodology to examine the barriers and facilitators within primary health care (PHC), and employed a general inductive approach to analyse the text data. The analysis of text data resulted in the emergence of interrelated themes, underpinned by subthemes. The patient, their circumstances and their characteristics and perceptions provided the first key theme and subthemes. The next key theme was primary health care providers, with subthemes of communication and values and beliefs. The general practice was the third theme and included multiple subthemes: implementation planning and pathway development, time and workload and roles and responsibilities. The final main theme was the health system with the subthemes linking to funding and leadership. This study determined the factors that act as barriers and facilitators to the effective management of those at high CV risk within the New Zealand PHC sector. General practice has a pivotal role in preventive health care, but to succeed there needs to be a refocusing of the PHC sector, requiring support from policy makers, District Health Boards and Primary Health Organisations, as well as those working in the sector.

Public transportation in the 1980's: responding to pressures of fiscal austerity. Final report

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

Meyer, M.D.; Hemily, P.B.

A telephone survey of 30 transit general managers was used to determine the general response of transit agencies to fiscal pressures. A more detailed case study of the Greater Bridgeport Transit District provided greater detail on the response process in one agency, especially focussing on the identification and implementation of feasible options. The concept of a transit agency's operational environment was used to identify the key analysis variables that guided the survey and case study. In general, these variables could be classified into two major categories: (1) those relating to the degree of decisionmaking independence of the agency, and (2)more » those relating to the degree to which an agency is capable of responding to financial pressures.« less

[Effects of critical ultrasonic management of Peking Union Medical College Hospital on the etiological diagnosis of patients with acute respiratory failure].

PubMed

Zhao, Hua; Wang, Xiaoting; Liu, Dawei; Zhang, Hongmin; He, Huaiwu; Long, Yun

2015-12-15

To evaluate the diagnostic value and potential therapeutic impact of Peking Union Medical College Hospital critical ultrasonic management (PCUM) in the early management of critically ill patients with acute respiratory failure (ARF). Patients admitted into the ICU of Peking Union Medical College Hospital for ARF were consecutively recruited over a 18-month period. Patients were randomly divided into conventional group and PCUM group (critical care ultrasonic examination was added in addition to conventional examinations). The two groups were compared with respect to time to preliminary diagnosis, time to final diagnosis, diagnostic accuracy, time to treatment response, time to other examination. A total of 187 patients were included in this study. The two groups showed no significant differences in general clinical information or final diagnosis (P > 0.05). The PCUM group had a shorter time to preliminary diagnosis, time to final diagnosis, time to treatment response, time to X-ray/CT examination, and a higher diagnostic accuracy than the conventional group (P < 0.001). PCUM had high sensitivity and specificity for the diagnosis of acute respiratory distress syndrome (ARDS) (sensitivity 92.0%, specificity 98.5%), acute pulmonary edema (sensitivity 94.7%, specificity 96.1%), pulmonary consolidation (sensitivity 85.7%, specificity 98.6%), COPD/asthma (sensitivity 84.2%, specificity 98.7%). The PCUM is seem to be an attractive complementary diagnostic tool and able to contribute to an early therapeutic decision for the patients with ARF.

Life Cycle Management Commands: Wartime Process or Long-Term Solution?

DTIC Science & Technology

2007-03-31

this memorandum. • 1998: The Director of the Army Acquisition Corps (AAC), Lieutenant General (LTG) Paul Kern, testified before Congress about two...the Army finally determined that PVS did not benefit the Army overall. 17 The Director of the Army Acquisition Corps (AAC), LTG Paul Kern, championed...2 and 3 on pages 10 and 11 of the study. 9 LTG Paul J. Kern, Military Deputy to the ASA(ALT), comments made to the Army Acquisition Corps (AAC

Apollo experience report: Very high frequency ranging system

NASA Technical Reports Server (NTRS)

Panter, W. C.; Shores, P. W.

1972-01-01

The history of the Apollo very-high-frequency ranging system development program is presented from the program-planning stage through the final-test and flight-evaluation stages. Block diagrams of the equipment are presented, and a description of the theory of operation is outlined. A sample of the distribution of errors measured in the aircraft-flight test program is included. The report is concluded with guidelines or recommendations for the management of development programs having the same general constraints.

Investigations into Generalization of Constraint-Based Scheduling Theories with Applications to Space Telescope Observation Scheduling

NASA Technical Reports Server (NTRS)

Muscettola, Nicola; Smith, Steven S.

1996-01-01

This final report summarizes research performed under NASA contract NCC 2-531 toward generalization of constraint-based scheduling theories and techniques for application to space telescope observation scheduling problems. Our work into theories and techniques for solution of this class of problems has led to the development of the Heuristic Scheduling Testbed System (HSTS), a software system for integrated planning and scheduling. Within HSTS, planning and scheduling are treated as two complementary aspects of the more general process of constructing a feasible set of behaviors of a target system. We have validated the HSTS approach by applying it to the generation of observation schedules for the Hubble Space Telescope. This report summarizes the HSTS framework and its application to the Hubble Space Telescope domain. First, the HSTS software architecture is described, indicating (1) how the structure and dynamics of a system is modeled in HSTS, (2) how schedules are represented at multiple levels of abstraction, and (3) the problem solving machinery that is provided. Next, the specific scheduler developed within this software architecture for detailed management of Hubble Space Telescope operations is presented. Finally, experimental performance results are given that confirm the utility and practicality of the approach.

75 FR 4451 - Financial Management Service; Proposed Collection of Information: Final Rule-Management of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Final Rule--Management of Federal Agency Disbursements. AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial Management...

78 FR 52954 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 52953 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 29763 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-21

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 45938 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-30

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 20337 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 43905 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-22

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 48882 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-12

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 14576 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 5820 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-28

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 32678 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-31

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 14318 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-05

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 9406 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-08

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 43904 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-22

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 36216 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 64521 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 36220 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 32679 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-31

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 36219 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 29761 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-21

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final notice... and FIS report are the basis of the floodplain management measures that a community is required either...

78 FR 14316 - Final Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-05

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0002] Final Flood Hazard Determinations AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final Notice... and FIS report are the basis of the floodplain management measures that a community is required either...

Management challenges and markets.

PubMed

Borgonovi, E; Brovetto, P R

1994-01-01

The scarcity of resources in healthcare systems has general causes and country-specific causes. Common to most healthcare systems is a strong emphasis on management and an increased attention to the role of the market. Management and market are concepts which need clarification: management applies not only to individual institutions but to systems of institutions. Market implies not only the pursuit of individual interests but also the assumption of responsibility. The design or redesign of healthcare systems must take into account the level of management skills which each system and its institutions can rely on. Cost patterns in a healthcare system develop around its institutional design. Different factors produce varying levels of costs in different healthcare systems. The same applies to the effort needed to reach a certain degree of effectiveness in output. An outline of strengths and weaknesses of options for the design of healthcare systems is presented in the final part of the article. These should always be considered together with the specific features of each country.

Benefits of an automated GLP final report preparation software solution.

PubMed

Elvebak, Larry E

2011-07-01

The final product of analytical laboratories performing US FDA-regulated (or GLP) method validation and bioanalysis studies is the final report. Although there are commercial-off-the-shelf (COTS) software/instrument systems available to laboratory managers to automate and manage almost every aspect of the instrumental and sample-handling processes of GLP studies, there are few software systems available to fully manage the GLP final report preparation process. This lack of appropriate COTS tools results in the implementation of rather Byzantine and manual processes to cobble together all the information needed to generate a GLP final report. The manual nature of these processes results in the need for several iterative quality control and quality assurance events to ensure data accuracy and report formatting. The industry is in need of a COTS solution that gives laboratory managers and study directors the ability to manage as many portions as possible of the GLP final report writing process and the ability to generate a GLP final report with the click of a button. This article describes the COTS software features needed to give laboratory managers and study directors such a solution.

Obsessive-compulsive disorder in the postpartum period: diagnosis, differential diagnosis and management.

PubMed

Sharma, Verinder; Sommerdyk, Christina

2015-07-01

Childbirth can trigger or exacerbate a variety of psychiatric disorders but the extant literature has focused primarily on mood disorders. Obsessive-compulsive disorder (OCD) after childbirth can occur alone or in combination with other psychiatric disorders such as major depressive disorder. Due to the general lack of awareness of the relationship between childbirth and OCD among clinicians as well as patients, the disorder may be underdiagnosed or misdiagnosed as major depressive disorder. This article describes the prevalence, clinical features, common psychiatric comorbidities, differential diagnosis and potential consequences of underdiagnosis or misdiagnosis. Using case vignettes strategies for its detection and clinical management are suggested. Finally, areas in need of further research are proposed.

A tool to measure whether business management capacity in general practice impacts on the quality of chronic illness care.

PubMed

Holton, Christine H; Proudfoot, Judith G; Jayasinghe, Upali W; Grimm, Jane; Bubner, Tanya K; Winstanley, Julie; Harris, Mark F; Beilby, Justin J

2010-11-01

Our aim was to develop a tool to identify specific features of the business and financial management of practices that facilitate better quality care for chronic illness in primary care. Domains of management were identified, resulting in the development of a structured interview tool that was administered in 97 primary care practices in Australia. Interview items were screened and subjected to factor analysis, subscales identified and the overall model fit determined. The instrument's validity was assessed against another measure of quality of care. Analysis provided a four-factor solution containing 21 items, which explained 42.5% of the variance in the total scores. The factors related to administrative processes, human resources, marketing analysis and business development. All scores increased significantly with practice size. The business development subscale and total score were higher for rural practices. There was a significant correlation between the business development subscale and quality of care. The indicators of business and financial management in the final tool appear to be useful predictors of the quality of care. The instrument may help inform policy regarding the structure of general practice and implementation of a systems approach to chronic illness care. It can provide information to practices about areas for further development.

5 CFR 470.311 - Final project approval.

Code of Federal Regulations, 2010 CFR

2010-01-01

... MANAGEMENT RESEARCH PROGRAMS AND DEMONSTRATIONS PROJECTS Regulatory Requirements Pertaining to Demonstration Projects § 470.311 Final project approval. (a) The Office of Personnel Management will consider all timely...) The Office of Personnel Management shall provide a copy of the final version of the project plan to...

General Characteristics and Treatment Possibilities of
Dairy Wastewater – A Review

PubMed Central

2017-01-01

Summary The milk processing industry is one of the world’s staple industries, thus the treatment possibilities of dairy effluents have been attracting more and more attention. The purpose of the paper is to review contemporary research on dairy wastewater. The origin, categories, as well as liquid by-products and general indicators of real dairy wastewater are described. Different procedures applied for dairy wastewater management are summarised. Attention is focused on in-factory treatment technologies with the emphasis on biological processes. Aerobic and anaerobic methods with both their advantages and disadvantages are discussed in detail. Consecutive anaerobic and aerobic systems are analysed, too. Finally, future research niches are identified. PMID:28559730

Intelligent fault diagnosis and failure management of flight control actuation systems

NASA Technical Reports Server (NTRS)

Bonnice, William F.; Baker, Walter

1988-01-01

The real-time fault diagnosis and failure management (FDFM) of current operational and experimental dual tandem aircraft flight control system actuators was investigated. Dual tandem actuators were studied because of the active FDFM capability required to manage the redundancy of these actuators. The FDFM methods used on current dual tandem actuators were determined by examining six specific actuators. The FDFM capability on these six actuators was also evaluated. One approach for improving the FDFM capability on dual tandem actuators may be through the application of artificial intelligence (AI) technology. Existing AI approaches and applications of FDFM were examined and evaluated. Based on the general survey of AI FDFM approaches, the potential role of AI technology for real-time actuator FDFM was determined. Finally, FDFM and maintainability improvements for dual tandem actuators were recommended.

5 CFR 470.311 - Final project approval.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 470.311 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL... Projects § 470.311 Final project approval. (a) The Office of Personnel Management will consider all timely...) The Office of Personnel Management shall provide a copy of the final version of the project plan to...

The Erasmus programme for postgraduate education in orthodontics in Europe: an update of the guidelines.

PubMed

Huggare, J; Derringer, K A; Eliades, T; Filleul, M P; Kiliaridis, S; Kuijpers-Jagtman, A; Martina, R; Pirttiniemi, P; Ruf, S; Schwestka-Polly, R

2014-06-01

In 1989, the ERASMUS Bureau of the European Cultural Foundation of the Commission of the European Communities funded the development of a new 3-year curriculum for postgraduate education in orthodontics. The new curriculum was created by directors for orthodontic education representing 15 European countries. The curriculum entitled 'Three years Postgraduate Programme in Orthodontics: the Final Report of the Erasmus Project' was published 1992. In 2012, the 'Network of Erasmus Based European Orthodontic Programmes' developed and approved an updated version of the guidelines. The core programme consists of eight sections: general biological and medical subjects; basic orthodontic subjects; general orthodontic subjects; orthodontic techniques; interdisciplinary subjects; management of health and safety; practice management, administration, and ethics; extramural educational activities. The programme goals and objectives are described and the competencies to be reached are outlined. These guidelines may serve as a baseline for programme development and quality assessment for postgraduate programme directors, national associations, and governmental bodies and could assist future residents when selecting a postgraduate programme.

Perception and understanding of invasive alien species issues by nature conservation and horticulture professionals in Belgium.

PubMed

Vanderhoeven, Sonia; Piqueray, Julien; Halford, Mathieu; Nulens, Greet; Vincke, Jan; Mahy, Grégory

2011-03-01

We conducted a survey to determine how two professional sectors in Belgium, horticulture professionals and nature reserve managers (those directly involved in conservation), view the issues associated with invasive plant species. We developed and utilized a questionnaire that addressed the themes of awareness, concept and use of language, availability of information, impacts and, finally, control and available solutions. Using co-inertia analyses, we tested to what extent the perception of invasive alien species (IAS) was dependent upon the perception of Nature in general. Only forty-two percent of respondent horticulture professionals and eighty-two percent of nature reserve managers had a general knowledge of IAS. Many individuals in both target groups nonetheless had an accurate understanding of the scientific issues. Our results therefore suggest that the manner in which individuals within the two groups view, or perceive, the IAS issue was more the result of lack of information than simply biased perceptions of target groups. Though IAS perceptions by the two groups diverged, they were on par with how they viewed Nature in general. The descriptions of IAS by participants converged with the ideas and concepts frequently found in the scientific literature. Both managers and horticulture professionals expressed a strong willingness to participate in programs designed to prevent the spread of, and damage caused by, IAS. Despite this, the continued commercial availability of many invasive species highlighted the necessity to use both mandatory and voluntary approaches to reduce their re-introduction and spread. The results of this study provide stakeholders and conservation managers with practical information on which communication and management strategies can be based.

Towards Excellence in Asthma Management: Final report of an eight-year program aimed at reducing care gaps in asthma management in Quebec

PubMed Central

Boulet, Louis-Philippe; Dorval, Eileen; Labrecque, Manon; Turgeon, Michel; Montague, Terrence; Thivierge, Robert L

2008-01-01

BACKGROUND AND OBJECTIVES: Asthma care in Canada and around the world persistently falls short of optimal treatment. To optimize care, a systematic approach to identifying such shortfalls or ‘care gaps’, in which all stakeholders of the health care system (including patients) are involved, was proposed. METHODS: Several projects of a multipartner, multidisciplinary disease management program, developed to optimize asthma care in Quebec, was conducted in a period of eight years. First, two population maps were produced to identify regional variations in asthma-related morbidity and to prioritize interventions for improving treatment. Second, current care was evaluated in a physician-patient cohort, confirming the many care gaps in asthma management. Third, two series of peer-reviewed outcome studies, targeting high-risk populations and specific asthma care gaps, were conducted. Finally, a process to integrate the best interventions into the health care system and an agenda for further research on optimal asthma management were proposed. RESULTS: Key observations from these studies included the identification of specific patterns of noncompliance in using inhaled corticosteroids, the failure of increased access to spirometry in asthma education centres to increase the number of education referrals, the transient improvement in educational abilities of nurses involved with an asthma hotline telephone service, and the beneficial effects of practice tools aimed at facilitating the assessment of asthma control and treatment needs by general practitioners. CONCLUSIONS: Disease management programs such as Towards Excellence in Asthma Management can provide valuable information on optimal strategies for improving treatment of asthma and other chronic diseases by identifying care gaps, improving guidelines implementation and optimizing care. PMID:18818784

Priority of road maintenance management based on halda reading range on NAASRA method

NASA Astrophysics Data System (ADS)

Surbakti, M.; Doan, A.

2018-02-01

The road pavement, constantly experiencing stress-strain due to traffic load through it, can cause damage to the pavement. Therefore, early detection and repair of the damage will be able to prevent more severe damage that can develop into pavement failure. A road condition survey is one of the earliest attempts to detect the initial damage of a pavement. In this case the driving comfort is the most important part for the driver in assessing road conditions that are affected by the level of road surface roughness. To determine the level of roughness of the road, one of the methods developed is the measurement using the NAASRA method. In this method the roughness of the road is an accumulation of the average unevenness of the road, with the general setting on halda of 100 m. However, with this 100-meter setting, in some places the final value of the roughness value is too large or too small so that it will result in the priority of the road maintenance. This is what underlies roughness research by comparing halda settings at 50 m and 200 m different from the general settings above.This study uses the International Roughness Index (IRI) method in determining the level of road stability concerning driving discomfort. IRI score obtained from direct survey in field by using Roughometer-NAASRA.The final result shows that there is a significant difference between the reading of halda which is set at 100 m reading with halda set with 50 and 200 meter readings. This may lead to differences in handling priorities, which may impact on the sustainability of road network maintenance management (Sustainaible Road Management)

78 FR 70225 - West Virginia: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-25

... Department of Environmental Protection, (WVDEP), Division of Water and Waste Management, 601 57th Street SE...] West Virginia: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY... for final authorization of revisions to its hazardous waste program under the Resource Conservation...

Creating and Disseminating Knowledge for Educational Reform: Policy Management of the National Institute of Education's Regional Educational Laboratories and National Research and Development Centers. A Report to the National Council on Educational Research. [Executive Summary and Final Report].

ERIC Educational Resources Information Center

Center for Leadership Development, Los Angeles, CA.

Drawing on interviews, documents, and eight studies, this policy research study offers information and recommendations in order to fulfill the responsibility of the National Council on Educational Research to establish general policies for, and review the conduct of, the National Institute of Education (NIE). Questions guiding this study are: the…

Report on the Audit of the Acquisition of the Tactical Air Operations Center/Modular Control Equipment

DTIC Science & Technology

1991-06-06

This is our final report on the Audit of the Acquisition of the Tactical Air Operations Center/Modular Control Equipment (TAOC/MCE) for your...matters of concern that could affect the acquisition of the TAOC/MCE. We performed the audit from March through December 1990. The audit objective was...controls related to the audit objectives. The audit was made in accordance with the Inspector General’s critical program management element approach

State of the art in pathology business process analysis, modeling, design and optimization.

PubMed

Schrader, Thomas; Blobel, Bernd; García-Rojo, Marcial; Daniel, Christel; Słodkowska, Janina

2012-01-01

For analyzing current workflows and processes, for improving them, for quality management and quality assurance, for integrating hardware and software components, but also for education, training and communication between different domains' experts, modeling business process in a pathology department is inevitable. The authors highlight three main processes in pathology: general diagnostic, cytology diagnostic, and autopsy. In this chapter, those processes are formally modeled and described in detail. Finally, specialized processes such as immunohistochemistry and frozen section have been considered.

Current Management of Patients With Diverticulosis and Diverticular Disease: A Survey From the 2nd International Symposium on Diverticular Disease.

PubMed

Tursi, Antonio; Picchio, Marcello; Elisei, Walter; Di Mario, Francesco; Scarpignato, Carmelo; Brandimarte, Giovanni

2016-10-01

Management of diverticular disease (DD) remains a point of debate. To investigate the current opinion of participants of the 2nd International Symposium on Diverticular Disease, on real-life management of patients with DD of the colon. Twelve questions were aimed at the diagnosis, treatment, and management options for diverticulosis and symptomatic DD. In total, 115 surveys from 8 European Countries were filled out. High fiber diet was widely prescribed in diverticulosis (59.1%). Probiotics (25%) were the most frequent prescribed drug, whereas 29.8% of participants did not prescribe any treatment in diverticulosis. Colonoscopy was frequently prescribed in symptomatic patients (69.3%), whereas 72.9% of participants did not prescribe any instrumental tool in their follow-up. Rifaximin, probiotics, and mesalazine were the most frequent prescribed drugs both in symptomatic patients (28.1, 14.9%, and 11.4%, respectively) and to prevent recurrence of the disease (42.5%, 12.4%, and 28.2%, respectively). With respect to laboratory exams, 57.9% of participants prescribed them during follow-up. The majority of participants (64.9%) managed suspected acute diverticulitis at home. Rifaximin, probiotics, and mesalazine were the most frequent prescribed drugs to prevent recurrence of the disease (32.2%, 13.2%, and 11.4%, respectively), whereas 25.4% of participants did not prescribe any drugs. Finally, no differences were found among gastroenterologists, surgeons, and general practitioners in managing this disease. This surveys shows that current management of DD is similar between different medical specialities, generally in line with current literature.

Scar modification. Techniques for revision and camouflage.

PubMed

Horswell, B B

1998-09-01

The surgery and management of scars is a protracted and staged process that includes preparation of the skin through hygienic measures, scar softening (if indicated) with steroids, massage and pressure dressings, skilled execution of the surgical plan, and thorough postoperative wound care. This process generally covers a 1-year period for the various stages mentioned. Many general host and local skin factors will directly affect the final revision result. The two most important indirect factors that the surgeon must endeavor to control are optimal patient preparation and cutaneous health, and patient compliance with, and an ability to carry out, those wound care measures that the surgeon prescribes. Keloid and burn contracture scars represent two entities that are complicated and challenging to treat owing to their abnormal morphophysiologic features. Management of these scars is prolonged, and the patient must understand that the ultimate result will usually be a compromise. New grafting techniques, such as cultured autodermal grafts, offer improved initial management of burn wounds that may subsequently optimize scar revision in these patients. Keloids, and to a lesser extent hypertrophic scars, require steroid injections, pressure treatment, careful surgery, and protracted wound support and pressure treatment (exceeding 6 months) after surgery.

Recommendations on the use of deep neuromuscular blockade by anaesthesiologists and surgeons. AQUILES (Anestesia QUIrúrgica para Lograr Eficiencia y Seguridad) Consensus.

PubMed

Errando-Oyonarte, C L; Moreno-Sanz, C; Vila-Caral, P; Ruiz de Adana-Belbel, J C; Vázquez-Alonso, E; Ramírez-Rodríguez, J M; Veiga-Ruiz, G; Guasch-Arévalo, E; Lora-Tamayo D'Ocón, J I

2017-02-01

Neuromuscular blockade enables airway management, ventilation and surgical procedures. However there is no national consensus on its routine clinical use. The objective was to establish the degree of agreement among anaesthesiologists and general surgeons on the clinical use of neuromuscular blockade in order to make recommendations to improve its use during surgical procedures. Multidisciplinary consensus study in Spain. Anaesthesiologists experts in neuromuscular blockade management (n=65) and general surgeons (n=36) were included. Delphi methodology was selected. A survey with 17 final questions developed by a dedicated scientific committee was designed. The experts answered the successive questions in two waves. The survey included questions on: type of surgery, type of patient, benefits/harm during and after surgery, impact of objective neuromuscular monitoring and use of reversal drugs, viability of a multidisciplinary and efficient approach to the whole surgical procedure, focussing on the level of neuromuscular blockade. Five recommendations were agreed: 1) deep neuromuscular blockade is very appropriate for abdominal surgery (degree of agreement 94.1%), 2) and in obese patients (76.2%); 3) deep neuromuscular blockade maintenance until end of surgery might be beneficial in terms of clinical aspects, such as as immobility or better surgical access (86.1 to 72.3%); 4) quantitative monitoring and reversal drugs availability is recommended (89.1%); finally 5) anaesthesiologists/surgeons joint protocols are recommended. Collaboration among anaesthesiologists and surgeons has enabled some general recommendations to be established on deep neuromuscular blockade use during abdominal surgery. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Occupational characteristics of adults with pediatric-onset spinal cord injury.

PubMed

Hwang, Miriam; Zebracki, Kathy; Vogel, Lawrence C

2015-01-01

Employment rates among individuals with spinal cord injury (SCI) are lower than in the general population and little is known about the specific occupations in which they are employed. To describe specific occupations of adults with pediatric-onset SCI using the 2010 Standard Occupational Classification (SOC) system and to determine associations between SOC occupations and demographic factors. Cross-sectional data specific to education and employment were collected from the last interviews of a larger longitudinal study. Occupations were categorized according to the 2010 SOC system. SOC groups were compared within gender level of injury and final education. Of the 461 total participants 219 (47.5%) were employed and specific occupations were available for 179. Among the SOC groups Education Law Community Service Arts and Media Occupations were most prevalent (30.2%) followed by Management Business and Finance Occupations (21.1%) Computer Engineering and Science Occupations (10.6%) Administrative and Office Support Occupations (10.0%) Service Occupations (7.3%) Healthcare Practitioners and Technical Occupations (3.9%) and Production Occupations (3.4%). Differences were found in the distribution of SOC groups between gender levels of injury and final education groups. A wide variety of occupations were reported in adults with pediatric-onset SCI generally in concordance with final education and functional ability levels.

Occupational Characteristics of Adults with Pediatric-Onset Spinal Cord Injury

PubMed Central

Zebracki, Kathy; Vogel, Lawrence C.

2015-01-01

Background: Employment rates among individuals with spinal cord injury (SCI) are lower than in the general population and little is known about the specific occupations in which they are employed. Objectives: To describe specific occupations of adults with pediatric-onset SCI using the 2010 Standard Occupational Classification (SOC) system and to determine associations between SOC occupations and demographic factors. Methods: Cross-sectional data specific to education and employment were collected from the last interviews of a larger longitudinal study. Occupations were categorized according to the 2010 SOC system. SOC groups were compared within gender level of injury and final education. Results: Of the 461 total participants 219 (47.5%) were employed and specific occupations were available for 179. Among the SOC groups Education Law Community Service Arts and Media Occupations were most prevalent (30.2%) followed by Management Business and Finance Occupations (21.1%) Computer Engineering and Science Occupations (10.6%) Administrative and Office Support Occupations (10.0%) Service Occupations (7.3%) Healthcare Practitioners and Technical Occupations (3.9%) and Production Occupations (3.4%). Differences were found in the distribution of SOC groups between gender levels of injury and final education groups. Conclusion: A wide variety of occupations were reported in adults with pediatric-onset SCI generally in concordance with final education and functional ability levels. PMID:25762856

Advances in management of low-risk febrile neutropenia.

PubMed

Teuffel, Oliver; Sung, Lillian

2012-02-01

To describe and discuss the most recent advances in the management of low-risk febrile neutropenia in children with cancer. Several risk stratification tools for children with febrile neutropenia have been developed, although none of these tools have been directly compared and few have been validated in independent populations. However, there is good evidence that, for pediatric patients with febrile neutropenia at low risk for severe infection, outpatient management is a well tolerated and efficacious alternative to inpatient care. Moreover, major progress has been made in obtaining and understanding perceived quality of life and preferences for outpatient management in pediatric cancer patients. Many parents prefer inpatient management although child quality of life is, in general, anticipated to be higher with outpatient intravenous therapy. Finally, outpatient strategies are more cost-effective as compared with traditional management in hospital. Outpatient management is a well tolerated and cost-effective strategy for low-risk febrile neutropenia in children with cancer, although parental preferences are highly variable for outpatient versus inpatient management. Future research should examine the effectiveness of outpatient strategies through conduct of large cohort studies. Other future work could focus on development of decision aids and other tools to facilitate ambulatory approaches.

78 FR 76176 - Notice of Availability of the Record of Decision for the Final Trail Management Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

...] Notice of Availability of the Record of Decision for the Final Trail Management Plan/Environmental Impact... (ROD) for the Final Trail Management Plan/ Environmental Impact Statement (Plan/EIS), Cuyahoga Valley... 1, the no-action alternative, the trails, authorized uses, and facilities addressed in this Plan/EIS...

75 FR 30483 - Atlantic Highly Migratory Species; Atlantic Shark Management Measures; Amendment 3

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

...NMFS publishes this final rule implementing the Final Amendment 3 to the Consolidated Atlantic Highly Migratory Species (HMS) Fishery Management Plan (FMP). As it developed Amendment 3, NMFS examined a full range of management alternatives available to rebuild blacknose sharks and end overfishing of blacknose and shortfin mako sharks, consistent with recent stock assessments, the Magnuson-Stevens Fishery Conservation and Management Act (Magnuson-Stevens Act), and other applicable law, and evaluated options for managing smooth dogfish as a highly migratory species under the HMS FMP. This final rule implements the final conservation and management measures in Amendment 3 for blacknose sharks, shortfin mako sharks, and smooth dogfish. In order to reduce confusion with spiny dogfish regulations, this final rule places both smooth dogfish and Florida smoothhound into the ``smoothhound shark complex.'' This final rule also announces the opening date and 2010 annual quotas for small coastal sharks (SCS). These changes could affect all fishermen, commercial and recreational, who fish for sharks in the Atlantic Ocean, the Gulf of Mexico, and the Caribbean Sea.

Policy revision in health enterprise information security: P3WG final report

NASA Astrophysics Data System (ADS)

Sostrom, Kristen; Collmann, Jeff R.

2003-05-01

Health information management policies usually address the use of paper records with little or no mention of electronic health records. Information Technology (IT) policies often ignore the health care business needs and operational use of the information stored in its systems. Representatives from the Telemedicine & Advanced Technology Research Center (TATRC), TRICARE and Offices of the Surgeon General of each Military Service, collectively referred to as the Policies, Procedures and Practices Work Group (P3WG) examined military policies and regulations relating to computer-based information systems and medical records management. Using an interdisciplinary and interservice QA approach they compared existing military policies with the Health Insurance Portability and Accountability Act (HIPAA) Security Rule to identify gaps and discrepancies. The final report, including a plain English explanation of the individual standards and relevance to the Department of Defense (DoD), a comparative analysis and recommendations, will feed in to the security management process and HIPAA implementation efforts at multiple levels within the DoD. In light of High Reliability Theory, this process models how large enterprises may coordinate policy revision and reform across broad organizational and work domains, building consensus on key policy reforms among military stakeholders across different disciplines, levels of command hierarchy and services.

The Future of General Internal Medicine

PubMed Central

Larson, Eric B; Fihn, Stephan D; Kirk, Lynne M; Levin, Wendy; Loge, Ronald V; Reynolds, Eileen; Sandy, Lewis; Schroeder, Steven; Wenger, Neil; Williams, Mark

2004-01-01

The Society of General Internal Medicine asked a task force to redefine the domain of general internal medicine. The task force believes that the chaos and dysfunction that characterize today's medical care, and the challenges facing general internal medicine, should spur innovation. These are our recommendations: while remaining true to its core values and competencies, general internal medicine should stay both broad and deep—ranging from uncomplicated primary care to continuous care of patients with multiple, complex, chronic diseases. Postgraduate and continuing education should develop mastery. Wherever they practice, general internists should be able to lead teams and be responsible for the care their teams give, embrace changes in information systems, and aim to provide most of the care their patients require. Current financing of physician services, especially fee-for-service, must be changed to recognize the value of services performed outside the traditional face-to-face visit and give practitioners incentives to improve quality and efficiency, and provide comprehensive, ongoing care. General internal medicine residency training should be reformed to provide both broad and deep medical knowledge, as well as mastery of informatics, management, and team leadership. General internal medicine residents should have options to tailor their final 1 to 2 years to fit their practice goals, often earning a certificate of added qualification (CAQ) in special generalist fields. Research will expand to include practice and operations management, developing more effective shared decision making and transparent medical records, and promoting the close personal connection that both doctors and patients want. We believe these changes constitute a paradigm shift that can benefit patients and the public and reenergize general internal medicine. PMID:14748863

Knowledge Regarding Basic Facts of Stroke Among Final Year MBBS Students and House Officers: A Cross-Sectional Survey of 708 Respondents from Pakistan.

