Evaluating an Anxiety Group for People with Learning Disabilities Using a Mixed Methodology

ERIC Educational Resources Information Center

Marwood, Hayley; Hewitt, Olivia

2013-01-01

The effectiveness of group therapy for people with learning disabilities and anxiety management issues is reviewed. People with learning disabilities face increased levels of psychological distress compared to the general population, yet are often faced with a lack of social support and poor coping techniques to manage their distress. A 6-week…

Risk management: Core principles and practices, and their relevance to wildland fire

Treesearch

Matthew P. Thompson; Donald G. MacGregor; Dave Calkin

2016-01-01

The Forest Service, U.S. Department of Agriculture faces a future of increasing complexity and risk, pressing financial issues, and the inescapable possibility of loss of human life. These issues are perhaps most acute for wildland fire management, the highest risk activity in which the Forest Service engages. Risk management (RM) has long been put forth as an...

Endourologic management of malignant ureteral obstruction: indications, results, and quality-of-life issues.

PubMed

Sountoulides, Petros; Pardalidis, Nikolaos; Sofikitis, Nikolaos

2010-01-01

Obstruction of the upper urinary tract is a problem commonly faced by practicing urologists. The constant evolution in endourology has effectively facilitated minimally invasive management of upper-tract obstruction. In a case in which malignancy is the cause of obstruction, however, the situation significantly changes. Questions arise regarding the need for relieving the obstruction, the means to accomplish this, and the benefits and drawbacks of each technique regarding both their efficacy and their impact on the patients well-being and the crucial issue of quality of life in the face of malignancy.

An Information Technology Manager's Guide to Campus Phone Operations.

ERIC Educational Resources Information Center

Sherron, Gene T.

Written for the information technology manager who is about to enter the telephone communications system business, this paper takes a "primer" approach, outlining the major issues in telecommunications which face all higher education campuses today. An introduction which places the issues into perspective is followed by a quick look at the history…

Focus on Balance, Not Black Swans

ERIC Educational Resources Information Center

Williams, Rodnie; Peterson, Josh

2012-01-01

The speed and access of information today has increased the scrutiny level facing risk managers in higher education. It is true that a more complex, more connected world has created new risks and new issues for university leadership. However, a lot of the same issues have remained constant for campuses: (1) emergency management; (2) campus safety;…

Young onset Parkinson's disease. Practical management of medical issues.

PubMed

Calne, Susan M; Kumar, Ajit

2008-01-01

Young Onset Parkinson's disease (YOPD) is defined as Parkinson's disease diagnosed between the ages of 21 and 40 years. Problems faced by this group are different from those faced by older subjects because they face decades with the illness. This article reviews current literature and offers suggestions for intervention when appropriate and practical suggestions in the areas of drug treatment, rehabilitation, nutrition, sexuality, pregnancy, menstruation and menopause. The suggestions are not exclusively restricted to the management of YOPD, but emphasis is placed on items where people with YOPD have either had particular difficulties or where they can proactively self-manage their illness.

Executive Programs for Brazilian Mid-Career Public Managers: Pitfalls and Challenges

ERIC Educational Resources Information Center

Pacheco, Regina Silvia; Franzese, Cibele

2017-01-01

This paper discusses the challenges of professional education for mid-career public managers at graduate level, pointing out pitfalls to avoid and obstacles to face. Analyzing the Brazilian case, the goal is to raise issues that may also be present in other cases. The main argument developed here is that the puzzle faced by graduate programs on…

Financial Awareness Education with Apprentices in the Australian Construction Industry: Program Evaluation

ERIC Educational Resources Information Center

Du Plessis, Karin; Green, Emma

2013-01-01

A financial awareness education program was implemented with construction industry apprentices in Victoria, Australia. The program included face-to-face delivery of education around a range of financial management issues that apprentices face as they begin their apprenticeship. The paper reports on an evaluation of the program, which included…

Future Trends in Park Protection.

ERIC Educational Resources Information Center

Dwyer, William O.; Murrell, Dan S.

1986-01-01

The roles of ranger and park police in America's parks have shifted from visitor protection and resources management to visitor management and resources protection. Eight issues facing park police are discussed. (MT)

17 CFR 230.460 - Distribution of preliminary prospectus.

Code of Federal Regulations, 2011 CFR

2011-04-01

... issued by a face-amount certificate company or a redeemable security issued by an open-end management... the effective date of the registration statement in the same fashion as is required in the case of...

17 CFR 230.460 - Distribution of preliminary prospectus.

Code of Federal Regulations, 2010 CFR

2010-04-01

... issued by a face-amount certificate company or a redeemable security issued by an open-end management... the effective date of the registration statement in the same fashion as is required in the case of...

Hunger strikers: historical perspectives from the emergency management of refugee camp asylum seekers.

PubMed

Burkle, Frederick M; Chan, Jimmy T S; Yeung, Richard D S

2013-12-01

The treatment of hunger strikers is always contentious, chaotic and complex. The management is particularly difficult for health professionals as it raises unprecedented clinical, ethical, moral, humanitarian, and legal questions. There are never any easy answers. The current situation of prisoners from the Iraq and Afghanistan Wars currently at the Guantanamo Bay Detention Center in Cuba demands unprecedented transparency, accountability and multilevel coordination to ensure that the rights of the strikers are properly met. There are scant references available in the scientific literature on the emergency management of these tragedies. This historical perspective documents the complex issues faced by emergency physicians in Hong Kong surrounding refugee camp asylum seekers from Vietnam in 1994 and is offered as a useful adjunct in understanding the complex issues faced by emergency health providers and managers.

Energy Management in Municipal Buildings.

ERIC Educational Resources Information Center

Massachusetts State Dept. of Community Affairs, Boston. Energy Conservation Project.

This manual is written for the manager or supervisor responsible for instituting an energy management program for municipal buildings. An introduction discusses the management issues facing municipal government in dealing with the need to reduce energy consumption. The guide reviews methods for central coordination of activity to ensure that…

MANUAL: REAL TIME CONTROL OF COMBINED SEWERS

EPA Science Inventory

Managers, engineers, and operators of combined urban sewer systems are faced with difficult problems related to the operation and maintenance of their facilities. In addition to the issues related to the operation and upkeep of the system, many sewerage agencies are facing increa...

Corporate Civil Disobedience in the Consumer Interest.

ERIC Educational Resources Information Center

Dennis, Michael R.; And Others

1994-01-01

Through catalytic issue management, corporations proactively seek to affect resolutions of issues in which they have some interest. Corporations now catalyze legal changes by purposely disobeying existing law, facing the associated consequences, and lobbying for desired changes. (Author)

Should pediatric neurosurgeons still manage neurotrauma today?

PubMed

Peter, Jonathan C

2010-02-01

Neurotrauma remains a major global burden of injury, especially for young patients, and will consequently always be a condition that pediatric neurosurgeons are called upon to treat. However, the face of modern neurotrauma management is changing, presenting important challenges to today's pediatric neurosurgeons. This article summarizes some of the issues in neurotrauma facing clinicians whose responsibility it is to treat these children. It is up to the individual neurosurgeon to familiarize him- or herself with the emerging literature on the modern management of pediatric neurotrauma.

Education Issues. GAO Transition Series.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

This summary report is one of a series addressing major policy, management, or program issues facing Congress and the administration. The issues identified in this report indicate the need to: reduce the cost and preserve the integrity of higher education student loan and grant programs; enhance the federal role in monitoring lenders, agencies,…

Analyzing the health care environment: "You can't hit what you can't see".

PubMed

Ginter, P M; Duncan, W J; Richardson, W D; Swayne, L E

1991-01-01

The health care environment of the 1990s promises to be every bit as dynamic and complex as the environment of the 1980s. Health care managers must identify emerging issues and incorporate these issues into the strategic management process. This article discusses a five-step process for analyzing the changing environment facing health care organizations.

Library Management Tips that Work

ERIC Educational Resources Information Center

Smallwood, Carol, Ed.

2011-01-01

There's no shortage of library management books out there--but how many of them actually tackle the little details of day-to-day management, the hard-to-categorize things that slip through the cracks of a larger handbook? "Library Management Tips that Work" does exactly that, addressing dozens of such issues facing library managers, including: (1)…

Managing Liability. Employment Discrimination: A Risk Management Strategy.

ERIC Educational Resources Information Center

McMullan, Sandra H.

This booklet discusses the risks that educational institutions face in regard to employment discrimination litigation and outlines a program to effectively manage such risks. Institutions need to address three main types of employment discrimination issues: sexual harassment, disability-based discrimination, and age discrimination. To deal with…

NATIONAL CONFERENCE ON RETROFIT OPPORTUNITIES ...

EPA Pesticide Factsheets

Water resource managers have been successful in developing approaches for reducing nonpoint source pollution in newly developing urban areas. Issues become increasingly complex, however, when managers are faced with the challenge of reducing nonpoint source impacts within previously developed urban environments. A diverse assortment of resource management tools, or

Managing Difficult Behaviour in Young Children.

ERIC Educational Resources Information Center

Slee, June

2003-01-01

Managing antisocial behavior is a critical issue facing those who work with young children, as the presence of early socialization problems is the single greatest predictor of adolescent and adult antisocial behavior. This booklet highlights the effectiveness of behavior management strategies that introduce and reinforce positive behaviors, rather…

Challenges to managing natural resource information

Treesearch

William L. Halvorson

2005-01-01

One of the most important issues facing resource managers today is that of information. In order to handle the numerous and diverse requirements for information, landscape-scale information management systems are needed that allow individual land management units to view their resource information in a regional context. The characteristics of such a system are: (1) the...

Managing pets with behavior problems: realistic expectations.

PubMed

Horwitz, Debra F

2008-09-01

Management solutions offer a useful tool for owners faced with behavior issues in their pets. In some cases management will improve the behavior and allow control. In other situations it may be only the first step in treatment. By offering management solutions, veterinarians can help owners with problem pets and begin the road to recovery.

Department of Education: Long-Standing Management Problems Hamper Reforms. Report to the Secretary of Education.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of Human Resources.

This general management review (one in a series of management reviews of federal departments and agencies) identifies key management issues facing the U.S. Department of Education. This review assesses the management of the department and identifies actions that can be taken to improve organizational performance. Data were derived from 151…

Managing the Mission: The Primary Challenge to Campus Child Care.

ERIC Educational Resources Information Center

Townley, Kim F.; Zeece, Pauline Davey

1991-01-01

Examines complex issues and challenges faced by a comprehensive child care system in its efforts to meet its teaching, research, and service missions. These issues and challenges are examined in terms of an expanded, integrated model for comprehensive child care. (SH)

Changing Managerial Imperatives. New Directions for Community Colleges, Number 84.

ERIC Educational Resources Information Center

Alfred, Richard L., Ed.; Carter, Patricia, Ed.

1993-01-01

Intended as a forum for the discussion of governance and management in community colleges, this book details current trends in management approaches at the institutions, provides a practical description of management roles and responsibilities for college faculty and staff, and examines critical issues facing leaders engaged in management…

Western flower thrips resistance to insecticides: detection, mechanisms, and management strategies

USDA-ARS?s Scientific Manuscript database

Insecticide resistance continues to be one of the most important issues facing agricultural production. The challenges in insecticide resistance and its management are exemplified by the situation with the western flower thrips Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae). This ...

From data to decisions: Processing information, biases, and beliefs for improved management of natural resources and environments

NASA Astrophysics Data System (ADS)

Glynn, Pierre D.; Voinov, Alexey A.; Shapiro, Carl D.; White, Paul A.

2017-04-01

Our different kinds of minds and types of thinking affect the ways we decide, take action, and cooperate (or not). Derived from these types of minds, innate biases, beliefs, heuristics, and values (BBHV) influence behaviors, often beneficially, when individuals or small groups face immediate, local, acute situations that they and their ancestors faced repeatedly in the past. BBHV, though, need to be recognized and possibly countered or used when facing new, complex issues or situations especially if they need to be managed for the benefit of a wider community, for the longer-term and the larger-scale. Taking BBHV into account, we explain and provide a cyclic science-infused adaptive framework for (1) gaining knowledge of complex systems and (2) improving their management. We explore how this process and framework could improve the governance of science and policy for different types of systems and issues, providing examples in the area of natural resources, hazards, and the environment. Lastly, we suggest that an "Open Traceable Accountable Policy" initiative that followed our suggested adaptive framework could beneficially complement recent Open Data/Model science initiatives.

Integrative complexity of wildfire management: development of a scale

Treesearch

Joshua Carroll; Alan Bright

2007-01-01

Wildfire in the West has become a controversial natural resource issue that has divided the public's perceptions regarding its management, and forest managers are now faced with the difficult task of making sound decisions while balancing these varying concerns. Two widely used wildfi re management practices are prescribed fire and mechanical thinning. In order to...

Challenges for Novice School Leaders: Facing Today's Issues in School Administration

ERIC Educational Resources Information Center

Beam, Andrea P.; Claxton, Russell L.; Smith, Samuel J.

2016-01-01

Challenges for novice school leaders evolve as information is managed differently and as societal and regulatory expectations change. This study addresses unique challenges faced by practicing school administrators (n = 159) during their first three years in a school leadership position. It focuses on their perceptions, how perceptions of present…

The Impact of Learner Characteristics on Learning Performance in Hybrid Courses among Japanese Students

ERIC Educational Resources Information Center

Nakayama, Minoru; Yamamoto, Hiroh; Santiago, Rowena

2007-01-01

To improve the management of hybrid courses, the relationship between learner characteristics and learning performance was analyzed in two regular university courses. Undergraduate and graduate students participated in two 15-week hybrid courses which consisted of face-to-face lectures (Information Industrial issues), and the corresponding modules…

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

Treesearch

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

1995-01-01

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

Food for Thought. The Changing Face of CTE

ERIC Educational Resources Information Center

Mischel, Susan

2005-01-01

As a former career and technical education teacher, this author was often faced with the issue of students segregating themselves by culture. This article describes how she managed to break down cultural barriers and prejudice through teamwork, cooking, and class goals set with high expectations. The course she offered included student "ownership"…

Simulation of agricultural management alternatives for watershed protection

USDA-ARS?s Scientific Manuscript database

The Bosque River Watershed in Texas is facing a suite of water quality issues including excess sediment, nutrient, and bacteria. The sources of the pollutants are improperly managed cropland and grazing land, dairy manure application, and effluent discharge from wastewater treatment facilities. Seve...

Patient accounts managers must broaden their horizons beyond their specialty.

PubMed

Herkimer, A G

1990-04-01

Healthcare professionals interested in advancing their careers and helping their institutions to survive need to develop an understanding of industry trends. Managers need to learn about the issues facing other departments if they are to play a role in solving problems.

Multiple use forest management in a catchment context

Treesearch

Wayne T. Swank

1998-01-01

Over the past several decades there has been an acceleration of needs, uses, and expectations of forest lands in many countries. Indeed, foresters in the United States are faced with exciting opportunities to provide answers on complex issues of planning, policy, and science related to multiple use management. Integrated catchment management provides a powerful...

So What Do Managers Say about Classroom Management? Qualitative Practitioner Research Exploring Managers' Views on Classroom Management

ERIC Educational Resources Information Center

Lebor, Mervyn

2016-01-01

The context of this article was that, after researching issues of classroom management for a number of years, I was asked by managers at different institutions to speak to their staff about strategies for helping to counteract the problems tutors faced in many classes on a day-to-day basis. The question that emerged was how might managers in the…

Treatment of Bipolar Disorder in the University Student Population

ERIC Educational Resources Information Center

Federman, Russ

2011-01-01

University counseling centers are faced with the challenge of effectively treating bipolar students while also utilizing brief treatment frameworks and managing high patient volumes. Potential destabilization, particularly within the elevated mood phase, poses significant behavioral management issues for university clinicians and administrators,…

Indigenous Digital Collections

ERIC Educational Resources Information Center

Nakata, N. M.

2007-01-01

The intersection of public institutions managing large amounts of information and knowledge and new information and communication technologies has brought forward exciting and innovative changes to the ways information and knowledge have been traditionally managed. This paper provides a brief snapshot of some of the key issues facing the library…

[Tenure--a Management Problem.

ERIC Educational Resources Information Center

Brassie, Stan

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

Critical Issues that Face Tertiary Education Institutions and Administration.

ERIC Educational Resources Information Center

Williams, Gareth

1983-01-01

Issues of the university's role in social and economic progress, educational demand, employment needs and patterns, changes in instructional methods, research, and managing change without growth are discussed. The need to extract long-term policy needs from the multiplicity of short-term administrative demands is examined. (MSE)

Instructional Design Issues for Current and Future Interactive Video Media.

ERIC Educational Resources Information Center

Hadley, James A.; Bentley, Joanne; Christiansen, Todd P.

2003-01-01

Addresses some of the issues that instructional designers will face in the near future and ways to deal with new instructional affordances and constraint, including: Menu and Audio, Video, Subpicture Interleaved, Streamlining Digital Media (MAVSI-SDM); three-dimensional flowcharting; designing multi-faceted storyboards and scripts; managing video,…

Management Matters. Changing to Flexible Scheduling

ERIC Educational Resources Information Center

Pappas, Marjorie L.

2005-01-01

Elementary school library media specialists state that one of the most frustrating issues they face is the fixed schedules in their library media centers. Beyond the cost effectiveness issue, the fixed schedule severely limits using the resources of the library media center for inquiry learning and collaborative teaching experiences between the…

Current issues and challenges in the management of bariatric patients.

PubMed

Bell, Sue Ellen

2005-01-01

Morbid obesity is an increasingly common healthcare problem, and providers and patients currently face numerous challenges in dealing with this problem effectively. Issues addressed in this article include the effect of stigma, the need for more evidence regarding effective management options, and the declining insurance coverage for bariatric surgery. The role of bariatric surgery in effective management of morbid obesity is discussed, along with the effect on and possible reasons for declining coverage. A comparison between benefits and coverage for bariatric surgery and angioplasty/stent placement is included.

Managing Digital Identity on Twitter: The Case of School Administrators

ERIC Educational Resources Information Center

Cho, Vincent; Jimerson, Jo Beth

2017-01-01

What does it mean to be and to act like a school leader online? Although many school leaders might be comfortable navigating issues of identity in face-to-face environments, online environments may present new and unprecedented challenges. These challenges may range from concerns about privacy and surveillance to questions about how best to…

Using positive youth development constructs to design a money management curriculum for junior secondary school students in Hong Kong.

PubMed

Lau, Patrick S Y; Lam, C M; Law, Ben M F; Poon, Y H

2011-01-01

This paper aims to discuss the relationships between the selected positive youth development constructs and the enhancement of Hong Kong junior secondary school students' money management skills, values, and attitudes. Various issues of money management of adolescents are reviewed. These issues include the need for money management programs for adolescents, the content and coverage of an appropriate money management program, and its relationships with the selected positive youth development constructs. The curriculum units for secondary 3 students are taken as examples to illustrate the design of the program. It is believed that promoting cognitive competence, self-efficacy, and spirituality could be an effective way to enhance students' money management skills, values, and attitudes, thus preparing them better for facing the finance-related issues in life.

Using Positive Youth Development Constructs to Design a Money Management Curriculum for Junior Secondary School Students in Hong Kong

PubMed Central

Lau, Patrick S. Y.; Lam, C. M.; Law, Ben M. F.; Poon, Y. H.

2011-01-01

This paper aims to discuss the relationships between the selected positive youth development constructs and the enhancement of Hong Kong junior secondary school students' money management skills, values, and attitudes. Various issues of money management of adolescents are reviewed. These issues include the need for money management programs for adolescents, the content and coverage of an appropriate money management program, and its relationships with the selected positive youth development constructs. The curriculum units for secondary 3 students are taken as examples to illustrate the design of the program. It is believed that promoting cognitive competence, self-efficacy, and spirituality could be an effective way to enhance students' money management skills, values, and attitudes, thus preparing them better for facing the finance-related issues in life. PMID:22125469

75 FR 22756 - Federal Advisory Committee; United States Army Science Board; Charter Renewal

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-30

... with the pressing and complex technology and business management issues facing the Department of the... Management Officer for the Department of Defense, 703-601-6128. SUPPLEMENTARY INFORMATION: The Board is a... relating to the Army's scientific, technical, manufacturing, acquisition, logistics, and business...

Career Management in Transition: HRD Themes from the Estonian Civil Service

ERIC Educational Resources Information Center

Rees, Christopher J.; Jarvalt, Jane; Metcalfe, Beverley

2005-01-01

Purpose: To explore, through a case study, some of the key career-related HRD issues that senior managers are currently facing in the Estonian civil service. Design/methodology/approach: Presents primary empirical research into career management in the Estonian civil service since 1991, that is, in the post-Soviet era. The research involved…

Pharmacy executive leadership issues and associated skills, knowledge, and abilities.

PubMed

Meadows, Andrew B; Maine, Lucinda L; Keyes, Elizabeth K; Pearson, Kathy; Finstuen, Kenn

2005-01-01

To identify challenges that current and future pharmacy executives are facing or will face in the future and to define what skills, knowledge, and abilities (SKAs) are required to successfully negotiate these challenges. Delphi method for executive decision making. Civilian pharmacy profession. 110 pharmacists who graduated from the GlaxoSmithKline Executive Management Program for Pharmacy Leaders. Two iterations of the Delphi method for executive decision making separated by an expert panel content analysis. Round 1--participants were asked to identify five major issues they believed to be of greatest importance to pharmacy leaders in the next 5-10 years and name specific SKAs that might be needed by future leaders to successfully deal with those issues. An expert panel reviewed the issues, classified issues into specific domains, and titled each domain. Round 2-participants rated the SKAs on a 7-point scale according to their individual assessment of importance in each domain. For Delphi rounds 1 and 2, response rates were 21.8% and 18.2%, respectively. More than 100 total issue statements were identified. The expert panel sorted the issues into five domains: management and development of the pharmacy workforce, pharmacy finance, total quality management of work-flow systems, influences on the practice of pharmacy, and professional pharmacy leadership. Five of the top 15 SKAs-and all four highest ranked items--came from the professional pharmacy leadership domain, including ability to see the big picture, ability to demonstrate the value of pharmacy services, ability to lead and manage in an ethical manner, and skills for influencing an organization's senior leadership. Through successful integration of communication skills, critical thinking, and problem solving techniques, future public-sector pharmacy executives will be better equipped to effectively position their organizations and the profession for the challenges that lie ahead.

From data to decisions: Processing information, biases, and beliefs for improved management of natural resources and environments

USGS Publications Warehouse

Glynn, Pierre D.; Voinov, Alexey A.; Shapiro, Carl D.; White, Paul A.

2017-01-01

Our different kinds of minds and types of thinking affect the ways we decide, take action, and cooperate (or not). Derived from these types of minds, innate biases, beliefs, heuristics, and values (BBHV) influence behaviors, often beneficially, when individuals or small groups face immediate, local, acute situations that they and their ancestors faced repeatedly in the past. BBHV, though, need to be recognized and possibly countered or used when facing new, complex issues or situations especially if they need to be managed for the benefit of a wider community, for the longer-term and the larger-scale. Taking BBHV into account, we explain and provide a cyclic science-infused adaptive framework for (1) gaining knowledge of complex systems and (2) improving their management. We explore how this process and framework could improve the governance of science and policy for different types of systems and issues, providing examples in the area of natural resources, hazards, and the environment. Lastly, we suggest that an “Open Traceable Accountable Policy” initiative that followed our suggested adaptive framework could beneficially complement recent Open Data/Model science initiatives.

Online Cultural Heritage Exhibitions: A Survey of Strategic Issues

ERIC Educational Resources Information Center

Liew, Chern Li

2006-01-01

Purpose: This paper seeks to report findings from a study that looked at a range of strategic issues faced in the development, management and maintenance of online cultural heritage exhibitions. The study examined exhibitions from different types of cultural agencies and asked questions about whether, for instance, the exhibitions are part of the…

Health and Human Services Issues. United States General Accounting Office Transition Series.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

Discussing major policy, management, and program issues facing Congress and the Clinton administration in the area of health and human services, this pamphlet provides recommendations for the Department of Health and Human Services (HHS) regarding the social security system, the welfare system, preventing child abuse, and safeguarding the nation's…

Labor Issues. Transition Series.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

Major policy, management, and program issues face the Congress and new administration in the area of labor. Many of the nation's youth are leaving school poorly prepared for the new work world. The nation already has a large group of economically disadvantaged people who lack necessary skills. Annually, 900,000 or more workers are at least…

Local Stakeholder Perception on Community Participation in Marine Protected Area Management: A Q-Method Approach

NASA Astrophysics Data System (ADS)

Megat Jamual Fawaeed, P. S.; Daim, M. S.

2018-02-01

Local stakeholder involvement in Marine Protected Area (MPA) management can bring to a successful MPA. Generally, participatory research in marine protected area management is exploring the relationship between marine protected area management approach adopted by the management agencies and the level of participation of local stakeholder whom reside within the marine protected areas. However, the scenario of local community participation in MPA management in Malaysia seems discouraging and does not align with the International Aichi Biodiversity Target 2020. In order to achieve the International Aichi Biodiversity Target 2020, this paper attempts to explore the methodology on participatory research towards the local stakeholder of Pulau Perhentian Marine Park (PPMP), Terengganu, Malaysia. A Q-methodology is used to investigate the perspective of local stakeholder who represents different stances on the issues, by having participants rank and sort a series of statements by comply quantitative and qualitative method in collecting the data. A structured questionnaire will be employed across this study by means of face-to-face interview. In total, 210 respondents from Kampung Pasir Hantu are randomly selected. Meanwhile, a workshop with the agency (Department of Marine Park) had been held to discuss about the issues faces on behalf of management that manage the PPMP. Using the Q-method, researcher acknowledged wise viewpoints, reflecting how different stakeholders’ perception and opinion about community participation with highlights the current level of community participation in MPA. Thus, this paper describes the phases involved in this study, methodology and analysis used in making a conclusion .

Tax Exemption Issues Facing Academic Health Centers in the Managed Care Environment.

ERIC Educational Resources Information Center

Jones, Darryll K.

1997-01-01

Traditional characteristics of academic health centers are outlined, and conflicts with managed care are identified. Operating strategies designed to resolve the conflicts are discussed in light of tax statutes and regulations, Internal Revenue Service interpretations, and case law. Detailed references are included to provide a complete resource…

The Acquisition and Management of Electronic Resources: Can Use Justify Cost?

ERIC Educational Resources Information Center

Koehn, Shona L.; Hawamdeh, Suliman

2010-01-01

As library collections increasingly become digital, libraries are faced with many challenges regarding the acquisition and management of electronic resources. Some of these challenges include copyright and fair use, the first-sale doctrine, licensing versus ownership, digital preservation, long-term archiving, and, most important, the issue of…

Computer Viruses. Legal and Policy Issues Facing Colleges and Universities.

ERIC Educational Resources Information Center

Johnson, David R.; And Others

Compiled by various members of the higher educational community together with risk managers, computer center managers, and computer industry experts, this report recommends establishing policies on an institutional level to protect colleges and universities from computer viruses and the accompanying liability. Various aspects of the topic are…

Individual Stress Management Coursework in Canadian Teacher Preparation Programs

ERIC Educational Resources Information Center

Harris, Gregory E.

2011-01-01

Teacher stress is a significant issue facing the teaching profession. The current paper explores individual stress management as a viable option to address stress in this profession. Specifically, Canadian teacher education programs are examined to identify the prevalence of pre-service teacher education courses focused on individual stress…

Wastes to Resources: Appropriate Technologies for Sewage Treatment and Conversion.

ERIC Educational Resources Information Center

Anderson, Stephen P.

Appropriate technology options for sewage management systems are explained in this four-chapter report. The use of appropriate technologies is advocated for its health, environmental, and economic benefits. Chapter 1 presents background information on sewage treatment in the United States and the key issues facing municipal sewage managers.…

NATIONAL CONFERENCE ON RETROFIT OPPORTUNITIES FOR WATER RESOURCE PROTECTION IN URBAN ENVIRONMENTS: PROCEEDINGS, CHICAGO, IL, FEBRUARY 9-12, 1998

EPA Science Inventory

Water resource managers have been successful in developing approaches for reducing nonpoint source pollution in newly developing urban areas. Issues become increasingly complex, however, when managers are faced with the challenge of reducing nonpoint source impacts within previo...

The Challenges and Opportunities of Residence Hall Facilities.

ERIC Educational Resources Information Center

Thaler-Carter, Ruth E.

2001-01-01

Explores the challenges facing college and university residence hall facility managers and how different schools address these issues in diverse ways. Ongoing concerns involving funding needs and maintenance are examined followed by discussions on the new challenges in managing student life, health, and safety. Concluding comments reveal where…

Role Management in a Privacy-Enhanced Collaborative Environment

ERIC Educational Resources Information Center

Lorenz, Anja; Borcea-Pfitzmann, Katrin

2010-01-01

Purpose: Facing the dilemma between collaboration and privacy is a continual challenge for users. In this setting, the purpose of this paper is to discuss issues of a highly flexible role management integrated in a privacy-enhanced collaborative environment (PECE). Design/methodology/approach: The general framework was provided by former findings…

Safety and Security: Lessons Learned from 9/11.

ERIC Educational Resources Information Center

Schmitz, William J.

2002-01-01

Discusses issues faced by the Borough of Manhattan Community College following the September 11th terrorist attacks: the expense of recovery and budgeting for it, developing an emergency preparedness plan, the characteristics of emergency management and disaster recovery plans, technology and its role in emergency management, being prepared for…

Beyond Civil Service: The Changing Face of Public Personnel Management.

ERIC Educational Resources Information Center

Klingner, Donald E.; Lynn, Dahlia Bradshaw

1997-01-01

Today, public services are often delivered by purchase-of-service agreements, privatization, franchising, vouchers, or other alternatives to civil service. Public personnel managers must now deal with broader policy issues, relationships with external organizations, and tighter focus on cost control, requiring new knowledge, skills, and abilities.…

Customer relationship management in the contract pharmaceutical industry: an exploratory study for measuring success.

PubMed

Kros, John F; Nadler, Scott; Molis, Justin

2007-01-01

Managing customer relationships is a very important issue in business-to-business markets. This research investigates the growing number of available resources defining Customer Relationship Management (CRM) efforts, and how they are being applied within the Contract Pharmaceutical Manufacturing industry. Exploratory study results using face-to-face and telephone questionnaires based on four criteria for rating a company's CRM efforts are presented. Data was collected from large Contract Pharmaceutical Manufacturing companies in the US market. The results and conclusions are discussed relating how the Contract Pharmaceutical Manufacturing industry is implementing CRM including some potential steps to take when considering a CRM initiative.

Initiatives (Part 1): Keystone; Cycle Time Puzzle, A Full-Scale Challenge; Foot to Foot, Face to Face; Change Management; Multi-Element Team Challenge.

ERIC Educational Resources Information Center

Schoel, Jim; Butler, Steve; Murray, Mark; Gass, Mike; Carrick, Moe

2001-01-01

Presents five group problem-solving initiatives for use in adventure and experiential settings, focusing on conflict resolution, corporate workplace issues, or adjustment to change. Includes target group, group size, time and space needs, activity level, overview, goals, props, instructions, and suggestions for framing and debriefing the…

The golden goose in the crosshairs: the transition to defined contribution pension plans in the public sector: unintended consequences.

PubMed

Johnson, Brian R

2013-01-01

State, county, and local governments are currently facing a myriad of economic issues, based on shrinking tax revenues combined with increased expenditures. Of these, the costs related to defined benefit pension plans are one of the most serious issues facing many public employers. Through a comprehensive review of the existing literature, this article examines how the shift from the defined benefit (DB) to defined contribution (DC) pension plan has the potential to enhance levels of labor unrest due to changes in union militancy, bargaining skills deficits, intra-organizational conflict, and issues related to economic trade-offs. Besides the capacity for immediate and deleterious ramifications in the collective bargaining process, the transition to the DC pension also presents some potentially negative consequences related to human resource management, including changes in the psychological contract, recruitment strategies, employee turnover, and changes in retirement patterns. Recommendations to improve labor relations and human resource management practices in the DC pension environment are also explored.

Current status of coastal zone issues and management in China: a review.

PubMed

Cao, Wenzhi; Wong, Ming H

2007-10-01

This paper identifies and examines social-economic and environmental issues recently emerged in China's coastal zone. Evaluation of management scheme and progress in perspectives of coordinated legislation, institutional arrangement, public participation, capacity building, and scientific research (mainly coastal planning and functional zoning) in China's coastal zone are made. The Chinese government has made a significant effort in developing legislation for the coastal zone. Jurisdictional and zoning boundaries, and allocating use rights for coastal and marine resources have been established. State Oceanic Administration is the leading agency responsible for China's ocean policymaking and overall management of ocean and coastal affairs. A demonstrated project for integrated coastal management in Xiamen has been implemented, and is characterized as "decentralization" approach in decision-making process. In view of the above, comprehensive coastal management in China is a big challenge, facing with many difficulties. Finally, recommendations are raised for tackling these issues for China's coastal zone management.

CALFED--An experiment in science and decisionmaking

USGS Publications Warehouse

Taylor, Kimberly A.; Jacobs, Katharine L.; Luoma, Samuel N.

2003-01-01

The CALFED Bay-Delta Program faces a challenging assignment: to develop a collaborative state-federal management plan for the complex river system and involve multiple stakeholders (primarily municipal, agricultural, and environmental entities) whose interests frequently are in direct conflict. Although many resource-management issues involve multiple stakeholders and conflict is integral to their discussion, the CALFED experience is unique because of its shared state and federal roles, the magnitude and significance of stakeholder participation, and the complexity of the scientific issues involved.

The Management of Student Affairs Programs in Community Colleges: Revamping Processes and Structures. Horizons Issues Monograph Series.

ERIC Educational Resources Information Center

Deegan, William L.

Based on a review of the management literature in the fields of business and education and on case studies, interviews, and discussions, this monograph identifies the prerequisites for the successful management of student affairs programs. Chapter 1 presents perspectives on the student affairs profession, summarizes the problems facing the field,…

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

Jacobson, L.N.

Traffic congestion and personal mobility preservation are the most challenging issues facing transportation professionals. From Phoenix to San Francisco to Washington, D.C., citizens are identifying transportation as their number one concern, outweighing issues such as pollution, overpopulation, unemployment, and crime. In the state of Washington, particularly in the greater Seattle area, congestion is likewise a major concern. In order to address the mobility problems facing the urban areas of Washington, the state initiated a new transportation research and implementation program in October 1987. The program is called Freeway and Arterial Management Effort (FAME). The focus of the program is discussedmore » by the author.« less

Financial Literacy. Snapshots. Volume 6, Issue 6, Article 1

ERIC Educational Resources Information Center

Thomson, Sue

2015-01-01

Young people face financial issues at an earlier age than their parents. Decisions about higher education, the need to be able to manage online payment facilities or even mobile phone plans require a level of financial literacy. PISA 2012 offered an opportunity to collect information about the financial literacy of Australian 15-year-old students,…

An Associational Research on Turkish Children's Environmentally Responsible Behaviors, Nature Relatedness, and Motive Concerns

ERIC Educational Resources Information Center

Bahar, Fatma; Sahin, Elvan

2017-01-01

Science education has changed in recent decades with respect to key issues faced in this century. These issues such as renewable energy, waste management, air quality, and biodiversity require dealing with the transition toward a sustainable future. Thus, to contribute to the reconceptualization of science education in a developing country, the…

Tribal wilderness research needs and issues in the United States and Canada

Treesearch

Dan McDonald; Tom McDonald; Leo H. McAvoy

2000-01-01

This paper represents a dialogue between tribal wilderness managers and researchers on the primary research needs of tribal wilderness in the United States and Canada. The authors identify a number of research priorities for tribal wildlands. The paper also discusses some major issues and challenges faced by researchers conducting research in areas that are culturally...

Case Study: University of Anyplace: Strategic Legal Risk Review.

ERIC Educational Resources Information Center

Hall, John T.; Ferguson, Rowan

2000-01-01

Considers legal issues and risks faced by a fictional American university as it seeks to establish an operation based in London. Addresses the first step in the process of risk management, the risk review exercise, and provides an explanation of the legal issues involved to allow progression to the second stage in the process (evaluation of the…

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

ERIC Educational Resources Information Center

Hayes, David; Widanski, Bozena

2013-01-01

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

Individualism-Collectivism and Job Satisfaction between Malaysia and Australia

ERIC Educational Resources Information Center

Noordin, Fauziah; Jusoff, Kamaruzaman

2010-01-01

Purpose: One of the main issues that many organizations will face in the coming years is the management of increasing diversity in the workforce. The purpose of this paper is to examine the levels of individualism and collectivism of managers in two different cultural environments, that is, Malaysia and Australia. Design/methodology/approach: Data…

Integrating Six Sigma Concepts in an MBA Quality Management Class

ERIC Educational Resources Information Center

Weinstein, Larry B.; Petrick, Joseph; Castellano, Joseph; Vokurka, Robert J.

2008-01-01

Instructors face enormous challenges in presenting effective instruction on concepts and tools of quality management. Most textbooks focus on presenting individual concepts or tools and fail to address complex issues confronted in real-world problem-solving situations. The supplementary use of cases does not help students to understand the dynamic…

Identification and Access Management: An Action Research Approach to Develop a Training Strategy for Higher Education

ERIC Educational Resources Information Center

San Nicolas-Rocca, Tonia

2010-01-01

Identification and access management has been among the top security issues facing institutions of higher education. Most institutions of higher education require end users to provide usernames and passwords to gain access to personally identifiable information (PII). This leaves universities vulnerable to unauthorized access and unauthorized…

Forest road erosion control using multiobjective optimization

Treesearch

Matthew Thompson; John Sessions; Kevin Boston; Arne Skaugset; David Tomberlin

2010-01-01

Forest roads are associated with accelerated erosion and can be a major source of sediment delivery to streams, which can degrade aquatic habitat. Controlling road-related erosion therefore remains an important issue for forest stewardship. Managers are faced with the task to develop efficient road management strategies to achieve conflicting environmental and economic...

Risk Management: Earning Recognition with an Automated Safety Program

ERIC Educational Resources Information Center

Lansberry, Linden; Strasburger, Tom

2012-01-01

Risk management is a huge task that requires diligent oversight to avoid penalties, fines, or lawsuits. Add in the burden of limited resources that schools face today, and the challenge of meeting the required training, reporting, compliance, and other administrative issues associated with a safety program is almost insurmountable. Despite an…

Survivorship in Non-Small Cell Lung Cancer: Challenges Faced and Steps Forward.

PubMed

Vijayvergia, Namrata; Shah, Prashant C; Denlinger, Crystal S

2015-09-01

Improvements in curative therapies and the advent of screening have led to increased numbers of non-small cell lung cancer (NSCLC) survivors. Most survivors have undergone invasive treatment (surgery, radiation therapy, and/or chemotherapy) and carry a higher comorbidity burden than survivors of other cancers. Overall quality of life (QOL) and health-related quality of life (HRQOL) suffer during the treatment phase, with the potential for long-term decline, and both clinical characteristics and treatment impact these measures. Physical and mental components of HRQOL seem to be most at risk for decline. The issues faced by survivors include physical symptoms such as respiratory issues, fatigue, hearing loss, neuropathy, and postsurgical pain; psychological distress leading to depression, financial issues, and poor compliance with recommended guidelines; and fear or risk of recurrence and secondary malignancies. This article summarizes the major issues faced by NSCLC survivors and suggests appropriate management. Future collaborative efforts are needed to further elucidate the complex issues that affect overall QOL and HRQOL in NSCLC survivors and to develop appropriate interventions in this large and diverse survivor population. Copyright © 2015 by the National Comprehensive Cancer Network.

A student's perspective of managing data collection in a complex qualitative study.

PubMed

Dowse, Eileen Mary; van der Riet, Pamela; Keatinge, Diana Rosemary

2014-11-01

To highlight from a doctoral student's perspective some of the unexpected and challenging issues that may arise when collecting data in a complex, qualitative study. Using a qualitative approach to undertaking a PhD requires commitment to the research topic, the acquisition of a variety of research skills and the development of expertise in writing. Despite close research supervision and guidance, the first author of this paper experienced unexpected hurdles when collecting data. This article highlights these hurdles and compares them with similar and dissimilar challenges raised by a social researcher with 30 years' experience (White 2012). The first author's experience of field research during her PhD candidature. Informed by a critical theoretical perspective, a snowballing technique was used to examine issues related to data collection by a doctoral student in a qualitative research study. The first author found the logistics of qualitative data collection, concerns about transparency, role confusion and power differentials with participants, and the effective use of video recording technology, unexpectedly challenging. Many of these issues are highlighted in the literature and/or during research supervision. However, the student researcher remains a novice when entering the field. It is often only on reflection after encountering the hurdle that the student recognises future pre-emptive or alternative methods of data collection. The challenges faced as a doctoral student managing the data collection phase of the study concurred with White's discussion of some of the 'real life challenges that novice researchers might face' (2012). Specific guidance and prudence are needed by research students to know when enough data have been collected for manageable analysis within the limits of candidature. Use of reflexivity and mindfulness practised by the student during this phase assisted the ability to reflect, respond and learn from issues as they arose and aim for a harmonious work, study and life balance. This paper highlights these issues and offers suggestions for other research higher degree students facing similar challenges when collecting data in a complex qualitative study.

Intersectionality at Work: South Asian Muslim Women's Experiences of Employment and Leadership in the United Kingdom.

PubMed

Tariq, Memoona; Syed, Jawad

2017-01-01

Drawing on qualitative interviews with 20 South Asian heritage, Muslim, female leaders, managers, and supervisors in the United Kingdom, we examine the multi-layered issues and challenges they face in pursuit of employment and leadership positions. The paper offers an intersectional perspective taking into account interconnected and overlapping factors (gender, ethnicity, religion, and family status) that affect not only the issues and challenges these women face in the labour market but also the individual agency and strategies they use to overcome any obstacles in the way of their employment and career. The results show that although Muslim women continue to face a myriad of challenges in the workplace, they are also able to tackle some of these issues through their individual strategies and networks, such as personal networks and further education. The study highlights the need for policymakers and employers to consider intersectionality to enable ethnic minority women's inclusion and leadership within and outside the workplace.

Psychosocial issues and mental health treatment recommendations for patients with hepatitis C.

PubMed

Silberbogen, Amy K; Ulloa, Erin W; Janke, E Amy; Mori, DeAnna L

2009-01-01

Mental health needs of patients with HCV are increasingly being addressed in medical contexts. The authors review the psychosocial issues relevant to patients with hepatitis C and provide mental health treatment recommendations. Patients with HCV are faced with a number of challenges, including adjustment to a chronic medical illness, management of symptoms and treatment side effects, and making and maintaining lifestyle changes. Given these issues, mental health clinicians have the opportunity to make a significant contribution to patient care. After reviewing the relevant research on these psychosocial issues, the authors have identified areas in which clinicians can intervene; these include adjustment to having a chronic medical illness, coping with stigma and relationship changes, management of side effects, and implementing healthy lifestyle changes.

Reconsidering Social Science Theories in Natural Resource Management Continuing Professional Education

ERIC Educational Resources Information Center

Stummann, C. B.; Gamborg, C.

2014-01-01

Over 25 years ago, the "wicked problems" concept was introduced into forestry to describe the increasingly complex work situations faced by many natural resource management (NRM) professionals and at the same time the demand and frequency of public involvement in NRM issues also grew. Research on the impact of these changes for NRM…

Perceptions of Women in Management: A Thematic Analysis of Razing the Glass Ceiling

ERIC Educational Resources Information Center

Baumgartner, Mindy S.; Schneider, David E.

2010-01-01

Despite advances that women have made in organizations over the past century, women continue to be underrepresented in upper management positions. Based on a review of literature, six issues that women face when encountering the glass ceiling were examined. The goal of the current study involved having women who have succeeded at breaking the…

A Guide to the Management of Curriculum Materials Centers for the 21st Century: The Promise and the Challenge.

