23 CFR 500.106 - PMS.

Code of Federal Regulations, 2013 CFR

2013-04-01

... process that provides information for use in implementing cost-effective pavement reconstruction, rehabilitation, and preventative maintenance programs and that results in pavements designed to accommodate... the “AASHTO Guidelines for Pavement Management Systems.” 1 1 AASHTO Guidelines for Pavement Management...

The role of the case manager in a disease management program.

PubMed

Huston, Carol J

2002-01-01

Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

The role of the case manager in a disease management program.

PubMed

Huston, C J

2001-01-01

Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

76 FR 709 - Guidelines for Awarding Clean Water Act Section 319 Base Grants to Indian Tribes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-06

... in implementing approved NPS management programs developed pursuant to section 319(b). The primary goal of the NPS management program is to control NPS pollution through implementation of management... may be used for a range of activities that implement the tribe's approved NPS management program...

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

PubMed

Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

2006-12-15

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

Clinical and economic evaluation of an evidence-based institutional epoetin-utilization management program.

PubMed

Buckley, Mitchell S; Kane-Gill, Sandra L; Patel, Shardool A

2013-03-01

Anemia is common in several patient populations, including those with chronic kidney disease, cancer, and HIV/AIDS, and may require treatment with erythropoietin-stimulating agents (ESAs). Given the potential risks of the ESA, epoetin, and the significant costs associated with this agent, a large teaching medical institution developed a the drug-utilization management program using evidence-based guidelines on appropriate use. This study was designed to determine the clinical and financial impact of the drug-utilization management program. This retrospective cohort study was conducted at the medical institution that implemented the program using clinical pharmacists. Patients were included if epoetin was administered during their hospital stay (evaluation period, December 1, 2010, to December 31, 2011). The rate of inappropriate epoetin prescribing and the economic impact of guideline implementation were evaluated using comparisons of data from cohorts prescribed epoetin before and after guideline implementation. Data from 796 patients were included in the analyses (pre-implementation, 496; post-implementation, 300). The proportion of patients prescribed epoetin was significantly smaller after guideline implementation (2.4% vs 1.6%; P < 0.001). The reduction in the total number of epoetin units administered was 45%. The significant reduction (25%) in inappropriate prescribing after guideline implementation was primarily attributed to a 17% decrease in epoetin use in nonspecific anemia. The reduction in inappropriate epoetin prescribing translated into a 23.8% reduction in costs (P < 0.001) associated with inappropriate epoetin use. The estimated annual cost-savings of this program was $198,352 ($16,529/mo). The implementation of a drug-utilization management program using clinical pharmacists who evaluated epoetin was associated with a decrease in inappropriate epoetin prescribing and with significant cost-savings. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

Impact on clinical practice of the implementation of guidelines for the toxicity management of targeted therapies in kidney cancer. The protect-2 study.

PubMed

Lainez, Nuria; García-Donas, Jesús; Esteban, Emilio; Puente, Javier; Sáez, M Isabel; Gallardo, Enrique; Pinto-Marín, Álvaro; Vázquez-Estévez, Sergio; León, Luis; García-Carbonero, Icíar; Suárez-Rodríguez, Cristina; Molins, Carmen; Climent-Duran, Miguel A; Lázaro-Quintela, Martín; González Del Alba, Aranzazu; Méndez-Vidal, María José; Chirivella, Isabel; Afonso, Francisco J; López-Brea, Marta; Sala-González, Nuria; Domenech, Montserrat; Basterretxea, Laura; Santander-Lobera, Carmen; Gil-Arnáiz, Irene; Fernández, Ovidio; Caballero-Díaz, Cristina; Mellado, Begoña; Marrupe, David; García-Sánchez, José; Sánchez-Escribano, Ricardo; Fernández Parra, Eva; Villa Guzmán, José C; Martínez-Ortega, Esther; Belén González, María; Morán, Marina; Suarez-Paniagua, Beatriz; Lecumberri, María J; Castellano, Daniel

2016-02-22

The impact of such recommendations after their implementation of guidelines has not usually been evaluated. Herein, we assessed the impact and compliance with the Spanish Oncology Genitourinary Group (SOGUG) Guidelines for toxicity management of targeted therapies in metastatic renal cell carcinoma (mRCC) in daily clinical practice. Data on 407 mRCC patients who initiated first-line targeted therapy during the year before and the year after publication and implementation of the SOGUG guideline program were available from 34 Spanish Hospitals. Adherence to SOGUG Guidelines was assessed in every cycle. Adverse event (AE) management was consistent with the Guidelines as a whole for 28.7% out of 966 post-implementation cycles compared with 23.1% out of 892 pre-implementation cycles (p = 0.006). Analysis of adherence by AE in non-compliant cycles showed significant changes in appropriate management of hypertension (33% pre-implementation vs. 44.5% post-implementation cycles; p < 0.0001), diarrhea (74.0% vs. 80.5%; p = 0.011) and dyslipemia (25.0% vs. 44.6%; p < 0.001). Slight but significant improvements in AE management were detected following the implementation of SOGUG recommendations. However, room for improvement in the management of AEs due to targeted agents still remains and could be the focus for further programs in this direction.

The Management Review and Analysis Program: An Assisted Self-Study to Secure Constructive Change in the Management of Research Libraries

ERIC Educational Resources Information Center

Webster, Duane E.

1974-01-01

The Management Review and Analysis Program, an assisted self-study strategy for large academic and research libraries, assists libraries in reviewing and analyzing their current management policies and practices, and provides guidelines for the application of contemporary principles of management for the improvement of library programs. (Author/LS)

Guidelines for developing traffic incident management plans for work zones

DOT National Transportation Integrated Search

2003-09-01

The Colorado Department of Transportation (CDOT) has led the development of a number of traffic incident management plans and programs throughout the state. These programs address procedural and coordination aspects of managing unplanned events on th...

[The use of systematic review to develop a self-management program for CKD].

PubMed

Lee, Yu-Chin; Wu, Shu-Fang Vivienne; Lee, Mei-Chen; Chen, Fu-An; Yao, Yen-Hong; Wang, Chin-Ling

2014-12-01

Chronic kidney disease (CKD) has become a public health issue of international concern due to its high prevalence. The concept of self-management has been comprehensively applied in education programs that address chronic diseases. In recent years, many studies have used self-management programs in CKD interventions and have investigated the pre- and post-intervention physiological and psychological effectiveness of this approach. However, a complete clinical application program in the self-management model has yet to be developed for use in clinical renal care settings. A systematic review is used to develop a self-management program for CKD. Three implementation steps were used in this study. These steps include: (1) A systematic literature search and review using databases including CEPS (Chinese Electronic Periodical Services) of Airiti, National Digital Library of Theses and Dissertations in Taiwan, CINAHL, Pubmed, Medline, Cochrane Library, and Joanna Briggs Institute. A total of 22 studies were identified as valid and submitted to rigorous analysis. Of these, 4 were systematic literature reviews, 10 were randomized experimental studies, and 8 were non-randomized experimental studies. (2) Empirical evidence then was used to draft relevant guidelines on clinical application. (3) Finally, expert panels tested the validity of the draft to ensure the final version was valid for application in practice. This study designed a self-management program for CKD based on the findings of empirical studies. The content of this program included: design principles, categories, elements, and the intervention measures used in the self-management program. This program and then was assessed using the content validity index (CVI) and a four-point Liker's scale. The content validity score was .98. The guideline of self-management program to CKD was thus developed. This study developed a self-management program applicable to local care of CKD. It is hoped that the guidelines developed in this study offer a reference for clinical caregivers to improve their healthcare practices.

[The German program for disease management guidelines: type 2 diabetes--diabetic retinopathy/maculopathy guideline 2006. Short review].

PubMed

Ollenschläger, Günter; Kopp, Ina; Thole, Henning; Lelgemann, Monika

2007-02-15

In Germany, the first national consensus between six medical scientific associations on evidence-based recommendations for prevention and therapy of retinopathy/maculopathy in type 2 diabetes was reached in fall 2006. The recommendations' main sources are the NICE Retinopathy Guideline 2002, and existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Type 2 Diabetes-Retinopathy/Maculopathy 2006 (www.diabetes.versorgungsleitlinien.de).

The effect of a disease management intervention on quality and outcomes of dementia care: a randomized, controlled trial.

PubMed

Vickrey, Barbara G; Mittman, Brian S; Connor, Karen I; Pearson, Marjorie L; Della Penna, Richard D; Ganiats, Theodore G; Demonte, Robert W; Chodosh, Joshua; Cui, Xinping; Vassar, Stefanie; Duan, Naihua; Lee, Martin

2006-11-21

Adherence to dementia guidelines is poor despite evidence that some guideline recommendations can improve symptoms and delay institutionalization of patients. To test the effectiveness of a dementia guideline-based disease management program on quality of care and outcomes for patients with dementia. Clinic-level, cluster randomized, controlled trial. 3 health care organizations collaborating with 3 community agencies in southern California. 18 primary care clinics and 408 patients with dementia age 65 years or older paired with 408 informal caregivers. Disease management program led by care managers and provided to 238 patient-caregiver pairs at 9 intervention clinics for more than 12 months. Adherence to 23 guideline recommendations (primary outcome) and receipt of community resources and patient and caregiver health and quality-of-care measures (secondary outcomes). The mean percentage of per-patient guideline recommendations to which care was adherent was significantly higher in the intervention group than in the usual care group (63.9% vs. 32.9%, respectively; adjusted difference, 30.1% [95% CI, 25.2% to 34.9%]; P < 0.001). Participants who received the intervention had higher care quality on 21 of 23 guidelines (P < or = 0.013 for all), and higher proportions received community agency assistance (P < or = 0.03) than those who received usual care. Patient health-related quality of life, overall quality of patient care, caregiving quality, social support, and level of unmet caregiving assistance needs were better for participants in the intervention group than for those in the usual care group (P < 0.05 for all). Caregiver health-related quality of life did not differ between the 2 groups. Participants were well-educated, were predominantly white, had a usual source of care, and were not institutionalized. Generalizability to other patients and geographic regions is unknown. Also, costs of a care management program under fee-for-service reimbursement may impede adoption. A dementia guideline-based disease management program led to substantial improvements in quality of care for patients with dementia. Current Controlled Trials identifier: ISRCTN72577751.

The road to JCAHO disease-specific care certification: a step-by-step process log.

PubMed

Morrison, Kathy

2005-01-01

In 2002, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) implemented Disease-Specific Care (DSC) certification. This is a voluntary program in which organizations have their disease management program evaluated by this regulatory agency. Some of the DSC categories are stroke, heart failure, acute MI, diabetes, and pneumonia. The criteria for any disease management program certification are: compliance with consensus-based national standards, effective use of established clinical practice guidelines to manage and optimize care, and an organized approach to performance measurement and improvement activities. Successful accomplishment of DSC certification defines organizations as Centers of Excellence in management of that particular disease. This article will review general guidelines for DSC certification with an emphasis on Primary Stroke Center certification.

Guidelines for disseminating road weather messages : improved road weather information for travelers.

DOT National Transportation Integrated Search

2013-01-01

The Federal Highway Administration (FHWA) Road Weather Management Program (RWMP) recently published a document titled Guidelines for Disseminating Road Weather Advisory and Control Information (FHWA-JPO-12- 046). The guidelines are intended for use b...

Thai district Leaders' perceptions of managing the direct observation treatment program in Trang Province, Thailand.

PubMed

Choowong, Jiraporn; Tillgren, Per; Söderbäck, Maja

2016-07-28

Thailand is 18th out of the 22 countries with the highest tuberculosis (TB) burden. It will be a challenge for Thailand to achieve the UN Millennium Development target for TB, as well as the new WHO targets for eliminating TB by 2035. More knowledge and a new approach are needed to tackle the complex challenges of managing the DOT program in Thailand. Contextual factors strongly influence the local implementation of evidence in practice. Using the PARIHS model, the aim has been to explore district leaders' perceptions of the management of the DOT program in Trang province, Thailand. A phenomenographic approach was used to explore the perceptions among district DOT program leaders in Trang province. We conducted semi-structured interviews with district leaders responsible for managing the DOT program in five districts. The analysis of the data transcriptions was done by grouping similarities and differences of perceptions, which were constructed in a hierarchical outcome space that shows a set of descriptive categories. The first descriptive category revealed a common perception of the leaders' duty and wish to comply with the NTP guidelines when managing and implementing the DOT program in their districts. More varied perceptions among the leaders concerned how to achieve successful treatment. Other perceptions concerned practical dilemmas, which included fear of infection, mutual distrust, and inadequate knowledge about TB. Further, the leaders perceived a need for improved management practices in implementing the TB guidelines. Using the PARIHS framework to gain a retrospective perspective on the district-level policy implementation of the DOT program and studying the leadership's perceptions about applying the guidelines to practice, has brought new knowledge about management practices. Additional support and resources from the regional level are needed to manage the challenges.

12 CFR Appendix B to Part 364 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2011 CFR

2011-01-01

... Part 364—Interagency Guidelines Establishing Information Security Standards Table of Contents I... Customer Information A. Information Security Program B. Objectives III. Development and Implementation of Customer Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and...

Computer Bits: Child Care Center Management Software Buying Guide Update.

ERIC Educational Resources Information Center

Neugebauer, Roger

1987-01-01

Compares seven center management programs used for basic financial and data management tasks such as accounting, payroll and attendance records, and mailing lists. Describes three other specialized programs and gives guidelines for selecting the best software for a particular center. (NH)

Guidelines for Automatic Data Processing Physical Security and Risk Management. Federal Information Processing Standards Publication 31.

ERIC Educational Resources Information Center

National Bureau of Standards (DOC), Washington, DC.

These guidelines provide a handbook for use by federal organizations in structuring physical security and risk management programs for their automatic data processing facilities. This publication discusses security analysis, natural disasters, supporting utilities, system reliability, procedural measures and controls, off-site facilities,…

Management guidelines for monitoring use on backcountry trails

Treesearch

R. E. Leonard; H. E. Echelberger; H. J. Plumley; L. W. Van Meter

1980-01-01

This state-of-the-art management guideline describes the importance of knowing backcountry use patterns and the questions that should be asked before embarking on a use-monitoring program. It summarizes information about six techniques for monitoring use of backcountry trails and provides practical information about site suitabilities, installation and maintenance...

Guidelines to Student Activity Fund Accounting. Revised.

ERIC Educational Resources Information Center

Association of School Business Officials International, Reston, VA.

This booklet provides guidelines to help school business officials develop sound procedures for keeping proper accounts of and managing the money raised and spent in the course of conducting student activity programs. The booklet notes the roles of the administrators and activity advisers related to management of the student activity fund, then…

Contact Us About Managing the Quality of Environmental Information

EPA Pesticide Factsheets

The contact us form for the EPA Quality Program regarding quality management activities for all environmental data collection and environmental technology programs performed by or for the Agency and the EPA Information Quality Guidelines.

14 CFR 91.1001 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... management services or program management services mean administrative and aviation support services... implementation of program safety guidelines; (ii) Employment, furnishing, or contracting of pilots and other... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC...

ENVIRONMENTAL TECHNOLOGY VERIFICATION PROGRAM: QUALITY AND MANAGEMENT PLAN FOR THE PILOT PERIOD (1995-2000)

EPA Science Inventory

Based upon the structure and specifications in ANSI/ASQC E4-1994, Specifications and Guidelines for Quality Systems for Environmental Data Collection and Environmental Technology Programs, the Environmental Technology Verification (ETV) program Quality and Management Plan (QMP) f...

Transition management - An analysis of strategic considerations for effective implementation

NASA Technical Reports Server (NTRS)

Hunsucker, John L.; Loos, David

1989-01-01

Six managerial guidelines are identified for facilitating successful change in an organization. They are: (1) the need for a catalyst to initiate change; (2) the setting of organizational goals which take into account the impact of technical, political, and cultural factors; (3) requiring a transition team to guide the change; (4) a demonstration by top management of a commitment to the change as well as their acting as change agents; (5) the utilization of employee participation and good communication to help overcome employee resistance; and (6) the evaluation of the change program as important to the success of present and future change programs. A description of each guideline is presented, and its importance is examined. Available options are also presented for management to deal with each of the guidelines.

The Records Management Officer in Local Government. Basic Records Management for Local Government, No. 2.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. State Archives and Records Administration.

This reports provides local governments with guidelines and suggestions for selecting a Records Management Officer to develop, organize, and direct a records management program. Such a program is described as an over-arching, continuing, administrative effort that manages recorded information from its initial creation to its final disposition.…

Reconciling pairs of concurrently used clinical practice guidelines using Constraint Logic Programming.

PubMed

Wilk, Szymon; Michalowski, Martin; Michalowski, Wojtek; Hing, Marisela Mainegra; Farion, Ken

2011-01-01

This paper describes a new methodological approach to reconciling adverse and contradictory activities (called points of contention) occurring when a patient is managed according to two or more concurrently used clinical practice guidelines (CPGs). The need to address these inconsistencies occurs when a patient with more than one disease, each of which is a comorbid condition, has to be managed according to different treatment regimens. We propose an automatic procedure that constructs a mathematical guideline model using the Constraint Logic Programming (CLP) methodology, uses this model to identify and mitigate encountered points of contention, and revises the considered CPGs accordingly. The proposed procedure is used as an alerting mechanism and coupled with a guideline execution engine warns the physician about potential problems with the concurrent application of two or more guidelines. We illustrate the operation of our procedure in a clinical scenario describing simultaneous use of CPGs for duodenal ulcer and transient ischemic attack.

Federal agency transportation management program handbook

DOT National Transportation Integrated Search

1999-04-01

This handbook provides Federal agencies in the National Capital Region (NCR) with procedures and guidelines on how to prepare a Transportation Management Program (TMP). The preparation of TMPs is one tool in the overall field of Travel Demand Managem...

Principles of disease management in neonatology.

PubMed

Bowen, F W; Gwiazdowski, S

1998-06-01

This article emphasizes the emerging facets of disease-management practice that impact directly on establishing a measured care system that can produce the information needed to establish a continuous quality improvement program. The areas discussed are risk assessment, clinical management guidelines and carepaths, and the measurement of system output known as clinical outcomes. The remainder of the article details the aspects of risk assessment, guideline function, and outcome assessment, critical in a disease-managed measured care system.

41 CFR Appendix D to Part 60 - 741-Guidelines Regarding Positions Engaged in Carrying Out a Contract

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true 741-Guidelines Regarding... Management Other Provisions Relating to Public Contracts OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS... performed and their relationship to contract performance. A position is included if its duties included work...

A Clostridium difficile infection (CDI) stewardship initiative improves adherence to practice guidelines for management of CDI.

PubMed

Jury, Lucy A; Tomas, Myreen; Kundrapu, Sirisha; Sitzlar, Brett; Donskey, Curtis J

2013-11-01

A Clostridium difficile infection (CDI) stewardship initiative reduced inappropriate prescription of empirical CDI therapy and improved timeliness of treatment and adherence to clinical practice guidelines for management of CDI. The initiative required minimal resources and could easily be incorporated into traditional antimicrobial stewardship programs.

41 CFR Appendix D to Part 60 - 741-Guidelines Regarding Positions Engaged in Carrying Out a Contract

Code of Federal Regulations, 2012 CFR

2012-07-01

... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true 741-Guidelines Regarding... Management Other Provisions Relating to Public Contracts OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS... performed and their relationship to contract performance. A position is included if its duties included work...

41 CFR Appendix D to Part 60 - 741-Guidelines Regarding Positions Engaged in Carrying Out a Contract

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true 741-Guidelines Regarding... Management Other Provisions Relating to Public Contracts OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS... performed and their relationship to contract performance. A position is included if its duties included work...

41 CFR Appendix D to Part 60 - 741-Guidelines Regarding Positions Engaged in Carrying Out a Contract

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false 741-Guidelines Regarding... Management Other Provisions Relating to Public Contracts OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS... performed and their relationship to contract performance. A position is included if its duties included work...

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

PubMed Central

2014-01-01

Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain.

PubMed

Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel Fgj; Hendriks, Erik Jm; Kremers, Stef Pj; van Peppen, Roland Ps; Rutten, Steven Tj; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob Ab

2014-01-15

Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process.

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

None

Document outlines the Federal Energy Management Program's standard procedures and guidelines for measurement and verification (M&V) for federal energy managers, procurement officials, and energy service providers.

USDA forest service southern region – It’s all about GRITS

Treesearch

Barbara S. Crane; Kevin M. Potter

2017-01-01

Genetic resource management programs across the U.S. Department of Agriculture Forest Service (USDA FS) play a key role in supporting successful land management activities. The programs are responsible for developing and providing plant material for revegetation, seed management guidelines, emergency fire recovery assistance, genetic conservation strategies, climate...

The potential of disease management for neuromuscular hereditary disorders.

PubMed

Chouinard, Maud-Christine; Gagnon, Cynthia; Laberge, Luc; Tremblay, Carmen; Côté, Charlotte; Leclerc, Nadine; Mathieu, Jean

2009-01-01

Neuromuscular hereditary disorders require long-term multidisciplinary rehabilitation management. Although the need for coordinated healthcare management has long been recognized, most neuromuscular disorders are still lacking clinical guidelines about their long-term management and structured evaluation plan with associated services. One of the most prevalent adult-onset neuromuscular disorders, myotonic dystrophy type 1, generally presents several comorbidities and a variable clinical picture, making management a constant challenge. This article presents a healthcare follow-up plan and proposes a nursing case management within a disease management program as an innovative and promising approach. This disease management program and model consists of eight components including population identification processes, evidence-based practice guidelines, collaborative practice, patient self-management education, and process outcomes evaluation (Disease Management Association of America, 2004). It is believed to have the potential to significantly improve healthcare management for neuromuscular hereditary disorders and will prove useful to nurses delivering and organizing services for this population.

Management of exercise-induced bronchospasm in NCAA athletic programs

PubMed Central

Parsons, Jonathan P.; Pestritto, Vincent; Phillips, Gary; Kaeding, Christopher; Best, Thomas M.; Wadley, Gail; Mastronarde, John G.

2009-01-01

Purpose The prevalence of exercise-induced bronchospasm (EIB) is significantly higher in athletes than the general population, and can result in significant morbidity in young, competitive athletes. Guidelines emphasize that education and written treatment protocols improve clinical outcomes for asthmatics. Evidence also supports objective testing when exercise-induced bronchospasm is suspected, immediate availability of rescue inhalers, and involvement of asthma specialists in the care of asthmatic athletes. We sought to determine how EIB is managed at National Collegiate Athletic Association (NCAA) sports medicine programs. Methods A survey consisting of multiple-choice questions related to exercise-induced bronchospasm in athletes was sent electronically to 3200 athletic trainers affiliated with NCAA sports medicine programs. Results 541 athletic trainers responded. A minority of athletic trainers surveyed (21%) indicated an asthma management protocol exists at their institution. 22% indicated that pulmonologists are on staff in or consultants to the sports medicine department. Many indicated a short-acting beta-agonist is not required to be available at all practices (39%) and games (41%) and few athletic trainers indicated their programs utilize objective testing to diagnose EIB (17%). Regression modeling demonstrated education about EIB and involvement of pulmonologists significantly improved adherence to current consensus guidelines. Conclusions Based on our data, many NCAA sports medicine programs do not manage athletes with EIB according to current consensus guidelines. This may result in inaccurate diagnoses and may be detrimental to clinical outcomes and the overall health of student athletes. Providing education about EIB and involvement of pulmonologists significantly increase adherence to guidelines which likely improves clinical care of athletes and potentially athletic performance. PMID:19276862

Pet Allergy Quiz

MedlinePlus

... Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Management Tips Practice Management Workshop Practice Tools Running ...

Economic value evaluation in disease management programs.

PubMed

Magnezi, Racheli; Reicher, Sima; Shani, Mordechai

2008-05-01

Chronic disease management has been a rapidly growing entity in the 21st century as a strategy for managing chronic illnesses in large populations. However, experience has shown that disease management programs have not been able to demonstrate their financial value. The objectives of disease management programs are to create quality benchmarks, such as principles and guidelines, and to establish a uniform set of metrics and a standardized methodology for evaluating them. In order to illuminate the essence of disease management and its components, as well as the complexity and the problematic nature of performing economic calculations of their profitability and value, we collected data from several reports that dealt with the economic intervention of disease management programs. The disease management economic evaluation is composed of a series of steps, including the following major categories: data/information technology, information generation, assessment/recommendations, actionable customer plans, and program assessment/reassessment. We demonstrate the elements necessary for economic analysis. Disease management is one of the most innovative tools in the managed care environment and is still in the process of being defined. Therefore, objectives should include the creation of quality measures, such as principles and guidelines, and the establishment of a uniform set of metrics and a standardized methodology for evaluating them.

Aging management guideline for commercial nuclear power plants - heat exchangers

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

Booker, S.; Lehnert, D.; Daavettila, N.

1994-06-01

This Aging Management Guideline (AMG) describes recommended methods for effective detection and mitigation of age-related degradation mechanisms in commercial nuclear power plant heat exchangers important to license renewal. The intent of this AMG is to assist plant maintenance and operations personnel in maximizing the safe, useful life of these components. It also supports the documentation of effective aging management programs required under the License Renewal Rule 10 CFR 54. This AMG is presented in a manner that allows personnel responsible for performance analysis and maintenance to compare their plant-specific aging mechanisms (expected or already experienced) and aging management program activitiesmore » to the more generic results and recommendations presented herein.« less

Pain management strategies and lessons from the military: A narrative review

PubMed Central

Vallerand, April Hazard; Cosler, Patricia; Henningfield, Jack E; Galassini, Pam

2015-01-01

BACKGROUND: Wounded soldiers often experience substantial pain, which must be addressed before returning to active duty or civilian life. The United States (US) military has instituted several guidelines and initiatives aimed at improving pain management by providing rapid access to medical care, and developing interdisciplinary multimodal pain management strategies based on outcomes observed both in combat and hospital settings. OBJECTIVE: To provide a narrative review regarding US military pain management guidelines and initiatives, which may guide improvements in pain management, particularly chronic pain management and prevention, for the general population. METHODS: A literature review of US military pain management guidelines and initiatives was conducted, with a particular focus on the potential of these guidelines to address shortcomings in chronic pain management in the general population. DISCUSSION: The application of US military pain management guidelines has been shown to improve pain monitoring, education and relief. In addition, the US military has instituted the development of programs and guidelines to ensure proper use and discourage aberrant behaviours with regard to opioid use, because opioids are regarded as a critical part of acute and chronic pain management schemes. Inadequate pain management, particularly inadequate chronic pain management, remains a major problem for the general population in the US. Application of military strategies for pain management to the general US population may lead to more effective pain management and improved long-term patient outcomes. PMID:26448972

NHDOT : process for municipally managed state aid highway program projects

DOT National Transportation Integrated Search

2006-05-23

The design and construction of Municipally Managed State Aid Highway Program projects must comply with the requirements in this guideline in order to receive State Aid under the applicable provisions of RSA 235. Under this process, State Aid Construc...

Guidelines for Documentation of Computer Programs and Automated Data Systems. (Category: Software; Subcategory: Documentation).

ERIC Educational Resources Information Center

Federal Information Processing Standards Publication, 1976

1976-01-01

These guidelines provide a basis for determining the content and extent of documentation for computer programs and automated data systems. Content descriptions of ten document types plus examples of how management can determine when to use the various types are included. The documents described are (1) functional requirements documents, (2) data…

Risk Management for Study Abroad Programs: Issues and Resources to Inform Program Development, Administration, and Training

ERIC Educational Resources Information Center

Rhodes, Gary

2014-01-01

This chapter provides a practical background to the health and safety risks and challenges for U.S. colleges and universities and other program providers. Potential risks, field-based guidelines, good practices, and resources to support the management of risks by study abroad offices will be covered.

Records Legislation for Local Governments.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. State Archives and Records Administration.

This information leaflet provides local governments with guidelines and suggestions for writing an ordinance, resolution, or local law to establish a records management program. Such a program is an over-arching, continuing, administrative effort which manages recorded information from initial creation to final disposition. It includes…

Maximizing Value for Training with ISO 9000.

ERIC Educational Resources Information Center

Russo, C. W. Russ; Russo, Tracy Callaway

1996-01-01

The International Organization for Standardization (ISO) has created quality assurance guidelines that help technology trainers and educators manage and organize training programs. This article briefly outlines program design principles, emphasizing needs analysis and outcome evaluation, performance documentation, and process management. ISO 9000…

Diagnosis, Management And Prevention Of Hepatitis C In Pakistan 2017.

PubMed

Umar, Muhammad; Khaar, Hamama-Tul-Bushra; Akhter, Tayyab Saeed; Aslam, Faiza; Ahmad, Syed Irfan; Asghar, Rai Mohammad; Khurram, Mohammad; Hussain, Tassawar; Salamat, Amjad; Khan, Anwar A; Fazal-E-Hadi; Minhas, Zahid Mahmood; Shah, Hasnain Ali; Farooqui, Javed; Naqvi, Asif Abbas; Mohsin, Aftab; Waseem-Ud-Din; Bhutta, Sohail Iqbal; Hasnain Syed, Sibt Ul; Qureshi, Saleem; Adam, Tashfeen; Uddin, Moazzam; Tayyab, Ghias-U-Nabi; Najeeb Ul Haq; Shoaib, Atifa; Ambreen, Saima; Shahzad, Arslan; Ikram, Nadeem; Nisar, Gul; Khan, Mohammad Mujeeb; Osama, Mohammad

2016-01-01

Since the advent of direct acting antiviral agents, there is a revolutionary change in the management of HCV infection. Newer drugs with different mechanism of action are being introduced and are expected to be available in coming few months in Pakistan as well. The main purpose of the guideline is to review and induct the latest research in field of HCV infection in Pakistani perspective so that our healthcare professionals can apply the new recommendations in timely and judicial manner. Target groups of guidelines are general physicians treating hepatitis C, hepatologists and gastroenterologists. Other beneficiaries of these guidelines are public health institutions of Pakistan, which provide free treatment to deserving patients under National Hepatitis Prevention and Control Program and Pakistan Bait-ul- Mal Program. These guidelines are based on the review of National consensus practice guidelines: Diagnosis, Management and Prevention of Hepatitis C Pakistan 2009. Published data in National and International Journals searched with the help of Google search and pub med, and 2015-16 guidelines of HCV by AASLD, EASL, APASL and WHO. Local studies are preferably added with references to enhance the Pakistani perspective. Evidence was also taken from published studies. Recommendations have been based upon evidence from national publications on the subject and scientific presentations at national liver meeting as well from experts' personal experience and opinion.

Reconciling Pairs of Concurrently Used Clinical Practice Guidelines Using Constraint Logic Programming

PubMed Central

Wilk, Szymon; Michalowski, Martin; Michalowski, Wojtek; Hing, Marisela Mainegra; Farion, Ken

2011-01-01

This paper describes a new methodological approach to reconciling adverse and contradictory activities (called points of contention) occurring when a patient is managed according to two or more concurrently used clinical practice guidelines (CPGs). The need to address these inconsistencies occurs when a patient with more than one disease, each of which is a comorbid condition, has to be managed according to different treatment regimens. We propose an automatic procedure that constructs a mathematical guideline model using the Constraint Logic Programming (CLP) methodology, uses this model to identify and mitigate encountered points of contention, and revises the considered CPGs accordingly. The proposed procedure is used as an alerting mechanism and coupled with a guideline execution engine warns the physician about potential problems with the concurrent application of two or more guidelines. We illustrate the operation of our procedure in a clinical scenario describing simultaneous use of CPGs for duodenal ulcer and transient ischemic attack. PMID:22195153

The Association of Shelter Veterinarians' 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs.

PubMed

Griffin, Brenda; Bushby, Philip A; McCobb, Emily; White, Sara C; Rigdon-Brestle, Y Karla; Appel, Leslie D; Makolinski, Kathleen V; Wilford, Christine L; Bohling, Mark W; Eddlestone, Susan M; Farrell, Kelly A; Ferguson, Nancy; Harrison, Kelly; Howe, Lisa M; Isaza, Natalie M; Levy, Julie K; Looney, Andrea; Moyer, Michael R; Robertson, Sheilah Ann; Tyson, Kathy

2016-07-15

As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs.

[The German program for disease management guidelines. Background, methods, and development process].

PubMed

Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika; Sänger, Sylvia; Heymans, Lothar; Thole, Henning; Trapp, Henrike; Lorenz, Wilfried; Selbmann, Hans-Konrad; Encke, Albrecht

2006-10-15

The Program for National Disease Management Guidelines (German DM-CPG Program) was established in 2002 by the German Medical Association (umbrella organization of the German Chambers of Physicians) and joined by the Association of the Scientific Medical Societies (AWMF; umbrella organization of more than 150 professional societies) and by the National Association of Statutory Health Insurance Physicians (NASHIP) in 2003. The program provides a conceptual basis for disease management, focusing on high-priority health-care topics and aiming at the implementation of best practice recommendations for prevention, acute care, rehabilitation and chronic care. It is organized by the German Agency for Quality in Medicine, a founding member of the Guidelines International Network (G-I-N). The main objective of the German DM-CPG Program is to establish consensus of the medical professions on evidence-based key recommendations covering all sectors of health-care provision and facilitating the coordination of care for the individual patient through time and across interfaces. Within the last year, DM-CPGs have been published for asthma, chronic obstructive pulmonary disease, type 2 diabetes, and coronary heart disease. In addition, experts from national patient self-help groups have been developing patient guidance based upon the recommendations for health-care providers. The article describes background, methods, and tools of the DM-CPG Program, and is the first of a publication series dealing with innovative recommendations and aspects of the program.

The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs

PubMed Central

Howlett, Jonathan G; McKelvie, Robert S; Costigan, Jeannine; Ducharme, Anique; Estrella-Holder, Estrellita; Ezekowitz, Justin A; Giannetti, Nadia; Haddad, Haissam; Heckman, George A; Herd, Anthony M; Isaac, Debra; Kouz, Simon; Leblanc, Kori; Liu, Peter; Mann, Elizabeth; Moe, Gordon W; O’Meara, Eileen; Rajda, Miroslav; Siu, Samuel; Stolee, Paul; Swiggum, Elizabeth; Zeiroth, Shelley

2010-01-01

Since 2006, the Canadian Cardiovascular Society heart failure (HF) guidelines have published annual focused updates for cardiovascular care providers. The 2010 Canadian Cardiovascular Society HF guidelines update focuses on an increasing issue in the western world – HF in ethnic minorities – and in an uncommon but important setting – the pregnant patient. Additionally, due to increasing attention recently given to the assessment of how care is delivered and measured, two critically important topics – disease management programs in HF and quality assurance – have been included. Both of these topics were written from a clinical perspective. It is hoped that the present update will become a useful tool for health care providers and planners in the ongoing evolution of care for HF patients in Canada. PMID:20386768

Developing guidelines for incorporating managing demand into WSDOT planning and programming: transportation demand management guidance for corridor planning studies.

DOT National Transportation Integrated Search

2016-02-01

The Washington State Department of Transportation (WSDOT) regional planning programs address current and forecasted deficiencies of State highways through the conduct of corridor studies. This Guidance for the conduct of corridor planning studies is ...

A Practical Procedure for Instituting a Chore and Allowance Program for Grade School Children: Specific Guidelines for Clinicians.

ERIC Educational Resources Information Center

Neul, Shari K. T.; Drabman, Ronald S.

2001-01-01

This article provides a use plan for instituting and maintaining a successful chore and allowance program for children. Specific guidelines are outlined regarding how to teach children basic money management skills. Explicit examples are offered for teaching these skills that can be easily adopted by parents and clinicians who specialize in…

Shifting from presumptive to test-based management of malaria - technical basis and implications for malaria control in Ghana.

PubMed

Baiden, F; Malm, K; Bart-Plange, C; Hodgson, A; Chandramohan, D; Webster, J; Owusu-Agyei, S

2014-06-01

The presumptive approach was the World Health Organisation (WHO) recommended to the management of malaria for many years and this was incorporated into syndromic guidelines such as the Integrated Management of Childhood Illnesses (IMCI). In early 2010 however, WHO issued revised treatment guidelines that call for a shift from the presumptive to the test-based approach. Practically, this implies that in all suspected cases, the diagnosis of uncomplicated malaria should be confirmed using rapid test before treatment is initiated. This revision effectively brings to an end an era of clinical practice that span several years. Its implementation has important implications for the health systems in malaria-endemic countries. On the basis of research in Ghana and other countries, and evidence from program work, the Ghana National Malaria Control Program has issued revised national treatment guidelines that call for implementation of test-based management of malaria in all cases, and across all age groups. This article reviews the evidence and the technical basis for the shift to test-based management and examines the implications for malaria control in Ghana.

Final Natural Resource Actions Environmental Assessment

DTIC Science & Technology

2005-06-22

populations through use of insecticides and rodenticides would be accomplished under the supervision of the Base Pest Management Office and coordinated... Insecticide , Fungicide, and Rodenticide Act; DoD Directive 4150.7, DoD Pest Management Program; AFI 32-1053, Pest Management Program; and the North... insecticide and herbicide. Grand Forks AFB constructed a 2,400-square-foot pest management facility in 1996 in accor- dance with the guidelines

Guidelines for developing transportation management plans in Virginia.

DOT National Transportation Integrated Search

2005-01-01

A transportation management plan (TMP) is a comprehensive program of traffic control, communication, operation, and demand management strategies designed to maintain acceptable levels of traffic flow in work zones. A systematic procedure and/or check...

Do Newborns Have More Complications When Mom Has Asthma?

MedlinePlus

... Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Management Tips Practice Management Workshop Practice Tools Running ...

The Records Advisory Board in Local Government.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. State Archives and Records Administration.

This information leaflet provides local governments with guidelines and suggestions for appointing a Records Advisory Board to assist in establishing and supporting a records management program. Such a program is an over-arching, continuing, administrative effort which manages recorded information from initial creation to final disposition. It…

Cholesterol treatment guidelines update.

PubMed

Safeer, Richard S; Ugalat, Prabha S

2002-03-01

Hypercholesterolemia is one of the major contributors to atherosclerosis and coronary heart disease in our society. The National Cholesterol Education Program of the National Institutes of Health has created a set of guidelines that standardize the clinical assessment and management of hypercholesterolemia for practicing physicians and other professionals in the medical community. In May 2001, the National Cholesterol Education Program released its third set of guidelines, reflecting changes in cholesterol management since their previous report in 1993. In addition to modifying current strategies of risk assessment, the new guidelines stress the importance of an aggressive therapeutic approach in the management of hypercholesterolemia. The major risk factors that modify low-density lipoprotein goals include age, smoking status, hypertension, high-density lipoprotein levels, and family history. The concept of "CHD equivalent" is introduced-conditions requiring the same vigilance used in patients with coronary heart disease. Patients with diabetes and those with a 10-year cardiac event risk of 20 percent or greater are considered CHD equivalents. Once low-density lipoprotein cholesterol is at an accepted level, physicians are advised to address the metabolic syndrome and hypertriglyceridemia.