PubMed

Khubaib, Mohammad U; Rathore, Farooq A; Waqas, Ahmed; Jan, Mohsin M; Sohail, Sana

2016-03-23

Stroke is the leading cause of neurological disability in the world. In Pakistan, house officers (HOs) are usually the first contact for a stroke patient in the emergency department. Sometimes they need to make quick decisions regarding diagnosis and management without specialist supervision. Thousands of current final year MBBS (Bachelor of Medicine, Bachelor of Surgery) students will be performing the duties of HOs soon. This study documents the knowledge and confidence levels of final year students and HOs in Pakistan regarding basic facts related to initial diagnosis and management of stroke. A questionnaire was developed using two standard textbooks of medicine and current stroke guidelines of the American Heart Association. The pre-tested self-administered questionnaire was distributed among 800 final year MBBS students and HOs in 14 medical colleges and hospitals in four different cities. The response rate was 88.5%. Data analysis was done using SPSS V.21. The CMH Lahore Medical College Ethics Review Committee approved this project. Respondents included medical students (n=496) and HOs (N= 212); most were female (n = 452, 63.9%). Of these, 31.4% had managed or assisted in the management of a patient with a stroke and had a higher confidence level in its diagnosis (p< 0.001) and management (p <0.001). Having a family member with stroke was associated with higher confidence in the diagnosis of stroke (p < 0.05) but not with confidence in its management (p = 0.41). Most correctly defined stroke (60.6%), identified the CT scan as the initial diagnostic modality (88.1%), knew the dosage of aspirin (64.9%), knew the time limit for thrombolysis (67.4%), and were familiar with the risk of deep vein thrombosis in immobilized stroke patients (85.4%). Less than half (44.5%) chose tissue plasminogen activator (t-PA) as the preferred initial intervention for acute ischemic stroke. This multicenter survey shows that the knowledge and confidence of medical students and HOs in Pakistan regarding initial diagnosis and management of stroke are inadequate in most domains. There is a need to improve the medical training for stroke in emergency departments for optimal outcomes. Public education campaigns about stroke should be conducted to increase the general awareness of the population about the prevention, signs, symptoms, and emergency steps to be taken when encountering a case of stroke.

Investment risk evaluation and countermeasures suggestions of Power Grid Corp under the background of electric power reform

NASA Astrophysics Data System (ADS)

Yang, Chunhui; Su, Zhixiong; Wang, Yuqing; Liu, Yiqun; Qi, Yongwei

2017-03-01

Investment management is an important part of Power Grid Corp. The new electricity reform put forward the general idea of "three release, three strengthening, one independence", which brings new risks to the investment management of the Power Grid Corp. First, the paper analyzes the new risks faced by the Power Grid Corp investment under the background of the electricity reform. Second, the AHP-Fuzzy evaluation model of investment risk of Power Grid Corp is established, and taking Shenzhen Power Supply Bureau as an example, the paper evaluated its risk level of investment plan in 2017. Finally, in the context of the electricity reform, the strategy of the Power Grid Corp's investment risk is proposed.

Effective Classroom Management and Instruction: An Exploration of Models. Executive Summary of Final Report.

ERIC Educational Resources Information Center

Evertson, Carolyn M.; And Others

A summary is presented of the final report, "Effective Classroom Management and Instruction: An Exploration of Models." The final report presents a set of linked investigations of the effects of training teachers in effective classroom management practices in a series of school-based workshops. Four purposes were addressed by the study: (1) to…

76 FR 81860 - Fisheries of the Exclusive Economic Zone Off Alaska; Gulf of Alaska; Final 2011 and 2012 Harvest...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-29

... required by the final rule implementing Amendment 83 to the Fishery Management Plan for Groundfish of the...-Stevens Fishery Conservation and Management Act. DATES: The final 2011 and 2012 harvest specifications and... resources of the GOA, dated November 2011, are available from the North Pacific Fishery Management Council...

Taipower`s radioactive waste management program

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

Lee, B.C.C.

1996-09-01

Nuclear safety and radioactive waste management are the two major concerns of nuclear power in Taiwan. Recognizing that it is an issue imbued with political and social-economic concerns, Taipower has established an integrated nuclear backend management system and its associated financial and mechanism. For LLW, the Orchid Island storage facility will play an important role in bridging the gap between on-site storage and final disposal of LLW. Also, on-site interim storage of spent fuel for 40 years or longer will provide Taipower with ample time and flexibility to adopt the suitable alternative of direct disposal or reprocessing. In other words,more » by so exercising interim storage option, Taipower will be in a comfortable position to safely and permanently dispose of radwaste without unduly forgoing the opportunities of adopting better technologies or alternatives. Furthermore, Taipower will spare no efforts to communicate with the general public and make her nuclear backend management activities accountable to them.« less

H-Coal Pilot Plant Phase II construction, Catlettsburg, Kentucky. Final construction management report, December 1976-February 1980. [February, 1977 to approximately January, 1980

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

Not Available

1983-03-01

This report covers the H-Coal Pilot Plant facility located in Catlettsburg, Kentucky. The authorization for this project was under DOE contract No. DE-AC05-78ET11052, formally ET-78-C-01-3224. Badger Plants, Inc. carried out the construction management of this facility. The estimated total cost is $147,265,013. A brief process/technical description of the Pilot Plant covers subjects such as objectives, capacity, expected life, etc. A brief technical description of each processing unit, including its purpose in the overall operations of the plant is given. A general description of the organizational history of the project is given. Current overall organization and a description of the responsibilitiesmore » of each participant are included. Badger Plant's organization at manager level is shown.« less

Technical area status report for waste destruction and stabilization

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

Dalton, J.D.; Harris, T.L.; DeWitt, L.M.

1993-08-01

The Office of Environmental Restoration and Waste Management (EM) was established by the Department of Energy (DOE) to direct and coordinate waste management and site remediation programs/activities throughout the DOE complex. In order to successfully achieve the goal of properly managing waste and the cleanup of the DOE sites, the EM was divided into five organizations: the Office of Planning and Resource Management (EM-10); the Office of Environmental Quality Assurance and Resource Management (EM-20); the Office of Waste Operations (EM-30); the Office of Environmental Restoration (EM-40); and the Office of Technology and Development (EM-50). The mission of the Office ofmore » Technology Development (OTD) is to develop treatment technologies for DOE`s operational and environmental restoration wastes where current treatment technologies are inadequate or not available. The Mixed Waste Integrated Program (MWIP) was created by OTD to assist in the development of treatment technologies for the DOE mixed low-level wastes (MLLW). The MWIP has established five Technical Support Groups (TSGs) whose purpose is to identify, evaluate, and develop treatment technologies within five general technical areas representing waste treatment functions from initial waste handling through generation of final waste forms. These TSGs are: (1) Front-End Waste Handling, (2) Physical/Chemical Treatment, (3) Waste Destruction and Stabilization, (4) Second-Stage Destruction and Offgas Treatment, and (5) Final Waste Forms. This report describes the functions of the Waste Destruction and Stabilization (WDS) group. Specifically, the following items are discussed: DOE waste stream identification; summary of previous efforts; summary of WDS treatment technologies; currently funded WDS activities; and recommendations for future activities.« less

Virginia Space Grant Consortium Management of National General Aviation Design Competition

NASA Technical Reports Server (NTRS)

2002-01-01

This report summarizes the management of the National General Aviation Design Competition on behalf of NASA, the FAA and the Air Force by the Virginia Space Grant Consortium (VSGC) for the time period October 1, 2000 through September 30, 2001. This was the VSGC's seventh and final year of managing the Competition, which the Consortium originally designed, developed and implemented for NASA and the FAA. The competition is now being managed in-house by NASA. Awards to winning university teams were presented at a ceremony held at AirVenture 2001, the Experimental Aircraft Association's Annual Convention and Fly-In at Oshkosh, Wis. by NASA and FAA officials. The competition called for individuals or teams of undergraduate and graduate students from U.S. engineering schools to participate in a major national effort to rebuild the U.S. general aviation sector. Participants were challenged to meet the engineering goals of the Advanced General Aviation Transport Experiment (AGATE) project. For the purpose of the contest, general aviation aircraft are typically defined as single or twin engine (turbine or piston), single-pilot, fixed-wing aircraft for 2 - 6 passengers. The competition seeks to raise student awareness of the importance of general aviation by having students address design challenges for a small aircraft transportation system. NASA, AFRL and the FAA hope to stimulate breakthroughs in technology and their application in the general aviation marketplace. National goals for revitalizing the industry offer excellent, open-ended design challenges with real world applications for the Innovative Design Category. Both individual and team submissions were encouraged. University faculty advisors and students consistently cite the value of this kind of educational experience for their engineering students. Eight proposals were submitted for the 2001 Competition for the Innovative Design Category. Eleven faculty members and 124 students participated. Since inception, more than 785 students and 60 faculty members have participated in the Competition. A review panel comprised of general aviation experts from the FAA, EAA, NASA and industry representatives reviewed the design packages and selected the winners. The VSGC coordinated marketing of the competition to a mailing list which included selected deans and department chairs from ABET-accredited institutions, Space Grant affiliates, faculty who had previously participated in or expressed interest in the Competition, and others.

Final Environmental Assessment. Physical Fitness Center Los Angeles Air Force Base

DTIC Science & Technology

2000-10-13

Coast Air Quality Management District (SCAQMD). 1996. Final 1997 Air Qaulity Management Plan. November. South Coast Air Quality Management District...resources including land use, geology and soils, water resources, biological resources, air quality, noise, traffic and transportation, waste management ...3-8 3.8 Solid and Hazardous Waste Management and Disposal

78 FR 59726 - Interim Final Appendix D of OMB Circular No. A-123, “Management's Responsibility for Internal...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-27

... OFFICE OF MANAGEMENT AND BUDGET Interim Final Appendix D of OMB Circular No. A-123, ``Management's Responsibility for Internal Control,'' and Suspension of Application of OMB Circular No. A-127, ``Financial Management Systems'' September 27, 2013. ACTION: Notice. SUMMARY: OMB Circular No. A-123, ``Management's...

Risk assessment techniques with applicability in marine engineering

NASA Astrophysics Data System (ADS)

Rudenko, E.; Panaitescu, F. V.; Panaitescu, M.

2015-11-01

Nowadays risk management is a carefully planned process. The task of risk management is organically woven into the general problem of increasing the efficiency of business. Passive attitude to risk and awareness of its existence are replaced by active management techniques. Risk assessment is one of the most important stages of risk management, since for risk management it is necessary first to analyze and evaluate risk. There are many definitions of this notion but in general case risk assessment refers to the systematic process of identifying the factors and types of risk and their quantitative assessment, i.e. risk analysis methodology combines mutually complementary quantitative and qualitative approaches. Purpose of the work: In this paper we will consider as risk assessment technique Fault Tree analysis (FTA). The objectives are: understand purpose of FTA, understand and apply rules of Boolean algebra, analyse a simple system using FTA, FTA advantages and disadvantages. Research and methodology: The main purpose is to help identify potential causes of system failures before the failures actually occur. We can evaluate the probability of the Top event.The steps of this analize are: the system's examination from Top to Down, the use of symbols to represent events, the use of mathematical tools for critical areas, the use of Fault tree logic diagrams to identify the cause of the Top event. Results: In the finally of study it will be obtained: critical areas, Fault tree logical diagrams and the probability of the Top event. These results can be used for the risk assessment analyses.

Recognizing and managing a deteriorating patient: a randomized controlled trial investigating the effectiveness of clinical simulation in improving clinical performance in undergraduate nursing students.

PubMed

Stayt, Louise Caroline; Merriman, Clair; Ricketts, Barry; Morton, Sean; Simpson, Trevor

2015-11-01

To report the results of a randomized controlled trial which explored the effectiveness of clinical simulation in improving the clinical performance of recognizing and managing an adult deteriorating patient in hospital. There is evidence that final year undergraduate nurses may lack knowledge, clinical skills and situation awareness required to manage a deteriorating patient competently. The effectiveness of clinical simulation as a strategy to teach the skills required to recognize and manage the early signs of deterioration needs to be evaluated. This study was a two centre phase II single, randomized, controlled trial with single blinded assessments. Data were collected in July 2013. Ninety-eight first year nursing students were randomized either into a control group, where they received a traditional lecture, or an intervention group where they received simulation. Participants completed a pre- and postintervention objective structured clinical examination. General Perceived Self Efficacy and Self-Reported Competency scores were measured before and after the intervention. Student satisfaction with teaching was also surveyed. The intervention group performed significantly better in the post-objective structured clinical examination. There was no significant difference in the postintervention General Perceived Self Efficacy and Self-Reported Competency scores between the control and intervention group. The intervention group was significantly more satisfied with their teaching method. Simulation-based education may be an effective educational strategy to teach nurses the skills to effectively recognize and manage a deteriorating patient. © 2015 John Wiley & Sons Ltd.

China's Classification-Based Forest Management: Procedures, Problems, and Prospects

NASA Astrophysics Data System (ADS)

Dai, Limin; Zhao, Fuqiang; Shao, Guofan; Zhou, Li; Tang, Lina

2009-06-01

China’s new Classification-Based Forest Management (CFM) is a two-class system, including Commodity Forest (CoF) and Ecological Welfare Forest (EWF) lands, so named according to differences in their distinct functions and services. The purposes of CFM are to improve forestry economic systems, strengthen resource management in a market economy, ease the conflicts between wood demands and public welfare, and meet the diversified needs for forest services in China. The formative process of China’s CFM has involved a series of trials and revisions. China’s central government accelerated the reform of CFM in the year 2000 and completed the final version in 2003. CFM was implemented at the provincial level with the aid of subsidies from the central government. About a quarter of the forestland in China was approved as National EWF lands by the State Forestry Administration in 2006 and 2007. Logging is prohibited on National EWF lands, and their landowners or managers receive subsidies of about 70 RMB (US10) per hectare from the central government. CFM represents a new forestry strategy in China and its implementation inevitably faces challenges in promoting the understanding of forest ecological services, generalizing nationwide criteria for identifying EWF and CoF lands, setting up forest-specific compensation mechanisms for ecological benefits, enhancing the knowledge of administrators and the general public about CFM, and sustaining EWF lands under China’s current forestland tenure system. CFM does, however, offer a viable pathway toward sustainable forest management in China.

Application of a theoretical model to evaluate COPD disease management.

PubMed

Lemmens, Karin M M; Nieboer, Anna P; Rutten-Van Mölken, Maureen P M H; van Schayck, Constant P; Asin, Javier D; Dirven, Jos A M; Huijsman, Robbert

2010-03-26

Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care.

Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip.

PubMed

Caniato, M; Tudor, T; Vaccari, M

2015-01-01

The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology, which involved a large number of stakeholders. Such an approach served to raise interest and awareness at different levels (public authorities, health providers, supporting actors, others), stimulate the discussion about the adoption of specific policies, and identify the effective way forward. Copyright © 2014 Elsevier Ltd. All rights reserved.

Application of a theoretical model to evaluate COPD disease management

PubMed Central

2010-01-01

Background Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. Methods A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Results Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. Conclusions The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care. PMID:20346135

Advanced Air Transportation Technologies Project, Final Document Collection

NASA Technical Reports Server (NTRS)

Mogford, Richard H.; Wold, Sheryl (Editor)

2008-01-01

This CD ROM contains a compilation of the final documents of the Advanced Air Transportation Technologies (AAIT) project, which was an eight-year (1996 to 2004), $400M project managed by the Airspace Systems Program office, which was part of the Aeronautics Research Mission Directorate at NASA Headquarters. AAIT focused on developing advanced automation tools and air traffic management concepts that would help improve the efficiency of the National Airspace System, while maintaining or enhancing safety. The documents contained in the CD are final reports on AAIT tasks that serve to document the project's accomplishments over its eight-year term. Documents include information on: Advanced Air Transportation Technologies, Autonomous Operations Planner, Collaborative Arrival Planner, Distributed Air/Ground Traffic Management Concept Elements 5, 6, & 11, Direct-To, Direct-To Technology Transfer, Expedite Departure Path, En Route Data Exchange, Final Approach Spacing Tool - (Active and Passive), Multi-Center Traffic Management Advisor, Multi Center Traffic Management Advisor Technology Transfer, Surface Movement Advisor, Surface Management System, Surface Management System Technology Transfer and Traffic Flow Management Research & Development.

Presenting an evaluation model of the trauma registry software.

PubMed

Asadi, Farkhondeh; Paydar, Somayeh

2018-04-01

Trauma is a major cause of 10% death in the worldwide and is considered as a global concern. This problem has made healthcare policy makers and managers to adopt a basic strategy in this context. Trauma registry has an important and basic role in decreasing the mortality and the disabilities due to injuries resulted from trauma. Today, different software are designed for trauma registry. Evaluation of this software improves management, increases efficiency and effectiveness of these systems. Therefore, the aim of this study is to present an evaluation model for trauma registry software. The present study is an applied research. In this study, general and specific criteria of trauma registry software were identified by reviewing literature including books, articles, scientific documents, valid websites and related software in this domain. According to general and specific criteria and related software, a model for evaluating trauma registry software was proposed. Based on the proposed model, a checklist designed and its validity and reliability evaluated. Mentioned model by using of the Delphi technique presented to 12 experts and specialists. To analyze the results, an agreed coefficient of %75 was determined in order to apply changes. Finally, when the model was approved by the experts and professionals, the final version of the evaluation model for the trauma registry software was presented. For evaluating of criteria of trauma registry software, two groups were presented: 1- General criteria, 2- Specific criteria. General criteria of trauma registry software were classified into four main categories including: 1- usability, 2- security, 3- maintainability, and 4-interoperability. Specific criteria were divided into four main categories including: 1- data submission and entry, 2- reporting, 3- quality control, 4- decision and research support. The presented model in this research has introduced important general and specific criteria of trauma registry software and sub criteria related to each main criteria separately. This model was validated by experts in this field. Therefore, this model can be used as a comprehensive model and a standard evaluation tool for measuring efficiency and effectiveness and performance improvement of trauma registry software. Copyright © 2018 Elsevier B.V. All rights reserved.

Dental solid and hazardous waste management and safety practices in developing countries: Nablus district, Palestine.

PubMed

Al-Khatib, Issam A; Monou, Maria; Mosleh, Salem A; Al-Subu, Mohammed M; Kassinos, Despo

2010-05-01

This study investigated the dental waste management practices and safety measures implemented by dentists in the Nablus district, Palestine. A comprehensive survey was conducted for 97 of the 134 dental clinics to assess the current situation. Focus was placed on hazardous waste produced by clinics and the handling, storage, treatment and disposal measures taken. Mercury, found in dental amalgam, is one of the most problematic hazardous waste. The findings revealed that there is no proper separation of dental waste by classification as demanded by the World Health Organization. Furthermore, medical waste is often mixed with general waste during production, collection and disposal. The final disposal of waste ends up in open dumping sites sometimes close to communities where the waste is burned. Correct management and safety procedures that could be effectively implemented in developing countries were examined. It was concluded that cooperation between dental associations, government-related ministries and authorities needs to be established, to enhance dental waste management and provide training and capacity building programs for all professionals in the medical waste management field.

77 FR 60919 - Tennessee: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-05

...: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY: Environmental..., Division of Solid Waste Management, 5th Floor, L & C Tower, 401 Church Street, Nashville, Tennessee 37243... RCRA hazardous waste management program. We granted authorization for changes to Tennessee's program on...

Review on the prevalence of diabetes and risk factors and situation of disease management in floating population in China.

PubMed

Han, Kaiyi; Yao, Jingjing; Yin, Xiao; Zhao, Mei; Sun, Qiang

2017-01-01

To give a comprehensive and basic understanding of diabetes and its risk factors in floating people in China. We use "(diabetes or type 2 diabetes or chronic disease) and (floating population or employed floating population)" as the key words to search in the China academic literature database (CNKI), Wan Fang database, PubMed and Web of Science for relevant literature and extract the data about the prevalence of diabetes, relevant risk factors and disease management of the floating population in China. Twenty-one literatures are entered into analysis finally, one is English and the rest are Chinese. According to the national survey, the prevalence rate of diabetes in floating population in China was 5. 1% (95%CI, 4.9% - 5.3%), which is lower than that of the general population(11.6%,95%CI, 11.3%-11.8%),and is consistent with the results of the local surveys. The comparison result between the prevalence of floating population and that of local population in each region differs in local surveys. In addition, the prevalence of male floating population is lower than that of the female population. Finally, as the age of the population rises, so does the prevalence of diabetes. As for the risk factors of chronical diseases, the overweight rate in every region is similar but the obesity rate differs in different regions (Ningxia,26.0%;Xiangshan,14.0%), and the obesity rate of the floating population is less than half of that of the general people(4.7%,11.9%). The awareness rate, treatment rate and control rate in the floating patients differ in the regional researches, but they all can't meet the goals set by the local health departments. Compared with the general population, the prevalence of diabetes in the floating population are lower. However, Considering the growing population number and the poor disease management of the floating patients, the potential threat brought by the diabetes in floating population is imponderable. The government should establish the national surveillance system of diabetes for the floating population, strengthen the construction of the primary medical institutions, and optimize the existing funding system.

Intelligent Internet-based information system optimises diabetes mellitus management in communities.

PubMed

Wei, Xuejuan; Wu, Hao; Cui, Shuqi; Ge, Caiying; Wang, Li; Jia, Hongyan; Liang, Wannian

2018-05-01

To evaluate the effect of an intelligent Internet-based information system upon optimising the management of patients diagnosed with type 2 diabetes mellitus (T2DM). In 2015, a T2DM information system was introduced to optimise the management of T2DM patients for 1 year in Fangzhuang community of Beijing, China. A total of 602 T2DM patients who were registered in the health service centre of Fangzhuang community were enrolled based on an isometric sampling technique. The data from 587 patients were used in the final analysis. The intervention effect was subsequently assessed by statistically comparing multiple parameters, such as the prevalence of glycaemic control, standard health management and annual outpatient consultation visits per person, before and after the implementation of the T2DM information system. In 2015, a total of 1668 T2DM patients were newly registered in Fangzhuang community. The glycaemic control rate was calculated as 37.65% in 2014 and significantly elevated up to 62.35% in 2015 ( p < 0.001). After application of the Internet-based information system, the rate of standard health management was increased from 48.04% to 85.01% ( p < 0.001). Among all registered T2DM patients, the annual outpatient consultation visits per person in Fangzhuang community was 24.88% in 2014, considerably decreased to 22.84% in 2015 ( p < 0.001) and declined from 14.59% to 13.66% in general hospitals ( p < 0.05). Application of the T2DM information system optimised the management of T2DM patients in Fangzhuang community and decreased the outpatient numbers in both community and general hospitals, which played a positive role in assisting T2DM patients and their healthcare providers to better manage this chronic illness.

Business planning health-check questionnaire: a survey of first, second, third and fourth wave NHS Trusts.

PubMed

Bennett, A R; Banks, J M

1999-02-01

This paper reports the results of primary research which was carried out in July 1995 with respect to business planning within first, second, third and fourth wave National Health Service (NHS) Trusts. The purpose of the research was to examine current practice in these Trusts in three areas--namely, the levels of responsibility for business planning in general, the business planning processes applied by these Trusts, and the tools and techniques used by business planning managers in the compilation of business plans. The research, based on a 37.5% response rate, concludes that, as a general rule, business planning in first, second, third and fourth wave NHS Trusts tends to be a board-level activity, where senior managers have a job title which reflects this function. Secondly, the research shows that by far the greatest challenge for Trusts lies in the external marketplace. In areas such as patient needs forecasting, competitive (Trust) intelligence, purchaser and general practice fundholder requirements, data are difficult to acquire. Finally, the evidence suggests that there is a significant gap between what is regarded as business planning practice in the NHS and what is actually applied as best practice. The report concludes that business planning in the NHS Trusts sampled appears to be an art rather than a science, and that many assumptions made by business planning managers are founded on qualitative information rather than on specific, measurable data derived from the external and internal market.

75 FR 10308 - Fire Management Plan, Final Environmental Impact Statement, Record of Decision, Grand Canyon...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-05

... DEPARTMENT OF THE INTERIOR National Park Service Fire Management Plan, Final Environmental Impact... Statement for the Fire Management Plan, Grand Canyon National Park. SUMMARY: Pursuant to the National... the Record of Decision for the Fire Management Plan, Grand Canyon National Park, Arizona. On January...

Farmer data sourcing. The case study of the spatial soil information maps in South Tyrol.

NASA Astrophysics Data System (ADS)

Della Chiesa, Stefano; Niedrist, Georg; Thalheimer, Martin; Hafner, Hansjörg; La Cecilia, Daniele

2017-04-01

Nord-Italian region South Tyrol is Europe's largest apple growing area exporting ca. 15% in Europe and 2% worldwide. Vineyards represent ca. 1% of Italian production. In order to deliver high quality food, most of the farmers in South Tyrol follow sustainable farming practices. One of the key practice is the sustainable soil management, where farmers collect regularly (each 5 years) soil samples and send for analyses to improve cultivation management, yield and finally profitability. However, such data generally remain inaccessible. On this regard, in South Tyrol, private interests and the public administration have established a long tradition of collaboration with the local farming industry. This has granted to the collection of large spatial and temporal database of soil analyses along all the cultivated areas. Thanks to this best practice, information on soil properties are centralized and geocoded. The large dataset consist mainly in soil information of texture, humus content, pH and microelements availability such as, K, Mg, Bor, Mn, Cu Zn. This data was finally spatialized by mean of geostatistical methods and several high-resolution digital maps were created. In this contribution, we present the best practice where farmers data source soil information in South Tyrol. Show the capability of a large spatial-temporal geocoded soil dataset to reproduce detailed digital soil property maps and to assess long-term changes in soil properties. Finally, implication and potential application are discussed.

Final Environmental Assessment for Construction and Operation of the Edgemeade Readiness Center and Tactical Unmanned Aerial System Storage and Maintenance Facility Idaho Army National Guard Elmore County, Idaho

DTIC Science & Technology

2010-07-01

Edgemeade Readiness Center are public lands managed by the BLM. These areas are primarily composed of undeveloped basalt plains dominated by 4.0 Affected...areas where new buildings would be constructed. 4.10.2 Existing Conditions Basaltic formations in the general vicinity are in abundance. The Snake...River has cut down through many of these formations leaving basalt plains and terraces several hundred feet above the valley floor. Subsequently

76 FR 62824 - Notice of Final Supplementary Rules for Public Lands in Colorado: Bangs Canyon Special Recreation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-11

... Management Area Management Plan (BCSRMAMP) and the Grand Junction Resource Management Plan (GJRMP). These... 43 U.S.C. 1740, 43 U.S.C. 315a, and 43 CFR 8365.1-6 II. Background Recreation resource management... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCON03000-L12200000-PA0000] Notice of Final...

Conflict Management in Schools: Sowing Seeds for a Safer Society. Final Report of the School Conflict Management Demonstration Project 1990-1993.

ERIC Educational Resources Information Center

Wheeler, Terrence; And Others

In August 1990, the Ohio Commission on Dispute Resolution and Conflict Management initiated a three-year School Conflict Management Demonstration Project. This publication is the final report on the Project. Twenty schools, which reflected the state's diversity, were selected to help assess the impact of the conflict management programs. The…

Limited by the host: Host age hampers establishment of holoparasite Cuscuta epithymum

NASA Astrophysics Data System (ADS)

Meulebrouck, Klaar; Verheyen, Kris; Brys, Rein; Hermy, Martin

2009-07-01

A good understanding of the relationship between plant establishment and the ecosystem of which they are part of is needed to conserve rare plant species. Introduction experiments offer a direct test of recruitment limitation, but generally only the seed germination and seedling phases are monitored. Thus the relative importance of different establishment stages in the process of recruitment is not considered. This is particularly true for parasitic plants where empirical data are generally missing. During two consecutive growing seasons we examined the effect of heathland management applications, degree of heathland succession (pioneer, building and mature phase) and seed-density on the recruitment and establishment of the endangered holoparasite Cuscuta epithymum. In general, recruitment after two growing seasons was low with 4.79% of the sown seeds that successfully emerged to the seedling stage and a final establishment of 89 flowering adults (i.e. <1.5% of the sown seeds). Although a higher seed-density resulted in a higher number of seedlings, seed-density did not significantly affected relative germination percentages. The management type and subsequent heath succession had no significant effect on seedling emergence; whereas, seedling attachment to the host, establishment and growth to full-grown size were hampered in older heath vegetation (i.e. high, dense, and mature canopy). Establishment was most successful in turf-cut pioneer heathland, characterised by a relatively open and low vegetation of young Calluna vulgaris. The age of C. vulgaris, C. epithymum's main host, proved to be the most limiting factor. These results emphasise the importance of site quality (i.e. successional phase of its host) on recruitment success of C. epithymum, which is directly affected by the management applied to the vegetation. Lack of any heathland management will thus seriously restrict establishment of the endangered parasite.

Guidelines for the evaluation and assessment of the sustainable use of resources and of wastes management at healthcare facilities.

PubMed

Townend, William K; Cheeseman, Christopher R

2005-10-01

This paper presents guidelines that can be used by managers of healthcare facilities to evaluate and assess the quality of resources and waste management at their facilities and enabling the principles of sustainable development to be addressed. The guidelines include the following key aspects which need to be considered when completing an assessment. They are: (a) general management; (b) social issues; (c) health and safety; (d) energy and water use; (e) purchasing and supply; (f) waste management (responsibility, segregation, storage and packaging); (g) waste transport; (h) recycling and re-use; (i) waste treatment; and (j) final disposal. They identify actions required to achieve a higher level of performance which can readily be applied to any healthcare facility, irrespective of the local level of social, economic and environmental development. The guidelines are presented, and the characteristics of facilities associated with sustainable (level 4) and unsustainable (level 0) healthcare resource and wastes management are outlined. They have been used to assess a major London hospital, and this highlighted a number of deficiencies in current practice, including a lack of control over purchasing and supply, and very low rates of segregation of municipal solid waste from hazardous healthcare waste.

Risk management. National Aeronautics and Space Administration (NASA). Interim rule adopted as final with changes.

PubMed

2000-11-22

This is a final rule amending the NASA FAR Supplement (NFS) to emphasize considerations of risk management, including safety, security (including information technology security), health, export control, and damage to the environment, within the acquisition process. This final rule addresses risk management within the context of acquisition planning, selecting sources, choosing contract type, structuring award fee incentives, administering contracts, and conducting contractor surveillance.

75 FR 26981 - Notice of Establishment of Interim Final Supplementary Rules for Public Lands Managed by the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-13

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCACO8000 L16100000 DX0000] Notice of..., California AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Establishment of Interim Final Supplementary Rules. SUMMARY: In accordance with the Record of Decision for the Sierra Resource Management Plan...

76 FR 52690 - Final Environmental Impact Statement on Nabesna Off-Road Vehicle Management Plan, Wrangell-St...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

...-Road Vehicle Management Plan, Wrangell-St. Elias National Park and Preserve AGENCY: National Park... a Final Environmental Impact Statement (FEIS) on Off-Road Vehicle Management in the Nabesna District... preferred alternative and four action alternatives for management of off-road vehicles in the Nabesna...

76 FR 6564 - Florida: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-07

...: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY: Environmental... implement the RCRA hazardous waste management program. We granted authorization for changes to their program..., 06/ 62-730.185(1) F.A.C. Universal Waste Management. 29/07. State Initiated Changes to the 62-730.210...

78 FR 12347 - Notice of Availability of the Proposed Resource Management Plan and Final Environmental Impact...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

... Historic trails. The four alternatives were: Alternative A: Continues existing management practices (no... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLWYR05000 L16100000.DQ0000 LXSS04 K0000] Notice of Availability of the Proposed Resource Management Plan and Final Environmental Impact Statement...

Specifics of MS training in the area of nuclear materials safe management for new-comers in nuclear power

NASA Astrophysics Data System (ADS)

Geraskin, N. I.; Glebov, V. B.

2017-01-01

The issues of specialists training in the field of nuclear materials safe management for the countries, who have taken a way of nuclear power development are analyzed. Arguments in justification of a need of these specialists training for the new-comers are adduced. The general characteristic of the reference MS program “Nuclear materials safe management” is considered. The peculiar features of the program, which is important for graduates from the new-comers have been analyzed. The best practices got as a result of implementation of the program in recent years for the students from Kazakhstan, Belarus, Azerbaijan, Tajikistan, Iran, Turkey and other countries are presented. Finally, the directions of international cooperation in further improvement and development of the program are considered.

Shuttle avionics and the goal language including the impact of error detection and redundancy management

NASA Technical Reports Server (NTRS)

Flanders, J. H.; Helmers, C. T.; Stanten, S. F.

1973-01-01

The relationship is examined between the space shuttle onboard avionics and the ground test computer language GOAL when used in the onboard computers. The study is aimed at providing system analysis support to the feasibility analysis of a GOAL to HAL translator, where HAL is the language used to program the onboard computers for flight. The subject is dealt with in three aspects. First, the system configuration at checkout, the general checkout and launch sequences, and the inventory of subsystems are described. Secondly, the hierarchic organization of onboard software and different ways of introducing GOAL-derived software onboard are described. Also the flow of commands and test data during checkout is diagrammed. Finally, possible impact of error detection and redundancy management on the GOAL language is discussed.

Implementation Of Quality Management System For Irradiation Processing Services

NASA Astrophysics Data System (ADS)

Lungu, Ion-Bogdan; Manea, Maria-Mihaela

2015-07-01

In today's market, due to an increasing competitiveness, quality management has set itself as an indispensable tool and a reference point for every business. It is ultimately focused on customer satisfaction which is a stringent factor for every business. Implementing and maintaining a QMS is a rather difficult, time consuming and expensive process which must be done with respect of many factors. The aim of this paper is to present a case study for implementing QMS ISO 9001 in a gamma irradiation treatment service provider. The research goals are the identification of key benefits, reasons, advantages, disadvantages, drawbacks etc for a successful QMS implementation and use. Finally, the expected results focus on creating a general framework for implementing an efficient QMS plan that can be easily adapted to other kind of services and markets.