ERIC Educational Resources Information Center

Carr, Jo Ann, Ed.

Curriculum Materials Centers (CMCs), resource centers that support teacher education programs, are facing many challenges, including maintaining funding, meeting increased expectations, and coping with changes in technology. This volume covers a wide range of management issues from the perspective of 18 librarians, including practical advice on…

Decentralization and Participatory Decision-Making: Implementing School-Based Management in the Abbott Districts.

ERIC Educational Resources Information Center

Walker, Elaine M.

2000-01-01

This study examined issues faced during implementation of school-based management (SBM) in New Jersey's special needs or Abbott districts, using a literature review, surveys of K-12 schools, and focus groups with central office administrators. The study examined forms of SBM, team operations, local autonomy versus state power, skills required to…

Draft position paper on knowledge management in space activities

NASA Technical Reports Server (NTRS)

Holm, Jeanne; Moura, Denis

2003-01-01

As other fields of industry, space activities are facing the challenge of Knowledge Management and the International Academy of Astronautics decided to settle in 2002 a Study Group to analyse the problem and issue general guidelines. This communication presents the draft position paper of this group in view to be discussed during the 2003 IAF Congress.

The Impact of Certification Type and Student Teaching Experience on Classroom Management in a Rural South Texas District

ERIC Educational Resources Information Center

Uriegas, Brian

2012-01-01

Teachers are entering the classroom through a variety of certification routes and programs responsible for training prospective teachers in the areas of curriculum, assessment, theory, pedagogy, and classroom management. Once certification is received, these teachers enter the classroom and face many issues, including discipline in the classroom…

"Sometimes, to Change the People, You've Got to Change the People": When Learning Is Not Enough

ERIC Educational Resources Information Center

Blackman, Deborah; Kennedy, Monica

2011-01-01

This paper discusses organisational learning and change management in a major change in an Australian University. The qualitative data highlight the issues faced in the management of change, particularly in the institutionalised resistance of organisational members. Analysis suggests that the development and consolidation of shared genres of doubt…

Hippocrates takes a blow: the Family and Medical Leave Act and health care administration.

PubMed

Wyld, D C

1995-12-01

This article examines the special legal and administrative issues for health care management that are posed by the recently enacted Family and Medical Leave Act (FMLA). Following a question-and-answer format, the article outlines the basic provisions of the law and answers what will likely be the most commonly faced administrative questions. It will be seen that FMLA issues and administration will be of significant concern to managers at all levels in health care organizations for some time to come. The conclusion of the article outlines a series of administrative steps that health care managers should undertake to proactively administer the federal leave law.

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

PubMed

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

2007-01-01

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

Using time management to achieve balance.

PubMed

Schroeder, R E

1998-01-01

A recent MGMA survey showed work-life balance as the number one issue facing group practice managers. This article explains techniques from the field of time management that will enable group practice managers to gain control of their schedules, reduce time pressures and stress and increase productivity. The article covers: goal setting, daily lists, handling paperwork, delegating and limiting involvement, socializing, communicating, overachieving, planning, writing, telephone calling, attending meetings, reading, financial planning, developing a philosophy, involving family, evaluating skills and teaching time management to employees.

Policies for managing urban growth and landscape change: a key to conservation in the 21st century

Treesearch

David N., tech. ed. Bengston

2005-01-01

Protecting natural areas in the face of urbanization is one of the most important challenges for conservation in the 21st century. The papers in this collection examine key issues related to growth management and selected approaches to managing urban growth and minimizing its social and environmental costs. They were presented at the 2004 annual meeting of the Society...

Mission analyses for manned flight experiments

NASA Technical Reports Server (NTRS)

Orth, J. E.

1973-01-01

The investigations to develop a high altitude aircraft program plan are reported along with an analysis of manned comet and asteroid missions, the development of shuttle sortie mission objectives, and an analysis of major management issues facing the shuttle sortie.

Use of communication technologies in document exchange for the management of construction projects

NASA Astrophysics Data System (ADS)

Mesároš, Peter; Mandičák, Tomáš

2016-06-01

Information and communication technologies represent a set of people, processes, technical and software tools providing collection, transport, storage and processing of data for distribution and presentation of information. Particularly communication systems are the main tool for information exchange. Of the other part, these technologies have a broad focus and use. One of them is the exchange of documents in the management of construction projects. Paper discusses the issue of exploitation level of communication technologies in construction project management. The main objective of this paper is to analyze exploitation level of communication technologies. Another aim of the paper is to compare exploitation level or rate of document exchange by electronic communication devices and face-to-face communication.

Erosion Control Management Plan for Army Training Lands

DTIC Science & Technology

1990-07-01

Functional Appropriateness of Control Appropriateness of Control for Natural Conditions Environmental Impact Considerations Appropriateness of Control...construction, maintenance, and repair projects are often related to environmental protection standards and natural resource guidelines. In such cases...SEP 17 90" The Army faces major land management issues in SEP 1 9O maintaining its training areas to be environmentally sound and support the mission

Whole-School Management Issues Concerning the PE Department: "A Natural Division of Labour?"

ERIC Educational Resources Information Center

Williams, Gareth Mark; Williams, Dean

2013-01-01

Utilising the labour ideas of Adam Smith and Emile Durkheim as a theoretical basis, the main objective of this study was to investigate the perception that Heads of Physical Education (HoPE) face unique management and leadership challenges. Results showed that HoPE believe that they are overburdened with tasks primarily involving the delegation of…

Seventy years of understory development by elevation class in a New Hampshire mixed forest: management implications

Treesearch

William B. Leak

2009-01-01

New England forest managers are faced with numerous environmental issues, such as global warming, nutrient depletion, and species declines that could influence the choice of appropriate silvicultural techniques and objectives. On the Bartlett Experimental Forest, New Hampshire, 70 years of change on more than 400 remeasured cruise plots by elevation classes ranging...

A Principle-Attribute Matrix for Environmentally Sustainable Management Education and Its Application: The Case for Change-Oriented Service-Learning Projects

ERIC Educational Resources Information Center

Rands, Gordon P.

2009-01-01

The environmental threats humanity faces have led businesses to increasingly commit to improve their environmental performance and to increasing attempts to address environmental issues in management education. This article presents a matrix of (a) principles that can underlie and (b) attributes that can be generated by environmentally focused…

Making a Difference: Leading and Managing for Quality Improvement in Adult and Community Learning.

ERIC Educational Resources Information Center

Ravenhall, Mark; Kenway, Mike

This guide looks at demands on leaders and managers in adult and community learning (ACL) in the roles and issues they face in the context of quality improvement (QI). It suggests practical approaches for improving the quality of provision for adults. The guide's design builds on current practice toward the desired state of excellence in all…

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

ERIC Educational Resources Information Center

Tan, Christine Nya-Ling

2016-01-01

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

Decision Making Under Uncertainty and Complexity: A Model-Based Scenario Approach to Supporting Integrated Water Resources Management

NASA Astrophysics Data System (ADS)

Liu, Y.; Gupta, H.; Wagener, T.; Stewart, S.; Mahmoud, M.; Hartmann, H.; Springer, E.

2007-12-01

Some of the most challenging issues facing contemporary water resources management are those typified by complex coupled human-environmental systems with poorly characterized uncertainties. In other words, major decisions regarding water resources have to be made in the face of substantial uncertainty and complexity. It has been suggested that integrated models can be used to coherently assemble information from a broad set of domains, and can therefore serve as an effective means for tackling the complexity of environmental systems. Further, well-conceived scenarios can effectively inform decision making, particularly when high complexity and poorly characterized uncertainties make the problem intractable via traditional uncertainty analysis methods. This presentation discusses the integrated modeling framework adopted by SAHRA, an NSF Science & Technology Center, to investigate stakeholder-driven water sustainability issues within the semi-arid southwestern US. The multi-disciplinary, multi-resolution modeling framework incorporates a formal scenario approach to analyze the impacts of plausible (albeit uncertain) alternative futures to support adaptive management of water resources systems. Some of the major challenges involved in, and lessons learned from, this effort will be discussed.

LEVEL I, II, AND III ECOREGIONS OF NORTH AMERICA

EPA Science Inventory

Many of the environmental issues which we face today are ecosystem in scope and do not correspond to jurisdictional or administrative boundaries. Adopting an ecosystem approach to environmental resource management and risk assessment requires an understanding of the spatial natu...

Health of adolescent refugees resettling in high-income countries.

PubMed

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

2016-07-01

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

Managing menstruation in the workplace: an overlooked issue in low- and middle-income countries.

PubMed

Sommer, Marni; Chandraratna, Sahani; Cavill, Sue; Mahon, Therese; Phillips-Howard, Penelope

2016-06-06

The potential menstrual hygiene management barriers faced by adolescent girls and women in workplace environments in low- and middle-income countries has been under addressed in research, programming and policy. Despite global efforts to reduce poverty among women in such contexts, there has been insufficient attention to the water and sanitation related barriers, specifically in relation to managing monthly menstruation, that may hinder girls' and women's contributions to the workplace, and their health and wellbeing. There is an urgent need to document the specific social and environmental barriers they may be facing in relation to menstrual management, to conduct a costing of the implications of inadequate supportive workplace environments for menstrual hygiene management, and to understand the implications for girls' and women's health and wellbeing. This will provide essential evidence for guiding national policy makers, the private sector, donors and activists focused on advancing girls' and women's rights.

Leadership, governance and management in dental education - new societal challenges.

PubMed

Townsend, G; Thomas, R; Skinner, V; Bissell, V; Cohen, L; Cowpe, J; Giuliani, M; Gomez-Roman, G; Hovland, E; Imtiaz, A; Kalkwarf, K; Kim, K-K; Lamster, I; Marley, J; Mattsson, L; Paganelli, C; Quintao, C; Swift, J; Thirawat, J; Williams, J; Soekanto, S; Jones, M

2008-02-01

Dental schools around the world face new challenges that raise issues with regard to how they are governed, led and managed. With rapid societal changes, including globalization and consumerism, the roles of universities and their funding have become intensely debated topics. When financial burdens on universities increase, so does the pressure on dental schools. This is exacerbated by the relative expense of running dental schools and also by the limited understanding of both university managers and the public of the nature and scope of dentistry as a profession. In these circumstances, it is essential for dental schools to have good systems of leadership and management in place so that they can not only survive in difficult times, but flourish in the longer term. This paper discusses the concept of governance and how it relates to leadership, management and administration in dental schools and hospitals. Various approaches to governance and management in dental schools on different continents and regions are summarized and contrasted. A number of general governance and leadership issues are addressed. For example, a basic principle supported by the Working Group is that an effective governance structure must link authority and responsibility to performance and review, i.e. accountability, and that the mechanism for achieving this should be transparent. The paper also addresses issues specific to governing, leading and managing dental schools. Being a dean of a modern dental school is a very demanding role and some issues relating to this role are raised, including: dilemmas facing deans, preparing to be dean and succession planning. The importance of establishing a shared vision and mission, and creating the right culture and climate within a dental school, are emphasized. The Working Group advocates establishing a culture of scholarship in dental schools for both teaching and research. The paper addresses the need for effective staff management, motivation and development, and highlights the salience of good communication. The Working Group suggests establishing an advisory board to the dean and school, including lay persons and other external stakeholders, as one way of separating governance and management to some extent and providing some checks and balances within a dental school. Several other suggestions and recommendations are made about governance, management and leadership issues, including the need for schools to promote an awareness of their roles by good communication and thereby influence perceptions of others about their roles and values.

Improving Voluntary Environmental Management Programs: Facilitating Learning and Adaptation

NASA Astrophysics Data System (ADS)

Genskow, Kenneth D.; Wood, Danielle M.

2011-05-01

Environmental planners and managers face unique challenges understanding and documenting the effectiveness of programs that rely on voluntary actions by private landowners. Programs, such as those aimed at reducing nonpoint source pollution or improving habitat, intend to reach those goals by persuading landowners to adopt behaviors and management practices consistent with environmental restoration and protection. Our purpose with this paper is to identify barriers for improving voluntary environmental management programs and ways to overcome them. We first draw upon insights regarding data, learning, and adaptation from the adaptive management and performance management literatures, describing three key issues: overcoming information constraints, structural limitations, and organizational culture. Although these lessons are applicable to a variety of voluntary environmental management programs, we then present the issues in the context of on-going research for nonpoint source water quality pollution. We end the discussion by highlighting important elements for advancing voluntary program efforts.

Community development : local growth issues : federal opportunities and challenges

DOT National Transportation Integrated Search

2000-09-06

Faced with a projected 50-percent increase in the U.S. population in the next 50 years, communities across the nation must address the challenges of planning for and managing growth. State and local governments are balancing the need for sustainable ...

VARIABILITY OF PARAMETERS MEASURED DURING THE RESUSPENSION OF SEDIMENTS WITH A PARTICULATE ENTRAINMENT SIMULATOR

EPA Science Inventory

Contaminated sediments are a problem facing many environmental managers concerned with issues such as maintenance dredging, habitat restoration and dredged material placement. Currently, there are few methods which can be used to assess contaminant remobilization potential from ...

Multidimensional Perspectives on Principal Leadership Effectiveness

ERIC Educational Resources Information Center

Beycioglu, Kadir, Ed.; Pashiardis, Petros, Ed.

2015-01-01

Exceptional management skills are crucial to success in educational environments. As school leaders, principals are expected to effectively supervise the school system while facing a multitude of issues and demands. "Multidimensional Perspectives on Principal Leadership Effectiveness" combines best practices and the latest approaches in…

Creating a physician network can pay off--with the right tools.

PubMed

1997-09-01

Putting together a physician practice group and then creating the management and administrative structure for that practice to financially succeed is one of the greatest challenges health systems face today. The marriage can work, experts tell Managed Care Strategies, but only with innovation and careful attention to details such as physician compensation design, governance issues, and methods for resolving conflict resolution.

National Symposium on Strategic Higher Education Finance & Management Issues in the 1990s. A World of Change: Applicability of Business Practices to Higher Education.

ERIC Educational Resources Information Center

Walsh, Michael H.

This paper presents the keynote speech from a symposium on finance and management in higher education. Following introductions, the speaker, an executive from the business community who also serves on several university governing boards, asserted that, like businesses, institutions of higher education face a nearly continual need to respond to…

Coast redwood science symposium—2016: Past successes and future direction

Treesearch

Richard B. Standiford; Yana Valachovic

2017-01-01

There is no more iconic tree or more closely watched forest ecosystem than coast redwood. With its limited range and high value, the coast redwood forest is a microcosm of many of the emerging science and management issues facing today’s forested landscapes. As new information is collected and new management approaches and treatments tried, it is critical that policies...

The LO Model and the Traditional French Organisational Culture: A Paradigmatic Contradiction Leading to a Limited Implementation

ERIC Educational Resources Information Center

Belet, Daniel

2010-01-01

This article deals with the issue of the very weak implementation of the LO model in France, although it appears as an appealing new management paradigm that can allow companies to better face a fast changing environment. The author argues that there is a strong philosophical contradiction between this innovative management model and the still…

Challenges in healthcare delivery in an economic downturn, in the Republic of Ireland.

PubMed

Carney, Marie

2010-07-01

The purpose of the present study was to discuss some of effects of the downturn in the Irish economy and to demonstrate that in the face of economic difficulties innovation in health care is still occurring. Staff that are managing and delivering healthcare need to know the challenges facing them and have an awareness of the importance of maintaining interest in innovative practice in turbulent times. Information obtained from several sources including government papers, the nursing regulatory board and quality authority documents and current best practice articles. Information was evaluated based on the study's aim. Issues emerging were that current challenges facing Irish health care delivery relate mainly to economic, clinical management, education and information technology factors and further reductions in the cost base of health care delivery remains focused on value for money. In the face of the economic downturn Ireland is achieving health targets and is now sitting in 13th place on the European health index, down from number 28 in 2008. This improvement in position has resulted from several new innovative work practices. As a result of cost reduction measures in place nurse managers will face greater challenges than ever before in meeting the objectives of the healthcare transformation programme.

Use of the Delphi process in paediatric cataract management.

PubMed

Serafino, Massimiliano; Trivedi, Rupal H; Levin, Alex V; Wilson, M Edward; Nucci, Paolo; Lambert, Scott R; Nischal, Ken K; Plager, David A; Bremond-Gignac, Dominique; Kekunnaya, Ramesh; Nishina, Sachiko; Tehrani, Nasrin N; Ventura, Marcelo C

2016-05-01

To identify areas of consensus and disagreement in the management of paediatric cataract using a modified Delphi approach among individuals recognised for publishing in this field. A modified Delphi method. International paediatric cataract experts with a publishing record in paediatric cataract management. The process consisted of three rounds of anonymous electronic questionnaires followed by a face-to-face meeting, followed by a fourth anonymous electronic questionnaire. The executive committee created questions to be used for the electronic questionnaires. Questions were designed to have unit-based, multiple choice or true-false answers. The questionnaire included issues related to the preoperative, intraoperative and postoperative management of paediatric cataract. Consensus based on 85% of panellists being in agreement for electronic questionnaires or 80% for the face-to-face meeting, and near consensus based on 70%. Sixteen of 22 invited paediatric cataract surgeons agreed to participate. We arrived at consensus or near consensus for 85/108 (78.7%) questions and non-consensus for the remaining 23 (21.3%) questions. Those questions where consensus was not reached highlight areas of either poor evidence or contradicting evidence, and may help investigators identify possible research questions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Water and fire safety issues addressed.

PubMed

Arrowsmith, Mike

2014-11-01

One of the four conference streams at last month's Healthcare Estates 2014 event focused on some of the key engineering challenges and opportunities facing healthcare estates managers and healthcare engineers. Mike Arrowsmith, HEJ's technical editor, provides an overview of the engineering sessions at this year's IHEEM conference.

Investigating the Role of Oysters in Altering Net N2 Fluxes Using Novel In-Situ Experimental Design

EPA Science Inventory

Coastal nutrient over-enrichment represents one of the most pressing environmental management issues faced worldwide. Oyster aquaculture and restoration are hypothesized to mitigate excessive nitrogen (N) loads via increasing benthic denitrification rates in coastal systems. Howe...

Transportation Practices in Community College Athletics

ERIC Educational Resources Information Center

LaVetter, David; Kim, Hyun Duck

2010-01-01

Over 45,000 U.S. community college athletes were transported to events during 2005-2006. Transporting college athletes has been an overlooked risk management issue facing administrators. Team travel accidents have caused death, injury, liability claims, property loss, and grief. National Junior College Athletic Association (NJCAA) member…

Directing Traffic: Managing Internet Bandwidth Fairly

ERIC Educational Resources Information Center

Paine, Thomas A.; Griggs, Tyler J.

2008-01-01

Educational institutions today face budgetary restraints and scarce resources, complicating the decision of how to allot bandwidth for campus network users. Additionally, campus concerns over peer-to-peer networking (specifically outbound Internet traffic) have increased because of bandwidth and copyright issues. In this article, the authors…

Endangered species and nature conservation: science issues and challenges.

PubMed

Szaro, Robert C

2008-06-01

The issues and challenges facing us in ensuring the survival of as many species and ecosystems as possible call for a renewed research focus to address how to improve management strategies and policy making now and into the future. The key issues to be addressed by activities of the International Union of Forest Research Organization's (IUFRO) Task Force on Endangered Species and Nature Conservation include such issues as: (i) preventing species from being listed by maintaining species populations at sufficient levels that they do not require listing; (ii) recovering threatened and endangered species; (iii) developing management practices and strategies; (iv) balancing actions affecting suites of threatened or endangered species; (v) developing conservation strategies for species without definitive taxonomic treatments; (vi) dealing with global change; (vii) dealing with invasive species; and (viii) restoring critical habitats. © 2008 ISZS, Blackwell Publishing and IOZ/CAS.

Manager`s views of public involvement

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

Branch, K.M.; Heerwagen, J.; Bradbury, J.

1995-12-01

Four issues commonly form the framework for debates about the acceptability of proposed projects or technologies--the substantive decision or technological choice; the treatment of the community by the proponent organization; the way the decision-making process has been structured and managed; and the status of institutional safeguards and protection. One of the clear messages of cultural theory is that differences in perspectives are a normal and inevitable part of society, and that attempts to resolve differences by persuasion are not likely to work. These findings are useful when considering the goals and possibilities of public involvement as a decision-making tool, andmore » when designing or evaluating public involvement training programs for managers. The research reported here examines the viewpoints and concerns of managers and decision-makers about the four issues identified above, with particular emphasis on their perspectives and concerns about opening decision-making processes to the public and about managers` roles and responsibilities for structuring and managing open decision-making processes. Implications of these findings for public involvement training for managers is also discussed. The data presented in this paper were obtained from face-to-face interviews with managers and decision-makers with experience managing a variety of hazardous waste management decision-making processes. We conducted these interviews in the course of four separate research projects: needs assessments to support the design and development of a public involvement training program for managers; a study of community residents` and managers` perspectives on the chemical stockpile disposal program; an evaluation of the effectiveness of public involvement training for managers in the Department of Energy; and a study to develop indicators of the benefits and costs of public involvement.« less

Technology-based interventions for weight management: current randomized controlled trial evidence and future directions

PubMed Central

Buscemi, Joanna; Hawkins, Misty A. W.; Wang, Monica L.; Breland, Jessica Y.; Ross, Kathryn M.; Kommu, Anupama

2018-01-01

Obesity is a prevalent health care issue associated with disability, premature morality, and high costs. Behavioral weight management interventions lead to clinically significant weight losses in overweight and obese individuals; however, many individuals are not able to participate in these face-to-face treatments due to limited access, cost, and/or time constraints. Technological advances such as widespread access to the Internet, increased use of smartphones, and newer behavioral self-monitoring tools have resulted in the development of a variety of eHealth weight management programs. In the present paper, a summary of the most current literature is provided along with potential solutions to methodological challenges (e.g., high attrition, minimal participant racial/ethnic diversity, heterogeneity of technology delivery modes). Dissemination and policy implications will be highlighted as future directions for the field of eHealth weight management. PMID:27783259

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

PubMed Central

Moise, Imelda K.; Mulhall, Peter F.

2016-01-01

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

A biopsychosocial model for the management of patients with sickle-cell disease transitioning to adult medical care.

PubMed

Crosby, Lori E; Quinn, Charles T; Kalinyak, Karen A

2015-04-01

The lifespan of patients with sickle-cell disease (SCD) continues to increase, and most affected individuals in high-resource countries now live into adulthood. This necessitates a successful transition from pediatric to adult health care. Care for transitioning patients with SCD often falls to primary care providers who may not be fully aware of the many challenges and issues faced by patients and the current management strategies for SCD. In this review, we aim to close the knowledge gap between primary care providers and specialists who treat transitioning patients with SCD. We describe the challenges and issues encountered by these patients, and we propose a biopsychosocial multidisciplinary approach to the management of the identified issues. Examples of this approach, such as transition-focused integrated care models and quality improvement collaboratives, with the potential to improve health outcomes in adulthood are also described.

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

PubMed

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

2013-08-01

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

Developing a holistic strategy for integrated waste management within municipal planning: challenges, policies, solutions and perspectives for Hellenic municipalities in the zero-waste, low-cost direction.

PubMed

Zotos, G; Karagiannidis, A; Zampetoglou, S; Malamakis, A; Antonopoulos, I-S; Kontogianni, S; Tchobanoglous, G

2009-05-01

The present position paper addresses contemporary waste management options, weaknesses and opportunities faced by Hellenic local authorities. It focuses on state-of-the-art, tested as well as innovative, environmental management tools on a municipal scale and identifies a range of different collaboration schemes between local authorities and related service providers. Currently, a policy implementation gap is still experienced among Hellenic local authorities; it appears that administration at the local level is inadequate to manage and implement many of the general policies proposed; identify, collect, monitor and assess relevant data; and safeguard efficient and effective implementation of MSWM practices in the framework of integrated environmental management as well. This shortfall is partly due to the decentralisation of waste management issues to local authorities without a parallel substantial budgetary and capacity support, thus resulting in local activity remaining often disoriented and isolated from national strategies, therefore yielding significant planning and implementation problems and delays against pressing issues at hand as well as loss or poor use of available funds. This paper develops a systemic approach for MSWM at both the household and the non-household level, summarizes state-of-the-art available tools and compiles a set of guidelines for developing waste management master plans at the municipal level. It aims to provide a framework in the MSWM field for municipalities in Greece as well as other countries facing similar problems under often comparable socioeconomic settings.

Practice management: observations, issues, and empirical evidence.

PubMed

Wong, H M; Braithwaite, J

2001-02-01

The primary objective of this study is to provide objective, empirical, evidence-based practice management information. This is a hitherto under-researched area of considerable interest for both the practitioner and educator. A questionnaire eliciting a mix of structured and free text responses was administered to a random sample of 480 practitioners who are members of the American Academy of Periodontology. Potential respondents not in private practice were excluded and the next listed person substituted. The results provide demographic and descriptive information about some of the main issues and problems facing practice managers, central to which are information technology (IT), financial, people management, and marketing. Human resource and marketing management appear to represent the biggest challenges. Periodontists running practices would prefer more information, development, and support in dealing with IT, finance, marketing, and people management. The empirical evidence reported here suggests that although tailored educational programs on key management issues at both undergraduate and postgraduate levels have become ubiquitous, nevertheless some respondents seek further training opportunities. Evidence-based practice management information will be invaluable to the clinician considering strategic and marketing planning, and also for those responsible for the design and conduct of predoctoral and postdoctoral programs.

Primary care management of patients following bariatric surgery.

PubMed

Doolen, Jessica L; Miller, Sally K

2005-11-01

To evaluate the nutritional, psychosocial, and other primary care issues faced by nurse practitioners (NPs) and their patients in the long-term management of the increasing population of patients who have had bariatric surgery. An extensive review of the literature provides the foundation for development of assessment and management strategies highlighted in a case study. Management of the patient after bariatric surgery does not end with successful surgical healing. Numerous long-term implications, including significant psychosocial and nutritional issues, require the informed attention of the primary care provider for the rest of the life span. Each year an increasing number of obese patients pursue a surgical solution to obesity, up to an estimated 100,000 in 2004. Numerous long-term health implications are specific to this population. NPs can improve the quality of primary care to these patients by being informed regarding the different procedures and their impact on physiologic phenomena, and the psychosocial issues inherent to extreme weight loss.

Building the office team: what's the payoff?

PubMed

Anthony, Carol; Marcelo, Karen

2007-01-01

Bogged down in the everyday mire of a busy medical practice with multiple locations, a management team was faced with issues of cohesiveness, employee morale, and communication. Enter an outside facilitator who, with the executive director and president of the organization, developed a plan for a management retreat and subsequent monthly management meetings. The results were nothing short of astonishing, with a shared vision and goals communicated throughout the organization, communication being consciously expanded to all locations, and palpable physician support of employees.

Challenges in the management of community pharmacies in Malaysia

PubMed Central

2017-01-01

Background: The provision of professional pharmacy services by community pharmacists continues to be limited, particularly in low and middle income countries. It was postulated that multiple management challenges faced by community pharmacists contribute to this situation. Objective: The primary aim of the research was to determine the challenges faced in the management of community pharmacies in Sarawak (the largest state in Malaysia), and practical strategies to cope and overcome the challenges. Methods: Semi-structured interviews were carried out with community pharmacists practising in Sarawak. Purposive and snowball sampling were employed to ensure a diverse group of informants. The interviews were audio-recorded and transcribed verbatim, with the resultant data analysed using thematic analysis. Data collection, coding, interpretation were carried out iteratively until theoretical saturation. Results: Twenty respondents from different demographic characteristics were recruited. Six major themes were identified. Management challenges faced by community pharmacists traverse five major domains: market competition, legislative issues, customers’ knowledge and expectations, macroeconomic impacts and operational challenges. Most of these challenges require government intervention to be resolved. In the meantime, improving customer service and expanding the range of professional services were seen as the most viable strategies to cope with existing challenges. The main concern is that current legislative and economic landscape may hinder these strategies. Enactment of dispensing separation and more protective measures against market competition were suggested to alleviate the challenges faced. Conclusion: Numerous management challenges faced by community pharmacists that distract them from delivering professional pharmacy services have been highlighted. Urgent affirmative actions by the government are warranted in supporting community pharmacists to realise and maximise their potentials. PMID:28690697

Health Management Information System utilization in Pakistan: challenges, pitfalls and the way forward.

PubMed

Qazi, Muhammad Suleman; Ali, Moazzam

2011-12-01

Use of data generated through the Health Management Information System (HMIS) in decision making has been facing various challenges ever since its inception in Pakistan. This descriptive qualitative study attempts to explore the perceptions of health managers to identify the status and issues in use of HMIS. Overall 26 managers (all men, ages ranging from 26 to 49 years; selected from federal level (2), provincial (4) and seven selected districts (20) from all four provinces) were interviewed face to face. The respondents identified a number of hurdles resulting in non-use, misuse and disuse of data. These included limited scope of HMIS, dubious data quality, political motives behind demand of data and an element of corruption in data reporting etc. A great deal of political and administrative will is required to institutionalize transparency in decision making in health management and HMIS is an important tool for doing so. Appropriate legislation and regulations are needed to create a conducive policy environment that would help in changing the existing decision making culture. The effective use of information requires that besides capacity development of district health managers in understanding and use of data, the higher level decision makers are provided with relevant data timely and in an easily understandable form along with the recommended actions pertinent to this data.

Fire management assessment of the Caribbean Pine (Pinus caribea) forest ecosystems on Andros and Abaco Islands, Bahamas

Treesearch

R. Myers; D. Wade; C. Bergh

2004-01-01

From 2-7 February 2003, a team of fire management and fire ecology experts visited the islands of Andros, Abaco, and New Providence in the Bahamas to gain insight into the fire issues facing the conservation of the Caribbean pine forests, which cover large percentages of each island. The objectives for the assessment were to: (1) Gather information on fire...

Placing learning needs in context: distance learning for clinical officers in Tanzania.

PubMed

Brigley, Stephen; Hosein, Ian; Myemba, Irnei

2009-04-01

Poor public health indicators in Tanzania have led to the upgrading of nursing and clinical personnel who currently have just core training. Clinical officers (COs) have 3 years training in basic and applied medicine and are responsible for healthcare of large and dispersed rural populations. UNESCO-Wales has funded colleagues in Wales (UK) to assist the upgrade of COs. An inquiry into their learning needs and the Tanzanian context has produced a framework for design of a module for COs on sexually transmissible infections and HIV & AIDS by distance learning. Face-to-face discussions were held with the Ministry of Health, healthcare workers, educators and administrators in Tanzania; a review of training documents was carried out; and a follow-up questionnaire issued to COs. The discussions and review highlighted teacher-centred approaches, and management, infrastructure and resources obstacles to curriculum change. Principal learning needs of COs around STIs were: counselling, syndromic management, drugs management, laboratory diagnosis, health education, resources, staffing and service morale. Placing learning needs in context in dialogue with Tanzanian colleagues was an advance on simple transfer of educational technologies and expertise. The inquiry resulted in a draft study guide and resources pack that were positively reviewed by Tanzanian tutors. Management and resources issues raised problems of sustainability in the module implementation.

Teaching ethics to engineers - a research-based perspective

NASA Astrophysics Data System (ADS)

Bowden, Peter

2010-10-01

This paper describes research underpinning a course, developed in Australia, on ethics for engineers. The methodology used, that of identifying the principal ethical issues facing the discipline and designing the course around these issues, would be applicable to other disciplines and in other countries. The course was based on the assumption that identifying the major ethical issues in the discipline, and subsequently presenting and analysing them in the classroom, would provide the future professional with knowledge of the ethical problems that they were likely to face on graduation. The student has then to be given the skills and knowledge to combat these concerns, should he/she wish to. These findings feed into several components of the course, such as the development of a code of ethics, the role of a professional society or industry association and the role of ethical theory The sources employed to identify the issues were surveys of the literature and about 30 case studies, in Australia and overseas. The issues thus identified were then put before a sample of engineering managers to assess the relevance to the profession.

Adopting Extensible Business Reporting Language (XBRL): A Grounded Theory

ERIC Educational Resources Information Center

Cruz, Marivic

2010-01-01

In 2007 and 2008, government challenges consisted of error prone, manually intensive, and inefficient environments for financial reporting. Banking regulators worldwide faced issues with respect to transparency, timeliness, quality, and managing risks associated with accounting opacity. The general problem was the existing reporting standards and…

Visions Management: Effective Teaching through Technology.

ERIC Educational Resources Information Center

Larson, Robert W.

In making effective use of technology, instructors must face several challenges, such as deciding which technology is really necessary for effective teaching and working with limited department budgets. In addressing these issues, faculty should be aware of three major trends in communications technology: miniaturization of the media of…

Community development : local growth issues--federal opportunities and challenges : report to Congressional requesters

DOT National Transportation Integrated Search

2000-09-01

Faced with a projected 50-percent increase in the U.S. population in the next 50 years, communities across the nation must address the challenges of planning for and managing growth. State and local governments are balancing the need for sustainable ...

AIDS and the Older Adult.

ERIC Educational Resources Information Center

Allers, Christopher T.

1990-01-01

Older adults are finding themselves the neighbors of Acquired Immunodeficiency Syndrome (AIDS) patients as well as the primary caregivers of infected adult children. Focuses on roles, issues, and conflicts older adults face in dealing with relatives or neighbors with AIDS. Case management and educational intervention strategies are also offered.…

An Air Force Guide for Effective Meeting Management

DTIC Science & Technology

2011-05-01

The inspection program to ensure its sustainment has faced increasing workload requirements due to structural issues related to heavy use and aging...26 Data Sources /Format...aircraft availability, the High Velocity Maintenance (HVM) concept is being implemented to replace the current PDM process for heavy maintenance

Encopresis in Children on the Autistic Spectrum.

ERIC Educational Resources Information Center

Radford, Jo; Anderson, Maggie

2003-01-01

Outlines problems faced by parents and caregivers of a child with encopresis. Differentiates between knowledge, skill, and volition issues when dealing with the encoprectic child; and suggests possible causal frameworks for the behavior. Concludes with suggestions for managing the teaching/learning situation arising from this behavior. (Author/KB)

Challenges of Developing New Classes of NASA Self-Managing Mission

NASA Technical Reports Server (NTRS)

Hinchey, M. G.; Rash, J. I.; Truszkowski, W. F.; Rouff, C. A.; Sterritt, R.

2005-01-01

NASA is proposing increasingly complex missions that will require a high degree of autonomy and autonomicity. These missions pose hereto unforeseen problems and raise issues that have not been well-addressed by the community. Assuring success of such missions will require new software development techniques and tools. This paper discusses some of the challenges that NASA and the rest of the software development community are facing in developing these ever-increasingly complex systems. We give an overview of a proposed NASA mission as well as techniques and tools that are being developed to address autonomic management and the complexity issues inherent in these missions.

Identifying challenges for academic leadership in medical universities in Iran.

PubMed

Bikmoradi, Ali; Brommels, Mats; Shoghli, Alireza; Khorasani-Zavareh, Davoud; Masiello, Italo

2010-05-01

CONTEXT The crucial role of academic leadership in the success of higher education institutions is well documented. Medical education in Iran has been integrated into the health care system through a complex organisational change. This has called into question the current academic leadership, making Iranian medical universities and schools a good case for exploring the challenges of academic leadership. OBJECTIVES This study explores the leadership challenges perceived by academic managers in medical schools and universities in Iran. METHODS A qualitative study using 18 face-to-face, in-depth interviews with academic managers in medical universities and at the Ministry of Health and Medical Education in Iran was performed. All interviews were recorded digitally, transcribed verbatim and analysed by qualitative content analysis. RESULTS The main challenges to academic leadership could be categorised under three themes, each of which included three sub-themes: organisational issues (inefficacy of academic governance; an overly extensive set of missions and responsibilities; concerns about the selection of managers); managerial issues (management styles; mismatch between authority and responsibilities; leadership capabilities), and organisational culture (tendency towards governmental management; a boss-centred culture; low motivation). CONCLUSIONS This study emphasises the need for academic leadership development in Iranian medical schools and universities. The ability of Iranian universities to grow and thrive will depend ultimately upon the application of leadership skills. Thus, it is necessary to better designate authorities, roles of academic staff and leaders at governance.

Science for Managing Riverine Ecosystems: Actions for the USGS Identified in the Workshop "Analysis of Flow and Habitat for Instream Aquatic Communities"

USGS Publications Warehouse

Bencala, Kenneth E.; Hamilton, David B.; Petersen, James H.

2006-01-01

Federal and state agencies need improved scientific analysis to support riverine ecosystem management. The ability of the USGS to integrate geologic, hydrologic, chemical, geographic, and biological data into new tools and models provides unparalleled opportunities to translate the best riverine science into useful approaches and usable information to address issues faced by river managers. In addition to this capability to provide integrated science, the USGS has a long history of providing long-term and nationwide information about natural resources. The USGS is now in a position to advance its ability to provide the scientific support for the management of riverine ecosystems. To address this need, the USGS held a listening session in Fort Collins, Colorado in April 2006. Goals of the workshop were to: 1) learn about the key resource issues facing DOI, other Federal, and state resource management agencies; 2) discuss new approaches and information needs for addressing these issues; and 3) outline a strategy for the USGS role in supporting riverine ecosystem management. Workshop discussions focused on key components of a USGS strategy: Communications, Synthesis, and Research. The workshop identified 3 priority actions the USGS can initiate now to advance its capabilities to support integrated science for resource managers in partner government agencies and non-governmental organizations: 1) Synthesize the existing science of riverine ecosystem processes to produce broadly applicable conceptual models, 2) Enhance selected ongoing instream flow projects with complementary interdisciplinary studies, and 3) Design a long-term, watershed-scale research program that will substantively reinvent riverine ecosystem science. In addition, topical discussion groups on hydrology, geomorphology, aquatic habitat and populations, and socio-economic analysis and negotiation identified eleven important complementary actions required to advance the state of the science and to develop the tools for supporting decisions on riverine ecosystem management. These eleven actions lie within the continuum of Communications, Synthesis, and Research.

It Is a Small World after All: Teaching Business Ethics in a Global Environment

ERIC Educational Resources Information Center

Budden, Connie B.; Budden, Michael C.

2011-01-01

Increasingly, managers and employees are facing ethical issues when conducting business in the global marketplace. Business educators attempting to teach appropriate ethical behavior and develop skills for dealing with complex ethical situations need to incorporate realistic case scenarios to challenge students. Such cases should appropriately…

Learning to See the (W)holes

ERIC Educational Resources Information Center

Burns, Barbara A.; Jordan, Thomas M.

2006-01-01

Business managers are faced with complex decisions involving a wide range of issues--technical, social, environmental, and financial--and their interaction. Our education system focuses heavily on presenting structured problems and teaching students to apply a set of tools or methods to solve these problems. Yet the most difficult thing to teach…

Preparing Women for the Profession: A Course Using Structured Role-Model Analysis.

ERIC Educational Resources Information Center

Sauer, Barbara L.; Koda-Kimble, Mary Anne

1989-01-01

A course was developed at the University of California, San Francisco, School of Pharmacy, addressing issues facing women. Female students discussed career planning and management, the complexities of balancing career and family life, and career commitment. The technique of structured role-model analysis was used. (Author/MLW)

Holistically Evaluating the Impact of Water and Land Use Management in the Santa Cruz Watershed

EPA Science Inventory

Governments, tribal leaders and citizens within the Santa Cruz watershed (United States, Mexico, the Tohono O'odham and the Pascua Yaqui Tribes) face environmental and economic issues of ensuring people have access to clean water and sanitation while vital ecosystems are protect...

Behind Closed Doors: School Nurses and Sexual Education

ERIC Educational Resources Information Center

Brewin, Dorothy; Koren, Ainat; Morgan, Betty; Shipley, Sara; Hardy, Rachel L.

2014-01-01

School nurses can play a key role in providing sexual education in schools. However, they often face barriers from the school administration and concerned parents. Additionally, school nurses may have limited formal preparation in managing sexual health issues. This study used a descriptive qualitative method to explore the school nurses'…

Organisational change. Grace under fire.

PubMed

Dickinson, Helen; Parker, Helen

2006-12-14

The success of organisational change is often thwarted by leaders' failure to consider staff feelings. Managers must communicate a clear vision for the future, even though they may be facing great professional uncertainty themselves. It is important to deal with post-merger issues such as helping staff to new roles and 'unlearning' old ways.

Current Issues in Chinese Higher Education. Education and Skills.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France).

The papers in this collection discuss the challenges and opportunities inherent in the fundamental reforms under way in the higher education sector in China. The chapters are: (1) "Introduction: Changing Patterns in University Management" (Thomas J. Alexander); (2) "What Is Facing Chinese Higher Education in the New Century?"…

Nutritional management of feedlot cattle to optimize performance and minimize environmental impact

USDA-ARS?s Scientific Manuscript database

The cattle feeding industry is a new but rapidly growing industry in Brazil and other parts of South America. This presentation/ manuscript provides a brief overview of potential environmental issues faced by concentrated cattle feeding operations, and methods to minimize adverse effects on the envi...

A Decision Support Tool to Evaluate Sources and Sinks of Nitrogen within a Watershed Framework

EPA Science Inventory

Human transformation of the nitrogen (N) cycle is causing a number of environmental and human health problems. Federal, state and local authorities focusing on management of N loadings face both technical and non-technical challenges. One technical issue is that we need a bette...

Issues of Global and Local Norm Use in Assessments of Motivation

ERIC Educational Resources Information Center

Kabacoff, Robert I.

2008-01-01

With the growth of globalization, organizations are facing an increased challenge to manage talent, improve employee engagement, develop effective teams, create succession pipelines, and increase organizational effectiveness in multinational settings. Given the need to evaluate and compare individuals from more than one country using standardized…

Evaluating the impacts of agricultural land management practices: A probabilistic hydrologic modeling approach

USDA-ARS?s Scientific Manuscript database

The complexity of the hydrologic system challenges the development of models. One issue faced during the model development stage is the uncertainty involved in model parameterization. Using a single optimized set of parameters (one snapshot) to represent baseline conditions of the system limits the ...

Internetworking Services and the Electronic Library.

ERIC Educational Resources Information Center

Brunell, David H.

1991-01-01

Discusses management issues that librarians face in offering public access to library resources through internetworking services, e.g., local area networks, campus networks, or the INTERNET. It is concluded that interface problems and lack of an effective technical support structure make access to library information on INTERNET more of an…

The Implications of Real Options on ERP-Enabled Adoption

ERIC Educational Resources Information Center

Nwankpa, Joseph K.

2012-01-01

Current research on Enterprise Resource Planning (ERP) systems and real options focuses on valuation and justification issues that manager's face prior to project approval with existing literature attempting to demonstrate that ERP systems as technology positioning investments have option-like characteristics thus making such ERP systems…

Internationalizing Business Education in Latin America: Issues and Challenges

ERIC Educational Resources Information Center

Elahee, Mohammad; Norbis, Mario

2009-01-01

This article examines the extent of internationalization of business education in Latin America and identifies the key challenges facing the Latin American business schools. Based on a survey of the business schools that are members of CLADEA (Consejo Latinoamericano de Escuelas de Administracion--Latin American Council of Management Schools), and…

Development of the renewal on the Standing Rock Sioux Reservation Project

USDA-ARS?s Scientific Manuscript database

The Standing Rock Sioux Reservation is comprised of 2.3 million acres of primarily rangeland that straddle the North Dakota – South Dakota border. Many of its inhabitants face issues with unemployment and dietary problems. In addition, there are concerns about the management of its natural resourc...

