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Sample records for future foodservice management

  1. Assessment of a Foodservice Management Sanitation Course.

    ERIC Educational Resources Information Center

    Cook, Charlotte C.; Casey, Ralph

    1979-01-01

    This study determined the extent to which a course in foodservice sanitation using National Institute for the Foodservice Industry materials affected the postcourse sanitation inspection scores in selected establishments. Both experimental and control establishments had significantly higher inspection scores after the course than they had prior to…

  2. A Biosecurity Checklist for School Foodservice Programs: Developing a Biosecurity Management Plan

    ERIC Educational Resources Information Center

    US Department of Agriculture, 2004

    2004-01-01

    The purpose of this document is to introduce the need for securing foodservice operations from bioterrorism, provide a checklist of suggestions for improving the security of foodservice operations, and assist individuals responsible for school food service programs in strengthening the safety of the foodservice operation. While not mandatory, the…

  3. Consumer perceptions on sustainable practices implemented in foodservice organizations in Korea

    PubMed Central

    Ju, Seyoung

    2016-01-01

    BACKGROUND/OBJECTIVES Sustainable practices in foodservice organizations including commercial and noncommercial ones are critical to ensure the protection of the environment for the future. With the rapid growth of the foodservice industry, wiser usage of input sources such as food, utilities, and single use packaging should be reconsidered for future generations. Therefore, this study aims to investigate the customer's perceptions on sustainable practices and to identify the relationship among sustainable practices, social contribution and purchase intention. SUBJECTS/METHODS The study was conducted using content analyses by reviewing articles on sustainable food service practices published domestically and abroad. Thereafter, data were collected with a face-to-face survey using a questionnaire and analyzed with factor analyses and multiple regressions. RESULTS Sustainable practices classified with factor analysis consisted of 6 dimensions of green food material procurement, sustainable food preparation, green packaging, preservation of energy, waste management, and public relations on green activity, with a total of 25 green activities in foodservice operations. Consumers were not very familiar with the green activities implemented in the foodservice unit, with the lowest awareness of "green food material procurement (2.46 out of 5 points)", and the highest awareness of "green packaging (3.74)" and "waste management (3.28). The factors influencing the perception of social contribution by foodservice organizations among 6 sustainable practice dimensions were found to be public relations on green activity (β = 0.154), waste management (β = 0.204) and sustainable food preparation (β = 0.183). Green packaging (β = 0.107) and the social contribution of the foodservice organization (β = 0.761) had strong relationships with the image of the organization. The purchase intentions of customers was affected only by the foodservice image (β = 0.775). CONCLUSIONS The

  4. A Survey to Determine if Significant Differences Exist in the Scoring of Select Management Areas for Fast Food and Full Service Restaurant Managers by Two-Year Foodservice Management Students.

    ERIC Educational Resources Information Center

    Bloom, Thomas A.

    A survey was conducted of students in 77 of the 144 two-year foodservice management programs in the United States to assess their knowledge of and attitudes toward fast food restaurant management as compared to full service restaurant management. A total of 1,403 students from 44 programs responded. Results indicated that the food service…

  5. Assessment of foodservice quality and identification of improvement strategies using hospital foodservice quality model

    PubMed Central

    Kim, Kyungjoo; Kim, Minyoung

    2010-01-01

    The purposes of this study were to assess hospital foodservice quality and to identify causes of quality problems and improvement strategies. Based on the review of literature, hospital foodservice quality was defined and the Hospital Foodservice Quality model was presented. The study was conducted in two steps. In Step 1, nutritional standards specified on diet manuals and nutrients of planned menus, served meals, and consumed meals for regular, diabetic, and low-sodium diets were assessed in three general hospitals. Quality problems were found in all three hospitals since patients consumed less than their nutritional requirements. Considering the effects of four gaps in the Hospital Foodservice Quality model, Gaps 3 and 4 were selected as critical control points (CCPs) for hospital foodservice quality management. In Step 2, the causes of the gaps and improvement strategies at CCPs were labeled as "quality hazards" and "corrective actions", respectively and were identified using a case study. At Gap 3, inaccurate forecasting and a lack of control during production were identified as quality hazards and corrective actions proposed were establishing an accurate forecasting system, improving standardized recipes, emphasizing the use of standardized recipes, and conducting employee training. At Gap 4, quality hazards were menus of low preferences, inconsistency of menu quality, a lack of menu variety, improper food temperatures, and patients' lack of understanding of their nutritional requirements. To reduce Gap 4, the dietary departments should conduct patient surveys on menu preferences on a regular basis, develop new menus, especially for therapeutic diets, maintain food temperatures during distribution, provide more choices, conduct meal rounds, and provide nutrition education and counseling. The Hospital Foodservice Quality Model was a useful tool for identifying causes of the foodservice quality problems and improvement strategies from a holistic point of view

  6. Forecasting in foodservice: model development, testing, and evaluation.

    PubMed

    Miller, J L; Thompson, P A; Orabella, M M

    1991-05-01

    This study was designed to develop, test, and evaluate mathematical models appropriate for forecasting menu-item production demand in foodservice. Data were collected from residence and dining hall foodservices at Ohio State University. Objectives of the study were to collect, code, and analyze the data; develop and test models using actual operation data; and compare forecasting results with current methods in use. Customer count was forecast using deseasonalized simple exponential smoothing. Menu-item demand was forecast by multiplying the count forecast by a predicted preference statistic. Forecasting models were evaluated using mean squared error, mean absolute deviation, and mean absolute percentage error techniques. All models were more accurate than current methods. A broad spectrum of forecasting techniques could be used by foodservice managers with access to a personal computer and spread-sheet and database-management software. The findings indicate that mathematical forecasting techniques may be effective in foodservice operations to control costs, increase productivity, and maximize profits.

  7. Forecasting in foodservice: model development, testing, and evaluation.

    PubMed

    Miller, J L; Thompson, P A; Orabella, M M

    1991-05-01

    This study was designed to develop, test, and evaluate mathematical models appropriate for forecasting menu-item production demand in foodservice. Data were collected from residence and dining hall foodservices at Ohio State University. Objectives of the study were to collect, code, and analyze the data; develop and test models using actual operation data; and compare forecasting results with current methods in use. Customer count was forecast using deseasonalized simple exponential smoothing. Menu-item demand was forecast by multiplying the count forecast by a predicted preference statistic. Forecasting models were evaluated using mean squared error, mean absolute deviation, and mean absolute percentage error techniques. All models were more accurate than current methods. A broad spectrum of forecasting techniques could be used by foodservice managers with access to a personal computer and spread-sheet and database-management software. The findings indicate that mathematical forecasting techniques may be effective in foodservice operations to control costs, increase productivity, and maximize profits. PMID:2019699

  8. Foodservice sourcebook: A quick-reference guide to industry information and sources

    SciTech Connect

    Not Available

    1990-02-01

    The purpose of this project was the development of a comprehensive, easily-updated sourcebook of information and references related to the foodservice industry for use by electric utility customer service staffs. The Foodservice Sourcebook'' consists of the following directories: (1)Foodservice Industry Leaders --- Leading Foodservice Operators (Fast Food; Full Service; Lodging; Diversified Restaurant, Cafeteria and Retail Chains, Transportation and Recreation Foodservice Operators; Contract Management Firms; Franchises; Parent and Subsidiary Company Finders; Institutional, Military, School, and Healthcare Foodservice Organizations; Independent Restaurant Operators), and Foodservice Trade and Restaurant Associations; (2) Equipment Manufacturer Directories --- Broilers; Fryers; Griddles; Hot Water Heaters; Ovens; Ranges; Refrigerators and Freezers; Steamers and Skillets; Ventilation and Exhaust Equipment; Warewashers; Leading Major Equipment Distributors; (3) Electric Utilities --- National Electric Customer Assistance Network; Electric Utility Foodservice Activities (Commercial Cooking, Test/Demonstration Kitchen, Equipment Efficiency Improvement, Lighting, Hot Water, Space Conditioning, and Refrigeration electric utility programs); (4) Foodservice Market Trends --- Excerpts from Restaurant Business: Restaurant Growth Index,'' September, 1989; (5) Foodservice Design/Operation Guide --- Excerpts from National Restaurant Association Facilities Operations Manual; and (6) Reference Bibliography --- Electric Power Research Institute, National Restaurant Association, and industry publications.

  9. The changing faces of foodservice.

    PubMed

    1991-03-20

    Asian and Hispanic immigrants will continue to flow into the United States through the '90s. The cultural diversity they bring can infuse an operation with energy. But language and cultural barriers will continue to challenge all levels and segments of foodservice. Our feature shows how operators can avoid misunderstandings with immigrant employees and patrons. PMID:10110329

  10. Importance of relationship quality and communication on foodservice for the elderly

    PubMed Central

    Back, Ki Joon; Shanklin, Carol W.

    2011-01-01

    In order to promote foodservice for the elderly, foodservice managers in Continuing Care Retirement Communities (CCRCs) must identify the main factors to enhance the satisfaction and behavioral intentions with food service. The purpose of this study was to investigate the relationships between relationship quality (consisting of trust, commitment, and satisfaction) and communication in the formation of elderly's behavioral intentions with food services at CCRCs. A survey was administered to residents in two CCRCs and a total of 327 residents participated. A tested structural equation model exhibited good model fit and explanatory power of the study construct. Satisfaction directly influenced word-of-mouth and service quality has an influence on commitment. Commitment was a significant determinant of behavioral intentions to eat more often in the dining room. Also, communication showed positive association with trust. The results provided strong evidence for the importance of satisfaction and communication as a consequence of relationship marketing efforts. Suggestions for future research to better understand the elderly' behavioral intention judgments were given. PMID:21487500

  11. Foodservice employees benefit from interventions targeting barriers to food safety.

    PubMed

    York, Valerie K; Brannon, Laura A; Shanklin, Carol W; Roberts, Kevin R; Howells, Amber D; Barrett, Elizabeth B

    2009-09-01

    The number of foodborne illnesses traced to improper food handling in restaurants indicates a need for research to improve food safety in these establishments. Therefore, this 2-year longitudinal study investigated the effectiveness of traditional ServSafe (National Restaurant Association Educational Foundation, Chicago, IL) food-safety training and a Theory of Planned Behavior intervention program targeting employees' perceived barriers and attitudes toward important food-safety behaviors. The effectiveness of the training and intervention was measured by knowledge scores and observed behavioral compliance rates related to food-safety practices. Employees were observed for handwashing, thermometer usage, and proper handling of work surfaces at baseline, after receiving ServSafe training, and again after exposure to the intervention targeting barriers and negative attitudes about food-safety practices. Repeated-measures analyses of variance indicated training improved handwashing knowledge, but the intervention was necessary to improve overall behavioral compliance and handwashing compliance. Results suggest that registered dietitians; dietetic technicians, registered; and foodservice managers should implement a combination of training and intervention to improve knowledge and compliance with food-safety behaviors, rather than relying on training alone. Challenges encountered while conducting this research are discussed, and recommendations are provided for researchers interested in conducting this type of research in the future.

  12. Foodservices at School.

    ERIC Educational Resources Information Center

    Van Egmond-Pannell, Dorothy

    This chapter of "Principles of School Business Management" provides an overview of the history, regulation, and administration of school lunch programs and related food services. The historical review discusses factors prompting federal intervention in food programs for school children and cites legislation mandating funding. The chapter then…

  13. Getting a taste for food waste: a mixed methods ethnographic study into hospital food waste before patient consumption conducted at three New Zealand foodservice facilities.

    PubMed

    Goonan, Sarah; Mirosa, Miranda; Spence, Heather

    2014-01-01

    Foodservice organizations, particularly those in hospitals, are large producers of food waste. To date, research on waste in hospitals has focused primarily on plate waste and the affect of food waste on patient nutrition outcomes. Less focus has been placed on waste generation at the kitchen end of the hospital food system. We used a novel approach to understand reasons for hospital food waste before consumption and offer recommendations on waste minimization within foodservices. A mixed methods ethnographic research approach was adopted. Three New Zealand hospital foodservices were selected as research sites, all of which were contracted to an external foodservice provider. Data collection techniques included document analyses, observations, focus groups with kitchen staff, and one-on-one interviews with managers. Thematic analysis was conducted to generate common themes. Most food waste occurred during service and as a result of overproduction. Attitudes and habits of foodservice personnel were considered influential factors of waste generation. Implications of food waste were perceived differently by different levels of staff. Whereas managers raised discussion from a financial perspective, kitchen staff drew upon social implications. Organizational plans, controls, and use of pre-prepared ingredients assisted in waste minimization. An array of factors influenced waste generation in hospital foodservices. Exploring attitudes and practices of foodservice personnel allowed an understanding of reasons behind hospital food waste and ways in which it could be minimized. This study provides a foundation for further research on sustainable behavior within the wider foodservice sector and dietetics practice. PMID:24231365

  14. Getting a taste for food waste: a mixed methods ethnographic study into hospital food waste before patient consumption conducted at three New Zealand foodservice facilities.

    PubMed

    Goonan, Sarah; Mirosa, Miranda; Spence, Heather

    2014-01-01

    Foodservice organizations, particularly those in hospitals, are large producers of food waste. To date, research on waste in hospitals has focused primarily on plate waste and the affect of food waste on patient nutrition outcomes. Less focus has been placed on waste generation at the kitchen end of the hospital food system. We used a novel approach to understand reasons for hospital food waste before consumption and offer recommendations on waste minimization within foodservices. A mixed methods ethnographic research approach was adopted. Three New Zealand hospital foodservices were selected as research sites, all of which were contracted to an external foodservice provider. Data collection techniques included document analyses, observations, focus groups with kitchen staff, and one-on-one interviews with managers. Thematic analysis was conducted to generate common themes. Most food waste occurred during service and as a result of overproduction. Attitudes and habits of foodservice personnel were considered influential factors of waste generation. Implications of food waste were perceived differently by different levels of staff. Whereas managers raised discussion from a financial perspective, kitchen staff drew upon social implications. Organizational plans, controls, and use of pre-prepared ingredients assisted in waste minimization. An array of factors influenced waste generation in hospital foodservices. Exploring attitudes and practices of foodservice personnel allowed an understanding of reasons behind hospital food waste and ways in which it could be minimized. This study provides a foundation for further research on sustainable behavior within the wider foodservice sector and dietetics practice.

  15. Associations among School Characteristics and Foodservice Practices in a Nationally Representative Sample of U.S. Schools

    PubMed Central

    Thomson, Jessica L.; Tussing-Humphreys, Lisa M.; Martin, Corby K.; LeBlanc, Monique M.; Onufrak, Stephen J.

    2012-01-01

    Objective Determine school characteristics associated with healthy/unhealthy foodservice offerings or healthy food preparation practices. Design Retrospective analysis of cross-sectional data. Setting Nationally representative sample of public and private elementary, middle and high schools. Participants 526 and 520 schools with valid data from the 2006 School Health Policies and Practices Study (SHPPS) Food Service School Questionnaire. Main Outcome Measure(s) Scores for healthy/unhealthy foodservice offerings and healthy food preparation practices. Analysis Multivariable regression to determine significant associations among school characteristics and offerings/preparation practices. Results Public schools and schools participating in USDA Team Nutrition reported more healthy offerings and preparation than private or non-participating schools, respectively. Elementary schools reported less unhealthy offerings than middle or high schools; middle schools reported less unhealthy offerings than high schools. Schools requiring foodservice managers to have a college education reported more healthy preparation while those requiring completion of a foodservice training program reported less unhealthy offerings and more healthy preparation than schools without these requirements. Conclusions and Implications Results suggest the school nutrition environment may be improved by requiring foodservice managers to hold a nutrition-related college degree and/or successfully pass a foodservice training program, and by participating in a school-based nutrition program, such as USDA Team Nutrition. PMID:22963956

  16. Utilizing On-Campus Foodservice Facilities as a Laboratory

    ERIC Educational Resources Information Center

    Dallmeyer, Martha A.

    2012-01-01

    In 2008, the Family and Consumer Sciences Department at Bradley University recognized the need to improve the quality of the laboratory experience in foodservice classes. A hands-on, real-world, learning experience was desired. Simultaneously, the university administration wanted to provide an on-campus foodservice for students from 8:00 p.m. to…

  17. Labor Productivity Standards in Texas School Foodservice Operations

    ERIC Educational Resources Information Center

    Sherrin, A. Rachelle; Bednar, Carolyn; Kwon, Junehee

    2009-01-01

    Purpose: Purpose of this research was to investigate utilization of labor productivity standards and variables that affect productivity in Texas school foodservice operations. Methods: A questionnaire was developed, validated, and pilot tested, then mailed to 200 randomly selected Texas school foodservice directors. Descriptive statistics for…

  18. Available Equipment in School Foodservice.

    ERIC Educational Resources Information Center

    Meyer, Mary Kay

    This report provides data on the National Food Service Management Institute's multi-year research project that identified type, style, age, and condition of available food service equipment in K-12 schools nationwide. The study found that smaller schools, serving less than 400 lunches per day, had kitchens equipped with ranges, small…

  19. Use of capital budgeting techniques by foodservice directors in for-profit and not-for-profit hospitals.

    PubMed

    Daniels, R D; Gregoire, M B

    1993-01-01

    Foodservice directors, who often control one of the largest cost centers in the hospital, are being challenged to manage resources more effectively. Capital budgeting techniques can help enhance a department's cost-effectiveness. The purpose of this study was to assess the use by foodservice directors in nongovernment, not-for-profit and investor-owned, for-profit hospitals of capital budgeting techniques such as payback period, average accounting rate of return, net present value, profitability index, and internal rate of return. Data collected from 84 directors included their use of capital budgeting techniques and operational information about their department. Results indicated that not-for-profit hospital foodservices had significantly more full-time equivalent employees than for-profit hospital foodservices--means of 66 and 52, respectively. Size of capital budget was not strongly correlated with any of the operational variables measured. Many of the directors in both types of hospitals used some capital budgeting techniques. However, directors in for-profit hospitals were much more likely than those in not-for-profit hospitals (92% vs 72%) to use capital budgeting techniques. PMID:8417095

  20. Progress Toward Future Runway Management

    NASA Technical Reports Server (NTRS)

    Lohr, Gary W.; Brown, Sherilyn A.; Atkins, Stephen; Eisenhawer, Stephen W.; Bott, Terrance F.; Long, Dou; Hasan, Shahab

    2011-01-01

    The runway is universally acknowledged as a constraining factor to capacity in the National Airspace System (NAS). It follows that investigation of the effective use of runways, both in terms of selection and assignment, is paramount to the efficiency of future NAS operations. The need to address runway management is not a new idea; however, as the complexities of factors affecting runway selection and usage increase, the need for effective research in this area correspondingly increases. Under the National Aeronautics and Space Administration s Airspace Systems Program, runway management is a key research area. To address a future NAS which promises to be a complex landscape of factors and competing interests among users and operators, effective runway management strategies and capabilities are required. This effort has evolved from an assessment of current practices, an understanding of research activities addressing surface and airspace operations, traffic flow management enhancements, among others. This work has yielded significant progress. Systems analysis work indicates that the value of System Oriented Runway Management tools is significantly increased in the metroplex environment over that of the single airport case. Algorithms have been developed to provide runway configuration recommendations for a single airport with multiple runways. A benefits analysis has been conducted that indicates the SORM benefits include supporting traffic growth, cost reduction as a result of system efficiency, NAS optimization from metroplex operations, fairness in aircraft operations, and rational decision making.

  1. Workplace foodservice; perception of quality and trust.

    PubMed

    Price, Sarah; Hartwell, Heather; Hemingway, Ann; Chapleo, Chris

    2016-02-01

    In settings such as workplaces there is a growing acceptance that the food provided has a significant impact on health and wellbeing. This is a captive environment where the overall contribution of the meal served could be an important element of the overall diet and represents an under researched area. Despite growing demand, little information is available; time pressure when making food choice alongside the challenge of understanding information provided can act as barriers for healthy selection and can also decrease confidence in the food system. We would also argue that the fundamental human right of informing consumers what they are eating is not currently being addressed and is underscored. This study used focus groups to explore criteria that motivate peoples' food choice in a workplace foodservice setting. Thematic analysis was applied to categorise data according to frequently occurring responses. Data were collected from four focus groups in Germany and the UK with a total of 23 participants. Although there is little expectation in the quality of food served in the workplace, respondents valued any transparency of information and the opportunity to socialise with other work colleagues. Criteria of importance were identified as: Value for money, Variety, Naturalness, Nutrition, Portion Size, Taste, Visual Appearance, Origin, Animal welfare, Environmental impact, Fair Trade and Organic. Gaining insight into these criteria can enable operators to meet the needs and expectations of their customers in order to increase confidence in the food provided and in addition signpost a healthier selection. PMID:26686582

  2. Workplace foodservice; perception of quality and trust.

    PubMed

    Price, Sarah; Hartwell, Heather; Hemingway, Ann; Chapleo, Chris

    2016-02-01

    In settings such as workplaces there is a growing acceptance that the food provided has a significant impact on health and wellbeing. This is a captive environment where the overall contribution of the meal served could be an important element of the overall diet and represents an under researched area. Despite growing demand, little information is available; time pressure when making food choice alongside the challenge of understanding information provided can act as barriers for healthy selection and can also decrease confidence in the food system. We would also argue that the fundamental human right of informing consumers what they are eating is not currently being addressed and is underscored. This study used focus groups to explore criteria that motivate peoples' food choice in a workplace foodservice setting. Thematic analysis was applied to categorise data according to frequently occurring responses. Data were collected from four focus groups in Germany and the UK with a total of 23 participants. Although there is little expectation in the quality of food served in the workplace, respondents valued any transparency of information and the opportunity to socialise with other work colleagues. Criteria of importance were identified as: Value for money, Variety, Naturalness, Nutrition, Portion Size, Taste, Visual Appearance, Origin, Animal welfare, Environmental impact, Fair Trade and Organic. Gaining insight into these criteria can enable operators to meet the needs and expectations of their customers in order to increase confidence in the food provided and in addition signpost a healthier selection.

  3. School Foodservice Costs: Location Matters. ERS Report Summary

    ERIC Educational Resources Information Center

    Ollinger, Michael; Ralston, Katherine; Guthrie, Joanne

    2011-01-01

    This study examines the extent to which location influences school foodservice costs per meal. It does not examine the effects of cost variation on financial solvency of an school food authority (SFA) or the adequacy of the US Department of Agriculture (USDA) meal reimbursements. Higher per meal costs do not necessarily indicate that an SFA is…

  4. Measuring School Foodservice Workers’ Perceptions of Organizational Culture

    Technology Transfer Automated Retrieval System (TEKTRAN)

    School foodservice workers (SFW) are a direct link to children eating school meals. SFW who perceive positive and supportive organizational culture at their school nutrition departments also may perceive that such environments foster their own promotion of healthful food choices by students. To date...

  5. Training Guide for Foodservice Personnel in Programs for Young Children. A Manual for Nutritionists, Dietitians, and Foodservice Specialists Who Are Developing and Conducting Training Programs.

    ERIC Educational Resources Information Center

    Development Associates, Inc., Arlington, VA.

    This manual is a competency-based curriculum planning guide for nutritionists, dietitians, and foodservice specialists to use in conducting preservice and inservice training programs for foodservice personnel in Head Start, day care, and other preschool programs. After an introductory chapter, which states the purpose of the manual, defines…

  6. A systematic review of hospital foodservice patient satisfaction studies.

    PubMed

    Dall'Oglio, Immacolata; Nicolò, Rosanna; Di Ciommo, Vincenzo; Bianchi, Natalia; Ciliento, Gaetano; Gawronski, Orsola; Pomponi, Manuel; Roberti, Marco; Tiozzo, Emanuela; Raponi, Massimiliano

    2015-04-01

    The quality of hospital foodservice is one of the most relevant items of health care quality perceived by patients and by their families. Patient satisfaction is considered a way of measuring the quality of services provided. The purpose of this study was to retrieve and review the literature describing patient satisfaction with hospital foodservices. The systematic review was conducted on three electronic archives, PubMed, Excerpta Medica Database, and the Cumulative Index to Nursing and Allied Health Literature (1988 through 2012), to search for any articles reporting patient satisfaction with hospital foodservices. A total of 319 studies were identified. After removing duplicates, 149 abstracts were reviewed, particular attention being given to the presence of a description of the tool used. Thirty-one articles were selected and the full texts were reviewed. Half the studies (n=15) were performed in North America. Patient satisfaction scores were generally high, with some variation among hospitals and different modes of food delivery that was investigated through intervention studies. Qualitative studies were also reported (ethnographic-anthropologic methods with interviews and focus groups). Quantitative tools were represented by questionnaires, some of which relied on previous literature and only a few were validated with factorial analysis and/or Cronbach's α for internal consistency. Most analyses were conducted assuming a parametric distribution of results, an issue not primarily tested. More studies on the quality of hospital foodservice have been carried out in North America than in Europe. Also, a variety of tools, most of which have not been validated, have been used by the different investigating facilities. PMID:25634093

  7. Training: An Opportunity for People with Disabilities in School Foodservice Operations

    ERIC Educational Resources Information Center

    Paez, Paola; Arendt, Susan; Strohbehn, Catherine

    2011-01-01

    Purpose/Objectives: This study assessed current training methods and topics used at public school foodservice operations as well as school foodservice representatives' attitudes toward training employees with disabilities. Methods: A mixed method approach of data collection included two phases. Phase I used a more qualitative approach; interviews…

  8. HB 1347 and Its Relationship to Foodservice Outsourcing in Illinois Public Schools

    ERIC Educational Resources Information Center

    Brashear, Gary L.

    2012-01-01

    This study examined foodservice outsourcing in the State of Illinois. School administrators currently outsourcing foodservice were surveyed about their perceptions of HB1347 and its components. This study looked at HB1347 in Illinois, and its effects on outsourcing in school districts. Data for this study was collected from a survey sent to 100%…

  9. Managing financial risk with options on futures.

    PubMed

    Bond, M T; Marshall, B S

    1995-05-01

    With the rise of managed care and capitation, more providers will be sharing in the financial risk of providing care. To help protect their organizations from the risk of unexpectedly high utilization under such a fixed-payment system, healthcare financial managers soon will be able to use options on futures contracts. These contracts provide wide profit potential but limited loss potential. Before investing in options on futures, however, healthcare financial managers should consider issues such as basis risk and trading costs.

  10. Moderating effects of leader-member exchange (LMX) on job burnout in dietitians and chefs of institutional foodservice

    PubMed Central

    2011-01-01

    The objectives of the study were to investigate job burnout and leader-member exchange (LMX) levels as well as to evaluate buffering effects of LMX on burnout among dietitians and chefs at institutional foodservices. Hypotheses were proposed based on the Job Demands-Resources model and LMX theory. The study population consisted of dietitians and chefs who were in charge of managing unit operations in a nationwide contract management company. Positive/negative affectivity, workload, job burnout, and LMX scales that had been validated in previous research were adopted. A total of 552 questionnaires were distributed and 154 responses were returned. Results indicated that respondents' burnout levels were moderate and emotional exhaustion was greater than cynicism. In terms of LMX, the surveyed dietitians and chefs showed higher respect toward their supervisors than loyalty. When positive affectivity and negative affectivity were controlled, workload influenced emotional exhaustion and professional efficacy significantly. With affectivity and workload controlled, however, LMX did not influence any dimensions of burnout. The moderating effect of LMX on the relationship between workload and cynicism was significant. That is, the effect of workload on cynicism was weak if the dietitians and chefs perceived the relationship with their supervisor positively. Based on the findings and literature reviewed, how to mitigate job burnout among foodservice managers is discussed. PMID:21487501

  11. Moderating effects of leader-member exchange (LMX) on job burnout in dietitians and chefs of institutional foodservice.

    PubMed

    Lee, Kyung-Eun

    2011-02-01

    The objectives of the study were to investigate job burnout and leader-member exchange (LMX) levels as well as to evaluate buffering effects of LMX on burnout among dietitians and chefs at institutional foodservices. Hypotheses were proposed based on the Job Demands-Resources model and LMX theory. The study population consisted of dietitians and chefs who were in charge of managing unit operations in a nationwide contract management company. Positive/negative affectivity, workload, job burnout, and LMX scales that had been validated in previous research were adopted. A total of 552 questionnaires were distributed and 154 responses were returned. Results indicated that respondents' burnout levels were moderate and emotional exhaustion was greater than cynicism. In terms of LMX, the surveyed dietitians and chefs showed higher respect toward their supervisors than loyalty. When positive affectivity and negative affectivity were controlled, workload influenced emotional exhaustion and professional efficacy significantly. With affectivity and workload controlled, however, LMX did not influence any dimensions of burnout. The moderating effect of LMX on the relationship between workload and cynicism was significant. That is, the effect of workload on cynicism was weak if the dietitians and chefs perceived the relationship with their supervisor positively. Based on the findings and literature reviewed, how to mitigate job burnout among foodservice managers is discussed.

  12. Microbial assessment in school foodservices and recommendations for food safety improvement.

    PubMed

    Yoon, Y; Kim, S R; Kang, D H; Shim, W B; Seo, E; Chung, D H

    2008-08-01

    This study evaluated microbial food safety in school foodservices. Five school foodservices were randomly selected, and samples from water, cooking utensils, tableware, foodservice surroundings, and linen were collected in summer and winter (N=420). Tap and drinking water samples were collected, samples of food contact surfaces were collected by swab-kit, and samples for foodservice workers' hands and gloves were prepared by glove juice method. Aerobic plate count (APC) and coliform bacterial populations were enumerated on plate count agar (PCA) and desoxycholate lactose agar, respectively. The presence of Escherichia coli, Salmonella, Listeria monocytogenes, and Staphylococcus aureus was also examined by biochemical identification tests. In addition, PCA agar for APCs and Baird-Parker agar for S. aureus were used to enumerate airborne microorganisms. Higher APCs (< 0 to 5.1 log CFU/mL) than acceptable level were generally observed in water samples, while low coliform counts were found in the samples. High APCs were enumerated in cooking utensils, foodservice workers, tableware, and food-service surroundings, and coliforms were also found in the samples for both seasons. The presence of Salmonella was found from only 10% of plastic glove samples (summer), and the presence of L. monocytogenes was not observed in all samples. S. aureus was detected in some of water, cooking utensils, tableware, employees, and foodservice surroundings, and E. coli was observed in cooking utensils (10% to 20%; summer). No obvious airborne bacteria were detected. These results showed that sanitation practice in school foodservices should be improved, and the results may be useful in microbial assessment of school foodservices.

  13. Developing future managers: education and practice.

    PubMed

    Lehmann, D M

    1997-06-01

    Selecting, educating, and training managers for the future is not optional. If you leave this to chance, then you leave the organization's future to chance. The concept of identifying personal core competencies of future managers parallels the General's challenge of the "fog of war." You cannot tell people in advance all the things they will encounter as they march the organization forward. You can only prepare them so that they can handle the unexpected and unforeseen challenges that will occur. Building into the leader the necessary personal core competency is the best preparation for surprises. The personal core competencies for our organization's work of the future are shown below: Manager's Core Competencies: Teaming, Leadership, Process Management, Systems, Business Savvy, Product Knowledge, Job Knowledge. Each core competency includes a description that paints a clear picture of our expectations of our future managers. Your competencies may have similar labels or titles, but the descriptions will be unique to the vision of the future challenges for your organization. PMID:9220894

  14. Audit to Target Food-Service Corporations

    ERIC Educational Resources Information Center

    Shah, Nirvi

    2011-01-01

    The author reports on the U.S. Department of Agriculture's plan to look closely at whether the food-service-management companies running many school cafeterias are passing along all the discounts and rebates they receive from their suppliers to the districts that hire them. The plan to probe companies will begin in August, said Alison Decker, a…

  15. 76 FR 62341 - Agency Information Collection Activities: Proposed Collection; Comment Request-School Foodservice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-07

    ..., contact John Endahl, Senior Program Analyst, Office of Research and Analysis, Food and Nutrition Service... Food and Nutrition Service Agency Information Collection Activities: Proposed Collection; Comment Request--School Foodservice Indirect Cost Study AGENCY: Food and Nutrition Service (FNS), United...

  16. The Future of Copyright Management: European Perspectives.

    ERIC Educational Resources Information Center

    Battisti, Michele

    This paper presents European perspectives on the future of copyright management. The first section is an overview of intellectual property rights in Europe, including differences between copyright countries and "droit d'auteur" countries. The second section addresses European Community legal policy, including examples related to the directives for…

  17. Corporate Philanthropy: Philosophy, Management, Trends, Future, Background.

    ERIC Educational Resources Information Center

    Council on Foundations, Inc., Washington, DC.

    Major policy considerations and the management of corporate philanthropy, along with new directions and future prospects of corporate philanthropy, are addressed in 40 articles written by chief executive officers, lawyers, economists, and other leading analysts. In addition, a list of resource materials, a glossary, and a list of organizations…

  18. The future of management: The NASA paradigm

    NASA Technical Reports Server (NTRS)

    Harris, Philip R.

    1992-01-01

    Prototypes of 21st century management, especially for large scale enterprises, may well be found within the aerospace industry. The space era inaugurated a number of projects of such scope and magnitude that another type of management had to be created to ensure successful achievement. The challenges will be not just in terms of technology and its management, but also human and cultural in dimension. Futurists, students of management, and those concerned with technological administration would do well to review the literature of emerging space management for its wider implications. NASA offers a paradigm, or demonstrated model, of future trends in the field of management at large. More research is needed on issues of leadership for Earth based project in space and space based programs with managers there. It is needed to realize that large scale technical enterprises, such as are undertaken in space, require a new form of management. NASA and other responsible agencies are urged to study excellence in space macromanagement, including the necessary multidisciplinary skills. Two recommended targets are the application of general living systems theory and macromanagement concepts for space stations in the 1990s.

  19. Current and Future Parts Management at NASA

    NASA Technical Reports Server (NTRS)

    Sampson, Michael J.

    2011-01-01

    This presentation provides a high level view of current and future electronic parts management at NASA. It describes a current perspective of the new human space flight direction that NASA is beginning to take and how that could influence parts management in the future. It provides an overview of current NASA electronic parts policy and how that is implemented at the NASA flight Centers. It also describes some of the technical challenges that lie ahead and suggests approaches for their mitigation. These challenges include: advanced packaging, obsolescence and counterfeits, the global supply chain and Commercial Crew, a new direction by which NASA will utilize commercial launch vehicles to get astronauts to the International Space Station.

  20. Structural Health Management for Future Aerospace Vehicles

    NASA Technical Reports Server (NTRS)

    Prosser, W. H.; Allison, S. G.; Woodard, S. E.; Wincheski, R. A.; Cooper, E. G.; Price, D. C.; Hedley, M.; Prokopenko, M.; Scott, D. A.; Tessler, A.

    2004-01-01

    Structural Health Management (SHM) will be of critical importance to provide the safety, reliability and affordability necessary for the future long duration space missions described in America's Vision for Space Exploration. Long duration missions to the Moon, Mars and beyond cannot be accomplished with the current paradigm of periodic, ground based structural integrity inspections. As evidenced by the Columbia tragedy, this approach is also inadequate for the current Shuttle fleet, thus leading to its initial implementation of on-board SHM sensing for impact detection as part of the return to flight effort. However, future space systems, to include both vehicles as well as structures such as habitation modules, will require an integrated array of onboard in-situ sensing systems. In addition, advanced data systems architectures will be necessary to communicate, store and process massive amounts of SHM data from large numbers of diverse sensors. Further, improved structural analysis and design algorithms will be necessary to incorporate SHM sensing into the design and construction of aerospace structures, as well as to fully utilize these sensing systems to provide both diagnosis and prognosis of structural integrity. Ultimately, structural integrity information will feed into an Integrated Vehicle Health Management (IVHM) system that will provide real-time knowledge of structural, propulsion, thermal protection and other critical systems for optimal vehicle management and mission control. This paper will provide an overview of NASA research and development in the area of SHM as well as to highlight areas of technology improvement necessary to meet these future mission requirements.

  1. Labor time spent in foodservice activities in one hospital: a 12-year profile.

    PubMed

    Matthews, M E; Zardain, M V; Mahaffey, M J

    1986-05-01

    Labor minutes per meal equivalent and percentage of time spent in direct work, indirect work, delay time, and total time were determined in an annual study of foodservice workers in a community hospital. Twelve activity sampling studies (from 1973 through 1984) were conducted for 7 days (Monday through Sunday), usually during the second week of February. The conventional foodservice, with the cook/hot-hold method of food production and service, averaged about 10 minutes for direct work, 1 minute for indirect work, 2 minutes for delay time, and 13 total labor minutes per meal equivalent for the 12 years. The data were similar to those of the study in the 1960s, of conventional hospital foodservices, with high productivity, which averaged about 11 minutes for direct work, 1 minute for indirect work, 2 minutes for delay time, and 14 total labor minutes per meal equivalent. Data averaged from the 1973 through 1984 studies compared with the data from the 1960s study showed that transportation, cleaning, and service required the most labor time (total of 58% in this study and total of 62% in the 1960s study). Methods reported in this article may be applied in other foodservices to identify labor time spent in work and delay activities to establish productivity guidelines for a foodservice department. PMID:3700926

  2. Waste Management System overview for future spacecraft.

    NASA Technical Reports Server (NTRS)

    Ingelfinger, A. L.; Murray, R. W.

    1973-01-01

    Waste Management Systems (WMS) for post Apollo spacecraft will be significantly more sophisticated and earthlike in user procedures. Some of the features of the advanced WMS will be accommodation of both males and females, automatic operation, either tissue wipe or anal wash, measurement and sampling of urine, feces and vomitus for medical analysis, water recovery, and solids disposal. This paper presents an overview of the major problems of and approaches to waste management for future spacecraft. Some of the processes discussed are liquid/gas separation, the Dry-John, the Hydro-John, automated sampling, vapor compression distillation, vacuum distillation-catalytic oxidation, incineration, and the integration of the above into complete systems.

  3. Food Safety Training Is Associated with Improved Knowledge and Behaviours among Foodservice Establishments' Workers

    PubMed Central

    Adesokan, Hezekiah Kehinde; Akinseye, Victor Oluwatoyin; Adesokan, Grace Abiodun

    2015-01-01

    Though several studies have evaluated the association between food safety training and behavior, little has investigated different training components in association with food handlers' performance. Foodservice workers (N = 211) with at least two years' experience were willing to participate and were selected from major foodservice establishments in Ibadan, southwestern Nigeria, and completed a survey to evaluate the association between training, training area, duration, and refresher training and food safety knowledge and practices. We observed an association between training and knowledge (P = 0.000) as well as practices (P = 0.05) of food safety while different training areas contributed similarly to food handlers' knowledge (P = 0.17) and practices (P = 0.08). However, there was a significant decline in knowledge (P = 0.01) and practices (P = 0.001) with an increase in training duration. Furthermore, foodservice employees with refresher training demonstrated significantly higher knowledge (P = 0.000) and practice (P = 0.003) levels than those without, being about 45 and 14 times more likely to, respectively, improve their knowledge (OR = 45; 95% CI: 3.47–584.34) and practice (OR = 13.5; 95% CI: 2.01–90.69). Researchers should always consider varying training components before making assertions regarding effectiveness of training on foodservice workers' behaviour. PMID:26904658

  4. Whole-Grain Continuing Education for School Foodservice Personnel: Keeping Kids from Falling Short

    ERIC Educational Resources Information Center

    Roth-Yousey, Lori; Barno, Trina; Caskey, Mary; Asche, Kimberly; Reicks, Marla

    2009-01-01

    Objective: The purpose of this project was to develop and test whole-grain continuing education for school foodservice personnel. Methods: A continuing education program was developed to address planning, purchasing, preparing, and serving whole-grain food in schools. Participants completed a pre-post questionnaire to assess changes in knowledge,…

  5. School Foodservice Personnel's Struggle with Using Labels to Identify Whole-Grain Foods

    ERIC Educational Resources Information Center

    Chu, Yen Li; Orsted, Mary; Marquart, Len; Reicks, Marla

    2012-01-01

    Objective: To describe how school foodservice personnel use current labeling methods to identify whole-grain products and the influence on purchasing for school meals. Methods: Focus groups explored labeling methods to identify whole-grain products and barriers to incorporating whole-grain foods in school meals. Qualitative analysis procedures and…

  6. School Foodservice Employees' Perceptions of Practice: Differences by Generational Age and Hours Worked

    ERIC Educational Resources Information Center

    Strohbehn, Catherine; Jun, Jinhyun; Arendt, Susan

    2014-01-01

    Purpose/Objectives: This study investigated the influences of school foodservice employees' age and average number of hours worked per week on perceived safe food handling practices, barriers, and motivators. Methods: A bilingual survey (English and Spanish) was developed to assess reported food safety practices, barriers, and motivators to…

  7. Diabetes Preparedness in Schools: What Do Foodservice Personnel Need to Know to Respond?

    ERIC Educational Resources Information Center

    Grenci, Alexandra

    2009-01-01

    Diabetes is increasing in youth, presenting a serious public health threat. Although type 1 diabetes has historically been more common in children, type 2 diabetes is on the rise, linked to increases in overweight and obesity among American youth, particularly those of high risk racial and ethnic groups. Foodservice personnel, along with other…

  8. Barriers and Opportunities Related to Whole Grain Foods in Minnesota School Foodservice

    ERIC Educational Resources Information Center

    Hesse, David; Braun, Curtis; Dostal, Allison; Jeffery, Robert; Marquart, Len

    2009-01-01

    Purpose/Objectives: The purpose of this research was to identify barriers and opportunities associated with the introduction of whole grain foods into school cafeterias. The primary objective was to elicit input from school foodservice personnel (SFP) regarding their experiences in ordering, purchasing, preparing, and serving whole grain foods in…

  9. Work/Life Practices and the Recruitment and Retention of Large School Districts' Foodservice Professionals

    ERIC Educational Resources Information Center

    Harrison, Mary Kate

    2010-01-01

    With the forthcoming retirement of school foodservice directors, the increasing pressures faced by employees at home and work, and the financial constraints of school districts, recruiting and retaining skilled and diverse employees will be challenging. Marketing work/life benefits to potential employees and supporting these policies to current…

  10. Educating Immigrant Hispanic Foodservice Workers about Food Safety Using Visual-Based Training

    ERIC Educational Resources Information Center

    Rajagopal, Lakshman

    2013-01-01

    Providing food safety training to a diverse workforce brings with it opportunities and challenges that must be addressed. The study reported here provides evidence for benefits of using visual-based tools for food safety training when educating immigrant, Hispanic foodservice workers with no or minimal English language skills. Using visual tools…

  11. Attitudes of School Foodservice Directors about the Potential Benefits of School Wellness Policies

    ERIC Educational Resources Information Center

    Longley, Carol; Sneed, Jeannie

    2009-01-01

    Purpose/Objectives: The Reauthorization Act of 2004 requires schools participating in the National School Lunch and School Breakfast Programs to establish a wellness policy. The purpose of this study was to examine school foodservice directors' attitudes about the potential benefits of the wellness policy. Methods: A survey research design was…

  12. Future Newspaper Managers Learn Basics at Oregon.

    ERIC Educational Resources Information Center

    Halverson, Roy

    1978-01-01

    Describes an experimental program that prepares students for careers in newspaper management with a sequence of courses in journalism, accounting, marketing, management, finance, and statistics, ending with an internship in the business office of a daily or weekly newspaper. (RL)

  13. Disease management: definitions, difficulties and future directions.

    PubMed Central

    Pilnick, A.; Dingwall, R.; Starkey, K.

    2001-01-01

    The last decade has seen a wide range of experiments in health care reform intended to contain costs and promote effectiveness. In the USA, managed care and disease management have been major strategies in this endeavour. It has been argued that their apparent success has strong implications for reform in other countries. However, in this paper we ask whether they are so easily exportable. We explain the concepts involved and set the development of managed care and disease management programmes in the context of the USA. The constituent elements of disease management are identified and discussed. Disease management is considered from the perspectives of the major stakeholders in the United Kingdom, and the differences between the models of health care in the United Kingdom's National Health Service and the USA are noted. A review is presented of evaluations of disease management programmes and of the weaknesses they highlight. The prospects for disease management in Europe are also discussed. PMID:11545333

  14. Adaptive management for a turbulent future.

    PubMed

    Allen, Craig R; Fontaine, Joseph J; Pope, Kevin L; Garmestani, Ahjond S

    2011-05-01

    The challenges that face humanity today differ from the past because as the scale of human influence has increased, our biggest challenges have become global in nature, and formerly local problems that could be addressed by shifting populations or switching resources, now aggregate (i.e., "scale up") limiting potential management options. Adaptive management is an approach to natural resource management that emphasizes learning through management based on the philosophy that knowledge is incomplete and much of what we think we know is actually wrong. Adaptive management has explicit structure, including careful elucidation of goals, identification of alternative management objectives and hypotheses of causation, and procedures for the collection of data followed by evaluation and reiteration. It is evident that adaptive management has matured, but it has also reached a crossroads. Practitioners and scientists have developed adaptive management and structured decision making techniques, and mathematicians have developed methods to reduce the uncertainties encountered in resource management, yet there continues to be misapplication of the method and misunderstanding of its purpose. Ironically, the confusion over the term "adaptive management" may stem from the flexibility inherent in the approach, which has resulted in multiple interpretations of "adaptive management" that fall along a continuum of complexity and a priori design. Adaptive management is not a panacea for the navigation of 'wicked problems' as it does not produce easy answers, and is only appropriate in a subset of natural resource management problems where both uncertainty and controllability are high. Nonetheless, the conceptual underpinnings of adaptive management are simple; there will always be inherent uncertainty and unpredictability in the dynamics and behavior of complex social-ecological systems, but management decisions must still be made, and whenever possible, we should incorporate

  15. Adaptive management for a turbulent future

    USGS Publications Warehouse

    Allen, C.R.; Fontaine, J.J.; Pope, K.L.; Garmestani, A.S.

    2011-01-01

    The challenges that face humanity today differ from the past because as the scale of human influence has increased, our biggest challenges have become global in nature, and formerly local problems that could be addressed by shifting populations or switching resources, now aggregate (i.e., "scale up") limiting potential management options. Adaptive management is an approach to natural resource management that emphasizes learning through management based on the philosophy that knowledge is incomplete and much of what we think we know is actually wrong. Adaptive management has explicit structure, including careful elucidation of goals, identification of alternative management objectives and hypotheses of causation, and procedures for the collection of data followed by evaluation and reiteration. It is evident that adaptive management has matured, but it has also reached a crossroads. Practitioners and scientists have developed adaptive management and structured decision making techniques, and mathematicians have developed methods to reduce the uncertainties encountered in resource management, yet there continues to be misapplication of the method and misunderstanding of its purpose. Ironically, the confusion over the term "adaptive management" may stem from the flexibility inherent in the approach, which has resulted in multiple interpretations of "adaptive management" that fall along a continuum of complexity and a priori design. Adaptive management is not a panacea for the navigation of 'wicked problems' as it does not produce easy answers, and is only appropriate in a subset of natural resource management problems where both uncertainty and controllability are high. Nonetheless, the conceptual underpinnings of adaptive management are simple; there will always be inherent uncertainty and unpredictability in the dynamics and behavior of complex social-ecological systems, but management decisions must still be made, and whenever possible, we should incorporate

  16. Adaptive Management for a Turbulent Future

    USGS Publications Warehouse

    Allen, Craig R.; Fontaine, Joseph J.; Pope, Kevin L.; Garmestani, Ahjond S.

    2011-01-01

    The challenges that face humanity today differ from the past because as the scale of human influence has increased, our biggest challenges have become global in nature, and formerly local problems that could be addressed by shifting populations or switching resources, now aggregate (i.e., "scale up") limiting potential management options. Adaptive management is an approach to natural resource management that emphasizes learning through management based on the philosophy that knowledge is incomplete and much of what we think we know is actually wrong. Adaptive management has explicit structure, including careful elucidation of goals, identification of alternative management objectives and hypotheses of causation, and procedures for the collection of data followed by evaluation and reiteration. It is evident that adaptive management has matured, but it has also reached a crossroads. Practitioners and scientists have developed adaptive management and structured decision making techniques, and mathematicians have developed methods to reduce the uncertainties encountered in resource management, yet there continues to be misapplication of the method and misunderstanding of its purpose. Ironically, the confusion over the term "adaptive management" may stem from the flexibility inherent in the approach, which has resulted in multiple interpretations of "adaptive management" that fall along a continuum of complexity and a priori design. Adaptive management is not a panacea for the navigation of 'wicked problems' as it does not produce easy answers, and is only appropriate in a subset of natural resource management problems where both uncertainty and controllability are high. Nonetheless, the conceptual underpinnings of adaptive management are simple; there will always be inherent uncertainty and unpredictability in the dynamics and behavior of complex social-ecological systems, but management decisions must still be made, and whenever possible, we should incorporate

  17. Future preparation of occupational health nurse managers.

    PubMed

    Scalzi, C C; Wilson, D L; Ebert, R

    1991-03-01

    This article presents the results of a national survey of job activities of corporate level occupational health nurse managers. The survey was designed to identify the relative amount of time spent and importance attributed to specific areas of their current job. In general this sample tended to have more management experience and educational preparation than previously cited studies: over 50% had completed a graduate degree. The scores for importance and time spent were highly correlated. That is, occupational health corporate nurse managers seemed to allocate their time to job responsibilities they considered most important. Management activities related to policy, practice standards, quality assurance, staff development, and systems for client care delivery appear to represent the core responsibilities of occupational health nursing management. Curriculum recommendations for management positions in occupational health include: health policy, program planning, and evaluation; business strategy; applications of management information systems; quality assurance; and marketing. PMID:2001272

  18. Ocular onchocerciasis: current management and future prospects

    PubMed Central

    Babalola, Olufemi Emmanuel

    2011-01-01

    This paper reviews the current management of onchocerciasis and its future prospects. Onchocerciasis is a disease affecting millions of people in Africa, South and Central America, and Yemen. It is spread by the blackfly as a vector and caused by the filarial nematode, Onchocerca volvulus. A serious attempt was made by the Onchocerciasis Control Program between 1975 and 2002 to eliminate the vector in eleven of the endemic countries in West Africa, and with remarkable success. Formerly, the treatment was with diethyl carbamazine for the microfilaria and suramin for the adult worm. These drugs are now known to be toxic and unsuitable for mass distribution. In particular, they precipitate optic nerve disease. With the discovery of ivermectin, a much safer microfilaricide, and the decision of Merck to distribute the drug free of charge for as long as needed, the strategy of control switched to mass drug administration through community-directed treatment with ivermectin. So far, millions have received this annual or biannual treatment through the African Program for Onchocerciasis Control and the Onchocerciasis Elimination Program for the Americas. However, the problem with ivermectin is that it is a monotherapy microfilaricide which has limited effect on the adult worm, and thus will need to be continued for the life span of the adult worm, which may last up to 15 years. There are also early reports of resistance. Serious encephalopathy and death may occur when ivermectin is used in subjects heavily infested with loiasis. It seems unlikely that a break in transmission will occur with community-directed treatment with ivermectin in Africa because of population migrations and the highly efficient vector, but in the Americas some countries such as Columbia and the Oaxaca focus in Mexico have reported eradication. Vector control is only now applicable in selected situations, and particularly to control the nuisance value of the blackfly. Trials are ongoing for

  19. Future developments in health care performance management

    PubMed Central

    Crema, Maria; Verbano, Chiara

    2013-01-01

    This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance. PMID:24255600

  20. Computer forecasting: The future of hydro management

    SciTech Connect

    Miller, D.E.; Stover, C.M.

    1994-06-01

    Hydro managers must consider the demands of power production, flood control, environmental mitigation, and downstream water use when making decisions about operating their facilities. Alabama Power Company uses a computer-based real-time decision support system to achieve the best balance possible among the competing uses.

  1. Training Our Future Teachers: Classroom Management. Revised

    ERIC Educational Resources Information Center

    Greenberg, Julie; Putman, Hannah; Walsh, Kate

    2014-01-01

    This report examines traditional teacher preparation in classroom management, which is a struggle for many teachers, especially new ones. 122 teacher preparation programs--both elementary and secondary, graduate and undergraduate--were examined to review the full breadth of the professional sequence. The following conclusions are made as a result…

  2. Managing Complex and Dynamic Systems For The Future

    SciTech Connect

    Jones, E J

    2003-11-11

    The challenges of modern complicated systems regarding their design, analysis, and management are put in a historical context to better propose a framework for the future involving complementary uses of testing, modeling, and performance functions.

  3. The Future of Air Traffic Management

    NASA Technical Reports Server (NTRS)

    Denery, Dallas G.; Erzberger, Heinz; Edwards, Thomas A. (Technical Monitor)

    1998-01-01

    A system for the control of terminal area traffic to improve productivity, referred to as the Center-TRACON Automation System (CTAS), is being developed at NASA's Ames Research Center under a joint program with the FAA. CTAS consists of a set of integrated tools that provide computer-generated advisories for en-route and terminal area controllers. The premise behind the design of CTAS has been that successful planning of traffic requires accurate trajectory prediction. Data bases consisting of representative aircraft performance models, airline preferred operational procedures and a three dimensional wind model support the trajectory prediction. The research effort has been the design of a set of automation tools that make use of this trajectory prediction capability to assist controllers in overall management of traffic. The first tool, the Traffic Management Advisor (TMA), provides the overall flow management between the en route and terminal areas. A second tool, the Final Approach Spacing Tool (FAST) provides terminal area controllers with sequence and runway advisories to allow optimal use of the runways. The TMA and FAST are now being used in daily operations at Dallas/Ft. Worth airport. Additional activities include the development of several other tools. These include: 1) the En Route Descent Advisor that assist the en route controller in issuing conflict free descents and ascents; 2) the extension of FAST to include speed and heading advisories and the Expedite Departure Path (EDP) that assists the terminal controller in management of departures; and 3) the Collaborative Arrival Planner (CAP) that will assist the airlines in operational decision making. The purpose of this presentation is to review the CTAS concept and to present the results of recent field tests. The paper will first discuss the overall concept and then discuss the status of the individual tools.

  4. Imagining flood futures: risk assessment and management in practice.

    PubMed

    Lane, Stuart N; Landström, Catharina; Whatmore, Sarah J

    2011-05-13

    The mantra that policy and management should be 'evidence-based' is well established. Less so are the implications that follow from 'evidence' being predictions of the future (forecasts, scenarios, horizons) even though such futures define the actions taken today to make the future sustainable. Here, we consider the tension between 'evidence', reliable because it is observed, and predictions of the future, unobservable in conventional terms. For flood risk management in England and Wales, we show that futures are actively constituted, and so imagined, through 'suites of practices' entwining policy, management and scientific analysis. Management has to constrain analysis because of the many ways in which flood futures can be constructed, but also because of commitment to an accounting calculus, which requires risk to be expressed in monetary terms. It is grounded in numerical simulation, undertaken by scientific consultants who follow policy/management guidelines that define the futures to be considered. Historical evidence is needed to deal with process and parameter uncertainties and the futures imagined are tied to pasts experienced. Reliance on past events is a challenge for prediction, given changing probability (e.g. climate change) and consequence (e.g. development on floodplains). So, risk management allows some elements of risk analysis to become unstable (notably in relation to climate change) but forces others to remain stable (e.g. invoking regulation to prevent inappropriate floodplain development). We conclude that the assumed separation of risk assessment and management is false because the risk calculation has to be defined by management. Making this process accountable requires openness about the procedures that make flood risk analysis more (or less) reliable to those we entrust to produce and act upon them such that, unlike the 'pseudosciences', they can be put to the test of public interrogation by those who have to live with their consequences

  5. Thermal Management Architecture for Future Responsive Spacecraft

    NASA Astrophysics Data System (ADS)

    Bugby, D.; Zimbeck, W.; Kroliczek, E.

    2009-03-01

    This paper describes a novel thermal design architecture that enables satellites to be conceived, configured, launched, and operationally deployed very quickly. The architecture has been given the acronym SMARTS for Satellite Modular and Reconfigurable Thermal System and it involves four basic design rules: modest radiator oversizing, maximum external insulation, internal isothermalization and radiator heat flow modulation. The SMARTS philosophy is being developed in support of the DoD Operationally Responsive Space (ORS) initiative which seeks to drastically improve small satellite adaptability, deployability, and design flexibility. To illustrate the benefits of the philosophy for a prototypical multi-paneled small satellite, the paper describes a SMARTS thermal control system implementation that uses: panel-to-panel heat conduction, intra-panel heat pipe isothermalization, radiator heat flow modulation via a thermoelectric cooler (TEC) cold-biased loop heat pipe (LHP) and maximum external multi-layer insulation (MLI). Analyses are presented that compare the traditional "cold-biasing plus heater power" passive thermal design approach to the SMARTS approach. Plans for a 3-panel SMARTS thermal test bed are described. Ultimately, the goal is to incorporate SMARTS into the design of future ORS satellites, but it is also possible that some aspects of SMARTS technology could be used to improve the responsiveness of future NASA spacecraft. [22 CFR 125.4(b)(13) applicable

  6. Corporate social responsibility and the future health care manager.

    PubMed

    Collins, Sandra K

    2010-01-01

    The decisions and actions of health care managers are oftentimes heavily scrutinized by the public. Given the current economic climate, managers may feel intense pressure to produce higher results with fewer resources. This could inadvertently test their moral fortitude and their social consciousness. A study was conducted to determine what corporate social responsibility orientation and viewpoint future health care managers may hold. The results of the study indicate that future health care managers may hold patient care in high regard as opposed to profit maximization. However, the results of the study also show that future managers within the industry may continue to need rules, laws, regulations, and legal sanctions to guide their actions and behavior.

  7. ESWL and the future of stone management.

    PubMed

    Eisenberger, F; Schmidt, A

    1993-01-01

    Based on optimal efficacy regarding disintegration and stone clearance, combined with minimal invasiveness, extracorporeal shockwave lithotripsy (ESWL) represents the first choice therapy for urolithiasis. Further developments in ESWL have related more to economic aspects than to improvement of disintegration efficacy or reduction of side effects. Routine indications for ESWL are well known and widely accepted. Its limitations are also well established: silent calyceal stones, calyceal diverticula stones, nephrolithiasis in horse-shoe kidneys, medullary sponge kidney, and residual fragments after ESWL. Although endourology provides new, less invasive and traumatic means of stone retrieval or disintegration, including laser lithotripsy, small ureteroscopes and actively deflectable uretero- and pyeloscopes, indications for an aggressive approach in such cases are limited to those who are symptomatic. In the case of distal ureteral calculi ureteroscopy in traureteral laser-induced shockwave lithotripsy open up new and interesting possibilities for the future.

  8. Peripartum cardiomyopathy: current management and future perspectives

    PubMed Central

    Hilfiker-Kleiner, Denise; Haghikia, Arash; Nonhoff, Justus; Bauersachs, Johann

    2015-01-01

    Pregnancy is associated with marked physiological changes challenging the cardiovascular system. Among the more severe pregnancy associated cardiovascular complications, peripartum cardiomyopathy (PPCM) is a potentially life-threatening heart disease emerging towards the end of pregnancy or in the first postpartal months in previously healthy women. A major challenge is to distinguish the peripartum discomforts in healthy women (fatigue, shortness of breath, and oedema) from the pathological symptoms of PPCM. Moreover, pregnancy-related pathologies such as preeclampsia, myocarditis, or underlying genetic disease show overlapping symptoms with PPCM. Difficulties in diagnosis and the discrimination from other pathological conditions in pregnancy may explain why PPCM is still underestimated. Additionally, underlying pathophysiologies are poorly understood, biomarkers are scarce and treatment options in general limited. Experience in long-term prognosis and management including subsequent pregnancies is just beginning to emerge. This review focuses on novel aspects of physiological and pathophysiological changes of the maternal cardiovascular system by comparing normal conditions, hypertensive complications, genetic aspects, and infectious disease in PPCM-pregnancies. It also presents clinical and basic science data on the current state of knowledge on PPCM and brings them in context thereby highlighting promising new insights in diagnostic tools and therapeutic approaches and management. PMID:25636745

  9. Financial Management of Libraries: Past Trends and Future Prospects.

    ERIC Educational Resources Information Center

    Roberts, Stephen A.

    2003-01-01

    The financial environment within library and information services is reviewed and a structure for financial management is presented based on funding source and level of commercial activity. Objectives for financial management of library and information services is developed and reviewed in light of future trends and stakeholder perspectives.…

  10. Content Management and the Future of Academic Libraries.

    ERIC Educational Resources Information Center

    Wu, Yuhfen Diana; Liu, Mengxiong

    2001-01-01

    Discusses Internet-based electronic content management in digital libraries and considers the future of academic libraries. Topics include digital technologies; content management systems; standards; bandwidth; security and privacy concerns; legal matters, including copyrights and ownership; lifecycle; and multilingual access and interface. (LRW)

  11. The future of managed care organization.

    PubMed

    Robinson, J C

    1999-01-01

    This paper analyzes the transformation of the central organization in the managed care system: the multiproduct, multimarket health plan. It examines vertical disintegration, the shift from ownership to contractual linkages between plans and provider organizations, and horizontal integration--the consolidation of erstwhile indemnity carriers, Blue Cross plans, health maintenance organizations (HMOs), and specialty networks. Health care consumers differ widely in their preferences and willingness to pay for particular products and network characteristics, while providers differ widely in their willingness to adopt particular organization and financing structures. This heterogeneity creates an enduring role for health plans that are diversified into multiple networks, benefit products, distribution channels, and geographic regions. Diversification now is driving health plans toward being national, full-service corporations and away from being local, single-product organizations linked to particular providers and selling to particular consumer niches. PMID:10091427

  12. Menu label accuracy at a university's foodservices. An exploratory recipe nutrition analysis.

    PubMed

    Feldman, Charles; Murray, Douglas; Chavarria, Stephanie; Zhao, Hang

    2015-09-01

    The increase in the weight of American adults and children has been positively associated with the prevalence of the consumption of food-away-from-home. The objective was to assess the accuracy of claimed nutritional information of foods purchased in contracted foodservices located on the campus of an institution of higher education. Fifty popular food items were randomly collected from five main dining outlets located on a selected campus in the northeastern United States. The sampling was repeated three times on separate occasions for an aggregate total of 150 food samples. The samples were then weighed and assessed for nutrient composition (protein, cholesterol, fiber, carbohydrates, total fat, calories, sugar, and sodium) using nutrient analysis software. Results were compared with foodservices' published nutrition information. Two group comparisons, claimed and measured, were performed using the paired-sample t-test. Descriptive statistics were used as well. Among the nine nutritional values, six nutrients (total fat, sodium, protein, fiber, cholesterol, and weight) had more than 10% positive average discrepancies between measured and claimed values. Statistical significance of the variance was obtained in four of the eight categories of nutrient content: total fat, sodium, protein, and cholesterol (P < .05). Significance was also reached in the variance of actual portion weight compared to the published claims (P < .001). Significant differences of portion size (weight), total fat, sodium, protein, and cholesterol were found among the sampled values and the foodservices' published claims. The findings from this study raise the concern that if the actual nutritional information does not accurately reflect the declared values on menus, conclusions, decisions and actions based on posted information may not be valid.

  13. Use of Visuals for Food Safety Education of Spanish-Speaking Foodservice Workers: A Case Study in Iowa

    ERIC Educational Resources Information Center

    Rajagopal, Lakshman

    2012-01-01

    Providing food safety training to an audience whose native language is not English is always a challenge. In the study reported here, minimal-text visuals in Spanish were used to train Hispanic foodservice workers about proper handwashing technique and glove use based on the 2005 Food Code requirements. Overall, results indicated that visuals…

  14. Using student opinion and design inputs to develop an informed university foodservice menu.

    PubMed

    Feldman, Charles; Harwell, Heather; Brusca, Joseph

    2013-10-01

    The potential for Universities and Colleges to be settings that promote health and wellbeing has become the subject for debate where the role of foodservice has been acknowledged as influential. The aim of this research was to evaluate an effective design to promote healthy selections from university foodservice menus. The research was designed around a grounded theory approach utilizing semiological prompts based on different existing nutrition labeling schemes. A total of 39 students (17 male, 22 female) participated in seven focus groups at Montclair State University, US. The participants of this study clearly called for nutrition labeling on college menus and a prototype design had been agreed. The students also itemized five nutrients they wanted listed in a Traffic Light system of colors and then quantified on the menu: calories, sodium, sugar, fat and carbohydrates, plus beneficial ingredients or nutrients for display in menu icons. The nutrients and display order varies somewhat from industry and government standards, though the student recommendations are suggestive of common understandings of published nutrient guidelines. Students have a stake in how menu information is presented on campus and their opinions could positively impact the general selection of healthy foods. PMID:23707359

  15. Future Directions of Management Science and Operations Management in Business School Curricula

    ERIC Educational Resources Information Center

    Fuller, Jack A.; Denton, James W.

    2006-01-01

    The fields of Management Science (MS) and Operations Management (OM) have co-existed in business school curricula for over a half century. This paper examines five trends that point toward a bright future for Operations Management in the business curriculum. These trends include an increasing emphasis on global competition, the growth of the…

  16. Interdisciplinary science for future governance and management of forests.

    PubMed

    Nordin, Annika; Sandström, Camilla

    2016-02-01

    The sustainable use of forests constitutes one of the great challenges for the future due to forests' large spatial coverage, long-term planning horizons and inclusion of many ecosystem services. The mission of the Future Forests programme is to provide a scientifically robust knowledge base for sustainable governance and management of forests preparing for a future characterized by globalization and climate change. In this introduction to the Special Issue, we describe the interdisciplinary science approach developed in close collaboration with actors in the Future Forests programme, and discuss the potential impacts of this science on society. In addition, we introduce the 13 scientific articles and present results produced by the programme. PMID:26744043

  17. Resolving future fire management conflicts using multicriteria decision making.

    PubMed

    Driscoll, Don A; Bode, Michael; Bradstock, Ross A; Keith, David A; Penman, Trent D; Price, Owen F

    2016-02-01

    Management strategies to reduce the risks to human life and property from wildfire commonly involve burning native vegetation. However, planned burning can conflict with other societal objectives such as human health and biodiversity conservation. These conflicts are likely to intensify as fire regimes change under future climates and as growing human populations encroach farther into fire-prone ecosystems. Decisions about managing fire risks are therefore complex and warrant more sophisticated approaches than are typically used. We applied a multicriteria decision making approach (MCDA) with the potential to improve fire management outcomes to the case of a highly populated, biodiverse, and flammable wildland-urban interface. We considered the effects of 22 planned burning options on 8 objectives: house protection, maximizing water quality, minimizing carbon emissions and impacts on human health, and minimizing declines of 5 distinct species types. The MCDA identified a small number of management options (burning forest adjacent to houses) that performed well for most objectives, but not for one species type (arboreal mammal) or for water quality. Although MCDA made the conflict between objectives explicit, resolution of the problem depended on the weighting assigned to each objective. Additive weighting of criteria traded off the arboreal mammal and water quality objectives for other objectives. Multiplicative weighting identified scenarios that avoided poor outcomes for any objective, which is important for avoiding potentially irreversible biodiversity losses. To distinguish reliably among management options, future work should focus on reducing uncertainty in outcomes across a range of objectives. Considering management actions that have more predictable outcomes than landscape fuel management will be important. We found that, where data were adequate, an MCDA can support decision making in the complex and often conflicted area of fire management. PMID

  18. Resolving future fire management conflicts using multicriteria decision making.

    PubMed

    Driscoll, Don A; Bode, Michael; Bradstock, Ross A; Keith, David A; Penman, Trent D; Price, Owen F

    2016-02-01

    Management strategies to reduce the risks to human life and property from wildfire commonly involve burning native vegetation. However, planned burning can conflict with other societal objectives such as human health and biodiversity conservation. These conflicts are likely to intensify as fire regimes change under future climates and as growing human populations encroach farther into fire-prone ecosystems. Decisions about managing fire risks are therefore complex and warrant more sophisticated approaches than are typically used. We applied a multicriteria decision making approach (MCDA) with the potential to improve fire management outcomes to the case of a highly populated, biodiverse, and flammable wildland-urban interface. We considered the effects of 22 planned burning options on 8 objectives: house protection, maximizing water quality, minimizing carbon emissions and impacts on human health, and minimizing declines of 5 distinct species types. The MCDA identified a small number of management options (burning forest adjacent to houses) that performed well for most objectives, but not for one species type (arboreal mammal) or for water quality. Although MCDA made the conflict between objectives explicit, resolution of the problem depended on the weighting assigned to each objective. Additive weighting of criteria traded off the arboreal mammal and water quality objectives for other objectives. Multiplicative weighting identified scenarios that avoided poor outcomes for any objective, which is important for avoiding potentially irreversible biodiversity losses. To distinguish reliably among management options, future work should focus on reducing uncertainty in outcomes across a range of objectives. Considering management actions that have more predictable outcomes than landscape fuel management will be important. We found that, where data were adequate, an MCDA can support decision making in the complex and often conflicted area of fire management.