Evaluation of a Pain Management Education Program and Operational Guideline on Nursing Practice, Attitudes, and Pain Management.

PubMed

Bonkowski, Sara L; De Gagne, Jennie C; Cade, Makia B; Bulla, Sally A

2018-04-01

Nurses lack adequate pain management knowledge, which can result in poorly managed postsurgical pain. This study aimed to develop, implement, and evaluate pain management education and operational guidelines to improve nursing knowledge and pain management. This quality improvement project employed convenience samples of surgical oncology nurses and postoperative patients. The intervention involved an online module, live education, and operational guideline for pain management. Nurses completed pre- and postintervention practice and attitudes surveys. Random chart reviews of intravenous narcotic administrations the day before discharge were completed to evaluate whether narcotic administration changed after intervention. Readmissions and Hospital Consumer Assessment of Healthcare Providers and Systems data were collected to determine whether the intervention influenced patient satisfaction. A statistically significant improvement in nursing practice and intravenous narcotic administrations demonstrated changes to pain management practices employed by the nursing staff. Although not statistically significant, fewer pain-related readmissions occurred postintervention. Findings demonstrate that targeted pain management continuing education, paired with operational guidelines, improves nursing practice and decreases intravenous narcotic administrations prior to discharge. J Contin Educ Nurs. 2018;49(4):178-185. Copyright 2018, SLACK Incorporated.

7 CFR 600.2 - National headquarters.

Code of Federal Regulations, 2010 CFR

2010-01-01

...; accepting departmental leadership for programs for other activities assigned by the Secretary of Agriculture... assist the Chief as follows: (1) Deputy Chief for Management. The Deputy Chief for Management is responsible for policies, guidelines, and standards for management services, human resources management...

Provider Experiences With the Identification, Management, and Treatment of Co-Occurring Chronic Non-cancer Pain and Substance Use in the Safety Net

PubMed Central

Chang, Jamie Suki; Kushel, Margot; Miaskowski, Christine; Ceasar, Rachel; Zamora, Kara; Hurstak, Emily; Knight, Kelly R.

2017-01-01

Background In the US and internationally, providers have adopted guidelines on the management of prescription opioids for chronic non-cancer pain (CNCP). For “high-risk” patients with co-occurring CNCP and a history of substance use, guidelines advise providers to monitor patients using urine toxicology screening tests, develop opioid management plans, and refer patients to substance use treatment. Objective We report primary care provider experiences in the safety net interpreting and implementing guideline recommendations for patients with CNCP and substance use. Methods We interviewed primary care providers who work in the safety net (N=23) on their experiences managing CNCP and substance use. We analyzed interviews using a content analysis method. Results Providers found management plans and urine toxicology screening tests useful for informing patients about clinic expectations of opioid therapy and substance use. However, they described that guideline-based clinic policies had unintended consequences, such as raising barriers to open, honest dialogue about substance use and treatment. While substance use treatment was recommended for “high-risk” patients, providers described lack of integration with and availability of substance use treatment programs. Conclusions Our findings indicate that clinicians in the safety net found guideline-based clinic policies helpful. However, effective implementation was challenged by barriers to open dialogue about substance use and limited linkages with treatment programs. Further research is needed to examine how the context of safety net settings shapes the management and treatment of co-occurring CNCP and substance use. PMID:27754719

[Consumer involvement in the Disease Management Guideline for Asthma--a background report].

PubMed

Senger, Sylvia; Lelgemann, Monika; Kopp, Ina

2006-01-01

In the past clinical guidelines were mainly developed by experts and in everyday clinical practice almost exclusively used by clinical experts, while issues that were relevant from the patients' (consumers') point of view tended to be neglected. But then, the majority of patient information has not been perceptibly connected to clinical guidelines. Connecting the development of clinical guidelines with the development of patient information publications would make good sense for both products, though. On the one hand, evidence-based treatment guidelines could be made available to the actual target group of the clinical care process--i.e. the patients or consumers--and on the other hand, patient experiences and competencies (social evidence) might inform the production of guidelines. Such a procedure demands the cooperation of clinical experts and patients. So far there are no generally accepted methods in Germany for the practical implementation of consumer involvement on both the organizational and content level with the aim of involving patients in the development process of guidelines as well as the production of the respective patient information versions. Such a methodology shall be established as part of the National Program for Disease Management Guidelines. For the first time in this program, patient involvement is being exercised within the scope of the National Disease Management Guideline for Asthma (NDM Asthma). Here, patients are involved in the NDM development process by providing the opportunity to comment on the consented guideline draft and to participate in the translation of the NDM Asthma into a patient version. The present paper is a background report describing the current state of work and indicating consequences for some future developments.

Promoting High-Value Practice by Reducing Unnecessary Transfusions With a Patient Blood Management Program.

PubMed

Sadana, Divyajot; Pratzer, Ariella; Scher, Lauren J; Saag, Harry S; Adler, Nicole; Volpicelli, Frank M; Auron, Moises; Frank, Steven M

2018-01-01

Although blood transfusion is a lifesaving therapy for some patients, transfusion has been named 1 of the top 5 overused procedures in US hospitals. As unnecessary transfusions only increase risk and cost without providing benefit, improving transfusion practice is an effective way of promoting high-value care. Most high-quality clinical trials supporting a restrictive transfusion strategy have been published in the past 5 to 10 years, so the value of a successful patient blood management program has only recently been recognized. We review the most recent transfusion practice guidelines and the evidence supporting these guidelines. We also discuss several medical societies' Choosing Wisely campaigns to reduce or eliminate overuse of transfusions. A blueprint is presented for developing a patient blood management program, which includes discussion of specific methods for optimizing transfusion practice.

Administration of Child Care Programs: Business Management. Instructor's Guide.

ERIC Educational Resources Information Center

Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

Designed for use by postsecondary child development instructors, this guide is organized into four units that expose students to the general competencies and business management aspects of child care program administration. Introductory materials discuss the use of the materials and provide guidelines for evaluating students. The four units cover…

Testing of best management practices for controlling highway runoff, Phase II.

DOT National Transportation Integrated Search

1994-01-01

In order to obtain the detailed information necessary to develop design guidelines for the stormwater best management practices (BMPs) included in the Virginia Department of Transportation's Stormwater Management Manual, a field program was initiated...

Aging Management Guideline for commercial nuclear power plants: Motor control centers; Final report

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

Toman, G.; Gazdzinski, R.; O`Hearn, E.

1994-02-01

This Aging Management Guideline (AMG) provides recommended methods for effective detection and mitigation of age-related degradation mechanisms in Boiling Water Reactor (BWR) and Pressurized Water Reactor (PWR) commercial nuclear power plant motor control centers important to license renewal. The intent of this AMG is to assist plant maintenance and operations personnel in maximizing the safe, useful life of these components. It also supports the documentation of effective aging management programs required under the License Renewal Rule 10 CFR Part 54. This AMG is presented in a manner that allows personnel responsible for performance analysis and maintenance to compare their plant-specificmore » aging mechanisms (expected or already experienced) and aging management program activities to the more generic results and recommendations presented herein.« less

Introduction to the MAST Program. MAS-100. Waste Isolation Division (WID). Management and Supervisor Training (MAST) Program.

ERIC Educational Resources Information Center

Westinghouse Electric Corp., Carlsbad, NM.

This module is part of a set of management and supervisor training (MAST) materials developed by the Department of Energy for the Waste Isolation Division. Its stated purpose is to provide participants with knowledge and skills necessary to take full advantage of the MAST learning experience. The module contains program guidelines, sample…

Organisation of Management Development Programmes.

ERIC Educational Resources Information Center

Markwell, D. S.; Roberts, T. J.

The purpose of this book is to provide practical guidelines for planning and implementing management development activities. In Part 1 Markwell establishes the framework for designing and organizing management development programs. The section covers the following topics: Practical Starting-Point for Management Development, Establishing Management…

Cytotoxic Drug Dispersal, Cytotoxic Safety, and Cytotoxic Waste Management: Practices and Proposed India-specific Guidelines

PubMed Central

Capoor, Malini R; Bhowmik, Kumar Tapas

2017-01-01

This article deals with practices related to cytotoxic drug dispersal, cytotoxic safety, and cytotoxic waste management and attempts at India-specific guidelines for their dispersal and disposal. The articles related to cytotoxic drug dispersal, cytotoxic safety, and cytotoxic waste management were reviewed from PubMed and their applicability in Indian health-care facilities (HCFs) was also reviewed. All HCFs dealing with cytotoxic drugs should consider cytotoxic policy, patient safety and health-care worker safety, and environmental monitoring program as per the available international guidelines customized as per Indian conditions. Utmost care in handling cytotoxic waste is quintessential. The formation of India-specific cytotoxic guidelines requires the inputs from all stakeholders. Cytotoxic waste, cytotoxic safety, and cytotoxic waste management should be the subject of a national strategy with an infrastructure, cradle-to-grave legislation, competent regulatory authority, and trained personnel. PMID:28900329

Human Research Program Unique Processes, Criteria, and Guidelines (UPCG). Revision C, July 28, 2011

NASA Technical Reports Server (NTRS)

Chin, Duane

2011-01-01

This document defines the processes, criteria, and guidelines exclusive to managing the Human Research Program (HRP). The intent of this document is to provide instruction to the reader in the form of processes, criteria, and guidelines. Of the three instructional categories, processes contain the most detail because of the need for a systematic series of actions directed to some end. In contrast, criteria have lesser detail than processes with the idea of creating a rule or principle structure for evaluating or testing something. Guidelines are a higher level indication of a course of action typically with the least amount of detail. The lack of detail in guidelines allows the reader flexibility when performing an action or actions.

Implementation of a drug-use and disease-state management program.

PubMed

Skledar, S J; Hess, M M

2000-12-15

A drug-use and disease-state management (DUDSM) program was instituted in 1996 at a teaching hospital associated with a large nonprofit health care system. The program's goals are to optimize pharmacotherapeutic regimens, evaluate health outcomes of identified disease states, and evaluate the economic impact of pharmacotherapeutic options for given disease states by developing practice guidelines. Through a re-engineering process, resources within the pharmacy department were identified that could be devoted to the DUDSM program, including the use of clinical pharmacy specialists, promotion of staff pharmacists into the DUDSM program, a pharmacy technician, and information systems support. A strength of the program is its systematic approach for developing and implementing new initiatives, as well as monitoring compliance with all initiatives on an ongoing basis. The initiative-design process incorporates continuous quality improvement principles, outcome design and evaluation, competency assessment for all pharmacists, multidisciplinary collaboration, and sophisticated information systems. Seventy-five initiatives have been implemented, ranging from simple dose-optimization strategies for specific drugs to complicated practice guidelines for managing specific disease states. Improved patient outcomes have been documented, including reduced length of stay, postsurgical wound infection, adverse drug reactions, and medication errors. Documented cost savings exceeded $4 million annually for fiscal years 1996-97 through 1999-2000. Overall compliance with DUDSM initiatives exceeds 80%, and physician service profiling has been initiated to monitor variant prescribing. The DUDSM program has successfully integrated practice guidelines into therapeutic decision-making, resulting in improved patient-care outcomes and cost savings.

40 CFR 60.2625 - When must I submit my waste management plan?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Waste Management...

40 CFR 60.2625 - When must I submit my waste management plan?

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Waste Management...

Managing challenging interactions with family caregivers in the cancer setting: Guidelines for clinicians (TRIO Guidelines-2).

PubMed

Laidsaar-Powell, Rebekah; Butow, Phyllis; Boyle, Frances; Juraskova, Ilona

2018-06-01

Family caregivers can, at times, add complexity to clinical encounters. Difficult family caregivers and dynamics may: derail consultation communication, reduce patient autonomy, and compromise effective clinical care. A paucity of practical strategies guiding effective clinician-family communication exists. This study aimed to develop and evaluate the first comprehensive, evidence-based guidelines (the TRIO guidelines) for oncology physicians and nurses to better manage several complex/challenging situations involving family members. TRIO Guidelines were based on a comprehensive review of literature, relevant guidelines, and feedback from an expert advisory group (n = 10). Draft guidelines underwent two rounds of evaluation via an online Delphi consensus process involving international experts (n = 35). Guidelines incorporate topic areas, strategies, and sub-strategies on managing challenging family involvement (7 topics). Example wording, behaviours and level of evidence are provided. Challenging triadic interactions require skillful navigation, and the TRIO Guidelines provide clear, specific, and evidence-based strategies for clinicians to utilise in these potentially stressful encounters. Training based on these guidelines may improve both patient care and clinician confidence. Implementation of these guidelines into medical/nursing curricula and as a component of continuing professional development programs will likely be highly beneficial. Copyright © 2018 Elsevier B.V. All rights reserved.

Human Engineering Guidelines for Management Information Systems. Change 1,

DTIC Science & Technology

1983-06-09

beginner . chapter offers guidelines concerning training. 0 A brief review available for the infrequent user. Major training factors * A program for a...the training include a program specifically designed L Li LL for the beginner or naive user? 8. Is there a brief review for the intermittent user? Ei Li...250 pages of text. Flowchart - A graphic representation, using standard symbols, which portrays logical data and process- ing requirements. Formatting

41 CFR 102-75.85 - Can disposal agencies transfer excess real property to agencies for programs that appear to be...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 75-REAL PROPERTY DISPOSAL Utilization of Excess Real Property Guidelines § 102-75.85 Can disposal agencies transfer... transfer excess real property to agencies for programs that appear to be scheduled for substantial...

District 1199C Training & Upgrading Fund. A Manual for Union-Management Educational Partnerships.

ERIC Educational Resources Information Center

Ryan, James T.

This manual provides guidelines for developing and implementing employee educational programs with the cooperation of unions and management. It establishes the need for such programs by explaining the current and future demographics of the workplace, then suggests ways to determine the need for education in any particular company. Information…

12 CFR Appendix B to Part 364 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2010 CFR

2010-01-01

... Relationships Risk Management Principles,” Nov. 1, 2001; FDIC FIL 68-99, Risk Assessment Tools and Practices for... Customer Information A. Information Security Program B. Objectives III. Development and Implementation of Customer Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and...

24 CFR 200.935 - Administrator qualifications and procedures for HUD building products certification programs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... guidelines in any quality assurance review: (1) ASQC Q9000-1-1994 Quality Management and Quality Assurance... Systems—Model for Quality Assurance in Final Inspection and Test; (5) ASQC Q9004-1-1994 Quality Management... in interpreting testing standards, test methods, evaluating test reports and quality control programs...

Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

PubMed

Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

2014-07-01

The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.

Human Factors Planning Guidelines

DOT National Transportation Integrated Search

1996-01-01

To ensure human factors considerations are fully incorporated in the system : development, the Integrated Product Team (IPT) or Program Manager initiates a : Human Factors Program (HFP) that addresses the human performance and human : resource parame...

Guidelines clarify managed care accounting procedures.

PubMed

Cheramy, S J; Garner, M

1989-08-01

Two new documents offer guidance for accounting issues involved in managed care programs. The American Institute of Certified Public Accountants' Statement of Position 89-5 and HFMA's Principles and Practices Board Statement No. 11 address risk contracting from the perspective of the managed care program and the healthcare provider, respectively. One key issue addressed in the documents is the timing of expense recognition of the costs of providing health services to members of managed care plans.

Continuity of operations planning in college athletic programs: The case for incorporating Federal Emergency Management Guidelines.

PubMed

Hall, Stacey A; Allen, Brandon L; Phillips, Dennis

2016-01-01

College athletic departments have a responsibility to provide a safe environment for student-athletes; however, most colleges do not have a crisis management plan that includes procedures for displaced student-athletes or alternate facilities to perform athletic events. Continuity of operations planning ensures athletic programs are equipped to maintain essential functions during, or shortly after, a disruption of operations due to possible hazards. Previous studies have identified a lack of emergency preparedness and continuity planning in college athletic departments. The purpose of this article is to illustrate in detail one approach to disaster planning for college athletic departments, namely the Federal Emergency Management Agency (FEMA) continuity of operations framework. By adhering to FEMA guidelines and promoting a best practices model, athletic programs can effectively plan to address potential hazards, as well as protect the organization's brand, image, and financial sustainability after a crisis event.

[National Disease Management Guideline for Asthma: recommendations and evidence for "asthma prevention" issues].

PubMed

Berdel, Dietrich; Buhl, Roland; Dierkesmann, Rainer; Niebling, Wilhelm; Schultz, Konrad; Ukena, Dieter; Worth, Heinrich; von Wichert, Peter; Ollenschläger, Günter; Kopp, Ina

2006-01-01

The National Disease Management Program (NDM Program) represents the basic content of structured, cross-sectoral healthcare. In particular, the NDM Program is directed towards coordinating different disciplines and areas of healthcare. The recommendations are developed through interdisciplinary consensus of the scientific medical societies on the basis of the best available evidence. Within this scope the scientific medical societies concerned with the prevention, diagnosis, therapy and rehabilitation of asthma consented upon a National Disease Management Guideline for Asthma in 2005. Among other things, the following cornerstones of asthma prevention were agreed upon: Breastfeeding and non-smoking were suggested as primary prevention measures for (expectant) parents. With respect to secondary prevention, recommendations have been made for allergen avoidance, active/passive smoking and immunotherapy. Regarding tertiary prevention, position statements on vaccination and specific immunotherapy are developed. The present paper presents both the original texts of the recommendations and the evidence underlying them.

Postdoctoral program guidelines.

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

Teich-McGoldrick, Stephanie; Miller, Andrew W.; Sava, Dorina Florentina

2012-04-01

We, the Postdoc Professional Development Program (PD2P) leadership team, wrote these postdoc guidelines to be a starting point for communication between new postdocs, their staff mentors, and their managers. These guidelines detail expectations and responsibilities of the three parties, as well as list relevant contacts. The purpose of the Postdoc Program is to bring in talented, creative people who enrich Sandia's environment by performing innovative R&D, as well as by stimulating intellectual curiosity and learning. Postdocs are temporary employees who come to Sandia for career development and advancement reasons. In general, the postdoc term is 1 year, renewable up tomore » five times for a total of six years. However, center practices may vary; check with your manager. At term, a postdoc may apply for a staff position at Sandia or choose to move to university, industry or another lab. It is our vision that those who leave become long-term collaborators and advocates whose relationships with Sandia have a positive effect upon our national constituency.« less

Marketing Education Program Management Guide.

ERIC Educational Resources Information Center

Blair, Betty; And Others

This guide was designed for use by marketing education teacher-coordinators and administrators in implementing marketing education programs. The document includes the following: an overall picture of administrative responsibilities related to high quality programs, guidelines and forms needed to deliver effective instruction, resources and…

Supported Employment Staff Training Manual.

ERIC Educational Resources Information Center

Inge, Katherine; And Others

This training manual provides practical guidelines for staff development in supported employment programs for individuals with severe disabilities. It provides information on designing and developing training programs using adult learning principles, for program managers or trainers responsible for implementing inservice training and technical…

The Stress Check Program: a new national policy for monitoring and screening psychosocial stress in the workplace in Japan.

PubMed

Kawakami, Norito; Tsutsumi, Akizumi

2016-01-01

The Japanese government launched a new occupational health policy called the Stress Check Program. This program mandates that all workplaces with 50 or more employees conduct the Stress Check Program for workers at least once a year. This article gives a brief overview and critical review of the program. We reviewed relevant laws, guidelines, and manuals, as well as the policy development process. The policy and the components of the program were compared using available scientific evidence and trends in the management of psychosocial factors at work according to the policies and guidelines of international bodies and European countries. The process of program policy development was based on a discussion among employer and employee representatives, occupational health professionals, and mental health experts. Scientific evidence shows that mandated components of the program (i.e., feedback of stress survey results and physician's interview) may be ineffective. However, additional components recommended to employers, such as stress management skill provision and work environment improvement, in conjunction with the program may be effective in improving psychosocial stress at work. The Stress Check Program is unique compared with the global trend for psychosocial risk management because it focuses on the assessment of stress among individual workers. The new program may be effective in improving worker mental health by facilitating the psychosocial risk management approach in Japan. Concerns regarding the program include mass leakage of collected information, and possible disadvantages for workers labeled as having high stress.

Utilizing Modern Technology in Adult and Continuing Education Programs.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Curriculum Development.

This publication, designed as a supplement to the manual entitled "Managing Programs for Adults" (1983), provides guidelines for establishing or expanding the use of video and computers by administration and staff of adult education programs. The first section presents the use of video technology for program promotion, instruction, and staff…

Challenges and solutions in the evaluation of a low back pain disease management program.

PubMed

Kotsos, Thomas; Muldowney, Kevin; Chapa, Griselda; Martin, J Eric; Linares, Antonio

2009-02-01

This paper examines a novel approach to evaluating a nurse-run telephonic low back pain (LBP) disease management (DM) program offered by a fully-insured commercial health plan population with approximately 150,000 members located in the northeastern United States. Members with at least 6 member months of eligibility were identified to have LBP using administrative claims and eligibility data. The LBP program relies on telephonic nurse management augmented by printed materials, adapting and advocating HEDIS imaging guidelines, and drug utilization review. Outcomes of this LBP DM program were assessed using a pre-post population-based approach as recommended in the DMAA Outcomes Guidelines Report. Baseline year and program year populations were segmented into 5 LBP clinical categories and each was weight adjusted using population size. LBP-related medical service utilization and pharmacy utilization also were evaluated. Individuals under active LBP management exhibited a decrease in LBP-related imaging and surgeries. Overall analgesic use also decreased. These data suggest the LBP DM program is associated with a decrease in imaging, surgeries, and analgesic use. The magnitude of the clinically segmented weight-adjusted return on investment (ROI) was lower than the unadjusted ROI, but was directionally positive indicating program impact. This adjustment is necessary in order to gain insight into and consistency of the results of a comprehensive LBP DM program evaluation.

15 CFR 923.21 - Areas of particular concern.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Special Management Areas § 923.21 Areas of particular... concern within the coastal zone, on a generic and/or site-specific basis, and broad guidelines on...

APSIC Guidelines for environmental cleaning and decontamination.

PubMed

Ling, Moi Lin; Apisarnthanarak, Anucha; Thu, Le Thi Anh; Villanueva, Victoria; Pandjaitan, Costy; Yusof, Mohamad Yasim

2015-01-01

This document is an executive summary of APSIC Guidelines for Environmental Cleaning and Decontamination. It describes best practices in routine cleaning and decontamination in healthcare facilities as well as in specific settings e.g. management of patients with isolation precautions, food preparation areas, construction and renovation, and following a flood. It recommends the implementation of environmental hygiene program to keep the environment safe for patients, staff and visitors visiting a healthcare facility. Objective assessment of cleanliness and quality is an essential component of this program as a method for identifying quality improvement opportunities. Recommendations for safe handling of linen and bedding; as well as occupational health and safety issues are included in the guidelines. A training program is vital to ensure consistent adherence to best practices.

40 CFR 256.11 - Recommendations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... authorized State hazardous waste management program under subtitle C of the Act. (e) The State plan should... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Identification of Responsibilities...

40 CFR 256.11 - Recommendations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... authorized State hazardous waste management program under subtitle C of the Act. (e) The State plan should... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Identification of Responsibilities...

Outpatient Management of Neonatal Abstinence Syndrome: A Quality Improvement Project.

PubMed

Chau, Kim T; Nguyen, Jacqueline; Miladinovic, Branko; Lilly, Carol M; Ashmeade, Terri L; Balakrishnan, Maya

2016-11-01

An increasing number of infants are diagnosed with neonatal abstinence syndrome (NAS). The study's primary objectives were to describe an academic medical center's level IV neonatal ICU's (NICU's) comprehensive outpatient NAS management effort, measure guideline compliance, and assess its safety. Secondary objectives were to describe the duration and cumulative methadone exposure, and to improve parent and provider knowledge of NAS. The study included 22 infants having a gestational age of 35-41 weeks, diagnosed with NAS, and discharged for outpatient methadone management. Discharges spanned 10 months and included 3 improvement periods. The outpatient program includes comprehensive discharge planning, a focused electronic health record (EHR) template, management guidelines, and parent and provider education. Providers complied with using the outpatient management guideline and EHR template, and assessed weight, NAS symptoms, and methadone dose during appointments. Two infants required NAS-related hospital readmission in the study period. From improvement period 1 to period 3 there was no difference in total outpatient days on methadone (58, 53, 74 days, respectively) or cumulative methadone dose (2.7, 2.6, 3.1mg/kg, respectively). A downward trend pattern in cumulative methadone exposure was noted in improvement period 2. Pre- and postimplementation surveys revealed that after implementation, parents had better understanding of NAS before delivery (71% vs. 100%, p = 0.009), while providers had increased comfort with outpatient management (24% vs. 67%, p < 0.001) and educating parents (48% vs. 82%, p = 0.001). This preliminary study suggests that outpatient NAS management can be safe when a comprehensive management program is implemented and can result in provider compliance with the program. Copyright 2016 The Joint Commission.

23 CFR 650.211 - Guidelines.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Protection Agency guidance document for the design of projects within coastal zone management areas. 3 This... requirements of section 6217(g) of the Coastal Zone Act Reauthorization Amendments of 1990 (Pub. L. 101-508... located in the coastal zone management areas of States with coastal zone management programs approved by...

23 CFR 650.211 - Guidelines.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Protection Agency guidance document for the design of projects within coastal zone management areas. 3 This... requirements of section 6217(g) of the Coastal Zone Act Reauthorization Amendments of 1990 (Pub. L. 101-508... located in the coastal zone management areas of States with coastal zone management programs approved by...

23 CFR 650.211 - Guidelines.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Protection Agency guidance document for the design of projects within coastal zone management areas. 3 This... requirements of section 6217(g) of the Coastal Zone Act Reauthorization Amendments of 1990 (Pub. L. 101-508... located in the coastal zone management areas of States with coastal zone management programs approved by...

23 CFR 650.211 - Guidelines.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Protection Agency guidance document for the design of projects within coastal zone management areas. 3 This... requirements of section 6217(g) of the Coastal Zone Act Reauthorization Amendments of 1990 (Pub. L. 101-508... located in the coastal zone management areas of States with coastal zone management programs approved by...

23 CFR 650.211 - Guidelines.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Protection Agency guidance document for the design of projects within coastal zone management areas. 3 This... requirements of section 6217(g) of the Coastal Zone Act Reauthorization Amendments of 1990 (Pub. L. 101-508... located in the coastal zone management areas of States with coastal zone management programs approved by...

Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care.

PubMed

Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

2012-10-01

Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ± 24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ± 7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1.

Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care

PubMed Central

Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

2012-01-01

Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ±24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ±7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1 PMID:22893665

Guideline-concordant weight-loss programs in an urban area are uncommon and difficult to identify through the Internet

PubMed Central

Bloom, Benjamin; Mehta, Ambereen K.; Clark, Jeanne M.; Gudzune, Kimberly A.

2015-01-01

Objective To determine the reliability of Internet-based information on community-based weight-loss programs and grade their degree of concordance with 2013 American Heart Association, American College of Cardiology, and The Obesity Society weight management guidelines. Methods We conducted an online search for weight-loss programs in the Maryland-Washington, DC-Virginia corridor. We performed content analysis to abstract program components from their websites, and then randomly selected 80 programs for a telephone survey to verify this information. We determined reliability of Internet information in comparison with telephone interview responses. Results Of the 191 programs, we graded 1% as high, 8% as moderate, and 91% as low with respect to guideline concordance based on website content. Fifty-two programs participated in the telephone survey (65% response rate). Program intensity, diet, physical activity, and use of behavioral strategies were underreported on websites as compared to description of these activities during phone interview. Within our subsample, we graded 6% of programs as high based on website information, whereas we graded 19% as high after telephone interview. Conclusions Most weight-loss programs in an urban, mid-Atlantic region do not currently offer guideline-concordant practices and fail to disclose key information online, which may make clinician referrals challenging. PMID:26861769

Guidelines for development of NASA (National Aeronautics and Space Administration) computer security training programs

NASA Technical Reports Server (NTRS)

Tompkins, F. G.

1983-01-01

The report presents guidance for the NASA Computer Security Program Manager and the NASA Center Computer Security Officials as they develop training requirements and implement computer security training programs. NASA audiences are categorized based on the computer security knowledge required to accomplish identified job functions. Training requirements, in terms of training subject areas, are presented for both computer security program management personnel and computer resource providers and users. Sources of computer security training are identified.

A Sawmill Manager Adapts To Change With Linear Programming

Treesearch

George F. Dutrow; James E. Granskog

1973-01-01

Linear programming provides guidelines for increasing sawmill capacity and flexibility and for determining stumpagepurchasing strategy. The operator of a medium-sized sawmill implemented improvements suggested by linear programming analysis; results indicate a 45 percent increase in revenue and a 36 percent hike in volume processed.

Design and implementation of an inpatient disease management program.

PubMed

Cooper, G S; Armitage, K B; Ashar, B; Costantini, O; Creighton, F A; Raiz, P; Wong, R C; Carlson, M D

2000-07-01

To describe the development and implementation of an inpatient disease management program. Prospective observational study. On the basis of opportunities for improving quality or efficiency of inpatient and emergency department care, 4 diagnoses, including congestive heart failure (CHF), gastrointestinal hemorrhage, community-acquired pneumonia and sickle-cell crisis were selected for implementation of a disease management program. For each diagnosis, a task force assembled a disease management team led by a "physician champion" and nurse care manager and identified opportunities for improvement through medical literature review and interviews with caregivers. A limited number of disease-specific guidelines and corresponding interventions were selected with consensus of the team and disseminated to caregivers. Physician and nurse team leaders were actively involved in patient care to facilitate adherence to guidelines. For quarter 2 to 4 of 1997, there were improvements in angiotensin-converting enzyme inhibitor use, daily weight compliance, assessment of left ventricular function, hospital costs, and length of stay for care-managed patients with CHF. Differences in utilization-related outcomes persisted even after adjustment for severity of illness. For the other 3 diagnoses, the observational period was shorter (quarter 4 only), and hence preliminary data showed similar hospital costs and length of stay for care-managed and noncare-managed patients. An interdisciplinary approach to inpatient disease management resulted in substantial improvements in both quality and efficiency of care for patients with CHF. Additional data are needed to determine the program's impact on outcomes of other targeted diagnoses.

Guidelines for the use of mathematics in operational area-wide integrated pest management programs using the sterile insect technique with a special focus on Tephritid Fruit Flies

USDA-ARS?s Scientific Manuscript database

Pest control managers can benefit from using mathematical approaches, particularly models, when implementing area-wide pest control programs that include sterile insect technique (SIT), especially when these are used to calculate required rates of sterile releases to result in suppression or eradica...

Professional education and hospital development for organ donation.

PubMed

Fukushima, N; Konaka, S; Kato, O; Ashikari, J

2012-05-01

Because of the strict Organ Transplantation Act, only 81 brain dead (BD) organ donations had been performed in Japan for 13 years since 1997. The Act was revised on July 17, 2010, allowing, organs to be donated after BD with consent from the family, if the subject had not denied organ donation previously. This act has lead to an expectation of a 6-7-fold increase in BD donation. The 82 organ procurement coordinators (OPC) in Japan include 32 belonging to the Japanese Organ Network (JOT) and the others to each administrative division. JOT has guideline manuals of standard roles and procedures of OPC during organ procurement from BD and cardiac death donors. To manage the increased organ donations after the revision of the act, we have modified the education system. First, we modified the guideline manuals for OPC to correspond to the revised Transplant Act and governmental guidelines. Second, all OPC gathered in a meeting room to learn the new organ procurement system to deal with the revised Transplant Act and guidelines. Third, a special education program for 2 months was provided for the 10 newcomers. Last, the practical training in each donor case for newcomers was performed by older OPC. Topics of the education program were the revised transplant act and guidelines, family approach to organ donation, BD diagnosis, donor evaluation and management, organ procurement and preservation, allocation system, hospital development and family care. In the future, each OPC will be divided into special categories, such as the donor family OPC, the donor management OPC, and the operating room OPC. Therefore, we need to construct separate special education programs for each category. Copyright © 2012 Elsevier Inc. All rights reserved.

Testing of best management practices for controlling highway runoff.

DOT National Transportation Integrated Search

1993-01-01

In order to obtain the necessary detailed design guidelines for storm water best management practices (BMPs) included in the Virginia Department of Transportation's storm water manual, a field program was initiated in 1991 for testing the pollutant r...

40 CFR 60.2630 - What should I include in my waste management plan?

Code of Federal Regulations, 2014 CFR

2014-07-01

...) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Waste Management.... Model Rule—Operator Training and Qualification ...

40 CFR 60.2630 - What should I include in my waste management plan?

Code of Federal Regulations, 2013 CFR

2013-07-01

...) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Waste Management.... Model Rule—Operator Training and Qualification ...

Water Management Plan for Fort Buchanan, Puerto Rico

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

Chvala, William D.; Sullivan, Gregory P.; Mcmordie, Katherine

2004-06-01

This document reports findings and recommendations as a result of a design assistance project with Fort Buchanan with the goals of developing a Water Management Plan (WMP). The WRMP developed during this task is an amalgam of the templates and guidelines from the Federal Energy Management Program and Army regulations.

Physicians' perspectives and practices regarding the fertility management of obese patients.

PubMed

Harris, Isiah D; Python, Johanne; Roth, Lauren; Alvero, Ruben; Murray, Shona; Schlaff, William D

2011-10-01

To assess the practice patterns and personal beliefs of fertility physicians who care for obese patients seeking assisted reproduction, we conducted a national survey of fertility program directors from both private and academic practices and discovered that although few practices have firm guidelines regarding the management of obese patients, the overwhelming majority of providers believe that body mass index guidelines or cutoffs should exist. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Space station pressurized laboratory safety guidelines

NASA Technical Reports Server (NTRS)

Mcgonigal, Les

1990-01-01

Before technical safety guidelines and requirements are established, a common understanding of their origin and importance must be shared between Space Station Program Management, the User Community, and the Safety organizations involved. Safety guidelines and requirements are driven by the nature of the experiments, and the degree of crew interaction. Hazard identification; development of technical safety requirements; operating procedures and constraints; provision of training and education; conduct of reviews and evaluations; and emergency preplanning are briefly discussed.

MSFC personnel management tasks: Recruitment and orientation of new employees

NASA Technical Reports Server (NTRS)

Brindley, T. A.

1980-01-01

In order to encourage highly motivated young students to learn about NASA and consider it for a career, a formal program is to be initiated whereby selected students can work on a voluntary basis at Marshall Space Flight Center (MSFC). The first task was to develop the working plan and procedures for this program, called Student Volunteer Service Program, in the writing of MSFC official guidelines, the Marshall Management Instruction (the MMI) which is a binding document that defines policy and establishes procedures and guidelines. Particular considerations written into the MMI after numerous consultations, interviews, and discussions about a satisfactory policy, include: arrangements to be made between the student, the school authorities, and concerned MSFC employees; management of the work assignments; and procedures for the student's welfare and safety. The second task was the development of a recruitment brochure for the attraction of new employees, especially scientists and engineers. The third task assigned was to develop a plan called Orientation of New Employees.

Promoting School Art: A Practical Approach.

ERIC Educational Resources Information Center

Dunn, Phillip C.; And Others

This publication provides art educators with a plan for becoming effective advocates for school art programming and management. Chapter 1 is designed to stimulate change in programs that train art educators, to offer practical guidelines and techniques for obtaining operational support for school art programs, and to describe various marketing…

Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats.

PubMed

Swanson, Jeffrey; Weissert, William G

2017-08-01

Case management programs often designate a nurse or social worker to take responsibility for guiding care when patients are expected to be expensive or risk a major decline. We hypothesized that though an intuitively appealing idea, careful program design and faithful implementation are essential if case management programs are to succeed. We employed two theory perspectives, principal-agent framework and street-level bureaucratic theory to describe the relationship between program designers (principals) and case managers (agents/street-level bureaucrats) to review 65 case management studies. Most programs were successful in limited program-specific process and outcome goals. But there was much less success in cost-saving or cost-effectiveness-the original and overarching goal of case management. Cost results might be improved if additional ideas of agency and street-level theory were adopted, specifically, incentives, as well as "green tape," clear rules, guidelines, and algorithms relating to resource allocation among patients.

The Lebanese Society for Infectious Diseases and Clinical Microbiology (LSIDCM) guidelines for adult community-acquired pneumonia (Cap) in Lebanon.

PubMed

Moghnieh, Rima; Yared Sakr, Nadine; Kanj, Souha S; Musharrafieh, Umayya; Husni, Rula; Jradeh, Mona; Al-Awar, Ghassan; Matar, Madona; Jureij, Wafa; Antoine, Saad; Azar, Eid; Abi Hanna, Pierre; Minari, Afaf; Hammoud, Jamale; Kfoury, Joumana; Mahfouz, Tahsin; Abou Chakra, Diaa; Zaatari, Mohamad; Tabbarah, Zuhayr A

2014-01-01

Adult community-acquired pneumonia (CAP) is a common cause of morbidity and mortality which is managed by different disciplines in a heterogeneous fashion. Development of consensus guidelines to standardize these wide variations in care has become a prime objective. The Lebanese Society of Infectious Diseases and Clinical Microbiology (LSIDCM) convened to set Lebanese national guidelines for the management of CAP since it is a major and a prevalent disease affecting the Lebanese population. These guidelines, besides being helpful in direct clinical practice, play a major role in establishing stewardship programs in hospitals in an effort to contain antimicrobial resistance on the national level. These guidelines are intended for primary care practitioners and emergency medicine physicians. They constitute an appropriate starting point for specialists' consultation being based on the available local epidemiological and resistance data. This document includes the following: 1/ Rationale and scope of the guidelines; 2/ Microbiology of CAP based on Lebanese data; 3/ Clinical presentation and diagnostic workup of CAP; 4/ Management and prevention strategies based on the IDSA/ATS Consensus Guidelines, 2007, and the ESCMID Guidelines, 2011, and tailored to the microbiological data in Lebanon; 5/ Comparison to regional guidelines. The recommendations made in this document were graded based on the strength of the evidence as in the 2007 IDSA/ATS Consensus Guidelines. Hopefully, these guidelines will be an important step towards standardization of CAP care in Lebanon and set the agenda for further research in this area.

Management of Urban Construction Programs. Volume II : Supplemental Information

DOT National Transportation Integrated Search

1981-06-01

This report is part of a program sponsored by the Office of Rail and Construction Technology of the Urban Mass Transportation Administration. The overall objective of the study is to develop guidelines that can be used by local government authorities...