Resveratrol and cancer: Challenges for clinical translation

PubMed Central

Singh, Chandra K.; Ndiaye, Mary A.; Ahmad, Nihal

2014-01-01

Significant work has been done towards identifying the health-beneficial effects of the grape antioxidant resveratrol in a variety of bioassay- and disease- models, with much research being focused on its possible application to cancer management. Despite the large number of preclinical studies dealing with different aspects of the biological effects of resveratrol, it’s translation to clinics is far from reality due to a variety of challenges. In this review, we discuss the issues and questions associated with resveratrol becoming an effective in vivo anticancer drug, from basic metabolic issues to the problems faced by incomplete understanding of the mechanism(s) of action in the body. We also explore efforts taken by researchers, both public and private, to contend with some of these issues. By examining the published data and previous clinical trials, we have attempted to identify the problems and issues that hinder the clinical translation of resveratrol for cancer management. PMID:25446990

Social, political, and institutional setting: Water management problems of the Rio Grande

USGS Publications Warehouse

Douglas, A.J.

2009-01-01

This paper discusses various water management issues facing federal, state, and local agencies charged with managing the water resources of the Rio Grande River Basin and its major tributaries. The Rio Grande - 3,058 km (=1,900 mi) long - is the fourth longest river in the United States. The river's basin is 870,236 km2 (=336,000 mi2) and for roughly two-thirds of its length it forms the United States-Mexican border. It is a major recreational resource providing world class trout fishing near its headwaters in Colorado's San Juan Mountains and shoreline, angling, and boating opportunities near the Colorado-New Mexico border. The Rio Grande is the principal tourist attraction of Big Bend National Park and flows through downtown Albuquerque and El Paso. Many reaches are wide and broad, but almost all are relatively shallow and not navigable by commercial ships. Nevertheless, it is one of the most important renewable water resources of the southwestern United States and North America. The issue of the "manageability" of the river in the face of social forces and disparate administrative jurisdictions that adversely impact Rio Grande flows is a thread linking various sections of the paper together. The length of the river; the fact that major reaches lie in Colorado, New Mexico, and Texas; and its unique role as an international boundary pose complex management problems. The allocation status quo formed by the complex nexus of existing river laws make it difficult to reshape Rio Grande management. ?? 2009 ASCE.

Multilevel water governance and problems of scale: setting the stage for a broader debate.

PubMed

Moss, Timothy; Newig, Jens

2010-07-01

Environmental governance and management are facing a multiplicity of challenges related to spatial scales and multiple levels of governance. Water management is a field particularly sensitive to issues of scale because the hydrological system with its different scalar levels from small catchments to large river basins plays such a prominent role. It thus exemplifies fundamental issues and dilemmas of scale in modern environmental management and governance. In this introductory article to an Environmental Management special feature on "Multilevel Water Governance: Coping with Problems of Scale," we delineate our understanding of problems of scale and the dimensions of scalar politics that are central to water resource management. We provide an overview of the contributions to this special feature, concluding with a discussion of how scalar research can usefully challenge conventional wisdom on water resource management. We hope that this discussion of water governance stimulates a broader debate and inquiry relating to the scalar dimensions of environmental governance and management in general.

Water Resources Management and Hydrologic Design Under Uncertain Climate Change Scenarios

NASA Astrophysics Data System (ADS)

Teegavarapu, R. S.

2008-05-01

The impact of climate change on hydrologic design and management of water resource systems could be one of the important challenges faced by future practicing hydrologists and water resources managers. Many water resources managers currently rely on the historical hydrological data and adaptive real-time operations without consideration of the impact of climate change on major inputs influencing the behavior of hydrologic systems and the operating rules. Issues such as risk, reliability and robustness of water resources systems under different climate change scenarios were addressed in the past. However, water resources management with the decision maker's preferences attached to climate change has never been dealt with. This presentation discusses issues related to impacts of climate change on water resources management and application of a soft-computing approach, fuzzy set theory, for climate-sensitive management of water resources systems. A real-life case study example is presented to illustrate the applicability of soft-computing approach for handling the decision maker's preferences in accepting or rejecting the magnitude and direction of climate change.

The impact of web-based and face-to-face simulation on patient deterioration and patient safety: protocol for a multi-site multi-method design.

PubMed

Cooper, Simon J; Kinsman, Leigh; Chung, Catherine; Cant, Robyn; Boyle, Jayne; Bull, Loretta; Cameron, Amanda; Connell, Cliff; Kim, Jeong-Ah; McInnes, Denise; McKay, Angela; Nankervis, Katrina; Penz, Erika; Rotter, Thomas

2016-09-07

There are international concerns in relation to the management of patient deterioration which has led to a body of evidence known as the 'failure to rescue' literature. Nursing staff are known to miss cues of deterioration and often fail to call for assistance. Medical Emergency Teams (Rapid Response Teams) do improve the management of acutely deteriorating patients, but first responders need the requisite skills to impact on patient safety. In this study we aim to address these issues in a mixed methods interventional trial with the objective of measuring and comparing the cost and clinical impact of face-to-face and web-based simulation programs on the management of patient deterioration and related patient outcomes. The education programs, known as 'FIRST(2)ACT', have been found to have an impact on education and will be tested in four hospitals in the State of Victoria, Australia. Nursing staff will be trained in primary (the first 8 min) responses to emergencies in two medical wards using a face-to-face approach and in two medical wards using a web-based version FIRST(2)ACTWeb. The impact of these interventions will be determined through quantitative and qualitative approaches, cost analyses and patient notes review (time series analyses) to measure quality of care and patient outcomes. In this 18 month study it is hypothesised that both simulation programs will improve the detection and management of deteriorating patients but that the web-based program will have lower total costs. The study will also add to our overall understanding of the utility of simulation approaches in the preparation of nurses working in hospital wards. (ACTRN12616000468426, retrospectively registered 8.4.2016).

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

PubMed Central

Heath, Sebastian E.; Linnabary, Robert D.

2015-01-01

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

Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue

PubMed Central

Hirsch, Jennifer S.; Nathanson, Constance; Parker, Richard G.

2015-01-01

In recent years, the menstrual hygiene management challenges facing schoolgirls in low-income-country contexts have gained global attention. We applied Gusfield’s sociological analysis of the culture of public problems to better understand how this relatively newly recognized public health challenge rose to the level of global public health awareness and action. We similarly applied the conceptualization by Dorfman et al. of the role of public health messaging in changing corporate practice to explore the conceptual frames and the news frames that are being used to shape the perceptions of menstrual hygiene management as an issue of social justice within the context of public health. Important lessons were revealed for getting other public health problems onto the global-, national-, and local-level agendas. PMID:25973831

Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue.

PubMed

Sommer, Marni; Hirsch, Jennifer S; Nathanson, Constance; Parker, Richard G

2015-07-01

In recent years, the menstrual hygiene management challenges facing schoolgirls in low-income-country contexts have gained global attention. We applied Gusfield's sociological analysis of the culture of public problems to better understand how this relatively newly recognized public health challenge rose to the level of global public health awareness and action. We similarly applied the conceptualization by Dorfman et al. of the role of public health messaging in changing corporate practice to explore the conceptual frames and the news frames that are being used to shape the perceptions of menstrual hygiene management as an issue of social justice within the context of public health. Important lessons were revealed for getting other public health problems onto the global-, national-, and local-level agendas.

Parental perspectives on inpatient versus outpatient management of pediatric febrile neutropenia.

PubMed

Diorio, Caroline; Martino, Julia; Boydell, Katherine Mary; Ethier, Marie-Chantal; Mayo, Chris; Wing, Richard; Teuffel, Oliver; Sung, Lillian; Tomlinson, Deborah

2011-01-01

To describe parent preference for treatment of febrile neutropenia and the key drivers of parental decision making, structured face-to-face interviews were used to elicit parent preferences for inpatient versus outpatient management of pediatric febrile neutropenia. Parents were presented with 4 different scenarios and asked to indicate which treatment option they preferred and to describe reasons for this preference during the face-to-face interview. Comments were recorded in writing by research assistants. A consensus approach to thematic analysis was used to identify themes from the written comments of the research assistants. A total of 155 parents participated in the study. Of these, 80 (51.6%) parents identified hospital-based intravenous treatment as the most preferred treatment scenario for febrile neutropenia. The major themes identified included convenience/disruptiveness, physical health, emotional well-being, and modifiers of parental decision making. Most parents preferred hospital-based treatment for febrile neutropenia. An understanding of issues that influence parental decision making may assist health care workers in planning program implementation and further support families in their decision-making process.

Perioperative management in myasthenia gravis: republication of a systematic review and a proposal by the guideline committee of the Japanese Association for Chest Surgery 2014.

PubMed

Kadota, Yoshihisa; Horio, Hirotoshi; Mori, Takeshi; Sawabata, Noriyoshi; Goto, Taichiro; Yamashita, Shin-ichi; Nagayasu, Takeshi; Iwasaki, Akinori

2015-04-01

Thymectomy is regarded as a useful therapeutic option for myasthenia gravis (MG), though perioperative management in MG patients is largely empirical. While evidence-based medicine is limited in the perioperative management of MG patients, treatment guidelines are required as a benchmark. We selected issues faced by physicians in clinical practice in the perioperative management of extended thymectomy for MG, and examined them with a review of the literature. The present guidelines have reached the stage of consensus within the Japanese Association for Chest Surgery.

If the face is familiar, the patient may be overusing healthcare.

PubMed

2014-01-01

Patients who use the healthcare system excessively, and often for avoidable issues, create a burden for hospitals and consume a significant portion of healthcare expenditures. Many frequent users have complex medical and psychosocial needs, are uninsured, or have behavioral health issues. Case managers should identify patients who are potential frequent utilizers and make sure they are connected with a primary care provider. Take the time to find out barriers to care and call in a social worker to help line up community resources.

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

PubMed Central

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

2016-01-01

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

Treatment of Opioid Dependent Pregnant Women: Clinical and Research Issues

PubMed Central

Jones, H.E.; Martin, P.R.; Heil, S.H.; Stine, S.M.; Kaltenbach, K.; Selby, P.; Coyle, M.G.; O’Grady, K.E.; Arria, A.M.; Fischer, G.

2008-01-01

This paper addresses common questions that clinicians face when treating pregnant women with opioid dependence. Guidance is provided to aid clinical decision-making, based on both research evidence and the collective clinical experience of the authors which include investigators in the Maternal Opioid Treatment: Human Experimental Research (MOTHER) project. MOTHER is a double-blind, double-dummy, flexible–dosing, parallel-group clinical trial examining the comparative safety and efficacy of methadone and buprenorphine for the opioid dependence treatment among pregnant women and their neonates. The paper begins with a discussion of appropriate assessment during pregnancy, and then addresses clinical management stages, including maintenance medication selection, induction and stabilization, opioid agonist medication management before, during and after delivery, pain management, breast-feeding, and transfer to aftercare. Lastly, other important clinical issues including managing co-occurring psychiatric disorders and medication interactions are discussed. PMID:18248941

An initial investigation on the challenges of managing construction workforce in Saudi Arabia

NASA Astrophysics Data System (ADS)

Al-Emad, N.; Rahman, I. A.

2017-11-01

Most of the construction workers in Saudi Arabia are foreigners from several countries having different knowledge, skills and cultures. These create challenges to administer the workers in ensuring project success. This paper presents an initial investigation to uncover the challenges faced by construction professionals in managing construction workforce in Saudi Arabia. It describes insight processes of handling the workforce during planning stage, recruitment procedures and construction stage based on interview with senior manager who are well experienced in handling mega construction projects in Saudi Arabia. The interview was carried out in semi structured mode where the interviewee was given ample time to express the experiences encountered in dealing the workforce issue. This preliminary work able to identify among important issues related to construction workers are restrictions to non-Muslim skilled workers, limited visa quota, being away from family, delay in salary payment, cheating of workers skill’s status, safety issues, communication barriers and living conditions. Hence, these issues require quality leadership attributes such as continuous empathy with workers, respectful, trustful, sincere, reliable, good communication skills and problem solving skills. These findings are useful to construction practitioners and also research work related to construction leadership in handling worker’s issues.

Major Topics of School Business Management.

ERIC Educational Resources Information Center

Clark, James E., Ed.; Hertz, Karl V., Ed.

Thirteen articles on major topics facing school business officials in the 1980s are presented in this book. The titles and their authors are (1) "The Pursuit of Equity in Financing Public Education," by R. Craig Wood, Helene B. Jones, and William L. Riley; (2) "Facilities: Major Issues Ahead," by C. William Day; (3)…

Learning about Feelings. Learning at Home Series.

ERIC Educational Resources Information Center

Linke, Pam

As part of a series of booklets designed to support parents and carers of young children in the home, this issue explores the challenges that all young children face in learning to manage their feelings and emotions so they can be safe, optimistic, and enthusiastic about life and learning. Following an introductory section emphasizing the early…

Challenges faced and tactics used to integrate real-time state police CAD data with the VDOT Richmond District Smart Traffic Center : lessons learned document

DOT National Transportation Integrated Search

2005-01-01

This document discusses the significant issues encountered during the development effort of integrating the Transportation Management System (OpenTMS) deployed at the VDOT Richmond District Smart Traffic Center (STC) with the real time State Police d...

Culturally Sensitive IS Teaching: Lessons Learned to Manage Motivation Issues

ERIC Educational Resources Information Center

Chen, Wenshin

2011-01-01

This paper seeks to raise awareness of culturally sensitive teaching that is largely overlooked in the IS teaching community. In a global, networked environment commonly faced by the contemporary business or academic world, it is imperative to prepare future IT professionals with adequate cultural understanding of such a multicultural environment…

Uncommon Territory: Declaration, and the Supervision of Queer Design Theses

ERIC Educational Resources Information Center

Ings, Welby John

2014-01-01

While attempting to develop authentic, practice-led inquiries into identity, queer students face unique issues. They often need to consider questions of community and frequently find themselves with one foot outside of the academic environment. Many also have to carefully consider the implications of declaration, and the management of trust. This…

The Rewards of Teaching Music in Urban Settings

ERIC Educational Resources Information Center

Bernard, Rhoda

2010-01-01

A great deal has been written about the challenges facing music educators who work in urban settings. The scarcity of instruments, textbooks, and other resources; a lack of parental and administrative support; and difficulties with classroom management are just a few of the issues that confront music teachers who work in urban communities.…

Applying Diversity Management Principles to Institutions of Christian Higher Education

ERIC Educational Resources Information Center

Fubara, Edward I.; Gardner, Matthew T.; Wolff, Jordan S.

2011-01-01

For a variety of reasons many Christian higher education institutions struggle to embrace issues of diversity. This paper explores some of the challenges facing Christian higher education institutions when it comes to embracing diversity, particularly in the area of employment. It begins with a discussion of basic diversity/diversity management…

Realizing the Potential of Information Resources: Information, Technology, and Services. Track 8: Academic Computing and Libraries.

ERIC Educational Resources Information Center

CAUSE, Boulder, CO.

Eight papers are presented from the 1995 CAUSE conference track on academic computing and library issues faced by managers of information technology at colleges and universities. The papers include: (1) "Where's the Beef?: Implementation of Discipline-Specific Training on Internet Resources" (Priscilla Hancock and others); (2)…

75 FR 38810 - National Advisory Council for Environmental Policy and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

...: Under the Federal Advisory Committee Act, Public Law 92463, EPA gives notice of a public teleconference... advice to the EPA Administrator on a broad range of environmental policy, technology, and management... developing to respond to EPA's request for advice on workforce issues the Agency is facing and how EPA can...

The Ontological Architectures in the Application of a Knowledge Management System for Curricular Assessment

ERIC Educational Resources Information Center

Olson, Brandon D.

2012-01-01

Institutions of higher education are facing increasing pressure to improve the effectiveness and quality of academic programs (Association of Governing Boards, Top public policy issues 2011-2012, 2011). These institutions apply curricular assessment processes as a means to evaluate and improve academic effectiveness and quality. Knowledge…

Where Does Conflict Management Fit in the System's Leadership Puzzle?

ERIC Educational Resources Information Center

Cook, Vickie S.; Johnston, Linda M.

2008-01-01

Superintendents are faced with conflicts every day. The conflicts arise around issues of personnel, community roles, funding, politics, and work/life balance. Good leadership involves an understanding of how to deal with conflict, whom to involve in the conflict resolution, how to set up structures and processes that ensure conflict doesn't…

A Phenomenological Study: Community Mental Health Centers Leaders Influence on Clinician Effectiveness

ERIC Educational Resources Information Center

Williams, Beth B.

2011-01-01

Some clinical leaders of community mental health centers are not aware of successful methods for supporting and empowering staff to be more effective, specifically when the staff is experiencing change because of new health information technology. Clinical leaders in community mental health face similar management issues as do other business,…

Energy Storage | Transportation Research | NREL

Science.gov Websites

Is Available for License Lithium-ion (Li-ion) battery overheating has led to numerous product recalls most challenging thermal management issues faced by electric-drive vehicles (EDVs)a battery internal internal short rather than mechanically damaging the battery exterior to activate the short, as most other

Rivers Run Through It: Discovering the Interior Columbia River Basin.

ERIC Educational Resources Information Center

Davis, Shelley; Wojtanik, Brenda Lincoln; Rieben, Elizabeth

1998-01-01

Explores the Columbia River Basin, its ecosystems, and challenges faced by natural resource managers. By studying the basin's complexity, students can learn about common scientific concepts such as the power of water and effects of rain shadows. Students can also explore social-scientific issues such as conflicts between protecting salmon runs and…

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

PubMed

Young, Guy

2010-09-01

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

Insights for conducting real-time focus groups online using a web conferencing service.

PubMed

Kite, James; Phongsavan, Philayrath

2017-01-01

Background Online focus groups have been increasing in use over the last 2 decades, including in biomedical and health-related research. However, most of this research has made use of text-based services such as email, discussion boards, and chat rooms, which do not replicate the experience of face-to-face focus groups. Web conferencing services have the potential to more closely match the face-to-face focus group experience, including important visual and aural cues. This paper provides critical reflections on using a web conferencing service to conduct online focus groups. Methods As part of a broader study, we conducted both online and face-to-face focus groups with participants. The online groups were conducted in real-time using the web conferencing service, Blackboard Collaborate TM . We used reflective practice to assess how the conduct and content of the groups were similar and how they differed across the two platforms. Results We found that further research using such services is warranted, particularly when working with hard-to-reach or geographically dispersed populations. The level of discussion and the quality of the data obtained was similar to that found in face-to-face groups. However, some issues remain, particularly in relation to managing technical issues experienced by participants and ensuring adequate recording quality to facilitate transcription and analysis. Conclusions Our experience with using web conferencing for online focus groups suggests that they have the potential to offer a realistic and comparable alternative to face-to-face focus groups, especially for geographically dispersed populations such as rural and remote health practitioners. Further testing of these services is warranted but researchers should carefully consider the service they use to minimise the impact of technical difficulties.

Creating a quality-improvement dialogue: utilizing knowledge from frontline staff, managers, and experts to foster health care quality improvement.

PubMed

Parker, Louise E; Kirchner, JoAnn E; Bonner, Laura M; Fickel, Jacqueline J; Ritchie, Mona J; Simons, Carol E; Yano, Elizabeth M

2009-02-01

There is a growing consensus that a hybrid of two common approaches to quality improvement (QI), local participatory QI and expert QI, might be the best method for achieving quality care. Achieving such a hybrid requires that content experts establish an ongoing dialogue with both frontline staff members and managers. In this study we examined frontline staff members' and managers' preferences regarding how to conduct such a dialogue, and we provide practical suggestions for implementation. The two groups shared a number of preferences (e.g., verbal face-to-face exchanges, discussions focused on quality of care). There were also some differences. For example, although managers were interested in discussions of business aspects (e.g., costs), frontline staff members were concerned with workload issues. Finally, although informants acknowledged that engaging in a QI dialogue was time consuming, they also believed it was essential if health care organizations are to improve the quality of care they provide.

Time Overrun in Construction Project

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Information superhighway: Issues affecting development

NASA Astrophysics Data System (ADS)

1994-09-01

Technological advances in the transmission of voice, video, and data are fostering fundamental changes in the telecommunications industry. For example, large local telephone companies plan to offer video services in competition with cable and broadcast television, while cable television companies plan to offer local telephone service over their wires in competition with the local telephone companies. The administration believes that these technological changes provide the opportunity to develop an 'Information Superhighway' that could provide every element of society with ready access to data, voice, and video communications. Concurrently, the Congress is considering sweeping changes to telecommunications regulations to keep pace with this dynamic industry. GAO prepared this report to serve as an overview of three key issues that decisionmakers may face as they deliberate telecommunications legislation; it focuses on three pivotal issues they face in formulating new telecommunications legislation: (1) managing the transition to a more competitive local telecommunications marketplace; (2) ensuring that all consumers have access to affordable telecommunications as competition develops; and (3) ensuring that the Information Superhighway provides adequate security, privacy, reliability, and interoperability.

Human rights and implications for managers.

PubMed

Bunner, K L

1994-01-01

Although the Canadian Human Rights Act was enacted in 1977 and The Charter of Rights and Freedoms was introduced in 1981, a paucity of Canadian literature regarding their implications for nursing managers is apparent. The modern nursing unit manager is faced with a variety of decisions pertaining to employment, performance evaluations, and delegation of responsibilities, which if not sensitively and fairly handled may expose the manager and the organization to non-defensible vulnerabilities. This paper briefly reviews pertinent human rights issues in the nursing setting and the effect of human rights considerations on the management of a nursing unit. Discrimination, harassment, the hiring process, performance appraisal and discipline are discussed along with recommendations regarding mandatory inservices for managers.

Building on common ground to address biodiversity conflicts and foster collaboration in environmental management.

PubMed

Lecuyer, Lou; White, Rehema M; Schmook, Birgit; Calmé, Sophie

2018-08-15

Conservation biology faces critical challenges that require collaborative approaches, including novel strategies to support interactions among actors in biodiversity conflicts. The goals of this study were to investigate the concept of common ground across multiple issues and to explore its practical application for the support of environmental management. We conceptually defined common ground as the areas of relevance underlying the suite of issues expressed by people regarding environmental management in a particular context. We then empirically tested this in the Calakmul region of Mexico, where the complex socio-historical context and high biodiversity have created environmental management challenges that are now being addressed by a local, multi-stakeholder management board. We conducted 26 open interviews with members of the board and a further round of quantitative prioritisation of issues raised. Using a coding process designed to reveal common ground, we categorized the issues at four levels ranging from coarse to fine (themes, topics, sub-topics and perspectives). We then analysed two levels, topics (n = 14 issues) and sub-topics (n = 51 issues). To do so, we built common ground matrices to identify and analyze common ground among actors and across issues. First, cluster and non-metrical data analyses revealed the diversity of actor positions and the lack of consistent grouping among actors by occupational activity. This demonstrated that focusing on actors' differences might be misleading, and that actors' views were not closely aligned with their roles. Second, we located issues according to their levels of common ground and importance among actors. We showed that by not focusing on single issue conflicts, the identification of common ground across multiple issues can pinpoint synergies. We then proposed a framework for collaboration that prioritizes issues of high importance with greater common ground (e.g. sustainable resource use activities), to support the development of trust and norms of reciprocity among actors, strengthening the potential for future cooperation. By adopting this approach, environmental managers could support the initial stages of collaborative conservation strategies, engaging with other actors to seek common ground, avoid the creation of polarised groups and help effectively manage biodiversity conflicts. Copyright © 2018 Elsevier Ltd. All rights reserved.

Management of pregnancy in women with genetic disorders, Part 1: Disorders of the connective tissue, muscle, vascular, and skeletal systems.

PubMed

Chetty, Shilpa Prema; Shaffer, Brian L; Norton, Mary E

2011-11-01

Due to early diagnosis and increasingly effective medical advances, the number of women with various genetic syndromes who are undergoing pregnancy is increasing, and this represents an important issue for providers of obstetric care. Each year more women with genetic disease reach childbearing age. Advances in assisted reproductive technology have enabled pregnancy in a cohort of woman who may experience impaired fertility due to their underlying diagnosis. Management of these women requires coordination of care by healthcare providers from multiple specialties to optimize outcomes. Potentially serious medical issues specific to each diagnosis often exist in the preconception, antepartum, intrapartum, and postpartum periods, all of which must be recognized to allow timely diagnosis and treatment. The fetus may also face issues related to risk for inheritance of the genetic disorder itself, as well as risks related to the chronic disease status of the mother. This article will explore the issues faced by women with various genetic disorders that may affect connective tissue, muscular, vascular, and skeletal systems. Obstetricians & Gynecologists and Family Physicians. After the completing the CME activity, physicians should be better able to classify the cardiovascular manifestations observed in Marfan syndrome and Ehlers-Danlos, evaluate prenatal diagnostic options and limitations for various genetic syndromes, assess the risks to the fetus in women with various genetic syndromes. Determine whether there is a preferred mode of delivery for pregnant patients with various genetic syndromes described in this paper.

China's water scarcity.

PubMed

Jiang, Yong

2009-08-01

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

U.S. Geological Survey Science Support Strategy for Biscayne National Park and Surrounding Areas in Southeastern Florida

USGS Publications Warehouse

Wolfert-Lohmann, Melinda A.; Langevin, Christian D.; Jones, Sonya A.; Reich, Chris D.; Wingard, Georgina L.; Kuffner, Ilsa B.; Cunningham, Kevin J.

2008-01-01

The U.S. Geological Survey conducts a wide range of research in and around the Biscayne National Park region of southern Florida. This research encompasses the biologic, ecologic, meteorologic, geologic, and hydrologic components of the system, including water-quality analyses, ground-water modeling, hydrogeologic-data collection, ecologic-habitat evaluations, wetlands characterizations, biogeochemistry of ecosystems, and paleo-ecologic analyses. Relevant information is provided herein for researchers and managers interested in the Biscayne Bay area and about current U.S. Geological Survey efforts that address important resource protection and management issues. Specifically, managers and scientists are provided with information on current and recently completed U.S. Geological Survey projects and a sample listing of potential U.S. Geological Survey research projects addressing relevant issues that face the study area.

Hyperpigmentation therapy: a review.

PubMed

Desai, Seemal R

2014-08-01

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

Optimizing the management of elderly colorectal surgery patients.

PubMed

Tan, Kok-Yang; Konishi, Fumio; Tan, Lawrence; Chin, Wui-Kin; Ong, Hean-Yee; Tan, Phyllis

2010-11-01

With the ever increasing number of geriatric surgical patients, there is a need to develop efficient processes that address all of the potential issues faced by patients during the perioperative period. This article explores the physiological changes in elderly surgical patients and the outcomes achieved after major abdominal surgery. Perioperative management strategies for elderly surgical patients in line with the practices of the Geriatric Surgical Team of Alexandra Health, Singapore, are also presented. A coordinated transdisciplinary approach best tackles the complexities encountered in these patients.

Beyond the classroom to coaching: preparing new nurse managers.

PubMed

DeCampli, Pamela; Kirby, Karen K; Baldwin, Claire

2010-01-01

Few would question that frontline nurse managers are critical to the success of any organization. They are the key interface with patients, nursing staff, medical staff, other clinical and ancillary staff, and administration. This makes the role one of the most difficult and one of the most important in any healthcare setting. Despite the importance of the role, many new managers receive little, if any, formal preparation. While hospitals are starting to send nurse managers to formal educational programs, the new manager receives little benefit if they do not have help putting it into practice. Even when there is a preceptor, chances are that new managers are still not getting what they need. Preceptors have multiple demands on their time and little, if any, formal preceptor training. One hospital that has successfully tackled this issue is Bryn Mawr Hospital, a Main Line Health System Magnet-designated hospital in suburban Philadelphia. Bryn Mawr Hospital engaged an experienced nurse executive to coach new nurse managers for 4 months on site. While participants agree face-to-face coaching is the most important component of this program, they also say having a seasoned coach gives them the confidence to ask questions they would not have felt comfortable exploring otherwise.

Realizing the Potential of Information Resources: Information, Technology, and Services. Track 4: Rethinking User Services.

ERIC Educational Resources Information Center

CAUSE, Boulder, CO.

Six papers and two abstracts of papers are presented from the 1995 CAUSE conference track on user services issues faced by managers of information technology at colleges and universities. The papers include: (1) "Academic Computing Services: MORE than a Utility" (Scott Bierman and Cathy Smith), which focuses on Carleton College's efforts…

Using the Arts to Raise Awareness and Communicate Environmental Information in the Extension Context

ERIC Educational Resources Information Center

Curtis, David J.

2011-01-01

Extension services face an increasing challenge as the state of Australia's environment declines. It is, therefore, opportune to explore some innovations in the way extension is traditionally delivered. This paper introduces the concept of the visual and performing arts being useful in extension of natural resources management issues such as land…

Administrative Problem-Solving for Writing Programs and Writing Centers: Scenarios in Effective Program Management.

ERIC Educational Resources Information Center

Myers-Breslin, Linda

Addressing the issues and problems faced by writing program administrators (WPAs) and writing center directors (WCDs), and how they can most effectively resolve the political, pedagogical, and financial questions that arise, this book presents essays from experienced WPAs and WCDs at a wide variety of institutions that offer scenarios and case…

Creating Regional Futures: A Scenario-Based Inter- and Transdisciplinary Case Study as a Model for Applied Student-Centred Learning in Geography

ERIC Educational Resources Information Center

Fromhold-Eisebith, Martina; Freyer, Bernhard; Mose, Ingo; Muhar, Andreas; Vilsmaier, Ulli

2009-01-01

Human geography students face changing qualification requirements due to a shift towards new topics, educational tasks and professional options regarding issues of spatial development. This "practical turn" raises the importance of inter- and transdisciplinary work, management and capability building skills, with case study projects and…

Exploring Efficacy in Negotiating Support: Women Re-Entry Students in Higher Education

ERIC Educational Resources Information Center

Filipponi-Berardinelli, Josephine Oriana

2013-01-01

The existing literature on women re-entry students reveals that women students concurrently struggle with family, work, and sometimes health issues. Women students often do not receive adequate support from their partners or from other sources in helping manage the multiple roles that compete for their time, and often face constraints that affect…

Difficulties in Reforming Education Policy: The Hong Kong Case.

ERIC Educational Resources Information Center

Godwin, C. D.

1999-01-01

Over the past decade, the education-policy machinery in Hong Kong has been faced with important quality issues emerging that concern the history and culture of the school system. Evaluates two change-management initiatives between 1990 and 1995 and examines their outcomes in light of the endemic features of Hong Kong civil-service culture and…

Natural resources research and management issues: 2007

Treesearch

Christine Vogt; James Absher; Alan Graefe; Bill Hammitt; Linda Kruger; Jerry Vaske

2008-01-01

This year (2007) at the Northeastern Recreation Research (NERR) Symposium, we took the opportunity to reflect on the past 15 to 20 years of recreation research and discuss the opportunities and challenges that might face us in the next decade. The session utilized a panel to entertain four primary questions focused on recreation research. Following a panel presentation...

Experimental forests and ranges as a network for for long-term data

Treesearch

Martin Vavra; John Mitchell

2010-01-01

In the new millennium, national leaders and policymakers are facing profound issues regarding people and the environment. Experimental Forests and Ranges (EFRs), managed by the Forest Service, U.S. Department of Agriculture (USDA), form a network of locations amenable to the development of long-term data collection across many major ecosystems of the continental United...

Detroit Business Leadership and Educational Change. Supporting Leaders for Tomorrow, Occasional Paper #7.

ERIC Educational Resources Information Center

Spratling, Cassandra

The growing proclivity of business leaders in some urban communities to become more deeply involved in the complex and politically volatile issue of school governance is assessed in this paper. The troubles facing Detroit public schools include a high dropout rate, illiteracy of graduates, and bad management of money and resources. In 1988,…

Realizing the Potential of Information Resources: Information, Technology, and Services. Track 3: Serving Clients with Client/Server.

ERIC Educational Resources Information Center

CAUSE, Boulder, CO.

Eight papers are presented from the 1995 CAUSE conference track on client/server issues faced by managers of information technology at colleges and universities. The papers include: (1) "The Realities of Client/Server Development and Implementation" (Mary Ann Carr and Alan Hartwig), which examines Carnegie Mellon University's transition…

Realizing the Potential of Information Resources: Information, Technology, and Services. Track 1: Strategic Planning.

ERIC Educational Resources Information Center

CAUSE, Boulder, CO.

Eight papers are presented from the 1995 CAUSE conference track on strategic planning issues faced by managers of information technology at colleges and universities. The papers include: (1) "Can Small Colleges Afford To Be Technology Leaders? Can They Afford Not To Be? (Martin Ringle and David Smallen); (2) "Strategic Planning Across…

Compassion in the workplace? Discrimination against an employee with cancer.

PubMed

2006-12-01

Rachel is a designer based in the UK. In the following account, she describes the experiences of her colleague Jack, designer and studio manager, during his battles with colon cancer and with his employers. The article raises the issues of difficulties faced in the workplace by patients with cancer and other life-threatening illnesses.

Facing the challenge of the young, the small, and the dead: Alaska's new frontier.

Treesearch

Sally Duncan

2000-01-01

Mandates to harvest, beetle infestations, log export restrictions, pulp mill closures, high transportation costs, ecological versus economic effects--the litany of challenges in the Alaska timber markets is sufficient to stymie land and timber managers. For decades, they have had to confront and make decisions about these conflicting issues without sufficient data...

Realizing the Potential of Information Resources: Information, Technology, and Services. Track 2: Policies and Standards.

ERIC Educational Resources Information Center

CAUSE, Boulder, CO.

Seven papers and one abstract of a paper are presented from the 1995 CAUSE conference track on policies and standards issues faced by managers of information technology at colleges and universities. The papers include: (1) "University/College Information System Structures and Policies: Do They Make a Difference? An Initial Assessment"…

General concepts in the management of a kidney transplant.

PubMed

Ortiz-Heredia, Luis; Cangiano, Jose L

2011-01-01

The management of a kidney transplant patient is, in most cases, challenging and requires a multidisciplinary approach. For the physician caring for the patient it is imperative to have a broad knowledge regarding several concepts on their management, as they are increasingly faced with long-term care. Baseline rapport and accessibility provides a pivotal role in the treatment, monitoring and preventive measures in the kidney transplant patient. Currently, most aspects regarding patient management vary according to each transplant center. This article describes the importance of several medical issues directed towards the clinician aiming to improve awareness and expand knowledge, with the development of a systematic approach.

Assessing the quality of the nation's water resources

USGS Publications Warehouse

Hamilton, Pixie A.

2002-01-01

This issue of IMPACT highlights findings from the first decade of studies (1991 to 2001) by the National Water-Quality Assessment (NAWQA) Program of the U.S. Geological Survey (USGS). The articles also discuss the Program’s approaches and models designed to help understand and estimate the fate and transport of contaminants in different geographic areas and environmental settings and over different time frames. NAWQA was established by Congress in 1991 with a goal of developing long-term, consistent, and comparable science-based information on nationwide water-quality conditions. This information is used to support sound management and policy decisions by decision makers at all levels – local, state, and national – who, every day, face complex regulations and management issues related to water resources.

Chronic disease management in Sub-Saharan Africa: whose business is it?

PubMed

Bischoff, Alexander; Ekoe, Tetanye; Perone, Nicolas; Slama, Slim; Loutan, Louis

2009-08-01

Public health specialists and clinicians alike agree that Humanity faces a global pandemic of chronic diseases in the 21(st) century. In this article we discuss the implications of this pandemic on another global issue, the health workforce. Because both issues are particularly acute in Sub-Saharan Africa (SSA), we will focus on this region and use Cameroon as a case in point. We first gauge the epidemic of chronic conditions in SSA. We then discuss the implications of chronic conditions for the reshaping of health systems and the health workforce. We conclude by making a strong case for the building up and strengthening the health workforce, insisting on the crucial role of nurses, their training, and involvement in chronic disease management.

Surrogacy in modern obstetric practice.

PubMed

Burrell, Celia; Edozien, Leroy C

2014-10-01

Surrogacy is rising in profile and prevalence, which means that perinatal care providers face an increasing likelihood of encountering a case in their clinical practice. Rapidly expanding scientific knowledge (for example, fetal programming) and technological advances (for example, prenatal screening and diagnosis) pose challenges in the management of the surrogate mother; in particular, they could exacerbate conflict between the interests of the baby, the surrogate mother, and the intending parent(s). Navigating these often-tranquil-but-sometimes-stormy waters is facilitated if perinatal care providers are aware of the relevant ethical, legal, and service delivery issues. This paper describes the ethical and legal context of surrogacy, and outlines key clinical practice issues in management of the surrogate mother. Copyright © 2014 Elsevier Ltd. All rights reserved.

Chronic Disease Management in Sub-Saharan Africa: Whose Business Is It?

PubMed Central

Bischoff, Alexander; Ekoe, Tetanye; Perone, Nicolas; Slama, Slim; Loutan, Louis

2009-01-01

Public health specialists and clinicians alike agree that Humanity faces a global pandemic of chronic diseases in the 21st century. In this article we discuss the implications of this pandemic on another global issue, the health workforce. Because both issues are particularly acute in Sub-Saharan Africa (SSA), we will focus on this region and use Cameroon as a case in point. We first gauge the epidemic of chronic conditions in SSA. We then discuss the implications of chronic conditions for the reshaping of health systems and the health workforce. We conclude by making a strong case for the building up and strengthening the health workforce, insisting on the crucial role of nurses, their training, and involvement in chronic disease management. PMID:19742159

Managing the professional nurse. Part I. The organizational theories.

PubMed

McClure, M L

1984-02-01

How do employment organizations outside the hospital field deal with issues such as staff productivity, motivation, burnout, and high turnover? In Part I of this two-part article, the author presents an overview of modern management theory and practice, drawn from the literature on organizational behavior. She shows how nursing administrators can use this scholarly foundation to better understand the organizing principles and problems of their departments. In Part II (to be published in March 1984), the author applies these classic and relevant theories to the specific challenges that face the manager of professional nurses.

Capacity planning in a transitional economy: What issues? Which models?

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

Mubayi, V.; Leigh, R.W.; Bright, R.N.

1996-03-01

This paper is devoted to an exploration of the important issues facing the Russian power generation system and its evolution in the foreseeable future and the kinds of modeling approaches that capture those issues. These issues include, for example, (1) trade-offs between investments in upgrading and refurbishment of existing thermal (fossil-fired) capacity and safety enhancements in existing nuclear capacity versus investment in new capacity, (2) trade-offs between investment in completing unfinished (under construction) projects based on their original design versus investment in new capacity with improved design, (3) incorporation of demand-side management options (investments in enhancing end-use efficiency, for example)more » within the planning framework, (4) consideration of the spatial dimensions of system planning including investments in upgrading electric transmission networks or fuel shipment networks and incorporating hydroelectric generation, (5) incorporation of environmental constraints and (6) assessment of uncertainty and evaluation of downside risk. Models for exploring these issues include low power shutdown (LPS) which are computationally very efficient, though approximate, and can be used to perform extensive sensitivity analyses to more complex models which can provide more detailed answers but are computationally cumbersome and can only deal with limited issues. The paper discusses which models can usefully treat a wide range of issues within the priorities facing decision makers in the Russian power sector and integrate the results with investment decisions in the wider economy.« less

Resolving complex research data management issues in biomedical laboratories: Qualitative study of an industry-academia collaboration.

PubMed

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

2016-04-01

This paper describes a distributed collaborative effort between industry and academia to systematize data management in an academic biomedical laboratory. Heterogeneous and voluminous nature of research data created in biomedical laboratories make information management difficult and research unproductive. One such collaborative effort was evaluated over a period of four years using data collection methods including ethnographic observations, semi-structured interviews, web-based surveys, progress reports, conference call summaries, and face-to-face group discussions. Data were analyzed using qualitative methods of data analysis to (1) characterize specific problems faced by biomedical researchers with traditional information management practices, (2) identify intervention areas to introduce a new research information management system called Labmatrix, and finally to (3) evaluate and delineate important general collaboration (intervention) characteristics that can optimize outcomes of an implementation process in biomedical laboratories. Results emphasize the importance of end user perseverance, human-centric interoperability evaluation, and demonstration of return on investment of effort and time of laboratory members and industry personnel for success of implementation process. In addition, there is an intrinsic learning component associated with the implementation process of an information management system. Technology transfer experience in a complex environment such as the biomedical laboratory can be eased with use of information systems that support human and cognitive interoperability. Such informatics features can also contribute to successful collaboration and hopefully to scientific productivity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Technology-driven dietary assessment: a software developer’s perspective

PubMed Central

Buday, Richard; Tapia, Ramsey; Maze, Gary R.

2015-01-01

Dietary researchers need new software to improve nutrition data collection and analysis, but creating information technology is difficult. Software development projects may be unsuccessful due to inadequate understanding of needs, management problems, technology barriers or legal hurdles. Cost overruns and schedule delays are common. Barriers facing scientific researchers developing software include workflow, cost, schedule, and team issues. Different methods of software development and the role that intellectual property rights play are discussed. A dietary researcher must carefully consider multiple issues to maximize the likelihood of success when creating new software. PMID:22591224

Driving and flying with epilepsy.

PubMed

Drazkowski, Joseph F

2007-07-01

Transportation issues in industrialized nations play an important role in the lives of most citizens. The acts of flying and driving, especially in the United States, intersect with many peoples' lives on almost a daily basis. Although some larger cities have modern and efficient public transportation systems, many do not, thus placing considerable responsibility on the individual to manage their own transportation needs. A person with epilepsy faces considerable challenges when it comes to transportation. Defining these challenges and understanding how to deal with the person with epilepsy and transportation issues is the focus of this article.

Hazardous healthcare waste management in the Kingdom of Bahrain.

PubMed

Mohamed, L F; Ebrahim, S A; Al-Thukair, A A

2009-08-01

Hazardous healthcare waste has become an environmental concern for many developing countries including the Kingdom of Bahrain. There have been several significant obstacles facing the Kingdom in dealing with this issue including; limited documentation regarding generation, handling, management, and disposal of waste. This in turn hinders efforts to plan better healthcare waste management. In this paper, hazardous waste management status in the Kingdom has been investigated through an extensive survey carried out on selected public and private healthcare premises. Hazardous waste management practices including: waste generation, segregation, storage, collection, transportation, treatment, and disposal were determined. The results of this study along with key findings are discussed and summarized. In addition; several effective recommendations and improvements of hazardous waste management are suggested.

Hazardous healthcare waste management in the Kingdom of Bahrain

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

Mohamed, L.F.; Ebrahim, S.A.; Al-Thukair, A.A.

2009-08-15

Hazardous healthcare waste has become an environmental concern for many developing countries including the Kingdom of Bahrain. There have been several significant obstacles facing the Kingdom in dealing with this issue including; limited documentation regarding generation, handling, management, and disposal of waste. This in turn hinders efforts to plan better healthcare waste management. In this paper, hazardous waste management status in the Kingdom has been investigated through an extensive survey carried out on selected public and private healthcare premises. Hazardous waste management practices including: waste generation, segregation, storage, collection, transportation, treatment, and disposal were determined. The results of this studymore » along with key findings are discussed and summarized. In addition; several effective recommendations and improvements of hazardous waste management are suggested.« less

Applying comprehensive environmental assessment to research planning for multiwalled carbon nanotubes: Refinements to inform future stakeholder engagement.

PubMed

Powers, Christina M; Grieger, Khara; Meacham, Connie A; Gooding, Meredith Lassiter; Gift, Jeffrey S; Lehmann, Geniece M; Hendren, Christine O; Davis, J Michael; Burgoon, Lyle

2016-01-01

Risk assessments and risk management efforts to protect human health and the environment can benefit from early, coordinated research planning by researchers, risk assessors, and risk managers. However, approaches for engaging these and other stakeholders in research planning have not received much attention in the environmental scientific literature. The Comprehensive Environmental Assessment (CEA) approach under development by the United States Environmental Protection Agency (USEPA) is a means to manage complex information and input from diverse stakeholder perspectives on research planning that will ultimately support environmental and human health decision making. The objectives of this article are to 1) describe the outcomes of applying lessons learned from previous CEA applications to planning research on engineered nanomaterial, multiwalled carbon nanotubes (MWCNTs) and 2) discuss new insights and refinements for future efforts to engage stakeholders in research planning for risk assessment and risk management of environmental issues. Although framed in terms of MWCNTs, this discussion is intended to enhance research planning to support assessments for other environmental issues as well. Key insights for research planning include the potential benefits of 1) ensuring that participants have research, risk assessment, and risk management expertise in addition to diverse disciplinary backgrounds; 2) including an early scoping step before rounds of formal ratings; 3) using a familiar numeric scale (e.g., US dollars) versus ordinal rating scales of "importance"; 4) applying virtual communication tools to supplement face-to-face interaction between participants; and 5) refining criteria to guide development of specific, actionable research questions. © 2015 SETAC.