Educational visiting and hypnosedative prescribing in general practice.

PubMed

Yeo, G T; de Burgh, S P; Letton, T; Shaw, J; Donnelly, N; Swinburn, M E; Phillips, S; Bridges-Webb, C; Mant, A

1994-03-01

Public concern about the prescription of hypnosedative drugs (mostly benzodiazepines) led to a controlled trial of an educational intervention to promote rational prescribing by general practitioners (GPs). This paper describes the educational intervention and its process evaluation. In urban and rural New South Wales 137 GPs were visited in office hours by a GP or pharmacist who had undergone communication skills training. Material offered to GPs included relaxation tapes and a booklet of problem-orientated management guidelines. The interview had three stages: rapport was established, then educational material was introduced and finally the visitor sought the doctor's agreement to review five patients on long-term benzodiazepines. The visits were well received. Several measures were composed to reflect doctors' motivation and interest in non-drug management; there was virtually no correlation between any of these process measures and the trial outcome: a change in prescribing behaviour. Self-rating of benzodiazepine prescribing greatly underestimated actual self-reported incidents of prescribing. We interpret this as a reminder that we do not always do what we mean to do, and that we do not always do what we think we do.

Excavated Soils Management Plan for AOCs 44 and 52, Fort Devens

DTIC Science & Technology

1994-05-01

I FORT DEVENS AOCs 44 AND 52 I I I FINAL EXCAVATED SOILS MANAGEMENT PLAN DATA ITEM A009I I U 20070424310 I CONTRACT DAAA15-91-D-0008 I U.S. ARMY...obselete FINAL EXCAVATED SOILS MANAGEMENT PLAN FOR AOCs 44 AND 52 FORT DEVENS Prepared for. U.S. Army Enviromnental Center Aberdeen Proving Ground, Maryland...BLANK 3 I I I I I I I I I I FINAL EXCAVATED SOILS MANAGEMENT PLAN FOR AOCs 44 AND 52 FORT DEVENS TABLE OF CONTENTS 1 Section Title Page No. 1.0

Acceptance model of a Hospital Information System.

PubMed

Handayani, P W; Hidayanto, A N; Pinem, A A; Hapsari, I C; Sandhyaduhita, P I; Budi, I

2017-03-01

The purpose of this study is to develop a model of Hospital Information System (HIS) user acceptance focusing on human, technological, and organizational characteristics for supporting government eHealth programs. This model was then tested to see which hospital type in Indonesia would benefit from the model to resolve problems related to HIS user acceptance. This study used qualitative and quantitative approaches with case studies at four privately owned hospitals and three government-owned hospitals, which are general hospitals in Indonesia. The respondents involved in this study are low-level and mid-level hospital management officers, doctors, nurses, and administrative staff who work at medical record, inpatient, outpatient, emergency, pharmacy, and information technology units. Data was processed using Structural Equation Modeling (SEM) and AMOS 21.0. The study concludes that non-technological factors, such as human characteristics (i.e. compatibility, information security expectancy, and self-efficacy), and organizational characteristics (i.e. management support, facilitating conditions, and user involvement) which have level of significance of p<0.05, significantly influenced users' opinions of both the ease of use and the benefits of the HIS. This study found that different factors may affect the acceptance of each user in each type of hospital regarding the use of HIS. Finally, this model is best suited for government-owned hospitals. Based on the results of this study, hospital management and IT developers should have more understanding on the non-technological factors to better plan for HIS implementation. Support from management is critical to the sustainability of HIS implementation to ensure HIS is easy to use and provides benefits to the users as well as hospitals. Finally, this study could assist hospital management and IT developers, as well as researchers, to understand the obstacles faced by hospitals in implementing HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

76 FR 62821 - Notice of Final Supplementary Rules for Public Lands in Colorado: North Fruita Desert Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-11

.... Background Recreation resource management decisions for the GJFO were detailed in the Grand Junction Resource Area (GJRA) Resource Management Plan (RMP) in 1987. The Grand Valley, including the North Fruita Desert... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCON03000-L12200000-PA0000] Notice of Final...

75 FR 32968 - Final Supplementary Rules for Public Land Administered by the Bureau of Land Management in...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-10

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCO910000, L71220000.PN0000, LVTFC002CO00] Final Supplementary Rules for Public Land Administered by the Bureau of Land Management in Colorado Relating to Camping and Occupancy of Public Lands AGENCY: Bureau of Land Management, Interior. ACTION...

Hazardous Waste Management System - Identification and Listing of Hazardous Waste - Recycled Used Oil Management Standards - Federal Register Notice, May 3, 1993

EPA Pesticide Factsheets

This action corrects several technical errors and provides clarifying amendments to the final recycled used oil management standards rule. The final rule was published on September 10, 1992 (57 FR 41566).

75 FR 6839 - Technical Service Provider Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-12

... Executive Order 12866, the Office of Management and Budget determined that this final rule is not a... or are eligible to participate in conservation programs to help them make land management decisions...: Covered Programs. The interim final rule incorporated reference to the Agricultural Management Assistance...

78 FR 25678 - Georgia: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-02

...: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY: Environmental... of changes to its hazardous waste program under the Resource Conservation and Recovery Act (RCRA... Gwendolyn Gleaton, Permits and State Programs Section, RCRA Programs and Materials Management Branch, RCRA...

Improving Water Resources System Operation by Direct Use of Hydroclimatic Information

NASA Astrophysics Data System (ADS)

Castelletti, A.; Pianosi, F.

2011-12-01

It is generally agreed that more information translates into better decisions. For instance, the availability of inflow predictions can improve reservoir operation; soil moisture data can be exploited to increase irrigation efficiency; etc. However, beyond this general statement, many theoretical and practical questions remain open. Provided that not all information sources are equally relevant, how does their value depend on the physical features of the water system and on the purposes of the system operation? What is the minimum lead time needed for anticipatory management to be effective? How does uncertainty in the information propagates through the modelling chain from hydroclimatic data through descriptive and decision models, and finally affect the decision? Is the data-predictions-decision paradigm truly effective or would it be better to directly use hydroclimatic data to take optimal decisions, skipping the intermediate step of hydrological forecasting? In this work we investigate these issues by application to the management of a complex water system in Northern Vietnam, characterized by multiple, conflicting objectives including hydropower production, flood control and water supply. First, we quantify the value of hydroclimatic information as the improvement in the system performances that could be attained under the (ideal) assumption of perfect knowledge of all future meteorological and hydrological input. Then, we assess and compare the relevance of different candidate information (meteorological or hydrological observations; ground or remote data; etc.) for the purpose of system operation by novel Input Variable Selection techniques. Finally, we evaluate the performance improvement made possible by the use of such information in re-designing the system operation.

10 CFR 473.24 - Final action and certification by manager.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Final action and certification by manager. 473.24 Section 473.24 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION AUTOMOTIVE PROPULSION RESEARCH AND DEVELOPMENT Review and Certification of Grants, Cooperative Agreements, Contracts, and Projects § 473.24 Final action...

10 CFR 473.24 - Final action and certification by manager.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Final action and certification by manager. 473.24 Section 473.24 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION AUTOMOTIVE PROPULSION RESEARCH AND DEVELOPMENT Review and Certification of Grants, Cooperative Agreements, Contracts, and Projects § 473.24 Final action...

10 CFR 473.24 - Final action and certification by manager.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Final action and certification by manager. 473.24 Section 473.24 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION AUTOMOTIVE PROPULSION RESEARCH AND DEVELOPMENT Review and Certification of Grants, Cooperative Agreements, Contracts, and Projects § 473.24 Final action...

10 CFR 473.24 - Final action and certification by manager.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Final action and certification by manager. 473.24 Section 473.24 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION AUTOMOTIVE PROPULSION RESEARCH AND DEVELOPMENT Review and Certification of Grants, Cooperative Agreements, Contracts, and Projects § 473.24 Final action...

10 CFR 473.24 - Final action and certification by manager.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Final action and certification by manager. 473.24 Section 473.24 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION AUTOMOTIVE PROPULSION RESEARCH AND DEVELOPMENT Review and Certification of Grants, Cooperative Agreements, Contracts, and Projects § 473.24 Final action...

78 FR 52909 - Consumer Financial Protection Bureau Notice of Availability of Final Environmental Assessment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

...: [email protected] . Mail/Hand Delivery/Courier: Michael Davis, Project Manager, Consumer Financial... application of best management practices (BMP) to minimize short term air quality and noise impact during... of Final Environmental Assessment (FINAL EA) and a Finding of No Significant Impact (FONSI) for...

77 FR 69788 - Colorado: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

...: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY: Environmental... authorization of changes to its hazardous waste program under the Resource Conservation and Recovery Act (RCRA). The EPA proposes to grant final authorization to the hazardous waste program changes submitted by the...

76 FR 31303 - Notice of Availability or Record of Decision and Final Findings of Approvability to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-31

... continued comprehensive protection of Washington's coastal resources. OCRM did not select either Alternative... Record of Decision and Final Findings of Approvability to the Washington Coastal Zone Management Program... and Coastal Resource Management. ACTION: Notice of Availability or Record of Decision and Final...

The future for weed control and technology.

PubMed

Shaner, Dale L; Beckie, Hugh J

2014-09-01

This review is both a retrospective (what have we missed?) and prospective (where are we going?) examination of weed control and technology, particularly as it applies to herbicide-resistant weed management (RWM). Major obstacles to RWM are discussed, including lack of diversity in weed management, unwillingness of many weed researchers to conduct real integrated weed management research or growers to accept recommendations, influence or role of agrichemical marketing and governmental policy and lack of multidisciplinary research. We then look ahead to new technologies that are needed for future weed control in general and RWM in particular, in areas such as non-chemical and chemical weed management, novel herbicides, site-specific weed management, drones for monitoring large areas, wider application of 'omics' and simulation model development. Finally, we discuss implementation strategies for integrated weed management to achieve RWM, development of RWM for developing countries, a new classification of herbicides based on mode of metabolism to facilitate greater stewardship and greater global exchange of information to focus efforts on areas that maximize progress in weed control and RWM. There is little doubt that new or emerging technologies will provide novel tools for RMW in the future, but will they arrive in time? © 2013 Her Majesty the Queen in Right of Canada Pest Management Science © 2013 Society of Chemical Industry.

76 FR 67092 - Magnuson-Stevens Act Provisions; Fisheries Off West Coast States; Pacific Coast Groundfish...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

... Coast Groundfish Fishery; Biennial Specifications and Management Measures; Inseason Adjustments AGENCY.... ACTION: Final rule; inseason adjustments to biennial groundfish management measures; request for comments. SUMMARY: This final rule announces inseason changes to management measures in the commercial Pacific Coast...

76 FR 6594 - North Carolina: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-07

... Carolina: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY: Environmental... authorization of the changes to its hazardous waste program under the Resource Conservation and Recovery Act... Section, RCRA Programs and Materials Management Branch, RCRA Division, U.S. Environmental Protection...

76 FR 6594 - Florida: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-07

...: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY: Environmental... of the changes to its hazardous waste program under the Resource Conservation and Recovery Act (RCRA... and State Programs Section, RCRA Programs and Materials Management Branch, RCRA Division, U.S...

77 FR 60963 - Tennessee: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-05

...: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY: Environmental... of the changes to its hazardous waste program under the Resource Conservation and Recovery Act (RCRA... Johnson, Permits and State Programs Section, RCRA Programs and Materials Management Branch, RCRA Division...

A collaborative project to improve identification and management of patients with chronic kidney disease in a primary care setting in Greater Manchester.

PubMed

Humphreys, John; Harvey, Gill; Coleiro, Michelle; Butler, Brook; Barclay, Anna; Gwozdziewicz, Maciek; O'Donoghue, Donal; Hegarty, Janet

2012-08-01

Research has demonstrated a knowledge and practice gap in the identification and management of chronic kidney disease (CKD). In 2009, published data showed that general practices in Greater Manchester had a low detection rate for CKD. A 12-month improvement collaborative, supported by an evidence-informed implementation framework and financial incentives. 19 general practices from four primary care trusts within Greater Manchester. Number of recorded patients with CKD on practice registers; percentage of patients on registers achieving nationally agreed blood pressure targets. The collaborative commenced in September 2009 and involved three joint learning sessions, interspersed with practice level rapid improvement cycles, and supported by an implementation team from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Greater Manchester. At baseline, the 19 collaborative practices had 4185 patients on their CKD registers. At final data collection in September 2010, this figure had increased by 1324 to 5509. Blood pressure improved from 34% to 74% of patients on practice registers having a recorded blood pressure within recommended guidelines. Evidence-based improvement can be implemented in practice for chronic disease management. A collaborative approach has been successful in enabling teams to test and apply changes to identify patients and improve care. The model has proved to be more successful for some practices, suggesting a need to develop more context-sensitive approaches to implementation and actively manage the factors that influence the success of the collaborative.

Integrated Traffic Flow Management Decision Making

NASA Technical Reports Server (NTRS)

Grabbe, Shon R.; Sridhar, Banavar; Mukherjee, Avijit

2009-01-01

A generalized approach is proposed to support integrated traffic flow management decision making studies at both the U.S. national and regional levels. It can consider tradeoffs between alternative optimization and heuristic based models, strategic versus tactical flight controls, and system versus fleet preferences. Preliminary testing was accomplished by implementing thirteen unique traffic flow management models, which included all of the key components of the system and conducting 85, six-hour fast-time simulation experiments. These experiments considered variations in the strategic planning look-ahead times, the replanning intervals, and the types of traffic flow management control strategies. Initial testing indicates that longer strategic planning look-ahead times and re-planning intervals result in steadily decreasing levels of sector congestion for a fixed delay level. This applies when accurate estimates of the air traffic demand, airport capacities and airspace capacities are available. In general, the distribution of the delays amongst the users was found to be most equitable when scheduling flights using a heuristic scheduling algorithm, such as ration-by-distance. On the other hand, equity was the worst when using scheduling algorithms that took into account the number of seats aboard each flight. Though the scheduling algorithms were effective at alleviating sector congestion, the tactical rerouting algorithm was the primary control for avoiding en route weather hazards. Finally, the modeled levels of sector congestion, the number of weather incursions, and the total system delays, were found to be in fair agreement with the values that were operationally observed on both good and bad weather days.

From the Children’s Oncology Group: Evidence-based recommendations for PEG-asparaginase nurse monitoring, hypersensitivity reaction management, and patient/family education

PubMed Central

Woods, Deborah; Winchester, Kari; Towerman, Alison; Gettinger, Katie; Carey, Christina; Timmermann, Karen; Langley, Rachel; Browne, Emily

2017-01-01

PEG-aspariginase is a backbone chemotherapy agent in pediatric acute lymphoblastic leukemia and in some non-Hodgkin lymphoma therapies. Nurses lack standardized guidelines for monitoring patients receiving PEG-asparaginase and for educating patients/families about hypersensitivity reaction risks. An electronic search of six databases using publication years 2000–2015 and multiple professional organizations and clinical resources was conducted. Evidence sources were reviewed for topic applicability. Each of the final 23 sources was appraised by two team members. The GRADE system was used to assign a quality and strength rating for each recommendation. Multiple recommendations were developed: four relating to nurse monitoring of patients during and after drug administration, eight guiding hypersensitivity reaction management, and four concerning patient/family educational content. These strong recommendations were based on moderate, low, or very-low quality evidence. Several recommendations relied upon generalized drug hypersensitivity guidelines. Additional research is needed to safely guide PEG-asparaginase monitoring, hypersensitivity reaction management and patient/family education. Nurses administering PEG-asparaginase play a critical role in the early identification and management of hypersensitivity reactions. PMID:28602129

Care home manager attitudes to balancing risk and autonomy for residents with dementia.

PubMed

Evans, Elizabeth A; Perkins, Elizabeth; Clarke, Pam; Haines, Alina; Baldwin, Ashley; Whittington, Richard

2018-02-01

To determine how care home managers negotiate the conflict between maintaining a safe environment while enabling the autonomy of residents with dementia. This is important because there is limited research with care home managers; yet, they are key agents in the implementation of national policies. Semi-structured interviews were conducted with 18 managers from care homes offering dementia care in the Northwest of England. Data were analysed using a thematic analysis approach. There were three areas in which care home staff reported balancing safety and risk against the individual needs of residents. First, the physical environment created a tension between safety and accessibility to the outside world, which meant that care homes provided highly structured or limited access to outdoor space. Second, care home managers reflected a balancing act between an individual's autonomy and the need to protect their residents' dignity. Finally, care home managers highlighted the ways in which an individual's needs were framed by the needs of other residents to the extent that on some occasions an individual's needs were subjugated to the needs of the general population of a home. There was a strong, even dominant, ethos of risk management and keeping people safe. Managing individual needs while maintaining a safe care home environment clearly is a constant dynamic interpersonal process of negotiating and balancing competing interests for care home managers.

Psychological and social consequences after reconstruction of upper extremity trauma: methods of detection and management.

PubMed

Galanakos, Spyridon P; Bot, Arjan G J; Zoubos, Aristides B; Soucacos, Panayotis N

2014-03-01

Upper extremity trauma and resulting disability is a stressful event and can affect a patient's personality. Several studies have shown that this injury type has serious psychological and/or social consequences. We systematically reviewed the evidence on the consequences of disability after a complex trauma (combination of soft tissue, osseous, vascular, and nerve involvement) of the upper extremity. We tried to find out the potential crucial factors that could determine the final hand function. In addition, we considered the challenges that need to be addressed to eliminate the adverse or negative effects that arise from upper limb trauma. In the literature, there is a growing interest to study changes in patients' quality of life and return to work. Psychological morbidity is an important part of patients' perceived general health. These issues could play an important role in the final functional outcome of the therapy. An early identification and treatment of trauma-related distress in patients may prevent progression of psychological pathology and mitigate negative effects on general health status. It may be important to evaluate the amount of psychological distress when caring for patients with hand injuries. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

75 FR 81187 - South Dakota: Final Authorization of State Hazardous Waste Management Program Revision

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-27

...: Final Authorization of State Hazardous Waste Management Program Revision AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed Rule. SUMMARY: The Solid Waste Disposal Act, as amended, commonly... Agency (EPA) to authorize states to operate their hazardous waste management programs in lieu of the...

Risk factors associated with Cryptosporidium parvum infection in dairy cattle in southeastern New York State.

PubMed

Mohammed, H O; Wade, S E; Schaaf, S

1999-06-01

An observational analytical epidemiologic study was carried out to identify factors associated with the risk of infection with Cryptosporidium parvum in dairy herds in southeastern New York state. A random sample of 2943 cattle on 109 farms was selected from the target population. Fecal samples were collected from animals in three different age groups and examined for the presence of C. parvum using a quantitative centrifugation concentration flotation method. Data on intrinsic, preweaning, postweaning, maternity, and general management factors were collected and evaluated for their association with the risk of infection with C. parvum. Indices for each of these categories of management were developed from factors significantly associated with the risk of infection with C. parvum. Significant factors were identified using the logistic regression statistical technique. A final analysis, including the indices, age, and season, was performed to identify factors significantly associated with the risk of infection with C. parvum while simultaneously controlling for the effect of other factors. The farm effect was evaluated using a mixed effect model. Preweaning factors found to be significantly associated with a decreased risk of infection were: use of ventilation in calf rearing areas, daily addition of bedding, feeding of milk replacer, daily disposal and cleaning of bedding, and use of antibiotics. Postweaning factors such as moving of the animals after weaning, cleaning of soiled bedding, and use of antibiotics and ionophores as preventive measures were significantly associated with the decreased risk of an infection with C. parvum. Consideration of maternity management factors showed that winter housing of cows individually within 2 months of calving, use of fresh colostrum to feed calves, and having a concrete floor in the calving area were significantly associated with decreased risk of C. parvum infection. The total number of dairy cattle, total number of other species of agricultural animals on the farm, and the distance of the barn water source from the septic system were found to be significantly associated with increased risk of C. parvum infection. In the final analysis, the risk of infection with C. parvum was significantly decreased with an increased value of the maternity management index score. The general management significantly affected the risk of infection with C. parvum where the risk increased with the increase of the value of the index. The risk of infection significantly decreased with increase in the age of the animal.

Non-operative management of hepatic trauma and the interventional radiology: an update review.

PubMed

Pereira, Bruno Monteiro Tavares

2013-10-01

The growing trend to manage hepatic injuries nonoperatively has been increasing demand for advanced endovascular interventions. This brings up the necessity for general and trauma surgeons to update their knowledge in such matter. Effective treatment mandates a multispecialty team effort that is usually led by the trauma surgeon and includes vascular surgery, orthopedics, and, increasingly, interventional radiology. The focus on hemorrhage control and the angiographer's unique access to vascular structures gives interventional radiology (IR) an important and increasingly recognized role in the treatment of patients with hemodynamic instability. Our aim is to review the basic concepts of IR primarily in hepatic trauma and secondarily in some other special situations. A liver vascular anatomy review is also needed for better understanding the roles of IR. As a final point we propose a guideline for the operative/nonoperative management of traumatic hepatic injuries. The benefit of multidisciplinary approach (TAE) appears to be a powerful weapon in the medical arsenal against the high mortality of injured trauma liver patients.

Management of bleeding from an abnormally located S6 arterial branch in a common origin with S2 branch during live surgery.

PubMed

Abu Akar, Firas; Gonzalez-Rivas, Diego; Fink, Daniel

2016-01-01

In 24 th /03/2016 we organized the first uniportal video-assisted thoracic surgery (VATS) live surgery workshop in Jerusalem at our institution with our special guest Dr. Diego Gonzalez-Rivas, more than 30 participants attended this workshop from Israeli and the Palestinian territories (cardiothoracic and vascular surgeons, general surgeons, anesthesiologists and nurses). During the workshop Dr. Gonzalez operated two complex cases while the first case was an anatomical S1 segmentectomy, the second case (the one which we are reporting in this paper) was bilobectomy of right middle and lower lobes, during this case a profuse bleeding appeared while introducing the stapler in the interlobar fissure, the source of this bleeding was an abnormally located arterial branch, however the bleeding managed perfectly by Dr. Gonzalez-Rivas, although this surgery kept all of us in a state, all the attendees were happy to see the way how this bleeding managed and everybody was satisfied with the final result.

Management of bleeding from an abnormally located S6 arterial branch in a common origin with S2 branch during live surgery

PubMed Central

Gonzalez-Rivas, Diego; Fink, Daniel

2016-01-01

In 24th/03/2016 we organized the first uniportal video-assisted thoracic surgery (VATS) live surgery workshop in Jerusalem at our institution with our special guest Dr. Diego Gonzalez-Rivas, more than 30 participants attended this workshop from Israeli and the Palestinian territories (cardiothoracic and vascular surgeons, general surgeons, anesthesiologists and nurses). During the workshop Dr. Gonzalez operated two complex cases while the first case was an anatomical S1 segmentectomy, the second case (the one which we are reporting in this paper) was bilobectomy of right middle and lower lobes, during this case a profuse bleeding appeared while introducing the stapler in the interlobar fissure, the source of this bleeding was an abnormally located arterial branch, however the bleeding managed perfectly by Dr. Gonzalez-Rivas, although this surgery kept all of us in a state, all the attendees were happy to see the way how this bleeding managed and everybody was satisfied with the final result. PMID:29399474

Hepatic encephalopathy: cause and possible management with botanicals.

PubMed

Tripathi, Suyash; Tripathi, Yamini B

2014-01-01

Hepatic encephalopathy is a brain functional disorder, characterized by neuropsychiatric abnormalities with liver failure. High blood ammonia, causing glutamate neurotoxicity is the basic cause, finally leading to low-grade cerebral edema. Its manifestation is more likely in patients of sepsis, oxidative stress, generalized inflammation, gut mal-functioning, amoebiaesis, viral hepatitis, nervous imbalance, etc. Thus, the therapeutic goals primarily include the maintenance of proper blood supply and prevention of hypoxic condition in liver, along with management of factors responsible for high blood ammonia, oxidative stress, inflammation, and high GI- serotonin. The drugs in clinical practice include lactulose, sodium benzoate, flumazenil and rifaximin, supplementation of zinc, branched chain amino acids (BCAA), l-ornithine-l aspartate, antioxidants and iNOS inhibitors. However, herbal formulations would be of great importance as it shows multi-targeted action because it possesses a natural cocktail of secondary metabolites. It can collectively act as an antioxidant, anti-inflammatory, prebiotic, hepatoprotective and neuron-protective agents. We have briefly outlined some of these plants and also recent patents useful in the management of hepatic encephalopathy.

MouseNet database: digital management of a large-scale mutagenesis project.

PubMed

Pargent, W; Heffner, S; Schäble, K F; Soewarto, D; Fuchs, H; Hrabé de Angelis, M

2000-07-01

The Munich ENU Mouse Mutagenesis Screen is a large-scale mutant production, phenotyping, and mapping project. It encompasses two animal breeding facilities and a number of screening groups located in the general area of Munich. A central database is required to manage and process the immense amount of data generated by the mutagenesis project. This database, which we named MouseNet(c), runs on a Sybase platform and will finally store and process all data from the entire project. In addition, the system comprises a portfolio of functions needed to support the workflow management of the core facility and the screening groups. MouseNet(c) will make all of the data available to the participating screening groups, and later to the international scientific community. MouseNet(c) will consist of three major software components:* Animal Management System (AMS)* Sample Tracking System (STS)* Result Documentation System (RDS)MouseNet(c) provides the following major advantages:* being accessible from different client platforms via the Internet* being a full-featured multi-user system (including access restriction and data locking mechanisms)* relying on a professional RDBMS (relational database management system) which runs on a UNIX server platform* supplying workflow functions and a variety of plausibility checks.

The effect of a mindful restaurant eating intervention on weight management in women.

PubMed

Timmerman, Gayle M; Brown, Adama

2012-01-01

To evaluate the effect of a Mindful Restaurant Eating intervention on weight management. Randomized control trial. Greater metropolitan area of Austin, Texas. Women (n = 35) 40-59 years old who eat out at least 3 times per week. The intervention, using 6 weekly 2-hour, small group sessions, focused on reducing calorie and fat intake when eating out through education, behavior change strategies, and mindful eating meditations. Weight, waist circumference, self-reported daily calorie and fat intake, self-reported calories and fat consumed when eating out, emotional eating, diet related self-efficacy, and barriers to weight management when eating out. General linear models examined change from baseline to final endpoint to determine differences in outcomes between the intervention and control group. Participants in the intervention group lost significantly more weight (P =.03), had lower average daily caloric (P = .002) and fat intake (P = .001), had increased diet-related self-efficacy (P = .02), and had fewer barriers to weight management when eating out (P = .001). Mindful Restaurant Eating intervention was effective in promoting weight management in perimenopausal women. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Integrated design and management of complex and fast track projects

NASA Astrophysics Data System (ADS)

Mancini, Dario

2003-02-01

Modern scientific and technological projects are increasingly in competition over scientific aims, technological innovation, performance, time and cost. They require a dedicated and innovative organization able to satisfy contemporarily various technical and logistic constraints imposed by the final user, and guarantee the satisfaction of technical specifications, identified on the basis of scientific aims. In order to satisfy all the above, the management has to be strategically innovative and intuitive, by removing, first of all, the bottlenecks that are pointed out, usually only at the end of the projects, as the causes of general dissatisfaction. More than 30 years spent working on complex multidisciplinary systems and 20 years of formative experience in managing contemporarily both scientific, technological and industrial projects have given the author the possibility to study, test and validate strategies for parallel project management and integrated design, merged in a sort of unique optimized task, using the newly-coined word "Technomethodology". The paper highlights useful information to be taken into consideration during project organization to minimize the program deviations from the expected goals and describe some of the basic meanings of this new advanced method that is the key for parallel successful management of multiple and interdisciplinary activities.

Management of relapsed multiple myeloma: recommendations of the International Myeloma Working Group.

PubMed

Laubach, J; Garderet, L; Mahindra, A; Gahrton, G; Caers, J; Sezer, O; Voorhees, P; Leleu, X; Johnsen, H E; Streetly, M; Jurczyszyn, A; Ludwig, H; Mellqvist, U-H; Chng, W-J; Pilarski, L; Einsele, H; Hou, J; Turesson, I; Zamagni, E; Chim, C S; Mazumder, A; Westin, J; Lu, J; Reiman, T; Kristinsson, S; Joshua, D; Roussel, M; O'Gorman, P; Terpos, E; McCarthy, P; Dimopoulos, M; Moreau, P; Orlowski, R Z; Miguel, J S; Anderson, K C; Palumbo, A; Kumar, S; Rajkumar, V; Durie, B; Richardson, P G

2016-05-01

The prognosis for patients multiple myeloma (MM) has improved substantially over the past decade with the development of new, more effective chemotherapeutic agents and regimens that possess a high level of anti-tumor activity. In spite of this important progress, however, nearly all MM patients ultimately relapse, even those who experience a complete response to initial therapy. Management of relapsed MM thus represents a vital aspect of the overall care for patients with MM and a critical area of ongoing scientific and clinical research. This comprehensive manuscript from the International Myeloma Working Group provides detailed recommendations on management of relapsed disease, with sections dedicated to diagnostic evaluation, determinants of therapy, and general approach to patients with specific disease characteristics. In addition, the manuscript provides a summary of evidence from clinical trials that have significantly impacted the field, including those evaluating conventional dose therapies, as well as both autologous and allogeneic stem cell transplantation. Specific recommendations are offered for management of first and second relapse, relapsed and refractory disease, and both autologous and allogeneic transplant. Finally, perspective is provided regarding new agents and promising directions in management of relapsed MM.

Chronic constipation: Current treatment options

PubMed Central

Liu, Louis Wing Cheong

2011-01-01

Chronic constipation is a common functional gastrointestinal disorder that affects patients of all ages. In 2007, a consensus group of 10 Canadian gastroenterologists developed a set of recommendations pertaining to the management of chronic constipation and constipation-dominant irritable bowel syndrome. Since then, tegaserod has been withdrawn from the Canadian market. A new, highly selective serotonin receptor subtype 4 agonist, prucalopride, has been examined in several large, randomized, placebo-controlled trials demonstrating its efficacy and safety in the management of patients with chronic constipation. Additional studies evaluating the use of stimulant laxatives, polyethylene glycol and probiotics in the management of chronic constipation have also been published. The present review summarizes the previous recommendations and new evidence supporting different treatment modalities – namely, diet and lifestyle, bulking agents, stool softeners, osmotic and stimulant laxatives, prucalopride and probiotics in the management of chronic constipation. A brief summary of lubiprostone and linaclotide is also presented. The quality of evidence is presented by adopting the Grading of Recommendations, Assessment, Development and Evaluation system. Finally, a management pyramid for patients with chronic constipation is proposed based on the quality of evidence, impact of each modality on constipation and on general health, and their availabilities in Canada. PMID:22114754

The Effect of a Mindful Restaurant Eating Intervention on Weight Management in Women

PubMed Central

Timmerman, Gayle M.; Brown, Adama

2011-01-01

Objective To evaluate the effect of a Mindful Restaurant Eating intervention on weight management. Design Random control trial. Setting Greater metropolitan area of Austin, Texas. Participants Women (n = 35) 40-59 years old who eat out at least 3 times per week. Intervention The intervention, using 6 weekly 2 hour small group sessions, focused on reducing calorie and fat intake when eating out through education, behavior change strategies, and mindful eating meditations. Main Outcome Measures Weight, waist circumference, self-reported daily calorie and fat intake, self-reported calories and fat consumed when eating out, emotional eating, diet related self-efficacy, and barriers to weight management when eating out. Analysis General linear models examined change from baseline to final endpoint to determine differences in outcomes between the intervention and control group. Results Participants in the intervention group lost significantly more weight (P =.03), had lower average daily caloric (P =.002) and fat intake (P =.001), had increased diet related self-efficacy (P =.02), and had fewer barriers to weight management when eating out (P =.001). Conclusions and Implications Mindful Restaurant Eating intervention was effective in promoting weight management in perimenopausal women. PMID:22243980

Requirements Analysis for the Army Safety Management Information System (ASMIS)

DTIC Science & Technology

1989-03-01

8217_>’ Telephone Number « .. PNL-6819 Limited Distribution Requirements Analysis for the Army Safety Management Information System (ASMIS) Final...PNL-6819 REQUIREMENTS ANALYSIS FOR THE ARMY SAFETY MANAGEMENT INFORMATION SYSTEM (ASMIS) FINAL REPORT J. S. Littlefield A. L. Corrigan March...accidents. This accident data is available under the Army Safety Management Information System (ASMIS) which is an umbrella for many databases

[Extravasation of contrast media at the puncture site: Strategies for managment].