Self-management for obesity and cardio-metabolic fitness: Description and evaluation of the lifestyle modification program of a randomised controlled trial

PubMed Central

Pettman, Tahna L; Misan, Gary MH; Owen, Katherine; Warren, Kate; Coates, Alison M; Buckley, Jonathan D; Howe, Peter RC

2008-01-01

Background Sustainable lifestyle modification strategies are needed to address obesity and cardiovascular risk factors. Intensive, individualised programs have been successful, but are limited by time and resources. We have formulated a group-based lifestyle education program based upon national diet and physical activity (PA) recommendations to manage obesity and cardio-metabolic risk factors. This article describes the content and delivery of this program, with information on compliance and acceptability. Methods Overweight/obese adults (n = 153) with metabolic syndrome were recruited from the community and randomly allocated to intervention (INT) or control (CON). Written copies of Australian national dietary and PA guidelines were provided to all participants. INT took part in a 16-week lifestyle program which provided a curriculum and practical strategies on 1) dietary and PA information based on national guidelines, 2) behavioural self-management tools, 3) food-label reading, supermarkets tour and cooking, 4) exercise sessions, and 5) peer-group support. Compliance was assessed using attendance records and weekly food/PA logs. Participants' motivations, perceived benefits and goals were assessed through facilitated discussion. Program acceptability feedback was collected through structured focus groups. Results Although completion of weekly food/PA records was poor, attendance at information/education sessions (77% overall) and exercise participation (66% overall) was high, and compared with CON, multiple markers of body composition and cardio-metabolic health improved in INT. Participants reported that the most useful program components included food-label reading, cooking sessions, and learning new and different physical exercises, including home-based options. Participants also reported finding self-management techniques helpful, namely problem solving and short-term goal setting. The use of a group setting and supportive 'peer' leaders were found to be supportive. More frequent clinical assessment was suggested for future programs. Conclusion This group-based lifestyle program achieved improvements in body composition and cardio-metabolic and physical fitness similar to individualised interventions which are more resource intensive to deliver. It confirmed that active training in lifestyle modification is more effective than passive provision of guidelines. Such programs should include social support and self-management techniques. Continued clinical follow up may be required for long-term maintenance in individuals attempting lifestyle behaviour change. Program facilitation by peers may help and should be further investigated in a community-based model. PMID:18954466

Issues in NASA Program and Project Management. Special Edition: A Collection of Papers on NASA Procedures and Guidance 7120.5A. Volume 14

NASA Technical Reports Server (NTRS)

Hoffman, Edward J. (Editor); Lawbaugh, William M. (Editor)

1998-01-01

A key aspect of NASA's new Strategic Management System is improving the way we plan, approve, execute and evaluate our programs and projects. To this end, NASA has developed the NASA Program and Project Management processes and Requirements-NASA Procedures and Guidelines (NPG) 7120.5A, which formally documents the "Provide Aerospace Products and Capabilities" crosscutting process, and defines the processes and requirements that are responsive to the Program/Project Management-NPD 7120.4A. The Program/Project Management-NPD 7120.4A, issued November 14, 1996, provides the policy for managing programs and projects in a new way that is aligned with the new NASA environment. An Agencywide team has spent thousands of hours developing the NASA Program and Project Management Processes and Requirements-NPG 7120.5A. We have created significant flexibility, authority and discretion for the program and project managers to exercise and carry out their duties, and have delegated the responsibility and the accountability for their programs and projects.

Protecting rare, old-growth, forest-associated species under the Survey and Manage program guidelines of the northwest forest plan.

Treesearch

Randy Molina; Bruce G. Marcot; Robin Lesher

2006-01-01

The Survey and Manage Program of the Northwest Forest Plan (MFP) represents an unparalleled attempt to protect rare, little-known species associated with late-successional and old-growth forests on more than 7.7 million ha of federal lands. Approximately 400 species of amphibians, bryophytes, fungi, lichens, mollusks, vascular plants, arthropod functional groups, and...

Guideline for the management of wounds in patients with lower-extremity neuropathic disease: an executive summary.

PubMed

Crawford, Penny Ellen; Fields-Varnado, Myra

2013-01-01

This article summarizes the WOCN Evidence-Based Clinical Practice Guideline for Management of Wounds in Patients with Lower Extremity Neuropathic Disease. It is intended for use by physicians, nurses, therapists, and other health care professionals who work with adults who have or are at risk for, lower-extremity neuropathic disease (LEND), and includes updated scientific literature available from January 2003 through February 2012. The full guideline contains definitions of lower extremity neuropathic disorders and disease, prevalence of the problem, relevance and significance of the disorders, as well as comprehensive information about etiology, the nervous system, pathogenesis, and the overall management goals for patients at risk for developing neuropathic foot ulcers. A detailed assessment section describes how to conduct a full clinical history and physical examination. The guideline also provides two approaches to interventions. The first focuses on prevention strategies to reduce the risk of developing LEND wounds or recurrence, including life-long foot offloading, routine dermal temperature surveillance, use of adjunctive therapies, medication management, and implementing lower extremity amputation prevention measures and patient self-care education. The second approach summarized LEND wound management strategies including wound cleansing, debridement, infection management, maintenance of intact peri-wound skin, nutrition considerations, pain and paresthesia management, edema management, offloading and management of gait and foot deformity, medication management, surgical options, adjunctive therapies, patient education, and health care provider follow-up. A comprehensive reference list, glossary of terms, and several appendices regarding an algorithm to determine wound etiology, pharmacology, Lower Extremity Amputation (LEAP) Program, diabetes foot screening and other information is available at the end of the guideline.

Targeting practitioners: A review of guidelines, training, and policy in pain management

PubMed Central

Barth, Kelly S.; Guille, Constance; McCauley, Jenna; Brady, Kathleen T.

2017-01-01

This paper reviews the current literature on clinical guidelines, practitioner training, and government/payer policies that have come forth in response to the national rise in prescription opioid overdoses. A review of clinical opioid prescribing guidelines highlights the need for more research on safe and effective treatment options for chronic pain, improved guidance for the best management of post-operative pain, and evaluation of the implementation and impact of guideline recommendations on patient risk and outcomes. Although there is increasing attention to training in pain management in medical schools and medical residency programs, educational opportunities remain highly variable, and the need for additional clinician training in the recognition and treatment of pain as well as opioid use disorder has been recognized. Mandated use of private, federal and state educational and clinical initiatives such as Risk Evaluation and Mitigation Strategies (REMS) and Prescription Drug Monitoring Programs (PDMPs) generally increase utilization of these initiatives, but more research is needed to determine the impact of these initiatives on provider behaviors, treatment access, and patient outcomes. Finally, there is an acute need for more research on safe and effective treatments for chronic pain as well as an increased multi-level focus on improving training and access to evidence-based treatment for opioid use disorder as well as non-pharmacologic and non-interventional chronic pain treatments, so that these guideline-recommended interventions can become mainstream, accessible, first-line interventions for chronic pain and/or opioid use disorders. PMID:28363316

Risk managers' descriptions of programs to support second victims after adverse events.

PubMed

White, Andrew A; Brock, Douglas M; McCotter, Patricia I; Hofeldt, Ron; Edrees, Hanan H; Wu, Albert W; Shannon, Sarah; Gallagher, Thomas H

2015-01-01

Guidelines call for healthcare organizations to provide emotional support for clinicians involved in adverse events, but little is known about how these organizations seek to meet this need. We surveyed US members of the American Society for Healthcare Risk Management (ASHRM) about the presence, features, and perceived efficacy of their organization's provider support program. The majority reported that their organization had a support program, but features varied widely and there are substantial opportunities to improve services. Provider support programs should enhance referral mechanisms and peer support, critically appraise the role of employee assistance programs, and demonstrate their value to institutional leaders. © 2015 American Society for Healthcare Risk Management of the American Hospital Association.

AIDS Clinical Trials Group Network

MedlinePlus

... ACTG (PDF - 42 KB) Bylaws, SOPs, and Guidelines Leadership and Operations Center Network Coordinating Center Statistical and Data Management Center Performance Evaluation Program Sites Community General Information ...

A Consortium for Teacher Preparation: Model Guidelines for Small Colleges.

ERIC Educational Resources Information Center

Fouts, Jeffrey T.

Guidelines have been developed for a consortium approach to teacher preparation in a small college that may need some expertise and access to teaching materials which can be provided by local school districts and other agencies. This approach to the design, management, and evaluation of the program offers the opportunity to involve the schools…

Planning for management information systems in drug treatment organizations.

PubMed

Zalkind, D; Zelon, H; Moore, M; Kaluzny, A

1979-02-01

An attempt to set up a management information system for individual drug abuse programs throughout a state is described. The principles upon which the system is based are discussed along with the problems encountered in its implementation. A series of guidelines for establishing management information systems in operating human services agencies is included.

Design and Verification Guidelines for Vibroacoustic and Transient Environments

NASA Technical Reports Server (NTRS)

1986-01-01

Design and verification guidelines for vibroacoustic and transient environments contain many basic methods that are common throughout the aerospace industry. However, there are some significant differences in methodology between NASA/MSFC and others - both government agencies and contractors. The purpose of this document is to provide the general guidelines used by the Component Analysis Branch, ED23, at MSFC, for the application of the vibroacoustic and transient technology to all launch vehicle and payload components and payload components and experiments managed by NASA/MSFC. This document is intended as a tool to be utilized by the MSFC program management and their contractors as a guide for the design and verification of flight hardware.

32 CFR 286.28 - General provisions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OF INFORMATION ACT PROGRAM DOD FREEDOM OF INFORMATION ACT PROGRAM REGULATION Fee Schedule § 286.28 General provisions. (a) Authorities. The Freedom of Information Act, as amended; the Paperwork Reduction... the Office of Management and Budget Uniform Freedom of Information Act Fee Schedule and Guidelines...

32 CFR 286.28 - General provisions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OF INFORMATION ACT PROGRAM DOD FREEDOM OF INFORMATION ACT PROGRAM REGULATION Fee Schedule § 286.28 General provisions. (a) Authorities. The Freedom of Information Act, as amended; the Paperwork Reduction... the Office of Management and Budget Uniform Freedom of Information Act Fee Schedule and Guidelines...

32 CFR 286.28 - General provisions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... OF INFORMATION ACT PROGRAM DOD FREEDOM OF INFORMATION ACT PROGRAM REGULATION Fee Schedule § 286.28 General provisions. (a) Authorities. The Freedom of Information Act, as amended; the Paperwork Reduction... the Office of Management and Budget Uniform Freedom of Information Act Fee Schedule and Guidelines...

Pilot education and safety awareness programs

NASA Technical Reports Server (NTRS)

Shearer, M.; Reynard, W. D.

1984-01-01

Guidelines necessary for the implementation of safety awareness programs for commuter airlines are discussed. A safety office can be viewed as fulfilling either an education and training function or a quality assurance function. Issues such as management structure, motivation, and cost limitations are discussed.

The Nebraska Blueprint for School Assessment Programs. Volume 2: Processes and Procedures.

ERIC Educational Resources Information Center

Kennedy, Dale

This is the second of three volumes designed to cover the problems and issues of developing and managing a school assessment program. The series offers guidelines and illustrations of several special aspects of assessment programs, such as administering tests and documenting their results. This volume deals with the planning of assessment…

12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

Code of Federal Regulations, 2014 CFR

2014-01-01

... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

Code of Federal Regulations, 2013 CFR

2013-01-01

... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

Code of Federal Regulations, 2011 CFR

2011-01-01

... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

Code of Federal Regulations, 2012 CFR

2012-01-01

... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

Paths to School Readiness: An In-Depth Look at Three Early Childhood Programs.

ERIC Educational Resources Information Center

Harvard Family Research Project, Cambridge, MA.

This report provides practitioners in the field of child and family services with important guidelines on early childhood education and family support programs including program design, community collaboration, funding, and staff management. The book presents the five main components of establishing an early childhood education and family support…

English as a Second Language: Implementing Effective Adult Education Programs.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento. Adult, Alternative, and Continuation Education Div.

The manual is designed to assist California educators and public in understanding the various aspects of an effective English-as-a-Second-Language (ESL) program for adults. It provides theory-based and practical guidelines for conceptualizing, planning, designing, managing, and evaluating such programs. Chapters address these topics: the adult ESL…

Achieving and maintaining asthma control in an urban pediatric disease management program: the Breathmobile Program.

PubMed

Jones, Craig A; Clement, Loran T; Morphew, Tricia; Kwong, Kenny Yat Choi; Hanley-Lopez, Jean; Lifson, Francene; Opas, Lawrence; Guterman, Jeffrey J

2007-06-01

National guidelines suggest that, with appropriate care, most patients can control their asthma. The probabilities of children achieving and maintaining control with ongoing care are unknown. We sought to evaluate the degree to which children in a lower socioeconomic urban setting achieve and maintain control of asthma with regular participation in a disease management program that provides guideline-based care. Interdisciplinary teams of asthma specialists use mobile clinics to offer ongoing care at schools and county clinics. A guideline-derived construct of asthma control is recorded at each visit. Two thousand one hundred eighty-five enrollees were eligible to evaluate the time to first achieve control, and 1591 patients were eligible to evaluate subsequent control maintenance. Depending on severity, 70% to 87% of patients with persistent asthma achieved control by visit 3, and 89% to 98% achieved control by visit 6. Subsequent control maintenance was highly variable. Thirty-nine percent of patients displayed well-controlled asthma (control at >90% of subsequent visits), whereas 13% displayed difficult-to-control asthma (<50% of subsequent visits). Patients from each baseline severity category were found in each group. Maintenance of control was influenced by physician-estimated compliance with the treatment plan, baseline severity, and the interval between clinic visits. Many children can achieve asthma control with regular visit intervals and guideline-based care; however, long-term control can be highly variable among patients in all severity categories. These findings highlight the need and feasibility for systematically tracking each patient's clinical response to individualize therapy and guide the use of population management strategies.

Managing bond proceeds improves financial performance.

PubMed

Mates, W J

1989-04-01

Healthcare organizations must actively manage tax-exempt bond proceeds after they are initially invested at the time of financing or refinancing. The Tax Reform Act of 1986 imposes serious penalties on issuers who fail to comply with its complex requirements. An active program of bond proceeds management enables organizations to avoid this pitfall and take advantage of legal investment opportunities. Such a program must start with a set of clear guidelines on permitted investments, target rates of return, acceptable levels of risk, and liquidity requirements.

Risk Management Structured for Today's Environment

NASA Technical Reports Server (NTRS)

Greenfield, Michael A.

1998-01-01

In NPG (NASA Procedures and Guidelines) 7120.5A, we define risk management as "an organized, systematic decision-making process that efficiently identifies, analyzes, plans, tracks, controls, and communicates and documents risk in order to increase the likelihood of achieving program/project goals." Effective risk management depends upon a thorough understanding of the concept of risk, the principles of risk management and the formation of a disciplined risk management process. In human spaceflight programs, NASA has always maintained a rigorous and highly structured risk management effort. When lives are at stake, NASA's missions must be 100% safe; the risk management approach used in human spaceflight has always been comprehensive.

Managing Asthma in Primary Care: Putting New Guideline Recommendations Into Context

PubMed Central

Wechsler, Michael E.

2009-01-01

Many patients with asthma are treated in the primary care setting. The primary care physician is therefore in a key position to recognize poorly controlled asthma and to improve asthma management for these patients. However, current evidence continues to show that, for a substantial number of patients, asthma control is inadequate for a wide variety of reasons, both physician-related and patient-related. The most recently updated treatment guidelines from the National Asthma Education and Prevention Program were designed to help clinicians, including primary care physicians, manage asthma more effectively with an increased focus on achieving and maintaining good asthma control over time. The current review is intended to assist primary care physicians in improving asthma control among their patients; this review clarifies the new guidelines and provides a specialist's perspective on diagnosis, appropriate therapy, disease control surveillance, and appropriate referral when necessary. This discussion is based primarily on the new guidelines and the references cited therein, supplemented by the author's own clinical experience. PMID:19648388

Innovative approaches to recurrent training

NASA Technical Reports Server (NTRS)

Noon, H.; Murphy, M.

1984-01-01

Innovative approaches to recurrent training for regional airline aircrews are explored. Guidelines for recurrent training programs which include in corporation of cockpit resource management are discussed. B.W.

Water resources management. World Bank policy paper; Gestion des ressources en eau

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

NONE

1993-12-31

The management framework presented in this study addresses the demand for water in Asia caused by rapid population growth and economic development. It focuses on three key actions to meet the challenge: evaluate how the region manages water resources; identify guidelines for the Bank`s water resource programs; and develop country-specific strategies and promote joint programs. Reforms built into the framework seek to modernize institutions that affect water sources. The authors suggest ways to improve planning and long-term management, streamline economic and financial policy, and upgrade `real-time` management, operation, and maintenance.

Regional forestry practices and forest management certification

Treesearch

Steverson O. Moffat; Frederick W. Cubbage; Matthew H. Pelkki

2001-01-01

Under a "mandated" management scenario, landowners in states with comprehensive forest practices laws meet more sustainable forestry standards and certification programs' guidelines than do owners in states with other regulatory approaches. This confers certification advantages to landowners in the Pacific Northwest where comprehensive forest laws...

20 CFR 638.802 - Student records management.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 638.802 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR JOB CORPS PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Administrative Provisions § 638.802 Student records management. The Job Corps Director shall develop guidelines for a system of maintaining records...

Intensive Lifestyle Intervention for Obesity: Principles, Practices, and Results.

PubMed

Webb, Victoria L; Wadden, Thomas A

2017-05-01

Using the Guidelines for the Management of Overweight and Obesity in Adults as a framework, this article reviews intensive lifestyle interventions for weight loss. The Guidelines recommend a minimum of 6 months of high-intensity, comprehensive lifestyle intervention, consisting of a reduced-calorie diet, increased physical activity, and behavior therapy. Persons with obesity typically lose approximately 8 kg (approximately 8% of initial weight) with this approach, accompanied by improvements in health and quality of life. To prevent weight regain, the Guidelines recommend a 1-year weight loss maintenance program that includes at least monthly counseling with a trained interventionist. Lifestyle interventions usually are delivered in-person; however, treatment increasingly is being disseminated through community- and commercial-based programs, as well as delivered by telephone, Internet, and smartphone platforms. These latter modalities expand treatment reach but usually produce smaller weight losses than in-person interventions. The review concludes with an examination of challenges in weight management. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

A unit-level perspective on the long-term sustainability of a nursing best practice guidelines program: An embedded multiple case study.

PubMed

Fleiszer, Andrea R; Semenic, Sonia E; Ritchie, Judith A; Richer, Marie-Claire; Denis, Jean-Louis

2016-01-01

Best practice guidelines are a tool for narrowing research-to-practice gaps and improving care outcomes. There is some empirical understanding of guideline implementation in nursing settings, yet there has been almost no consideration of the longer-term sustainability of guideline-based practice improvements. Many healthcare innovations are not sustained, underscoring the need for knowledge about how to promote their survival. To understand how a nursing best practice guidelines program was sustained on acute healthcare center nursing units. We undertook a qualitative descriptive case study of an organization-wide nursing best practice guidelines program with four embedded nursing unit subcases. The setting was a large, tertiary/quaternary urban health center in Canada. The nursing department initiated a program to enhance patient safety through the implementation of three guidelines: falls prevention, pressure ulcer prevention, and pain management. We selected four inpatient unit subcases that had differing levels of program sustainability at an average of almost seven years post initial program implementation. Data sources included 39 key informant interviews with nursing leaders/administrators and frontline nurses; site visits; and program-related documents. Data collection and content analysis were guided by a framework for the sustainability of healthcare innovations. Program sustainability was characterized by three elements: benefits, routinization, and development. Seven key factors most accounted for the differences in the level of program sustainability between subcases. These factors were: perceptions of advantages, collaboration, accountability, staffing, linked levels of leadership, attributes of formal unit leadership, and leaders' use of sustainability activities. Some prominent relationships between characteristics and factors explained long-term program sustainability. Of primary importance was the extent to which unit leaders used sustainability-oriented activities in both regular and responsive ways to attend to the relationships between sustainability characteristics and factors. Continued efforts are required to ensure long-term program sustainability on nursing units. Persistent and adaptive orchestration of sustainability-oriented activities by formal unit leadership teams is necessary for maintaining best practice guidelines over the long term. Leaders should consider a broad conceptualization of sustainability, beyond guideline-based benefits and routinization, because the development of unit capacity in response to changing circumstances appears essential. Copyright © 2015 Elsevier Ltd. All rights reserved.

Perceptions about the management of dyslipidaemia among physicians in Jamaica and Trinidad.

PubMed

Monsanto, H A; Prann, M; Quijada, J G

2007-09-01

Proper management of dyslipidaemia in patients may reduce morbidity and mortality related to coronary heart disease. To determine physician perceptions of the management of dyslipidaemia in Jamaica and Trinidad Personal interviews were conducted from March to May, 2005, by an independent research firm using a structured questionnaire. A total of 111 interviews were conducted, 61 in Jamaica and 50 in Trinidad Respondents were mostly primary care physicians (PCP) or internal medicine physicians (76.5%) and 58% were in private practice. The most important factors for prescribing a drug for dyslipidaemia were related to efficacy (76%), safety (59%) and price (36%). The majority (92%) reported using treatment guidelines. The National Cholesterol Education Program (NCEP) guidelines were the most widely mentioned by physicians but there were reports of using guidelines from other organizations and physician groups. Nearly a third of all physicians, most of whom were PCPs, had not heard of the NCEP The LDL-C level at which drug therapy should be started and the LDL-C treatment goals were higher among Jamaican physicians. Physicians are aware of the existence of treatment guidelines for dyslipidaemia. However, the source and adherence to the guidelines varies according to country and specialty. Information about the proper management of dyslipidaemia must be reinforced by professional societies and government agencies.

Making Use of a Decade of Widely Varying Historical Data: SARP Project - "Full Life-Cycle Defect Management"

NASA Technical Reports Server (NTRS)

Shull, Forrest; Godfrey, Sally; Bechtel, Andre; Feldmann, Raimund L.; Regardie, Myrna; Seaman, Carolyn

2008-01-01

A viewgraph presentation describing the NASA Software Assurance Research Program (SARP) project, with a focus on full life-cycle defect management, is provided. The topics include: defect classification, data set and algorithm mapping, inspection guidelines, and tool support.

Manual for a Volunteer Services System.

ERIC Educational Resources Information Center

Helgerson, Linda; And Others

This manual presents guidelines for planning, monitoring, and controlling the development and operation of volunteer assistance programs. The materials included address questions related to both the process of establishing a volunteer program and the administration of a volunteer management system. The manual is not intended to provide a blueprint…

7 CFR 1484.33 - Must Cooperators follow certain financial management guidelines?

Code of Federal Regulations, 2011 CFR

2011-01-01

...) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS PROGRAMS TO HELP DEVELOP FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Program Operations § 1484.33 Must Cooperators... expenditure made in a foreign currency and the basis for such calculation; (4) Copies of reimbursement claims...

Five Fundamentals of Financial Health--Guidelines for Building Financial Strength.

ERIC Educational Resources Information Center

Brower, Mary R.; Sull, Theresa M.

2003-01-01

Identifies five fundamental indicators of good financial management for child care programs. Offers composites of child care program experiences to illustrate these fundamentals: enrollment at capacity with a waiting list, tuition based on full cost of care, family fees paid on time, program's bills and taxes paid on time, and a cash reserve in…

Program Risk Planning with Risk as a Resource

NASA Technical Reports Server (NTRS)

Ray, Paul S.

1998-01-01

The current focus of NASA on cost effective ways of achieving mission objectives has created a demand for a change in the risk management process of a program. At present, there is no guidelines as to when risk taking is justified due to high cost for a marginal improvement in risk. As a remedial step, Dr. Greenfield of NASA, developed a concept of risk management with risk as a resource. In the report, the following topics are addressed: (1) the risk management approach; (2) planning risk and program life cycle; (3) key components of a typical program; (4) the risk trading methodology; (5) review and decision process; (6) merits of the proposed risk planning approach; and (7) recommendations.

"Utstein style" spreadsheet and database programs based on Microsoft Excel and Microsoft Access software for CPR data management of in-hospital resuscitation.

PubMed

Adams, Bruce D; Whitlock, Warren L

2004-04-01

In 1997, The American Heart Association in association with representatives of the International Committee on Resuscitation (ILCOR) published recommended guidelines for reviewing, reporting and conducting in-hospital cardiopulmonary resuscitation (CPR) outcomes using the "Utstein style". Using these guidelines, we developed two Microsoft Office based database management programs that may be useful to the resuscitation community. We developed a user-friendly spreadsheet based on MS Office Excel. The user enters patient variables such as name, age, and diagnosis. Then, event resuscitation variables such as time of collapse and CPR team arrival are entered from a "code flow sheet". Finally, outcome variables such as patient condition at different time points are recorded. The program then makes automatic calculations of average response times, survival rates and other important outcome measurements. Also using the Utstein style, we developed a database program based on MS Office Access. To promote free public access to these programs, we established at a website. These programs will help hospitals track, analyze, and present their CPR outcomes data. Clinical CPR researchers might also find the programs useful because they are easily modified and have statistical functions.

40 CFR 256.05 - Annual work program.

Code of Federal Regulations, 2012 CFR

2012-07-01

....05 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Purpose, General Requirements... implementation of the State plan. ...

Practices in management of cancer treatment-related cardiovascular toxicity: A cardio-oncology survey.

PubMed

Jovenaux, Ludovic; Cautela, Jennifer; Resseguier, Noemie; Pibarot, Michele; Taouqi, Myriam; Orabona, Morgane; Pinto, Johan; Peyrol, Michael; Barraud, Jeremie; Laine, Marc; Bonello, Laurent; Paganelli, Franck; Barlesi, Fabrice; Thuny, Franck

2017-08-15

Cardiovascular toxicity has become a challenging issue during cancer therapy. Nonetheless, there is a lack of consensual guidelines for their management. We aimed to determine the current practices of oncologists regarding cardiovascular toxicity related to anthracyclines, trastuzumab and angiogenic inhibitors and to gather their opinions on the development of cardio-oncology programs. A cross-sectional declarative study was submitted to French oncologists in the form of an individual, structured questionnaire. A total of 303 oncologists responded to the survey. Ninety-nine percent of oncologists prescribed cardiotoxic therapies, including anthracyclines (83%), trastuzumab (51%) and other angiogenic inhibitors (64%). The method adopted for managing cardiovascular toxicity was based on guidelines from expert oncology societies for only 35% of oncologists. None was aware of recommendations from expert cardiology societies. Prescription of pre-, peri- and post-therapy cardiovascular assessment was inconsistent and significantly less frequent for all classes of angiogenic inhibitors than for anthracyclines and trastuzumab (P<0.0001). Relative to pre-therapy assessment, post-therapy assessment was prescribed significantly less often for all cancer therapies (P<0.0001). Attitudes regarding the onset of left ventricular dysfunction were much more inconsistent when angiogenic inhibitors were involved. Additionally, the management of hypertension and QT prolongation was also inconsistent. Finally, 88% of oncologists supported projects of cardio-oncology programs development. Practices of oncologists are disparate in the field of cardiovascular toxicity. This finding underlines the complexity of managing many different situations and the need for distribution of formal guidelines from oncology and cardiology expert societies. The development of personalized cardio-oncology programs seems essential. Copyright © 2017 Elsevier B.V. All rights reserved.

30 Key Steps to Successful Diversity Management: Mentoring, Networking, and Sponsorship.

ERIC Educational Resources Information Center

Gant, Lenora Peters

2000-01-01

Outlines three components that are necessary for successful diversity management programs: mentoring, networking, and sponsorship. Provides 10 guidelines under each aspect to help employees feel loyalty and a personal attachment to an organization, feel included in day-to-day operations, and to help with employee retention. (LRW)

Support for the development and implementation of an access management program through research and analysis of collision data : final report.

DOT National Transportation Integrated Search

2015-11-11

The South Carolina Access and Roadside Management Standards (ARMS) provides standards and guidelines for : permitting access encroachments onto SCDOT right-of-way. In April, 2013, SCDOT initiated research that would be : used to update this manual wi...

7 CFR 1484.33 - Must Cooperators follow certain financial management guidelines?

Code of Federal Regulations, 2010 CFR

2010-01-01

... management system that conforms to generally accepted accounting principles. (b) A Cooperator shall institute... documents relating to program activities for 5 calendar years following the end of the applicable marketing... that allows it to provide information by marketing plan year, country or region, activity number, and...

IPM for Schools: A How-To Manual.

ERIC Educational Resources Information Center

Daar, Sheila; Drlik, Tanya; Olkowski, Helga; Olkowski, William

This report presents guidelines for developing an Integrated Pest Management (IPM) approach for educational facilities, and discusses the unique opportunities an IPM program can provide in the school science curriculum. This includes the hands-on experience IPM affords to students in the areas of biology, ecology, and least-toxic management of…

40 CFR 256.05 - Annual work program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 256.05 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Purpose, General Requirements... implementation of the State plan. ...

40 CFR 256.05 - Annual work program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 256.05 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Purpose, General Requirements... implementation of the State plan. ...

12 CFR Appendix D-2 to Part 208 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2010 CFR

2010-01-01

... Relationships Risk Management Principles,” Nov. 1, 2001; FDIC FIL 68-99, Risk Assessment Tools and Practices for.... Definitions II. Standards for Safeguarding Customer Information A. Information Security Program B. Objectives III. Development and Implementation of Customer Information Security Program A. Involve the Board of...

12 CFR Appendix F to Part 225 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2010 CFR

2010-01-01

... Relationships Risk Management Principles,” Nov. 1, 2001; FDIC FIL 68-99, Risk Assessment Tools and Practices for.... Standards for Safeguarding Customer Information A. Information Security Program B. Objectives III. Development and Implementation of Customer Information Security Program A. Involve the Board of Directors B...

The Safety "Use Case": Co-Developing Chemical Information Management and Laboratory Safety Skills

ERIC Educational Resources Information Center

Stuart, Ralph B.; McEwen, Leah R.

2016-01-01

The 2015 edition of the American Chemical Society's "Guidelines and Evaluation Procedures for Bachelor's Degree Programs" identifies six skill sets that undergraduate chemistry programs should instill in their students. In our roles as support staff for chemistry departments at two different institutions (one a Primarily Undergraduate…

Creative Administration in Recreation and Parks.

ERIC Educational Resources Information Center

Kraus, Richard G.; Curtis, Joseph E.

This book is designed to serve as a basic text for those who seek to enter the field of operating recreation programs and park facilities. Emphasis is given to the administration of public departments, and guidelines are also provided for the management of voluntary agencies and therapeutic recreation programs. In addition to background…

Using "get with the guidelines" to improve cardiovascular secondary prevention.

PubMed

LaBresh, Kenneth A; Gliklich, Richard; Liljestrand, James; Peto, Randolph; Ellrodt, A Gray

2003-10-01

"Get With The Guidelines (GWTG)" was developed and piloted by the American Heart Association (AHA), New England Affiliate; MassPRO, Inc.; and other organizations to reduce the gap in the application of secondary prevention guidelines in hospitalized cardiovascular disease patients. Collaborative learning programs and technology solutions were created for the project. The interactive Web-based patient management tool (PMT) was developed using quality measures derived from the AHA/American College of Cardiology secondary prevention guidelines. It provided data entry, embedded reminders and guideline summaries, and online reports of quality measure performance, including comparisons with the aggregate performance of all hospitals. Multidisciplinary teams from 24 hospitals participated in the 2000-2001 pilot. Four collaborative learning sessions and monthly conference calls supported team interaction. Best-practices sharing and the use of an Internet tool enabled hospitals to change systems and collect data on 1,738 patients. The GWTG program, a template of learning sessions with didactic presentations, best-practices sharing, and collaborative multidisciplinary team meetings supported by the Internet-based data collection and reporting system, can be extended to multiple regions without requiring additional development. Following the completion of the pilot, the AHA adopted GWTG as a national program.

Department of Defense Systems Engineering FY 2012 Annual Report

DTIC Science & Technology

2013-03-01

by the Utility Helicopter PMO, is utilizing the latest Defense Acquisition Guidelines and previously approved PEO AVN SEP examples to develop all...efforts. As a whole, all of PEO AVN Program Management Offices understand the importance of systems engineering. They stress the continued use of...established SE guidelines, practices and procedures throughout our acquisition processes. PEO AVN , working with the AMRDEC SE Division, has

Guidelines for Management Consulting Programs for Small-Scale Enterprise. Appropriate Technologies for Development. Manual M-14.

ERIC Educational Resources Information Center

Vaughan, Gary L.

This manual is designed to assist management consultants in working with small-scale entrepreneurs in developing countries. Addressed in an overview of the small-scale enterprise (SSE) are: the role of the SSE in third world development, problems of SSEs, and target firms. The second chapter deals with various forms of management assistance to…

Planning and Management Systems for State Programs of Vocational and Technical Education: An Application of Research.

ERIC Educational Resources Information Center

Nowrasteh, Daryush M.

This publication is designed to serve state-level planners interested in reviewing the key concepts of state planning and management systems. The compact nature of the review and its organization in guideline format should provide a ready reference for the practitioner seeking to develop and improve management systems for vocational education in…

40 CFR 60.2755 - When must I submit my waste management plan?

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Recordkeeping and...

40 CFR 60.2755 - When must I submit my waste management plan?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Recordkeeping and...

A World of Fashion Course for Fashion-Oriented Students. Career Education in Home Economics. Final Report.

ERIC Educational Resources Information Center

Pew, Lou Ann

The document consists of a brief project report, copies of program publicity and related correspondence, and one of the nine learning packets developed for use in the program. The purpose of the project was to develop guidelines for planning, conducting, managing, and evaluating a simulation program for teaching the skills and competencies…

Service patrol handbook.

DOT National Transportation Integrated Search

2008-11-01

This Handbook provides an overview of the Full-Function Service Patrol (FFSP) and describes desired program characteristics from the viewpoint of an agency that is responsible for funding, managing, and operating the services. Presented guidelines an...

Developing an interdisciplinary community-based sports concussion management program.

PubMed

LoGalbo, Anthony; Salinas, Christine M; Dougherty, Michael; Field, Mel

2014-01-01

The increasing incidence and associated consequences of sport-related concussion have been at the forefront of public health concerns in recent years, prompting the need for safe and effective management guidelines and availability of appropriately trained healthcare providers. In this report we provide practical and user-friendly information regarding several important factors to consider when developing a sports concussion program, including how to select relevant team members, assess community needs and available resources, provide concussion education, secure and nurture partnerships with athletic programs, implement management strategies that align with current practice standards, and cater to athletes' unique needs in terms of program accessibility. It is hoped that the knowledge shared and proposed recommendations will be beneficial for guiding both newly developing and established concussion programs alike. © 2014 S. Karger AG, Basel.

Emergency management training program: Guide to good practice

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

Not Available

1991-07-01

The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate componentsmore » of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager`s point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.« less

Asthma - what to ask the doctor - adult

MedlinePlus

... I have a fire in my fireplace or wood-burning stove? What sort of changes do I ... 42. National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management ...

41 CFR 102-192.170 - What are GSA's responsibilities in mail management?

Code of Federal Regulations, 2012 CFR

2012-01-01

..., and guidelines; (b) Conduct research to improve practices and programs; (c) Collect and disseminate... agencies; (e) Conduct studies, inspections, or surveys; (f) Promote economy and efficiency in the selection...

41 CFR 102-192.170 - What are GSA's responsibilities in mail management?

Code of Federal Regulations, 2013 CFR

2013-07-01

..., and guidelines; (b) Conduct research to improve practices and programs; (c) Collect and disseminate... agencies; (e) Conduct studies, inspections, or surveys; (f) Promote economy and efficiency in the selection...

Sexually transmitted disease syndromic case management through public sector facilities: development and assessment study in Punjab Pakistan.

PubMed

Khan, Muhammad Amir; Javed, Wajiha; Ahmed, Maqsood; Walley, John; Munir, Muhammad Arif

2014-01-01

Sexually transmitted infections (STIs) are a priority health problem. We proposed a prospective study in two districts of Punjab, using an intervention package, which included guidelines and protocols on syndrome-based management of STIs, adapted in light of technical guidelines from the National AIDS Control Program and the World Health Organization. The aim of this study was to assess the operational effectiveness of STI case management guidelines and to assess factors that determine the adherence to guidelines for management of STIs at public health facilities in Pakistan. A prospective study lasting 18 months (January 2008 to June 2009), which reviewed early implementation experiences of updated case management guidelines for delivery of syndrome-based STI/reproductive tract infection care, through public-sector health care facilities. The project was implemented in two districts of Punjab, Sargodha and Jhang. A Cox regression model with stratification was done. The prevalence of STI was 26 per 100,000 patients. In women, the reported symptoms were 80% vaginal discharge and 12% abdominal pain. Forty-four percent of men had a genital ulcer and 29% of men had genital discharge. Age of participants ranged from 13 to 60 years. The study comprised 28.6% men and 71.4% women. The majority of the population attending these clinics was from rural areas (70%). The variables independently associated with adherence to guidelines were availability of male paramedic, age of patient, and type of diagnosis made. There was an important interaction (effect modification) present between the area of health facility and patient sex. Screening, diagnosis, and treatment costs for many STIs are expensive and thus an easier, low-cost, syndrome-based public health strategy is the adoption of the proposed STI syndrome case management guidelines. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

12 CFR Appendix F to Part 225 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2013 CFR

2013-01-01

... arrangements in place to control risks. C. Manage and Control Risk. Each bank holding company shall: 1. Design... GOVERNORS OF THE FEDERAL RESERVE SYSTEM (CONTINUED) BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL.... Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F...

41 CFR 60-20.2 - Recruitment and advertisement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Recruitment and advertisement. 60-20.2 Section 60-20.2 Public Contracts and Property Management Other Provisions Relating to Public Contracts OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS, EQUAL EMPLOYMENT OPPORTUNITY, DEPARTMENT OF LABOR 20-SEX DISCRIMINATION GUIDELINES §...

Study on Integrated Pest Management for Libraries and Archives.

ERIC Educational Resources Information Center

Parker, Thomas A.

This study addresses the problems caused by the major insect and rodent pests and molds and mildews in libraries and archives; the damage they do to collections; and techniques for their prevention and control. Guidelines are also provided for the development and initiation of an Integrated Pest Management program for facilities housing library…

Integrated Management of Structural Pests in Schools.

ERIC Educational Resources Information Center

Illinois State Dept. of Public Health, Springfield.