Challenge theme 2: assuring water availability and quality in the 21st century: Chapter 4 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

USGS Publications Warehouse

Callegary, James; Langeman, Jeff; Leenhouts, Jim; Martin, Peter

2013-01-01

Along the United States–Mexican border, the health of communities, economies, and ecosystems is inextricably intertwined with the availability and quality of water, but effective water management in the Borderlands is complicated. Water users compete for resources, and their needs are increasing. Managers are faced with issues such as finding a balance between agriculture and rapidly growing cities or maintaining public supplies while ensuring sufficient resources for aquatic ecosystems. In addition to human factors, the dry climate of the Borderlands, as compared to more temperate regions, also increases the challenge of balancing water supplies between humans and ecosystems. Warmer, drier, and more variable conditions across the southwestern United States—the projected results of climate change (Seager and others, 2007)—would further stress water supplies.

Gender and sexual health in clinical practice in Lebanon

PubMed Central

El-Kak, F.; Jurdi, R.; Kaddour, A.; Zurayk, H.

2006-01-01

This study examines the readiness of obstetricians/gynecologists (Ob/Gyns) in Lebanon to provide sexual consultation, their degree of comfort when discussing issues of sexual health, and their attitudes regarding assessment, treatment, and referral. Data on these concepts were collected through face-to-face interviews with 286 randomly selected Ob/Gyns. Most Ob/Gyns reported feeling comfortable discussing sexuality during consultations, which they attributed much more to professional experience than to training. Most Ob/Gyns reported giving proper time for management of sexual health issues and follow-up, as these issues are brought up frequently by their women clients. However, results suggest that only one-third (31%) of Lebanese Ob/Gyns nearly always take the initiative in asking patients about their sexual health. Moreover, almost 45% of participating Ob/Gyns did not recognize a strong relationship between reproductive health and sexual functioning. Gender was not found to be an important predictor for any of the indicators measured in the present study. Ob/Gyns in Lebanon are significant consultants on various sexual issues, and they need better postgraduate training, continuing medical education, and access to medical congress resources on the topic of sexuality and its relationship to reproductive health. PMID:15548405

Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea.

PubMed

Oh, Jinjoo; Oh, Seieun

2017-12-01

The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.

Increasing the Value of Age: Guidance in Employers' Age Management Strategies. Research Paper No 44

ERIC Educational Resources Information Center

Cedefop - European Centre for the Development of Vocational Training, 2015

2015-01-01

The European active population is ageing. In the face of growing skills shortages, both national States and employers need to prolong the working lives of their most experienced workers. While enterprises strive to respond to this challenge, most still have not fully explored the potential of guidance activities in addressing age-related issues in…

Functional Coherence in the State Education Agency: A Structure for Performance Management. Solutions. Issue No. 4

ERIC Educational Resources Information Center

Redding, Sam; Nafziger, Dean

2013-01-01

The purpose of the state education agency (SEA) is to focus the entire education system on helping students become capable in college and career in an increasingly complex world. One of the most vexing problems facing SEAs today is how to meet increasing demands for performance while adjusting to significant resource reductions. Meeting that…

We've Let Student Loans Become a Horror Story ... Now Is Time to Face It

ERIC Educational Resources Information Center

Combe, Paul

2013-01-01

This article highlights an issue that has been slowly simmering over the past 30 years--Student Debt. As government loans quietly edged out grants, and college tuition continued to rise, debt has been piled on students without adequately preparing them to manage it. Research reports about 30% of the 37 million Americans with student loans are…

Limiting recreational use in wilderness: Research issues and management challenges in appraising their effectiveness

Treesearch

Stephen F. McCool

2001-01-01

Limits on the overall number of recreationists permitted to enter or visit wilderness, national park backcountry or whitewater rivers have been formally established for about 30 years. Such limits have usually been established to protect biophysical or social conditions from unacceptable impacts in the face of rapidly rising amounts of visitation. Use limits are one of...

Suggestions and Procedures for Choosing a Chinese Institution of Higher Education as a Partner

ERIC Educational Resources Information Center

Willis, Mike

2007-01-01

China has one of the largest and most complex higher education systems in the world, and a key challenge facing any foreign education institution is how to select an appropriate potential partner. This paper considers how a number of foreign university managers selected a university in China. Issues of location, ranking, status, programs, mutual…

Managing the Foreign Language Classroom: Reflections from the Preservice Field and Beyond

ERIC Educational Resources Information Center

Evans, Elizabeth Julie

2012-01-01

Each day, foreign language teachers are faced with issues that render the control of the K-12 classroom challenging, at best, and virtually impossible at worst. Even preservice foreign language teachers, those going through a teacher education program towards K-12 licensure, understand that no content can be taught or learned if there is mayhem in…

Identifying the Criteria for Planning the Selection and Succession of a CIO: A Phenomenological Study

ERIC Educational Resources Information Center

Williamson, Charles E.

2010-01-01

Many challenges face CIOs in their management of IT systems; yet, very little research is available regarding the issues and constraints associated with their role. CIO leadership is still a subject of inquiry for those with aspirations to pursue such a position. The specific problem of the current qualitative phenomenological study concerned the…

The FireBGCv2 landscape fire and succession model: a research simulation platform for exploring fire and vegetation dynamics

Treesearch

Robert E. Keane; Rachel A. Loehman; Lisa M. Holsinger

2011-01-01

Fire management faces important emergent issues in the coming years such as climate change, fire exclusion impacts, and wildland-urban development, so new, innovative means are needed to address these challenges. Field studies, while preferable and reliable, will be problematic because of the large time and space scales involved. Therefore, landscape simulation...

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

Treesearch

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

2013-01-01

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

The Troublesome Triplets: Issues in Teaching Reliability, Validity and Generalisation to Business Students

ERIC Educational Resources Information Center

Quinton, Sarah; Smallbone, Teresa

2005-01-01

This discussion paper focuses on the problem of how to approach teaching abstract concepts to business and management students at both undergraduate and postgraduate level. Students are faced with the problem of how to identify and assess the rigour of what they read, how to generalise from the results of their research and how to judge the extent…

Animal Health and Welfare Issues Facing Organic Production Systems

PubMed Central

Sutherland, Mhairi A.; Webster, Jim; Sutherland, Ian

2013-01-01

Simple Summary The demand for organically grown, animal derived produce is increasing due to a growing desire for consumer products that have minimal chemical inputs and high animal welfare standards. Evaluation of the scientific literature suggests that a major challenge facing organic animal production systems is the management and treatment of health-related issues. However, implementation of effective management practices can help organic animal producers achieve and maintain high standards of health and welfare, which is necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. Abstract The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. PMID:26479750

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

PubMed

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

2003-01-01

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

Women's work. Maintaining a healthy body weight.

PubMed

Welch, Nicky; Hunter, Wendy; Butera, Karina; Willis, Karen; Cleland, Verity; Crawford, David; Ball, Kylie

2009-08-01

This study describes women's perceptions of the supports and barriers to maintaining a healthy weight among currently healthy weight women from urban and rural socio-economically disadvantaged areas. Using focus groups and interviews, we asked women about their experiences of maintaining a healthy weight. Overwhelmingly, women described their healthy weight practices in terms of concepts related to work and management. The theme of 'managing health' comprised issues of managing multiple responsibilities, time, and emotions associated with healthy practices. Rural women faced particular difficulties in accessing supports at a practical level (for example, lack of childcare) and due to the gendered roles they enacted in caring for others. Family background (in particular, mothers' attitudes to food and weight) also appeared to influence perceptions about healthy weight maintenance. In the context of global increases in the prevalence of obesity, the value of initiatives aimed at supporting healthy weight women to maintain their weight should not be under-estimated. Such initiatives need to work within the social and personal constraints that women face in maintaining good health.

The precautionary principle and pharmaceutical risk management.

PubMed

Callréus, Torbjörn

2005-01-01

Although it is often vigorously contested and has several different formulations, the precautionary principle has in recent decades guided environmental policy making in the face of scientific uncertainty. Originating from a criticism of traditional risk assessment, the key element of the precautionary principle is the justification for acting in the face of uncertain knowledge about risks. In the light of its growing invocation in various areas that are related to public health and recently in relation to drug safety issues, this article presents an introductory review of the main elements of the precautionary principle and some arguments conveyed by its advocates and opponents. A comparison of the characteristics of pharmaceutical risk management and environmental policy making (i.e. the setting within which the precautionary principle evolved), indicates that several important differences exist. If believed to be of relevance, in order to avoid arbitrary and unpredictable decision making, both the interpretation and possible application of the precautionary principle need to be adapted to the conditions of pharmaceutical risk management.

A proposal of optimal sampling design using a modularity strategy

NASA Astrophysics Data System (ADS)

Simone, A.; Giustolisi, O.; Laucelli, D. B.

2016-08-01

In real water distribution networks (WDNs) are present thousands nodes and optimal placement of pressure and flow observations is a relevant issue for different management tasks. The planning of pressure observations in terms of spatial distribution and number is named sampling design and it was faced considering model calibration. Nowadays, the design of system monitoring is a relevant issue for water utilities e.g., in order to manage background leakages, to detect anomalies and bursts, to guarantee service quality, etc. In recent years, the optimal location of flow observations related to design of optimal district metering areas (DMAs) and leakage management purposes has been faced considering optimal network segmentation and the modularity index using a multiobjective strategy. Optimal network segmentation is the basis to identify network modules by means of optimal conceptual cuts, which are the candidate locations of closed gates or flow meters creating the DMAs. Starting from the WDN-oriented modularity index, as a metric for WDN segmentation, this paper proposes a new way to perform the sampling design, i.e., the optimal location of pressure meters, using newly developed sampling-oriented modularity index. The strategy optimizes the pressure monitoring system mainly based on network topology and weights assigned to pipes according to the specific technical tasks. A multiobjective optimization minimizes the cost of pressure meters while maximizing the sampling-oriented modularity index. The methodology is presented and discussed using the Apulian and Exnet networks.

Ethics in an operations management course.

PubMed

Rudnicka, Ewa A

2005-10-01

Graduates of the management major at the University of Pittsburgh at Greensburg find employment in a variety of organizations. As future managers with employees from different professions, students expressed an interest in discussing ethics cases in the operations management class. The semester starts with students familiarizing themselves with various professional and corporate codes of ethics. Throughout the semester a number of short ethics' cases in operations' areas such as inventory management, scheduling, facility location, and product design are introduced to illustrate ethical issues that a manager and his/her employees might face. Students prepare individual responses before the in-class discussions. The semester ends with a long group ethics case discussion and formal case presentations. In the end-of-semester survey, students responded very favorably to an ethics component in the operations management class.

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

NASA Astrophysics Data System (ADS)

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

2018-06-01

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

Strategic Directions Within Health Care Institutions: The Role of the Physician

PubMed Central

McDaniel, Reuben R.; Ashmos, Donde P.

1986-01-01

The nature of the strategic problem faced by health care institutions is identified. Physicians are urged to be involved in the strategic decision-making process and are offered several alternative roles that they might play in strategy development. A set of conceptual frameworks from the generic management decision-making literature is used to organize the analysis in addition to the literature of health care management. This combination affords a different perspective into the nature of the problems and new insights into these critical issues. PMID:3746932

Using a Prediction Model to Manage Cyber Security Threats.

PubMed

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

2015-01-01

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

Using a Prediction Model to Manage Cyber Security Threats

PubMed Central

Muthu Sivashanmugam, Premapriya

2015-01-01

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

The paradox of managing a project-oriented matrix: establishing coherence within chaos.

PubMed

Greiner, L E; Schein, V E

1981-01-01

Projects that require the flexible coordination of multidisciplinary teams have tended to adopt a matrix structure to accomplish complex tasks. Yet these project-oriented matrix structures themselves require careful coordination if they are to realize the objectives set for them. The authors identify the basic organizational questions that project-oriented matrix organizations must face. They examine the relationship between responsibility and authority; the tradeoffs between economic efficiency and the technical quality of the work produced; and the sensitive issues of managing individualistic, highly trained professionals while also maintaining group cohesiveness.

Chinese hotel general managers' perspectives on energy-saving practices

NASA Astrophysics Data System (ADS)

Zhu, Yidan

As hotels' concern about sustainability and budget-control is growing steadily, energy-saving issues have become one of the important management concerns hospitality industry face. By executing proper energy-saving practices, previous scholars believed that hotel operation costs can decrease dramatically. Moreover, they believed that conducting energy-saving practices may eventually help the hotel to gain other benefits such as an improved reputation and stronger competitive advantage. The energy-saving issue also has become a critical management problem for the hotel industry in China. Previous research has not investigated energy-saving in China's hotel segment. To achieve a better understanding of the importance of energy-saving, this document attempts to present some insights into China's energy-saving practices in the tourist accommodations sector. Results of the study show the Chinese general managers' attitudes toward energy-saving issues and the differences among the diverse hotel managers who responded to the study. Study results indicate that in China, most of the hotels' energy bills decrease due to the implementation of energy-saving equipments. General managers of hotels in operation for a shorter period of time are typically responsible for making decisions about energy-saving issues; older hotels are used to choosing corporate level concerning to this issue. Larger Chinese hotels generally have official energy-saving usage training sessions for employees, but smaller Chinese hotels sometimes overlook the importance of employee training. The study also found that for the Chinese hospitality industry, energy-saving practices related to electricity are the most efficient and common way to save energy, but older hotels also should pay attention to other ways of saving energy such as water conservation or heating/cooling system.

A Survey of Public Opinion on Cat (Felis catus) Predation and the Future Direction of Cat Management in New Zealand.

PubMed

Walker, Jessica K; Bruce, Stephanie J; Dale, Arnja R

2017-07-03

Cat predation is a prominent issue in New Zealand that provokes strong and opposing views. We explored, via 1011 face-to-face questionnaires, public opinion on (a) support for a National Cat Management Strategy (78% support); (b) concern regarding predation of wildlife by owned and un-owned cats (managed stray, unmanaged stray, and feral cats); (c) the acceptability of management techniques for owned cats; and (d) the acceptability of population management techniques for un-owned cats. The highest concern was expressed regarding the predation of non-native and native wildlife by feral cats (60 and 86% repectively), followed by unmanaged stray cats (59 and 86% respectively), managed stray cats (54 and 82% respectively), and finally owned cats (38 and 69% repectively). Limits to the number of cats owned and cat restriction zones received high levels of support (>65%), and compulsory microchipping, Council registration, and de-sexing were supported by the majority (>58%). Public support of population control methods for unowned cats was explored, and the influence of participant demographic variables on responses is described. These findings provide insight into public opinion regarding the management of cats in New Zealand, which should be considered during the development of legislation in this area.

Hospital waste management in developing countries: A mini review.

PubMed

Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz; Geng, Yong

2017-06-01

Health care activities can generate different kinds of hazardous wastes. Mismanagement of these wastes can result in environmental and occupational health risks. Developing countries are resource-constrained when it comes to safe management of hospital wastes. This study summarizes the main issues faced in hospital waste management in developing countries. A review of the existing literature suggests that regulations and legislations focusing on hospital waste management are recent accomplishments in many of these countries. Implementation of these rules varies from one hospital to another. Moreover, wide variations exist in waste generation rates within as well as across these countries. This is mainly attributable to a lack of an agreement on the definitions and the methodology among the researchers to measure such wastes. Furthermore, hospitals in these countries suffer from poor waste segregation, collection, storage, transportation and disposal practices, which can lead to occupational and environmental risks. Knowledge and awareness regarding proper waste management remain low in the absence of training for hospital staff. Moreover, hospital sanitary workers, and scavengers, operate without the provision of safety equipment or immunization. Unsegregated waste is illegally recycled, leading to further safety risks. Overall, hospital waste management in developing countries faces several challenges. Sustainable waste management practices can go a long way in reducing the harmful effects of hospital wastes.

Aligning USGS senior leadership structure with the USGS science strategy

USGS Publications Warehouse

,

2010-01-01

The U.S. Geological Survey (USGS) is realigning its management and budget structure to further enhance the work of its science programs and their interdisciplinary focus areas related to the USGS Science Strategy as outlined in 'Facing Tomorrow's Challenges-U.S. Geological Survey Science in the Decade 2007-2017' (U.S. Geological Survey, 2007). In 2007, the USGS developed this science strategy outlining major natural-science issues facing the Nation and focusing on areas where natural science can make a substantial contribution to the well being of the Nation and the world. These areas include global climate change, water resources, natural hazards, energy and minerals, ecosystems, and data integration.

Water management, purification, and conservation in arid climates. Volume 1: Water management

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

Goosen, M.F.A.; Shayya, W.H.

1999-07-01

Arid regions are already feeling the severe restraining effects of potable water shortages. In coming years, humid and sub-humid regions of the world will also have to face many of these same problems. In the future, serious conflicts may arise not because of a lack of oil, but due to water shortages. Are there solutions to these problems? Aside from increasing public awareness about the importance of water, society needs to take a three pronged approach: water needs to be effectively managed, it needs to be economically purified, and it needs to be conserved. Only by doing these three thingsmore » in unison can they hope to alleviate the water problems faced by arid regions of the world. This book presents information valuable to seeking, finding and using current technologies to help solve these problems now. Volume 1 examines water management problems in detail, along with water problems and water resources in arid climates, and includes chapters that cover aspects of water management. Water purification technology is another key issue. The economics of this technology is becoming more critical in arid areas due to increasing urbanization and industrialization.« less

A management-control system to assist with the development, contracting, and monitoring of new services for older people: you can always get what you want (with apologies to the Rolling Stones).

PubMed

Jacobs, Stephen

2007-10-01

Implementing community services can be a very complex process where people end up "not seeing the wood for the trees" and then accepting a compromise nobody wants. Neither agency theory nor stewardship theory is particularly robust when explaining the reality that funders and managers of community health service for older people face in managing contracts. There are particular difficulties with goal divergence between policy directives and implementation practices, which result from goals not being well understood and performance requirements being ambiguously defined and infrequently monitored. This leads to accountability issues for public managers, and raises efficiency and effectiveness issues. This paper provides an interim report on a project developing a management-control system to provide a process for health planners and funders to use when developing and contracting services. A major focus is inviting stakeholders into a process of communication that ensures that they have shared understandings of where they want to get to, and what has to be done to get there.

Nursing's new frontier: reinventing our practice in a restructured health care system.

PubMed

Barter, M; Furmidge, M L

1995-12-01

Nurse managers who are faced with the challenge of maintaining productivity in today's turbulent health care environment need new strategies for managing a redesigned workforce. Registered nurses have assumed leadership responsibilities in work teams that include other nurses, licensed personnel from other disciplines, and unlicensed assistive personnel (UAP). Myths, rumors, and questions deserve thoughtful consideration and response if managers want full cooperation from team leaders. Legal and professional issues relating to assignment, delegation, and supervision of a multidisciplinary team must be understood by everyone. Team leaders must have clearly defined boundaries of authority and an understanding of the competencies of each team member to be effective.

Effects of situational conditions on students' views of business ethics.

PubMed

Matsui, Tamao; Kakuyama, Takashi; Tsuzuki, Yukie

2003-12-01

This study investigated undergraduates' responses regarding selected ethical issues facing managers and employees of today's businesses. The focus of the study lies in the influences of two situational variables (organizational roles and prospects) on students' response pattern. Japanese students (306 men and 81 women, M = 20.1 yr., SD = 2.2) imagined that they were managers or operative employees of a middle-sized manufacturing company and that their company had high or low prospects. The response pattern tended to be more ethical for "managers," whereas the response pattern tended to be less ethical for "employees" in a "low prospect" than in a "high prospect" company.

Making waste management public (or falling back to sleep)

PubMed Central

Lougheed, Scott; Rowe, R Kerry; Kuyvenhoven, Cassandra

2014-01-01

Human-produced waste is a major environmental concern, with communities considering various waste management practices, such as increased recycling, landfilling, incineration, and waste-to-energy technologies. This article is concerned with how and why publics assemble around waste management issues. In particular, we explore Noortje Marres and Bruno Latour’s theory that publics do not exist prior to issues but rather assemble around objects, and through these assemblages, objects become matters of concern that sometimes become political. The article addresses this theory of making things public through a study of a small city in Ontario, Canada, whose landfill is closed and waste diversion options are saturated, and that faces unsustainable costs in shipping its waste to the United States, China, and other regions. The city’s officials are undertaking a cost–benefit assessment to determine the efficacy of siting a new landfill or other waste management facility. We are interested in emphasizing the complexity of making (or not making) landfills public, by exploring an object in action, where members of the public may or may not assemble, waste may or may not be made into an issue, and waste is sufficiently routinized that it is not typically transformed from an object to an issue. We hope to demonstrate Latour’s third and fifth senses of politics best account for waste management’s trajectory as a persistent yet inconsistent matter of public concern. PMID:25051590

Future scenarios of Korea national parks: Delphi survey of Korean parks of experts

Treesearch

Byung-kyu Lee; Wilbur F. LaPage

2003-01-01

A three-wave Delphi survey of a panel of 40 key experts very knowledgeable of Korean national parks was conducted between February 2001 and March in 2002. In Wave 1, park professionals, environmental Nongovernmental Organizations (NGOs) managers, and a retiree identified the issues the Korean park system is facing. Findings from Wave 1 of the survey were analyzed and...

Proceedings of a symposium on oak woodlands: ecology, management, and urban interface issues; 19–22 March 1996; San Luis Obispo, CA

Treesearch

Norman H. Pillsbury; Jared Verner; William D. Tietje

1997-01-01

Oak woodlands, the predominant vegetation type in the most inhabitable areas of California, comprise 10 million acres in the State and have been used primarily for livestock production. Today, residential intrusion into oak woodlands results in habitat fragmentation and degradation of economic, esthetic, and ecological values. Decision makers must face up to the...

Strategic Planning, Assessment and Accountability: Their Impact on the Establishment of Centers of Excellence in Academic Departments. AIR 1998 Annual Forum Paper.

ERIC Educational Resources Information Center

Pollicino, Elizabeth B.; Hall, Clover W.

This paper reviews the literature on academic quality programs and examines issues faced at one institution in which two initiatives emphasizing student outcomes and faculty performance as indicators of quality are underway. In its review of the literature the paper focuses on concepts such as total quality management, peer or student evaluation…

Army Logistician. Volume 39, Issue 2, March-April 2007

DTIC Science & Technology

2007-04-01

Most Army Reduces Tactical Supply System Footprint by thoMas h. aMent, jr. Centralizing all of the Army’s Corps/Theater Automated Data Processing...Middleware, which comprises both hardware and software, revises data in the Standard Army Retail Supply System (SARSS), thereby extending the use of the...Logistics: Supply Based or Distribution Based? The Changing Face of Fuel Management Combat Logistics Patrol Methodology Distribution-Based

Gender and Environmental Sustainability: Issues and Problems Involved for Persons with Special Needs in Nigeria

ERIC Educational Resources Information Center

Egaga, Patrick I.; Aderibigbe, S. Akinwumi

2015-01-01

Sustainability of the environment is one of the major problems facing African people, most especially Nigerians. It is unfortunate that women, by the nature of their daily activities of managing the homes and families are in touch with nature and environment and are at greater risk of health hazards and foetal damage. This paper focuses on the…

Funds for the Future. Report of the Twentieth Century Fund Task Force on College and University Endowment Policy.

ERIC Educational Resources Information Center

Williamson, J. Peter

The Task Force on College and University Endowment Policy examines endowment policy in a broad context. They feel that it is important to preserve private colleges and universities and develop a sense of mission about how best to pursue this objective. The Task Force reviews policy issues faced by managers of endowment funds for institutions of…

Looking at Leadership: Some Neglected Issues

DTIC Science & Technology

1977-10-01

problems. (3) Use of power Using social skills, rewards and punishments to control organizational events. A way to study leaders is to simulate the...conditions managers face. Simulation paradigms allow detailed ex- amination of the complex forces impacting on organizations from without and within...modifying the impacts of other variables. Given this horrendous complexity, it is no surprise that Vaill (in press) has questioned whether it makes much

Status of e-Learning Quality in Kenya: Case of Jomo Kenyatta University of Agriculture and Technology Postgraduate Students

ERIC Educational Resources Information Center

Hadullo, Kennedy; Oboko, Robert; Omwenga, Elijah

2018-01-01

There is a substantial increase in the use of learning management systems (LMSs) to support e-learning in higher education institutions, particularly in developing countries. This has been done with some measures of success and failure as well. There is evidence from literature that the provision of e-learning faces several quality issues relating…

The Campus Safety Imperative: A Qualitative Study of A State Higher Education System's Initiatives to Respond to Violence on Campus

ERIC Educational Resources Information Center

Atkins, Kemal M.

2017-01-01

Crisis management is a critical issue facing higher education. Higher education leaders and campus safety advocates agree that the Virginia Tech massacre changed perceptions and approaches to campus safety at colleges and universities nationally. In the University of North Carolina System, it was the two murders of University of North Carolina at…

An Issue of Learning: The Effect of Visual Split Attention in Classes for Deaf and Hard of Hearing Students

ERIC Educational Resources Information Center

Mather, Susan M.; Clark, M. Diane

2012-01-01

One of the ongoing challenges teachers of students who are deaf or hard of hearing face is managing the visual split attention implicit in multimedia learning. When a teacher presents various types of visual information at the same time, visual learners have no choice but to divide their attention among those materials and the teacher and…

From Scientific Management to Social Justice...and Back Again? Pedagogical Shifts in the Study and Practice of Educational Leadership

ERIC Educational Resources Information Center

Brooks, Jeffrey S.; Miles, Mark

2006-01-01

This article presents an historical overview of pedagogical orientations of school leadership in the United States, and then considers issues facing contemporary educational leaders in this context. Our survey begins with a consideration of the early influence of Frederick Taylor and ends in the present day, a time when the fields of practice and…

The hierarchy of work pursuits of public health managers.

PubMed

Braithwaite, Jeffrey; Luft, Sabine; Bender, Wolfgang; Callen, Joanne; Westbrook, Johanna I; Westbrook, Mary T; Mallock, Nadine A; Iedema, Rick; Hindle, Donald; Jochelson, Tanya

2007-05-01

How public health is managed in various settings is an important but under-examined issue. We examine themes in the management literature, contextualize issues facing public health managers and investigate the relative importance placed on their various work pursuits using a 14-activity management model empirically derived from studies of clinician-managers in hospitals. Ethnographic case studies of 10 managers in nine diverse public health settings were conducted. The case study accounts of managers' activities were content analysed, and substantive words encapsulating their work were categorized using the model. Managerial activities of the nine public health managers were ranked according to the number of words describing each activity. Kendall's coefficient of concordance yielded W = 0.710, P < 0.000, revealing significant similarity between the activity patterns of the public health managers. A rank order correlation between the activity patterns of the average ranks for the public health sample and for the hospital clinician-managers (n = 52) was R = 0.420, P = 0.131, indicating no significant relationship between relative activity priorities of the two groups. Public health managers put less emphasis on pursuits associated with structure, hierarchy and education, and more on external relations and decision-making. The model of hospital clinician-managers' managerial activities is applicable to public health managers while identifying differences in the way the two groups manage. The findings suggest that public health management work is more managerialist than previously thought.

What Can You Do with a Returned Sample of Martian Dust?

NASA Technical Reports Server (NTRS)

Zolensky, Michael E.; Nakamura-Messenger, K.

2007-01-01

A major issue that we managed to successfully address for the Stardust Mission was the magnitude and manner of preliminary examination (PET) of the returned samples, which totaled much less than 1 mg. Not since Apollo and Luna days had anyone faced this issue, and the lessons of Apollo PET were not extremely useful because of the very different sample masses in this case, and the incredible advances in analytical capabilities since the 1960s. This paper reviews some of the techniques for examination of small very rare samples that would be returned from Mars missions.

Issues and Concerns Faced by Undergraduate Language Student Teachers during Teaching Practicum Experiences

ERIC Educational Resources Information Center

Ali, Mohd Sofi; Othman, Abdul Jalil; Karim, Abdul Faruk Abdul

2014-01-01

This study examined specific issues and concerns faced by Bachelor of Education student teachers majoring in Language and Literature during their 12-week teaching practicum experience. Specifically, three main areas of concerns were examined. They were: (1) specific issues and concerns related to the implementation of teaching practicum faced by…

Supply Chain Management on IBS Implementation in Klang Valley Construction Industry: Challenges and Issues

NASA Astrophysics Data System (ADS)

Azrizal Fauzi, Mohd; Hasim, Sulaiman; Awang, Anizah; Ridzuan, Ahmad Ruslan Mohd; Nur Yunus, Juzailah

2017-12-01

Industrialized Building System (IBS) is a system where the components of the building are manufactured in a factory and it will be transported to the site to form the structures. The supply chain management (SCM) is a system where the delivery flows of the IBS products from manufacturers to the site. The aim of this research is to identify the major challenges and to analyze the issues on IBS implementation in SCM in Klang Valley from the manufacturers perspective. The methodology used in this paper is based on primary data through questionnaire and interview. Questionnaires were sent to the Manufacturers. It can be concluded that this paper attempts to present more on the challenges and issues that those companies of manufacturers faced during their success journey in finding integration in their supply chain. The main contributions of this paper are integrating all the supply chain integration challenges and issues on IBS. Therefore, these contributions will be helpful for the organization of manufacturers and IBS players that establish the integration in their SCM.

Web-Based Geospatial Tools to Address Hazard Mitigation, Natural Resource Management, and Other Societal Issues

USGS Publications Warehouse

Hearn,, Paul P.

2009-01-01

Federal, State, and local government agencies in the United States face a broad range of issues on a daily basis. Among these are natural hazard mitigation, homeland security, emergency response, economic and community development, water supply, and health and safety services. The U.S. Geological Survey (USGS) helps decision makers address these issues by providing natural hazard assessments, information on energy, mineral, water and biological resources, maps, and other geospatial information. Increasingly, decision makers at all levels are challenged not by the lack of information, but by the absence of effective tools to synthesize the large volume of data available, and to utilize the data to frame policy options in a straightforward and understandable manner. While geographic information system (GIS) technology has been widely applied to this end, systems with the necessary analytical power have been usable only by trained operators. The USGS is addressing the need for more accessible, manageable data tools by developing a suite of Web-based geospatial applications that will incorporate USGS and cooperating partner data into the decision making process for a variety of critical issues. Examples of Web-based geospatial tools being used to address societal issues follow.

Efficacy of Seren@ctif, a Computer-Based Stress Management Program for Patients With Adjustment Disorder With Anxiety: Protocol for a Controlled Trial

PubMed Central

Leterme, Anne-Claire; Rougegrez, Laure; Duhamel, Alain; Vaiva, Guillaume

2017-01-01

Background Adjustment disorder with anxiety (ADA) is the most frequent and best characterized stress-related psychiatric disorder. The rationale for prescription of benzodiazepine monotherapy is a public health issue. Cognitive behavioral stress management programs have been studied in many countries. Several reports have shown beyond reasonable doubt their efficiency at reducing perceived stress and anxiety symptoms and improving patient quality of life. Considering the number of people who could benefit from such programs but are unable to access them, self-help programs have been offered. First presented as books, these programs became enriched with computer-based and digital supports. Regrettably, programs for stress management based on cognitive behavioral therapy (CBT), both face-to-face and digital support, have been only minimally evaluated in France. To our knowledge, the Seren@ctif program is the first French language self-help program for stress management using digital supports. Objective The aim of this study is to assess the effectiveness of a 5-week standardized stress management program for reducing anxiety conducted via eLearning (iCBT) or through face-to-face interviews (CBT) with patients suffering from ADA compared with a wait list control group (WLC). These patients seek treatment in a psychiatric unit for anxiety disorders at a university hospital. The primary outcome is change in the State Trait Anxiety Inventory scale trait subscale (STAI-T) between baseline and 2-month visit. Methods This is a multicenter, prospective, open label, randomized controlled study in 3 parallel groups with balanced randomization (1:1:1): computer-based stress management with minimal contact (not fully automated) (group 1), stress management with face-to-face interviews (group 2), and a WLC group that receives usual health care from a general practitioner (group 3). Programs are based on standard CBT principles and include 5 modules in 5 weekly sessions that include the following topics: stress and stress reaction and assessment; deep respiration and relaxation techniques; cognitive restructuring, mindfulness, and acceptance; behavioral skills as problem solving; and time management, healthy behaviors, and emotion regulation. In the Internet-based group, patients have minimal contact with a medical professional before and after every session. In the first session, a flash memory drive is supplied containing videos, audio files, a self-help book portfolio in the form of an eGuide, and log books providing the exercises to be completed between 2 sessions. The patient is encouraged to practice a 20-minute daily exercise 5 or 6 times per week. In the face-to-face group, patients receive the same program from a therapist with 5 weekly sessions without digital support. Interviews and self-assessments were collected face-to-face with the investigator. Results The feasibility of this program is being tested, and results show good accessibility in terms of acceptance, understanding, and treatment credibility. Results are expected in 2018. Conclusions To our knowledge, this is the first French study to examine the effectiveness of a computer-based stress management program for patients with ADA. The Seren@ctif program may be useful within the framework of a psychoeducative approach. It could also be advised for people suffering from other diseases related to stress and for people with a clinical level of perceived stress. Trial Registration Clinicaltrials.gov NCT02621775; https://clinicaltrials.gov/ct2/show/NCT02621775 (Archived by WebCite at http://www.webcitation.org/6tQrkPs1u) PMID:28970192

The complete "how to" guide for selecting a disease management vendor.

PubMed

Linden, Ariel; Roberts, Nancy; Keck, Kevin

2003-01-01

Decision-makers in health plans, large medical groups, and self-insured employers face many challenges in selecting and implementing disease management programs. One strategy is the "buy" approach, utilizing one or more of the many vendors to provide disease management services for the purchasing organization. As a relatively new field, the disease management vendor landscape is continually changing, uncovering the many uncertainties about demonstrating outcomes, corporate stability, or successful business models. Given the large investment an organization may make in each disease management program (many cost 1 million dollars or more in annual fees for a moderately sized population), careful consideration must be given in selecting a disease management partner. This paper describes, in detail, the specific steps necessary and the issues to consider in achieving a successful contract with a vendor for full-service disease management.

Treating transsexuals in India: History, prerequisites for surgery and legal issues

PubMed Central

Gupta, Richie; Murarka, Anil

2009-01-01

Authors in their clinical practice came across transsexual patients, who were determined to get their gender affirmed by undergoing a change of sex. This motivated the authors to review the literature extensively regarding transsexualism and report their experience. Opinions were taken from legal luminaries practicing in related fields. They also took inputs from several patients who were at various stages of psychiatric analysis and hormone therapy and also those, who had completed their treatment procedures. A paucity of the Indian inputs in medical literature concerning transsexualism was noted by the authors They also found deficiencies in the Indian Law, as applied to the individuals undergoing gender affirmation surgery (GAS). In this paper they have enumerated these deficiencies. Though GAS has been legally allowed in U.K. since 1967, in America since 1972, and in various other countries, Indian Laws are silent on the issue. An Indian surgeon dealing with transsexual patients is faced with a number of issues like consent for the procedure, safe guarding the surgeon or gender team from future litigation. Another issue is postoperative sexual and legal status of the patient. Present Indian Laws regarding marriage, adultery, sexual and unnatural offences, adoptions, maintenance, succession, labour and industrial laws will require modifications when dealing with these individuals and protecting their rights. Authors have tried to deal with all these issues that an individual surgeon faces when he manages a transsexual patient. PMID:20368863

Fine sediment in pools: An index of how sediment is affecting a stream channel

Treesearch

Tom Lisle; Sue Hilton

1991-01-01

One of the basic issues facing managers of fisheries watersheds is how inputs of sediment affect stream channels. In some cases we can measure and even roughly predict effects of land use on erosion and delivery of sediment from hillslopes to streams. But we are at a loss about how a given increase in sediment load will affect channel morphology, flow conditions, and...

Market value: an underused financial planning tool.

PubMed

Harris, J P; Schimmel, V E

1987-04-01

Two issues facing CFOs are capital formation and the long-range financial impact of strategic planning decisions. For not-for-profit organizations, debt capacity is the main determining factor of capital formation while investment analysis is the key to the financial evaluation of strategic planning options. And, the market, or sale, value of the organization can serve as an effective tool to manage current debt capacity and future investment decisions.

Is your financial house in order?

PubMed

Kubik, M J

1998-01-01

In today's rapidly changing world individuals are being faced by many new issues that are challenging their ability to survive financially. It is therefore important that we recognize the need to manage our financial lives. To do that requires a commitment of time to identify assets held and determine how best to protect them, set future financial goals, and then determine how assets can be used to reach those goals.

Revised U.S. Climate Science Plan Still Lacking in Key Areas

NASA Astrophysics Data System (ADS)

Showstack, Randy

2004-03-01

A U.S. National Research Council committee has found that a revised strategic plan for the U.S. Climate Change Science Program (CCSP) includes elements ``that could permit it to effectively guide research on climate and associated global changes over the next decades.'' However, the committee noted that the revision, issued by the CCSP, faces major hurdles related to funding, program priorities, management structure, and maintaining political independence.

The hidden challenges in role transitions and how leadership coaching can help new leaders find solid ground.

PubMed

Weinstock, Beth

2011-01-01

Leadership coaching is becoming an increasingly important intervention that helps individual nurse executives and managers develop and use the best of their strengths, gifts, and talents. As the need for leadership in nursing becomes urgent and brave souls move into the positions of greater authority and potential impact, they will face challenges as they move up in rank. This article identifies the hidden and often-overlooked challenges that are faced by new leaders as they transition into roles of increased responsibility, and it demonstrates how leadership coaching can help new leaders make successful transitions. As the current health care crisis creates opportunity for new leaders, those who opt for promotions and lateral shifts encounter both expected and surprising challenges. The expected challenges include mastering new content skills, learning new organizational structures, and getting to know new teams. The less obvious stressors include issues of self-esteem, assertiveness, self-consciousness, self-criticism, perfectionism, new boundaries, changing identities, and finding one's own leadership style. These important issues are often kept out of conscious awareness and overlooked at great cost to the individual leader and her institution. Leadership coaching can provide support and practical strategies for managing and overcoming these hidden challenges.

Big hat, no cattle: managing human resources.

PubMed

Skinner, W

1981-01-01

When faced with business problems, managers naturally make identifying the trouble their priority. Once that is done, at least half the job is over; finding solutions is just a matter of time. This hasn't been so, however, with the human resources problem: how to motivate employees. Sixty years ago, the Hawthorne experiments revealed the issue, and ever since, managers, researchers, and consultants have been searching for the answer to the human resources problem. Why aren't employees as productive, loyal, and dedicated to their companies as their managers know they can be? The author of this article proposes four reasons why actuality has fallen so far below expectation in personnel management, namely, that managers' expectations have been too high in the first place, that the concepts staff professionals offer managers are frequently contradictory, that the corporate role of personnel has always been problematic, and finally, that managers hold assumptions concerning their employees that undermine efforts to motivate them.

Progress and challenges to the global waste management system.

PubMed

Singh, Jagdeep; Laurenti, Rafael; Sinha, Rajib; Frostell, Björn

2014-09-01

Rapid economic growth, urbanization and increasing population have caused (materially intensive) resource consumption to increase, and consequently the release of large amounts of waste to the environment. From a global perspective, current waste and resource management lacks a holistic approach covering the whole chain of product design, raw material extraction, production, consumption, recycling and waste management. In this article, progress and different sustainability challenges facing the global waste management system are presented and discussed. The study leads to the conclusion that the current, rather isolated efforts, in different systems for waste management, waste reduction and resource management are indeed not sufficient in a long term sustainability perspective. In the future, to manage resources and wastes sustainably, waste management requires a more systems-oriented approach that addresses the root causes for the problems. A specific issue to address is the development of improved feedback information (statistics) on how waste generation is linked to consumption. © The Author(s) 2014.

Fish stocking in protected areas: Summary of a workshop

USGS Publications Warehouse

Corn, Paul Stephen; Knapp, Roland A.

2000-01-01

Native and nonnative sport fish have been introduced into the majority of historically fishless lakes in wilderness, generating conflicts between managing wilderness as natural ecosystems and providing opportunities for recreation. Managers faced with controversial and difficult decisions about how to manage wilderness lakes may not always have ready access to research relevant to these decisions. To address this problem, and to expose scientists to the concerns and constraints of managers and wilderness users, a workshop was held in October 1998 at the Flathead Lake Biological Station in Polson, Montana. Participants included 43 scientists, state and federal managers, wilderness users and advocates and students. Four subject areas were addressed: federal, state, tribal and user perspectives, community and ecosystem effects, species effects and management recommendations. Papers from the workshop are being developed for an issue of the journal Ecosystems.

Business Ethics 101 for the biotech industry.

PubMed

MacDonald, Chris

2004-01-01

Biotechnology companies face ethical challenges of two distinct types: bioethical challenges faced on account of the nature of work in the life sciences, and corporate ethical challenges on account of their nature as commercial entities. The latter set of challenges has received almost no attention at all in the academic literature or media. This paper begins to remedy that lacuna, examining ethical issues that arise specifically on account of the status of biotech companies as commercial entities. The focus here is on three representative issues: product safety, corporate social responsibility, and corporate governance. It is argued that each of these issues poses particular ethical challenges for companies in the biotech sector. In the area of product safety, it is noted that biotech companies face particular challenges in determining what counts as a "safe" product, given the contentious nature of what might count as a "harm" in the biotech field. In the area of corporate social responsibility, the adoption of a "stakeholder approach" and an attempt to manage the social consequences of products pose special challenges for biotech companies. This is due to the enormous range of groups and individuals claiming to have a stake in the doings of such companies, and the trenchant controversies over just what the social consequences of various biotechnologies might be. In the area of corporate governance, biotech companies need to seek out and follow best practices regarding the ways in which information, authority, and influence flow between a company's shareholders, managers, and Board of Directors, if they are to avoid duplicating the ethical and financial scandal that brought down ImClone. An important meta-issue, here--one that renders each of these corporate ethical challenges more vexing--is the difficulty of finding the appropriate benchmarks for ethical corporate behavior in a field as controversial, and as rapidly evolving, as biotechnology. Three programmatic suggestions can be made: Firstly, scholars and others interested in the ethical performance of the biotech sector must seek out and build opportunities for richer interdisciplinary collaboration. Secondly, companies within the biotech sector must seek out expertise and build capacity and competency in dealing with the corporate ethical issues that arise in their sector. Finally, companies in the biotech sector should explore the opportunities for collective problem solving afforded by the existence of local, national, and international industry associations such as the Biotechnology Industry Organization, BIOTECanada, and EuropaBio.

Telemedicine for wound management

PubMed Central

Chittoria, Ravi K.

2012-01-01

The escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer) and real-time transmission (synchronous transfer, e.g. video conference), are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process. PMID:23162242

Medical Big Data Warehouse: Architecture and System Design, a Case Study: Improving Healthcare Resources Distribution.

PubMed

Sebaa, Abderrazak; Chikh, Fatima; Nouicer, Amina; Tari, AbdelKamel

2018-02-19

The huge increases in medical devices and clinical applications which generate enormous data have raised a big issue in managing, processing, and mining this massive amount of data. Indeed, traditional data warehousing frameworks can not be effective when managing the volume, variety, and velocity of current medical applications. As a result, several data warehouses face many issues over medical data and many challenges need to be addressed. New solutions have emerged and Hadoop is one of the best examples, it can be used to process these streams of medical data. However, without an efficient system design and architecture, these performances will not be significant and valuable for medical managers. In this paper, we provide a short review of the literature about research issues of traditional data warehouses and we present some important Hadoop-based data warehouses. In addition, a Hadoop-based architecture and a conceptual data model for designing medical Big Data warehouse are given. In our case study, we provide implementation detail of big data warehouse based on the proposed architecture and data model in the Apache Hadoop platform to ensure an optimal allocation of health resources.