PubMed

Pacheco Compaña, F J; Gago Vidal, B; Méndez Díaz, C

2014-01-01

The incidence of contrast medium extravasation at the venipuncture site has increased with the generalized use of automatic injectors. Most extravasations only cause slight edema and erythema. Nevertheless, in some cases extravasation can result in severe skin lesions or even in compartment syndrome. Lesions caused by extravasation usually resolve spontaneously with conservative treatment. Although the complications of extravasation are well known, institutional protocols are normally lacking and the criteria for taking action and the type of treatment, whether based on the literature or personal preferences, tend to vary. In this article, we review the incidence, risk factors, clinical manifestations, and options for preventing and treating contrast medium extravasation in soft tissues. Finally, we present the protocol we use to manage extravasation at our hospital. Copyright © 2013 SERAM. Published by Elsevier Espana. All rights reserved.

ALARA implementation throughout project life cycle

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

Haynes, M.J.

1995-03-01

A strength of radiation protection programs generally has been endorsement and application of the ALARA principle. In Ontario Hydro, which currently operates 20 commercial size nuclear units, great strides have been made in the last three decades in reducing occupational radiation exposure per unit of electricity generated. This paper will discuss specific applications of elements of the overall ALARA program which have most contributed to dose reduction as the nuclear program has expanded. This includes such things as management commitment, ALARA application in the design phase and major rehabilitation work, the benefits of the self protection concept, a specific examplemore » of elimination (or reduction) of the source term and the importance of dose targets. Finally, it is concluded that the major opportunities for further improvements may lie in the area of information management.« less

Comprehensive Self-Management Strategies.

PubMed

Bourbeau, J; Lavoie, K L; Sedeno, M

2015-08-01

In this article, we provide a review of the literature on self-management interventions and we are giving some thought to how, when, and by whom they should be offered to patients. The present literature based on randomized clinical trials has demonstrated benefits (reduced hospital admissions and improved health status) for chronic obstructive pulmonary disease (COPD) patients undergoing self-management interventions, although there are still problems with the heterogeneity among interventions, study populations, follow-up time, and outcome measures that make generalization difficult in real life. Key to the success, self-management intervention has to target behavior change. Proper self-management support is a basic prerequisite, for example, techniques and skills used by health care providers "case manager" to instrument patients with the knowledge, confidence, and skills required to effectively self-manage their disease. To improve health behaviors and engagement in self-management, self-management interventions need to target enhancing intrinsic motivation to change. This will best be done using client-centered communication (motivational communication) that encourages patients to express what intrinsically motivates them (e.g., consistent with their values or life goals) to adopt certain health behavior, with the goal of helping them overcome their ambivalence about change. Finally, if we want to be able to design and implement self-management interventions that are integrated, coherent, and have a strong likelihood of success, we need to take a more careful look and give more attention at the case manager, the patient (patient evaluation), and the quality assurance. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

77 FR 65401 - Notice of Availability of the Final Environmental Impact Statement for the Restoration Design...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-26

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLAZ910000.L13400000.DT0000.LXSS058A0000] Notice of Availability of the Final Environmental Impact Statement for the Restoration Design Energy Project and Proposed Resource Management Plan Amendments, AZ AGENCY: Bureau of Land Management, Interior...

75 FR 6218 - New Melones Lake Area Resource Management Plan, Tuolumne and Calaveras Counties, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-08

... DEPARTMENT OF THE INTERIOR Bureau of Reclamation New Melones Lake Area Resource Management Plan...) has made available for public review a Final RMP/EIS for the New Melones Lake Area. The Final RMP/EIS... Dan Holsapple, Acting New Melones Resource Manager, Bureau of Reclamation, at 209-536- 9094...

76 FR 30942 - Notice of Availability of the Final Environmental Impact Statement for Improvements to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-27

... Calexico, California. The Final EIS provides GSA and its stakeholders an analysis of the environmental... Sheehan, NEPA Project Manager, Portfolio Management Division, Capital Investment Branch (9P2PTC), U.S.../nepalibrary . Dated: May 19, 2011. Samuel R. Mazzola, Director, Portfolio Management Division, Pacific Rim...

Advisory Committee on human radiation experiments. Final report, Supplemental Volume 2. Sources and documentation

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

NONE

This volume and its appendixes supplement the Advisory Committee`s final report by reporting how we went about looking for information concerning human radiation experiments and intentional releases, a description of what we found and where we found it, and a finding aid for the information that we collected. This volume begins with an overview of federal records, including general descriptions of the types of records that have been useful and how the federal government handles these records. This is followed by an agency-by-agency account of the discovery process and descriptions of the records reviewed, together with instructions on how tomore » obtain further information from those agencies. There is also a description of other sources of information that have been important, including institutional records, print resources, and nonprint media and interviews. The third part contains brief accounts of ACHRE`s two major contemporary survey projects (these are described in greater detail in the final report and another supplemental volume) and other research activities. The final section describes how the ACHRE information-nation collections were managed and the records that ACHRE created in the course of its work; this constitutes a general finding aid for the materials deposited with the National Archives. The appendices provide brief references to federal records reviewed, descriptions of the accessions that comprise the ACHRE Research Document Collection, and descriptions of the documents selected for individual treatment. Also included are an account of the documentation available for ACHRE meetings, brief abstracts of the almost 4,000 experiments individually described by ACHRE staff, a full bibliography of secondary sources used, and other information.« less

Herd factors associated with dairy cow mortality.

PubMed

McConnel, C; Lombard, J; Wagner, B; Kopral, C; Garry, F

2015-08-01

Summary studies of dairy cow removal indicate increasing levels of mortality over the past several decades. This poses a serious problem for the US dairy industry. The objective of this project was to evaluate associations between facilities, herd management practices, disease occurrence and death rates on US dairy operations through an analysis of the National Animal Health Monitoring System's Dairy 2007 survey. The survey included farms in 17 states that represented 79.5% of US dairy operations and 82.5% of the US dairy cow population. During the first phase of the study operations were randomly selected from a sampling list maintained by the National Agricultural Statistics Service. Only farms that participated in phase I and had 30 or more dairy cows were eligible to participate in phase II. In total, 459 farms had complete data for all selected variables and were included in this analysis. Univariable associations between dairy cow mortality and 162 a priori identified operation-level management practices or characteristics were evaluated. Sixty of the 162 management factors explored in the univariate analysis met initial screening criteria and were further evaluated in a multivariable model exploring more complex relationships. The final weighted, negative binomial regression model included six variables. Based on the incidence rate ratio, this model predicted 32.0% less mortality for operations that vaccinated heifers for at least one of the following: bovine viral diarrhea, infectious bovine rhinotracheitis, parainfluenza 3, bovine respiratory syncytial virus, Haemophilus somnus, leptospirosis, Salmonella, Escherichia coli or clostridia. The final multivariable model also predicted a 27.0% increase in mortality for operations from which a bulk tank milk sample tested ELISA positive for bovine leukosis virus. Additionally, an 18.0% higher mortality was predicted for operations that used necropsies to determine the cause of death for some proportion of dead dairy cows. The final model also predicted that increased proportions of dairy cows with clinical mastitis and infertility problems were associated with increased mortality. Finally, an increase in mortality was predicted to be associated with an increase in the proportion of lame or injured permanently removed dairy cows. In general terms, this model identified that mortality was associated with reproductive problems, non-infectious postpartum disease, infectious disease and infectious disease prevention, and information derived from postmortem evaluations. Ultimately, addressing excessive mortality levels requires a concerted effort that recognizes and appropriately manages the numerous and diverse underlying risks.

Final year dental students in New Zealand: Self-reported confidence levels prior to BDS graduation.

PubMed

Murray, C; Chandler, N

2016-12-01

It is expected that the graduating dental student will have acquired the skills and knowledge to confidently treat most circumstances that they may encounter in private practice. The aims of this study were to evaluate final year dental students' self-reported levels of confidence in expected core skills just prior to graduation and to explore their career intentions both directly after graduating as well as in the longer term. After ethical approval was obtained, a survey and participant information sheet was distributed to all final year undergraduate dental students in 2014. Statistical analysis was carried out using SPSS version 22.0 with the alpha value set at 0.05. The response rate was 69% (58/84). Most (44.8%) were going to be working in New Zealand private practices with 34.5% definitely considering specializing. The majority reported high self-confidence levels for sealant restorations (96.6%) and radiography (94.8%), while very few were confident in carrying out soft tissue biopsies (1 .8%) or restoring dental implants and treating medical emergencies (10.5%). Some gender differences were found. The general finding was that most NZ graduates perceived themselves to be confident in managing the most fundamental aspects of general practice. Similar to their counterparts around the world, they will benefit from further mentoring and additional exposure to the more complex clinical tasks such as the restoration of implants and soft tissue biopsies.

The evaluation of a framework for measuring the non-technical ward round skills of final year nursing students: An observational study.

PubMed

Murray, Kara; McKenzie, Karen; Kelleher, Michael

2016-10-01

The importance of non-technical skills (NTS) to patient outcomes is increasingly being recognised, however, there is limited research into how such skills can be taught and evaluated in student nurses in relation toward rounds. This pilot study describes an evaluation of a NTS framework that could potentially be used to measure ward round skills of student nurses. The study used an observational design. Potential key NTS were identified from existing literature and NTS taxonomies. The proposed framework was then used to evaluate whether the identified NTS were evident in a series of ward round simulations that final year general nursing students undertook as part of their training. Finally, the views of a small group of qualified nurse educators, qualified nurses and general nursing students were sought about whether the identified NTS were important and relevant to practice. The proposed NTS framework included seven categories: Communication, Decision Making, Situational Awareness, Teamwork and Task Management, Student Initiative and Responsiveness to Patient. All were rated as important and relevant to practice. The pilot study suggests that the proposed NTS framework could be used as a means of evaluating student nurse competencies in respect of many non-technical skills required for a successful ward round. Further work is required to establish the validity of the framework in educational settings and to determine the extent to which it is of use in a non-simulated ward round setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

Do they see eye to eye? Management and employee perspectives of high-performance work systems and influence processes on service quality.

PubMed

Liao, Hui; Toya, Keiko; Lepak, David P; Hong, Ying

2009-03-01

Extant research on high-performance work systems (HPWSs) has primarily examined the effects of HPWSs on establishment or firm-level performance from a management perspective in manufacturing settings. The current study extends this literature by differentiating management and employee perspectives of HPWSs and examining how the two perspectives relate to employee individual performance in the service context. Data collected in three phases from multiple sources involving 292 managers, 830 employees, and 1,772 customers of 91 bank branches revealed significant differences between management and employee perspectives of HPWSs. There were also significant differences in employee perspectives of HPWSs among employees of different employment statuses and among employees of the same status. Further, employee perspective of HPWSs was positively related to individual general service performance through the mediation of employee human capital and perceived organizational support and was positively related to individual knowledge-intensive service performance through the mediation of employee human capital and psychological empowerment. At the same time, management perspective of HPWSs was related to employee human capital and both types of service performance. Finally, a branch's overall knowledge-intensive service performance was positively associated with customer overall satisfaction with the branch's service. (c) 2009 APA, all rights reserved.

Final Report Ra Power Management 1255 10-15-16 FINAL_Public

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

Iverson, Aaron

Ra Power Management (RPM) has developed a cloud based software platform that manages the financial and operational functions of third party financed solar projects throughout their lifecycle. RPM’s software streamlines and automates the sales, financing, and management of a portfolio of solar assets. The software helps solar developers automate the most difficult aspects of asset management, leading to increased transparency, efficiency, and reduction in human error. More importantly, our platform will help developers save money by improving their operating margins

Operations-oriented performance measures for freeway management systems : final report.

DOT National Transportation Integrated Search

2008-12-01

This report describes the second and final year activities of the project titled Using Operations-Oriented Performance Measures to Support Freeway Management Systems. Work activities included developing a prototype system architecture for testi...

Family and medical leave. Office of Personnel Management. Final rule.

PubMed

2000-05-08

The Office of Personnel Management is issuing final regulations on the Family and Medical Leave Act of 1993 to ensure that both employees' and agencies' rights are protected and their responsibilities fulfilled.

77 FR 61751 - Farm Credit Administration Board; Sunshine Act; Regular Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-11

... meeting is: Open Session A. Approval of Minutes September 13, 2012 B. New Business Final Rule--Investment Management Final Rule--Farmer Mac Investment Management Bookletter--Providing Credit to Farmers and Ranchers...

50 CFR 424.18 - Final rules-general.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A LISTING ENDANGERED AND THREATENED SPECIES AND DESIGNATING CRITICAL HABITAT Revision of the Lists § 424.18 Final rules—general. (a) Contents... any conservation measures available under the rule. Publication of a final rule to list, delist, or...

Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip

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

Caniato, M., E-mail: marcocaniato@gmail.com; Tudor, T.; Vaccari, M.

Highlights: • We systematically review scientific literature about health-care waste management. • We identify and discuss gaps, trends, efforts, and key-factors. • We suggest areas for improvement and best practices reported in literature. • We include recommendations for policy makers, practitioners and researchers. • We promote a holistic and harmonized approach to health-care waste management. - Abstract: The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Usingmore » social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology, which involved a large number of stakeholders. Such an approach served to raise interest and awareness at different levels (public authorities, health providers, supporting actors, others), stimulate the discussion about the adoption of specific policies, and identify the effective way forward.« less

78 FR 57878 - Notice of Availability of the Proposed Bureau of Land Management Tres Rios Field Office and San...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-20

... and Resource Management Plan/Final Environmental Impact Statement AGENCY: Bureau of Land Management... Environmental Impact Statement (LRMP/Final EIS) for the San Juan Public Lands Planning Area in Colorado, and by... and woodlands; and other components of the biological, physical and cultural environment. Copies of...

77 FR 16058 - Willapa National Wildlife Refuge, Pacific County, WA; Record of Decision for Final Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-19

... National Wildlife Refuge System, consistent with sound principles of fish and wildlife management... implementation. Alternative 2 is the foundation of our CCP. The CCP will guide our management and administration... management issues in our Draft and Final CCP/EIS. To address these issues, we developed and evaluated three...

78 FR 25092 - Prime Hook National Wildlife Refuge, Sussex County, DE; Record of Decision for Final...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-29

... consistent with sound principles of fish and wildlife management, conservation, legal mandates, and our policies, as well as respond to key issues and public concerns. In addition to outlining broad management... B, as described in the final CCP, will guide our management and administration of the refuge over...

78 FR 23588 - Final Supplementary Rules for the Morley Nelson Snake River Birds of Prey National Conservation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-19

... Conservation Area (NCA), addressed in the September 2008 Resource Management Plan (RMP) and Record of Decision... an array of management actions designed to conserve natural and cultural resources on BLM... analysis can be found in Chapter 4 of the Proposed Resource Management Plan and Final Environmental Impact...

Assessment of general education teachers' Tier 1 classroom practices: contemporary science, practice, and policy.

PubMed

Reddy, Linda A; Fabiano, Gregory A; Jimerson, Shane R

2013-12-01

Progress monitoring is a type of formative assessment. Most work on progress monitoring in elementary school settings has been focused on students. However, teachers also can benefit from frequent evaluations. Research addressing teacher progress monitoring is critically important given the recent national focus on teacher evaluation and effectiveness. This special topic section of School Psychology Quarterly is the first to showcase the current research on measuring Tier 1 instructional and behavioral management practices used by prekindergarten and elementary school teachers in general education settings. The three studies included in the special section describe the development and validation efforts of several teacher observational and self-report measures of instruction and/or behavioral management. These studies provide evidence for the utility of such assessments for documenting the use of classroom practices, and these assessment results may be leveraged in innovative coaching models to promote best practice. These articles also offer insight and ideas for the next generation of teacher practice assessment for the field. Finally, the special topic is capped by a commentary synthesizing the current work and offers "big ideas" for future measurement development, policy, and professional development initiatives. PsycINFO Database Record (c) 2013 APA, all rights reserved.

41 CFR 102-192.130 - What are your general responsibilities as an agency mail manager?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What are your general... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION ADMINISTRATIVE PROGRAMS 192-MAIL MANAGEMENT Agency Mail Manager Requirements § 102-192.130 What are your general...

Methodology to design a municipal solid waste generation and composition map: a case study.

PubMed

Gallardo, A; Carlos, M; Peris, M; Colomer, F J

2014-11-01

The municipal solid waste (MSW) management is an important task that local governments as well as private companies must take into account to protect human health, the environment and to preserve natural resources. To design an adequate MSW management plan the first step consist in defining the waste generation and composition patterns of the town. As these patterns depend on several socio-economic factors it is advisable to organize them previously. Moreover, the waste generation and composition patterns may vary around the town and over the time. Generally, the data are not homogeneous around the city as the number of inhabitants is not constant nor it is the economic activity. Therefore, if all the information is showed in thematic maps, the final waste management decisions can be made more efficiently. The main aim of this paper is to present a structured methodology that allows local authorities or private companies who deal with MSW to design its own MSW management plan depending on the available data. According to these data, this paper proposes two ways of action: a direct way when detailed data are available and an indirect way when there is a lack of data and it is necessary to take into account bibliographic data. In any case, the amount of information needed is considerable. This paper combines the planning methodology with the Geographic Information Systems to present the final results in thematic maps that make easier to interpret them. The proposed methodology is a previous useful tool to organize the MSW collection routes including the selective collection. To verify the methodology it has been successfully applied to a Spanish town. Copyright © 2014 Elsevier Ltd. All rights reserved.

Methodology to design a municipal solid waste generation and composition map: a case study.

PubMed

Gallardo, A; Carlos, M; Peris, M; Colomer, F J

2015-02-01

The municipal solid waste (MSW) management is an important task that local governments as well as private companies must take into account to protect human health, the environment and to preserve natural resources. To design an adequate MSW management plan the first step consists in defining the waste generation and composition patterns of the town. As these patterns depend on several socio-economic factors it is advisable to organize them previously. Moreover, the waste generation and composition patterns may vary around the town and over the time. Generally, the data are not homogeneous around the city as the number of inhabitants is not constant nor it is the economic activity. Therefore, if all the information is showed in thematic maps, the final waste management decisions can be made more efficiently. The main aim of this paper is to present a structured methodology that allows local authorities or private companies who deal with MSW to design its own MSW management plan depending on the available data. According to these data, this paper proposes two ways of action: a direct way when detailed data are available and an indirect way when there is a lack of data and it is necessary to take into account bibliographic data. In any case, the amount of information needed is considerable. This paper combines the planning methodology with the Geographic Information Systems to present the final results in thematic maps that make easier to interpret them. The proposed methodology is a previous useful tool to organize the MSW collection routes including the selective collection. To verify the methodology it has been successfully applied to a Spanish town. Copyright © 2014 Elsevier Ltd. All rights reserved.

A total system approach to sustainable pest management

PubMed Central

Lewis, W. J.; van Lenteren, J. C.; Phatak, Sharad C.; Tumlinson, J. H.

1997-01-01

A fundamental shift to a total system approach for crop protection is urgently needed to resolve escalating economic and environmental consequences of combating agricultural pests. Pest management strategies have long been dominated by quests for “silver bullet” products to control pest outbreaks. However, managing undesired variables in ecosystems is similar to that for other systems, including the human body and social orders. Experience in these fields substantiates the fact that therapeutic interventions into any system are effective only for short term relief because these externalities are soon “neutralized” by countermoves within the system. Long term resolutions can be achieved only by restructuring and managing these systems in ways that maximize the array of “built-in” preventive strengths, with therapeutic tactics serving strictly as backups to these natural regulators. To date, we have failed to incorporate this basic principle into the mainstream of pest management science and continue to regress into a foot race with nature. In this report, we establish why a total system approach is essential as the guiding premise of pest management and provide arguments as to how earlier attempts for change and current mainstream initiatives generally fail to follow this principle. We then draw on emerging knowledge about multitrophic level interactions and other specific findings about management of ecosystems to propose a pivotal redirection of pest management strategies that would honor this principle and, thus, be sustainable. Finally, we discuss the potential immense benefits of such a central shift in pest management philosophy. PMID:9356432

41 CFR 101-25.101-1 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true General. 101-25.101-1 Section 101-25.101-1 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 25-GENERAL 25.1-General Policies...

15 CFR 904.305 - Final administrative decision.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Permit Sanctions and Denials General § 904.305 Final administrative decision. (a) If no request...

15 CFR 904.305 - Final administrative decision.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Permit Sanctions and Denials General § 904.305 Final administrative decision. (a) If no request...

77 FR 28305 - Temporary Rule To Delay Start Date of 2012-2013 South Atlantic Black Sea Bass Commercial Fishing...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

... the biomass to increase. The management measures also address the derby-style fishery (the race to... implementation of the final rule for Amendment 18A to the Fishery Management Plan (FMP) for the Snapper-Grouper... final rule implementing management measures in Amendment 18A is not expected to be effective until after...

76 FR 54247 - Supawna Meadows National Wildlife Refuge, Salem County, NJ; Final Comprehensive Conservation Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-31

..., New Jersey. In this final CCP, we describe how we will manage this refuge for the next 15 years..., and other wildlife. We would continue to actively manage tidal marsh and grassland habitats, and would... consideration would be to manage a diversity of other refuge wetland and upland habitats to benefit breeding and...

JPL-20170825-CASSINf-0001-Cassini Nears the End of Its Mission Video File

NASA Image and Video Library

2017-08-25

On Sept. 15, 2017, NASA's Cassini spacecraft will end it mission by diving into the atomosphere of Saturn. Animation: one of Cassini's final passes between Saturn and its rings, Cassini's final 22 orbits, final plunge. Footage: construction of Cassini at JPL. Interview excerpts from Linda Spilker, Cassini Project Scientist; Earl Maize, Cassini Project Manager; Julie Webster, Cassini Spacecraft Operations Manager.

Interacting factors associated with Low antibiotic prescribing for respiratory tract infections in primary health care - a mixed methods study in Sweden.

PubMed

Strandberg, Eva Lena; Brorsson, Annika; André, Malin; Gröndal, Hedvig; Mölstad, Sigvard; Hedin, Katarina

2016-07-18

Prescribing of antibiotics for common infections varies widely, and there is no medical explanation. Systematic reviews have highlighted factors that may influence antibiotic prescribing and that this is a complex process. It is unclear how factors interact and how the primary care organization affects diagnostic procedures and antibiotic prescribing. Therefore, we sought to explore and understand interactions between factors influencing antibiotic prescribing for respiratory tract infections in primary care. Our mixed methods design was guided by the Triangulation Design Model according to Creswell. Quantitative and qualitative data were collected in parallel. Quantitative data were collected by prescription statistics, questionnaires to patients, and general practitioners' audit registrations. Qualitative data were collected through observations and semi-structured interviews. From the analysis of the data from the different sources an overall theme emerged: A common practice in the primary health care centre is crucial for low antibiotic prescribing in line with guidelines. Several factors contribute to a common practice, such as promoting management and leadership, internalized guidelines including inter-professional discussions, the general practitioner's diagnostic process, nurse triage, and patient expectation. These factors were closely related and influenced each other. The results showed that knowledge must be internalized and guidelines need to be normative for the group as well as for every individual. Low prescribing is associated with adapted and transformed guidelines within all staff, not only general practitioners. Nurses' triage and self-care advice played an important role. Encouragement from the management level stimulated inter-professional discussions about antibiotic prescribing. Informal opinion moulders talking about antibiotic prescribing was supported by the managers. Finally, continuous professional development activities were encouraged for up-to-date knowledge.

A review of initial investigations to utilize ERTS-1 data in determining the availability and distribution of living marine resources. [fish harvesting and management in Gulf of Mexico

NASA Technical Reports Server (NTRS)

Stevenson, W. H.; Kemmerer, A. J.; Atwell, B. H.; Maughan, P. M.

1974-01-01

This study was initiated in July 1972 to determine the reliability of satellite and high altitude sensors to provide data about oceanographic parameters in coastal waters; demonstrate the use of remotely sensed oceanographic information to predict the distribution and abundance of adult menhaden; and, demonstrate the potential of using satellite acquired information for improving the harvest and management of a fishery resource. The study focused on coastal are as in the north central portion of the Gulf of Mexico including parts of Alabama, Mississippi and Louisiana. The area used in the final analysis was limited to the Mississippi Sound, which is approximately 145 kilometers (90 miles) long and 16 kilometers (10 miles) wide, has an average water depth of about 3.7 meters (12 feet), and in general characterizes an estuarine environment.

Short-rotation management of Eucalyptus: Guidelines for plantations in Hawaii. Forest Service general technical report (Final)

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

Whitesell, C.D.; DeBell, D.S.; Schubert, T.H.

1992-11-01

A 10-year research and development program was conducted on the island of Hawaii, where nearly 230,000 acres are suitable for growing biomass in short-rotation Eucalyptus plantations. Successful techniques are described for seedling production, plantation establishment (site preparation, weed control, planting), maintenance (weed control, fertilization), biomass yield estimation, and harvest. Basic biological relationships are described to aid decisions on site selection, initial spacing, fertilizer schedules, and rotation length. Environmental issues likely to be faced by growers of Eucalyptus plantations are discussed, including soil erosion, nutrient depletion, and monocultures. Continuing programs for tree improvement, monitoring, and silviculture research are recommeded. Production costsmore » for biomass yields are estimated for three promising management regimes, representing pure Eucalyptus plantings at dense and wide spacings and a mixed species plantation where Albizia is used as a nurse crop to provide nitrogen needed for optimum Eucalyptus growth.« less

Computer-aided dispatch--traffic management center field operational test final detailed test plan : WSDOT deployment

DOT National Transportation Integrated Search

2003-10-01

The purpose of this document is to expand upon the evaluation components presented in "Computer-aided dispatch--traffic management center field operational test final evaluation plan : WSDOT deployment". This document defines the objective, approach,...

Computer-aided dispatch--traffic management center field operational test : Washington State final report

DOT National Transportation Integrated Search

2006-05-01

This document provides the final report for the evaluation of the USDOT-sponsored Computer-Aided Dispatch - Traffic Management Center Integration Field Operations Test in the State of Washington. The document discusses evaluation findings in the foll...

Closed-incision negative-pressure therapy in high-risk general surgery patients following laparotomy: a retrospective study.

PubMed

Zaidi, A; El-Masry, S

2017-03-01

Surgical site infection (SSI) and wound dehiscence are dreaded complications following laparotomy in general surgical patients, and can potentially occur more often in various comorbid states. Negative-pressure wound therapy (NPWT) has a positive effect of on open and complicated wounds and so has been used for at-risk surgical incisions with the aim of redistributing lateral tension and holding incision edges together. The aim of the present study was to compare the rate of wound complications following laparotomy in high-risk general surgical patients with a clean incision treated with closed-incision negative-pressure therapy (ciNPT) with those receiving conventional care. A retrospective review was performed of the hospital medical records of patients who underwent laparotomy between 1 October 2010 and 31 March 2012. Records of 69 patients who received ciNPT and 112 who were managed by adherent gauze dressings were included in the final analysis. Two (2.9%) patients in the ciNPT group and 23 (20.5%) in the non-NPWT group developed a wound complication following laparotomy (P < 0.0009). The relative risk (RR) was 0.14 (0.03-0.58), suggesting that infection is less likely to occur in ciNPT-treated incisions, compared with gauze dressings. ciNPT was associated with a positive clinical outcome and was a safe and effective method of postsurgical management in our general surgery patients considered to have risk of developing wound complications following laparotomy. © 2016 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.

49 CFR 386.36 - Motions for final agency order.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Form and content. (1) Movant's filing must contain a motion and memorandum of law, which may be... 49 Transportation 5 2014-10-01 2014-10-01 false Motions for final agency order. 386.36 Section 386... MATERIALS PROCEEDINGS General Rules and Hearings § 386.36 Motions for final agency order. (a) Generally...

49 CFR 386.36 - Motions for final agency order.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Form and content. (1) Movant's filing must contain a motion and memorandum of law, which may be... 49 Transportation 5 2013-10-01 2013-10-01 false Motions for final agency order. 386.36 Section 386... MATERIALS PROCEEDINGS General Rules and Hearings § 386.36 Motions for final agency order. (a) Generally...

49 CFR 386.36 - Motions for final agency order.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Form and content. (1) Movant's filing must contain a motion and memorandum of law, which may be... 49 Transportation 5 2012-10-01 2012-10-01 false Motions for final agency order. 386.36 Section 386... MATERIALS PROCEEDINGS General Rules and Hearings § 386.36 Motions for final agency order. (a) Generally...

49 CFR 386.36 - Motions for final agency order.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Form and content. (1) Movant's filing must contain a motion and memorandum of law, which may be... 49 Transportation 5 2011-10-01 2011-10-01 false Motions for final agency order. 386.36 Section 386... MATERIALS PROCEEDINGS General Rules and Hearings § 386.36 Motions for final agency order. (a) Generally...

49 CFR 386.36 - Motions for final agency order.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Form and content. (1) Movant's filing must contain a motion and memorandum of law, which may be... 49 Transportation 5 2010-10-01 2010-10-01 false Motions for final agency order. 386.36 Section 386... MATERIALS PROCEEDINGS General Rules and Hearings § 386.36 Motions for final agency order. (a) Generally...

DIRAC3 - the new generation of the LHCb grid software

NASA Astrophysics Data System (ADS)

Tsaregorodtsev, A.; Brook, N.; Casajus Ramo, A.; Charpentier, Ph; Closier, J.; Cowan, G.; Graciani Diaz, R.; Lanciotti, E.; Mathe, Z.; Nandakumar, R.; Paterson, S.; Romanovsky, V.; Santinelli, R.; Sapunov, M.; Smith, A. C.; Seco Miguelez, M.; Zhelezov, A.

2010-04-01

DIRAC, the LHCb community Grid solution, was considerably reengineered in order to meet all the requirements for processing the data coming from the LHCb experiment. It is covering all the tasks starting with raw data transportation from the experiment area to the grid storage, data processing up to the final user analysis. The reengineered DIRAC3 version of the system includes a fully grid security compliant framework for building service oriented distributed systems; complete Pilot Job framework for creating efficient workload management systems; several subsystems to manage high level operations like data production and distribution management. The user interfaces of the DIRAC3 system providing rich command line and scripting tools are complemented by a full-featured Web portal providing users with a secure access to all the details of the system status and ongoing activities. We will present an overview of the DIRAC3 architecture, new innovative features and the achieved performance. Extending DIRAC3 to manage computing resources beyond the WLCG grid will be discussed. Experience with using DIRAC3 by other user communities than LHCb and in other application domains than High Energy Physics will be shown to demonstrate the general-purpose nature of the system.

The effectiveness of clinical supervision for a group of ward managers based in a district general hospital: an evaluative study.

PubMed

Davis, Cynthia; Burke, Linda

2012-09-01

To present an evaluative audit assessing the effectiveness of clinical supervision for ward managers. A year-long project to introduce clinical supervision to ward managers was implemented and evaluated. The objectives were to evaluate staff perceptions of implementing clinical supervision and determine its outcomes. An audit evaluation process was used. Findings are presented against perceptions, implementation and reported outcomes of clinical supervision. Insights were gained into its relevance and importance to nurses and the organisation. Findings show that clinical supervision was perceived to be effective and helped improve patient care, but some feared it becoming a form of managerial control. Ward managers perceived advantages for personal and professional development from adopting this process. There is a need for greater understanding of clinical supervision before Trusts implement it. The introduction of a resource pack for clinical areas would also be of value. Finally, there needs to be a named person who has a special knowledge of clinical supervision to act as a champion and change agent in effecting implementation at both the executive level and within each clinical area. © 2011 Blackwell Publishing Ltd.

24 CFR 202.5 - General approval standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... corporation or other chartered institution, a permanent organization having succession or a partnership. A... general partner must be designated as the managing general partner. The managing general partner shall comply with the requirements of paragraphs (b), (c) and (f) of this section. The managing general partner...

75 FR 63103 - Federal Travel Regulation (FTR); Lodging and Transportation Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-14

... GENERAL SERVICES ADMINISTRATION 41 CFR Parts 301-10, 301-11, 301-50, 301-73, and Appendix D to... Policy, General Services Administration (GSA). ACTION: Final rule. SUMMARY: The General Services... lodging and transportation. This final rule also updates an acronym and references to such in the FTR...

7 CFR 1717.609 - RUS approval of general manager.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false RUS approval of general manager. 1717.609 Section... Operational Controls § 1717.609 RUS approval of general manager. (a) If a borrower's mortgage or loan contract... general manager of the borrower's system, such approval is hereby granted provided that the borrower is in...

[Quality management (TQM) in public health-care (PHC): principles for cost-performance calculations and cost reductions with better quality].

PubMed

Bergholz, W

2008-11-01

In many high-tech industries, quality management (QM) has enabled improvements of quality by a factor of 100 or more, in combination with significant cost reductions. Compared to this, the application of QM methods in health care is in its initial stages. It is anticipated that stringent process management, embedded in an effective QM system will lead to significant improvements in health care in general and in the German public health service in particular. Process management is an ideal platform for controlling in the health care sector, and it will significantly improve the leverage of controlling to bring down costs. Best practice sharing in industry has led to quantum leap improvements. Process management will enable best practice sharing also in the public health service, in spite of the highly diverse portfolio of services that the public health service offers in different German regions. Finally, it is emphasised that "technical" QM, e.g., on the basis of the ISO 9001 standard is not sufficient to reach excellence. It is necessary to integrate soft factors, such as patient or employee satisfaction, and leadership quality into the system. The EFQM model for excellence can serve as proven tool to reach this goal.