The state of Illinois is encouraging schools to better inspect and evaluate the causes of their pest infestation problems through use of the Integrated Pest Management (IPM) guidelines developed by the Illinois Department of Public Health. This guide reviews the philosophy and organization of an IPM program for structural pests in schools,…

Improving the application of a practice guideline for the assessment and treatment of suicidal behavior by training the full staff of psychiatric departments via an e-learning supported Train-the-Trainer program: study protocol for a randomized controlled trial.

PubMed

de Beurs, Derek P; de Groot, Marieke H; de Keijser, Jos; Verwey, Bastiaan; Mokkenstorm, Jan; Twisk, Jos W R; van Duijn, Erik; van Hemert, Albert M; Verlinde, Lia; Spijker, Jan; van Luijn, Bert; Vink, Jan; Kerkhof, Ad J F M

2013-01-09

In 2012, in The Netherlands a multidisciplinary practice guideline for the assessment and treatment of suicidal behavior was issued. The release of guidelines often fails to change professional behavior due to multiple barriers. Structured implementation may improve adherence to guidelines. This article describes the design of a study measuring the effect of an e-learning supported Train-the-Trainer program aiming at the training of the full staff of departments in the application of the guideline. We hypothesize that both professionals and departments will benefit from the program. In a multicenter cluster randomized controlled trial, 43 psychiatric departments spread over 10 regional mental health institutions throughout The Netherlands will be clustered in pairs with respect to the most prevalent diagnostic category of patients and average duration of treatment. Pair members are randomly allocated to either the experimental or the control condition. In the experimental condition, the full staff of departments, that is, all registered nurses, psychologists, physicians and psychiatrists (n = 532, 21 departments) will be trained in the application of the guideline, in a one-day small interactive group Train-the-Trainer program. The program is supported by a 60-minute e-learning module with video vignettes of suicidal patients and additional instruction. In the control condition (22 departments, 404 professionals), the guideline shall be disseminated in the traditional way: through manuals, books, conferences, internet, reviews and so on. The effectiveness of the program will be assessed at the level of both health care professionals and departments. We aim to demonstrate the effect of training of the full staff of departments with an e-learning supported Train-the-Trainer program in the application of a new clinical guideline. Strengths of the study are the natural setting, the training of full staff, the random allocation to the conditions, the large scale of the study and the willingness of both staff and management to participate in the study. Dutch trial register: NTR3092.

Improving the application of a practice guideline for the assessment and treatment of suicidal behavior by training the full staff of psychiatric departments via an e-learning supported Train-the-Trainer program: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background In 2012, in The Netherlands a multidisciplinary practice guideline for the assessment and treatment of suicidal behavior was issued. The release of guidelines often fails to change professional behavior due to multiple barriers. Structured implementation may improve adherence to guidelines. This article describes the design of a study measuring the effect of an e-learning supported Train-the-Trainer program aiming at the training of the full staff of departments in the application of the guideline. We hypothesize that both professionals and departments will benefit from the program. Method In a multicenter cluster randomized controlled trial, 43 psychiatric departments spread over 10 regional mental health institutions throughout The Netherlands will be clustered in pairs with respect to the most prevalent diagnostic category of patients and average duration of treatment. Pair members are randomly allocated to either the experimental or the control condition. In the experimental condition, the full staff of departments, that is, all registered nurses, psychologists, physicians and psychiatrists (n = 532, 21 departments) will be trained in the application of the guideline, in a one-day small interactive group Train-the-Trainer program. The program is supported by a 60-minute e-learning module with video vignettes of suicidal patients and additional instruction. In the control condition (22 departments, 404 professionals), the guideline shall be disseminated in the traditional way: through manuals, books, conferences, internet, reviews and so on. The effectiveness of the program will be assessed at the level of both health care professionals and departments. Discussion We aim to demonstrate the effect of training of the full staff of departments with an e-learning supported Train-the-Trainer program in the application of a new clinical guideline. Strengths of the study are the natural setting, the training of full staff, the random allocation to the conditions, the large scale of the study and the willingness of both staff and management to participate in the study. Trial registration Dutch trial register: NTR3092 PMID:23302322

Emergency management training program: Guide to good practice

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

Not Available

1991-07-01

The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate componentsmore » of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager's point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.« less

Handicap Accessibility: A Self-Evaluation Guidebook for ACTION and Its Grantees. Handbook 240.

ERIC Educational Resources Information Center

ACTION, Washington, DC. Office of Equal Opportunity.

This handbook is designed to assist managers of ACTION grantee programs in evaluating the degree to which the needs of persons with disabilities are incorporated into their programs for physical accessibility of buildings and facilities. After a general discussion of self-evaluation principles and accessibility guidelines, a checklist is provided…

Mud Mountain Wildlife Inventory and Habitat Analysis.

DTIC Science & Technology

1979-01-01

PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT, TASK Intern Program AREA & WORK UNIT NUMBERS Western Interstate Commission for...RIPARIAN ZONE CHARACTERISTICS .... .......... .26 5 SNAG SUCCESSION CHARACTERISTICS .. .. . .... ... 29 6 THREE SISTERS- GRASS MOUNTAIN AREA ...recommendations appropriate with regard to their wildlife potential. Throughout the report, essential habitat areas have been noted. Management guidelines

An overview of revised NASA safety standard 1740.14

NASA Technical Reports Server (NTRS)

Reynolds, Robert; Eichler, Peter; Johnson, Nicholas

1997-01-01

Following a broad review of the debris control guidelines outside of NASA and according to additional feedback on the guidelines from within NASA, revisions were made to the NASA safety standard 1740.14. The NASA policy to limit the generation of orbital debris on NASA missions, stated in the NASA management instruction 1700.8 and implemented in the form of the NASA safety standard (NSS) 1740.14 is described together with the revisions implemented. The overall direction of the guidelines is the same, but the details of many of the guidelines were changed, including: changes for tether programs and for the control of operational debris. The NASA will continue to review the guidelines as new measurements and improved models of the environment are obtained.

Managing distress in oncology patients: description of an innovative online educational program for nurses.

PubMed

Pasacreta, Jeannie V; Kenefick, Amy L; McCorkle, Ruth

2008-01-01

The American Psychosocial Oncology Society and the Individual Cancer Assistance Network have launched the online continuing education accredited program "ICAN: Distress Management for Oncology Nursing" to address the ability of oncology nurses to assess, treat, and refer patients with a range of psychosocial problems. An important goal of the program is to reduce traditional barriers to psychosocial oncology education by providing the oncology nursing community with easy access to information from experts in the field. There are 4 Internet webcasts: Nurse's Role in Recognizing Distress in Patients and Caregivers; Assessment Recommendations; Treatment Strategies; and Principles and Guidelines for Psychotherapy and Referral. The program examines the prevalence and dimensions of patient distress and offers instruction on how to effectively integrate screening tools, such as the Distress Thermometer and Problem Check List, into clinical practice. It provides details on relevant interventions and referral algorithms based on the National Comprehensive Cancer Network Guidelines for Distress Management. It explores the devastating impact of psychological distress on quality of life, and the unique position of nurses in busy inpatient settings, outpatient clinics, and offices to detect, intervene, and refer to appropriate services. Providing information over the Internet addresses common barriers to learning, including schedule and time constraints.

Comparison of DOE and NIRMA approaches to configuration management programs

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

Yang, E.Y.; Kulzick, K.C.

One of the major management programs used for commercial, laboratory, and defense nuclear facilities is configuration management. The safe and efficient operation of a nuclear facility requires constant vigilance in maintaining the facility`s design basis with its as-built condition. Numerous events have occurred that can be attributed to (either directly or indirectly) the extent to which configuration management principles have been applied. The nuclear industry, as a whole, has been addressing this management philosophy with efforts taken on by its constituent professional organizations. The purpose of this paper is to compare and contrast the implementation plans for enhancing a configurationmore » management program as outlined in the U.S. Department of Energy`s (DOE`s) DOE-STD-1073-93, {open_quotes}Guide for Operational Configuration Management Program,{close_quotes} with the following guidelines developed by the Nuclear Information and Records Management Association (NIRMA): 1. PP02-1994, {open_quotes}Position Paper on Configuration Management{close_quotes} 2. PP03-1992, {open_quotes}Position Paper for Implementing a Configuration Management Enhancement Program for a Nuclear Facility{close_quotes} 3. PP04-1994 {open_quotes}Position Paper for Configuration Management Information Systems.{close_quotes}« less

Implementation of a 12-week disease management program improved clinical outcomes and quality of life in adults with asthma in a rural district hospital: pre- and post-intervention study.

PubMed

Chamnan, Parinya; Boonlert, Kittipa; Pasi, Wanit; Yodsiri, Songkran; Pong-on, Sirinya; Khansa, Bhoonsab; Yongkulwanitchanan, Pichapat

2010-03-01

Despite the availability of effective medical treatment and disease management guidelines, asthma remains a poorly controlled disease in developing countries. There is little evidence of the effectiveness of disease management guidelines in rural clinical practice. The effect of disease management guidelines on clinical outcomes and quality of life in asthmatic patients in a rural community hospital was examined. Fifty-seven patients aged > or = 16 years with physician-diagnosed asthma from a hospital outpatient clinic in Ubon-ratchathani, Thailand, were recruited. Asthma diagnosis was confirmed by reviewing clinical records. We implemented a 12-week disease management program, including the use of written asthma treatment plan and asthma action plan tailored to individual patients. Using one-group pre- and post-intervention design, we compared the average number of emergency visits and hospitalizations from acute asthmatic attacks before and after the implementation of interventions using the Wilcoxon matched-pairs signed-rank test. We also compared patient's asthma quality of life (AQL) scores, measured using the 7-point scaled Mini Asthma Quality of Life Questionnaire. It was found that among the 57 patients, 38 (67%) were women, and the mean age (SD) of the patients was 47.6 (17.0) years. Sixteen patients (28%) had a family history of asthma. Emergency visits decreased from 0.48 (SD = 0.83) per patient before implementation of interventions to 0.11 (0.37) per patient after implementation of interventions (p = 0.003). Hospitalizations with acute asthma attacks reduced from 0.14 (0.35) per patient to 0.04 (0.27) per patient (p = 0.034). Overall AQL scores increased significantly from 3.7 to 5.4 (p < 0.001), with most improvement observed in symptoms and emotions. It was concluded that implementation of a 12-week asthma disease management program could reduce emergency visits and hospitalizations, and improve patients' quality of life in a rural practice setting.

Strategies to control costs and quality: a focus on outcomes research for disease management.

PubMed

Villagra, Victor

2004-04-01

Rapid adoption of disease management has outpaced systematic evaluation of its net value in improving health outcomes and mitigating healthcare cost. This article identifies areas in which outcomes research in disease management is needed to demonstrate its value or to enhance its performance. Patient identification for disease management relies on administrative database queries but the trade-offs in sensitivity, specificity, and predictive value of alternative queries are not well known. Large-scale deployment, rapid patient engagement, and repeated interactions between patients and nurses could be important attributes for attaining measurable improvements in quality and cost reduction over short periods of time, but these hypothesis need to be tested. There is a trend toward integration of multiple chronic disease management programs onto a single platform. To support this trend, there is a need for a corresponding set of integrated clinical guidelines or "meta-guidelines" that combine the contents of individual practice guidelines. The relative contribution of various disease management interventions in improving clinical results, lowering costs, and their respective ease of implementation is not known. Research leading to a better understanding of tradeoffs could lead to more rational resource allocation and better overall outcomes. Coordination between disease management programs and physician practices is lacking. Research aimed at defining operational and technical interfaces and cultural and behavioral professional adjustments necessary to achieve integration and coordination is needed. The lack of a consistent analytical framework for evaluating clinical and financial outcomes has made comparisons of reported results impossible and has rendered many reports unreliable. Theoretical work on a standard methodology that integrates clinical and financial outcomes and empiric validation is needed.

Running Head: Feasibility of Blood Management. Feasibility Study of a Blood Management Program in the Mike O’Callaghan Federal Hospital

DTIC Science & Technology

2009-06-02

transition to bloodless surgery (Northeast Baptist Hospital, 2008). The newsletter also included a transcript from a local news story on their...and Procedures Several locally developed instructions address procedures that have the potential to facilitate blood management efforts. Appendix B... local Blood Management 19 instruction developed by the Operating Room Services personnel, details the guidelines for using the Cell Saver

Naval Leadership: A Study of Views on Leadership Competencies and Methods to Reinforce Leadership Skills

DTIC Science & Technology

1990-12-01

stated these problems -- racism , sexism , drug and alcohol abuse -- were a result of the poor leadership ability in Navymiddle management [Ref. 3... The HRM program instituted a formal course of instruction to teach leadership theories . The leadership training of the Human Resource Management...management practices based on the guidelines developed by W. E. Demming [Ref. 14]. The TQL practice involves integrating management and statistical methods to

Creating a multidisciplinary low back pain guideline: anatomy of a guideline adaptation process.

PubMed

Harstall, Christa; Taenzer, Paul; Angus, Donna K; Moga, Carmen; Schuller, Tara; Scott, N Ann

2011-08-01

A collaborative, multidisciplinary guideline adaptation process was developed to construct a single overarching, evidence-based clinical practice guideline (CPG) for all primary care practitioners responsible for the management of low back pain (LBP) to curb the use of ineffective treatments and improve patient outcomes. The adaptation strategy, which involved multiple committees and partnerships, leveraged existing knowledge transfer connections to recruit guideline development group (GDG) members and ensure that all stakeholders had a voice in the guideline development process. Videoconferencing was used to coordinate the large, geographically dispersed GDG. Information services and health technology assessment experts were used throughout the process to lighten the GDG's workload. The GDG reviewed seven seed guidelines and drafted an Alberta-specific guideline during 10 half-day meetings over a 12-month period. The use of ad hoc subcommittees to resolve uncertainties or disagreements regarding evidence interpretation expedited the process. Challenges were encountered in dealing with subjectivity, guideline appraisal tools, evidence source limitations and inconsistencies, and the lack of sophisticated evidence analysis inherent in guideline adaptation. Strategies for overcoming these difficulties are discussed. Guideline adaptation is useful when resources are limited and good-quality seed CPGs exist. The Ambassador Program successfully utilized existing stakeholder interest to create an overarching guideline that aligned guidance for LBP management across multiple primary care disciplines. Unforeseen challenges in guideline adaptation can be overcome with credible seed guidelines, a consistently applied and transparent methodology, and clear documentation of the subjective contextualization process. Multidisciplinary stakeholder input and an open, trusting relationship among all contributors will ensure that the end product is clinically meaningful. © 2010 Blackwell Publishing Ltd.

Childhood Injuries--Causes, Preventive Theories and Case Studies.

ERIC Educational Resources Information Center

Fisher, Leslie

1988-01-01

Provides a priori historical experiences and illustrations of several roles played by health practitioners in applied injury prevention. Reviews various models and assesses their strengths and weaknesses. Suggests guidelines for program management. (Author/CW)

Ambiguities in the Guidelines for the Management of Arterial Hypertension: Indian Perspective with a Call for Global Harmonization.

PubMed

Rehan, Harmeet Singh; Grover, Abhinav; Hungin, A P S

2017-02-01

Many medical professional societies have formulated guidelines to treat hypertension, but there existed differences with respect to diagnosis, blood pressure (BP) targets, pharmacotherapy of hypertension, and grades of evidence. A MEDLINE search for hypertension guidelines was performed to compare Indian guidelines for hypertension (IGH) with these guidelines. A majority of the guidelines had consensus on the cutoff value (140/90 mmHg, recorded twice) to diagnose hypertension. The Joint National Committee 8 (JNC 8), IGH, Japanese Society of hypertension (JSH), Canadian Hypertension Education Program (CHEP), and American Society of Hypertension/International Society of Hypertension (ASH/ISH) guidelines provide a higher BP target for the elderly hypertensive populations, while the National Institute for Health and Care Excellence (NICE) and European Society of Hypertension (ESH) guidelines provided a lower BP target for the elderly patients. However, a meta-analysis showed benefits of having a systolic BP target of <130 mmHg for all patients. Treatment of hypertension according to JNC 8, NICE, and ASH/ISH guidelines varies among the black and the non-black population which recommended thiazide or calcium channel blockers for the black population. There is no special mention of pharmacotherapy or BP targets for the South Asian population in various guidelines including IGH despite evidence of higher risk of hypertension-associated complications in this population. It is suggested that all the available guidelines should be harmonized with highest level of evidence available to minimize ambiguities associated with management of hypertension.

The implementation of a community-based aerobic walking program for mild to moderate knee osteoarthritis (OA): a knowledge translation (KT) randomized controlled trial (RCT): Part I: The Uptake of the Ottawa Panel clinical practice guidelines (CPGs)

PubMed Central

2012-01-01

Background The implementation of evidence based clinical practice guidelines on self-management interventions to patients with chronic diseases is a complex process. A multifaceted strategy may offer an effective knowledge translation (KT) intervention to promote knowledge uptake and improve adherence in an effective walking program based on the Ottawa Panel Evidence Based Clinical Practice Guidelines among individuals with moderate osteoarthritis (OA). Methods A single-blind, randomized control trial was conducted. Patients with mild to moderate (OA) of the knee (n=222) were randomized to one of three KT groups: 1) Walking and Behavioural intervention (WB) (18 males, 57 females) which included the supervised community-based aerobic walking program combined with a behavioural intervention and an educational pamphlet on the benefits of walking for OA; 2) Walking intervention (W) (24 males, 57 females) wherein participants only received the supervised community-based aerobic walking program intervention and the educational pamphlet; 3) Self-directed control (C) (32 males, 52 females) wherein participants only received the educational pamphlet. One-way analyses of variance were used to test for differences in quality of life, adherence, confidence, and clinical outcomes among the study groups at each 3 month assessment during the 12-month intervention period and 6-month follow-up period. Results Short-term program adherence was greater in WB compared to C (p<0.012) after 3 months. No statistical significance (p> 0.05) was observed for long-term adherence (6 to 12 months), and total adherence between the three groups. The three knowledge translation strategies demonstrated equivalent long-term results for the implementation of a walking program for older individuals with moderate OA. Lower dropout rates as well as higher retention rates were observed for WB at 12 and 18 months. Conclusion The additional knowledge translation behavioural component facilitated the implementation of clinical practice guidelines on walking over a short-term period. More studies are needed to improve the long-term walking adherence or longer guidelines uptake on walking among participants with OA. Particular attention should be taken into account related to patient’s characteristic and preference. OA can be managed through the implementation of a walking program based on clinical practice guidelines in existing community-based walking clubs as well as at home with the minimal support of an exercise therapist or a trained volunteer. Trial Registration Current Controlled Trials IRSCTNO9193542 PMID:23061875

12 CFR Appendix B to Part 30 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2012 CFR

2012-01-01

... risks. C. Manage and Control Risk. Each bank shall: 1. Design its information security program to... A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service...) Aggregate information, such as the mean credit score, derived from a group of consumer reports; or (B) Blind...

12 CFR Appendix B to Part 30 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2010 CFR

2010-01-01

... risks. C. Manage and Control Risk. Each bank shall: 1. Design its information security program to... A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service...) Aggregate information, such as the mean credit score, derived from a group of consumer reports; or (B) Blind...

12 CFR Appendix F to Part 225 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2011 CFR

2011-01-01

... arrangements in place to control risks. C. Manage and Control Risk. Each bank holding company shall: 1. Design... GOVERNORS OF THE FEDERAL RESERVE SYSTEM BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL (REGULATION Y) Pt.... Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F...

Assessing seven decades of carbon accumulation in two U.S. northern hardwood forests

Treesearch

Coeli Hoover

2011-01-01

Forests play a key role in the global carbon cycle, and programs aimed at mitigating greenhouse gas emissions through the protection and enhancement of forest carbon stocks are growing in number. Adding greenhouse gas mitigation as a management objective presents managers with a considerable challenge, because data and guidelines are scarce. Long-term inventory...

Chapter 9. Data Management, Storage, and Reporting

Treesearch

Linda A. Spencer; Mary M. Manning; Bryce Rickel

2013-01-01

Data collected for a habitat monitoring program must be managed and stored to be accessible for current and future use inside and outside the Forest Service. Information maintenance and dissemination are important to the Forest Service; they are part of the U.S. Department of Agriculture (USDA) guidelines for information quality (USDA 2002) under the Data Quality Act...

The Con Edison Emergency Child Care Plan for Management Employees: Summary Plan Description.

ERIC Educational Resources Information Center

Consolidated Edison Co., Brooklyn, NY.

This summary plan description offers guidelines for participation in a pilot program that provides short-term emergency care for children of Con Edison managers who are under 13 years old. The plan offers professional, in-home child care that can be used when usual arrangements have collapsed. The summary plan description addresses the following…

Aircraft operations management manual

NASA Technical Reports Server (NTRS)

1992-01-01

The NASA aircraft operations program is a multifaceted, highly diverse entity that directly supports the agency mission in aeronautical research and development, space science and applications, space flight, astronaut readiness training, and related activities through research and development, program support, and mission management aircraft operations flights. Users of the program are interagency, inter-government, international, and the business community. This manual provides guidelines to establish policy for the management of NASA aircraft resources, aircraft operations, and related matters. This policy is an integral part of and must be followed when establishing field installation policy and procedures covering the management of NASA aircraft operations. Each operating location will develop appropriate local procedures that conform with the requirements of this handbook. This manual should be used in conjunction with other governing instructions, handbooks, and manuals.

Guidelines for management of noxious weeds at Hanford

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

Roos, R.C.; Malady, M.B.

1995-10-27

Integrated Pest Management Services is responsible for management and control of noxious weeds on the Hanford Site. Weed species and populations are prioritized and objective defined, according to potential site and regional impact. Population controls are implemented according to priority. An integrated approach is planned for noxious weed control in which several management options are considered and implemented separately or in coordination to best meet management objectives. Noxious weeds are inventories and monitored to provide information for planning and program review.

Effects of Medicaid disease management programs on medical expenditures: Evidence from a natural experiment in Georgia.

PubMed

Kranker, Keith

2016-03-01

In recent decades, most states' Medicaid programs have introduced disease management programs for chronically ill beneficiaries. Interventions assist beneficiaries and their health care providers to appropriately manage chronic health condition(s) according to established clinical guidelines. Cost containment has been a key justification for the creation of these programs despite mixed evidence they actually save money. This study evaluates the effects of a disease management program in Georgia by exploiting a natural experiment that delayed the introduction of high-intensity services for several thousand beneficiaries. Expenditures for medical claims decreased an average of $89 per person per month for the high- and moderate-risk groups, but those savings were not large enough to offset the total costs of the program. Impacts varied by the intensity of interventions, over time, and across disease groups. Heterogeneous treatment effect analysis indicates that decreases in medical expenditures were largest at the most expensive tail of the distribution. Copyright © 2016 Elsevier B.V. All rights reserved.

Management for Educational Development in Sri Lanka.

ERIC Educational Resources Information Center

Fernando, Neil, Ed.

This document reports on 4 broad action programs, constituting a total of 15 projects, in 4 pilot districts in Sri Lanka. The programs, part of a larger effort by the Ministry of Education to actualize policy guidelines, have been attempts to bridge gaps between the capability and efficiency of the established school system and the multiple levels…

40 CFR 256.27 - Recommendation for schedules leading to compliance with the prohibition of open dumping.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Solid Waste Disposal Programs § 256.27 Recommendation for schedules leading...

40 CFR 256.26 - Requirement for schedules leading to compliance with the prohibition of open dumping.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Solid Waste Disposal Programs § 256.26 Requirement for schedules leading to...

40 CFR 256.26 - Requirement for schedules leading to compliance with the prohibition of open dumping.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Solid Waste Disposal Programs § 256.26 Requirement for schedules leading to...

40 CFR 256.27 - Recommendation for schedules leading to compliance with the prohibition of open dumping.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Solid Waste Disposal Programs § 256.27 Recommendation for schedules leading...

Get the Most from Your Cash Flow.

ERIC Educational Resources Information Center

Bauer, Richard I.

1995-01-01

Provides guidelines for overseeing a school district's cash-flow management program: (1) receipts into cash; (2) types of float; (3) concentration account or controlled-disbursement account; (4) bank-account analysis; and (5) safety. One figure is included. (LMI)

The effectiveness of German disease management programs (DMPs) in patients with type 2 diabetes mellitus and coronary heart disease: results from an observational longitudinal study.

PubMed

Laxy, Michael; Stark, Renée; Meisinger, Christa; Kirchberger, Inge; Heier, Margit; von Scheidt, Wolfgang; Holle, Rolf

2015-01-01

Although the population-based German disease management programs (DMPs) for diabetes mellitus (DM) and coronary heart disease (CHD) are among the biggest worldwide, evidence on the effectiveness of these programs is still inconclusive or missing, particularly for high risk patients with comorbidities. The objective of this study was therefore to analyze the impact of DMPs on process and outcome parameters in patients with both, type 2 DM and CHD. Analyses are based on two postal surveys of patients from the KORA myocardial infarction registry (southern Germany) with type 2 DM and on two postal validation studies with patients' general physicians (2006, n = 312 and 2011, n = 212). The association between DMP enrollment (being enrolled in either DMP-DM or DMP-CHD) and guideline care (defined by several process indicators) at baseline (2006) and its development until follow-up (2011) was analyzed using logistic regression models accounting for the repeated measurements structure. The impact of DMP enrollment/guideline care on cumulated (quality-adjusted) life years ((QA)LYs) over a 4-year time horizon (2006-2010) was assessed using multiple linear regression methods. Logistic regression models were applied to analyze the association between DMP status and patient self-management at follow-up. Being enrolled in a DMP was associated with better guideline care at baseline [OR = 2.3 (95 % CI 1.27-4.03)], but not at follow-up [OR = 0.80 (95 % CI 0.40-1.58); p value for time-interaction <0.01]. DMP enrollment was not significantly [+0.15 LYs (95 % CI -0.07, 0.37); +0.06 QALYs (95 % CI -0.15, 0.26)], but treatment according to guideline care significantly [+0.40 LYs (95 % CI 0.21-0.60); +0.28 QALYs (95 % CI 0.10-0.45)] associated with higher (quality-adjusted) survival over the 4-year follow-up period. DMP enrollees further reported a somewhat better self-management than patients not being enrolled into a DMP. The results of this study concerning the effectiveness of DMPs in patients with DM and CHD are mixed, but are weakly in favor of DMPs. However, we found a clear positive impact of guideline care on quality adjusted survival in this patient group. The development of the association between DMP enrollment and guideline care over the follow-up time indicates some external effects, which should be the subject of further investigations.

Hazards in the hospital.

PubMed

Seibert, P J

1994-02-01

In an earlier article (JAVMA, Jan 15, 1994), the author outlined some of the first steps necessary in establishing a hospital safety program that will comply with current Occupational Safety and Health Administration (OSHA) guidelines. One of the main concerns of the OSHA guidelines is that there be written plans for managing hazardous materials, performing dangerous jobs, and dealing with other potential safety problems. In this article, the author discusses potentially hazardous situations commonly found in veterinary practices and provides details on how to minimize the risks associated with those situations and how to implement safety procedures that will comply with the OSHA guidelines.

ASVCP quality assurance guidelines: external quality assessment and comparative testing for reference and in-clinic laboratories.

PubMed

Camus, Melinda S; Flatland, Bente; Freeman, Kathleen P; Cruz Cardona, Janice A

2015-12-01

The purpose of this document is to educate providers of veterinary laboratory diagnostic testing in any setting about comparative testing. These guidelines will define, explain, and illustrate the importance of a multi-faceted laboratory quality management program which includes comparative testing. The guidelines will provide suggestions for implementation of such testing, including which samples should be tested, frequency of testing, and recommendations for result interpretation. Examples and a list of vendors and manufacturers supplying control materials and services to veterinary laboratories are also included. © 2015 American Society for Veterinary Clinical Pathology.

DEC Ada interface to Screen Management Guidelines (SMG)

NASA Technical Reports Server (NTRS)

Laomanachareon, Somsak; Lekkos, Anthony A.

1986-01-01

DEC's Screen Management Guidelines are the Run-Time Library procedures that perform terminal-independent screen management functions on a VT100-class terminal. These procedures assist users in designing, composing, and keeping track of complex images on a video screen. There are three fundamental elements in the screen management model: the pasteboard, the virtual display, and the virtual keyboard. The pasteboard is like a two-dimensional area on which a user places and manipulates screen displays. The virtual display is a rectangular part of the terminal screen to which a program writes data with procedure calls. The virtual keyboard is a logical structure for input operation associated with a physical keyboard. SMG can be called by all major VAX languages. Through Ada, predefined language Pragmas are used to interface with SMG. These features and elements of SMG are briefly discussed.

NASA Safety Standard: Guidelines and Assessment Procedures for Limiting Orbital Debris

NASA Technical Reports Server (NTRS)

1995-01-01

Collision with orbital debris is a hazard of growing concern as historically accepted practices and procedures have allowed man-made objects to accumulate in orbit. To limit future debris generation, NASA Management Instruction (NMI) 1700.8, 'Policy to Limit Orbital Debris Generation,' was issued in April of 1993. The NMI requires each program to conduct a formal assessment of the potential to generate orbital debris. This document serves as a companion to NMI 1700.08 and provides each NASA program with specific guidelines and assessment methods to assure compliance with the NMI. Each main debris assessment issue (e.g., Post Mission Disposal) is developed in a separate chapter.

[Consolidation of international guidelines for the management of canine populations in urban areas and proposal of performance indicators].

PubMed

Garcia, Rita de Cassia Maria; Calderón, Néstor; Ferreira, Fernando

2012-08-01

The objective of this study is to propose a generic program for the management of urban canine populations with suggestion of performance indicators. The following international guidelines on canine population management were revised and consolidated: World Health Organization, World Organisation for Animal Health, World Society for the Protection of Animals, International Companion Animal Management Coalition, and the Food and Agriculture Organization. Management programs should cover: situation diagnosis, including estimates of population size; social participation with involvement of various sectors in the planning and execution of strategies; educational actions to promote humane values, animal welfare, community health, and responsible ownership (through purchase or adoption); environmental and waste management to eliminate sources of food and shelter; registration and identification of animals; animal health care, reproductive control; prevention and control of zoonoses; control of animal commerce; management of animal behavior and adequate solutions for abandoned animals; and laws regulating responsible ownership, prevention of abandonment and zoonoses. To monitor these actions, four groups of indicators are suggested: animal population indicators, human/animal interaction indicators, public service indicators, and zoonosis indicators. The management of stray canine populations requires political, sanitary, ethologic, ecologic, and humanitarian strategies that are socially acceptable and environmentally sustainable. Such measures must also include the control of zoonoses such as rabies and leishmaniasis, considering the concept of "one health," which benefits both the animals and people in the community.

A new "loyalty rewards" program in health care customer relationships.

PubMed

Macstravic, Scott

2006-01-01

"Loyalty rewards" in sponsored DM and HRM programs can apply to both providers and consumers. Physicians and hospitals can be paid to "loyally" adhere to payers' guidelines for managing diseases and risks. Many payer and their outsourced vendor programs include significant efforts to create collaborations between payer and provider, rather than relying on unilateral efforts. And growing numbers are rewarding providers for their efforts and results achieved.

Analysis of structural dynamic data from Skylab. Volume 1: Technical discussion

NASA Technical Reports Server (NTRS)

Demchak, L.; Harcrow, H.

1976-01-01

A compendium of Skylab structural dynamics analytical and test programs is presented. These programs are assessed to identify lessons learned from the structural dynamic prediction effort and to provide guidelines for future analysts and program managers of complex spacecraft systems. It is a synopsis of the structural dynamic effort performed under the Skylab Integration contract and specifically covers the development, utilization, and correlation of Skylab Dynamic Orbital Models.

DoD Consumer Affairs Program

DTIC Science & Technology

1982-08-12

Suggestion boxes. 11 Customer "Want" slips. (c) Communications to Consumers on Issues and Decisions. Consumers are informed of issues and pending final...of Federal Consumer Programs," September 26, 1979 (c) DoD Directive 5000. 19, "Policies for the Management and Control of Intotmation Requirements...b) to update responsibilities and guidelines for the DoD Consumer Affairs Program. B. APPLICABILITY This Directive applies to the Office of the

An ongoing six-year innovative osteoporosis disease management program: challenges and success in an IPA physician group environment.

PubMed

Woo, Ann; Hittell, Jodi; Beardsley, Carrie; Noh, Charles; Stoukides, Cheryl A; Kaul, Alan F

2004-01-01

The goal of this ongoing comprehensive osteoporosis disease management initiative is to provide the adult primary care physicians' (PCPs) offices with a program enabling them to systematically identify and manage their population for osteoporosis. For over six years, Hill Physicians Medical Group (Hill Physicians) has implemented multiple strategies to develop a best practice for identifying and treating members who were candidates for osteoporosis therapy. Numerous tools were used to support this disease management effort, including: evidence-based clinical practice guidelines, patient education sessions, the Simple Calculated Osteoporosis Risk Estimation (SCORE) questionnaire tool, member specific reports for PCPs, targeted member mailings, office-based Peripheral Instantaneous X-ray Imaging (PIXI) test and counseling, dual x-ray absorptiometry (DEXA) scan guidelines, and web-based Electronic Simple Calculated Osteoporosis Risk Estimation (eSCORE) questionnaire tools. Hill Physicians tabulated results for patients who completed 2649 SCORE tests, screened 978 patients with PIXI tests, and identified 338 osteopenic and 124 osteoporotic patients. The preliminary results of this unique six-year ongoing educational initiative are slow but promising. New physician offices express interest in participating and those offices that have participated in the program continue to screen for osteoporosis. Hill Physicians' message is consistent and is communicated to the physicians repeatedly in different ways in accordance with the principles of educational outreach. Physicians who have conducted the program have positive feedback from their patients and office staff and have begun to communicate their experience to their peers.

Risk management in obstetric care for family physicians: results of a 10-year project.

PubMed

Nesbitt, Thomas S; Hixon, Allen; Tanji, Jeffrey L; Scherger, Joseph E; Abbott, Dana

2003-01-01

Malpractice issues within the United States remain a critical factor for family physicians providing obstetric care. Although tort reform is being widely discussed, little has been written regarding the malpractice crisis from a risk management perspective. Between 1989 and 1998, a 10-year risk management study at the UC Davis Health System provided a unique collaboration between researchers, a mutual insurance carrier and family physicians practicing obstetrics. Physicians were asked to comply with standardized clinical guidelines, attend continuing medical education (CME) seminars, and submit obstetric medical records for review. Feedback analysis was provided to each physician on their records, and the insurance carrier tracked interim malpractice claims. One hundred and ninety-four physicians participated, attending to 32,831 births. Compliance with project guidelines was 91%. Five closed obstetric cases were reported with only one settlement reported to the National Provider Data Bank. Physicians believed the project was beneficial to their practices. Family physicians practicing obstetrics are willing to participate in a collaborative risk management program and are compliant with standardized clinical guidelines. The monetary award for successful malpractice claims was relatively low. This collaborative risk management model may offer a potential solution to the current malpractice crisis.

The Education Review Board: A Mechanism for Managing Potential Conflicts of Interest in Medical Education.

PubMed

Borus, Jonathan F; Alexander, Erik K; Bierer, Barbara E; Bringhurst, F Richard; Clark, Christopher; Klanica, Kaley E; Stewart, Erin C; Friedman, Lawrence S

2015-12-01

Concerns about the influence of industry support on medical education, research, and patient care have increased in both medical and political circles. Some academic medical centers, questioning whether industry support of medical education could be appropriate and not a conflict of interest, banned such support. In 2009, a Partners HealthCare System commission concluded that interactions with industry remained important to Partners' charitable academic mission and made recommendations to transparently manage such relationships. An Education Review Board (ERB) was created to oversee and manage all industry support of Partners educational activities.Using a case review method, the ERB developed guidelines to implement the commission's recommendations. A multi-funder rule was established that prohibits industry support from only one company for any Partners educational activity. Within that framework, the ERB established guidelines on industry support of educational conferences, clinical fellowships, and trainees' expenses for attending external educational programs; gifts of textbooks and other educational materials; promotional opportunities associated with Partners educational activities; Partners educational activities under contract with an industry entity; and industry-run programs using Partners resources.Although many changes have resulted from the implementation of the ERB guidelines, the number of industry grants for Partners educational activities has remained relatively stable, and funding for these activities declined only moderately during the first three full calendar years (2011-2013) of ERB oversight. The ERB continually educates both the Partners community and industry about the rationale for its guidelines and its openness to their refinement in response to changes in the external environment.

Effective health care corporate compliance.

PubMed

Saum, T B; Byassee, J

2000-01-01

The pace and intensity of oversight and investigation of health care organizations has greatly increased at all levels. Well run organizations with ethical management committed to following all laws and regulations are still at risk for compliance violations and punitive penalties. Under the Federal Sentencing Guidelines, organizations with an "effective" corporate compliance program may receive reduced penalties. The seven components of an effective program as defined in the guidelines are: (1) Standards and procedures; (2) oversight responsibilities; (3) employee training; (4) monitoring and auditing; (5) reporting systems; (6) enforcement and discipline; and (7) response and prevention. Lack of a compliance program needlessly exposes the organization to an avoidable risk of damage from non-compliance--whether intentional or not. Moreover, an effective program can contribute to the efficient operation of the organization and be a key piece of its corporate culture.

Apollo experience report: Very high frequency ranging system

NASA Technical Reports Server (NTRS)

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

1972-01-01

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

A patient-based study on the adherence of physicians to guidelines for the management of type 2 diabetes in Turkey.

PubMed

Satman, Ilhan; Imamoglu, Sazi; Yilmaz, Candeger

2012-10-01

To evaluate physicians' adherence to guidelines by Diabetes Study Group of The Society of Endocrinology and Metabolism of Turkey (SEMT). The medical records of 1790 patients with type 2 diabetes (mean age, 58.7 ± 10.9 years; diabetes duration, 7.7 ± 7.5 years) followed by 180 physicians during last 12 months were reviewed. Adherence to SEMT guidelines was analysed under medical history, physical examination and laboratory evaluations subheadings, each scored on a 10-point scale. Effects of patients' age, gender, diabetes duration, body mass index, chronic complications, physicians' specialty and institution on guideline adherence were evaluated. Follow-up procedures were >75% compliant for 52% of patients. Full adherence to medical history, physical examination and laboratory aspects of SEMT guidelines were met in 68.6%, 8.3% and 19.2% of patients, respectively. Older patients and males fared better for laboratory evaluations. All aspects of guideline adherence were poor in patients with short duration of diabetes and in the absence of chronic complications. State institutions and family practitioners had lower adherence scores for physical examination and laboratory evaluation. Overall guideline adherence of physicians was suboptimal. Educational programs emphasizing the preventive aspect of diabetes management, targeted towards family practitioners and state institutions, may improve guideline adherence and patient outcome. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Wilderness monitoring and data management

USGS Publications Warehouse

Riebau, A. R.