Best practices in peri-operative management of patients with skeletal dysplasias.

PubMed

White, Klane K; Bompadre, Viviana; Goldberg, Michael J; Bober, Michael B; Cho, Tae-Joon; Hoover-Fong, Julie E; Irving, Melita; Mackenzie, William G; Kamps, Shawn E; Raggio, Cathleen; Redding, Gregory J; Spencer, Samantha S; Savarirayan, Ravi; Theroux, Mary C

2017-10-01

Patients with skeletal dysplasia frequently require surgery. This patient population has an increased risk for peri-operative complications related to the anatomy of their upper airway, abnormalities of tracheal-bronchial morphology and function; deformity of their chest wall; abnormal mobility of their upper cervical spine; and associated issues with general health and body habitus. Utilizing evidence analysis and expert opinion, this study aims to describe best practices regarding the peri-operative management of patients with skeletal dysplasia. A panel of 13 multidisciplinary international experts participated in a Delphi process that included a thorough literature review; a list of 22 possible care recommendations; two rounds of anonymous voting; and a face to face meeting. Those recommendations with more than 80% agreement were considered as consensual. Consensus was reached to support 19 recommendations for best pre-operative management of patients with skeletal dysplasia. These recommendations include pre-operative pulmonary, polysomnography; cardiac, and neurological evaluations; imaging of the cervical spine; and anesthetic management of patients with a difficult airway for intubation and extubation. The goals of this consensus based best practice guideline are to provide a minimum of standardized care, reduce perioperative complications, and improve clinical outcomes for patients with skeletal dysplasia. © 2017 Wiley Periodicals, Inc.

Defining snow drought and why it matters

USGS Publications Warehouse

Harpold, Adrian; Dettinger, Michael; Rajagopal, Seshadri

2017-01-01

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

Limb deficiency and prosthetic management. 2. Aging with limb loss.

PubMed

Flood, Katherine M; Huang, Mark E; Roberts, Toni L; Pasquina, Paul F; Nelson, Virginia S; Bryant, Phillip R

2006-03-01

This self-directed learning module highlights the issues faced by people aging with limb loss. It is part of the study guide on limb deficiency and vascular rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the impact that limb loss has on health and physical function throughout the life span. Case examples are used to illustrate what effect limb loss in childhood or young adulthood has on the incidence and management of new impairments or disease processes commonly associated with aging. To discuss the impact of early-life limb loss on the incidence and management of physiologic and functional changes associated with aging.

Childhood fever management program for Korean pediatric nurses: A comparison between blended and face-to-face learning method.

PubMed

Jeong, Yong Sun; Kim, Jin Sun

2014-01-01

A blended learning can be a useful learning strategy to improve the quality of fever and fever management education for pediatric nurses. This study compared the effects of a blended and face-to-face learning program on pediatric nurses' childhood fever management, using theory of planned behavior. A nonequivalent control group pretest-posttest design was used. A fever management education program using blended learning (combining face-to-face and online learning components) was offered to 30 pediatric nurses, and 29 pediatric nurses received face-to-face education. Learning outcomes did not significantly differ between the two groups. However, learners' satisfaction was higher for the blended learning program than the face-to-face learning program. A blended learning pediatric fever management program was as effective as a traditional face-to-face learning program. Therefore, a blended learning pediatric fever management-learning program could be a useful and flexible learning method for pediatric nurses.

Local newspapers, drinking water pathways, and dimensions of knowledge: Public awareness amid the hydrofracking debate

NASA Astrophysics Data System (ADS)

Berg, Weston

Studies on determinants of pro-environmental behavior have found environmental knowledge to be a prerequisite for public participation. While much has been written on correlations between media coverage and environmental knowledge in general, a gap exists concerning the linkages between media coverage and knowledge of an individual's local environment. This study measures public awareness of local drinking water supplies in urban communities, using a face-to-face survey of 90 respondents in three upstate New York cities. The findings show no significant correlation between newspaper coverage of local water issues and awareness of one's drinking water source; however, the surveys revealed high correlations between such awareness and home ownership (as opposed to renting) and between awareness and receiving a water bill. In addition, there was a positive correlation between reading about a local water-related issue (in this case, hydraulic fracturing for natural gas in the Marcellus Shale) in a local newspaper and possessing basic knowledge of that issue. These findings contribute to previous research on environmental knowledge, and have practical applications in efforts addressing: civic engagement, public understanding of science, citizen participation, and democratic practices. Keywords: Public understanding, environmental communication, water resources management, hydraulic fracturing, schema theory

Special Issues in Working with Gifted Minority Adolescents.

ERIC Educational Resources Information Center

Lindstrom, Rena R.; Van Sant, Sondra

1986-01-01

Gifted adolescents from minority groups face the same issues all gifted young people face, but the addition of racial and cultural factors increases the complexity of these issues. Discusses individual versus cultural pressures that affect identity, issues related to assisting students with long-range planning, and two models for programming.…

Issues Validation: A New Environmental Scanning Technique for Family Life Educators.

ERIC Educational Resources Information Center

Weigel, Randy R.; And Others

1992-01-01

Three-state study used Issues Validation, environmental scanning process for family life educators that combines literature reviews, professional and public opinion, and survey research to identify issues facing families and youth. Samples of residents, local advisory committees, and community professionals ranked 30 issues facing families and…

Issues engulfed Saudi Arabia construction workers

NASA Astrophysics Data System (ADS)

Al-Emad, N. H.; Rahman, I. A.

2018-04-01

This paper presents an exploratory study conducted in Makkah city to uncover issues faced by construction workers from the construction leaders’ perspective. Eleven construction leaders/experts were interviewed to unleash their experiences on handling the foreign workers working in Makkah construction projects. Most of the experts are senior management staffs with more than 10 years’ working experience in Saudi Arabia construction industry. The interviews were carried out in semi structured mode where all the information was captured manually and also electronically. The identified issues were sorted based on its commonality into 10 clusters. Hence in each cluster, the numbers of issue considered by the experts are reflecting the importance of that particular cluster. The result of the clusters according to the number of issues mentioned by the experts are safety issues, restricted government regulation, demotivated issues, lack of quality workers, poor living quality, communication barriers, adaption issues, poor attitudes, lack of logistical arrangements and lack of education. With these identified issues it will assist the construction players in the construction industry of Saudi Arabia in dealing with their workers.

The new challenges of end-of-life tyres management systems: A Spanish case study

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

Uruburu, Ángel, E-mail: angel.uruburu@upm.es; Ponce-Cueto, Eva, E-mail: eva.ponce@upm.es; Center for Transportation and Logistics, Massachusetts Institute of Technology, Cambridge, MA

Highlights: ► Impact of the implementation of the Directive 2008/98/EC in Spain for end-of-life tyres. ► Characterization of the reverse supply chain for collecting, recovering, and treating end-of-life tyres. ► Identification of challenges to be coped and issues to be covered. ► Potential new applications for end-of-life tyres and development of new management related strategies. - Abstract: Directive 2008/98/EC released by the European Union represents a significant step forward in all relevant aspects of waste management. Under the already established, extended produced responsibility (EPR) principle, new policies have been enunciated to continuously achieve better overall environmental performance of key productsmore » throughout their life phases. This paper discusses how the directive is being articulated in Spain by the main integrated management system (IMS) for end-of-life (EOL) tyres since its creation in 2006. Focusing on the IMS technological, economic and legal aspects, the study provides a global perspective and evaluation of how the IMS is facing the current issues to resolve, the new challenges that have appeared and the management vision for the coming years.« less

International nurse migration: lessons from the Philippines.

PubMed

Brush, Barbara L; Sochalski, Julie

2007-02-01

Developed countries facing nursing shortages have increasingly turned to aggressive foreign nurse recruitment, primarily from developing nations, to offset their lagging domestic nurse supplies and meet growing health care demands. Few donor nations are prepared to manage the loss of their nurse workforce to migration. The sole country with an explicit nurse export policy and the world's leading donor of nurse labor - the Philippines - is itself facing serious provider maldistribution and countrywide health disparities. Examining the historical roots of Philippines nurse migration provides lessons from which other nurse exporting countries may learn. The authors discuss factors that have predicated nurse migration and policies that have eased the way. Furthermore, the authors analyze how various stakeholders influence migratory patterns, the implications of migration for nurses and the public in their care, and the challenges that future social policy and political systems face in addressing global health issues engendered by unfettered recruitment of nurses and other health workers.

Water security and its challenges for Malaysia

NASA Astrophysics Data System (ADS)

Malek, M. A.; Nor, M. A. M.; P, Leong Y.

2013-06-01

Water Security in Malaysia is a national issue. The Malaysian water services industry faces issues which need to be tackled immediately for it to be viable and sustainable. Among them are the decentralized water services sector, ineffective governance structure, unsustainable tariffs, huge investments required to develop the water supply and sewerage infrastructure, inefficient operation by the operators and high non-revenue water (NRW) losses. In Malaysia, the "Sectorial" approach embedded in the present water management system and its transformation towards "Integrated Water Resources Management" (IWRM), is still in a state of inertia. This paper presents the need to transform, from a "Supply" Management mode (a characteristic of a developing country) to a "Water Demand" Management mode (a characteristic of a developed country). Issues on "Water Demand" Management for the Environment which can be a threat to the need for sustainable development for biodiversity are highlighted here. Reliable water accounting systems are found still lacking in this country, especially in the Agriculture and Environmental Sectors, where figures are still highly based on "traditional" assumptions. Water Quality deterioration remains an issue especially for the Water Supply and Environment Sectors. Available surface water resource is depleting in many regions and states in the Peninsular. Apart from the Reduce, Reuse and Recycle (3R) option for surface water, another option would be to begin a concerted effort for groundwater exploitation. However there are still grey areas of knowledge in the groundwater resources in this country for affirmative decisions and development of appropriate policies. It is also found that, there are no concerted plans to prepare the public for the change from "Supply" Management to "Demand" Management. In a developed nation, this change is through stakeholder platforms and supported by appropriate policies, rules and regulations that are based on validated Sciences, Technologies and Innovations (STI). Transforming from "Supply" Management to "Demand" Management is a formidable task. This requires the wisdom and knowledge of all experts in the Water Resources Sector.

How hepatitis C patients manage the treatment process of pegylated interferon and ribavirin therapy: a qualitative study.

PubMed

Tsai, Shu-Mei; Kao, Jung-Ta; Tsai, Yun-Fang

2016-07-11

Hepatitis C virus (HCV) infection is a global public health issue. Adequate treatment for hepatitis C patients is important, but anticipated side effects make patients fearful of receiving treatment. Little is known about the experiences of hepatitis C patients who have completed treatment with pegylated interferon and ribavirin. The purpose of this study was to explore the experiences of hepatitis C patients who had undergone therapy with pegylated interferon and ribavirin and gain an understanding of what factors contributed to completion of treatment. This was a qualitative study with 21 adult hepatitis C patients purposively sampled from outpatient liver clinics of a medical university hospital in Taichung City, Taiwan. Participants had completed 6-12 months of therapy with pegylated interferon and ribavirin. Data were collected through individual, face-to-face, in-depth interviews conducted in the participants' homes from June-October 2013. Data were analysed using conventional content analysis. Data analysis revealed three themes that described the strategies employed to alleviate and ease symptoms and manage the processes involved: restructuring their lifestyle, adopting a positive attitude, and seeking support. Hepatitis C patients face many challenges during treatment with pegylated interferon and ribavirin. These findings provide knowledge that can be used in designing effective programs to help other Hepatitis C patients manage the side effects of pegylated interferon and ribavirin therapy, complete treatment and improve quality of life.

"Members of the same club": challenges and decisions faced by US IRBs in identifying and managing conflicts of interest.

PubMed

Klitzman, Robert

2011-01-01

Conflicts of interest (COIs) in research have received increasing attention, but many questions arise about how Institutional Review Boards (IRBs) view and approach these. I conducted in-depth interviews of 2 hours each with 46 US IRB chairs, administrators, and members, exploring COI and other issues related to research integrity. I contacted leaders of 60 IRBs (every fourth one among the top 240 institutions by NIH funding), and interviewed IRB leaders from 34 of these institutions (response rate = 55%). Data were analyzed using standard qualitative methods, informed by Grounded Theory. IRBs confront financial and non-financial COIs of PIs, institutions, and IRBs themselves. IRB members may seek to help, or compete with, principal investigators (PIs). Non-financial COI also often appear to be "indirect financial" conflicts based on gain (or loss) not to oneself, but to one's colleagues or larger institution. IRBs faced challenges identifying and managing these COI, and often felt that they could be more effective. IRBs' management of their own potential COI vary, and conflicted members may observe, participate, and/or vote in discussions. Individual IRB members frequently judge for themselves whether to recuse themselves. Challenges arise in addressing these issues, since institutions and PIs need funding, financial information is considered confidential, and COI can be unconscious. This study, the first to explore qualitatively how IRBs confront COIs and probe how IRBs confront non-financial COIs, suggests that IRBs face several types of financial and non-financial COIs, involving themselves, PIs, and institutions, and respond varyingly. These data have critical implications for practice and policy. Disclosure of indirect and non-financial COIs to subjects may not be feasible, partly since IRBs, not PIs, are conflicted. Needs exist to consider guidelines and clarifications concerning when and how, in protocol reviews, IRB members should recuse themselves from participating, observing, and/or voting.

“Members of the Same Club”: Challenges and Decisions Faced by US IRBs in Identifying and Managing Conflicts of Interest

PubMed Central

Klitzman, Robert

2011-01-01

Conflicts of interest (COIs) in research have received increasing attention, but many questions arise about how Institutional Review Boards (IRBs) view and approach these. Methods I conducted in-depth interviews of 2 hours each with 46 US IRB chairs, administrators, and members, exploring COI and other issues related to research integrity. I contacted leaders of 60 IRBs (every fourth one among the top 240 institutions by NIH funding), and interviewed IRB leaders from 34 of these institutions (response rate = 55%). Data were analyzed using standard qualitative methods, informed by Grounded Theory. Results IRBs confront financial and non-financial COIs of PIs, institutions, and IRBs themselves. IRB members may seek to help, or compete with, principal investigators (PIs). Non-financial COI also often appear to be “indirect financial” conflicts based on gain (or loss) not to oneself, but to one's colleagues or larger institution. IRBs faced challenges identifying and managing these COI, and often felt that they could be more effective. IRBs' management of their own potential COI vary, and conflicted members may observe, participate, and/or vote in discussions. Individual IRB members frequently judge for themselves whether to recuse themselves. Challenges arise in addressing these issues, since institutions and PIs need funding, financial information is considered confidential, and COI can be unconscious. Conclusions This study, the first to explore qualitatively how IRBs confront COIs and probe how IRBs confront non-financial COIs, suggests that IRBs face several types of financial and non-financial COIs, involving themselves, PIs, and institutions, and respond varyingly. These data have critical implications for practice and policy. Disclosure of indirect and non-financial COIs to subjects may not be feasible, partly since IRBs, not PIs, are conflicted. Needs exist to consider guidelines and clarifications concerning when and how, in protocol reviews, IRB members should recuse themselves from participating, observing, and/or voting. PMID:21829516

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

PubMed

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

2017-09-01

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

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

PubMed

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

2017-05-01

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

Consensus on diagnosis and empiric antibiotic therapy of febrile neutropenia

PubMed Central

Giurici, Nagua; Zanazzo, Giulio A.

2011-01-01

Controversial issues on the management of empiric therapy and diagnosis of febrile neutropenia (FN) were faced by a Consensus Group of the Italian Association of Pediatric Hematology-Oncology (AIEOP). In this paper we report the suggestions of the consensus process regarding the role of aminoglycosides, glycopeptides and oral antibiotics in empiric therapy of FN, the rules for changing or discontinuing the therapy as well as the timing of the blood cultures. PMID:21647277

Organisational performance and business continuity management: a theoretical perspective and a case study.

PubMed

Sawalha, Ihab Hanna Salman

2013-01-01

This paper seeks to extend the research relating to the strategic view of business continuity management (BCM) to the context of organisational performance (OP). It discusses potential performance consequences resulting from applying BCM aspects/elements within an organisation. The paper contributes to the understanding of the role of BCM in OP by discussing how deployment of BCM key aspects/elements can improve OP. Two main issues are discussed: first, background to performance and the elements of OP; and secondly, the role of BCM in achieving optimised OP. These issues are significant, as they go further than the extant literature relating to the significance of BCM and its potential influence on OP. The study focuses on Jordanian banks as a case study and as a way of illustrating how BCM helps improve OP for those organisations facing performance shortcomings or difficulties.

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

Park, Nam-Gyu; Grätzel, Michael; Miyasaka, Tsutomu

Solar cells employing a halide perovskite with an organic cation now show power conversion efficiency of up to 22%. But, these cells are facing issues towards commercialization, such as the need to achieve long-term stability and the development of a manufacturing method for the reproducible fabrication of high-performance devices. We propose a strategy to obtain stable and commercially viable perovskite solar cells. A reproducible manufacturing method is suggested, as well as routes to manage grain boundaries and interfacial charge transport. Electroluminescence is regarded as a metric to gauge theoretical efficiency. We highlight how optimizing the design of device architectures ismore » important not only for achieving high efficiency but also for hysteresis-free and stable performance. Here, we argue that reliable device characterization is needed to ensure the advance of this technology towards practical applications. We believe that perovskite-based devices can be competitive with silicon solar modules, and discuss issues related to the safe management of toxic material.« less

Lessons learned from the implementation of a Web-based nursing intervention.

PubMed

Bond, Gail E

2006-01-01

The emergence of the World Wide Web in the last decade has introduced the belief that the Internet has the potential to revolutionize healthcare delivery and empower consumers. Given the power of technology to change the way we live, the healthcare community has begun to explore the feasibility of delivering interventions via the Web, including personalized care with chronic disease management. The purpose of this article is to describe this researcher's experience with the development and implementation of a Web-based intervention to enhance diabetes self-management for older adults. Challenges faced by the project involved inadequate funding to cover technology issues (programming, graphics design, etc),decisions regarding the appropriate environment/framework, and questions on how to merge the practice and theory of a given discipline with the limitations of Internet technology. This article will examine and discuss these issues and make recommendations on possible methods of improving the process.

Research Involving Health Providers and Managers: Ethical Issues Faced by Researchers Conducting Diverse Health Policy and Systems Research in Kenya.

PubMed

Molyneux, Sassy; Tsofa, Benjamin; Barasa, Edwine; Nyikuri, Mary Muyoka; Waweru, Evelyn Wanjiku; Goodman, Catherine; Gilson, Lucy

2016-12-01

There is a growing interest in the ethics of Health Policy and Systems Research (HPSR), and especially in areas that have particular ethical salience across HPSR. Hyder et al (2014) provide an initial framework to consider this, and call for more conceptual and empirical work. In this paper, we respond by examining the ethical issues that arose for researchers over the course of conducting three HPSR studies in Kenya in which health managers and providers were key participants. All three studies involved qualitative work including observations and individual and group interviews. Many of the ethical dilemmas researchers faced only emerged over the course of the fieldwork, or on completion, and were related to interactions and relationships between individuals operating at different levels or positions in health/research systems. The dilemmas reveal significant ethical challenges for these forms of HPSR, and show that potential 'solutions' to dilemmas often lead to new issues and complications. Our experiences support the value of research ethics frameworks, and suggest that these can be enriched by incorporating careful consideration of context embedded social relations into research planning and conduct. Many of these essential relational elements of ethical practice, and of producing quality data, are given stronger emphasis in social science research ethics than in epidemiological, clinical or biomedical research ethics, and are particularly relevant where health systems are understood as social and political constructs. We conclude with practical and research implications. © 2016 The Authors Developing World Bioethics Published by John Wiley & Sons Ltd.

Seeing through their eyes: lived experiences of people with retinitis pigmentosa

PubMed Central

Prem Senthil, M; Khadka, J; Pesudovs, K

2017-01-01

Purpose Retinitis pigmentosa (RP) is the most common retinal degeneration causing blindness. Although their clinical problems are amenable for the clinical diagnosis, their day-to-day problems for having to live with the disease are mostly unexplored. This study aims to explore and understand the issues and impact of people with RP on quality of life (QoL). Methods A qualitative research methodology to facilitate the understanding of the experiences of people with RP was carried out. Data were collected through audio-recorded semi-structured interviews. Thematic analysis occurred through the process of line-by-line coding, aggregation, and theme development using the NVivo-10 software. Results Twenty-three interviews were conducted (mean age=56 years; females, 14). We identified five major QoL themes: (1) struggle to perform important day-to-day tasks; (2) concerns about disease progression, disease outcome and personal safety; (3) facing a lot of emotional and psychological challenges; (4) experiencing a myriad of visual symptoms; and (5) adopting different strategies to cope and manage stressful circumstances. Difficulty in performing important day-to-day tasks was the most prominent QoL issue among these people. Their major concerns were going blind and uncertainties about their future. They face a lot of emotional and psychological challenges to adapt to the physiological stress associated with the progressive vision loss. However, they adopt several coping strategies to manage the stressful circumstances. Conclusions People with RP experience a myriad of QoL issues. Despite all the hardship, they remain optimistic and learn to accept their eye condition and move on in life. PMID:28085147

Ethical and social issues facing obstetricians in low-income countries.

PubMed

Ogwuegbu, Chigbu Chibuike; Eze, Onah Hyacinth

2009-06-01

A review of publications on ethical and social issues from low-income countries was done with the aim of highlighting the major ethical and social issues facing obstetricians in these countries. Low-income countries were identified using the World Health Organization income group classification of member nations. Obstetricians in low-income countries face a wide range of special social and ethical issues that reflect the peculiarities of their practice environment characterized by poverty, low education, deep attachment to tradition and culture, low social status of women, and high levels of physician's paternalism.

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

PubMed

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

2012-05-01

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

Remote Patient Management in Automated Peritoneal Dialysis: A Promising New Tool.

PubMed

Drepper, Valérie Jotterand; Martin, Pierre-Yves; Chopard, Catherine Stoermann; Sloand, James A

2018-01-01

Remote patient management (RPM) has the potential to help clinicians detect early issues, allowing intervention prior to development of more significant problems. A 23-year-old end-stage kidney disease patient required urgent start of renal replacement therapy. A newly available automated peritoneal dialysis (APD) RPM system with cloud-based connectivity was implemented in her care. Pre-defined RPM threshold parameters were set to identify clinically relevant issues. Red flag dashboard alerts heralded prolonged drain times leading to clinical evaluation with subsequent diagnosis of and surgical repositioning for catheter displacement, although it took several days for newly-RPM-exposed staff to recognize this issue. Post-PD catheter repositioning, drain times were again normal as indicated by disappearance of flag alerts and unremarkable cycle volume profiles. Identification of < 90% adherence to prescribed PD therapy was then documented with the RPM system, alerting the clinical staff to address this important issue given its association with significant negative clinical outcomes. Healthcare providers face a "learning curve" to effect optimal utilization of the RPM tool. Larger scale observational studies will determine the impact of RPM on APD technique survival and resource utilization. Copyright © 2018 International Society for Peritoneal Dialysis.

Global Interconnectivity Between Mobile Satellite and Terrestrial Users: Call Signalling Issues and Challenges

NASA Technical Reports Server (NTRS)

Estabrook, Polly; Moon, Todd; Spade, Rob

1996-01-01

This paper will discuss some of the challenges in connecting mobile satellite users and mobile terrestrial users in a cost efficient manner and with a grade of service comparable to that of satellite to fixed user calls. Issues arising from the translation between the mobility management protocols resident at the satellite Earth station and those resident at cellular switches - either GSM (Group Special Mobile) or IS-41 (used by U.S. digital cellular systems) type - will be discussed. The impact of GSM call routing procedures on the call setup of a satellite to roaming GSM user will be described. Challenges facing provision of seamless call handoff between satellite and cellular systems will be given. A summary of the issues explored in the paper are listed and future work outlined.

The population, environment, and health nexus: an Arab world perspective.

PubMed

Kulczycki, A; Saxena, P C

1998-01-01

This report describes models of the links between population growth, environmental degradation, and health in Arab countries and in the world; management of the commons; urbanization and water as critical issues; and challenges in Lebanon. It is concluded that the complexity of interrelationships is difficult to untangle. Researchers frequently neglect health issues in modeling the relationships. The lack of attention to the health, development, and environment nexus has serious implications in the Middle East and North Africa. In Lebanon, national strategies do not include a national waste management strategy based on reduction, reuse, and recycling. Most Arab countries face the major issue of the lack of adequate planning in many economic sectors, which results in imbalances in supply and demand. Most Arab countries do not have adequate statistical databases upon which to base development, planning, and policy-making. The last census in Lebanon was in 1932. Information is missing on health. Health economics are ignored. It is not possible to estimate the health costs due to deficiencies in sanitation, hygiene, water, and air quality. Capacity building for environmental management and intersectoral collaboration is hampered. Arab countries with large oil reserves have ignored the population and environment links. Poorer countries will suffer the most from limited renewable water resources and their decline due to population growth. The political agenda in Arab countries should give priority to health, environment, development, and population issues.

The primary health care physician and the cancer patient: tips and strategies for managing sexual health

PubMed Central

Zhou, Eric S.; Nekhlyudov, Larissa

2015-01-01

There is a large and growing population of long-term cancer survivors. Primary care physicians (PCPs) are playing an increasingly greater role in the care of these patients across the continuum of cancer survivorship. In this role, PCPs are faced with the responsibility of managing a range of medical and psychosocial late effects of cancer treatment. In particular, the sexual side effects of treatment which are common and have significant impact on quality of life for the cancer survivor, often go unaddressed. This is an area of clinical care and research that has received increasing attention, highlighted by the presentation of this special issue on Cancer and Sexual Health. The aims of this review are 3-fold. First, we seek to overview common presentations of sexual dysfunction related to major cancer diagnoses in order to give the PCP a sense of the medical issues that the survivor may present with. Barriers to communication about sexual health issues between patient/PCPs in order are also described in order to emphasize the importance of PCPs initiating this important conversation. Next, we provide strategies and resources to help guide the PCP in the management of sexual dysfunction in cancer survivors. Finally, we discuss case examples of survivorship sexual health issues and highlight the role that a PCP can play in each of these case examples. PMID:26816826

Older LGBT adult training panels: an opportunity to educate about issues faced by the older LGBT community.

PubMed

Rogers, Anissa; Rebbe, Rebecca; Gardella, Chanel; Worlein, Mary; Chamberlin, Mya

2013-01-01

Older lesbian, gay, bisexual, and transgender (LGBT) adults face unique issues that can impede their well-being. Although many advances have helped address these issues, there is a need for education efforts that raise awareness of service providers about these issues. This study explores evaluation data of training panels provided by older LGBT adults and the views of training participants on issues faced by the older LGBT community after attending the panels. Participants were 605 students and professionals from over 34 education and communication settings. Implications for trainings on participants and older LGBT trainers are discussed.

[Effective delegation].

PubMed

Fang, Li; Hung, Chich-Hsiu

2008-12-01

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

Clinical track faculty: merits and issues.

PubMed

Lee, Won-Hee; Kim, Cho Ja; Roh, Young Sook; Shin, Hyunsook; Kim, Mi Ja

2007-01-01

Clinical track faculty (CTF) has been in operation for more than two decades in the United States, and 12 of the top 20 schools of nursing with the highest National Institutes of Health funding in the United States have CTF in place. Yet, only limited articles have been published regarding the merits and issues related to its operation. This article examines the advantages/merits of establishing CTF in schools of nursing, discusses the qualification criteria and types of appointment for CTF, and analyzes issues related to operating CTF in Korea. A questionnaire survey and two workshops were conducted involving faculty from a college of nursing and clinical nurse managers from university-affiliated medical centers and community agencies. Most of the respondents indicated that establishing CTF was advantageous. Merits included the following: increasing reality-based clinical education and training; decreasing the reality shock of students; increasing student satisfaction; and linking education, practice, and research more effectively. Major issues were as follows: getting the approval of medical centers/universities; developing an agreement on CTF operation between the college of nursing and clinical agencies; clarifying types and criteria of appointment and promotion; and developing a statement on role and compensation policies. Most issues are similar to what U.S. schools of nursing have faced, except for the first one. In conclusion, establishing CTF in Korea appears to be highly desirable. Merits outweigh issues/concerns, and Korean nursing schools may look for an opportune time for obtaining the approval of medical centers/universities. Nursing schools in other countries that face a similar challenge of providing clinical teaching with high research performance may consider instituting CTF.

Why Leading Consumer Product Companies Develop Proactive Chemical Management Strategies.

PubMed

Scruggs, Caroline E; Van Buren, Harry J

2016-05-01

Scholars have studied the various pressures that companies face related to socially responsible behavior when stakeholders know the particular social issues under consideration. Many have examined social responsibility in the context of environmental responsibility and the general approaches companies take regarding environmental management. The issue of currently unregulated, but potentially hazardous, chemicals in consumer products is not well understood by the general public, but a number of proactive consumer product companies have voluntarily adopted strategies to minimize use of such chemicals. These companies are exceeding regulatory requirements by restricting from their products chemicals that could harm human or environmental health, despite the fact that these actions are costly. They do not usually advertise the details of their strategies to end consumers. This article uses interviews with senior environmental directors of 20 multinational consumer product companies to investigate why these companies engage in voluntary chemicals management. The authors conclude that the most significant reasons are to achieve a competitive advantage and stay ahead of regulations, manage relationships and maintain legitimacy with stakeholders, and put managerial values into practice. Many of the characteristics related to the case of chemicals management are extendable to other areas of stakeholder management in which risks to stakeholders are either unknown or poorly understood.

Why Leading Consumer Product Companies Develop Proactive Chemical Management Strategies

PubMed Central

Scruggs, Caroline E.; Van Buren, Harry J.

2014-01-01

Scholars have studied the various pressures that companies face related to socially responsible behavior when stakeholders know the particular social issues under consideration. Many have examined social responsibility in the context of environmental responsibility and the general approaches companies take regarding environmental management. The issue of currently unregulated, but potentially hazardous, chemicals in consumer products is not well understood by the general public, but a number of proactive consumer product companies have voluntarily adopted strategies to minimize use of such chemicals. These companies are exceeding regulatory requirements by restricting from their products chemicals that could harm human or environmental health, despite the fact that these actions are costly. They do not usually advertise the details of their strategies to end consumers. This article uses interviews with senior environmental directors of 20 multinational consumer product companies to investigate why these companies engage in voluntary chemicals management. The authors conclude that the most significant reasons are to achieve a competitive advantage and stay ahead of regulations, manage relationships and maintain legitimacy with stakeholders, and put managerial values into practice. Many of the characteristics related to the case of chemicals management are extendable to other areas of stakeholder management in which risks to stakeholders are either unknown or poorly understood. PMID:27471326

Health care in China: improvement, challenges, and reform.

PubMed

Wang, Chen; Rao, Keqin; Wu, Sinan; Liu, Qian

2013-02-01

Over the past 2 decades, significant progress has been made in improving the health-care system and people's health conditions in China. Following rapid economic growth and social development, China's health-care system is facing new challenges, such as increased health-care demands and expenditure, inefficient use of health-care resources, unsatisfying implementation of disease management guidelines, and inadequate health-care insurance. Facing these challenges, the Chinese government carried out a national health-care reform in 2009. A series of policies were developed and implemented to improve the health-care insurance system, the medical care system, the public health service system, the pharmaceutical supply system, and the health-care institution management system in China. Although these measures have shown promising results, further efforts are needed to achieve the ultimate goal of providing affordable and high-quality care for both urban and rural residents in China. This article not only covers the improvement, challenges, and reform of health care in general in China, but also highlights the status of respiratory medicine-related issues.

Ethical challenges in pain management post-surgery.

PubMed

Rejeh, Nahid; Ahmadi, Fazlollah; Mohamadi, Eesa; Anoosheh, Moniereh; Kazemnejad, Anooshirvan

2009-03-01

This qualitative study describes ethical challenges faced by Iranian nurses in the process of pain management in surgical units. To address this issue, semistructured interviews were conducted with 26 nurses working in surgery units in three large university hospitals in Tehran. An analysis of the transcripts revealed three main categories: institutional limitations; nurses' proximity to and involvement with pain and suffering; and nurses' fallibility. Specific themes identified within the categories were: insufficient resources, medical hierarchy; difficulties with believing patients' complaints regarding pain and suffering; and experiencing the consequences of poor judgments. Our findings lead us to conclude that, as nurses are much closer to patients' pain and suffering than other health professionals, being aware of their ethical problems, and being able to reflect on them and discuss and learn from them, will reduce the burden of the ethical challenges faced. The findings will help nurses in other countries to devise suitable ways to reduce the ethical burdens they bear in their daily practice.

[The roles and functions of volunteer counselors to the elderly].

PubMed

Chen, Chun-Yu

2004-06-01

In Taiwan's current counseling centers for the elderly, large numbers of volunteers are supervised by only a few social workers or nurses, so the roles and functions of these volunteers are very important. A neat summary of the services provided by the volunteers would include: (1) Direct services: telephone counseling, telephone interviewing, case handling, mail counseling, resource provision. (2) Indirect services: fundraising, supervision. (3) Administration: administrative assistance, management of institutional web sites. (4) Strategic consultancy: consultancy, provision of expertise. (5) Advocacy: service as educators and spokespersons; public relations and marketing. (6) MANAGEMENT: team leadership, plan implementation. To sum up, their functions are, by means of telephone and face-to-face contact, to provide information to the elderly about finances, medical services, housing, citizenship, the dignity of life and death, and related issues, as well as to serve as advocates for the provision of resources--such as educational courses--and to facilitate such provision. Indeed, the roles and functions of volunteer counselors become more diverse and more comprehensive by the day.

A new approach to design and use of management information.

PubMed

Daft, R L; MacIntosh, N B

1978-01-01

Information, that is both accurate and timely, is probably the most important resource needed by managers to make sound decisions regarding the problems and issues facing their organizations. Unfortunately, sophisticated information systems often fail to meet this need. Managers complain that the data produced by information systems arrive too late, are too general and lack accuracy. Daft and MacIntosh studied the system problems of a number of organizations, discovering that understanding their work activities is critical to the design of successful information systems. The authors also considered the volume of information, preciseness of information and the way in which it is handled by users to develop a model describing information systems. The article illustrates how the model was applied successfully to four case situations.

Health Policy and Management: in praise of political science. Comment on "On Health Policy and Management (HPAM): mind the theory-policy-practice gap".

PubMed

Hunter, David J

2015-03-12

Health systems have entered a third era embracing whole systems thinking and posing complex policy and management challenges. Understanding how such systems work and agreeing what needs to be put in place to enable them to undergo effective and sustainable change are more pressing issues than ever for policy-makers. The theory-policy-practice-gap and its four dimensions, as articulated by Chinitz and Rodwin, is acknowledged. It is suggested that insights derived from political science can both enrich our understanding of the gap and suggest what changes are needed to tackle the complex challenges facing health systems. © 2015 by Kerman University of Medical Sciences.

Health-adjusted premium subsidies in the Netherlands.

PubMed

van de Ven, Wynand P M M; van Vliet, René C J A; Lamers, Leida M

2004-01-01

The Dutch government has decided to proceed with managed competition in health care. In this paper we report on progress made with health-based risk adjustment, a key issue in managed competition. In 2004 both Diagnostic Cost Groups (DCGs) computed from hospital diagnoses only and Pharmacy-based Cost Groups (PCGs) computed from out-patient prescription drugs are used to set the premium subsidies for competing risk-bearing sickness funds. These health-based risk adjusters appear to be effective and complementary. Risk selection is not a major problem in the Netherlands. Despite the progress made, we are still faced with a full research agenda for risk adjustment in the coming years.

BatTool: an R package with GUI for assessing the effect of White-nose syndrome and other take events on Myotis spp. of bats

PubMed Central

2014-01-01

Background Myotis species of bats such as the Indiana Bat and Little Brown Bat are facing population declines because of White-nose syndrome (WNS). These species also face threats from anthropogenic activities such as wind energy development. Population models may be used to provide insights into threats facing these species. We developed a population model, BatTool, as an R package to help decision makers and natural resource managers examine factors influencing the dynamics of these species. The R package includes two components: 1) a deterministic and stochastic model that are accessible from the command line and 2) a graphical user interface (GUI). Results BatTool is an R package allowing natural resource managers and decision makers to understand Myotis spp. population dynamics. Through the use of a GUI, the model allows users to understand how WNS and other take events may affect the population. The results are saved both graphically and as data files. Additionally, R-savvy users may access the population functions through the command line and reuse the code as part of future research. This R package could also be used as part of a population dynamics or wildlife management course. Conclusions BatTool provides access to a Myotis spp. population model. This tool can help natural resource managers and decision makers with the Endangered Species Act deliberations for these species and with issuing take permits as part of regulatory decision making. The tool is available online as part of this publication. PMID:24955110

BatTool: an R package with GUI for assessing the effect of White-nose syndrome and other take events on Myotis spp. of bats

USGS Publications Warehouse

Erickson, Richard A.; Thogmartin, Wayne E.; Szymanski, Jennifer A.

2014-01-01

Background: Myotis species of bats such as the Indiana Bat and Little Brown Bat are facing population declines because of White-nose syndrome (WNS). These species also face threats from anthropogenic activities such as wind energy development. Population models may be used to provide insights into threats facing these species. We developed a population model, BatTool, as an R package to help decision makers and natural resource managers examine factors influencing the dynamics of these species. The R package includes two components: 1) a deterministic and stochastic model that are accessible from the command line and 2) a graphical user interface (GUI). Results: BatTool is an R package allowing natural resource managers and decision makers to understand Myotis spp. population dynamics. Through the use of a GUI, the model allows users to understand how WNS and other take events may affect the population. The results are saved both graphically and as data files. Additionally, R-savvy users may access the population functions through the command line and reuse the code as part of future research. This R package could also be used as part of a population dynamics or wildlife management course. Conclusions: BatTool provides access to a Myotis spp. population model. This tool can help natural resource managers and decision makers with the Endangered Species Act deliberations for these species and with issuing take permits as part of regulatory decision making. The tool is available online as part of this publication.

BatTool: an R package with GUI for assessing the effect of White-nose syndrome and other take events on Myotis spp. of bats.

PubMed

Erickson, Richard A; Thogmartin, Wayne E; Szymanski, Jennifer A

2014-01-01

Myotis species of bats such as the Indiana Bat and Little Brown Bat are facing population declines because of White-nose syndrome (WNS). These species also face threats from anthropogenic activities such as wind energy development. Population models may be used to provide insights into threats facing these species. We developed a population model, BatTool, as an R package to help decision makers and natural resource managers examine factors influencing the dynamics of these species. The R package includes two components: 1) a deterministic and stochastic model that are accessible from the command line and 2) a graphical user interface (GUI). BatTool is an R package allowing natural resource managers and decision makers to understand Myotis spp. population dynamics. Through the use of a GUI, the model allows users to understand how WNS and other take events may affect the population. The results are saved both graphically and as data files. Additionally, R-savvy users may access the population functions through the command line and reuse the code as part of future research. This R package could also be used as part of a population dynamics or wildlife management course. BatTool provides access to a Myotis spp. population model. This tool can help natural resource managers and decision makers with the Endangered Species Act deliberations for these species and with issuing take permits as part of regulatory decision making. The tool is available online as part of this publication.

Violence against doctors, a serious concern for healthcare organizations to ponder about.

PubMed

Ahmed, Farah; Khizar Memon, Muhammad; Memon, Sidra

2018-01-01

Aggression and Violence against primary care physicians is reportedly common in Pakistan but there is no any documented study to-date on this burning issue. A formed written questionnaire was distributed among 769 primary care physicians aged 31 ± 7.68 years. Apart from the demographic data, the questionnaire included questions regarding the level of safety that primary care physicians felt during their work setups and on-call duties, along with the experience of aggression against them by the perpetrators & the support provided by the hospital management in such cases. Response rate was 68% i.e. 524 physicians agreed to participate in the study. It was found that majority (85%) of the physicians has faced mild events, 62% have faced moderate events and roughly 38% were subjected to severe violence. Some physicians revealed more than one form of aggression being faced by them in 12 months preceding months which makes the collective percentage greater than 100%. Verbal abuse is the most frequent type of mistreatment faced by the doctors from the patients or their attendants. A considerable number of physicians participated have faced mild violence in which verbal abuse was commonest; followed by moderate and severe events.

Steady flow rate to a partially penetrating well with seepage face in an unconfined aquifer

NASA Astrophysics Data System (ADS)

Behrooz-Koohenjani, Siavash; Samani, Nozar; Kompani-Zare, Mazda

2011-06-01

The flow rate to fully screened, partially penetrating wells in an unconfined aquifer is numerically simulated using MODFLOW 2000, taking into account the flow from the seepage face and decrease in saturated thickness of the aquifer towards the well. A simple three-step method is developed to find the top of the seepage face and hence the seepage-face length. The method is verified by comparing it with the results of previous predictive methods. The results show that the component of flow through the seepage face can supply a major portion of the total pumping rate. Variations in flow rate as a function of the penetration degree, elevation of the water level in the well and the distance to the far constant head boundary are investigated and expressed in terms of dimensionless curves and equations. These curves and equations can be used to design the degree of penetration for which the allowable steady pumping rate is attained for a given elevation of water level in the well. The designed degree of penetration or flow rate will assure the sustainability of the aquifer storage, and can be used as a management criterion for issuing drilling well permits by groundwater protection authorities.

What happens to work if you're unwell? Beliefs and attitudes of managers and employees with musculoskeletal pain in a public sector setting.

PubMed

Wynne-Jones, Gwenllian; Buck, Rhiannon; Porteous, Carol; Cooper, Lucy; Button, Lori A; Main, Chris J; Phillips, Ceri J

2011-03-01

Musculoskeletal complaints can impact on work in terms of productivity, sickness absence and long term incapacity for work. While employee attitudes and knowledge can drive absenteeism and presenteeism behaviour, managers also play an important role in influencing this via the quality of their relationships with employees and their role in implementing organisational policies and procedures. The aims of this study were to investigate the beliefs and attitudes of managers and employees with musculoskeletal pain about sickness absence, presenteeism, and return to work and to identify areas of consensus and conflict. 18 employees with musculoskeletal pain and 20 managers from two large public sector organisations in South Wales, UK, took part in individual face-to-face interviews. Data were analysed thematically using NVivo. Employees' and managers' reports indicated that there was a strong culture of presenteeism in these organisations. Establishing the legitimacy of complaints was a salient theme for both managers and employees, although their views were in conflict. Employees reported feeling that contact with employers was intrusive when sickness absence was legitimate. Managers were supportive of those who they felt were 'genuinely' unwell, but also cited examples of people 'working the system' and not reporting absences appropriately. These issues require careful consideration of the rights and responsibilities of both employees and employers, where strategies for improving communication, trust, and creating an environment conducive to successful return to work need to be investigated.

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

PubMed

Agamuthu, P; Fauziah, S H

2011-01-01

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

Efficacy of Seren@ctif, a Computer-Based Stress Management Program for Patients With Adjustment Disorder With Anxiety: Protocol for a Controlled Trial.