A regenerative approach towards mucosal fenestration closure

PubMed Central

Gandi, Padma; Anumala, Naveen; Reddy, Amarender; Viswa Chandra, Rampalli

2013-01-01

Mucosal fenestration is an opening or an interstice through the oral mucosa. A lesion which occurs with greater frequency than generally realised, its occurrence is attributed to a myriad of causes. Mucogingival procedures including connective tissue grafts, free gingival grafts and lateral pedicle grafts are generally considered to be the treatment of choice in the closure of a mucosal fenestration. More often, these procedures are performed in conjunction with other procedures such as periradicular surgery and with bone grafts. However, the concomitant use of gingival grafts and bone grafts in mucosal fenestrations secondary to infections in sites exhibiting severe bone loss is highly debatable. In this article, we report two cases of mucosal fenestrations secondary to trauma and their management by regenerative periodontal surgery with the placement of guided tissue regeneration membrane and bone graft. The final outcome was a complete closure of the fenestration in both the cases. PMID:23749826

Cardea: Dynamic Access Control in Distributed Systems

NASA Technical Reports Server (NTRS)

Lepro, Rebekah

2004-01-01

Modern authorization systems span domains of administration, rely on many different authentication sources, and manage complex attributes as part of the authorization process. This . paper presents Cardea, a distributed system that facilitates dynamic access control, as a valuable piece of an inter-operable authorization framework. First, the authorization model employed in Cardea and its functionality goals are examined. Next, critical features of the system architecture and its handling of the authorization process are then examined. Then the S A M L and XACML standards, as incorporated into the system, are analyzed. Finally, the future directions of this project are outlined and connection points with general components of an authorization system are highlighted.

Gastric perforation secondary to metastasis from breast cancer.

PubMed

Wong, Chee Siong; Gumber, Ashutosh; Kiruparan, Pasupathy; Blackmore, Alexander

2016-07-18

Gastric perforation secondary to metastasis from breast cancer occurs infrequently. We present the case of a 72-year-old postmenopausal female patient with a known history of lobular carcinoma of the breast who presented to a district general hospital with a clinical diagnosis of an acute abdomen. Further contrast-enhanced CT scan demonstrated free gas and fluid in the abdomen. She underwent emergency exploratory laparotomy and onlay Graham's omentopexy patch due to 1×1 cm prepyloric gastric perforation. Final histopathology proved the presence of metastatic malignant cells in the breast origin. We discuss the issues involved in postoperative investigation and management. 2016 BMJ Publishing Group Ltd.

A business model analysis of telecardiology service.

PubMed

Lin, Shu-Hsia; Liu, Jorn-Hon; Wei, Jen; Yin, Wei-Hsian; Chen, Hung-Hsin; Chiu, Wen-Ta

2010-12-01

Telecare has become an increasingly common medical service in recent years. However, new service must be close to the market and be market-driven to have a high likelihood of success. This article analyzes the business model of a telecardiology service managed by a general hospital. The methodology of the article is as follows: (1) initially it describes the elements of the service based on the ontology of the business model, (2) then it transfers these elements into the choices for business model dynamic loops and examines their validity, and (3) finally provides an empirical financial analysis of the service to assess the profit-making possibilities.

Fort Collins Science Center: Ecosystem Dynamics

USGS Publications Warehouse

Bowen, Zack

2004-01-01

Current studies fall into five general areas. Herbivore-Ecosystem Interactions examines the efficacy of multiple controls on selected herbivore populations and cascading effects through predator-herbivore-plant-soil linkages. Riparian Ecology is concerned with interactions among streamflow, fluvial geomorphology, and riparian vegetation. Integrated Fire Science focuses on the effects of fire on plant and animal communities at multiple scales, and on the interactions between post-fire plant, runoff, and erosion processes. Reference Ecosystems comprises long-term, place-based studies of ecosystem biogeochemistry. Finally, Integrated Assessments is investigating how to synthesize multiple ecosystem stressors and responses over complex landscapes in ways that are useful for management and planning.

Processing Solutions for Big Data in Astronomy

NASA Astrophysics Data System (ADS)

Fillatre, L.; Lepiller, D.

2016-09-01

This paper gives a simple introduction to processing solutions applied to massive amounts of data. It proposes a general presentation of the Big Data paradigm. The Hadoop framework, which is considered as the pioneering processing solution for Big Data, is described together with YARN, the integrated Hadoop tool for resource allocation. This paper also presents the main tools for the management of both the storage (NoSQL solutions) and computing capacities (MapReduce parallel processing schema) of a cluster of machines. Finally, more recent processing solutions like Spark are discussed. Big Data frameworks are now able to run complex applications while keeping the programming simple and greatly improving the computing speed.

On Decision-Making Among Multiple Rule-Bases in Fuzzy Control Systems

NASA Technical Reports Server (NTRS)

Tunstel, Edward; Jamshidi, Mo

1997-01-01

Intelligent control of complex multi-variable systems can be a challenge for single fuzzy rule-based controllers. This class of problems cam often be managed with less difficulty by distributing intelligent decision-making amongst a collection of rule-bases. Such an approach requires that a mechanism be chosen to ensure goal-oriented interaction between the multiple rule-bases. In this paper, a hierarchical rule-based approach is described. Decision-making mechanisms based on generalized concepts from single-rule-based fuzzy control are described. Finally, the effects of different aggregation operators on multi-rule-base decision-making are examined in a navigation control problem for mobile robots.

Computer-aided dispatch--traffic management center field operational test : state of Utah final report

DOT National Transportation Integrated Search

2006-07-01

This document provides the final report for the evaluation of the USDOT-sponsored Computer-Aided Dispatch Traffic Management Center Integration Field Operations Test in the State of Utah. The document discusses evaluation findings in the followin...

Computer-aided dispatch--traffic management center field operational test final test plans : state of Utah

DOT National Transportation Integrated Search

2004-01-01

The purpose of this document is to expand upon the evaluation components presented in "Computer-aided dispatch--traffic management center field operational test final evaluation plan : state of Utah". This document defines the objective, approach, an...

78 FR 4430 - Chassahowitzka National Wildlife Refuge, FL; Final Comprehensive Conservation Plan and Finding of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-22

..., Florida. In the final CCP, we describe how we will manage this refuge for the next 15 years. ADDRESSES.... Research will include a broader suite of species, as well as habitat studies to adaptively manage for...

Case-based Influence in Conflict Management

DTIC Science & Technology

2014-10-31

AFRL-OSR-VA-TR-2014-0337 CASE-BASED INFLUENCE IN CONFLICT MANAGEMENT Robert Axelrod ARTIS RESEARCH & RISK MODELING Final Report 10/31/2014...FA9550-10-1-0373 Dr. Robert Axelrod - PI Dr. Richard Davis- PD ARTIS Research & Risk Modeling ARTIS 5741 Canyon Ridge North Cave Creek, AZ 85331-9318...analysis of the timing of cyber conflict that quickly received attention from over 30 countries. 3 1 Axelrod , Final Report and Publications Final

Practical Approaches to Curriculum Development. A Management Handbook. Project HIRE: A Curriculum Management System for Instructing the Handicapped. Final Report, Volume 2.

ERIC Educational Resources Information Center

Gardner, David C.; Beatty, Grace Joely

Within the context of the major objectives of developing, field testing, and refining the curriculum materials described in volume 1 of this final report (CE 024 117), Volume 2 describes and critiques the management system used by Project HIRE in that development process. (See Note for availability of curriculum materials.) Chapter 1 introduces…

Development of a comprehensive model for stakeholder management in mental healthcare.

PubMed

Bierbooms, Joyce; Van Oers, Hans; Rijkers, Jeroen; Bongers, Inge

2016-06-20

Purpose - Stakeholder management is not yet incorporated into the standard practice of most healthcare providers. The purpose of this paper is to assess the applicability of a comprehensive model for stakeholder management in mental healthcare organization for more evidence-based (stakeholder) management. Design/methodology/approach - The assessment was performed in two research parts: the steps described in the model were executed in a single case study at a mental healthcare organization in the Netherlands; and a process and effect evaluation was done to find the supporting and impeding factors with regard to the applicability of the model. Interviews were held with managers and directors to evaluate the effectiveness of the model with a view to stakeholder management. Findings - The stakeholder analysis resulted in the identification of eight stakeholder groups. Different expectations were identified for each of these groups. The analysis on performance gaps revealed that stakeholders generally find the collaboration with a mental healthcare provider "sufficient." Finally a prioritization showed that five stakeholder groups were seen as "definite" stakeholders by the organization. Practical implications - The assessment of the model showed that it generated useful knowledge for more evidence-based (stakeholder) management. Adaptation of the model is needed to increase its feasibility in practice. Originality/value - Provided that the model is properly adapted for the specific field, the analysis can provide more knowledge on stakeholders and can help integrate stakeholder management as a comprehensive process in policy planning.

Adaptation of a difficult-to-manage asthma programme for implementation in the Dutch context: a modified e-Delphi.

PubMed

Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; In 't Veen, Johannes C C M

2017-02-09

Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories 'the A-I of difficult-to-manage asthma' to resonate with an established Dutch 'A-E acronym for determining asthma control'. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme.

Burns teaching in UK medical schools: Is it enough?

PubMed

Zinchenko, Ruslan; Perry, Fiona M; Dheansa, Baljit S

2016-02-01

Burns are frequently seen and managed in non-specialist settings. The crowding of the UK medical undergraduate curriculum may have resulted in the reduction of teaching on burns. To determine the burns education experience and the level of competence among UK final year medical students in assessing and acutely managing patients with burns. An online questionnaire was circulated among UK final year medical students. There was a total of 348 respondents. The majority of the respondents (70%) have not received any specific teaching on how to manage patients with burns. Nearly two-thirds of the students (66%) have never seen a patient being managed for burns throughout their training. Over 90% of respondents stated that they would not feel confident in initially managing a burn in the emergency department. The majority of the respondents (57%) have not heard of the criteria for referring a burns patient for further specialist management. There was almost universal agreement about the importance of knowing how to manage a burn initially. There seems to be a lack of consistent undergraduate training in burns management and final year students lack the experience and knowledge to initially manage burns. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Digital Aquifer - Integrating modeling, technical, software and policy aspects to develop a groundwater management tool

NASA Astrophysics Data System (ADS)

Tirupathi, S.; McKenna, S. A.; Fleming, K.; Wambua, M.; Waweru, P.; Ondula, E.

2016-12-01

Groundwater management has traditionally been observed as a study for long term policy measures to ensure that the water resource is sustainable. IBM Research, in association with the World Bank, extended this traditional analysis to include realtime groundwater management by building a context-aware, water rights management and permitting system. As part of this effort, one of the primary objectives was to develop a groundwater flow model that can help the policy makers with a visual overview of the current groundwater distribution. In addition, the system helps the policy makers simulate a range of scenarios and check the sustainability of the groundwater resource in a given region. The system also enables a license provider to check the effect of the introduction of a new well on the existing wells in the domain as well as the groundwater resource in general. This process simplifies how an engineer will determine if a new well should be approved. Distance to the nearest well neighbors and the maximum decreases in water levels of nearby wells are continually assessed and presented as evidence for an engineer to make the final judgment on approving the permit. The system also facilitates updated insights on the amount of groundwater left in an area and provides advice on how water fees should be structured to balance conservation and economic development goals. In this talk, we will discuss the concept of Digital Aquifer, the challenges in integrating modeling, technical and software aspects to develop a management system that helps policy makers and license providers with a robust decision making tool. We will concentrate on the groundwater model developed using the analytic element method that plays a very important role in the decision making aspects. Finally, the efficiency of this system and methodology is shown through a case study in Laguna Province, Philippines, which was done in collaboration with the National Water Resource Board, Philippines and World Bank.

Is disease management relevant in Europe: some evidence from the United Kingdom.

PubMed

Mason, A; Drummond, M; Towse, A

1999-07-01

Actions or approaches by the pharmaceutical industry, going under the general label 'disease management', have become very popular in the USA. However, there appears to be uncertainty about what exactly 'disease management' is and about the extent to which it can be applied in Europe. A postal questionnaire on disease management was sent out to senior personnel in the UK NHS and pharmaceutical industry. The survey aimed to explore the meaning of the term 'disease management' and its relevance to the NHS, assessing how perspectives differed between the two groups of respondents. Views on the barriers to the increase of disease management within the NHS were also sought. Finally, respondents were asked to indicate any involvement in joint disease management ventures. Most respondents agreed that disease management included estimating the total cost of managing a disease (92%) and the devising of clinical guidelines (97%). When asked about the particular role a pharmaceutical company might play, the level of agreement dropped in both groups of respondents, but by a greater degree in the NHS group. In defining disease management for themselves, just 4% of respondents referred to a 'partnership' between the NHS and the pharmaceutical industry. It would seem that, for the majority of respondents, 'joint ventures' are a possible, but not a necessary, means of undertaking disease management. Almost 30% of NHS respondents and 55% of industry respondents indicated that their Authority or company had experience of a joint venture in disease management. The major perceived barrier to an increase in disease management was NHS suspicion of pharmaceutical companies (86% of all respondents), with the difficulty in drawing up contracts coming a close second (79%).

76 FR 48006 - Limited Federal Implementation Plan; Prevention of Significant Deterioration; California; North...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... Implementation Plan; Prevention of Significant Deterioration; California; North Coast Unified Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: EPA is finalizing a limited Federal Implementation Plan (FIP) for the North Coast Unified Air Quality Management...

77 FR 38801 - Environmental Impacts Statements; Notice of Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... Resource Management (VRM) Plan, Amendment, Class Designation, Carbon County, WY, Review Period Ends: 07/30... Final Vehicle Management Plan, Implementation, Denali National Park and Preserve, AK, Review Period Ends.... EIS No. 20120199, Final EIS, RUS, MS, ADOPTION--Kemper County Integrated Gasification Combined Cycle...

Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General's Exclusion Authorities. Final rule.

PubMed

2017-01-12

This final rule amends the regulations relating to exclusion authorities under the authority of the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS or the Department). The final rule incorporates statutory changes, early reinstatement provisions, and policy changes, and clarifies existing regulatory provisions.

Organizational downsizing: a review of literature for planning and research.

PubMed

Davis, Jullet A; Savage, Grant; Stewart, R Thomas

2003-01-01

The use of downsizing as management's strategic response to environmental and institutional changes is prevalent in all U.S. industries, including healthcare. The popular and research literature is inundated with reports on companies undergoing various stages of restructuring, which often include one or more staff reductions. This article provides a review of downsizing literature published from 1985 to 2002. Although the findings and conclusions of these articles are generally inconsistent, the prevailing opinion is that for downsizing to be successful, effective planning must occur long before, during, and after downsizing. Additionally, a downsizing plan should be included in the strategic management plan of all organizations, regardless of whether they plan to downsize or not. By including such a plan, the organization will be better prepared to begin the staff-reduction process should it be forced to do so in response to environmental changes. Finally, providing ample support and protection for staff is key to the organization's recovery and growth. The lessons provided in this literature review should assist healthcare managers in deciding how to plan and structure potential staff reductions.

Use of topographic and climatological models in a geographical data base to improve Landsat MSS classification for Olympic National Park

NASA Technical Reports Server (NTRS)

Cibula, William G.; Nyquist, Maurice O.

1987-01-01

An unsupervised computer classification of vegetation/landcover of Olympic National Park and surrounding environs was initially carried out using four bands of Landsat MSS data. The primary objective of the project was to derive a level of landcover classifications useful for park management applications while maintaining an acceptably high level of classification accuracy. Initially, nine generalized vegetation/landcover classes were derived. Overall classification accuracy was 91.7 percent. In an attempt to refine the level of classification, a geographic information system (GIS) approach was employed. Topographic data and watershed boundaries (inferred precipitation/temperature) data were registered with the Landsat MSS data. The resultant boolean operations yielded 21 vegetation/landcover classes while maintaining the same level of classification accuracy. The final classification provided much better identification and location of the major forest types within the park at the same high level of accuracy, and these met the project objective. This classification could now become inputs into a GIS system to help provide answers to park management coupled with other ancillary data programs such as fire management.

Dimensions rurales-urbaines de la gestion scolaire en contexte de décroissance des clientèles et des compression budgétaires

NASA Astrophysics Data System (ADS)

Crespo, Manuel; Haché, Jean B.; Desranleau, Claude

1985-12-01

Using data collected in a provincial poll and provided by the Ministry of Education of Quebec, this article analyzes the impact of the urban-rural variable on different aspects of the management of school commissions at a time of economic recession and population decrease. The reduction in school enrollees as much as that of the educational personnel is more considerable in the urban environment than the rural one. When analyzing the consequences of management strategies in all assessments the decrease in enrolments and the urban-rural variable show constant results. Although some of these effects are direct, in most cases, however, they tend to be indirect because of the decrease in the number of staff members. In general, the consequences of management are less positive in the urban environment than in the rural one. Finally, according to the respondents the quality of the service linked to teaching has deteriorated more so in the urban environment than compared to the rural one.

Virtual reality or real virtuality: the space of flows and nursing practice.

PubMed

Barnes, Lynne; Rudge, Trudy

2005-12-01

The use of virtual environments for the provision of health-care is on the increase, and with each new development brings debates about their impact on care, nursing and nursing practice. Such environments offer opportunities for extending care and improvements in communication. Others believe these developments threaten aspects of nursing they hold sacrosanct. This paper explores the development of an assemblage of computer networks, databases, information systems, software programs and management systems that together work to manage health-care in Australia, namely casemix. We contend that spatial theories on network society show how this assemblage co-ordinates and operates to manage care. We discuss how this assemblage affects care and suggest that changes in organisation may be a part of the shift in how bodily organisation occurs more generally, but more specifically in health-care. We also suggest how nurses are enrolled in and by such networks, leading to transformation in nurses' practices. Finally, we argue that using spatial forms of analysis allows an interpretation of such assemblages that may account for their strengths and their shortcomings.

A component-based system for agricultural drought monitoring by remote sensing.

PubMed

Dong, Heng; Li, Jun; Yuan, Yanbin; You, Lin; Chen, Chao

2017-01-01

In recent decades, various kinds of remote sensing-based drought indexes have been proposed and widely used in the field of drought monitoring. However, the drought-related software and platform development lag behind the theoretical research. The current drought monitoring systems focus mainly on information management and publishing, and cannot implement professional drought monitoring or parameter inversion modelling, especially the models based on multi-dimensional feature space. In view of the above problems, this paper aims at fixing this gap with a component-based system named RSDMS to facilitate the application of drought monitoring by remote sensing. The system is designed and developed based on Component Object Model (COM) to ensure the flexibility and extendibility of modules. RSDMS realizes general image-related functions such as data management, image display, spatial reference management, image processing and analysis, and further provides drought monitoring and evaluation functions based on internal and external models. Finally, China's Ningxia region is selected as the study area to validate the performance of RSDMS. The experimental results show that RSDMS provide an efficient and scalable support to agricultural drought monitoring.

A component-based system for agricultural drought monitoring by remote sensing

PubMed Central

Yuan, Yanbin; You, Lin; Chen, Chao

2017-01-01

In recent decades, various kinds of remote sensing-based drought indexes have been proposed and widely used in the field of drought monitoring. However, the drought-related software and platform development lag behind the theoretical research. The current drought monitoring systems focus mainly on information management and publishing, and cannot implement professional drought monitoring or parameter inversion modelling, especially the models based on multi-dimensional feature space. In view of the above problems, this paper aims at fixing this gap with a component-based system named RSDMS to facilitate the application of drought monitoring by remote sensing. The system is designed and developed based on Component Object Model (COM) to ensure the flexibility and extendibility of modules. RSDMS realizes general image-related functions such as data management, image display, spatial reference management, image processing and analysis, and further provides drought monitoring and evaluation functions based on internal and external models. Finally, China’s Ningxia region is selected as the study area to validate the performance of RSDMS. The experimental results show that RSDMS provide an efficient and scalable support to agricultural drought monitoring. PMID:29236700

A multiple criteria analysis for household solid waste management in the urban community of Dakar.

PubMed

Kapepula, Ka-Mbayu; Colson, Gerard; Sabri, Karim; Thonart, Philippe

2007-01-01

Household solid waste management is a severe problem in big cities of developing countries. Mismanaged solid waste dumpsites produce bad sanitary, ecological and economic consequences for the whole population, especially for the poorest urban inhabitants. Dealing with this problem, this paper utilizes field data collected in the urban community of Dakar, in view of ranking nine areas of the city with respect to multiple criteria of nuisance. Nine criteria are built and organized in three families that represent three classical viewpoints: the production of wastes, their collection and their treatment. Thanks to the method PROMETHEE and the software ARGOS, we do a pair-wise comparison of the nine areas, which allows their multiple criteria rankings according to each viewpoint and then globally. Finding the worst and best areas in terms of nuisance for a better waste management in the city is our final purpose, fitting as well as possible the needs of the urban community. Based on field knowledge and on the literature, we suggest applying general and area-specific remedies to the household solid waste problems.

Livestock impacts for management of reclaimed land at Navajo Mine: The decision-making process

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

Estrada, O.J.; Grogan, S.; Gadzia, K.L.

1997-12-31

Livestock grazing is the post-mining use for reclaimed land at Navajo Mine, a large surface coal mine on the Navajo Nation in northwest New Mexico. The Navajo Mine Grazing Management Program (GMP) uses holistic management on approximately 2,083 ha of reclaimed land to plan for final liability release and return of the land to the Navajo Nation, and to minimize the potential for post-release liability. The GMP began in 1991 to establish that livestock grazing on the reclaimed land is sustainable. Assuming that sustainability requires alternatives to conventional land management practices, the GMP created a Management Team consisting of companymore » staff, local, Navajo Nation, and Federal government officials, and technical advisors. Community members contributed to the formation of a holistic goal for the GMP that articulates their values and their desire for sustainable grazing. Major decisions (e.g., artificial insemination, water supply, supplemental feed) are tested against the goal. Biological changes in the land and the grazing animals are monitored daily to provide early feedback to managers, and annually to document the results of grazing. To date, the land has shown resilience to grazing and the animals have generally prospered. Community participation in the GMP and public statements of support by local officials indicate that the GMP`s strategy is likely to succeed.« less

Resolving Complex Research Data Management Issues in Biomedical Laboratories: Qualitative Study of an Industry-Academia Collaboration

PubMed Central

Myneni, Sahiti; Patel, Vimla L.; Bova, G. Steven; Wang, Jian; Ackerman, Christopher F.; Berlinicke, Cynthia A.; Chen, Steve H.; Lindvall, Mikael; Zack, Donald J.

2016-01-01

This paper describes a distributed collaborative effort between industry and academia to systematize data management in an academic biomedical laboratory. Heterogeneous and voluminous nature of research data created in biomedical laboratories make information management difficult and research unproductive. One such collaborative effort was evaluated over a period of four years using data collection methods including ethnographic observations, semi-structured interviews, web-based surveys, progress reports, conference call summaries, and face-to-face group discussions. Data were analyzed using qualitative methods of data analysis to 1) characterize specific problems faced by biomedical researchers with traditional information management practices, 2) identify intervention areas to introduce a new research information management system called Labmatrix, and finally to 3) evaluate and delineate important general collaboration (intervention) characteristics that can optimize outcomes of an implementation process in biomedical laboratories. Results emphasize the importance of end user perseverance, human-centric interoperability evaluation, and demonstration of return on investment of effort and time of laboratory members and industry personnel for success of implementation process. In addition, there is an intrinsic learning component associated with the implementation process of an information management system. Technology transfer experience in a complex environment such as the biomedical laboratory can be eased with use of information systems that support human and cognitive interoperability. Such informatics features can also contribute to successful collaboration and hopefully to scientific productivity. PMID:26652980

Organic farming favours insect-pollinated over non-insect pollinated forbs in meadows and wheat fields.

PubMed

Batáry, Péter; Sutcliffe, Laura; Dormann, Carsten F; Tscharntke, Teja

2013-01-01

The aim of this study was to determine the relative effects of landscape-scale management intensity, local management intensity and edge effect on diversity patterns of insect-pollinated vs. non-insect pollinated forbs in meadows and wheat fields. Nine landscapes were selected differing in percent intensively used agricultural area (IAA), each with a pair of organic and conventional winter wheat fields and a pair of organic and conventional meadows. Within fields, forbs were surveyed at the edge and in the interior. Both diversity and cover of forbs were positively affected by organic management in meadows and wheat fields. This effect, however, differed significantly between pollination types for species richness in both agroecosystem types (i.e. wheat fields and meadows) and for cover in meadows. Thus, we show for the first time in a comprehensive analysis that insect-pollinated plants benefit more from organic management than non-insect pollinated plants regardless of agroecosystem type and landscape complexity. These benefits were more pronounced in meadows than wheat fields. Finally, the community composition of insect-pollinated and non-insect-pollinated forbs differed considerably between management types. In summary, our findings in both agroecosystem types indicate that organic management generally supports a higher species richness and cover of insect-pollinated plants, which is likely to be favourable for the density and diversity of bees and other pollinators.

Organic Farming Favours Insect-Pollinated over Non-Insect Pollinated Forbs in Meadows and Wheat Fields

PubMed Central

Batáry, Péter; Sutcliffe, Laura; Dormann, Carsten F.; Tscharntke, Teja

2013-01-01

The aim of this study was to determine the relative effects of landscape-scale management intensity, local management intensity and edge effect on diversity patterns of insect-pollinated vs. non-insect pollinated forbs in meadows and wheat fields. Nine landscapes were selected differing in percent intensively used agricultural area (IAA), each with a pair of organic and conventional winter wheat fields and a pair of organic and conventional meadows. Within fields, forbs were surveyed at the edge and in the interior. Both diversity and cover of forbs were positively affected by organic management in meadows and wheat fields. This effect, however, differed significantly between pollination types for species richness in both agroecosystem types (i.e. wheat fields and meadows) and for cover in meadows. Thus, we show for the first time in a comprehensive analysis that insect-pollinated plants benefit more from organic management than non-insect pollinated plants regardless of agroecosystem type and landscape complexity. These benefits were more pronounced in meadows than wheat fields. Finally, the community composition of insect-pollinated and non-insect-pollinated forbs differed considerably between management types. In summary, our findings in both agroecosystem types indicate that organic management generally supports a higher species richness and cover of insect-pollinated plants, which is likely to be favourable for the density and diversity of bees and other pollinators. PMID:23382979

75 FR 14070 - Redelegation of Authority of Assistant Attorney General, Civil Division, to Branch Directors...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... Attorney General, Civil Division, to Branch Directors, Heads of Offices and United States Attorneys in Civil Division Cases AGENCY: Office of the Assistant Attorney General, Civil Division, Department of Justice. ACTION: Final rule. SUMMARY: This final rule amends Civil Directive 14-95, published in the...

Assessment of medical waste management in seven hospitals in Lagos, Nigeria.

PubMed

Awodele, Olufunsho; Adewoye, Aishat Abiodun; Oparah, Azuka Cyril

2016-03-15

Medical waste (MW) can be generated in hospitals, clinics and places where diagnosis and treatment are conducted. The management of these wastes is an issue of great concern and importance in view of potential public health risks associated with such wastes. The study assessed the medical waste management practices in selected hospitals and also determined the impact of Lagos Waste Management Authority (LAWMA) intervention programs. A descriptive cross-sectional survey method was used. Data were collected using three instrument (questionnaire, site visitation and in -depth interview). Two public (hospital A, B) and five private (hospital C, D, E, F and G) which provide services for low, middle and high income earners were used. Data analysis was done with SPSS version 20. Chi-squared test was used to determine level of significance at p < 0.05. The majority 56 (53.3%) of the respondents were females with mean age of 35.46 (±1.66) years. The hospital surveyed, except hospital D, disposes both general and medical waste separately. All the facilities have the same process of managing their waste which is segregation, collection/on-site transportation, on-site storage and off-site transportation. Staff responsible for collecting medical waste uses mainly hand gloves as personal protective equipment. The intervention programs helped to ensure compliance and safety of the processes; all the hospitals employ the services of LAWMA for final waste disposal and treatment. Only hospital B offered on-site treatment of its waste (sharps only) with an incinerator while LAWMA uses hydroclave to treat its wastes. There are no policies or guidelines in all investigated hospitals for managing waste. An awareness of proper waste management amongst health workers has been created in most hospitals through the initiative of LAWMA. However, hospital D still mixes municipal and hazardous wastes. The treatment of waste is generally done by LAWMA using hydroclave, to prevent environmental hazards except hospital B that treats its sharp with an incinerator. In order to enhance uniform and appropriate waste management practices in the entire State, there is need for capacity building at all levels and also policies and guidelines formulations.

California Air Quality State Implementation Plans; Final Approval; Butte County Air Quality Management District; Stationary Source Permits

EPA Pesticide Factsheets

EPA is taking final action to approve a revision to the Butte County Air Quality Management District (BCAQMD) portion of the California State Implementation Plan (SIP). This revision concerns the District's New Source Review (NSR) permitting program.

76 FR 71465 - Defense Federal Acquisition Regulation Supplement: Management of Manufacturing Risk in Major...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

... Government procurement. Mary Overstreet, Editor, Defense Acquisition Regulations System. Interim Rule Adopted... Federal Acquisition Regulation Supplement: Management of Manufacturing Risk in Major Defense Acquisition...). ACTION: Final rule. SUMMARY: DoD is adopting as final, without change, an interim rule amending the...

75 FR 23582 - Annular Casing Pressure Management for Offshore Wells

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-04

... DEPARTMENT OF THE INTERIOR Minerals Management Service 30 CFR Part 250 [Docket ID: MMS-2007-OMM... Service (MMS), Interior. ACTION: Final rule. SUMMARY: This final rule will establish regulations to... safety and environmental protection, and require Outer Continental Shelf lessees to follow best industry...

78 FR 25579 - Georgia: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-02

... prohibitions imposed by Federal regulations that EPA promulgates pursuant to the Hazardous and Solid Waste...: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY: Environmental... authorization of changes to its hazardous waste program under the Resource Conservation and Recovery Act (RCRA...

Model Orlando regionally efficient travel management coordination center (MORE TMCC), phase II : final report.

DOT National Transportation Integrated Search

2012-09-01

The final report for the Model Orlando Regionally Efficient Travel Management Coordination Center (MORE TMCC) presents the details of : the 2-year process of the partial deployment of the original MORE TMCC design created in Phase I of this project...

41 CFR 101-39.300 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FEDERAL PROPERTY MANAGEMENT REGULATIONS AVIATION, TRANSPORTATION, AND MOTOR VEHICLES 39-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.3-Use and Care of GSA Interagency Fleet Management System Vehicles § 101-39.300 General. (a) The objective of the General Services Administration (GSA) Interagency Fleet Management System...

Improved near real-time data management procedures for the Mediterranean ocean Forecasting System-Voluntary Observing Ship program

NASA Astrophysics Data System (ADS)

Manzella, G. M. R.; Scoccimarro, E.; Pinardi, N.; Tonani, M.

2003-01-01

A "ship of opportunity" program was launched as part of the Mediterranean Forecasting System Pilot Project. During the operational period (September 1999 to May 2000), six tracks covered the Mediterranean from the northern to southern boundaries approximately every 15 days, while a long eastwest track from Haifa to Gibraltar was covered approximately every month. XBT data were collected, sub-sampled at 15 inflection points and transmitted through a satellite communication system to a regional data centre. It was found that this data transmission system has limitations in terms of quality of the temperature profiles and quantity of data successfully transmitted. At the end of the MFSPP operational period, a new strategy for data transmission and management was developed. First of all, VOS-XBT data are transmitted with full resolution. Secondly, a new data management system, called Near Real Time Quality Control for XBT (NRT.QC.XBT), was defined to produce a parallel stream of high quality XBT data for further scientific analysis. The procedure includes: (1) Position control; (2) Elimination of spikes; (3) Re-sampling at a 1 metre vertical interval; (4) Filtering; (5) General malfunctioning check; (6) Comparison with climatology (and distance from this in terms of standard deviations); (7) Visual check; and (8) Data consistency check. The first six steps of the new procedure are completely automated; they are also performed using a new climatology developed as part of the project. The visual checks are finally done with a free-market software that allows NRT final data assessment.

Review article: the pathophysiology and medical management of diverticulosis and diverticular disease of the colon.