1994-01-01

In the last decade, increased public interest in natural areas has resulted in increased monitoring activity by federal wilderness managers to assess the status of wilderness values. Wilderness values are those large-scale entities of wilderness which comprise, in sum, wilderness character. Data collected through wilderness monitoring must support the maintenance of wilderness values. Wilderness monitoring must include the development of clear data management strategies and provisions for hypothesis testing. Unfortunately, some monitoring programs do not support the status assessment of wilderness values. Often wilderness monitoring programs have neglected even the most rudimentary principles of data management. This paper presents a model for wilderness monitoring, guidelines for data management, and an overview of a PC-compatible wilderness monitoring data base, the Monitoring Information Data Analysis System (MIDAS).

Getting Down to Business.

ERIC Educational Resources Information Center

Dessoff, Alan L.

1995-01-01

This article presents five basic guidelines for initiating a successful alumni merchandising program: (1) shop around for the best vendor; (2) decide what to sell; (3) manage merchandise properly; (4) watch out for risky business; and (5) get what you pay for. (MDM)

48 CFR 323.7100 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ENVIRONMENT, ENERGY AND WATER EFFICIENCY, RENEWABLE ENERGY TECHNOLOGIES, OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Green Purchasing Requirements 323.7100 Policy. (a) The HHS guidelines and procedures for “green... Program Managers, are responsible for establishing the necessary local procedures and appropriate training...

Assessment of data quality and reporting systems for underserved populations: the case of integrated community case management programs in Nigeria.

PubMed

Nyangara, Florence M; Hai, Tajrina; Zalisk, Kirsten; Ozor, Lynda; Ufere, Joy; Isiguzo, Chinwoke; Abubakar, Ibrahim Ndaliman

2018-05-01

Decision makers are searching for reliable data and best practices to support the implementation and scale-up of the integrated community case management (iCCM) programs in underserved areas to reduce under-five mortality in low-income countries. This study assesses data quality and reporting systems of the World Health Organization supported Rapid Access Expansion program implementing iCCM in Abia and Niger States, Nigeria. This cross-sectional study used data from 16 primary health facilities in both states. Data were collected through review of registers and monthly summary reports of 140 community-oriented resource persons (CORPs), assessments of the five dimensions of the data reporting systems and 46 key informant interviews with stakeholders. Data quality was assessed by availability, completeness and consistency. Each component of the reporting system was assessed on a 3-point scale (weak, satisfactory and strong). Results show that both the structure, functions and capabilities, as well as data collection and reporting tools dimensions of the reporting system were strong, scoring (2.80, 2.73) for Abia and (2.88, 2.75) for Niger, respectively. Data management processes and links with national reporting system components scored low 2 s, indicating fair strength. Data availability, completeness and consistency were found to be good, an indication of adequate training and supervision of CORPs and community health extension workers. Indicator definitions and reporting guidelines were the weakest dimension of the system due to lack of data reporting guidelines in both states. In conclusion, the results indicate satisfactory data reporting systems and good quality data during early implementation of iCCM programs in the two states. Hence, countries planning to adopt and implement iCCM programs should first develop structures, establish national standardized tools for collecting and reporting data, provide for adequate training and supervision of community health workers and develop reporting guidelines for all reporting levels to ensure data quality.

What's next for dyslipidemia management? The 2013 ACC/AHA Guidelines, the NLA recommendations, and beyond.

PubMed

Waite, Laura H; Phan, Yvonne L; Spinler, Sarah A

2016-01-01

To compare and contrast the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines and the 2014/2015 National Lipid Association (NLA) Recommendations for Management of Dyslipidemia in the context of evolving evidence. Guidelines from the National Cholesterol Education Program (NCEP), ACC/AHA, and NLA; recent clinical trials involving non-statin therapies. Not applicable. At the authors' discretion, preference was given to references focusing on guidelines and recent clinical trials involving dyslipidemia management. In late 2013, the ACC/AHA released guidelines on the treatment of blood cholesterol to reduce risk for atherosclerotic cardiovascular disease (ASCVD) in adults. Reflecting contemporary evidence-based literature, low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) numeric treatment goals were eliminated, and a new method of risk assessment (the Pooled Cohort Equations) was recommended. The guidelines emphasized lipid lowering in 4 patient populations proven to benefit from statin therapy, recommending moderate to high-intensity statin dosing, with no additional drug therapies and limited ongoing monitoring. Clinical controversies ignited by these guidelines led to the publication of recommendations by the NLA in 2014 and 2015. Part 1 of the NLA recommendations incorporated parts of both the ATP III guidelines and the 2013 ACC/AHA guidelines along with updated original recommendations. These recommendations provided numeric LDL-C, non-HDL-C, and apolipoprotein B treatment goals and potential additional ASCVD risk factors, with stepwise risk assessment based on traditional cardiac risk factors and multiple assessment tools. In addition to statins, the 2014 NLA recommendations highlighted the benefit of additional or alternative lipid-lowering therapies. Part 2 of the NLA recommendations expanded the guidance for treatment of special populations and prioritized ezetimibe as a non-statin agent based on recent evidence. Finally, the US Food and Drug Administration recently approved 2 medications from a new class, the PCSK9 inhibitors, although their role in therapy remains unclear pending outcomes data. We aim to highlight the core recommendations of recent guideline publications and to discuss similarities and differences in the context of the future management of dyslipidemia. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Effects of a german asthma disease management program using sickness fund claims data.

PubMed

Windt, Roland; Glaeske, Gerd

2010-08-01

The purpose of this study was to assess outcomes of a nationwide asthma disease management (DM) program in Germany. A retrospective observational study with propensity-score matching was performed using claims data of sickness funds exclusively. Effects were analyzed on the basis of a match of 317 program participants and nonparticipants with similar propensity score and age. Hospitalization or oral corticosteroid user rates were comparable in both groups, whereas there are significantly more subjects in the DM group with a prescription of an inhaled corticosteroid and fewer with a prescription of a cromolyn/reproterol combination. There are also less "doctor hoppers" in the DM group, defined as subjects with antiasthmatic drug prescriptions of at least three physicians. The results suggest that the impact of a nationwide disease management program for asthma is weak in respect of clinically relevant endpoints, but there are indications that medication in a DM program approximates asthma guidelines more closely.

Multifamily Retrofit Project Manager Job/Task Analysis and Report: September 2013

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

Owens, C. M.

The development of job/task analyses (JTAs) is one of three components of the Guidelines for Home Energy Professionals project and will allow industry to develop training resources, quality assurance protocols, accredited training programs, and professional certifications. The Multifamily Retrofit Project Manager JTA identifies and catalogs all of the tasks performed by multifamily retrofit project managers, as well as the knowledge, skills, and abilities (KSAs) needed to perform the identified tasks.

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

PubMed Central

Van der Wees, Philip J; Hendriks, Erik JM; Custers, Jan WH; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-01-01

Background Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Method Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Results Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. Conclusion As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program. PMID:18036215

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy.

PubMed

Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-11-23

Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program.

NPS TINYSCOPE Program Management

DTIC Science & Technology

2010-09-01

SMDC - Space and Missile Defense Command SOW - Statement of Work STEM - Science, Technology, Engineering and Mathematics STP - Space Test Program...the project. A statement of work ( SOW ) is typically used to document broad responsibilities, deliverables, and the work activities required in a...given project. The SOW acts as a guideline Summary of TINYSCOPE and Argus Requirements Requirement Threshold Objective Mission IOC Sep 2011 ASAP

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

PubMed

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

2015-01-01

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

The 1984 ASEE-NASA summer faculty fellowship program (aeronautics and research)

NASA Technical Reports Server (NTRS)

Dah-Nien, F.; Hodge, J. R.; Emad, F. P.

1984-01-01

The 1984 NASA-ASEE Faculty Fellowship Program (SFFP) is reported. The report includes: (1) a list of participants; (2) abstracts of research projects; (3) seminar schedule; (4) evaluation questionnaire; and (5) agenda of visitation by faculty programs committee. Topics discussed include: effects of multiple scattering on laser beam propagation; information management; computer techniques; guidelines for writing user documentation; 30 graphics software; high energy electron and antiproton cosmic rays; high resolution Fourier transform infrared spectrum; average monthly annual zonal and global albedos; laser backscattering from ocean surface; image processing systems; geomorphological mapping; low redshift quasars; application of artificial intelligence to command management systems.

Los Angeles congestion reduction demonstration (Metro ExpressLanes) program. National evaluation : safety data test plan.

DOT National Transportation Integrated Search

1999-07-01

This document presents human factors guidelines for designers, owners operators, and planners involved in the development and operation of traffic management centers. Dimensions of the work environment affecting operator and system performance are ad...

Ideas for Directors.

ERIC Educational Resources Information Center

Child Care Information Exchange, 1989

1989-01-01

Presents a variety of ideas and guidelines for day care directors on such topics as managing a procrastinator; improving annual reports; quality commandments; mini fiestas for children, parents, and teachers; selective reading for directors; morning exercise programs for the staff; and suggestions for successful fundraising. (BB)

Development of an accommodative smartphone app for medical guidelines in pediatric emergencies.

PubMed

Schmucker, Michael; Heid, Jörn; Haag, Martin

2014-01-01

One of the outcomes of a training concept for physicians and nurses concerning pediatric emergencies at the Heidelberg University Hospital was that the work and procedures in childhood emergencies could be simplified by replacing the existing paper-based guidelines with a smartphone app. Since the project funds for this were already used up, a group of students from the master program "Medical Informatics" of Heidelberg and Heilbronn Universities took over the development of the app. Particular attention was given to the need for compatibility with the variety of devices (device size and screen resolution) and platform independence. The guidelines themselves were scripted in HTML5, JavaScript and CSS (responsive web design); managed by a container programmed in Sencha Touch. Even though the app is not yet available in the App-Store due to the limited timeframe, the students gained a great deal of valuable experience in developing platform independent software for mobile devices.

Flexible benefits and managed care: making it work.

PubMed

Sperling, K L

1991-01-01

The concept of integrating flexible benefits and managed care may seem contradictory. Flexible benefits seek to maximize choice, while managed care attempts to restrict choice. Can these two disciplines be intertwined without delivering conflicting messages to employees? The answer is definitely yes. By following some basic ground rules in design, flexible benefits and managed care can be combined effectively in a way that is attractive to both employers and employees. This article presents some general guidelines for designing a successful "managed flex" program and raises other issues as well, including financial, administrative and communication concerns.

Guidelines for preparing a quality assurance plan for district offices of the U.S. Geological Survey

USGS Publications Warehouse

Schroder, L.J.; Shampine, W.J.

1992-01-01

The U.S. Geological Survey has a policy that requires each District office to prepare a Quality Assurance Plan. This plan is a combination of a District's management principles and quality assurance processes. The guidelines presented in this report provide a framework or expanded outline that a District can use to prepare a plan. Parti- cular emphasis is given to a District's: (1) quality assurance policies; (2) organization and staff responsibilities; and (3) program and project planning. The guidelines address the 'how', 'what', and 'who' questions that need to be answered when a District Quality Assurance Plan is prepared.

Reducing environmental noise impacts: A USAREUR noise management program handbook

NASA Astrophysics Data System (ADS)

Feather, Timothy D.; Shekell, Ted K.

1991-06-01

Noise pollution is a major environmental problem faced by the U.S. Army in Europe. Noise-related complaints from German citizens can escalate into intense political issues in German communities. This in turn hampers efficient operation of military training and often times threatens the Army's mission. In order to remedy these problems, USAREUR has developed a noise management program. A successful noise management program will limit the impact of unavoidable noise on the populace. This report, a component of the noise management program, is a reference document for noise management planning. It contains guidelines and rules-of-thumb for noise management. This document contains procedures which operation and training level personnel can understand and apply in their day to day noise management planning. Noise mitigation tips are given. Basic technical information that will aid in understanding noise mitigation is provided along with noise management through land use planning. Noise management for specific components of the military community, (airfields, base operations, training areas, and housing and recreation areas) are addressed. The nature of noise generated, means of noise abatement at the source, path, and receiver (both physical and organizational/public relations methods), and a case study example are described.

Does your equipment maintenance management program measure up?

PubMed

Deinstadt, Deborah C

2003-01-01

Identifying a clear maintenance philosophy is the first step toward choosing the right program for your healthcare organization. The second step is gaining a clear understanding of how proposed savings and improvements will be delivered. The third and last step is requiring that the proposed company or manager have specific tools in place for measuring and analyzing program performance. There are three primary philosophies underlying current equipment management options. These include risk-transfer philosophy (e.g., maintenance insurance, service contracts, multi-vendor and outsource programs), asset management philosophy (e.g., programs delivering a management system based on managed time-and-materials), and internal management (in-house managed programs). The last step in selecting the right program is insisting that proper performance measurements be built into the proposed management program. A well-managed program provides results in three general areas: financial outcomes, operational improvements and process improvements. Financial outcomes are the easiest to measure. Operational and process improvements are more challenging to assess but equally important to the program's overall success. To accurately identify results in these three areas, the overall management program should measure the following eight separate components: procedures and support for department staff; equipment inventory, benchmark costs, and budget guidelines; experienced equipment support team; objective, independent analysis of maintenance events; repair documentation and reporting; vendor relations; equipment acquisition analysis; and recommendations for improvement. Do everything you reasonably can to assure that the selected company can work side-by-side with you, providing objective, measurable advice that is ultimately in your best interest. You will then know that you have been thorough in your marketplace selection and can confidently move into implementation, expecting tangible and successful results.

[Practice guidelines for pain management in Mexico].

PubMed

Guevara-López, Uriah; Covarrubias-Gómez, Alfredo; Rodríguez-Cabrera, Rafael; Carrasco-Rojas, Antonio; Aragón, Griselda; Ayón-Villanueva, Hortensia

2007-01-01

It has been documented that pain, in its diverse modalities, is the most common cause of medical attention in Mexico. Due to the increased frequency, pain management has been under consideration in health programs. On the other hand, inadequate pain management can cause severe physical, psychoaffective, and socioeconomic repercussions for patients, families, and public health services. Despite this panorama, there has been no agreement to establish better diagnostic and therapeutic methods. Three consensus groups were reunited in different times; those were integrated by medical experts from private and public institutions and form diverse states of the Mexican Republic. To assure the development of these practice guidelines, these experts had experience in the assessment and treatment of painful conditions. Following the methodology used for other consensus groups, diverse meetings were held to review medical evidence about the assessment and treatment of acute, perioperative and cancer pain. A series of recommendations were obtained and classified according to their methodological strength. As a result of these meetings, a series of recommendations based on the medical evidence were obtained. These recommendations are outlined in three practice guidelines that are intended to allow Mexican practitioners to provide optimal management for painful conditions.

How can primary care providers manage pediatric obesity in the real world?

PubMed

Hopkins, Kristy F; Decristofaro, Claire; Elliott, Lydia

2011-06-01

To provide information regarding evidence-based interventions and clinical practice guidelines as a basis for a clinical toolkit utilizing a step management approach for the primary care provider in managing childhood obesity. Evidence-based literature including original clinical trials, literature reviews, and clinical practice guidelines. Interventions can be stratified based on initial screening of children and adolescents so that selection of treatment options is optimized. For all treatments, lifestyle modifications include attention to diet and activity level. Levels of initial success, as well as maintenance of target body mass index, may be related to the intensity and duration of interventions; involvement of family may increase success rates. For failed lifestyle interventions, or for patients with extreme obesity and/or certain comorbidities, pharmacologic or surgical options should be considered. Many intensive programs have shown success, but the resources required for these approaches may be unavailable to the typical community provider and family. However, using current guidelines, the primary care provider can initiate and manage ongoing interventions in pediatric obesity. A toolkit for primary care implementation and maintenance interventions is provided. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

Orientaciones Tecnicas para el Mejoramiento de la Administracion Educacional--Necesidades, Posibilidades y Perspectivas (Technical Guidelines on the Improvement of Educational Administration--Needs, Possibilities, and Perspectives).

ERIC Educational Resources Information Center

Valle, Victor M.

The success of development programs in educational systems is dependent, to a large extent, on the quality and relevancy of their management. Many worthwhile, well conceived and planned educational reforms have failed due to poor management. Therefore, both ministries of education and international organizations of technical cooperation have…

Guidelines for Preventing Workplace Violence for Health Care and Social Service Workers

DTIC Science & Technology

1998-01-01

commitment, including the endorse- ment and visible involvement of top management , provides the motivation and resources to deal effec- tively with workplace...program to ensure that all managers , supervisors, and employ- ees understand their obligations. • Appropriate allocation of authority and resources to...operations, employee assistance, security, occupational safety and health, legal, and human resources staff. The team or coordinator can review injury

Achieving Success in Small Business: A Self-Instruction Program for Small Business Owner-Managers. Developing Ads That Produce Results.

ERIC Educational Resources Information Center

Virginia Polytechnic Inst. and State Univ., Blacksburg. Div. of Vocational-Technical Education.

This self-instructional module on developing ads that produce results is the sixth in a set of twelve modules designed for small business owner-managers. Competencies for this module are (1) identify three guidelines to be considered when you invest money in advertising, (2) identify the five basic elements of a printed advertisement, and (3)…

Standards guide for space and earth sciences computer software

NASA Technical Reports Server (NTRS)

Mason, G.; Chapman, R.; Klinglesmith, D.; Linnekin, J.; Putney, W.; Shaffer, F.; Dapice, R.

1972-01-01

Guidelines for the preparation of systems analysis and programming work statements are presented. The data is geared toward the efficient administration of available monetary and equipment resources. Language standards and the application of good management techniques to software development are emphasized.

Guidelines for the prevention of ventilator-associated pneumonia and their implementation. The Spanish "Zero-VAP" bundle.

PubMed

Álvarez Lerma, F; Sánchez García, M; Lorente, L; Gordo, F; Añón, J M; Álvarez, J; Palomar, M; García, R; Arias, S; Vázquez-Calatayud, M; Jam, R

2014-05-01

"Zero-VAP" is a proposal for the implementation of a simultaneous multimodal intervention in Spanish intensive care units (ICU) consisting of a bundle of ventilator-associated pneumonia (VAP) prevention measures. An initiative of the Spanish Societies of Intensive Care Medicine and of Intensive Care Nurses, the project is supported by the Spanish Ministry of Health, and participation is voluntary. In addition to guidelines for VAP prevention, the "Zero-VAP" Project incorporates an integral patient safety program and continuous online validation of the application of the bundle. For the latter, VAP episodes and participation indices are entered into the web-based Spanish ICU Infection Surveillance Program "ENVIN-HELICS" database, which provides continuous information about local, regional and national VAP incidence rates. Implementation of the guidelines aims at the reduction of VAP to less than 9 episodes per 1000 days of mechanical ventilation. A total of 35 preventive measures were initially selected. A task force of experts used the Grading of Recommendations, Assessment, Development and Evaluation Working Group methodology to generate a list of 7 basic "mandatory" recommendations (education and training in airway management, strict hand hygiene for airway management, cuff pressure control, oral hygiene with chlorhexidine, semi-recumbent positioning, promoting measures that safely avoid or reduce time on ventilator, and discouraging scheduled changes of ventilator circuits, humidifiers and endotracheal tubes) and 3 additional "highly recommended" measures (selective decontamination of the digestive tract, aspiration of subglottic secretions, and a short course of iv antibiotic). We present the Spanish VAP prevention guidelines and describe the methodology used for the selection and implementation of the recommendations and the organizational structure of the project. Compared to conventional guideline documents, the associated safety assurance program, the online data recording and compliance control systems, as well as the existence of a pre-defined objective are the distinct features of "Zero VAP". Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Evaluation Guidelines for the Clinical and Translational Science Awards (CTSAs)

PubMed Central

Rubio, Doris M.; Thomas, Veronica G.

2013-01-01

Abstract The National Center for Advancing Translational Sciences (NCATS), a part of the National Institutes of Health, currently funds the Clinical and Translational Science Awards (CTSAs), a national consortium of 61 medical research institutions in 30 states and the District of Columbia. The program seeks to transform the way biomedical research is conducted, speed the translation of laboratory discoveries into treatments for patients, engage communities in clinical research efforts, and train a new generation of clinical and translational researchers. An endeavor as ambitious and complex as the CTSA program requires high‐quality evaluations in order to show that the program is well implemented, efficiently managed, and demonstrably effective. In this paper, the Evaluation Key Function Committee of the CTSA Consortium presents an overall framework for evaluating the CTSA program and offers policies to guide the evaluation work. The guidelines set forth are designed to serve as a tool for education within the CTSA community by illuminating key issues and practices that should be considered during evaluation planning, implementation, and utilization. Additionally, these guidelines can provide a basis for ongoing discussions about how the principles articulated in this paper can most effectively be translated into operational reality. PMID:23919366

Workplace Violence Training Programs for Health Care Workers: An Analysis of Program Elements.

PubMed

Arbury, Sheila; Hodgson, Michael; Zankowski, Donna; Lipscomb, Jane

2017-06-01

Commercial workplace violence (WPV) prevention training programs differ in their approach to violence prevention and the content they present. This study reviews 12 such programs using criteria developed from training topics in the Occupational Safety and Health Administration's (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers and a review of the WPV literature. None of the training programs addressed all the review criteria. The most significant gap in content was the lack of attention to facility-specific risk assessment and policies. To fill this gap, health care facilities should supplement purchased training programs with specific training in organizational policies and procedures, emergency action plans, communication, facility risk assessment, and employee post-incident debriefing and monitoring. Critical to success is a dedicated program manager who understands risk assessment, facility clinical operations, and program management and evaluation.

Implementing practice guidelines: lessons from public mental health settings.

PubMed

Parks, Joseph J

2007-01-01

There is evidence that state-of-the-art psychiatric treatments are not being translated into community settings, resulting in the de facto denial of up-to-date psychiatric care for many Americans with mental illness. Although multiple models of evidence-based care exist, little is known about how to disseminate information regarding these models to clinicians in real-world practice. Suggested solutions have included the use of published practice guidelines, such as the American Psychiatric Association Practice Guidelines and the Expert Consensus Guidelines, or algorithm-based programs, such as the Texas Medication Algorithm Project. Unfortunately, the real-world utility of practice guidelines tends to be limited, because their implementation depends entirely on practitioner self-motivation. Similarly, the use of algorithm-based programs may be limited by their pervasive high specificity, practitioner resistance, and various patient misperceptions. Another solution is the implementation of evidence-based practices (EBPs), such as the Substance Abuse and Mental Health Services Administration (SAMHSA) EBPs. However, states' use of the SAMHSA EBPs has been hampered by misalignment of the funding structure, lack of information regarding EBPs, high costs to train and supervise staff, staff turnover, and a lack of resources. As a result, federal and clinical/professional agencies have called for a change in the nation's mental health care delivery system, supplying persuasive arguments for the economic and clinical superiority of integrated care models. One such model, the Missouri Medical Risk Management (MRM) Program for Medicaid Recipients with Schizophrenia, currently assists patients identified as being at high risk for adverse medical and behavioral outcomes. Preliminary results from the Missouri MRM Program are described.

Implementing a resource management program for accreditation process at the medical laboratory.

PubMed

Yenice, Sedef

2009-03-01

To plan for and provide adequate resources to meet the mission and goals of a medical laboratory in compliance with the requirements for laboratory accreditation by Joint Commission International. The related policies and procedures were developed based on standard requirements for resource management. Competency assessment provided continuing education and performance feedback to laboratory employees. Laboratory areas were designed for the efficient and safe performance of laboratory work. A physical environment was built up where hazards were controlled and personnel activities were managed to reduce the risk of injuries. An Employees Occupational Safety and Health Program (EOSHP) was developed to address all types of hazardous materials and wastes. Guidelines were defined to verify that the methods would produce accurate and reliable results. An active resource management program will be an effective way of assuring that systems are in control and continuous improvement is in progress.

Challenges in knowledge translation: the early years of Cancer Care Ontario's Program in Evidence-Based Care.

PubMed

Browman, G P

2012-02-01

Cancer Care Ontario's Program in Evidence-Based Care (pebc) was formalized in 1997 to produce clinical practice guidelines for cancer management for the Province of Ontario. At the time, the gap between guideline development and implementation was beginning to be acknowledged. The Program implemented strategies to promote use of guidelines. The program had to overcome numerous social challenges to survive. Prospective strategies useful to practitioners-including participation, transparent communication, a methodological vision, and methodology skills development offerings-were used to create a culture of research-informed oncology practice within a broad community of practitioners.Reactive strategies ensured the survival of the program in the early years, when some within the influential academic community and among decision-makers were skeptical about the feasibility of a rigorous methodologic approach meeting the fast turnaround times necessary for policy. The paper details the pebc strategies within the context of what was known about knowledge translation (kt) at the time, and it tries to identify key success factors. Many of the barriers faced in the implementation of kt-and the strategies for overcoming them-are unavailable in the public domain because the relevant reporting does not fit the traditional paradigm for publication. Telling the "stories behind the story" should be encouraged to enhance the practice of kt beyond the science.

HerzMobil Tirol network: rationale for and design of a collaborative heart failure disease management program in Austria.

PubMed

Von der Heidt, Andreas; Ammenwerth, Elske; Bauer, Karl; Fetz, Bettina; Fluckinger, Thomas; Gassner, Andrea; Grander, Willhelm; Gritsch, Walter; Haffner, Immaculata; Henle-Talirz, Gudrun; Hoschek, Stefan; Huter, Stephan; Kastner, Peter; Krestan, Susanne; Kufner, Peter; Modre-Osprian, Robert; Noebl, Josef; Radi, Momen; Raffeiner, Clemens; Welte, Stefan; Wiseman, Andreas; Poelzl, Gerhard

2014-11-01

Heart failure (HF) is approaching epidemic proportions worldwide and is the leading cause of hospitalization in the elderly population. High rates of readmission contribute substantially to excessive health care costs and highlight the fragmented nature of care available to HF patients. Disease management programs (DMPs) have been implemented to improve health outcomes, patient satisfaction, and quality of life, and to reduce health care costs. Telemonitoring systems appear to be effective in the vulnerable phase after discharge from hospital to prevent early readmissions. DMPs that emphasize comprehensive patient education and guideline-adjusted therapy have shown great promise to result in beneficial long-term effects. It can be speculated that combining core elements of the aforementioned programs may substantially improve long-term cost-effectiveness of patient management.We introduce a collaborative post-discharge HF disease management program (HerzMobil Tirol network) that incorporates physician-controlled telemonitoring and nurse-led care in a multidisciplinary network approach.

Disease management programs for heart failure: not just for the 'sick' heart failure population.

PubMed

McDonald, Ken; Conlon, Carmel; Ledwidge, Mark

2007-02-01

The development of disease management programs has been a major advance in heart failure care, bringing about significant improvements for the heart failure population, with reduction in readmission, better use of guideline therapy and improved survival. However, at present, the majority of such programs focus their attention only on the sicker segment of this population, with little application of this important service to the broader heart failure population, where potentially benefits may be even more impressive. This has led to an imbalance in the care of patients with heart failure, where aspects of management such as regular structured review and education are preferentially given to the group at the later stages of the natural history of the syndrome. This paper argues for a far wider application of the disease management program concept in heart failure care so as to bring the benefits of specialist care, patient education and follow-up to patients at an earlier stage in the natural history of heart failure.

Value-based insurance plus disease management increased medication use and produced savings.

PubMed

Gibson, Teresa B; Mahoney, John; Ranghell, Karlene; Cherney, Becky J; McElwee, Newell

2011-01-01

We evaluated the effects of implementing a value-based insurance design program for patients with diabetes in two groups within a single firm. One group participated in disease management; the other did not. We matched members of the two groups to similar enrollees within the company that did not offer the value-based program. We found that participation in both value-based insurance design and disease management resulted in sustained improvement over time. Use of diabetes medications increased 6.5 percent over three years. Adherence to diabetes medical guidelines also increased, producing a return on investment of $1.33 saved for every dollar spent during a three-year follow-up period.

78 FR 28137 - Exchange Visitor Program-Fees and Charges

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... following the guidelines set forth in Office of Management and Budget (OMB) Circular A-25 regarding such fee... allowed so that academic institutions could properly budget for the 47% increase in the application fee... efficiency and enhance the office's customer service. Five [[Page 28138

Increased Rail Transit Vehicle Crashworthiness in Head-On Collisions. Volume III. Guidelines for Evaluation and Development of New Railcar Designs.

DOT National Transportation Integrated Search

1980-06-01

As systems manager for the Urban Mass Transportation Administration (UMTA) Rail System Supporting Technology Program, the Transportation Systems Center (TSC) is conducting research and development efforts directed toward the introduction of improved ...

77 FR 5155 - Interest Rate Risk Policy and Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-02

... directors and management; appropriate IRR measurement and monitoring systems; good internal controls; and informed decision-making based on IRR measurement system results. It also provides guidelines for... technical aspects of IRR measurement methods. Of these, some said Appendix B implied a preference for the...

Energy Management in Schools.

ERIC Educational Resources Information Center

Canadian School Trustees Association, Ottawa (Ontario).

This booklet provides the basic information for starting an energy conservation program. Guidelines for involving all school personnel and promoting energy conservation throughout the entire Canadian education system are provided. Outlined in the booklet are methods for climate proofing the building envelope and making the system air tight,…

A Planning Process and the Integration of Institutional Research.

ERIC Educational Resources Information Center

Spencer, R.; And Others

Consisting mainly of charts, graphs, and lists, this publication presents materials used in the Delaware County Community College (DCCC) planning and institutional research processes. Guidelines for establishing DCCC mission, goals, objectives, and management by objectives performance standards relative to planning changes, instructional programs,…

Developing International Links through Work Exchange. An Exchange between Australia and Canada.

ERIC Educational Resources Information Center

Williams, Rosie

2001-01-01

Describes a work exchange experience between volunteer managers in Australia and Canada. Offers guidelines for initiating the program including developing a rationale and an exchange agreement. Discusses first impressions, initial problems, and differences and similarities between the two contexts. (JOW)

A novel Web-based graduate medical education management system including ACGME compliance algorithms.

PubMed

Gauger, Paul G; Davis, Janice W; Orr, Peter J

2002-09-01

Administration of graduate medical education programs has become more difficult as compliance with ACGME work guidelines has assumed increased importance. These guidelines have caused many changes in the resident work environment, including the emergence of complicated cross-cover arrangements. Many participating residents (each with his or her own individual scheduling requirements) usually generate these schedules. Accordingly, schedules are often not submitted in a timely fashion and they may not be in compliance with the ACGME guidelines for maximum on-call assignments and mandatory days off. Our objective was the establishment of a Web-based system that guides residents in creating on-call schedules that follow ACGME guidelines while still allowing maximum flexibility -- thus allowing each resident to maintain an internal locus of control. A versatile and scalable system with password-protected user (resident) and administrator interfaces was created. An entire academic year is included, and past months and years are automatically archived. The residents log on within the first 15 days of the preceding month and choose their positions in a schedule template. They then make adjustments while receiving immediate summary feedback on compliance with ACGME guidelines. The schedule is electronically submitted to the educational administrator for final approval. If a cross-cover system is required, the program automatically generates an optimal schedule using both of the approved participating service schedules. The residents then have an additional five-day period to make adjustments in the cross-cover schedule while still receiving compliance feedback. The administrator again provides final approval electronically. The communication interface automatically pages or e-mails the residents when schedules are updated or approved. Since the information exists in a relational database, simple reporting tools are included to extract the information necessary to generate records for institutional GME management. Implementation of this program has been met with great enthusiasm from the institutional stakeholders. Specifically, residents have embraced the ability to directly control their schedules and have gained appreciation for the regulatory matrix in which they function. Institutional administrators have praised the improvement in compliance and the ease of documentation. We anticipate that the system will also meet with approval from reviewing regulatory bodies, as it generates and stores accurate information about the resident work environment. This program is robust and versatile enough to be modified for any GME training program in the country.

Advanced Practice Internship: Experiential Learning in a Drug Use and Disease State Management Program

PubMed Central

Skledar, Susan J.; McKaveney, Teresa P.; Ward, Charles O.; Culley, Colleen M.; Ervin, Kelly C.; Weber, Robert J.

2006-01-01

Objective Establish a 3-year hospital internship within a drug use and disease state management program that would provide doctor of pharmacy students with experiential learning while still completing their classroom studies. Design As paid interns, students engaged in group and individual activities that assessed clinical practice guidelines. Patient monitoring and clinical intervention techniques were learned through prospective evaluation of drug therapy. Students designed evidence-based treatment guidelines and participated in all phases of development, including multidisciplinary approval, implementation, and evaluation stages. Assessment Student competency was continually monitored through direct observation by a preceptor and written examinations. Patient case studies, group discussions, and poster presentations allowed assessment of student growth in knowledge and communication skills. Conclusion The comprehensive structure of this internship provides a broad perspective for understanding the role of the hospital pharmacist in providing pharmaceutical care. Close supervision maximizes student learning potential and fosters a mentoring relationship for both personal and professional growth. PMID:17136188

Primary care physicians' utilization of type 2 diabetes screening guidelines and referrals to behavioral interventions: a survey-linked retrospective study.

PubMed

Mehta, Sandhya; Mocarski, Michelle; Wisniewski, Tami; Gillespie, Karin; Narayan, K M Venkat; Lang, Kathleen

2017-01-01

To assess primary care physicians' (PCPs) knowledge of type 2 diabetes screening guidelines (American Diabetes Association (ADA) and 2008 US Preventive Services Task Force (USPSTF)), the alignment between their self-reported adherence and actual practice, and how often PCPs recommended diabetes prevention and self-management education programs (DPP/DSME). An online survey of PCPs to understand knowledge and adherence toward use of USPSTF/ADA guidelines and recommendation of DPP/DSME. Patient data from electronic medical records (EMRs) for each PCP were used to identify rates of screening in eligible patients as per guidelines and the two sources were compared to assess concordance. Of 305 surveyed physicians, 38% reported use of both guidelines (33% use ADA only, 25% USPSTF only). Approximately one-third of physicians who reported use of USPSTF/ADA guidelines had non-concordant EMR data. Similarly, while most PCPs reported they are 'very likely' to screen patients with risk factors listed in guidelines, for each criterion at least one-fourth (24%) of PCPs survey responses were non-concordant with EMRs. PCPs reported they provide referral to DPP and DSME on average to 45% and 67% of their newly diagnosed patients with pre-diabetes and diabetes, respectively. Findings show disconnect between PCPs' perceptions of adherence to screening guidelines and actual practice, and highlight limited referrals to DPP/DSME programs. More research is needed to understand barriers to guideline consistent screening and uptake of DPP/DSME, particularly in light of recent policy changes such as the linking USPSTF criteria to reimbursement and expected Medicare DPP reimbursement in 2018.

A randomized trial of an acid-peptic disease management program in a managed care environment.

PubMed

Ofman, Joshua J; Segal, Richard; Russell, Wayne L; Cook, Deborah J; Sandhu, Meenu; Maue, Susan K; Lowenstein, Edward H; Pourfarzib, Ray; Blanchette, Erv; Ellrodt, Gray; Weingarten, Scott R

2003-06-01

To study the effectiveness of a disease management program for patients with acid-related disorders. A cluster-randomized clinical trial of 406 patients comparing a disease management program with "usual practice." Enrolled patients included those presenting with new dyspepsia and chronic users of antisecretory drugs in 8 geographically separate physician offices associated with the Orlando Health Care Group. There were 35 providers in the intervention group and 48 in the control group. The disease management program included evidence-based practice guidelines implemented by using physician champions, academic detailing, and multidisciplinary teams. Processes of care, patient symptoms, quality of life, costs, and work days lost were measured 6 months after patient enrollment. Compared with usual practice, disease management was associated with improvements in Helicobacter pylori testing (61% vs 9%; P = .001), use of recommended H pylori treatment regimens (96% vs 10%; P = .001), and discontinuation rates of proton pump therapy after treatment (70% vs 36%; P = .04). There were few differences in patient quality of life or symptoms between the 2 study groups. Disease management resulted in fewer days of antisecretory therapy (71.7 vs 88.1 days; P = .02) but no difference in total costs. This disease management program for patients with acid-related disorders led to improved processes of care. The effectiveness of such a program in other settings requires further study.

Underground storage tank management plan

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

NONE

1994-09-01

The Underground Storage Tank (UST) Management Program at the Oak Ridge Y-12 Plant was established to locate UST systems in operation at the facility, to ensure that all operating UST systems are free of leaks, and to establish a program for the removal of unnecessary UST systems and upgrade of UST systems that continue to be needed. The program implements an integrated approach to the management of UST systems, with each system evaluated against the same requirements and regulations. A common approach is employed, in accordance with Tennessee Department of Environment and Conservation (TDEC) regulations and guidance, when corrective actionmore » is mandated. This Management Plan outlines the compliance issues that must be addressed by the UST Management Program, reviews the current UST inventory and compliance approach, and presents the status and planned activities associated with each UST system. The UST Management Plan provides guidance for implementing TDEC regulations and guidelines for petroleum UST systems. (There are no underground radioactive waste UST systems located at Y-12.) The plan is divided into four major sections: (1) regulatory requirements, (2) implementation requirements, (3) Y-12 Plant UST Program inventory sites, and (4) UST waste management practices. These sections describe in detail the applicable regulatory drivers, the UST sites addressed under the Management Program, and the procedures and guidance used for compliance with applicable regulations.« less

Implementation of a solvent management program to control paint shop volatile organic compounds

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

Floer, M.M.; Hicks, B.H.

1997-12-31

The majority of automobile assembly plant volatile organic compound (VOC) emissions are generated from painting operations. Typical paint operations generate more than 90 percent of the total plant emissions and, up to, 50 percent can be released by cleaning sources. Plant practices which contribute to the release of VOC emissions include the cleaning of paint lines and equipment, tanks, spray booths, floors and vehicles. Solvents continue to be the largest contributing source of VOC emissions in an automotive paint shop. To reduce overall VOC emissions, environmental regulations and guidelines were introduced under the Clean Air Act; Pollution Prevention and Wastemore » Minimization programs, Control Techniques, and special air permit conditions. The introduction of these regulations and guidelines has driven industry toward continual refinement of their present cleaning methods while pursuing new techniques and technologies. Industry has also shown a proactive approach by introducing new waterborne and powder coating paint technologies to reduce overall emissions. As new paint technologies are developed and introduced, special attention must be given to the types of materials utilized for cleaning. The development and implementation of a solvent management program allows a facility to standardize a program to properly implement materials, equipment, technologies and work practices to reduce volatile organic compound emissions, meet strict cleaning requirements posed by new paint technologies and produce a vehicle which meets the high quality standards of the customer. This paper will assess the effectiveness of a solvent management program by examining pollution prevention initiatives and data from four different painting operations.« less

Guidelines for the Development and Implementation of a Logistic Resource Annex to the Five Year Defense Program. Volume 4. A Logistic Resource Annex for the Marine Corps Section of the DNFYP

DTIC Science & Technology

1978-10-01

Information ; Logistics Planning; Management Planning and Control; Management Information Systems; Management; Military Supplies; Acquisition; JO...Arlington, Virginia 22202 Contract DAHC 15-73C-0200 Task 78-II-1 CONTENTS GLOSSARY : v SUMMARY ix I. INTRODUCTION 1 II. MARINE CORPS SUPPORT OP...Materiel Command Navy Cost Information System/FYDP Subsystem Non-Industrial Fund Non-Telecommunications Offfice of the Assistant Secretary of Defense

Stakeholder perspectives on implementing a universal Lynch syndrome screening program: a qualitative study of early barriers and facilitators.