  19. Social Networks and Welfare in Future Animal Management.

    PubMed

    Koene, Paul; Ipema, Bert

    2014-03-17

    It may become advantageous to keep human-managed animals in the social network groups to which they have adapted. Data concerning the social networks of farm animal species and their ancestors are scarce but essential to establishing the importance of a natural social network for farmed animal species. Social Network Analysis (SNA) facilitates the characterization of social networking at group, subgroup and individual levels. SNA is currently used for modeling the social behavior and management of wild animals and social welfare of zoo animals. It has been recognized for use with farm animals but has yet to be applied for management purposes. Currently, the main focus is on cattle, because in large groups (poultry), recording of individuals is expensive and the existence of social networks is uncertain due to on-farm restrictions. However, in many cases, a stable social network might be important to individual animal fitness, survival and welfare. For instance, when laying hens are not too densely housed, simple networks may be established. We describe here small social networks in horses, brown bears, laying hens and veal calves to illustrate the importance of measuring social networks among animals managed by humans. Emphasis is placed on the automatic measurement of identity, location, nearest neighbors and nearest neighbor distance for management purposes. It is concluded that social networks are important to the welfare of human-managed animal species and that welfare management based on automatic recordings will become available in the near future.

  20. Water management: Current and future challenges and research directions

    NASA Astrophysics Data System (ADS)

    Cosgrove, William J.; Loucks, Daniel P.

    2015-06-01

    Water distinguishes our planet compared to all the others we know about. While the global supply of available freshwater is more than adequate to meet all current and foreseeable water demands, its spatial and temporal distributions are not. There are many regions where our freshwater resources are inadequate to meet domestic, economic development and environmental needs. In such regions, the lack of adequate clean water to meet human drinking water and sanitation needs is indeed a constraint on human health and productivity and hence on economic development as well as on the maintenance of a clean environment and healthy ecosystems. All of us involved in research must find ways to remove these constraints. We face multiple challenges in doing that, especially given a changing and uncertain future climate, and a rapidly growing population that is driving increased social and economic development, globalization, and urbanization. How best to meet these challenges requires research in all aspects of water management. Since 1965, the journal Water Resources Research has played an important role in reporting and disseminating current research related to managing the quantity and quality and cost of this resource. This paper identifies the issues facing water managers today and future research needed to better inform those who strive to create a more sustainable and desirable future.

  1. Microbiological evaluation of foodservice contact surfaces in Iowa assisted-living facilities.

    PubMed

    Sneed, Jeannie; Strohbehn, Catherine; Gilmore, Shirley A; Mendonca, Aubrey

    2004-11-01

    A study of 40 assisted-living facilities in Iowa was conducted to assess the microbiological quality of food-contact surfaces (work tables/counters, cooking equipment such as mixing bowls, and cutting boards) and a surface that could cross-contaminate food (refrigerator or freezer handles) to determine the effectiveness of cleaning and sanitation. Standards were set for foodservice for aerobic plate count, Enterobacteriaceae, and Staphylococcus aureus . Two facilities met standards for all five surfaces for each of the three tests. Fewer facilities met the standard for aerobic plate count than for the other two tests, and nearly three fourths of the facilities failed to meet the aerobic plate count for cutting boards. Critically, cross-contamination from these surfaces could result in contamination of food; thus, attention needs to be given to training and supervision to ensure proper hand washing and appropriate cleaning and sanitation procedures to reduce or eliminate cross-contamination. PMID:15499361

  2. JPL Project Information Management: A Continuum Back to the Future

    NASA Technical Reports Server (NTRS)

    Reiz, Julie M.

    2009-01-01

    This slide presentation reviews the practices and architecture that support information management at JPL. This practice has allowed concurrent use and reuse of information by primary and secondary users. The use of this practice is illustrated in the evolution of the Mars Rovers from the Mars Pathfinder to the development of the Mars Science Laboratory. The recognition of the importance of information management during all phases of a project life cycle has resulted in the design of an information system that includes metadata, has reduced the risk of information loss through the use of an in-process appraisal, shaping of project's appreciation for capturing and managing the information on one project for re-use by future projects as a natural outgrowth of the process. This process has also assisted in connection of geographically disbursed partners into a team through sharing information, common tools and collaboration.

  3. Social Networks and Welfare in Future Animal Management

    PubMed Central

    Koene, Paul; Ipema, Bert

    2014-01-01

    Simple Summary Living in a stable social environment is important to animals. Animal species have developed social behaviors and rules of approach and avoidance of conspecifics in order to co-exist. Animal species are kept or domesticated without explicit regard for their inherent social behavior and rules. Examples of social structures are provided for four species kept and managed by humans. This information is important for the welfare management of these species. In the near future, automatic measurement of social structures will provide a tool for daily welfare management together with nearest neighbor information. Abstract It may become advantageous to keep human-managed animals in the social network groups to which they have adapted. Data concerning the social networks of farm animal species and their ancestors are scarce but essential to establishing the importance of a natural social network for farmed animal species. Social Network Analysis (SNA) facilitates the characterization of social networking at group, subgroup and individual levels. SNA is currently used for modeling the social behavior and management of wild animals and social welfare of zoo animals. It has been recognized for use with farm animals but has yet to be applied for management purposes. Currently, the main focus is on cattle, because in large groups (poultry), recording of individuals is expensive and the existence of social networks is uncertain due to on-farm restrictions. However, in many cases, a stable social network might be important to individual animal fitness, survival and welfare. For instance, when laying hens are not too densely housed, simple networks may be established. We describe here small social networks in horses, brown bears, laying hens and veal calves to illustrate the importance of measuring social networks among animals managed by humans. Emphasis is placed on the automatic measurement of identity, location, nearest neighbors and nearest neighbor distance for

  4. Future of medical knowledge management and decision support.

    PubMed

    Greenes, Robert A

    2002-01-01

    Attempts to predict the future are typically off the mark. Beyond the challenges of forecasting the stock market or the weather, dramatic instances of notoriously inaccurate prognostications have been those by the US patent office in the late 1800s about the future of inventions, by Thomas Watson in the 1930s about the market for large computers, and by Bill Gates in the early 1990s about the significance of the Internet. When one seeks to make predictions about health care, one finds that, beyond the usual uncertainties regarding the future, additional impediments to forecasting are the discontinuities introduced by advances in biomedical science and technology, the impact of information technology, and the reorganizations and realignments attending various approaches to health care delivery and finance. Changes in all three contributing areas themselves can be measured in "PSPYs", or paradigm shifts per year. Despite these risks in forecasting, I believe that certain trends are sufficiently clear that I am willing to venture a few predictions. Further, the predictions I wish to make suggest a goal for the future that can be achieved, if we can align the prevailing political, financial, biomedical, and technical forces toward that end. Thus, in a sense this is a call to action, to shape the future rather than just let it happen. This chapter seeks to lay out the direction we are heading in knowledge management and decision support, and to delineate an information technology framework that appears desirable. I believe the framework to be discussed is of importance to the health care-related knowledge management and decision making activities of the consumer and patient, the health care provider, and health care delivery organizations and insurers. The approach is also relevant to the other dimensions of academic health care institution activities, notably the conduct of research and the processes of education and learning. PMID:12026135

  5. Increasing Awareness of Sustainable Water Management for Future Civil Engineers

    NASA Astrophysics Data System (ADS)

    Ilic, Suzana; Karleusa, Barbara; Deluka-Tibljas, Aleksandra

    2010-05-01

    There are more than 1.2 billion people around the world that do not have access to drinking water. While there are plans under the United Nations Millennium Development Goals to halve this number by 2015, there are a number of regions that will be exposed to water scarcity in the coming future. Providing sufficient water for future development is a great challenge for planners and designers of water supply systems. In order to design sustainable water supplies for the future, it is important to learn how people consume water and how water consumption can be reduced. The education of future civil engineers should take into account not only technical aspects of the water supply but also the accompanying social and economical issues, and appreciated the strengths and weaknesses of traditional solutions. The Faculty of Civil Engineering, at the University of Rijeka, has begun incorporating a series of activities that engage undergraduate students and the local community to develop a mutual understanding of the future needs for sustainable management. We present one of the activities, collaboration with the Lancaster Environment Centre at Lancaster University in the UK through the field course Water and environmental management in Mediterranean context. The course, which is designed for the Lancaster University geography students, features a combination of field trips and visits to provide an understanding of the socio-economic and environmental context of water management in two counties (Istra and Primorsko-Goranska). Students from Lancaster visit the Croatian water authority and a regional water company, where they learn about current management practices and problems in managing water supplies and demand through the year. They make their own observations of current management practices in the field and learn about water consumption from the end users. One day field visit to a village in the area that is still not connected to the main water supply system is

  6. Sustainable WEE management in Malaysia: present scenarios and future perspectives

    NASA Astrophysics Data System (ADS)

    Rezaul Hasan Shumon, Md; Ahmed, S.

    2013-12-01

    Technological advances have resulted development of a lot of electronic products for continuously increasing number of customers. As the customer taste and features of these products change rapidly, the life cycles have come down tremendously. Therefore, a large volume of e-wastes are now emanated every year. This scenario is very much predominant in Malaysia. On one hand e-wastes are becoming environmental hazards and affecting the ecological imbalance. On the other, these wastes are remaining still economically valuable. In Malaysia, e-waste management system is still in its nascent state. This paper describes the current status of e-waste generation and recycling and explores issues for future e-waste management system in Malaysia from sustainable point of view. As to draw some factual comparisons, this paper reviews the e-waste management system in European Union, USA, Japan, as a benchmark. Then it focuses on understanding the Malaysian culture, consumer discarding behavior, flow of the materials in recycling, e-waste management system, and presents a comparative view with the Swiss e-waste system. Sustainable issues for e-waste management in Malaysia are also presented. The response adopted so far in collection and recovery activities are covered in later phases. Finally, it investigates the barriers and challenges of e-waste system in Malaysia.

  7. Challenges in IPF diagnosis, current management and future perspectives.

    PubMed

    Wells, Athol U; Costabel, Ulrich; Poletti, Venerino; Crestani, Bruno; Egan, Jim; Margaritopoulos, George; Antoniou, Katerina

    2015-01-01

    Recent developments have clarified our understanding of IPF and improved outcomes with two viable new therapeutic options, pirfenidone and nintedanib. In spite of these advances, questions and challenges concerning IPF still remain. Here we will focus on some of these unresolved areas: the diagnosis of IPF is hindered by limitations in current practice guidelines, surgical lung biopsy is contraindicated in many patients, the accuracy of prognostic evaluation needs to be increased and tolerability factors can jeopardise adherence to treatment. We will also identify new developments shaping the future of IPF management such as cryobiopsy, increased understanding of genetic factors and new treatment paradigms, which may help to fulfil currently unmet needs.

  8. Management of Nasopharyngeal Carcinoma: Current Practice and Future Perspective.

    PubMed

    Lee, Anne W M; Ma, Brigette B Y; Ng, Wai Tong; Chan, Anthony T C

    2015-10-10

    Nasopharyngeal carcinoma of the undifferentiated subtype is endemic to southern China, and patient prognosis has improved significantly over the past three decades because of advances in disease management, diagnostic imaging, radiotherapy technology, and broader application of systemic therapy. Despite the excellent local control with modern radiotherapy, distant failure remains a key challenge. Advances in molecular technology have helped to decipher the molecular pathogenesis of nasopharyngeal carcinoma as well as its etiologic association with the Epstein-Barr virus. This in turn has led to the discovery of novel biomarkers and drug targets, rendering this cancer site a current focus for new drug development. This article reviews and appraises the key literature on the current management of nasopharyngeal carcinoma and future directions in clinical research.

  9. Multiple system atrophy: current and future approaches to management

    PubMed Central

    Flabeau, Olivier; Meissner, Wassilios G.; Tison, François

    2010-01-01

    Multiple system atrophy (MSA) is a rare neurodegenerative disorder without any effective treatment in slowing or stopping disease progression. It is characterized by poor levodopa responsive Parkinsonism, cerebellar ataxia, pyramidal signs and autonomic failure in any combination. Current therapeutic strategies are primarily based on dopamine replacement and improvement of autonomic failure. However, symptomatic management remains disappointing and no curative treatment is yet available. Recent experimental evidence has confirmed the key role of alpha-synuclein aggregation in the pathogenesis of MSA. Referring to this hypothesis, transgenic and toxic animal models have been developed to assess candidate drugs for MSA. The standardization of diagnosis criteria and assessment procedures will allow large multicentre clinical trials to be conducted. In this article we review the available symptomatic treatment, recent results of studies investigating potential neuroprotective drugs, and future approaches for the management in MSA. PMID:21179616

  10. Managed care, capitation, and the future of nephrology.

    PubMed

    Steinman, T I

    1997-10-01

    Within the next decade, it is predicted that more than 90% of the United States population will receive its health insurance through managed care. Capitation will be the reimbursement mechanism to health care providers as the major way of controlling costs. Currently, managed care has had little experience with capitation payments for chronically ill patients, who consume large financial and physical resources. The end-stage renal disease (ESRD) population represents a vulnerable group of patients, and their care may be compromised in a capitated environment. Nephrologists will need to serve as advocates for ESRD patients through a mechanism of quality of care, driven by a continuous quality improvement model. Cost-effective delivery of care will occur as nephrologists join together to form Independent Practice Associations (IPAs). In this article, the role of a nephrologist in a capitated environment is outlined in detail, and background for the basis of managed care growth is provided as a framework for understanding the change in our health care delivery system. After formation of a nephrology IPA, there will most likely be a linkage with a management service organization (MSO). A business plan driven by the highest principles will allow nephrologists to work together as a cohesive force in accepting global risk capitated contracts. The starting point is for ESRD care, and the future includes pre-ESRD care. PMID:9335392

  11. Selective breeding: the future of TB management in African buffalo?

    PubMed

    le Roex, N; Berrington, C M; Hoal, E G; van Helden, P D

    2015-09-01

    The high prevalence of bovine tuberculosis (BTB) in African buffalo (Syncerus caffer) in regions of southern African has a negative economic impact on the trade of animals and animal products, represents an ecological threat to biodiversity, and poses a health risk to local communities through the wildlife-cattle-human interface. Test and cull methods may not be logistically feasible in many free-range wildlife systems, and with the presence of co-existing BTB hosts and the limited effectiveness of the BCG vaccine in buffalo, there is a need for alternative methods of BTB management. Selective breeding for increased resistance to BTB in buffalo may be a viable method of BTB management in the future, particularly if genetic information can be incorporated into these schemes. To explore this possibility, we discuss the different strategies that can be employed in selective breeding programmes, and consider the implementation of genetic improvement schemes. We reflect on the suitability of applying this strategy for enhanced BTB resistance in African buffalo, and address the challenges of this approach that must be taken into account. Conclusions and the implications for management are presented.

  12. Projected future climate change and Baltic Sea ecosystem management

    NASA Astrophysics Data System (ADS)

    Andersson, Agneta

    2015-04-01

    Climate change is likely to have large effects on the Baltic Sea ecosystem. Simulations indicate 2-4oC warming and 50-80% decreasing ice cover by 2100. Precipitation may increase ~30% in the north, causing increased land runoff of allochthonous organic matter (AOM) and organic pollutants. Salinity will decrease by about 2 units. Coupled physical-biogeochemical models indicate that in the south, bottom-water anoxia may spread, reducing cod recruitment and increasing sediment phosphorus release, promoting cyanobacterial blooms. In the north, heterotrophic bacteria will be favoured by AOM while phytoplankton may become hampered. More trophic levels in the food web will increase energy losses and consequently reduce fish production. Future management of the Baltic Sea must consider effects of climate change on the ecosystem dynamics and functions, as well as effects of anthrophogenic nutrient and pollutant load. Monitoring should have a holistic approach and encompass both autotrophic (phytoplankton) and heterotrophic (e.g. bacterial) processes.

  13. Planning and managing future space facility projects. [management by objectives and group dynamics

    NASA Technical Reports Server (NTRS)

    Sieber, J. E.; Wilhelm, J. A.; Tanner, T. A.; Helmreich, R. L.; Burgenbauch, S. F.

    1979-01-01

    To learn how ground-based personnel of a space project plan and organize their work and how such planning and organizing relate to work outcomes, longitudinal study of the management and execution of the Space Lab Mission Development Test 3 (SMD 3) was performed at NASA Ames Research Center. A view of the problems likely to arise in organizations and some methods of coping with these problems are presented as well as the conclusions and recommendations that pertain strictly to SMD 3 management. Emphasis is placed on the broader context of future space facility projects and additional problems that may be anticipated. A model of management that may be used to facilitate problem solving and communication - management by objectives (MBO) is presented. Some problems of communication and emotion management that MBO does not address directly are considered. Models for promoting mature, constructive and satisfying emotional relationships among group members are discussed.

  14. HACCP models for quality control of entrée production in hospital foodservice systems. I. Development of hazard analysis critical control point models.

    PubMed

    Bobeng, B J; David, B D

    1978-11-01

    HACCP models were developed as part of a research project for quality control of entrée production in three types of hospital foodservice systems: Conventional, cook/chill, and cook/freeze. Critical control points at process stages were identified. Time-temperature was a critical control point throughout entrée production in each model; time-temperature parameters were established for critical control points. Equipment sanitation and personnel sanitation are critical control points for which standards must be established by each foodservice system. Determination of the effectiveness of control measures included continuous monitoring of critical control points for time-temperature. Sanitation of equipment and personnel should be monitored using standards established by the foodservice system.

  15. Evaluating stakeholder participation in water management: intermediary outcomes as potential indicators for future resource management outcomes

    NASA Astrophysics Data System (ADS)

    Carr, Gemma; Bloeschl, Guenter; Loucks, Daniel Pete

    2013-04-01

    . Furthermore, failure to achieve intermediary outcomes correlates to failure to achieve resource management outcomes. Evaluating intermediary outcomes leads to both a broader assessment of a programme's achievements at the time of evaluation, and can indicate whether a programme will go on to achieve resource management objectives in the future.

  16. 17 CFR 1.73 - Clearing futures commission merchant risk management.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... merchant risk management. 1.73 Section 1.73 Commodity and Securities Exchanges COMMODITY FUTURES TRADING... commission merchant risk management. (a) Each futures commission merchant that is a clearing member of a... for clearing, it shall establish and maintain systems of risk management controls reasonably...

  17. Current management of diabetes mellitus and future directions in care.

    PubMed

    Chatterjee, Sudesna; Davies, Melanie J

    2015-11-01

    The last 90 years have seen considerable advances in the management of type 1 and type 2 diabetes. Prof MacLean of Guy's Hospital wrote in the Postgraduate Medical Journal in 1926 about the numerous challenges that faced patients and their healthcare professionals in delivering safe and effective diabetes care at that time. The discovery of insulin in 1922 heralded a new age in enabling long-term glycaemic control, which reduced morbidity and mortality. Thirty years later, the first oral agents for diabetes, the biguanides and sulfonylureas, appeared and freed type 2 patients from having to inject insulin following diagnosis. Improvements in insulin formulations over the decades, including rapid-acting and long-acting insulin analogues that more closely mimic physiological insulin secretion, have increased the flexibility and efficacy of type 1 diabetes management. The last two decades have seen major advances in technology, which has manifested in more accurate glucose monitoring systems and insulin delivery devices ('insulin pump'). Increased understanding of the pathophysiological deficits underlying type 2 diabetes has led to the development of targeted therapeutic approaches such as on the small intestine (glucagon-like peptide-1 receptor analogues and dipeptidyl-peptidase IV inhibitors) and kidneys (sodium-glucose cotransporter-2 inhibitors). A patient-centred approach delivered by a multidisciplinary team is now advocated. Glycaemic targets are set according to individual circumstances, taking into account factors such as weight, hypoglycaemia risk and patient preference. Stepwise treatment guidelines devised by international diabetes organisations standardise and rationalise management. Structured education programmes and psychological support are now well-established as essential for improving patient motivation and self-empowerment. Large multicentre randomised trials have confirmed the effectiveness of intensive glycaemic control on microvascular

  18. Current management of diabetes mellitus and future directions in care.

    PubMed

    Chatterjee, Sudesna; Davies, Melanie J

    2015-11-01

    The last 90 years have seen considerable advances in the management of type 1 and type 2 diabetes. Prof MacLean of Guy's Hospital wrote in the Postgraduate Medical Journal in 1926 about the numerous challenges that faced patients and their healthcare professionals in delivering safe and effective diabetes care at that time. The discovery of insulin in 1922 heralded a new age in enabling long-term glycaemic control, which reduced morbidity and mortality. Thirty years later, the first oral agents for diabetes, the biguanides and sulfonylureas, appeared and freed type 2 patients from having to inject insulin following diagnosis. Improvements in insulin formulations over the decades, including rapid-acting and long-acting insulin analogues that more closely mimic physiological insulin secretion, have increased the flexibility and efficacy of type 1 diabetes management. The last two decades have seen major advances in technology, which has manifested in more accurate glucose monitoring systems and insulin delivery devices ('insulin pump'). Increased understanding of the pathophysiological deficits underlying type 2 diabetes has led to the development of targeted therapeutic approaches such as on the small intestine (glucagon-like peptide-1 receptor analogues and dipeptidyl-peptidase IV inhibitors) and kidneys (sodium-glucose cotransporter-2 inhibitors). A patient-centred approach delivered by a multidisciplinary team is now advocated. Glycaemic targets are set according to individual circumstances, taking into account factors such as weight, hypoglycaemia risk and patient preference. Stepwise treatment guidelines devised by international diabetes organisations standardise and rationalise management. Structured education programmes and psychological support are now well-established as essential for improving patient motivation and self-empowerment. Large multicentre randomised trials have confirmed the effectiveness of intensive glycaemic control on microvascular

  19. Management of diabetic nephropathy: Recent progress and future perspective.

    PubMed

    Ahmad, Jamal

    2015-01-01

    Diabetic nephropathy (DN), a leading cause of end-stage renal disease (ESRD) affecting ∼20-30% diabetics, is associated with increased cardiovascular mortality. The progression of kidney disease in patients with diabetes can take many years. It occurs as a result of interaction between both genetic and environmental factors in individuals with both type 1 and type 2 diabetes. Hyperglycaemia, hypertension, and genetic pre-disposition are the main risk factors besides elevated serum lipids, smoking habits, and the amount of dietary proteins. Interventions such as glycaemic control, blood pressure control and inhibition of the renin-angiotensin-aldosterone system have been shown to slow this progression. Despite the implementation of these strategies, the number of patients with diabetes that ultimately develop end-stage renal disease remains high. The treatment of DN, therefore, has posed a formidable challenge besides optimization of renin-angiotensin-aldosterone system blockade in patients with DN; additional investigation has focused on the potential of novel therapies that target various pathways upregulated by hyperglycaemia or other targets believed to promote the progression of DN such as oxidative stress, inflammation, endothelin system and vitamin D receptors. This review article addresses the pathogenesis and some of the well established principles regarding the progression and accepted management of DN, and also includes the perspectives of novel anti-DN agents and the future directions for the prevention of DN.

  20. Water management in Egypt for facing the future challenges.

    PubMed

    Omar, Mohie El Din M; Moussa, Ahmed M A

    2016-05-01

    The current water shortage in Egypt is 13.5 Billion cubic meter per year (BCM/yr) and is expected to continuously increase. Currently, this water shortage is compensated by drainage reuse which consequently deteriorates the water quality. Therefore, this research was commenced with the objective of assessing different scenarios for 2025 using the Water Evaluation and Planning (WEAP) model and by implementing different water sufficiency measures. Field data were assembled and analyzed, and different planning alternatives were proposed and tested in order to design three future scenarios. The findings indicated that water shortage in 2025 would be 26 BCM/yr in case of continuation of current policies. Planning alternatives were proposed to the irrigation canals, land irrigation timing, aquatic weeds in waterways and sugarcane areas in old agricultural lands. Other measures were suggested to pumping rates of deep groundwater, sprinkler and drip irrigation systems in new agricultural lands. Further measures were also suggested to automatic daily surveying for distribution leak and managing the pressure effectively in the domestic and industrial water distribution systems. Finally, extra measures for water supply were proposed including raising the permitted withdrawal limit from deep groundwater and the Nubian aquifer and developing the desalination resource. The proposed planning alternatives would completely eliminate the water shortage in 2025.

  1. Sports concussion assessment and management: future research directions.

    PubMed

    McCrea, Michael; Broshek, Donna K; Barth, Jeffrey T

    2015-01-01

    Over the past 2 decades, major progress has been achieved toward advancing the translational science of sport-related concussion (SRC), paving the way for evidence-based guidelines for injury diagnosis, evaluation and management. Several key empirical questions on the basic and clinical science of SRC, however, remain unanswered. The aim of this summary article is to highlight gaps in the existing science of SRC and to propose a platform for the next generation of SRC research. The article is framed around addressing two key questions that have major significance to protecting the health and safety of athletes affected by SRC, including: (a) Who is at risk of slow recovery or poor outcome after SRC, and why? (b) How does one modify the risks of slow recovery and poor outcome after SRC? Another aim of this article is to stimulate thought among researchers who will carry the science of SRC into the future, including neuropsychology leaders in the field. Implications for the broader science of traumatic brain injury are also discussed.

  2. Oral Cavity Carcinoma: Current Management, Controversies, and Future Directions.

    PubMed

    Chinn, Steven B; Myers, Jeffrey N

    2015-10-10

    Oral cavity carcinoma (OCC) remains a major cause of morbidity and mortality in patients with head and neck cancer. Although the incidence has decreased over the last decade, outcomes remain stagnant with only a 5% improvement in overall survival in the last 20 years. Although surgical resection remains the primary treatment modality, several areas of controversy exist with regard to work-up, management of the primary and neck tumors, and adjuvant therapy. As surgical techniques evolve, so has the delivery of radiotherapy and systemic treatment, which have helped to improve the outcomes for patients with advanced disease. Recently, the addition of cetuximab has shown promise as a way to improve outcomes while minimizing toxicity, and this remains an active area of study in the adjuvant setting. Advances in microvascular free-flap reconstruction have extended the limits of resection and enabled enhanced restoration of function and cosmesis. While these advances have led to limited survival benefit, evaluation of alternative modalities has gained interest on the basis of success in other head and neck subsites. Organ preservation with definitive chemoradiotherapy, though proven in the larynx and pharynx, remains controversial in OCC. Likewise, although the association of human papillomavirus is well established in oropharyngeal carcinoma, it has not been proven in the pathogenesis or survival of OCC. Future study of the molecular biology and pathogenesis of OCC should offer additional insight into screening, treatment selection, and novel therapeutic approaches.

  3. Water management in Egypt for facing the future challenges.

    PubMed

    Omar, Mohie El Din M; Moussa, Ahmed M A

    2016-05-01

    The current water shortage in Egypt is 13.5 Billion cubic meter per year (BCM/yr) and is expected to continuously increase. Currently, this water shortage is compensated by drainage reuse which consequently deteriorates the water quality. Therefore, this research was commenced with the objective of assessing different scenarios for 2025 using the Water Evaluation and Planning (WEAP) model and by implementing different water sufficiency measures. Field data were assembled and analyzed, and different planning alternatives were proposed and tested in order to design three future scenarios. The findings indicated that water shortage in 2025 would be 26 BCM/yr in case of continuation of current policies. Planning alternatives were proposed to the irrigation canals, land irrigation timing, aquatic weeds in waterways and sugarcane areas in old agricultural lands. Other measures were suggested to pumping rates of deep groundwater, sprinkler and drip irrigation systems in new agricultural lands. Further measures were also suggested to automatic daily surveying for distribution leak and managing the pressure effectively in the domestic and industrial water distribution systems. Finally, extra measures for water supply were proposed including raising the permitted withdrawal limit from deep groundwater and the Nubian aquifer and developing the desalination resource. The proposed planning alternatives would completely eliminate the water shortage in 2025. PMID:27222745

  4. Water management in Egypt for facing the future challenges

    PubMed Central

    Omar, Mohie El Din M.; Moussa, Ahmed M.A.

    2016-01-01

    The current water shortage in Egypt is 13.5 Billion cubic meter per year (BCM/yr) and is expected to continuously increase. Currently, this water shortage is compensated by drainage reuse which consequently deteriorates the water quality. Therefore, this research was commenced with the objective of assessing different scenarios for 2025 using the Water Evaluation and Planning (WEAP) model and by implementing different water sufficiency measures. Field data were assembled and analyzed, and different planning alternatives were proposed and tested in order to design three future scenarios. The findings indicated that water shortage in 2025 would be 26 BCM/yr in case of continuation of current policies. Planning alternatives were proposed to the irrigation canals, land irrigation timing, aquatic weeds in waterways and sugarcane areas in old agricultural lands. Other measures were suggested to pumping rates of deep groundwater, sprinkler and drip irrigation systems in new agricultural lands. Further measures were also suggested to automatic daily surveying for distribution leak and managing the pressure effectively in the domestic and industrial water distribution systems. Finally, extra measures for water supply were proposed including raising the permitted withdrawal limit from deep groundwater and the Nubian aquifer and developing the desalination resource. The proposed planning alternatives would completely eliminate the water shortage in 2025. PMID:27222745

  5. Current Management of Alcoholic Hepatitis and Future Therapies

    PubMed Central

    Saberi, Behnam; Dadabhai, Alia S.; Jang, Yoon-Young; Gurakar, Ahmet; Mezey, Esteban

    2016-01-01

    Abstract Alcohol is one of the most common etiologies of liver disease, and alcoholic liver disease overall is the second most common indication for liver transplantation in the United States. It encompasses a spectrum of disease, including fatty liver disease, alcoholic hepatitis (AH), and alcoholic cirrhosis. AH can range from mild to severe disease, with severe disease being defined as: Discriminant Function (DF) ≥ 32, or Model for End-stage Liver Disease (MELD) ≥ 21, or presence of hepatic encephalopathy. Management of the mild disease consists mainly of abstinence and supportive care. Severe AH is associated with significant mortality. Currently, there is no ideal medical treatment for this condition. Besides alcohol cessation, corticosteroids have been used with conflicting results and are associated with an inherent risk of infection. Overall steroids have shown short term benefit when compared to placebo, but they have no obvious long term benefits. Pentoxifylline does not improve survival in patients with severe AH and is no longer recommended based on the results of the STOPAH (Steroid Or Pentoxifylline for Alcoholic Hepatitis) trial. Anti-tumor necrosis factor (TNF) agents are associated with increased risk of life threatening infections and death. Currently, early stage trials are underway, mainly targeting novel pathways based on disease pathogenesis, including modulation of innate immune system, inhibition of gut-liver axis and cell death pathways, and activation of transcription factor farnesyl X receptor (FXR). Future treatment may lie in human induced pluripotent stem cell (iPSC) technology, which is currently under investigation for the study of pathogenesis, drug discovery, and stem cell transplantation. Liver transplantation has been reported with good results in highly selected patients but is controversial due to limited organ supply. PMID:27350941

  6. Case Management in Community Corrections: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

    2012-01-01

    Case management is commonly regarded as the foundation of effective service provision across a wide range of human service settings. This article considers the case management that is offered to clients of community corrections, identifying the distinctive features of case management in this particular setting, and reviewing the empirical evidence…

  7. The Future of Management as Design: A Thought Experiment

    ERIC Educational Resources Information Center

    Bouchard, Veronique; del Forno, Leon

    2012-01-01

    Purpose: Management practices and education are presently in a stage of reappraisal and a growing number of scholars and experts are suggesting that managers should be taught and adopt the approach and methodologies of designers. The purpose of this paper is to imagine the impact of this move and to try and foresee whether "management as design"…

  8. Preparing Future Leaders: Project Management Strategies for Service Learning

    ERIC Educational Resources Information Center

    Munger, Roger; Gutowski, Amanda

    2008-01-01

    This article makes a case for teaching project management strategies in service-learning courses. The authors describe three specific documents students can create to help them manage a service-learning project and then present strategies that can help students manage their project teams. Such skills, the authors argue, provide the tools students…

  9. Meeting future information needs for Great Lakes fisheries management

    USGS Publications Warehouse

    Christie, W.J.; Collins, John J.; Eck, Gary W.; Goddard, Chris I.; Hoenig, John M.; Holey, Mark; Jacobson, Lawrence D.; MacCallum, Wayne; Nepszy, Stephen J.; O'Gorman, Robert; Selgeby, James

    1987-01-01

    Description of information needs for management of Great Lakes fisheries is complicated by recent changes in biology and management of the Great Lakes, development of new analytical methodologies, and a transition in management from a traditional unispecies approach to a multispecies/community approach. A number of general problems with the collection and management of data and information for fisheries management need to be addressed (i.e. spatial resolution, reliability, computerization and accessibility of data, design of sampling programs, standardization and coordination among agencies, and the need for periodic review of procedures). Problems with existing data collection programs include size selectivity and temporal trends in the efficiency of fishing gear, inadequate creel survey programs, bias in age estimation, lack of detailed sea lamprey (Petromyzon marinus) wounding data, and data requirements for analytical techniques that are underutilized by managers of Great Lakes fisheries. The transition to multispecies and community approaches to fisheries management will require policy decisions by the management agencies, adequate funding, and a commitment to develop programs for collection of appropriate data on a long-term basis.

  10. Educating Future Therapists about the Controversy Surrounding Managed Behavioral Healthcare.

    ERIC Educational Resources Information Center

    Chambliss, Catherine

    The mental health care delivery system is undergoing a metamorphosis of unprecedented proportion as managed care covers more and more patients. This dramatic change has its critics (many mental health professionals) and its enthusiastics (the managed behavioral health care companies). Some of these issues are presented in this paper. There is…

  11. 17 CFR 1.11 - Risk Management Program for futures commission merchants.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Risk Management Program for... Reporting Requirements § 1.11 Risk Management Program for futures commission merchants. (a) Applicability... connection therewith, other than for risk management purposes; and (iii) Any personnel exercising...

  12. Product line management: its meaning and future promise.

    PubMed

    Salter, V

    1986-05-01

    The concept of product line management has recently drawn much attention in the health care field. The impetus has come from both marketing and accounting professionals as they have sought to find solutions to identified problems. Examined here are the roots of product line management, the reasons for the growth in the application of the concept in health care, and whether it promises to solve the problems faced by health care organizations in the current highly competitive environment.

  13. What Is the Future of Electronic Resource Management Systems?

    ERIC Educational Resources Information Center

    Tijerina, Bonnie; King, Douglas

    2008-01-01

    In a time of constant change, sometimes it is worthwhile to ruminate on the future and how things ought to be. "Journal of Electronic Resources Librarianship" wanted to capture some of these ruminations from around the field in a new column called "E-Opinions from the Field" where readers are asked to send in their thoughts on a topic and respond…

  14. Managing immune diseases in the smartphone era: how have apps impacted disease management and their future?

    PubMed

    Gallagher, Joe; O'Donoghue, John; Car, Josip

    2015-04-01

    Immunology, similar to other areas of clinical science, is a data-rich discipline that involves a great deal of interaction between healthcare professionals and their patients. The focus of this editorial is to review the challenges and opportunities for mobile healthcare applications within immunology. It is clear that further research is required to fully maximize the potential of mobile apps (e.g., regulations and guidelines, electronic health). However, it is equally clear that mobile healthcare applications have had a positive impact on patient outcomes (better response rates, more efficient usage of time and more accurate diagnosis). Overall, healthcare applications have a fundamental role to play in the future management of diseases as they will help to ensure that we deliver more effective patient care.

  15. Training future surgeons for management roles: the resident-surgeon-manager conference.

    PubMed

    Hanna, Waël C; Mulder, David S; Fried, Gerald M; Elhilali, Mostafa; Khwaja, Kosar A

    2012-10-01

    have the responsibility of preparing their residents for leadership and managerial roles in their future careers. An annual seminar serves as a starting point that could be built on for incorporating formal management training in surgical residency curricula.

  16. Education and training of future wetland scientists and managers

    USGS Publications Warehouse

    Wilcox, D.A.

    2008-01-01

    Wetland science emerged as a distinct discipline in the 1980s. In response, courses addressing various aspects of wetland science and management were developed by universities, government agencies, and private firms. Professional certification of wetland scientists began in the mid-1990s to provide confirmation of the quality of education and experience of persons involved in regulatory, management, restoration/construction, and research involving wetland resources. The education requirements for certification and the need for persons with specific wetland training to fill an increasing number of wetland-related positions identified a critical need to develop curriculum guidelines for an undergraduate wetland science and management major for potential accreditation by the Society of Wetland Scientists. That proposed major contains options directed toward either wetland science or management. Both options include required basic courses to meet the general education requirements of many universities, required upper-level specialized courses that address critical aspects of physical and biological sciences applicable to wetlands, and a minimum of four additional upper-level specialized courses that can be used to tailor a degree to students' interests. The program would be administered by an independent review board that would develop guidelines and evaluate university applications for accreditation. Students that complete the required coursework will fulfill the education requirements for professional wetland scientist certification and possess qualifications that make them attractive candidates for graduate school or entry-level positions in wetland science or management. Universities that offer this degree program could gain an advantage in recruiting highly qualified students with an interest in natural resources. Alternative means of educating established wetland scientists are likewise important, especially to provide specialized knowledge and experience or

  17. Future Urbanization and the Management of Urban Heat Risk

    NASA Astrophysics Data System (ADS)

    Marcotullio, P. J.

    2015-12-01

    We present urbanization scenarios that identify a range of urban population estimates to 2100 on a global spatial grid. We associate these data with model outputs that estimate future temperature using IPCC RCP8.5 scenarios for 2030, 2050, 2070 and 2080 using minimum, maximum and mean urban population per grid cell exposure to average summer temperatures of > 35° C to identify national, regional and global totals. After an examination of urban extreme heat morbidity and mortality trends we review the range of policies (across sectors such as energy, buildings, health and hospitals, water supply, transportation, etc.,) with particular emphasis on knowledge from different sources, technologies and experiences - including indigenous knowledge systems, currently deployed in cities around the world that respond to this threat. Finally, we identify potential synergies, trade-offs and maladaptations in urban adaptation responses to extreme heat given estimated future population exposure.

  18. Primary Sclerosing Cholangitis: Current and Future Management Strategies

    PubMed Central

    Eaton, John E.; Talwalkar, Jayant A.

    2013-01-01

    Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease. The etiology of this disorder is unknown and there are no effective medical therapies. PSC is associated with inflammatory bowel disease and an increased risk for hepatobiliary and colorectal malignancies. The aim of this review is to highlight the clinical features and diagnostic approach to patients with suspected PSC, characterize associated comorbidities, review screening strategies for PSC associated malignancies and review contemporary and future therapies. PMID:23682242

  19. Managing electricity reliability risk through the futures markets

    SciTech Connect

    Siddiqui, Afzal S.

    2000-10-01

    In competitive electricity markets, the vertically integrated utilities that were responsible for ensuring system reliability in their own service territories, or groups of territories, often cease to exist. Typically, the burden falls to an independent system operator (ISO) to insure that enough ancillary services (AS) are available for safe, stable, and reliable operation of the grid, typically defined, in part, as compliance with officially approved engineering specifications for minimum levels of AS. In order to characterize the behavior of market participants (generators, retailers, and an ISO) in a competitive electricity market with reliability requirements, we model a spot market for electricity and futures markets for both electricity and AS. By assuming that each participant seeks to maximize its expected utility of wealth and that all markets clear, we solve for the optional quantities of electricity and AS traded in each market by all participants, as well as the corresponding market-clearing prices. We show that future prices for both electricity and AS depend on expectations of the spot price, statistical aspects of system demand, and production cost parameters. More important, our model captures the fact that electricity and AS are substitute products for the generators, implying that anticipated changes in the spot market will affect the equilibrium futures positions of both electricity and AS. We apply our model to the California electricity and AS markets to test its viability.

  20. WATERSHED MANAGEMENT ON THE PAJARITO PLATEAU: PAST, PRESENT, AND FUTURE

    SciTech Connect

    K. MULLEN; K. BITNER

    2001-01-01

    Los Alamos National Laboratory (LANL) developed a draft watershed-management plan that pertains to the 43-mi{sup 2} area within the LANL boundaries. The watershed-management plan was started in 1996 with a number of overall goals: (1) to be a good steward of the natural resources entrusted to the laboratory, (2) to provide long-term evaluation regarding success of the Environmental Restoration Project in acceptably cleaning up sites, (3) compliance with the storm water National Pollution Discharge Elimination System program, and (4) upgrading the LANL environmental surveillance program that has been ongoing since the 1940s. LANL has an extensive network consisting of 53 surface-water-monitoring stations located in every major canyon, upstream and downstream of LANL, and at most confluences. Monitoring of the network has been ongoing for about 20 years. The stations are equipped with ultrasonic transducers that trip automated samplers to collect water samples from every flow event. These data have been reported every year in the report series Environmental Surveillance at Los Alamos, but have not been used to analyze watershed health. The focus of the LANL watershed-management plan is to use water quality data to monitor watershed health and to implement management actions when LANL activities, past or present, adversely impact the health of the watershed.

  1. Educators and Resource Managers: A Partnership with a Future.

    ERIC Educational Resources Information Center

    Schafer, Rudolph J. H.

    This document addresses the need for educators and natural resource management personnel to work together in developing environmental education programs. The goals suggested for such programs include: (1) providing each individual with the ability to develop a lifestyle which is compatible with a healthy and productive ecosystem; and (2)…

  2. Navy Computer Managed Instruction: Past, Present, and Future.

    ERIC Educational Resources Information Center

    Hansen, Duncan N.; And Others

    The Navy computer-managed instruction system (Navy CMI) is a large, multi-site operation. Research findings show that it is yielding benefits in terms of cost savings. During fiscal year 1975, savings of over ten million dollars were realized, mostly due to course reductions ranging from 24 to 80 percent and reductions in on-board students. It has…

  3. Detecting biological responses to flow management: Missed opportunities; future directions

    USGS Publications Warehouse

    Souchon, Y.; Sabaton, C.; Deibel, R.; Reiser, D.; Kershner, J.; Gard, M.; Katopodis, C.; Leonard, P.; Poff, N.L.; Miller, W.J.; Lamb, B.L.

    2008-01-01

    The conclusions of numerous stream restoration assessments all around the world are extremely clear and convergent: there has been insufficient appropriate monitoring to improve general knowledge and expertise. In the specialized field of instream flow alterations, we consider that there are several opportunities comparable to full-size experiments. Hundreds of water management decisions related to instream flow releases have been made by government agencies, native peoples, and non-governmental organizations around the world. These decisions are based on different methods and assumptions and many flow regimes have been adopted by formal or informal rules and regulations. Although, there have been significant advances in analytical capabilities, there has been very little validation monitoring of actual outcomes or research related to the response of aquatic dependent species to new flow regimes. In order to be able to detect these kinds of responses and to better guide decision, a general design template is proposed. The main steps of this template are described and discussed, in terms of objectives, hypotheses, variables, time scale, data management, and information, in the spirit of adaptive management. The adoption of such a framework is not always easy, due to differing interests of actors for the results, regarding the duration of monitoring, nature of funding and differential timetables between facilities managers and technicians. Nevertheless, implementation of such a framework could help researchers and practitioners to coordinate and federate their efforts to improve the general knowledge of the links between the habitat dynamics and biological aquatic responses. Copyright ?? 2008 John Wiley & Sons, Ltd.

  4. The Future of Management Education in Australia: Challenges and Innovations

    ERIC Educational Resources Information Center

    Hall, Richard; Agarwal, Renu; Green, Roy

    2013-01-01

    Purpose -- The purpose of this paper is to undertake a survey of the external and internal forces changing the nature of business schools and business education. It aims to investigate how management education responds to increasing productivity, innovation and capability challenges, examine how MBA programs currently meet these demands, and how…

  5. Women in Management: Leadership Theories, Research Results, and Future Directions.

    ERIC Educational Resources Information Center

    Putnam, Linda L.

    This review of the literature about women in management advocates the pursuit of research on women executives as unique components in the organizational setting, with the warning that careful and unremitting attention be paid to the selection of theoretical perspectives. It examines trait and role theory, and discusses such factors as…

  6. Business Administration and Management: Current Trends and Future Directions.

    ERIC Educational Resources Information Center

    Flewellen, William C., Jr.

    Drawing from site visits to 39 public and private colleges in Massachusetts, this report presents an evaluation of college programs in business administration and management and recommendations for improvement. Section 1 provides an overview of the statewide study and its findings. After identifying the colleges visited and the members of the…

  7. Plan Your Future! Career Management Skills for Students of Languages

    ERIC Educational Resources Information Center

    Randall, Laurence

    2016-01-01

    At the University of Westminster, the Department of Modern Languages and Cultures has developed a student employability and work-integrated learning project, "Career Management Skills" (CMS), for undergraduate language students. The main objective was to develop a comprehensive employability strategy for all students on all undergraduate…

  8. Future space transportation requirements for the management of orbital debris

    NASA Technical Reports Server (NTRS)

    Petro, Andrew J.; Loftus, Joseph P., Jr.

    1989-01-01

    Launch vehicle upper stages continue to contribute to future orbital debris scenarios whenever they undergo explosive propulsion system failures, as well as by remaining on orbit as potential collision targets for smaller orbiting bodies. No active measures have been instituted to date in order to remove nonfunctional satellites or spent rocket stages from earth orbit; they are nevertheless conceivable, and classifiable as (1) orbital-maneuvering retrieval; (2) self-disposal; and (3) propulsive deorbit or atmospheric drag augmentation. Illustrative cases and parametric assessments of these methods' feasibility and cost are presented.

  9. Clinical management of dilated cardiomyopathy: current knowledge and future perspectives.

    PubMed

    Merlo, Marco; Cannatá, Antonio; Vitagliano, Alice; Zambon, Elena; Lardieri, Gerardina; Sinagra, Gianfranco

    2016-01-01

    Dilated cardiomyopathy (DCM) is a primary heart muscle disease characterized by a progressive dilation and dysfunction of either the left or both ventricles. The management of DCM is currently challenging for clinicians. The persistent lack of knowledge about the etiology and pathophysiology of this disease continues to determine important fields of uncertainty in managing this condition. Molecular cardiology and genetics currently represent the most crucial horizon of increasing knowledge. Understanding the mechanisms underlying the disease allows clinicians to treat this disease more effectively and to further improve outcomes of DCM patients through advancements in etiologic characterization, prognostic stratification and individualized therapy. Left ventricular reverse remodeling predicts a lower rate of major cardiac adverse events independently from other factors. Optimized medical treatment and device implantation are pivotal in inducing left ventricular reverse remodeling. Newly identified targets, such as angiotensin-neprilysin inhibition, phosphodiesterase inhibition and calcium sensitizing are important in improving prognosis in patients affected by DCM.

  10. Towards "DRONE-BORNE" Disaster Management: Future Application Scenarios

    NASA Astrophysics Data System (ADS)

    Tanzi, Tullio Joseph; Chandra, Madhu; Isnard, Jean; Camara, Daniel; Sebastien, Olivier; Harivelo, Fanilo

    2016-06-01

    Information plays a key role in crisis management and relief efforts for natural disaster scenarios. Given their flight properties, UAVs (Unmanned Aerial Vehicles) provide new and interesting perspectives on the data gathering for disaster management. A new generation of UAVs may help to improve situational awareness and information assessment. Among the advantages UAVs may bring to the disaster management field, we can highlight the gain in terms of time and human resources, as they can free rescue teams from time-consuming data collection tasks and assist research operations with more insightful and precise guidance thanks to advanced sensing capabilities. However, in order to be useful, UAVs need to overcome two main challenges. The first one is to achieve a sufficient autonomy level, both in terms of navigation and interpretation of the data sensed. The second major challenge relates to the reliability of the UAV, with respect to accidental (safety) or malicious (security) risks. This paper first discusses the potential of UAV in assisting in different humanitarian relief scenarios, as well as possible issues in such situations. Based on recent experiments, we discuss the inherent advantages of autonomous flight operations, both lone flights and formation flights. The question of autonomy is then addressed and a secure embedded architecture and its specific hardware capabilities is sketched out. We finally present a typical use case based on the new detection and observation abilities that UAVs can bring to rescue teams. Although this approach still has limits that have to be addressed, technically speaking as well as operationally speaking, it seems to be a very promising one to enhance disaster management efforts activities.

  11. Conflict Detection and Resolution for Future Air Transportation Management

    NASA Technical Reports Server (NTRS)

    Krozel, Jimmy; Peters, Mark E.; Hunter, George

    1997-01-01

    With a Free Flight policy, the emphasis for air traffic control is shifting from active control to passive air traffic management with a policy of intervention by exception. Aircraft will be allowed to fly user preferred routes, as long as safety Alert Zones are not violated. If there is a potential conflict, two (or more) aircraft must be able to arrive at a solution for conflict resolution without controller intervention. Thus, decision aid tools are needed in Free Flight to detect and resolve conflicts, and several problems must be solved to develop such tools. In this report, we analyze and solve problems of proximity management, conflict detection, and conflict resolution under a Free Flight policy. For proximity management, we establish a system based on Delaunay Triangulations of aircraft at constant flight levels. Such a system provides a means for analyzing the neighbor relationships between aircraft and the nearby free space around air traffic which can be utilized later in conflict resolution. For conflict detection, we perform both 2-dimensional and 3-dimensional analyses based on the penetration of the Protected Airspace Zone. Both deterministic and non-deterministic analyses are performed. We investigate several types of conflict warnings including tactical warnings prior to penetrating the Protected Airspace Zone, methods based on the reachability overlap of both aircraft, and conflict probability maps to establish strategic Alert Zones around aircraft.

  12. Control of Future Air Traffic Systems via Complexity Bound Management

    NASA Technical Reports Server (NTRS)

    Alexandrov, Natalia

    2013-01-01

    The complexity of the present system for managing air traffic has led to "discreteness" in approaches to creating new concepts: new concepts are created as point designs, based on experience, expertise, and creativity of the proposer. Discrete point designs may be highly successful but they are difficult to substantiate in the face of equally strong substantiation of competing concepts, as well as the state of the art in concept evaluation via simulations. Hybrid concepts may present a compromise - the golden middle. Yet a hybrid of sometimes in principle incompatible concepts forms another point design that faces the challenge of substantiation and validation. We are faced with the need to re-design the air transportation system ab initio. This is a daunting task, especially considering the problem of transitioning from the present system to any fundamentally new system. However, design from scratch is also an opportunity to reconsider approaches to new concept development. In this position paper we propose an approach, Optimized Parametric Functional Design, for systematic development of concepts for management and control of airspace systems, based on optimization formulations in terms of required system functions and states. This reasoning framework, realizable in the context of ab initio system design, offers an approach to deriving substantiated airspace management and control concepts. With growing computational power, we hope that the approach will also yield a methodology for actual dynamic control of airspace

  13. Leadership succession planning: an evidence-based approach for managing the future.

    PubMed

    Redman, Richard W

    2006-06-01

    Leadership succession planning is a key business strategy to help organizational leaders deal effectively with the future. Evidence from industry provides a variety of best practices that can ensure that a pipeline of leaders will be available when they are needed. The author addresses the essential needs that individuals face when developing a cadre of available leaders prepared for managing an uncertain future.

  14. Diversity in engineering: managing the workforce of the future

    SciTech Connect

    Layne, Peggy; Arenberg, Carol

    2002-07-03

    On October 29-30, 2001, the National Academy of Engineering Committee on Diversity in the Engineering Workforce brought together representatives of corporations that have been recognized for their successful diversity programs and members of the NAE Forum on Diversity to participate in a workshop entitled ''Best Practices in Managing Diversity''. The purpose of the workshop was to identify and describe corporate programs that have successfully recruited, retained, and advanced women and minorities in engineering careers and to discuss metrics by which to evaluate diversity programs.

  15. An Information Management System for CHIKYU Operation and its Future

    NASA Astrophysics Data System (ADS)

    Kuramoto, S.; Matsuda, S.; Ito, H.

    2005-12-01

    The CDEX (Center for Deep Earth Exploration, JAMSTEC) is an implementing organization of a riser drilling vessel, CHIKYU ("Earth"). CHIKYU has a large capability to produce a wide variety of data, core measurement data, logging data, mud logging data, cuttings data and monitoring data in boreholes, etc. Also CDEX conducts site survey for safety drilling and publication before and after cruises. It is critical that these diverse data be managed using a unified, coherent method, and that they be organized and provided to users in an intuitive, clearly understandable way that reflects the aims and underlying philosophies of the IODP and JAMSTEC. It is crucial that these data are accessible to users through an integrated interface in which all data formats, management tools, and procedures are standardized. Meeting these goals will assure total usability for scientists, administrators, and the public, from data creation to uploading and cataloging, to end use and publication. CDEX is developing an integrated information management system, call "SIO7" (Scientific Information from 7 Oceans) for CHIKYU operation, and would like to extend to adopt various information handling systems in geosciences. The SIO7 composed of 2 major systems, J-CORES (JAMSTEC Core Systematics) and DEXIS (Deep Earth Exploration Information System) (see http://sio7.jamstec.go.jp/ for the details). J-CORES is a database system designated to manage all aspects of core data. The system is modeled on the JANUS system developed by and for ODP, but implements an extended, somewhat modified data model. The functions that support onboard and real time data input operations have also been strengthened. A variety of data visualization and visual core description functions have been added, and data loading from those applications has been automated, making the system as a whole both powerful and easy to use. On the other hand, DEXIS is developed based on the combination and integration of existing off

  16. Breast cancer survivorship symptom management: current perspective and future development

    PubMed Central

    van Londen, G; Beckjord, EB; Dew, MA; Cuijpers, P; Tadic, S; Brufsky, A

    2013-01-01

    SUMMARY Increasing numbers and longevity of cancer survivors has furthered our insight into the factors affecting their health outcomes, suggesting that multiple factors play a role (e.g., effects of cancer treatments and health behaviors). Emotional and physical symptoms may not always receive sufficient attention. In this short narrative review highlighting recent literature, we describe the most common physical and emotional symptoms of breast cancer survivors aged 50 years and older and outline a multidisciplinary symptom management approach, regardless of symptom etiology. PMID:23814614

  17. Management of Dynamic Biomedical Terminologies: Current Status and Future Challenges

    PubMed Central

    Dos Reis, J. C.; Pruski, C.

    2015-01-01

    Summary Objectives Controlled terminologies and their dependent artefacts provide a consensual understanding of a domain while reducing ambiguities and enabling reasoning. However, the evolution of a domain’s knowledge directly impacts these terminologies and generates inconsistencies in the underlying biomedical information systems. In this article, we review existing work addressing the dynamic aspect of terminologies as well as their effects on mappings and semantic annotations. Methods We investigate approaches related to the identification, characterization and propagation of changes in terminologies, mappings and semantic annotations including techniques to update their content. Results and conclusion Based on the explored issues and existing methods, we outline open research challenges requiring investigation in the near future. PMID:26293859

  18. Low Anterior Resection Syndrome: Current Management and Future Directions.

    PubMed

    Ridolfi, Timothy J; Berger, Nicholas; Ludwig, Kirk A

    2016-09-01

    Outcomes for rectal cancer surgery have improved significantly over the past 20 years with increasing rates of survival and recurrence, specifically local recurrence. These gains have been realized during a period of time in which there has been an increasing emphasis on sphincter preservation. As we have become increasingly aggressive in avoiding resection of the anus, we have begun accepting bowel dysfunction as a normal outcome. Low anterior resection syndrome, defined as a constellation of symptoms including incontinence, frequency, urgency, or feelings of incomplete emptying, has a significant impact on quality of life and results in many patients opting for a permanent colostomy to avoid these symptoms. In this article, we will highlight the most recent clinical and basic science research on this topic and discuss areas of future investigation. PMID:27582649

  19. Future directions for the management of pain in osteoarthritis

    PubMed Central

    Sofat, Nidhi; Kuttapitiya, Anasuya

    2014-01-01

    Osteoarthritis (OA) is the predominant form of arthritis worldwide, resulting in a high degree of functional impairment and reduced quality of life owing to chronic pain. To date, there are no treatments that are known to modify disease progression of OA in the long term. Current treatments are largely based on the modulation of pain, including NSAIDs, opiates and, more recently, centrally acting pharmacotherapies to avert pain. This review will focus on the rationale for new avenues in pain modulation, including inhibition with anti-NGF antibodies and centrally acting analgesics. The authors also consider the potential for structure modification in cartilage/bone using growth factors and stem cell therapies. The possible mismatch between structural change and pain perception will also be discussed, introducing recent techniques that may assist in improved patient phenotyping of pain subsets in OA. Such developments could help further stratify subgroups and treatments for people with OA in future. PMID:25018771

  20. Management of Hepatocellular Carcinoma: Current Status and Future Directions

    PubMed Central

    Au, Jennifer S.; Frenette, Catherine T.

    2015-01-01

    Hepatocellular carcinoma (HCC) is the second most common cause of cancer death worldwide. This cancer commonly arises against a background of chronic liver disease. As a result, a patient with HCC requires multidisciplinary care. Treatment options vary widely based on tumor burden and metastases. The most widely utilized staging system is the Barcelona Clinic Liver Cancer staging system, which recommends treatments based on tumor size and the underlying liver disease and functional status of the patient. Treatment options range from surgical resection or transplantation to locoregional therapies with modalities such as radiofrequency ablation and transarterial chemoembolization to systemic chemotherapies. Future care involves the development of combination therapies that afford the best tumor response, further clarification of the patients best suited for therapies and the development of new oral chemotherapeutic agents. PMID:26087860

  1. California Groundwater Management During Drought: Existing and Future Regulatory Approaches

    NASA Astrophysics Data System (ADS)

    Ekdahl, E.; Boland-Brien, S.; Vanderburgh, B.; Landau, K.; Bean, J.; Peltier, T.

    2015-12-01

    Groundwater has served as an effective buffer to California's crippling drought of 2012-2015, allowing continued agricultural production in many areas where surface water deliveries have been curtailed. However, over-reliance on groundwater has caused plummeting groundwater levels in much of the state's heavily agricultural regions, with annual groundwater overdraft state-wide estimated in the millions of acre-feet per year. Prior to 2015, California water law did not allow for the effective monitoring or assessment of groundwater use; passage of new state regulations will require development of locally-managed plans that, for the first time, require comprehensive groundwater management and groundwater basin sustainability. Because these plans are not required to be implemented for another 25 years, groundwater levels will likely continue to decrease. Some communities that are 100-percent reliant on groundwater as a source of municipal supply may face shortages and supply issues, which may exacerbate known water quality concerns. Examination of community water systems that are reliant on groundwater, their existing water quality issues, and their response to the current drought (through existing mandatory conservation requirements imposed by California state regulators) can identify areas that are particularly susceptible to continued groundwater overdraft.

  2. Alternative futures for health economics: implications for nursing management.

    PubMed

    Mannion, Russell; Small, Neil; Thompson, Carl

    2005-09-01

    As nursing has been subject to successive waves of 'managerialism' there has been a drive on the part of government and elements within the profession to enhance the science base and promote cost-effective health care interventions. This has generated new interest in the 'economics of nursing' as efficiency and 'value for money' are viewed as necessary precondition for the provision of a high quality nursing service. As an academic subject health economics has brought an elegant set of theories to bear on the topic of health and health care. However, mainstream health economics is premised on a series of simplifying assumptions that, if applied uncritically, can induce a range of unintended and adverse consequences. This paper asks how ideas developed in one sphere (health economics) can be become influential in another (nursing management and practice) and it seeks explanations in the theories of Michel Foucault, specifically in his exploration of the reciprocal relationship between power and knowledge. How are our assumptions about what is possible and desirable shaped, how far do mechanisms of surveillance and self-subjugation extend? A range of alternative economic approaches have been developed which challenge many mainstream health economics assumptions. Some of these are better suited to the complex social environment present within health care. Nurses, nurse managers and researchers should question the assumptions of dominant economic models and explore a range of economic frameworks when planning services and evaluating their practice. PMID:16108775

  3. Managers' perceptions of radiographers' skills: current and future needs.

    PubMed

    Akroyd, D; Wold, B

    1996-01-01

    As the healthcare delivery system changes, it is imperative to assess the skills of practitioners to ensure consistency between educational preparation and work place needs. The purpose of this study was to examine radiology managers' perception of selected workplace skills and new radiography graduates' ability to perform them. A random sample of 1,932 members of the American Healthcare Radiology Administrators (AHRA) received a questionnaire containing 35 skills categorized as basic, intermediate or advanced. Skills were ranked by the magnitude of the difference between managers' rating of importance of each skill and their rating of graduates' ability to perform that skill satisfactorily. In the basic skill area, the four top-ranked skills represented problem-solving ability or critical thinking. Of the five highest-ranked intermediate skills, the top three were patient care skills: venipuncture, taking vital signs and monitoring patient equipment. In the advanced skill area, six skills exhibited high values for the difference between importance and ability. Two of those related to patient care, three were non-technical and the sixth was the ability to perform CT in addition to basic radiography. Employers and educators should work together to seek educational methods that produce radiographers who are better prepared for the fast-changing workplace.

  4. HACCP models for quality control of entrée production in hospital foodservice systems. II. Quality assessment of beef loaves utilizing HACCP models.

    PubMed

    Bobeng, B J; David, B D

    1978-11-01

    HACCP models were developed for quality control of entrée production in three hospital foodservice systems: Conventional, cook/chill, and cook/freeze (1). The three systems were stimulated in a laboratory to evaluate the effectiveness of the HACCP models for quality control and to generate quantitative data for evaluating and comparing the quality of beef loaves produced under controlled conditions. Attributes measured were weight (yield) and microbiologic, nutritional, and sensory qualities. The only significant difference in the beef loaves among systems was sensory quality. Scores for overall acceptability of beef loaves in the conventional system were significantly greater (P less than 0.05) than for those of the cook/chill and cook/freeze systems. The HACCP models were effective quality control tools for entrée production; implementation of the HACCP system is recommended for hospital foodservices. The importance of the time-temperature critical point for monitoring control points in hospital foodservice systems is emphasized.

  5. Environmental Quality of the Pensacola Bay System: Retrospective Review for Future Resource Management and Rehabilitation

    EPA Science Inventory

    The objective of this report is to summarize the scattered environmental information for the PBS which is essential for understanding its current environmental condition and trend and needed for future cost-effective and science-based resource management. The management and regul...

  6. A Critical Appraisal of Recent Advances and Future Directions in Value Management

    ERIC Educational Resources Information Center

    Fong, Patrick Sik-Wah

    2004-01-01

    At present, value management (VM) is struggling to survive amidst other management fads. The problem is that it is still not recognized as a professional or academic discipline. There is no sound academic base and a lack of understanding by the public, owners and corporate organizations. The future survival of VM is therefore always being…

  7. AEM and NMR: Tools for the Future of Groundwater Management

    NASA Astrophysics Data System (ADS)

    Abraham, J. D.; Cannia, J. C.; Lawrie, K.

    2012-12-01

    Within the world, understanding groundwater resources and their management are growing in importance to society as groundwater resources are stressed by drought and continued development. To minimize conflicts, tools and techniques need to be applied to support knowledge-based decisions and management. Airborne electromagnetic (AEM) surveys provide high-quality subsurface data not available from any other source for building the complex hydrogeologic frameworks needed by water-resource managers for effective groundwater management. Traditionally, point data, such as borehole logs, borehole geophysics, surface geophysics, and aquifer tests were interpolated over long distances to create hydrogeologic frameworks. These methods have enjoyed a long history of being the best available technology to inform our understanding of groundwater and how it moves. The AEM techniques proivde pathway for geoscientists to follow to develop more accurate descriptions of the hydrogeological framework. However, the critical and challenging measurements in characterizing aquifers include effective porosity and hydraulic conductivity. These parameters are not reliable derived from AEM. Typically, values for effective porosity and hydraulic conductivity are derived by lithological comparisons with published data; direct measurements of hydraulic conductivity acquired by a few constant head aquifer tests or slug tests; and expensive and time consuming laboratory measurements of cores which can be biased by sampling and the difficulty of making measurements on unconsolidated materials. Aquifer tests are considered to be the best method to gather information on hydraulic conductivity but are rare because of cost and difficult logistics. Also they are unique in design and interpretation from site to site. Nuclear Magnetic Resonance (NMR) can provide a direct measurement of the presence of water in the pore space of aquifer materials. Detection and direct measurement is possible due to the

  8. Insect resistance management in GM crops: past, present and future.

    PubMed

    Bates, Sarah L; Zhao, Jian-Zhou; Roush, Richard T; Shelton, Anthony M

    2005-01-01

    Transgenic plants expressing insecticidal proteins from the bacterium Bacillus thuringiensis (Bt) were first commercialized in 1996 amid concern from some scientists, regulators and environmentalists that the widespread use of Bt crops would inevitably lead to resistance and the loss of a 'public good,' specifically, the susceptibility of insect pests to Bt proteins. Eight years later, Bt corn and cotton have been grown on a cumulative area >80 million ha worldwide. Despite dire predictions to the contrary, resistance to a Bt crop has yet to be documented, suggesting that resistance management strategies have been effective thus far. However, current strategies to delay resistance remain far from ideal. Eight years without resistance provides a timely opportunity for researchers, regulators and industry to reassess the risk of resistance and the most effective strategies to preserve Bt and other novel insect-resistant crops in development.

  9. Records Management: Preserving the Past to Make the Future

    NASA Technical Reports Server (NTRS)

    Petro, Kathryn

    2004-01-01

    As an intern in the Records Management Office at NASA, I have learned the importance of records management and teamwork. I work in building 60 with Kevin Coleman, the Records and Forms Manager and History Officer, and Deborah Demaline, the senior records specialist. Prior to my internship, I had never paid attention to records and their role in operating a business. However, after my first assignment of identifying files and filling out a C-277 form, I realized the importance of preserving each file. Since NASA is a government agency, keeping our records in a safe and easily accessible area is a major priority. As the records have accumulated over the years, and the destruction of records has been put on hold due to the fairly recent tobacco litigation; the amount of NASA s records has been quickly accumulating. Currently, our records are stored at Plum Brook in Sandusky, Ohio. Recently, rain has leaked through the bunkers and caused damage to some of our records boxes. Plum Brook has been experiencing difficulty in finding the funds to repair the damage. NASA Glenn is reluctant to give Plum Brook more money because the staff at the Sandusky site has not shown us a detailed summary of what they are doing with the funds we give them annually. Even though storing our records at Plum Brook comes with little cost, there are plenty other companies that offer a records storage area and a special software database for easy record retrieval. My assignment is to do a feasibility study on these companies to see how they compare in providing the appropriate criteria for NASA Glenn's needs. Other research I am doing is on which companies will allow us to convert our physical records into an electronic database for quicker retrieval and to eliminate the cost of storing our records in a facility altogether. The two studies have required me to not only work closely with the Records Management Department, but also the Information Technology staff. It has been important for me to

  10. Contemporary management of prosthetic valve endocarditis: principals and future outlook.

    PubMed

    O'Connor, Cormac T; Kiernan, Thomas J

    2015-05-01

    Infective endocarditis involving prosthetic valves accounts for 20% of all endocarditis cases. Rising in prevalence due to increasing placement of valvular prostheses, prosthetic valve endocarditis (PVE) is more difficult to diagnose by conventional methods, associated with more invasive infection and increased mortality. This report explores the existing literature in identifying a direct approach to the management of PVE; such as adjuncts to establishing a diagnosis (for instance positron emission tomography/computed tomography and radiolabeled leukocyte scintigraphy), the trends in specific pathogens associated with PVE and the recommended antimicrobials for each. The patterns of disease requiring surgical intervention are also highlighted and explored. In addition, a 5-year outlook offers consolidated knowledge on epidemiological trends of both culprit organisms and population subgroups suffering (and projected to suffer) from PVE.