PubMed

Servant, Dominique; Leterme, Anne-Claire; Barasino, Olivia; Rougegrez, Laure; Duhamel, Alain; Vaiva, Guillaume

2017-10-02

Adjustment disorder with anxiety (ADA) is the most frequent and best characterized stress-related psychiatric disorder. The rationale for prescription of benzodiazepine monotherapy is a public health issue. Cognitive behavioral stress management programs have been studied in many countries. Several reports have shown beyond reasonable doubt their efficiency at reducing perceived stress and anxiety symptoms and improving patient quality of life. Considering the number of people who could benefit from such programs but are unable to access them, self-help programs have been offered. First presented as books, these programs became enriched with computer-based and digital supports. Regrettably, programs for stress management based on cognitive behavioral therapy (CBT), both face-to-face and digital support, have been only minimally evaluated in France. To our knowledge, the Seren@ctif program is the first French language self-help program for stress management using digital supports. The aim of this study is to assess the effectiveness of a 5-week standardized stress management program for reducing anxiety conducted via eLearning (iCBT) or through face-to-face interviews (CBT) with patients suffering from ADA compared with a wait list control group (WLC). These patients seek treatment in a psychiatric unit for anxiety disorders at a university hospital. The primary outcome is change in the State Trait Anxiety Inventory scale trait subscale (STAI-T) between baseline and 2-month visit. This is a multicenter, prospective, open label, randomized controlled study in 3 parallel groups with balanced randomization (1:1:1): computer-based stress management with minimal contact (not fully automated) (group 1), stress management with face-to-face interviews (group 2), and a WLC group that receives usual health care from a general practitioner (group 3). Programs are based on standard CBT principles and include 5 modules in 5 weekly sessions that include the following topics: stress and stress reaction and assessment; deep respiration and relaxation techniques; cognitive restructuring, mindfulness, and acceptance; behavioral skills as problem solving; and time management, healthy behaviors, and emotion regulation. In the Internet-based group, patients have minimal contact with a medical professional before and after every session. In the first session, a flash memory drive is supplied containing videos, audio files, a self-help book portfolio in the form of an eGuide, and log books providing the exercises to be completed between 2 sessions. The patient is encouraged to practice a 20-minute daily exercise 5 or 6 times per week. In the face-to-face group, patients receive the same program from a therapist with 5 weekly sessions without digital support. Interviews and self-assessments were collected face-to-face with the investigator. The feasibility of this program is being tested, and results show good accessibility in terms of acceptance, understanding, and treatment credibility. Results are expected in 2018. To our knowledge, this is the first French study to examine the effectiveness of a computer-based stress management program for patients with ADA. The Seren@ctif program may be useful within the framework of a psychoeducative approach. It could also be advised for people suffering from other diseases related to stress and for people with a clinical level of perceived stress. Clinicaltrials.gov NCT02621775; https://clinicaltrials.gov/ct2/show/NCT02621775 (Archived by WebCite at http://www.webcitation.org/6tQrkPs1u). ©Dominique Servant, Anne-Claire Leterme, Olivia Barasino, Laure Rougegrez, Alain Duhamel, Guillaume Vaiva. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 02.10.2017.

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.

Development of an e-supported illness management and recovery programme for consumers with severe mental illness using intervention mapping, and design of an early cluster randomized controlled trial.

PubMed

Beentjes, Titus A A; van Gaal, Betsie G I; Goossens, Peter J J; Schoonhoven, Lisette

2016-01-19

E-mental health is a promising medium to keep mental health affordable and accessible. For consumers with severe mental illness the evidence of the effectiveness of e-health is limited. A number of difficulties and barriers have to be addressed concerning e-health for consumers with severe mental illness. One possible solution might be to blend e-health with face-to-face delivery of a recovery-oriented treatment, like the Illness Management & Recovery (IMR) programme. This paper describes the development of an e-health application for the IMR programme and the design of an early clustered randomized controlled trial. We developed the e-IMR intervention according to the six-step protocol of Intervention Mapping. Consumers joined the development group to address important and relevant issues for the target group. Decisions during the six-step development process were based on qualitative evaluations of the Illness Management & Recovery programme, structured interviews, discussion in the development group, and literature reviews on qualitative papers concerning consumers with severe mental illness, theoretical models, behavioural change techniques, and telemedicine for consumers with severe mental illness. The aim of the e-IMR intervention is to help consumers with severe mental illness to involve others, manage achieving goals, and prevent relapse. The e-IMR intervention consists of face-to-face delivery of the Illness Management & Recovery programme and an e-health application containing peer-testimonials on videos, follow up on goals and coping strategies, monitoring symptoms, solving problems, and communication opportunities. We designed an early cluster randomized controlled trial that will evaluate the e-IMR intervention. In the control condition the Illness Management & Recovery programme is provided. The main effect-study parameters are: illness management, recovery, psychiatric symptoms severity, self-management, quality of life, and general health. The process of the IMR program will be evaluated on fidelity and feasibility in semi-structured interviews with participants and trainers. Intervention Mapping provided a systematic procedure for the development of this e-health intervention for consumers with severe mental illness and the preparation of an early randomized controlled trial. The trial is registered in the Dutch Trial Register: NTR4772 .

Policy issues facing the Comprehensive Test Ban Treaty and prospects for the future

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

Sweeney, J.

1999-04-01

This report is divided into the following 5 sections: (1) Background; (2) Major Issues Facing Ratification of CTBT; (3) Current Status on CTBT Ratification; (4) Status of CTBT Signatories and Ratifiers; and (5) CTBT Activities Not Prohibited. The major issues facing ratification of CTBT discussed here are: impact on CTBT of START II and ABM ratification; impact of India and Pakistan nuclear tests; CTBT entry into force; and establishment of the Comprehensive Nuclear Test-Ban Treaty Organization.

Critical Social Theory: Core Tenets, Inherent Issues

ERIC Educational Resources Information Center

Freeman, Melissa; Vasconcelos, Erika Franca S.

2010-01-01

This chapter outlines the core tenets of critical social theory and describes inherent issues facing evaluators conducting critical theory evaluation. Using critical pedagogy as an example, the authors describe the issues facing evaluators by developing four of the subtheories that comprise a critical social theory: (a) a theory of false…

The surgical management of fibrous dysplasia of bone.

PubMed

Stanton, Robert P; Ippolito, Ernesto; Springfield, Dempsey; Lindaman, Lynn; Wientroub, Shlomo; Leet, Arabella

2012-05-24

The surgical management of Polyostotic Fibrous Dysplasia (FD) of bone is technically demanding. The most effective methods to manage the associated bone deformity remain unclear. The marked variation in the degree and pattern of bone involvement has made it difficult to acquire data to guide the surgeon's approach to these patients. In light of the paucity of data, but need for guidance, recognized experts in the management of these patients came together at the National Institutes of Health in Bethesda, Maryland as part of an International meeting to address issues related to fibrous dysplasia of bone to discuss and refine their recommendations regarding the surgical indications and preferred methods for the management of these challenging patients. The specific challenges, recommended approaches, and "lessons learned" are presented in hopes that surgeons faced with typical deformities can be guided in the surgical reconstruction of both children and adults with FD.

Lower Urinary Tract Injuries Following Blunt Trauma: A Review of Contemporary Management

PubMed Central

Kong, Jennifer P. L; Bultitude, Matthew F; Royce, Peter; Gruen, Russell L; Cato, Alex; Corcoran, Niall M

2011-01-01

Lower urinary tract trauma, although relatively uncommon in blunt trauma, can lead to significant morbidity when diagnosed late or left untreated; urologists may only encounter a handful of these injuries in their career. This article reviews the literature and reports on the management of these injuries, highlighting the issues facing clinicians in this subspecialty. Also presented is a structured review detailing the mechanisms, classification, diagnosis, management, and complications of blunt trauma to the bladder and urethra. The prognosis for bladder rupture is excellent when treated. Significant intraperitoneal rupture or involvement of the bladder neck mandates surgical repair, whereas smaller extraperitoneal lacerations may be managed with catheterization alone. With the push for management of trauma patients in larger centers, urologists in these hospitals are seeing increasing numbers of lower urinary tract injuries. Prospective analysis may be achieved in these centers to address the current lack of Level 1 evidence. PMID:22114545

Increasing Capacity Exploitation in Food Supply Chains Using Grid Concepts

NASA Astrophysics Data System (ADS)

Volk, Eugen; Müller, Marcus; Jacob, Ansger; Racz, Peter; Waldburger, Martin

Food supply chains today are characterized by fixed trade relations with long term contracts established between heterogeneous supply chain companies. Production and logistics capacities of these companies are often utilized in an economically inefficient manner only. In addition, increased consumer awareness in food safety issues renders supply chain management even more challenging, since integrated tracking and tracing along the whole food supply chain is needed. Facing these issues of supply chain management complexity and completely documented product quality, this paper proposes a full lifecycle solution for dynamic capacity markets based on concepts used in the field of Grid [1], like management of Virtual Organization (VO) combined with Service Level Agreement (SLA). The solution enables the cost-efficient utilization of real world capacities (e.g., production capacities or logistics facilities) by using a simple, browser-based portal. Users are able to enter into product-specific negotiations with buyers and suppliers of a food supply chain, and to obtain real-time access to product information including SLA evaluation reports. Thus, business opportunities in wider market access, process innovation, and trustworthy food products are offered for participating supply chain companies.

Unobtrusive integration of data management with fMRI analysis.

PubMed

Poliakov, Andrew V; Hertzenberg, Xenia; Moore, Eider B; Corina, David P; Ojemann, George A; Brinkley, James F

2007-01-01

This note describes a software utility, called X-batch which addresses two pressing issues typically faced by functional magnetic resonance imaging (fMRI) neuroimaging laboratories (1) analysis automation and (2) data management. The first issue is addressed by providing a simple batch mode processing tool for the popular SPM software package (http://www.fil.ion. ucl.ac.uk/spm/; Welcome Department of Imaging Neuroscience, London, UK). The second is addressed by transparently recording metadata describing all aspects of the batch job (e.g., subject demographics, analysis parameters, locations and names of created files, date and time of analysis, and so on). These metadata are recorded as instances of an extended version of the Protégé-based Experiment Lab Book ontology created by the Dartmouth fMRI Data Center. The resulting instantiated ontology provides a detailed record of all fMRI analyses performed, and as such can be part of larger systems for neuroimaging data management, sharing, and visualization. The X-batch system is in use in our own fMRI research, and is available for download at http://X-batch.sourceforge.net/.

Green reconstruction of the tsunami-affected areas in India using the integrated coastal zone management concept.

PubMed

Sonak, Sangeeta; Pangam, Prajwala; Giriyan, Asha

2008-10-01

A tsunami, triggered by a massive undersea earthquake off Sumatra in Indonesia, greatly devastated the lives, property and infrastructure of coastal communities in the coastal states of India, Andaman and Nicobar Islands, Indonesia, Sri Lanka, Malaysia and Thailand. This event attracted the attention of environmental managers at all levels, local, national, regional and global. It also shifted the focus from the impact of human activities on the environment to the impacts of natural hazards. Recovery/reconstruction of these areas is highly challenging. A clear understanding of the complex dynamics of the coast and the types of challenges faced by the several stakeholders of the coast is required. Issues such as sustainability, equity and community participation assume importance. The concept of ICZM (integrated coastal zone management) has been effectively used in most parts of the world. This concept emphasizes the holistic assessment of the coast and a multidisciplinary analysis using participatory processes. It integrates anthropocentric and eco-centric approaches. This paper documents several issues involved in the recovery of tsunami-affected areas and recommends the application of the ICZM concept to the reconstruction efforts.

Challenge theme 7: Information support for management of border security and environmental protection: Chapter 9 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

USGS Publications Warehouse

Parcher, Jean W.; Page, William R.

2013-01-01

Historically, international borders were located far from the major political and economic capitals of their countries and rarely received adequate planning or infrastructure development. Today, as a result of global economics and increased movement of goods between nations, border regions play a much greater role in commerce, tourism, and transportation. For example, Mexico is the second largest destination for United States exports (Woodrow Wilson Center Mexico Institute, 2009). The rapid population and economic growth along the United States–Mexican border, undocumented human border crossings, and the unique natural diversity of resources in the Borderlands present challenges for border security and environmental protection. Assessing risks and implementing sustainable growth policies to protect the environment and quality of life greatly increase in complexity when the issues cross an international border, where social services, environmental regulations, lifestyles, and cultural beliefs are unique for each country. Shared airsheds, water and biological resources, national security issues, and disaster management needs require an integrated binational approach to assess risks and develop binational management strategies.

Environmental management plan (EMP) for Melamchi water supply project, Nepal.

PubMed

Khadka, Ram B; Khanal, Anil B

2008-11-01

More than 1.5 million people live in the Kathmandu valley. The valley is facing an extreme shortage of water supply. At the same time the demand is escalating rapidly. To address this issue of scarcity of water, the government of Nepal has proposed a project of inter-basin transfer of water from Melamchi River located 40 km north-east of the Kathmandu valley. The project will cover two districts and three municipalities and will potentially have significant impacts on the environment. In accordance with the Environmental Protection Regulation of Nepal (1997), the Melamchi Water Supply Project (MWSP) has undergone an EIA during the feasibility study stage of the proposed project. The recommendations contained in the EIA were integrated into the project design for implementation in 2006. This paper summarizes the background of MWSP, the environmental concerns described in the EIA and the status of Environmental Management Plan (EMP) developed to address environmental compliance and other issues involving participation and support of the local people. This paper also provides some lessons to learn on the modalities of addressing the demands and grievances of the local people concerning environmental management.

FORT Molecular Ecology Laboratory

USGS Publications Warehouse

Oyler-McCance, Sara J.; Stevens, P.D.

2011-01-01

The mission of the U.S. Geological Survey (USGS) at the Fort Collins Science Center Molecular Ecology Laboratory is to use the tools and concepts of molecular genetics to address a variety of complex management questions and conservation issues facing the management of the Nation's fish and wildlife resources. Together with our partners, we design and implement studies to document genetic diversity and the distribution of genetic variation among individuals, populations, and species. Information from these studies is used to support wildlife-management planning and conservation actions. Current and past studies have provided information to assess taxonomic boundaries, inform listing decisions made under the Endangered Species Act, identify unique or genetically depauperate populations, estimate population size or survival rates, develop management or recovery plans, breed wildlife in captivity, relocate wildlife from one location to another, and assess the effects of environmental change.

Physician styles of patient management as a potential source of disparities: cluster analysis from a factorial experiment.

PubMed

Lutfey, Karen E; Gerstenberger, Eric; McKinlay, John B

2013-06-01

To identify styles of physician decision making (as opposed to singular clinical actions) and to analyze their association with variations in the management of a vignette presentation of coronary heart disease (CHD). Primary data were collected from primary care physicians in North and South Carolina. In a balanced factorial experimental design, primary care physicians viewed one of 16 (2(4)) video vignette presentations of CHD and provided detailed information about how they would manage the case. 256 MD primary care physicians were interviewed face-to-face in North and South Carolina. We identify three clusters depicting unique styles of CHD management that are robust to controls for physician (gender and level of experience) and patient characteristics (age, gender, socioeconomic status, and race) as well as key organizational features of physicians' work settings. Physicians in Cluster 1 "Cardiac" (N = 92) were more likely to focus on cardiac issues compared with their counterparts; physicians in Cluster 2 "Talkers" (N = 93) were more likely to give advice and take additional medical history; whereas physicians in Cluster 3 "Minimalists" (N = 71) were less likely than their counterparts to take action on any of the types of management behavior. Variations in styles of decision making, which encompass multiple outcome variables and extend beyond individual-level demographic predictors, may add to our understanding of disparities in health quality and outcomes. © Health Research and Educational Trust.

Regional Variations of Public Perception on Contaminated Industrial Sites in China and Its Influencing Factors

PubMed Central

Li, Xiaonuo; Jiao, Wentao; Xiao, Rongbo; Chen, Weiping; Bai, Yanying

2016-01-01

Public involvement is critical in sustainable contaminated site management. It is important for China to improve public knowledge and participation, foster dialogue between urban managers and laypeople, and accelerate the remediation and redevelopment processes in contaminated site management. In this study, we collected 1812 questionnaires from nine cities around China through face-to-face interviews and statistically analyzed the perception of residents concerning contaminated sites. The results show that respondents’ concern about soil pollution was lower than for other environmental issues and their knowledge of soil contamination was limited. The risks posed by contaminated industrial sites were well recognized by respondents, but they were unsatisfied with the performance of local agencies regarding information disclosure, publicity and education and public participation. Respondents believed that local governments and polluters should take the primary responsibility for contaminated site remediation. Most of them were unwilling to pay for contaminated site remediation and preferred recreational or public service redevelopment. Moreover, our research indicated that public perception varied among different cities. This variation was mainly determined by implementations of policy instruments and additionally affected by remediation technology, pollutant type, regional policy response and living distance. PMID:27070632

Assessment and management of suicide risk in primary care.

PubMed

Saini, Pooja; While, David; Chantler, Khatidja; Windfuhr, Kirsten; Kapur, Navneet

2014-01-01

Risk assessment and management of suicidal patients is emphasized as a key component of care in specialist mental health services, but these issues are relatively unexplored in primary care services. To examine risk assessment and management in primary and secondary care in a clinical sample of individuals who were in contact with mental health services and died by suicide. Data collection from clinical proformas, case records, and semistructured face-to-face interviews with general practitioners. Primary and secondary care data were available for 198 of the 336 cases (59%). The overall agreement in the rating of risk between services was poor (overall κ = .127, p = .10). Depression, care setting (after discharge), suicidal ideation at last contact, and a history of self-harm were associated with a rating of higher risk. Suicide prevention policies were available in 25% of primary care practices, and 33% of staff received training in suicide risk assessments. Risk is difficult to predict, but the variation in risk assessment between professional groups may reflect poor communication. Further research is required to understand this. There appears to be a relative lack of suicide risk assessment training in primary care.

Novel and emerging approaches to combat adolescent obesity

PubMed Central

Sharma, Manoj; Branscum, Paul

2010-01-01

Overweight and obesity continue to be health concerns facing today’s adolescent population. Along with metabolic and physical problems associated with obesity, today’s obese adolescents also face many psychological issues such as high rates of depression, anxiety, and social discrimination. Obesity is commonly recognized as having many causes, such as genetic, lifestyle and environmental. There are four major modalities for management of overweight and obesity in adolescents: dietary management, increasing physical activity, pharmacological therapy, and bariatric surgery. The purpose of this study was to conduct a review of novel and emerging approaches for preventing and managing adolescent obesity. It was found that while not always the case, theory driven approaches are being better utilized in newer interventions especially by those directed toward prevention. New theories that are being used are the theories of reasoned action, planned behavior, intervention mapping, and social marketing. Schools are found to be the most common place for such interventions, which is appropriate since virtually all children attend some form of private or public school. Limitations found in many studies include the underuse of process evaluations, the low number of studies attempted, environmental or policy changes, and that not all studies used a similar control group for comparison. PMID:24600257

Novel and emerging approaches to combat adolescent obesity.

PubMed

Sharma, Manoj; Branscum, Paul

2010-01-01

Overweight and obesity continue to be health concerns facing today's adolescent population. Along with metabolic and physical problems associated with obesity, today's obese adolescents also face many psychological issues such as high rates of depression, anxiety, and social discrimination. Obesity is commonly recognized as having many causes, such as genetic, lifestyle and environmental. There are four major modalities for management of overweight and obesity in adolescents: dietary management, increasing physical activity, pharmacological therapy, and bariatric surgery. The purpose of this study was to conduct a review of novel and emerging approaches for preventing and managing adolescent obesity. It was found that while not always the case, theory driven approaches are being better utilized in newer interventions especially by those directed toward prevention. New theories that are being used are the theories of reasoned action, planned behavior, intervention mapping, and social marketing. Schools are found to be the most common place for such interventions, which is appropriate since virtually all children attend some form of private or public school. Limitations found in many studies include the underuse of process evaluations, the low number of studies attempted, environmental or policy changes, and that not all studies used a similar control group for comparison.

Regional Variations of Public Perception on Contaminated Industrial Sites in China and Its Influencing Factors.

PubMed

Li, Xiaonuo; Jiao, Wentao; Xiao, Rongbo; Chen, Weiping; Bai, Yanying

2016-04-08

Public involvement is critical in sustainable contaminated site management. It is important for China to improve public knowledge and participation, foster dialogue between urban managers and laypeople, and accelerate the remediation and redevelopment processes in contaminated site management. In this study, we collected 1812 questionnaires from nine cities around China through face-to-face interviews and statistically analyzed the perception of residents concerning contaminated sites. The results show that respondents' concern about soil pollution was lower than for other environmental issues and their knowledge of soil contamination was limited. The risks posed by contaminated industrial sites were well recognized by respondents, but they were unsatisfied with the performance of local agencies regarding information disclosure, publicity and education and public participation. Respondents believed that local governments and polluters should take the primary responsibility for contaminated site remediation. Most of them were unwilling to pay for contaminated site remediation and preferred recreational or public service redevelopment. Moreover, our research indicated that public perception varied among different cities. This variation was mainly determined by implementations of policy instruments and additionally affected by remediation technology, pollutant type, regional policy response and living distance.

Constructing and Communicating Privacy Boundaries: How Family Medicine Physicians Manage Patient Requests for Religious Disclosure in the Clinical Interaction.

PubMed

Canzona, Mollie Rose; Peterson, Emily Bylund; Villagran, Melinda M; Seehusen, Dean A

2015-01-01

Religion/spirituality (R/S) is an important component of some patients' psychosocial framework when facing illness. While many patients report an increased desire for R/S dialogue in clinical interaction, especially when facing a frightening diagnosis, some physicians report discomfort talking about R/S and hold various beliefs regarding the appropriateness of such discussions. Not only do physicians manage conversations centering on patient disclosures in the clinical visit, they must also navigate requests to share their own personal information. Farber et al. (2000) found that over a 12-month period nearly 40% of physicians reported that patients asked questions that transgressed professional boundaries. This article uses Petronio's communication privacy management theory as a lens through which to situate our understanding of how family medicine physicians construct and communicate privacy boundaries in response to patient requests for religious disclosure. Results provide an in-depth theoretical understanding of issues surrounding religious disclosure in the medical visit and expand the discussion on health care providers' personal and professional privacy boundaries as documented by Petronio and Sargent (2011). Implications for health care training and practice are discussed.

Advantages, Disadvantages, Indications, Contraindications and Surgical Technique of Laryngeal Airway Mask

PubMed Central

Shekar, Ashim; Balakrishna, Ramdas; Sudarshan, H.; Veena, G. C.; Bhuvaneshwari, S.

2017-01-01

The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice. Despite wide spread use the definitive role of the laryngeal mask airway is yet to be established. In some situations, such as after failed tracheal intubation or in oral surgery its use is controversial. There are several unresolved issues, for example the effect of the laryngeal mask on regurgitation and whether or not cricoids pressure prevents placement of mask. We review the techniques of insertion, details of misplacement, and complications associated with use of the laryngeal mask. We then attempt to clarify the role of laryngeal mask in air way management during anesthesia, discussing the advantages and disadvantages as well as indications and contraindications of its use in oral and maxillofacial surgery. PMID:29349045

Advantages, Disadvantages, Indications, Contraindications and Surgical Technique of Laryngeal Airway Mask.

PubMed

Jannu, Anubhav; Shekar, Ashim; Balakrishna, Ramdas; Sudarshan, H; Veena, G C; Bhuvaneshwari, S

2017-12-01

The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice. Despite wide spread use the definitive role of the laryngeal mask airway is yet to be established. In some situations, such as after failed tracheal intubation or in oral surgery its use is controversial. There are several unresolved issues, for example the effect of the laryngeal mask on regurgitation and whether or not cricoids pressure prevents placement of mask. We review the techniques of insertion, details of misplacement, and complications associated with use of the laryngeal mask. We then attempt to clarify the role of laryngeal mask in air way management during anesthesia, discussing the advantages and disadvantages as well as indications and contraindications of its use in oral and maxillofacial surgery.

Space resources. Volume 4: Social concerns

NASA Technical Reports Server (NTRS)

Mckay, Mary Fae (Editor); Mckay, David S. (Editor); Duke, Michael B. (Editor)

1992-01-01

Space resources must be used to support life on the Moon and exploration of Mars. This volume, Social Concerns, covers some of the most important issues which must be addressed in any major program for the human exploration of space. The volume begins with a consideration of the economics and management of large scale space activities. Then the legal aspects of these activities are discussed, particularly the interpretation of treaty law with respect to the Moon and asteroids. The social and cultural issues of moving people into space are considered in detail, and the eventual emergence of a space culture different from the existing culture is envisioned. The environmental issues raised by the development of space settlements are faced. Some innovative approaches are proposed to space communities and habitats and self-sufficiency is considered along with human safety at a lunar base or outpost.

BRCA1 genetic mutation and its link to ovarian cancer: implications for advanced practice nurses.

PubMed

Brunsvold, Amy N; Wung, Shu-Fen; Merkle, Carrie J

2005-12-01

The purpose of this paper is to review (a) the linkage between the BRCA1 gene and ovarian cancer and (b) BRCA1 testing and its related issues. This review is aimed for nurse practitioners (NPs), who may be in positions to identify those at risk for BRCA1-associated ovarian cancer and to assist patients with related issues. Data sources include reviews and original research from scholarly journals and Internet sites. Ovarian cancer is a deadly disease. Identification of those at risk because of BRCA1 mutation is possible through genetic testing. Testing for BRCA1 gene mutations has many implications whether results are positive or negative. Those with positive results will be faced with decisions regarding the best management strategies. Negative results do not completely eliminate ovarian cancer risk. Current management options for carriers of the BRCA1 mutation include taking no action, increasing surveillance for ovarian cancer, and chemoprevention with oral contraceptives or prophylactic oophorectomy for those who have completed childbearing. It is essential that NPs have knowledge underlying the issues and concerns of patients and their families at risk for BRCA1-associated ovarian cancer. NPs are in a unique position to help identify BRCA1 mutation carriers and to assist them and their families with the complex issues involving genetic testing and management options. Understanding these issues will allow NPs to give appropriate care that may include making appropriate referrals to certified genetic counselors and having balanced discussions on treatment options. Such measurements may improve early diagnosis of ovarian cancer and increase survival from this disease.

Face Values: The Use of Sensitive Error Correction to Address Adolescents' "Face" Issues in the Modern Languages Classroom

ERIC Educational Resources Information Center

Crichton, Hazel; Templeton, Brian; Valdera, Francisco

2017-01-01

Anxiety about "performing" in a foreign language in front of classmates may inhibit learners' contributions in the modern languages class through fear of embarrassment over possible error production. The issue of "face", perceived social standing in the eyes of others, presents a sensitive matter for young adolescents…

Critical Problems Facing Technology Education: Perceptions of Indiana Teachers

ERIC Educational Resources Information Center

Lazaros, Edward J.; Rogers, George E.

2006-01-01

In 1993 Wicklein conducted a study to determine the present and the future critical issues and problems facing the technology education (TE) profession. The Wicklein study questioned 25 panelists from 15 states and the District of Columbia to ascertain the issues and problems facing TE. However, in the Wicklein study, only seven of the panelists…

Virtual Modeling for Cities of the Future. State-Of Art and Virtual Modeling for Cities of the Future. State-Of Art AN

NASA Astrophysics Data System (ADS)

Valencia, J.; Muñoz-Nieto, A.; Rodriguez-Gonzalvez, P.

2015-02-01

3D virtual modeling, visualization, dissemination and management of urban areas is one of the most exciting challenges that must face geomatics in the coming years. This paper aims to review, compare and analyze the new technologies, policies and software tools that are in progress to manage urban 3D information. It is assumed that the third dimension increases the quality of the model provided, allowing new approaches to urban planning, conservation and management of architectural and archaeological areas. Despite the fact that displaying 3D urban environments is an issue nowadays solved, there are some challenges to be faced by geomatics in the coming future. Displaying georeferenced linked information would be considered the first challenge. Another challenge to face is to improve the technical requirements if this georeferenced information must be shown in real time. Are there available software tools ready for this challenge? Are they useful to provide services required in smart cities? Throughout this paper, many practical examples that require 3D georeferenced information and linked data will be shown. Computer advances related to 3D spatial databases and software that are being developed to convert rendering virtual environment to a new enriched environment with linked information will be also analyzed. Finally, different standards that Open Geospatial Consortium has assumed and developed regarding the three-dimensional geographic information will be reviewed. Particular emphasis will be devoted on KML, LandXML, CityGML and the new IndoorGML.

US Forest Service and National Park Service Wilderness Aircraft Overflight Study: Sociological background and study plans

NASA Technical Reports Server (NTRS)

Harrison, Robin T.; Hartmann, Lawrence

1990-01-01

The background and sociological aspects of the combined U.S. Forest Service and National Park Service Wilderness Aircraft Overflight Study (WACOS) are presented. The WACOS broaches a new area of research by combining aspects of outdoor recreation sociology and aircraft noise response studies. The tasks faced create new challenges and require innovative solutions. Background information on the WACOS is presented with special emphasis on sociological considerations. At the time of this writing, no data have yet been collected, so this paper will present background information, related issues, and plans for data collection. Some recent studies indicate that managers of Forest Service wildernesses and National Park Service areas consider aircraft overflights to be a problem to their users in some areas. Additional relevant background research from outdoor recreation sociology is discussed, followed by presentation of the authors' opinions of the most salient sociological issues faced by this study. The goals and desired end products are identified next, followed by a review of the methods anticipated to be used to obtain these results. Finally, a discussion and conclusion section is provided.

Fishes in a changing world: learning from the past to promote sustainability of fish populations.

PubMed

Gordon, T A C; Harding, H R; Clever, F K; Davidson, I K; Davison, W; Montgomery, D W; Weatherhead, R C; Windsor, F M; Armstrong, J D; Bardonnet, A; Bergman, E; Britton, J R; Côté, I M; D'agostino, D; Greenberg, L A; Harborne, A R; Kahilainen, K K; Metcalfe, N B; Mills, S C; Milner, N J; Mittermayer, F H; Montorio, L; Nedelec, S L; Prokkola, J M; Rutterford, L A; Salvanes, A G V; Simpson, S D; Vainikka, A; Pinnegar, J K; Santos, E M

2018-03-01

Populations of fishes provide valuable services for billions of people, but face diverse and interacting threats that jeopardize their sustainability. Human population growth and intensifying resource use for food, water, energy and goods are compromising fish populations through a variety of mechanisms, including overfishing, habitat degradation and declines in water quality. The important challenges raised by these issues have been recognized and have led to considerable advances over past decades in managing and mitigating threats to fishes worldwide. In this review, we identify the major threats faced by fish populations alongside recent advances that are helping to address these issues. There are very significant efforts worldwide directed towards ensuring a sustainable future for the world's fishes and fisheries and those who rely on them. Although considerable challenges remain, by drawing attention to successful mitigation of threats to fish and fisheries we hope to provide the encouragement and direction that will allow these challenges to be overcome in the future. © 2018 The Authors. Journal of Fish Biology published by John Wiley & Sons Ltd on behalf of The Fisheries Society of the British Isles.

Suburban wildlife: Lessons, challenges, and opportunities

USGS Publications Warehouse

DeStefano, S.; Deblinger, R.D.; Miller, C.

2005-01-01

The United States, as well as most developed and many developing nations worldwide, is becoming increasingly urban and suburban.Although urban, suburban, and commercial development account for less than one percent to just over 20% of land use among states, 50-90% of the residents of those states can be classified as urban or suburban dwellers. The population of the U.S. as a whole has risen from being > 95% rural in the 1790s to about 80% urban-suburban today. With these changes in land use and demographic patterns come changes in values and attitudes; many urbanites and suburbanites view wildlife and nature differently than rural residents. These are among the challenges faced by wildlife biologists and natural resource managers in a rapidly urbanizing world. In 2003, we convened a symposium to discuss issues related to suburban wildlife. The papers presented in this special issue of Urban Ecosystems address the lessons learned from the early and recently rapidly expanding literature, the challenges we face today, and the opportunities that can help deal with what is one of the biggest challenges to conservation in a modernizing world. ?? 2005 Springer Science + Business Media, Inc.

Ethical issues in managed care for the obstetrician and gynecologist.

PubMed

Finnerty, J J; Pinkerton, J A

1998-08-01

The practice of medicine is now managed. Of this there is no doubt. The individual physician is placed in an ever-increasingly vulnerable position. He or she must cope with a myriad of contractual arrangements with strange concepts such as "withholds," "capitation," "covered lives," "limited liability on the part of the managed care organization;" "outcomes analysis," "practice guidelines," and, last but not least, "gag rules." Patients are being denied care that the physician may consider, if not essential, at least most desirable. On the one hand, the physician must serve a fiduciary obligation to the patient and act as the patient's advocate; on the other hand, the physician's income may be proportionally dependent on limiting the extent of the patient's access to unlimited care. The physician may be limited by restrictions imposed by the managed care organization as to what disclosures he or she may make to the patient regarding limitations of care. We will explore these issues from an ethical perspective and attempt to offer some insights on the basis of a review of the comments of many knowledgeable commentators on this topic, and we will explore the virtues that physicians will need to rely on to come to grips with the dilemmas they will face in the future with managed care.

Taking action against ocean acidification: a review of management and policy options.

PubMed

Billé, Raphaël; Kelly, Ryan; Biastoch, Arne; Harrould-Kolieb, Ellycia; Herr, Dorothée; Joos, Fortunat; Kroeker, Kristy; Laffoley, Dan; Oschlies, Andreas; Gattuso, Jean-Pierre

2013-10-01

Ocean acidification has emerged over the last two decades as one of the largest threats to marine organisms and ecosystems. However, most research efforts on ocean acidification have so far neglected management and related policy issues to focus instead on understanding its ecological and biogeochemical implications. This shortfall is addressed here with a systematic, international and critical review of management and policy options. In particular, we investigate the assumption that fighting acidification is mainly, but not only, about reducing CO2 emissions, and explore the leeway that this emerging problem may open in old environmental issues. We review nine types of management responses, initially grouped under four categories: preventing ocean acidification; strengthening ecosystem resilience; adapting human activities; and repairing damages. Connecting and comparing options leads to classifying them, in a qualitative way, according to their potential and feasibility. While reducing CO2 emissions is confirmed as the key action that must be taken against acidification, some of the other options appear to have the potential to buy time, e.g. by relieving the pressure of other stressors, and help marine life face unavoidable acidification. Although the existing legal basis to take action shows few gaps, policy challenges are significant: tackling them will mean succeeding in various areas of environmental management where we failed to a large extent so far.

Taking Action Against Ocean Acidification: A Review of Management and Policy Options

NASA Astrophysics Data System (ADS)

Billé, Raphaël; Kelly, Ryan; Biastoch, Arne; Harrould-Kolieb, Ellycia; Herr, Dorothée; Joos, Fortunat; Kroeker, Kristy; Laffoley, Dan; Oschlies, Andreas; Gattuso, Jean-Pierre

2013-10-01

Ocean acidification has emerged over the last two decades as one of the largest threats to marine organisms and ecosystems. However, most research efforts on ocean acidification have so far neglected management and related policy issues to focus instead on understanding its ecological and biogeochemical implications. This shortfall is addressed here with a systematic, international and critical review of management and policy options. In particular, we investigate the assumption that fighting acidification is mainly, but not only, about reducing CO2 emissions, and explore the leeway that this emerging problem may open in old environmental issues. We review nine types of management responses, initially grouped under four categories: preventing ocean acidification; strengthening ecosystem resilience; adapting human activities; and repairing damages. Connecting and comparing options leads to classifying them, in a qualitative way, according to their potential and feasibility. While reducing CO2 emissions is confirmed as the key action that must be taken against acidification, some of the other options appear to have the potential to buy time, e.g. by relieving the pressure of other stressors, and help marine life face unavoidable acidification. Although the existing legal basis to take action shows few gaps, policy challenges are significant: tackling them will mean succeeding in various areas of environmental management where we failed to a large extent so far.

[Description of the process of preparation and response of local health authorities facing the introduction of the Chikungunya virus in Colombia, 2014].

PubMed

Alarcón-Cruz, Ángela P; Prieto-Suárez, Edgar

2016-06-01

Objective To describe the process of preparation and response of local health authorities in key public health issues while facing the introduction stage of an unusual virus: Chikungunya in Colombia in 2014. Methods A cross-sectional study was conducted using a survey that was developed for this study and sent to Public Health coordinators and to the person in charge of vector borne-diseases in the country's territorial entities. Results 23 out of the 35 territories at risk from the transmission of Chikungunya agreed to answer the survey. A global review of the survey scores for each evaluated section shows better performances in the areas of knowledge management, comprehensive patient care, epidemiological intelligence, and health promotion. According to the results of this study, the epidemiological surveillance system during the Chikungunya epidemic had a low acceptability and flexibility, possibly contributing to the underreporting of cases. Conclusions In general, knowledge and implementation by local authorities of the Integrated Health Strategy- EGI (Estrategia de Gestión Integral, by its Spanish acronym)- for vector-borne diseases was evident from the themes evaluated in this study. However, it is necessary to reinforce the communication of risks, laboratory, and outbreak and contingencies management areas faced during the introduction of new viruses.

Identifying the challenges and facilitators of implementing a COPD care bundle.

PubMed

Lennox, Laura; Green, Stuart; Howe, Cathy; Musgrave, Hannah; Bell, Derek; Elkin, Sarah

2014-01-01

Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges.

Recreating America's Community Colleges: Critical Policy Issues Facing America's Community Colleges

ERIC Educational Resources Information Center

Honeyman, David S.; Sullivan, Michael D.

2006-01-01

During the conduct of the 2004 Community Colleges Futures Assembly, sponsored by the University of Florida, delegates to the meeting identified three critical policy issues facing America's community colleges and challenged the delegates attending the 2005 Assembly to debate these issues and make recommendations. A total of 252 higher-education…

Critical Issues Children Face in the 2000s

ERIC Educational Resources Information Center

Crockett, Deborah

2003-01-01

Children will face many critical issues in the 21st century. Unfortunately, most of these issues are not new and have remained the same from previous years. Millions of children lack safe, affordable, quality child care and early childhood education while their parents work. Seven and one-half million children are at home alone without…

Challenges Faced by Teachers Implementing Socio-Scientific Issues as Core Elements in Their Classroom Practices

ERIC Educational Resources Information Center

Bossér, Ulrika; Lundin, Mattias; Lindahl, Mats; Linder, Cedric

2015-01-01

Teachers may face considerable challenges when implementing socio-scientific issues (SSI) in their classroom practices, such as incorporating student-centred teaching practices and exploring knowledge and values in the context of socioscientific issues. This year-long study explores teachers' reflections on the process of developing their…

Implementing programs for chronic illness management: the case of hypertension services.

PubMed

Christianson, J B; Pietz, L; Taylor, R; Woolley, A; Knutson, D J

1997-11-01

This article describes the process by which HealthSystem Minnesota (a vertically integrated health care organization), functioning in a competitive managed care environment, has been implementing a hypertension services program. The program involves a team approach to care, with emphasis on patient participation in treatment; decentralized care delivery by nurse coordinators at primary care practice sites; ongoing training and education for patients and providers; and the continuous monitoring and evaluation of patient outcomes and satisfaction. JOB-LEVEL ISSUES: A variety of issues, such as the role and responsibilities of the nurse coordinator, became evident as the program moved towards operational status at four primary care practice sites, which prolonged the implementation period. PROCESS-LEVEL ISSUES: Issues relating to work process changes were more complicated to resolve and required, in some cases, changes in the proposed model. The most significant process-level issues related to educating physicians about the program to secure their participation and support. ORGANIZATION-LEVEL ISSUES: Such issues, which were the most difficult for program implementors to anticipate and resolve, included an organizational culture that emphasized decision making autonomy at primary practice sites. In part, the difficulty encountered in resolving organization-level issues reflected the implementors' lack of awareness of the strength or complexity of the environmental pressures facing the organization, as well as a lack of sensitivity to nuances relating to organizational culture. Two groups of hypertensive patients--at the implementation and comparison sites--will be compared with respect to satisfaction with care, clinical outcomes, and costs. Expansion of the model to patients with other chronic conditions is under consideration.

Innovative Approaches to Collaborative Groundwater Governance in the United States: Case Studies from Three High-Growth Regions in the Sun Belt.

PubMed

Megdal, Sharon B; Gerlak, Andrea K; Huang, Ling-Yee; Delano, Nathaniel; Varady, Robert G; Petersen-Perlman, Jacob D

2017-05-01

Groundwater is an increasingly important source of freshwater, especially where surface water resources are fully or over-allocated or becoming less reliable due to climate change. Groundwater reliance has created new challenges for sustainable management. This article examines how regional groundwater users coordinate and collaborate to manage shared groundwater resources, including attention to what drives collaboration. To identify and illustrate these facets, this article examines three geographically diverse cases of groundwater governance and management from the United States Sun Belt: Orange County Water District in southern California; Prescott Active Management Area in north-central Arizona; and the Central Florida Water Initiative in central Florida. These regions have different surface water laws, groundwater allocation and management laws and regulations, demographics, economics, topographies, and climate. These cases were selected because the Sun Belt faces similar pressures on groundwater due to historical and projected population growth and limited availability of usable surface water supplies. Collectively, they demonstrate groundwater governance trends in the United States, and illustrate distinctive features of regional groundwater management strategies. Our research shows how geophysical realities and state-level legislation have enabled and/or stimulated regions to develop groundwater management plans and strategies to address the specific issues associated with their groundwater resources. We find that litigation involvement and avoidance, along with the need to finance projects, are additional drivers of regional collaboration to manage groundwater. This case study underscores the importance of regionally coordinated and sustained efforts to address serious groundwater utilization challenges faced by the regions studied and around the world.

Innovative Approaches to Collaborative Groundwater Governance in the United States: Case Studies from Three High-Growth Regions in the Sun Belt

NASA Astrophysics Data System (ADS)

Megdal, Sharon B.; Gerlak, Andrea K.; Huang, Ling-Yee; Delano, Nathaniel; Varady, Robert G.; Petersen-Perlman, Jacob D.

2017-05-01

Groundwater is an increasingly important source of freshwater, especially where surface water resources are fully or over-allocated or becoming less reliable due to climate change. Groundwater reliance has created new challenges for sustainable management. This article examines how regional groundwater users coordinate and collaborate to manage shared groundwater resources, including attention to what drives collaboration. To identify and illustrate these facets, this article examines three geographically diverse cases of groundwater governance and management from the United States Sun Belt: Orange County Water District in southern California; Prescott Active Management Area in north-central Arizona; and the Central Florida Water Initiative in central Florida. These regions have different surface water laws, groundwater allocation and management laws and regulations, demographics, economics, topographies, and climate. These cases were selected because the Sun Belt faces similar pressures on groundwater due to historical and projected population growth and limited availability of usable surface water supplies. Collectively, they demonstrate groundwater governance trends in the United States, and illustrate distinctive features of regional groundwater management strategies. Our research shows how geophysical realities and state-level legislation have enabled and/or stimulated regions to develop groundwater management plans and strategies to address the specific issues associated with their groundwater resources. We find that litigation involvement and avoidance, along with the need to finance projects, are additional drivers of regional collaboration to manage groundwater. This case study underscores the importance of regionally coordinated and sustained efforts to address serious groundwater utilization challenges faced by the regions studied and around the world.

Using virtual machine monitors to overcome the challenges of monitoring and managing virtualized cloud infrastructures

NASA Astrophysics Data System (ADS)

Bamiah, Mervat Adib; Brohi, Sarfraz Nawaz; Chuprat, Suriayati

2012-01-01

Virtualization is one of the hottest research topics nowadays. Several academic researchers and developers from IT industry are designing approaches for solving security and manageability issues of Virtual Machines (VMs) residing on virtualized cloud infrastructures. Moving the application from a physical to a virtual platform increases the efficiency, flexibility and reduces management cost as well as effort. Cloud computing is adopting the paradigm of virtualization, using this technique, memory, CPU and computational power is provided to clients' VMs by utilizing the underlying physical hardware. Beside these advantages there are few challenges faced by adopting virtualization such as management of VMs and network traffic, unexpected additional cost and resource allocation. Virtual Machine Monitor (VMM) or hypervisor is the tool used by cloud providers to manage the VMs on cloud. There are several heterogeneous hypervisors provided by various vendors that include VMware, Hyper-V, Xen and Kernel Virtual Machine (KVM). Considering the challenge of VM management, this paper describes several techniques to monitor and manage virtualized cloud infrastructures.