PubMed

Schneider, Jennifer L; Davis, James; Kauffman, Tia L; Reiss, Jacob A; McGinley, Cheryl; Arnold, Kathleen; Zepp, Jamilyn; Gilmore, Marian; Muessig, Kristin R; Syngal, Sapna; Acheson, Louise; Wiesner, Georgia L; Peterson, Susan K; Goddard, Katrina A B

2016-02-01

Evidence-based guidelines recommend that all newly diagnosed colon cancer be screened for Lynch syndrome (LS), but best practices for implementing universal tumor screening have not been extensively studied. We interviewed a range of stakeholders in an integrated health-care system to identify initial factors that might promote or hinder the successful implementation of a universal LS screening program. We conducted interviews with health-plan leaders, managers, and staff. Interviews were audio-recorded and transcribed. Thematic analysis began with a grounded approach and was also guided by the Practical Robust Implementation and Sustainability Model (PRISM). We completed 14 interviews with leaders/managers and staff representing involved clinical and health-plan departments. Although stakeholders supported the concept of universal screening, they identified several internal (organizational) and external (environment) factors that promote or hinder implementation. Facilitating factors included perceived benefits of screening for patients and organization, collaboration between departments, and availability of organizational resources. Barriers were also identified, including: lack of awareness of guidelines, lack of guideline clarity, staffing and program "ownership" concerns, and cost uncertainties. Analysis also revealed nine important infrastructure-type considerations for successful implementation. We found that clinical, laboratory, and administrative departments supported universal tumor screening for LS. Requirements for successful implementation may include interdepartmental collaboration and communication, patient and provider/staff education, and significant infrastructure and resource support related to laboratory processing and systems for electronic ordering and tracking.

Policy guidelines for collective bargaining and family planning.

PubMed

Finnigan, O D; Parulan, D

1973-01-01

The benfits of establishing family planning through collective bargaining to both labor and management are discussed. Until workers can be convinced that their children will receive health care, education and employment, and that they will be economically secure in old age, it is difficult to convince them of the many benefits of child spacing and small family size. In 1953, it was calculated by management in a Japanese steel factory that about 70% of all acidents could be attributable to difficulties in the private lives of employees. In order to ease problems in the home, collective agreements were initiated by management in the Nippon Express Company to provide family planning services. Labor agreed as long as the workers were to share in the economic awards which came from participation. Costs of implementing the family planning programs were fully offset by the decrease in expenditure on family allowances, confinement, nursing, and so on. In India some ten estates began a program in which a certain amount of money is paid into an account for every month that a woman does not become pregnant. If the woman becomes pregnant, she forfeits a substantial amount of the fund. This money comes directly from the funds which would normally have to be set aside to provide for maternity and child support programs. Certain guidelines are presented in the paper to outline the areas of responsibility of labor and management in the provision of family planning services. Among the many possibilities mentioned is the idea that both labor and management could look into the conceivability of plowing back a portion of whatever savings are accrued by management into a pension scheme to compensate workers for the loss of labor caused by having fewer children than were previously anticipated.

Medicare's chronic care improvement pilot program: what is its potential?

PubMed

Super, Nora

2004-05-10

This paper describes the voluntary chronic care improvement program under traditional fee-for-service Medicare as authorized by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 (Public Law 108-173; section 721). This brief analyzes the emerging issues raised by this new program, including which chronic conditions and regional areas will be targeted, the types of entities that may participate, the physician's role in care management, and the adoption and use of health information technology and evidence-based clinical guidelines.

Development of a self-management program for employees with complaints of the arm, neck, and/or shoulder: an intervention mapping approach.

PubMed

Hutting, Nathan; Detaille, Sarah I; Engels, Josephine A; Heerkens, Yvonne F; Staal, J Bart; Nijhuis-van der Sanden, Maria Wg

2015-01-01

To develop a self-management program with an additional eHealth module, using the six steps of the intervention mapping (IM) protocol, to help employees with complaints of the arm, neck, and/or shoulder (CANS) cope with their problems. In Step 1 of the IM protocol, a needs assessment was performed consisting of a review of the Dutch multidisciplinary guidelines on CANS, and of focus group sessions with employees with CANS (n=15) and with relevant experts (n=17). After the needs assessment, the objectives of the intervention and the determinants of self-management at work were formulated (Step 2). Furthermore, theory-based intervention methods and practical strategies were selected (Step 3), and an intervention program (including the eHealth module) was developed (Step 4). Finally, plans for implementation and evaluation of the program were developed (Steps 5 and 6). Step 1 of the IM protocol revealed that employees with CANS should be stimulated to search for information about the cause of their complaints, about how to deal with their complaints, and in which manner they can influence their complaints themselves. In Step 2, the overall goal of the intervention was defined as "self-management behavior at work" with the aim to alleviate the perceived disability of the participants. Step 3 described how the intervention methods were translated into practical strategies, and goal setting was introduced as an important method for increasing self-efficacy. The product of Step 4 was the final program plan, consisting of 6-weekly group sessions of 2.5 hours each and an eHealth module. In Step 5, a recruitment plan and course materials were developed, a steering committee was set up, trainers were recruited, and the final program was tested. In Step 6, an evaluation plan was developed, which consists of a randomized controlled trial with a 12-month follow-up period and a qualitative evaluation (interviews) with some of the participants. This study resulted in a theory- and practice-based self-management program, based on behavioral change theories, guideline-related evidence, and practice-based knowledge that fits the needs of employees with CANS.

[Return to work management of people with temporary disability].

PubMed

Okreglicka, Małgorzata

2011-01-01

There is a large and growing body of scientific evidence that return to work usually provides significant overall health benefit, and staying off work needlessly results in poorer overall health outcomes. Thus, employers, employees (patients), and insurers all benefit from individuals returning to work in usual time periods. Disability duration guidelines can be an important tool helping the injured workers to get back on the job. The return to work process needs to be accepted by all parties (physicians, employees, employers, insurers) as defensible, fair and evidence-based. "The medical disability advisor--Workplace guidelines for disability duration" by Presley Reed is the backbone of communication, understanding and measurement in case management programs, having great impact on many parties and steps during a case life cycle.

75 FR 48934 - Coral Reef Conservation Program Implementation Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

...-01] RIN 0648-ZC19 Coral Reef Conservation Program Implementation Guidelines AGENCY: National Oceanic... Guidelines (Guidelines) for the Coral Reef Conservation Program (CRCP or Program) under the Coral Reef... assistance for coral reef conservation projects under the Act. NOAA revised the Implementation Guidelines for...

Cost and Performance Report: Solar-Powered Remediation and pH Control

DTIC Science & Technology

2017-04-01

OMB (Office of Management and Budget) Circular A-94. 2016. Guidelines and Discount Rates for Benefit - Cost Analysis of Federal Programs. Rahner D...ER-201033) Solar-Powered Remediation and pH Control April 2017 This document has been cleared for public release; Distribution Statement A...Program (ESTCP). The publication of this report does not indicate endorsement by the Department of Defense, nor should the contents be construed

Risk Scan: A Review of Risk Assessment Capability and Maturity within the Canadian Safety and Security Program

DTIC Science & Technology

2014-06-01

SCADA / ICS Cyber Test Lab initiated in 2013 Psychosocial – academic research exists,; opportunity for sharing and developing impact assessment...ecosystems and species at risk), accidents / system failure (rail; pipelines ; ferries CSSP strategy for the North Focus on regional l(and local) problem...Guidance; business planning; environmental scan; proposal evaluation; and performance measurement Program Risk Management – Guidelines for project

Quality of care for patients with type 2 diabetes mellitus in the Netherlands and the United States: a comparison of two quality improvement programs.

PubMed

Valk, Gerlof D; Renders, Carry M; Kriegsman, Didi M W; Newton, Katherine M; Twisk, Jos W R; van Eijk, Jacques Th M; van der Wal, Gerrit; Wagner, Edward H

2004-08-01

To assess differences in diabetes care and patient outcomes by comparing two multifaceted quality improvement programs in two different countries, and to increase knowledge of effective elements of such programs. Primary care in the ExtraMural Clinic (EMC) of the Department of General Practice of the Vrije Universiteit in Amsterdam, the Netherlands, and the Group Health Cooperative (GHC), a group-model health maintenance organization (HMO) in western Washington State in the United States. Data were collected from 1992 to 1997. In this observational study two diabetes cohorts in which a quality improvement program was implemented were compared. Both programs included a medical record system, clinical practice guidelines, physician educational meetings, audit, and feedback. Only the Dutch program (EMC) included guidelines on the structure of diabetes care and a recall system. Only the GHC program included educational outreach visits, formation of multidisciplinary teams, and patient self-management support. Included were 379 EMC patients, and 2,119 GHC patients with type 2 diabetes mellitus. Main process outcomes were: annual number of diabetes visits, and number of HbA1c and blood lipid measurements. Main patient outcomes were HbA1c and blood lipid levels. Multilevel analysis was used to adjust for dependency between repeated observations within one patient and for clustering of patients within general practices. In the EMC process outcomes and glycemic control improved more than at GHC, however, GHC had better baseline measures. There were no differences between programs on blood lipid control. During follow-up, intensification of pharmacotherapy was noted at both sites. Differences noted between programs were in line with differences in diabetes guidelines. Following implementation of guidelines and organizational improvement efforts, change occurred primarily in the process outcomes, rather than in the patient outcomes. Although much effort was put into improving process and patient outcomes, both complex programs still showed only moderate effects.

10 CFR 436.108 - Waivers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Waivers. 436.108 Section 436.108 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Guidelines for General Operations Plans § 436.108 Waivers. (a) Any Federal agency may submit a written request to the Under...

Drug Testing Park Law Enforcement Officers.

ERIC Educational Resources Information Center

Murrell, Dan S.; And Others

1991-01-01

Discusses drug testing for park law enforcement officers, presenting drug screening guidelines for park managers. The article examines how to establish programs, whether to screen, legal aspects, and implications of the Handicap Act (which makes it difficult to dismiss employees claiming the handicap of substance abuse without providing…

48 CFR 1615.404-4 - Profit.

Code of Federal Regulations, 2011 CFR

2011-10-01

... contracts by use of a weighted guidelines structured approach. The service charge so determined will be the... 1615.404-4 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT FEDERAL EMPLOYEES... Contract Pricing 1615.404-4 Profit. (a) When the pricing of FEHB Program contracts is determined by cost...

48 CFR 1615.404-4 - Profit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... contracts by use of a weighted guidelines structured approach. The service charge so determined will be the... 1615.404-4 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT FEDERAL EMPLOYEES... Contract Pricing 1615.404-4 Profit. (a) When the pricing of FEHB Program contracts is determined by cost...

SOCIO-ECONOMIC IMPACT EVALUATION OF LAKE IMPROVEMENT PROJECTS AND LAKE MANAGEMENT GUIDELINES

EPA Science Inventory

Under Public Law 92-500, the U.S. Environmental Protection Agency embarked on a major program of cost sharing grants to implement lake rehabilitation and protection projects. Improvement of water quality impacts the lives of people and organizations; however, the methods used to ...

Guidelines for Selecting a Construction Approach for Education Building Programs.

ERIC Educational Resources Information Center

Barton Malow Co., Southfield, MI.

This book discusses the advantages and disadvantages of the two most common construction planning methods utilized for educational facilities: general contracting and construction management. Diagrams are provided that illustrate the chain of command and communication within each approach, and highlight considerations that every school district…

18 CFR 740.12 - Amendments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Amendments. 740.12 Section 740.12 Conservation of Power and Water Resources WATER RESOURCES COUNCIL STATE WATER MANAGEMENT PLANNING PROGRAM § 740.12 Amendments. The Council may amend all or portions of these guidelines in...

18 CFR 740.12 - Amendments.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Amendments. 740.12 Section 740.12 Conservation of Power and Water Resources WATER RESOURCES COUNCIL STATE WATER MANAGEMENT PLANNING PROGRAM § 740.12 Amendments. The Council may amend all or portions of these guidelines in...

18 CFR 740.12 - Amendments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Amendments. 740.12 Section 740.12 Conservation of Power and Water Resources WATER RESOURCES COUNCIL STATE WATER MANAGEMENT PLANNING PROGRAM § 740.12 Amendments. The Council may amend all or portions of these guidelines in...

18 CFR 740.12 - Amendments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Amendments. 740.12 Section 740.12 Conservation of Power and Water Resources WATER RESOURCES COUNCIL STATE WATER MANAGEMENT PLANNING PROGRAM § 740.12 Amendments. The Council may amend all or portions of these guidelines in...

18 CFR 740.12 - Amendments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Amendments. 740.12 Section 740.12 Conservation of Power and Water Resources WATER RESOURCES COUNCIL STATE WATER MANAGEMENT PLANNING PROGRAM § 740.12 Amendments. The Council may amend all or portions of these guidelines in...

10 CFR 436.104 - Energy conservation measures and standards.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Energy conservation measures and standards. 436.104 Section 436.104 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Guidelines for General Operations Plans § 436.104 Energy conservation measures and standards. (a...

10 CFR 436.104 - Energy conservation measures and standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Energy conservation measures and standards. 436.104 Section 436.104 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Guidelines for General Operations Plans § 436.104 Energy conservation measures and standards. (a...

10 CFR 436.104 - Energy conservation measures and standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Energy conservation measures and standards. 436.104 Section 436.104 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Guidelines for General Operations Plans § 436.104 Energy conservation measures and standards. (a...

10 CFR 436.104 - Energy conservation measures and standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Energy conservation measures and standards. 436.104 Section 436.104 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Guidelines for General Operations Plans § 436.104 Energy conservation measures and standards. (a...

10 CFR 436.104 - Energy conservation measures and standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Energy conservation measures and standards. 436.104 Section 436.104 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Guidelines for General Operations Plans § 436.104 Energy conservation measures and standards. (a...

Management of fibromyalgia syndrome – an interdisciplinary evidence-based guideline

PubMed Central

Häuser, Winfried; Arnold, Bernhard; Eich, Wolfgang; Felde, Eva; Flügge, Christl; Henningsen, Peter; Herrmann, Markus; Köllner, Volker; Kühn, Edeltraud; Nutzinger, Detlev; Offenbächer, Martin; Schiltenwolf, Marcus; Sommer, Claudia; Thieme, Kati; Kopp, Ina

2008-01-01

The prevalence of fibromyalgia syndrome (FMS) of 1–2% in the general population associated with high disease-related costs and the conflicting data on treatment effectiveness had led to the development of evidence-based guidelines designed to provide patients and physicians guidance in selecting among the alternatives. Until now no evidence-based interdisciplinary (including patients) guideline for the management of FMS was available in Europe. Therefore a guideline for the management of fibromyalgia syndrome (FMS) was developed by 13 German medical and psychological associations and two patient self-help organisations. The task was coordinated by two German scientific umbrella organisations, the Association of the Scientific Medical Societies in Germany AWMF and the German Interdisciplinary Association of Pain Therapy DIVS. A systematic search of the literature including all controlled studies, systematic reviews and meta-analyses of pharmacological and non-pharmacological treatments of FMS was performed in the Cochrane Library (1993–12/2006), Medline (1980–12/2006), PsychInfo (1966–12/2006) and Scopus (1980–12/ 2006). Levels of evidence were assigned according to the classification system of the Oxford-Centre for Evidence Based Medicine. Grading of the strengths of recommendations was done according to the German program for disease management guidelines. Standardized procedures were used to reach a consensus on recommendations. The guideline was reviewed and finally approved by the boards of the societies involved and published online by the AWMF on april 25, 2008: http://www.uni-duesseldorf.de/AWMF/ll/041-004.htm. A short version of the guideline for patients is available as well: http://www.uni-duesseldorf.de/AWMF/ll/041-004p.htm. The following procedures in the management of FMS were strongly recommended: information on diagnosis and therapeutic options and patient-centered communication, aerobic exercise, cognitive and operant behavioural therapy, multicomponent treatment and amitriptyline. Based on expert opinion, a stepwise FMS-management was proposed. Step 1 comprises confirming the diagnosis and patient education and treatment of physical or mental comorbidities or aerobic exercise or cognitive behavioural therapy or amitriptyline. Step 2 includes multicomponent treatment. Step 3 comprises no further treatment or self-management (aerobic exercise, stress management) and/or booster multicomponent therapy and/or pharmacological therapy (duloxetine or fluoxetine or paroxetine or pregabalin or tramadol/aminoacetophen) and/or psychotherapy (hypnotherapy or written emotional disclosure) and/or physical therapy (balneotherapy or whole body heat therapy) and/or complementary therapies (homoeopathy or vegetarian diet). The choice of treatment options should be based on informed decision-making and respect of the patients’ preferences. PMID:19675740

Weight management in Canada: an environmental scan of health services for adults with obesity

PubMed Central

2014-01-01

Background Obesity in Canada is a growing concern, but little is known about the available services for managing obesity in adults. Our objectives were to (a) survey and describe programs dedicated to weight management and (b) evaluate program adherence to established recommendations for care. Methods We conducted an online environmental scan in 2011 to identify adult weight management services throughout Canada. We examined the degree to which programs adhered to the 2006 Canadian Clinical Practice Guidelines on the Management and Prevention of Obesity in Adults and Children (CCPGO) and the analysis criteria developed by the Association pour la Santé Publique du Québec (ASPQ). Results A total of 83 non-surgical (34 community-based, 42 primary care-based, 7 hospital-based) and 33 surgical programs were identified. All programs encouraged patient self-management. However, few non-surgical programs adhered to the CCPGO recommendations for assessment and intervention, and there was a general lack of screening for eating disorders, depression and other psychiatric diseases across all programs. Concordance with the ASPQ criteria was best among primary care-based programs, but less common in other settings with deficits most frequently revealed in multidisciplinary health assessment/management and physical activity counselling. Conclusions With more than 60% of Canadians overweight or obese, our findings highlight that availability of weight management services is far outstripped by need. Our observation that evidence-based recommendations are applied inconsistently across the country validates the need for knowledge translation of effective health services for managing obesity in adults. PMID:24521300

Total energy management for nursing homes and other long-term care institutions

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

Not Available

1977-01-01

The purpose of this publication is to provide the basic instruction needed to implement the most effective form of energy conservation--Total Energy Management, or TEM--in your long-term care facility. The effort required is worthwhile for many different reasons: TEM is self-paying; TEM promotes energy conservation without negative impact on health care services; and energy costs will continue to escalate. Following the introductory chapter, chapters are titled: Understanding Energy Consumption; Initiating a Total Energy Management Program; Developing Energy Consumption Data; Conducting the Facility Survey; Developing and Implementing the Basic Plan; Communication and Motivation; Monitoring Your Program and Keeping It Effective; andmore » Guidelines for Energy Conservation. Two appendices furnish information on building information for TEM and sources of information for energy management. (MCW)« less

Implementation of a commercial-grade dedication program - Benefits and lessons learned

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

Harrington, M.; MacFarlane, I.

1991-01-01

The recent issuance of industry guidelines, the Nuclear Management and Resources Council procurement initiative, and a US Nuclear Regulatory Commission NRC generic letter on commercial-grade item dedication (CGD) has been viewed by many utility managers and executives as only adding to the existing burden of compliance with regulatory requirements. While the incorporation of these documents into existing CGD programs has created additional costs, the resulting enhanced dedication programs have also produced benefits beyond regulatory compliance, and some lessons have been learned. This paper discusses the benefits and the lessons learned during implementation of an enhanced CGD program at New Hampshiremore » Yankee's (NHY's) Seabrook nuclear plant. Based on NHY's experience, it is believed that the benefits described in this paper can be realized by other utilities implementing CGD programs.« less

A multi-objective programming model for assessment the GHG emissions in MSW management

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

Mavrotas, George, E-mail: mavrotas@chemeng.ntua.gr; Skoulaxinou, Sotiria; Gakis, Nikos

2013-09-15

Highlights: • The multi-objective multi-period optimization model. • The solution approach for the generation of the Pareto front with mathematical programming. • The very detailed description of the model (decision variables, parameters, equations). • The use of IPCC 2006 guidelines for landfill emissions (first order decay model) in the mathematical programming formulation. - Abstract: In this study a multi-objective mathematical programming model is developed for taking into account GHG emissions for Municipal Solid Waste (MSW) management. Mathematical programming models are often used for structure, design and operational optimization of various systems (energy, supply chain, processes, etc.). The last twenty yearsmore » they are used all the more often in Municipal Solid Waste (MSW) management in order to provide optimal solutions with the cost objective being the usual driver of the optimization. In our work we consider the GHG emissions as an additional criterion, aiming at a multi-objective approach. The Pareto front (Cost vs. GHG emissions) of the system is generated using an appropriate multi-objective method. This information is essential to the decision maker because he can explore the trade-offs in the Pareto curve and select his most preferred among the Pareto optimal solutions. In the present work a detailed multi-objective, multi-period mathematical programming model is developed in order to describe the waste management problem. Apart from the bi-objective approach, the major innovations of the model are (1) the detailed modeling considering 34 materials and 42 technologies, (2) the detailed calculation of the energy content of the various streams based on the detailed material balances, and (3) the incorporation of the IPCC guidelines for the CH{sub 4} generated in the landfills (first order decay model). The equations of the model are described in full detail. Finally, the whole approach is illustrated with a case study referring to the application of the model in a Greek region.« less

Orthotic intervention incorporating the dart-thrower's motion as part of conservative management guidelines for treatment of scapholunate injury.

PubMed

Anderson, Hamish; Hoy, Greg

2016-01-01

Case series. This paper describes conservative guidelines for the management of scapho-lunate interosseous ligament (SLIL) injury including fabrication of an orthosis that restricts active wrist movement to the dart-throwers (DTM) plane. The dart throwers' orthosis (DTO) was designed as a response to biomechanical studies suggesting that restraining motion to the DTM would off-load a deficient SLIL. After six weeks of wearing the DTO, the 5 patients in this case series initiated an exercise program that incorporated wrist proprioceptive training and specific muscle strengthening. The DTO was designed to incorporate controlled movement in order to better integrate the secondary wrist stabilizers in wrists that had a deficient SLIL. The orthosis and the exercise program harnessed proprioceptive influences using active motion within the DTM plane, and stimulated mechanoreceptors so as to enhance stability. All patients demonstrated improvement in subjective and objective outcomes including self-reported pain and function. Orthotic intervention that controls motion within the DTM, combined with an appropriate proprioceptive rehabilitation program, may provide a viable conservative treatment option for patients with a similar clinical presentation. 4. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Asian consensus workshop report: expert consensus guideline for the management of intermediate and advanced hepatocellular carcinoma in Asia.

PubMed

Han, Kwang-Hyub; Kudo, Masatochi; Ye, Sheng-Long; Choi, Jong Young; Poon, Roonni Tung-Ping; Seong, Jinsil; Park, Joong-Won; Ichida, Takafumi; Chung, Jin Wook; Chow, Pierce; Cheng, Ann-Lii

2011-01-01

Hepatocellular carcinoma (HCC) is a highly prevalent disease in many Asian countries, accounting for 80% of victims worldwide. Screening programs improve the detection of early HCC and have a positive impact on survival, but the majority of HCC patients in Asia still present with advanced stage disease. The treatment outcomes of HCC are affected by multiple variables, including liver function, performance status of the patient, and tumor stage. Therefore, it is not easy to apply a multidisciplinary therapeutic approach for optimal management. At present, limited numbers of HCC patients are eligible for curative therapies such as surgery or ablation in Asia. Therefore, most patients are eligible for only palliative treatments. For optimal management, the treatment choice is guided by staging systems and treatment guidelines. Numerous staging systems have been proposed and treatment guidelines vary by region. According to the Barcelona Clinic Liver Cancer (BCLC) guideline based on evidence from randomized clinical trials, only transarterial chemoembolization (TACE) is recommended for intermediate stage HCC and sorafenib for advanced stage HCC. However, treatment guidelines from Asian countries have adopted several other therapeutic modalities such as a surgical approach, hepatic arterial infusion chemotherapy, external radiation, and their combinations based on clinical experiences for intermediate and advanced stage HCC. Although TACE is the main therapeutic modality in the intermediate stage, overall therapeutic outcomes depend on the tumor size. In the advanced stage, the prognosis depends on the tumor status, e.g. major vessel invasion or extrahepatic spread. Thus, a new staging system representing prognoses suitable for Asian HCC patients and a corresponding optimal treatment algorithm should be further investigated using evidence-based data, which will finally bring about an Asian consensus for the management of intermediate and advanced stage HCC. Copyright © 2011 S. Karger AG, Basel.

An evaluation and comparison of conservation guidelines for an at-risk migratory songbird

USGS Publications Warehouse

McNeil, Darin J.; Aldinger, Kyle R.; Bakermans, Marja H.; Lehman, Justin A.; Tisdale, Anna C.; Jones, John A.; Wood, Petra B.; Buehler, David A.; Smalling, Curtis G.; Siefferman, Lynn; Larkin, Jeffrey L.

2017-01-01

For at-risk wildlife species, it is important to consider conservation within the process of adaptive management. Golden-winged Warblers (Vermivora chrysoptera) are Neotropical migratory songbirds that are experiencing long-term population declines due in part to the loss of early-successional nesting habitat. Recently-developed Golden-winged Warbler habitat management guidelines are being implemented by USDA: Natural Resource Conservation Service (2014) and its partners through the Working Lands For Wildlife (WLFW) program. During 2012–2014, we studied the nesting ecology of Golden-winged Warblers in managed habitats of the eastern US that conformed to WLFW conservation practices. We evaluated five NRCS “management scenarios” with respect to nesting success and attainment of recommended nest site vegetation conditions outlined in the Golden-winged Warbler breeding habitat guidelines. Using estimates of territory density, pairing rate, nest survival, and clutch size, we also estimated fledgling productivity (number of fledglings/ha) for each management scenario. In general, Golden-winged Warbler nest survival declined as each breeding season advanced, but nest survival was similar across management scenarios. Within each management scenario, vegetation variables had little influence on nest survival. Still, percent Rubus cover and density of >2 m tall shrubs were relevant in some management scenarios. All five management scenarios rarely attained recommended levels of nest site vegetation conditions for Golden-winged, yet nest survival was high. Fledgling productivity estimates for each management scenario ranged from 2.1 to 8.6 fledglings/10 hectares. Our results indicate that targeted habitat management for Golden-winged Warblers using a variety of management techniques on private lands has the capability to yield high nest survival and fledgling productivity, and thus have the potential to contribute to the species recovery.

Limitations and challenges towards an effective business continuity management in Nuklear Malaysia

NASA Astrophysics Data System (ADS)

Hamid, A. H. A.

2018-01-01

One of Nuklear Malaysia’s top concerns is radiological and nuclear safety as well as security preparedness of its operational facility management, which was bonded by Act 304, Directive 20 and International Atomic Energy Agency (IAEA) guidelines. In 2012, the Malaysian government initialised the Business Continuity Management System under the supervision of Malaysian Administrative Modernization and Management Planning Unit (MAMPU), referring to MAMPU.BPICT.700-4/2/11 (3), ISO 22301:2012 and Business Continuity Good Practice Guidelines 2013 documentation. These standards are integral to the implementation of a resilient management program that indicates an organisation’s capability to prevent any accident from occurring and spreading its impact, which includes sufficient recovery action to post-accident situation towards a normal operational and managerial state. Unfortunately, there is a lack of certified Business Continuity Management standard among the public sector agencies compared to local private sectors. Subsequently, Nuklear Malaysia has been selected by MAMPU and CyberSecurity Malaysia as one of the pioneering agencies to be certified accordingly. This paper significantly recognized Nuklear Malaysia’s effort to plan, analyse, design, implement, review and validate the establishment of this standard currently. The project was implemented using a case study approach to complete the required certification activities. As a result, this paper proposed benchmarking the selected literature reviews against the Nuklear Malaysia experience to determine best practices in implementing and managing Business Continuity effectively. It concluded that a resilient Business Continuity Management program needs to be incorporated into Nuclear Malaysia’s capabilities in ensuring its mitigation capacities to survive any unexpected event and subsequently overcome future challenges.

50 CFR 253.18 - Program operating guidelines.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Program operating guidelines. 253.18 Section 253.18 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC... Guarantee Program § 253.18 Program operating guidelines. The Division may issue Program operating guidelines...

Increased statin eligibility based on ACC/AHA versus NCEP guidelines for high cholesterol management in Chile.

PubMed

Echeverría, Guadalupe; Dussaillant, Catalina; Villarroel, Luis; Rigotti, Attilio

2016-01-01

In 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) jointly released new guidelines for cardiovascular risk assessment and cholesterol management that substantially modified the previous recommendations proposed by the National Cholesterol Education Program (NCEP) in 2001. The relative impact of these new guidelines on potential statin use has not been estimated in Latin American populations. To estimate and compare eligibility for statin therapy based on ACC/AHA and NCEP guidelines in adult Chilean population. Using data from the last National Health Survey (2009-2010 NHS), we conducted a cross-sectional analysis in a ​representative sample of the Chilean adult population and calculated the proportion of individuals that would receive statins under each set of guidelines. According to ACC/AHA guidelines, the population eligible for statin treatment increased from 21.7% (NCEP guidelines) to 33.2% (overall 53% increase). This effect was more pronounced among women (29.6% under ACC/AHA vs 15.6% under NCEP) and with those of advanced age (75% of the subjects >60 years of age compared with 46% under NCEP). The newly eligible group included more women and older subjects and individuals with lower LDL cholesterol levels. Compared with NCEP recommendations, the new ACC/AHA guidelines significantly increased the number of Chilean adults eligible for statin therapy. Full implementation of the new recommendations may have important public health implications in Chile and other Latin American countries, as more women and older subjects without cardiovascular disease would qualify for statin treatment. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

User's Manual for Program PeakFQ, Annual Flood-Frequency Analysis Using Bulletin 17B Guidelines

USGS Publications Warehouse

Flynn, Kathleen M.; Kirby, William H.; Hummel, Paul R.

2006-01-01

Estimates of flood flows having given recurrence intervals or probabilities of exceedance are needed for design of hydraulic structures and floodplain management. Program PeakFQ provides estimates of instantaneous annual-maximum peak flows having recurrence intervals of 2, 5, 10, 25, 50, 100, 200, and 500 years (annual-exceedance probabilities of 0.50, 0.20, 0.10, 0.04, 0.02, 0.01, 0.005, and 0.002, respectively). As implemented in program PeakFQ, the Pearson Type III frequency distribution is fit to the logarithms of instantaneous annual peak flows following Bulletin 17B guidelines of the Interagency Advisory Committee on Water Data. The parameters of the Pearson Type III frequency curve are estimated by the logarithmic sample moments (mean, standard deviation, and coefficient of skewness), with adjustments for low outliers, high outliers, historic peaks, and generalized skew. This documentation provides an overview of the computational procedures in program PeakFQ, provides a description of the program menus, and provides an example of the output from the program.

Implementing clinical guidelines for chronic obstructive pulmonary disease: barriers and solutions

PubMed Central

Overington, Jeff D.; Huang, Yao C.; Abramson, Michael J.; Brown, Juliet L.; Goddard, John R.; Bowman, Rayleen V.; Fong, Kwun M.

2014-01-01

Chronic obstructive pulmonary disease (COPD) is a complex chronic lung disease characterised by progressive fixed airflow limitation and acute exacerbations that frequently require hospitalisation. Evidence-based clinical guidelines for the diagnosis and management of COPD are now widely available. However, the uptake of these COPD guidelines in clinical practice is highly variable, as is the case for many other chronic disease guidelines. Studies have identified many barriers to implementation of COPD and other guidelines, including factors such as lack of familiarity with guidelines amongst clinicians and inadequate implementation programs. Several methods for enhancing adherence to clinical practice guidelines have been evaluated, including distribution methods, professional education sessions, electronic health records (EHR), point of care reminders and computer decision support systems (CDSS). Results of these studies are mixed to date, and the most effective ways to implement clinical practice guidelines remain unclear. Given the significant resources dedicated to evidence-based medicine, effective dissemination and implementation of best practice at the patient level is an important final step in the process of guideline development. Future efforts should focus on identifying optimal methods for translating the evidence into everyday clinical practice to ensure that patients receive the best care. PMID:25478199

Assessment of readiness for clinical decision support to aid laboratory monitoring of immunosuppressive care at U.S. liver transplant centers.

PubMed

Jacobs, J; Weir, C; Evans, R S; Staes, C

2014-01-01

Following liver transplantation, patients require lifelong immunosuppressive care and monitoring. Computerized clinical decision support (CDS) has been shown to improve post-transplant immunosuppressive care processes and outcomes. The readiness of transplant information systems to implement computerized CDS to support post-transplant care is unknown. a) Describe the current clinical information system functionality and manual and automated processes for laboratory monitoring of immunosuppressive care, b) describe the use of guidelines that may be used to produce computable logic and the use of computerized alerts to support guideline adherence, and c) explore barriers to implementation of CDS in U.S. liver transplant centers. We developed a web-based survey using cognitive interviewing techniques. We surveyed 119 U.S. transplant programs that performed at least five liver transplantations per year during 2010-2012. Responses were summarized using descriptive analyses; barriers were identified using qualitative methods. Respondents from 80 programs (67% response rate) completed the survey. While 98% of programs reported having an electronic health record (EHR), all programs used paper-based manual processes to receive or track immunosuppressive laboratory results. Most programs (85%) reported that 30% or more of their patients used external laboratories for routine testing. Few programs (19%) received most external laboratory results as discrete data via electronic interfaces while most (80%) manually entered laboratory results into the EHR; less than half (42%) could integrate internal and external laboratory results. Nearly all programs had guidelines regarding pre-specified target ranges (92%) or testing schedules (97%) for managing immunosuppressive care. Few programs used computerized alerting to notify transplant coordinators of out-of-range (27%) or overdue laboratory results (20%). Use of EHRs is common, yet all liver transplant programs were largely dependent on manual paper-based processes to monitor immunosuppression for post-liver transplant patients. Similar immunosuppression guidelines provide opportunities for sharing CDS once integrated laboratory data are available.

Impact of electronic health record clinical decision support on the management of pediatric obesity.

PubMed

Shaikh, Ulfat; Berrong, Jeanette; Nettiksimmons, Jasmine; Byrd, Robert S

2015-01-01

Clinicians vary significantly in their adherence to clinical guidelines for overweight/obesity. This study assessed the impact of electronic health record-based clinical decision support in improving the diagnosis and management of pediatric obesity. The study team programmed a point-of-care alert linked to a checklist and standardized documentation templates to appear during health maintenance visits for overweight/obese children in an outpatient teaching clinic and compared outcomes through medical record reviews of 574 (287 control and 287 intervention) visits. The results demonstrated a statistically significant increase in the diagnosis of overweight/obesity, scheduling of follow-up appointments, frequency of ordering recommended laboratory investigations, and assessment and counseling for nutrition and physical activity. Although clinical guideline adherence increased significantly, it was far from universal. It is unknown if modest improvements in adherence to clinical guidelines translate to improvements in children's health. However, this intervention was relatively easy to implement and produced measurable improvements in health care delivery. © 2014 by the American College of Medical Quality.

40 CFR 60.2615 - What must I do if I plan to permanently close my CISWI unit and not restart it?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model... plan is due. Model Rule—Waste Management Plan ...

40 CFR 60.2615 - What must I do if I plan to permanently close my CISWI unit and not restart it?

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model... plan is due. Model Rule—Waste Management Plan ...

The Vermont Guide for Teaching Adolescents with Special Needs. Final Report.

ERIC Educational Resources Information Center

Halloran, William E., Comp.; And Others

Presented for classroom teachers, program supervisors, and resource specialists is a curriculum guide in the areas of home management and career preparation for adolescents with special needs. Introductory information includes explanations of the format and use of the guide and suggestions for evaluating student performance. Guidelines provided…

Think First: Addressing Aggressive Behavior in Secondary Schools

ERIC Educational Resources Information Center

Larson, Jim

2005-01-01

This highly practical book presents a complete anger and aggression management training program for middle and high school students. The volume incorporates a newly revised version of the author's proven "Think First" manual, which includes step-by-step skills training guidelines and 20 reproducible handouts and forms. Also provided are…

15 CFR 923.21 - Areas of particular concern.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Areas of particular concern. 923.21... concern. (a) The management program must include an inventory and designation of areas of particular concern within the coastal zone, on a generic and/or site-specific basis, and broad guidelines on...

Advisory on Relocatable and Renovated Classrooms. IAQ Info Sheet.

ERIC Educational Resources Information Center

California State Dept. of Health Services, Berkeley.

Many California school districts, in complying with the Class Size Reduction Program, will obtain relocatable classrooms directly from manufacturers who are under no specific guidelines or codes relative to indoor air quality (IAQ). This document, designed to aid school facility managers in minimizing potential IAQ problems, summarizes the indoor…

25 CFR 122.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES MANAGEMENT OF OSAGE JUDGMENT FUNDS FOR EDUCATION § 122.1 Purpose and scope. (a) The purpose of this part is to set forth procedures and guidelines to govern the use of authorized funds in education programs for the benefit of Osage Tribal members...

Genetic monitoring as a promising tool for conservation and management

Treesearch

Michael K. Schwartz; Gordon Luikart; Robin S. Waples

2007-01-01

In response to ever-increasing anthropogenic changes to natural ecosystems, regional, national and international organizations have established guidelines for monitoring biological diversity. Most monitoring programs, however, do not take full advantage of the potential afforded by molecular genetic markers, which can provide information relevant to both ecological and...

Guide to Software Conversion Management. [Final Report.

ERIC Educational Resources Information Center

Skall, M., Ed.

Based mainly on interviews conducted at 14 federal agencies that had completed or were involved in software conversion projects, this publication provides guidelines for the entire process of software conversion. This is defined as the transformation, without functional change, of computer programs or data elements to permit their use on a…

10 CFR 436.106 - Reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Reporting requirements. 436.106 Section 436.106 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Guidelines for... shall submit an “Annual Report on Energy Management” based on fiscal year data to the Secretary of DOE...