  11. Integrated water and waste management system for future spacecraft

    NASA Technical Reports Server (NTRS)

    Ingelfinger, A. L.; Murray, R. W.

    1974-01-01

    Over 200 days of continuous testing have been completed on an integrated waste management-water recovery system developed by General Electric under a jointly funded AEC/NASA/AF Contract. The 4 man system provides urine, feces, and trash collection; water reclamation; storage, heating and dispensing of the water; storage and disposal of the feces and urine residue and all of other nonmetallic waste material by incineration. The heat required for the 1200 deg F purification processes is provided by a single 420-w radioisotope heater. A second 836-w radioisotope heater supplemented by 720 w of electrical heat provides for distillation and water heating. Significant test results are no pre-or-post treatment, greater than 98 per cent potable water recovery, approximately 95 per cent reduction in solids weight and volume, all outflows are sterile with the water having no bacteria or virus, and the radioisotope capsule radiation level is only 7.9 mrem/hr unshielded at 1 m (neutrons and gamma).

  12. Current and future management of pediatric venous thromboembolism

    PubMed Central

    Kerlin, Bryce A.

    2013-01-01

    Venous thromboembolism (VTE) is an increasingly common complication encountered in tertiary care pediatric settings. The purpose of this review is to summarize the epidemiology, current and emerging pharmacotherapeutic options, and management of this disease. Over 70% of VTE occur in children with chronic diseases. Although they are seen in children of all ages, adolescents are at greatest risk. Pediatric VTE is associated with an increased risk of in-hospital mortality; recurrent VTE and post-thrombotic syndrome are commonly seen in survivors. In recent years, anticoagulation with low molecular weight heparin has emerged as the mainstay of therapy, but compliance is limited by its onerous subcutaneous administration route. New anticoagulants either already approved for use in adults or in the pipeline offer the possibility of improved dose stability and oral routes of administration. Current recommended anticoagulation course durations are derived from very limited case series and cohort data, or extrapolations from adult literature. However, the pathophysiologic underpinnings of pediatric VTE are dissimilar from those seen in adults and are often variable within groups of pediatric patients. Clinical studies and trials in pediatric VTE are underway which will hopefully improve the quality of evidence from which therapeutic guidelines are derived. PMID:22367975

  13. Future project concerning mass disaster management: a forensic odontology prospectus.

    PubMed

    Nuzzolese, Emilio; Di Vella, Giancarlo

    2007-08-01

    The world has experienced a plethora of mass disasters in recent years: acts of terrorism, bombings, earthquakes, hurricanes, typhoons, air crashes and other transportation mishaps, not to mention armed conflicts and migrants drowned in the Mediterranean Sea. In reviewing mass disasters to date, the principal difficulties have not changed: (1) large numbers of humans fragmented, co-mingled, and burned remains; (2) difficulty in determining who was involved in the disaster; (3) acquisition of useful medical and dental records and radiographs; (4) legal, jurisdictional, organisational, and political issues; (5) internal and external documentation and communication problems; (6) application of universal human forensic identification codes. Forensic dentistry plays a major role in victim identification. DNA and dental identification of human remains depends on sufficient availability of ante mortem information, existence of sufficient post mortem material and a comparison or match between ante and post mortem details. Forensic odontology is a specialty with a specific training, and cannot simply be carried out by dentists without such training. Strategies for developing an international forensic odontology capacity and resources are needed for the management of dead bodies following a mass disaster, together with universal guidelines and codes. To this end, Interpol's forms have proved to be a good starting point to meet these requirements.

  14. Groundwater management in Cusco region, Peru Present and future challenges

    NASA Astrophysics Data System (ADS)

    Guttman, Joseph; Berger, Diego; Pumayalli Saloma, Rene

    2013-04-01

    efficiency of such irrigation systems is about 35% (most of the water recharges to the underground or is lost by evaporation). Slightly increasing the efficiency by only 10-20% together with bringing additional water would cause a dramatic change in the farmer's life and in their income. A Pre-feasibility study indicates that there are deeper subsurface groundwater systems that flow from the Andes Mountain downstream to the valleys. The deeper systems are most probably separated from the spring systems. The deeper groundwater systems are flowing from the Andes Mountains downstream via individual paths, in places where both sides of the faults contain permeable layers and through several alluvial fans. Detailed researches are planned in the next few years to identify those individual sites and to locate sites for drilling boreholes (observation and production). Today, an integrated water resources management at the local and regional level is lacking. The feasibility studies will include recommendations to the regional government on how to implement such an integrated management program together with capacity building of the institutional capability of regional governments.

  15. The sensitivity of current and future forest managers to climate-induced changes in ecological processes.

    PubMed

    Seidl, Rupert; Aggestam, Filip; Rammer, Werner; Blennow, Kristina; Wolfslehner, Bernhard

    2016-05-01

    Climate vulnerability of managed forest ecosystems is not only determined by ecological processes but also influenced by the adaptive capacity of forest managers. To better understand adaptive behaviour, we conducted a questionnaire study among current and future forest managers (i.e. active managers and forestry students) in Austria. We found widespread belief in climate change (94.7 % of respondents), and no significant difference between current and future managers. Based on intended responses to climate-induced ecosystem changes, we distinguished four groups: highly sensitive managers (27.7 %), those mainly sensitive to changes in growth and regeneration processes (46.7 %), managers primarily sensitive to regeneration changes (11.2 %), and insensitive managers (14.4 %). Experiences and beliefs with regard to disturbance-related tree mortality were found to particularly influence a manager's sensitivity to climate change. Our findings underline the importance of the social dimension of climate change adaptation, and suggest potentially strong adaptive feedbacks between ecosystems and their managers.

  16. Sustainable water management under future uncertainty with eco-engineering decision scaling

    USGS Publications Warehouse

    Poff, N LeRoy; Brown, Casey M; Grantham, Theodore; Matthews, John H; Palmer, Margaret A.; Spence, Caitlin M; Wilby, Robert L.; Haasnoot, Marjolijn; Mendoza, Guillermo F; Dominique, Kathleen C; Baeza, Andres

    2015-01-01

    Managing freshwater resources sustainably under future climatic and hydrological uncertainty poses novel challenges. Rehabilitation of ageing infrastructure and construction of new dams are widely viewed as solutions to diminish climate risk, but attaining the broad goal of freshwater sustainability will require expansion of the prevailing water resources management paradigm beyond narrow economic criteria to include socially valued ecosystem functions and services. We introduce a new decision framework, eco-engineering decision scaling (EEDS), that explicitly and quantitatively explores trade-offs in stakeholder-defined engineering and ecological performance metrics across a range of possible management actions under unknown future hydrological and climate states. We illustrate its potential application through a hypothetical case study of the Iowa River, USA. EEDS holds promise as a powerful framework for operationalizing freshwater sustainability under future hydrological uncertainty by fostering collaboration across historically conflicting perspectives of water resource engineering and river conservation ecology to design and operate water infrastructure for social and environmental benefits.

  17. Sustainable water management under future uncertainty with eco-engineering decision scaling

    NASA Astrophysics Data System (ADS)

    Poff, N. Leroy; Brown, Casey M.; Grantham, Theodore E.; Matthews, John H.; Palmer, Margaret A.; Spence, Caitlin M.; Wilby, Robert L.; Haasnoot, Marjolijn; Mendoza, Guillermo F.; Dominique, Kathleen C.; Baeza, Andres

    2016-01-01

    Managing freshwater resources sustainably under future climatic and hydrological uncertainty poses novel challenges. Rehabilitation of ageing infrastructure and construction of new dams are widely viewed as solutions to diminish climate risk, but attaining the broad goal of freshwater sustainability will require expansion of the prevailing water resources management paradigm beyond narrow economic criteria to include socially valued ecosystem functions and services. We introduce a new decision framework, eco-engineering decision scaling (EEDS), that explicitly and quantitatively explores trade-offs in stakeholder-defined engineering and ecological performance metrics across a range of possible management actions under unknown future hydrological and climate states. We illustrate its potential application through a hypothetical case study of the Iowa River, USA. EEDS holds promise as a powerful framework for operationalizing freshwater sustainability under future hydrological uncertainty by fostering collaboration across historically conflicting perspectives of water resource engineering and river conservation ecology to design and operate water infrastructure for social and environmental benefits.

  18. Conjunctive management of surface and groundwater resources under projected future climate change scenarios

    DOE PAGES

    Mani, Amir; Tsai, Frank T. -C.; Kao, Shih-Chieh; Naz, Bibi S.; Ashfaq, Moetasim; Rastogi, Deeksha

    2016-06-16

    Our study introduces a mixed integer linear fractional programming (MILFP) method to optimize conjunctive use of future surface water and groundwater resources under projected climate change scenarios. The conjunctive management model maximizes the ratio of groundwater usage to reservoir water usage. Future inflows to the reservoirs were estimated from the future runoffs projected through hydroclimate modeling considering the Variable Infiltration Capacity model, and 11 sets of downscaled Coupled Model Intercomparison Project phase 5 global climate model projections. Bayesian model averaging was adopted to quantify uncertainty in future runoff projections and reservoir inflow projections due to uncertain future climate projections. Optimizedmore » conjunctive management solutions were investigated for a water supply network in northern Louisiana which includes the Sparta aquifer. Runoff projections under climate change scenarios indicate that runoff will likely decrease in winter and increase in other seasons. Ultimately, results from the developed conjunctive management model with MILFP indicate that the future reservoir water, even at 2.5% low inflow cumulative probability level, could counterbalance groundwater pumping reduction to satisfy demands while improving the Sparta aquifer through conditional groundwater head constraint.« less

  19. Conjunctive management of surface and groundwater resources under projected future climate change scenarios

    NASA Astrophysics Data System (ADS)

    Mani, Amir; Tsai, Frank T.-C.; Kao, Shih-Chieh; Naz, Bibi S.; Ashfaq, Moetasim; Rastogi, Deeksha

    2016-09-01

    This study introduces a mixed integer linear fractional programming (MILFP) method to optimize conjunctive use of future surface water and groundwater resources under projected climate change scenarios. The conjunctive management model maximizes the ratio of groundwater usage to reservoir water usage. Future inflows to the reservoirs were estimated from the future runoffs projected through hydroclimate modeling considering the Variable Infiltration Capacity model, and 11 sets of downscaled Coupled Model Intercomparison Project phase 5 global climate model projections. Bayesian model averaging was adopted to quantify uncertainty in future runoff projections and reservoir inflow projections due to uncertain future climate projections. Optimized conjunctive management solutions were investigated for a water supply network in northern Louisiana which includes the Sparta aquifer. Runoff projections under climate change scenarios indicate that runoff will likely decrease in winter and increase in other seasons. Results from the developed conjunctive management model with MILFP indicate that the future reservoir water, even at 2.5% low inflow cumulative probability level, could counterbalance groundwater pumping reduction to satisfy demands while improving the Sparta aquifer through conditional groundwater head constraints.

  20. Environmental management practices and engineering science: a review and typology for future research.

    PubMed

    Evangelinos, Konstantinos I; Allan, Stuart; Jones, Keith; Nikolaou, Ioannis E

    2014-04-01

    Current literature describes a number of environmental management practices and cleaner production methods that facilitate different industrial sectors to address their various environmental impacts. The high number of present practices makes their use especially difficult and complicated. This paper aims to shed light on this field by providing a typology of those environmental management practices (such as environmental management systems, environmental indicators assessment methodologies, and cleaner productions methods) and their limitations. It also describes the strengths and weaknesses of using such tools and thoughts for future research.

  1. The North American Collections Inventory Project: Implications for the Future of Coordinated Management of Research Collections.

    ERIC Educational Resources Information Center

    Farrell, David; Reed-Scott, Jutta

    1989-01-01

    Describes the accomplishments of a cooperative effort to develop an online inventory of research library collections. Topics covered include the development of collection mapping tools and resources; the establishment of general requirements and policies; and the implications for the future of coordinated management of research collections. (20…

  2. From Administrative Theory and Practice to Sport and Lifestyle Management: Past, Present and Future.

    ERIC Educational Resources Information Center

    Moriarty, Dick

    The field of sport and lifestyle management (SLM) includes three major eras which parallel cycles of conflict or stages of growth, development, and decline outlined in research. A review of relevant literature and examination of the situation in both Canada and the United States indicate that in the future SLM should return to a goal of service…

  3. The SEA of the Future: Leveraging Performance Management to Support School Improvement. Volume 1

    ERIC Educational Resources Information Center

    Gross, Betheny, Ed.; Jochim, Ashley, Ed.

    2013-01-01

    "The SEA of the Future" is an education publication series examining how state education agencies can shift from a compliance to a performance-oriented organization through strategic planning and performance management tools to meet growing demands to support education reform while improving productivity. This inaugural edition of…

  4. Using foresight methods to anticipate future threats: the case of disease management.

    PubMed

    Ma, Sai; Seid, Michael

    2006-01-01

    We describe a unique foresight framework for health care managers to use in longer-term planning. This framework uses scenario-building to envision plausible alternate futures of the U.S. health care system and links those broad futures to business-model-specific "load-bearing" assumptions. Because the framework we describe simultaneously addresses very broad and very specific issues, it can be easily applied to a broad range of health care issues by using the broad framework and business-specific assumptions for the particular case at hand. We illustrate this method using the case of disease management, pointing out that although the industry continues to grow rapidly, its future also contains great uncertainties.

  5. Past, current and future fire frequency in the Canadian boreal forest: implications for sustainable forest management.

    PubMed

    Bergeron, Yves; Flannigan, Mike; Gauthier, Sylvie; Leduc, Alain; Lefort, Patrick

    2004-08-01

    Over the past decades, there has been an increasing interest in the development of forest management approaches that are based on an understanding of historical natural disturbance dynamics. The rationale for such an approach is that management to favor landscape compositions and stand structures similar to those of natural ecosystems should also maintain biological diversity and essential ecological functions. In fire-dominated landscapes, this approach is possible only if current and future fire frequencies are sufficiently low, comparing to pre-industrial fire frequency, that we can substitute fire by forest management. We address this question by comparing current and future fire frequency to historical reconstruction of fire frequency from studies realized in the Canadian boreal forest. Current and simulated future fire frequencies using 2 and 3 x CO2 scenarios are lower than the historical fire frequency for many sites, suggesting that forest management could potentially be used to recreate the forest age structure of fire-controlled pre-industrial landscapes. There are however, important limitations to the current even-age management.

  6. Characterizing the Leaching Behavior of Coal Combustion Residues using the Leaching Environmental Assessment Framework (LEAF) to Inform Future Management Decisions

    EPA Science Inventory

    Abstract for presentation on Characterizing the Leaching Behavior of Coal Combustion Residues using the Leaching Environmental Assessment Framework (LEAF) to Inform Future Management Decisions. The abstract is attached.

  7. Stormwater quality management in rail transportation--past, present and future.

    PubMed

    Vo, Phuong Tram; Ngo, Huu Hao; Guo, Wenshan; Zhou, John L; Listowski, Andrzej; Du, Bin; Wei, Qin; Bui, Xuan Thanh

    2015-04-15

    Railways currently play an important role in sustainable transportation systems, owing to their substantial carrying capacity, environmental friendliness and land-saving advantages. Although total pollutant emissions from railway systems are far less than that of automobile vehicles, the pollution from railway operations should not be underestimated. To date, both scientific and practical papers dealing with stormwater management for rail tracks have solely focused on its drainage function. Unlike roadway transport, the potential of stormwater pollution from railway operations is currently mishandled. There have been very few studies into the impact of its operations on water quality. Hence, upon the realisation on the significance of nonpoint source pollution, stormwater management priorities should have been re-evaluated. This paper provides an examination of past and current practices of stormwater management in the railway industry, potential sources of stormwater pollution, obstacles faced in stormwater management and concludes with strategies for future management directions.

  8. Human-Centered Technologies and Procedures for Future Air Traffic Management

    NASA Technical Reports Server (NTRS)

    Smith, Philip; Woods, David; McCoy, Elaine; Billings, Charles; Sarter, Nadine; Denning, Rebecca; Dekker, Sidney

    1997-01-01

    The use of various methodologies to predict the impact of future Air Traffic Management (ATM) concepts and technologies is explored. The emphasis has been on the importance of modeling coordination and cooperation among multiple agents within this system, and on understanding how the interactions among these agents will be influenced as new roles, responsibilities, procedures and technologies are introduced. To accomplish this, we have been collecting data on performance under the current air traffic management system, identifying critical problem areas and looking for examples suggestive of general approaches for solving such problems. Using the results of these field studies, we have developed a set of concrete scenarios centered around future designs, and have studied performance in these scenarios with a set of 40 controllers, dispatchers, pilots and traffic managers.

  9. Adaptive harvest management of North American waterfowl populations - recent successes and future prospects

    USGS Publications Warehouse

    Nichols, J.D.; Runge, M.C.; Johnson, F.A.; Williams, B.K.; Schodde, Richard; Hannon, Susan; Scheiffarth, Gregor; Bairlein, Franz

    2006-01-01

    The history of North American waterfowl harvest management has been characterized by attempts to use population monitoring data to make informed harvest management decisions. Early attempts can be characterized as intuitive decision processes, and later efforts were guided increasingly by population models and associated predictions. In 1995, a formal adaptive management process was implemented, and annual decisions about duck harvest regulations in the United States are still based on this process. This formal decision process is designed to deal appropriately with the various forms of uncertainty that characterize management decisions, environmental uncertainty, structural uncertainty, partial controllability and partial observability. The key components of the process are (1) objectives, (2) potential management actions, (3) model(s) of population response to management actions, (4) credibility measures for these models, and (5) a monitoring program. The operation of this iterative process is described, and a brief history of a decade of its use is presented. Future challenges range from social and political issues such as appropriate objectives and management actions, to technical issues such as multispecies management, geographic allocation of harvest, and incorporation of actions that include habitat acquisition and management.

  10. Greenhouse gas emissions from alternative futures of deforestation and agricultural management in the southern Amazon.

    PubMed

    Galford, Gillian L; Melillo, Jerry M; Kicklighter, David W; Cronin, Timothy W; Cerri, Carlos E P; Mustard, John F; Cerri, Carlos C

    2010-11-16

    The Brazilian Amazon is one of the most rapidly developing agricultural areas in the world and represents a potentially large future source of greenhouse gases from land clearing and subsequent agricultural management. In an integrated approach, we estimate the greenhouse gas dynamics of natural ecosystems and agricultural ecosystems after clearing in the context of a future climate. We examine scenarios of deforestation and postclearing land use to estimate the future (2006-2050) impacts on carbon dioxide (CO(2)), methane (CH(4)), and nitrous oxide (N(2)O) emissions from the agricultural frontier state of Mato Grosso, using a process-based biogeochemistry model, the Terrestrial Ecosystems Model (TEM). We estimate a net emission of greenhouse gases from Mato Grosso, ranging from 2.8 to 15.9 Pg CO(2)-equivalents (CO(2)-e) from 2006 to 2050. Deforestation is the largest source of greenhouse gas emissions over this period, but land uses following clearing account for a substantial portion (24-49%) of the net greenhouse gas budget. Due to land-cover and land-use change, there is a small foregone carbon sequestration of 0.2-0.4 Pg CO(2)-e by natural forests and cerrado between 2006 and 2050. Both deforestation and future land-use management play important roles in the net greenhouse gas emissions of this frontier, suggesting that both should be considered in emissions policies. We find that avoided deforestation remains the best strategy for minimizing future greenhouse gas emissions from Mato Grosso.

  11. Adapting to a Changing Colorado River: Making Future Water Deliveries More Reliable Through Robust Management Strategies

    NASA Astrophysics Data System (ADS)

    Groves, D.; Bloom, E.; Fischbach, J. R.; Knopman, D.

    2013-12-01

    The U.S. Bureau of Reclamation and water management agencies representing the seven Colorado River Basin States initiated the Colorado River Basin Study in January 2010 to evaluate the resiliency of the Colorado River system over the next 50 years and compare different options for ensuring successful management of the river's resources. RAND was asked to join this Basin Study Team in January 2012 to help develop an analytic approach to identify key vulnerabilities in managing the Colorado River basin over the coming decades and to evaluate different options that could reduce this vulnerability. Using a quantitative approach for planning under uncertainty called Robust Decision Making (RDM), the RAND team assisted the Basin Study by: identifying future vulnerable conditions that could lead to imbalances that could cause the basin to be unable to meet its water delivery objectives; developing a computer-based tool to define 'portfolios' of management options reflecting different strategies for reducing basin imbalances; evaluating these portfolios across thousands of future scenarios to determine how much they could improve basin outcomes; and analyzing the results from the system simulations to identify key tradeoffs among the portfolios. This talk will describe RAND's contribution to the Basin Study, focusing on the methodologies used to to identify vulnerabilities for Upper Basin and Lower Basin water supply reliability and to compare portfolios of options. Several key findings emerged from the study. Future Streamflow and Climate Conditions Are Key: - Vulnerable conditions arise in a majority of scenarios where streamflows are lower than historical averages and where drought conditions persist for eight years or more. - Depending where the shortages occur, problems will arise for delivery obligations for the upper river basin and the lower river basin. The lower river basin is vulnerable to a broader range of plausible future conditions. Additional Investments in

  12. Current and future developments in managed care in the United States and implications for Europe

    PubMed Central

    Lagoe, Ronald; Aspling, Deborah L; Westert, Gert P

    2005-01-01

    The paper reviews and evaluates current and future approaches to cost containment in the United States. Managed care was once seen as an effective approach to supporting health care quality while containing costs in the USA. In recent years payors started to look in other directions, since prospects for limiting expenses faded. Nowadays consumer driven health plans seem to be on the rise. The reasons for the decline of managed care, the growing popularity of the consumer driven health plans and the implications for Europe are discussed. PMID:15774017

  13. The current and future role of endomicroscopy in the management of inflammatory bowel disease

    PubMed Central

    Nguyen, Douglas L.; Lee, John G.; Parekh, Nimisha K.; Samarasena, Jason; Bechtold, Matthew L.; Chang, Kenneth

    2015-01-01

    Confocal laser-induced endomicroscopy (CLE), first introduced in 2003, allows the capture of images of “virtual histology” of the gastrointestinal mucosa during endoscopy, providing the opportunity to retrieve real-time visualization of the pathology of the mucosal epithelium with its cellular and subcellular structures. This new endoscopic imaging technique serves as an adjunctive diagnostic tool to the traditional ileocolonoscopy in the management of inflammatory bowel disease (IBD) patients. In multiple clinical trials, CLE has been shown to improve detection of dysplasia, assess disease activity, predict future clinical relapses, and assess potential responsiveness to anti-tumor necrosis factor therapy. This review explores in depth the current and future role of CLE in the management of IBD patients. PMID:26130373

  14. Agile Development Processes: Delivering a Successful Data Management Platform Now and in the Future

    NASA Astrophysics Data System (ADS)

    Deaubl, E.; Lowry, S.

    2007-10-01

    Developing a flexible, extensible architecture for scientific data archival and management is a monumental task under older, big design, up-front methodologies. We will describe how we are using agile development techniques in our service oriented architecture (SOA)-based platform to integrate astronomer and operator input into the development process, deliver functional software earlier, and ensure that the software is maintainable and extensible in the future.

  15. Shaping Future Phosphorus Management Pathways by Understanding the Past and Present

    NASA Astrophysics Data System (ADS)

    Metson, G. S.; Compton, J.; Cordell, D.; Harrison, J.; Iwaniec, D.

    2015-12-01

    Sustainable phosphorus (P) management in agricultural and urban ecosystems is necessary to ensure global food security and healthy aquatic ecosystems. Researchers and decision-makers alike need to understand how social, economic, political, and biophysical factors interact to create risks and opportunities around future P cycling. For example, P can accumulate in soils and be lost to waterways over a long-time scale. Such lags between application, use, and transport of P could affect our ability to identify sources of P enrichment of surface waters and, consequently, influence the development of strategies to limit water quality degradation. To enhance understanding of the relationship between human activities, P loading to the landscape and P loading to surface waters, we are examining cumulative P additions from 1950 to 2007 at the county level for the major US hydrologic basins. We examine the temporal relationship between net P additions and water quality in order to identify especially important time periods for P management. We also compare the timing of P additions and losses across hydrologic basins. Concurrently, the P-FUTURES project, a partnership between researchers and stakeholders to advance and understand the process of social transformation, focuses on the role of urban ecosystems in future sustainable P management. In this project we are using a cross-city comparison approach and transdisciplinary methods, including participatory workshops and future visioning activities, to determine pathways to more sustainable P management in Phoenix, USA; Sydney, Australia; Hanoi, Vietnam; and Blantyre, Malawi. In Blantyre for example we have identified possible synergies between decreasing nutrient losses and deforestation and existing municipal goals to increase affordable hydroelectric power. Preliminary results from both on-going projects allow us to gain insight into how local context shapes P cycling and locally-appropriate solutions.

  16. Shaping Future Phosphorus Management Pathways by Understanding the Past and Present

    NASA Astrophysics Data System (ADS)

    Migliavacca, M.; Richardson, A. D.; Cescatti, A.; Cremonese, E.; Keenan, T. F.; Sonnentag, O.

    2014-12-01

    Sustainable phosphorus (P) management in agricultural and urban ecosystems is necessary to ensure global food security and healthy aquatic ecosystems. Researchers and decision-makers alike need to understand how social, economic, political, and biophysical factors interact to create risks and opportunities around future P cycling. For example, P can accumulate in soils and be lost to waterways over a long-time scale. Such lags between application, use, and transport of P could affect our ability to identify sources of P enrichment of surface waters and, consequently, influence the development of strategies to limit water quality degradation. To enhance understanding of the relationship between human activities, P loading to the landscape and P loading to surface waters, we are examining cumulative P additions from 1950 to 2007 at the county level for the major US hydrologic basins. We examine the temporal relationship between net P additions and water quality in order to identify especially important time periods for P management. We also compare the timing of P additions and losses across hydrologic basins. Concurrently, the P-FUTURES project, a partnership between researchers and stakeholders to advance and understand the process of social transformation, focuses on the role of urban ecosystems in future sustainable P management. In this project we are using a cross-city comparison approach and transdisciplinary methods, including participatory workshops and future visioning activities, to determine pathways to more sustainable P management in Phoenix, USA; Sydney, Australia; Hanoi, Vietnam; and Blantyre, Malawi. In Blantyre for example we have identified possible synergies between decreasing nutrient losses and deforestation and existing municipal goals to increase affordable hydroelectric power. Preliminary results from both on-going projects allow us to gain insight into how local context shapes P cycling and locally-appropriate solutions.

  17. Management of brain metastasis: past lessons, modern management, and future considerations.

    PubMed

    Koay, Eugene; Sulman, Erik P

    2012-02-01

    Brain metastasis is a major challenge for patients, physicians, and the broader health care system, with approximately 170,000 new cases per year. After a diagnosis of brain metastasis, patients have a poor prognosis, but modern management has made significant advances in the past two decades to improve palliative efficacy and patient survival through a multidisciplinary approach. A number of factors must be taken into consideration in the treatment approach, including the number of intracranial lesions, the control of extracranial disease, and the patient's overall health, while weighing the benefits of treatment against the toxicities, both acute and chronic. With quality of life as an emphasis, emerging concepts for modern management of brain metastasis have sought to minimize long-term toxicities. The economic impact of such strategies for patients and the health care system has been demonstrated in some studies, but has not been a consistent area of focus. Each of these strategies, as well as novel therapeutics, has embraced the concept of personalized treatment. This review will discuss the current knowledge of modern multidisciplinary management of brain metastasis and look forward to emerging concepts.

  18. Putting watershed restoration in context: alternative future scenarios influence management outcomes.

    PubMed

    Fullerton, A H; Steel, E A; Caras, Y; Sheer, M; Olson, P; Kaje, J

    2009-01-01

    Predicting effects of habitat restoration is an important step for recovery of imperiled anadromous salmonid populations. Habitat above three major hydropower dams in the Lewis River watershed, southwestern Washington, USA, will soon become accessible to anadromous fish. We used multiple models to estimate habitat conditions above dams and fish population responses. Additionally, we used scenario planning to predict how habitat and fish will respond to potential future trends in land use due to human population growth and riparian conservation policies. Finally, we developed a hypothetical management strategy (i.e., a set of prioritized restoration projects in specific locations within the watershed) as an example of how a fixed amount of restoration funds might be spent to enhance the success of reintroducing fish above dams. We then compared predicted outcomes from this new strategy to those of six previously modeled strategies. We estimated how the choice of the best management strategy might differ among alternative future scenarios. Results suggest that dam passage will provide access to large amounts of high-quality habitat that will benefit fish populations. Moreover, conservation of existing riparian areas, if implemented, has the potential to improve conditions to a much greater extent than restoration strategies examined, despite expected urban growth. We found that the relative performance of management strategies shifted when fish were allowed to migrate above dams, but less so among alternative futures examined. We discuss how predicted outcomes from these seven hypothetical management strategies could be used for developing an on-the-ground strategy to address a real management situation. PMID:19323185

  19. Putting watershed restoration in context: alternative future scenarios influence management outcomes.

    PubMed

    Fullerton, A H; Steel, E A; Caras, Y; Sheer, M; Olson, P; Kaje, J

    2009-01-01

    Predicting effects of habitat restoration is an important step for recovery of imperiled anadromous salmonid populations. Habitat above three major hydropower dams in the Lewis River watershed, southwestern Washington, USA, will soon become accessible to anadromous fish. We used multiple models to estimate habitat conditions above dams and fish population responses. Additionally, we used scenario planning to predict how habitat and fish will respond to potential future trends in land use due to human population growth and riparian conservation policies. Finally, we developed a hypothetical management strategy (i.e., a set of prioritized restoration projects in specific locations within the watershed) as an example of how a fixed amount of restoration funds might be spent to enhance the success of reintroducing fish above dams. We then compared predicted outcomes from this new strategy to those of six previously modeled strategies. We estimated how the choice of the best management strategy might differ among alternative future scenarios. Results suggest that dam passage will provide access to large amounts of high-quality habitat that will benefit fish populations. Moreover, conservation of existing riparian areas, if implemented, has the potential to improve conditions to a much greater extent than restoration strategies examined, despite expected urban growth. We found that the relative performance of management strategies shifted when fish were allowed to migrate above dams, but less so among alternative futures examined. We discuss how predicted outcomes from these seven hypothetical management strategies could be used for developing an on-the-ground strategy to address a real management situation.

  20. Measuring impact of protected area management interventions: current and future use of the Global Database of Protected Area Management Effectiveness.

    PubMed

    Coad, Lauren; Leverington, Fiona; Knights, Kathryn; Geldmann, Jonas; Eassom, April; Kapos, Valerie; Kingston, Naomi; de Lima, Marcelo; Zamora, Camilo; Cuardros, Ivon; Nolte, Christoph; Burgess, Neil D; Hockings, Marc

    2015-11-01

    Protected areas (PAs) are at the forefront of conservation efforts, and yet despite considerable progress towards the global target of having 17% of the world's land area within protected areas by 2020, biodiversity continues to decline. The discrepancy between increasing PA coverage and negative biodiversity trends has resulted in renewed efforts to enhance PA effectiveness. The global conservation community has conducted thousands of assessments of protected area management effectiveness (PAME), and interest in the use of these data to help measure the conservation impact of PA management interventions is high. Here, we summarize the status of PAME assessment, review the published evidence for a link between PAME assessment results and the conservation impacts of PAs, and discuss the limitations and future use of PAME data in measuring the impact of PA management interventions on conservation outcomes. We conclude that PAME data, while designed as a tool for local adaptive management, may also help to provide insights into the impact of PA management interventions from the local-to-global scale. However, the subjective and ordinal characteristics of the data present significant limitations for their application in rigorous scientific impact evaluations, a problem that should be recognized and mitigated where possible. PMID:26460133

  1. Measuring impact of protected area management interventions: current and future use of the Global Database of Protected Area Management Effectiveness.

    PubMed

    Coad, Lauren; Leverington, Fiona; Knights, Kathryn; Geldmann, Jonas; Eassom, April; Kapos, Valerie; Kingston, Naomi; de Lima, Marcelo; Zamora, Camilo; Cuardros, Ivon; Nolte, Christoph; Burgess, Neil D; Hockings, Marc

    2015-11-01

    Protected areas (PAs) are at the forefront of conservation efforts, and yet despite considerable progress towards the global target of having 17% of the world's land area within protected areas by 2020, biodiversity continues to decline. The discrepancy between increasing PA coverage and negative biodiversity trends has resulted in renewed efforts to enhance PA effectiveness. The global conservation community has conducted thousands of assessments of protected area management effectiveness (PAME), and interest in the use of these data to help measure the conservation impact of PA management interventions is high. Here, we summarize the status of PAME assessment, review the published evidence for a link between PAME assessment results and the conservation impacts of PAs, and discuss the limitations and future use of PAME data in measuring the impact of PA management interventions on conservation outcomes. We conclude that PAME data, while designed as a tool for local adaptive management, may also help to provide insights into the impact of PA management interventions from the local-to-global scale. However, the subjective and ordinal characteristics of the data present significant limitations for their application in rigorous scientific impact evaluations, a problem that should be recognized and mitigated where possible.

  2. Measuring impact of protected area management interventions: current and future use of the Global Database of Protected Area Management Effectiveness

    PubMed Central

    Coad, Lauren; Leverington, Fiona; Knights, Kathryn; Geldmann, Jonas; Eassom, April; Kapos, Valerie; Kingston, Naomi; de Lima, Marcelo; Zamora, Camilo; Cuardros, Ivon; Nolte, Christoph; Burgess, Neil D.; Hockings, Marc

    2015-01-01

    Protected areas (PAs) are at the forefront of conservation efforts, and yet despite considerable progress towards the global target of having 17% of the world's land area within protected areas by 2020, biodiversity continues to decline. The discrepancy between increasing PA coverage and negative biodiversity trends has resulted in renewed efforts to enhance PA effectiveness. The global conservation community has conducted thousands of assessments of protected area management effectiveness (PAME), and interest in the use of these data to help measure the conservation impact of PA management interventions is high. Here, we summarize the status of PAME assessment, review the published evidence for a link between PAME assessment results and the conservation impacts of PAs, and discuss the limitations and future use of PAME data in measuring the impact of PA management interventions on conservation outcomes. We conclude that PAME data, while designed as a tool for local adaptive management, may also help to provide insights into the impact of PA management interventions from the local-to-global scale. However, the subjective and ordinal characteristics of the data present significant limitations for their application in rigorous scientific impact evaluations, a problem that should be recognized and mitigated where possible. PMID:26460133

  3. Baltic Sea ecosystem-based management under climate change: Synthesis and future challenges.

    PubMed

    Blenckner, Thorsten; Österblom, Henrik; Larsson, Per; Andersson, Agneta; Elmgren, Ragnar

    2015-06-01

    Ecosystem-based management (EBM) has emerged as the generally agreed strategy for managing ecosystems, with humans as integral parts of the managed system. Human activities have substantial effects on marine ecosystems, through overfishing, eutrophication, toxic pollution, habitat destruction, and climate change. It is important to advance the scientific knowledge of the cumulative, integrative, and interacting effects of these diverse activities, to support effective implementation of EBM. Based on contributions to this special issue of AMBIO, we synthesize the scientific findings into four components: pollution and legal frameworks, ecosystem processes, scale-dependent effects, and innovative tools and methods. We conclude with challenges for the future, and identify the next steps needed for successful implementation of EBM in general and specifically for the Baltic Sea. PMID:26022332

  4. Baltic Sea ecosystem-based management under climate change: Synthesis and future challenges.

    PubMed

    Blenckner, Thorsten; Österblom, Henrik; Larsson, Per; Andersson, Agneta; Elmgren, Ragnar

    2015-06-01

    Ecosystem-based management (EBM) has emerged as the generally agreed strategy for managing ecosystems, with humans as integral parts of the managed system. Human activities have substantial effects on marine ecosystems, through overfishing, eutrophication, toxic pollution, habitat destruction, and climate change. It is important to advance the scientific knowledge of the cumulative, integrative, and interacting effects of these diverse activities, to support effective implementation of EBM. Based on contributions to this special issue of AMBIO, we synthesize the scientific findings into four components: pollution and legal frameworks, ecosystem processes, scale-dependent effects, and innovative tools and methods. We conclude with challenges for the future, and identify the next steps needed for successful implementation of EBM in general and specifically for the Baltic Sea.

  5. Food Preparation. I: Food Facts for Home. II: Facts about Foodservice.

    ERIC Educational Resources Information Center

    Procter and Gamble Educational Services, Cincinnati, OH.

    This package is intended for use in home economics classes focusing on nutrition and food preparation and service. The teaching guide is divided into two parts. The first centers on selected first-time facts on nutrition, meal planning, and basic food preparation skills. It includes modules on nutrition, meal management, initial steps in food…

  6. Sanitary Food Service; Instructor's Guide to Be Used in Training Food-Service Personnel.

    ERIC Educational Resources Information Center

    Public Health Service (DHEW), Cincinnati, OH.

    Instructors of civilian and/or military food service employees are given suggestions for the flexible use of this guide, then receive more detailed guidelines for grouping trainees, managing classes, planning lessons, and adapting the food service course to various groups and teaching situations. Specific content (principles to be taught) and…

  7. Energy, water and carbon balance of managed forests: comparing the future to the past

    NASA Astrophysics Data System (ADS)

    Loustau, Denis; Moreaux, Virginie; Moisy, Christophe; Picart, Delphine; Lafont, Sébastien; Benest, Fabienne; Lagouarde, Jean-PIerre; Bosc, Alexandre

    2014-05-01

    Intensification of forest management concerns a growing fraction of temperate and tropical forests. It is thought to affect wider areas in the near future for facing biomass, fiber and wood demands. Intensively managed forests are submitted to increased soil preparation, fertilization, drainage, thinning, clear-cutting, whole tree - harvesting and rotation shortening. They are composed of fast growing stands commonly planted with enhanced tree varieties or clones of eucalypts, pines, poplars, willows among others. Altogether these practices have substantial effects on forest exchanges with atmosphere and groundwater and therefore on local and regional climates and water resources. Using data collected from flux tower sites, MODIS products and forest and soil inventories together with our process based model of forest growth, GO+, we analysed the impacts of intensified management on forest canopy exchanges of heat, short and longwave radiations, water and CO2 and its interaction with soil and climate. Results obtained under present climate conditions evidenced interactions between intensification effects and soil and climate conditions. We show that biophysical impacts on radiative forcing potential, through albedo increase and convective fluxes of heat and water, are in the same order of magnitude than changes in the biogeochemical cycle of carbon. Drought affects dramatically the net carbon and water balances of forest stands independent of management and age. However, the effects of successive management operations (ploughing, vegetation burial, thinning) overtook climate impacts and make the young stands and intensive alternatives more independent and resilient to climate change impacts. The model applications to the analysis of future climate scenarios allowed to attributing the role of management alternatives, soil conditions and climate and their interactions. For intensively managed forests, the frequency of soil preparation operations, the management

  8. UNDERSTANDING THE PAST, MANAGING THE FUTURE - Remotely sensed analysis of the urban sprawl of Istanbul for supporting decision making for a sustainable future

    NASA Astrophysics Data System (ADS)

    Altan, O.; Kemper, G.

    2012-07-01

    The GIS based analysis of the land use change of Istanbul delivers a huge and comprehensive database that can be used for further analysis. Trend analysis and scenarios enable a view to the future that highlights the needs for a proper planning. Also the understanding via comparison to other cities assists in order not to copy errors from other cities. GIS in combination with ancillary data open a wide field for managing the future of Istanbul.

  9. The Indus basin in the framework of current and future water resources management

    NASA Astrophysics Data System (ADS)

    Laghari, A. N.; Vanham, D.; Rauch, W.

    2012-04-01

    The Indus basin is one of the regions in the world that is faced with major challenges for its water sector, due to population growth, rapid urbanisation and industrialisation, environmental degradation, unregulated utilization of the resources, inefficient water use and poverty, all aggravated by climate change. The Indus Basin is shared by 4 countries - Pakistan, India, Afghanistan and China. With a current population of 237 million people which is projected to increase to 319 million in 2025 and 383 million in 2050, already today water resources are abstracted almost entirely (more than 95% for irrigation). Climate change will result in increased water availability in the short term. However in the long term water availability will decrease. Some current aspects in the basin need to be re-evaluated. During the past decades water abstractions - and especially groundwater extractions - have augmented continuously to support a rice-wheat system where rice is grown during the kharif (wet, summer) season (as well as sugar cane, cotton, maize and other crops) and wheat during the rabi (dry, winter) season. However, the sustainability of this system in its current form is questionable. Additional water for domestic and industrial purposes is required for the future and should be made available by a reduction in irrigation requirements. This paper gives a comprehensive listing and description of available options for current and future sustainable water resources management (WRM) within the basin. Sustainable WRM practices include both water supply management and water demand management options. Water supply management options include: (1) reservoir management as the basin is characterised by a strong seasonal behaviour in water availability (monsoon and meltwater) and water demands; (2) water quality conservation and investment in wastewater infrastructure; (3) the use of alternative water resources like the recycling of wastewater and desalination; (4) land use

  10. Climate change and forests of the future: Managing in the face of uncertainty

    USGS Publications Warehouse

    Millar, C.I.; Stephenson, N.L.; Stephens, S.L.

    2007-01-01

    We offer a conceptual framework for managing forested ecosystems under an assumption that future environments will be different from present but that we cannot be certain about the specifics of change. We encourage flexible approaches that promote reversible and incremental steps, and that favor ongoing learning and capacity to modify direction as situations change. We suggest that no single solution fits all future challenges, especially in the context of changing climates, and that the best strategy is to mix different approaches for different situations. Resources managers will be challenged to integrate adaptation strategies (actions that help ecosystems accommodate changes adaptively) and mitigation strategies (actions that enable ecosystems to reduce anthropogenic influences on global climate) into overall plans. Adaptive strategies include resistance options (forestall impacts and protect highly valued resources), resilience options (improve the capacity of ecosystems to return to desired conditions after disturbance), and response options (facilitate transition of ecosystems from current to new conditions). Mitigation strategies include options to sequester carbon and reduce overall greenhouse gas emissions. Priority-setting approaches (e.g., triage), appropriate for rapidly changing conditions and for situations where needs are greater than available capacity to respond, will become increasingly important in the future. ?? 2007 by the Ecological Society of America.

  11. Intelligent biomedical clothing for personal health and disease management: state of the art and future vision.

    PubMed

    Lymberis, Andreas; Olsson, Silas

    2003-01-01

    Telemedicine has been introduced to overcome distance in order to get prompt access to medical knowledge and appropriate health care. More recently, work in telemedicine has aimed at developing solutions to support the management of chronic diseases such as diabetes, and lung and heart diseases, as well as to provide support for home care services. Telemedicine is also entering the fields of health promotion/prevention disease, life style management, and well-being. The evolution and broadening of telemedicine gives birth to a nomenclature that includes "e-health," "telehealth," and "telecare." The latest developments in microsystems and nanotechnologies as well as in information processing and communication technologies allow miniaturization and non-invasive smart monitoring of physiological and physical data. Ongoing cutting-edge multidisciplinary research in textile fibers, biomedical sensors, and wireless and mobile telecommunications integrated with telemedicine, aims at developing intelligent biomedical clothing (IBC) that could pave the way to support personalized management of health and diseases at the point of need and at any time. In this study, we aim to describe the current status of multidisciplinary research and development of IBC, based on bibliographic research and reports from seminars, workshops, conferences, and working groups. A further aim is to inform the developers, the decision makers, and users in the health and healthcare sector regarding future solutions to support personalized health care and disease management. Both the textile sector and healthcare sector are looking with great interest at the innovative products and applications that could result from the integration of microsystems, nanotechnologies, biomedical sensors, textiles, and mobile telecommunications. For health monitoring, disease prevention and management, rehabilitation, and sport medicine, IBC may offer, in the mid-term future, a unique, wearable non

  12. Drivers in current and future municipal solid waste management systems: cases in Yokohama and Boston.

    PubMed

    Contreras, Francisco; Ishii, Satoshi; Aramaki, Toshiya; Hanaki, Keisuke; Connors, Stephen

    2010-01-01

    Despite some progress, municipal solid waste (MSW) still poses pressure on cities and remains one of the major challenges in environmental management. There is no single solution to the problem since the drivers behind MSW systems may vary significantly from city to city. In this context, the development of a common strategy to attain a sustainable management has been increasingly difficult. This paper presents an issue-driven analytical framework to evaluate the past, present and future MSW management strategy for the cities of Yokohama and Boston considering four driver categories while evaluating if the relevance of these drivers has changed over time. These categories represent: (i) legal drivers (e.g. laws and regulations); (ii) technology development and institutional drivers (e.g. available technologies); (iii) regional and international drivers (e.g. solid waste flow as recyclable resources); and (iv) socio-economic drivers (e.g. population trends and public awareness). The analysis indicated that solid waste management capacity for both cases was under stress due to different reasons. In the case of Boston, the moratorium for disposal facilities played an important role while increasing population was a key driver for the city of Yokohama. The future management scenario suggests that various waste-to-energy alternatives and strong solid waste reduction policies will play a key role for Boston. In Yokohama, a shift on waste composition and generation triggered by a demographic change may open the path for new technologies while also considering the international demand of solid waste as a recyclable resource.

  13. Prognostics and Health Management of Wind Turbines: Current Status and Future Opportunities

    SciTech Connect

    Sheng, Shuangwen

    2015-12-14

    Prognostics and health management is not a new concept. It has been used in relatively mature industries, such as aviation and electronics, to help improve operation and maintenance (O&M) practices. In the wind industry, prognostics and health management is relatively new. The level for both wind industry applications and research and development (R&D) has increased in recent years because of its potential for reducing O&M cost of wind power, especially for turbines installed offshore. The majority of wind industry application efforts has been focused on diagnosis based on various sensing and feature extraction techniques. For R&D, activities are being conducted in almost all areas of a typical prognostics and health management framework (i.e., sensing, data collection, feature extraction, diagnosis, prognosis, and maintenance scheduling). This presentation provides an overview of the current status of wind turbine prognostics and health management that focuses on drivetrain condition monitoring through vibration, oil debris, and oil condition analysis techniques. It also discusses turbine component health diagnosis through data mining and modeling based on supervisory control and data acquisition system data. Finally, it provides a brief survey of R&D activities for wind turbine prognostics and health management, along with future opportunities.

  14. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research

    PubMed Central

    Magnuson, Allison; Allore, Heather; Cohen, Harvey Jay; Mohile, Supriya G.; Williams, Grant R.; Chapman, Andrew; Extermann, Martine; Olin, Rebecca L.; Targia, Valerie; Mackenzie, Amy; Holmes, Holly M.; Hurria, Arti

    2016-01-01

    Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. “GA with management” is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer patients, GA with management has been shown to improve a variety of outcomes, such as reducing functional decline and health care utilization. However, the role of GA with management in the older adult with cancer is less well established. Rigorous clinical trials of GA with management are necessary to develop an evidence base and support its use in the routine oncology care of older adults. At the recent U-13 conference, “Design and Implementation of Intervention Studies to Improve or Maintain Quality of Survivorship in Older and/or Frail Adults with Cancer,” a session was dedicated to developing research priorities in GA with management. Here we summarize identified knowledge gaps in GA with management studies for older patients with cancer and propose areas for future research. PMID:27197915

  15. Management of atrial fibrillation in the Emergency Department: current approach and future expectations.

    PubMed

    Russo, V; Navarin, S; Zampini, G; Magrini, L; Mann, C; Muiesan, M L; De Caterina, R; Yılmaz, M B; Beton, O; Monzani, V; Kubica, J; Müller, C; Di Somma, S

    2013-12-01

    Atrial fibrillation (AF) is the most common cardiac dysrhythmia and occurs in 3.3%-10% of emergency admissions. It is frequently quoted for people over the age of 75, but the cases of AF in young subjects without structural heart disease are also increasing, therefore, leading to the evaluation of "lonely atrial fibrillation" as a new challenge for the clinician. The first diagnosis and treatment often occur in the emergency room and the emergency physician has therefore to evaluate the initial step towards the therapeutic decisions. Although international standard guidelines are available, AF treatment in the Emergency Department (ED) is still heterogeneous in terms of the management strategy chosen. There are two main strategies for the management of AF: rate and rhythm control. Moreover, antithrombotic treatment is pivotal in AF to prevent cardioembolic stroke and it is considered a primary objective after an accurate assessment of antithrombotic treatment risks and benefits. The introduction of innovative echocardiographic approach, directly in ED, seems to improve the management and risk stratification of patients with AF. This review aims to provide an overview about the current approach and the future expectations in the management of AF in ED. This manuscript represents a synopsis of the lectures on AF management in the ED of the Third Italian GREAT Network Congress, that was hold in Rome, 15-19 October 2012. We decided to use only the most relevant references for each contribution as suggested by each participant at this review.

  16. Specific intensive care management of patients with traumatic brain injury: Present and future

    PubMed Central

    Chowdhury, Tumul; Kowalski, Stephen; Arabi, Yaseen; Dash, Hari Hara

    2014-01-01

    Traumatic brain injury (TBI) is a major global problem and affects approximately 10 million peoples annually; therefore has a substantial impact on the health-care system throughout the world. In this article, we have summarized various aspects of specific intensive care management in patients with TBI including the emerging evidence mainly after the Brain Trauma Foundation (BTF) 2007 and also highlighted the scope of the future therapies. This review has involved the relevant clinical trials and reviews (from 1 January 2007 to 31 March 2013), which specifically discussed about the topic. Though, BTF guideline based management strategies could provide standardized protocols for the management of patients with TBI and have some promising effects on mortality and morbidity; there is still need of inclusion of many suggestions based on various published after 2007. The main focus of majority of these trials remained to prevent or to treat the secondary brain injury. The future therapy will be directed to treat injured neurons and may benefit the outcome. There is also urgent need to develop some good prognostic indicators as well. PMID:24843345

  17. [Marketing mix in a radiology department: challenges for future radiologists in management].

    PubMed

    Claikens, B

    1998-08-01

    Radiology has gained an enviable position among medial specialities. Developments in new technology expand its horizons and the volume of radiologic imaging techniques and procedures increase far more than the overall growth in health care services. In this position radiology has become a prime target for restrictions, cutbacks, controlled financing in an area of managed care and new national health care policy based on partially fixed budgets. Future health care takers have to choose the best available diagnostic and therapeutic techniques. Evidence based medicine, cost-utility analysis, diagnostic performance analysis, patient outcome analysis, technology assessment and guidelines for practice are means to guide us through our obligatory choice. Our major objective is to use the most performant available imaging technique or intervention to achieve the best possible outcome for our patient at lower possible costs. A strategic response from radiologists is required to meet the imperatives of this new management situation. They must do far more than interpret imaging procedures. They must work as efficient managers of imaging resources, organise their practices and define their marketing-strategies using the different, so-called, marketing-mix elements. The challenges will be great but the rewards are worth our best efforts. In this article we highlight the marketing responsibilities of future radiologists and their clinical practice in this new socio-economic environment and we present different useful marketing tools. PMID:9828543

  18. [Marketing mix in a radiology department: challenges for future radiologists in management].

    PubMed

    Claikens, B

    1998-08-01

    Radiology has gained an enviable position among medial specialities. Developments in new technology expand its horizons and the volume of radiologic imaging techniques and procedures increase far more than the overall growth in health care services. In this position radiology has become a prime target for restrictions, cutbacks, controlled financing in an area of managed care and new national health care policy based on partially fixed budgets. Future health care takers have to choose the best available diagnostic and therapeutic techniques. Evidence based medicine, cost-utility analysis, diagnostic performance analysis, patient outcome analysis, technology assessment and guidelines for practice are means to guide us through our obligatory choice. Our major objective is to use the most performant available imaging technique or intervention to achieve the best possible outcome for our patient at lower possible costs. A strategic response from radiologists is required to meet the imperatives of this new management situation. They must do far more than interpret imaging procedures. They must work as efficient managers of imaging resources, organise their practices and define their marketing-strategies using the different, so-called, marketing-mix elements. The challenges will be great but the rewards are worth our best efforts. In this article we highlight the marketing responsibilities of future radiologists and their clinical practice in this new socio-economic environment and we present different useful marketing tools.

  19. Will antimicrobial resistance of BRD pathogens impact BRD management in the future?

    PubMed

    Brumbaugh, Gordon W

    2014-12-01

    Resistance is a qualitative interpretation of antimicrobial activity in vitro. Critical to management of bovine respiratory disease (BRD) is the clinical response in vivo. Attempts to connect activity in vitro to response in vivo have been complicated by the complexity of BRD, interpretation of antimicrobial activity in vitro, and inconsistent measures of clinical success or failure. During recent history, the discovery, development, and commercialization of antimicrobials have decreased. In response to resistance, voluntary and imposed restrictions on use of antimicrobials have been implemented. Resistance can be reversed using technology and knowledge of mechanisms of resistance. Perhaps approaches that reverse resistance will be used in clinical management of BRD in the future. The short answer to the question posed in the title is, 'yes.' Since antimicrobial drugs were discovered, resistance has been a consideration for selection of treatment of any infectious disease and BRD is not unique. In the opinion of the author, the more important question is, 'How will antimicrobial resistance of BRD pathogens impact BRD management in the future?'

  20. Structural Analysis Methods for Structural Health Management of Future Aerospace Vehicles

    NASA Technical Reports Server (NTRS)

    Tessler, Alexander

    2007-01-01

    Two finite element based computational methods, Smoothing Element Analysis (SEA) and the inverse Finite Element Method (iFEM), are reviewed, and examples of their use for structural health monitoring are discussed. Due to their versatility, robustness, and computational efficiency, the methods are well suited for real-time structural health monitoring of future space vehicles, large space structures, and habitats. The methods may be effectively employed to enable real-time processing of sensing information, specifically for identifying three-dimensional deformed structural shapes as well as the internal loads. In addition, they may be used in conjunction with evolutionary algorithms to design optimally distributed sensors. These computational tools have demonstrated substantial promise for utilization in future Structural Health Management (SHM) systems.

  1. The future is no longer what it used to be. Managing health telematics projects.

    PubMed

    Demeester, M; Beuscart, R

    1997-09-01

    Future used to mean global progress and convergence of science and technology and society. Today, we observe the decoupling of the two poles of knowledge formation and application (i.e. science and technology, and culture and society, respectively) and also fierce confrontation between them. The key issue to reconcile the two poles is to re-invent the link between them. The new future lies in the development of mental and technical capacities for change and the creation of new forms of solidarity. We propose, as a general attitude, to reactivate and develop the four principles of efficacy-effectiveness-efficiency, hospitality, responsibility and pertinence. Translated into driving forces for the development of health care telematic projects, they amount to the acceptance of and capacity for enterprise-wide solutions, hospitality and capacity to acquire outside knowledge, self-managed, multi-functional team work spirit, reengineering mentality to achieve pertinent technico-cultural solutions.

  2. The future is no longer what it used to be. Managing health telematics projects.

    PubMed

    Demeester, M; Beuscart, R

    1997-09-01

    Future used to mean global progress and convergence of science and technology and society. Today, we observe the decoupling of the two poles of knowledge formation and application (i.e. science and technology, and culture and society, respectively) and also fierce confrontation between them. The key issue to reconcile the two poles is to re-invent the link between them. The new future lies in the development of mental and technical capacities for change and the creation of new forms of solidarity. We propose, as a general attitude, to reactivate and develop the four principles of efficacy-effectiveness-efficiency, hospitality, responsibility and pertinence. Translated into driving forces for the development of health care telematic projects, they amount to the acceptance of and capacity for enterprise-wide solutions, hospitality and capacity to acquire outside knowledge, self-managed, multi-functional team work spirit, reengineering mentality to achieve pertinent technico-cultural solutions. PMID:9290915

  3. Development and Application of Future Climate Scenarios for Natural Resource Management in Southwestern Colorado

    NASA Astrophysics Data System (ADS)

    Rangwala, I.; Rondeau, R.; Wyborn, C.; Clifford, K. R.; Travis, W.

    2015-12-01

    Locally relevant projections of climate change provide critical insights for natural resource managers seeking to adapt their management activities to climate change in the context of uncertainty. To provide such information, we developed climate scenarios, in form of narratives and quantitative information, of future climate change and its impacts in southwestern Colorado. This information was intended to provide detailed insights into the range of changes that natural resource managers may face in the future. The scenarios were developed in an iterative process through interactions among the ecologists, social and climate scientists. In our scenario development process, climate uncertainty is acknowledged by having multiple scenarios, where each scenario is regarded as a storyline with equal likelihood as another scenario. We quantified changes in several decision relevant climate and ecological responses based on our best available understanding and provided a tight storyline for each scenario to facilitate (a) a more augmented use of scientific information in a decision-making process, (b) differential responses from stakeholders across the different scenarios, and (c) identification of strategies that could work across these multiple scenarios. Here, we discuss the process of selecting the scenarios, quantifying climate and ecological responses, and the criteria for building the narrative for each scenario. We also discuss the process by which these scenarios get used, and provide an assessment of their effectiveness and users' feedbacks that could inform the future development of these tools and processes. This research involvement and collaboration occurred, in part, as a result of the PACE Fellowship Program that is associated with NOAA Climate Program Office and the U.S. CLIVAR community.

  4. Education for Cultivating Future Factory Managers by Industry-College Cooperation

    NASA Astrophysics Data System (ADS)

    Tennichi, Michio; Yamada, Hirofumi; Matsui, Hiroshi; Furuya, Shigehiko; Ito, Kouhei

    In 2007, Kanazawa Technical College was designated by the Ministry of Education, Culture, Sports, Science and Technology as an institute on a Project to the Cultivation of Practical Engineers by Cooperative Education and is to complete the project. Our project aims at accomplishing “Education Program Development and Practice for Cultivating Future Factory Managers Beginning at Age 16” , with the object of the cooperative project by local businesses, Ishikawa Prefecture and Kanazawa Institute of Technology. This paper reports as follows. (1) Outline of this project (2) Results from the project we have tackled. (3) Safety education in order to begin mechanical hands-on training at the first grade.

  5. Comprehensive management of pressure ulcers in spinal cord injury: Current concepts and future trends

    PubMed Central

    Kruger, Erwin A.; Pires, Marilyn; Ngann, Yvette; Sterling, Michelle; Rubayi, Salah

    2013-01-01

    Pressure ulcers in spinal cord injury represent a challenging problem for patients, their caregivers, and their physicians. They often lead to recurrent hospitalizations, multiple surgeries, and potentially devastating complications. They present a significant cost to the healthcare system, they require a multidisciplinary team approach to manage well, and outcomes directly depend on patients' education, prevention, and compliance with conservative and surgical protocols. With so many factors involved in the successful treatment of pressure ulcers, an update on their comprehensive management in spinal cord injury is warranted. Current concepts of local wound care, surgical options, as well as future trends from the latest wound healing research are reviewed to aid medical professionals in treating patients with this difficult problem. PMID:24090179

  6. Future perspectives of Smartphone applications for rheumatic diseases self-management.

    PubMed

    Azevedo, Ana Rita Pereira; de Sousa, Hugo Manuel Lopes; Monteiro, Joaquim António Faria; Lima, Aurea Rosa Nunes Pereira

    2015-03-01

    Rheumatic diseases (RD) self-management interventions are designed to improve health-related quality of life, health care utilization, and perceived self-efficacy. Despite these demonstrated good results, there are several issues that hinder or render less appealing these interventions. One economically and socially viable solution is exploiting the potential of Smartphone technology. This potential comes from Smartphones pervasive presence in actual society, combined with the advantages of being personal, intuitive, and computationally powerful, with capability to support applications and assist its user throughout different activities of daily living and environments persistently. With their global acceptance increasing quickly, there is a great opportunity for mobile health in using Smartphone applications for RD self-management. Besides the potential of such applications, research on the development and evaluation of such applications is in the early stages. Therefore, it is important to foresee its future applicability in order to meet the needs of the twenty-first century.

  7. Barriers to the management of Diabetes Mellitus - is there a future role for Laser Doppler Flowmetry?

    PubMed

    Au, Minnie; Rattigan, Stephen

    2012-01-01

    Diabetes Mellitus (DM) is a chronic disease that carries a significant disease burden in Australia and worldwide. The aim of this paper is to identify current barriers in the management of diabetes, ascertain whether there is a benefit from early detection and determine whether LDF has the potential to reduce the disease burden of DM by reviewing the literature relating to its current uses and development. In this literature review search terms included; laser Doppler flowmetry, diabetes mellitus, barriers to management, uses, future, applications, vasomotion, subcutaneous, cost. Databases used included Google Scholar, Scopus, Science Direct and Medline. Publications from the Australian government and textbooks were also utilised. Articles reviewed had access to the full text and were in English. PMID:23382766

  8. Salmon Futures: Stakeholder-driven salmon management scenarios under changing environmental conditions on Alaska's Kenai Peninsula

    NASA Astrophysics Data System (ADS)

    Trammell, E. J.; Krupa, M.

    2015-12-01

    Understanding the adaptive capacity of individuals within natural resource management agencies is a key component of assessing the vulnerability of salmon to future environmental change. We seek to explore the adaptive capacity of natural resource agencies on Alaska's Kenai Peninsula by exploring the drivers and implications of different salmon allocation scenarios through participatory workshops with managers. We present here the initial results from the first workshop, which explores the various drivers responsible for changes in salmon allocation. Ranging from global to local, and biophysical to socioeconomic, these drivers are also linked to specific actors in the region. These complex interactions comprise the Kenai Peninsula's social-ecological system and determine its ability to react to change. Using a stakeholder-driven scenario framework, we aim to: 1) explore the adaptive capacity of natural resource agencies in the region by exploring and exposing managers to different but logically coherent salmon allocation scenarios; 2) build stakeholder confidence in the science of environmental change on the Kenai Peninsula; and 3) develop a decision support tool that helps regional resource managers better understand their changing environment. We utilize and present the scenario framework as a platform for integrating hydrologic, landscape, and cultural change information into actionable decisions, crafted by the stakeholders, so that landscape change on the Kenai becomes more coordinated.

  9. The future of capitation: the physician role in managing change in practice.

    PubMed

    Goodson, J D; Bierman, A S; Fein, O; Rask, K; Rich, E C; Selker, H P

    2001-04-01

    Capitation-based reimbursement significantly influences the practice of medicine. As physicians, we need to assure that payment models do not jeopardize the care we provide when we accept higher levels of personal financial risk. In this paper, we review the literature relevant to capitation, consider the interaction of financial incentives with physician and medical risk, and conclude that primary care physicians need to work to assure that capitated systems incorporate checks and balances which protect both patients and providers. We offer the following proposals for individuals and groups considering capitated contracts: (1) reimbursement for primary care physicians should recognize both individual patient encounters and the administrative work of patient care management; (2) reimbursement for subspecialists should recognize both access to subspecialty knowledge and expertise as well as patient care encounters, but in some situations, subspecialists may provide the majority of care to individual patients and will be reimbursed as primary care providers; (3) groups of physicians should accept financial risk for patient care only if they have the tools and resources to manage the care; (4) physicians sharing risk for patient care should meet regularly to discuss care and resource management; and (5) physicians must disclose the financial relationships they have with health plans and medical care organizations, and engage patients and communities in discussions about resource allocation. As a payment model, capitation offers opportunities for primary care physicians to influence the future of health care by improving the management of resources at a local level. PMID:11318926

  10. CURRENT PROGRESS AND FUTURE PLANS FOR THE DOE OFFICE OF ENVIRONMENTAL MANAGEMENT INTERNATIONAL PROGRAM

    SciTech Connect

    Marra, J; Kurt D Gerdes, K; David Peeler, D; John Harbour, J; Kevin Fox, K

    2007-11-16

    The U.S. Department of Energy's (DOE) Office of Environmental Management (EM) has collaborated with various international institutes for many years on radioactive waste management challenges of mutual concern. Currently, DOE-EM is performing collaborative work with researchers at the Khlopin Radium Institute and the SIA Radon Institute in Russia and the Ukraine's International Radioecology Laboratory to explore issues related to high-level waste and to investigate experience and technologies that could support DOE-EM site cleanup needs. Specific initiatives include: (1) Application of the Cold Crucible Induction Heated Melter to DOE Wastes--SIA Radon and Savannah River National Laboratory; (2) Improved Solubility and Retention of Troublesome Components in SRS and Hanford Waste Glasses--Khlopin Radium Institute, Pacific Northwest National Laboratory and Savannah River National Laboratory; and (3) Long-term Impacts from Radiation/Contamination within the Chernobyl Exclusion Zone--International Radioecology Laboratory and Savannah River National Laboratory. This paper provides an overview of the status of the current International Program task activities. The paper will also provide insight into the future direction for the program. Specific ties to the current DOE-EM technology development multi-year planning effort will be highlighted as well as opportunities for future international collaborations.

  11. Ants in the Hospital Environment: Ecological Parameters as Support for Future Management Strategies.

    PubMed

    de Castro, M M; Almeida, M; Fernandes, E F; Prezoto, F

    2016-06-01

    Urban ants cause many losses to human society, and they represent a potential threat to public health in hospital environments due to their ability to transport pathogenic organisms. We evaluated several ecological parameters (richness, abundance, constancy, and evenness), their fluctuation during the seasons, and identified species that occur outside the natural range of the ant fauna of a hospital environment, as support for future management strategies. Ant sampling was held every 2 months by using attractive bait traps in the morning and evening, leading to the sampling of 10,342 individuals belonging to six subfamilies and 26 species. Myrmicinae showed higher richness (n = 12) and abundance (n = 7336), with Pheidole susannae Forel being the most abundant species. The most constant species (100%) were P. susannae and Tetramorium simillimum (Smith). Among the most abundant species, Monomorium floricola (Jerdon) and Tapinoma melanocephalum (Fabricius) are considered as species that occur outside the natural range. No difference was observed between species richness and abundance. The Shannon (2.247), dominance (0.1395) and evenness indices (0.6897) indicated a stability of the community throughout the year with high diversity and low dominance of species. The sampled data constitute a new series of information on a long-term ecological approach to support future management strategies in hospital environments and allow for more efficient pest control.

  12. Conservation of greater sage-grouse- a synthesis of current trends and future management

    USGS Publications Warehouse

    Connelly, John W.; Knick, Steven T.; Braun, Clait E.; Baker, William L.; Beever, Erik A.; Christiansen, Thomas J.; Doherty, Kevin E.; Garton, Edward O.; Hagen, Christian A.; Hanser, Steven E.; Johnson, Douglas H.; Leu, Matthias; Miller, Richard F.; Naugle, David E.; Oyler-McCance, Sara J.; Pyke, David A.; Reese, Kerry P.; Schroeder, Michael A.; Stiver, San J.; Walker, Brett L.; Wisdorn, Michael J.