How 'blended' is blended learning?: students' perceptions of issues around the integration of online and face-to-face learning in a Continuing Professional Development (CPD) health care context.

PubMed

Glogowska, Margaret; Young, Pat; Lockyer, Lesley; Moule, Pam

2011-11-01

This paper explores students' perceptions of blended learning modules delivered in a Continuing Professional Development (CPD) health care context in the UK. 'Blended learning' is the term used to describe a hybrid model of learning where traditional face-to-face teaching approaches and newer electronic learning activities and resources are utilised together. A new model of CPD for health care practitioners based on a blended learning approach was developed at a university in the south west of England. As part of the evaluation of the new modules, a qualitative study was conducted, in which 17 students who had experienced the modules were interviewed by telephone. Three main themes emerged from the interviews relating to the 'blended' nature of the blended learning modules. These were i) issues around the opportunities for discussion of online materials face-to-face; ii) issues of what material should be online versus face-to-face and iii) balancing online and face-to-face components. Teaching staff engaged in the development of blended learning courses need to pay particular attention to the ways in which they develop and integrate online and face-to-face materials. More attention needs to be paid to allowing opportunity for students to come together to create a 'community of inquiry'. Copyright © 2011 Elsevier Ltd. All rights reserved.

Proceedings Interagency Endangered Species Symposium Held in Washington, DC on April 26-28, 1994

DTIC Science & Technology

1994-08-01

Hawaiian forest birds, the Puerto Rican parrot, eastern timber wolf , desert tortoise, and West Indian manatee. In concert with client agencies, NBS is...fishes than any other state. Reclamation’s complex Central Arizona Project, which can provide most of the state’s 2.8 million acre/feet share of Colorado ...conflicts with the needs of bald eagles. Lower Colorado Region One major issue facing the Lower Colorado Region is the long-term operation and Management of

Addressing the Economic Security Issues Facing Same-Sex Couples.

ERIC Educational Resources Information Center

Dolan, Elizabeth M.; Stum, Marlene S.; Rupured, Michael

1999-01-01

Provides educators and researchers with an awareness of the financial security issues faced by same-sex couples and offers suggestions for incorporating the discussion of these ideas into existing curricula and research. (Author/JOW)

Ethics Issues Arising in the Transition to Learning Health Care Systems: Results from Interviews with Leaders from 25 Health Systems.

PubMed

Morain, Stephanie R; Kass, Nancy E

2016-01-01

There is increased interest in transitioning to a "learning health care system" (LHCS). While this transition brings the potential for significant benefits, it also presents several ethical considerations. Identifying the ethical issues faced by institutions in this transition is critical for realizing the goals of learning health care so that these issues can be anticipated and, where possible, resolved. 29 semi-structured telephone interviews were conducted with leaders within 25 health care institutions. Respondents were recruiting using purposive sampling, targeting institutions considered as LHCS leaders. All interviews were audiorecorded and transcribed. NVIVO10 software was used to support qualitative analysis. Respondents described seven ethical challenges: (1) ethical oversight of learning activities; (2) transparency of learning activities to patients; (3) potential tensions between improving quality and reducing costs; (4) data sharing and data management; (5) lag time between discovery and implementation; (6) transparency to patients about quality; and (7) randomization for quality improvement initiatives. To move towards LHCS, several ethical considerations require further attention, including: the continued appropriateness of the research-treatment distinction; policy frameworks for privacy and data sharing; informing patients about learning activities; obligations to share data on quality; and the potential for trade-offs between quality improvement and cost control. To our knowledge, this is the first project to ask leaders from health care systems committed to ongoing learning about the ethical issues they have faced in this effort. Their experiences can provide guidance on relevant ethical issues, and what might be done to resolve them.

Challenges and opportunities in healthcare volunteer management: insights from volunteer administrators.

PubMed

Rogers, Sean E; Rogers, Carmen M; Boyd, Karen D

2013-01-01

Volunteer administrators from 105 hospitals in five states in the northeast and southern United States provided open-ended survey responses about what they perceived to be the most pressing challenges and opportunities facing healthcare volunteer management. Taken together, these 105 hospitals used a total of 39,008 volunteers and 5.3 million volunteer hours during a 12-month period between 2010 and 2011. A qualitative content analysis of administrator responses suggests that primary challenges include volunteer recruitment and retention, administrative issues, and operational difficulties brought about by the current economic crisis. Key opportunities include more explicitly linking the volunteer function to hospital outcomes and community impact, expanding volunteer recruitment pools and roles and jobs, and developing organizational support for volunteers and making the volunteer management function more efficient and effective.

Palo Alto Research Center - Smart Embedded Network of Sensors with an Optical Readout

ScienceCinema

Raghavan, Ajay; Sahu, Saroj; Bringans, Ross; Johnson, Noble; Kiesel, Peter; Saha, Bhaskar

2018-05-18

PARC is developing new fiber optic sensors that would be embedded into batteries to monitor and measure key internal parameters during charge and discharge cycles. Two significant problems with today's best batteries are their lack of internal monitoring capabilities and their design oversizing. The lack of monitoring interferes with the ability to identify and manage performance or safety issues as they arise, which are presently managed by very conservative design oversizing and protection approaches that result in cost inefficiencies. PARC's design combines low-cost, embedded optical battery sensors and smart algorithms to overcome challenges faced by today's best battery management systems. These advanced fiber optic sensing technologies have the potential to dramatically improve the safety, performance, and life-time of energy storage systems.

Examining the Role, Values, and Legal Policy Issues Facing Public Library Resources in Supporting Students to Achieve Academic Success

ERIC Educational Resources Information Center

Achinewhu-Nworgu, Elizabeth; Azaiki, Steve; Nworgu, Queen Chioma

2016-01-01

This paper aims to present the role, values, and legal policy issues facing public Library resources in supporting students to achieve academic success. Research indicates that majority of people that own or work in the Library tend to ignore some of the vital roles, values and legal policy issues paramount to libraries. Some of these issues are…

Recommendations of Common Data Elements to Advance the Science of Self-management of Chronic Conditions

PubMed Central

Moore, Shirley M.; Schiffman, Rachel; Waldrop-Valverde, Drenna; Redeker, Nancy S.; McCloskey, Donna Jo; Kim, Miyong T.; Heitkemper, Margaret M.; Guthrie, Barbara J.; Dorsey, Susan G.; Docherty, Sharron L.; Barton, Debra; Bailey, Donald E.; Austin, Joan K.; Grady, Patricia

2017-01-01

Purpose Common data elements (CDEs) are increasingly being used by researchers to promote data sharing across studies. The purposes of this article are to (a) describe the theoretical, conceptual, and definition issues in the development of a set of CDEs for research addressing self-management of chronic conditions; (b) propose an initial set of CDEs and their measures to advance the science of self-management; and (c) recommend implications for future research and dissemination. Design and Methods Between July 2014 and December 2015 the directors of the National Institute of Nursing Research (NINR)-funded P20 and P30 centers of excellence and NINR staff met in a series of telephone calls and a face-to-face NINR-sponsored meeting to select a set of recommended CDEs to be used in self-management research. A list of potential CDEs was developed from examination of common constructs in current self-management frameworks, as well as identification of variables frequently used in studies conducted in the centers of excellence. Findings The recommended CDEs include measures of three self-management processes: activation, self-regulation, and self-efficacy for managing chronic conditions, and one measure of a self-management outcome, global health. Conclusions The self-management of chronic conditions, which encompasses a considerable number of processes, behaviors, and outcomes across a broad range of chronic conditions, presents several challenges in the identification of a parsimonious set of CDEs. This initial list of recommended CDEs for use in self-management research is provisional in that it is expected that over time it will be refined. Comment and recommended revisions are sought from the research and practice communities. Clinical Relevance The use of CDEs can facilitate generalizability of research findings across diverse population and interventions. PMID:27486851

Recommendations of Common Data Elements to Advance the Science of Self-Management of Chronic Conditions.

PubMed

Moore, Shirley M; Schiffman, Rachel; Waldrop-Valverde, Drenna; Redeker, Nancy S; McCloskey, Donna Jo; Kim, Miyong T; Heitkemper, Margaret M; Guthrie, Barbara J; Dorsey, Susan G; Docherty, Sharron L; Barton, Debra; Bailey, Donald E; Austin, Joan K; Grady, Patricia

2016-09-01

Common data elements (CDEs) are increasingly being used by researchers to promote data sharing across studies. The purposes of this article are to (a) describe the theoretical, conceptual, and definition issues in the development of a set of CDEs for research addressing self-management of chronic conditions; (b) propose an initial set of CDEs and their measures to advance the science of self-management; and (c) recommend implications for future research and dissemination. Between July 2014 and December 2015 the directors of the National Institute of Nursing Research (NINR)-funded P20 and P30 centers of excellence and NINR staff met in a series of telephone calls and a face-to-face NINR-sponsored meeting to select a set of recommended CDEs to be used in self-management research. A list of potential CDEs was developed from examination of common constructs in current self-management frameworks, as well as identification of variables frequently used in studies conducted in the centers of excellence. The recommended CDEs include measures of three self-management processes: activation, self-regulation, and self-efficacy for managing chronic conditions, and one measure of a self-management outcome, global health. The self-management of chronic conditions, which encompasses a considerable number of processes, behaviors, and outcomes across a broad range of chronic conditions, presents several challenges in the identification of a parsimonious set of CDEs. This initial list of recommended CDEs for use in self-management research is provisional in that it is expected that over time it will be refined. Comment and recommended revisions are sought from the research and practice communities. The use of CDEs can facilitate generalizability of research findings across diverse population and interventions. © 2016 Sigma Theta Tau International.

Issues and Impediments Faced by Canadian Teachers While Integrating ICT in Pedagogical Practice

ERIC Educational Resources Information Center

Saxena, Anoop

2017-01-01

Teachers in many schools struggle to integrate Information and Communications Technology (ICT) as part of their teaching practice. Among the issues faced by teachers when attempting to integrate ICT into their classrooms are gaps in ICT knowledge and skills, lack of training and inadequate support and scaffolding. Other issues include inability to…

Issues Facing Urban Agriscience Teachers: A Delphi Study

ERIC Educational Resources Information Center

Warner, Wendy J.; Washburn, Shannon G.

2009-01-01

This national study used the Delphi technique to identify the issues facing urban agriscience teachers. The first round of the study used a questionnaire with one open-ended question to generate responses from the expert panel. In the second round, respondents were asked to rate their level of agreement with 72 issues identified in round one using…

Aniakchak National Monument and Preserve: Geologic resources inventory report

USGS Publications Warehouse

Hults, Chad P.; Neal, Christina

2015-01-01

This GRI report is a companion document to previously completed GRI digital geologic map data. It was written for resource managers to support science-informed decision making. It may also be useful for interpretation. The report was prepared using available geologic information, and the NPS Geologic Resources Division conducted no new fieldwork in association with its preparation. Sections of the report discuss distinctive geologic features and processes within the park, highlight geologic issues facing resource managers, describe the geologic history leading to the present-day landscape, and provide information about the GRI geologic map data. A poster illustrates these data. The Map Unit Properties Table summarizes report content for each geologic map unit.

Total quality management in the hospital setting.

PubMed

Ernst, D F

1994-01-01

With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

Malaysia’s First Transplanted Case of Chronic Granulomatous Disease: The Journey of Overcoming Obstacles

PubMed Central

Ismail, Intan Hakimah; Jamli, Faizah Mohamed; Othman, Ida Shahnaz; Noh, Lokman Mohd; Abdul Latiff, Amir Hamzah

2016-01-01

The awareness of primary immunodeficiency (PID) in Malaysia is still not forthcoming. Certain practical issues such as lack of clinical immunologists and specialized laboratory diagnostic facilities remain to be addressed. However, great efforts taken by passionate clinicians and scientists in the immunology networking have ascertained some prevalence. Despite the limitation, all suspected cases of PID are being properly investigated and competently managed. In this case report we highlighted the obstacles we faced in managing PID patients, particularly preparing for bone marrow transplant. This is the first transplanted case of chronic granulomatous disease in Malaysia, which emphasizes the importance of collaborative work to ensure further morbidities or mortalities are prevented. PMID:27417247

Malaysia's First Transplanted Case of Chronic Granulomatous Disease: The Journey of Overcoming Obstacles.

PubMed

Ismail, Intan Hakimah; Jamli, Faizah Mohamed; Othman, Ida Shahnaz; Noh, Lokman Mohd; Abdul Latiff, Amir Hamzah

2016-05-17

The awareness of primary immunodeficiency (PID) in Malaysia is still not forthcoming. Certain practical issues such as lack of clinical immunologists and specialized laboratory diagnostic facilities remain to be addressed. However, great efforts taken by passionate clinicians and scientists in the immunology networking have ascertained some prevalence. Despite the limitation, all suspected cases of PID are being properly investigated and competently managed. In this case report we highlighted the obstacles we faced in managing PID patients, particularly preparing for bone marrow transplant. This is the first transplanted case of chronic granulomatous disease in Malaysia, which emphasizes the importance of collaborative work to ensure further morbidities or mortalities are prevented.

Managing the demands of the preregistration mental health nursing programme: The views of students with mental health conditions.

PubMed

Ramluggun, Pras; Lacy, Mary; Cadle, Martha; Anjoyeb, Mahmood

2018-05-30

An increasing number of students with a pre-existing mental health condition are enrolling on preregistration mental health nursing programmes. The challenges faced by these students in managing the demands of the programme have not been fully explored. Mental health and well-being is an integral part of providing a healthy university in which students can flourish. The purpose of the study was to explore how students with an underlying mental health issue manage the demands of the mental health nursing programme. The outcomes of the study are aimed at informing inclusive teaching and learning and current student support provision. Ethics approval was given. Students from two universities in South East England who met the criterion of having a pre-existing mental health condition when enrolling on the mental health preregistration nursing programme were invited to take part. Nine students took part in the study. Using an interpretative descriptive design, 1:1 face-to-face, audio-taped, semistructured interviews were undertaken. The data were analysed using a framework approach, and this revealed four main themes: timing of disclosure; managing lived experience in learning environments; students' coping mechanisms, and experience of support. Recommendations for practice was that approved education institutes (AEIs) should ensure they have a robust, inclusive practice by implementing strategies to develop these students' resilience, and enhance their learning and the current support provisions. This will ensure the barriers to disclosing their mental health conditions are recognized and minimized to enable these students to fully contribute to their own learning and teaching experience. © 2018 Australian College of Mental Health Nurses Inc.

The many faces of research on face perception.

PubMed

Little, Anthony C; Jones, Benedict C; DeBruine, Lisa M

2011-06-12

Face perception is fundamental to human social interaction. Many different types of important information are visible in faces and the processes and mechanisms involved in extracting this information are complex and can be highly specialized. The importance of faces has long been recognized by a wide range of scientists. Importantly, the range of perspectives and techniques that this breadth has brought to face perception research has, in recent years, led to many important advances in our understanding of face processing. The articles in this issue on face perception each review a particular arena of interest in face perception, variously focusing on (i) the social aspects of face perception (attraction, recognition and emotion), (ii) the neural mechanisms underlying face perception (using brain scanning, patient data, direct stimulation of the brain, visual adaptation and single-cell recording), and (iii) comparative aspects of face perception (comparing adult human abilities with those of chimpanzees and children). Here, we introduce the central themes of the issue and present an overview of the articles.

Tracking and forecasting the Nation’s water quality - Priorities and strategies for 2013-2023

USGS Publications Warehouse

Rowe, Gary L.; Gilliom, Robert J.; Woodside, Michael D.

2013-01-01

Water-quality issues facing the Nation are growing in number and complexity, and solutions are becoming more challenging and costly. Key factors that affect the quality of our drinking water supplies and ecosystem health include contaminants of human and natural origin in streams and groundwater; excess nutrients and sediment; alteration of natural streamflow; eutrophication of lakes, reservoirs, and coastal estuaries; and changes in surface and groundwater quality associated with changes in climate, land and water use, and management practices. Tracking and forecasting the Nation's water quality in the face of these and other pressing water-quality issues are important goals for 2013-2023, the third decade of the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) program. In consultation with stakeholders and the National Research Council, a new strategic Science Plan has been developed that describes a strategy for building upon and enhancing assessment of the Nation's freshwater quality and aquatic ecosystems. The plan continues strategies that have been central to the NAWQA program's long-term success, but it also makes adjustments to the monitoring and modeling approaches NAWQA will use to address critical data and science information needs identified by stakeholders. This fact sheet describes surface-water and groundwater monitoring and modeling activities that will start in fiscal year 2013. It also provides examples of the types of data and information products planned for the next decade, including (1) restored monitoring for reliable and timely status and trend assessments, (2) maps and models that show the distribution of selected contaminants (such as atrazine, nitrate, and arsenic) in streams and aquifers, and (3) Web-based modeling tools that allow managers to evaluate how water quality may change in response to different scenarios of population growth, climate change, or land-use management.

Public health emergencies and the public health/managed care challenge.

PubMed

Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

2002-01-01

The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

Scientific authorship. Part 2. History, recurring issues, practices, and guidelines.

PubMed

Claxton, Larry D

2005-01-01

One challenge for most scientists is avoiding and resolving issues that center around authorship and the publishing of scientific manuscripts. While trying to place the research in proper context, impart new knowledge, follow proper guidelines, and publish in the most appropriate journal, the scientist often must deal with multi-collaborator issues like authorship allocation, trust and dependence, and resolution of publication conflicts. Most guidelines regarding publications, commentaries, and editorials have evolved from the ranks of editors in an effort to diminish the issues that faced them as editors. For example, the Ingelfinger rule attempts to prevent duplicate publications of the same study. This paper provides a historical overview of commonly encountered scientific authorship issues, a comparison of opinions on these issues, and the influence of various organizations and guidelines in regards to these issues. For example, a number of organizations provide guidelines for author allocation; however, a comparison shows that these guidelines differ on who should be an author, rules for ordering authors, and the level of responsibility for coauthors. Needs that emerge from this review are (a) a need for more controlled studies on authorship issues, (b) an increased awareness and a buy-in to consensus views by non-editor groups, e.g., managers, authors, reviewers, and scientific societies, and (c) a need for editors to express a greater understanding of authors' dilemmas and to exhibit greater flexibility. Also needed are occasions (e.g., an international congress) when editors and others (managers, authors, etc.) can directly exchange views, develop consensus approaches and solutions, and seek agreement on how to resolve authorship issues. Open dialogue is healthy, and it is essential for scientific integrity to be protected so that younger scientists can confidently follow the lead of their predecessors.

Municipal solid waste management in the Southern Province of Sri Lanka: Problems, issues and challenges

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

Vidanaarachchi, Chandana K.; Yuen, Samuel T.S.; Pilapitiya, Sumith

2006-07-01

This paper describes the problems, issues and challenges faced by Sri Lanka based on the outcome of a recent study conducted in the country's Southern Province. The study consists of a public survey, discussions with local authority staff involved in waste management, discussions with Provincial Council and Government officials, dialogue with local politicians, review of documents and field observations. The study revealed that only 24% of the households have access to waste collection and that in rural areas it was less than 2%. A substantial number of households in areas without waste collection expect local authorities to collect their waste.more » The study also showed that most sites in the province are under capacity to handle any increased demand. Urgent and immediate improvement of the waste disposal sites is necessary to meet the current demand for improved waste collection. The study also revealed that there is a high willingness of people for home composting.« less

Towards stable and commercially available perovskite solar cells

DOE PAGES

Park, Nam-Gyu; Grätzel, Michael; Miyasaka, Tsutomu; ...

2016-10-17

Solar cells employing a halide perovskite with an organic cation now show power conversion efficiency of up to 22%. But, these cells are facing issues towards commercialization, such as the need to achieve long-term stability and the development of a manufacturing method for the reproducible fabrication of high-performance devices. We propose a strategy to obtain stable and commercially viable perovskite solar cells. A reproducible manufacturing method is suggested, as well as routes to manage grain boundaries and interfacial charge transport. Electroluminescence is regarded as a metric to gauge theoretical efficiency. We highlight how optimizing the design of device architectures ismore » important not only for achieving high efficiency but also for hysteresis-free and stable performance. Here, we argue that reliable device characterization is needed to ensure the advance of this technology towards practical applications. We believe that perovskite-based devices can be competitive with silicon solar modules, and discuss issues related to the safe management of toxic material.« less

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the design and operation of multi-center clinical trials: a qualitative research study.

PubMed

Eisenstein, Eric L; Diener, Lawrence W; Nahm, Meredith; Weinfurt, Kevin P

2011-12-01

New technologies may be required to integrate the National Institutes of Health's Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies.

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

PubMed Central

Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

2013-01-01

New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies. PMID:20703765

Managing the pursuit of health and wealth: the key challenges.

PubMed

Fidler, David P; Drager, Nick; Lee, Kelley

2009-01-24

This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series.

Neural networks for data mining electronic text collections

NASA Astrophysics Data System (ADS)

Walker, Nicholas; Truman, Gregory

1997-04-01

The use of neural networks in information retrieval and text analysis has primarily suffered from the issues of adequate document representation, the ability to scale to very large collections, dynamism in the face of new information and the practical difficulties of basing the design on the use of supervised training sets. Perhaps the most important approach to begin solving these problems is the use of `intermediate entities' which reduce the dimensionality of document representations and the size of documents collections to manageable levels coupled with the use of unsupervised neural network paradigms. This paper describes the issues, a fully configured neural network-based text analysis system--dataHARVEST--aimed at data mining text collections which begins this process, along with the remaining difficulties and potential ways forward.

Introduction to "northern Gulf of Mexico ecosystem change and hazards susceptibility"

USGS Publications Warehouse

Brock, J.C.; Lavoie, D.L.; Poore, R.Z.

2009-01-01

The northern Gulf of Mexico and its diverse natural resources are threatened by population and development pressure, and by the impacts of rising sea level and severe storms. In the wake of the devastating 2005 hurricane season, and in response to the complex management issues facing the region, the U.S. Geological Survey organized the multidisciplinary "Northern Gulf of Mexico Ecosystem Change and Hazards Susceptibility" project. This special issue of Geo-Marine Letters hosts a few of the early results in the form of 11 papers covering three themes: (1) the control exerted by the underlying geologic framework on geomorphology and nearshore processes and features; (2) impact of human activities on nearshore water quality; and (3) hurricanes and associated effects. ?? 2009 US Government.

Managing the pursuit of health and wealth: the key challenges

PubMed Central

Fidler, David P; Drager, Nick; Lee, Kelley

2009-01-01

This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series. PMID:19167061

The Effects of Health Education through Face To Face Teaching and Educational Movies, on Suburban Women in Childbearing Age.

PubMed

Vameghi, R; Mohammad, K; Karimloo, M; Soleimani, F; Sajedi, F

2010-01-01

The aim of the study was to compare the effects of 'face-to-face education' and 'educational movies' on 'knowledge' and 'practice' of women of child-bearing-age, in terms of health-care during pregnancy and during infancy in a suburban region near Tehran City, Iran. In this quasi-experimental study, the sample included 873 married women. Questionnaires for knowledge and practice assessment were designed. The women were assigned to three groups: control (group I), face-to-face education (group II), and educational movie (group III). Knowledge questionnaires were completed before and immediately after intervention. Practice questionnaires were completed before and three months after intervention. Both questionnaires consisted of two types of questions: type A (concerning infant care issues) and type B (concerning prenatal health care). There was a significant difference in post-test knowledge between groups I and II and between groups I and III, but not between groups II and III. In terms of post-test practice, the changes were determined for every individual question, and significantly, better results were seen in group II, especially concerning type B questions. Face to face education lead to better practice than educational movies. In addition, significantly better practice occurred regarding child health care issues rather than prenatal issues in both groups. Realistic and tangible issues, those easy to practice, and with little or no economical burden imposed on the family, progressed from the knowledge state to the practice state more successfully in both groups.

Expanding Medicaid managed care: the right choice for Texas?

PubMed

Reddy, Swapna; Finley, Marisa; Posey, Dan; Rohack, James J

2012-10-01

We set out to determine whether expanding Medicaid managed care in Texas is the solution to the challenges faced by the state of meeting the healthcare needs of a rapidly growing Medicaid population while addressing its own fiscal limitations. We reviewed the Texas Medicaid program, the potential effects of federal healthcare reform, and the state political climate through the perspectives (advantages and disadvantages) of the primary stakeholders: patients, practitioners, hospitals, and insurers. Research was performed through online, federal and state regulatory, and legislative review. In addition, we reviewed government and peer-reviewed reports and articles pertaining to issues related to Medicaid populations, healthcare practitioners, and hospitals that serve them. Each primary stakeholder had potential advantages and disadvantages associated with the expansion of Medicaid managed care. We conclude that expanding Medicaid managed care, if done in a manner responsive to the needs of recipients, can meet enrollees' healthcare needs while controlling the state's costs.

Chronic disease management and the home-care alternative in Ontario, Canada.

PubMed

Tsasis, Peter

2009-08-01

The pressure on our health-care system to deliver efficient, quality and cost-effective care is increasing. The debate on its sustainability is also expanding. These challenges can be managed with revisions to our health-care policy frameworks governing how and what public health-care services are delivered. Chronic disease management and home care can together ease many of the present and future pressures facing the health-care system. However, the current level of investment and the present policy are not effectively supporting movement in this direction. Updating the Canada Health Act to reflect the realities of our health-care system, and developing policies to support the areas of interdisciplinary teamwork and system integration are needed to facilitate chronic disease management and home care in Canada. This article lays out the challenges, highlights the impending issues and suggests a framework for moving forward.

The aging nursing workforce: How to retain experienced nurses.

PubMed

Cohen, Jeremye D

2006-01-01

In the face of an anticipated nursing shortage, healthcare organizations must evaluate their culture, operations, and compensation system to ensure that these elements align with organizational efforts to retain nurses who are approaching retirement age. Management should focus on enhancing elements of job satisfaction and job embeddedness that will motivate nurses to remain both in the workforce and with their employer. Although much of this responsibility falls on the nurse manager, nurse managers are often not provided the necessary support by top management and are neither recognized nor held accountable for nurse turnover. Other retention initiatives can include altering working conditions to reduce both physical and mental stress and addressing issues of employee health and safety. As for compensation, organizations may be well-served by offering senior nursing staff flexible working hours, salary structures that reward experience, and benefit programs that hold value for an aging workforce.

Different models to mobilize peer support to improve diabetes self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research.

PubMed

Heisler, Michele

2010-06-01

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.

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

Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

PubMed Central

Rusnak, James E.

1987-01-01

Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The hospital must insure the CMMS project provides a means to implement an integrated on-line hospital information data base for use by departments in operating under a DRG-based Prospective Payment System. This paper presents guidelines for use in selecting a Case Mix Mangement System to meet the hospital's financial and operations planning, budgeting, marketing, and other management needs, while considering the data base implications of the implementation.

Stresses and satisfactions of the two-pharmacist relationship.

PubMed

Stanton, A L; Berger, B A

1987-12-01

Potential advantages and disadvantages of dual-career relationships are identified, and strategies for addressing common issues encountered by dual-career couples are presented. With regard to career issues, clarification of expectations and discussion between partners regarding career commitment, job selection and mobility, and maintenance of professional identity is emphasized. Benefits of dual-career relationships include shared occupational interests, financial rewards, and respect for each partner's professional expertise. Strategies for managing domestic responsibilities include modifying standards, setting priorities, and distributing tasks evenly among family members. Pharmacist couples who are parents have chosen several routes in managing child-care issues, including postponing childbearing until each adult's career is established, decreasing one partner's career involvement, and hiring community or in-home caretakers. Sharing equally in child care can help prevent an excessive workload for one parent. Progressive family-oriented employment practices may also aid dual-career couples with children. Striking a balance between career and family is identified as perhaps the most challenging task facing the dual-career couple; time distribution must be adjusted according to the couple's priorities. Identifying realistic priorities, negotiating honestly regarding attainment of mutual and individual goals, and maintaining flexibility are key in achieving success in the professional and private lives of two-pharmacist couples.

Enhancing introductory hydrology curriculum by integrating perspectives from multi-disciplinary graduate fields of study

NASA Astrophysics Data System (ADS)

Arnold, T. E.; Henson, W.; Reijo, C. J.; Laing, J.; Weinkam, G.

2015-12-01

A cross-disciplinary hydrology course was developed that combined field and classroom based techniques to educate undergraduate level students on issues related to water resources in Florida, USA. Six instructors from separate departments brought a different perspective, research experience, and view on water quality and quantity issues. The course progressed by examining hydrologic processes at different spatio-temporal scales beginning with the geologic scale (the formation of aquifers) and ending with present-day water management and policy concerns. We were challenged to introduce students from various academic backgrounds and levels to the core concepts of hydrology and water chemistry. Additionally, the instructors faced the task of making our research fit together seamlessly, such that one topic would naturally progress to the next topic. We ensured that students' knowledge progressed enough so they could address complex management issues through critical thinking and application of basic field techniques. It is our objective to share the experiences and challenges in developing an interdisciplinary course that: 1) introduced new research ideas and concepts from six separate fields, 2) enhanced lecture concepts by hands-on, field-based activities, and 3) would keep students from science and non-science backgrounds engaged and challenged but not overwhelmed.

Using decision analysis to choose phosphorus targets for Lake Erie.

PubMed

Anderson, R M; Hobbs, B F; Koonce, J F; Locci, A B

2001-02-01

Lake Erie water quality has improved dramatically since the degraded conditions of the 1960s. Additional gains could be made, but at the expense of further investment and reductions in fishery productivity. In facing such cross-jurisdictional issues, natural resource managers in Canada and the United States must grapple with conflicting objectives and important uncertainties, while considering the priorities of the public that live in the basin. The techniques and tools of decision analysis have been used successfully to deal with such decision problems in a range of environmental settings, but infrequently in the Great Lakes. The objective of this paper is to illustrate how such techniques might be brought to bear on an important, real decision currently facing Lake Erie resource managers and stakeholders: the choice of new phosphorus loading targets for the lake. The heart of our approach is a systematic elicitation of stakeholder preferences and an investigation of the degree to which different phosphorus-loading policies might satisfy ecosystem objectives. Results show that there are potential benefits to changing the historical policy of reducing phosphorus loads in Lake Erie. Copyright 2001 Springer-Verlag

The economic case for low carbon waste management in rapidly growing cities in the developing world: The case of Palembang, Indonesia.

PubMed

Papargyropoulou, Effie; Colenbrander, Sarah; Sudmant, Andrew Heshedahl; Gouldson, Andy; Tin, Lee Chew

2015-11-01

The provision of appropriate waste management is not only an indicator of development but also of broader sustainability. This is particularly relevant to expanding cities in developing countries faced with rising waste generation and associated environmental health problems. Despite these urgent issues, city authorities often lack the evidence required to make well-informed decisions. This study evaluates the carbon and economic performance of low-carbon measures in the waste sector at a city level, within the context of a developing country. Palembang in Indonesia is used as a case of a medium-sized city in a newly industrialized country, with relevance to other similar cities in the developing world. Evidence suggests that the waste sector can achieve substantial carbon emission reductions, and become a carbon sink, in a cost effective way. Hence there is an economic case for a low carbon development path for Palembang, and possibly for other cities in developing and developed countries facing similar challenges. Copyright © 2015 Elsevier Ltd. All rights reserved.

Conservation in the face of climate change: The roles of alternative models, monitoring, and adaptation in confronting and reducing uncertainty

USGS Publications Warehouse

Conroy, M.J.; Runge, M.C.; Nichols, J.D.; Stodola, K.W.; Cooper, R.J.

2011-01-01

The broad physical and biological principles behind climate change and its potential large scale ecological impacts on biota are fairly well understood, although likely responses of biotic communities at fine spatio-temporal scales are not, limiting the ability of conservation programs to respond effectively to climate change outside the range of human experience. Much of the climate debate has focused on attempts to resolve key uncertainties in a hypothesis-testing framework. However, conservation decisions cannot await resolution of these scientific issues and instead must proceed in the face of uncertainty. We suggest that conservation should precede in an adaptive management framework, in which decisions are guided by predictions under multiple, plausible hypotheses about climate impacts. Under this plan, monitoring is used to evaluate the response of the system to climate drivers, and management actions (perhaps experimental) are used to confront testable predictions with data, in turn providing feedback for future decision making. We illustrate these principles with the problem of mitigating the effects of climate change on terrestrial bird communities in the southern Appalachian Mountains, USA. ?? 2010 Elsevier Ltd.

Future Issues Facing Administrators in Pharmaceutical Education.

ERIC Educational Resources Information Center

Fink, Joseph L., III

1986-01-01

Issues facing pharmaceutical education include the need to keep up with advancing technology, the need to keep faculty from overemphasizing technology to the detriment of other responsibilities, motivating and rewarding faculty, dealing with loss of faculty productivity, and part-time faculty. (MSE)

Establishing a Conceptual Foundation for Addressing Challenges Facing Food-Energy-Water Management

NASA Astrophysics Data System (ADS)

Goldsby, M.; Padowski, J.; Katz, S.; Brady, M.; Hampton, S. E.

2017-12-01

Ensuring the security of food, energy and water in the face of a changing environment is a top societal priority. In order to make sound policy decisions aimed at meeting those needs, policy-makers need decision-relevant information. As such, considerable effort and resources have recently been devoted to investigating the Food-Energy-Water (FEW) Nexus in order to better provide that information. However, despite the increased research activity into FEW systems and FEW problems, little attention has been devoted to the fundamental conceptual issues underlying contemporary FEW systems. Consequently, this inattention has led to conceptual confusion about what is and what is not a FEW system. This project aims to fill that lacuna in order to better facilitate the FEW research agenda. Toward that end, we identify three features that distinguish FEW problems from other resource management problems: (1) the production and management of the resources in each sector of a FEW system is specialized to its own sector; (2) interdependencies exist between sectors such that overproduction in one sector, for example, may have impacts on other sectors; and (3) there are real limits to FEW resource availability as well as limits on the ability to transact across sector boundaries. We contend that once armed with this distinction, one can model the stocks and flows of FEW capital in a conceptually rigorous way that may lead to operational innovations of FEW management.

Addressing the Health and Wellness Needs of Vulnerable Rockaway Residents in the Wake of Hurricane Sandy: Findings From a Health Coaching and Community Health Worker Program.

PubMed

Russell, David; Oberlink, Mia R; Shah, Shivani; Evans, Lauren; Bassuk, Karen

To describe the design and participants of a program that employed health coaches and community health workers to address the social, health, and long-term disaster recovery needs of Rockaway residents roughly 2 years after Hurricane Sandy made landfall. Baseline and exit questionnaires, containing demographic, health, and health care utilization measures, were administered to participants at the start and end of the program. Enrollment and encounter information was captured in program administrative records. Descriptive statistics were used to summarize participant characteristics, personal goals, referrals to local organizations and agencies, and outcomes. Qualitative analyses were used to identify recurring themes in challenges faced by participants and barriers to health and wellness. The program served 732 community residents, of whom 455 (62%) completed baseline and exit questionnaires. Participants were directly and/or indirectly impacted by Hurricane Sandy through property damage, closures of health care facilities, limited employment opportunities, and trouble securing affordable housing. Furthermore, many participants faced considerable adversities and struggled to manage chronic health conditions. Personal goals set by participants included locating health care and other resources (44%), weight management and healthy eating (35%), and self-management of chronic conditions (24%). Health coaches and community health workers engaged participants an average of 4 times-providing counseling and referrals to local organizations and services, including medical and dental services (29%), city-issued identification cards (27%), and health insurance and other entitlements (23%). Comparisons of baseline and exit surveys indicated significant improvements in self-reported health, health care utilization, and confidence managing health issues. No significant improvement was observed in the use of preventive health care services. The program represents a model for engaging vulnerable populations and addressing social and economic barriers to health and wellness during the long-term disaster recovery phase. Health coaches and community health workers may be instrumental in helping to address the health and wellness needs of vulnerable residents living in disaster-affected areas.

Homeland Security. Management Challenges Facing Federal Leadership

DTIC Science & Technology

2002-12-01

Security Management Challenges Facing Federal Leadership 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...including attention to management practices and key success factors. HOMELAND SECURITY Management Challenges Facing Federal Leadership www.gao.gov/cgi...significant management and coordination challenges if it is to provide this leadership and be successful in preventing and responding to any future

"Beauty lies in the eye of the beholder"? Aspects of beauty and attractiveness.

PubMed

Borelli, Claudia; Berneburg, Mirjam

2010-05-01

Discussing aesthetic issues and their management with patients is a growing area of dermatologic practice. Sometimes treatment options within one's own discipline are rapidly discussed, without a clear idea of the various aspects of the face which all combine to produce beauty and attractiveness. We review various features leading to the impression of beauty and attractiveness. Familiarity with these concepts should facilitate a broader discussion with the patient on the aspects of beauty and attractiveness beyond the borders of one's own discipline and also lead to multidisciplinary treatment options. We also examine the question how much the personality of the beholder himself is involved in the perception of attractiveness and beauty (of the person sitting opposite to him). The "ideal" face has an average profile with slightly protrusive and full lips. Attractiveness increases with average features and symmetry. Moreover, particular features such as the scheme of childlike characteristics combined with aspects of maturity and expression make a female face appear especially beautiful. Which attributes contribute to attractiveness of a man's face are controversial. Clear male signals such as a strong chin are likely not to increase attractiveness.

A Discussion of the Issue of Football Helmet Removal in Suspected Cervical Spine Injuries

PubMed Central

Segan, Ross D.; Cassidy, Christine; Bentkowski, Jamie

1993-01-01

In some areas, it is a commonly accepted emergency medical technician protocol to remove a helmet during the initial management of suspected cervical spine injures. After a comprehensive survey of relevant literature, four primary reasons why Emergency Medical Services professionals would desire to remove a helmet emerge. Sources suggest that the presence of a helmet might: 1) interfere with immobilization of the athlete; 2) interfere with the ability to visualize injuries; 3) cause hyperflexion of the cervical spine; and 4) prevent proper airway management during a cardiorespiratory emergency. Many available protocols are designed for the removal of closed chamber motorcycle helmets that do not have removable face masks. There are a great number of differing viewpoints regarding this issue. The varying viewpoints are results of the failure of many emergency medical technician management protocols to address the unique situation presented by a football helmet. We: 1) demonstrate that football helmet removal is potentially dangerous and unnecessary, 2) suggest that cardiorespiratory emergencies can be effectively managed without removing the helmet, and 3) provide sports medicine professional with information that may be used to establish a joint Emergency Medical Services/Sports Medicine emergency action plan. ImagesFig. 1.Fig 2.Fig 3.Fig 4.Fig 5.Fig 6. PMID:16558244

Changing workforce demographics necessitates succession planning in health care.

PubMed

Collins, Sandra K; Collins, Kevin S

2007-01-01

Health care organizations continue to be plagued by labor shortage issues. Further complicating the already existing workforce challenges is an aging population poised to retire en masse within the next few years. With fewer cohorts in the age group of 25 to 44 years (Vital Speeches Day. 2004:71:23-27), a more mobile workforce (Grow Your Own Leaders: How to Identify, Develop, and Retain Leadership Talent, 2002), and an overall reduction in the number of individuals seeking employment in the health care field (J Healthc Manag. 2003:48:6-11), the industry could be faced with an unmanageable number of vacant positions throughout the organization. Bracing for the potential impact of these issues is crucial to the ongoing business continuity of health care organization. Many health care organizations have embraced succession planning to combat the potential labor famine. However, the health care industry as a whole seems to lag behind other industries in terms of succession planning efforts (Healthc Financ Manage. 2005;59:64-67). This article seeks to provide health care managers with a framework for improving the systematic preparation of the next generation of managers by analyzing the succession planning process. The proposition of these models is to initiate and simplify the gap reduction between theoretical concepts and future organizational application.

Key water issues now facing our nation

USGS Publications Warehouse

Hirsch, Robert M.; Miller, Timothy L.; Hamilton, Pixie A.; Gilliom, Robert J.

2008-01-01

Challenges to sustaining sufficient and high-quality water for human consumption, industry, farms, energy production, and ecosystem services continue to intensify in many parts of the Nation. We face four key water issues that call for support from the science and engineering communities.

The sudden removal of user fees: the perspective of a frontline manager in Burundi.

PubMed

Nimpagaritse, Manassé; Bertone, Maria Paola

2011-11-01

In May 2006, the President of Burundi announced the removal of user fees in all health centres and hospitals for children under 5 and women giving birth. As other studies also point out, the policy was adopted extremely suddenly, without much reflection on its ultimate aims and on the operational dimension of its implementation. From the perspective of a frontline manager, this paper provides a descriptive case study of the abolition of user fees in the Muramvya District and a first-hand account of the effects of the sudden reform in the management of a district and a district hospital. The analysis highlights the challenges that the district and hospital teams faced. The main issues were: the reduction of financial flows, which prevented the possibility of investments and caused frequent drugs stock-outs; the reduced quality of the services and the disruption of the referral system; the motivation of the health staff who saw the administrative workload increase (not necessarily because of increased utilization) and faced 'ethical dilemmas' caused by the imprecise targeting of the reform. Undoubtedly, the removal of user fees for certain groups was an equitable and necessary measure in an extremely poor country such as Burundi. However, the suddenness of the decision and the lack of preparation had critical and long-lasting consequences for the entire health system. This analysis, performed from the frontline perspective, clarifies the importance of a rigorous planning of any reform, as well as of involving peripheral actors and understanding the complex challenges that they face.

The dilemma of diabetic patients living with hypoglycaemia.

PubMed

Wu, Fei-Ling; Juang, Jyuhn-Huarng; Yeh, Mei Chang

2011-08-01

To examine the impact of the threat of hypoglycaemic episodes on people with diabetes in Taiwan. Intensive diabetes treatment in people with diabetes helps them to achieve better glycaemic control. However, it also causes more frequent hypoglycaemic episodes and has an impact on their overall quality of life. Hypoglycaemia is accompanied by various distressing symptoms which may cause excessive fear, affecting decision making in hypoglycaemic management. Purposive sampling and in-depth, face-to-face interviews were used to collect data. Semi-structured interviews were conducted from July 2008-January 2009 with 17 individuals treated with insulin who had previous hypoglycaemic episodes. Data were analysed using qualitative content analysis. Four themes were generated from the analysis, 'inability to control fluctuations in health', 'challenges to interpersonal relationships', 'facing the disease alone' and 'finding a balance between competing symptoms'. Hypoglycaemia is a major health issue for many people with diabetes. Understanding individuals' experiences with hypoglycaemic episodes should help practitioners become more fully involved in promoting self-management. We identified key areas that health care providers should address, including concerns about patient education and professional support for people with diabetes experiencing hypoglycaemia, to enhance problem solving skills for them and their families. We recommend that health care providers make proper use of support groups for family caregivers or other important individuals in the lives of people with diabetes to provide education, clarification, support and guidance. In addition, health care providers also need to provide clients with hypoglycaemia-related emotional support, while enhancing diabetes self-management and problem-solving skills. © 2011 Blackwell Publishing Ltd.

Challenges faced by primary care physicians when prescribing for patients with chronic diseases in a teaching hospital in Malaysia: a qualitative study.