10 CFR 436.106 - Reporting requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Reporting requirements. 436.106 Section 436.106 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Guidelines for... shall submit an “Annual Report on Energy Management” based on fiscal year data to the Secretary of DOE...

10 CFR 436.106 - Reporting requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Reporting requirements. 436.106 Section 436.106 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Guidelines for... shall submit an “Annual Report on Energy Management” based on fiscal year data to the Secretary of DOE...

10 CFR 436.106 - Reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Reporting requirements. 436.106 Section 436.106 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Guidelines for... shall submit an “Annual Report on Energy Management” based on fiscal year data to the Secretary of DOE...

10 CFR 436.106 - Reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Reporting requirements. 436.106 Section 436.106 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Guidelines for... shall submit an “Annual Report on Energy Management” based on fiscal year data to the Secretary of DOE...

40 CFR 256.24 - Recommendations for closing or upgrading open dumps.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Solid Waste Disposal Programs § 256.24 Recommendations for closing or upgrading open dumps. (a) All... feasibility of resource recovery or resource conservation to reduce the solid waste volume entering a facility...

40 CFR 256.24 - Recommendations for closing or upgrading open dumps.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Solid Waste Disposal Programs § 256.24 Recommendations for closing or upgrading open dumps. (a) All... feasibility of resource recovery or resource conservation to reduce the solid waste volume entering a facility...

C.U.B.E. Program Administration Materials.

ERIC Educational Resources Information Center

Vincennes Univ., IN.

This manual consists of forms and guidelines for use in administering the adult basic education teaching/learning management system called CUBE (Continuity and Unity in Basic Education). Provided in the manual are a variety of orientation forms, including daily attendance records, enrollment forms, publication release forms, and fact sheets on the…

Management of Chronic Infectious Diseases in School Children. Revised Edition.

ERIC Educational Resources Information Center

Illinois State Board of Education, Springfield.

This manual contains current guidelines for Illinois school personnel to follow when working with children who have infectious diseases. The first chapter focuses on school district development of policies and procedures and program implementation. The next chapter provides information on characteristics, mode of transmission, prevention, and…

A Save-Energy, Save-Money Program That Pays Off

ERIC Educational Resources Information Center

Embersits, John F.

1976-01-01

Suggested guidelines for energy saving on campus include a 3-phase plan: (1) Quick Fix--effective management of what you already have; (2) Refitting--modification of existing systems and installation of simple controls; (3) Systems Convert--installation of computerized controls, waste-heat recovery, solid-waste recovery utilization and other…

Gout treatment: survey of Brazilian rheumatology residents.

PubMed

Amorim, Rodrigo Balbino Chaves; Vargas-Santos, Ana Beatriz; Pereira, Leticia Rocha; Coutinho, Evandro Silva Freire; da Rocha Castelar-Pinheiro, Geraldo

2017-05-01

To assess the current practices in gout management among Brazilian rheumatology residents. We performed a cross-sectional online survey among all the rheumatology residents and those rheumatologists who had just completed their training (post-residency (PR)) regarding their approach to gout management. Results were compared with the 2012 American College of Rheumatology (ACR) gout guidelines and with the responses of a previous survey with a representative sample of practicing Brazilian rheumatologists (RHE). We received 224 responses (83%) from 271 subjects. Among all respondents, the first-choice treatment for gout flares was the combination of a nonsteroidal anti-inflammatory drug + colchicine for otherwise healthy patients. A target serum urate <6 mg/dL for patients without tophi was reported by >75%. Less than 70% reported starting allopurinol at low doses (≤100 mg/day) for patients with normal renal function and <50% reported maintaining urate-lowering therapy indefinitely for patients without tophi. Among residents and PR, the residency stage was the main predictor of concordance with the ACR guidelines, with PR achieving the greatest rates. Reported practices were commonly concordant with the 2012 ACR gout guidelines, especially among PR. However, some important aspects of gout management need improvement. These results will guide the development of a physician education program to improve the management of gout patients in Brazil.

Development of new canine and feline preventive healthcare guidelines designed to improve pet health.

PubMed

2011-01-01

The American Veterinary Medical Association (AVMA) and American Animal Hospital Association (AAHA) have jointly introduced the first Canine and Feline Preventive Healthcare Guidelines. These consensus statements provide veterinarians with a new resource for improving patient care by emphasizing the value and scope of regular pet examinations. The two guidelines provide complete recommendations for comprehensive preventive healthcare programs, published as accessible, single-page documents. The guidelines are based on the subjective-objective-assessment-plan (SOAP) methodology of case management, a proven approach traditionally used with sick or injured patients. This logical and disciplined process is equally applicable to healthy patients and is designed to consistently deliver optimal patient care. The guidelines recommend visits for health examinations on at least an annual basis, recognizing that for many pets, more frequent visits may be appropriate, depending on the individual needs of the patient. The guidelines also provide detailed diagnostic, therapeutic, prevention, and follow up plans, to be accompanied by appropriate documentation. The inclusive content and concise format of the guidelines are designed to maximize their practical value and make them easy to implement.

Focused Review of Perioperative Care of Patients with Pulmonary Hypertension and Proposal of a Perioperative Pathway.

PubMed

Steppan, Jochen; Diaz-Rodriguez, Natalia; Barodka, Viachaslau M; Nyhan, Daniel; Pullins, Erica; Housten, Traci; Damico, Rachel L; Mathai, Stephen C; Hassoun, Paul M; Berkowitz, Dan E; Maxwell, Bryan G; Kolb, Todd M

2018-01-15

Morbidity and mortality risk increase considerably for patients with pulmonary hypertension (PH) undergoing non-cardiac surgery. Unfortunately, there are no comprehensive, evidence-based guidelines for perioperative evaluation and management of these patients. We present a brief review of the literature on perioperative outcomes for patients with PH and describe the implementation of a collaborative perioperative management program for these high-risk patients at a tertiary academic center.

An Evaluation of the Latent Tuberculosis Control Program in the United States Military at Accession

DTIC Science & Technology

2010-10-15

and costs associated with lost productivity. Cost-of-illness estimates for the health outcomes will be obtained from the TRICARE management agency...National Collaborating Centre for Chronic Conditions. Tuberculosis: national clinical guidelines for diagnosis, management , prevention, and control...N, Ranganathan SC. A three- way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children. PLoS ONE. 2008;3(7):e2624

[Factors influencing the quality of clinical practice guidelines in ovarian cancer].

PubMed

Castillo-Londoño, J S; Medina-Torres, Y A; Sandoval-Salinas, C; Buitrago-Gutierrez, G; Torres-Ibargüen, M Z; Gonzalez-Rangel, A L

To identify the characteristics of the published clinical practice guidelines for the management of epithelial ovarian cancer that suggest a good methodological quality. A literature review was performed on 25 clinical practice guidelines for epithelial ovarian cancer that were identified in different databases (MEDLINE, Guidelines International Network, National Guidelines Clearing house) published between 2007 and 2014. The quality of the guidelines was evaluated using the Appraisal of Guidelines Research and Evaluation II tool. Descriptive and bivariate analyses were performed to assess the association between the quality of the guidelines and of some of their features and their developers. Just under half (48%) of the guidelines were rated as low quality. Scientific societies or independent centres and private funding, or under-reporting the source of funding, were statistically associated with lower quality of clinical practice guidelines (P<.01). The guidelines developed by National Program Guidelines had a median of consistently higher scores in all domains of the Appraisal of Guidelines Research and Evaluation II, with significant differences in the definition of scope and objectives, the participation of stakeholders, the methodological rigour of development, and applicability to the context. Features such as the nature of the developer and funding of the guidelines are predictors of quality that should be taken into account prior to the use of the recommendations of a document. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Development and feasibility of an evidence-informed self-management education program in pediatric concussion rehabilitation.

PubMed

Hunt, Anne W; De Feo, Luciano; Macintyre, Jennifer; Greenspoon, Dayna; Dick, Talia; Mah, Katherine; Paniccia, Melissa; Provvidenza, Christine; Reed, Nick

2016-08-17

Concussion is a considerable public health problem in youth. However, identifying, understanding and implementing best evidence informed recovery guidelines may be challenging for families given the vast amount of information available in the public domains (e.g. Internet). The objective of this study was to develop, implement and evaluate the feasibility of an evidence-informed self-management education program for concussion recovery in youth. Synthesis of best evidence, principles of knowledge translation and exchange, and expert opinion were integrated within a self-management program framework to develop a comprehensive curriculum. The program was implemented and evaluated in a children's rehabilitation hospital within a universal health care system. A retrospective secondary analysis of anonymous data from a program evaluation survey was used to evaluate program feasibility, to identify features of importance to program participants and to assess changes in participants' knowledge. The program, "Concussion & You" includes a comprehensive, evidence informed, population specific curriculum that teaches participants practical strategies for management of return to school and play, sleep, nutrition, relaxation and energy conservation. A 'wheel of health' is used to facilitate participants' self-management action plan. Results from eighty-seven participant surveys indicate that the program is feasible and participant knowledge increased in all areas of the program with the highest changes reported in knowledge about sleep hygiene, rest and energy conservation. Findings indicate that "Concussion & You" is a feasible program that is acceptable to youth and their families, and fills a health system service gap.

Do guidelines influence the implementation of health programs? — Uganda’s experience

PubMed Central

2012-01-01

Background A guideline contains processes and procedures intended to guide health service delivery. However, the presence of guidelines may not guarantee their implementation, which may be a result of weaknesses in the development process. This study was undertaken to describe the processes of developing health planning, services management, and clinical guidelines within the health sector in Uganda, with the goal of understanding how these processes facilitate or abate the utility of guidelines. Methods Qualitative and quantitative research methods were used to collect and analyze data. Data collection was undertaken at the levels of the central Ministry of Health, the district, and service delivery. Qualitative methods included review of documents, observations, and key informant interviews, as well as quantitative aspects included counting guidelines. Quantitative data were analyzed with Microsoft Excel, and qualitative data were analyzed using deductive content thematic analysis. Results There were 137 guidelines in the health sector, with programs related to Millennium Development Goals having the highest number (n = 83). The impetus for guideline development was stated in 78% of cases. Several guidelines duplicated content, and some conflicted with each other. The level of consultation varied, and some guidelines did not consider government-wide policies and circumstances at the service delivery level. Booklets were the main format of presentation, which was not tailored to the service delivery level. There was no framework for systematic dissemination, and target users were defined broadly in most cases. Over 60% of guidelines available at the central level were not available at the service delivery level, but there were good examples in isolated cases. There was no framework for systematic monitoring of use, evaluation, and review of guidelines. Suboptimal performance of the supervision framework that would encourage the use of guidelines, assess their utilization, and provide feedback was noted. Conclusions Guideline effectiveness is compromised by the development process. To ensure the production of high-quality guidelines, efforts must be employed at the country and regional levels. The regional level can facilitate pooling resources and expertise in knowledge generation, methodology development, guideline repositories, and capacity building. Countries should establish and enforce systems and guidance on guideline development. PMID:23068082

Phase II -- Photovoltaics for Utility Scale Applications (PVUSA): Safety and health action plan

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

Berg, K.

1994-09-01

To establish guidelines for the implementation and administration of an injury and illness prevention program for PVUSA and to assign specific responsibilities for the execution of the program. To provide a basic Safety and Health Action Plan (hereinafter referred to as Plan) that assists management, supervision, and project personnel in the recognition, evaluation, and control of hazardous activities and/or conditions within their respective areas of responsibility.

Quality Assurance Program for Molecular Medicine Laboratories

PubMed Central

Hajia, M; Safadel, N; Samiee, S Mirab; Dahim, P; Anjarani, S; Nafisi, N; Sohrabi, A; Rafiee, M; Sabzavi, F; Entekhabi, B

2013-01-01

Background: Molecular diagnostic methods have played and continuing to have a critical role in clinical laboratories in recent years. Therefore, standardization is an evolutionary process that needs to be upgrade with increasing scientific knowledge, improvement of the instruments and techniques. The aim of this study was to design a quality assurance program in order to have similar conditions for all medical laboratories engaging with molecular tests. Methods: We had to design a plan for all four elements; required space conditions, equipments, training, and basic guidelines. Necessary guidelines was prepared and confirmed by the launched specific committee at the Health Reference Laboratory. Results: Several workshops were also held for medical laboratories directors and staffs, quality control manager of molecular companies, directors and nominees from universities. Accreditation of equipments and molecular material was followed parallel with rest of program. Now we are going to accredit medical laboratories and to evaluate the success of the program. Conclusion: Accreditation of medical laboratory will be succeeding if its basic elements are provided in advance. Professional practice guidelines, holding training and performing accreditation the molecular materials and equipments ensured us that laboratories are aware of best practices, proper interpretation, limitations of techniques, and technical issues. Now, active external auditing can improve the applied laboratory conditions toward the defined standard level. PMID:23865028

Quality assurance program for molecular medicine laboratories.

PubMed

Hajia, M; Safadel, N; Samiee, S Mirab; Dahim, P; Anjarani, S; Nafisi, N; Sohrabi, A; Rafiee, M; Sabzavi, F; Entekhabi, B

2013-01-01

Molecular diagnostic methods have played and continuing to have a critical role in clinical laboratories in recent years. Therefore, standardization is an evolutionary process that needs to be upgrade with increasing scientific knowledge, improvement of the instruments and techniques. The aim of this study was to design a quality assurance program in order to have similar conditions for all medical laboratories engaging with molecular tests. We had to design a plan for all four elements; required space conditions, equipments, training, and basic guidelines. Necessary guidelines was prepared and confirmed by the launched specific committee at the Health Reference Laboratory. Several workshops were also held for medical laboratories directors and staffs, quality control manager of molecular companies, directors and nominees from universities. Accreditation of equipments and molecular material was followed parallel with rest of program. Now we are going to accredit medical laboratories and to evaluate the success of the program. Accreditation of medical laboratory will be succeeding if its basic elements are provided in advance. Professional practice guidelines, holding training and performing accreditation the molecular materials and equipments ensured us that laboratories are aware of best practices, proper interpretation, limitations of techniques, and technical issues. Now, active external auditing can improve the applied laboratory conditions toward the defined standard level.

Assessment of MSFC's supervisory training programs and courses. [marshall space flight center

NASA Technical Reports Server (NTRS)

Brindley, T. A.

1982-01-01

Courses and special programs to train supervisors at Marshall Space Flight Center (MSFC) were to determine the adequacy of the present MSFC Supervisory Training Program and to recommend changes, if appropriate. The content, procedures, and student evaluations of the required Office of Personnel Management (OPM) 80 hours training for supervisors, the optional 120 hours, the MSFC Management Development Program (MDP), NASA's Management Education Program (MEP), various OPM and special contract programs, pertinent procedural guidelines, regulations, and letters, as well as various MSFC computer reports which indicate who took what training were analyzed. Various interviews with MSFC personnel involved in training are included. Recommendations consist of: (1) the choice of courses selected for the basic required OPM 80 hours be improved; (2) the optional 120 hours be discontinued and a shorter module be developed dealing with managerial decision making and human relations skills; (3) the MDP and MEP be continued as at present; and (4) that a broad array of developmental strategies be incorporated to provide a variety of opportunities for supervisory improvement.

Analysis of exchanges between novice and cooperating teachers during internships using the NCATE/NASPE Standards for Teacher Preparation in Physical Education as guidelines.

PubMed

Banville, Dominique

2006-06-01

To be recognized as an accredited program, Physical Education Teacher Education (PETE) programs in the country must abide by guidelines put forward by the National Association for Sport and Physical Education (NASPE), in collaboration with the National Council for the Accreditation of Teacher Education (NCATE). The guidelines are divided into nine standards and identify a number of outcomes (NASPE, 1998). The purpose of this study was to determine the nature of the exchanges between novice teachers (NTs) and cooperating teachers (CTs), when using the NASPE Standards (1998) as a reference point, and determine if the focus of the exchanges differed over time and according to data source. Six pairs of CTs and their NT participated in the study. Data were collected through recorded conversations between NTs and their CT as well as NTs' logs. Data showed that the majority of conversations focused on planning and instruction (Standard 6) and management and motivation (Standard 4), while few related to diverse learners (Standard 3), growth and development (Standard 2), and communication (Standard 5). The small amount of information shared by CTs in some standards indicates a need for PETE programs to share the guidelines with CTs to make them aware of the importance of offering a variety of topics to interns, because CTs are the primary source of information during this crucial experience.

Predictors of workplace sexual health policy at sex work establishments in the Philippines.

PubMed

Withers, M; Dornig, K; Morisky, D E

2007-09-01

Based on the literature, we identified manager and establishment characteristics that we hypothesized are related to workplace policies that support HIV protective behavior. We developed a sexual health policy index consisting of 11 items as our outcome variable. We utilized both bivariate and multivariate analysis of variance. The significant variables in our bivariate analyses (establishment type, number of employees, manager age, and membership in manager association) were entered into a multivariate regression model. The model was significant (p<.01), and predicted 42) of the variability in the development and management of a workplace sexual health policy supportive of condom use. The significant predictors were number of employees and establishment type. In addition to individually-focused CSW interventions, HIV prevention programs should target managers and establishment policies. Future HIV prevention programs may need to focus on helping smaller establishments, in particular those with less employees, to build capacity and develop sexual health policy guidelines.

Critical features of peer assessment of clinical performance to enhance adherence to a low back pain guideline for physical therapists: a mixed methods design.

PubMed

Maas, Marjo J M; van Dulmen, Simone A; Sagasser, Margaretha H; Heerkens, Yvonne F; van der Vleuten, Cees P M; Nijhuis-van der Sanden, Maria W G; van der Wees, Philip J

2015-11-12

Clinical practice guidelines are intended to improve the process and outcomes of patient care. However, their implementation remains a challenge. We designed an implementation strategy, based on peer assessment (PA) focusing on barriers to change in physical therapy care. A previously published randomized controlled trial showed that PA was more effective than the usual strategy "case discussion" in improving adherence to a low back pain guideline. Peer assessment aims to enhance knowledge, communication, and hands-on clinical skills consistent with guideline recommendations. Participants observed and evaluated clinical performance on the spot in a role-play simulating clinical practice. Participants performed three roles: physical therapist, assessor, and patient. This study explored the critical features of the PA program that contributed to improved guideline adherence in the perception of participants. Dutch physical therapists working in primary care (n = 49) organized in communities of practice (n = 6) participated in the PA program. By unpacking the program we identified three main tasks and eleven subtasks. After the program was finished, a questionnaire was administered in which participants were asked to rank the program tasks from high to low learning value and to describe their impact on performance improvement. Overall ranking results were calculated. Additional semi-structured interviews were conducted to elaborate on the questionnaires results and were transcribed verbatim. Questionnaires comments and interview transcripts were analyzed using template analysis. Program tasks related to performance in the therapist role were perceived to have the highest impact on learning, although task perceptions varied from challenging to threatening. Perceptions were affected by the role-play format and the time schedule. Learning outcomes were awareness of performance, improved attitudes towards the guideline, and increased self-efficacy beliefs in managing patients with low back pain. Learning was facilitated by psychological safety and the quality of feedback. The effectiveness of PA can be attributed to the structured and performance-based design of the program. Participants showed a strong cognitive and emotional commitment to performing the physical therapist role. That might have contributed to an increased awareness of strength and weakness in clinical performance and a motivation to change routine practice.

An Audit of Diabetes Self-Management Education Programs in South Africa.

PubMed

Dube, Loveness; Van den Broucke, Stephan; Dhoore, William; Kalweit, Kerry; Housiaux, Marie

2015-11-17

Diabetes is a significant contributor to the burden of disease worldwide. Since its treatment requires extensive self-care, self-management education is widely recommended, particularly in resource limited settings. This study aimed to review the current state of policies and implementation of diabetes self-management education (DSME) in South Africa, with a specific focus on cultural appropriateness. The audit involved a review of policy documents and semi-structured questionnaires with providers and experts in public and private health services. Forty-four respondents were interviewed. Documents were analysed with reference to the International Standards for Diabetes Education from the International Diabetes Federation. Data were entered and analysed in excel to give a description of the DSME programs and ad hoc interventions. Three guidelines for Type 2 diabetes and two for chronic diseases were retrieved, but none were specifically dedicated to DSME. Five structured programs and 22 ad-hoc interventions were identified. DSME is mostly provided by doctors, nurses and dieticians and not consistently linked to other initiatives such as support groups. Health education materials are mainly in English with limited availability. DSME in South Africa is limited in scope, content and consistency, especially in the public services. A National curricula and materials for diabetes education need to be developed and adapted to the socio-economic context, culture and literacy levels of the target populations. It is recommended that DSME would be addressed in national policies and guidelines to guide the development and implementation of standardised programs. Significance for public healthDiabetes significantly contributes to the global burden of disease. This burden is especially felt in developing countries, where resources are limited and the health system simultaneously has to deal with communicable and non-communicable diseases. While there is a growing body of literature on the development and implementation of diabetes self-management education, nearly all programs originate from developed countries. Very little is known about the current state of diabetes self-management education in developing countries. By focusing on diabetes self-management education in Southern Africa, the current paper provides policy makers and decision makers in South Africa with information that will help decide on where and how to intervene with regard to diabetes self-management education. The paper also has relevance for decision makers from other developing countries by providing recommendations on diabetes policies and diabetes self-management education.

77 FR 13585 - Electricity Subsector Cybersecurity Risk Management Process Guideline

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... DEPARTMENT OF ENERGY Electricity Subsector Cybersecurity Risk Management Process Guideline AGENCY: Office of Electricity Delivery and Energy Reliability, Department of Energy. ACTION: Notice of public... Electricity Subsector Cybersecurity Risk Management Process guideline. The guideline describes a risk...

The management approach to the NASA space station definition studies at the Manned Spacecraft Center

NASA Technical Reports Server (NTRS)

Heberlig, J. C.

1972-01-01

The overall management approach to the NASA Phase B definition studies for space stations, which were initiated in September 1969 and completed in July 1972, is reviewed with particular emphasis placed on the management approach used by the Manned Spacecraft Center. The internal working organizations of the Manned Spacecraft Center and its prime contractor, North American Rockwell, are delineated along with the interfacing techniques used for the joint Government and industry study. Working interfaces with other NASA centers, industry, and Government agencies are briefly highlighted. The controlling documentation for the study (such as guidelines and constraints, bibliography, and key personnel) is reviewed. The historical background and content of the experiment program prepared for use in this Phase B study are outlined and management concepts that may be considered for future programs are proposed.

System looks outside its own walls to find innovative way to cut kids' asthma admissions.

PubMed

1999-10-01

Atlanta children's hospital system initiates outpatient pediatric asthma disease management program to reduce inpatient admissions and ER visits while reducing costs. Children's Healthcare of Atlanta turned to the primary care physician community for front-line support in keeping mild asthma cases out of the hospital. By offering evidence-based practice guidelines, training for staff, and educational materials for patients and their families, the Partnership to ACE Asthma program is off to a running start. Learn how to set up a similar program.

Energy plan, 1981

NASA Astrophysics Data System (ADS)

1981-12-01

The planning procedures for the energy program and policy guidelines for energy planning are presented. Future changes in marginal costs and directions indicated for economically efficient pricing are assessed. The aim of the conservation program is to close the gap between the amounts of conservation which is rationally cost effective and that projected to occur anyway through normal market forces. An overview of energy demand and proposed plans for energy supply are given. Liquid fuels have priority although work on coal receives new emphasis. A better program on energy demand and management is suggested.

2014 UK national guideline for the management of anogenital herpes.

PubMed

Patel, Raj; Green, John; Clarke, Emily; Seneviratne, Kanchana; Abbt, Naomi; Evans, Ceri; Bickford, Jane; Nicholson, Marian; O'Farrell, Nigel; Barton, Simon; FitzGerald, Mark; Foley, Elizabeth

2015-10-01

These guidelines concern the management of anogenital herpes simplex virus infections in adults and give advice on diagnosis, management, and counselling of patients. This guideline replaces the 2007 BASHH herpes guidelines and includes new sections on herpes proctitis, key points to cover with patients regarding transmission and removal of advice on the management of HSV in pregnancy which now has a separate joint BASHH/RCOG guideline. © The Author(s) 2015.

Pautas para Programas de Asesoramiento Gestional para Microempresas (Guidelines for Management Consulting Programs for Small-Scale Enterprise). Appropriate Technologies for Development. Peace Corps Information Collection & Exchange Manual Series No. M-27.

ERIC Educational Resources Information Center

Vaughan, Gary L.

Written in Spanish, this manual is designed to assist management consultants in working with small-scale entrepreneurs in developing countries. Addressed in an overview of the small-scale enterprise (SSE) are the role of the SSE in Third World development, problems of SSEs, and target firms. The second chapter deals with various forms of…

Group-based education for patients with type 2 diabetes: a survey of Australian dietitians.

PubMed

Odgers-Jewell, Kate; Isenring, Elisabeth A; Thomas, Rae; Reidlinger, Dianne P

2017-09-01

Group-based education has the potential to substantially improve the outcomes of individuals with type 2 diabetes mellitus (T2DM) and reduce the enormous burden that chronic diseases place on healthcare systems worldwide. Despite this proven effectiveness, the utilisation of group services for the management of T2DM by Australian dietitians is surprisingly low. This study surveyed a sample of 263 Australian dietitians to explore the utilisation of group-based education for T2DM, as well as dietitians' preferences for practice and training. The results of this study indicate that Australian dietitians are currently under-utilising group-based education programs for the management of T2DM, with the primary reasons identified as a lack of training provided to dietitians in the area, limited access to facilities suitable for conducting group education, the perceived poor cost-effectiveness of these programs, and the lack of evidence-based practice guidelines for the group-based management of persons with T2DM. Additionally, the majority of preferences for further training were for either face-to-face or web-based formal training conducted over 3-6h. Clear, evidence-based practice guidelines and training resources for group education for the management of T2DM are needed in order to encourage better utilisation of group-based education by Australian dietitians.

The Breast Health Global Initiative: clinical practice guidelines for management of breast cancer in low- and middle-income countries.

PubMed

Yip, Cheng Har; Anderson, Benjamin O

2007-08-01

Breast cancer is an increasingly urgent problem in low- and mid-level resource countries of the world. Despite knowing the optimal management strategy based on guidelines developed in wealthy countries, clinicians are forced to provide less-than-optimal care to patients when diagnostic and/or treatment resources are lacking. For this reason, it is important to identify which resources commonly applied in resource-abundant countries most effectively fill the healthcare needs in limited-resource regions, where patients commonly present with more advanced disease at diagnosis, and to provide guidance on how new resource allocations should be made in order to maximize improvement in outcome. Established in 2002, the Breast Health Global Initiative (BHGI) created an international health alliance to develop evidence-based guidelines for countries with limited resources (low- and middle-income countries) to improve breast health outcomes. The BHGI serves as a program for international guideline development and as a hub for linkage among clinicians, governmental health agencies and advocacy groups to translate guidelines into policy and practice. The BHGI collaborated with 12 national and international health organizations, cancer societies and nongovernmental organizations to host two BHGI international summits. The evidence-based BHGI Guidelines, developed at the 2002 Global Summit, were published in 2003 as a theoretical treatise on international breast healthcare. These guidelines were then updated and expanded at the 2005 Global Summit into a fully comprehensive and flexible framework to permit incremental improvements in healthcare delivery, based upon outcomes, cost, cost-effectiveness and use of healthcare services.

Operating Manual for Two-Year Campus Programs.

ERIC Educational Resources Information Center

Ohio Board of Regents, Columbus.

Guidelines and accompanying forms are provided in this operations manual designed as a guide for the management and development of the instructional units at the member institutions of Ohio's two-year college system. The manual first presents the mission statement of the two-year colleges, defines the various types of colleges in the system, and…

12 CFR Appendix D-2 to Part 208 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2014 CFR

2014-01-01

.... Design its information security program to control the identified risks, commensurate with the... Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the... score, derived from a group of consumer reports; or (B) Blind data, such as payment history on accounts...

12 CFR Appendix B to Part 570 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2011 CFR

2011-01-01

... arrangements in place to control risks. C. Manage and Control Risk. You shall: 1. Design your information... Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board G... include: (A) Aggregate information, such as the mean credit score, derived from a group of consumer...

12 CFR Appendix B to Part 570 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2013 CFR

2013-01-01

... arrangements in place to control risks. C. Manage and Control Risk. You shall: 1. Design your information... Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board G... include: (A) Aggregate information, such as the mean credit score, derived from a group of consumer...

12 CFR Appendix B to Part 570 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2014 CFR

2014-01-01

... arrangements in place to control risks. C. Manage and Control Risk. You shall: 1. Design your information... Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board G... include: (A) Aggregate information, such as the mean credit score, derived from a group of consumer...

12 CFR Appendix D-2 to Part 208 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2011 CFR

2011-01-01

.... Design its information security program to control the identified risks, commensurate with the... Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the... score, derived from a group of consumer reports; or (B) Blind data, such as payment history on accounts...

Managing Mergers of Human Service Agencies: People, Programs, and Procedures.

ERIC Educational Resources Information Center

Taylor, Joseph; And Others

1992-01-01

Offers detailed guidelines that could be used as standard operating procedures for the merger of voluntary social service agencies. Discusses a survey of 32 agencies that merged during the years 1973 to 1986. Issues related to the roles of organization, staff, and service delivery in such mergers receive particular attention. (Author/BB)

Copyright Law and Content Protection Mechanisms: Digital Rights Management for Teacher Educators

ERIC Educational Resources Information Center

Ludlow, Barbara L.; Duff, Michael C.

2007-01-01

The integration of new technologies using digital media materials in preservice and inservice programs to prepare educational personnel presents both opportunities and challenges for teacher educators in special education. The TEACH Act of 2002 provided some guidelines for appropriate use of copyrighted materials in face-to-face, televised, and…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-08

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

Stress Associated with Handicapped Children: Guidelines for Family Management.

ERIC Educational Resources Information Center

Tynan, Donna D.; Fritsch, Ronald E.

The literature on coping with stressful life events and the literature on parental issues related to the birth of a handicapped child suggest that such variables as understanding of the nature, intensity, and duration of parental responses figure prominently in their adjustment to the disability. The development of support programs designed to…

Ada Adoption Handbook: A Program Manager’s Guide, Version 2.0

DTIC Science & Technology

1992-10-01

specifically Ada oriented: "* Compilation order tool: A capability that, when given a set of Ada units, determines the com- pilation order. "* Automatic...July 1992. 146. Knapper. R. J., Linn, C. J.. & Salasin, J. Guidelines for Tailoring DOD-S TD-2167A for SOS Software Development. IDA Paper P- 2018

[Impact of rational use of antibiotics in a third level clinic in Colombia].

PubMed

Pallares, Christian J; Cataño, Juan C

2017-06-01

The increasing resistance of bacteria to antibiotics threatens the survival of patients and health costs. To determine the impact of an antimicrobial stewardship program in bacterial resistance and antibiotic consumption. Quasi experimental study in a third level clinic in the city of Medellin, that evaluate in two time periods (pre-intervention between October 2012 and September 2013 and post intervention between October 2013 and September 2014) the impact of an antimicrobial stewardship program in terms of antibiotic consumption and bacterial ecology. Adherence to institutional guidelines for management of infections in the post-intervention period was 82%. Antibiotic consumption of meropenem, ceftriaxone, vancomycin and colistin decreased, and imipenem, daptomycin and linezolid was increased. A significant decrease in antibiotic resistance in Pseudomonas aeruginosa was observed, including carbapenems. An increase of extended spectrum beta lactamase production (ESBL) in Enterobacteriaceae (especially E. coli) and piperacillin/tazobactam resistance was observed. The construction and implementation of a strategy in hospitals with guidelines for managing infectious diseases, restrictions in antibiotic use, a permanent monitoring system for the formulation of antibiotics, achieved a positive impact on reducing antibiotic use and bacterial resistance.

Multi-community command and control systems in law enforcement: An introductory planning guide

NASA Technical Reports Server (NTRS)

Sohn, R. L.; Garcia, E. A.; Kennedy, R. D.

1976-01-01

A set of planning guidelines for multi-community command and control systems in law enforcement is presented. Essential characteristics and applications of these systems are outlined. Requirements analysis, system concept design, implementation planning, and performance and cost modeling are described and demonstrated with numerous examples. Program management techniques and joint powers agreements for multicommunity programs are discussed in detail. A description of a typical multi-community computer-aided dispatch system is appended.

Hospital Guidelines for Diabetes Management and the Joint Commission-American Diabetes Association Inpatient Diabetes Certification.

PubMed

Arnold, Pamela; Scheurer, Danielle; Dake, Andrew W; Hedgpeth, Angela; Hutto, Amy; Colquitt, Caroline; Hermayer, Kathie L

2016-04-01

The Joint Commission Advanced Inpatient Diabetes Certification Program is founded on the American Diabetes Association's Clinical Practice Recommendations and is linked to the Joint Commission Standards. Diabetes currently affects 29.1 million people in the USA and another 86 million Americans are estimated to have pre-diabetes. On a daily basis at the Medical University of South Carolina (MUSC) Medical Center, there are approximately 130-150 inpatients with a diagnosis of diabetes. The program encompasses all service lines at MUSC. Some important features of the program include: a program champion or champion team, written blood glucose monitoring protocols, staff education in diabetes management, medical record identification of diabetes, a plan coordinating insulin and meal delivery, plans for treatment of hypoglycemia and hyperglycemia, data collection for incidence of hypoglycemia, and patient education on self-management of diabetes. The major clinical components to develop, implement, and evaluate an inpatient diabetes care program are: I. Program management, II. Delivering or facilitating clinical care, III. Supporting self-management, IV. Clinical information management and V. performance measurement. The standards receive guidance from a Disease-Specific Care Certification Advisory Committee, and the Standards and Survey Procedures Committee of the Joint Commission Board of Commissioners. The Joint Commission-ADA Advanced Inpatient Diabetes Certification represents a clinical program of excellence, improved processes of care, means to enhance contract negotiations with providers, ability to create an environment of teamwork, and heightened communication within the organization. Published by Elsevier Inc.

Guideline Implementation: Surgical Smoke Safety.

PubMed

Fencl, Jennifer L

2017-05-01

Research conducted during the past four decades has demonstrated that surgical smoke generated from the use of energy-generating devices in surgery contains toxic and biohazardous substances that present risks to perioperative team members and patients. Despite the increase in information available, however, perioperative personnel continue to demonstrate a lack of knowledge of these hazards and lack of compliance with recommendations for evacuating smoke during surgical procedures. The new AORN "Guideline for surgical smoke safety" provides guidance on surgical smoke management. This article focuses on key points of the guideline to help perioperative personnel promote smoke-free work environments; evacuate surgical smoke; and develop education programs and competency verification tools, policies and procedures, and quality improvement initiatives related to controlling surgical smoke. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

EMS-physicians' self reported airway management training and expertise; a descriptive study from the Central Region of Denmark

PubMed Central

2011-01-01

Background Prehospital advanced airway management, including prehospital endotracheal intubation is challenging and recent papers have addressed the need for proper training, skill maintenance and quality control for emergency medical service personnel. The aim of this study was to provide data regarding airway management-training and expertise from the regional physician-staffed emergency medical service (EMS). Methods The EMS in this part of The Central Region of Denmark is a two tiered system. The second tier comprises physician staffed Mobile Emergency Care Units. The medical directors of the programs supplied system data. A questionnaire addressing airway management experience, training and knowledge was sent to the EMS-physicians. Results There are no specific guidelines, standard operating procedures or standardised program for obtaining and maintaining skills regarding prehospital advanced airway management in the schemes covered by this study. 53/67 physicians responded; 98,1% were specialists in anesthesiology, with an average of 17,6 years of experience in anesthesiology, and 7,2 years experience as EMS-physicians. 84,9% reported having attended life support course(s), 64,2% an advanced airway management course. 24,5% fulfilled the curriculum suggested for Danish EMS physicians. 47,2% had encountered a difficult or impossible PHETI, most commonly in a patient in cardiac arrest or a trauma patient. Only 20,8% of the physicians were completely familiar with what back-up devices were available for airway management. Conclusions In this, the first Danish study of prehospital advanced airway management, we found a high degree of experience, education and training among the EMS-physicians, but their equipment awareness was limited. Check-outs, guidelines, standard operating procedures and other quality control measures may be needed. PMID:21303510

Increasing fruit and vegetable consumption among schoolchildren: efforts in middle-income countries.

PubMed

Wijesinha-Bettoni, Ramani; Orito, Aya; Löwik, Marianne; Mclean, Catherine; Muehlhoff, Ellen

2013-03-01

To reverse the trend of rising child obesity rates in many middle-income countries, recommendations include increasing fruit and vegetable consumption. Schools can positively impact children's eating behavior, and multicomponent interventions that include the curriculum, school food environments, and parental involvement are most effective. To find out how fruits and vegetables feature in the dietary guidelines provided to schools, what specific schemes are available for providing these foods, the extent to which nutrition education is included in the curriculum, and how vegetables and fruits are procured in primary schools. In 2008, a survey questionnaire previously validated and revised was sent electronically to national program managers and focal points for school feeding programs in 58 middle-income countries. The rationale was to obtain information relevant to the entire country from these key informants. The survey response rate was 46%. The information provided by 22 respondents in 18 countries was included in the current study. On average, respondents answered 88% of the questions analyzed in this paper. Of the respondents, 73% worked for the national authority responsible for school food programs, with 45% at the program coordinator or director level. Few countries have any special fruit and vegetable schemes; implementation constraints include cost and lack of storage facilities. Although 11 of 18 countries have both nutrient-based guidelines and school food guidelines for meals, fruits and vegetables are often not adequately specified. In some countries, nutrition education, special activities, school gardens, and parental participation are used to promote fruits and vegetables. Specific schemes are needed in some, together with school food guidelines that include fruits and vegetables.

IEC 61511 and the capital project process--a protective management system approach.

PubMed

Summers, Angela E

2006-03-17

This year, the process industry has reached an important milestone in process safety-the acceptance of an internationally recognized standard for safety instrumented systems (SIS). This standard, IEC 61511, documents good engineering practice for the assessment, design, operation, maintenance, and management of SISs. The foundation of the standard is established by several requirements in Part 1, Clauses 5-7, which cover the development of a management system aimed at ensuring that functional safety is achieved. The management system includes a quality assurance process for the entire SIS lifecycle, requiring the development of procedures, identification of resources and acquisition of tools. For maximum benefit, the deliverables and quality control checks required by the standard should be integrated into the capital project process, addressing safety, environmental, plant productivity, and asset protection. Industry has become inundated with a multitude of programs focusing on safety, quality, and cost performance. This paper introduces a protective management system, which builds upon the work process identified in IEC 61511. Typical capital project phases are integrated with the management system to yield one comprehensive program to efficiently manage process risk. Finally, the paper highlights areas where internal practices or guidelines should be developed to improve program performance and cost effectiveness.