    2011-01-01

    Recent analyses of Greater Sage-Grouse (Centrocercus urophasianus) populations indicate substantial declines in many areas but relatively stable populations in other portions of the species? range. Sagebrush (Artemisia spp.) habitats neces-sary to support sage-grouse are being burned by large wildfires, invaded by nonnative plants, and developed for energy resources (gas, oil, and wind). Management on public lands, which con-tain 70% of sagebrush habitats, has changed over the last 30 years from large sagebrush control projects directed at enhancing livestock grazing to a greater emphasis on projects that often attempt to improve or restore ecological integrity. Never-theless, the mandate to manage public lands to provide traditional consumptive uses as well as recreation and wilderness values is not likely to change in the near future. Consequently, demand and use of resources contained in sagebrush land-scapes plus the associated infrastructure to sup-port increasing human populations in the western United States will continue to challenge efforts to conserve Greater Sage-Grouse. The continued widespread distribution of sage-grouse, albeit at very low densities in some areas, coupled with large areas of important sagebrush habitat that are relatively unaffected by the human footprint, sug-gest that Greater Sage-Grouse populations may be able to persist into the future. We summarize the status of sage-grouse populations and habitats, provide a synthesis of major threats and chal-lenges to conservation of sage-grouse, and suggest a roadmap to attaining conservation goals.

  13. Current Progress and Future Plans for the DOE Office of Environmental Management International Program

    SciTech Connect

    Gerdes, K.D.; Marra, J. C.; Peeler, D.K.; Harbour, M.J.J.R.; Fox, K.M.; Vienna, J.D.; Aloy, A.S.; Stefanovsky, S.V.; Bondarkov, M.D.

    2008-07-01

    The U.S. Department of Energy's (DOE) Office of Environmental Management (EM) has collaborated with various international institutes for many years on radioactive waste management challenges of mutual concern. Currently, DOE-EM is performing collaborative work with researchers at the Khlopin Radium Institute and the SIA Radon Institute in Russia and the Ukraine's International Radioecology Laboratory to explore issues related to high-level waste and to investigate experience and technologies that could support DOE-EM site cleanup needs. Specific initiatives include: - Application of the Cold Crucible Induction Heated Melter to DOE Wastes - SIA Radon and Savannah River National Laboratory; - Improved Solubility and Retention of Troublesome Components in SRS and Hanford Waste Glasses - Khlopin Radium Institute, Pacific Northwest National Laboratory and Savannah River National Laboratory; - Long-term Impacts from Radiation/Contamination within the Chernobyl Exclusion Zone, International Radioecology Laboratory and Savannah River National Laboratory. This paper provides an overview of the status of the current International Program task activities. The paper will also provide insight into the future direction for the program. Specific ties to the current DOE-EM technology development multi-year planning effort will be highlighted as well as opportunities for future international collaborations. (authors)

  14. Embryo futures and stem cell research: the management of informed uncertainty.

    PubMed

    Ehrich, Kathryn; Williams, Clare; Farsides, Bobbie; Scott, Rosamund

    2012-01-01

    In the social worlds of assisted conception and stem cell science, uncertainties proliferate and particular framings of the future may be highly strategic. In this article we explore meanings and articulations of the future using data from our study of ethical and social issues implicated by the donation of embryos to human embryonic stem cell research in three linked assisted conception units and stem cell laboratories in the UK. Framings of the future in this field inform the professional management of uncertainty and we explore some of the tensions this involves in practice. The bifurcation of choices for donating embryos into accepting informed uncertainty or not donating at all was identified through the research process of interviews and ethics discussion groups. Professional staff accounts in this study contained moral orientations that valued ideas such as engendering patient trust by offering full information, the sense of collective ownership of the National Heath Service and publicly funded science and ideas for how donors might be able to give restricted consent as a third option.

  15. Landfill taxes and Enhanced Waste Management: Combining valuable practices with respect to future waste streams.

    PubMed

    Hoogmartens, Rob; Eyckmans, Johan; Van Passel, Steven

    2016-09-01

    Both landfill taxes and Enhanced Waste Management (EWM) practices can mitigate the scarcity issue of landfill capacity by respectively reducing landfilled waste volumes and valorising future waste streams. However, high landfill taxes might erode incentives for EWM, even though EWM creates value by valorising waste. Concentrating on Flanders (Belgium), the paper applies dynamic optimisation modelling techniques to analyse how landfill taxation and EWM can reinforce each other and how taxation schemes can be adjusted in order to foster sustainable and welfare maximising ways of processing future waste streams. Based on the Flemish simulation results, insights are offered that are generally applicable in international waste and resource management policy. As shown, the optimal Flemish landfill tax that optimises welfare in the no EWM scenario is higher than the one in the EWM scenario (93 against €50/ton). This difference should create incentives for applying EWM and is driven by the positive external effects that are generated by EWM practices. In Flanders, as the current landfill tax is slightly lower than these optimal levels, the choice that can be made is to further increase taxation levels or show complete commitment to EWM. A first generally applicable insight that was found points to the fact that it is not necessarily the case that the higher the landfill tax, the more effective waste management improvements can be realised. Other insights are about providing sufficient incentives for applying EMW practices and formulating appropriate pleas in support of technological development. By these insights, this paper should provide relevant information that can assist in triggering the transition towards a resource-efficient, circular economy in Europe. PMID:27067099

  16. Landfill taxes and Enhanced Waste Management: Combining valuable practices with respect to future waste streams.

    PubMed

    Hoogmartens, Rob; Eyckmans, Johan; Van Passel, Steven

    2016-09-01

    Both landfill taxes and Enhanced Waste Management (EWM) practices can mitigate the scarcity issue of landfill capacity by respectively reducing landfilled waste volumes and valorising future waste streams. However, high landfill taxes might erode incentives for EWM, even though EWM creates value by valorising waste. Concentrating on Flanders (Belgium), the paper applies dynamic optimisation modelling techniques to analyse how landfill taxation and EWM can reinforce each other and how taxation schemes can be adjusted in order to foster sustainable and welfare maximising ways of processing future waste streams. Based on the Flemish simulation results, insights are offered that are generally applicable in international waste and resource management policy. As shown, the optimal Flemish landfill tax that optimises welfare in the no EWM scenario is higher than the one in the EWM scenario (93 against €50/ton). This difference should create incentives for applying EWM and is driven by the positive external effects that are generated by EWM practices. In Flanders, as the current landfill tax is slightly lower than these optimal levels, the choice that can be made is to further increase taxation levels or show complete commitment to EWM. A first generally applicable insight that was found points to the fact that it is not necessarily the case that the higher the landfill tax, the more effective waste management improvements can be realised. Other insights are about providing sufficient incentives for applying EMW practices and formulating appropriate pleas in support of technological development. By these insights, this paper should provide relevant information that can assist in triggering the transition towards a resource-efficient, circular economy in Europe.

  17. Managed care: future good news or bad news for vascular surgeons.

    PubMed

    Hallett, J W

    1998-08-01

    Recently, William W. McGuire, Chief Executive Officer of United Health-Care, emphasized that the key from the patient's viewpoint is access. He stated, "We use the term gateway rather than gatekeeper." He emphasizes the importance of direct access of the patient to the right physician, whether it be a specialist or a generalist. Although some health care strategists believe that patients should initially see a generalist before receiving specialty care, this approach may not save dollars in the long run. Managed care is likely to have a major impact on vascular surgeons. Currently, business purchasing cooperatives are one model for containing costs of expensive invasive procedures among the working population. Such cooperatives are likely to achieve a stronger penetration in the health care market and to negotiate aggressively for packaged fee contracts for specialized cardiovascular care and procedures. Because the vast majority of vascular patients are more than 65 years of age, the movement of Medicare toward managed care may also affect vascular surgery in a major way. If vascular surgeons are to survive financially in the managed care environment, they must continue to provide evidence-based solutions to clinical problems at a reasonable cost and with good outcomes. They must also understand that involvement in the administrative and political leadership of health care is essential to maintaining some influence on the future reimbursement for our services.

  18. Modelling coral reef futures to inform management: can reducing local-scale stressors conserve reefs under climate change?

    PubMed

    Gurney, Georgina G; Melbourne-Thomas, Jessica; Geronimo, Rollan C; Aliño, Perry M; Johnson, Craig R

    2013-01-01

    Climate change has emerged as a principal threat to coral reefs, and is expected to exacerbate coral reef degradation caused by more localised stressors. Management of local stressors is widely advocated to bolster coral reef resilience, but the extent to which management of local stressors might affect future trajectories of reef state remains unclear. This is in part because of limited understanding of the cumulative impact of multiple stressors. Models are ideal tools to aid understanding of future reef state under alternative management and climatic scenarios, but to date few have been sufficiently developed to be useful as decision support tools for local management of coral reefs subject to multiple stressors. We used a simulation model of coral reefs to investigate the extent to which the management of local stressors (namely poor water quality and fishing) might influence future reef state under varying climatic scenarios relating to coral bleaching. We parameterised the model for Bolinao, the Philippines, and explored how simulation modelling can be used to provide decision support for local management. We found that management of water quality, and to a lesser extent fishing, can have a significant impact on future reef state, including coral recovery following bleaching-induced mortality. The stressors we examined interacted antagonistically to affect reef state, highlighting the importance of considering the combined impact of multiple stressors rather than considering them individually. Further, by providing explicit guidance for management of Bolinao's reef system, such as which course of management action will most likely to be effective over what time scales and at which sites, we demonstrated the utility of simulation models for supporting management. Aside from providing explicit guidance for management of Bolinao's reef system, our study offers insights which could inform reef management more broadly, as well as general understanding of reef

  19. Modelling Coral Reef Futures to Inform Management: Can Reducing Local-Scale Stressors Conserve Reefs under Climate Change?

    PubMed Central

    Gurney, Georgina G.; Melbourne-Thomas, Jessica; Geronimo, Rollan C.; Aliño, Perry M.; Johnson, Craig R.

    2013-01-01

    Climate change has emerged as a principal threat to coral reefs, and is expected to exacerbate coral reef degradation caused by more localised stressors. Management of local stressors is widely advocated to bolster coral reef resilience, but the extent to which management of local stressors might affect future trajectories of reef state remains unclear. This is in part because of limited understanding of the cumulative impact of multiple stressors. Models are ideal tools to aid understanding of future reef state under alternative management and climatic scenarios, but to date few have been sufficiently developed to be useful as decision support tools for local management of coral reefs subject to multiple stressors. We used a simulation model of coral reefs to investigate the extent to which the management of local stressors (namely poor water quality and fishing) might influence future reef state under varying climatic scenarios relating to coral bleaching. We parameterised the model for Bolinao, the Philippines, and explored how simulation modelling can be used to provide decision support for local management. We found that management of water quality, and to a lesser extent fishing, can have a significant impact on future reef state, including coral recovery following bleaching-induced mortality. The stressors we examined interacted antagonistically to affect reef state, highlighting the importance of considering the combined impact of multiple stressors rather than considering them individually. Further, by providing explicit guidance for management of Bolinao's reef system, such as which course of management action will most likely to be effective over what time scales and at which sites, we demonstrated the utility of simulation models for supporting management. Aside from providing explicit guidance for management of Bolinao's reef system, our study offers insights which could inform reef management more broadly, as well as general understanding of reef

  20. New directions in cardiac arrhythmia management: present challenges and future solutions.

    PubMed

    Nattel, Stanley; Andrade, Jason; Macle, Laurent; Rivard, Lena; Dyrda, Katia; Mondesert, Blandine; Khairy, Paul

    2014-12-01

    Cardiac arrhythmias are a major contributor to population morbidity and mortality. Enormous advances in arrhythmia management have occurred over the 60 years since the founding of the Montreal Heart Institute, but important challenges remain. The purpose of this article is to identify the areas of cardiac arrhythmia therapy that need improvement and to discuss the evolving approaches that promise solutions. Challenges in diagnosis, detection, and risk-stratification include difficulties in separating benign from high-risk syncope and pinpointing the underlying causes, the detection of silent atrial fibrillation in patients at risk of stroke, and inadequate identification of sudden-death risk. Implantable devices are limited by the need for battery and device replacements, device complications like infection and dysfunction, and lead complications like fracture, infection, or displacement. Antiarrhythmic drug therapy, although widely used, is plagued by a very limited range of available agents, supply issues, insufficient efficacy, and significant adverse effect risk. Health economic concerns include the high cost of new technologies, challenges in establishing cost effectiveness, and restrictive practices of government or third-party payers. Major improvements in arrhythmia management can be expected from new discoveries and technological developments in genetics, innovative diagnostic tools for arrhythmia monitoring, imaging and analysis, new approaches to antiarrhythmic drug development, biological therapies, and continuing improvement in implantable device technology like further miniaturization, leadless technology, and use of novel energy sources. As exciting as the developments in arrhythmia management have been in the past, we can look forward to exponential improvement in our ability to manage arrhythmia patients in the near future.

  1. Evaluating watershed service availability under future management and climate change scenarios in the Pangani Basin

    NASA Astrophysics Data System (ADS)

    Notter, Benedikt; Hurni, Hans; Wiesmann, Urs; Ngana, James O.

    Watershed services are the benefits people obtain from the flow of water through a watershed. While demand for such services is increasing in most parts of the world, supply is getting more insecure due to human impacts on ecosystems such as climate or land use change. Population and water management authorities therefore require information on the potential availability of watershed services in the future and the trade-offs involved. In this study, the Soil and Water Assessment Tool (SWAT) is used to model watershed service availability for future management and climate change scenarios in the East African Pangani Basin. In order to quantify actual “benefits”, SWAT2005 was slightly modified, calibrated and configured at the required spatial and temporal resolution so that simulated water resources and processes could be characterized based on their valuation by stakeholders and their accessibility. The calibrated model was then used to evaluate three management and three climate scenarios. The results show that by the year 2025, not primarily the physical availability of water, but access to water resources and efficiency of use represent the greatest challenges. Water to cover basic human needs is available at least 95% of time but must be made accessible to the population through investments in distribution infrastructure. Concerning the trade-off between agricultural use and hydropower production, there is virtually no potential for an increase in hydropower even if it is given priority. Agriculture will necessarily expand spatially as a result of population growth, and can even benefit from higher irrigation water availability per area unit, given improved irrigation efficiency and enforced regulation to ensure equitable distribution of available water. The decline in services from natural terrestrial ecosystems (e.g. charcoal, food), due to the expansion of agriculture, increases the vulnerability of residents who depend on such services mostly in times

  2. Recent Developments in Neurofibromatoses and RASopathies: Management, Diagnosis and Current and Future Therapeutic Avenues

    PubMed Central

    Rauen, Katherine A.; Huson, Susan M.; Burkitt-Wright, Emma; Evans, D Gareth; Farschtschi, Said; Ferner, Rosalie E; Gutmann, David H.; Hanemann, C Oliver; Kerr, Bronwyn; Legius, Eric; Parada, Luis F; Patton, Michael; Peltonen, Juha; Ratner, Nancy; Riccardi, Vincent M.; van der Vaart, Thijs; Vikkula, Miikka; Viskochil, David H.; Zenker, Martin; Upadhyaya, Meena

    2014-01-01

    Neurofibromatosis type 1 was the first RASopathy and is now one of many RASopathies that are caused by germline mutations in genes that encode components of the Ras/mitogen-activated protein kinase (MAPK) pathway. Their common underlying pathogenetic etiology causes significant overlap in phenotypic features which includes craniofacial dysmorphology, cardiac, cutaneous, musculoskeletal, GI and ocular abnormalities, and a predisposition to cancer. The proceedings from the symposium “Recent Developments in Neurofibromatoses and RASopathies: Management, Diagnosis and Current and Future Therapeutic Avenues” chronicle this timely and topical clinical translational research symposium. The overarching goal was to bring together clinicians, basic scientists, physician-scientists, advocate leaders, trainees, students and individuals with Ras pathway syndromes to discuss the most state-of-the-art basic science and clinical issues in an effort to spark collaborations directed towards the best practices and therapies for individuals with RASopathies. PMID:25393061

  3. Revisiting extreme storms of the past 100 years for future safety of large water management infrastructures

    NASA Astrophysics Data System (ADS)

    Chen, Xiaodong; Hossain, Faisal

    2016-07-01

    Historical extreme storm events are widely used to make Probable Maximum Precipitation (PMP) estimates, which form the cornerstone of large water management infrastructure safety. Past studies suggest that extreme precipitation processes can be sensitive to land surface feedback and the planetary warming trend, which makes the future safety of large infrastructures questionable given the projected changes in land cover and temperature in the coming decades. In this study, a numerical modeling framework was employed to reconstruct 10 extreme storms over CONUS that occurred during the past 100 years, which are used by the engineering profession for PMP estimation for large infrastructures such as dams. Results show that the correlation in daily rainfall for such reconstruction can range between 0.4 and 0.7, while the correlation for maximum 3-day accumulation (a standard period used in infrastructure design) is always above 0.5 for post-1948 storms. This suggests that current numerical modeling and reanalysis data allow us to reconstruct big storms after 1948 with acceptable accuracy. For storms prior to 1948, however, reconstruction of storms shows inconsistency with observations. Our study indicates that numerical modeling and data may not have advanced to a sufficient level to understand how such old storms (pre-1948) may behave in future warming and land cover conditions. However, the infrastructure community can certainly rely on the use of model reconstructed extreme storms of the 1948-present period to reassess safety of our large water infrastructures under assumed changes in temperature and land cover.

  4. Aeronautical Communications Research and Development Needs for Future Air Traffic Management Applications

    NASA Technical Reports Server (NTRS)

    Kerczewski, Robert J.

    2002-01-01

    Continuing growth in regional and global air travel has resulted in increasing traffic congestion in the air and on the ground. In spite of occasional temporary downturns due to economic recessions and catastrophic events, average growth rates of air travel have remained high since the 1960s. The resulting congestion, which constrains expansion of the air transportation industry, inflicts schedule delays and decreases overall system efficiency, creating a pressing need to develop more efficient methods of air traffic management (ATM). New ATM techniques, procedures, air space automation methods, and decision support tools are being researched and developed for deployment in time frames stretching from the next few years to the year 2020 and beyond. As these methods become more advanced and increase in complexity, the requirements for information generation, sharing and transfer among the relevant entities in the ATM system increase dramatically. However, current aeronautical communications systems will be inadequate to meet the future information transfer demands created by these advanced ATM systems. Therefore, the NASA Glenn Research Center is undertaking research programs to develop communication, methods and key technologies that can meet these future requirements. As part of this process, studies, workshops, testing and experimentation, and research and analysis have established a number of research and technology development needs. The purpose of this paper is to outline the critical research and technology needs that have been identified in these activities, and explain how these needs have been determined.

  5. The past, present, and future of U.S. utility demand-side management programs

    SciTech Connect

    Eto, J.

    1996-12-01

    Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers` energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in response to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests.

  6. Scenarios of Future Water use on Mediterranean Islands based on an Integrated Assessment of Water Management

    NASA Astrophysics Data System (ADS)

    Lange, M. A.

    2006-12-01

    The availability of water in sufficient quantities and adequate quality presents considerable problems on Mediterranean islands. Because of their isolation and thus the impossibility to draw on more distant or more divers aquifers, they rely entirely on precipitation as natural replenishing mechanism. Recent observations indicate decreasing precipitation, increasing evaporation and steadily growing demand for water on the islands. Future climate change will exacerbate this problem, thus increasing the already pertinent vulnerability to droughts. Responsible planning of water management strategies requires scenarios of future supply and demand through an integrated assessment including climate scenarios based on regional climate modeling as well as scenarios on changes in societal and economical determinants of water demand. Constructing such strategies necessitates a thorough understanding about the interdependencies and feedbacks between physical/hydrological and socio-economic determinants of water balances on an island. This has to be based on a solid understanding of past and present developments of these drivers. In the framework of the EU-funded MEDIS project (Towards sustainable water use on Mediterranean Islands: addressing conflicting demands and varying hydrological, social and economic conditions, EVK1-CT-2001-00092), detailed investigations on present vulnerabilities and adaptation strategies to droughts have been carried out on Mallorca, Corsica, Sicily, Crete and Cyprus. This was based on an interdisciplinary study design including hydrological, geophysical, agricultural-, social and political sciences investigations. A central element of the study has been the close interaction with stakeholders on the islands and their contribution to strategy formulation. An important result has been a specification of vulnerability components including: a physical/environmental-, an economical/regulatory- and a social/institutional/political component. Their

  7. Potential Effects of Future Climate Change on the Bioclimatic Habitat of Ecoregions and Managed Lands in Oregon

    NASA Astrophysics Data System (ADS)

    Shafer, S. L.; Saltré, F.; Bartlein, P. J.

    2011-12-01

    Conservation and natural resource managers need information on the potential effects of climate change for the species and ecosystems they manage. We evaluated potential future changes in climate and bioclimatic habitat for ecoregions (as defined by The Nature Conservancy) and managed areas (e.g., national parks) in Oregon, USA. We used future climate simulations for the 21st century from the World Climate Research Programme's Coupled Model Intercomparison Project phase 3 (CMIP3) data set that were produced under the A2 greenhouse gases emissions scenario by three coupled atmosphere-ocean general circulation models (CCSM3, CGCM3.1(T47), UKMO-HadCM3). Projected future climate anomalies were interpolated using geographic-distance-weighted bilinear interpolation to a 30-arc-second (~1-km) grid encompassing the state of Oregon. The interpolated anomalies were applied to 1961-1990 30-year mean climate data (PRISM Climate Group, Oregon State Univ.). Bioclimatic variables (e.g., growing degree days) were calculated using the interpolated climate data and soil data from the CONUS-Soil data set (Miller and White 1998). We chose bioclimatic variables that represent important physiological and environmental limits for Oregon species and habitats of management concern. Maps and multivariate descriptive plots were used to evaluate the direction, magnitude, and spatial patterns of projected future climate and bioclimatic changes. The results indicate which ecoregions and managed areas would experience the largest climate and bioclimatic changes under each of the potential future climate simulations.

  8. Pharmacist-managed clinics for patient education and counseling in Japan: current status and future perspectives.

    PubMed

    Yamada, Kiyofumi; Nabeshima, Toshitaka

    2015-01-01

    To improve the adherence to and knowledge about pharmacotherapy in outpatients and to maximize the efficacy and minimize the adverse drug events, the first pharmacist-managed clinic (PMC) in Japan was established for anticoagulation therapy at Nagoya University Hospital in 2000. Since then, various PMCs such as for asthma/chronic obstructive pulmonary disease, Alzheimer's disease, hypercholesterolemia, chronic hepatitis C, cancer chemotherapy, palliative care, chronic kidney disease, and continuous ambulatory peritoneal dialysis have been established and expanded to many hospitals in Japan. Accumulating evidences suggest that PMCs have some beneficial effects on patients' adherence to and knowledge about their pharmacotherapy as well as the clinical outcome, besides being cost-effective. Notably, PMCs for cancer chemotherapy have been approved as a new medical service in hospitals in 2014, which is covered by the universal health coverage in Japan. In this review article, the current status of PMCs for patient education and counseling in Japan and their impact on pharmaceutical care and management are critically reviewed. Furthermore, future perspectives on PMCs are discussed. PMID:26819713

  9. Is EDI dead? The future of the Internet in supply chain management.

    PubMed

    Peters, L R

    2000-08-01

    I have been involved in materials management for about 30 years (that is not something many of us really want to admit--it says we are getting old), and over that time I have seen many methods of communication come and go. In the 1960s, we used seven-part carbon forms to generate orders. We also used the keypunch card or IBM card to send our request for materials to our supplier. The supplier would acknowledge our order and provide us with a promise date. This could be done by mail using these cards or by forwarding the information to us electronically for conversion to cards. I could trace the history of communication in painful detail, but that is not important. What is important is that the only thing that has remained constant in those past 30 years has been change. We have all heard that before, but we seem to forget it. This presentation will look at the future of EDI and the Internet in supply chain management.

  10. Preeclampsia – Aetiology, Current Diagnostics and Clinical Management, New Therapy Options and Future Perspectives

    PubMed Central

    Tallarek, A.-C.; Huppertz, B.; Stepan, H.

    2012-01-01

    Preeclampsia is a multisystem disease for which the exact causes have not yet been sufficiently clarified. However, in the past few years it has become clear that a placental imbalance between angiogenic and anti-angiogenic proteins is the decisive pathogenetic factor for the occurrence of preeclampsia. With the possibility to measure these angiogenic factors (sFlt-1/PlGF ratio) in maternal blood full new diagnostic possibilities have been opened that enable the certain diagnosis or exclusion of the diseases as well as a short-term prognosis to be made. In secondary prevention the current data situation for ASA confirms a moderate but measurable utility. The management concept depends on gestational age. In the case of early clinical manifestations (< 34th week of pregnancy) the clinical management in a perinatal centre remains unchanged with foeto-maternal monitoring and induction of pulmonary maturation, symptomatic therapy under careful blood pressure lowering and determination of the optimal delivery time. A balance must be made here between foetal immaturity and maternal risks upon prolongations. The pathomechanism of anti-angiogenic overload with sFlt-1 provides a starting point for first therapeutic interventions. The present article gives an overview of current diagnostic options and presents possible future therapeutic perspectives for discussion. PMID:26640284

  11. Diagnosis and Management of Autoimmune Hepatitis: Current Status and Future Directions

    PubMed Central

    Czaja, Albert J.

    2016-01-01

    Autoimmune hepatitis is characterized by autoantibodies, hypergammaglobulinemia, and interface hepatitis on histological examination. The features lack diagnostic specificity, and other diseases that may resemble autoimmune hepatitis must be excluded. The clinical presentation may be acute, acute severe (fulminant), or asymptomatic; conventional autoantibodies may be absent; centrilobular necrosis and bile duct changes may be present; and the disease may occur after liver transplantation or with features that suggest overlapping disorders. The diagnostic criteria have been codified, and diagnostic scoring systems can support clinical judgment. Nonstandard autoantibodies, including antibodies to actin, α-actinin, soluble liver antigen, perinuclear antineutrophil antigen, asialoglycoprotein receptor, and liver cytosol type 1, are tools that can support the diagnosis, especially in patients with atypical features. Prednisone or prednisolone in combination with azathioprine is the preferred treatment, and strategies using these medications in various doses can ameliorate treatment failure, incomplete response, drug intolerance, and relapse after drug withdrawal. Budesonide, mycophenolate mofetil, and calcineurin inhibitors can be considered in selected patients as frontline or salvage therapies. Molecular (recombinant proteins and monoclonal antibodies), cellular (adoptive transfer and antigenic manipulation), and pharmacological (antioxidants, antifibrotics, and antiapoptotic agents) interventions constitute future directions in management. The evolving knowledge of the pathogenic pathways and the advances in technology promise new management algorithms. PMID:26934884

  12. The SPi chip as an integrated power management device for serial powering of future HEP experiments

    SciTech Connect

    Trimpl, M.; Deptuch, G.; Gingu, C.; Yarema, R.; Holt, R.; Weber, M.; Kierstead, J.; Lynn, D.; /Brookhaven

    2009-01-01

    Serial powering is one viable and very efficient way to distribute power to future high energy physics (HEP) experiments. One promising way to realize serial powering is to have a power management device on the module level that provides the necessary voltage levels and features monitoring functionality. The SPi (Serial Powering Interface) chip is such a power manager and is designed to meet the requirements imposed by current SLHC upgrade plans. It incorporates a programmable shunt regulator, two linear regulators, current mode ADCs to monitor the current distribution on the module, over-current detection, and also provides module power-down capabilities. Compared to serially powered setups that use discrete components, the SPi offers a higher level of functionality in much less real estate and is designed to be radiation tolerant. Bump bonding techniques are used for chip on board assembly providing the most reliable connection at lowest impedance. This paper gives an overview of the SPi and outlines the main building blocks of the chip. First stand alone tests are presented showing that the chip is ready for operation in serially powered setups.

  13. The future water environment--using scenarios to explore the significant water management challenges in England and Wales to 2050.

    PubMed

    Henriques, C; Garnett, K; Weatherhead, E K; Lickorish, F A; Forrow, D; Delgado, J

    2015-04-15

    Society gets numerous benefits from the water environment. It is crucial to ensure that water management practices deliver these benefits over the long-term in a sustainable and cost-effective way. Currently, hydromorphological alterations and nutrient enrichment pose the greatest challenges in European water bodies. The rapidly changing climatic and socio-economic boundary conditions pose further challenges to water management decisions and the achievement of policy goals. Scenarios are a strategic tool useful in conducting systematic investigations of future uncertainties pertaining to water management. In this study, the use of scenarios revealed water management challenges for England and Wales to 2050. A set of existing scenarios relevant to river basin management were elaborated through stakeholder workshops and interviews, relying on expert knowledge to identify drivers of change, their interdependencies, and influence on system dynamics. In a set of four plausible alternative futures, the causal chain from driving forces through pressures to states, impacts and responses (DPSIR framework) was explored. The findings suggest that scenarios driven by short-term economic growth and competitiveness undermine current environmental legislative requirements and exacerbate the negative impacts of climate change, producing a general deterioration of water quality and physical habitats, as well as reduced water availability with adverse implications for the environment, society and economy. Conversely, there are substantial environmental improvements under the scenarios characterised by long-term sustainability, though achieving currently desired environmental outcomes still poses challenges. The impacts vary across contrasting generic catchment types that exhibit distinct future water management challenges. The findings suggest the need to address hydromorphological alterations, nutrient enrichment and nitrates in drinking water, which are all likely to be

  14. The future water environment--using scenarios to explore the significant water management challenges in England and Wales to 2050.

    PubMed

    Henriques, C; Garnett, K; Weatherhead, E K; Lickorish, F A; Forrow, D; Delgado, J

    2015-04-15

    Society gets numerous benefits from the water environment. It is crucial to ensure that water management practices deliver these benefits over the long-term in a sustainable and cost-effective way. Currently, hydromorphological alterations and nutrient enrichment pose the greatest challenges in European water bodies. The rapidly changing climatic and socio-economic boundary conditions pose further challenges to water management decisions and the achievement of policy goals. Scenarios are a strategic tool useful in conducting systematic investigations of future uncertainties pertaining to water management. In this study, the use of scenarios revealed water management challenges for England and Wales to 2050. A set of existing scenarios relevant to river basin management were elaborated through stakeholder workshops and interviews, relying on expert knowledge to identify drivers of change, their interdependencies, and influence on system dynamics. In a set of four plausible alternative futures, the causal chain from driving forces through pressures to states, impacts and responses (DPSIR framework) was explored. The findings suggest that scenarios driven by short-term economic growth and competitiveness undermine current environmental legislative requirements and exacerbate the negative impacts of climate change, producing a general deterioration of water quality and physical habitats, as well as reduced water availability with adverse implications for the environment, society and economy. Conversely, there are substantial environmental improvements under the scenarios characterised by long-term sustainability, though achieving currently desired environmental outcomes still poses challenges. The impacts vary across contrasting generic catchment types that exhibit distinct future water management challenges. The findings suggest the need to address hydromorphological alterations, nutrient enrichment and nitrates in drinking water, which are all likely to be

  15. Seawater intrusion processes, investigation and management: Recent advances and future challenges

    NASA Astrophysics Data System (ADS)

    Werner, Adrian D.; Bakker, Mark; Post, Vincent E. A.; Vandenbohede, Alexander; Lu, Chunhui; Ataie-Ashtiani, Behzad; Simmons, Craig T.; Barry, D. A.

    2013-01-01

    Seawater intrusion (SI) is a global issue, exacerbated by increasing demands for freshwater in coastal zones and predisposed to the influences of rising sea levels and changing climates. This review presents the state of knowledge in SI research, compares classes of methods for assessing and managing SI, and suggests areas for future research. We subdivide SI research into categories relating to processes, measurement, prediction and management. Considerable research effort spanning more than 50 years has provided an extensive array of field, laboratory and computer-based techniques for SI investigation. Despite this, knowledge gaps exist in SI process understanding, in particular associated with transient SI processes and timeframes, and the characterization and prediction of freshwater-saltwater interfaces over regional scales and in highly heterogeneous and dynamic settings. Multidisciplinary research is warranted to evaluate interactions between SI and submarine groundwater discharge, ecosystem health and unsaturated zone processes. Recent advances in numerical simulation, calibration and optimization techniques require rigorous field-scale application to contemporary issues of climate change, sea-level rise, and socioeconomic and ecological factors that are inseparable elements of SI management. The number of well-characterized examples of SI is small, and this has impeded understanding of field-scale processes, such as those controlling mixing zones, saltwater upconing, heterogeneity effects and other factors. Current SI process understanding is based mainly on numerical simulation and laboratory sand-tank experimentation to unravel the combined effects of tides, surface water-groundwater interaction, heterogeneity, pumping and density contrasts. The research effort would benefit from intensive measurement campaigns to delineate accurately interfaces and their movement in response to real-world coastal aquifer stresses, encompassing a range of geological and

  16. An approach for the anticipatory and participatory management of current and future flood risks

    NASA Astrophysics Data System (ADS)

    Luther, J.

    2012-04-01

    concepts and the application of respective techniques are thus reviewed and incorporated with regard to their suitability for an integrated management of current and future flood risks. In particular, "hybrid scenarios" with qualitative and quantitative components represented by nested models as well as assumptions across different spatiotemporal scales, respectively, are suggested for dealing with the uncertainties when assessing flood risks throughout a system's possible evolution. The (initially top-down developed) approach and its components will be briefly presented. These "scenario products" could later serve as a stimulus for discussions that bring together different actors and enhance - and eventually legitimise - the scenarios further in a "scenario process": (1) A first step is the conceptualisation of a flood risk system following the SPRC-model. Its physical geographical and anthropogenic factors may either be subject to autonomous trends, target-oriented control, or facultative system behaviour (e.g. dike breaches). With this concept, the integration of different processes and scales is aspired. (2) Secondly, it is conceptually shown how the risk cascade for present and future states of the flood risk system can be calculated based on coupled models ranging from climate change projections to a damage simulation models. (3) Thirdly, ways to develop socioeconomic storylines for the development frameworks and guiding principles for the strategic alternatives are presented and the futures are combined. This involves making plausible and consistent assumptions for many system factors and their drivers and finding ways to harmonise existing data for the same areas and time steps. (4) Fourthly, selected futures can be analysed and evaluated ex ante applying the coupled models of the second step to derive the emerging flood risks. The evaluation addresses, amongst other aspects, the identification of (i) the sensitivity of all scenarios against the current strategic

  17. Arctic Observing Network Data Management: Current Capabilities and Their Promise for the Future

    NASA Astrophysics Data System (ADS)

    Collins, J.; Fetterer, F.; Moore, J. A.

    2008-12-01

    CADIS (the Cooperative Arctic Data and Information Service) serves as the data management, discovery and delivery component of the Arctic Observing Network (AON). As an International Polar Year (IPY) initiative, AON comprises 34 land, atmosphere and ocean observation sites, and will acquire much of the data coming from the interagency Study of Environmental Arctic Change (SEARCH). CADIS is tasked with ensuring that these observational data are managed for long term use by members of the entire Earth System Science community. Portions of CADIS are either in use by the community or available for testing. We now have an opportunity to evaluate the feedback received from our users, to identify any design shortcomings, and to identify those elements which serve their purpose well and will support future development. This presentation will focus on the nuts-and-bolts of the CADIS development to date, with an eye towards presenting lessons learned and best practices based on our experiences so far. The topics include: - How did we assess our users' needs, and how are those contributions reflected in the end product and its capabilities? - Why did we develop a CADIS metadata profile, and how does it allow CADIS to support preservation and scientific interoperability? - How can we shield the user from metadata complexities (especially those associated with various standards) while still obtaining the metadata needed to support an effective data management system? - How can we bridge the gap between the data storage formats considered convenient by researchers in the field, and those which are necessary to provide data interoperability? - What challenges have been encountered in our efforts to provide access to federated data (data stored outside of the CADIS system)? - What are the data browsing and visualization needs of the AON community, and which tools and technologies are most promising in terms of supporting those needs? A live demonstration of the current

  18. Knowledge Management - A Necessity For The Training Of Future Specialists Of The Sustainable Entreprises

    NASA Astrophysics Data System (ADS)

    Rotaru, Ionela Magdalena

    2015-09-01

    The world we are living in is shaped by what is a reality for years already: globalisation of economy. The lack of borders makes the impact that technology has on society to be a major one. The virtual world so accessible today is not just about new markets, access to cheaper work force, work online but also fierce competition. The common denominator of most efforts in the area of industry is performance. Limits continuously moving willingness to pay for products that delineate the performance delivered be the same range. Here too we can see the role of the education. For example, Landes shows that both knowledge and know-how are the ones that determine how well off societies are. The education of engineers is therefore critical to every nation to ensure the prosperity of its citizens. This paper here intends to approach the educational process of the engineering specific area of knowledge from the management perspective. The training process becomes sustainable in accordance with the requirements of the future: trained specialists for sustainable enterprises.

  19. Making the next steps in psoriatic arthritis management: current status and future directions

    PubMed Central

    Sritheran, Diviya; Leung, Ying Ying

    2015-01-01

    Psoriatic arthritis (PsA) is a chronic inflammatory condition with articular and extra-articular manifestations: peripheral arthritis, axial disease, enthesitis, dactylitis, and skin and nail disease. It is associated with cardiovascular comorbidities. It is now recognized as a new entity, different from rheumatoid arthritis and other spondyloarthritis in terms of clinical manifestations, pathogenesis, and response to therapies. Anti-tumor necrosis factors (anti-TNFs) have demonstrated clinical efficacies exceeding that of conventional disease modifying antirheumatic drugs (DMARDs). The current treatment paradigms recommend early diagnosis and treatment, and a strategic and target orientated approach, aiming at a low disease activity status. New understanding in the immunopathogenesis of PsA has led to new treatment targets. This review addresses the evidence of current treatment for each of the domains as an aid to the clinician managing these patients in the clinic. Some new therapeutic targets are presented. We highlight the importance of development and validation in outcome measures, including that of composite scores that capture various disease domains that will facilitate future clinical trials to inform the best treatment. PMID:26425146

  20. Spinal muscular atrophy: classification, diagnosis, management, pathogenesis, and future research directions.

    PubMed

    Kostova, Felina V; Williams, Virginia C; Heemskerk, Jill; Iannaccone, Susan; Didonato, Christine; Swoboda, Kathryn; Maria, Bernard L

    2007-08-01

    Spinal muscular atrophy is an autosomal recessive neurodegenerative disorder that affects the motor neurons responsible for movement of the proximal muscles of the trunk and body. To date, the disease can be classified into 3 main categories based on severity and age of onset. During the October 18th symposium held in Pittsburgh, Pennsylvania, researchers met to (1) describe current diagnostic strategies, (2) discuss recent thoughts on pathogenesis, (3) review current therapies and clinical trials, and (4) define future research directions. In her opening remarks, Dr Story Landis, director of the National Institute of Neurological Disorders and Stroke, emphasized the degree to which the Neurobiology of Disease in Children conference series has broadened awareness of the many rare diseases affecting children, not only through the advancement of research but also by educating practitioners about diagnostic strategies. Dr Landis also discussed the role this conference may play in fostering research that seeks to develop a single mechanism of therapy for spinal muscular atrophy. She also discussed the current funding situation at the National Institutes of Health and addressed the crucial function of volunteer research organizations that sponsor research in further improving management of this condition. This article summarizes the presentations and includes the verbatim edited transcript of question-and-answer sessions.

  1. Aggression in Tephritidae Flies: Where, When, Why? Future Directions for Research in Integrated Pest Management

    PubMed Central

    Benelli, Giovanni

    2014-01-01

    True fruit flies (Diptera: Tephritidae) include over 4000 species, many of which constitute enormous threats to fruit and vegetable production worldwide. A number of Tephritidae are lekking species, forming aggregations in which males fight to defend a small territory where they court females and mate. Male-male contests also occur in non-lekking species, characterized by resource defense polygyny. Tephritidae females display agonistic behavior to maintain single oviposition sites and reduce larval competition for food. Here, how, where, when and why aggressive interactions occur in Tephritidae flies is reviewed. A number of neglected issues deserving further research are highlighted, with a special focus on diel periodicity of aggression, cues evoking aggressive behavior, the role of previous experience on fighting success and the evolution of behavioral lateralization of aggressive displays. In the final section, future directions to exploit this knowledge in Integrated Pest Management, with particular emphasis on enhancement of Sterile Insect Technique and interspecific competitive displacement in the field are suggested. PMID:26463064

  2. Making the next steps in psoriatic arthritis management: current status and future directions.

    PubMed

    Sritheran, Diviya; Leung, Ying Ying

    2015-10-01

    Psoriatic arthritis (PsA) is a chronic inflammatory condition with articular and extra-articular manifestations: peripheral arthritis, axial disease, enthesitis, dactylitis, and skin and nail disease. It is associated with cardiovascular comorbidities. It is now recognized as a new entity, different from rheumatoid arthritis and other spondyloarthritis in terms of clinical manifestations, pathogenesis, and response to therapies. Anti-tumor necrosis factors (anti-TNFs) have demonstrated clinical efficacies exceeding that of conventional disease modifying antirheumatic drugs (DMARDs). The current treatment paradigms recommend early diagnosis and treatment, and a strategic and target orientated approach, aiming at a low disease activity status. New understanding in the immunopathogenesis of PsA has led to new treatment targets. This review addresses the evidence of current treatment for each of the domains as an aid to the clinician managing these patients in the clinic. Some new therapeutic targets are presented. We highlight the importance of development and validation in outcome measures, including that of composite scores that capture various disease domains that will facilitate future clinical trials to inform the best treatment.

  3. Public perceptions of demand-side management and a smarter energy future

    NASA Astrophysics Data System (ADS)

    Spence, Alexa; Demski, Christina; Butler, Catherine; Parkhill, Karen; Pidgeon, Nick

    2015-06-01

    Demand-side management (DSM) is a key aspect of many future energy system scenarios. DSM refers to a range of technologies and interventions designed to create greater efficiency and flexibility on the demand-side of the energy system. Examples include the provision of more information to users to support efficient behaviour and new `smart’ technologies that can be automatically controlled. Key stated outcomes of implementing DSM are benefits for consumers, such as cost savings and greater control over energy use. Here, we use results from an online survey to examine public perceptions and acceptability of a range of current DSM possibilities in a representative sample of the British population (N = 2,441). We show that, although cost is likely to be a significant reason for many people to take up DSM measures, those concerned about energy costs are actually less likely to accept DSM. Notably, individuals concerned about climate change are more likely to be accepting. A significant proportion of people, particularly those concerned about affordability, indicated unwillingness or concerns about sharing energy data, a necessity for many forms of DSM. We conclude substantial public engagement and further policy development is required for widespread DSM implementation.

  4. CO2 evaporative cooling: The future for tracking detector thermal management

    NASA Astrophysics Data System (ADS)

    Tropea, P.; Daguin, J.; Petagna, P.; Postema, H.; Verlaat, B.; Zwalinski, L.

    2016-07-01

    In the last few years, CO2 evaporative cooling has been one of the favourite technologies chosen for the thermal management of tracking detectors at LHC. ATLAS Insertable B-Layer and CMS Pixel phase 1 upgrade have adopted it and their systems are now operational or under commissioning. The CERN PH-DT team is now merging the lessons learnt on these two systems in order to prepare the design and construction of the cooling systems for the new Upstream Tracker and the Velo upgrade in LHCb, due by 2018. Meanwhile, the preliminary design of the ATLAS and CMS full tracker upgrades is started, and both concepts heavily rely on CO2 evaporative cooling. This paper highlights the performances of the systems now in operation and the challenges to overcome in order to scale them up to the requirements of the future generations of trackers. In particular, it focuses on the conceptual design of a new cooling system suited for the large phase 2 upgrade programmes, which will be validated with the construction of a common prototype in the next years.

  5. Management of locally advanced breast cancer-perspectives and future directions.

    PubMed

    Tryfonidis, Konstantinos; Senkus, Elzbieta; Cardoso, Maria J; Cardoso, Fatima

    2015-03-01

    Locally advanced breast cancer (LABC) constitutes a heterogeneous entity that includes advanced-stage primary tumours, cancers with extensive nodal involvement and inflammatory breast carcinomas. Although the definition of LABC can be broadened to include some large operable breast tumours, we use this term to strictly refer to inoperable cancers that are included in the above-mentioned categories. The prognosis of such tumours is often unfavourable; despite aggressive treatment, many patients eventually develop distant metastases and die from the disease. Advances in systemic therapy, including radiation treatment, surgical techniques and the development of new targeted agents have significantly improved clinical outcomes for patients with this disease. Notwithstanding these advances, LABC remains an important clinical problem, particularly in developing countries and those without widely adapted breast cancer awareness programmes. The optimal management of LABC requires a multidisciplinary approach, a well-coordinated treatment schedule and close cooperation between medical, surgical and radiation oncologists. In this Review, we discuss the current state of the art and possible future treatment strategies for patients with LABC. PMID:25668732

  6. Present and future utility of computed tomography scanning in the assessment and management of COPD.

    PubMed

    Ostridge, Kristoffer; Wilkinson, Tom M A

    2016-07-01

    Computed tomography (CT) is the modality of choice for imaging the thorax and lung structure. In chronic obstructive pulmonary disease (COPD), it used to recognise the key morphological features of emphysema, bronchial wall thickening and gas trapping. Despite this, its place in the investigation and management of COPD is yet to be determined, and it is not routinely recommended. However, lung CT already has important clinical applications where it can be used to diagnose concomitant pathology and determine which patients with severe emphysema are appropriate for lung volume reduction procedures. Furthermore, novel quantitative analysis techniques permit objective measurements of pulmonary and extrapulmonary manifestations of the disease. These techniques can give important insights into COPD, and help explore the heterogeneity and underlying mechanisms of the condition. In time, it is hoped that these techniques can be used in clinical trials to help develop disease-specific therapy and, ultimately, as a clinical tool in identifying patients who would benefit most from new and existing treatments. This review discusses the current clinical applications for CT imaging in COPD and quantification techniques, and its potential future role in stratifying disease for optimal outcome. PMID:27230448

  7. Adaptive harvest management of North American waterfowl populations: a brief history and future prospects

    USGS Publications Warehouse

    Nichols, J.D.; Runge, M.C.; Johnson, F.A.; Williams, B.K.

    2007-01-01

    Since 1995, the US Fish and Wildlife Service has used an adaptive approach to the management of sport harvest of mid-continent Mallard ducks (Anas platyrhynchos) in North America. This approach differs from many current approaches to conservation and management in requiring close collaboration between managers and scientists. Key elements of this process are objectives, alternative management actions, models permitting prediction of system responses, and a monitoring program. The iterative process produces optimal management decisions and leads to reduction in uncertainty about response of populations to management. This general approach to management has a number of desirable features and is recommended for use in many other programs of management and conservation.

  8. The Skills and Training Needed by Farm Management Researchers in the Future: Discussion. Economics Staff Paper 93-4.

    ERIC Educational Resources Information Center

    Franklin, Douglas R.

    In view of continuing trends in farming and the trend toward increasing farm diversification and specialization, the National Association of State Universities and Land Grant Colleges and individual researchers have proposed their own lists of the skills that will be needed by farm management researchers in the future. Because farm management…

  9. Changes in the Management of Information in Audio-Visual Archives following Digitization: Current and Future Outlook

    ERIC Educational Resources Information Center

    Caldera-Serrano, Jorge

    2008-01-01

    This article attempts to offer an overview of the current changes that are being experienced in the management of audio-visual documentation and those that can be forecast in the future as a result of the migration from analogue to digital information. For this purpose the documentary chain will be used as a basis to analyse individually the tasks…

  10. Attitudes toward Business Ethics and Degree of Opinion Leadership of Future Managers In the United States, Finland, and China

    ERIC Educational Resources Information Center

    Comegys, Charles; Vaisanen, Jaani; Lupton, Robert A.; Rawlinson, David R.

    2013-01-01

    The purpose of this study was to compare the attitudes towards business ethics of future managers in three countries: the United State, Finland, and China, and determine whether business ethics attitudes differed by the student's major, class year, GPA, gender, age, and the number of ethics and religious studies courses completed.…

  11. Using ecological forecasting of future vegetation transition and fire frequency change in the Sierra Nevada to assess fire management strategies

    NASA Astrophysics Data System (ADS)

    Thorne, J. H.; Schwartz, M. W.; Holguin, A. J.; Moritz, M.; Batllori, E.; Folger, K.; Nydick, K.

    2013-12-01

    Ecological systems may respond in complex manners as climate change progresses. Among the responses, site-level climate conditions may cause a shift in vegetation due to the physiological tolerances of plant species, and the fire return interval may change. Natural resource managers challenged with maintaining ecosystem health need a way to forecast how these processes may affect every location, in order to determine appropriate management actions and prioritize locations for interventions. We integrated climate change-driven vegetation type transitions with projected change in fire frequency for 45,203 km2 of the southern Sierra Nevada, California, containing over 10 land management agencies as well as private lands. This Magnitude of Change (MOC) approach involves classing vegetation types in current time according to their climate envelopes, and identifying which sites will in the future have climates beyond what that vegetation currently occurs in. Independently, fire models are used to determine the change in fire frequency for each site. We examined 82 vegetation types with >50 grid cell occurrences. We found iconic resources such as the giant sequoia, lower slope oak woodlands, and high elevation conifer forests are projected as highly vulnerable by models that project a warmer drier future, but not as much by models that project a warmer future that is not drier than current conditions. Further, there were strongly divergent vulnerabilities of these forest types across land ownership (National Parks versus US Forest Service lands), and by GCM. For example, of 50 giant sequoia (Sequoiadendron giganteum) groves and complexes, all but 3 (on Sierra National Forest) were in the 2 highest levels of risk of climate and fire under the GFDL A2 projection, while 15 groves with low-to-moderate risk were found on both the National Parks and National Forests 18 in the 2 under PCM A2. Landscape projections of potential MOC suggest that the region is likely to experience

  12. Methodology To Define Drought Management Scenarios Based On Accumulated Future Projections Of Risk

    NASA Astrophysics Data System (ADS)

    Haro-Monteagudo, David; Solera-Solera, Abel; Andreu-Álvarez, Joaquín

    2014-05-01

    Drought is a serious threat to many water resources systems in the world. Especially to those in which the equilibrium between resources availability and water uses is very fragile, making that deviation below normality compromises the capacity of the system to cope with all the demands and environmental requirements. Since droughts are not isolated events but instead they develop through time in what could be considered a creeping behavior, it is very difficult to determine when an episode starts and how long will it last. Because this is a major concern for water managers and society in general, scientific research has strived to develop indices that allow evaluating the risk of a drought event occurrence. These indices often have as basis previous and current state variables of the system that combined between them supply decision making responsible with an indication of the risk of being in a situation of drought, normally through the definition of a drought scenario situation. While this way of proceeding has found to be effective in many systems, there are cases in which indicators systems fail to define the appropriate on-going drought scenario early enough to start measures that allowed to minimize the possible impacts. This is the case, for example, of systems with high seasonal precipitation variability. The use of risk assessment models to evaluate future possible states of the system becomes handy in cases like the previous one, although they are not limited to such systems. We present a method to refine the drought scenario definition within a water resources system. To implement this methodology, we use a risk assessment model generalized to water resources systems based in the stochastic generation of multiple possible future streamflows generation and the simulation of the system from a Monte-Carlo approach. We do this assessment every month of the year up to the end of the hydrologic year that normally corresponds with the end of the irrigation

  13. The National Electronic Library: A Guide to the Future for Library Managers. The Greenwood Library Management Collection.

    ERIC Educational Resources Information Center

    Pitkin, Gary M., Ed.

    As a reference guide for library professionals, this volume helps librarians prepare for the future in the growing electronic environment by examining the historical and theoretical background of the National Electronic Library and assessing the role of libraries in the past, present, and future. The book is divided in two sections: "The National…

  14. Development and consideration of global policies for managing the future risks of poliovirus outbreaks: insights and lessons learned through modeling.

    PubMed

    Thompson, Kimberly M; Duintjer Tebbens, Radboud J; Pallansch, Mark A; Kew, Olen M; Sutter, Roland W; Aylward, R Bruce; Watkins, Margaret; Gary, Howard; Alexander, James P; Venczel, Linda; Johnson, Denise; Cáceres, Victor M; Sangrujee, Nalinee; Jafari, Hamid; Cochi, Stephen L

    2006-12-01

    The success of the Global Polio Eradication Initiative promises to bring large benefits, including sustained improvements in quality of life (i.e., cases of paralytic disease and deaths avoided) and costs saved from cessation of vaccination. Obtaining and maintaining these benefits requires that policymakers manage the transition from the current massive use of oral poliovirus vaccine (OPV) to a world without OPV and free of the risks of potential future reintroductions of live polioviruses. This article describes the analytical journey that began in 2001 with a retrospective case study on polio risk management and led to development of dynamic integrated risk, economic, and decision analysis tools to inform global policies for managing the risks of polio. This analytical journey has provided several key insights and lessons learned that will be useful to future analysts involved in similar complex decision-making processes. PMID:17184398

  15. The Energy-Water Nexus: Managing the Links between Energy and Water for a Sustainable Future

    NASA Astrophysics Data System (ADS)

    Hussey, Karen; Petit, Carine

    2010-05-01

    Water and energy are both indispensable inputs to modern economies but currently both resources are under threat owing to the impacts of an ever-increasing population and associated demand, unsustainable practices in agriculture and manufacturing, and the implications of a changing climate. However, it is where water and energy rely on each other that pose the most complex challenges for policy-makers. Water is needed for mining coal, drilling oil, refining gasoline, and generating and distributing electricity; and, conversely, vast amounts of energy are needed to pump, transport, treat and distribute water, particularly in the production of potable water through the use of desalination plants and waste water treatment plants. Despite the links, and the urgency in both sectors for security of supply, in existing policy frameworks energy and water policies are developed largely in isolation from one another. Worse still, some policies designed to encourage alternative energy supplies give little thought to the resultant consequences on water resources, and, similarly, policies designed to secure water supplies pay little attention to the resultant consequences on energy use. The development of new technologies presents both opportunities and challenges for managing the energy-water nexus but a better understanding of the links between energy and water is essential in any attempt to formulate policies for more resilient and adaptable societies. The energy-water nexus must be adequately integrated into policy and decision-making or governments run the risk of contradicting their efforts, and therefore failing in their objectives, in both sectors. A series of COST Exploratory Workshops, drawing on on-going research in the energy-water nexus from a number of international teams, identified the implications of the energy-water nexus on the development of (i) energy policies (ii) water resource management policies and (iii) climate adaptation and mitigation policies. A

  16. Planning the future of JPL's management and administrative support systems around an integrated database

    NASA Technical Reports Server (NTRS)

    Ebersole, M. M.

    1983-01-01

    JPL's management and administrative support systems have been developed piece meal and without consistency in design approach over the past twenty years. These systems are now proving to be inadequate to support effective management of tasks and administration of the Laboratory. New approaches are needed. Modern database management technology has the potential for providing the foundation for more effective administrative tools for JPL managers and administrators. Plans for upgrading JPL's management and administrative systems over a six year period evolving around the development of an integrated management and administrative data base are discussed.

  17. Preparing Los Alamos National Laboratory's Waste Management Program for the Future - 12175

    SciTech Connect

    Jones, Scotty W.; Dorries, Alison M.; Singledecker, Steven; Henckel, George

    2012-07-01

    The waste management program at Los Alamos National Laboratory (LANL) is undergoing significant transition to establish a lean highly functioning waste management program that will succeed the large environmental cleanup waste management program. In the coming years, the environmental cleanup activities will be mostly completed and the effort will change to long-term stewardship. What will remain in waste management is a smaller program focused on direct off-site shipping to cost-effectively enable the enduring mission of the laboratory in support of the national nuclear weapons program and fundamental science and research. It is essential that LANL implement a highly functioning efficient waste management program in support of the core missions of the national weapons program and fundamental science and research - and LANL is well on the way to that goal. As LANL continues the transition process, the following concepts have been validated: - Business drivers including the loss of onsite disposal access and completion of major environmental cleanup activities will drive large changes in waste management strategies and program. - A well conceived organizational structure; formal management systems; a customer service attitude; and enthusiastic managers are core to a successful waste management program. - During times of organizational transition, a project management approach to managing change in a complex work place with numerous complex deliverables is successful strategy. - Early and effective engagement with waste generators, especially Project Managers, is critical to successful waste planning. - A well-trained flexible waste management work force is vital. Training plans should include continuous training as a strategy. - A shared fate approach to managing institutional waste decisions, such as the LANL Waste Management Recharge Board is effective. - An efficient WM program benefits greatly from modern technology and innovation in managing waste data and

  18. Future Challenges in Managing Human Health and Performance Risks for Space Flight

    NASA Technical Reports Server (NTRS)

    Corbin, Barbara J.; Barratt, Michael

    2013-01-01

    The global economy forces many nations to consider their national investments and make difficult decisions regarding their investment in future exploration. To enable safe, reliable, and productive human space exploration, we must pool global resources to understand and mitigate human health & performance risks prior to embarking on human exploration of deep space destinations. Consensus on the largest risks to humans during exploration is required to develop an integrated approach to mitigating risks. International collaboration in human space flight research will focus research on characterizing the effects of spaceflight on humans and the development of countermeasures or systems. Sharing existing data internationally will facilitate high quality research and sufficient power to make sound recommendations. Efficient utilization of ISS and unique ground-based analog facilities allows greater progress. Finally, a means to share results of human research in time to influence decisions for follow-on research, system design, new countermeasures and medical practices should be developed. Although formidable barriers to overcome, International working groups are working to define the risks, establish international research opportunities, share data among partners, share flight hardware and unique analog facilities, and establish forums for timely exchange of results. Representatives from the ISS partnership research and medical communities developed a list of the top ten human health & performance risks and their impact on exploration missions. They also drafted a multilateral data sharing plan to establish guidelines and principles for sharing human spaceflight data. Other working groups are also developing methods to promote international research solicitations. Collaborative use of analog facilities and shared development of space flight research and medical hardware continues. Establishing a forum for exchange of results between researchers, aerospace physicians

  19. Sustaining a Mature Risk Management Process: Ensuring the International Space Station for a Vibrant Future

    NASA Technical Reports Server (NTRS)

    Raftery, Michael; Carter-Journet, Katrina

    2013-01-01

    The International Space Station (ISS) risk management methodology is an example of a mature and sustainable process. Risk management is a systematic approach used to proactively identify, analyze, plan, track, control, communicate, and document risks to help management make risk-informed decisions that increase the likelihood of achieving program objectives. The ISS has been operating in space for over 14 years and permanently crewed for over 12 years. It is the longest surviving habitable vehicle in low Earth orbit history. Without a mature and proven risk management plan, it would be increasingly difficult to achieve mission success throughout the life of the ISS Program. A successful risk management process must be able to adapt to a dynamic program. As ISS program-level decision processes have evolved, so too has the ISS risk management process continued to innovate, improve, and adapt. Constant adaptation of risk management tools and an ever-improving process is essential to the continued success of the ISS Program. Above all, sustained support from program management is vital to risk management continued effectiveness. Risk management is valued and stressed as an important process by the ISS Program.

  20. The Perceptions of Non Music Staff and Senior Management of the Impact of the Implementation of the Musical Futures Approach on the Whole School

    ERIC Educational Resources Information Center

    Hallam, Susan; Creech, Andrea; McQueen, Hilary

    2016-01-01

    This research aimed to provide an account of the impact of the Musical Futures approach on the wider school community in Musical Futures "Champion Schools". Questionnaires were completed by 344 non-music teachers. Interviews were undertaken with members of senior management teams. The majority of staff indicated that Musical Futures had…

  1. An overview of food waste management in developing countries: Current status and future perspective.

    PubMed

    Thi, Ngoc Bao Dung; Kumar, Gopalakrishnan; Lin, Chiu-Yue

    2015-07-01

    Food waste (FW) related issues in developing countries is currently considered to be a major threatening factor for sustainable development and FW management systems. Due to incomplete FW management systems, many developing countries are facing challenges, such as environmental and sanitary problems that are caused by FW. The difference in FW generation trends between developing countries and developed countries was reviewed in this work, which demonstrated that the effects of income level, population growth, and public participation in FW management are very important. Thus, this work aimed to provide an overview of recycling activities, related regulations, and current FW treatment technology in developing countries by following some case studies. Taiwan, has been suggested as being a successful case in terms of FW management, and is therefore a typical model for developing countries to follow. Finally, an integrative management system as a suitable model for FW management has been suggested for developing countries.

  2. The Future of Asset Management for Human Space Exploration: Supply Classification and an Integrated Database

    NASA Technical Reports Server (NTRS)

    Shull, Sarah A.; Gralla, Erica L.; deWeck, Olivier L.; Shishko, Robert

    2006-01-01

    One of the major logistical challenges in human space exploration is asset management. This paper presents observations on the practice of asset management in support of human space flight to date and discusses a functional-based supply classification and a framework for an integrated database that could be used to improve asset management and logistics for human missions to the Moon, Mars and beyond.

  3. Stories of management in the future by young adults and young nurses.

    PubMed

    Harmoinen, Merja; Niiranen, Kaisa; Niiranen, Vuokko; Astedt-Kurki, Päivi; Suominen, Tarja

    2014-04-11

    Abstract Aim: The aim of this study was to describe the phenomenon of management by way of the ideas by secondary school students and young nurses. Background: Young adults are changing workplaces more than ever before, yet their work expectations and perspectives of management differ to those of previous generations. Methods: The data was collected from upper secondary school students and professionally educated nurses (n = 68), some of whom were immigrants (n = 41). Framed essays were used as a research method and emergent data was analysed using content analysis. Results: According to the results, good management involves systematic management, equality, appreciation of know-how, and the promotion of wellbeing at work. Conclusion: New perspectives on management were drawn from the study, in particular the multiple dimensions of equality in workplace organization and the manager's role in an employee's professional development process. Implication for nursing management: The interactive skills of the manager are emphasized in promoting wellbeing at work. This is especially so in multi-cultural teams, where the manager is expected to be adept at understanding intercultural communication and the values of young employees.

  4. Stories of management in the future by young adults and young nurses.

    PubMed

    Harmoinen, Merja; Niiranen, Kaisa; Niiranen, Vuokko; Astedt-Kurki, Päivi; Suominen, Tarja

    2014-04-11

    Abstract Aim: The aim of this study was to describe the phenomenon of management by way of the ideas by secondary school students and young nurses. Background: Young adults are changing workplaces more than ever before, yet their work expectations and perspectives of management differ to those of previous generations. Methods: The data was collected from upper secondary school students and professionally educated nurses (n = 68), some of whom were immigrants (n = 41). Framed essays were used as a research method and emergent data was analysed using content analysis. Results: According to the results, good management involves systematic management, equality, appreciation of know-how, and the promotion of wellbeing at work. Conclusion: New perspectives on management were drawn from the study, in particular the multiple dimensions of equality in workplace organization and the manager's role in an employee's professional development process. Implication for nursing management: The interactive skills of the manager are emphasized in promoting wellbeing at work. This is especially so in multi-cultural teams, where the manager is expected to be adept at understanding intercultural communication and the values of young employees. PMID:24720464

  5. Role of future scenarios in understanding deep uncertainty in long-term air quality management

    EPA Science Inventory

    The environment and its interactions with human systems, whether economic, social or political, are complex. Relevant drivers may disrupt system dynamics in unforeseen ways, making it difficult to predict future conditions. This kind of deep uncertainty presents a challenge to ...

  6. The role of future scenarios to understand deep uncertainty for air quality management.

    EPA Science Inventory

    The environment and its interaction with human systems (economic, social and political) is complex and dynamic. Key drivers may disrupt systemdynamics in unforeseen ways, making it difficult to predict future conditions precisely. This kind of deep uncertainty presents a challeng...

  7. THE FUTURE OF SUSTAINABLE MANAGEMENT APPROACHES AND REVITALIZATION TOOLS-ELECTRONIC (SMARTE): 2006-2010

    EPA Science Inventory

    SMARTe is being developed to give stakeholders information resources, analytical tools, communication strategies, and a decision analysis approach to be able to make better decisions regarding future uses of property. The development of the communication tools and decision analys...

  8. Mobile phone health apps for diabetes management: current evidence and future developments.

    PubMed

    Goyal, S; Cafazzo, J A

    2013-12-01

    Can an app help manage diabetes? We discuss how the advent of mobile health apps in connecting patients to providers is creating new opportunities for the management of diabetes. Although there are promising outcomes, there is still much to be learned about how such technology could be fully exploited.

  9. Competencies of Front-Line Managers in Supported Accommodation: Issues for Practice and Future Research

    ERIC Educational Resources Information Center

    Clement, Tim; Bigby, Christine

    2012-01-01

    Background: Front-line managers of supported accommodation for people with intellectual disability are assumed to have a key role in the realisation of outcomes for service users. Yet, their job has been little researched. A job analysis from Minnesota that identified 142 competencies required of effective front-line managers was used to examine…

  10. What Might Online Delivery Teach Us about Blended Management Education? Prior Perspectives and Future Directions

    ERIC Educational Resources Information Center

    Arbaugh, J. B.

    2014-01-01

    Although the term has roots in the training and development literature, "blended learning" has only recently begun to be studied in management education. This article examines the literatures of blended and fully online management education to determine whether there are factors that may influence instructional effectiveness that are…

  11. Mobile phone health apps for diabetes management: current evidence and future developments.

    PubMed

    Goyal, S; Cafazzo, J A

    2013-12-01

    Can an app help manage diabetes? We discuss how the advent of mobile health apps in connecting patients to providers is creating new opportunities for the management of diabetes. Although there are promising outcomes, there is still much to be learned about how such technology could be fully exploited. PMID:24106313

  12. Financial Success for Young Adults and Recent Graduates: Managing Money, Credit, and Your Future

    ERIC Educational Resources Information Center

    Arrowood, Janet C.

    2006-01-01

    There are numerous financial planning and money management handbooks, but few focus on the needs of young adults between 16 and 25 years of age. Colleges and some high schools are increasingly offering courses covering money management, but the materials are more "economics-focused" than "real-world" focused. Young people are huge consumers who…

  13. Intertidal zone management in the Western Indian Ocean: assessing current status and future possibilities using expert opinions.

    PubMed

    Nordlund, Lina Mtwana; de la Torre-Castro, Maricela; Erlandsson, Johan; Conand, Chantal; Muthiga, Nyawira; Jiddawi, Narriman; Gullström, Martin

    2014-12-01

    This expert opinion study examined the current status of the intertidal zone in the Western Indian Ocean (WIO) and ranked and discussed future management approaches. Information was gathered from scientists, practitioners, and managers active in the WIO region through a questionnaire and a workshop. The experts stated that the productive intertidal environment is highly valuable for reasons such as recreation, erosion protection, and provision of edible invertebrates and fish. Several anthropogenic pressures were identified, including pollution, harbor activities, overexploitation, and climate change. The experts considered the WIO intertidal zone as generally understudied, undermanaged, and with poor or no monitoring. The most important management strategies according to the expert opinions are to develop and involve local people in integrated coastal zone management (ICZM), to increase knowledge on species-environment relationships, and to develop awareness campaigns and education programs. To improve coastal environmental management and conservation, we argue that the intertidal zone should be treated as one organizational management unit within the larger framework of ICZM.

  14. Flood Risk Management Policy in Scotland: Research Questions Past, Present and Future

    NASA Astrophysics Data System (ADS)

    Wilkinson, Mark; Hastings, Emily; MacDonald, Jannette

    2016-04-01

    Scotland's Centre of Expertise for Waters (CREW) delivers accessible research and expert opinion to support the Scottish Government and its delivery partners in the development and implementation of water policy. It was established in 2011 by the Scottish Government (Rural and Environmental Science and Analytical Services) in recognition of a gap in the provision of short term advice and research to policy (development and implementation). Key policy areas include the Water Framework Directive, Floods Directive, Drinking Water Directive, Habitats Directive and Scotland's Hydro Nation Strategy. CREW is unique in its demand-driven and free service for policy makers and practitioners, managing the engagement between scientists, policy makers and practitioners to work effectively across this interface. The users of CREW are the Scottish Government, Scottish Environment Protection Agency, Scottish Natural Heritage and Scottish Water. CREW has funded around 100 projects relating to water policy since its inception in 2011. Of these, a significant number relate to flood risk management policy. Based on a review of work to date, this poster will give an overview of these projects and a forward look at the challenges that remain. From learning from community led flood risk management to surface water flood forecasting for urban communities, links will be made between sustainable and traditional flood risk management while considering the perceptions of stakeholders to flood risk management. How can we deliver fully integrated flood risk management options? How policy makers, scientists and land managers can better work together will also be explored.