PubMed

Sellappans, Renukha; Lai, Pauline Siew Mei; Ng, Chirk Jenn

2015-08-27

The aim of this study was to identify the challenges faced by primary care physicians (PCPs) when prescribing medications for patients with chronic diseases in a teaching hospital in Malaysia. 3 focus group discussions were conducted between July and August 2012 in a teaching primary care clinic in Malaysia. A topic guide was used to facilitate the discussions which were audio-recorded, transcribed verbatim and analysed using a thematic approach. PCPs affiliated to the primary care clinic were purposively sampled to include a range of clinical experience. Sample size was determined by thematic saturation of the data. 14 family medicine trainees and 5 service medical officers participated in this study. PCPs faced difficulties in prescribing for patients with chronic diseases due to a lack of communication among different healthcare providers. Medication changes made by hospital specialists, for example, were often not communicated to the PCPs leading to drug duplications and interactions. The use of paper-based medical records and electronic prescribing created a dual record system for patients' medications and became a problem when the 2 records did not tally. Patients sometimes visited different doctors and pharmacies for their medications and this resulted in the lack of continuity of care. PCPs also faced difficulties in addressing patients' concerns, and dealing with patients' medication requests and adherence issues. Some PCPs lacked time and knowledge to advise patients about their medications and faced difficulties in managing side effects caused by the patients' complex medication regimen. PCPs faced prescribing challenges related to patients, their own practice and the local health system when prescribing for patients with chronic diseases. These challenges must be addressed in order to improve chronic disease management in primary care and, more importantly, patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Is Isolation a Problem? Issues Faced by Rural Libraries and Rural Library Staff in South Australia

ERIC Educational Resources Information Center

Haines, Rebecca; Calvert, Philip J.

2009-01-01

The aim of this research was to investigate current issues faced by public library staff in rural South Australia and to examine some of the reasons why people choose to work in rural libraries. The study took a mixed methods approach, combining interviews and questionnaires to gain a fuller understanding of the issues and experiences of rural…

Online faculty development for creating E-learning materials.

PubMed

Niebuhr, Virginia; Niebuhr, Bruce; Trumble, Julie; Urbani, Mary Jo

2014-01-01

Faculty who want to develop e-learning materials face pedagogical challenges of transforming instruction for the online environment, especially as many have never experienced online learning themselves. They face technical challenges of learning new software and time challenges of not all being able to be in the same place at the same time to learn these new skills. The objective of the Any Day Any Place Teaching (ADAPT) faculty development program was to create an online experience in which faculty could learn to produce e-learning materials. The ADAPT curriculum included units on instructional design, copyright principles and peer review, all for the online environment, and units on specific software tools. Participants experienced asynchronous and synchronous methods, including a learning management system, PC-based videoconferencing, online discussions, desktop sharing, an online toolbox and optional face-to-face labs. Project outcomes were e-learning materials developed and participants' evaluations of the experience. Likert scale responses for five instructional units (quantitative) were analyzed for distance from neutral using one-sample t-tests. Interview data (qualitative) were analyzed with assurance of data trustworthiness and thematic analysis techniques. Participants were 27 interprofessional faculty. They evaluated the program instruction as easy to access, engaging and logically presented. They reported increased confidence in new skills and increased awareness of copyright issues, yet continued to have time management challenges and remained uncomfortable about peer review. They produced 22 new instructional materials. Online faculty development methods are helpful for faculty learning to create e-learning materials. Recommendations are made to increase the success of such a faculty development program.

The impact of using computer decision-support software in primary care nurse-led telephone triage: interactional dilemmas and conversational consequences.

PubMed

Murdoch, Jamie; Barnes, Rebecca; Pooler, Jillian; Lattimer, Valerie; Fletcher, Emily; Campbell, John L

2015-02-01

Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. Although computer decision-support software (CDSS) is increasingly used by nurses to triage patients, little is understood about how interaction is organized in this setting. Specifically any interactional dilemmas this computer-mediated setting invokes; and how these may be consequential for communication with patients. Using conversation analytic methods we undertook a multi-modal analysis of 22 audio-recorded telephone triage nurse-caller interactions from one GP practice in England, including 10 video-recordings of nurses' use of CDSS during triage. We draw on Goffman's theoretical notion of participation frameworks to make sense of these interactions, presenting 'telling cases' of interactional dilemmas nurses faced in meeting patient's needs and accurately documenting the patient's condition within the CDSS. Our findings highlight troubles in the 'interactional workability' of telephone triage exposing difficulties faced in aligning the proximal and wider distal context that structures CDSS-mediated interactions. Patients present with diverse symptoms, understanding of triage consultations, and communication skills which nurses need to negotiate turn-by-turn with CDSS requirements. Nurses therefore need to have sophisticated communication, technological and clinical skills to ensure patients' presenting problems are accurately captured within the CDSS to determine safe triage outcomes. Dilemmas around how nurses manage and record information, and the issues of professional accountability that may ensue, raise questions about the impact of CDSS and its use in supporting nurses to deliver safe and effective patient care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Square2 - A Web Application for Data Monitoring in Epidemiological and Clinical Studies

PubMed

Schmidt, Carsten Oliver; Krabbe, Christine; Schössow, Janka; Albers, Martin; Radke, Dörte; Henke, Jörg

2017-01-01

Valid scientific inferences from epidemiological and clinical studies require high data quality. Data generating departments therefore aim to detect data irregularities as early as possible in order to guide quality management processes. In addition, after the completion of data collections the obtained data quality must be evaluated. This can be challenging in complex studies due to a wide scope of examinations, numerous study variables, multiple examiners, devices, and examination centers. This paper describes a Java EE web application used to monitor and evaluate data quality in institutions with complex and multiple studies, named Square 2 . It uses the Java libraries Apache MyFaces 2, extended by BootsFaces for layout and style. RServe and REngine manage calls to R server processes. All study data and metadata are stored in PostgreSQL. R is the statistics backend and LaTeX is used for the generation of print ready PDF reports. A GUI manages the entire workflow. Square 2 covers all steps in the data monitoring workflow, including the setup of studies and their structure, the handling of metadata for data monitoring purposes, selection of variables, upload of data, statistical analyses, and the generation as well as inspection of quality reports. To take into account data protection issues, Square 2 comprises an extensive user rights and roles concept.

Challenges in developing physician leadership and management.

PubMed

Guthrie, M B

1999-01-01

Many of the issues confronting healthcare organizations require physician involvement and understanding, and the physician executive is a tool to achieving physician participation. Physician leaders can become the mediators between physicians and organizational management, minimizing miscommunication and maximizing agreement and understanding. Yet few doctors seem willing to stand up and speak positively for the plans and proposals that will move the institution forward, and healthcare executives are often frustrated by physician leadership that fails to articulate and implement the vision and objectives of the organization. Understanding physician leadership and exploring the challenges in managing and leading physicians require an understanding of the physician mindset--a completely different mindset than that of the typical healthcare executive. Beginning with a discussion of the unique situation faced by physicians in leadership positions, this article attempts to define the obstacles faced by both the physician and the executive in developing the role of physician executive. After reviewing the opportunities open to physician executives for improving leadership ability, the author presents the essential characteristics and core skills for effective leadership. The second half of the article suggests ways in which an organization can reemphasize physician leadership development within an organization from selection of potential candidates to creating training and networking opportunities and offering appropriate incentives.

Bioterrorism: Preparing the Plastic Surgeon

PubMed Central

Chopra, Karan; Conde-Green, Alexandra; Folstein, Matthew K.; Knepp, Erin K.; Christy, Michael R.; Singh, Devinder P.

2011-01-01

Introduction: Many medical disciplines, such as emergency medicine, trauma surgery, dermatology, psychiatry, family practice, and dentistry have documented attempts at assessing the level of bioterrorism preparedness in their communities. Currently, there is neither such an assessment nor an existing review of potential bioterrorism agents as they relate to plastic surgery. Therefore, the purpose of this article is to present plastic surgeons with a review of potential bioterrorism agents. Methods: A review of the literature on bioterrorism agents and online resources of the Centers for Disease Control and Prevention was conducted. Category A agents were identified and specific attention was paid to the management issues that plastic surgeons might face in the event that these agents are used in an attack. Results: Disease entities reviewed were smallpox, anthrax, plague, viral hemorrhagic fever, tularemia, and botulism. For each agent, we presented the microbiology, pathophysiology, clinical presentation, potential for weaponization, medical management, and surgical issues related to the plastic surgeon. Conclusion: This article is the first attempt at addressing preparedness for bioterrorism in the plastic surgery community. Many other fields have already started a similar process. This article represents a first step in developing evidence-based consensus guidelines and recommendations for the management of biological terrorism for plastic surgeons. PMID:22132252

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.

The science, information, and engineering needed to manage water availability and quality in 2050: Chapter 23

USGS Publications Warehouse

Hirsch, Robert M.

2012-01-01

This chapter explores four water resources issues: 1) hydrologic variability, hazards, water supply and ecosystem preservation; 2) urban landscape design; 3) non-point source water quality, and 4) climate change, resiliency, and nonstationarity. It also considers what science, technology, and engineering practice may be needed in the coming decades to sustain water supplies and ecosystems in the face of increasing stresses from a growing demand for water. Dealing with these four water resource issues in the highly uncertain future would will demand predictive models that are rooted in real-world data. In a non-stationary world, continuity of observations is crucial. All watersheds are influenced by human actions through changes in land use, water use, and climate. The focus of water planning and management between today and 2050 will depend more than ever on collection and analysis of long-term data to learn about the evolving state of the system, understanding ecosystem processes in the water and on the landscape, and finding innovative ways to manage water as a shared resource. This includes sharing water with our neighbors on the landscape, sharing with the other species that depend on water, and sharing with future generations.

In view of standardization Part 2: Management of challenges in the initial treatment of burn patients in Burn Centers in Germany, Austria and Switzerland.

PubMed

Ziegler, Benjamin; Hirche, Christoph; Horter, Johannes; Kiefer, Jurij; Grützner, Paul Alfred; Kremer, Thomas; Kneser, Ulrich; Münzberg, Matthias

2017-03-01

Initial therapy of severe burns in specialized burn trauma centers is a challenging task faced by the treating multi-professional and interdisciplinary team. A lack of consistent operating procedures and varying structural conditions was recently demonstrated in preliminary data of our group. These results raised the question on how specific treatment measures in acute burn care are met in the absence of standardized guidelines. A specific questionnaire containing 57 multiple-choice questions was sent to all 22 major burn centers in Germany, Austria and Switzerland. The survey included standards of airway management and ventilation, fluid management and circulation, body temperature monitoring and management, topical burn wound treatment and a microbiological surveillance. Additionally, the distribution of standardized course systems was covered. 17 out of 22 questionnaires (77%) were returned completed. Regarding volume resuscitation, results showed a similar approach in estimating initial fluid while discrepancies persisted in the use of colloidal fluid and human albumin. Elective tracheostomy and the need for bronchoscopy with suspected inhalation injury were the most controversial issues revealed by the survey. Topical treatment of burned body surface also followed different principles regarding the use of synthetic epidermal skin substitutes or enzymatic wound debridement. Less discrepancy was found in basic diagnostic measures, body temperature management, estimation of the extent of burns and microbiological surveillance. While many burn-related issues are clearly not questionable and managed in a similar way in most participating facilities, we were able to show that the most contentious issues in burn trauma management involve initial volume resuscitation, management of inhalation trauma and topical burn wound treatment. Further research is required to address these topics and evaluate a potential superiority of a regime in order to increase the level of evidence. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

The implications of new forest tenure reforms and forestry property markets for sustainable forest management and forest certification in China.

PubMed

Chen, Juan; Innes, John L

2013-11-15

This study examines issues existing in the southern collective forests in China, particularly prior to the implementation of new forest tenure reforms, such as continued illegal logging and timber theft, inadequate availability of finance and inconsistent forest-related policies. Such problems are believed to be hindering the adoption of sustainable forest management (SFM) and forest certification by forest farmers in China. Two strategies were introduced by the Chinese government with the purpose of addressing these issues, namely forest tenure reforms and their associated supporting mechanism, forestry property markets. Through two case studies in southern China, we investigated the effectiveness of the two strategies as well as their implications for the adoption of SFM and forest certification. The two cases were Yong'an in Fujian province and Tonggu in Jiangxi province. Personal interviews with open-ended questions were conducted with small-scale forest farmers who had already benefited from the two strategies as well as market officers working for the two selected forestry property markets. The study identified eight issues constraining the potential adoption of SFM and certification in China, including limited finance, poorly developed infrastructure and transport systems, insecure forest tenures, inconsistent forest policies, low levels of awareness, illegal forest management practices, lack of local cooperative organizations, and inadequate knowledge and technical transfer. We found that the new forest tenure reforms and forestry property markets had generally fulfilled their original objectives and had the capacity to assist in addressing many of the issues facing forests prior to the reforms. Copyright © 2013 Elsevier Ltd. All rights reserved.

Developing a framework of, and quality indicators for, general practice management in Europe.

PubMed

Engels, Yvonne; Campbell, Stephen; Dautzenberg, Maaike; van den Hombergh, Pieter; Brinkmann, Henrik; Szécsényi, Joachim; Falcoff, Hector; Seuntjens, Luc; Kuenzi, Beat; Grol, Richard

2005-04-01

To develop a framework for general practice management made up of quality indicators shared by six European countries. Two-round postal Delphi questionnaire in the setting of general practice in Belgium, France, Germany, The Netherlands, Switzerland and the United Kingdom. Six national expert panels, each consisting of 10 members, primarily primary care practitioners and experts in the field of quality in primary care participated in the study. The main outcome measures were: (a) a European framework with indicators for the organization of primary care; and (b) ratings of the face validity of the usefulness of the indicators by expert panels in six countries. Agreement was reached about a definition of practice management across five domains (infrastructure, staff, information, finance, and quality and safety), and a common set of indicators for the organization of general practice. The panellist response rate was 95%. Sixty-two indicators (37%) were rated face valid by all six panels. Examples include out of hours service, accessibility, the content of doctors' bags and staff involvement in quality improvement. No indicators were rated invalid by all six panels. It proved to be possible to develop a European set of indicators for assessing the quality of practice management, despite the differences in health care systems and cultures in the six different countries. These indicators will now be used in a quality assessment procedure of practice management in nine European countries. While organizational indicators are part of the new GMS contract in the UK, this research shows that many practice management issues within primary care are also of relevance in other European countries.

Facilitating the improved management of waste in South Africa through a national waste information system

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

Godfrey, Linda

2008-07-01

Developing a waste information system (WIS) for a country is more than just about collecting routine data on waste; it is about facilitating the improved management of waste by providing timely, reliable information to the relevant role-players. It is a means of supporting the waste governance challenges facing South Africa - challenges ranging from strategic waste management issues at national government to basic operational challenges at local government. The paper addresses two hypotheses. The first is that the identified needs of government can provide a platform from which to design a national WIS framework for a developing country such asmore » South Africa, and the second is that the needs for waste information reflect greater, currently unfulfilled challenges in the sustainable management of waste. Through a participatory needs analysis process, it is shown that waste information is needed by the three spheres of government, to support amongst others, informed planning and decision-making, compliance monitoring and enforcement, community participation through public access to information, human, infrastructure and financial resource management and policy development. These needs for waste information correspond closely with key waste management challenges currently facing the country. A shift in governments approach to waste, in line with national and international policy, is evident from identified current and future waste information needs. However, the need for information on landfilling remains entrenched within government, possibly due to the poor compliance of landfill sites in South Africa and the problems around the illegal disposal of both general and hazardous waste.« less

Major Issues Facing the Conservation Movement in the Coming Decade and Beyond.

ERIC Educational Resources Information Center

Strong, Maurice

1984-01-01

The key issues facing the conservation movement may be grouped into three areas: (1) threats to human health; (2) threats to food and fuel supplies; and (3) long-term threats to the biosphere. Each of these areas is discussed. (JN)

AANA Journal course: update for nurse anesthetists--ERR WATCH: anesthesia crisis resource management from the nurse anesthetist's perspective.

PubMed

Fletcher, J L

1998-12-01

Anesthesia crisis resource management (ACRM) was developed by David Gaba, MD, and colleagues at Stanford University in the early 1990s. Derived from cockpit resource management of the aviation industry, ACRM addresses the issues of human performance and patient safety in anesthesia. Due to the inherent complexity of our dynamic work environment, we are frequently faced with situations that could escalate into critical incidents. ACRM explains the role of personal and environmental factors that can contribute to the evolution of critical incidents and provides the practitioner with some behavioral and intellectual guidelines to manage the risks more effectively. ERR WATCH is an acronym I developed to interpret the principles of ACRM from the nurse anesthetist's perspective. It provides a quick review of the major principles of ACRM, which are Environment, Resources, Reevaluation, Workload, Attention, Teamwork, Communication, and Help. Used together with good clinical management, these principles may provide an edge in solving complex problems and improving performance.

Quicker, slicker, and better? An evaluation of a web-based human resource management system

NASA Astrophysics Data System (ADS)

Gibb, Stephen; McBride, Andrew

2001-10-01

This paper reviews the design and development of a web based Human Resource Management (HRM) system which has as its foundation a 'capability profiler' tool for analysing individual or team roles in organisations. This provides a foundation for managing a set of integrated activities in recruitment and selection, performance and career management, and training and development for individuals, teams, and whole organisations. The challenges of representing and processing information about the human side of organisation encountered in the design and implementation of such systems are evident. There is a combination of legal, practical, technical and philosophical issues to be faced in the processes of defining roles, selecting staff, monitoring and managing the performance of employees in the design and implementation of such systems. The strengths and weaknesses of web based systems in this context are evaluated. This evaluation highlights both the potential, given the evolution of broader Enterprise Resource Planning (ERP) systems and strategies in manufacturing, and concerns about the migration of HRM processes to such systems.

Strategy for managing water in the Middle East and North Africa. Arabic edition

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

Berkoff, J.

1995-03-21

Proposes a practical, step-by-step approach to managing water resources in a coordinated and sustainable manner. The people of the Middle East and North Africa have faced scarce water resources since time immemorial. Today, burgeoning populations dwarf the concerns of the past. New strategies for planning and managing water are urgently needed to avoid escalating conflicts and to reverse environmental degradation. This booklet details the implications of a new World Bank policy for the region, calling for a strong effort by governments and Bank staff to manage water resources in a coordinated and sustainable manner. A practical, step-by-step strategy is proposedmore » that could lead to new Bank-funded operations throughout the water sector. The issues involved are complex but must be addressed if water scarcity is not to hinder development projects. The strategy proposed in this booklet could help build a new partnership for sustainable water management between the World Bank and regional governments.« less

Requirement analysis for the one-stop logistics management of fresh agricultural products

NASA Astrophysics Data System (ADS)

Li, Jun; Gao, Hongmei; Liu, Yuchuan

2017-08-01

Issues and concerns for food safety, agro-processing, and the environmental and ecological impact of food production have been attracted many research interests. Traceability and logistics management of fresh agricultural products is faced with the technological challenges including food product label and identification, activity/process characterization, information systems for the supply chain, i.e., from farm to table. Application of one-stop logistics service focuses on the whole supply chain process integration for fresh agricultural products is studied. A collaborative research project for the supply and logistics of fresh agricultural products in Tianjin was performed. Requirement analysis for the one-stop logistics management information system is studied. The model-driven business transformation, an approach uses formal models to explicitly define the structure and behavior of a business, is applied for the review and analysis process. Specific requirements for the logistic management solutions are proposed. Development of this research is crucial for the solution of one-stop logistics management information system integration platform for fresh agricultural products.

Diagnosis and management of Duchenne muscular dystrophy, part 3: primary care, emergency management, psychosocial care, and transitions of care across the lifespan

PubMed Central

Birnkrant, David J; Bushby, Katharine; Bann, Carla M; Apkon, Susan D; Blackwell, Angela; Colvin, Mary K; Cripe, Linda; Herron, Adrienne R; Kennedy, Annie; Kinnett, Kathi; Naprawa, James; Noritz, Garey; Poysky, James; Street, Natalie; Trout, Christina J; Weber, David R; Ward, Leanne M

2018-01-01

Improvements in the function, quality of life, and longevity of patients with Duchenne muscular dystrophy (DMD) have been achieved through a multidisciplinary approach to management across a range of health-care specialties. In part 3 of this update of the DMD care considerations, we focus on primary care, emergency management, psychosocial care, and transitions of care across the lifespan. Many primary care and emergency medicine clinicians are inexperienced at managing the complications of DMD. We provide a guide to the acute and chronic medical conditions that these first-line providers are likely to encounter. With prolonged survival, individuals with DMD face a unique set of challenges related to psychosocial issues and transitions of care. We discuss assessments and interventions that are designed to improve mental health and independence, functionality, and quality of life in critical domains of living, including health care, education, employment, interpersonal relationships, and intimacy. PMID:29398641

A case study of the Australian Plague Locust Commission and environmental due diligence: why mere legislative compliance is no longer sufficient for environmentally responsible locust control in Australia.

PubMed

Story, Paul G; Walker, Paul W; McRae, Heath; Hamilton, John G

2005-07-01

The Australian Plague Locust Commission (APLC) manages locust populations across 2 million square kilometers of eastern Australia using the aerial application of chemical and biological control agents to protect agricultural production. This occurs via a preventative control strategy involving ultralow-volume spray equipment to distribute small droplets of control agent over a target area. The economic costs of, and potential gains stemming from, locust control are well documented. The application of insecticides, however, to fragile arid and semiarid ecosystems is a task that brings with it both real and perceived environmental issues. The APLC is proactive in addressing these issues through a combination of targeted environmental operational research, an ISO-14001-aligned Environmental Management System (EMS), and links with environmental regulatory and research institutions. Increasing due diligence components within Australian environmental legislation dictate that mere legislative compliance is no longer sufficient for industries to ensure that they meet their environmental obligations. The development of external research links and the formulation of an EMS for locust control have enabled the APLC to identify environmental issues and trends, quantify objective environmental targets and strategies, and facilitate continuous improvement in its environmental performance, while maintaining stakeholder support. This article outlines the environmental issues faced by the APLC, the research programs in place to address these issues, and the procedures in place to incorporate research findings into the organization's operational structure.

Learning from Experience, Volume 2: Lessons from the U.S. Navy’s Ohio, Seawolf, and Virginia Submarine Programs

DTIC Science & Technology

2011-01-01

valid OMB control number. 1. REPORT DATE 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Learning from...MURPHY MARK V. ARENA • KRISTY N. KAMARCK • GORDON T. LEE LEARNING FROM EXPERIENCE Lessons from the U.S. Navy’s Ohio, Seawolf, and Virginia Submarine...managers of new programs may not have the benefit of learning from the challenges faced and the issues solved in past programs. Recognizing the

Empirical and Face Validity of Software Maintenance Defect Models Used at the Jet Propulsion Laboratory

NASA Technical Reports Server (NTRS)

Taber, William; Port, Dan

2014-01-01

At the Mission Design and Navigation Software Group at the Jet Propulsion Laboratory we make use of finite exponential based defect models to aid in maintenance planning and management for our widely used critical systems. However a number of pragmatic issues arise when applying defect models for a post-release system in continuous use. These include: how to utilize information from problem reports rather than testing to drive defect discovery and removal effort, practical model calibration, and alignment of model assumptions with our environment.

Security and privacy issues of personal health.

PubMed

Blobel, Bernd; Pharow, Peter

2007-01-01

While health systems in developed countries and increasingly also in developing countries are moving from organisation-centred to person-centred health service delivery, the supporting communication and information technology is faced with new risks regarding security and privacy of stakeholders involved. The comprehensively distributed environment puts special burden on guaranteeing communication security services, but even more on guaranteeing application security services dealing with privilege management, access control and audit regarding social implication and connected sensitivity of personal information recorded, processed, communicated and stored in an even internationally distributed environment.

Second line options for hyperlipidemia management after cardiac transplantation.

PubMed

Shah, M K H; Critchley, W R; Yonan, N; Williams, S G; Shaw, S M

2013-06-01

Despite widespread statin therapy, 91% of cardiac transplant patients have hyperlipidemia within 5 years from cardiac transplantation. The implications of this are profound, particularly given that coronary allograft vasculopathy is a leading cause of death. Unfortunately the solution is not easy, with problems of toleration at higher statin doses and a lack of good quality evidence for second line agents. We review the literature and discuss some of the key issues transplant physicians are faced with when considering alternatives to statin therapy. © 2012 Blackwell Publishing Ltd.

Risk Analysis for Unintentional Slide Deployment During Airline Operations.

PubMed

Ayra, Eduardo S; Insua, David Ríos; Castellanos, María Eugenia; Larbi, Lydia

2015-09-01

We present a risk analysis undertaken to mitigate problems in relation to the unintended deployment of slides under normal operations within a commercial airline. This type of incident entails relevant costs for the airline industry. After assessing the likelihood and severity of its consequences, we conclude that such risks need to be managed. We then evaluate the effectiveness of various countermeasures, describing and justifying the chosen ones. We also discuss several issues faced when implementing and communicating the proposed measures, thus fully illustrating the risk analysis process. © 2015 Society for Risk Analysis.

The A to Z of healthcare data breaches.

PubMed

Kobus, Theodore J

2012-01-01

There currently exists a myriad of privacy laws that impact a healthcare entity, including more than 47 notification laws that require notification when a data breach occurs, as well as the breach notification requirements of the Health Information Technology for Economic and Clinical Health Act. Given the plethora of issues a healthcare entity faces, there are certain principles that can be built into an organization's philosophy that will comply with the law and help protect it from reputational harm. © 2012 American Society for Healthcare Risk Management of the American Hospital Association.

Teachers' beliefs about mental health needs in inner city elementary schools.

PubMed

Walter, Heather J; Gouze, Karen; Lim, Karen G

2006-01-01

To survey teachers' beliefs about mental health service needs in inner city elementary schools. A total of 119 teachers from six elementary schools in a major city in the midwestern United States were surveyed to assess their beliefs about the major mental health problems facing their schools, the major barriers to surmounting those problems, their preferences for mental health topics for in-service education, and their education, experience, knowledge, attitudes, and self-efficacy pertaining to mental health issues. Disruptive behavior was endorsed by approximately 50% of teachers as the largest mental health problem facing their schools, and lack of information/training was endorsed as the greatest barrier to surmounting mental health problems. The highest-rated topics for in-service education were disruptive behavior disorders and implementing behavior plans. Although most teachers had taught students with mental health problems, most had had little education in mental health and little consultation with mental health professionals. Correspondingly, teachers' knowledge about mental health issues was limited, and they did not feel confident about their ability to manage mental health problems in their classrooms. Teachers would benefit from education, training, and consultation from mental health professionals if they serve as effective gatekeepers to mental health services.

Fatigue factors affecting metropolitan bus drivers: a qualitative investigation.

PubMed

Biggs, Herbert; Dingsdag, Donald; Stenson, Nick

2009-01-01

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

Managing biodiversity for a competitive ecotourism industry in tropical developing countries: New opportunities in biological fields

NASA Astrophysics Data System (ADS)

Hakim, Luchman

2017-11-01

Managing biodiversity for sustainable and competitive ecotourism destinations requires a basic understanding of the principles of biology, which are poorly understood in tropical developing countries, including Indonesia. This paper describes the current status of tourism in Indonesia, identifies environment and biodiversity vulnerability in tourism destinations, and explores the challenges of the biological field in supporting ecotourism development. This review found that tourism, especially nature-based and ecotourism, has grown significantly in Indonesia, and the contribution of Indonesian biodiversity has been identified as significant. Threats to biodiversity, however, are found in nature-based tourism destinations. Issues related to pollution, exotic plant species invasion, habitat changes and degradation, habitat loss, and wildlife disturbance are widely reported, indicating the importance of such issues in destination management. Pollution is found in both terrestrial and aquatic ecosystems. Water pollution is an important issue among lakes and rivers. To date, there are few assessments of the impact of tourism activities on aquatic ecosystems, resulting in the management of aquatic ecosystems facing numerous difficulties. These studies identify the invasive plants found, which become a crucial problem in many nature-based tourism destinations, and which significantly contribute to a reduction in the existence of many flora-fauna in a wild habitat. Habitat changes and degradation are mostly influenced by tourism infrastructure development. Massive infrastructure development often leads to habitat loss, which is a crucial step in local biodiversity extinction. Increasing and uncontrolled visitor behaviors influence animal behavior changes, which is recognized as a dangerous phenomenon affecting animal survival in the future. An agenda for future integrative biological research is needed to improve resource management, to increase sustainability and the competitiveness of the tourism industry in Indonesia.

Data management, archiving, visualization and analysis of space physics data

NASA Technical Reports Server (NTRS)

Russell, C. T.

1995-01-01

A series of programs for the visualization and analysis of space physics data has been developed at UCLA. In the course of those developments, a number of lessons have been learned regarding data management and data archiving, as well as data analysis. The issues now facing those wishing to develop such software, as well as the lessons learned, are reviewed. Modern media have eased many of the earlier problems of the physical volume required to store data, the speed of access, and the permanence of the records. However, the ultimate longevity of these media is still a question of debate. Finally, while software development has become easier, cost is still a limiting factor in developing visualization and analysis software.

Workforce Issues Facing HRD.

ERIC Educational Resources Information Center

1995

These four papers are from a symposium facilitated by Eugene Andette on work force issues facing human resources development (HRD) at the 1995 Academy of Human Resource Development conference. "Meaning Construction and Personal Transformation: Alternative Dimensions of Job Loss" (Terri A. Deems) reports a study conducted to explore the ways…

Relationship challenges and relationship maintenance activities following disclosure of transsexualism.

PubMed

Alegría, C Aramburu

2010-12-01

• Transsexual persons are increasing their visibility in society, and health care providers and others (such as social workers) will be called upon to help with issues that transsexual persons face. Challenges that face transsexual persons often include issues involving relationships. Psychiatric and mental health nurses and other caregivers can increase their therapeutic skills in working with couples that include transsexual persons by becoming aware of these challenges and subsequent activities that can help with them. • This research study looks at couple relationships in which one partner reveals male-to-female transsexual identity. These are relationships that were established as man-woman and now will transition into relationships that include a male-to-female person and a female partner. • Common challenges for these couples include issues related to: (1) sexual identity and relationship uncertainty; (2) male-to-female transition decision making; and (3) presenting in public. • Relationship maintenance activities that helped the couples in the study maintain and strengthen their relationships through these challenges include: (1) communication; (2) self-talk (for example, putting the situation in perspective); (3) social networks; (4) positive interactions; (5) impression management (for example, managing displays of affection in public); and (6) social activism. This qualitative study describes the relational dynamics that help sustain relationships of couples that include male-to-female transsexual persons (MTF) and their natal female partners (NF) following disclosure of transsexualism. Relationship challenges and relationship maintenance activities are identified. Each partner in 17 MTF-NF couples participated in individual surveys and interviews. The data were coded for themes related to relationship challenges and activities. MTF-NF couples experience challenges within the contexts of their relationships and of society. These challenges include: (1) sexual identity and relationship uncertainty; (2) male-to-female transition decision making; and (3) public presentation. Relationship maintenance activities enabled the study couples to maintain and strengthen their relationships through these challenges. These activities include: (1) communication; (2) self-talk; (3) social networks; (4) positivity; (5) impression management; and (6) social activism. Via this report, psychiatric and mental health nurses can increase their therapeutic skills in working with MTF-NF couples. © 2010 Blackwell Publishing.

Effects of Face-to-Face and Computer-Mediated Constructive Controversy on Social Interdependence, Motivation, and Achievement

ERIC Educational Resources Information Center

Roseth, Cary J.; Saltarelli, Andy J.; Glass, Chris R.

2011-01-01

Cooperative learning capitalizes on the relational processes by which peers promote learning, yet it remains unclear whether these processes operate similarly in face-to-face and online settings. This study addresses this issue by comparing face-to-face and computer-mediated versions of "constructive controversy", a cooperative learning procedure…

Growing Up Whole

PubMed Central

Alarcon, Renato D.

2005-01-01

Objective: This is the second phase of a study aimed at determining the cultural characteristics, psychiatric needs, acculturative stressors, and management approaches of immigrant Somali children's experience in the United States. Methods: A 10-year demographics review of the Minnesota Departments of Human Services, and Children, Families, and Learning was completed. Data was obtained through unstructured interviews with educational staff, healthcare providers, and Somali children and their families in three communities, regarding cultural characteristics, barriers to care, perceptions of medical/psychiatric needs, and issues of acculturation. Health professionals/psychiatrists at a tertiary care center were also surveyed. Results: Identified acculturation issues of adolescent Somali immigrants included acculturative stress, racial discrimination, khat use, legal difficulties, language barriers, school opportunities, changes in family dynamics and developmental issues, clinical vulnerabilities, unique experiences of adolescent females, and development of new public/social behavior patterns. Conclusion: Immigrant Somali adolescents are at high risk for mental health problems due to the unique challenges they face as they attempt to assimilate two very polar cultures into one self-identity during a phase of development characterized by physical, cognitive, and emotional upheaval. Current management experiences warrant recommendations that include integration of community services, schools, and the medical system to provide education in cultural diversity, multicultural school and community publications, team sports, individual education plans, support groups, and Somali representation in school staff that has established trust with families and acceptance of mental health issues and care. PMID:21152169

A Comparison of the Effectiveness of a Game Informed Online Learning Activity and Face to Face Teaching in Increasing Knowledge about Managing Aggression in Health Settings

ERIC Educational Resources Information Center

McKenzie, Karen

2013-01-01

The present study compared the impact of face to face teaching with a short online game informed learning activity on health participants' knowledge about, and confidence in, managing aggressive situations. Both forms of teaching resulted in a significant increase in participants' knowledge and confidence. Face to face training led to…

Colorectal cancer: complexities and challenges in managed care.

PubMed

Minkoff, Neil B

2007-08-01

Managed care weighs advances and associated costs to determine whether the combination of longer life at sometimes significantly increased cost represents value. The price of treatment is only 1 factor. To review treatment decision processes for oncologic agents in managed care environments. Price can be exceptionally high for individuals. But if the population size is low, the per-member-per-month (PMPM) impact can be almost negligible, unlike treatments that have moderate costs but are used ubiquitously. Cancer therapies have, for the most part, escaped managed care's notice. For 2007, the national Cancer Institute projects that antineoplastic agents will consume almost a quarter of the overall drug spend. The Medicare population is a unique concern with regard to cancer. Traditionally, Medicare reimbursement of chemotherapeutic agents was based on average wholesale price (AWP) discounting, not the oncologist's purchasing cost. This allowed oncologists to use reimbursement for infusions to support their medical practices. The proposed plan of the Center for Medicare & Medicaid Services (CMS) to use average sales price (ASP) plus 6% to reimburse for drugs used in the office setting leads to significant problems. Pharmacy and therapeutics committees will also face challenges: fewer data are available for some agents because they have become available through the U.S. Food and drug administration's Fast Track, Priority review, or accelerated approval processes. Oncology disease management programs must reach out to patients and not necessarily deal with oncology issues directly, but address tangential issues that impact care, especially depression and pain management.

Rim Sim: A Role-Play Simulation

USGS Publications Warehouse

Barrett, Robert C.; Frew, Suzanne L.; Howell, David G.; Karl, Herman A.; Rudin, Emily B.

2003-01-01

Rim Sim is a 6-hour, eight-party negotiation that focuses on creating a framework for the long-term disaster-recovery efforts. It involves a range of players from five countries affected by two natural disasters: a typhoon about a year ago and an earthquake about 6 months ago. The players are members of an International Disaster Working Group (IDWG) that has been created by an international commission. The IDWG has been charged with drawing up a framework for managing two issues: the reconstruction of regionally significant infrastructure and the design of a mechanism for allocating funding to each country for reconstruction of local infrastructure and ongoing humanitarian needs. The first issue will involve making choices among five options (two harbor options, two airport options, and one rail-line option), each of which will have three levels at which to rebuild. The second issue will involve five starting-point options. Participants are encouraged to invent other options for both issues. The goal of Rim Sim is to raise questions about traditional approaches to disaster-preparedness planning and reconstruction efforts in an international setting, in this case the Pacific Rim. Players must confront the reverberating effects of disasters and the problems of using science and technical information in decisionmaking, and are introduced to a consensus-building approach emphasizing face-to-face dialog and multinational cooperation in dealing with humanitarian concerns, as well as long-term efforts to reconstruct local and regional infrastructure. The Rim Sim simulation raises four key points: ripple effects of disasters, role of science, multiparty negotiation, and building personal relationships.

Army Communicator. Volume 32, Number 3, Summer 2007

DTIC Science & Technology

2007-01-01

goal of bringing people from across the Army together to talk about the issues and challenges they are experiencing in the field and try to work out...actually facing the challenges . Each work- shop had a mediator who collected information on issues being faced and suggested solutions to these problems...these possible items that Signal Center actions may be put forth to bring about resolutions to the challenges facing the warfighter in the field. “I

Civil Rights Issues Facing Arab Americans in Michigan.

ERIC Educational Resources Information Center

Michigan State Advisory Committee to the U.S. Commission on Civil Rights.

This report is a summary statement of the Michigan Advisory Committee's study on civil rights issues facing Arab American communities in Michigan. It is based on information received by the Committee at a community forum held in Dearborn, Michigan, in 1999. Six sections focus on: (1) "Introduction," including Arab American demographics…

The Importance of Exposure in Addressing Current and Emerging Air Quality Issues

EPA Science Inventory

The air quality issues that we face today and will face in the future are becoming increasingly more complex and require an improved understanding of human exposure to be effectively addressed. The objectives of this paper are (1) to discuss how concepts of human exposure and ex...

Review of Issues Facing Congress. News from Capitol Hill.

ERIC Educational Resources Information Center

Heinz, Ann Simeo

2001-01-01

Discusses various topics that have faced the 107th U.S. Congress, such as tax cuts, judicial appointments, domestic issues, patients' bill of rights, stem cell research, election law, and campaign finance reform. Includes information on U.S. Senate and federal judicial appointments. Provides ideas for student learning activities. (CMK)

Critical Issues Facing America's Community Colleges: A Summary of the Community College Futures Assembly 2008

ERIC Educational Resources Information Center

Basham, Matthew J.; Campbell, Dale F.; Mendoza, Pilar

2008-01-01

Three focus groups consisting of board of trustee members, community college presidents, senior administrators, administrators, and faculty members developed critical issues facing community colleges with respect to instructional planning and services; planning, governance, and finance; and workforce development. Thereafter, the delegation of more…

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY 2018 POSITION STATEMENT ON INTEGRATION OF INSULIN PUMPS AND CONTINUOUS GLUCOSE MONITORING IN PATIENTS WITH DIABETES MELLITUS.

PubMed

Grunberger, George; Handelsman, Yehuda; Bloomgarden, Zachary T; Fonseca, Vivian A; Garber, Alan J; Haas, Richard A; Roberts, Victor L; Umpierrez, Guillermo E

2018-03-01

This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician. AACE/ACE Task Force on Integration of Insulin Pumps and Continuous Glucose Monitoring in the Management of Patients With Diabetes Mellitus Chair George Grunberger, MD, FACP, FACE Task Force Members Yehuda Handelsman, MD, FACP, FNLA, MACE Zachary T. Bloomgarden, MD, MACE Vivian A. Fonseca, MD, FACE Alan J. Garber, MD, PhD, FACE Richard A. Haas, MD, FACE Victor L. Roberts, MD, MBA, FACP, FACE Guillermo E. Umpierrez, MD, CDE, FACP, FACE Abbreviations: AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology A1C = glycated hemoglobin BGM = blood glucose monitoring CGM = continuous glucose monitoring CSII = continuous subcutaneous insulin infusion DM = diabetes mellitus FDA = Food & Drug Administration MDI = multiple daily injections T1DM = type 1 diabetes mellitus T2DM = type 2 diabetes mellitus SAP = sensor-augmented pump SMBG = self-monitoring of blood glucose STAR 3 = Sensor-Augmented Pump Therapy for A1C Reduction phase 3 trial.

Plasma facing components: a conceptual design strategy for the first wall in FAST tokamak

NASA Astrophysics Data System (ADS)

Labate, C.; Di Gironimo, G.; Renno, F.

2015-09-01

Satellite tokamaks are conceived with the main purpose of developing new or alternative ITER- and DEMO-relevant technologies, able to contribute in resolving the pending issues about plasma operation. In particular, a high criticality needs to be associated to the design of plasma facing components, i.e. first wall (FW) and divertor, due to physical, topological and thermo-structural reasons. In such a context, the design of the FW in FAST fusion plant, whose operational range is close to ITER’s one, takes place. According to the mission of experimental satellites, the FW design strategy, which is presented in this paper relies on a series of innovative design choices and proposals with a particular attention to the typical key points of plasma facing components design. Such an approach, taking into account a series of involved physical constraints and functional requirements to be fulfilled, marks a clear borderline with the FW solution adopted in ITER, in terms of basic ideas, manufacturing aspects, remote maintenance procedure, manifolds management, cooling cycle and support system configuration.

Improving Posthospital Discharge Telephone Reach Rates Through Prehospital Discharge Face-to-Face Meetings.

PubMed

Vergara, Franz H; Sheridan, Daniel J; Sullivan, Nancy J; Budhathoki, Chakra

The purpose of this study was to determine whether a face-to-face meeting with patients by a telephonic case manager prehospital discharge would result in increased telephone follow-up (TFU) reach rates posthospital discharge. Acute care adult medicine inpatient units. A quasiexperimental design was utilized. Two adult inpatient medicine units were selected as the intervention and comparison groups. The framework of the study is the transitions theory. A convenience sampling technique was used, whereby 88 eligible patients on the intervention unit received face-to-face meetings prehospital discharge whereas 123 patients on the comparison unit received standard care (no face-to-face meetings). Cross-tabulation and chi-square tests were employed to examine the association of face-to-face meeting intervention and TFU reach rates. Implementing brief (<10 min) face-to-face meetings by a telephonic case manager prehospital discharge resulted in a TFU reach rate of 87% on the intervention unit, whereas the comparison unit only had a 58% TFU reach rate (p < .001). Increasing reach rates by a telephonic case manager facilitates communication with more patients posthospital discharge. A brief prehospital discharge face-to-face meeting with patients assisted them to understand the reasons for a posthospital discharge telephone call, identified the best times to call using accurate telephone numbers, and taught patients how best to prepare for the call. In addition, by meeting patients face-to-face, the telephonic case manager was no longer an unknown person on the telephone asking them questions about their medical condition. These factors combined may have significantly helped to increase TFU reach rates.

The use of online discussions for post-clinical conference.

PubMed

Berkstresser, Kristie

2016-01-01

Nurse educators, at every level of pre-licensure nursing education, are charged with developing critical thinking skills within their students. Post-clinical conference is one teaching strategy that nurse educators can employ to help promote the development of critical thinking skills in pre-licensure nursing students. However, traditional face-to-face post-clinical conference is marred with issues and concerns, as identified in the nursing education literature. An alternative to face-to-face post-clinical conference, asynchronous online learning environment, mitigates the issues and concerns associated with traditional post-clinical conference. Adult learning theory supports the use of asynchronous online learning environment because the asynchronous online learning environment promotes student-centered teaching strategy in place of teacher-centered learning, which by its nature traditional face-to-face post-clinical conference tends to support. Copyright © 2015 Elsevier Ltd. All rights reserved.

REMOTES: reliable and modular telescope solution for seamless operation and monitoring of various observation facilities

NASA Astrophysics Data System (ADS)

Jakubec, M.; Skala, P.; Sedlacek, M.; Nekola, M.; Strobl, J.; Blazek, M.; Hudec, R.

2012-09-01

Astronomers often need to put several pieces of equipment together and have to deploy them at a particular location. This task could prove to be a really tough challenge, especially for distant observing facilities with intricate operating conditions, poor communication infrastructure and unreliable power source. To have this task even more complicated, they also expect secure and reliable operation in both attended and unattended mode, comfortable software with user-friendly interface and full supervision over the observation site at all times. During reconstruction of the D50 robotic telescope facility, we faced many of the issues mentioned above. To get rid of them, we based our solution on a flexible group of hardware modules controlling the equipment of the observation site, connected together by the Ethernet network and orchestrated by our management software. This approach is both affordable and powerful enough to fulfill all of the observation requirements at the same time. We quickly figured out that the outcome of this project could also be useful for other observation facilities, because they are probably facing the same issues we have solved during our project. In this contribution, we will point out the key features and benefits of the solution for observers. We will demonstrate how the solution works at our observing location. We will also discuss typical management and maintenance scenarios and how we have supported them in our solution. Finally, the overall architecture and technical aspects of the solution will be presented and particular design and technology decisions will be clarified.