PubMed

Tursi, A; Papa, A; Danese, S

2015-09-01

The incidence of diverticulosis and diverticular disease of the colon, including diverticulitis, is increasing worldwide, and becoming a significant burden on national health systems. Treatment of patients with diverticulosis and DD is generally based on high-fibre diet and antibiotics, respectively. However, new pathophysiological knowledge suggests that further treatment may be useful. To review the current treatment of diverticulosis and diverticular disease. A search of PubMed and Medline databases was performed to identify articles relevant to the management of diverticulosis and diverticular disease. Major international conferences were also reviewed. Two randomised controlled trials (RCT) found the role of antibiotics in managing acute diverticulitis to be questionable, particularly in patients with no complicating comorbidities. One RCT found mesalazine to be effective in preventing acute diverticulitis in patients with symptomatic uncomplicated diverticular disease. The role of rifaximin or mesalazine in preventing diverticulitis recurrence, based on the results of 1 and 4 RCTs, respectively, remains unclear. RCTs found rifaximin and mesalazine to be effective in treating symptomatic uncomplicated diverticular disease. The use of probiotics in diverticular disease and in preventing acute diverticulitis occurrence/recurrence appears promising but unconclusive. Finally, the role of fibre in treating diverticulosis remains unclear. Available evidence suggests that antibiotics have a role only in the treatment of complicated diverticulitis. It appears to be some evidence for a role for rifaximin and mesalazine in treating symptomatic uncomplicated diverticular disease. Finally, there is not currently adequate evidence to recommend any medical treatment for the prevention of diverticulitis recurrence. © 2015 John Wiley & Sons Ltd.

The effectiveness of competency-based education in equipping primary health care workers to manage chronic disease in Australian general practice settings.

PubMed

Glasgow, Nicholas J; Wells, Robert; Butler, James; Gear, Anna

2008-04-21

To review the literature on the effectiveness of competency-based education (CBE) as a means of equipping the Australian general practice workforce to deliver optimal chronic disease outcomes to articulate policy options for the Australian context. Systematic review of the literature (1991-2005) using a narrative approach followed by analysis of the findings using the actors/context/ processes/content framework of Buse et al. Few high-quality studies were identified. National policy options include incorporating clear statements about education and training, research and evaluation in any policy document targeting chronic disease; and provision of funding to enhance general practice teaching facilities and/or facilitate the development of supportive coordinating and administrative structures for training practices. Designers of CBE should consider five key questions: Are the educational objectives of the CBE clearly aligned with the chronic disease or workforce-related outcomes of interest? Is the design of the CBE sound? Have similar educational programs targeting the same outcomes been identified and every attempt made to maximise synergies between programs? Are the educational designers fully aware of and working within the existing complexity of the training environment? Are all involved in the program actively managing the process of change? Policy options range from those relatively simple and achievable to more complex and difficult. The full report is available at http://www.anu.edu.au/aphcri/Domain/Workforce/final_25_glasgow.pdf.

76 FR 38685 - Draft General Management Plan Amendment/Environmental Impact Statement, Tumacacori National...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-01

... experience at Tumacacori by developing access to these associated mission resources. A general management... DEPARTMENT OF THE INTERIOR National Park Service Draft General Management Plan Amendment... Management Plan, Tumacacori National Historical Park, in favor of an Environmental Assessment. SUMMARY: The...

Interprofessional Collaboration between General Physicians and Emergency Department Teams in Belgium: A Qualitative Study

PubMed Central

Tricas-Sauras, Sandra; Darras, Elisabeth; Macq, Jean

2017-01-01

This study aimed to assess interprofessional collaboration between general physicians and emergency departments in the French speaking regions of Belgium. Eight group interviews were conducted both in rural and urban areas, including in Brussels. Findings showed that the relational components of collaboration, which are highly valued by individuals involved, comprise mutual acquaintanceship and trust, shared power and objectives. The organizational components of collaboration included out-of-hours services, role clarification, leadership and overall environment. Communication and patient’s role were also found to be key elements in enhancing or hindering collaboration across these two levels of care. Relationships between general physicians and emergency departments’ teams were tightly linked to organizational factors and the general macro-environment. Health system regulation did not appear to play a significant role in promoting collaboration between actors. A better role clarification is needed in order to foster multidisciplinary team coordination for a more efficient patient management. Finally, economic power and private practice impeded interprofessional collaboration between the care teams. In conclusion, many challenges need to be addressed for achievement of a better collaboration and more efficient integration. Not only should integration policies aim at reinforcing the role of general physicians as gatekeepers, also they should target patients’ awareness and empowerment. PMID:29588632

76 FR 6561 - North Carolina: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-07

... Carolina: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY: Environmental... authorization of the changes to its hazardous waste program under the Resource Conservation and Recovery Act... authorization during the comment period, the decision to authorize North Carolina's changes to its hazardous...

Climate Change and Interacting Stressors: Implications for Coral Reef Management in American Samoa (Final Report)

EPA Science Inventory

EPA announced the release of the final document, Climate Change and Interacting Stressors: Implications for Coral Reef Management in American Samoa. This report provides a synthesis of information on the interactive effects of climate change and other stressors on the reef...

77 FR 60137 - Lee Metcalf National Wildlife Refuge, Ravalli County, MT; Final Comprehensive Conservation Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-02

.... The final plan identifies goals, objectives, and strategies that describe the future management of the... management purpose, for migratory birds'' (Migratory Bird Conservation Act); and (2) ``for (a) incidental... participate in interpretive programs in the indoor and outdoor classrooms. The Refuge provides habitat for...

Final Approval of California Air Plan Revision; Antelope Valley Air Quality Management District; VOCs From Motor Vehicle Assembly Coating Operations

EPA Pesticide Factsheets

EPA is taking final action to approve a revision to the Antelope Valley Air Quality Management District (AVAQMD) portion of the California SIP concerning the emissions of volatile organic compounds (VOCs) from motor vehicle assembly coating operations.

The Vocational Education Component of the Rhode Island Educational Management Information System.

ERIC Educational Resources Information Center

Galamaga, Donald P.; Bartolomeo, Paul A.

The document describes the implementation (Phase Two) of the Vocational Educational module--one component of an educational management information system. Phase Two entails the technical effort of final system design, final output specifications, edit specifications, system software selection, computer programing, systems documentation and the…

76 FR 60525 - Final Wilderness and Backcountry Management Plan and Environmental Impact Statement for Isle...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... and Environmental Impact Statement for Isle Royale National Park, MI AGENCY: National Park Service... the availability of a Final Wilderness and Backcountry Management Plan and Environmental Impact... the Internet through the NPS Planning, Environment, and Public Comment Web site ( http://parkplanning...

78 FR 17392 - Idaho Power Company; Notice of Availability of Final Environmental Assessment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-21

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project Nos. 1975-102; 2061-086] Idaho Power Company; Notice of Availability of Final Environmental Assessment In accordance with the National... Counties, Idaho. Both projects occupy lands managed by the Bureau of Land Management. The Lower Salmon...

78 FR 15299 - New York: Final Authorization of State Hazardous Waste Management Program Revision

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-11

... authorization of changes to its hazardous waste program under the Solid Waste Disposal Act, as amended, commonly... Solid Waste Amendments of 1984 (HSWA). New Federal requirements and prohibitions imposed by Federal...: Final Authorization of State Hazardous Waste Management Program Revision AGENCY: Environmental...

78 FR 10606 - Final Management Plan and Environmental Assessment for Monitor National Marine Sanctuary: Notice...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-14

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Final Management Plan and... Administration (NOAA), Department of Commerce (DOC). ACTION: Notice of public availability. SUMMARY: NOAA is... the wreck of the famed Civil War ironclad, USS Monitor, best known for its battle with the Confederate...

Effects of Climate Change on Aquatic Invasive Species and Implications for Management and Research (Final Report)

EPA Science Inventory

EPA announced the availability of the final report, Effects of Climate Change on Aquatic Invasive Species and Implications for Management and Research . This report reviews available literature on climate-change effects on aquatic invasive species (AIS) and examines sta...

76 FR 55384 - Notice of Decision Not To Reissue National Pollutant Discharge Elimination System (NPDES) General...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-07

... Discharge Elimination System (NPDES) General Permit for the Final Beneficial Reuse or Disposal of Municipal... intend to reissue the NPDES General Permit for the Final Beneficial Reuse or Disposal of Municipal Sewage... part except in accordance with such requirements. Authority: Clean Water Act, 33 U.S.C. 1251 et seq...

Managing high-risk patients: the Mass General care management programme

PubMed Central

Kodner, Dennis L.

2015-01-01

The Massachusetts General Care Management Program (Mass General CMP or CMP) was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS) beneficiaries—primarily older persons—with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each). It started during the first phase at Massachusetts General Hospital, a major academic medical centre in Boston, Massachusetts in collaboration with Massachusetts General Physicians Organisation. During the second phase, the programme expanded to two more affiliated sites in and around the Boston area, including a community hospital, as well as incorporated several modifications primarily focused on the management of transitions to post-acute care in skilled nursing facilities. At the close of the demonstration in July 2012, Mass General Massachusetts General Care Management Program became a component of a new Pioneer accountable care organisation (ACO). The Massachusetts General Care Management Program is focused on individuals meeting defined eligibility criteria who are offered care that is integrated by a case manager embedded in a primary care practice. The demonstration project showed substantial cost savings compared to fee-for-service patients served in the traditional Medicare system but no impact on hospital readmissions. The Massachusetts General Care Management Program does not rest upon a “whole systems” approach to integrated care. It is an excellent example of how an innovative care co-ordination programme can be implemented in an existing health-care organisation without making fundamental changes in its underlying structure or the way in which direct patient care services are paid for. The accountable care organisation version of the Massachusetts General Care Management Program includes the staffing structure, standards of practice, collaborative approach to care transitions and information technology tools that were used in the original demonstration project. PMID:26417211

Solar Decathlon 2017: Final Report and Lessons Learned

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

Incorporated, Energetics

This final report introduces the Solar Decathlon 2017 Program Administrator, Core Advisory Committee, event sponsors and donors, and regional stakeholders that were integral to the success of Solar Decathlon 2017. The substantial balance of this report presents evaluative metrics and lessons learned about the primary aspects of administering Solar Decathlon 2017, including Project Management, Competition and Site Management, Stakeholder Engagement, Communications, Sponsor Management, Education Programming, and Volunteer Coordination. Several appendices compliment the discussion.

The expanded Global Registry of Acute Coronary Events: baseline characteristics, management practices, and hospital outcomes of patients with acute coronary syndromes.

PubMed

Goodman, Shaun G; Huang, Wei; Yan, Andrew T; Budaj, Andrzej; Kennelly, Brian M; Gore, Joel M; Fox, Keith A A; Goldberg, Robert J; Anderson, Frederick A

2009-08-01

The Global Registry of Acute Coronary Events (GRACE)-a prospective, multinational study of patients hospitalized with acute coronary syndromes (ACSs)-was designed to improve the quality of care for patients with an ACS. Expanded GRACE aims to test the feasibility of a simplified data collection tool and provision of quarterly feedback to index individual hospital management practices to an international reference cohort. We describe the objectives; study design; study and data management; and the characteristics, management, and hospital outcomes of patients > or =18 years old enrolled with a presumptive diagnosis of ACS. From 2001 to 2007, 31,982 patients were enrolled at 184 hospitals in 25 countries; 30% were diagnosed with ST-segment elevation myocardial infarction, 31% with non-ST-segment myocardial infarction, 26% with unstable angina, and 12% with another cardiac/noncardiac final diagnosis. The median age was 65 (interquartile range 55-75) years; 24% were >75 years old, and 33% were women. In general, increases were observed over time across the spectrum of ACS (1) in the use in the first 24 hours and at discharge of aspirin, clopidogrel, beta-blockers, and angiotensin-converting enzyme inhibitors/receptor blockers; (2) in the use at discharge of statins; (3) in the early use of glycoprotein IIb/IIIa inhibitors and low-molecular-weight heparin; and (4) in the use of cardiac catheterization and percutaneous coronary intervention. An increase in the use of primary percutaneous coronary intervention and a similar decrease in the use of fibrinolysis in ST-segment elevation myocardial infarction were also seen. Over the course of 7 years, general increases in the use of evidence-based therapies for ACS patients were observed in the expanded GRACE.

Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care

PubMed Central

2011-01-01

Background Primary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD), patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio), we have developed and tested a set of standardized measures, linked to previously developed quality indicators. Methods A structured stepwise procedure was followed to develop measures. First, the research team allocated 106 validated quality indicators to one of the three target populations (established CVD, at high risk, at low risk) and to different data-collection methods (data abstraction from the medical records, a patient survey, an interview with lead practice GP/a practice survey). Secondly, we selected a number of other validated measures to enrich the assessment. A pilot study was performed to test the feasibility. Finally, we revised the measures based on the findings. Results The EPA-Cardio measures consisted of abstraction forms from the medical-records data of established Coronary Heart Disease (CHD)-patients - and high-risk groups, a patient questionnaire for each of the 3 groups, an interview questionnaire for the lead GP and a questionnaire for practice teams. The measures were feasible and accepted by general practices from different countries. Conclusions An internationally standardized measure of cardiovascular risk management, linked to validated quality indicators and tested for feasibility in general practice, is now available. Careful development and pilot testing of the measures are crucial in international studies of quality of healthcare. PMID:21473758

78 FR 48660 - Agency Information Collection Activities; Comment Request; Student Assistance General Provisions...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

...; Comment Request; Student Assistance General Provisions--Subpart K--Cash Management AGENCY: Federal Student... of Collection: Student Assistance General Provisions--Subpart K--Cash Management OMB Control Number... administration of 34 CFR 668 Subpart K Cash Management of the Student Assistance General Provisions. The...

Participation of general practitioners in disease management: experiences from The Netherlands.

PubMed

Steuten, L M G; Vrijhoef, H J M; Spreeuwenberg, C; Van Merode, G G

2002-01-01

To investigate the extent to which GPs in The Netherlands participate in disease management and how personal opinions, impeding and promoting incentives as well as physician characteristics influence their attitude towards disease management. The attitude-model of Fishbein and Ajzen was used to describe the attitude of GPs towards disease management and main influencing factors. After interviewing seventeen representatives of the GPs and testing a questionnaire, the final questionnaire was sent to all GPs in The Netherlands (7680 GPs) barring those involved in the testing of the questionnaire. At least 10.4% of all Dutch GPs are active in disease management. The main factors predicting a positive attitude towards disease management are the following: GPs' opinion that they are improving quality and efficiency of care when executing disease management, presence of a good quality network between actors involved prior to the start of disease management, working in a health centre, and performing sideline activities besides their daily activities as GPs. The main factors predicting a negative attitude are: GPs' opinion that the investment-time is too high, lack of reimbursement for disease management activities, working in a solo practice, and not performing any sideline activities beside their daily activities as GP. The factors predicting a negative attitude of Dutch GPs towards disease management dominate the factors predicting a positive attitude. The arguments in favour of disease management are matters of belief, for example concerning improvements in the quality of care, while arguments against are more concrete barriers e.g. high workload and financial reimbursement. Placed on the innovation timeline, the 10.4% participation might be taken to represent the start of a trend.

Participation of general practitioners in disease management: experiences from the Netherlands

PubMed Central

Steuten, L.M.G.; Vrijhoef, H.J.M.; Spreeuwenberg, C.; Van Merode, G.G.

2002-01-01

Abstract Objective To investigate the extent to which GPs in the Netherlands participate in disease management and how personal opinions, impeding and promoting incentives as well as physician characteristics influence their attitude towards disease management. Methods The attitude-model of Fishbein and Ajzen was used to describe the attitude of GPs towards disease management and main influencing factors. After interviewing seventeen representatives of the GPs and testing a questionnaire, the final questionnaire was sent to all GPs in the Netherlands (7680 GPs) barring those involved in the testing of the questionnaire. Results At least 10.4% of all Dutch GPs are active in disease management. The main factors predicting a positive attitude towards disease management are the following: GPs' opinion that they are improving quality and efficiency of care when executing disease management, presence of a good quality network between actors involved prior to the start of disease management, working in a health centre, and performing sideline activities besides their daily activities as GPs. The main factors predicting a negative attitude are: GPs' opinion that the investment-time is too high, lack of reimbursement for disease management activities, working in a solo practice, and not performing any sideline activities beside their daily activities as GP. Conclusions The factors predicting a negative attitude of Dutch GPs towards disease management dominate the factors predicting a positive attitude. The arguments in favour of disease management are matters of belief, for example concerning improvements in the quality of care, while arguments against are more concrete barriers e.g. high workload and financial reimbursement. Placed on the innovation timeline, the 10.4% participation might be taken to represent the start of a trend. PMID:16896373

41 CFR 105-1.101 - General Services Administration Property Management Regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

...-INTRODUCTION 1.1-Regulations System § 105-1.101 General Services Administration Property Management Regulations... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false General Services Administration Property Management Regulations. 105-1.101 Section 105-1.101 Public Contracts and Property...

75 FR 28055 - General Management Plan; Joshua Tree National Park; San Bernardino and Riverside Counties, CA...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

... DEPARTMENT OF THE INTERIOR National Park Service General Management Plan; Joshua Tree National... National Park Service is updating the General Management Plan (GMP) for Joshua Tree National Park... park management and resource analysis, other designations such as establishment of 594,502 acres by...

24 CFR 990.310 - Purpose-General policy on financial management, monitoring and reporting.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Management Systems, Monitoring, and Reporting § 990.310 Purpose—General policy on financial management, monitoring and reporting. All PHA financial management systems, reporting, and monitoring of program... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Purpose-General policy on financial...

10 CFR 2.332 - General case scheduling and management.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false General case scheduling and management. 2.332 Section 2... Management for NRC Adjudicatory Hearings § 2.332 General case scheduling and management. (a) Scheduling order... the issues presented, relevant considerations which a party may bring to the attention of the...

78 FR 47410 - General Management Plan, Draft Environmental Impact Statement, Gateway National Recreation Area...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

...] General Management Plan, Draft Environmental Impact Statement, Gateway National Recreation Area, New... (NPS) is releasing a Draft Environmental Impact Statement (DEIS) for the General Management Plan (GMP... alternatives to guide the management of the site over the next 20 years. The NPS preferred alternative...

Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression, anxiety, pain, and psychological distress.

PubMed

Marchand, William R

2012-07-01

Mindfulness has been described as a practice of learning to focus attention on moment-bymoment experience with an attitude of curiosity, openness, and acceptance. Mindfulness practices have become increasingly popular as complementary therapeutic strategies for a variety of medical and psychiatric conditions. This paper provides an overview of three mindfulness interventions that have demonstrated effectiveness for psychiatric symptoms and/or pain. The goal of this review is to provide a synopsis that practicing clinicians can use as a clinical reference concerning Zen meditation, mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT). All three approaches originated from Buddhist spiritual practices, but only Zen is an actual Buddhist tradition. MBSR and MBCT are secular, clinically based methods that employ manuals and standardized techniques. Studies indicate that MBSR and MBCT have broad-spectrum antidepressant and antianxiety effects and decrease general psychological distress. MBCT is strongly recommended as an adjunctive treatment for unipolar depression. The evidence suggests that both MBSR and MBCT have efficacy as adjunctive interventions for anxiety symptoms. MBSR is beneficial for general psychological health and stress management in those with medical and psychiatric illness as well as in healthy individuals. Finally, MBSR and Zen meditation have a role in pain management.

Galileo Press Conference from JPL. Parts 1 and 2

NASA Technical Reports Server (NTRS)

1992-01-01

This two-tape Jet Propulsion Laboratory (JPL) video production presents a Dec. 8, 1992 press conference held at JPL to discuss the final Galileo spacecraft encounter with Earth before beginning its journey to Jupiter. The main theme of the conference was centered on the significance of the 2nd and final Earth/Moon flyby as being the spacecraft's last planetary encounter in the solar system before reaching Jupiter, as well as final flight preparations prior to its final journey. Each person of the five member panel was introduced by Robert MacMillan (JPL Public Information Mgr.) before giving brief presentations including slides and viewgraphs covering their area of expertise regarding Galileo's current status and future plans. After the presentations, the media was given an opportunity to ask questions of the panel regarding the mission. Mr. Wesley Huntress (Dir. of Solar System Exploration (NASA)), William J. ONeill (Galileo Project Manager), Neal E. Ausman, Jr. (Galileo Mission Director), Dr. Torrence V. Johnson (Galileo Project Scientist) and Dr. Ronald Greeley (Member, Imaging Team, Colorado St. Univ.) made up the panel and discussed topics including: Galileo's interplanetary trajectory; project status and performance review; instrument calibration activities; mission timelines; lunar observation and imaging; and general lunar science. Also included in the last three minutes of the video are simulations and images of the 2nd Galileo/Moon encounter.

78 FR 6218 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Reef Fish Fishery of the Gulf of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

...NMFS issues this final rule to implement management measures described in Amendment 38 to the Fishery Management Plan for the Reef Fish Resources of the Gulf of Mexico (FMP) prepared by the Gulf of Mexico (Gulf) Fishery Management Council (Council). This final rule modifies post-season accountability measures (AMs) that affect the recreational harvest of shallow-water grouper species (SWG), changes the trigger for recreational sector AMs for gag and red grouper, and revises the Gulf reef fish framework procedure. The intent of this final rule is to achieve optimum yield (OY) while ensuring the Gulf reef fish fishery resources are utilized efficiently.

77 FR 8855 - Final Reissuance of the NPDES General Permit for Facilities Related to Oil and Gas Extraction in...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-15

... Protection Agency. ACTION: Notice of Final NPDES General Permit. SUMMARY: The Director of the Water Quality... Extraction Point Source Category as authorized by section 402 of the Clean Water Act, 33 U.S.C. 1342 (CWA... change to the proposed permit. A copy of the Region's responses to comments and the final permit may be...

Appraisal of cooperation with a palliative care case manager by general practitioners and community nurses: a cross-sectional questionnaire study.

PubMed

van der Plas, Annicka G M; Onwuteaka-Philipsen, Bregje D; Vissers, Kris C; Deliens, Luc; Jansen, Wim J J; Francke, Anneke L

2016-01-01

To investigate how general practitioners and community nurses value the support that they receive from a nurse case manager with expertise in palliative care, whether they think the case manager is helpful in realizing appropriate care and what characteristics of the patient and case management are associated with this view. For sustainable palliative care in an ageing society, basic palliative care is provided by generalists and specialist palliative care is reserved for complex situations. Acceptance of and cooperation with specialist palliative care providers by the general practitioner and community nurse is pivotal. Cross-sectional questionnaire study. Questionnaire data from 168 general practitioners and 125 community nurses were analysed using chi-square tests, univariate and multivariate logistic regression. Data were gathered between March 2011-December 2013. Of general practitioners, 46% rated the case manager as helpful in realizing care that is appropriate for the patient; for community nurses this was 49%. The case manager did not hinder the process of care and had added value for patients, according to the general practitioners and community nurses. The tasks of the case manager were associated with whether or not the case manager was helpful in realizing appropriate care, whereas patient characteristics and the number of contacts with the case manager were not. General practitioners and community nurses are moderately positive about the support from the case manager. To improve cooperation further, case managers should invest in contact with general practitioners and community nurses. © 2015 John Wiley & Sons Ltd.

A process for developing standards to promote quality in general practice.

PubMed

Khoury, Julie; Krejany, Catherine J; Versteeg, Roald W; Lodewyckx, Michaela A; Pike, Simone R; Civil, Michael S; Jiwa, Moyez

2018-06-02

Since 1991, the Royal Australian College of General Practitioners' (RACGP) Standards for General Practices (the Standards) have provided a framework for quality care, risk management and best practice in the operation of Australian general practices. The Standards are also linked to incentives for general practice remuneration. These Standards were revised in 2017. The objective of this study is to describe the process undertaken to develop the fifth edition Standards published in 2017 to inform future standards development both nationally and internationally. A modified Delphi process was deployed to develop the fifth edition Standards. Development was directed by the RACGP and led by an expert panel of GPs and representatives of stakeholder groups who were assisted and facilitated by a team from RACGP. Each draft was released for stakeholder feedback and tested twice before the final version was submitted for approval by the RACGP board. Four rounds of consultation and two rounds of piloting were carried out over 32 months. The Standards were redrafted after each round. One hundred and fifty-two individuals and 225 stakeholder groups participated in the development of the Standards. Twenty-three new indicators were recommended and grouped into three sections in a new modular structure that was different from the previous edition. The Standards represent the consensus view of national stakeholders on the indicators of quality and safety in Australian general practice and primary care.

Management in general practice: the challenge of the new General Medical Services contract.

PubMed

Checkland, Kath

2004-10-01

Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Three general practices in England, chosen using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed by such a manager, the limits of his or her authority, and the management of performance in this role.

Management in general practice: the challenge of the new General Medical Services contract

PubMed Central

Checkland, Kath

2004-01-01

Background: Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. Aim: To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. Design of study: In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Setting: Three general practices in England, chosen using purposeful sampling. Method: Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Results: Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. Conclusion: The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed by such a manager, the limits of his or her authority, and the management of performance in this role. PMID:15469672

75 FR 63851 - Draft General Management Plan and Environmental Impact Statement, Hampton National Historic Site...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-18

... DEPARTMENT OF THE INTERIOR National Park Service Draft General Management Plan and Environmental... the Interior. ACTION: Notice of Availability of the Draft General Management Plan and Environmental... 63852

77 FR 24483 - Wausau Paper Mills, LLC; Notice of Final Land Management Plan and Soliciting Comments, Motions To...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... Mills, LLC; Notice of Final Land Management Plan and Soliciting Comments, Motions To Intervene, and...: Wausau Paper Mills, LLC. e. Name of Project: Rhinelander Hydroelectric Project. f. Location: The upper.... Applicant Contact: Mr. Tim Hasbargen, Wausau Paper Mills, LLC, 515 Davenport St., Rhinelander, Wisconsin...

77 FR 67661 - Notice of Availability of the Final Environmental Impact Statement for the Restoration Design...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-13

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLAZ910000.L13400000.DT0000.LXSS058A0000] Notice of Availability of the Final Environmental Impact Statement for the Restoration Design Energy... Management, Interior. ACTION: Correction. SUMMARY: This notice corrects acreages and information referenced...

FOCUS: a fire management planning system -- final report

Treesearch

Frederick W. Bratten; James B. Davis; George T. Flatman; Jerold W. Keith; Stanley R. Rapp; Theodore G. Storey

1981-01-01

FOCUS (Fire Operational Characteristics Using Simulation) is a computer simulation model for evaluating alternative fire management plans. This final report provides a broad overview of the FOCUS system, describes two major modules-fire suppression and cost, explains the role in the system of gaming large fires, and outlines the support programs and ways of...

77 FR 39180 - Withdrawal of Direct Final Rule Revising the California State Implementation Plan, South Coast...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-02

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0236; FRL-9690-9] Withdrawal of Direct Final Rule Revising the California State Implementation Plan, South Coast Air Quality Management... State Implementation Plan (SIP). This revision concerned South Coast Air Quality Management District...

Reflections on Strategic Enrollment Management Structures and Strategies. Part Three

ERIC Educational Resources Information Center

Kalsbeek, David H.

2007-01-01

This article is the third and final in a series prepared originally for AACRAO's Fifteenth Annual Strategic Enrollment Management Conference (SEM XV). Through this series, David Kalsbeek introduces a four-fold typology for differentiating institutional approaches to SEM. In this final reflection, he suggests that grounding this typology in Jungian…

75 FR 21342 - Notice of Availability of the Final Environmental Impact Statement for the Mona to Oquirrh...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... Corridor Project, Utah, and the Proposed Pony Express Resource Management Plan Amendment AGENCY: Bureau of...)/Proposed Resource Management Plan Amendment (RMPA) for the Mona to Oquirrh Transmission Corridor Project... Final EIS/Proposed RMPA for the Mona to Oquirrh Transmission Corridor Project have been sent to affected...

78 FR 25762 - Notice of Availability of the Final Trail Management Plan/Final Environmental Impact Statement...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-02

... DEPARTMENT OF THE INTERIOR National Park Service [NPS-MWR-CUVA-12176; PPMWMWROW2/PPMPSAS1Y.YP0000... Cuyahoga Valley National Park, Ohio AGENCY: National Park Service, Interior. ACTION: Notice of availability... design for new trails and trail facilities, and maintenance and best management practices. The Guidelines...

78 FR 22560 - OMB Final Sequestration Report to the President and Congress for Fiscal Year 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-16

... OFFICE OF MANAGEMENT AND BUDGET OMB Final Sequestration Report to the President and Congress for Fiscal Year 2013 AGENCY: Executive Office of the President, Office of Management and Budget. ACTION.... SUMMARY: Public Law 112-25, the Budget Control Act of 2011 amended the Balanced Budget and Emergency...

78 FR 15338 - New York: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-11

... authorization of changes to its hazardous waste program under the Solid Waste Disposal Act, as amended, commonly... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 271 [EPA-R02-RCRA-2013-0144; FRL-9693-3] New York: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY: Environmental...

77 FR 76515 - Notice of Availability of the National Petroleum Reserve-Alaska Final Integrated Activity Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-28

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLAK930000.L13100000.DS0000] Notice of Availability of the National Petroleum Reserve-Alaska Final Integrated Activity Plan/Environmental Impact... of Land Management (BLM), Alaska State Office, is issuing the National Petroleum Reserve in Alaska...

75 FR 18877 - Notice of Final Supplementary Rules for Public Lands in Colorado: Gunnison Gorge National...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-13

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCOS05400-L17110000 PA000 LXSIGGCA0000] Notice of Final Supplementary Rules for Public Lands in Colorado: Gunnison Gorge National Conservation Area (GGNCA) and Adjacent Public Lands Administered by the Bureau of Land Management Uncompahgre Field...

Semiautomated Management Of Arriving Air Traffic

NASA Technical Reports Server (NTRS)

Erzberger, Heinz; Nedell, William

1992-01-01

System of computers, graphical workstations, and computer programs developed for semiautomated management of approach and arrival of numerous aircraft at airport. System comprises three subsystems: traffic-management advisor, used for controlling traffic into terminal area; descent advisor generates information integrated into plan-view display of traffic on monitor; and final-approach-spacing tool used to merge traffic converging on final approach path while making sure aircraft are properly spaced. Not intended to restrict decisions of air-traffic controllers.

Final Environmental Impact Statement Establishment and Operation of an Intelligence, Surveillance, Reconnaissance, and Strike Capability Andersen Air Force Base, Guam

DTIC Science & Technology

2007-01-01

Mariana Fruit Bat Pup Recruitment at Pati Point Colony; • Brown Tree Snake Interdiction and Control; and • Adaptive Management and Ground Track...establishment of a mitigation monitoring plan and adaptive management program. FUTURE ACTIONS As discussed in the Final EIS, the Air Force recognizes that...would initiate modifications to aircraft ground tracks and profiles over sensitive areas through an adaptive management strategy. This adaptive

Authentic leadership, performance, and job satisfaction: the mediating role of empowerment.

PubMed

Wong, Carol A; Laschinger, Heather K S

2013-04-01

To report a study conducted to test a model linking authentic leadership of managers with nurses' perceptions of structural empowerment, performance, and job satisfaction. Authentic leadership has been proposed as the root element of effective leadership needed to build healthier work environments because there is special attention to the development of empowering leader-follower relationships. Although the influence of leadership style and empowerment on job satisfaction is well documented, there are few studies examining the influence of authentic leadership on nurses' empowerment and work outcomes. A non-experimental, predictive survey. In 2008, a random sample of 600 Registered Nurses working in acute care hospitals across Ontario in Canada was surveyed. The final sample consisted of 280 (48% response rate) nurses. Variables were measured using the Authentic Leadership Questionnaire, Conditions of Work Effectiveness Questionnaire, Global Job Satisfaction Survey, and General Performance scale. The theoretical model was tested using structural equation modelling. The final model fit the data acceptably. Authentic leadership significantly and positively influenced staff nurses' structural empowerment, which in turn increased job satisfaction and self-rated performance. The results suggest that the more managers are seen as authentic, by emphasizing transparency, balanced processing, self-awareness and high ethical standards, the more nurses perceive they have access to workplace empowerment structures, are satisfied with their work, and report higher performance. © 2012 Blackwell Publishing Ltd.

76 FR 56220 - Draft Environmental Impact Statement for General Management Plan for Golden Gate National...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-12

... Environmental Impact Statement for General Management Plan for Golden Gate National Recreation Area and Muir... Management Plan for Golden Gate National Recreation Area and Muir Woods National Monument. SUMMARY: In accord... Environmental Impact Statement (Draft EIS) for the updating the General Management Plan (GMP) for Golden Gate...

41 CFR 101-25.114 - Supply management surveys and assistance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Supply management surveys...-GENERAL 25.1-General Policies § 101-25.114 Supply management surveys and assistance. Under the provisions of 40 U.S.C. 487, the General Services Administration will perform surveys and/or reviews of...

12 CFR 615.5180 - Interest rate risk management by banks-general.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Interest rate risk management by banks-general... FISCAL AFFAIRS, LOAN POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Risk Assessment and Management § 615.5180 Interest rate risk management by banks—general. The board of directors of each Farm Credit Bank...

12 CFR 615.5180 - Interest rate risk management by banks-general.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Interest rate risk management by banks-general... FISCAL AFFAIRS, LOAN POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Risk Assessment and Management § 615.5180 Interest rate risk management by banks—general. The board of directors of each Farm Credit Bank...