  15. Human-Centered Technologies and Procedures for Future Air Traffic Management: A Preliminary Overview of 1996 Studies and Results

    NASA Technical Reports Server (NTRS)

    Smith, Philip; McCoy, Elaine; Denning, Rebecca; Woods, David; Sarter, Nadine; Dekker, Sidney; Billings, Charles

    1996-01-01

    In this project, we have been exploring the use of a general methodology to predict the impact of future Air Traffic Management (ATM) concepts and technologies. In applying this methodology, our emphasis has been on the importance of modeling coordination and cooperation among the multiple agents within this system, and on understanding how the interactions among these agents will be influenced as new roles, responsibilities, procedures and technologies are introduced. To accomplish this, we have been collecting data on performance under the current air traffic management system, trying to identify critical problem areas and looking for exemplars suggestive of general approaches for solving such problems. Based on the results of these field studies, we have developed a set of scenarios centered around potential future system designs, and have conducted studies using these scenarios involving a total 40 controllers, dispatchers, pilots and traffic managers. The purpose of this report is to provide NASA with an early summary of the major recommendations that have resulted from our research under the AATT Program thus far. Recommendations 1-3 deal with general approaches that our findings suggest should be incorporated in future AATT Program activities, while Recommendations 4-11 identify some specific topics and technologies that merit research and development activities. Detailed technical reports containing supporting data, as well as the results of our still ongoing analyses, will be provided at a later date. The remainder of this report is organized as follows. Section 1 briefly describes the general design philosophy supported by our empirical studies. Section 2 presents the research methods we have used for identifying requirements for future system designs and for evaluating alternative design solutions. Section 3 discusses preliminary results from an initial set of investigations that we have conducted using these research methods. Section 4 then provides an

  16. Copeptin in acute coronary syndromes and heart failure management: State of the art and future directions.

    PubMed

    Schurtz, Guillaume; Lamblin, Nicolas; Bauters, Christophe; Goldstein, Patrick; Lemesle, Gilles

    2015-01-01

    Over the past two decades, the use of multiple biomarkers has changed cardiovascular disease management. Recently, several trials have assessed the diagnostic and prognostic performances of copeptin, especially in patients with heart failure or acute coronary syndromes. Primary results are interesting, with copeptin looking promising for: the management of patients who present at emergency departments early after chest pain onset and the risk stratification of patients with heart failure. The purpose of this article is to review the data on the place of copeptin in the management of patients with chest pain or heart failure.

  17. Copeptin in acute coronary syndromes and heart failure management: State of the art and future directions.

    PubMed

    Schurtz, Guillaume; Lamblin, Nicolas; Bauters, Christophe; Goldstein, Patrick; Lemesle, Gilles

    2015-01-01

    Over the past two decades, the use of multiple biomarkers has changed cardiovascular disease management. Recently, several trials have assessed the diagnostic and prognostic performances of copeptin, especially in patients with heart failure or acute coronary syndromes. Primary results are interesting, with copeptin looking promising for: the management of patients who present at emergency departments early after chest pain onset and the risk stratification of patients with heart failure. The purpose of this article is to review the data on the place of copeptin in the management of patients with chest pain or heart failure. PMID:26071835

  18. Managing women's and children's services: contemporary models as a template for the future.

    PubMed

    Ropp, A L

    2001-06-01

    Historically hospitals have struggled with organizational design and management of services within a single institution. The traditional design has been a bureaucracy with a hierarchical management structure. As individual hospitals develop new business relationships to form health systems, there is a need for innovative solutions that provide the flexibility and responsiveness necessary for successful health care management. One traditional business model, the SBU, or strategic business unit, may serve as a template for the development of product or service lines. The SBU has application for selected portions of a health care organization. The SBU will be discussed as it specifically relates to women's and children's health care services.

  19. Belowground Ecology of Scarabs Feeding on Grass Roots: Current Knowledge and Future Directions for Management in Australasia.

    PubMed

    Frew, Adam; Barnett, Kirk; Nielsen, Uffe N; Riegler, Markus; Johnson, Scott N

    2016-01-01

    Many scarab beetles spend the majority of their lives belowground as larvae, feeding on grass roots. Many of these larvae are significant pests, causing damage to crops and grasslands. Damage by larvae of the greyback cane beetle (Dermolepida albohirtum), for example, can cause financial losses of up to AU$40 million annually to the Australian sugarcane industry. We review the ecology of some scarab larvae in Australasia, focusing on three subfamilies; Dynastinae, Rutelinae, and Melolonthinae, containing key pest species. Although considerable research on the control of some scarab pests has been carried out in Australasia, for some species, the basic biology and ecology remains largely unexplored. We synthesize what is known about these scarab larvae and outline key knowledge gaps to highlight future research directions with a view to improve pest management. We do this by presenting an overview of the scarab larval host plants and feeding behavior; the impacts of abiotic (temperature, moisture, and fertilization) and biotic (pathogens, natural enemies, and microbial symbionts) factors on scarab larvae and conclude with how abiotic and biotic factors can be applied in agriculture for improved pest management, suggesting future research directions. Several host plant microbial symbionts, such as arbuscular mycorrhizal fungi and endophytes, can improve plant tolerance to scarabs and reduce larval performance, which have shown promise for use in pest management. In addition to this, several microbial scarab pathogens have been isolated for commercial use in pest management with particularly promising results. The entomopathogenic fungus Metarhizium anisopliae caused a 50% reduction in cane beetle larvae while natural enemies such as entomopathogenic nematodes have also shown potential as a biocontrol. Key abiotic factors, such as soil water, play an important role in affecting both scarab larvae and these control agents and should therefore feature in future multi

  20. Belowground Ecology of Scarabs Feeding on Grass Roots: Current Knowledge and Future Directions for Management in Australasia

    PubMed Central

    Frew, Adam; Barnett, Kirk; Nielsen, Uffe N.; Riegler, Markus; Johnson, Scott N.

    2016-01-01

    Many scarab beetles spend the majority of their lives belowground as larvae, feeding on grass roots. Many of these larvae are significant pests, causing damage to crops and grasslands. Damage by larvae of the greyback cane beetle (Dermolepida albohirtum), for example, can cause financial losses of up to AU$40 million annually to the Australian sugarcane industry. We review the ecology of some scarab larvae in Australasia, focusing on three subfamilies; Dynastinae, Rutelinae, and Melolonthinae, containing key pest species. Although considerable research on the control of some scarab pests has been carried out in Australasia, for some species, the basic biology and ecology remains largely unexplored. We synthesize what is known about these scarab larvae and outline key knowledge gaps to highlight future research directions with a view to improve pest management. We do this by presenting an overview of the scarab larval host plants and feeding behavior; the impacts of abiotic (temperature, moisture, and fertilization) and biotic (pathogens, natural enemies, and microbial symbionts) factors on scarab larvae and conclude with how abiotic and biotic factors can be applied in agriculture for improved pest management, suggesting future research directions. Several host plant microbial symbionts, such as arbuscular mycorrhizal fungi and endophytes, can improve plant tolerance to scarabs and reduce larval performance, which have shown promise for use in pest management. In addition to this, several microbial scarab pathogens have been isolated for commercial use in pest management with particularly promising results. The entomopathogenic fungus Metarhizium anisopliae caused a 50% reduction in cane beetle larvae while natural enemies such as entomopathogenic nematodes have also shown potential as a biocontrol. Key abiotic factors, such as soil water, play an important role in affecting both scarab larvae and these control agents and should therefore feature in future multi

  1. Belowground Ecology of Scarabs Feeding on Grass Roots: Current Knowledge and Future Directions for Management in Australasia.

    PubMed

    Frew, Adam; Barnett, Kirk; Nielsen, Uffe N; Riegler, Markus; Johnson, Scott N

    2016-01-01

    Many scarab beetles spend the majority of their lives belowground as larvae, feeding on grass roots. Many of these larvae are significant pests, causing damage to crops and grasslands. Damage by larvae of the greyback cane beetle (Dermolepida albohirtum), for example, can cause financial losses of up to AU$40 million annually to the Australian sugarcane industry. We review the ecology of some scarab larvae in Australasia, focusing on three subfamilies; Dynastinae, Rutelinae, and Melolonthinae, containing key pest species. Although considerable research on the control of some scarab pests has been carried out in Australasia, for some species, the basic biology and ecology remains largely unexplored. We synthesize what is known about these scarab larvae and outline key knowledge gaps to highlight future research directions with a view to improve pest management. We do this by presenting an overview of the scarab larval host plants and feeding behavior; the impacts of abiotic (temperature, moisture, and fertilization) and biotic (pathogens, natural enemies, and microbial symbionts) factors on scarab larvae and conclude with how abiotic and biotic factors can be applied in agriculture for improved pest management, suggesting future research directions. Several host plant microbial symbionts, such as arbuscular mycorrhizal fungi and endophytes, can improve plant tolerance to scarabs and reduce larval performance, which have shown promise for use in pest management. In addition to this, several microbial scarab pathogens have been isolated for commercial use in pest management with particularly promising results. The entomopathogenic fungus Metarhizium anisopliae caused a 50% reduction in cane beetle larvae while natural enemies such as entomopathogenic nematodes have also shown potential as a biocontrol. Key abiotic factors, such as soil water, play an important role in affecting both scarab larvae and these control agents and should therefore feature in future multi

  2. Value-based leadership. Is your hospital management team prepared for the future?

    PubMed

    Stempniak, Marty

    2013-05-01

    This foldout section looks at the seven steps to a value-structured hospital, 10 must-do strategies for thriving in the new health care era, and what new skills management, physicians and trustees should have.

  3. PREDICTIVE UNCERTAINTY IN HYDROLOGIC AND WATER QUALITY MODELING: APPROACHES, APPLICATION TO ENVIRONMENTAL MANAGEMENT, AND FUTURE CHALLENGES

    EPA Science Inventory

    Extant process-based hydrologic and water quality models are indispensable to water resources planning and environmental management. However, models are only approximations of real systems and often calibrated with incomplete and uncertain data. Reliable estimates, or perhaps f...

  4. Pain management for the cancer patient - current practice and future developments.

    PubMed

    Auret, Kirsten; Schug, Stephan A

    2013-12-01

    Anaesthesiologists will be asked to provide pain management for cancer patients in the absence of more specialised services, when interventional techniques are indicated and in the postoperative period. In all these settings, the complexity of cancer pain and its psychosocial connotations need to be considered to provide appropriate and holistic care. Principles of systemic pain management, effective in most patients, continue to follow established guidelines; identification of neuropathic pain and its appropriate treatment is important here. Interventional pain relief is required in a minority of cancer patients, but it should be considered when appropriate and then done with best available expertise. Neurolytic procedures have lost importance here over the years. Postoperative pain management should be multimodal with consideration of regional techniques when applicable. In managing postoperative pain in cancer patients, opioid tolerance needs to be addressed to avoid withdrawal and poor analgesia. Preventive techniques aiming to reduce chronic postoperative pain should be considered. PMID:24267557

  5. Early Management of Patients With Acute Heart Failure: State of the Art and Future Directions

    PubMed Central

    Collins, Sean P.; Storrow, Alan B.; Levy, Phillip D.; Albert, Nancy; Butler, Javed; Ezekowitz, Justin A.; Felker, G. Michael; Fermann, Gregory J.; Fonarow, Gregg C.; Givertz, Michael M.; Hiestand, Brian; Hollander, Judd E.; Lanfear, David E.; Pang, Peter S.; Peacock, W. Frank; Sawyer, Douglas B.; Teerlink, John R.; Lenihan, Daniel J.

    2015-01-01

    Heart failure (HF) afflicts nearly 6 million Americans, resulting in 1 million emergency department (ED) visits and over 1 million annual hospital discharges. The majority of inpatient admissions originate in the ED; thus, it is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics, and alternatives to hospitalization. This article discusses contemporary ED management as well as the necessary next steps for ED-based acute HF research. PMID:25423908

  6. The role of future scenarios to understand deep uncertainty in air quality management

    EPA Science Inventory

    The environment and it’s interaction with human systems (economic, social and political) is complex and dynamic. Key drivers may disrupt system dynamics in unforeseen ways, making it difficult to predict future conditions precisely. This kind of deep uncertainty presents ...

  7. Provoking Aspiration: Risk-Management through the Cultivation of Future Selves in College Recruitment

    ERIC Educational Resources Information Center

    Posecznick, Alex

    2015-01-01

    Drawing upon data from an ethnography of college admissions, I describe how the admissions' personnel and faculty mobilize persuasive scripts that invite prospective students to reimagine themselves as subjects with a fluid set of aspirations within the context of risky futures. The focus here is not on the representations of the college itself,…

  8. The Database Business: Managing Today--Planning for Tomorrow. Issues and Futures.

    ERIC Educational Resources Information Center

    Aitchison, T. M.; And Others

    1988-01-01

    Current issues and the future of the database business are discussed in five papers. Topics covered include aspects relating to the quality of database production; international ownership in the U.S. information marketplace; an overview of pricing strategies in the electronic information industry; and pricing issues from the viewpoints of online…

  9. Environmental assessment of waste management in Greenland: current practice and potential future developments.

    PubMed

    Eisted, Rasmus; Christensen, Thomas H

    2013-05-01

    The majority of the waste in Greenland is disposed of in open dumps or incinerated in simple small-scale incinerators. There are relatively few environmental regulations that control the emissions of leachate, landfill gas and/or flue gases from incineration. Only some scrap metal and hazardous waste are collected separately and exported to Europe. The impacts from the current waste management system were modelled from a life-cycle perspective using the LCA-waste model EASEWASTE. Impacts with regard to global warming, acidification, etc. are small (a few hundred person-equivalents (PE) for a system serving 56 000 inhabitants), but significant environmental loads are caused by air emissions from the incinerators and leachate from the landfills. Several alternative management scenarios were modelled and results show that increased use of incineration, full utilization of the heat production for district heating and separation of hazardous waste probably could improve Greenland's waste management system. Segregation of recyclable materials as paper, cardboard and biowaste will do little to environmentally improve the waste management system due to loss of energy recovery from incineration and the long transport of the recyclables to markets. Export of waste to Denmark for incineration at modern waste incinerators with advanced flue gas cleaning could also be considered as a means to achieve better environmental performance of the waste management system.

  10. Critical education in resource and environmental management: Learning and empowerment for a sustainable future

    SciTech Connect

    Diduck, A.

    1999-10-01

    Changing rom current patterns of resource use to a sustainable and equitable economy is a complex and intractable problem. This paper suggests that critical education may form part of the solution. Critical environmental assessment (EA) education, the model explored in this paper, offers a tool for resource and environmental managers to use in managing public involvement processes. This model challenges current patterns of resource use and addresses criticisms of public involvement processes. Critical EA education, involving both cognitive development and personal empowerment, focuses on critical intelligence, problem solving and social action. The concept is offered as a means to facilitate and improve public involvement and, thereby, empower local communities to take greater control of resource use decisions affecting their lives. Positive implications of critical EA education for change, complexity, uncertainty and conflict, which are four enduring themes in resource and environmental management, are discussed in the paper. The implications include: cognitive development and personal empowerment at the level of local resource communities; simplification of the often complex discourse encountered in resource management; reduction in feelings of powerlessness often experienced by members of the public in environmental assessment scenarios; a reduction of ignorance and indeterminacy regarding resource management issues; conflict resolution at the cognitive level; and, clarification of the opposing values, interests or actions at the heart of a conflict.

  11. Contact heterogeneities in feral swine: implications for disease management and future research

    USGS Publications Warehouse

    Pepin, Kim; Davis, Amy J.; Beasley, James; Boughton, Raoul; Campbell, Tyler; Cooper, Susan; Gaston, Wes; Hartley, Stephen B.; Kilgo, John C.; Wisely, Samantha; Wyckoff, Christy; VerCauteren, Kurt

    2016-01-01

    Contact rates vary widely among individuals in socially structured wildlife populations. Understanding the interplay of factors responsible for this variation is essential for planning effective disease management. Feral swine (Sus scrofa) are a socially structured species which pose an increasing threat to livestock and human health, and little is known about contact structure. We analyzed 11 GPS data sets from across the United States to understand the interplay of ecological and demographic factors on variation in co-location rates, a proxy for contact rates. Between-sounder contact rates strongly depended on the distance among home ranges (less contact among sounders separated by >2 km; negligible between sounders separated by >6 km), but other factors causing high clustering between groups of sounders also seemed apparent. Our results provide spatial parameters for targeted management actions, identify data gaps that could lead to improved management and provide insight on experimental design for quantitating contact rates and structure.

  12. Meeting the future challenges of air quality management in the United States.

    PubMed

    Bradley, Michael J

    2008-01-01

    The U.S. Clean Air Act (CAA, or the Act) and its amendments has achieved substantial progress in cleaning up the nation's air. Over the past 30 years, the CAA reduced emissions of the 6 principal ("criteria") pollutants by over 25%, even while gross domestic product (GDP) has increased over 150% and population and energy consumption rose by nearly 40%. However, despite the tremendous gains the Act has brought, the country's air quality management (AQM) system still faces substantial challenges. In response to a congressional request for an independent evaluation of the overall effectiveness of the CAA, the National Research Council formed the Committee on Air Quality Management. Composed of 25 members with diverse areas of air quality expertise, the committee was charged with developing scientific and technical recommendations for strengthening the nation's AQM system. In 2004, the National Academies published their recommendations in a text entitled Air Quality Management in the United States (National Research Council, 2004).

  13. Optimal management of lower pole stones: the direction of future travel

    PubMed Central

    Moore, Sacha L.; Bres-Niewada, Ewa; Cook, Paul; Wells, Hannah

    2016-01-01

    Introduction Kidney stone disease is increasing worldwide with its most common location being in the lower pole. A clear strategy for effective management of these stones is essential in the light of ever increasing choice, effectiveness, and complications of different treatment options. Material and methods This review identifies the latest and clinically relevant publications focused on optimal management of lower pole stones. Results We present an up-to-date European Association of Urology and American Urological Association algorithm for lower pole stones, risks and benefits of different treatments, and changing landscape with the miniaturization of percutaneous stone treatments. Conclusions Available literature seems to be deficient on quality of life, patient centered decision making, and cost analysis of optimal management with no defined standard of ‘stone free rate’, all of which are critical in any surgical consultation and outcome analysis. PMID:27729994

  14. Battery Monitoring and Electrical Energy Management. Precondition for future vehicle electric power systems

    NASA Astrophysics Data System (ADS)

    Meissner, Eberhard; Richter, Gerolf

    New vehicle electric systems are promoted by the needs of fuel economy and ecology as well as by new functions for the improvement of safety and comfort, reliability, and the availability of the vehicle. Electrically controlled and powered systems for braking, steering and stabilisation need a reliable supply of electrical energy. The planned generation of electrical energy (only when it is economically beneficial meaningful), an adequate storage, and thrifty energy housekeeping with an intelligent integration of the battery as the storage medium into the overall concept of the vehicle Energy Management, and early detection of possible restrictions of reliability by Battery Monitoring allows for actions by the Energy Management well in advance, while the driver need not be involved at all. To meet today's requirements for Battery Monitoring and Energy Management, solutions have been developed for series vehicles launched in years 2001-2003, operating at the 14 V level.

  15. Decision-support Systems: Do they have a Future in Estuarine Management?

    NASA Astrophysics Data System (ADS)

    Jones, P. D.; Tyler, A. O.; Wither, A. W.

    2002-12-01

    Estuaries are highly complex ecosystems. Consequently they present daunting challenges to planners and regulators responsible for devising ' sustainable development ' strategies or for taking rapid decisions with respect to ' crisis management '. Over the lifetime of the Estuarine and Coastal Sciences Association, there have been significant developments in both the range and sophistication of the tools available to assist with these tasks. Indeed, managers are now faced with a confusing plethora of possibilities that may, or may not, help in achieving the optimum solution to a given problem. Typical problems confronting managers and the systems available to resolve the issues are considered. By way of illustration, we present some examples based on our experience over the last 25 years in the Mersey Estuary (which has seen dramatic improvements in water quality and a number of major proposed developments), from the Ribble Estuary and from along the north-west coast of the U.K.

  16. Studying the Past for the Future: Managing Modern Biodiversity from Historic and Prehistoric Data

    SciTech Connect

    Foster, Professor Thomas; Olsen, Lisa M; Dale, Virginia H; Chen, Alice

    2010-01-01

    Management of biodiversity and anthropogenic effects on the environment are some of the most difficult challenges facing humans today. In this paper, we describe how archaeological, historical, and ecological data can be combined to identify metrics of ecological change. Archaeological surveys, historic witness tree data, analysis of ancient pollen, and recent satellite imagery are combined to create indicators of change that are useable by modem environmental managers at Fort Benning Military Reservation in Georgia and Alabama in the United States. Archaeological data were collected at 30 meter intervals, historic vegetation data were collected from early nineteenth century survey maps, and ancient pollen and charcoal were collected from soil cores in lakes. We show how data sets collected with disparate goals from anthropology and ecology can be applied to make policy decisions about environmental management.

  17. Paradigms in the management of hepatic hydrothorax: past, present, and future.

    PubMed

    Kumar, Sachin; Sarin, Shiv Kumar

    2013-03-01

    Hepatic hydrothorax (HH) is an infrequent but a well-known complication of portal hypertension in patients with end-stage liver disease. The estimated prevalence of HH is around 4-6 % in cirrhotics. Thoracentesis and pleural fluid analysis is a must for establishing the diagnosis of this transudative effusion in the absence of primary cardiopulmonary disease. Management strategies include sodium restriction, diuretics, thoracentesis, transjugular intrahepatic portosystemic shunt, pleurodesis, and video assisted thoracic surgery in selected patients. Liver transplantation remains the ultimate definitive management paradigm. Refractory HH thus warrants prompt consideration of liver transplantation.

  18. Future Directions: Advances and Implications of Virtual Environments Designed for Pain Management

    PubMed Central

    Soomro, Ahmad; Riva, Giuseppe; Wiederhold, Mark D.

    2014-01-01

    Abstract Pain symptoms have been addressed with a variety of therapeutic measures in the past, but as we look to the future, we begin encountering new options for patient care and individual health and well-being. Recent studies indicate that computer-generated graphic environments—virtual reality (VR)—can offer effective cognitive distractions for individuals suffering from pain arising from a variety of physical and psychological illnesses. Studies also indicate the effectiveness of VR for both chronic and acute pain conditions. Future possibilities for VR to address pain-related concerns include such diverse groups as military personnel, space exploration teams, the general labor force, and our ever increasing elderly population. VR also shows promise to help in such areas as drug abuse, at-home treatments, and athletic injuries. PMID:24892206

  19. Future directions: advances and implications of virtual environments designed for pain management.

    PubMed

    Wiederhold, Brenda K; Soomro, Ahmad; Riva, Giuseppe; Wiederhold, Mark D

    2014-06-01

    Pain symptoms have been addressed with a variety of therapeutic measures in the past, but as we look to the future, we begin encountering new options for patient care and individual health and well-being. Recent studies indicate that computer-generated graphic environments--virtual reality (VR)--can offer effective cognitive distractions for individuals suffering from pain arising from a variety of physical and psychological illnesses. Studies also indicate the effectiveness of VR for both chronic and acute pain conditions. Future possibilities for VR to address pain-related concerns include such diverse groups as military personnel, space exploration teams, the general labor force, and our ever increasing elderly population. VR also shows promise to help in such areas as drug abuse, at-home treatments, and athletic injuries.

  20. Future water supply management adaptation measures - case study of Ljubljana field aquifer

    NASA Astrophysics Data System (ADS)

    Čenčur Curk, B.; Zajc Benda, T.; Souvent, P.; Bračič Železnik, B.; Bogardi, I.

    2012-04-01

    The main drinking water supply problems are related to the significant change of groundwater quantity and quality observed in the last decades as an effect of land use practices and very likely also climate change. The latter may affect the ability of drinking water suppliers to provide enough water of sufficient quality to the consumers. These topics were studied in the frame of SEE project CC-WaterS (Climate Change and Impact on Water Supply) with the main goal to develop a water supply management system regarding optimisation of water extraction and land use restrictions under climate change scenarios for water suppliers, since existing management practices are mostly inadequate to reduce impacts of CC on water supply reliability. The main goal was a designation of appropriate measures and risk assessment to adapt water supply to changing climate and land use activities considering socio-economic aspects. This was accomplished by using 'Fuzzy Decimaker', which is a tool for selecting and ranking risk reduction measures or management actions for local waterworks or water authorities under the pressure of climate change. Firstly, management options were selected and ranked. For public water supply of Ljubljana, the capital of Slovenia, several management options were selected. For improvement of water supply and preservation of water resource quantities there is a need for engineering interventions, such as reducing water losses on pipelines. For improving drinking water safety and preserving water resource quality farmers are not allowed to use fertilisers in the first safeguarding zone and they get compensations for income reduction because of lower farming production. Compensations for farming restrictions in the second safeguarding zone were applied as additional management option. On the other hand, drinking water treatment is another management option to be considered. Trends in groundwater level are decreasing, above all recharge areas of waterworks

  1. Self-Reported Changes in Food Safety Behaviors among Foodservice Employees: Impact of a Retail Food Safety Education Program

    ERIC Educational Resources Information Center

    Anding, Jenna D.; Boleman, Chris; Thompson, Britta

    2007-01-01

    A food safety education program developed for retail food establishments was evaluated to assess the extent to which participants were practicing selected behaviors linked to reducing the risk of foodborne disease both before and after the program. Scores from the state health department's Certified Food Manager (CFM) exam also were examined.…

  2. Pheromone-Based Pest Management in China: Past, Present, and Future Prospects.

    PubMed

    Cui, Gen Zhong; Zhu, Junwei Jerry

    2016-07-01

    Semiochemical-based pest management technology has been widely used to monitor and control insect pests in agricultural, forestry, and public health sectors in the western world. It became a popular tool in the early 1970s with tremendous efforts in developing environment-friendly control technologies for the integrated pest management. However, in China, similar research lagged 15 to 20 years and was not initiated until the late 1980s. In this review, we present the early history of pheromone research that has led to the current practical applications in China, particularly in the development of pheromone-based pest management products. We also provide information regarding the current status of pheromone-based product manufacturing, marketing, and regulatory issues related to local semiochemical industries, which may be useful to other international companies interested in pursuing business in China. In addition, we share some research topics that represent new directions of the present pheromone research to explore novel tools for advancing semiochemical-based pest management in China. PMID:27481347

  3. Pheromone-based pest management in china: past, present and future prospects

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Semiochemical-based pest management technology has been widely used to monitor and control insect pests in agricultural, forestry, and public health sectors in the western world. It became a popular tool in the early 1970s with tremendous efforts in developing environment-friendly control technologi...

  4. Optimally managing water resources in large river basins for an uncertain future

    USGS Publications Warehouse

    Roehl, Edwin A.; Conrads, Paul A.

    2014-01-01

    One of the challenges of basin management is the optimization of water use through ongoing regional economic development, droughts, and climate change. This paper describes a model of the Savannah River Basin designed to continuously optimize regulated flow to meet prioritized objectives set by resource managers and stakeholders. The model was developed from historical data by using machine learning, making it more accurate and adaptable to changing conditions than traditional models. The model is coupled to an optimization routine that computes the daily flow needed to most efficiently meet the water-resource management objectives. The model and optimization routine are packaged in a decision support system that makes it easy for managers and stakeholders to use. Simulation results show that flow can be regulated to substantially reduce salinity intrusions in the Savannah National Wildlife Refuge while conserving more water in the reservoirs. A method for using the model to assess the effectiveness of the flow-alteration features after the deepening also is demonstrated.

  5. Biologically Based Methods for Pest Management in Agriculture under Changing Climates: Challenges and Future Directions

    PubMed Central

    Chidawanyika, Frank; Mudavanhu, Pride; Nyamukondiwa, Casper

    2012-01-01

    The current changes in global climatic regimes present a significant societal challenge, affecting in all likelihood insect physiology, biochemistry, biogeography and population dynamics. With the increasing resistance of many insect pest species to chemical insecticides and an increasing organic food market, pest control strategies are slowly shifting towards more sustainable, ecologically sound and economically viable options. Biologically based pest management strategies present such opportunities through predation or parasitism of pests and plant direct or indirect defense mechanisms that can all be important components of sustainable integrated pest management programs. Inevitably, the efficacy of biological control systems is highly dependent on natural enemy-prey interactions, which will likely be modified by changing climates. Therefore, knowledge of how insect pests and their natural enemies respond to climate variation is of fundamental importance in understanding biological insect pest management under global climate change. Here, we discuss biological control, its challenges under climate change scenarios and how increased global temperatures will require adaptive management strategies to cope with changing status of insects and their natural enemies. PMID:26466733

  6. Managing the University Campus: Exploring Models for the Future and Supporting Today's Decisions

    ERIC Educational Resources Information Center

    den Heijer, Alexandra

    2012-01-01

    Managing contemporary campuses and taking decisions that will impact on those of tomorrow is a complex task for universities worldwide. It involves strategic, financial, functional and physical aspects as well as multiple stakeholders. This article summarises the conclusions of a comprehensive PhD research project which was enriched with lessons…

  7. Leadership Values, Trust and Negative Capability: Managing the Uncertainties of Future English Higher Education

    ERIC Educational Resources Information Center

    Jameson, Jill

    2012-01-01

    The complex leadership attribute of "negative capability" in managing uncertainty and engendering trust may be amongst the qualities enabling institutions to cope with multiple recent government policy challenges affecting English higher education, including significant increases in student fees. Research findings are reported on changes in…

  8. Changing Our Future: Issues in Leadership and Management Skills and the Information Profession.

    ERIC Educational Resources Information Center

    Mercer, Prue

    This paper explores the issues and opportunities for information providers in a digital environment where the skills of management of change and leadership are necessary to create vital and healthy organizations. The first section discusses challenges of the digital environment and skills for the information profession, including the impact of…

  9. Pheromone-Based Pest Management in China: Past, Present, and Future Prospects.

    PubMed

    Cui, Gen Zhong; Zhu, Junwei Jerry

    2016-07-01

    Semiochemical-based pest management technology has been widely used to monitor and control insect pests in agricultural, forestry, and public health sectors in the western world. It became a popular tool in the early 1970s with tremendous efforts in developing environment-friendly control technologies for the integrated pest management. However, in China, similar research lagged 15 to 20 years and was not initiated until the late 1980s. In this review, we present the early history of pheromone research that has led to the current practical applications in China, particularly in the development of pheromone-based pest management products. We also provide information regarding the current status of pheromone-based product manufacturing, marketing, and regulatory issues related to local semiochemical industries, which may be useful to other international companies interested in pursuing business in China. In addition, we share some research topics that represent new directions of the present pheromone research to explore novel tools for advancing semiochemical-based pest management in China.

  10. Fact Finding Report. Commission on the Future of Worker-Management Relations.

    ERIC Educational Resources Information Center

    Department of Commerce, Washington, DC.

    This report presents findings of a commission that held hearings and examined quantitative and qualitative evidence on the current state of worker-management relations in the United States. Chapter I identifies those facts about the changing economic and social environment that bear directly on the mission statement of the commission (to ensure…

  11. The Future of Medical Schools and Teaching Hospitals in the Era of Managed Care.

    ERIC Educational Resources Information Center

    Pardes, Herbert

    1997-01-01

    Academic medical centers, threatened by erosion of infrastructure, declining academic workforce, marketplace forces diminishing quality and access, and shrinking funds, must not rely on managed care, the pharmaceutical industry, or foundations to provide necessary support. They must communicate the dangers they face and persuade government to…

  12. The Future of Teaching as a Profession: Assessing Classroom Management Skills.

    ERIC Educational Resources Information Center

    Rosner, Frieda C.

    The initial phase of the National Teacher Examination classroom management test for entry level teachers has been completed. Two systematic reviews of the literature on classroom techniques resulted in the identification and description of a wide range of managerial strategies--authoritarian, behavior modification, permissive, intimidation. Also…

  13. Pathways to a Sustainable Future: A Curriculum Guide for Maine Schools Exploring Waste Management Issues.

    ERIC Educational Resources Information Center

    Chewonki Foundation, Wiscasset, ME.

    This action guide is designed to help students and teachers become aware of the concepts and issues of waste management, and to motivate them to action in the classroom, school, home, and community. The guide emphasizes interdisciplinary activities that concentrate on the process of problem solving. Activities are identified by appropriate grade…

  14. MacDonald Dettwiler real-time emergency management via satellite — status update and future directions

    NASA Astrophysics Data System (ADS)

    Hargreaves, David; Knight, Tony; Brownsword, Pat

    Real-time wireless communications between permanent command centres, field command posts, and field resources such as field crews, helicopters and other mobile equipment are a necessity for most emergency management and coordination organizations worldwide. Space-based technologies such as satellite positioning systems, satellite communications systems and Earth observations systems have the potential to fill many of these needs. MacDonald Dettwiler's Real-time Emergency Management via Satellite (REMSAT) system addresses this gap by providing an integrated system that has now been used operationally in a forest fire fighting role over the past 2 years. This paper will provide the concept of operations, an overview of the initial REMSAT system, and the results of the field tests including recommendations for future systems.

  15. Impacts of agricultural management and climate change on future soil organic carbon dynamics in North China Plain.

    PubMed

    Wang, Guocheng; Li, Tingting; Zhang, Wen; Yu, Yongqiang

    2014-01-01

    Dynamics of cropland soil organic carbon (SOC) in response to different management practices and environmental conditions across North China Plain (NCP) were studied using a modeling approach. We identified the key variables driving SOC changes at a high spatial resolution (10 km × 10 km) and long time scale (90 years). The model used future climatic data from the FGOALS model based on four future greenhouse gas (GHG) concentration scenarios. Agricultural practices included different rates of nitrogen (N) fertilization, manure application, and stubble retention. We found that SOC change was significantly influenced by the management practices of stubble retention (linearly positive), manure application (linearly positive) and nitrogen fertilization (nonlinearly positive) - and the edaphic variable of initial SOC content (linearly negative). Temperature had weakly positive effects, while precipitation had negligible impacts on SOC dynamics under current irrigation management. The effects of increased N fertilization on SOC changes were most significant between the rates of 0 and 300 kg ha-1 yr-1. With a moderate rate of manure application (i.e., 2000 kg ha-1 yr-1), stubble retention (i.e., 50%), and an optimal rate of nitrogen fertilization (i.e., 300 kg ha-1 yr-1), more than 60% of the study area showed an increase in SOC, and the average SOC density across NCP was relatively steady during the study period. If the rates of manure application and stubble retention doubled (i.e., manure application rate of 4000 kg ha-1 yr-1 and stubble retention rate of 100%), soils across more than 90% of the study area would act as a net C sink, and the average SOC density kept increasing from 40 Mg ha-1 during 2010s to the current worldwide average of ∼ 55 Mg ha-1 during 2060s. The results can help target agricultural management practices for effectively mitigating climate change through soil C sequestration.

  16. Evidence base and future research directions in the management of low back pain

    PubMed Central

    Abbott, Allan

    2016-01-01

    Low back pain (LBP) is a prevalent and costly condition. Awareness of valid and reliable patient history taking, physical examination and clinical testing is important for diagnostic accuracy. Stratified care which targets treatment to patient subgroups based on key characteristics is reliant upon accurate diagnostics. Models of stratified care that can potentially improve treatment effects include prognostic risk profiling for persistent LBP, likely response to specific treatment based on clinical prediction models or suspected underlying causal mechanisms. The focus of this editorial is to highlight current research status and future directions for LBP diagnostics and stratified care. PMID:27004162

  17. Management Choices in an Uncertain Future: Navigating Snow, Precipitation, and Temperature Projections in the Pacific Northwest U.S. to Assess Water Management Alternatives

    NASA Astrophysics Data System (ADS)

    Luce, C.

    2014-12-01

    Climate and hydrology models are regularly applied to assess potential changes in water resources and to inform adaptation decisions. An increasingly common question is, "What if we are wrong?" While climate models show substantial agreement on metrics such as pressure, temperature, and wind, they are notoriously uncertain in projecting precipitation change. The response to that uncertainty varies depending on the water management context and the nature of the uncertainty. In the southwestern U.S., large storage reservoirs (relative to annual supply) and general expectations of decreasing precipitation have guided extensive discussion on water management towards uncertainties in annual-scale water balances, precipitation, and evapotranspiration. In contrast, smaller reservoirs and little expectation for change in annual precipitation have focused discussions of Pacific Northwest water management toward shifts in runoff seasonality. The relative certainty of temperature impacts on snowpacks compared to the substantial uncertainty in precipitation has yielded a consistent narrative on earlier snowmelt. This narrative has been reinforced by a perception of essentially the same behavior in the historical record. This perception has led to calls in the political arena for more reservoir storage to replace snowpack storage for water supplies. Recent findings on differences in trends in precipitation at high versus low elevations, however, has recalled the uncertainty in precipitation futures and generated questions about alternative water management strategies. An important question with respect to snowpacks is whether the precipitation changes matter in the context of such substantial projections for temperature change. Here we apply an empirical snowpack model to analyze spatial differences in the uncertainty of snowpack responses to temperature and precipitation forcing across the Pacific Northwest U.S. The analysis reveals a strong geographic gradient in uncertainty

  18. Computer-Aided Nodule Assessment and Risk Yield Risk Management of Adenocarcinoma: The Future of Imaging?

    PubMed

    Foley, Finbar; Rajagopalan, Srinivasan; Raghunath, Sushravya M; Boland, Jennifer M; Karwoski, Ronald A; Maldonado, Fabien; Bartholmai, Brian J; Peikert, Tobias

    2016-01-01

    Increased clinical use of chest high-resolution computed tomography results in increased identification of lung adenocarcinomas and persistent subsolid opacities. However, these lesions range from very indolent to extremely aggressive tumors. Clinically relevant diagnostic tools to noninvasively risk stratify and guide individualized management of these lesions are lacking. Research efforts investigating semiquantitative measures to decrease interrater and intrarater variability are emerging, and in some cases steps have been taken to automate this process. However, many such methods currently are still suboptimal, require validation and are not yet clinically applicable. The computer-aided nodule assessment and risk yield software application represents a validated tool for the automated, quantitative, and noninvasive tool for risk stratification of adenocarcinoma lung nodules. Computer-aided nodule assessment and risk yield correlates well with consensus histology and postsurgical patient outcomes, and therefore may help to guide individualized patient management, for example, in identification of nodules amenable to radiological surveillance, or in need of adjunctive therapy. PMID:27568149

  19. Endoscopic Mucosal Resection in the Management of Esophageal Neoplasia: Current Status and Future Directions

    PubMed Central

    Namasivayam, Vikneswaran; Wang, Kenneth K.; Prasad, Ganapathy A

    2010-01-01

    Endoscopic mucosal resection has expanded the role of the gastroenterologist in the management of esophageal neoplasia from screening and diagnosis to staging and endoscopic treatment. Its rise to prominence is a reflection of the long identified need to obtain histological information regarding depth of invasion and neoplastic margins during therapy that previously could not be achieved with ablative techniques. The resultant improvement in diagnosis and staging has allowed for better selection of patients for endoscopic therapy who may be spared invasive surgery. The clinical indications, endoscopic techniques, outcomes and complications in the management of esophageal neoplasia are reviewed in this manuscript. Training requirements to achieve proficiency in EMR as well as potential quality measures to assess competence are also proposed in this review. PMID:20541628

  20. Computer-Aided Nodule Assessment and Risk Yield Risk Management of Adenocarcinoma: The Future of Imaging?

    PubMed

    Foley, Finbar; Rajagopalan, Srinivasan; Raghunath, Sushravya M; Boland, Jennifer M; Karwoski, Ronald A; Maldonado, Fabien; Bartholmai, Brian J; Peikert, Tobias

    2016-01-01

    Increased clinical use of chest high-resolution computed tomography results in increased identification of lung adenocarcinomas and persistent subsolid opacities. However, these lesions range from very indolent to extremely aggressive tumors. Clinically relevant diagnostic tools to noninvasively risk stratify and guide individualized management of these lesions are lacking. Research efforts investigating semiquantitative measures to decrease interrater and intrarater variability are emerging, and in some cases steps have been taken to automate this process. However, many such methods currently are still suboptimal, require validation and are not yet clinically applicable. The computer-aided nodule assessment and risk yield software application represents a validated tool for the automated, quantitative, and noninvasive tool for risk stratification of adenocarcinoma lung nodules. Computer-aided nodule assessment and risk yield correlates well with consensus histology and postsurgical patient outcomes, and therefore may help to guide individualized patient management, for example, in identification of nodules amenable to radiological surveillance, or in need of adjunctive therapy.

  1. Emissions of methane from northern peatlands: a review of management impacts and future implications

    NASA Astrophysics Data System (ADS)

    Abdalla, Mohamed; Hastings, Astley; Mander, Ulo; Smith, Pete; Nilsson, Mats

    2016-04-01

    Northern peatlands constitute a significant source of atmospheric methane (CH4). However, management of undisturbed peatlands, as well as restoration of disturbed peatlands, will alter the exchange of methane with the atmosphere. The aim of this literature review and meta-analysis was to collate and analyse recent literature to improve our understanding of the impacts of management on CH4 emissions from northern peatlands i.e. latitude 40 to 70o N. Results show that CH4 emissions from natural northern peatlands range from 0 to 154 g C m-2 yr-1 and the overall annual average (mean ± standard deviation) is 11.7 ± 21 g C m-2 yr-1 with the highest emissions from fen ecosystems. Drainage significantly (p<0.05) reduces CH4 emissions to the atmosphere, on average by 84%. However, restoration by rewetting of peatlands and application of N fertilizer both significantly (p<0.05) increase the emissions compared to the original pre-management CH4 fluxes. Methane emissions are mainly controlled by water table (WT) depth, plant community composition and soil pH. Although temperature is not a good predictor of CH4 emissions by itself, the interaction between temperatures, plant community cover, WT depth and soil pH is important. According to short-term forecasts of climate change, these complex interactions will be the main determinant of increased CH4 emissions from northern peatlands. However, to fully evaluate the net effect of management practice on high latitude peatlands both net ecosystem exchange (NEE) and carbon exports needs to be considered.

  2. Whither CRM? Future directions in Crew Resource Management training in the cockpit and elsewhere

    NASA Technical Reports Server (NTRS)

    Helmreich, Robert L.

    1993-01-01

    The past decade has shown worldwide adoption of human factors training in civil aviation, now known as Crew Resource Management (CRM). The shift in name from cockpit to crew reflects a growing trend to extend the training to other components of the aviation system including flight attendants, dispatchers, maintenance personnel, and Air Traffic Controllers. The paper reports findings and new directions in research into human factors.

  3. Nitrogen dynamics in managed boreal forests: Recent advances and future research directions.

    PubMed

    Sponseller, Ryan A; Gundale, Michael J; Futter, Martyn; Ring, Eva; Nordin, Annika; Näsholm, Torgny; Laudon, Hjalmar

    2016-02-01

    Nitrogen (N) availability plays multiple roles in the boreal landscape, as a limiting nutrient to forest growth, determinant of terrestrial biodiversity, and agent of eutrophication in aquatic ecosystems. We review existing research on forest N dynamics in northern landscapes and address the effects of management and environmental change on internal cycling and export. Current research foci include resolving the nutritional importance of different N forms to trees and establishing how tree-mycorrhizal relationships influence N limitation. In addition, understanding how forest responses to external N inputs are mediated by above- and belowground ecosystem compartments remains an important challenge. Finally, forestry generates a mosaic of successional patches in managed forest landscapes, with differing levels of N input, biological demand, and hydrological loss. The balance among these processes influences the temporal patterns of stream water chemistry and the long-term viability of forest growth. Ultimately, managing forests to keep pace with increasing demands for biomass production, while minimizing environmental degradation, will require multi-scale and interdisciplinary perspectives on landscape N dynamics.

  4. Scanning the future--ultrasonography as a reproductive management tool for dairy cattle.

    PubMed

    Fricke, P M

    2002-08-01

    Application of transrectal real-time ultrasonography as a research tool to study bovine reproduction represents a technological breakthrough that has revolutionized our understanding of reproductive biology in cattle. The widespread adoption and use of ultrasonography for routine reproductive examinations of dairy cattle by bovine practitioners is the next contribution this technology will make to the dairy industry. Assessment of pregnancy status and fetal viability early postbreeding to identify cows that fail to conceive improves reproductive efficiency by decreasing the interval between artificial insemination services and increasing artificial insemination service rate. Early identification of cows carrying twin fetuses will allow for implementation of differential management strategies to abrogate negative effects of twinning during the periparturient period once such strategies have been developed. Ovarian and uterine pathologies not accurately detected via rectal palpation can easily be visualized by ultrasound, and appropriate therapies can be implemented. Determination of fetal sex in utero is useful when coupled with a management decision that justifies the expense of fetal sexing. Development of integrated reproductive management systems that combine ultrasound with new and existing reproductive technologies will further enhance the practical applications of ultrasonography. Development of Extension education programs to train bovine practitioners to use ultrasound for routine reproductive examinations is a critical step toward rapid implementation of this technology into the dairy industry. PMID:12214984

  5. Hydrological connectivity for catchment management: research approaches, pathways and future agendas

    NASA Astrophysics Data System (ADS)

    Bracken, L. J.; Ali, G.; Roy, A. G.; Smith, M. W.; Tetzlaf, D.; Wainwright, J.

    2012-04-01

    The concept of hydrological connectivity is an overarching framework for understanding runoff and runon that has come to the fore in the last decade. Catchment management is a vital end-use of research around hydrological connectivity. The purpose of management is usually to maintain appropriate (dis)connectivity for different niches (hydrological, ecological, geomorphological), especially to be able to deal with what happens when structures are perturbed. Thus, for effective management and intervention in catchments a process-based understanding of connectivity is required so that: i) the conceptual rather than solely empirical understanding drives how managers interpret a system; and ii) there is an understanding of how continuous flow fields develop under different sets of environmental conditions to enable managers to know when, where and how to intervene successfully in catchment processes. Presently there is confusion around the structure: process dichotomy, shifting focus from understanding static indices influencing hydrological connectivity, to understanding the dynamics of process. Understanding different types and states of connections in catchments is helpful, but it is better to have an appreciation of processes to know that intervention is occurring in the most suitable way, or to prioritize limited resources. The aim of this presentation is to: i) evaluate the extent to which different concepts of hydrological connectivity have emerged from different approaches to measure and predict flow in different environments; ii) discuss the extent to which these different concepts are mutually compatible; and iii) explore what further research needs to be carried out to contribute to a unified understanding of hydrological processes. Approaches to investigating hydrological connectivity can be categorised as those: evaluating soil-moisture patterns (soil-moisture connectivity); understanding hillslope runoff patterns and processes (flow-process connectivity

  6. A future Demand Side Management (DSM) opportunity for utility as variable renewable penetrate scale up using agriculture.

    NASA Astrophysics Data System (ADS)

    Ines, A.; Bhattacharjee, A.; Modi, V.; Robertson, A. W.; Lall, U.; Kocaman Ayse, S.; Chaudhary, S.; Kumar, A.; Ganapathy, A.; Kumar, A.; Mishra, V.

    2015-12-01

    Energy demand management, also known as demand side management (DSM), is the modification of consumer demand for energy through various methods such as smart metering, incentive based schemes, payments for turning off loads or rescheduling loads. Usually, the goal of demand side management is to encourage the consumer to use less power during periods of peak demand, or to move the time of energy use to off-peak times. Peak demand management does not necessarily decrease total energy consumption, but could be expected to reduce the need for investments in networks and/or power plants for meeting peak demands. Electricity use can vary dramatically on short and medium time frames, and the pricing system may not reflect the instantaneous cost as additional higher-cost that are brought on-line. In addition, the capacity or willingness of electricity consumers to adjust to prices by altering elasticity of demand may be low, particularly over short time frames. In the scenario of Indian grid setup, the retail customers do not follow real-time pricing and it is difficult to incentivize the utility companies for continuing the peak demand supply. A question for the future is how deeper penetration of renewable will be handled? This is a challenging problem since one has to deal with high variability, while managing loss of load probabilities. In the case of managing the peak demand using agriculture, in the future as smart metering matures with automatic turn on/off for a pump, it will become possible to provide an ensured amount of water or energy to the farmer while keeping the grid energized for 24 hours. Supply scenarios will include the possibility of much larger penetration of solar and wind into the grid. While, in absolute terms these sources are small contributors, their role will inevitably grow but DSM using agriculture could help reduce the capital cost. The other option is of advancing or delaying pump operating cycle even by several hours, will still ensure

  7. Future of Management of Multiple Sclerosis in the Middle East: A Consensus View from Specialists in Ten Countries

    PubMed Central

    Aljumah, Mohammed; Alsharoqi, I.; Bohlega, Saeed A.; Dahdaleh, Maurice; Deleu, Dirk; Esmat, Khaled; Khalifa, Ahmad; Sahraian, Mohammad A.; Szólics, Miklós; AlTahan, Abdulrahman; Yamout, Bassem I.; Rieckmann, Peter

    2013-01-01

    The prevalence of multiple sclerosis (MS) is now considered to be medium-to-high in the Middle East and is rising, particularly among women. While the characteristics of the disease and the response of patients to disease-modifying therapies are generally comparable between the Middle East and other areas, significant barriers to achieving optimal care for MS exist in these developing nations. A group of physicians involved in the management of MS in ten Middle Eastern countries met to consider the future of MS care in the region, using a structured process to reach a consensus. Six key priorities were identified: early diagnosis and management of MS, the provision of multidisciplinary MS centres, patient engagement and better communication with stakeholders, regulatory body education and reimbursement, a commitment to research, and more therapy options with better benefit-to-risk ratios. The experts distilled these priorities into a single vision statement: “Optimization of patient-centred multidisciplinary strategies to improve the quality of life of people with MS.” These core principles will contribute to the development of a broader consensus on the future of care for MS in the Middle East. PMID:24455267

  8. Future of management of multiple sclerosis in the middle East: a consensus view from specialists in ten countries.

    PubMed

    Aljumah, Mohammed; Alroughani, Raed; Alsharoqi, I; Bohlega, Saeed A; Dahdaleh, Maurice; Deleu, Dirk; Esmat, Khaled; Khalifa, Ahmad; Sahraian, Mohammad A; Szólics, Miklós; Altahan, Abdulrahman; Yamout, Bassem I; Rieckmann, Peter; Daif, Abdulkader

    2013-01-01

    The prevalence of multiple sclerosis (MS) is now considered to be medium-to-high in the Middle East and is rising, particularly among women. While the characteristics of the disease and the response of patients to disease-modifying therapies are generally comparable between the Middle East and other areas, significant barriers to achieving optimal care for MS exist in these developing nations. A group of physicians involved in the management of MS in ten Middle Eastern countries met to consider the future of MS care in the region, using a structured process to reach a consensus. Six key priorities were identified: early diagnosis and management of MS, the provision of multidisciplinary MS centres, patient engagement and better communication with stakeholders, regulatory body education and reimbursement, a commitment to research, and more therapy options with better benefit-to-risk ratios. The experts distilled these priorities into a single vision statement: "Optimization of patient-centred multidisciplinary strategies to improve the quality of life of people with MS." These core principles will contribute to the development of a broader consensus on the future of care for MS in the Middle East.

  9. Convergent evolution of health information management and health informatics: a perspective on the future of information professionals in health care.

    PubMed

    Gibson, C J; Dixon, B E; Abrams, K

    2015-01-01

    Clearly defined boundaries are disappearing among the activities, sources, and uses of health care data and information managed by health information management (HIM) and health informatics (HI) professionals. Definitions of the professional domains and scopes of practice for HIM and HI are converging with the proliferation of information and communication technologies in health care settings. Convergence is changing both the roles that HIM and HI professionals serve in their organizations as well as the competencies necessary for training future professionals. Many of these changes suggest a blurring of roles and responsibilities with increasingly overlapping curricula, job descriptions, and research agendas. Blurred lines in a highly competitive market create confusion for students and employers. In this essay, we provide some perspective on the changing landscape and suggest a course for the future. First we review the evolving definitions of HIM and HI. We next compare the current domains and competencies, review the characteristics as well as the education and credentialing of both disciplines, and examine areas of convergence. Given the current state, we suggest a path forward to strengthen the contributions HIM and HI professionals and educators make to the evolving health care environment. PMID:25848421

  10. Lessons learnt from past Flash Floods and Debris Flow events to propose future strategies on risk management

    NASA Astrophysics Data System (ADS)

    Cabello, Angels; Velasco, Marc; Escaler, Isabel

    2010-05-01

    Floods, including flash floods and debris flow events, are one of the most important hazards in Europe regarding both economic and life loss. Moreover, changes in precipitation patterns and intensity are very likely to increase due to the observed and predicted global warming, rising the risk in areas that are already vulnerable to floods. Therefore, it is very important to carry out new strategies to improve flood protection, but it is also crucial to take into account historical data to identify high risk areas. The main objective of this paper is to show a comparative analysis of the flood risk management information compiled in four test-bed basins (Llobregat, Guadalhorce, Gardon d'Anduze and Linth basins) from three different European countries (Spain, France and Switzerland) and to identify which are the lessons learnt from their past experiences in order to propose future strategies on risk management. This work is part of the EU 7th FP project IMPRINTS which aims at reducing loss of life and economic damage through the improvement of the preparedness and the operational risk management of flash flood and debris flow (FF & DF) events. The methodology followed includes the following steps: o Specific survey on the effectivity of the implemented emergency plans and risk management procedures sent to the test-bed basin authorities that participate in the project o Analysis of the answers from the questionnaire and further research on their methodologies for risk evaluation o Compilation of available follow-up studies carried out after major flood events in the four test-bed basins analyzed o Collection of the lessons learnt through a comparative analysis of the previous information o Recommendations for future strategies on risk management based on lessons learnt and management gaps detected through the process As the Floods Directive (FD) already states, the flood risks associated to FF & DF events should be assessed through the elaboration of Flood Risk

  11. PET-Based Personalized Management in Clinical Oncology: An Unavoidable Path for the Foreseeable Future.

    PubMed

    Basu, Sandip; Alavi, Abass

    2016-07-01

    It is imperative that the thrust of clinical practice in the ensuing years would be to develop personalized management model for various disorders. PET-computed tomography (PET-CT) based molecular functional imaging has been increasingly utilized for assessment of tumor and other nonmalignant disorders and has the ability to explore disease phenotype on an individual basis and address critical clinical decision making questions related to practice of personalized medicine. Hence, it is essential to make a concerted systematic effort to explore and define the appropriate place of PET-CT in personalized clinical practice in each of malignancies, which would strengthen the concept further. The potential advantages of PET based disease management can be classified into broad categories: (1) Traditional: which includes assessment of disease extent such as initial disease staging and restaging, treatment response evaluation particularly early in the course and thus PET-CT response adaptive decision for continuing the same regimen or switching to salvage schedules; there has been continuous addition of newer application of PET based disease restaging in oncological parlance (eg, Richter transformation); (2) Recent and emerging developments: this includes exploring tumor biology with FDG and non-FDG PET tracers. The potential of multitracer PET imaging (particularly new and novel tracers, eg, 68Ga-DOTA-TOC/NOC/TATE in NET, 68Ga-PSMA and 18F-fluorocholine in prostate carcinoma, 18F-fluoroestradiol in breast carcinoma) has provided a scientific basis to stratify and select appropriate targeted therapies (both radionuclide and nonradionuclide treatment), a major boost for individualized disease management in clinical oncology. Integrating the molecular level information obtained from PET with structural imaging further individualizing treatment plan in radiation oncology, precision of interventions and biopsies of a particular lesion and forecasting disease prognosis.

  12. Future Landsat Thermal Data for Energy Balance Modeling and Water Resource Management

    NASA Astrophysics Data System (ADS)

    Irons, J. R.; Richardson, C. M.; Reuter, D. C.

    2009-12-01

    Surface energy balance models driven by thermal infrared remote sensing data are now being used to estimate evapotranspiration rates to monitor water consumption over the landscape at various scales. In particular, thermal images from the Thematic Mapper and Enhanced Thematic Mapper - Plus sensors aboard the Landsat 5 and Landsat 7 satellites, respectively, are being applied to water resource management for irrigated agriculture at the management scale; that is, at the scale of individual irrigated fields. The continuation of this application has been uncertain due to the age of the current satellites and a lack of commitment to set thermal imaging requirements for the follow-on satellite, the Landsat Data Continuity Mission (LDCM). The inclusion of a Thermal InfraRed Sensor (TIRS) on the LDCM payload at last seems likely. TIRS is under development at the NASA Goddard Space Flight Center and the design has undergone successful system requirements and preliminary design reviews. Additionally, TIRS was included as a component of the baseline LDCM system in the mission-level preliminary design review. The TIRS baseline design employs cryo-cooled quantum well infrared photodiode arrays to collect data for two thermal spectral bands with a spatial resolution of 100 m across a 185-km field-of-view. TIRS will be operated in concert with the other LDCM sensor, the Operational Land Imager (OLI) to provide spatially and temporally coincident images for both the TIRS thermal bands and the OLI reflective spectral bands. This presentation will discuss TIRS requirements, the baseline design, and the suitability of the sensor for water resource management relative to the thermal data from the earlier Landsat satellites. Final approval for the flight of TIRS aboard the LDCM is awaiting a final NASA decision expected in the timeframe of the Fall Meeting.

  13. PET-Based Personalized Management in Clinical Oncology: An Unavoidable Path for the Foreseeable Future.

    PubMed

    Basu, Sandip; Alavi, Abass

    2016-07-01

    It is imperative that the thrust of clinical practice in the ensuing years would be to develop personalized management model for various disorders. PET-computed tomography (PET-CT) based molecular functional imaging has been increasingly utilized for assessment of tumor and other nonmalignant disorders and has the ability to explore disease phenotype on an individual basis and address critical clinical decision making questions related to practice of personalized medicine. Hence, it is essential to make a concerted systematic effort to explore and define the appropriate place of PET-CT in personalized clinical practice in each of malignancies, which would strengthen the concept further. The potential advantages of PET based disease management can be classified into broad categories: (1) Traditional: which includes assessment of disease extent such as initial disease staging and restaging, treatment response evaluation particularly early in the course and thus PET-CT response adaptive decision for continuing the same regimen or switching to salvage schedules; there has been continuous addition of newer application of PET based disease restaging in oncological parlance (eg, Richter transformation); (2) Recent and emerging developments: this includes exploring tumor biology with FDG and non-FDG PET tracers. The potential of multitracer PET imaging (particularly new and novel tracers, eg, 68Ga-DOTA-TOC/NOC/TATE in NET, 68Ga-PSMA and 18F-fluorocholine in prostate carcinoma, 18F-fluoroestradiol in breast carcinoma) has provided a scientific basis to stratify and select appropriate targeted therapies (both radionuclide and nonradionuclide treatment), a major boost for individualized disease management in clinical oncology. Integrating the molecular level information obtained from PET with structural imaging further individualizing treatment plan in radiation oncology, precision of interventions and biopsies of a particular lesion and forecasting disease prognosis. PMID

  14. Evaluation and Management of Hepatic Encephalopathy: Current Status and Future Directions

    PubMed Central

    Suraweera, Duminda; Sundaram, Vinay; Saab, Sammy

    2016-01-01

    Hepatic encephalopathy is a spectrum of neurocognitive manifestations often seen in patients with liver injury or rarely in patients with portosystemic shunting without liver injury. It can be divided into minimal (covert) hepatic encephalopathy and overt hepatic encephalopathy, depending on the severity. Patients with hepatic encephalopathy have compromised clinical outcomes, decreased quality of life, and increased healthcare utilization, often resulting in a heavy financial and personal burden on caregivers. The diagnosis remains largely clinical, with the exclusion of possible other causes for the altered mental status. Current treatment strategies include nonabsorbable disaccharides and antibiotics. This review will focus on the diagnosis, management and clinical impact of hepatic encephalopathy. PMID:27377741

  15. The jellyfish joyride: causes, consequences and management responses to a more gelatinous future.

    PubMed

    Richardson, Anthony J; Bakun, Andrew; Hays, Graeme C; Gibbons, Mark J

    2009-06-01

    Human-induced stresses of overfishing, eutrophication, climate change, translocation and habitat modification appear to be promoting jellyfish (pelagic cnidarian and ctenophore) blooms to the detriment of other marine organisms. Mounting evidence suggests that the structure of pelagic ecosystems can change rapidly from one that is dominated by fish (that keep jellyfish in check through competition or predation) to a less desirable gelatinous state, with lasting ecological, economic and social consequences. Management actions needed to stop such changes require tactical coping strategies and longer-term preventative responses based on fundamental and targeted research on this understudied group.

  16. Strategic effects of future environmental policy commitments: climate change, solar radiation management and correlated air pollutants.

    PubMed

    Qu, Jingwen; Silva, Emilson Caputo Delfino

    2015-03-15

    We study the effects of environmental policy commitments in a futuristic world in which solar radiation management (SRM) can be utilized to reduce climate change damages. Carbon and sulfur dioxide emissions (correlated pollutants) can be reduced through tradable permits. We show that if nations simultaneously commit to carbon permit policies, national SRM levels rise with carbon quotas. Alternatively, if they simultaneously commit to SRM policies, the global temperature falls with each unit increase in the global SRM level. A nation always wishes to be a leader in policymaking, but prefers carbon to SRM policymaking. The globe prefers SRM policy commitments.

  17. Pharmacotherapy for the management of achalasia: Current status, challenges and future directions

    PubMed Central

    Nassri, Ammar; Ramzan, Zeeshan

    2015-01-01

    This article reviews currently available pharmacological options available for the treatment of achalasia, with a special focus on the role of botulinum toxin (BT) injection due to its superior therapeutic effect and side effect profile. The discussion on BT includes the role of different BT serotypes, better pharmacological formulations, improved BT injection techniques, the use of sprouting inhibitors, designer recombinant BT formulations and alternative substances used in endoscopic injections. The large body of ongoing research into achalasia and BT may provide a stronger role for BT injection as a form of minimally invasive, cost effective and efficacious form of therapy for patients with achalasia. The article also explores current issues and future research avenues that may prove beneficial in improving the efficacy of pharmacological treatment approaches in patients with achalasia. PMID:26558149

  18. Current and future management of diabetic retinopathy: a personalized evidence-based approach

    PubMed Central

    Fante, Ryan J; Gardner, Thomas W; Sundstrom, Jeffrey M

    2014-01-01

    Summary Diabetic retinopathy (DR) is the leading cause of new-onset blindness in working-age individuals in the USA and represents a growing worldwide epidemic. Classic risk factors for onset or progression of DR include poor glycemic control, hypertension and hyperlipidemia; however, these factors account for only a small proportion of the risk of DR. New systemic risk factors are emerging, which may allow for personalized risk profiling and targeted treatment by physicians. In addition, early studies of vitreous fluid in patients with DR have resulted in a new paradigm: diabetes causes inflammation in the retina, which is mediated by multiple small signaling molecules that induce angiogenesis and vascular permeability. Future treatment of DR may involve two approaches: early vitreous analysis, followed by drug treatment targeted to the unique vitreous composition of the patient; and collaboration between ophthalmologists and primary care providers to address the unique systemic risk profile of each diabetic patient. PMID:24932222

  19. Progress of hearing loss in neurofibromatosis type 2: implications for future management.

    PubMed

    Kontorinis, Georgios; Nichani, Jaya; Freeman, Simon R; Rutherford, Scott A; Mills, Samantha; King, Andrew T; Mawman, Deborah; Huson, Sue; O'Driscoll, Martin; Gareth Evans, D; Lloyd, Simon K W

    2015-11-01

    The objective of this study was to describe changes in hearing over time in patients with neurofibromatosis type 2 (NF2) treated conservatively. A retrospective case review was conducted in a tertiary referral centre. Pure tone audiometry, speech discrimination scores, serviceable hearing (American Academy of Otolaryngology class A or B) and measurement of vestibular schwannoma (VS) size on magnetic resonance imaging were evaluated in 56 patients (89 ears) with NF2 with at least one conservatively managed VS. Over a mean follow-up period of 7 years (range 0.8-21 years) pure tone average thresholds increased gradually with a mean annual rate of 1.3 dB for the right ear (p = 0.0003) and 2 dB for the left ear (p = 0.0009). Speech discrimination scores dropped with an average annual rate of 1.3 and 0.34% in the right and left ear, respectively. Patients maintained serviceable hearing for an average of 7.6 years (range 2.7-19.3 years). The average annual VS growth was 0.4 mm without any correlation with hearing loss. There was a correlation between patients' age and pure tone threshold increase (p < 0.05 for both ears). In this selected population of patients with NF2, hearing threshold increases were very slow. In NF2 patients with indolently behaving tumours, serviceable hearing can be maintained for a significant length of time, making conservative management an attractive option.

  20. Impact of peatland drainage and restoration on esker groundwater resources: modeling future scenarios for management

    NASA Astrophysics Data System (ADS)

    Rossi, Pekka M.; Ala-aho, Pertti; Doherty, John; Kløve, Bjørn

    2014-08-01

    Esker aquifers are common groundwater bodies in Europe. Management of these aquifers should take account of the sustainability of groundwater-dependent ecosystems and land use in an integrated way. An unconfined esker aquifer in northern Finland was modelled with MODFLOW to determine how groundwater resources are impacted by the surrounding peatland drainage scheme and to simulate scenarios for possible drainage restoration. The impacts of groundwater abstraction and climate change were also simulated. A calibration-constrained Monte Carlo method was used to provide information on the uncertainties associated with model predictions. The results suggest that peatland drainage in the vicinity of eskers can have a significant role in lowering the water table, even though climate variability may mask these impacts. Drainage restoration by filling the ditches might have positive impacts on the aquifer water levels. Comparison of water-table changes caused by peatland drainage with the changes brought by water abstraction and climate variability helped to quantify impacts of different land-use scenarios and facilitated discussion with the local stakeholders. Based on this study, more attention should be devoted to peatland drainage schemes in integrated groundwater management of esker aquifers.

  1. Predicting global invasion risks: a management tool to prevent future introductions

    PubMed Central

    Fletcher, D. H.; Gillingham, P. K.; Britton, J. R.; Blanchet, S.; Gozlan, R. E.

    2016-01-01

    Predicting regions at risk from introductions of non-native species and the subsequent invasions is a fundamental aspect of horizon scanning activities that enable the development of more effective preventative actions and planning of management measures. The Asian cyprinid fish topmouth gudgeon Pseudorasbora parva has proved highly invasive across Europe since its introduction in the 1960s. In addition to direct negative impacts on native fish populations, P. parva has potential for further damage through transmission of an emergent infectious disease, known to cause mortality in other species. To quantify its invasion risk, in regions where it has yet to be introduced, we trained 900 ecological niche models and constructed an Ensemble Model predicting suitability, then integrated a proxy for introduction likelihood. This revealed high potential for P. parva to invade regions well beyond its current invasive range. These included areas in all modelled continents, with several hotspots of climatic suitability and risk of introduction. We believe that these methods are easily adapted for a variety of other invasive species and that such risk maps could be used by policy-makers and managers in hotspots to formulate increased surveillance and early-warning systems that aim to prevent introductions and subsequent invasions. PMID:27199300

  2. Applications of Artificial Neural Networks in integrated water management: fiction or future?

    PubMed

    Schulze, F H; Wolf, H; Jansen, H W; van der Veer, P

    2005-01-01

    An Artificial Neural Network (ANN) is nowadays recognized as a very promising tool for relating input data to output data. It is said that the possibilities of artificial neural networks are unlimited. Here we focus on the potential role of neural networks in integrated water management. An Artificial Neural Network (ANN) is a mathematical methodology which describes relations between cause (input data) and effects (output data) irrespective of the process laying behind and without the need for making assumptions considering the nature of the relations. The applications are widespread and vary from optimization of measuring networks, operational water management, prediction of drinking water consumption, on-line steering of wastewater treatment plants and sewage systems, up to more specific applications such as establishing a relationship between the observed erosion of groyne field sediments and the characteristics of passing vessels on the river Rhine. Especially where processes are complex, neural networks can open new possibilities for understanding and modelling these kinds of complex processes. Besides explaining the method of ANN this paper shows different applications. Three examples have been worked out in more detail. An intelligent monitoring system is shown for the on-line prediction of water consumption, ANN are successfully used for sludge cost monitoring and optimizing wastewater treatment and the usage of ANN is shown in optimizing and monitoring water quality measuring networks. An ANN appears to be a multiuse and powerful tool for modelling complex processes.

  3. The survival of platypus in captivity: a reappraisal with recommendations for veterinary management and future research.

    PubMed

    Serena, M; Williams, G A

    1993-02-01

    Data are presented on the duration of survival of platypus held in the collections of the 5 Australian zoos displaying the species over the period 1987-1991. Of 10 living platypus, five had survived for 7 or more years. Similarly, of 10 captive animals that died during the period, six had survived for 6 or more years. Five purpose-caught animals were integrated into captive collections over the period; all of these were alive at the end of 1991. The high survival of captive platypus documented in this study contrasts with the conclusion of Whittington (1991) that the duration of survival of platypus in captivity is generally short. This primarily reflects differences in the nature of the two sets of data: Whittington's analysis was based on incomplete records dating back to 1934, and also categorised as 'managed in captivity' those wild platypus that died at zoos while under veterinary care. A series of recommendations on current captive management issues includes the need for improved veterinary knowledge of platypus.

  4. Shaping the future: A strategic plan for natural resources and environmental management education

    SciTech Connect

    1994-02-01

    As the 21st century nears, the use of natural resources and the preservation of environmental quality are the focus of increased worldwide attention. The Cooperative Extension System (CES) thereby is presented with expanded opportunities and responsibilities for outreach education in natural resources and environmental management (NREM). To meet this challenge, a 17-member team of Extension professionals-selected to represent the geographic, academic, and cultural diversity of the CES-has prepared this report. This document is a plan to guide the Cooperative Extension System in strengthening programs in the area of natural resources and environmental management education. The implementation of this systemwide Strategic Plan and of similar state plans will expand the scope and effectiveness of NREM education and facilitate better service to diverse customers. State NREM support teams will be established to provide leadership, coordinate educational needs and priorities, and increase the resources available for NREM programming. A national NREM support team also will be formed to provide national coordination, resource development, and accountability.

  5. Review: dairy cattle reproductive physiology research and management--past progress and future prospects.

    PubMed

    Foote, R H

    1996-06-01

    Artificial insemination developed as the solution for two important problems in the dairy cattle industry during the past 50 yr: 1) the need for genetic improvement and 2) the elimination of costly venereal diseases. Cooperation among researchers, extension workers, veterinarians, dairy producers, and emerging AI organizations in pooling their expertise, was instrumental to the remarkably rapid development of AI. The cooperation of universities, government, and producers to fund teams of reproductive specialists to collaborate and transfer findings quickly to potential users was a major component of this successful venture. Money invested in these experiments was estimated to have returned about $100 for each $1 invested. Successful freezing of sperm led to the development of the field of cryobiology, and AI paved the way for embryo transfer. The development of ultrasound equipment; various types of rapid hormone assays; prostaglandins, progestogens, and GnRH; and computerization made possible various alternative management plans for controlling reproduction. Multidisciplinary, multigeographical teams that gather basic needed information have the potential for making excellent progress. As herd size increases, new programs for efficient reproductive management and for identifying needed research through computer modeling are a must. Sexed embryos from elite cows and bulls will be used selectively. When embryonic stem cell technology becomes practical, it will revolutionize cattle breeding. PMID:8827461

  6. Managing Earth to Make Future Development More Sustainable: Learning From a Megacity Like Hong Kong

    NASA Astrophysics Data System (ADS)

    Yim, W. W.; Ollier, C. D.

    2008-12-01

    Selected recent findings related to climate change in Hong Kong include: (1) The Hong Kong seafloor has yielded a ~0.5-million year record of climate and sea-level changes. (2) Greenhouse gases produced naturally from sub-aerially exposed continental shelves were a probable forcing mechanism in triggering the termination of past ice ages. (3) An analysis of annual mean temperature records has revealed that the urban heat island effect has contributed ~75 % of the warming. (4) Past volcanic eruptions are found to lower Hong Kong's temperature and to cause extremely dry and wet years. (5) No evidence can be found for an increase in frequency and intensity of typhoons based on the analysis of an 8,000-year record in the Pearl River Estuary. (6) The observed rate of sea-level rise in the South China Sea is much slower than the predictions of the IPCC Fourth Assessment. For the Earth's management, population growth and the depletion of non-renewable resources must be recognized as unsustainable. The human impact on the natural hydrological cycle is an important forcing mechanism in climate change. In order to delay the demise of the human race, management must include curbing population growth and much more waste recycling than at present.

  7. The Costs of Climate Change: Impact of Future Snow Cover Projections on Valuation of Albedo in Forest Management

    NASA Astrophysics Data System (ADS)

    Burakowski, E. A.; Lutz, D. A.

    2014-12-01

    Surface albedo provides an important climate regulating ecosystem service, particularly in the mid-latitudes where seasonal snow cover influences surface radiation budgets. In the case of substantial seasonal snow cover, the influence of albedo can equal or surpass the climatic benefits of carbon sequestration from forest growth. Climate mitigation platforms should therefore consider albedo in their framework in order to integrate these two climatic services in an economic context for the effective design and implementation of forest management projects. Over the next century, the influence of surface albedo is projected to diminish under higher emissions scenarios due to an overall decrease in snow depth and duration of snow cover in the mid-latitudes. In this study, we focus on the change in economic value of winter albedo in the northeastern United States projected through 2100 using the Special Report on Emissions Scenarios (SRES) a1 and b1 scenarios. Statistically downscaled temperature and precipitation are used as input to the Variable Infiltration Capacity (VIC) model to provide future daily snow depth fields through 2100. Using VIC projections of future snow depth, projected winter albedo fields over deforested lands were generated using an empirical logarithmic relationship between snow depth and albedo derived from a volunteer network of snow observers in New Hampshire over the period Nov 2011 through 2014. Our results show that greater reductions in snow depth and the number of winter days with snow cover in the a1 compared to the b1 scenario reduce wintertime albedo when forested lands are harvested. This result has implications on future trade-offs among albedo, carbon storage, and timber value that should be investigated in greater detail. The impacts of forest harvest on radiative forcing associated with energy redistribution (e.g., latent heat and surface roughness length) should also be considered in future work.

  8. FuturICT: Participatory computing to understand and manage our complex world in a more sustainable and resilient way

    NASA Astrophysics Data System (ADS)

    Helbing, D.; Bishop, S.; Conte, R.; Lukowicz, P.; McCarthy, J. B.

    2012-11-01

    We have built particle accelerators to understand the forces that make up our physical world. Yet, we do not understand the principles underlying our strongly connected, techno-socio-economic systems. We have enabled ubiquitous Internet connectivity and instant, global information access. Yet we do not understand how it impacts our behavior and the evolution of society. To fill the knowledge gaps and keep up with the fast pace at which our world is changing, a Knowledge Accelerator must urgently be created. The financial crisis, international wars, global terror, the spreading of diseases and cyber-crime as well as demographic, technological and environmental change demonstrate that humanity is facing serious challenges. These problems cannot be solved within the traditional paradigms. Moving our attention from a component-oriented view of the world to an interaction-oriented view will allow us to understand the complex systems we have created and the emergent collective phenomena characterising them. This paradigm shift will enable new solutions to long-standing problems, very much as the shift from a geocentric to a heliocentric worldview has facilitated modern physics and the ability to launch satellites. The FuturICT flagship project will develop new science and technology to manage our future in a complex, strongly connected world. For this, it will combine the power of information and communication technology (ICT) with knowledge from the social and complexity sciences. ICT will provide the data to boost the social sciences into a new era. Complexity science will shed new light on the emergent phenomena in socially interactive systems, and the social sciences will provide a better understanding of the opportunities and risks of strongly networked systems, in particular future ICT systems. Hence, the envisaged FuturICT flagship will create new methods and instruments to tackle the challenges of the 21st century. FuturICT could indeed become one of the most

  9. Applied historical ecology: Using the past to manage for the future

    USGS Publications Warehouse

    Swetnam, T.W.; Allen, C.D.; Betancourt, J.L.

    1999-01-01

    Applied historical ecology is the use of historical knowledge in the management of ecosystems. Historical perspectives increase our understanding of the dynamic nature of landscapes and provide a frame of reference for assessing modern patterns and processes. Historical records, however, are often too brief or fragmentary to be useful, or they are not obtainable for the process or structure of interest. Even where long historical time series can be assembled, selection of appropriate reference conditions may be complicated by the past influence of humans and the many potential reference conditions encompassed by nonequilibrium dynamics. These complications, however, do not lessen the value of history; rather they underscore the need for multiple, comparative histories from many locations for evaluating both cultural and natural causes of variability, as well as for characterizing the overall dynamical properties of ecosystems. Historical knowledge may not simplify the task of setting management goals and making decisions, but 20th century trends, such as increasingly severe wildfires, suggest that disregarding history can be perilous. We describe examples from our research in the southwestern United States to illustrate some of the values and limitations of applied historical ecology. Paleoecological data from packrat middens and other natural archives have been useful for defining baseline conditions of vegetation communities, determining histories and rates of species range expansions and contractions, and discriminating between natural and cultural causes of environmental change. We describe a montane grassland restoration project in northern New Mexico that was justified and guided by an historical sequence of aerial photographs showing progressive tree invasion during the 20th century. Likewise, fire scar chronologies have been widely used to justify and guide fuel reduction and natural five reintroduction in forests. A southwestern network of fire histories

  10. The Great Barrier Reef World Heritage Area seagrasses: Managing this iconic Australian ecosystem resource for the future

    NASA Astrophysics Data System (ADS)

    Coles, Robert G.; Rasheed, Michael A.; McKenzie, Len J.; Grech, Alana; York, Paul H.; Sheaves, Marcus; McKenna, Skye; Bryant, Catherine

    2015-02-01

    The Great Barrier Reef World Heritage Area (GBRWHA) includes one of the world's largest areas of seagrass (35,000 km2) encompassing approximately 20% of the world's species. Mapping and monitoring programs sponsored by the Australian and Queensland Governments and Queensland Port Authorities have tracked a worrying decrease in abundance and area since 2007. This decline has almost certainly been the result of a series of severe tropical storms and associated floods exacerbating existing human induced stressors. A complex variety of marine and terrestrial management actions and plans have been implemented to protect seagrass and other habitats in the GBRWHA. For seagrasses, these actions are inadequate. They provide an impression of effective protection of seagrasses; reduce the sense of urgency needed to trigger action; and waste the valuable and limited supply of "conservation capital". There is a management focus on ports, driven by public concerns about high profile development projects, which exaggerates the importance of these relatively concentrated impacts in comparison to the total range of threats and stressors. For effective management of seagrass at the scale of the GBRWHA, more emphasis needs to be placed on the connectivity between seagrass meadow health, watersheds, and all terrestrial urban and agricultural development associated with human populations. The cumulative impacts to seagrass from coastal and marine processes in the GBRWHA are not evenly distributed, with a mosaic of high and low vulnerability areas. This provides an opportunity to make choices for future coastal development plans that minimise stress on seagrass meadows.

  11. Current and future initiatives for vascular health management in clinical practice.

    PubMed

    Cameron, James D; Asmar, Roland; Struijker-Boudier, Harry; Shirai, Kohji; Sirenko, Yuriy; Kotovskaya, Yulia; Topouchian, Jirar

    2013-01-01

    Central arterial structure and function comprise a primary determinant of vascular health, and are integral to the important concept of ventriculo-vascular coupling or interaction. Central aortic stiffening is a major influence on central blood pressure, and directly relates to coronary perfusion. The joint session of the International Society of Vascular Health (Eastern Region) and the Ukrainian Congress of Cardiology was held in Kiev, Ukraine, on September 23, 2011; it provided an expert forum to discuss arterial evaluations, clinical applications, and progress toward translating arterial protection into cardiovascular benefits. The conclusions of the expert panel were: 1. Aortic stiffness is not presently a treatment target but may be useful for substratifying cardiovascular risk in individuals in order to better target the intensity of conventional therapy, and it may be useful in assessing response to treatment. 2. Crosstalk between macro- and microcirculation in hypertension has important implications for pharmacological treatment. An antihypertensive regimen should abolish the vicious cycle between the increased resistance in the microcirculation and the increased stiffness of the larger arteries. Such treatment should be based on drugs with multiple actions on the vascular tree, or on drug combinations that target the various segments of the arterial system. 3. Several blood pressure-independent mechanisms of large artery stiffness exist. Future considerations for clinical understanding of large artery stiffness should involve new drugs and new evaluation methods - with a focus on vascular health, for the initiation of cardiovascular prevention, for newly designed studies for treatment evaluation, and for new studies of drug combinations. 4. Arterial stiffening is a sign of cardiovascular aging and is a major factor affecting the biomechanics of large arteries. Arterial stiffness is an attractive therapeutic target in terms of vascular aging. Healthy

  12. How risk management can prevent future wildfire disasters in the wildland-urban interface

    PubMed Central

    Calkin, David E.; Cohen, Jack D.; Finney, Mark A.; Thompson, Matthew P.

    2014-01-01

    Recent fire seasons in the western United States are some of the most damaging and costly on record. Wildfires in the wildland-urban interface on the Colorado Front Range, resulting in thousands of homes burned and civilian fatalities, although devastating, are not without historical reference. These fires are consistent with the characteristics of large, damaging, interface fires that threaten communities across much of the western United States. Wildfires are inevitable, but the destruction of homes, ecosystems, and lives is not. We propose the principles of risk analysis to provide land management agencies, first responders, and affected communities who face the inevitability of wildfires the ability to reduce the potential for loss. Overcoming perceptions of wildland-urban interface fire disasters as a wildfire control problem rather than a home ignition problem, determined by home ignition conditions, will reduce home loss. PMID:24344292

  13. How risk management can prevent future wildfire disasters in the wildland-urban interface.

    PubMed

    Calkin, David E; Cohen, Jack D; Finney, Mark A; Thompson, Matthew P

    2014-01-14

    Recent fire seasons in the western United States are some of the most damaging and costly on record. Wildfires in the wildland-urban interface on the Colorado Front Range, resulting in thousands of homes burned and civilian fatalities, although devastating, are not without historical reference. These fires are consistent with the characteristics of large, damaging, interface fires that threaten communities across much of the western United States. Wildfires are inevitable, but the destruction of homes, ecosystems, and lives is not. We propose the principles of risk analysis to provide land management agencies, first responders, and affected communities who face the inevitability of wildfires the ability to reduce the potential for loss. Overcoming perceptions of wildland-urban interface fire disasters as a wildfire control problem rather than a home ignition problem, determined by home ignition conditions, will reduce home loss.

  14. The Global Rise of Zero Liquid Discharge for Wastewater Management: Drivers, Technologies, and Future Directions.

    PubMed

    Tong, Tiezheng; Elimelech, Menachem

    2016-07-01

    Zero liquid discharge (ZLD)-a wastewater management strategy that eliminates liquid waste and maximizes water usage efficiency - has attracted renewed interest worldwide in recent years. Although implementation of ZLD reduces water pollution and augments water supply, the technology is constrained by high cost and intensive energy consumption. In this critical review, we discuss the drivers, incentives, technologies, and environmental impacts of ZLD. Within this framework, the global applications of ZLD in the United States and emerging economies such as China and India are examined. We highlight the evolution of ZLD from thermal- to membrane-based processes, and analyze the advantages and limitations of existing and emerging ZLD technologies. The potential environmental impacts of ZLD, notably greenhouse gas emission and generation of solid waste, are discussed and the prospects of ZLD technologies and research needs are highlighted. PMID:27275867

  15. The management and welfare of working animals: identifying problems, seeking solutions and anticipating the future.

    PubMed

    Abul Rahman, S; Reed, K

    2014-04-01

    Working animals, mainly equids, camelids and bovids, are draught animals that perform transport and traction activities. In developed countries technological development has resulted in animal power being minimised, however, in developing countries most agricultural operations are still being conducted by animals, and animal welfare is a major concern. Inadequate knowledge and inappropriate attitudes and practices regarding the management and welfare of working animals are the main contributory factors to welfare problems. The paper highlights the situation of working animals in developing countries, especially those of equids in Africa and Asia and bullocks in India, which are examined as examples. There is much room for improvement in the welfare of working animals, via the provision of basic veterinary care, technical advice on health and husbandry, including foot care, improved design and maintenance of harnesses and other equipment, and the development of appropriate policies and legislation. The paper discusses the role of the World Organisation for Animal Health in addressing these issues.

  16. The Global Rise of Zero Liquid Discharge for Wastewater Management: Drivers, Technologies, and Future Directions.

    PubMed

    Tong, Tiezheng; Elimelech, Menachem

    2016-07-01

    Zero liquid discharge (ZLD)-a wastewater management strategy that eliminates liquid waste and maximizes water usage efficiency - has attracted renewed interest worldwide in recent years. Although implementation of ZLD reduces water pollution and augments water supply, the technology is constrained by high cost and intensive energy consumption. In this critical review, we discuss the drivers, incentives, technologies, and environmental impacts of ZLD. Within this framework, the global applications of ZLD in the United States and emerging economies such as China and India are examined. We highlight the evolution of ZLD from thermal- to membrane-based processes, and analyze the advantages and limitations of existing and emerging ZLD technologies. The potential environmental impacts of ZLD, notably greenhouse gas emission and generation of solid waste, are discussed and the prospects of ZLD technologies and research needs are highlighted.

  17. Current and future directions in clinical fatigue management: An update for emergency medicine practitioners.

    PubMed

    Cheng, Yi Han; Roach, Gregory D; Petrilli, Renee Ma

    2014-12-01

    Physicians worldwide are working round the clock to meet the demands of healthcare systems, especially in acute medical settings such as EDs. Demanding shift work schedules cause fatigue and thus deterioration in mood and motor performance. This article explores the effects of sleep deprivation, focusing on cognition, executive decision-making and the implications for clinical care. Humans are capable of functioning and even adapting to sleep restriction; however, clinicians should be aware of pitfalls and absolute minimums for sleep. Fatigue management training shows promise in enhancing safety in aviation and might have a role in medical shift work. Strategic napping improves performance during night shift in the ED, but does not fully negate fatigue. Drugs offer limited benefit for performance under sleep-deprived conditions, and whenever possible, sleep and/or strategic napping takes precedence.

  18. Report: future industrial solid waste management in pars Special Economic Energy Zone (PSEEZ), Iran.

    PubMed

    Mokhtarani, Babak; Moghaddam, Mohammad Reza Alavi; Mokhtarani, Nader; Khaledi, Hossein Jomeh

    2006-06-01

    The Pars Special Economic Energy Zone (PSEEZ) is located in the south of Iran, on the northern coastline of the Persian Gulf. This area was established in 1998 for the utilization of south Pars field oil and gas resources. This field is one of the largest gas resources in the world and contains about 6% of the total fossil fuels known. Petrochemical industries, gas refineries and downstream industries are being constructed in this area. At present there are three gas refineries in operation and five more gas refineries are under construction. In this study, different types of solid waste including municipal solid waste (MSW) and industrial wastes were investigated separately. The aim of the study was to focus on the management of the industrial wastes in order to minimize the environmental impact. In the first stage, the types and amounts of industrial waste in PSEEZ were evaluated by an inventory. The main types of industrial waste are oil products (fuel oil, light oil, lubricating oil), spent catalysts, adsorbents, resins, coke, wax and packaging materials. The waste management of PSEEZ is quite complex because of the different types of industry and the diversity of industrial residues. In some cases recycling/reuse of waste is the best option, but treatment and disposal are also necessary tools. Recently a design has been prepared for a disposal site in PSEEZ for the industrial waste that cannot be reused or recycled. The total surface area of this disposal site where the industrial waste should be tipped for the next 20 years was estimated to be about 42 000 m2.

  19. Report: future industrial solid waste management in pars Special Economic Energy Zone (PSEEZ), Iran.

    PubMed

    Mokhtarani, Babak; Moghaddam, Mohammad Reza Alavi; Mokhtarani, Nader; Khaledi, Hossein Jomeh

    2006-06-01

    The Pars Special Economic Energy Zone (PSEEZ) is located in the south of Iran, on the northern coastline of the Persian Gulf. This area was established in 1998 for the utilization of south Pars field oil and gas resources. This field is one of the largest gas resources in the world and contains about 6% of the total fossil fuels known. Petrochemical industries, gas refineries and downstream industries are being constructed in this area. At present there are three gas refineries in operation and five more gas refineries are under construction. In this study, different types of solid waste including municipal solid waste (MSW) and industrial wastes were investigated separately. The aim of the study was to focus on the management of the industrial wastes in order to minimize the environmental impact. In the first stage, the types and amounts of industrial waste in PSEEZ were evaluated by an inventory. The main types of industrial waste are oil products (fuel oil, light oil, lubricating oil), spent catalysts, adsorbents, resins, coke, wax and packaging materials. The waste management of PSEEZ is quite complex because of the different types of industry and the diversity of industrial residues. In some cases recycling/reuse of waste is the best option, but treatment and disposal are also necessary tools. Recently a design has been prepared for a disposal site in PSEEZ for the industrial waste that cannot be reused or recycled. The total surface area of this disposal site where the industrial waste should be tipped for the next 20 years was estimated to be about 42 000 m2. PMID:16784172

  20. Management of aortic graft infections - the present strategy and future perspectives.

    PubMed

    Treska, V; Certik, B; Molacek, J

    2016-01-01

    Aortic graft infections (AGI) are serious complications of open and endovascular types of surgery with an incidence rate of 0.6-3 %. AGI are associated with 30-60 % perioperative mortality and 40-60 % morbidity rate with limb amputation rates between 10 % and 40 %. The economic cost of AGI is substantial. At the time of aortic reconstruction, almost 90 % of patients have one or more predisposing factors for AGI. The diagnosis is based on clinical symptomatology, laboratory markers, microbial cultures, and imaging modalities. The general principle of surgical treatment lies in the removal of infected graft, debridement of infected periprosthetic tissues, and vascular reconstruction by in situ or extra-anatomic bypass with long-term antibiotic therapy. The conservative treatment is used only for selected patients with endograft infection. This review summarizes the current knowledge about the incidence, predisposing factors, etiology, diagnosis, treatment options, and prevention of aortic vascular graft and endograft infections. With the growing number of endovascular procedures we can expect more cases of infected aortic endografts in patients with severe comorbidities in the near future, where the recent radical surgical approach (graft excision, debridement, and new revascularization) cannot be used. Therefore the less invasive, sophisticated and individualized treatment strategies will have to be used in search of the best therapeutic approach to each specific patient (Fig. 4, Ref. 82). PMID:26925740

  1. The future of water resources systems analysis: Toward a scientific framework for sustainable water management

    NASA Astrophysics Data System (ADS)

    Brown, Casey M.; Lund, Jay R.; Cai, Ximing; Reed, Patrick M.; Zagona, Edith A.; Ostfeld, Avi; Hall, Jim; Characklis, Gregory W.; Yu, Winston; Brekke, Levi

    2015-08-01

    This paper presents a short history of water resources systems analysis from its beginnings in the Harvard Water Program, through its continuing evolution toward a general field of water resources systems science. Current systems analysis practice is widespread and addresses the most challenging water issues of our times, including water scarcity and drought, climate change, providing water for food and energy production, decision making amid competing objectives, and bringing economic incentives to bear on water use. The emergence of public recognition and concern for the state of water resources provides an opportune moment for the field to reorient to meet the complex, interdependent, interdisciplinary, and global nature of today's water challenges. At present, water resources systems analysis is limited by low scientific and academic visibility relative to its influence in practice and bridled by localized findings that are difficult to generalize. The evident success of water resource systems analysis in practice (which is set out in this paper) needs in future to be strengthened by substantiating the field as the science of water resources that seeks to predict the water resources variables and outcomes that are important to governments, industries, and the public the world over. Doing so promotes the scientific credibility of the field, provides understanding of the state of water resources and furnishes the basis for predicting the impacts of our water choices.

  2. Clinical trials of the surgical management of urolithiasis: current status and future needs.

    PubMed

    Keeley, Francis X; Assimos, Dean G

    2009-01-01

    We reviewed the literature on the surgical treatment of urolithiasis. All prospective, randomized trials on the surgical treatment of stone disease were reviewed. Percutaneous nephrolithotomy (PNL) is superior to shockwave lithotripsy (SWL) or open surgery in the treatment of staghorn calculi. For ureteral stones, ureteroscopy appears to result in a higher stone-free rate and lower need for retreatment compared with SWL but has a higher complication rate and increased hospital stay. For lower pole renal calculi, PNL results in a higher stone-free rate and lower need for retreatment compared with SWL but has a higher complication rate and increased hospital stay. Most areas of surgical stone treatment have been addressed by a randomized controlled trial; however, most trials were of poor quality. Trials tend to focus only on radiologic outcomes. No study to date has been able to show a measurable quality of life benefit to patients, possibly because no condition-specific quality of life instruments have been developed. In addition, economic impact, both direct and indirect, has been rarely characterized. The surgical treatment of kidney stones is poorly researched. Future trials should be performed with adequate funding and patient-focused outcomes.

  3. Denosumab and giant cell tumour of bone—a review and future management considerations

    PubMed Central

    Xu, S.F.; Adams, B.; Yu, X.C.; Xu, M.

    2013-01-01

    Giant cell tumour of bone (gctb) is one type of giant-cell-rich bone lesion characterized by the presence of numerous multinucleated osteoclast-type giant cells. Giant cells are known to express rankl (receptor activator of nuclear factor κB ligand) and are responsible for the aggressive osteolytic nature of the tumour. No available treatment option is definitively effective in curing this disease, especially in surgically unsalvageable cases. In recent years, several studies of denosumab in patients with advanced or unresectable gctb have shown objective changes in tumour composition, reduced bony destruction, and clinical benefit. Denosumab is a fully human monoclonal antibody that targets and binds with high affinity and specificity to rankl. Several large phase iii studies have shown that denosumab is more effective than bisphosphonates in reducing skeletal morbidity arising from a wide range of tumours and that it can delay bone metastasis. The relevant articles are reviewed here. The controversies related to the future use of denosumab in the treatment of gctb are discussed. PMID:24155640

  4. Recent Progress and Future Issues in the Management of Abusive Head Trauma

    PubMed Central

    NISHIMOTO, Hiroshi

    2015-01-01

    Head trauma is the leading cause of death in child abuse cases and one of the important issues in the care of abused children. Since the Child Abuse Prevention Law was enforced in 2000 in Japan, various measures have been taken to prevent child abuse over the following decade. Accordingly, medical research on abusive head trauma (AHT) has advanced, leading to significant progress in the medical diagnosis of AHT. This progress has been brought about by (1) the widespread establishment of child protection teams (CPTs) at core hospitals, (2) the progress in neuroradiological imaging and ophthalmoscopic technologies, and (3) the introduction of postmortem imaging. However, the pathological condition of patients with AHT, particularly that of the diffuse brain swelling type, still remains poorly understood. As a result, no clear treatment strategies for AHT have been developed and no treatment outcomes have been improved to date. The development of new treatment strategies for AHT and the construction of a comprehensive database that supports clinical studies are required in the future. PMID:25797781

  5. The present and the future in the diagnosis and management of celiac disease

    PubMed Central

    Castillo, Natalia E.; Theethira, Thimmaiah G.; Leffler, Daniel A.

    2015-01-01

    Celiac disease is an autoimmune enteropathy caused by gluten in genetically predisposed individuals. In celiac disease, adaptive and innate immune activation results in intestinal damage and a wide range of clinical manifestations. In the past, celiac disease was thought to result in signs and symptoms solely related to the gastrointestinal tract. Now, more than half of the adult population presents with extra-intestinal manifestations that can also be expected to improve on a gluten-free diet. For this reason, it is recommended that physicians have a low threshold of suspicion for celiac disease. Current knowledge of the immune pathogenesis of this autoimmune disease has served as a catalyst for the development of novel diagnostic tools and therapeutics. Over the years, highly sensitive and specific serological assays, in addition to genetic markers, have been found to target specific steps in the cascade pathway of celiac disease. Also the advent of the gluten challenge has enabled experts to design diagnostic algorithms and monitor clinical responses in clinical trials. The gluten challenge has provided substantial benefit in the advance of novel therapeutics as an adjuvant treatment to the gluten free diet. Generally, a strict gluten-free diet is highly burdensome to patients and can be limited in its efficacy. Alternative therapies—including gluten modification, modulation of intestinal permeability and immune response—could be central to the future treatment of celiac disease. PMID:25326000

  6. Proximal gastric vagotomy: does it have a place in the future management of peptic ulcer?

    PubMed

    Johnson, A G

    2000-03-01

    Proximal gastric vagotomy (PGV) is a modification of truncal vagotomy, which was introduced by Dragstedt for the treatment of duodenal ulcer (DU) in 1943. It is a technically demanding operation; but when performed by an experienced surgeon, it is safe and gives a cure rate for DU of more than 90%, with minimal side effects. The operation permanently alters the natural history of the disease and may be used for gastric ulcer (GU), with ulcer excision; but it is not as effective. Further adaptations, such as posterior truncal vagotomy with anterior seromyotomy, were introduced to simplify and shorten the operation, but they did not receive wide acceptance. Recently, with the identification of Helicobacter, it was found that DU can also be cured by eliminating the infection. PGV is therefore used electively in patients with persistent DU that is not Helicobacter-positive or in the few in whom Helicobacter cannot be eliminated. In patients with bleeding or perforated DUs, PGV may be used in conjunction with underrunning the vessel or patching the perforation. However, few surgeons doing emergency peptic ulcer surgery have experience with PGV, so simple suture followed by medical treatment is the safest option. Because elective PGV is now a rare procedure, patients should be referred to a center with special expertise. If Helicobacter becomes resistant to antibiotics in the future, surgery may be needed regularly again, but the technical nuances would have to be learned.

  7. Tick-borne encephalitis (TBE) trends in epidemiology and current and future management.

    PubMed

    Petri, Eckhardt; Gniel, Dieter; Zent, Olaf

    2010-07-01

    Tick-borne encephalitis (TBE) is considered an international health issue, as the number of risk areas and reported cases across Europe, Russia, and parts of Asia continues to increase. The incidence of TBE has fluctuated considerably from year to year in many countries, but in the past decade the number of TBE cases has significantly increased in the Baltic states, the Czech Republic, and Germany, in addition to occurring in countries previously considered to be free from TBE, such as Denmark (specifically the main island of Zealand), France, and Italy. A number of factors have been suggested to explain the increase in incidence, including climate change, and increased travel and outdoor pursuits, placing people in increased contact with infected ticks. There is no causal treatment available once infected, but TBE can be effectively prevented by vaccination, for which several vaccines are widely available. Three vaccination schedules are available for immunization against TBE, and the recommendations for TBE vaccination vary considerably across the countries in which TBE foci are found. However, plans are in place to raise awareness of TBE and to standardize the vaccination programme across Europe, with the aim of reducing the number of future cases of TBE. PMID:20970726

  8. Tissue engineering for the management of chronic wounds: current concepts and future perspectives.

    PubMed

    Wong, Victor W; Gurtner, Geoffrey C

    2012-10-01

    Chronic wounds constitute a significant and growing biomedical burden. With the increasing growth of populations prone to dysfunctional wound healing, there is an urgent and unmet need for novel strategies to both prevent and treat these complications. Tissue engineering offers the potential to create functional skin, and the synergistic efforts of biomedical engineers, material scientists, and molecular and cell biologists have yielded promising therapies for non-healing wounds. However, traditional paradigms for wound healing focus largely on the role of inflammatory cells and fail to incorporate more recent research highlighting the importance of stem cells and matrix dynamics in skin repair. Approaches to chronic wound healing centred on inflammation alone are inadequate to guide the development of regenerative medicine-based technologies. As the molecular pathways and biologic defects underlying non-healing wounds are further elucidated, multifaceted bioengineering systems must advance in parallel to exploit this knowledge. In this viewpoint essay, we highlight the current concepts in tissue engineering for chronic wounds and speculate on areas for future research in this increasingly interdisciplinary field.

  9. Forecasting the Future Food Service World of Work. Final Report. Volume I. The Future of Food Service 1985-1990. Service Management Reports.

    ERIC Educational Resources Information Center

    Powers, Thomas F.

    Based on a study on the future of the food service industry, volume I of this three-volume report contains a series of scenarios intended to make 10- to 15-year projections into the future of the food service industry and to serve as a basis for replanning the vocational-technical curricula in the food service area. The scenarios are "canonical…

  10. Chronic hepatitis B: Virology, natural history, current management and a glimpse at future opportunities.

    PubMed

    Gish, Robert G; Given, Bruce D; Lai, Ching-Lung; Locarnini, Stephen A; Lau, Johnson Y N; Lewis, David L; Schluep, Thomas

    2015-09-01

    The host immune system plays an important role in chronic hepatitis B (CHB), both in viral clearance and hepatocellular damage. Advances in our understanding of the natural history of the disease have led to redefining the major phases of infection, with the "high replicative, low inflammatory" phase now replacing what was formerly termed the "immune tolerant" phase, and the "nonreplicative phase" replacing what was formerly termed the "inactive carrier" phase. As opposed to the earlier view that HBV establishes chronic infection by exploiting the immaturity of the neonate's immune system, new findings on trained immunity show that the host is already somewhat "matured" following birth, and is actually very capable of responding immunologically, potentially altering future hepatitis B treatment strategies. While existing therapies are effective in reducing viral load and necroinflammation, often restoring the patient to near-normal health, they do not lead to a cure except in very rare cases and, in many patients, viremia rebounds after cessation of treatment. Researchers are now challenged to devise therapies that will eliminate infection, with a particular focus on eliminating the persistence of viral cccDNA in the nuclei of hepatocytes. In the context of chronic hepatitis B, new definitions of 'cure' are emerging, such as 'functional' and 'virological' cure, defined by stable off-therapy suppression of viremia and antigenemia, and the normalization of serum ALT and other liver-related laboratory tests. Continued advances in the understanding of the complex biology of chronic hepatitis B have resulted in the development of new, experimental therapies targeting viral and host factors and pathways previously not accessible to therapy, approaches which may lead to virological cures in the near term and functional cures upon long term follow-up. This article forms part of a symposium in Antiviral Research on "An unfinished story: from the discovery of the Australia

  11. Data management and its role in delivering science at DOE BES user facilities - Past, Present, and Future

    NASA Astrophysics Data System (ADS)

    Miller, Stephen D.; Herwig, Kenneth W.; Ren, Shelly; Vazhkudai, Sudharshan S.; Jemian, Pete R.; Luitz, Steffen; Salnikov, Andrei A.; Gaponenko, Igor; Proffen, Thomas; Lewis, Paul; Green, Mark L.

    2009-07-01

    The primary mission of user facilities operated by Basic Energy Sciences under the Department of Energy is to produce data for users in support of open science and basic research [1]. We trace back almost 30 years of history across selected user facilities illustrating the evolution of facility data management practices and how these practices have related to performing scientific research. The facilities cover multiple techniques such as X-ray and neutron scattering, imaging and tomography sciences. Over time, detector and data acquisition technologies have dramatically increased the ability to produce prolific volumes of data challenging the traditional paradigm of users taking data home upon completion of their experiments to process and publish their results. During this time, computing capacity has also increased dramatically, though the size of the data has grown significantly faster than the capacity of one's laptop to manage and process this new facility produced data. Trends indicate that this will continue to be the case for yet some time. Thus users face a quandary for how to manage today's data complexity and size as these may exceed the computing resources users have available to themselves. This same quandary can also stifle collaboration and sharing. Realizing this, some facilities are already providing web portal access to data and computing thereby providing users access to resources they need [2]. Portal based computing is now driving researchers to think about how to use the data collected at multiple facilities in an integrated way to perform their research, and also how to collaborate and share data. In the future, inter-facility data management systems will enable next tier cross-instrument-cross facility scientific research fuelled by smart applications residing upon user computer resources. We can learn from the medical imaging community that has been working since the early 1990's to integrate data from across multiple modalities to achieve

  12. Admixture Between Historically Isolated Mitochondrial Lineages in Captive Western Gorillas: Recommendations for Future Management

    PubMed Central

    Dew, J. Larry; Bergl, Richard A.; Jensen-Seaman, Michael I.; Anthony, Nicola M.

    2015-01-01

    Although captive populations of western gorilla have been maintained in the United States for over a century, little is known about the geographic origins and genetic composition of the current zoo population. Furthermore, although previous mitochondrial analyses have shown that free-range gorilla populations exhibit substantial regional differentiation, nothing is known of the extent to which this variation has been preserved in captive populations. To address these questions, we combined 379 pedigree records with data from 52 mitochondrial sequences to infer individual haplogroup affiliations, geographical origin of wild founders and instances of inter-breeding between haplogroups in the United States captive gorilla population. We show that the current captive population contains all major mitochondrial lineages found within wild western lowland gorillas. Levels of haplotype diversity are also comparable to those found in wild populations. However, the majority of captive gorilla matings have occurred between individuals with different haplogroup affiliations. Although restricting crosses to individuals within the same haplogroup would preserve the phylogeographic structure present in the wild, careful management of captive populations is required to minimize the risk of drift and inbreeding. However, when captive animals are released back into the wild, we recommend that efforts should be made to preserve natural phylogeographic structure. PMID:25790828

  13. Managing the future: the Special Virus Leukemia Program and the acceleration of biomedical research.

    PubMed

    Scheffler, Robin Wolfe

    2014-12-01

    After the end of the Second World War, cancer virus research experienced a remarkable revival, culminating in the creation in 1964 of the United States National Cancer Institute's Special Virus Leukemia Program (SVLP), an ambitious program of directed biomedical research to accelerate the development of a leukemia vaccine. Studies of cancer viruses soon became the second most highly funded area of research at the Institute, and by far the most generously funded area of biological research. Remarkably, this vast infrastructure for cancer vaccine production came into being before a human leukemia virus was shown to exist. The origins of the SVLP were rooted in as much as shifts in American society as laboratory science. The revival of cancer virus studies was a function of the success advocates and administrators achieved in associating cancer viruses with campaigns against childhood diseases such as polio and leukemia. To address the urgency borne of this new association, the SVLP's architects sought to lessen the power of peer review in favor of centralized Cold War management methods, fashioning viruses as "administrative objects" in order to accelerate the tempo of biomedical research and discovery.

  14. Drug nanocarrier, the future of atopic diseases: Advanced drug delivery systems and smart management of disease.

    PubMed

    Shao, Mei; Hussain, Zahid; Thu, Hnin Ei; Khan, Shahzeb; Katas, Haliza; Ahmed, Tarek A; Tripathy, Minaketan; Leng, Jing; Qin, Hua-Li; Bukhari, Syed Nasir Abbas

    2016-11-01

    Atopic dermatitis (AD) is a chronically relapsing skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin-E (IgE), T-lymphocytes and mast cells. The key pathophysiological factors causing this disease are immunological disorders and the compromised epidermal barrier integrity. Pruritus, intense itching, psychological stress, deprived physical and mental performance and sleep disturbance are the hallmark features of this dermatological complication. Preventive interventions which include educational programs, avoidance of allergens, exclusive care towards skin, and the rational selection of therapeutic regimen play key roles in the treatment of dermatosis. In last two decades, it is evident from a plethora of studies that scientific focus is being driven from conventional therapies to the advanced nanocarrier-based regimen for an effective management of AD. These nanocarriers which include polymeric nanoparticles (NPs), hydrogel NPs, liposomes, ethosomes, solid lipid nanoparticles (SLNs) and nanoemulsion, provide efficient roles for the target specific delivery of the therapeutic payload. The success of these targeted therapies is due to their pharmaceutical versatility, longer retention time at the target site, avoiding off-target effects and preventing premature degradation of the incorporated drugs. The present review was therefore aimed to summarise convincing evidence for the therapeutic superiority of advanced nanocarrier-mediated strategies over the conventional therapies used in the treatment of AD.

  15. Modeling Future Conservation of Hawaiian Honeycreepers by Mosquito Management and Translocation of Disease-Tolerant Amakihi

    PubMed Central

    Hobbelen, Peter H. F.; Samuel, Michael D.; LaPointe, Dennis A.; Atkinson, Carter T.

    2012-01-01

    Avian malaria is an important cause of the decline of endemic Hawaiian honeycreepers. Because of the complexity of this disease system we used a computer model of avian malaria in forest birds to evaluate how two proposed conservation strategies: 1) reduction of habitat for mosquito larvae and 2) establishment of a low-elevation, malaria-tolerant honeycreeper (Hawaii Amakihi) to mid-elevation forests would affect native Hawaiian honeycreeper populations. We evaluated these approaches in mid-elevation forests, where malaria transmission is seasonal and control strategies are more likely to work. Our model suggests the potential benefit of larval habitat reduction depends on the level of malaria transmission, abundance of larval cavities, and the ability to substantially reduce these cavities. Permanent reduction in larval habitat of >80% may be needed to control abundance of infectious mosquitoes and benefit bird populations. Establishment of malaria-tolerant Amakihi in mid-elevation forests increases Amakihi abundance, creates a larger disease reservoir, and increases the abundance of infectious mosquitoes which may negatively impact other honeycreepers. For mid-elevation sites where bird populations are severely affected by avian malaria, malaria-tolerant Amakihi had little impact on other honeycreepers. Both management strategies may benefit native Hawaiian honeycreepers, but benefits depend on specific forest characteristics, the amount of reduction in larval habitat that can be achieved, and how malaria transmission is affected by temperature. PMID:23185375

  16. Modeling future conservation of Hawaiian Honeycreepers by mosquito management and translocation of disease-tolerant Amakihi

    USGS Publications Warehouse

    Hobbelen, Peter H. F.; Samuel, Michael D.; Lapointe, Dennis; Atkinson, Carter T.

    2012-01-01

    Avian malaria is an important cause of the decline of endemic Hawaiian honeycreepers. Because of the complexity of this disease system we used a computer model of avian malaria in forest birds to evaluate how two proposed conservation strategies: 1) reduction of habitat for mosquito larvae and 2) establishment of a low-elevation, malaria-tolerant honeycreeper (Hawaii Amakihi) to mid-elevation forests would affect native Hawaiian honeycreeper populations. We evaluated these approaches in mid-elevation forests, where malaria transmission is seasonal and control strategies are more likely to work. Our model suggests the potential benefit of larval habitat reduction depends on the level of malaria transmission, abundance of larval cavities, and the ability to substantially reduce these cavities. Permanent reduction in larval habitat of >80% may be needed to control abundance of infectious mosquitoes and benefit bird populations. Establishment of malaria-tolerant Amakihi in mid-elevation forests increases Amakihi abundance, creates a larger disease reservoir, and increases the abundance of infectious mosquitoes which may negatively impact other honeycreepers. For mid-elevation sites where bird populations are severely affected by avian malaria, malaria-tolerant Amakihi had little impact on other honeycreepers. Both management strategies may benefit native Hawaiian honeycreepers, but benefits depend on specific forest characteristics, the amount of reduction in larval habitat that can be achieved, and how malaria transmission is affected by temperature.

  17. Pathogenesis and management of serrated polyps: current status and future directions.

    PubMed

    Anderson, Joseph C

    2014-11-01

    Hyperplastic or serrated polyps were once believed to have little to no clinical significance. A subset of these polyps are now considered to be precursors to colorectal cancers (CRC) in the serrated pathway that may account for at least 15% of all tumors. The serrated pathway is distinct from the two other CRC pathways and involves an epigenetic hypermethylation mechanism of CpG islands within promoter regions of tumor suppressor genes. This process results in the formation of CpG island methylator phenotype tumors. Serrated polyps are divided into hyperplastic polyps, sessile serrated adenomas/polyps (SSA/Ps), and traditional serrated adenomas (TSAs). The SSA/P and the TSA have the potential for dysplasia and subsequent malignant transformation. The SSA/Ps are more common and are more likely to be flat than TSAs. Their flat morphology may make them difficult to detect and thus explain the variation in detection rates among endoscopists. Challenges for endoscopists also include the difficulty in pathological interpretation as well surveillance of these lesions. Furthermore, serrated polyps may be inadequately resected by endoscopists. Thus, it is not surprising that the serrated pathway has been linked with interval cancers. This review will provide the physician or clinician with the knowledge to manage patients with serrated polyps.

  18. Could gestational diabetes mellitus be managed through dietary bioactive compounds? Current knowledge and future perspectives.

    PubMed

    Santangelo, Carmela; Zicari, Alessandra; Mandosi, Elisabetta; Scazzocchio, Beatrice; Mari, Emanuela; Morano, Susanna; Masella, Roberta

    2016-04-14

    Gestational diabetes mellitus (GDM) is a serious problem growing worldwide that needs to be addressed with urgency in consideration of the resulting severe complications for both mother and fetus. Growing evidence indicates that a healthy diet rich in fruit, vegetables, nuts, extra-virgin olive oil and fish has beneficial effects in both the prevention and management of several human diseases and metabolic disorders. In this review, we discuss the latest data concerning the effects of dietary bioactive compounds such as polyphenols and PUFA on the molecular mechanisms regulating glucose homoeostasis. Several studies, mostly based on in vitro and animal models, indicate that dietary polyphenols, mainly flavonoids, positively modulate the insulin signalling pathway by attenuating hyperglycaemia and insulin resistance, reducing inflammatory adipokines, and modifying microRNA (miRNA) profiles. Very few data about the influence of dietary exposure on GDM outcomes are available, although this approach deserves careful consideration. Further investigation, which includes exploring the 'omics' world, is needed to better understand the complex interaction between dietary compounds and GDM.

  19. Could gestational diabetes mellitus be managed through dietary bioactive compounds? Current knowledge and future perspectives.

    PubMed

    Santangelo, Carmela; Zicari, Alessandra; Mandosi, Elisabetta; Scazzocchio, Beatrice; Mari, Emanuela; Morano, Susanna; Masella, Roberta

    2016-04-14

    Gestational diabetes mellitus (GDM) is a serious problem growing worldwide that needs to be addressed with urgency in consideration of the resulting severe complications for both mother and fetus. Growing evidence indicates that a healthy diet rich in fruit, vegetables, nuts, extra-virgin olive oil and fish has beneficial effects in both the prevention and management of several human diseases and metabolic disorders. In this review, we discuss the latest data concerning the effects of dietary bioactive compounds such as polyphenols and PUFA on the molecular mechanisms regulating glucose homoeostasis. Several studies, mostly based on in vitro and animal models, indicate that dietary polyphenols, mainly flavonoids, positively modulate the insulin signalling pathway by attenuating hyperglycaemia and insulin resistance, reducing inflammatory adipokines, and modifying microRNA (miRNA) profiles. Very few data about the influence of dietary exposure on GDM outcomes are available, although this approach deserves careful consideration. Further investigation, which includes exploring the 'omics' world, is needed to better understand the complex interaction between dietary compounds and GDM. PMID:26879600

  20. Managing the future: the Special Virus Leukemia Program and the acceleration of biomedical research.

    PubMed

    Scheffler, Robin Wolfe

    2014-12-01

    After the end of the Second World War, cancer virus research experienced a remarkable revival, culminating in the creation in 1964 of the United States National Cancer Institute's Special Virus Leukemia Program (SVLP), an ambitious program of directed biomedical research to accelerate the development of a leukemia vaccine. Studies of cancer viruses soon became the second most highly funded area of research at the Institute, and by far the most generously funded area of biological research. Remarkably, this vast infrastructure for cancer vaccine production came into being before a human leukemia virus was shown to exist. The origins of the SVLP were rooted in as much as shifts in American society as laboratory science. The revival of cancer virus studies was a function of the success advocates and administrators achieved in associating cancer viruses with campaigns against childhood diseases such as polio and leukemia. To address the urgency borne of this new association, the SVLP's architects sought to lessen the power of peer review in favor of centralized Cold War management methods, fashioning viruses as "administrative objects" in order to accelerate the tempo of biomedical research and discovery. PMID:25459347

  1. Drug nanocarrier, the future of atopic diseases: Advanced drug delivery systems and smart management of disease.

    PubMed

    Shao, Mei; Hussain, Zahid; Thu, Hnin Ei; Khan, Shahzeb; Katas, Haliza; Ahmed, Tarek A; Tripathy, Minaketan; Leng, Jing; Qin, Hua-Li; Bukhari, Syed Nasir Abbas

    2016-11-01

    Atopic dermatitis (AD) is a chronically relapsing skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin-E (IgE), T-lymphocytes and mast cells. The key pathophysiological factors causing this disease are immunological disorders and the compromised epidermal barrier integrity. Pruritus, intense itching, psychological stress, deprived physical and mental performance and sleep disturbance are the hallmark features of this dermatological complication. Preventive interventions which include educational programs, avoidance of allergens, exclusive care towards skin, and the rational selection of therapeutic regimen play key roles in the treatment of dermatosis. In last two decades, it is evident from a plethora of studies that scientific focus is being driven from conventional therapies to the advanced nanocarrier-based regimen for an effective management of AD. These nanocarriers which include polymeric nanoparticles (NPs), hydrogel NPs, liposomes, ethosomes, solid lipid nanoparticles (SLNs) and nanoemulsion, provide efficient roles for the target specific delivery of the therapeutic payload. The success of these targeted therapies is due to their pharmaceutical versatility, longer retention time at the target site, avoiding off-target effects and preventing premature degradation of the incorporated drugs. The present review was therefore aimed to summarise convincing evidence for the therapeutic superiority of advanced nanocarrier-mediated strategies over the conventional therapies used in the treatment of AD. PMID:27592075

  2. Integrated and adaptive management for sustainable water use along ephemeral rivers under severe uncertainty of future flood regimes

    NASA Astrophysics Data System (ADS)

    Arnold, Sven; Attinger, Sabine; Frank, Karin; Baxter, Peter; Hildebrandt, Anke

    2010-05-01

    Ephemeral rivers are located throughout the world's arid regions. They are characterised by temporary surface flow that strongly varies between seasons and years. Along the river course often a coupled eco-hydrological vegetation-groundwater system has established, which is referred to as linear oasis, reflecting the ecological and socio-economic importance of ephemeral rivers in otherwise dry areas. The Kuiseb River denotes such a linear oasis and is one of the most diversely used environments among the ephemeral rivers in Namibia. Along the entire river course surface runoff and ground water are exploited for drinking, farming, and mining. The middle section of the Kuiseb River is characterised by strong eco-hydrological feedbacks between the vegetation and the ground water resource. Temporary floods infiltrate into sediments, which are accumulated in geological pools of impermeable bedrocks. This enables the formation of shallow ground water. The low depth to ground water allows root water uptake by plants and the establishment of a thriving ecosystem. The sustainable use of ecological and hydrological resources along ephemeral rivers is crucial to preserve the natural ecosystem. However, the investigation of management strategies that consider both the regulation of water extraction and vegetation structure requires models that explicitly consider the feedbacks between the water resource and the ecosystem structure. Further, uncertainties arise from stochastic hydrologic drivers such as flash flood events. Particularly in the face of climate change, the management strategies have to be applicable to a wide range of possible flood regimes, i.e. they have to be robust to the uncertainty of future flood regimes. In this study we assess a variety of management strategies regarding their robustness under different theoretical ecosystems and under uncertainty in the future stochastic flood regimes along the Kuiseb River. We consider the trade-off between ecological

  3. Assessing the future of diffuse optical imaging technologies for breast cancer management

    SciTech Connect

    Tromberg, Bruce J.; Pogue, Brian W.; Paulsen, Keith D.; Yodh, Arjun G.; Boas, David A.; Cerussi, Albert E.

    2008-06-15

    Diffuse optical imaging (DOI) is a noninvasive optical technique that employs near-infrared (NIR) light to quantitatively characterize the optical properties of thick tissues. Although NIR methods were first applied to breast transillumination (also called diaphanography) nearly 80 years ago, quantitative DOI methods employing time- or frequency-domain photon migration technologies have only recently been used for breast imaging (i.e., since the mid-1990s). In this review, the state of the art in DOI for breast cancer is outlined and a multi-institutional Network for Translational Research in Optical Imaging (NTROI) is described, which has been formed by the National Cancer Institute to advance diffuse optical spectroscopy and imaging (DOSI) for the purpose of improving breast cancer detection and clinical management. DOSI employs broadband technology both in near-infrared spectral and temporal signal domains in order to separate absorption from scattering and quantify uptake of multiple molecular probes based on absorption or fluorescence contrast. Additional dimensionality in the data is provided by integrating and co-registering the functional information of DOSI with x-ray mammography and magnetic resonance imaging (MRI), which provide structural information or vascular flow information, respectively. Factors affecting DOSI performance, such as intrinsic and extrinsic contrast mechanisms, quantitation of biochemical components, image formation/visualization, and multimodality co-registration are under investigation in the ongoing research NTROI sites. One of the goals is to develop standardized DOSI platforms that can be used as stand-alone devices or in conjunction with MRI, mammography, or ultrasound. This broad-based, multidisciplinary effort is expected to provide new insight regarding the origins of breast disease and practical approaches for addressing several key challenges in breast cancer, including: Detecting disease in mammographically dense tissue

  4. Alpha-emitter radium-223 in the management of solid tumors: current status and future directions.

    PubMed

    Nilsson, Sten

    2014-01-01

    Bone metastases, which are commonly seen in patients with advanced cancers, are a major cause of skeletal events, disability, and death. Radium-223 dichloride (radium-223; Xofigo, formerly Alpharadin), a first-in-class, alpha-emitting radiopharmaceutical that selectively targets bone metastases with high-energy short-range alpha-particles, has been approved for the treatment of patients with castration-resistant prostate cancer (CRPC) with symptomatic bone metastases and no known visceral metastases. Approval is based on results of the randomized phase III trial Alpharadin in Symptomatic Prostate Cancer (ALSYMPCA), in which radium-223 prolonged overall survival and time to first symptomatic skeletal event versus placebo among patients with CRPC with symptomatic bone metastases and was generally well tolerated, with low myelosuppression rates and manageable gastrointestinal adverse events. Long-term follow-up of the ALSYMPCA safety population showed that the incidence of myelosuppression remained low among patients treated with radium-223, with no additional safety issues of acute myelogenous leukemia, myelodysplastic syndrome, aplastic anemia, or primary bone cancer within approximately 1.5 years after treatment. The radium-223 overall survival benefit and low toxicity make it an effective, well-tolerated, and novel treatment option for CRPC and symptomatic bone metastases and opens the possibility of exploring radium-223 in the treatment of bone metastases from other cancers. A phase I clinical trial of patients with breast and prostate cancer with skeletal metastases demonstrated that radium-223 was safe and well tolerated at all therapeutically relevant dosages. Moreover, a phase IIa trial of patients with advanced breast cancer and progressive bone-dominant disease demonstrated that radium-223 targeted areas of increased bone metabolism and showed biologic activity.

  5. Alpha-emitter radium-223 in the management of solid tumors: current status and future directions.

    PubMed

    Nilsson, Sten

    2014-01-01

    Bone metastases, which are commonly seen in patients with advanced cancers, are a major cause of skeletal events, disability, and death. Radium-223 dichloride (radium-223; Xofigo, formerly Alpharadin), a first-in-class, alpha-emitting radiopharmaceutical that selectively targets bone metastases with high-energy short-range alpha-particles, has been approved for the treatment of patients with castration-resistant prostate cancer (CRPC) with symptomatic bone metastases and no known visceral metastases. Approval is based on results of the randomized phase III trial Alpharadin in Symptomatic Prostate Cancer (ALSYMPCA), in which radium-223 prolonged overall survival and time to first symptomatic skeletal event versus placebo among patients with CRPC with symptomatic bone metastases and was generally well tolerated, with low myelosuppression rates and manageable gastrointestinal adverse events. Long-term follow-up of the ALSYMPCA safety population showed that the incidence of myelosuppression remained low among patients treated with radium-223, with no additional safety issues of acute myelogenous leukemia, myelodysplastic syndrome, aplastic anemia, or primary bone cancer within approximately 1.5 years after treatment. The radium-223 overall survival benefit and low toxicity make it an effective, well-tolerated, and novel treatment option for CRPC and symptomatic bone metastases and opens the possibility of exploring radium-223 in the treatment of bone metastases from other cancers. A phase I clinical trial of patients with breast and prostate cancer with skeletal metastases demonstrated that radium-223 was safe and well tolerated at all therapeutically relevant dosages. Moreover, a phase IIa trial of patients with advanced breast cancer and progressive bone-dominant disease demonstrated that radium-223 targeted areas of increased bone metabolism and showed biologic activity. PMID:24857093

  6. Pathobiology and management of prostate cancer-induced bone pain: recent insights and future treatments.

    PubMed

    Muralidharan, Arjun; Smith, Maree T

    2013-10-01

    Prostate cancer (PCa) has a high propensity for metastasis to bone. Despite the availability of multiple treatment options for relief of PCa-induced bone pain (PCIBP), satisfactory relief of intractable pain in patients with advanced bony metastases is challenging for the clinicians because currently available analgesic drugs are often limited by poor efficacy and/or dose-limiting side effects. Rodent models developed in the past decade show that the pathobiology of PCIBP comprises elements of inflammatory, neuropathic and ischemic pain arising from ectopic sprouting and sensitization of sensory nerve fibres within PCa-invaded bones. In addition, at the cellular level, PCIBP is underpinned by dynamic cross talk between metastatic PCa cells, cellular components of the bone matrix, factors associated with the bone microenvironment as well as peripheral components of the somatosensory system. These insights are aligned with the clinical management of PCIBP involving use of a multimodal treatment approach comprising analgesic agents (opioids, NSAIDs), radiotherapy, radioisotopes, cancer chemotherapy agents and bisphosphonates. However, a major drawback of most rodent models of PCIBP is their short-term applicability due to ethical concerns. Thus, it has been difficult to gain insight into the mal(adaptive) neuroplastic changes occurring at multiple levels of the somatosensory system that likely contribute to intractable pain at the advanced stages of metastatic disease. Specifically, the functional responsiveness of noxious circuitry as well as the neurochemical signature of a broad array of pro-hyperalgesic mediators in the dorsal root ganglia and spinal cord of rodent models of PCIBP is relatively poorly characterized. Hence, recent work from our laboratory to develop a protocol for an optimized rat model of PCIBP will enable these knowledge gaps to be addressed as well as identification of novel targets for drug discovery programs aimed at producing new analgesics

  7. Current and future applications of dried blood spots in viral disease management.

    PubMed

    Snijdewind, Ingrid J M; van Kampen, Jeroen J A; Fraaij, Pieter L A; van der Ende, Marchina E; Osterhaus, Albert D M E; Gruters, Rob A

    2012-03-01

    Almost five decades after their first application in diagnostics, dried blood spot (DBS) cards remain to be of key interest in many research areas and clinical applications. The advantages of sample stability during transport and storage, can now be combined with the high sensitivity of novel diagnostic techniques for the measurement and analysis of nucleic acids, proteins and small molecules which may overcome the limitations of the small samples sizes in DBS cards. Here we present a survey of the literature on the use of DBS cards for diagnosis, monitoring and epidemiological studies of virus infections other than HIV, including CMV, HBV, HCV, HAV, HEV, HTLV, EBV, HSV, measles-, rubella- and dengue-virus. The minimal invasiveness of sampling and the relative ease of handling and storing DBS cards is expected to offer additional opportunities to measure and analyze biomarkers of viral disease in resource poor settings or when limited amount of blood can be obtained. Large retrospective studies of virus infections in newborns using stored DBS cards have already been undertaken for screening of congenital infections. In addition, DBS cards have been used prospectively for prevalence studies, outbreak surveillance, mass screening for viral infections, follow-up of chronic infection and its treatment in resource-limited areas. We do not expect that current wet sampling techniques of plasma or serum will be replaced by DBS sampling but it allows extension of sampling in persons and settings that are currently difficult to access or that lack suitable storage facilities. In conclusion, DBS card sampling and storage will aid adequate outbreak management of existing and emerging viral diseases. PMID:22244848

  8. Second European Round Table on the Future Management of HIV: 10-11 October 2014, Barcelona, Spain.

    PubMed

    Rokx, Casper; Richman, Douglas D; Müller-Trutwin, Michaela; Silvestri, Guido; Lunzen, Jan; Khoo, Saye; Lichterfeld, Mathias; Altfeld, Marcus; Perno, Carlo Federico; Hunt, Peter W; Mallon, Paddy; Rockstroh, Jürgen K; Pozniak, Anton L; Clotet, Bonaventura; Boucher, Charles Ab

    2015-07-01

    The Second European Round Table on the Future Management of HIV took place in Barcelona, 10-11 October 2014 and focused on the HIV-1 reservoir, strategies for HIV cure and primary HIV infection (PHI). Important issues in the HIV-1 reservoir research field are the validity of reservoir measurement techniques and the potential of new drugs to target latently infected cells. Current HIV-1 cure concepts are based on theoretical assumptions of biologically plausible mechanisms, supported by several clinical observations. Three main potential strategies are under investigation in order to achieve a sterilising cure or maintain HIV-1 remission: latency reversal resulting in antigen expression and viral cytolysis or immune targeted cell-death; immunological control of the reservoir; or replacement of the complete autologous haematopoietic and lymphoid stem-cell repertoire by transplantation. An interesting opportunity for restricting the size of the reservoir entails the early initiation of antiretroviral treatment (ART) during PHI. In terms of the reservoir, early treatment limits its size, alters its composition, and restricts the genetic variability of integrated proviral HIV-1 DNA. The challenges ahead involve the identification of patients undergoing seroconversion to HIV-1 and the prompt initiation of treatment. How the seemingly beneficial impact of early treatment will make cure more feasible, and whether the positive effects of the cure efforts outweigh the potentially negative impact of life-long ART, are important aspects of future collaborative research prospects.

  9. Second European Round Table on the Future Management of HIV: 10-11 October 2014, Barcelona, Spain.

    PubMed

    Rokx, Casper; Richman, Douglas D; Müller-Trutwin, Michaela; Silvestri, Guido; Lunzen, Jan; Khoo, Saye; Lichterfeld, Mathias; Altfeld, Marcus; Perno, Carlo Federico; Hunt, Peter W; Mallon, Paddy; Rockstroh, Jürgen K; Pozniak, Anton L; Clotet, Bonaventura; Boucher, Charles Ab

    2015-01-01

    The Second European Round Table on the Future Management of HIV took place in Barcelona, 10-11 October 2014 and focused on the HIV-1 reservoir, strategies for HIV cure and primary HIV infection (PHI). Important issues in the HIV-1 reservoir research field are the validity of reservoir measurement techniques and the potential of new drugs to target latently infected cells. Current HIV-1 cure concepts are based on theoretical assumptions of biologically plausible mechanisms, supported by several clinical observations. Three main potential strategies are under investigation in order to achieve a sterilising cure or maintain HIV-1 remission: latency reversal resulting in antigen expression and viral cytolysis or immune targeted cell-death; immunological control of the reservoir; or replacement of the complete autologous haematopoietic and lymphoid stem-cell repertoire by transplantation. An interesting opportunity for restricting the size of the reservoir entails the early initiation of antiretroviral treatment (ART) during PHI. In terms of the reservoir, early treatment limits its size, alters its composition, and restricts the genetic variability of integrated proviral HIV-1 DNA. The challenges ahead involve the identification of patients undergoing seroconversion to HIV-1 and the prompt initiation of treatment. How the seemingly beneficial impact of early treatment will make cure more feasible, and whether the positive effects of the cure efforts outweigh the potentially negative impact of life-long ART, are important aspects of future collaborative research prospects. PMID:27482415

  10. The SOLUTIONS project: challenges and responses for present and future emerging pollutants in land and water resources management.

    PubMed

    Brack, Werner; Altenburger, Rolf; Schüürmann, Gerrit; Krauss, Martin; López Herráez, David; van Gils, Jos; Slobodnik, Jaroslav; Munthe, John; Gawlik, Bernd Manfred; van Wezel, Annemarie; Schriks, Merijn; Hollender, Juliane; Tollefsen, Knut Erik; Mekenyan, Ovanes; Dimitrov, Saby; Bunke, Dirk; Cousins, Ian; Posthuma, Leo; van den Brink, Paul J; López de Alda, Miren; Barceló, Damià; Faust, Michael; Kortenkamp, Andreas; Scrimshaw, Mark; Ignatova, Svetlana; Engelen, Guy; Massmann, Gudrun; Lemkine, Gregory; Teodorovic, Ivana; Walz, Karl-Heinz; Dulio, Valeria; Jonker, Michiel T O; Jäger, Felix; Chipman, Kevin; Falciani, Francesco; Liska, Igor; Rooke, David; Zhang, Xiaowei; Hollert, Henner; Vrana, Branislav; Hilscherova, Klara; Kramer, Kees; Neumann, Steffen; Hammerbacher, Ruth; Backhaus, Thomas; Mack, Juliane; Segner, Helmut; Escher, Beate; de Aragão Umbuzeiro, Gisela

    2015-01-15

    SOLUTIONS (2013 to 2018) is a European Union Seventh Framework Programme Project (EU-FP7). The project aims to deliver a conceptual framework to support the evidence-based development of environmental policies with regard to water quality. SOLUTIONS will develop the tools for the identification, prioritisation and assessment of those water contaminants that may pose a risk to ecosystems and human health. To this end, a new generation of chemical and effect-based monitoring tools is developed and integrated with a full set of exposure, effect and risk assessment models. SOLUTIONS attempts to address legacy, present and future contamination by integrating monitoring and modelling based approaches with scenarios on future developments in society, economy and technology and thus in contamination. The project follows a solutions-oriented approach by addressing major problems of water and chemicals management and by assessing abatement options. SOLUTIONS takes advantage of the access to the infrastructure necessary to investigate the large basins of the Danube and Rhine as well as relevant Mediterranean basins as case studies, and puts major efforts on stakeholder dialogue and support. Particularly, the EU Water Framework Directive (WFD) Common Implementation Strategy (CIS) working groups, International River Commissions, and water works associations are directly supported with consistent guidance for the early detection, identification, prioritisation, and abatement of chemicals in the water cycle. SOLUTIONS will give a specific emphasis on concepts and tools for the impact and risk assessment of complex mixtures of emerging pollutants, their metabolites and transformation products. Analytical and effect-based screening tools will be applied together with ecological assessment tools for the identification of toxicants and their impacts. The SOLUTIONS approach is expected to provide transparent and evidence-based candidates or River Basin Specific Pollutants in the case

  11. Evolutionary algorithms for the optimal management of coastal groundwater: A comparative study toward future challenges

    NASA Astrophysics Data System (ADS)

    Ketabchi, Hamed; Ataie-Ashtiani, Behzad

    2015-01-01

    This paper surveys the literature associated with the application of evolutionary algorithms (EAs) in coastal groundwater management problems (CGMPs). This review demonstrates that previous studies were mostly relied on the application of limited and particular EAs, mainly genetic algorithm (GA) and its variants, to a number of specific problems. The exclusive investigation of these problems is often not the representation of the variety of feasible processes may be occurred in coastal aquifers. In this study, eight EAs are evaluated for CGMPs. The considered EAs are: GA, continuous ant colony optimization (CACO), particle swarm optimization (PSO), differential evolution (DE), artificial bee colony optimization (ABC), harmony search (HS), shuffled complex evolution (SCE), and simplex simulated annealing (SIMPSA). The first application of PSO, ABC, HS, and SCE in CGMPs is reported here. Moreover, the four benchmark problems with different degree of difficulty and variety are considered to address the important issues of groundwater resources in coastal regions. Hence, the wide ranges of popular objective functions and constraints with the number of decision variables ranging from 4 to 15 are included. These benchmark problems are applied in the combined simulation-optimization model to examine the optimization scenarios. Some preliminary experiments are performed to select the most efficient parameters values for EAs to set a fair comparison. The specific capabilities of each EA toward CGMPs in terms of results quality and required computational time are compared. The evaluation of the results highlights EA's applicability in CGMPs, besides the remarkable strengths and weaknesses of them. The comparisons show that SCE, CACO, and PSO yield superior solutions among the EAs according to the quality of solutions whereas ABC presents the poor performance. CACO provides the better solutions (up to 17%) than the worst EA (ABC) for the problem with the highest decision

  12. Present-day challenges and future solutions in postoperative pain management: results from PainForum 2014

    PubMed Central

    Kuusniemi, Kristiina; Pöyhiä, Reino

    2016-01-01

    This paper is a summary of presentations on postoperative pain control by the authors at the 2014 PainForum meeting in People’s Republic of China. Postoperative pain is often untreated or undertreated and may lead to subsequent chronic pain syndromes. As more procedures migrate to the outpatient setting, postoperative pain control will become increasingly more challenging. Evidence-based guidelines for postoperative pain control recommend pain assessment using validated tools on a consistent basis. In this regard, consistency may be more important than the specific tool selected. Many hospitals have introduced a multidisciplinary acute pain service (APS), which has been associated with improved patient satisfaction and fewer adverse events. Patient education is an important component of postoperative pain control, which may be most effective when clinicians chose a multimodal approach, such as paracetamol (acetaminophen) and opioids. Opioids are a mainstay of postoperative pain control but require careful monitoring and management of side effects, such as nausea, vomiting, dizziness, and somnolence. Opioids may be administered using patient-controlled analgesia systems. Protocols for postoperative pain control can be very helpful to establish benchmarks for pain management and assure that clinicians adhere to evidence-based standards. The future of postoperative pain control around the world will likely involve more and better established APSs and greater communication between patients and clinicians about postoperative pain. The changes necessary to implement and move forward with APSs is not a single step but rather one of continuous improvement and ongoing change. PMID:26893579

  13. Prediction of future methane emission from irrigated rice paddies in central Thailand under different water management practices.