29 CFR 541.201 - Directly related to management or general business operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... management or general business operations. (a) To qualify for the administrative exemption, an employee's... operations of the employer or the employer's customers. The phrase “directly related to the management or... 29 Labor 3 2010-07-01 2010-07-01 false Directly related to management or general business...

76 FR 51395 - Draft Environmental Impact Statement for the General Management Plan (DEIS/GMP), Canaveral...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-18

... Statement for the General Management Plan (DEIS/GMP), Canaveral National Seashore, FL AGENCY: National Park... General Management Plan (DEIS/GMP), Canaveral National Seashore (Seashore). SUMMARY: Pursuant to 42 U.S.C... DEIS/GMP for Canaveral National Seashore, Florida. The document provides a framework for management...

12 CFR 615.5180 - Interest rate risk management by banks-general.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Interest rate risk management by banks-general... FISCAL AFFAIRS, LOAN POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Risk Assessment and Management § 615.5180 Interest rate risk management by banks—general. The board of directors of each Farm Credit Bank...

10 CFR 51.90 - Final environmental impact statement-general.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Final environmental impact statement-general. 51.90 Section 51.90 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) ENVIRONMENTAL PROTECTION REGULATIONS FOR DOMESTIC LICENSING AND RELATED REGULATORY FUNCTIONS National Environmental Policy Act-Regulations...

15 CFR 923.3 - General requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

...: resource protection, management of coastal development, and simplification of governmental processes. These...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS General § 923.3 General requirements. (a) The...

15 CFR 923.3 - General requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

...: resource protection, management of coastal development, and simplification of governmental processes. These...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS General § 923.3 General requirements. (a) The...

15 CFR 923.3 - General requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

...: resource protection, management of coastal development, and simplification of governmental processes. These...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS General § 923.3 General requirements. (a) The...

15 CFR 923.3 - General requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

...: resource protection, management of coastal development, and simplification of governmental processes. These...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS General § 923.3 General requirements. (a) The...

15 CFR 923.3 - General requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

...: resource protection, management of coastal development, and simplification of governmental processes. These...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS General § 923.3 General requirements. (a) The...

75 FR 1806 - Draft General Management Plan and Environmental Impact Statement, New River Gorge National River, WV

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-13

... DEPARTMENT OF THE INTERIOR National Park Service Draft General Management Plan and Environmental... Interior. ACTION: Notice of availability of the Draft General Management Plan and Environmental Impact...

Leadership and management skills of general practice nurses: experience or education?

PubMed

Lau, Rosalind; Cross, Wendy; Moss, Cheryle; Campbell, Annie; De Castro, Magali; Oxley, Victoria

2014-12-01

A key finding of this qualitative exploratory descriptive study into advanced nursing for general practice nurses (Australian setting) revealed that participants viewed leadership and management as best learnt 'apprenticeship' style on the job by years of experience. Participants (48) comprised of general practice nurses, practice managers and general practitioners from metropolitan Melbourne were interviewed. Other findings demonstrated that the participants generally had limited awareness that postgraduate education can assist in the development of leadership and management in advanced nursing practice. The participants lacked clarity about professional competencies and generally did not connect these to leadership and management. Professional bodies need to take the opportunity to promote awareness of the national competency standards. All three groups of participants expressed hopes about the future provision of professional development opportunities and support by the Medicare Local for leadership and management aspirations within advanced practice nursing.

Optimizing care in osteoporosis: The Canadian quality circle project

PubMed Central

Ioannidis, George; Thabane, Lehana; Gafni, Amiram; Hodsman, Anthony; Kvern, Brent; Johnstone, Dan; Plumley, Nathalie; Salach, Lena; Jiwa, Famida; Adachi, Jonathan D; Papaioannou, Alexandra

2008-01-01

Background While the Osteoporosis Canada 2002 Canadian guidelines provided evidence based strategies in preventing, diagnosing, and managing this condition, publication and distribution of guidelines have not, in and of themselves, been shown to alter physicians clinical approaches. We hypothesize that primary care physicians enrolled in the Quality Circle project would change their patient management of osteoporosis in terms of awareness of osteoporosis risk factors and bone mineral density testing in accordance with the guidelines. Methods The project consisted of five Quality Circle phases that included: 1) Training & Baseline Data Collection, 2) First Educational Intervention & First Follow-Up Data Collection 3) First Strategy Implementation Session, 4) Final Educational Intervention & Final Follow-up Data Collection, and 5) Final Strategy Implementation Session. A total of 340 circle members formed 34 quality circles and participated in the study. The generalized estimating equations approach was used to model physician awareness of risk factors for osteoporosis and appropriate utilization of bone mineral density testing pre and post educational intervention (first year of the study). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. Results After the 1st year of the study, physicians' certainty of their patients' risk factor status increased. Certainty varied from an OR of 1.4 (95% CI: 1.1, 1.8) for prior vertebral fracture status to 6.3 (95% CI: 2.3, 17.9) for prior hip fracture status. Furthermore, bone mineral density testing increased in high risk as compared with low risk patients (OR: 1.4; 95% CI: 1.2, 1.7). Conclusion Quality Circle methodology was successful in increasing both physicians' awareness of osteoporosis risk factors and appropriate bone mineral density testing in accordance with the 2002 Canadian guidelines. PMID:18828906

Office of General Counsel Total Quality Management Plan

DTIC Science & Technology

1989-07-01

20503. IRT DATE 3. REPORT TYPE AND DATES COVERED y 1989 5. FUNDING NUMBERS Office of General Counsel Total Quality Management Plan 6. AUTHOR(S) 7...of General Counsel. - r DTIC 65 LE- E CTEn’" SEP291 989 14. SUBJECT TERMS 15. NUMBER OF PAGES TQM (Total Quality Management ), Office of General...89) Pra-ifcr~bed ANSI Sid 139-1S ""-"’- ", ~ mmmmmu10n S S OFFICE OF GENERAL COUNSEL TOTAL QUALITY MANAGEMENT PLAN Acc’, ’ 7or. .?:" t ’_7 Codes K 89

Adaptation of a difficult-to-manage asthma programme for implementation in the Dutch context: a modified e-Delphi

PubMed Central

Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; in ’t Veen, Johannes C C M

2017-01-01

Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories ‘the A–I of difficult-to-manage asthma’ to resonate with an established Dutch ‘A–E acronym for determining asthma control’. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme. PMID:28184039

Development Issues on Linked Data Weblog Enrichment

NASA Astrophysics Data System (ADS)

Ruiz-Rube, Iván; Cornejo, Carlos M.; Dodero, Juan Manuel; García, Vicente M.

In this paper, we describe the issues found during the development of LinkedBlog, a Linked Data extension for WordPress blogs. This extension enables to enrich text-based and video information contained in blog entries with RDF triples that are suitable to be stored, managed and exploited by other web-based applications. The issues have to do with the generality, usability, tracking, depth, security, trustiness and performance of the linked data enrichment process. The presented annotation approach aims at maintaining web-based contents independent from the underlying ontological model, by providing a loosely coupled RDFa-based approach in the linked data application. Finally, we detail how the performance of annotations can be improved through a semantic reasoner.

MPF Lander Measured Surface Pressure

NASA Image and Video Library

1997-10-14

Here is a comparison of the most recent 24-hour met sessions. Note the general trend of increasing pressure with time into the mission. This indicates that the South polar cap is reducing, freeing CO2 into the atmosphere. Also note small pressure features around noon, which we think are "dust-devils." Sojourner spent 83 days of a planned seven-day mission exploring the Martian terrain, acquiring images, and taking chemical, atmospheric and other measurements. The final data transmission received from Pathfinder was at 10:23 UTC on September 27, 1997. Although mission managers tried to restore full communications during the following five months, the successful mission was terminated on March 10, 1998. http://photojournal.jpl.nasa.gov/catalog/PIA00976

TA-60 Warehouse and Salvage SWPPP Rev 2 Jan 2017-Final

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

Burgin, Jillian Elizabeth

The Stormwater Pollution Prevention Team (PPT) for the TA-60-0002 Salvage and Warehouse Area consists of operations and management personnel from the facility, Multi-Sector General Permitting (MSGP) stormwater personnel from Environmental Compliance Programs (EPC-CP) organization, and Deployed Environmental Professionals. The EPC-CP representative is responsible for Laboratory compliance under the National Pollutant Discharge Elimination System (NPDES) permit regulations. The team members are selected on the basis of their familiarity with the activities at the facility and the potential impacts of those activities on stormwater runoff. The Warehouse and Salvage Yard are a single shift operation; therefore, a member of the PPT ismore » always present during operations.« less

Human resource management in general practice: survey of current practice.

PubMed Central

Newton, J; Hunt, J; Stirling, J

1996-01-01

BACKGROUND: The organization and management of general practice is changing as a result of government policies designed to expand primary health care services. One aspect of practice management which has been underresearched concerns staffing: the recruitment, retention, management and motivation of practice managers. AIM: A study set out to find out who is routinely involved in making decisions about staffing matters in general practice, to establish the extent to which the human resource management function is formalized and specialized, and to describe the characteristics of the practice managers. METHOD: A postal questionnaire was sent to a stratified random sample of 750 general practices in England and Wales in February 1994 enquiring about the practice (for example, the fundholding status and number of general practitioner partners), how the practice dealt with a range of staffing matters and about the practice manager (for example, employment background and training in human resource management). Practices were classed as small (single-handed and two or three general practitioner partners), medium (four or five partners) or large (six or more partners). RESULTS: Replies were received from 477 practices (64%). Practice managers had limited authority to make decisions alone in the majority of practices although there was a greater likelihood of them taking independent action as the size of practice increased. Formality in handling staffing matters (as measured by the existence and use of written policies and procedures) also increased with practice size. Larger practices were more likely than smaller practices to have additional tiers in their management structure through the creation of posts with the titles assistant practice manager, fund manager and senior receptionist. Most practice managers had been recruited from within general practice but larger practices were more likely than smaller practices to recruit from outwith general practice. Three quarters of practice managers reported having received some type of formal training in staff management. CONCLUSION: This study shows that practice size is a major factor associated with differences in the organization and management of staffing. Any initiatives which increase the scale of primary care functions and services would have to address the issues of communication and coordination that might be associated with such a change. PMID:8855013

Implementing an EMIS: The right way and the wrong way

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

Mayer, G.J.; Schroeder, J.V.

1999-07-01

The information age has touched all corners of business and private life. Environmental managers are not exempt from its touch. Today's environmental manager has the difficult job of keeping the company in compliance as well as acting as environmental historian. Much more environmental information is available today than ever before. Compounding this problem is the fact that environmental functions were not exempt from corporate streamlining, belt tightening and budget cutting. Finally, with corporations increasingly considering environmental costs as a function that should be managed as actively as any other area of the business, the demand for systematic environmental information managementmore » tools is increasing rapidly. Today's environmental professional is faced with the need to manage more information with less available staff time, to do it faster, better and cheaper, and to have the information available at his/her fingertips. Deciding on the right Environmental Management Information System (EMIS) solution can be quite difficult. Numerous off-the-shelf solutions exist and customized system development is always an option. Implementation of an EMIS is generally a costly project, both in terms of dollars and in terms of manpower distractions and process changes. Therefore, getting it right the first time is critical. Like a construction project, when you turn on the switch, the equipment is expected to perform as planned and designed.« less

The value of plain abdominal radiographs in management of abdominal emergencies in Luth.

PubMed

Ashindoitiang, J A; Atoyebi, A O; Arogundade, R A

2008-01-01

The plain abdominal x-ray is still the first imaging modality in diagnosis of acute abdomen. The aim of this study was to find the value of plain abdominal x-ray in the management of abdominal emergencies seen in Lagos university teaching hospital. The accurate diagnosis of the cause of acute abdominal pain is one of the most challenging undertakings in emergency medicine. This is due to overlapping of clinical presentation and non-specific findings of physical and even laboratory data of the multifarious causes. Plain abdominal radiography is one investigation that can be obtained readily and within a short period of time to help the physician arrive at a correct diagnosis The relevance of plain abdominal radiography was therefore evaluated in the management of abdominal emergencies seen in Lagos over a 12 month period (April 2002 to March 2003). A prospective study of 100 consecutively presenting patients with acute abdominal conditions treated by the general surgical unit of Lagos University Teaching Hospital was undertaken. All patients had supine and erect abdominal x-ray before any therapeutic intervention was undertaken. The diagnostic features of the plain films were compared with final diagnosis to determine the usefulness of the plain x-ray There were 54 males and 46 females (M:F 1.2:1). Twenty-four percent of the patients had intestinal obstruction, 20% perforated typhoid enteritis; gunshot injuries and generalized peritonitis each occurred in 13%, blunt abdominal trauma in 12%, while 8% and 10% had acute appendicitis and perforated peptic ulcer disease respectively. Of 100 patients studied, 54% had plain abdominal radiographs that showed positive diagnostic features. Plain abdominal radiograph showed high sensitivity in patients with intestinal obstruction 100% and perforated peptic ulcer 90% but was less sensitive in patients with perforated typhoid, acute appendicitis, and blunt abdominal trauma and generalized peritonitis. In conclusion, this study shows that abdominal radiographs are useful when appropriate criteria are followed in requesting for the investigation. The investigation should be requested for all patients with moderate to severe abdominal tenderness, those with gunshot injuries, blunt abdominal trauma and generalized peritonitis. It should be an integral part of management of patients with clinical suspicion of bowel obstruction and gastrointestinal perforation.

Review of Special Standards in Quality Management Systems Audits in Automotive Production

NASA Astrophysics Data System (ADS)

Šurinová, Yulia

2013-12-01

Quality management systems (QMS) in automotive industry generally have several differences in comparison with other industrial branches. Different customers have their own specific requirements, including requirements for quality audits. Audits are one of the coretools of quality management to make the PDCA (Plan - Do - Check - Act) cycle work. As a matter of fact, compliance with ISO/TS 16949:2009 requirements is a condition for supplying the automotive industry. However, there are some standards which co-exist together with the ISO 9001 based management systems and technical specification for QMS in automotive ISO/TS16949. Which are those specific standards in automotive industry and what standard to use and why - those are the questions to be answered in this paper. The aim of the paper is to review what standards are used for audits implementation in automotive industry in the Slovak Republic, and why the organizations keep following those "extra" standards even if certification for ISO/TS 16949 is required by all the car makers. The paper is structured as follows: after short introduction to the topic and related terms, presented is our methodology. . In the third section, the achieved results are discussed. And finally, the principal findings of the paper, limitations and conclusions are presented.

The heterogeneous management of pediatric ankle traumas: A retrospective descriptive study.

PubMed

Voizard, Philippe; Moore, James; Leduc, Stéphane; Nault, Marie-Lyne

2018-06-01

Frequent misdiagnosis of pediatric ankle traumas leads to inappropriate management, which may result in residual pain, instability, slower return to physical activity, and long-term degenerative changes. The purpose of this study was to evaluate the consistency of diagnosis, management, and the treatment of acute lateral pediatric ankle trauma in a tertiary care pediatric hospital. The hypothesis was that the initial diagnosis is often incorrect, and the treatment varies considerably amongst orthopedic surgeons.We conducted a retrospective study of all cases of ankle sprains and Salter-Harris one (SH1) fractures referred to our orthopedic surgery service between May and August 2014. Exclusion criteria included ankle fractures other than SH1 types, and cases where treatment was initially undertaken elsewhere before referral to our service. Primary outcome was the difference between initial and final diagnosis.Among 3047 cases reviewed, 31 matched our inclusion criteria. Initial diagnosis was 20 SH1 fractures, 8 acute ankle sprains, and 3 uncertain, with a change in diagnosis for 48.5% at follow-up.Accurate diagnosis can be difficult in pediatric ankle trauma, with case management and specific treatments varying considerably. This study reinforces the need to evaluate the safety of a general treatment algorithm for all lateral ankle trauma with normal radiographs.Level of evidence III.

The tissue bank at the Instituto Nacional de Investigaciones Nucleares: ISO 9001:2000 certification of its quality management system.

PubMed

Martínez-Pardo, María Esther; Mariano-Magaña, David

2007-01-01

Tissue banking is a complex operation concerned with the organisation and coordination of all the steps, that is, from donor selection up to storage and distribution of the final products for therapeutic, diagnostic, instruction and research purposes. An appropriate quality framework should be established in order to cover all the specific methodology as well as the general aspects of quality management, such as research and development, design, instruction and training, specific documentation, traceability, corrective action, client satisfaction, and the like. Such a framework can be obtained by developing a quality management system (QMS) in accordance with a suitable international standard: ISO 9001:2000. This paper presents the implementation process of the tissue bank QMS at the Instituto Nacional de Investigaciones Nucleares in Mexico. The objective of the paper is to share the experience gained by the tissue bank personnel [radiosterilised tissue bank (BTR)] at the Instituto Nacional de Investigaciones Nucleares (ININ, National Institute of Nuclear Research), during implementation of the ISO 9001:2000 certification process. At present, the quality management system (QMS) of ININ also complies with the Mexican standard NMX-CC-9001:2000. The scope of this QMS is Research, Development and Processing of Biological Tissues Sterilised by Gamma Radiation, among others.

75 FR 18261 - Magnuson-Stevens Fishery Conservation and Management Act Provisions; Fisheries of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

...This final rule implements measures approved under Amendment 16 to the NE Multispecies Fishery Management Plan (FMP). Amendment 16 was developed by the New England Fishery Management Council (Council) as part of the biennial adjustment process in the FMP to update status determination criteria for all regulated NE multispecies or ocean pout stocks; to adopt rebuilding programs for NE multispecies stocks newly classified as being overfished and subject to overfishing; and to revise management measures, including significant revisions to the sector management measures, necessary to end overfishing, rebuild overfished regulated NE multispecies and ocean pout stocks, and mitigate the adverse economic impacts of increased effort controls. This final rule also implements new requirements under Amendment 16 for establishing acceptable biological catch (ABC), annual catch limits (ACLs), and accountability measures (AMs) for each stock managed under the FMP, pursuant to the Magnuson-Stevens Fishery Conservation and Management Act (Magnuson-Stevens Act). Finally, this action adds Atlantic wolffish to the list of species managed by the FMP. This action is necessary to address the results of the most recent stock assessment, which indicate that several additional regulated species are overfished and subject to overfishing, and that stocks currently classified as overfished require additional reductions in fishing mortality to rebuild by the end of their rebuilding periods.

46 CFR 112.20-1 - General.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source § 112.20-1 General. This subpart contains requirements applicable to emergency power installations having both a temporary and a final...

46 CFR 112.20-1 - General.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source § 112.20-1 General. This subpart contains requirements applicable to emergency power installations having both a temporary and a final...

46 CFR 112.20-1 - General.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source § 112.20-1 General. This subpart contains requirements applicable to emergency power installations having both a temporary and a final...

46 CFR 112.20-1 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source § 112.20-1 General. This subpart contains requirements applicable to emergency power installations having both a temporary and a final...

46 CFR 112.20-1 - General.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source § 112.20-1 General. This subpart contains requirements applicable to emergency power installations having both a temporary and a final...

Impact of associated injuries in the Floating knee: A retrospective study

PubMed Central

Rethnam, Ulfin; Yesupalan, Rajam S; Nair, Rajagopalan

2009-01-01

Background Floating knee injuries are usually associated with other significant injuries. Do these injuries have implications on the management of the floating knee and the final outcome of patients? Our study aims to assess the implications of associated injuries in the management and final outcome of floating knee. Methods 29 patients with floating knees were assessed in our institution. A retrospective analysis of medical records and radiographs were done and all associated injuries were identified. The impact of associated injuries on delay in initial surgical management, delay in rehabilitation & final outcome of the floating knee were assessed. Results 38 associated injuries were noted. 7 were associated with ipsilateral knee injuries. Lower limb injuries were most commonly associated with the floating knee. Patients with some associated injuries had a delay in surgical management and others a delay in post-operative rehabilitation. Knee ligament and vascular injuries were associated with poor outcome. Conclusion The associated injuries were quite frequent with the floating knee. Some of the associated injuries caused a delay in surgical management and post-operative rehabilitation. In assessment of the final outcome, patients with associated knee and vascular injuries had a poor prognosis. Majority of the patients with associated injuries had a good or excellent outcome. PMID:19144197

Pathogen evolution across the agro-ecological interface: implications for disease management.

PubMed

Burdon, Jeremy J; Thrall, Peter H

2008-02-01

Infectious disease is a major causal factor in the demography of human, plant and animal populations. While it is generally accepted in medical, veterinary and agricultural contexts that variation in host resistance and pathogen virulence and aggressiveness is of central importance to understanding patterns of infection, there has been remarkably little effort to directly investigate causal links between population genetic structure and disease dynamics, and even less work on factors influencing host-pathogen coevolution. The lack of empirical evidence is particularly surprising, given the potential for such variation to not only affect disease dynamics and prevalence, but also when or where new diseases or pathotypes emerge. Increasingly, this lack of knowledge has led to calls for an integrated approach to disease management, incorporating both ecological and evolutionary processes. Here, we argue that plant pathogens occurring in agro-ecosystems represent one clear example where the application of evolutionary principles to disease management would be of great benefit, as well as providing model systems for advancing our ability to generalize about the long-term coevolutionary dynamics of host-pathogen systems. We suggest that this is particularly the case given that agro-ecological host-pathogen interactions represent a diversity of situations ranging from those that only involve agricultural crops through to those that also include weedy crop relatives or even unrelated native plant communities. We begin by examining some of the criteria that are important in determining involvement in agricultural pathogen evolution by noncrop plants. Throughout we use empirical examples to illustrate the fact that different processes may dominate in different systems, and suggest that consideration of life history and spatial structure are central to understanding dynamics and direction of the interaction. We then discuss the implications that such interactions have for disease management in agro-ecosystems and how we can influence those outcomes. Finally, we identify several major gaps where future research could increase our ability to utilize evolutionary principles in managing disease in agro-ecosystems.

MO-E-18A-01: Imaging: Best Practices In Pediatric Imaging

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

Willis, C; Strauss, K; MacDougall, R

This imaging educational program will focus on solutions to common pediatric imaging challenges. The speakers will present collective knowledge on best practices in pediatric imaging from their experience at dedicated children's hospitals. Areas of focus will include general radiography, the use of manual and automatic dose management in computed tomography, and enterprise-wide radiation dose management in the pediatric practice. The educational program will begin with a discussion of the complexities of exposure factor control in pediatric projection radiography. Following this introduction will be two lectures addressing the challenges of computed tomography (CT) protocol optimization in the pediatric population. The firstmore » will address manual CT protocol design in order to establish a managed radiation dose for any pediatric exam on any CT scanner. The second CT lecture will focus on the intricacies of automatic dose modulation in pediatric imaging with an emphasis on getting reliable results in algorithmbased technique selection. The fourth and final lecture will address the key elements needed to developing a comprehensive radiation dose management program for the pediatric environment with particular attention paid to new regulations and obligations of practicing medical physicists. Learning Objectives: To understand how general radiographic techniques can be optimized using exposure indices in order to improve pediatric radiography. To learn how to establish diagnostic dose reference levels for pediatric patients as a function of the type of examination, patient size, and individual design characteristics of the CT scanner. To learn how to predict the patient's radiation dose prior to the exam and manually adjust technique factors if necessary to match the patient's dose to the department's established dose reference levels. To learn how to utilize manufacturer-provided automatic dose modulation technology to consistently achieve patient doses within the department's established size-based diagnostic reference range. To understand the key components of an enterprise-wide pediatric dose management program that integrates the expanding responsibilities of medial physicists in the new era of dose monitoring.« less

77 FR 16472 - Fisheries of the Northeastern United States; Atlantic Mackerel, Squid, and Butterfish Fisheries...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-21

...NMFS is implementing final 2012 specifications and management measures for Atlantic mackerel (mackerel), and 2012-2014 specifications for Illex and longfin squid, and interim final 2012 specifications and management measures for butterfish. This is the first year that the specifications are being set for Atlantic mackerel and butterfish under the provisions of the Mid-Atlantic Fishery Management Council's (Council) Annual Catch Limit and Accountability Measure Omnibus Amendment. This action also adjusts the closure threshold for the commercial mackerel fishery to 95 percent (from 90 percent), and allows the use of jigging gear to target longfin squid if the longfin squid fishery is closed due to the butterfish mortality cap. Finally, this rule makes minor corrections in existing regulatory text to clarify the intent of the regulations. These specifications and management measures promote the utilization and conservation of the Atlantic Mackerel, Squid, and Butterfish (MSB) resource.

Reclaimed wastewater quality enhancement by oxygen injection during transportation.

PubMed

Rodríguez-Gómez, L E; Alvarez, M; Rodríguez-Sevilla, J; Marrero, M C; Hernández, A

2011-01-01

In-sewer treatments have been studied in sewer systems, but few have been carried out on reclaimed wastewater systems. A study of oxygen injection has been performed in a completely filled gravity pipe, 0.6 m in diameter and 62 km long, in cast iron with concrete inside coating, which is part of the reclaimed wastewater reuse scheme of Tenerife (Spain). A high pressure oxygen injection system was installed at 16.0 km from pipe inlet and a constant dosage of 30 mg/L O(2) has been injected during six months, under three different operational modes (low COD, 63 mg/L; high COD, 91 mg/L; and partially nitrified water). Oxygen has been consumed in nitrification and organic matter reduction. Generally, nitrification is clearly favored instead of the organic matter oxidation. Nitrification occurs, in general, with nitrite accumulation due to the presence of free ammonia above 1 mg/L. Denitrification is in all cases incomplete due to a limitation of easily biodegradable organic matter content, inhibiting the appearance of anaerobic conditions and sulfide generation. A notable reduction of organic matter parameters is achieved (TSS below 10 mg/L), which is significantly higher than that observed under the ordinary transport conditions without oxygen. This leads to a final cost reduction, and the oxygen injection system helps water reuse managers to maintain a final good water quality in the case of a treatment plant malfunction.

78 FR 32442 - Record of Decision for the General Management Plan, Blue Ridge Parkway, Virginia and North Carolina

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-30

....YP0000] Record of Decision for the General Management Plan, Blue Ridge Parkway, Virginia and North... the availability of the Record of Decision (ROD) for the General Management Plan (GMP) for Blue Ridge... will provide a better balance between traditional parkway experiences and modern-day management...

Triage Decision Trees and Triage Protocols: Changing Strategies for Medical Rescue in Civilian Mass Casualty Situations.

DTIC Science & Technology

1984-02-06

MASS CASUALTY SITUATIONS FINAL REPORT for 0O FEDERAL EMERGENCY MANAGEMENT AGENCY WASHINGTON, D.C. 20472 FEMA CONTRACT NUMBER EMW-C-1202 e FEMA WORK UNIT...20006 FINAL REPORT for FEDERAL EMERGENCY MANAGEMENT AGENCY WASHINGTON, D.C. 20472 FEMA CONTRACT NUMBER EMW-C-1202 FEMA WORK UNIT NUMBER 2412G...February 1984 This repnrt has been reviewed in the Federal Emergency Management Agency and approved for publication. Approval does not signify that the

Diatoms to human uses: linking nitrogen deposition, aquatic eutrophication, and ecosystem services

DOE PAGES

Rhodes, Charles; Bingham, Andrew; Heard, Andrea M.; ...

2017-07-24

Nitrogen (N) loading to aquatic ecosystems can lead to eutrophication, changing the ecosystem within a waterbody, including primary productivity, water clarity, and food web dynamics. Nutrient loading often first affects the primary productivity of aquatic systems through shifts in phytoplankton communities. However, ecologically important changes in phytoplankton are often not relatable to the general public—whose behavior would need to change to alter patterns of nutrient loading. Therefore, we use the STressor–Ecological Production function–final ecosystem Services Framework to develop 154 chains that link changes in biological indicators of aquatic eutrophication (a shift in phytoplankton community) to final ecosystem services that peoplemore » use or appreciate. We identify 13 ecological production functions (EPF) within three different ecosystems (alpine lakes, lakes, and estuaries) that connect changes in phytoplankton and algae to ecological endpoints that the general public and policy makers can appreciate. Using the Final Ecosystem Goods and Services Classification System, we identify 18 classes of human beneficiaries that potentially will be impacted by a change in one of these endpoints. We further assign strength-of-science scores to each link within the EPFs for the 154 chains according to how well each link is supported by current peer-reviewed literature. By identifying many pathways through which excess N loading in U.S. surface waters can affect ecosystems and ultimately the beneficiaries of ecosystem services, this work intends to draw attention to gaps in empirical ecological literature that constrain understanding of the magnitude of effects that excess N loading can have on human well-being. Here, results highlight the importance of intersections between the natural and social sciences when managers and policy makers evaluate impacts from ecological stressors. A balance between knowledgeable specialists proved key to applying this approach and will continue to remain important.« less

Diatoms to human uses: linking nitrogen deposition, aquatic eutrophication, and ecosystem services

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

Rhodes, Charles; Bingham, Andrew; Heard, Andrea M.

Nitrogen (N) loading to aquatic ecosystems can lead to eutrophication, changing the ecosystem within a waterbody, including primary productivity, water clarity, and food web dynamics. Nutrient loading often first affects the primary productivity of aquatic systems through shifts in phytoplankton communities. However, ecologically important changes in phytoplankton are often not relatable to the general public—whose behavior would need to change to alter patterns of nutrient loading. Therefore, we use the STressor–Ecological Production function–final ecosystem Services Framework to develop 154 chains that link changes in biological indicators of aquatic eutrophication (a shift in phytoplankton community) to final ecosystem services that peoplemore » use or appreciate. We identify 13 ecological production functions (EPF) within three different ecosystems (alpine lakes, lakes, and estuaries) that connect changes in phytoplankton and algae to ecological endpoints that the general public and policy makers can appreciate. Using the Final Ecosystem Goods and Services Classification System, we identify 18 classes of human beneficiaries that potentially will be impacted by a change in one of these endpoints. We further assign strength-of-science scores to each link within the EPFs for the 154 chains according to how well each link is supported by current peer-reviewed literature. By identifying many pathways through which excess N loading in U.S. surface waters can affect ecosystems and ultimately the beneficiaries of ecosystem services, this work intends to draw attention to gaps in empirical ecological literature that constrain understanding of the magnitude of effects that excess N loading can have on human well-being. Here, results highlight the importance of intersections between the natural and social sciences when managers and policy makers evaluate impacts from ecological stressors. A balance between knowledgeable specialists proved key to applying this approach and will continue to remain important.« less

41 CFR 101-39.400 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FEDERAL PROPERTY MANAGEMENT REGULATIONS AVIATION, TRANSPORTATION, AND MOTOR VEHICLES 39-INTERAGENCY FLEET... responsible for the operation of General Services Administration (GSA) Interagency Fleet Management System... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true General. 101-39.400...

Attitudes and practices of Chinese physicians regarding chronic kidney disease and acute kidney injury management: a questionnaire-based cross-sectional survey in secondary and tertiary hospitals.

PubMed

Wu, Yanhua; Chen, Yuanhan; Chen, Shixin; He, Yani; Liang, Huaban; Dong, Wei; Liang, Xinling

2018-05-10

This questionnaire-based cross-sectional survey reported the attitudes and practices of Chinese doctors regarding chronic kidney disease (CKD) and acute kidney injury (AKI) management. An online questionnaire consisting of general information, awareness of CKD and AKI, education status, renal laboratory items, and clinical practices between February 20, 2017 and August 15, 2017. Among the 1289 respondents from secondary and tertiary hospitals in 30 provinces, 718 (55.7%) were nephrologists, 94.3% had the ability to evaluate glomerular filtration rates, and 98.8% could evaluate urinary protein excretion, indicating that Chinese doctors met the minimum requirements to manage CKD. However, nearly half of all respondents reported that easy methods for spot urine creatinine-adjusted urinary protein assessments were unavailable. Awareness of the CKD risk stratification system and AKI definition was inadequate, and only 54.2% of respondents reported that they had received nutritional education for renal diseases. Although most of the respondents were nephrologists at university hospitals, 66.4% and 76.3% of respondents reported nephrology referrals and nephrology consultations, respectively, after AKI, suggesting an insufficient role for nephrologists. Finally, management models differed significantly, indicating that universal guidelines for CKD and AKI management are required across China. Several considerable challenges remain regarding CKD and AKI management in China, including inadequate knowledge and training systems, an absence of clinical protocols, and insufficient multidisciplinary cooperation.

Applicability of risk-based management and the need for risk-based economic decision analysis at hazardous waste contaminated sites.

PubMed

Khadam, Ibrahim; Kaluarachchi, Jagath J

2003-07-01

Decision analysis in subsurface contamination management is generally carried out through a traditional engineering economic viewpoint. However, new advances in human health risk assessment, namely, the probabilistic risk assessment, and the growing awareness of the importance of soft data in the decision-making process, require decision analysis methodologies that are capable of accommodating non-technical and politically biased qualitative information. In this work, we discuss the major limitations of the currently practiced decision analysis framework, which evolves around the definition of risk and cost of risk, and its poor ability to communicate risk-related information. A demonstration using a numerical example was conducted to provide insight on these limitations of the current decision analysis framework. The results from this simple ground water contamination and remediation scenario were identical to those obtained from studies carried out on existing Superfund sites, which suggests serious flaws in the current risk management framework. In order to provide a perspective on how these limitations may be avoided in future formulation of the management framework, more matured and well-accepted approaches to decision analysis in dam safety and the utility industry, where public health and public investment are of great concern, are presented and their applicability in subsurface remediation management is discussed. Finally, in light of the success of the application of risk-based decision analysis in dam safety and the utility industry, potential options for decision analysis in subsurface contamination management are discussed.