    PubMed

    Minamikawa, Kazunori; Fumoto, Tamon; Iizumi, Toshichika; Cha-Un, Nittaya; Pimple, Uday; Nishimori, Motoki; Ishigooka, Yasushi; Kuwagata, Tsuneo

    2016-10-01

    There is concern about positive feedbacks between climate change and methane (CH4) emission from rice paddies. However, appropriate water management may mitigate the problem. We tested this hypothesis at six field sites in central Thailand, where the irrigated area is rapidly increasing. We used DNDC-Rice, a process-based biogeochemistry model adjusted based on rice growth data at each site to simulate CH4 emission from a rice-rice double cropping system from 2001 to 2060. Future climate change scenarios consisting of four representative concentration pathways (RCPs) and seven global climate models were generated by statistical downscaling. We then simulated CH4 emission in three water management practices: continuous flooding (CF), single aeration (SA), and multiple aeration (MA). The adjusted model reproduced the observed rice yield and CH4 emission well at each site. The simulated CH4 emissions in CF from 2051 to 2060 were 5.3 to 7.8%, 9.6 to 16.0%, 7.3 to 18.0%, and 13.6 to 19.0% higher than those from 2001 to 2010 in RCPs 2.6, 4.5, 6.0, and 8.5, respectively, at the six sites. Regionally, SA and MA mitigated CH4 emission by 21.9 to 22.9% and 53.5 to 55.2%, respectively, relative to CF among the four RCPs. These mitigation potentials by SA and MA were comparable to those from 2001 to 2010. Our results indicate that climate change in the next several decades will not attenuate the quantitative effect of water management practices on mitigating CH4 emission from irrigated rice paddies in central Thailand.

  14. Prediction of future methane emission from irrigated rice paddies in central Thailand under different water management practices.

    PubMed

    Minamikawa, Kazunori; Fumoto, Tamon; Iizumi, Toshichika; Cha-Un, Nittaya; Pimple, Uday; Nishimori, Motoki; Ishigooka, Yasushi; Kuwagata, Tsuneo

    2016-10-01

    There is concern about positive feedbacks between climate change and methane (CH4) emission from rice paddies. However, appropriate water management may mitigate the problem. We tested this hypothesis at six field sites in central Thailand, where the irrigated area is rapidly increasing. We used DNDC-Rice, a process-based biogeochemistry model adjusted based on rice growth data at each site to simulate CH4 emission from a rice-rice double cropping system from 2001 to 2060. Future climate change scenarios consisting of four representative concentration pathways (RCPs) and seven global climate models were generated by statistical downscaling. We then simulated CH4 emission in three water management practices: continuous flooding (CF), single aeration (SA), and multiple aeration (MA). The adjusted model reproduced the observed rice yield and CH4 emission well at each site. The simulated CH4 emissions in CF from 2051 to 2060 were 5.3 to 7.8%, 9.6 to 16.0%, 7.3 to 18.0%, and 13.6 to 19.0% higher than those from 2001 to 2010 in RCPs 2.6, 4.5, 6.0, and 8.5, respectively, at the six sites. Regionally, SA and MA mitigated CH4 emission by 21.9 to 22.9% and 53.5 to 55.2%, respectively, relative to CF among the four RCPs. These mitigation potentials by SA and MA were comparable to those from 2001 to 2010. Our results indicate that climate change in the next several decades will not attenuate the quantitative effect of water management practices on mitigating CH4 emission from irrigated rice paddies in central Thailand. PMID:27239710

  15. It’s about time: How do sky surveys manage uncertainty about scientific needs many years into the future

    NASA Astrophysics Data System (ADS)

    Darch, Peter T.; Sands, Ashley E.

    2016-06-01

    Sky surveys, such as the Sloan Digital Sky Survey (SDSS) and the Large Synoptic Survey Telescope (LSST), generate data on an unprecedented scale. While many scientific projects span a few years from conception to completion, sky surveys are typically on the scale of decades. This paper focuses on critical challenges arising from long timescales, and how sky surveys address these challenges.We present findings from a study of LSST, comprising interviews (n=58) and observation. Conceived in the 1990s, the LSST Corporation was formed in 2003, and construction began in 2014. LSST will commence data collection operations in 2022 for ten years.One challenge arising from this long timescale is uncertainty about future needs of the astronomers who will use these data many years hence. Sources of uncertainty include scientific questions to be posed, astronomical phenomena to be studied, and tools and practices these astronomers will have at their disposal. These uncertainties are magnified by the rapid technological and scientific developments anticipated between now and the start of LSST operations.LSST is implementing a range of strategies to address these challenges. Some strategies involve delaying resolution of uncertainty, placing this resolution in the hands of future data users. Other strategies aim to reduce uncertainty by shaping astronomers’ data analysis practices so that these practices will integrate well with LSST once operations begin.One approach that exemplifies both types of strategy is the decision to make LSST data management software open source, even now as it is being developed. This policy will enable future data users to adapt this software to evolving needs. In addition, LSST intends for astronomers to start using this software well in advance of 2022, thereby embedding LSST software and data analysis approaches in the practices of astronomers.These findings strengthen arguments for making the software supporting sky surveys available as open

  16. Forecasting the Future Food Service World of Work. Final Report. Volume III. Technical Papers on the Future of the Food Service Industry. Service Management Reports.

    ERIC Educational Resources Information Center

    Powers, Thomas F., Ed.; Swinton, John R., Ed.

    This third and final volume of a study on the future of the food service industry contains the technical papers on which the information in the previous two volumes was based. The papers were written by various members of the Pennsylvania State University departments of economics, food science, nutrition, social psychology, and engineering and by…

  17. Synthetic drought event sets: thousands of meteorological drought events for risk-based management under present and future conditions

    NASA Astrophysics Data System (ADS)

    Guillod, Benoit P.; Massey, Neil; Otto, Friederike E. L.; Allen, Myles R.; Jones, Richard; Hall, Jim W.

    2016-04-01

    Droughts and related water scarcity can have large impacts on societies and consist of interactions between a number of natural and human factors. Meteorological conditions are usually the first natural trigger of droughts, and climate change is expected to impact these and thereby the frequency and intensity of the events. However, extreme events such as droughts are, by definition, rare, and accurately quantifying the risk related to such events is therefore difficult. The MaRIUS project (Managing the Risks, Impacts and Uncertainties of drought and water Scarcity) aims at quantifying the risks associated with droughts in the UK under present and future conditions. To do so, a large number of drought events, from climate model simulations downscaled at 25km over Europe, are being fed into hydrological models of various complexity and used for the estimation of drought risk associated with human and natural systems, including impacts on the economy, industry, agriculture, terrestrial and aquatic ecosystems, and socio-cultural aspects. Here, we present the hydro-meteorological drought event set that has been produced by weather@home [1] for MaRIUS. Using idle processor time on volunteers' computers around the world, we have run a very large number (10'000s) of Global Climate Model (GCM) simulations, downscaled at 25km over Europe by a nested Regional Climate Model (RCM). Simulations include the past 100 years as well as two future horizons (2030s and 2080s), and provide a large number of sequences of spatio-temporally consistent weather, which are consistent with the boundary forcing such as the ocean, greenhouse gases and solar forcing. The drought event set for use in impact studies is constructed by extracting sequences of dry conditions from these model runs, leading to several thousand drought events. In addition to describing methodological and validation aspects of the synthetic drought event sets, we provide insights into drought risk in the UK, its

  18. Massive PCDD/F contamination at the Khimprom organochlorine plant in Ufa--a review and recommendations for future management.

    PubMed

    Amirova, Zarema; Weber, Roland

    2015-10-01

    The Khimprom plant in Ufa was one of the largest organochlorine production facilities in Russia. This paper summarises the residual pollution of the site with polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and highlights the current and future challenges in relation to remediation of the site. Preliminary assessment of the pollution shows large-scale PCDD/F contamination at the site from half a century production of organochlorine pesticides and solvents. This contamination is affecting the city, and 2500 residents live within 3 km with a further 350,000 living within 7 km of the factory. The current PCDD/F pollution of the site and the continuing releases highlight the urgent need for further investigations, for the site to be secured and for the contamination to be remediated. The production history of the plant means that also other unintentionally POPs, mercury and chlorinated solvents need to be considered. The current regulatory framework for PCDD/F-contaminated soil and for defining hazardous waste in the Russian Federation is not appropriate for the management of PCDD/F-contaminated sites. It is therefore suggested that a science-based regulatory framework should be developed. The Russian Federation recently ratified the Stockholm Convention providing a foundation for the development of appropriate regulations and for further assessment, securing and remediation of the site. The impacts of pollution from the Khimprom plant demonstrate that the assessment and management of the organochlorine production sites should be a priority in the implementation of the Stockholm Convention by the Russian Federation and other countries. PMID:26201658

  19. Interface Management between General Practitioners and Rheumatologists—Results of a Survey Defining a Concept for Future Joint Recommendations

    PubMed Central

    Puchner, Rudolf; Edlinger, Michael; Mur, Erich; Eberl, Gabriele; Herold, Manfred; Kufner, Peter; Puchner, Antonia; Puchner, Stephan E.; Redlich, Kurt; Alkin, Alois; Machold, Klaus

    2016-01-01

    Objective To measure the views of general practitioners (GPs) and rheumatologists in a nationwide evaluation, so as to optimise their cooperation in managing patients with inflammatory rheumatic diseases. Methods A questionnaire covering aspects of collaboration was sent, both by mail and/or by email, to all GPs and rheumatologists in Austria. Topics covered were (i) examinations and interventions to be performed before referral, (ii) the spectrum of diseases to be referred, and (iii) the role of GPs in follow-up and continuous management of patients. Results 1,229 GPs of the 4,016 GPs (31%) and 110 of the 180 rheumatologists (61%) responded to the questionnaire. In cases of suspected arthritis, 99% of the GPs and 92% of the rheumatologists recommended specific laboratory tests, and 92% and 70%, respectively, recommended X-rays of affected joints before referral. Rheumatoid arthritis and spondyloarthritis, psoriatic arthritis and connective tissue disease were unanimously seen as indications for referral to a rheumatologist. Only 12% of rheumatologists felt responsible for the treatment of hand osteoarthritis and fibromyalgia. 80% of GPs and 85% of rheumatologists were of the opinion that treatment with disease-modifying drugs should be initiated by a specialist. Subsequent drug prescription and administration by GPs was supported by a majority of GPs and rheumatologists, with a concomitant rheumatologist follow-up every three to six months. Conclusion The considerable consensus between the two professional groups constitutes a solid base for future joint recommendations, with the aim to accelerate the diagnostic process and the initiation of adequate therapy. PMID:26741702

  20. The TU-025 Keishibukuryogan for Hot Flash Management in Postmenopausal Women: Results and Lessons for Future Research

    PubMed Central

    Plotnikoff, Gregory A.; Watanabe, Kenji; Torkelson, Carolyn; La Valleur, June; Radosevich, David M.

    2011-01-01

    Objective To assess the efficacy of TU-025, keishibukuryogan, a Japanese prescription herbal medicine used for hot flash management, in American women. Methods This randomized, double-blind, placebo-controlled, phase II trial enrolled 178 postmenopausal women, aged 45–58 years, with a Mayo hot flash score greater than 28 per week and who met other inclusion criteria. After a one-week placebo run-in period, participants were randomly assigned to either 12 weeks of placebo, 7.5 g/day or 12.5 g/day. Primary and secondary outcomes were measured by the Mayo Clinic Hot Flash Diary, the Greene Climacteric Index and the Pittsburgh Sleep Quality Index. Results At three months, hot flash scores, climacteric symptoms and sleep quality improved by 34% in the placebo group, 40% in the 7.5 g/day group and 38% in the 12.5 g/day group. (p < 0.001). However, the differences in changes between groups were not statistically significant (p = 0.990). Diarrhea unexpectedly developed in 20% of participants receiving active medication. Conclusions For American women, unlike the clinical experience for Japanese women, TU-025 did not significantly reduce the frequency and severity of hot flash symptoms, improve climacteric symptoms or benefit sleep quality. This study identified several potentially significant methodological factors to be considered in future scientific assessments of traditional Asian medicines. PMID:21738077

  1. Thermal aspects of future spacecraft thermal management systems. Interim report, 1 January 1984-1 October 1985

    SciTech Connect

    Sheffield, J.W.; Kher, R.P.

    1986-07-01

    This report addresses the conceptual design of spacecraft thermal management systems (SCTMS) and their components to provide a basis for the development and implementation of future technologies. In the analysis, components of the SCTMS include: heat pipes, latent thermal energy storage materials, radiators, and other thermal structures. The design problem becomes one of selecting a combination of these components subject to both spacecraft mission and launch requirements. To assist in this design process, a knowledge-based software was developed in the artificial intelligence programming language, PROLOG. This software serves as a design assistant for the development of SCTMS. It supports facilities such as data-base retrieval, numerical computation, and logical decision making. With these features one can automatically consider all relevant combinations of components, technologies, and materials for the design problem. The goal has been to duplicate, wherever possible, the decision processes of an experienced designer by putting significant decision making, search, and retrieval facilities at his or her disposal. Other objectives were to determine the capabilities of the phase-change materials (PCMs) selected by the knowledge-based system. Tests were carried to evaluate properties and thermal behavior of a PCM in pellet form. Two types of PCMs demonstrated potential for SCTMS were calcium chloride hexahydrate and the form stable crystalline polymer, high density polyethylene.

  2. Bill E. Kunkle Interdisciplinary Beef Symposium: Practical developments in managing animal welfare in beef cattle: what does the future hold?

    PubMed

    Lyles, J L; Calvo-Lorenzo, M S

    2014-12-01

    Interest in the welfare of cattle in the beef industry has intensified over time because of ethical concerns and varying societal perceptions that exist about the treatment and living conditions of farm animals. The definition of welfare will vary according to an individual's philosophies (how one defines and prioritizes what is "good"), experiences (societal and cultural influences of animal roles and relationships), and involvement in the livestock industry (knowledge of how livestock operations work and why). Many welfare concerns in the beef industry could be mitigated by enhancing traditional husbandry practices that utilize practical improvements to alleviate or eliminate heat stress, pain from routine husbandry procedures, negative cattle handling, and the transitional effects of weaning, dry feeding, transportation, and comingling of calves. Recent concerns about the potential welfare effects of feeding technologies such as β-adrenergic agonists (BAA) have emerged and led to industry-wide effects, including the removal of a single BAA product from the market and the development of BAA-specific welfare audits. Altogether, the beef industry continues to be challenged by welfare issues that question a large range of practices, from traditional husbandry to newer technological advancements. As welfare awareness increases, efforts to improve livestock care and management must focus on scientific investigations, practical solutions, consumer perceptions, and educational tools that advance knowledge and training in livestock welfare. Furthermore, the future of beef cattle welfare must align welfare concerns with other aspects of sustainable beef production such as environmental quality, profitability, food safety, and nutritional quality.

  3. Bill E. Kunkle Interdisciplinary Beef Symposium: Practical developments in managing animal welfare in beef cattle: what does the future hold?

    PubMed

    Lyles, J L; Calvo-Lorenzo, M S

    2014-12-01

    Interest in the welfare of cattle in the beef industry has intensified over time because of ethical concerns and varying societal perceptions that exist about the treatment and living conditions of farm animals. The definition of welfare will vary according to an individual's philosophies (how one defines and prioritizes what is "good"), experiences (societal and cultural influences of animal roles and relationships), and involvement in the livestock industry (knowledge of how livestock operations work and why). Many welfare concerns in the beef industry could be mitigated by enhancing traditional husbandry practices that utilize practical improvements to alleviate or eliminate heat stress, pain from routine husbandry procedures, negative cattle handling, and the transitional effects of weaning, dry feeding, transportation, and comingling of calves. Recent concerns about the potential welfare effects of feeding technologies such as β-adrenergic agonists (BAA) have emerged and led to industry-wide effects, including the removal of a single BAA product from the market and the development of BAA-specific welfare audits. Altogether, the beef industry continues to be challenged by welfare issues that question a large range of practices, from traditional husbandry to newer technological advancements. As welfare awareness increases, efforts to improve livestock care and management must focus on scientific investigations, practical solutions, consumer perceptions, and educational tools that advance knowledge and training in livestock welfare. Furthermore, the future of beef cattle welfare must align welfare concerns with other aspects of sustainable beef production such as environmental quality, profitability, food safety, and nutritional quality. PMID:25253809

  4. Assessing and Managing the Current and Future Pest Risk from Water Hyacinth, (Eichhornia crassipes), an Invasive Aquatic Plant Threatening the Environment and Water Security

    PubMed Central

    Brunel, Sarah

    2016-01-01

    Understanding and managing the biological invasion threats posed by aquatic plants under current and future climates is a growing challenge for biosecurity and land management agencies worldwide. Eichhornia crassipes is one of the world’s worst aquatic weeds. Presently, it threatens aquatic ecosystems, and hinders the management and delivery of freshwater services in both developed and developing parts of the world. A niche model was fitted using CLIMEX, to estimate the potential distribution of E. crassipes under historical and future climate scenarios. Under two future greenhouse gas emission scenarios for 2080 simulated with three Global Climate Models, the area with a favourable temperature regime appears set to shift polewards. The greatest potential for future range expansion lies in Europe. Elsewhere in the northern hemisphere temperature gradients are too steep for significant geographical range expansion under the climate scenarios explored here. In the Southern Hemisphere, the southern range boundary for E. crassipes is set to expand southwards in Argentina, Australia and New Zealand; under current climate conditions it is already able to invade the southern limits of Africa. The opportunity exists to prevent its spread into the islands of Tasmania in Australia and the South Island of New Zealand, both of which depend upon hydroelectric facilities that would be threatened by the presence of E. crassipes. In Europe, efforts to slow or stop the spread of E. crassipes will face the challenge of limited internal biosecurity capacity. The modelling technique demonstrated here is the first application of niche modelling for an aquatic weed under historical and projected future climates. It provides biosecurity agencies with a spatial tool to foresee and manage the emerging invasion threats in a manner that can be included in the international standard for pest risk assessments. It should also support more detailed local and regional management. PMID:27513336

  5. Assessing and Managing the Current and Future Pest Risk from Water Hyacinth, (Eichhornia crassipes), an Invasive Aquatic Plant Threatening the Environment and Water Security.

    PubMed

    Kriticos, Darren J; Brunel, Sarah

    2016-01-01

    Understanding and managing the biological invasion threats posed by aquatic plants under current and future climates is a growing challenge for biosecurity and land management agencies worldwide. Eichhornia crassipes is one of the world's worst aquatic weeds. Presently, it threatens aquatic ecosystems, and hinders the management and delivery of freshwater services in both developed and developing parts of the world. A niche model was fitted using CLIMEX, to estimate the potential distribution of E. crassipes under historical and future climate scenarios. Under two future greenhouse gas emission scenarios for 2080 simulated with three Global Climate Models, the area with a favourable temperature regime appears set to shift polewards. The greatest potential for future range expansion lies in Europe. Elsewhere in the northern hemisphere temperature gradients are too steep for significant geographical range expansion under the climate scenarios explored here. In the Southern Hemisphere, the southern range boundary for E. crassipes is set to expand southwards in Argentina, Australia and New Zealand; under current climate conditions it is already able to invade the southern limits of Africa. The opportunity exists to prevent its spread into the islands of Tasmania in Australia and the South Island of New Zealand, both of which depend upon hydroelectric facilities that would be threatened by the presence of E. crassipes. In Europe, efforts to slow or stop the spread of E. crassipes will face the challenge of limited internal biosecurity capacity. The modelling technique demonstrated here is the first application of niche modelling for an aquatic weed under historical and projected future climates. It provides biosecurity agencies with a spatial tool to foresee and manage the emerging invasion threats in a manner that can be included in the international standard for pest risk assessments. It should also support more detailed local and regional management. PMID:27513336

  6. Advanced medium-voltage bidirectional dc-dc conversion systems for future electric energy delivery and management systems

    NASA Astrophysics Data System (ADS)

    Fan, Haifeng

    2011-12-01

    The distributed renewable energy generation and utilization are constantly growing, and are expected to be integrated with the conventional grid. The growing pressure for innovative solutions will demand power electronics to take an even larger role in future electric energy delivery and management systems, since power electronics are required for the conversion and control of electric energy by most dispersed generation systems Furthermore, power electronics systems can provide additional intelligent energy management, grid stability and power quality capabilities. Medium-voltage isolated dc-dc converter will become one of the key interfaces for grid components with moderate power ratings. To address the demand of medium voltage (MV) and high power capability for future electric energy delivery and management systems, the power electronics community and industry have been reacting in two different ways: developing semiconductor technology or directly connecting devices in series/parallel to reach higher nominal voltages and currents while maintaining conventional converter topologies; and by developing new converter topologies with traditional semiconductor technology, known as multilevel converters or modular converters. The modular approach uses the well-known, mature, and cheaper power semiconductor devices by adopting new converter topologies. The main advantages of the modular approach include: significant improvement in reliability by introducing desired level of redundancy; standardization of components leading to reduction in manufacturing cost and time; power systems can be easily reconfigured to support varying input-output specifications; and possibly higher efficiency and power density of the overall system. Input-series output-parallel (ISOP) modular configuration is a good choice to realize MV to low voltage (LV) conversion for utility application. However, challenges still remain. First of all, for the high-frequency MV utility application, the low

  7. Compounds with anti-influenza activity: present and future of strategies for the optimal treatment and management of influenza. Part II: Future compounds against influenza virus.

    PubMed

    Gasparini, R; Amicizia, D; Lai, P L; Bragazzi, N L; Panatto, D

    2014-12-01

    In the first part of this overview, we described the life cycle of the influenza virus and the pharmacological action of the currently available drugs. This second part provides an overview of the molecular mechanisms and targets of still-experimental drugs for the treatment and management of influenza. Briefly, we can distinguish between compounds with anti-influenza activity that target influenza virus proteins or genes, and molecules that target host components that are essential for viral replication and propagation. These latter compounds have been developed quite recently. Among the first group, we will focus especially on hemagglutinin, M2 channel and neuraminidase inhibitors. The second group of compounds may pave the way for personalized treatment and influenza management. Combination therapies are also discussed. In recent decades, few antiviral molecules against influenza virus infections have been available; this has conditioned their use during human and animal outbreaks. Indeed, during seasonal and pandemic outbreaks, antiviral drugs have usually been administered in mono-therapy and, sometimes, in an uncontrolled manner to farm animals. This has led to the emergence of viral strains displaying resistance, especially to compounds of the amantadane family. For this reason, it is particularly important to develop new antiviral drugs against influenza viruses. Indeed, although vaccination is the most powerful means of mitigating the effects of influenza epidemics, antiviral drugs can be very useful, particularly in delaying the spread of new pandemic viruses, thereby enabling manufacturers to prepare large quantities of pandemic vaccine. In addition, antiviral drugs are particularly valuable in complicated cases of influenza, especially in hospitalized patients. To write this overview, we mined various databases, including Embase, PubChem, DrugBank and Chemical Abstracts Service, and patent repositories.

  8. Forecasting the Future Food Service World of Work. Final Report. Volume II. Centralized Food Service Systems. Service Management Reports.

    ERIC Educational Resources Information Center

    Powers, Thomas F., Ed.; Swinton, John R., Ed.

    Volume II of a three-volume study on the future of the food service industry considers the effects that centralized food production will have on the future of food production systems. Based on information from the Fair Acres Project and the Michigan State University Vegetable Processing Center, the authors describe the operations of a centralized…

  9. Provision of weight management advice for obese women during pregnancy: a survey of current practice and midwives' views on future approaches.

    PubMed

    Macleod, Maureen; Gregor, Amy; Barnett, Carol; Magee, Elizabeth; Thompson, Joyce; Anderson, Annie S

    2013-10-01

    A semi-structured, web-based questionnaire was developed to survey midwives (n = 241) employed by NHS Tayside, UK, to identify current practice and views on weight management of obese women during pregnancy and the puerperium. A total of 78 (32%) midwives submitted responses following email invitation. Most respondents (79%) reported always calculating women's body mass index (BMI) at booking, with 73% routinely explaining the BMI category. In terms of future practice for obese women, although few respondents (15%) currently offer personalised advice regarding weight management based on a woman's diet and physical activity levels, 77% of respondents thought such advice would be appropriate and 69% thought it could possibly be feasible to offer such advice. The respondents viewed weight management to be of importance and felt that universal advice is appropriate, but confidence in discussing weight management and knowledge of the subject was low. Strategies to improve midwife confidence and weight management services should include training, ongoing support and definition of the midwife's role within the multidisciplinary team to support practice in the future. PMID:22288981

  10. Industry 4.0: Reality, Future or just Science Fiction? How to Convince Today's Management to Invest in Tomorrow's Future! Successful Strategies for Industry 4.0 and Manufacturing IT.

    PubMed

    Gentner, Stephan

    2016-01-01

    Manufacturing IT and Industry 4.0 is the Fourth Industrial Revolution with a potential of 12 bn Euros in Germany's chemicals industry. But Switzerland is currently the best prepared of all countries in Europe. Many of the ideas are still very vague. This article discusses how to identify what is already reality, which ideas might become reality in the future and which ideas will stay science fiction. As projects in Manufacturing IT and Industry 4.0 are different from classical technical projects other strategies, for example agile project management, are necessary to secure success. PMID:27646544

  11. Industry 4.0: Reality, Future or just Science Fiction? How to Convince Today's Management to Invest in Tomorrow's Future! Successful Strategies for Industry 4.0 and Manufacturing IT.

    PubMed

    Gentner, Stephan

    2016-01-01

    Manufacturing IT and Industry 4.0 is the Fourth Industrial Revolution with a potential of 12 bn Euros in Germany's chemicals industry. But Switzerland is currently the best prepared of all countries in Europe. Many of the ideas are still very vague. This article discusses how to identify what is already reality, which ideas might become reality in the future and which ideas will stay science fiction. As projects in Manufacturing IT and Industry 4.0 are different from classical technical projects other strategies, for example agile project management, are necessary to secure success.

  12. Surgical Management of Early-Stage Non-small Cell Lung Carcinoma and the Present and Future Roles of Adjuvant Therapy: A Review for the Radiation Oncologist

    SciTech Connect

    Medford-Davis, Laura; DeCamp, Malcom; Recht, Abram; Flickinger, John; Belani, Chandra P.; Varlotto, John

    2012-12-01

    We review the evidence for optimal surgical management and adjuvant therapy for patients with stages I and II non-small cell lung cancer (NSCLC) along with factors associated with increased risks of recurrence. Based on the current evidence, we recommend optimal use of mediastinal lymph node dissection, adjuvant chemotherapy, and post-operative radiation therapy, and make suggestions for areas to explore in future prospective randomized clinical trials.

  13. How to manage future groundwater resource of China under climate change and urbanization: An optimal stage investment design from modern portfolio theory.

    PubMed

    Hua, Shanshan; Liang, Jie; Zeng, Guangming; Xu, Min; Zhang, Chang; Yuan, Yujie; Li, Xiaodong; Li, Ping; Liu, Jiayu; Huang, Lu

    2015-11-15

    Groundwater management in China has been facing challenges from both climate change and urbanization and is considered as a national priority nowadays. However, unprecedented uncertainty exists in future scenarios making it difficult to formulate management planning paradigms. In this paper, we apply modern portfolio theory (MPT) to formulate an optimal stage investment of groundwater contamination remediation in China. This approach generates optimal weights of investment to each stage of the groundwater management and helps maximize expected return while minimizing overall risk in the future. We find that the efficient frontier of investment displays an upward-sloping shape in risk-return space. The expected value of groundwater vulnerability index increases from 0.6118 to 0.6230 following with the risk of uncertainty increased from 0.0118 to 0.0297. If management investment is constrained not to exceed certain total cost until 2050 year, the efficient frontier could help decision makers make the most appropriate choice on the trade-off between risk and return.

  14. How to manage future groundwater resource of China under climate change and urbanization: An optimal stage investment design from modern portfolio theory.

    PubMed

    Hua, Shanshan; Liang, Jie; Zeng, Guangming; Xu, Min; Zhang, Chang; Yuan, Yujie; Li, Xiaodong; Li, Ping; Liu, Jiayu; Huang, Lu

    2015-11-15

    Groundwater management in China has been facing challenges from both climate change and urbanization and is considered as a national priority nowadays. However, unprecedented uncertainty exists in future scenarios making it difficult to formulate management planning paradigms. In this paper, we apply modern portfolio theory (MPT) to formulate an optimal stage investment of groundwater contamination remediation in China. This approach generates optimal weights of investment to each stage of the groundwater management and helps maximize expected return while minimizing overall risk in the future. We find that the efficient frontier of investment displays an upward-sloping shape in risk-return space. The expected value of groundwater vulnerability index increases from 0.6118 to 0.6230 following with the risk of uncertainty increased from 0.0118 to 0.0297. If management investment is constrained not to exceed certain total cost until 2050 year, the efficient frontier could help decision makers make the most appropriate choice on the trade-off between risk and return. PMID:26295936

  15. Current limits and future challenges in the management of renal dysfunction in patients with cirrhosis: report from the International Club of Ascites.

    PubMed

    Angeli, Paolo; Sanyal, Arun; Moller, Soren; Alessandria, Carlo; Gadano, Adrian; Kim, Ray; Sarin, Shiv K; Bernardi, Mauro

    2013-01-01

    Advanced cirrhosis is often complicated by a multi organ failure syndrome which involves many different organs besides the liver. The high morbidity and mortality secondary to this clinical setting is often related to renal dysfunction, either alone or, more frequently, in combination with other organ dysfunction. A clear definition of renal dysfunction, an accurate differential diagnostic process of its different phenotypes as well as of full understanding of its pathophysiological mechanisms are crucial to the development of strategies for the management of this complication. This article is based either on the more recent knowledge on renal dysfunction in advanced cirrhosis or current opinions among the members of the International Club of Ascites (ICA) on the management of this complication, obtained through a survey and discussed during the EASL-ICA Joint Meeting in Berlin in March 2011. It reviews critically our current knowledge and it outlines future perspectives, on the management of renal dysfunction in patients with cirrhosis.

  16. Different models to mobilize peer support to improve diabetes self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research

    PubMed Central

    2010-01-01

    Much of diabetes care needs to be carried out by patients between office visits with their health care providers. Yet, many patients face difficulties carrying out these tasks. In addition, many adults with diabetes cannot count on effective support from their families and friends to help them with their self-management. Peer support programmes are a promising approach to enhance social and emotional support, assist patients in daily management and living with diabetes and promote linkages to clinical care. This background paper provides a brief overview of different approaches to mobilize peer support for diabetes self-management support, discusses evidence to date on the effectiveness of each of these models, highlights logistical and evaluation issues for each model and concludes with a discussion of directions for future research in this area. PMID:19293400

  17. An Analysis of the Managerial Responsibilities and Educational Needs of Word Processing Managers with Implications for Future Word Processing Management Training.

    ERIC Educational Resources Information Center

    Loth, Robert E.

    1983-01-01

    Assessed the perceived managerial preparedness of word processing managers in selected Ohio businesses and compared the findings with current literature, word processing curricula in two-and four-year colleges and universities, and the curricular elements in the IBM Word Processing Managers' Seminar. Developed specific training topics for word…

  18. Habitat overlap between southern bluefin tuna and yellowfin tuna in the east coast longline fishery - implications for present and future spatial management

    NASA Astrophysics Data System (ADS)

    Hartog, Jason R.; Hobday, Alistair J.; Matear, Richard; Feng, Ming

    2011-03-01

    Southern bluefin tuna (SBT) are presently a quota-managed species in the multi-species eastern Australian tuna and billfish longline fishery (ETBF). Capture of SBT is regulated by quota, as is access to regions likely to contain SBT. A habitat prediction model combining data from an ocean model and pop-up satellite archival tags is used to define habitat zones based on the probability of SBT occurrence. These habitat zones are used by fishery managers to restrict access by ETBF fishers to SBT habitat during a May-November management season. The zones display a distinct seasonal cycle driven by the seasonal southward expansion and northward contraction of the East Australia Current (EAC) and as a result access by fishers to particular ocean regions changes seasonally. This species also overlaps with the commercially valuable yellowfin tuna (YFT), thus, we modified the SBT model to generate YFT habitat predictions in order to investigate habitat overlap between SBT and YFT. There is seasonal variation in the overlap of the core habitat between these two species, with overlap early (May-Jul) in the management season and habitat separation occurring towards the end (Aug-Nov). The EAC is one of the fastest warming ocean regions in the southern hemisphere. To consider the future change in distribution of these two species compared to the present and to explore the potential impact on fishers and managers of the future, we use future ocean predictions from the CSIRO Bluelink ocean model for the year 2064 to generate habitat predictions. As the ocean warms on the east coast of Australia and the EAC extends southward, our model predicts the suitable habitat for SBT and YFT will move further south. There was an increase in the overlap of SBT and YFT habitat throughout the management season, due to regional variation of each species' habitat. These results illustrate that a management tradeoff exists between restricting fisher access to SBT habitat and allowing access to YFT

  19. PREDICTIVE UNCERTAINTY IN HYDROLOGIC AND WATER QUALITY MODELING: APPROACHES, APPLICATION TO ENVIRONMENTAL MANAGEMENT, AND FUTURE CHALLENGES (PRESENTATION)

    EPA Science Inventory

    Extant process-based hydrologic and water quality models are indispensable to water resources planning and environmental management. However, models are only approximations of real systems and often calibrated with incomplete and uncertain data. Reliable estimates, or perhaps f...

  20. The past, present, and future of biologically-based weed management on rangeland watersheds in the western United States

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Saltcedar (Tamarix spp.) are exotic, invasive perennials introduced into the western U.S.A. from Eurasia, and are among the most damaging weeds in western riparian habitats. Here we provide an update of Tamarix spp. control by Diorhabda elongata in the Intermountain West, and describe future researc...

  1. Assessing future scenarios for health care waste management using a multi-criteria decision analysis tool: A case study in the Turkish West Black Sea Region.

    PubMed

    Ciplak, Nesli

    2015-08-01

    The aim of this paper is to identify the best possible health care waste management option in the West Black Sea Region by taking into account economic, social, environmental, and technical aspects in the concept of multi-criteria decision analysis. In the scope of this research, three different health care waste management scenarios that consist of different technology alternatives were developed and compared using a decision-making computer software, called Right Choice, by identifying various criteria, measuring them, and ranking their relative importance from the point of key stakeholders. The results of the study show that the decentralized autoclave technology option coupled with the disposal through land-filling with energy recovery has potential to be an optimum option for health care waste management system, and an efficient health care waste segregation scheme should be given more attention by the authorities in the region. Furthermore, the discussion of the results points out multidisciplinary approach and the equilibrium between social, environmental, economic, and technical criteria. The methodology used in this research was developed in order to enable the decision makers to gain an increased perception of a decision problem. In general, the results and remarks of this study can be used as a basis of future planning and anticipation of needs for investment in the area of health care waste management in the region and also in developing countries that are dealing with the similar waste management problems.

  2. Assessing future scenarios for health care waste management using a multi-criteria decision analysis tool: A case study in the Turkish West Black Sea Region.

    PubMed

    Ciplak, Nesli

    2015-08-01

    The aim of this paper is to identify the best possible health care waste management option in the West Black Sea Region by taking into account economic, social, environmental, and technical aspects in the concept of multi-criteria decision analysis. In the scope of this research, three different health care waste management scenarios that consist of different technology alternatives were developed and compared using a decision-making computer software, called Right Choice, by identifying various criteria, measuring them, and ranking their relative importance from the point of key stakeholders. The results of the study show that the decentralized autoclave technology option coupled with the disposal through land-filling with energy recovery has potential to be an optimum option for health care waste management system, and an efficient health care waste segregation scheme should be given more attention by the authorities in the region. Furthermore, the discussion of the results points out multidisciplinary approach and the equilibrium between social, environmental, economic, and technical criteria. The methodology used in this research was developed in order to enable the decision makers to gain an increased perception of a decision problem. In general, the results and remarks of this study can be used as a basis of future planning and anticipation of needs for investment in the area of health care waste management in the region and also in developing countries that are dealing with the similar waste management problems. PMID:26211633

  3. Preserving the Finger Lakes for the Future: A Prototype Decision Support System for Water Resource Management, Open Space, and Agricultural Protection

    NASA Technical Reports Server (NTRS)

    Brower, Robert

    2004-01-01

    This report summarizes the activity conducted under NASA Grant NAG13-02059 entitled "Preserving the Finger Lakes for the Future" A Prototype Decision Support System for Water Resources Management, Open Space and Agricultural Protection, for the period of September 26, 2003 to September 25, 2004. The RACNE continues to utilize the services of its affiliate, the Institute for the Application of Geospatial Technology at Cayuga Community College, Inc. (IAGT), for the purposes of this project under its permanent operating agreement with IAGT. IAGT is a 501(c)(3) not-for-profit Corporation created by the RACNE for the purpose of carrying out its programmatic and administrative mission. The "Preserving the Finger Lakes for the Future" project has progressed and evolved as planned, with the continuation or initiation of a number of program facets at programmatic, technical, and inter-agency levels. The project has grown, starting with the well received core concept of the Virtual Management Operations Center (VMOC), to the functional Watershed Virtual Management Operations Center (W-VMOC) prototype, to the more advanced Finger Lakes Decision Support System (FLDSS) prototype, deployed for evaluation and assessment to a wide variety of agencies and organizations in the Finger Lakes region and beyond. This suite of tools offers the advanced, compelling functionality of interactive 3D visualization interfaced with 2D mapping, all accessed via Internet or virtually any kind of distributed computer network.

  4. Specific transport and storage solutions : waste management facing current and future stakes of the nuclear fuel cycle

    SciTech Connect

    Choho, T.; Blachet, L.; Deniau, H.; Gagner, L.; Gendreau, F.; Presta, A.

    2007-07-01

    With major projects ongoing or being planned, and also with the daily management of radioactive waste from nuclear facilities, the role of transport and/or storage packaging has been often overlooked. Indeed, the packaging development process and transport solutions implemented are a key part of the waste management challenge : protection of people and of the environment. During over four decades, the AREVA Group has developed a complete and coherent system for the transport of waste produced by nuclear industries. The transport solutions integrate the factors to consider, as industrial transportation needs, various waste forms, associated hazards and current regulations. Thus, TN International has designed, licensed and manufactured a large number of different transport, storage and dual purpose cask models for residues and all kinds of radioactive wastes. The present paper proposes to illustrate how a company acting both as a cask designer and a carrier is key to the waste management issue and how it can support the waste management policy of nuclear waste producers through their operational choices. We will focus on the TN International technical solutions implemented to guarantee safe and secure transportation and storage solutions. We will describe different aspects of the cask design process, insisting on how it enables to fulfil both customer needs and regulation requirements. We will also mention the associated services developed by the AREVA Business Unit Logistics (TN International, TRANSNUCLEAR, MAINCO, and LMC) in order to manage transportation of liquid and solid waste towards interim or final storage sites. (authors)

  5. Flood-risk management strategies for an uncertain future: living with Rhine River floods in The Netherlands?

    PubMed

    Klijn, Frans; van Buuren, Michaël; van Rooij, Sabine A M

    2004-05-01

    Social pressure on alluvial plains and deltas is large, both from an economic point of view and from a nature conservation point of view. Gradually, flood risks increase with economic development, because the expected damage increases, and with higher dikes, because the flooding depth increases. Global change, changing social desires, but also changing views, require a revision of flood-risk management strategies for the long term. These should be based on resilience as opposed to the resistence strategy of heightening dikes. Resilience strategies for flood-risk management imply that the river is allowed to temporarily flood large areas, whereas the flood damage is minimized by adapting land use. Such strategies are thus based on risk management and 'living with floods' instead of on hazard control. For The Netherlands, one of the most densely populated deltas in the world, alternative resilience strategies have been elaborated and assessed for their hydraulic functioning and 'sustainability criteria'.

  6. Four Generations of Maintenance Resource Management Programs in the United States: An Analysis of the Past, Present, and Future

    NASA Technical Reports Server (NTRS)

    Taylor, James C.; Patankar, Manoj S.

    2001-01-01

    This paper analyzes four generations of Maintenance Resource Management (MRM) programs implemented by aviation maintenance organizations in the United States. Data collected from over ten years of survey research and field observations are used for this analysis; they are presented in a case-study format. The first three generations of MRM programs were episodic efforts to increase safety through teamwork, focus group discussions, and awareness courses, respectively. Now, the fourth generation programs, characterized by a commitment to long-term communication and behavioral changes in maintenance, are set to build on those earlier generations, toward a culture of mutual trust between mechanics, their managers, and regulators.

  7. Future Water Management in the South Platte River Basin: Impacts of Hydraulic Fracturing, Population, Agriculture, and Climate Change in a Semi-Arid Region.

    NASA Astrophysics Data System (ADS)

    Walker, E. L.; Hogue, T. S.; Anderson, A. M.; Read, L.

    2015-12-01

    In semi-arid basins across the world, the gap between water supply and demand is growing due to climate change, population growth, and shifts in agriculture and unconventional energy development. Water conservation efforts among residential and industrial water users, recycling and reuse techniques and innovative regulatory frameworks for water management strive to mitigate this gap, however, the extent of these strategies are often difficult to quantify and not included in modeling water allocations. Decision support systems (DSS) are purposeful for supporting water managers in making informed decisions when competing demands create the need to optimize water allocation between sectors. One region of particular interest is the semi-arid region of the South Platte River basin in northeastern Colorado, where anthropogenic and climatic effects are expected to increase the gap between water supply and demand in the near future. Specifically, water use in the South Platte is impacted by several high-intensity activities, including unconventional energy development, i.e. hydraulic fracturing, and large withdrawals for agriculture; these demands are in addition to a projected population increase of 100% by 2050. The current work describes the development of a DSS for the South Platte River basin, using the Water Evaluation and Planning system software (WEAP) to explore scenarios of how variation in future water use in the energy, agriculture, and municipal sectors will impact water allocation decisions. Detailed data collected on oil and gas water use in the Niobrara shale play will be utilized to predict future sector use. We also employ downscaled climate projections for the region to quantify the potential range of water availability in the basin under each scenario, and observe whether or not, and to what extent, climate may impact management decisions at the basin level.

  8. Preeclampsia and future cardiovascular disease in women: How good are the data and how can we manage our patients?

    PubMed

    Seely, Ellen W; Tsigas, Eleni; Rich-Edwards, Janet W

    2015-06-01

    Women with a history of preeclampsia have double the risk of future heart disease and stroke, and elevated risks of hypertension and diabetes. The American Heart Association (AHA) and the American College of Obstetrics and Gynecology now include preeclampsia as a risk factor for future cardiovascular disease (CVD) with the recommendation of obtaining a history of preeclampsia and improving lifestyle behaviors for women with such a history. Research has progressed from asking whether preeclampsia is associated with CVD to how preeclampsia is associated with CVD, and the implications for prevention of CVD among women with a history of preeclampsia. A history of preeclampsia "unmasks" future CVD risk; research is inconclusive whether it also causes vascular damage that leads to CVD. For women with prior preeclampsia, the AHA recommends CVD risk reduction actions similar to those for other "at risk" groups: cessation of cigarette smoking, physical activity, weight reduction if overweight or obese and counseling to follow a "DASH" like diet. The efficacy of these lifestyle modifications to lower risk of CVD in women with prior preeclampsia remains to be determined. Barriers exist to implementing lifestyle improvement measures in this population, including lack of awareness of both patients and clinicians of this link between preeclampsia and CVD. We review patient, provider, and systems level barriers and solutions to leverage this information to prevent CVD among women with a history of preeclampsia. PMID:26117165

  9. Preeclampsia and future cardiovascular disease in women: How good are the data and how can we manage our patients?

    PubMed

    Seely, Ellen W; Tsigas, Eleni; Rich-Edwards, Janet W

    2015-06-01

    Women with a history of preeclampsia have double the risk of future heart disease and stroke, and elevated risks of hypertension and diabetes. The American Heart Association (AHA) and the American College of Obstetrics and Gynecology now include preeclampsia as a risk factor for future cardiovascular disease (CVD) with the recommendation of obtaining a history of preeclampsia and improving lifestyle behaviors for women with such a history. Research has progressed from asking whether preeclampsia is associated with CVD to how preeclampsia is associated with CVD, and the implications for prevention of CVD among women with a history of preeclampsia. A history of preeclampsia "unmasks" future CVD risk; research is inconclusive whether it also causes vascular damage that leads to CVD. For women with prior preeclampsia, the AHA recommends CVD risk reduction actions similar to those for other "at risk" groups: cessation of cigarette smoking, physical activity, weight reduction if overweight or obese and counseling to follow a "DASH" like diet. The efficacy of these lifestyle modifications to lower risk of CVD in women with prior preeclampsia remains to be determined. Barriers exist to implementing lifestyle improvement measures in this population, including lack of awareness of both patients and clinicians of this link between preeclampsia and CVD. We review patient, provider, and systems level barriers and solutions to leverage this information to prevent CVD among women with a history of preeclampsia.

  10. Current status and future directions of precision aerial application for site-specific crop management in the USA

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The first variable-rate aerial application system was developed about a decade ago in the USA and since then, aerial application has benefitted from these technologies. Many areas of the United States rely on readily available agricultural airplanes or helicopters for pest management, and variable-...

  11. The importance of intraspecific variation in tree responses to elevated [CO2]: breeding and management of future forests

    Technology Transfer Automated Retrieval System (TEKTRAN)

    One strategy for managing forests to sustain or increase productivity under global climate change is to initiate breeding programs which maximize responses to elevated [CO2] within species. The basis for any breeding program is intraspecific variation in the traits of interest, and for forests, grow...

  12. The relationship of work satisfaction and organizational commitment to retirement intention.

    PubMed

    DeMicco, F J; Olsen, M D

    1988-08-01

    The relationship between attitudes, job satisfaction, and organizational commitment has been shown to influence turnover/retirement. This relationship is important because of changing demographic patterns in the U.S. that are contributing to present and future foodservice labor shortages. The labor shortage has potential for retarding the long-term growth of the foodservice industry. However, recruitment and retention of older workers could be a factor in controlling the problem. Therefore, the major purpose of this research was to obtain information from current older foodservice employees to permit the determination of how various aspects of their jobs affect job satisfaction and organizational commitment and, thus, intention to remain on the job by delaying retirement. Non-management-level hospital and college/university foodservice workers aged 55 years and older (no. = 243) were surveyed. Hospital employees were selected from corporate rosters provided by a major contract foodservice company. College and university employees were selected from the roster of the National Association of College and University Food Services (NACUFS). No statistically meaningful relationship (r greater than or equal to .30) between work satisfaction (measured by the Minnesota Satisfaction Questionnaire) and organizational commitment (measured by the Organizational Commitment Questionnaire), as correlated with retirement intention, was found. Although not considered meaningful, a slight statistical relationship was found (r = .15, p less than .02) between intrinsic satisfaction and the desire to delay retirement (work intention). PMID:3397466

  13. Evidence of recent climate change within the historic range of Rio Grande cutthroat trout: implications for management and future persistence

    USGS Publications Warehouse

    Zeigler, Matthew P.; Todd, Andrew S.; Caldwell, Colleen A.

    2012-01-01

    Evidence of anthropogenically influenced climate change has motivated natural resource managers to incorporate adaptive measures to minimize risks to sensitive and threatened species. Detecting trends in climate variables (i.e., air temperature and hydrology) can serve as a valuable management tool for protecting vulnerable species by increasing our understanding of localized conditions and trends. The Rio Grande cutthroat trout Oncorhynchus clarkii virginalis has suffered a severe decline in its historical distribution, with the majority of current populations persisting in isolated headwater streams. To evaluate recent climate change within the subspecies' historical range, we examined trends in average air temperatures, biologically important hydrological variables (timing of snowmelt and seasonal flows), and the April 1 snow water equivalent over the last 45 years (1963–2007). While rates of change in all three metrics were variable across sites, rangewide patterns were evident. Across the subspecies' historical range, average annual air temperatures increased (0.29°C per decade) and the timing of snowmelt shifted 10.6 d earlier in the year (2.3 d/decade). Flows increased during biologically important periods, including winter (January 1–March 31; 6.6% increase per decade), prespawning (April 1–May 14; 6.9% increase per decade), and spawning (May 15–June 15; 4.2% increase per decade) and decreased in summer (June 16–September 15; 1.9% decrease per decade). Evidence of decreasing April 1 snow water equivalent (5.3% per decade) was also observed. While the impacts of these changes at the population level are equivocal, it is likely that negative effects would influence the subspecies by altering its distribution, decreasing available habitat, and altering the timing of important life history components. Continued monitoring and proactive management will be required to increase the resiliency of remaining populations to ensure long-term persistence and

  14. Pain management in cats--past, present and future. Part 2. Treatment of pain--clinical pharmacology.

    PubMed

    Robertson, S A; Taylor, P M

    2004-10-01

    Opioids have an unjustified reputation for causing mania in cats, but with refinements in dosing they are now used successfully in this species. The mu-opioid agonists are generally considered the best analgesics. Morphine (0.1-0.3 mg/kg) is effective in a clinical setting. Methadone (up to 0.5 mg/kg) has a similar profile to morphine. Pethidine (Demerol, meperidine; 2-5 mg/kg) is a useful analgesic with a faster onset but shorter duration of action than morphine. Oxymorphone and hydromorphone (0.05-0.1 mg/kg) are widely used in the USA. These opioids are more potent (up to 10 times), and longer acting than morphine in cats. Butorphanol (0.1-0.4 mg/kg) is a mu-opioid antagonist that produces its analgesic actions through kappa agonist activity. It rapidly reaches a ceiling effect, is short acting and is a weaker analgesic than pure mu opioids. Buprenorphine (0.01-0.02 mg/kg), a partial mu-agonist, is the most popular opioid used in small animal practice in the UK, other parts of Europe, Australia and South Africa. In clinical studies it has produced better analgesia than several other opioids and appears to be highly suitable for perioperative pain management in cats. NSAIDs are also used in cats for pain management, although cats metabolise these differently from other species. With appropriate dosing, carprofen (1-4 mg/kg) and meloxicam (0.3 mg/kg) have proved highly effective with few side effects. The use of ketoprofen (2 mg/kg), tolfenamic acid (4 mg/kg) and vedaprofen (0.5 mg/kg) has been reported in cats. Other less traditional analgesics such as ketamine, medetomidine and local anaesthetics are also used for clinical pain management. The transmucosal, transdermal and epidural routes offer novel methods for administration of analgesic drugs and have considerable potential for improving techniques in feline pain management. PMID:15363764

  15. Problems, Needs, and Useful Strategies in Older Adults Self-Managing Epilepsy: Implications for Patient Education and Future Intervention Programs

    PubMed Central

    Miller, Wendy R.; Bakas, Tamilyn; Buelow, Janice M.

    2014-01-01

    Objective The purpose of this study was to determine, in a sample of older adults diagnosed with epilepsy, perceived self-management problems and needs encountered since diagnosis, as well as strategies used to address problems and needs. Methods Qualitative description was used. 20 older adults engaged in face-to-face interviews. Interviews were analyzed via content analysis. Results Participants reported problems, needs, and strategies in six categories: Information, Physical and Emotional Symptoms, Memory and Concentration, Medications, Commitments, and Relationships. Conclusion Participants noted some problems and needs previously documented in the literature, though current results have built upon extant literature to reveal etiologies of and contexts surrounding problems and needs; new findings were also revealed. This knowledge can be used by health care providers in counseling and educating older adults with epilepsy, and can inform formal self-management interventions. Practice Implications Determining needs from the patient’s perspective is consistent with today’s focus on patient-centered care. Current findings have led to an organizing framework for problems and needs of older adults with epilepsy. More research is needed to develop the framework so that it can serve as a template for an intervention. In the interim, findings can inform educational practices of those caring for this population. PMID:24317297

  16. Future water quality monitoring--adapting tools to deal with mixtures of pollutants in water resource management.

    PubMed

    Altenburger, Rolf; Ait-Aissa, Selim; Antczak, Philipp; Backhaus, Thomas; Barceló, Damià; Seiler, Thomas-Benjamin; Brion, Francois; Busch, Wibke; Chipman, Kevin; López de Alda, Miren; Umbuzeiro, Gisela de Aragão; Escher, Beate I; Falciani, Francesco; Faust, Michael; Focks, Andreas; Hilscherova, Klara; Hollender, Juliane; Hollert, Henner; Jäger, Felix; Jahnke, Annika; Kortenkamp, Andreas; Krauss, Martin; Lemkine, Gregory F; Munthe, John; Neumann, Steffen; Schymanski, Emma L; Scrimshaw, Mark; Segner, Helmut; Slobodnik, Jaroslav; Smedes, Foppe; Kughathas, Subramaniam; Teodorovic, Ivana; Tindall, Andrew J; Tollefsen, Knut Erik; Walz, Karl-Heinz; Williams, Tim D; Van den Brink, Paul J; van Gils, Jos; Vrana, Branislav; Zhang, Xiaowei; Brack, Werner

    2015-04-15

    mixtures. Thirdly, effect-directed analysis (EDA) will be applied to identify major drivers of mixture toxicity. Refinements of EDA include the use of statistical approaches with monitoring information for guidance of experimental EDA studies. These three approaches will be explored using case studies at the Danube and Rhine river basins as well as rivers of the Iberian Peninsula. The synthesis of findings will be organised to provide guidance for future solution-oriented environmental monitoring and explore more systematic ways to assess mixture exposures and combination effects in future water quality monitoring.

  17. Future water quality monitoring--adapting tools to deal with mixtures of pollutants in water resource management.

    PubMed

    Altenburger, Rolf; Ait-Aissa, Selim; Antczak, Philipp; Backhaus, Thomas; Barceló, Damià; Seiler, Thomas-Benjamin; Brion, Francois; Busch, Wibke; Chipman, Kevin; López de Alda, Miren; Umbuzeiro, Gisela de Aragão; Escher, Beate I; Falciani, Francesco; Faust, Michael; Focks, Andreas; Hilscherova, Klara; Hollender, Juliane; Hollert, Henner; Jäger, Felix; Jahnke, Annika; Kortenkamp, Andreas; Krauss, Martin; Lemkine, Gregory F; Munthe, John; Neumann, Steffen; Schymanski, Emma L; Scrimshaw, Mark; Segner, Helmut; Slobodnik, Jaroslav; Smedes, Foppe; Kughathas, Subramaniam; Teodorovic, Ivana; Tindall, Andrew J; Tollefsen, Knut Erik; Walz, Karl-Heinz; Williams, Tim D; Van den Brink, Paul J; van Gils, Jos; Vrana, Branislav; Zhang, Xiaowei; Brack, Werner

    2015-04-15

    mixtures. Thirdly, effect-directed analysis (EDA) will be applied to identify major drivers of mixture toxicity. Refinements of EDA include the use of statistical approaches with monitoring information for guidance of experimental EDA studies. These three approaches will be explored using case studies at the Danube and Rhine river basins as well as rivers of the Iberian Peninsula. The synthesis of findings will be organised to provide guidance for future solution-oriented environmental monitoring and explore more systematic ways to assess mixture exposures and combination effects in future water quality monitoring. PMID:25644849

  18. Stress in mangrove forests: Early detection and preemptive rehabilitation are essential for future successful worldwide mangrove forest management.

    PubMed

    Lewis, Roy R; Milbrandt, Eric C; Brown, Benjamin; Krauss, Ken W; Rovai, André S; Beever, James W; Flynn, Laura L

    2016-08-30

    Mangrove forest rehabilitation should begin much sooner than at the point of catastrophic loss. We describe the need for "mangrove forest heart attack prevention", and how that might be accomplished in a general sense by embedding plot and remote sensing monitoring within coastal management plans. The major cause of mangrove stress at many sites globally is often linked to reduced tidal flows and exchanges. Blocked water flows can reduce flushing not only from the seaward side, but also result in higher salinity and reduced sediments when flows are blocked landward. Long-term degradation of function leads to acute mortality prompted by acute events, but created by a systematic propensity for long-term neglect of mangroves. Often, mangroves are lost within a few years; however, vulnerability is re-set decades earlier when seemingly innocuous hydrological modifications are made (e.g., road construction, blocked tidal channels), but which remain undetected without reasonable large-scale monitoring. PMID:26971817

  19. Stress in mangrove forests: early detection and preemptive rehabilitation are essential for future successful worldwide mangrove forest management

    USGS Publications Warehouse

    Lewis, Roy R; Milbrandt, Eric C; Brown, Benjamin; Krauss, Ken W.; Rovai, Andre S; Beever, James W.; Flynn, Laura L

    2016-01-01

    Mangrove forest rehabilitation should begin much sooner than at the point of catastrophic loss. We describe the need for “mangrove forest heart attack prevention”, and how that might be accomplished in a general sense by embedding plot and remote sensing monitoring within coastal management plans. The major cause of mangrove stress at many sites globally is often linked to reduced tidal flows and exchanges. Blocked water flows can reduce flushing not only from the seaward side, but also result in higher salinity and reduced sediments when flows are blocked landward. Long-term degradation of function leads to acute mortality prompted by acute events, but created by a systematic propensity for long-term neglect of mangroves. Often, mangroves are lost within a few years; however, vulnerability is re-set decades earlier when seemingly innocuous hydrological modifications are made (e.g., road construction, blocked tidal channels), but which remain undetected without reasonable large-scale monitoring.

  20. Stress in mangrove forests: Early detection and preemptive rehabilitation are essential for future successful worldwide mangrove forest management.

    PubMed

    Lewis, Roy R; Milbrandt, Eric C; Brown, Benjamin; Krauss, Ken W; Rovai, André S; Beever, James W; Flynn, Laura L

    2016-08-30

    Mangrove forest rehabilitation should begin much sooner than at the point of catastrophic loss. We describe the need for "mangrove forest heart attack prevention", and how that might be accomplished in a general sense by embedding plot and remote sensing monitoring within coastal management plans. The major cause of mangrove stress at many sites globally is often linked to reduced tidal flows and exchanges. Blocked water flows can reduce flushing not only from the seaward side, but also result in higher salinity and reduced sediments when flows are blocked landward. Long-term degradation of function leads to acute mortality prompted by acute events, but created by a systematic propensity for long-term neglect of mangroves. Often, mangroves are lost within a few years; however, vulnerability is re-set decades earlier when seemingly innocuous hydrological modifications are made (e.g., road construction, blocked tidal channels), but which remain undetected without reasonable large-scale monitoring.

  1. The assessment and management of pain among older people in care homes: current status and future directions.

    PubMed

    Cowan, David T; Fitzpatrick, Joanne M; Roberts, Julia D; While, Alison E; Baldwin, Julie

    2003-03-01

    Pain is highlighted as a significant, yet neglected problem among older people, particularly in long-term care settings. The effects of inadequate assessment and treatment of pain among older people may lead to multiple problems. Problems arise due to cognitive impairment of clients and inadequate assessment by healthcare professionals. Analgesics are under-used and there is a need for improved education of both healthcare professionals and older people regarding attitudes to pain and ageing. Research is needed into the prevalence of pain among older people in United Kingdom (UK) care homes, how best to further educate healthcare professionals regarding pain management and how to enable older people to be facilitative partners in this process.

  2. Oral cancer: reviewing the present understanding of its molecular mechanism and exploring the future directions for its effective management.

    PubMed

    Nagpal, Jatin K; Das, Bibhu R

    2003-04-01

    The present review aims to analyze the information available regarding the molecular mechanisms of Oral Carcinogenesis and explore the future directions where the field of Cancer Biology is venturing. Oncologists have excellently followed the proverb "Necessity is the mother of Invention". The desire to be more precise and comprehensive in their studies has led to the invention of some of the most innovative techniques like laser capture microdissection, comparative genomic hybridization, microarrays, and protein chips etc. Various Biotech companies and Cancer Institutes are on a hunt for anti-cancer drugs and molecular markers for cancers. These revolutionary approaches and the new breed of Oncologists have made the field very exciting and have generated the hope that finally the war against cancer would be won. In the end it is urged that the lead taken in other cancers like colon, breast, leukemia will be emulated in oral cancer. This is expected to provide a molecular blueprint for HNSCC, thus helping to identify suitable markers for the early detection of pre-neoplastic lesions, as well as novel targets for its pharmacological intervention. PMID:12618193

  3. Old Dog New Tricks: Use of Point-based Crop Models in Grid-based Regional Assessment of Crop Management Technologies Impact on Future Food Security

    NASA Astrophysics Data System (ADS)

    Koo, J.; Wood, S.; Cenacchi, N.; Fisher, M.; Cox, C.

    2012-12-01

    HarvestChoice (harvestchoice.org) generates knowledge products to guide strategic investments to improve the productivity and profitability of smallholder farming systems in sub-Saharan Africa (SSA). A keynote component of the HarvestChoice analytical framework is a grid-based overlay of SSA - a cropping simulation platform powered by process-based, crop models. Calibrated around the best available representation of cropping production systems in SSA, the simulation platform engages the DSSAT Crop Systems Model with the CENTURY Soil Organic Matter model (DSSAT-CENTURY) and provides a virtual experimentation module with which to explore the impact of a range of technological, managerial and environmental metrics on future crop productivity and profitability, as well as input use. For each of 5 (or 30) arc-minute grid cells in SSA, a stack of model input underlies it: datasets that cover soil properties and fertility, historic and future climate scenarios and farmers' management practices; all compiled from analyses of existing global and regional databases and consultations with other CGIAR centers. Running a simulation model is not always straightforward, especially when certain cropping systems or management practices are not even practiced by resource-poor farmers yet (e.g., precision agriculture) or they were never included in the existing simulation framework (e.g., water harvesting). In such cases, we used DSSAT-CENTURY as a function to iteratively estimate relative responses of cropping systems to technology-driven changes in water and nutrient balances compared to zero-adoption by farmers, while adjusting model input parameters to best mimic farmers' implementation of technologies in the field. We then fed the results of the simulation into to the economic and food trade model framework, IMPACT, to assess the potential implications on future food security. The outputs of the overall simulation analyses are packaged as a web-accessible database and published

  4. The genetics of Charcot-Marie-Tooth disease: current trends and future implications for diagnosis and management.

    PubMed

    Hoyle, J Chad; Isfort, Michael C; Roggenbuck, Jennifer; Arnold, W David

    2015-01-01

    Charcot-Marie-Tooth (CMT) disease is the most common hereditary polyneuropathy and is classically associated with an insidious onset of distal predominant motor and sensory loss, muscle wasting, and pes cavus. Other forms of hereditary neuropathy, including sensory predominant or motor predominant forms, are sometimes included in the general classification of CMT, but for the purpose of this review, we will focus primarily on the forms associated with both sensory and motor deficits. CMT has a great deal of genetic heterogeneity, leading to diagnostic considerations that are still rapidly evolving for this disorder. Clinical features, inheritance pattern, gene mutation frequencies, and electrodiagnostic features all are helpful in formulating targeted testing algorithms in practical clinical settings, but these still have shortcomings. Next-generation sequencing (NGS), combined with multigene testing panels, is increasing the sensitivity and efficiency of genetic testing and is quickly overtaking targeted testing strategies. Currently, multigene panel testing and NGS can be considered first-line in many circumstances, although obtaining initial targeted testing for the PMP22 duplication in CMT patients with demyelinating conduction velocities is still a reasonable strategy. As technology improves and cost continues to fall, targeted testing will be completely replaced by multigene NGS panels that can detect the full spectrum of CMT mutations. Nevertheless, clinical acumen is still necessary given the variants of uncertain significance encountered with NGS. Despite the current limitations, the genetic diagnosis of CMT is critical for accurate prognostication, genetic counseling, and in the future, specific targeted therapies. Although whole exome and whole genome sequencing strategies have the power to further elucidate the genetics of CMT, continued technological advances are needed. PMID:26527893

  5. Current management and future directions for the treatment of patients hospitalized for heart failure with low blood pressure.

    PubMed

    Gheorghiade, Mihai; Vaduganathan, Muthiah; Ambrosy, Andrew; Böhm, Michael; Campia, Umberto; Cleland, John G F; Fedele, Francesco; Fonarow, Gregg C; Maggioni, Aldo P; Mebazaa, Alexandre; Mehra, Mandeep; Metra, Marco; Nodari, Savina; Pang, Peter S; Ponikowski, Piotr; Sabbah, Hani N; Komajda, Michel; Butler, Javed

    2013-03-01

    Although patients hospitalized with heart failure have relatively low in-hospital mortality, the post-discharge rehospitalization and mortality rates remain high despite advances in treatment. Most patients admitted for heart failure have normal or high blood pressure, but 15-25 % have low systolic blood pressure with or without signs and/or symptoms of hypoperfusion. All pharmacological agents known to improve the prognosis of patients with heart failure also reduce blood pressure, and this limits their use in patients with heart failure and low blood pressure (HF-LBP). However, patients with HF-LBP have much higher in-hospital and post-discharge mortality. In these patients, a conceptually important therapeutic target is to improve cardiac output in order to alleviate signs of hypoperfusion. Accordingly, the majority of these patients will require an inotrope as cardiac dysfunction is the cause of their low cardiac output. However, the short-term use of currently available inotropes has been associated with further decreases in blood pressure and increases in heart rate, myocardial oxygen consumption and arrhythmias. Agents that improve cardiac contractility without this undesirable effects should be developed. To the best of our knowledge, the epidemiology, pathophysiology and therapy of patients with HF-LBP have not been addressed thoroughly. In June 2010, a workshop that included scientists and clinicians was held in Rome, Italy. The objectives of this meeting were to (1) develop a working definition for HF-LBP, (2) describe its clinical characteristics and pathophysiology, (3) review current therapies and their limitations, (4) discuss novel agents in development and (5) create a framework for the design and conduct of future clinical trials.

  6. The genetics of Charcot–Marie–Tooth disease: current trends and future implications for diagnosis and management

    PubMed Central

    Hoyle, J Chad; Isfort, Michael C; Roggenbuck, Jennifer; Arnold, W David

    2015-01-01

    Charcot–Marie–Tooth (CMT) disease is the most common hereditary polyneuropathy and is classically associated with an insidious onset of distal predominant motor and sensory loss, muscle wasting, and pes cavus. Other forms of hereditary neuropathy, including sensory predominant or motor predominant forms, are sometimes included in the general classification of CMT, but for the purpose of this review, we will focus primarily on the forms associated with both sensory and motor deficits. CMT has a great deal of genetic heterogeneity, leading to diagnostic considerations that are still rapidly evolving for this disorder. Clinical features, inheritance pattern, gene mutation frequencies, and electrodiagnostic features all are helpful in formulating targeted testing algorithms in practical clinical settings, but these still have shortcomings. Next-generation sequencing (NGS), combined with multigene testing panels, is increasing the sensitivity and efficiency of genetic testing and is quickly overtaking targeted testing strategies. Currently, multigene panel testing and NGS can be considered first-line in many circumstances, although obtaining initial targeted testing for the PMP22 duplication in CMT patients with demyelinating conduction velocities is still a reasonable strategy. As technology improves and cost continues to fall, targeted testing will be completely replaced by multigene NGS panels that can detect the full spectrum of CMT mutations. Nevertheless, clinical acumen is still necessary given the variants of uncertain significance encountered with NGS. Despite the current limitations, the genetic diagnosis of CMT is critical for accurate prognostication, genetic counseling, and in the future, specific targeted therapies. Although whole exome and whole genome sequencing strategies have the power to further elucidate the genetics of CMT, continued technological advances are needed. PMID:26527893

  7. Contemporary Role of the Decipher® Test in Prostate Cancer Management: Current Practice and Future Perspectives

    PubMed Central

    Dalela, Deepansh; Löppenberg, Björn; Sood, Akshay; Sammon, Jesse; Abdollah, Firas

    2016-01-01

    We performed a systematic literature search to identify original articles and editorials about the Decipher® Prostate Cancer Test (GenomeDx Biosciences, San Diego, CA) to provide an overview of the current literature and its present role in urologic clinical practice. The Decipher test, which uses the expression of 22 selected RNA markers (from a total of over 1.4 million), showed a very high discrimination in predicting clinical metastasis (0.75–0.83) and cancer-specific mortality (0.78) in external validation studies, outperforming all routinely available clinicopathologic characteristics. Further, the timing of postoperative radiotherapy (adjuvant vs salvage) may be guided based on Decipher scores. The Decipher test was also the only independent predictor of clinical metastasis in patients with biochemical recurrence after surgery. The Decipher Genomic Resource Information Database (GRID) is a novel research tool that captures 1.4 million marker expressions per patient and may facilitate precision-guided, individualized care to patients with prostate cancer. In this era of precision medicine, Decipher, along with the Decipher GRID platform, is a promising genomic tool that may aid in managing prostate cancer patients throughout the continuum of care and delivering appropriate treatment at an individualized level. PMID:27162506

  8. Management of Microbial Communities through Transient Disturbances Enhances the Functional Resilience of Nitrifying Gas-Biofilters to Future Disturbances.

    PubMed

    Cabrol, Léa; Poly, Franck; Malhautier, Luc; Pommier, Thomas; Lerondelle, Catherine; Verstraete, Willy; Lepeuple, Anne-Sophie; Fanlo, Jean-Louis; Le Roux, Xavier

    2016-01-01

    Microbial communities have a key role for the performance of engineered ecosystems such as waste gas biofilters. Maintaining constant performance despite fluctuating environmental conditions is of prime interest, but it is highly challenging because the mechanisms that drive the response of microbial communities to disturbances still have to be disentangled. Here we demonstrate that the bioprocess performance and stability can be improved and reinforced in the face of disturbances, through a rationally predefined strategy of microbial resource management (MRM). This strategy was experimentally validated in replicated pilot-scale nitrifying gas-biofilters, for the two steps of nitrification. The associated biological mechanisms were unraveled through analysis of functions, abundances and community compositions for the major actors of nitrification in these biofilters, that is, ammonia-oxidizing bacteria (AOB) and Nitrobacter-like nitrite-oxidizers (NOB). Our MRM strategy, based on the application of successive, transient perturbations of increasing intensity, enabled to steer the nitrifier community in a favorable way through the selection of more resistant AOB and NOB sharing functional gene sequences close to those of, respectively, Nitrosomonas eutropha and Nitrobacter hamburgensis that are well adapted to high N load. The induced community shifts resulted in significant enhancement of nitrification resilience capacity following the intense perturbation.

  9. Integrated landscape approaches to managing social and environmental issues in the tropics: learning from the past to guide the future.

    PubMed

    Reed, James; Van Vianen, Josh; Deakin, Elizabeth L; Barlow, Jos; Sunderland, Terry

    2016-07-01

    Poverty, food insecurity, climate change and biodiversity loss continue to persist as the primary environmental and social challenges faced by the global community. As such, there is a growing acknowledgement that conventional sectorial approaches to addressing often inter-connected social, environmental, economic and political challenges are proving insufficient. An alternative is to focus on integrated solutions at landscape scales or 'landscape approaches'. The appeal of landscape approaches has resulted in the production of a significant body of literature in recent decades, yet confusion over terminology, application and utility persists. Focusing on the tropics, we systematically reviewed the literature to: (i) disentangle the historical development and theory behind the framework of the landscape approach and how it has progressed into its current iteration, (ii) establish lessons learned from previous land management strategies, (iii) determine the barriers that currently restrict implementation of the landscape approach and (iv) provide recommendations for how the landscape approach can contribute towards the fulfilment of the goals of international policy processes. This review suggests that, despite some barriers to implementation, a landscape approach has considerable potential to meet social and environmental objectives at local scales while aiding national commitments to addressing ongoing global challenges.

  10. Integrated landscape approaches to managing social and environmental issues in the tropics: learning from the past to guide the future.

    PubMed

    Reed, James; Van Vianen, Josh; Deakin, Elizabeth L; Barlow, Jos; Sunderland, Terry

    2016-07-01

    Poverty, food insecurity, climate change and biodiversity loss continue to persist as the primary environmental and social challenges faced by the global community. As such, there is a growing acknowledgement that conventional sectorial approaches to addressing often inter-connected social, environmental, economic and political challenges are proving insufficient. An alternative is to focus on integrated solutions at landscape scales or 'landscape approaches'. The appeal of landscape approaches has resulted in the production of a significant body of literature in recent decades, yet confusion over terminology, application and utility persists. Focusing on the tropics, we systematically reviewed the literature to: (i) disentangle the historical development and theory behind the framework of the landscape approach and how it has progressed into its current iteration, (ii) establish lessons learned from previous land management strategies, (iii) determine the barriers that currently restrict implementation of the landscape approach and (iv) provide recommendations for how the landscape approach can contribute towards the fulfilment of the goals of international policy processes. This review suggests that, despite some barriers to implementation, a landscape approach has considerable potential to meet social and environmental objectives at local scales while aiding national commitments to addressing ongoing global challenges. PMID:26990574

  11. Management of Microbial Communities through Transient Disturbances Enhances the Functional Resilience of Nitrifying Gas-Biofilters to Future Disturbances.

    PubMed

    Cabrol, Léa; Poly, Franck; Malhautier, Luc; Pommier, Thomas; Lerondelle, Catherine; Verstraete, Willy; Lepeuple, Anne-Sophie; Fanlo, Jean-Louis; Le Roux, Xavier

    2016-01-01

    Microbial communities have a key role for the performance of engineered ecosystems such as waste gas biofilters. Maintaining constant performance despite fluctuating environmental conditions is of prime interest, but it is highly challenging because the mechanisms that drive the response of microbial communities to disturbances still have to be disentangled. Here we demonstrate that the bioprocess performance and stability can be improved and reinforced in the face of disturbances, through a rationally predefined strategy of microbial resource management (MRM). This strategy was experimentally validated in replicated pilot-scale nitrifying gas-biofilters, for the two steps of nitrification. The associated biological mechanisms were unraveled through analysis of functions, abundances and community compositions for the major actors of nitrification in these biofilters, that is, ammonia-oxidizing bacteria (AOB) and Nitrobacter-like nitrite-oxidizers (NOB). Our MRM strategy, based on the application of successive, transient perturbations of increasing intensity, enabled to steer the nitrifier community in a favorable way through the selection of more resistant AOB and NOB sharing functional gene sequences close to those of, respectively, Nitrosomonas eutropha and Nitrobacter hamburgensis that are well adapted to high N load. The induced community shifts resulted in significant enhancement of nitrification resilience capacity following the intense perturbation. PMID:26651080

  12. The Future of Career.

    ERIC Educational Resources Information Center

    Collin, Audrey, Ed.; Young, Richard A., Ed.

    This book presents many views of the concept of "career," reviewing its past and considering its future in an international context including viewpoints from sociology, psychology, and human resources management. Following an introduction, "Framing the Future of Career" (Richard Young and Audrey Collin), the book contains the following 17…

  13. Role of tolvaptan in the management of hyponatremia in patients with lung and other cancers: current data and future perspectives.

    PubMed

    Thajudeen, Bijin; Salahudeen, Abdulla K

    2016-01-01

    Hyponatremia is the most frequently observed electrolyte abnormality in clinical practice, and its frequency is almost double in hospitalized cancer patients. As a subset of cancer, hyponatremia is quite common in lung cancer patients, and it is often coupled with the diagnosis of syndrome of inappropriate antidiuretic hormone secretion. The presence of hyponatremia is consequential in that its presence adversely affects cancer patients' prognosis and outcomes. Limited data suggest that correcting hyponatremia in lung cancer patients can increase response to anticancer treatment, may help reduce length of hospital stay and cost, and reduce morbidity and mortality. The type of treatment for hyponatremia depends on several factors; the key factors are the duration and severity of neurological symptoms of hyponatremia and the status of extracellular volume. When hyponatremia is caused by syndrome of inappropriate antidiuretic hormone, hypertonic saline is indicated for acute symptomatic cases, whereas fluid restriction is recommended in chronic asymptomatic hyponatremia. The latter allows a slower rate of correction, thus avoiding the dreaded complication of osmotic demyelination syndrome. Fluid restriction is, however, insufficient or impractical, and often the use of pharmacological therapy such as antidiuretic hormone receptor antagonists becomes necessary. Availability of these antagonists as an effective treatment in the management of hyponatremia has been a major breakthrough, and furthermore, its clinical or investigational use in cancer-related hyponatremia may offer a potential opportunity to gain further insights into the prognostic impact of hyponatremia correction on cancer patients' outcomes. Tolvaptan is a prototype of ADH receptor antagonists that acts at renal tubular levels to increase free water excretion without inducing major systemic electrolyte abnormalities such as hypokalemia or alkalosis. The aim of this paper is to provide a brief review

  14. Role of tolvaptan in the management of hyponatremia in patients with lung and other cancers: current data and future perspectives

    PubMed Central

    Thajudeen, Bijin; Salahudeen, Abdulla K

    2016-01-01

    Hyponatremia is the most frequently observed electrolyte abnormality in clinical practice, and its frequency is almost double in hospitalized cancer patients. As a subset of cancer, hyponatremia is quite common in lung cancer patients, and it is often coupled with the diagnosis of syndrome of inappropriate antidiuretic hormone secretion. The presence of hyponatremia is consequential in that its presence adversely affects cancer patients’ prognosis and outcomes. Limited data suggest that correcting hyponatremia in lung cancer patients can increase response to anticancer treatment, may help reduce length of hospital stay and cost, and reduce morbidity and mortality. The type of treatment for hyponatremia depends on several factors; the key factors are the duration and severity of neurological symptoms of hyponatremia and the status of extracellular volume. When hyponatremia is caused by syndrome of inappropriate antidiuretic hormone, hypertonic saline is indicated for acute symptomatic cases, whereas fluid restriction is recommended in chronic asymptomatic hyponatremia. The latter allows a slower rate of correction, thus avoiding the dreaded complication of osmotic demyelination syndrome. Fluid restriction is, however, insufficient or impractical, and often the use of pharmacological therapy such as antidiuretic hormone receptor antagonists becomes necessary. Availability of these antagonists as an effective treatment in the management of hyponatremia has been a major breakthrough, and furthermore, its clinical or investigational use in cancer-related hyponatremia may offer a potential opportunity to gain further insights into the prognostic impact of hyponatremia correction on cancer patients’ outcomes. Tolvaptan is a prototype of ADH receptor antagonists that acts at renal tubular levels to increase free water excretion without inducing major systemic electrolyte abnormalities such as hypokalemia or alkalosis. The aim of this paper is to provide a brief review

  15. Establishment of a Wolbachia Superinfection in Aedes aegypti Mosquitoes as a Potential Approach for Future Resistance Management

    PubMed Central

    De Bruyne, Jyotika Taneja; Kien, Duong Hue T.; Hoang, Nhat Le Thanh; Chau, Nguyen Van Vinh; Iturbe-Ormaetxe, Iñaki; Simmons, Cameron P.; O’Neill, Scott L.

    2016-01-01

    Wolbachia pipientis is an endosymbiotic bacterium estimated to chronically infect between 40–75% of all arthropod species. Aedes aegypti, the principle mosquito vector of dengue virus (DENV), is not a natural host of Wolbachia. The transinfection of Wolbachia strains such as wAlbB, wMel and wMelPop-CLA into Ae. aegypti has been shown to significantly reduce the vector competence of this mosquito for a range of human pathogens in the laboratory. This has led to wMel-transinfected Ae. aegypti currently being released in five countries to evaluate its effectiveness to control dengue disease in human populations. Here we describe the generation of a superinfected Ae. aegypti mosquito line simultaneously infected with two avirulent Wolbachia strains, wMel and wAlbB. The line carries a high overall Wolbachia density and tissue localisation of the individual strains is very similar to each respective single infected parental line. The superinfected line induces unidirectional cytoplasmic incompatibility (CI) when crossed to each single infected parental line, suggesting that the superinfection would have the capacity to replace either of the single constituent infections already present in a mosquito population. No significant differences in fitness parameters were observed between the superinfected line and the parental lines under the experimental conditions tested. Finally, the superinfected line blocks DENV replication more efficiently than the single wMel strain when challenged with blood meals from viremic dengue patients. These results suggest that the deployment of superinfections could be used to replace single infections and may represent an effective strategy to help manage potential resistance by DENV to field deployments of single infected strains. PMID:26891349

  16. Data Management and the National Climate Assessment: Best Practices, Lessons Learned, and Future Applications: A Data Quality Solution

    NASA Astrophysics Data System (ADS)

    Kunkel, K.; Champion, S.

    2015-12-01

    Data Management and the National Climate Assessment: A Data Quality Solution Sarah M. Champion and Kenneth E. Kunkel Cooperative Institute for Climate and Satellites, Asheville, NC The Third National Climate Assessment (NCA), anticipated for its authoritative climate change analysis, was also a vanguard in climate communication. From the cutting-edge website to the organization of information, the Assessment content appealed to, and could be accessed by, many demographics. One such pivotal presentation of information in the NCA was the availability of complex metadata directly connected to graphical products. While the basic metadata requirement is federally mandated through a series of federal guidelines as a part of the Information Quality Act, the NCA is also deemed a Highly Influential Scientific Assessment, which requires demonstration of the transparency and reproducibility of the content. To meet these requirements, the Technical Support Unit (TSU) for the NCA embarked on building a system for collecting and presenting metadata that not only met these requirements, but one that has since been employed in support of additional Assessments. The metadata effort for this NCA proved invaluable for many reasons, one of which being that it showcased that there is a critical need for a culture change within the scientific community to support collection and transparency of data and methods to the level produced with the NCA. Irregardless of being federally mandated, it proves to simply be a good practice in science communication. This presentation will detail the collection system built by the TSU, the improvements employed with additional Assessment products, as well as illustrate examples of successful transparency. Through this presentation, we hope to impel the discussion in support of detailed metadata becoming the cultural norm within the scientific community to support influential and highly policy-relevant documents such as the NCA.

  17. Range Analysis and Terrain Preference of Adult Southern White Rhinoceros (Ceratotherium simum) in a South African Private Game Reserve: Insights into Carrying Capacity and Future Management.

    PubMed

    Thompson, S; Avent, T; Doughty, L S

    2016-01-01

    The Southern white rhinoceros (Ceratotherium simum) is a threatened species, central to the tourism appeal of private game reserves in South Africa. Privately owned reserves in South Africa tend to be smaller than government run reserves such as Kruger National Park. Because of their relatively small size and the often heterogeneous nature of the landscape private game reserve managers benefit from detailed knowledge of white rhinoceros terrain selection preferences, which can be assessed from their ranging behaviours. We collected adult and sub-adult white rhinoceros distribution data over a 15 month period, calculating individual range size using kernel density estimation analysis within a GIS. From this, terrain selectivity was calculated using 50% and 95% kernels to extract terrain composition values. Jacob's correction of the Ivlev's selectivity index was subsequently applied to the terrain composition of each individual to identify trends in selectivity. Results reveal that adult males hold exclusive territories considerably smaller than those found in previous work conducted in "open" or large reserves. Similarly, results for the size of male versus female territories were also not in keeping with those from previous field studies, with males, rather than females, having the larger territory requirement. Terrain selection for both genders and age classes (adult and sub-adult) showed a strong preference for open grassland and avoidance of hill slope and riparian terrains. This research reveals white rhinoceros terrain selection preferences and how they influence range requirements in small, closed reserves. We conclude that this knowledge will be valuable in future white rhinoceros conservation management in small private game reserves, particularly in decisions surrounding removal of surplus individuals or augmentation of existing populations, calculation of reserve carrying capacity and future private reserve acquisition. PMID:27622566

  18. Range Analysis and Terrain Preference of Adult Southern White Rhinoceros (Ceratotherium simum) in a South African Private Game Reserve: Insights into Carrying Capacity and Future Management

    PubMed Central

    Thompson, S.; Doughty, L. S.

    2016-01-01

    The Southern white rhinoceros (Ceratotherium simum) is a threatened species, central to the tourism appeal of private game reserves in South Africa. Privately owned reserves in South Africa tend to be smaller than government run reserves such as Kruger National Park. Because of their relatively small size and the often heterogeneous nature of the landscape private game reserve managers benefit from detailed knowledge of white rhinoceros terrain selection preferences, which can be assessed from their ranging behaviours. We collected adult and sub-adult white rhinoceros distribution data over a 15 month period, calculating individual range size using kernel density estimation analysis within a GIS. From this, terrain selectivity was calculated using 50% and 95% kernels to extract terrain composition values. Jacob’s correction of the Ivlev’s selectivity index was subsequently applied to the terrain composition of each individual to identify trends in selectivity. Results reveal that adult males hold exclusive territories considerably smaller than those found in previous work conducted in “open” or large reserves. Similarly, results for the size of male versus female territories were also not in keeping with those from previous field studies, with males, rather than females, having the larger territory requirement. Terrain selection for both genders and age classes (adult and sub-adult) showed a strong preference for open grassland and avoidance of hill slope and riparian terrains. This research reveals white rhinoceros terrain selection preferences and how they influence range requirements in small, closed reserves. We conclude that this knowledge will be valuable in future white rhinoceros conservation management in small private game reserves, particularly in decisions surrounding removal of surplus individuals or augmentation of existing populations, calculation of reserve carrying capacity and future private reserve acquisition. PMID:27622566

  19. Range Analysis and Terrain Preference of Adult Southern White Rhinoceros (Ceratotherium simum) in a South African Private Game Reserve: Insights into Carrying Capacity and Future Management.

    PubMed

    Thompson, S; Avent, T; Doughty, L S

    2016-01-01

    The Southern white rhinoceros (Ceratotherium simum) is a threatened species, central to the tourism appeal of private game reserves in South Africa. Privately owned reserves in South Africa tend to be smaller than government run reserves such as Kruger National Park. Because of their relatively small size and the often heterogeneous nature of the landscape private game reserve managers benefit from detailed knowledge of white rhinoceros terrain selection preferences, which can be assessed from their ranging behaviours. We collected adult and sub-adult white rhinoceros distribution data over a 15 month period, calculating individual range size using kernel density estimation analysis within a GIS. From this, terrain selectivity was calculated using 50% and 95% kernels to extract terrain composition values. Jacob's correction of the Ivlev's selectivity index was subsequently applied to the terrain composition of each individual to identify trends in selectivity. Results reveal that adult males hold exclusive territories considerably smaller than those found in previous work conducted in "open" or large reserves. Similarly, results for the size of male versus female territories were also not in keeping with those from previous field studies, with males, rather than females, having the larger territory requirement. Terrain selection for both genders and age classes (adult and sub-adult) showed a strong preference for open grassland and avoidance of hill slope and riparian terrains. This research reveals white rhinoceros terrain selection preferences and how they influence range requirements in small, closed reserves. We conclude that this knowledge will be valuable in future white rhinoceros conservation management in small private game reserves, particularly in decisions surrounding removal of surplus individuals or augmentation of existing populations, calculation of reserve carrying capacity and future private reserve acquisition.

  20. SMART DOCS: A New Patient-Centered Outcomes and Coordinated-Care Management Approach for the Future Practice of Sleep Medicine

    PubMed Central

    Kushida, Clete A.; Nichols, Deborah A.; Holmes, Tyson H.; Miller, Ric; Griffin, Kara; Cardell, Chia-Yu; Hyde, Pamela R.; Cohen, Elyse; Manber, Rachel; Walsh, James K.

    2015-01-01

    The practice of medicine is currently undergoing a transformation to become more efficient, cost-effective, and patient centered in its delivery of care. The aim of this article is to stimulate discussion within the sleep medicine community in addressing these needs by our approach as well as other approaches to sleep medicine care. The primary goals of the Sustainable Methods, Algorithms, and Research Tools for Delivering Optimal Care Study (SMART DOCS) are: (1) to introduce a new Patient-Centered Outcomes and Coordinated-Care Management (PCCM) approach for the future practice of sleep medicine, and (2) to test the PCCM approach against a Conventional Diagnostic and Treatment Outpatient Medical Care (CONV) approach in a randomized, two-arm, single-center, long-term, comparative effectiveness trial. The PCCM approach is integrated into a novel outpatient care delivery model for patients with sleep disorders that includes the latest technology, allowing providers to obtain more accurate and rapid diagnoses and to make evidence-based treatment recommendations, while simultaneously enabling patients to have access to personalized medical information and reports regarding their diagnosis and treatment so that they can make more informed health care decisions. Additionally, the PCCM approach facilitates better communication between patients, referring primary care physicians, sleep specialists, and allied health professionals so that providers can better assist patients in achieving their preferred outcomes. A total of 1,506 patients 18 y or older will be randomized to either the PCCM or CONV approach and will be followed for at least 1 y with endpoints of improved health care performance, better health, and cost control. Clinical Trials Registration: ClinicalTrials.gov Identifier: NCT02037438. Citation: Kushida CA, Nichols DA, Holmes TH, Miller R, Griffin K, Cardell CY, Hyde PR, Cohen E, Manber R, Walsh JK. SMART DOCS: a new patient-centered outcomes and coordinated

  1. A Brief Review of the Need for Robust Smart Wireless Sensor Systems for Future Propulsion Systems, Distributed Engine Controls, and Propulsion Health Management

    NASA Technical Reports Server (NTRS)

    Hunter, Gary W.; Behbahani, Alireza

    2012-01-01

    Smart Sensor Systems with wireless capability operational in high temperature, harsh environments are a significant component in enabling future propulsion systems to meet a range of increasingly demanding requirements. These propulsion systems must incorporate technology that will monitor engine component conditions, analyze the incoming data, and modify operating parameters to optimize propulsion system operations. This paper discusses the motivation towards the development of high temperature, smart wireless sensor systems that include sensors, electronics, wireless communication, and power. The challenges associated with the use of traditional wired sensor systems will be reviewed and potential advantages of Smart Sensor Systems will be discussed. A brief review of potential applications for wireless smart sensor networks and their potential impact on propulsion system operation, with emphasis on Distributed Engine Control and Propulsion Health Management, will be given. A specific example related to the development of high temperature Smart Sensor Systems based on silicon carbide electronics will be discussed. It is concluded that the development of a range of robust smart wireless sensor systems are a foundation for future development of intelligent propulsion systems with enhanced capabilities.

  2. Challenges in the Diagnosis and Management of Well-Differentiated Neuroendocrine Tumors of the Lung (Typical and Atypical Carcinoid): Current Status and Future Considerations

    PubMed Central

    2015-01-01

    Neuroendocrine tumors (NET) of the lung represent approximately 25% of all primary lung tumors and can be classified as low grade (typical carcinoids), intermediate grade (atypical carcinoids), or high grade (large cell neuroendocrine carcinoma or small cell lung carcinoma). Low- and intermediate-grade lung NET are increasingly recognized as biologically distinct from high-grade lung NET based on clinical behavior and underlying molecular abnormalities. This review summarizes current knowledge and challenges in the diagnosis and management of low- and intermediate-grade lung NET. Accurate histopathologic classification of lung NET is critical to determining appropriate treatment options but can be challenging even for experts. For low- and intermediate-grade lung NET, surgery remains the mainstay of treatment for localized disease. Although no standard systemic therapy has been established for the treatment of advanced, unresectable disease, a number of promising treatment options are emerging, including somatostatin analogs, temozolomide-based chemotherapy, targeted therapy with mammalian target of rapamycin or vascular endothelial growth factor inhibitors, and peptide receptor radionuclide therapy. Given the difficulty in accurately diagnosing these tumors, and the paucity of data supporting establishment of standard systemic therapy options, management of patients within the setting of a multidisciplinary team, including specialists with expertise in NET, is recommended. Ongoing and future clinical trials hopefully will provide stronger evidence to support treatment recommendations for low- and intermediate-grade lung NET. Implications for Practice: Treatment of neuroendocrine tumors (NET), particularly those of lung origin, continues to evolve. This review seeks to educate oncologists on the most up-to-date options and supporting data regarding management of two rare lung neoplasms, typical and atypical carcinoid tumors. Although surgical resection has been the

  3. Assessing Potential Future Carbon Dynamics with Climate Change and Fire Management in a Mountainous Landscape on the Olympic Peninsula, Washington, USA

    NASA Astrophysics Data System (ADS)

    Kennedy, R. S.

    2010-12-01

    Forests of the mountainous landscapes of the maritime Pacific Northwestern USA may have high carbon sequestration potential via their high productivity and moderate to infrequent fire regimes. With climate change, there may be shifts in incidence and severity of fire, especially in the drier areas of the region, via changes to forest productivity and hydrology, and consequent effects to C sequestration and forest structure. To explore this issue, I assessed potential effects of fire management (little fire suppression/wildland fire management/highly effective fire suppression) under two climate change scenarios on future C sequestration dynamics (amounts and spatial pattern) in Olympic National Park, WA, over a 500-year simulation period. I used the simulation platform FireBGCv2, which contains a mechanistic, individual tree succession model, a spatially explicit climate-based biophysical model that uses daily weather data, and a spatially explicit fire model incorporating ignition, spread, and effects on ecosystem components. C sequestration patterns varied over time and spatial and temporal patterns differed somewhat depending on the climate change scenario applied and the fire management methods employed. Under the more extreme climate change scenario with little fire suppression, fires were most frequent and severe and C sequestration decreased. General trends were similar under the more moderate climate change scenario, as compared to current climate, but spatial patterns differed. Both climate change scenarios under highly effective fire suppression showed about 50% of starting total C after the initial transition phase, whereas with 10% fire suppression both scenarios exhibited about 10% of starting amounts. Areas of the landscape that served as refugia for older forest under increasing frequency of high severity fire were also hotspots for C sequestration in a landscape experiencing increasing frequency of disturbance with climate change.

  4. Futures Conditional.

    ERIC Educational Resources Information Center

    Theobald, Robert

    The readings presented here are designed to help the reader perceive the future more vividly. Part one of the book suggests the various ways in which the future can be seen; it includes science fiction and the views of various analysts as to what the future holds. Part two collects printed materials about the future from various sources, including…

  5. Current treatment and future prospects for the management of acute coronary syndromes: consensus recommendations of the 1997 ushuaia conference, tierra del fuego, Argentina.

    PubMed

    Gurfinkel, E

    1998-01-01

    Management of acute coronary syndromes, particularly unstable angina, acute myocardial infarction and non-Q-wave myocardial infarction, is one of the most common and costly problems facing modern medicine. Furthermore, the increasing availability of new research and clinical information relevant to the treatment of these conditions means that continuing reappraisal of management strategies is necessary. Accordingly, the Ushuaia conference, Tierra Del Fuego, Argentina, was convened to discuss current approaches and future treatment prospects for patients with these conditions. The conference was comprised of leading Argentinian cardiologists whose primary aim was to formulate consensus recommendations regarding the management of patients with acute coronary syndromes. The first of the major recommendations for the pharmacological management of acute coronary syndromes arising from the Ushuaia Consensus Conference was that aspirin (200 to 500mg initially, then 100 to 325 mg/day) should be administered to all patients except those for whom aspirin is absolutely (or relatively, depending on the clinician's discretion) contraindicated. In such cases, ticlopidine is a suitable alternative. Intravenous nitrates are indicated for patients with angina pain (24 to 48 hours' duration), ECG changes, recurrence of angina, or signs of heart failure; in other cases, oral, transdermal or sublingual nitrates may be administered. Use of beta-blockers is recommended except when absolutely contraindicated or when there is a strong suspicion of vasospasm as a dominant mechanism in angina. Intravenous administration of these agents is preferred in patients with tachycardia, arterial hypertension or angina. Calcium antagonists are generally not recommended as first choice therapy, but can be indicated (preferably using agents that decrease heart rate) when beta-blockers are contraindicated or when there is a strong suspicion of vasospasm as a dominant mechanism in angina. Calcium

  6. Environmental impact assessment and monetary ecosystem service valuation of an ecosystem under different future environmental change and management scenarios; a case study of a Scots pine forest.

    PubMed

    Schaubroeck, Thomas; Deckmyn, Gaby; Giot, Olivier; Campioli, Matteo; Vanpoucke, Charlotte; Verheyen, Kris; Rugani, Benedetto; Achten, Wouter; Verbeeck, Hans; Dewulf, Jo; Muys, Bart

    2016-05-15

    For a sustainable future, we must sustainably manage not only the human/industrial system but also ecosystems. To achieve the latter goal, we need to predict the responses of ecosystems and their provided services to management practices under changing environmental conditions via ecosystem models and use tools to compare the estimated provided services between the different scenarios. However, scientific articles have covered a limited amount of estimated ecosystem services and have used tools to aggregate services that contain a significant amount of subjective aspects and that represent the final result in a non-tangible unit such as 'points'. To resolve these matters, this study quantifies the environmental impact (on human health, natural systems and natural resources) in physical units and uses an ecosystem service valuation based on monetary values (including ecosystem disservices with associated negative monetary values). More specifically, the paper also focuses on the assessment of ecosystem services related to pollutant removal/generation flows, accounting for the inflow of eutrophying nitrogen (N) when assessing the effect of N leached to groundwater. Regarding water use/provisioning, evapotranspiration is alternatively considered a disservice because it implies a loss of (potential) groundwater. These approaches and improvements, relevant to all ecosystems, are demonstrated using a Scots pine stand from 2010 to 2089 for a combination of three environmental change and three management scenarios. The environmental change scenarios considered interannual climate variability trends and included alterations in temperature, precipitation, nitrogen deposition, wind speed, Particulate matter (PM) concentration and CO2 concentration. The addressed flows/ecosystem services, including disservices, are as follows: particulate matter removal, freshwater loss, CO2 sequestration, wood production, NOx emissions, NH3 uptake and nitrogen pollution/removal. The monetary

  7. Environmental impact assessment and monetary ecosystem service valuation of an ecosystem under different future environmental change and management scenarios; a case study of a Scots pine forest.

    PubMed

    Schaubroeck, Thomas; Deckmyn, Gaby; Giot, Olivier; Campioli, Matteo; Vanpoucke, Charlotte; Verheyen, Kris; Rugani, Benedetto; Achten, Wouter; Verbeeck, Hans; Dewulf, Jo; Muys, Bart

    2016-05-15

    For a sustainable future, we must sustainably manage not only the human/industrial system but also ecosystems. To achieve the latter goal, we need to predict the responses of ecosystems and their provided services to management practices under changing environmental conditions via ecosystem models and use tools to compare the estimated provided services between the different scenarios. However, scientific articles have covered a limited amount of estimated ecosystem services and have used tools to aggregate services that contain a significant amount of subjective aspects and that represent the final result in a non-tangible unit such as 'points'. To resolve these matters, this study quantifies the environmental impact (on human health, natural systems and natural resources) in physical units and uses an ecosystem service valuation based on monetary values (including ecosystem disservices with associated negative monetary values). More specifically, the paper also focuses on the assessment of ecosystem services related to pollutant removal/generation flows, accounting for the inflow of eutrophying nitrogen (N) when assessing the effect of N leached to groundwater. Regarding water use/provisioning, evapotranspiration is alternatively considered a disservice because it implies a loss of (potential) groundwater. These approaches and improvements, relevant to all ecosystems, are demonstrated using a Scots pine stand from 2010 to 2089 for a combination of three environmental change and three management scenarios. The environmental change scenarios considered interannual climate variability trends and included alterations in temperature, precipitation, nitrogen deposition, wind speed, Particulate matter (PM) concentration and CO2 concentration. The addressed flows/ecosystem services, including disservices, are as follows: particulate matter removal, freshwater loss, CO2 sequestration, wood production, NOx emissions, NH3 uptake and nitrogen pollution/removal. The monetary

  8. Modeling the impact of development and management options on future water resource use in the Nyangores sub-catchment of the Mara Basin in Kenya

    NASA Astrophysics Data System (ADS)

    Omonge, Paul; Herrnegger, Mathew; Fürst, Josef; Olang, Luke

    2016-04-01

    Despite the increasing water insecurity consequent of competing uses, the Nyangores sub-catchment of Kenya is yet to develop an inclusive water use and allocation plan for its water resource systems. As a step towards achieving this, this contribution employed the Water Evaluation and Planning (WEAP) system to evaluate selected policy based water development and management options for future planning purposes. Major water resources of the region were mapped and quantified to establish the current demand versus supply status. To define a reference scenario for subsequent model projections, additional data on urban and rural water consumption, water demand for crop types, daily water use for existing factories and industries were also collated through a rigorous fieldwork procedure. The model was calibrated using the parameter estimation tool (PEST) and validated against observed streamflow data, and subsequently used to simulate feasible management options. Due to lack of up-to-date data for the current year, the year 2000 was selected as the base year for the scenario simulations up to the year 2030, which has been set by the country for realizing most flagship development projects. From the results obtained, the current annual water demand within the sub-catchment is estimated to be around 27.2 million m3 of which 24% is being met through improved and protected water sources including springs, wells and boreholes, while 76% is met through informal and unprotected sources which are insufficient to cater for future increases in demand. Under the reference scenario, the WEAP model predicted an annual total inadequate supply of 8.1 million m3 mostly in the dry season by the year 2030. The current annual unmet water demand is 1.3 million m3 and is noteworthy in the dry seasons of December through February at the irrigation demand site. The monthly unmet domestic demand under High Population Growth (HPG) was projected to be 1.06 million m3 by the year 2030. However

  9. Future accelerators (?)

    SciTech Connect

    John Womersley

    2003-08-21

    I describe the future accelerator facilities that are currently foreseen for electroweak scale physics, neutrino physics, and nuclear structure. I will explore the physics justification for these machines, and suggest how the case for future accelerators can be made.

  10. Land use efficiency: anticipating future demand for land-sector greenhouse gas emissions abatement and managing trade-offs with agriculture, water, and biodiversity.

    PubMed

    Bryan, Brett A; Crossman, Neville D; Nolan, Martin; Li, Jing; Navarro, Javier; Connor, Jeffery D

    2015-11-01

    Competition for land is increasing, and policy needs to ensure the efficient supply of multiple ecosystem services from land systems. We modelled the spatially explicit potential future supply of ecosystem services in Australia's intensive agricultural land in response to carbon markets under four global outlooks from 2013 to 2050. We assessed the productive efficiency of greenhouse gas emissions abatement, agricultural production, water resources, and biodiversity services and compared these to production possibility frontiers (PPFs). While interacting commodity markets and carbon markets produced efficient outcomes for agricultural production and emissions abatement, more efficient outcomes were possible for water resources and biodiversity services due to weak price signals. However, when only two objectives were considered as per typical efficiency assessments, efficiency improvements involved significant unintended trade-offs for the other objectives and incurred substantial opportunity costs. Considering multiple objectives simultaneously enabled the identification of land use arrangements that were efficient over multiple ecosystem services. Efficient land use arrangements could be selected that meet society's preferences for ecosystem service provision from land by adjusting the metric used to combine multiple services. To effectively manage competition for land via land use efficiency, market incentives are needed that effectively price multiple ecosystem services. PMID:26147156

  11. Land use efficiency: anticipating future demand for land-sector greenhouse gas emissions abatement and managing trade-offs with agriculture, water, and biodiversity.

    PubMed

    Bryan, Brett A; Crossman, Neville D; Nolan, Martin; Li, Jing; Navarro, Javier; Connor, Jeffery D

    2015-11-01

    Competition for land is increasing, and policy needs to ensure the efficient supply of multiple ecosystem services from land systems. We modelled the spatially explicit potential future supply of ecosystem services in Australia's intensive agricultural land in response to carbon markets under four global outlooks from 2013 to 2050. We assessed the productive efficiency of greenhouse gas emissions abatement, agricultural production, water resources, and biodiversity services and compared these to production possibility frontiers (PPFs). While interacting commodity markets and carbon markets produced efficient outcomes for agricultural production and emissions abatement, more efficient outcomes were possible for water resources and biodiversity services due to weak price signals. However, when only two objectives were considered as per typical efficiency assessments, efficiency improvements involved significant unintended trade-offs for the other objectives and incurred substantial opportunity costs. Considering multiple objectives simultaneously enabled the identification of land use arrangements that were efficient over multiple ecosystem services. Efficient land use arrangements could be selected that meet society's preferences for ecosystem service provision from land by adjusting the metric used to combine multiple services. To effectively manage competition for land via land use efficiency, market incentives are needed that effectively price multiple ecosystem services.

  12. Future of groundwater modeling

    USGS Publications Warehouse

    Langevin, Christian D.; Panday, Sorab

    2012-01-01

    With an increasing need to better manage water resources, the future of groundwater modeling is bright and exciting. However, while the past can be described and the present is known, the future of groundwater modeling, just like a groundwater model result, is highly uncertain and any prediction is probably not going to be entirely representative. Thus we acknowledge this as we present our vision of where groundwater modeling may be headed.

  13. Future land use plan

    SciTech Connect

    1995-08-31

    The US Department of Energy`s (DOE) changing mission, coupled with the need to apply appropriate cleanup standards for current and future environmental restoration, prompted the need for a process to determine preferred Future Land Uses for DOE-owned sites. DOE began the ``Future Land Use`` initiative in 1994 to ensure that its cleanup efforts reflect the surrounding communities` interests in future land use. This plan presents the results of a study of stakeholder-preferred future land uses for the Brookhaven National Laboratory (BNL), located in central Long Island, New York. The plan gives the Laboratory`s view of its future development over the next 20 years, as well as land uses preferred by the community were BNL ever to cease operations as a national laboratory (the post-BNL scenario). The plan provides an overview of the physical features of the site including its history, topography, geology/hydrogeology, biological inventory, floodplains, wetlands, climate, and atmosphere. Utility systems and current environmental operations are described including waste management, waste water treatment, hazardous waste management, refuse disposal and ground water management. To complement the physical descriptions of the site, demographics are discussed, including overviews of the surrounding areas, laboratory population, and economic and non-economic impacts.

  14. Illinois Occupational Skill Standards: Foodservice Cluster.

    ERIC Educational Resources Information Center

    Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

    This document of skill standards for the food service cluster serves as a guide to workforce preparation program providers in defining content for their programs and to employers to establish the skills and standards necessary for job acquisition. These 41 occupational skill standards describe what people should know and be able to do in an…

  15. Sheep farmer opinions on the current and future role of veterinarians in flock health management on sheep farms: a qualitative study.

    PubMed

    Kaler, Jasmeet; Green, L E

    2013-11-01

    A 2009 UK Government report on veterinary expertise in food animal production highlighted that there was insufficient herd health expertise among veterinarians and lack of appropriate business models to deliver veterinary services to the livestock sector. Approximately two thirds of sheep farmers only contact their veterinarian for emergencies and one fifth have all year round contact. The aim of the current study was to understand sheep farmers' perception, the current and future role of veterinarians in flock health management using qualitative methodology. The eligibility criteria were male farmers with a flock size of at least 200 adult sheep. Seven focus groups of farmers (n=45) stratified by three regions and two age groups (≤50 and >50) were conducted. Thematic analysis of the discussions indicated that most farmers considered and used their veterinarian as a fire-fighter, whilst other advice was gathered free of charge when the veterinarian was on the farm for other reasons (typically seeing cattle) or by telephone. A small group of farmers were using their veterinarian or a sheep consultant proactively with regular contact and found this financially beneficial. Farmers indicated that the key barriers to using a veterinarian proactively were inconsistent service, high turnover of veterinarians, lack of expertise of sheep farming among veterinarians and concern about independence of advice. Although economics was also mentioned as a key barrier to using veterinarians more proactively, most farmers did not know where they gained and lost income from their flock; there was heavy reliance on the single farm payment scheme (SPS) and very few farmers kept records from which they could investigate where there were inefficiencies in production. Overall sheep farmers considered sheep farming complex and that each farm was unique and that they themselves were the experts to manage their flock. We conclude that there is an impasse: veterinarians might need to

  16. Sheep farmer opinions on the current and future role of veterinarians in flock health management on sheep farms: A qualitative study

    PubMed Central

    Kaler, Jasmeet; Green, L.E.

    2013-01-01

    A 2009 UK Government report on veterinary expertise in food animal production highlighted that there was insufficient herd health expertise among veterinarians and lack of appropriate business models to deliver veterinary services to the livestock sector. Approximately two thirds of sheep farmers only contact their veterinarian for emergencies and one fifth have all year round contact. The aim of the current study was to understand sheep farmers’ perception, the current and future role of veterinarians in flock health management using qualitative methodology. The eligibility criteria were male farmers with a flock size of at least 200 adult sheep. Seven focus groups of farmers (n = 45) stratified by three regions and two age groups (≤50 and >50) were conducted. Thematic analysis of the discussions indicated that most farmers considered and used their veterinarian as a fire-fighter, whilst other advice was gathered free of charge when the veterinarian was on the farm for other reasons (typically seeing cattle) or by telephone. A small group of farmers were using their veterinarian or a sheep consultant proactively with regular contact and found this financially beneficial. Farmers indicated that the key barriers to using a veterinarian proactively were inconsistent service, high turnover of veterinarians, lack of expertise of sheep farming among veterinarians and concern about independence of advice. Although economics was also mentioned as a key barrier to using veterinarians more proactively, most farmers did not know where they gained and lost income from their flock; there was heavy reliance on the single farm payment scheme (SPS) and very few farmers kept records from which they could investigate where there were inefficiencies in production. Overall sheep farmers considered sheep farming complex and that each farm was unique and that they themselves were the experts to manage their flock. We conclude that there is an impasse: veterinarians might need to

  17. Future integrated design process

    NASA Technical Reports Server (NTRS)

    Meyer, D. D.

    1980-01-01

    The design process is one of the sources used to produce requirements for a computer system to integrate and manage product design data, program management information, and technical computation and engineering data management activities of the aerospace design process. Design activities were grouped chronologically and explored for activity type, activity interface, data quantity, and data flow. The work was based on analysis of the design process of several typical aerospace products, including both conventional and supersonic airplanes and a hydrofoil design. Activities examined included research, preliminary design, detail design, manufacturing interface, product verification, and product support. The design process was then described in an IPAD environment--the future.

  18. Is management essential to improving the performance and sustainability of health care systems and organizations? A systematic review and a roadmap for future studies.

    PubMed

    Lega, Federico; Prenestini, Anna; Spurgeon, Peter

    2013-01-01

    Recent studies have highlighted the importance of management in the health care sector. Positive correlations have been found between clinical and economic performance. Although there is still controversy regarding what kind of management and which managers should lead health care organizations and health systems, we now have interesting evidence to analyze. Starting with a systematic review of the literature, this article presents and discusses the streams of knowledge regarding how management can influence the quality and sustainability of health systems and organizations. Through the analysis of 37 studies, we found that the performance of health care systems and organizations seems to be correlated with management practices, leadership, manager characteristics, and cultural attributes that are associated with managerial values and approaches. There is also evidence that health care organizations run by doctors perform better than others. Finally, we provide a roadmap that indicates how the relationship between the management and performance of health systems and organizations can be further and more effectively investigated.

  19. Managers' perceptions of customers' satisfactions with their hospital cafeteria services.

    PubMed

    Johnston, C M; Upton, E M

    1991-01-01

    It is important that hospital cafeterias deliver products that create customer satisfaction so that financial objectives are met. An exploratory descriptive survey of 12 selected hospital cafeterias used a self-administered questionnaire to determine how satisfied customers were with services provided. It also asked cafeteria managers to give their perceptions of their customers' relative satisfaction/dissatisfaction with the service. Principal components analysis, followed by varimax rotation, identified four underlying constructs of the 15 pre-selected foodservice characteristics used to measure relative satisfaction. A multiple regression model, controlling for country, hospital size and customer demographics, in which the dependent variable was overall rating, found that the independent variables, the underlying rating constructs--food and service--made a much greater impact on overall rating than environment and accessibility. Most cafeteria managers' predictions about their customers' satisfaction were within two standard deviations of their customers' mean scores of satisfaction. While the managers' close association with their service may have accounted for this, it does not necessarily follow that they have the power to implement policy and product improvements. PMID:10111595

  20. Technology's Role in NASA's Future

    NASA Video Gallery

    NASA Chief Technologist Bobby Braun talks to NASA managers about the vital role technology research and development will play in NASA's future. Braun discusses how NASA will use new technologies to...

  1. Future Climate Analysis

    SciTech Connect

    James Houseworth

    2001-10-12

    This Analysis/Model Report (AMR) documents an analysis that was performed to estimate climatic variables for the next 10,000 years by forecasting the timing and nature of climate change at Yucca Mountain (YM), Nevada (Figure 1), the site of a potential repository for high-level radioactive waste. The future-climate estimates are based on an analysis of past-climate data from analog meteorological stations, and this AMR provides the rationale for the selection of these analog stations. The stations selected provide an upper and a lower climate bound for each future climate, and the data from those sites will provide input to the infiltration model (USGS 2000) and for the total system performance assessment for the Site Recommendation (TSPA-SR) at YM. Forecasting long-term future climates, especially for the next 10,000 years, is highly speculative and rarely attempted. A very limited literature exists concerning the subject, largely from the British radioactive waste disposal effort. The discussion presented here is one method, among many, of establishing upper and lower bounds for future climate estimates. The method used here involves selecting a particular past climate from many past climates, as an analog for future climate. Other studies might develop a different rationale or select other past climates resulting in a different future climate analog. Revision 00 of this AMR was prepared in accordance with the ''Work Direction and Planning Document for Future Climate Analysis'' (Peterman 1999) under Interagency Agreement DE-AI08-97NV12033 with the U.S. Department of Energy (DOE). The planning document for the technical scope, content, and management of ICN 01 of this AMR is the ''Technical Work Plan for Unsaturated Zone (UZ) Flow and Transport Process Model Report'' (BSC 2001a). The scope for the TBV resolution actions in this ICN is described in the ''Technical Work Plan for: Integrated Management of Technical Product Input Department''. (BSC 2001b, Addendum B

  2. Futur "simple" et futur "proche" ("Simple" Future and "Immediate" Future).

    ERIC Educational Resources Information Center

    Franckel, Jean-Jacques

    1984-01-01

    An analysis of the use of simple and immediate future tenses in French shows that the expression of time is controlled more by context and modals than by specifically temporal cues. The role of negation in this situation is discussed. (MSE)

  3. University Management, Present and Future: How and by Whom? Report of the International Workshop on University Reform, 2011. RIHE International Seminar Reports. No.18

    ERIC Educational Resources Information Center

    Research Institute for Higher Education, Hiroshima University (NJ3), 2012

    2012-01-01

    The Research Institute for Higher Education (RIHE) at Hiroshima University, through special funding by the Ministry of Education and Science in 2008, has been implementing a research project on the reform of higher education in the knowledge-based society of the 21st century. Research into the design of the future higher education system,…

  4. Modelling nitrogen in the Yeşilirmak River catchment in Northern Turkey: impacts of future climate and environmental change and implications for nutrient management.

    PubMed

    Hadjikakou, Michalis; Whitehead, Paul G; Jin, Li; Futter, Martyn; Hadjinicolaou, Panos; Shahgedanova, Maria

    2011-05-15

    Recent research in catchments of rapidly developing countries such as Brazil and China suggests that many catchments of the developing world are already showing signs of nitrogen pollution reminiscent of past experiences in developed countries. This paper looks at both the individual and combined effects of future climate change and other likely environmental changes on in-stream nitrate concentrations in a catchment in Northern Turkey. A model chain comprised of simulated future temperature and precipitation from a Regional Circulation Model (RCM), a conceptual hydrological model (HBV) and a widely tested integrated catchment nitrogen model (INCA-N) is used to model future changes in nitrate concentrations. Two future periods (2021-2050 and 2069-2098) are compared to the 1961-1990 baseline period in order to assess the effectiveness of several possible interventions available to catchment authorities. The simulations show that in the urbanised part of the catchment, the effects of climate change and other environmental changes act in the same direction, leading to peak nitrate concentrations of 7.5 mg N/l for the 2069-2098 period, which corresponds to a doubling of the baseline values. Testing different available policy options reveals that the installation of wastewater treatment works (WWTWs) in all major settlements of the catchment could ensure nitrate levels are kept at near their baseline values for the 2021-2050 period. Nevertheless, a combination of measures including WWTWs, meadow creation, international agreements to reduce atmospheric N concentrations and controls on agricultural practises will be required for 2069-2098. The approach presented in this article could be employed in order to anticipate future pollution problems and to test appropriate solutions, some of which will necessitate international co-operation, in other catchments around the world.

  5. Early management of patients with acute heart failure: state of the art and future directions. A consensus document from the society for academic emergency medicine/heart failure society of America acute heart failure working group.

    PubMed

    Collins, Sean; Storrow, Alan B; Albert, Nancy M; Butler, Javed; Ezekowitz, Justin; Felker, G Michael; Fermann, Gregory J; Fonarow, Gregg C; Givertz, Michael M; Hiestand, Brian; Hollander, Judd E; Lanfear, David E; Levy, Phillip D; Pang, Peter S; Peacock, W Frank; Sawyer, Douglas B; Teerlink, John R; Lenihan, Daniel J

    2015-01-01

    Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency department (ED) visits and over one million annual hospital discharges. An aging population and improved survival from cardiovascular diseases is expected to further increase HF prevalence. Emergency providers play a significant role in the management of patients with acute heart failure (AHF). It is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics and alternatives to hospitalization. Further, clinical trials must be conducted in the ED in order to improve the evidence base and drive optimal initial therapy for AHF. Should ongoing and future studies suggest early phenotype-driven therapy improves in-hospital and post-discharge outcomes, ED treatment decisions will need to evolve accordingly. The potential impact of future studies which incorporate risk-stratification into ED disposition decisions cannot be underestimated. Predictive instruments that identify a cohort of patients safe for ED discharge, while simultaneously addressing barriers to successful outpatient management, have the potential to significantly impact quality of life and resource expenditures.

  6. TUBERCULOSIS AND BRUCELLOSIS IN WOOD BISON (BISON BISON ATHABASCAE) IN NORTHERN CANADA: A RENEWED NEED TO DEVELOP OPTIONS FOR FUTURE MANAGEMENT.

    PubMed

    Shury, Todd K; Nishi, John S; Elkin, Brett T; Wobeser, Gary A

    2015-07-01

    Effective, long-term strategies to manage the threat of bovine tuberculosis and brucellosis spillback from northern, diseased bison to the Canadian cattle herd and adjacent disease-free wood bison (Bison bison athabascae) herds have eluded policy makers in recent decades. A controversial plan to depopulate infected herds and repopulate them with disease-free wood bison was rejected in 1990 because of significant public concern. Since then, technical advances in vaccine technology, genetic salvage, selective culling, and diagnostic test development have occurred. Containment strategies to reduce further spread of these diseases are a necessary first step; recent progress has been made in this area, but challenges remain. This progress has produced more options for management of these herds in northern Canada, and it is time to consider wood bison conservation and long-term disease eradication as equally important goals that must satisfy concerns of conservation groups, agriculture sectors, aboriginal groups, and the general public. Management of wildlife disease reservoirs in other areas, including Yellowstone and Riding Mountain national parks, has demonstrated that effective disease management is possible. Although combinations of different strategies, including vaccination, genetic salvage techniques, and selective culling, that use sensitive and specific diagnostic tests may offer alternatives to depopulation/repopulation, they also have logistic constraints and cost implications that will need consideration in a multistakeholder, collaborative-management framework. We feel the time is right for this discussion, so a long-term solution to this problem can be applied. PMID:25973624

  7. TUBERCULOSIS AND BRUCELLOSIS IN WOOD BISON (BISON BISON ATHABASCAE) IN NORTHERN CANADA: A RENEWED NEED TO DEVELOP OPTIONS FOR FUTURE MANAGEMENT.

    PubMed

    Shury, Todd K; Nishi, John S; Elkin, Brett T; Wobeser, Gary A

    2015-07-01

    Effective, long-term strategies to manage the threat of bovine tuberculosis and brucellosis spillback from northern, diseased bison to the Canadian cattle herd and adjacent disease-free wood bison (Bison bison athabascae) herds have eluded policy makers in recent decades. A controversial plan to depopulate infected herds and repopulate them with disease-free wood bison was rejected in 1990 because of significant public concern. Since then, technical advances in vaccine technology, genetic salvage, selective culling, and diagnostic test development have occurred. Containment strategies to reduce further spread of these diseases are a necessary first step; recent progress has been made in this area, but challenges remain. This progress has produced more options for management of these herds in northern Canada, and it is time to consider wood bison conservation and long-term disease eradication as equally important goals that must satisfy concerns of conservation groups, agriculture sectors, aboriginal groups, and the general public. Management of wildlife disease reservoirs in other areas, including Yellowstone and Riding Mountain national parks, has demonstrated that effective disease management is possible. Although combinations of different strategies, including vaccination, genetic salvage techniques, and selective culling, that use sensitive and specific diagnostic tests may offer alternatives to depopulation/repopulation, they also have logistic constraints and cost implications that will need consideration in a multistakeholder, collaborative-management framework. We feel the time is right for this discussion, so a long-term solution to this problem can be applied.

  8. Energy Conservation in Foodservice: A Course for Foodservice Personnel. Instructor's Guide. Course Outline and Instructional Materials.

    ERIC Educational Resources Information Center

    Forrest, Lewis C., Jr.

    Lesson plans and student handouts for a course dealing with conserving energy in food service operations comprise this publication. The course is intended for all persons involved in the preparation of food in public and commercial institutions. By using the strategies discussed, participants should be able to analyze energy usage, identify…

  9. Preserving the Finger Lakes for the Future: A Prototype Decision Support System for Water Resource Management, Open Space, and Agricultural Protection

    NASA Technical Reports Server (NTRS)

    Brower, Robert

    2003-01-01

    As described herein, this project has progressed well, with the initiation or completion of a number of program facets at programmatic, technical, and inter-agency levels. The concept of the Virtual Management Operations Center has taken shape, grown, and has been well received by parties from a wide variety of agencies and organizations in the Finger Lakes region and beyond. As it has evolved in design and functionality, and to better illustrate its current focus for this project, it has been given the expanded name of Watershed Virtual Management Operations Center (W-VMOC). It offers the advanced, compelling functionality of interactive 3D visualization interfaced with 2D mapping, all accessed via Internet or virtually any kind of distributed computer network. This strong foundation will allow the development of a Decision Support System (DSS) with anticipated enhanced functionality to be applied to the myriad issues involved in the wise management of the Finger Lakes region.

  10. Integrating sepsis management recommendations into clinical care guidelines for district hospitals in resource-limited settings: the necessity to augment new guidelines with future research.

    PubMed

    Jacob, Shevin T; Lim, Matthew; Banura, Patrick; Bhagwanjee, Satish; Bion, Julian; Cheng, Allen C; Cohen, Hillary; Farrar, Jeremy; Gove, Sandy; Hopewell, Philip; Moore, Christopher C; Roth, Cathy; West, T Eoin

    2013-04-18

    Several factors contribute to the high mortality attributed to severe infections in resource-limited settings. While improvements in survival and processes of care have been made in high-income settings among patients with severe conditions, such as sepsis, guidelines necessary for achieving these improvements may lack applicability or have not been tested in resource-limited settings. The World Health Organization's recent publication of the Integrated Management of Adolescent and Adult Illness District Clinician Manual provides details on how to optimize management of severely ill, hospitalized patients in such settings, including specific guidance on the management of patients with septic shock and respiratory failure without shock. This manuscript provides the context, process and underpinnings of these sepsis guidelines. In light of the current deficits in care and the limitations associated with these guidelines, the authors propose implementing these standardized best practice guidelines while using them as a foundation for sepsis research undertaken in, and directly relevant to, resource-limited settings.

  11. Building the future of healthcare. Part III: managing the build. Hospital leaders are moving forward using specialized IT tools to help them manage today's complex new-construction projects.

    PubMed

    Lawrence, Daphne

    2010-05-01

    Hospital leaders are increasing making use of project management information systems (PMIS), which are built around documentation and communication of project-specific information. PMIS solutions are being applied to the daunting challenge of managing the large volumes of information involved in new construction projects. Project management tools usually utilize a portal. These tools can interface with administrative systems for best effect. CIOs and other senior executives emphasize that good leadership and execution are fundamental to success, and that automated project management tools are supports, not substitutes for good strategic planning and execution.

  12. [Issues Associated with the Management of Clinical Laboratories and Their Future: What is the Problem in Our Laboratory?--Chairmen's Introductory Remarks].

    PubMed

    Morikane, Keita; Kaku, Mitsuo

    2015-03-01

    The management of clinical laboratories in hospitals has to be changed in accordance with the trends in the healthcare-providing system. In this symposium, six presenters talked about various issues associated with their laboratories. The issues raised included conflict between specialty and generality, phlebotomy as a duty of laboratory technologists, management of the phlebotomy section, imbalance of numbers between retirees and newcomers, and cooperation with the division of clinical research. Presenters, chairmen, and the audience were able to understand that we are now facing these issues, and we could identify some of their solutions. PMID:26524864

  13. Alaskan resources, current development. Traditional cultural values, and the role of LANDSAT data in current and future land use management planning

    NASA Technical Reports Server (NTRS)

    Laperriere, A. J.

    1975-01-01

    Past, present, and proposed applications of LANDSAT data for renewable resource assessments in Alaska are described. Specific projects briefly discussed include: a feasibility investigation applying LANDSAT data to caribou habitat mapping in northeast Alaska, analysis of a native corporate region in southwest Alaska, analysis of a game management unit in interior Alaska, and two proposed analyses in northwest Alaska. These analyses principally address range evaluations concerning caribou, moose, and Dall sheep, but results have application to other renewable resource themes. Application of resource assessment results to a statewide land use management plan is discussed.

  14. [Issues Associated with the Management of Clinical Laboratories and Their Future: What is the Problem in Our Laboratory?--Chairmen's Introductory Remarks].

    PubMed

    Morikane, Keita; Kaku, Mitsuo

    2015-03-01

    The management of clinical laboratories in hospitals has to be changed in accordance with the trends in the healthcare-providing system. In this symposium, six presenters talked about various issues associated with their laboratories. The issues raised included conflict between specialty and generality, phlebotomy as a duty of laboratory technologists, management of the phlebotomy section, imbalance of numbers between retirees and newcomers, and cooperation with the division of clinical research. Presenters, chairmen, and the audience were able to understand that we are now facing these issues, and we could identify some of their solutions.

  15. Future trends.

    PubMed

    Friedberg, Richard C; Weiss, Ronald L

    2007-12-01

    Several current forces have set anticipated future changes in health care in motion, or, at least, have set the stage for change. End-consumer demand increasingly drives the market; as a result, entire businesses are transforming or emerging anew to meet these demands. In general, consumers demand high quality at reasonable cost, to be delivered as fast as possible with minimal inconvenience. The health care consumer takes this expectation further, to include the desire for all helpful information regarding one's health to be made readily available for him/her to make the best decision and minimize morbidity, mortality, misdiagnosis, and inconvenience. This article addresses the impact upon the laboratory by considering four key interrelated dynamics that affect these trends: market, medicine, technology, and information systems. PMID:17950906

  16. Prevalence of outsourcing and perception of clinical nutrition managers on performance of health care dietetics services.

    PubMed

    Kwon, Junehee; Yoon, Barbara J H

    2003-08-01

    A nationwide survey of clinical dietitians and clinical nutrition managers was conducted to assess the prevalence of outsourcing in health care dietetics services and to evaluate perceived performance of dietetics services. A questionnaire was developed, validated by an expert panel, and pilot tested prior to data collection. Members of the Clinical Nutrition Management Dietetic Practice Group (N=1,668) were selected as the study sample. Of 431 respondents, 152 (35.3%) indicated that management of both patient and cafeteria foodservices was outsourced. When mean scores of perceived performance ratings were compared using t test, respondents from self-operated facilities rated several items related to patient and cafeteria food quality and material and human resource utilization higher than respondents at contract-managed facilities. No significant differences were found in performance related to decision-making process, buying power, or training programs. Results suggest that careful weighing of advantages and disadvantages of outsourcing is needed before making decisions regarding outsourcing dietetics services.

  17. Prepared for the future? Evaluating the costs and benefits of voluntary work for natural disaster management under a changing climate - data on recent flood events, stakeholder needs and policy applications

    NASA Astrophysics Data System (ADS)

    Pfurtscheller, Clemens; Brucker, Anja; Seebauer, Sebastian

    2014-05-01

    Voluntary emergency and relief services, such as fire brigades or rescue organisations, form the backbone of disaster management in most of European countries. In Austria, disaster management relies on the cooperation between governmental and non-governmental institutions: When a disaster occurs, the volunteer organizations act as auxiliaries to the responsible disaster management authority. The assessment of costs and benefits of these emergency services is a crucial component of risk and disaster management strategies, since public means are getting scarcer and these costs can reach critical levels for low-income municipalities. As extreme events and emergency operations are likely to increase due to climate change, the efficient allocation of public budgets for risk and disaster management becomes more important. Hence, both, the costs and the benefits must be known, but voluntary and professional work is hardly documented and assessed comprehensively. Whereas the costs of emergency services can be calculated using market values and an analysis of public and institutional budgets, the benefits of voluntary efforts cannot be assessed easily. We present empirical data on costs of voluntary and professional emergency services during the floods of 2002, 2005 and 2013 in Austria and Germany on different scales, obtained from public authorities, fire brigades and by means of public surveys. From these results, we derive a calculation framework and data requirements for assessing costs of emergency services. To consider the different stakeholders needs of administration, emergency institutions and voluntary members, we carried out workshops, first to identify future challenges in voluntary work for disaster management instigated by climate change and second, to develop approaches how the voluntary system can be uphold when facing increasing adverse impacts of natural hazards. The empirical results as well as the workshop outcome shall be translated into policy

  18. The role of climate and vegetation change in shaping past and future fire regimes in the northwestern US and the implications for ecosystem management

    USGS Publications Warehouse

    Whitlock, C.; Shafer, S.L.; Marlon, J.

    2003-01-01

    Fire is an important part of the disturbance regimes of northwestern US forests and its role in maintaining and altering forest vegetation is evident in the paleoecological record of the region. Long-term reconstructions of Holocene fire regimes, provided by the analysis of charcoal, pollen, and other fire proxies in a network of lake records, indicate that the Pacific Northwest and summer-dry regions of the northern Rocky Mountains experienced their highest fire activity in the early Holocene (11,000-7000 years ago) and during the Medieval Warm Period (ca. 1000 years ago) when drought conditions were more severe than today. In contrast, in summer-wet areas of the northern Rocky Mountains, the period of highest fire activity was registered in the last 7000 years when dry woodland vegetation developed. When synthesized across the entire northwestern US, the paleoecological record reveals that past and present fire regimes are strongly controlled by climate changes occurring on multiple time scales. The scarcity of fires in the 20th century in some northwestern US ecosystems may be the result of successful fire suppression policies, but in wetter forests this absence is consistent with long-term fire regime patterns. In addition, simulations of potential future climate and vegetation indicate that future fire conditions in some parts of the northwestern US could be more severe than they are today. The Holocene record of periods of intensified summer drought is used to assess the nature of future fire-climate-vegetation linkages in the region. ?? 2003 Elsevier Science B.V. All rights reserved.

  19. A primer on potential impacts, management priorities, and future directions for Elodea spp. in high latitude systems: learning from the Alaskan experience

    USGS Publications Warehouse

    Carey, Michael P.; Sethi, Suresh A; Larsen, Sabrina J; Rich, Cecil F

    2016-01-01

    Invasive species introductions in Arctic and Subarctic ecosystems are growing as climate change manifests and human activity increases in high latitudes. The aquatic plants of the genus Elodea are potential invaders to Arctic and Subarctic ecosystems circumpolar and at least one species is already established in Alaska, USA. To illustrate the problems of preventing, eradicating, containing, and mitigating aquatic, invasive plants in Arctic and Subarctic ecosystems, we review the invasion dynamics of Elodea and provide recommendations for research and management efforts in Alaska. Foremost, we conclude the remoteness of Arctic and Subarctic systems such as Alaska is no longer a protective attribute against invasions, as transportation pathways now reach throughout these regions. Rather, high costs of operating in remote Arctic and Subarctic systems hinders detection of infestations and limits eradication or mitigation, emphasizing management priorities of prevention and containment of aquatic plant invaders in Alaska and other Arctic and Subarctic systems.

  20. The development of reproductive management practices in New Zealand: what will the future hold in a consumer-focused, environmentally-conscious, export-driven marketplace?

    PubMed

    Burke, C R; Verkerk, G A

    2010-01-01

    The New Zealand (NZ) economy and its dairy industry are sensitive to global consumer perception of farming practices used to generate milk products because milk exports account for > 25% of national export earnings and > 90% of milk produced is exported as products. Astute management of product image and market risk is, therefore, important for the viability of the industry and country. More than 95% of milk produced in NZ comes from strictly seasonal, pasture-based systems, with associated constraints on reproductive performance. Increasing herd sizes, operational changes and genetic selection priorities have further challenged dairy farmers to achieve optimal levels of herd fertility. Reproductive management practices have developed to address the need to maintain a 365-day inter-calving interval, essentially through maximizing the number of cyclic cows during the breeding period and minimizing the duration of the seasonal calving period. Aspects of the hormonal interventions developed and routinely used to achieve these objectives have been the subject of product quality and market risk concerns forcing the industry to explore alternative ways of achieving reproductive performance goals. One approach has been to exploit the inherently high level of fertility in NZ dairy herds. This approach has seen the inclusion of fertility-related traits in the national genetic evaluation system to prevent further decline in genetic fertility. More recently, a nationally coordinated extension program has been adopted to support farmers and their advisors to identify, prioritize and improve on key management areas for incremental gains in herd reproductive performance. Advances in automation and bio-sensing are yet to make a significant impact, but remain potentially valuable additions in supporting the dairy farmer to manage the areas having the largest effects on reproductive performance. PMID:21755683