An integrated approach for improving occupational health and safety management: the voluntary protection program in Taiwan.

PubMed

Su, Teh-Sheng; Tsai, Way-Yi; Yu, Yi-Chun

2005-05-01

A voluntary compliance program for occupational health and safety management, Voluntary Protection Programs (VPP), was implemented with a strategy of cooperation and encouragement in Taiwan. Due to limitations on increasing the human forces of inspection, a regulatory-based guideline addressing the essence of Occupational Health and Safety Management Systems (OHSMS) was promulgated, which combined the resources of third parties and insurance providers to accredit a self-improving worksite with the benefits of waived general inspection and a merit contributing to insurance premium payment reduction. A designated institute accepts enterprise's applications, performs document review and organizes the onsite inspection. A final review committee of Council of Labor Affairs (CLA) confers a two-year certificate on an approved site. After ten years, the efforts have shown a dramatic reduction of occupational injuries and illness in the total number of 724 worksites granted certification. VPP worksites, in comparison with all industries, had 49% lower frequency rate in the past three years. The severity rate reduction was 80% in the same period. The characteristics of Taiwan VPP program and international occupational safety and health management programs are provided. A Plan-Do-Check-Act management cycle was employed for pursuing continual improvements to the culture fostered. The use of a quantitative measurement for assessing the performance of enterprises' occupational safety and health management showed the efficiency of the rating. The results demonstrate that an employer voluntary protection program is a promising strategy for a developing country.

Resolving complex research data management issues in biomedical laboratories: Qualitative study of an industry-academia collaboration.

PubMed

Myneni, Sahiti; Patel, Vimla L; Bova, G Steven; Wang, Jian; Ackerman, Christopher F; Berlinicke, Cynthia A; Chen, Steve H; Lindvall, Mikael; Zack, Donald J

2016-04-01

This paper describes a distributed collaborative effort between industry and academia to systematize data management in an academic biomedical laboratory. Heterogeneous and voluminous nature of research data created in biomedical laboratories make information management difficult and research unproductive. One such collaborative effort was evaluated over a period of four years using data collection methods including ethnographic observations, semi-structured interviews, web-based surveys, progress reports, conference call summaries, and face-to-face group discussions. Data were analyzed using qualitative methods of data analysis to (1) characterize specific problems faced by biomedical researchers with traditional information management practices, (2) identify intervention areas to introduce a new research information management system called Labmatrix, and finally to (3) evaluate and delineate important general collaboration (intervention) characteristics that can optimize outcomes of an implementation process in biomedical laboratories. Results emphasize the importance of end user perseverance, human-centric interoperability evaluation, and demonstration of return on investment of effort and time of laboratory members and industry personnel for success of implementation process. In addition, there is an intrinsic learning component associated with the implementation process of an information management system. Technology transfer experience in a complex environment such as the biomedical laboratory can be eased with use of information systems that support human and cognitive interoperability. Such informatics features can also contribute to successful collaboration and hopefully to scientific productivity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Resource management and operations in central North Dakota: Climate change scenario planning workshop summary November 12-13, 2015, Bismarck, ND

USGS Publications Warehouse

Fisichelli, Nicholas A.; Schuurman, Gregor; Symstad, Amy J.; Ray, Andrea; Friedman, Jonathan M.; Miller, Brian; Rowland, Erika

2016-01-01

The Scaling Climate Change Adaptation in the Northern Great Plains through Regional Climate Summaries and Local Qualitative-Quantitative Scenario Planning Workshops project synthesizes climate data into 3-5 distinct but plausible climate summaries for the northern Great Plains region; crafts quantitative summaries of these climate futures for two focal areas; and applies these local summaries by developing climate-resource-management scenarios through participatory workshops and, where possible, simulation models. The two focal areas are central North Dakota and southwest South Dakota (Figure 1). The primary objective of this project is to help resource managers and scientists in a focal area use scenario planning to make management and planning decisions based on assessments of critical future uncertainties.This report summarizes project work for public and tribal lands in the central North Dakota focal area, with an emphasis on Knife River Indian Villages National Historic Site. The report explainsscenario planning as an adaptation tool in general, then describes how it was applied to the central North Dakota focal area in three phases. Priority resource management and climate uncertainties were identified in the orientation phase. Local climate summaries for relevant, divergent, and challenging climate scenarios were developed in the second phase. In the final phase, a two-day scenario planning workshop held November 12-13, 2015 in Bismarck, ND, featured scenario development and implications, testing management decisions, and methods for operationalizing scenario planning outcomes.

Resource management and operations in southwest South Dakota: Climate change scenario planning workshop summary January 20-21, 2016, Rapid City, SD

USGS Publications Warehouse

Fisichelli, Nicholas A.; Schuurman, Gregor W.; Symstad, Amy J.; Ray, Andrea; Miller, Brian; Cross, Molly; Rowland, Erika

2016-01-01

The Scaling Climate Change Adaptation in the Northern Great Plains through Regional Climate Summaries and Local Qualitative-Quantitative Scenario Planning Workshops project synthesizes climate data into 3-5 distinct but plausible climate summaries for the northern Great Plains region; crafts quantitative summaries of these climate futures for two focal areas; and applies these local summaries by developing climate-resource-management scenarios through participatory workshops and, where possible, simulation models. The two focal areas are central North Dakota and southwest South Dakota (Figure 1). The primary objective of this project is to help resource managers and scientists in a focal area use scenario planning to make management and planning decisions based on assessments of critical future uncertainties.This report summarizes project work for public and tribal lands in the southwest South Dakota grasslands focal area, with an emphasis on Badlands National Park and Buffalo Gap National Grassland. The report explains scenario planning as an adaptation tool in general, then describes how it was applied to the focal area in three phases. Priority resource management and climate uncertainties were identified in the orientation phase. Local climate summaries for relevant, divergent, and challenging climate scenarios were developed in the second phase. In the final phase, a two-day scenario planning workshop held January 20-21, 2016 in Rapid City, South Dakota, featured scenario development and implications, testing management decisions, and methods for operationalizing scenario planning outcomes.

Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia.

PubMed

Grever, Michael R; Abdel-Wahab, Omar; Andritsos, Leslie A; Banerji, Versha; Barrientos, Jacqueline; Blachly, James S; Call, Timothy G; Catovsky, Daniel; Dearden, Claire; Demeter, Judit; Else, Monica; Forconi, Francesco; Gozzetti, Alessandro; Ho, Anthony D; Johnston, James B; Jones, Jeffrey; Juliusson, Gunnar; Kraut, Eric; Kreitman, Robert J; Larratt, Loree; Lauria, Francesco; Lozanski, Gerard; Montserrat, Emili; Parikh, Sameer A; Park, Jae H; Polliack, Aaron; Quest, Graeme R; Rai, Kanti R; Ravandi, Farhad; Robak, Tadeusz; Saven, Alan; Seymour, John F; Tadmor, Tamar; Tallman, Martin S; Tam, Constantine; Tiacci, Enrico; Troussard, Xavier; Zent, Clive S; Zenz, Thorsten; Zinzani, Pier Luigi; Falini, Brunangelo

2017-02-02

Hairy cell leukemia is an uncommon hematologic malignancy characterized by pancytopenia and marked susceptibility to infection. Tremendous progress in the management of patients with this disease has resulted in high response rates and improved survival, yet relapse and an appropriate approach to re-treatment present continuing areas for research. The disease and its effective treatment are associated with immunosuppression. Because more patients are being treated with alternative programs, comparison of results will require general agreement on definitions of response, relapse, and methods of determining minimal residual disease. The development of internationally accepted, reproducible criteria is of paramount importance in evaluating and comparing clinical trials to provide optimal care. Despite the success achieved in managing these patients, continued participation in available clinical trials in the first-line and particularly in the relapse setting is highly recommended. The Hairy Cell Leukemia Foundation convened an international conference to provide common definitions and structure to guide current management. There is substantial opportunity for continued research in this disease. In addition to the importance of optimizing the prevention and management of the serious risk of infection, organized evaluations of minimal residual disease and treatment at relapse offer ample opportunities for clinical research. Finally, a scholarly evaluation of quality of life in the increasing number of survivors of this now manageable chronic illness merits further study. The development of consensus guidelines for this disease offers a framework for continued enhancement of the outcome for patients.

Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia

PubMed Central

Abdel-Wahab, Omar; Andritsos, Leslie A.; Banerji, Versha; Barrientos, Jacqueline; Blachly, James S.; Call, Timothy G.; Catovsky, Daniel; Dearden, Claire; Demeter, Judit; Else, Monica; Forconi, Francesco; Gozzetti, Alessandro; Ho, Anthony D.; Johnston, James B.; Jones, Jeffrey; Juliusson, Gunnar; Kraut, Eric; Kreitman, Robert J.; Larratt, Loree; Lauria, Francesco; Lozanski, Gerard; Montserrat, Emili; Parikh, Sameer A.; Park, Jae H.; Polliack, Aaron; Quest, Graeme R.; Rai, Kanti R.; Ravandi, Farhad; Robak, Tadeusz; Saven, Alan; Seymour, John F.; Tadmor, Tamar; Tallman, Martin S.; Tam, Constantine; Tiacci, Enrico; Troussard, Xavier; Zent, Clive S.; Zenz, Thorsten; Zinzani, Pier Luigi; Falini, Brunangelo

2017-01-01

Hairy cell leukemia is an uncommon hematologic malignancy characterized by pancytopenia and marked susceptibility to infection. Tremendous progress in the management of patients with this disease has resulted in high response rates and improved survival, yet relapse and an appropriate approach to re-treatment present continuing areas for research. The disease and its effective treatment are associated with immunosuppression. Because more patients are being treated with alternative programs, comparison of results will require general agreement on definitions of response, relapse, and methods of determining minimal residual disease. The development of internationally accepted, reproducible criteria is of paramount importance in evaluating and comparing clinical trials to provide optimal care. Despite the success achieved in managing these patients, continued participation in available clinical trials in the first-line and particularly in the relapse setting is highly recommended. The Hairy Cell Leukemia Foundation convened an international conference to provide common definitions and structure to guide current management. There is substantial opportunity for continued research in this disease. In addition to the importance of optimizing the prevention and management of the serious risk of infection, organized evaluations of minimal residual disease and treatment at relapse offer ample opportunities for clinical research. Finally, a scholarly evaluation of quality of life in the increasing number of survivors of this now manageable chronic illness merits further study. The development of consensus guidelines for this disease offers a framework for continued enhancement of the outcome for patients. PMID:27903528

10 CFR 51.94 - Requirement to consider final environmental impact statement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Requirement to consider final environmental impact...-Regulations Implementing Section 102(2) Final Environmental Impact Statements-General Requirements § 51.94 Requirement to consider final environmental impact statement. The final environmental impact statement...

California State Implementation Plan; Final Approval of Revision; Yolo-Solano Air Quality Management District; Reasonably Available Control Technology Requirements for 1997 8-hour Ozone NAAQS

EPA Pesticide Factsheets

EPA is taking final action to approve a revision to the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California SIP concerning YSAQMD regarding RACT)requirements the 1997 8-hour ozone NAAQS and approve negative declarations into SIP.

75 FR 36064 - Stellwagen Bank National Marine Sanctuary Final Revised Management Plan: Notice of Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

... on the Web site: http://stellwagen.noaa.gov . For a hard copy or data CD of the plan contact the sanctuary office at the contact number identified below. DATES: The final revised management plan is available to the public on June 17, 2010. FOR FURTHER INFORMATION CONTACT: Anne Smrcina, Stellwagen Bank...

77 FR 15795 - Notice of Availability of a Final Environmental Impact Statement for the Gasco Energy Inc. Uinta...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLUTG01100-12-L13110000-EJ0000] Notice of Availability of a Final Environmental Impact Statement for the Gasco Energy Inc. Uinta Basin Natural Gas Development Project, Uintah County, UT AGENCY: Bureau of Land Management, Interior. ACTION: Notice of...

Research to Develop Effective Teaching and Management Techniques for Severely Disturbed and Retarded Children. Final Report.

ERIC Educational Resources Information Center

Kauffman, James M.; Birnbrauer, Jay S.

The final report of a project on teaching and management techniques with severely disturbed and/or retarded children presents analysis of single subject research using contingent imitation of the child as an intervention technique. The effects of this technique were examined on the following behaviors: toyplay and reciprocal imitation, self…

GENERAL VIEW OF THE FINAL PRODUCTION LINE OF THE FIRST ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

GENERAL VIEW OF THE FINAL PRODUCTION LINE OF THE FIRST B-29 SHOWING THE LINK-BELT CONVEYOR SYSTEM AND WOOD BLOCK FLOORING. WHO, 1944 - Offutt Air Force Base, Glenn L. Martin-Nebraska Bomber Plant, Building D, Peacekeeper Drive, Bellevue, Sarpy County, NE

50 CFR 424.18 - Final rules-general.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A LISTING ENDANGERED AND THREATENED SPECIES AND DESIGNATING CRITICAL HABITAT Revision of the Lists § 424.18 Final rules—general. (a... rule to list, delist, or reclassify a species or designate or revise critical habitat will also provide...

50 CFR 424.18 - Final rules-general.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A LISTING ENDANGERED AND THREATENED SPECIES AND DESIGNATING CRITICAL HABITAT Revision of the Lists § 424.18 Final rules—general. (a) Contents... reclassify a species or designate or revise critical habitat shall also provide a summary of factors...

77 FR 61605 - Notice of Proposed NPDES General Permit; Final NPDES General Permit for New and Existing Sources...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-10

... as listed below. A copy of the Region's responses to comments and the final permit may be obtained... testing requirements for discharges containing methanol up to 20 bbl/ event and ethylene glycol up to 200...

50 CFR 424.18 - Final rules-general.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A LISTING ENDANGERED AND THREATENED SPECIES AND DESIGNATING CRITICAL HABITAT Revision of the Lists § 424.18 Final rules—general. (a... rule to list, delist, or reclassify a species or designate or revise critical habitat will also provide...

Litter assessment on 99 Cuban beaches: A baseline to identify sources of pollution and impacts for tourism and recreation.

PubMed

Botero, C M; Anfuso, G; Milanes, C; Cabrera, A; Casas, G; Pranzini, E; Williams, A T

2017-05-15

Litter presence was assessed on the entire Cuban coastline, and includes 99 beaches from all Cuban regions, during field work carried out in 2012 and 2015. A standard method verified in several countries was applied, which classified beaches for nine types of litter into four grades (A-excellent to D-poor). Almost half of the Cuban beaches obtained excellent cleanliness scores, although many needed to be better managed. In this baseline, the most common types of residue were general litter (8% grade D and 35% grades B/C) and potentially harmful litter (<68% with grade A). Resort beaches and those with international visitors showed the best litter management. Tourism Impacts seems to be related to visitor origin therefore choices to develop sustainable tourism in rural and village beaches (64%) appears low, if beach cleaning gross investment is focused on resort beaches (24%). Finally, this paper highlights geographical distribution and types of litter patterns. Copyright © 2017 Elsevier Ltd. All rights reserved.

What are the most promising strategies for the therapeutic immunomodulation of allergic diseases?

PubMed

Tokura, Y; Röcken, M; Clark, R A; Haliasos, E; Takigawa, M; Sinha, A A

2001-04-01

Specific immunotherapy and other immunomodulatory strategies have long been a stronghold in the management of allergic diseases. In particular, "immunodeviation-therapy" or "vaccination for allergies", i.e. the redirection of Th2-type immune responses towards a Th1-response pattern, has become an ever more popular concept. The present feature of CONTROVERSIES complements our previous discussion of atopy (Röcken et al., Exp Dermatol 7: 97--104, 1998), and is dedicated to a critical analysis of the general problems and limitations one faces with the main immunomodulatory strategies traditionally considered in this context. We also explore alternative approaches that appear promising in order to achieve both a more effective and/or a more specific immunotherapy of allergic diseases. Given that the mast cell remains a key protagonist in the pathogenesis of allergic diseases finally, this feature examines how innovative, more selectively mast cell-targeted strategies may be developed for the management of allergic diseases.

General patterns of managerial approaches to work motivation: Implications for rehabilitation professionals involved in occupational rehabilitation.

PubMed

Murphy, G C; Foreman, P

1993-03-01

Calls for rehabilitation counselors to learn more about the world of work have been recently repeated. The validity of these calls is suggested by a group of studies which indicate that the rehabilitation counseling literature has an established emphasis on matters of counseling and adjustment rather than on matters related to behavior in organizations. A survey of rehabilitation counsellors' beliefs about key topics in organizational behavior indicates that their beliefs are often discrepant with those of practicing managers and supervisors. A summary of dominant models of work motivation adopted by managerial workers is presented and some implications for occupational rehabilitation practice identified. Finally, some contemporary literature relevant to managerial approaches to employee motivation are identified and it is suggested that familiarity with this literature could assist rehabilitation practitioners move from a more narrow occupational rehabilitation role to a broader involvement in organizational life via the expansion of the disability management approach in work organizations.

Galileo spacecraft power management and distribution system

NASA Technical Reports Server (NTRS)

Detwiler, R. C.; Smith, R. L.

1990-01-01

The Galileo PMAD (power management and distribution system) is described, and the design drivers that established the final as-built hardware are discussed. The spacecraft is powered by two general-purpose heat-source-radioisotope thermoelectric generators. Power bus regulation is provided by a shunt regulator. Galileo PMAD distributes a 570-W beginning of mission (BOM) power source to a user complement of some 137 load elements. Extensive use of pyrotechnics requires two pyro switching subassemblies. They initiate 148 squibs which operate the 47 pyro devices on the spacecraft. Detection and correction of faults in the Galileo PMAD is an autonomous feature dictated by requirements for long life and reliability in the absence of ground-based support. Volatile computer memories in the spacecraft command and data system and attitude control system require a continuous source of backup power during all anticipated power bus fault scenarios. Power for the Jupiter Probe is conditioned, isolated, and controlled by a Probe interface subassembly. Flight performance of the spacecraft and the PMAD has been successful to date, with no major anomalies.

Precision vineyard management from space - from Bacchus to Eneide

NASA Astrophysics Data System (ADS)

Cheli, Simonetta; Fusco, Luigi; Sandrelli, Stefano

2005-08-01

In a highly competitive global market such as the wine business, consistent quality is a must, especially if Europe wants to maintain its position as world leader. It currently accounts for 55% of the world's vine-growing areas, 60% of wine production and 70% of exports. In this very special sector of agriculture, technology and science play fundamental roles in all phases of activity, from the start of the vine-growing season, through the ripening of the grapes, to the bottling of the wine. The quality of the wine produced depends on many parameters, including the soil characteristics in the area, the weather and growth conditions during the season, the ability to monitor and control vine diseases, the degree of maturity of the grapes at harvest time, their grade, colour, organic acis, etc. during fermentation and, finally, the wine production techniques employed. In general, however, European vineyard managers still have little access to technical means or reliable systems to guide them in their decision-making.

Treat-to-target trials in diabetes.

PubMed

Wangnoo, Subhash K; Sethi, Bipin; Sahay, Rakesh K; John, Mathew; Ghosal, Samit; Sharma, Surendra K

2014-03-01

Treat-to-target is a therapeutic concept that considers well defined and specific physiologic targets as aims in controlling the pathophysiology of the disease. It has been widely used in diseases that pathophysiology includes, chronic metabolic and physiological disturbances, namely rheumatic conditions, vascular medicine and diabetes. In diabetes, the availability of "gold-standard" quantitative measures like fasting plasma glucose and glycated hemoglobin make the application of treat-to-target trials especially pertinent. Treatment modalities which have used single therapeutic agents or combinations or in combination with a variety of titration algorithms and implementation protocols have broadened our understanding of diabetes management with specific reference to insulin initiation and maintenance. Treat-to-target trials have been used to investigate a wide variety of questions including efficacy, safety, effect of treatment on comorbidities and patient satisfaction, ideal mechanisms to implement insulin initiation etc. A more generalized acceptance and implementation of treat-to-target trials may finally revolutionize diabetes management by combining aspects of individual care with standard treatment protocols.

Think manager--think male in adolescents and its relation to sexism and emotions in leadership.

PubMed

García-Ael, Cristina; Cuadrado, Isabel; Molero, Fernando

2013-01-01

From the perspective of the Think manager--think male, this study was conducted to examine the type of leadership role depending on gender in a sample of 158 Spanish adolescents -according to three types of leaders: "male middle leader", "female middle leader" and "middle leader in general". The kind of emotional expression (positive and negative) evoked by their leadership behaviors (task- and relationship- oriented) was also analyzed. Lastly, whether adolescents' sexist beliefs affected the attribution of traits and the emotional expression towards these leaders was examined. Results showed that task-oriented traits were more characteristic of the leadership role than relationship-oriented traits. Adolescents expressed more positive emotions towards a task-oriented leader and towards a leader behaving in ways associated with both task- and relationship- oriented styles, but only for men. Finally, hostile sexism predicted fewer task-oriented traits to female leaders, more negative affect towards task-oriented male leaders and towards counter-stereotypic leaders. These results were moderated by the sex of adolescents.

Cerebrospinal Fluid HIV Escape from Antiretroviral Therapy.

PubMed

Ferretti, Francesca; Gisslen, Magnus; Cinque, Paola; Price, Richard W

2015-06-01

CNS infection is a nearly constant facet of systemic CNS infection and is generally well controlled by suppressive systemic antiretroviral therapy (ART). However, there are instances when HIV can be detected in the cerebrospinal fluid (CSF) despite suppression of plasma viruses below the clinical limits of measurement. We review three types of CSF viral escape: asymptomatic, neuro-symptomatic, and secondary. The first, asymptomatic CSF escape, is seemingly benign and characterized by lack of discernable neurological deterioration or subsequent CNS disease progression. Neuro-symptomatic CSF escape is an uncommon, but important, entity characterized by new or progressive CNS disease that is critical to recognize clinically because of its management implications. Finally, secondary CSF escape, which may be even more uncommon, is defined by an increase of CSF HIV replication in association with a concomitant non-HIV infection, as a consequence of the local inflammatory response. Understanding these CSF escape settings not only is important for clinical diagnosis and management but also may provide insight into the CNS HIV reservoir.

Narcolepsy and syndromes of primary excessive daytime somnolence.

PubMed

Black, Jed E; Brooks, Stephen N; Nishino, Seiji

2004-09-01

Excessive daytime sleepiness (EDS) or somnolence is common in our patients and in society in general. The most common cause of EDS is "voluntary" sleep restriction. Other common causes include sleep-fragmenting disorders such as the obstructive sleep apnea syndrome. Somewhat less familiar to the clinician are EDS conditions arising from central nervous system dysfunction. Of these so-called primary disorders of somnolence, narcolepsy is the most well known and extensively studied, yet often misunderstood and misdiagnosed. Idiopathic hypersomnia, the recurrent hypersomnias, and EDS associated with nervous system disorders also must be well-understood to provide appropriate evaluation and management of the patient with EDS. This review summarizes the distinguishing features of these clinical syndromes of primary EDS. A brief overview of the pharmacological management of primary EDS is included. Finally, in view of the tremendous advances that have occurred in the past few years in our understanding of the pathophysiology of canine and human narcolepsy, we also highlight these discoveries.

Transportation Management For Corridors And Activity Centers: Opportunities And Experiences, Final Report

DOT National Transportation Integrated Search

1986-05-01

THIS REPORT CONSISTS OF TWO SECTIONS, TRANSPORTATION MANAGEMENT FOR CORRIDORS AND TRANSPORTATION MANAGEMENT FOR ACTIVITY CENTERS, THAT DESCRIBE TRANSPORTATION MANAGEMENT EXPERIENCES IN THE UNITED STATES. : CASE STUDIES ARE THE FOCUS OF EACH SECTIO...

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

NASA Astrophysics Data System (ADS)

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

2013-04-01

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

77 FR 63326 - Huron Wetland Management District, Madison Wetland Management District, and Sand Lake Wetland...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-16

... FXRS1265066CCP0] Huron Wetland Management District, Madison Wetland Management District, and Sand Lake Wetland... assessment (EA) involving Huron, Madison, and Sand Lake Wetland Management Districts (Districts). In this..., Madison Wetland Management District, Sand Lake Wetland Management District final CCP'' in the subject line...

75 FR 79389 - Notice of Availability of the Record of Decision for the General Management Plan/Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-20

...: The primary function of a general management plan is to clearly define a park's purpose and management... Record of Decision for the General Management Plan/Environmental Impact Statement for the Roosevelt...: Pursuant to Section 102(2)(C) of the National Environmental Policy Act of 1969, as amended [42 U.S.C. 4332...

76 FR 64085 - Post-2014 Resource Pool-Loveland Area Projects, Final Power Allocation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

... power allocation. SUMMARY: The Western Area Power Administration (Western), a Federal power marketing..., Final Power Allocation developed under the requirements of subpart C-Power Marketing Initiative of the Energy Planning and Management Program (Program) Final Rule, 10 CFR part 905. These final power...

Dual-Use Aspects of System Health Management

NASA Technical Reports Server (NTRS)

Owens, P. R.; Jambor, B. J.; Eger, G. W.; Clark, W. A.

1994-01-01

System Health Management functionality is an essential part of any space launch system. Health management functionality is an integral part of mission reliability, since it is needed to verify the reliability before the mission starts. Health Management is also a key factor in life cycle cost reduction and in increasing system availability. The degree of coverage needed by the system and the degree of coverage made available at a reasonable cost are critical parameters of a successful design. These problems are not unique to the launch vehicle world. In particular, the Intelligent Vehicle Highway System, commercial aircraft systems, train systems, and many types of industrial production facilities require various degrees of system health management. In all of these applications, too, the designers must balance the benefits and costs of health management in order to optimize costs. The importance of an integrated system is emphasized. That is, we present the case for considering health management as an integral part of system design, rather than functionality to be added on at the end of the design process. The importance of maintaining the system viewpoint is discussed in making hardware and software tradeoffs and in arriving at design decisions. We describe an approach to determine the parameters to be monitored in any system health management application. This approach is based on Design of Experiments (DOE), prototyping, failure modes and effects analyses, cost modeling and discrete event simulation. The various computer-based tools that facilitate the approach are discussed. The approach described originally was used to develop a fault tolerant avionics architecture for launch vehicles that incorporated health management as an integral part of the system. Finally, we discuss generalizing the technique to apply it to other domains. Several illustrations are presented.

European survey of diagnosis and management of the polycystic ovary syndrome: results of the ESE PCOS Special Interest Group's Questionnaire.

PubMed

Conway, Gerard; Dewailly, Didier; Diamanti-Kandarakis, Evanthia; Escobar-Morreale, Hector F; Franks, Steven; Gambineri, Alessandra; Kelestimur, Fahrettin; Macut, Djuro; Micic, Dragan; Pasquali, Renato; Pfeifer, Marija; Pignatelli, Duarte; Pugeat, Michel; Yildiz, Bulent

2014-10-01

There is evidence for differences between endocrinologists and other specialists in their approach to diagnosis and management of the polycystic ovary syndrome (PCOS). A mailed survey consisting of a simple questionnaire aiming to understand current practice for diagnosis and management of the PCOS by specialists across Europe. The questionnaire consisted of 23 questions grouped to achieve information on i) the general characteristics of the respondents, ii) patients with PCOS seen by endocrinologists, iii) the main diagnostic criteria, iv) biochemical parameters used in the differential diagnosis of hyperandrogenism, v) long-term concerns, and, finally vi) treatment choices. A total of 357 questionnaires representing 13.3% of the members of European Society of Endocrinology (ESE) were available for final analysis; 93% of the respondents were endocrinologists In relation to the diagnostic criteria, respondents were most likely to select menstrual irregularity as the most frequent criteria used for the diagnosis of PCOS although very high rates were achieved for the use of hirsutism and biochemical hyperandrogenism. It therefore appears that the NIH criteria were followed by the majority of respondents. The most frequent biochemical parameters in the differential diagnosis of hyperandrogenism were total testosterone or free androgen index. Obesity and type 2 diabetes were regarded as the principal long-term concerns for PCOS. The most common treatments for patients with PCOS were metformin (33%), lifestyle modification (25%), and oral contraceptives (22%). More direct treatments of infertility include clomiphene citrate alone or in combination with metformin, prescribed by 9 and 23%, respectively, whereas only 6% used other methods for induction of ovulation. The survey produced by ESE is a good start for evaluating the perspective in the diagnosis and treatment of PCOS by endocrinologists in Europe. © 2014 European Society of Endocrinology.

Asthma medication adherence among urban teens: a qualitative analysis of barriers, facilitators and experiences with school-based care.

PubMed

Blaakman, Susan W; Cohen, Alyssa; Fagnano, Maria; Halterman, Jill S

2014-06-01

Teens with persistent asthma do not always receive daily preventive medications or do not take them as prescribed, despite established clinical guidelines. The purpose of this study was to understand urban teens' experiences with asthma management, preventive medication adherence and participation in a school-based intervention. Teens (12-15 years) with persistent asthma, and prescribed preventive medication, participated in a pilot study that included daily observed medication therapy at school and motivational interviewing. Semi-structured interviews occurred at final survey. Qualitative content analysis enabled data coding to identify themes. Themes were classified as "general asthma management" or "program-specific." For general management, routines were important, while hurrying interfered with taking medications. Forgetfulness was most commonly linked to medication nonadherence. Competing demands related to school preparedness and social priorities were barriers to medication use. Independence with medications was associated with several benefits (e.g. avoiding parental nagging and feeling responsible/mature). Program-specific experiences varied. Half of teens reported positive rapport with their school nurse, while a few felt that their nurse was dismissive. Unexpected benefits and barriers within the school structure included perceptions about leaving the classroom, the distance to the nurse's office, the necessity of hall passes and morning school routines. Importantly, many teens connected daily medication use with fewer asthma symptoms, incenting continued adherence. Teens with asthma benefit from adherence to preventive medications but encounter numerous barriers to proper use. Interventions to improve adherence must accommodate school demands and unique teen priorities. The school nurse's role as an ally may support teens' transition to medication independence.

10 CFR 51.91 - Final environmental impact statement-contents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Final environmental impact statement-contents. 51.91... Implementing Section 102(2) Final Environmental Impact Statements-General Requirements § 51.91 Final environmental impact statement—contents. (a)(1) The final environmental impact statement will include responses...

Assessing Complex Emergency Management with Clinical Case-Vignettes: A Validation Study

PubMed Central

2015-01-01

Objective To evaluate whether responses to dynamic case-vignettes accurately reflect actual practices in complex emergency situations. We hypothesized that when obstetricians were faced with vignette of emergency situation identical to one they previously managed, they would report the management strategy they actually used. On the other hand, there is no reason to suppose that their response to a vignette based on a source case managed by another obstetrician would be the same as the actual management. Methods A multicenter vignette-based study was used in 7 French maternity units. We chose the example of severe postpartum hemorrhage (PPH) to study the use of case-vignettes for assessing the management of complex situations. We developed dynamic case-vignettes describing incidents of PPH in several steps, using documentation in patient files. Vignettes described the postpartum course and included multiple-choice questions detailing proposed clinical care. Each participating obstetrician was asked to evaluate 4 case-vignettes: 2 directly derived from cases they previously managed and 2 derived from other obstetricians’ cases. We compared the final treatment decision in vignette responses to those documented in the source-case by the overall agreement and the Kappa coefficient, both for the cases the obstetricians previously managed and the cases of others. Results Thirty obstetricians participated. Overall agreement between final treatment decisions in case-vignettes and documented care for cases obstetricians previously managed was 82% (Kappa coefficient: 0.75, 95% CI [0.62–0.88]). Overall agreement between final treatment decisions in case-vignettes and documented care in vignettes derived from other obstetricians’ cases was only 48% (Kappa coefficient: 0.30, 95% CI [0.12–0.48]). Final agreement with documented care was significantly better for cases based on their own previous cases than for others (p<0.001). Conclusions Dynamic case-vignettes accurately reflect actual practices in complex emergency situations. Therefore, they can be used to assess the quality of management in these situations. PMID:26383261

East Europe Report, Political, Sociological and Military Affairs.

DTIC Science & Technology

1984-10-12

federal secretary’s assistant, Colonel General Veljko Kadijevic, Lieutenant Colonel General Avgust Vrtar, Major General Bogdan Rencelj and Major General...the self-management and other rights of the working people. Djordje Scepancevic, president of the collegial management organ, and Slobodan Mandic ...specific responsibility. Statements by Djordje Scepancevic, president of the Jugoalat management^ and by Slobodan Mandic , president of the Workers