Resistance Exercise to Prevent and Manage Sarcopenia and Dynapenia

PubMed Central

Law, Timothy D.; Clark, Leatha A.; Clark, Brian C.

2016-01-01

For well over twenty centuries the muscle wasting (sarcopenia) and weakness (dynapenia) that occurs with old age has been a predominant concern of mankind. Exercise has long been suggested as a treatment to combat sarcopenia and dynapenia, as it exerts effects on both the nervous and muscular systems that are critical to positive physiological and functional adaptations (e.g., enhanced muscle strength). For more than two decades scientists have recognized the profound role that progressive resistance exercise training can have on increasing muscle strength, muscle size and functional capacity in older adults. In this review article we discuss how resistance exercise training can be used in the management and prevention of sarcopenia and dynapenia. We first provide an overview of the evidence for this notion and highlight certain critical factors— namely exercise intensity, volume and progression— that are key to optimizing the resistance exercise prescription. We then highlight how many, if not most, of the commonly prescribed exercise programs for seniors are not the ‘best practices’, and subsequently present easy-to-read guidelines for a well-rounded resistance exercise training program designed for the management and prevention of sarcopenia and dynapenia, including example training programs for the beginner through the advanced senior resistance exerciser. These guidelines have been written for the academician as well as the student and health care provider across a variety of disciplines, including those in the long term care industry, such as wellness instructors or activity directors. PMID:27134329

Resistance Exercise to Prevent and Manage Sarcopenia and Dynapenia.

PubMed

Law, Timothy D; Clark, Leatha A; Clark, Brian C

For well over twenty centuries the muscle wasting (sarcopenia) and weakness (dynapenia) that occurs with old age has been a predominant concern of mankind. Exercise has long been suggested as a treatment to combat sarcopenia and dynapenia, as it exerts effects on both the nervous and muscular systems that are critical to positive physiological and functional adaptations (e.g., enhanced muscle strength). For more than two decades scientists have recognized the profound role that progressive resistance exercise training can have on increasing muscle strength, muscle size and functional capacity in older adults. In this review article we discuss how resistance exercise training can be used in the management and prevention of sarcopenia and dynapenia. We first provide an overview of the evidence for this notion and highlight certain critical factors- namely exercise intensity, volume and progression- that are key to optimizing the resistance exercise prescription. We then highlight how many, if not most, of the commonly prescribed exercise programs for seniors are not the 'best practices', and subsequently present easy-to-read guidelines for a well-rounded resistance exercise training program designed for the management and prevention of sarcopenia and dynapenia, including example training programs for the beginner through the advanced senior resistance exerciser. These guidelines have been written for the academician as well as the student and health care provider across a variety of disciplines, including those in the long term care industry, such as wellness instructors or activity directors.

Examining Guidelines for School-Based Breakfast Programs in Canada: A Systematic Review of the Grey Literature.

PubMed

Godin, Katelyn M; Kirkpatrick, Sharon I; Hanning, Rhona M; Stapleton, Jackie; Leatherdale, Scott T

2017-06-01

School breakfast programs are widespread and serve varying objectives regarding youth health promotion. Evidence-based guidelines for breakfast programs may be important in maximizing their effectiveness related to student outcomes, yet it is unclear what is available in Canada. A systematic review was conducted to identify and compare Canadian guidelines related to breakfast programs. Data sources included grey literature databases, customized search engines, targeted websites, and content expert consultations. Eligible guidelines met the following criteria: government and nongovernment sources at the federal and provincial/territorial levels, current version, and intended for program coordinators. Recommendations for program delivery were extracted, categorized, and mapped onto the 4 environments outlined in the ANGELO framework, and they were classified as "common" or "inconsistent" across guidelines. Fifteen sets of guidelines were included. No guidelines were available from federal or territorial governments and 4 provincial governments. There were few references to peer-reviewed literature within the guidelines and despite many common recommendations for program delivery, conflicting recommendations were also identified. Potential barriers to program participation, including a lack of consideration of allergies and other dietary restrictions, were identified. Future research should identify how guidelines are implemented and evaluate what effect their implementation has on program delivery and student outcomes.

Underground storage tank management plan, Oak Ridge Y-12 Plant, Oak Ridge, Tennessee

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

NONE

1997-09-01

The Underground Storage Tank (UST) Program at the Oak Ridge Y-12 Plant was established to locate UST systems at the facility and to ensure that all operating UST systems are free of leaks. UST systems have been removed or upgraded in accordance with Tennessee Department of Environment and Conservation (TDEC) regulations and guidance. With the closure of a significant portion of the USTs, the continuing mission of the UST Management Program is to manage the remaining active UST systems and continue corrective actions in a safe regulatory compliant manner. This Program outlines the compliance issues that must be addressed, reviewsmore » the current UST inventory and compliance approach, and presents the status and planned activities associated with each UST system. The UST Program provides guidance for implementing TDEC regulations and guidelines for petroleum UST systems. The plan is divided into three major sections: (1) regulatory requirements, (2) active UST sites, and (3) out-of-service UST sites. These sections describe in detail the applicable regulatory drivers, the UST sites addressed under the Program, and the procedures and guidance for compliance.« less

Design of a medical and laboratory equipment management program for the new standards certification achievement in Mexico.

PubMed

Franco-Clark, D; Pimentel-Aguilar, A B; Rodriguez-Vera, R

2010-01-01

Certification for healthcare institutions in Mexico is ruled by 2009 standards homologated with the Joint Commission International criteria. Nowadays, healthcare requires of medical equipment and devices, so it has become necessary to implement guidelines for its adequate management in order to reach the highest level of quality and safety at the lowest cost. The objective of this work was to develop a Medical and Laboratory Equipment Management Program, oriented to the improvement of quality, effectiveness and efficiency of the technological resources in order to meet the certification requirements. The result of this work allows to have an auto evaluation tool that focuses the efforts of the National Institute for Respiratory Diseases to the achievement of the new requirements established for the certification.

Michigan Oncology Medical Home Demonstration Project: First-Year Results.

PubMed

Kuntz, Gordon; Tozer, Jane; Snegosky, Jeff; Fox, John; Neumann, Kurt

2014-03-01

The Michigan Oncology Medical Home Demonstration Project (MOMHDP) is an innovative multipractice oncology medical home model, supported by payment reform. Sponsored by Priority Health, Physician Resource Management, and ION Solutions, MOMHDP includes four oncology practices and 29 physicians. Oncology practices used existing technologies, with MOMHDP providing evidence-based treatment guideline selection and compliance tracking, automated physician order entry, a patient portal, symptom management/standardized nurse triage, and advance care planning. To support changes in care and administrative models and to focus on quality, MOMHDP modifies provider payments. The program replaces the average sales price payment methodology with a drug acquisition reimbursement plus a care management fee, calculated to increase total drug reimbursement. Additionally, it reimburses for chemotherapy and treatment planning and advance care planning consultation. There is also a shared savings opportunity. MOMHDP will be enhanced in its second year to include a survivorship program, patient distress screening, imaging guidelines, and standardized patient satisfaction surveys. Priority Health patients receiving chemotherapy for a cancer diagnosis were recruited to the program. Results for this group were compared with a control group of patients from a prior period. In addition to the financial results, the project also accomplished the following: (1) adherence to practice-selected guidelines, (2) institution of advance care planning, (3) effective and standardized symptom management; and (4) payment reform. We have identified a number of critical success factors: strong payer/provider collaboration built on trust through transparent use and cost data; timing of clinical standardization must come from the practices, so they can effectively absorb new approaches; having comprehensive, written program documentation and consistently applied training facilitate practice understanding; existing, off-the-shelf technologies help control costs; independent clinical, administrative, and technical coordination improves provider/payer collaboration; everything takes longer than anticipated, including practice commitment, contracting, and technology implementation. Practices are willing to take on clinical standardization with payment reform. Neither practice size nor technology platform variation was a barrier to participation or success in the project. These results represent preliminary reporting from the first multipractice oncology medical home in the United States, to our knowledge, with payer support that includes payment reform. The results are promising, and the concept warrants further study, review, and reporting. [Table: see text].

Development of a self-management program for employees with complaints of the arm, neck, and/or shoulder: an intervention mapping approach

PubMed Central

Hutting, Nathan; Detaille, Sarah I; Engels, Josephine A; Heerkens, Yvonne F; Staal, J Bart; Nijhuis-van der Sanden, Maria WG

2015-01-01

Purpose To develop a self-management program with an additional eHealth module, using the six steps of the intervention mapping (IM) protocol, to help employees with complaints of the arm, neck, and/or shoulder (CANS) cope with their problems. Methods In Step 1 of the IM protocol, a needs assessment was performed consisting of a review of the Dutch multidisciplinary guidelines on CANS, and of focus group sessions with employees with CANS (n=15) and with relevant experts (n=17). After the needs assessment, the objectives of the intervention and the determinants of self-management at work were formulated (Step 2). Furthermore, theory-based intervention methods and practical strategies were selected (Step 3), and an intervention program (including the eHealth module) was developed (Step 4). Finally, plans for implementation and evaluation of the program were developed (Steps 5 and 6). Results Step 1 of the IM protocol revealed that employees with CANS should be stimulated to search for information about the cause of their complaints, about how to deal with their complaints, and in which manner they can influence their complaints themselves. In Step 2, the overall goal of the intervention was defined as “self-management behavior at work” with the aim to alleviate the perceived disability of the participants. Step 3 described how the intervention methods were translated into practical strategies, and goal setting was introduced as an important method for increasing self-efficacy. The product of Step 4 was the final program plan, consisting of 6-weekly group sessions of 2.5 hours each and an eHealth module. In Step 5, a recruitment plan and course materials were developed, a steering committee was set up, trainers were recruited, and the final program was tested. In Step 6, an evaluation plan was developed, which consists of a randomized controlled trial with a 12-month follow-up period and a qualitative evaluation (interviews) with some of the participants. Conclusion This study resulted in a theory- and practice-based self-management program, based on behavioral change theories, guideline-related evidence, and practice-based knowledge that fits the needs of employees with CANS. PMID:26170689

Quality of Care for Patients with Type 2 Diabetes Mellitus in the Netherlands and the United States: A Comparison of Two Quality Improvement Programs

PubMed Central

Valk, Gerlof D; Renders, Carry M; Kriegsman, Didi MW; Newton, Katherine M; Twisk, Jos WR; van Eijk, Jacques ThM; van der Wal, Gerrit; Wagner, Edward H

2004-01-01

Objective To assess differences in diabetes care and patient outcomes by comparing two multifaceted quality improvement programs in two different countries, and to increase knowledge of effective elements of such programs. Study Setting Primary care in the ExtraMural Clinic (EMC) of the Department of General Practice of the Vrije Universiteit in Amsterdam, the Netherlands, and the Group Health Cooperative (GHC), a group-model health maintenance organization (HMO) in western Washington State in the United States. Data were collected from 1992 to 1997. Study Design In this observational study two diabetes cohorts in which a quality improvement program was implemented were compared. Both programs included a medical record system, clinical practice guidelines, physician educational meetings, audit, and feedback. Only the Dutch program (EMC) included guidelines on the structure of diabetes care and a recall system. Only the GHC program included educational outreach visits, formation of multidisciplinary teams, and patient self-management support. Data Collection Included were 379 EMC patients, and 2,119 GHC patients with type 2 diabetes mellitus. Main process outcomes were: annual number of diabetes visits, and number of HbA1c and blood lipid measurements. Main patient outcomes were HbA1c and blood lipid levels. Multilevel analysis was used to adjust for dependency between repeated observations within one patient and for clustering of patients within general practices. Principal Findings In the EMC process outcomes and glycemic control improved more than at GHC, however, GHC had better baseline measures. There were no differences between programs on blood lipid control. During follow-up, intensification of pharmacotherapy was noted at both sites. Differences noted between programs were in line with differences in diabetes guidelines. Conclusions Following implementation of guidelines and organizational improvement efforts, change occurred primarily in the process outcomes, rather than in the patient outcomes. Although much effort was put into improving process and patient outcomes, both complex programs still showed only moderate effects. PMID:15230924

Comprehensive Auditing in Nuclear Medicine Through the International Atomic Energy Agency Quality Management Audits in Nuclear Medicine (QUANUM) Program. Part 1: the QUANUM Program and Methodology.

PubMed

Dondi, Maurizio; Torres, Leonel; Marengo, Mario; Massardo, Teresa; Mishani, Eyal; Van Zyl Ellmann, Annare; Solanki, Kishor; Bischof Delaloye, Angelika; Lobato, Enrique Estrada; Miller, Rodolfo Nunez; Paez, Diana; Pascual, Thomas

2017-11-01

An effective management system that integrates quality management is essential for a modern nuclear medicine practice. The Nuclear Medicine and Diagnostic Imaging Section of the International Atomic Energy Agency (IAEA) has the mission of supporting nuclear medicine practice in low- and middle-income countries and of helping them introduce it in their health-care system, when not yet present. The experience gathered over several years has shown diversified levels of development and varying degrees of quality of practice, among others because of limited professional networking and limited or no opportunities for exchange of experiences. Those findings triggered the development of a program named Quality Management Audits in Nuclear Medicine (QUANUM), aimed at improving the standards of NM practice in low- and middle-income countries to internationally accepted standards through the introduction of a culture of quality management and systematic auditing programs. QUANUM takes into account the diversity of nuclear medicine services around the world and multidisciplinary contributions to the practice. Those contributions include clinical, technical, radiopharmaceutical, and medical physics procedures. Aspects of radiation safety and patient protection are also integral to the process. Such an approach ensures consistency in providing safe services of superior quality to patients. The level of conformance is assessed using standards based on publications of the IAEA and the International Commission on Radiological Protection, and guidelines from scientific societies such as Society of Nuclear Medicine and Molecular Imaging (SNMMI) and European Association of Nuclear Medicine (EANM). Following QUANUM guidelines and by means of a specific assessment tool developed by the IAEA, auditors, both internal and external, will be able to evaluate the level of conformance. Nonconformances will then be prioritized and recommendations will be provided during an exit briefing. The same tool could then be applied to assess any improvement after corrective actions are taken. This is the first comprehensive audit program in nuclear medicine that helps evaluate managerial aspects, safety of patients and workers, clinical practice, and radiopharmacy, and, above all, keeps them under control all together, with the intention of continuous improvement. Copyright © 2017. Published by Elsevier Inc.

A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan

PubMed Central

Yokoo, Kyoko; Funaba, Yuuki; Fukushima, Sayo; Fukuhara, Rie; Uchida, Mieko; Aiba, Satoru; Doi, Miki; Nishimura, Akira; Hayakawa, Masahiro; Nishimura, Yutaka; Oohira, Mitsuko

2017-01-01

Background: Neonatal pain management guidelines have been released; however, there is insufficient systematic institutional support for the adoption of evidence-based pain management in Japan. Purpose: To evaluate the impact of a collaborative quality improvement program on the implementation of pain management improvements in Japanese neonatal intensive care units (NICUs). Methods: Seven Japanese level III NICUs participated in a neonatal pain management quality improvement program based on an Institute for Healthcare Improvement collaborative model. The NICUs developed evidence-based practice points for pain management and implemented these over a 12-month period. Changes were introduced through a series of Plan-Do-Study-Act cycles, and throughout the process, pain management quality indicators were tracked as performance measures. Jonckheere's trend test and the Cochran-Armitage test for trend were used to examine the changes in quality indicator implementations over time (baseline, 3 months, 6 months, and 12 months). Findings: Baseline pain management data from the 7 sites revealed substantial opportunities for improvement of pain management, and testing changes in the NICU setting resulted in measurable improvements in pain management. During the intervention phase, all participating sites introduced new pain assessment tools, and all sites developed electronic medical record forms to capture pain score, interventions, and infant responses to interventions. Implications for Practice: The use of collaborative quality improvement techniques played a key role in improving pain management in the NICUs. Implications for Research: Collaborative improvement programs provide an attractive strategy for solving evidence-practice gaps in the NICU setting. PMID:28114148

40 CFR 60.35e - Waste management guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Waste management guidelines. 60.35e... (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Hospital/Medical/Infectious Waste Incinerators § 60.35e Waste management guidelines. For approval, a State...

Disease management programs for the underserved.

PubMed

Horswell, Ronald; Butler, Michael K; Kaiser, Michael; Moody-Thomas, Sarah; McNabb, Shannon; Besse, Jay; Abrams, Amir

2008-06-01

Disease management has become an important tool for improving population patient outcomes. The Louisiana State University Health Care Services Division (HCSD) has used this tool to provide care to a largely uninsured population for approximately 10 years. Eight programs currently exist within the HCSD focusing on diabetes, asthma, congestive heart failure, HIV, cancer screening, smoking cessation, chronic kidney disease, and diet, exercise, and weight control. These programs operate at hospital and clinic sites located in 8 population centers throughout southern Louisiana. The programs are structured to be managed at the system level with a clinical expert for each area guiding the scope of the program and defining new goals. Care largely adheres to evidence-based guidelines set forth by professional organizations. To monitor quality of care, indicators are defined within each area and benchmarked to achieve the most effective measures in our population. For example, hemoglobin A1c levels have shown improvements with nearly 54% of the population <7.0%. To support these management efforts, HCSD utilizes an electronic data repository that allows physicians to track patient labs and other tests as well as reminders. To ensure appropriate treatment, patients are able to enroll in the Medication Assistance program. This largely improves adherence to medications for those patients unable to afford them otherwise.

School and the Concussed Youth – Recommendations for Concussion Education and Management

PubMed Central

Sady, Maegan D.; Vaughan, Christopher G.; Gioia, Gerard A.

2011-01-01

Synopsis School learning and performance is arguably the critical centerpiece of child and adolescent development, and there can be significant temporary upset in cognitive processing after a mild traumatic brain injury, also called a concussion. This injury results in a cascade of neurochemical abnormalities, and in the wake of this dysfunction, both physical activity and cognitive activity become sources of additional neurometabolic demand on the brain and may cause symptoms to re-emerge or worsen. This paper provides a foundation for post-injury management of cognitive activity, particularly in the school setting, including design and implementation of school-wide concussion education and management programs. Definitions of cognitive over-exertion and cognitive rest are provided, with guidelines for managing cognitive load in individuals based on their symptom profile and neurocognitive performance. On a broader scale, guidance for the development of comprehensive concussion education and management programs in schools is provided. Proactive management could facilitate recovery by ensuring less cognitive exertion and stress during the recovery period. PMID:22050944

Electronic Handbooks Simplify Process Management

NASA Technical Reports Server (NTRS)

2012-01-01

Getting a multitude of people to work together to manage processes across many organizations for example, flight projects, research, technologies, or data centers and others is not an easy task. Just ask Dr. Barry E. Jacobs, a research computer scientist at Goddard Space Flight Center. He helped NASA develop a process management solution that provided documenting tools for process developers and participants to help them quickly learn, adapt, test, and teach their views. Some of these tools included editable files for subprocess descriptions, document descriptions, role guidelines, manager worksheets, and references. First utilized for NASA's Headquarters Directives Management process, the approach led to the invention of a concept called the Electronic Handbook (EHB). This EHB concept was successfully applied to NASA's Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs, among other NASA programs. Several Federal agencies showed interest in the concept, so Jacobs and his team visited these agencies to show them how their specific processes could be managed by the methodology, as well as to create mockup versions of the EHBs.

Cancer related fatigue: implementing guidelines for optimal management.

PubMed

Pearson, Elizabeth J M; Morris, Meg E; McKinstry, Carol E

2017-07-18

Cancer-related fatigue (CRF) is a key concern for people living with cancer and can impair physical functioning and activities of daily living. Evidence-based guidelines for CRF are available, yet inconsistently implemented globally. This study aimed to identify barriers and enablers to applying a cancer fatigue guideline and to derive implementation strategies. A mixed-method study explored the feasibility of implementing the CRF guideline developed by the Canadian Association for Psychosocial Oncology (CAPO). Health professionals, managers and consumers from different practice settings participated in a modified Delphi study with two survey rounds. A reference group informed the design of the study including the surveys. The first round focused on guideline characteristics, compatibility with current practice and experience, and behaviour change. The second survey built upon and triangulated the first round. Forty-five health practitioners and managers, and 68 cancer survivors completed the surveys. More than 75% of participants endorsed the CAPO cancer related fatigue guidelines. Some respondents perceived a lack of resources for accessible and expert fatigue management services. Further barriers to guideline implementation included complexity, limited practical details for some elements, and lack of clinical tools such as assessment tools or patient education materials. Recommendations to enhance guideline applicability centred around four main themes: (1) balancing the level of detail in the CAPO guideline with ease of use, (2) defining roles of different professional disciplines in CRF management, (3) how best to integrate CRF management into policy and practice, (4) how best to ensure a consumer-focused approach to CRF management. Translating current knowledge on optimal management of CRF into clinical practice can be enhanced by the adoption of valid guidelines. This study indicates that it is feasible to adopt the CAPO guidelines. Clinical application may be further enhanced with guideline adaptation, professional education and integration with existing practices.

Study of Current Practice and Future Advancements in Blood Management and Effectiveness of a Multimodality Training Program on Improving Transfusion Knowledge, Practice and Outcomes

DTIC Science & Technology

2012-08-01

to trauma, surgery or blood diseases such as anemia, hemophilia or sickle- cell disease. But transfusions carry risks. Current practices are often...Blood Management Topic 4: Diagnosis of Red cell disorders and oxygen carrying capacity Topic 5: Diagnosis of Disorders in homeostasis Topic 6...the Clinical Transfusion Medicine Committee of the AABB. Red Blood Cell Transfusion: A Clinical Practice Guideline From the AABB. Ann Intern Med

Directives Relatives a l'Elaboration de Programmes de Conseil en Gestion pour Petites Entreprises (Guidelines for Management Consulting Programs for Small-Scale Enterprise). Appropriate Technologies for Development. Peace Corps Information Collection & Exchange Manual Series No. M-29.

ERIC Educational Resources Information Center

Vaughan, Gary L.

Written in French, this manual is designed to assist management consultants in working with small-scale entrepreneurs in developing countries. Addressed in an overview of the small-scale enterprise (SSE) are the role of the SSE in Third World development, problems of SSEs, and target firms. The second chapter deals with various forms of management…

Legal and regulatory challenges in public-private managed behavioral healthcare program procurement: moving beyond the conflicts.

PubMed

TenHoor, W J; Harbin, H

1995-01-01

In the past year a number of states have initiated managed behavioral healthcare proposals to reform the delivery of public mental health services. Those in Florida, Iowa and Pennsylvania have been met with administrative and legal challenges. Given the potential controversies surrounding this procurement process, the authors suggest some guidelines on how to improve the process and thereby enhance public/private collaborations--to the benefit of states, behavioral healthcare providers and clients.

Management of recurrent depression.

PubMed

Howell, Cate; Marshall, Charlotte; Opolski, Melissa; Newbury, Wendy

2008-09-01

Depression is a potentially recurring or chronic disorder. The provision of evidence based treatment and effective practice organisation is central to chronic disease management, and these principles can be applied to managing depression. This article outlines the principles of chronic disease management, including the use of management plans and a team care approach, and their application to the management of depression. Treatment approaches that systematically assist patients in managing their chronic disease are more effective than those based on acute care. Depression treatment guidelines are available, as well as primary care initiatives which facilitate comprehensive and long term mental health care, including relapse prevention strategies. A number of risk factors for depression relapse have been identified, and research has recommended that novel intensive relapse prevention programs need to be developed.

41 CFR 109-38.502 - Guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38-MOTOR EQUIPMENT MANAGEMENT 38.5-Scheduled Maintenance § 109-38.502 Guidelines. ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Guidelines. 109-38.502 Section 109-38.502 Public Contracts and Property Management Federal Property Management Regulations System...

Landowner Satisfaction with the Wetland Reserve Program in Texas: A Mixed-Methods Analysis

NASA Astrophysics Data System (ADS)

Stroman, Dianne; Kreuter, Urs P.

2016-01-01

Using mail survey data and telephone interviews, we report on landowner satisfaction with permanent easements held by the Natural Resources Conservation Service (NRCS) throughout Texas. This study found that landowners were dissatisfied with the NRCS Wetland Reserve Program (WRP), conflicting with results of previous studies. The objective of this study was to explore specific reasons for frustration expressed by landowners with the program. We found three predominant themes underpinning program dissatisfaction: (1) upfront restoration failures, (2) overly restrictive easement constraints, and (3) bureaucratic hurdles limiting landowners' ability to conduct adaptive management on their easement property. The implications of this study suggest that attitudes of landowners participating in the WRP may limit the long-term effectiveness of this program. Suggestions for improving the program include implementing timely, ecologically sound restoration procedures and streamlining and simplifying the approval process for management activity requests. In addition, the NRCS should consider revising WRP restriction guidelines in order to provide more balance between protection goals and landowner autonomy.

Quality management as knowledge sharing: experiences of the Napa County Health and Human Services Agency.

PubMed

Harrison, Lindsay

2012-01-01

Lacking a coordinated effort in utilizing data and tracking program outcomes, one agency developed a Quality Management (QM) division to facilitate and manage more effective data use. To support this process, the agency sought to develop a collective, agency-wide understanding and investment in improving and measuring client outcomes. Similarly, the agency also focused efforts on creating a culture of transparency and accountability, with goals of improving service, increasing agency integrity, meeting regulatory compliance, and engaging in effective risk management. Operationalizing the QM initiative involved developing procedures, systems, and guidelines that would facilitate the generation of reliable and accurate data that could be used to inform program change and decision-making. This case study describes this agency's experience in successfully creating and implementing a QM initiative aimed at engaging in greater knowledge sharing. Copyright © Taylor & Francis Group, LLC

Total quality in acute care hospitals: guidelines for hospital managers.

PubMed

Holthof, B

1991-08-01

Quality improvement can not focus exclusively on peer review and the scientific evaluation of medical care processes. These essential elements have to be complemented with a focus on individual patient needs and preferences. Only then will hospitals create the competitive advantage needed to survive in an increasingly market-driven hospital industry. Hospital managers can identify these patients' needs by 'living the patient experience' and should then set the hospital's quality objectives according to its target patients and their needs. Excellent quality program design, however, is not sufficient. Successful implementation of a quality improvement program further requires fundamental changes in pivotal jobholders' behavior and mindset and in the supporting organizational design elements.

The Wrong Tool for the Job: Diabetes Public Health Programs and Practice Guidelines

PubMed Central

López, Andrea; Black, Karen; Schillinger, Dean

2011-01-01

We surveyed state diabetes programs to determine whether they develop and disseminate diabetes guidelines. We found they largely disseminate clinical practice guidelines developed from subspecialty organizations, do not prioritize among the many recommendations contained in diabetes guidelines, and have not adapted guidelines to focus on population rather than individual health. An opportunity exists for state diabetes control programs to better align guidelines with public health goals. PMID:21852653

Laboratory Directed Research and Development Annual Report - Fiscal Year 2000

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

Fisher, Darrell R.; Hughes, Pamela J.; Pearson, Erik W.

The projects described in this report represent the Laboratory's investment in its future and are vital to maintaining the ability to develop creative solutions for the scientific and technical challenges faced by DOE and the nation. In accordance with DOE guidelines, the report provides, a) a director's statement, b) an overview of the laboratory's LDRD program, including PNNL's management process and a self-assessment of the program, c) a five-year project funding table, and d) project summaries for each LDRD project.

Education and training of future wetland scientists and managers

USGS Publications Warehouse

Wilcox, D.A.

2008-01-01

Wetland science emerged as a distinct discipline in the 1980s. In response, courses addressing various aspects of wetland science and management were developed by universities, government agencies, and private firms. Professional certification of wetland scientists began in the mid-1990s to provide confirmation of the quality of education and experience of persons involved in regulatory, management, restoration/construction, and research involving wetland resources. The education requirements for certification and the need for persons with specific wetland training to fill an increasing number of wetland-related positions identified a critical need to develop curriculum guidelines for an undergraduate wetland science and management major for potential accreditation by the Society of Wetland Scientists. That proposed major contains options directed toward either wetland science or management. Both options include required basic courses to meet the general education requirements of many universities, required upper-level specialized courses that address critical aspects of physical and biological sciences applicable to wetlands, and a minimum of four additional upper-level specialized courses that can be used to tailor a degree to students' interests. The program would be administered by an independent review board that would develop guidelines and evaluate university applications for accreditation. Students that complete the required coursework will fulfill the education requirements for professional wetland scientist certification and possess qualifications that make them attractive candidates for graduate school or entry-level positions in wetland science or management. Universities that offer this degree program could gain an advantage in recruiting highly qualified students with an interest in natural resources. Alternative means of educating established wetland scientists are likewise important, especially to provide specialized knowledge and experience or updates related to new management discoveries, policies, and regulations. ?? 2008 The Society of Wetland Scientists.

An integrated approach for improving occupational health and safety management: the voluntary protection program in Taiwan.

PubMed

Su, Teh-Sheng; Tsai, Way-Yi; Yu, Yi-Chun

2005-05-01

A voluntary compliance program for occupational health and safety management, Voluntary Protection Programs (VPP), was implemented with a strategy of cooperation and encouragement in Taiwan. Due to limitations on increasing the human forces of inspection, a regulatory-based guideline addressing the essence of Occupational Health and Safety Management Systems (OHSMS) was promulgated, which combined the resources of third parties and insurance providers to accredit a self-improving worksite with the benefits of waived general inspection and a merit contributing to insurance premium payment reduction. A designated institute accepts enterprise's applications, performs document review and organizes the onsite inspection. A final review committee of Council of Labor Affairs (CLA) confers a two-year certificate on an approved site. After ten years, the efforts have shown a dramatic reduction of occupational injuries and illness in the total number of 724 worksites granted certification. VPP worksites, in comparison with all industries, had 49% lower frequency rate in the past three years. The severity rate reduction was 80% in the same period. The characteristics of Taiwan VPP program and international occupational safety and health management programs are provided. A Plan-Do-Check-Act management cycle was employed for pursuing continual improvements to the culture fostered. The use of a quantitative measurement for assessing the performance of enterprises' occupational safety and health management showed the efficiency of the rating. The results demonstrate that an employer voluntary protection program is a promising strategy for a developing country.

Guidelines for Project Management

NASA Technical Reports Server (NTRS)

Ben-Arieh, David

2001-01-01

Project management is an important part of the professional activities at Kennedy Space Center (KSC). Project management is the means by which many of the operations at KSC take shape. Moreover, projects at KSC are implemented in a variety of ways in different organizations. The official guidelines for project management are provided by NASA headquarters and are quite general. The project reported herein deals with developing practical and detailed project management guidelines in support of the project managers. This report summarizes the current project management effort in the Process Management Division and presents a new modeling approach of project management developed by the author. The report also presents the Project Management Guidelines developed during the summer.

Systematic review of guidelines for the physical management of osteoarthritis.

PubMed

Larmer, Peter J; Reay, Nicholas D; Aubert, Elizabeth R; Kersten, Paula

2014-02-01

To undertake a systematic critical appraisal of guidelines to provide a summary of recommendations for the physical management of osteoarthritis (OA). The Cochrane Library, MEDLINE, CINAHL, SPORTDiscus with Full Text, Scopus, ScienceDirect, PEDro, and Google Scholar databases were searched (2000-2013) to identify all guidelines, protocols, and recommendations for the management or treatment of OA. In addition, Internet searches of all relevant arthritis organizations were undertaken. All searches were performed between July 2012 and end of April 2013. Guidelines that included only pharmacological, injection therapy, or surgical interventions were excluded. Guidelines published only in English were retrieved. OA guidelines developed from evidence-based research, consensus, and/or expert opinion were retrieved. There were no restrictions on severity or site of OA, sex, or age. Nineteen guidelines were identified for evaluation. The quality of all guidelines was critically appraised using the Appraisal of Guidelines for REsearch and Evaluation II instrument. Each guideline was independently reviewed. All relevant recommendations for the physical management of OA were synthesized, graded, and ranked according to available evidence. Seventeen guidelines with recommendations on the physical management of OA met the inclusion criteria and underwent a full critical appraisal. There were variations in the interventions, levels of evidence, and strength of recommendations across the guidelines. Forty different interventions were identified. Recommendations were graded from "strongly recommended" to "unsupported." Exercise and education were found to be strongly recommended by most guidelines. Exercise and education were key recommendations supporting the importance of rehabilitation in the physical management of OA. This critical appraisal can assist health care providers who are involved in the management of people with OA. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Planning and Preparation for CD-ROM Implementation: The Citadel Library.

ERIC Educational Resources Information Center

Maynard, J. Edmund

Management guidelines for library planning and a strategic planning program profile based on the literature were used in the planning process for implementing access to databases on CD-ROM at the Daniel Library of the Citadel, Military College of South Carolina. According to this model, the planning process would consist of five stages: (1)…

Analysis, Modeling, and Simulation (AMS) testbed framework for Dynamic Mobility Applications (DMA) and Active Transportation and Demand Management (ATDM) programs.

DOT National Transportation Integrated Search

1997-08-01

This document provides guidelines for the review of state ITS/CVO business plans by the FHWA. The purpose of the review is to ensure that the state business plans have been developed in a manner consistent with the FHWAs intent in awarding ITS/CVO...

Methods of Evaluation To Determine the Preservation Needs in Libraries and Archives: A RAMP Study with Guidelines.

ERIC Educational Resources Information Center

Cunha, George M.

This Records and Archives Management Programme (RAMP) study is intended to assist in the development of basic training programs and courses in document preservation and restoration, and to promote harmonization of such training both within the archival profession and within the broader information field. Based on the assumption that conservation…

Investigating Alternatives to the Fish Early Life-Stage Test: A Strategy for Discovering and Annotating Adverse Outcome Pathways for Early Fish Development

EPA Science Inventory

The fish early life-stage (FELS) test (OECD Test Guideline 210) is the primary test used internationally to estimate chronic fish toxicity in support of ecological risk assessments and chemical management programs. As part of an on-going effort to develop efficient and cost-effec...

Short-rotation management of Eucalyptus: guidelines for plantations in Hawaii

Treesearch

Craig D. Whitesell; Dean S. DeBell; Thomas H. Schubert; Robert F. Strand; Thomas B. Crabb

1992-01-01

A 10-year research and development program was conducted by the BioEnergy Development Corporation, USDA Forest Service, and U.S. Department of Energy on the island of Hawaii, where nearly 230,000 acres are suitable for growing biomass in short-rotation Eucalyptus plantations. Successful techniques are described for seedling production, plantation establishment (site...

Management of Cancer Cachexia and Guidelines Implementation in a Comprehensive Cancer Center: A Physician-Led Cancer Nutrition Program Adapted to the Practices of a Country.

PubMed

Senesse, Pierre; Isambert, Agnès; Janiszewski, Chloé; Fiore, Stéphanie; Flori, Nicolas; Poujol, Sylvain; Arroyo, Eric; Courraud, Julie; Guillaumon, Vanessa; Mathieu-Daudé, Hélène; Colasse, Sophie; Baracos, Vickie; de Forges, Hélène; Thezenas, Simon

2017-09-01

Cancer-associated cachexia is correlated with survival, side-effects, and alteration of the patients' well-being. We implemented an institution-wide multidisciplinary supportive care team, a Cancer Nutrition Program (CNP), to screen and manage cachexia in accordance with the guidelines and evaluated the impact of this new organization on nutritional care and funding. We estimated the workload associated with nutrition assessment and cachexia-related interventions and audited our clinical practice. We then planned, implemented, and evaluated the CNP, focusing on cachexia. The audit showed a 70% prevalence of unscreened cachexia. Parenteral nutrition was prescribed to patients who did not meet the guideline criteria in 65% cases. From January 2009 to December 2011, the CNP team screened 3078 inpatients. The screened/total inpatient visits ratio was 87%, 80%, and 77% in 2009, 2010, and 2011, respectively. Cachexia was reported in 74.5% (n = 2253) patients, of which 94.4% (n = 1891) required dietary counseling. Over three years, the number of patients with artificial nutrition significantly decreased by 57.3% (P < 0.001), and the qualitative inpatients enteral/parenteral ratio significantly increased: 0.41 in 2009, 0.74 in 2010, and 1.52 in 2011. Between 2009 and 2011, the CNP costs decreased significantly for inpatients nutritional care from 528,895€ to 242,272€, thus financing the nutritional team (182,520€ per year). Our results highlight the great benefits of implementing nutritional guidelines through a physician-led multidisciplinary team in charge of nutritional care in a comprehensive cancer center. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Guideline-directed low-density lipoprotein management in high-risk patients with ischemic stroke: findings from Get with the Guidelines-Stroke 2003 to 2012.

PubMed

Saposnik, Gustavo; Fonarow, Gregg C; Pan, Wenquin; Liang, Li; Hernandez, Adrian F; Schwamm, Lee H; Smith, Eric E

2014-11-01

Limited information is available on stroke prevention in high-risk patients with preexisting cardiovascular disease. Our aim was to use admission low-density lipoprotein (LDL) values to evaluate differences in the attainment of National Cholesterol Education Program-Adult Treatment Panel III guidelines goals at the time of the index event in high-risk patients with stroke and preexisting cardio- or cerebrovascular disease. Observational study, using data from the Get-With-The-Guidelines-Stroke Registry including 913 436 patients with an acute ischemic stroke or transient ischemic attack from April 2003 to September 2012. Participants were classified as high risk if they had history of transient ischemic attack (TIA), stroke (cardiovascular disease), and coronary artery disease (CAD). Of the 913 436 patients admitted with an acute stroke or TIA, 194 557 (21.3%) had previous stroke/TIA, 148 833 (16.3%) had previous CAD, and 88 605 (9.7%) had concomitant CAD and cardiovascular disease. Overall, only 68% of patients with stroke were at their preadmission National Cholesterol Education Program III guideline-recommended LDL target; 51.3% had LDL <100 mg/dL; and only 19.8% had LDL<70 mg/dL. Among those presenting with a recurrent stroke, >45% had LDL>100 mg/dL. When compared with patients with CAD, patients with previous TIA/stroke were less likely to have LDL<100 or <70 mg/dL. In multivariable analysis, older age, men, white race, lack of major vascular risk factors, previous use of cholesterol-lowering therapy, and care provided in larger hospitals were associated with meeting LDL targets on admission testing. Management of dyslipidemia in high-risk patients with preexistent CAD or stroke continues to be suboptimal. Only 1 in 5 patients with prior TIA/stroke had LDL levels <70 mg/dL. © 2014 American Heart Association, Inc.

Management of cosmic radiation exposure for aircraft crew in Japan.

PubMed

Yasuda, Hiroshi; Sato, Tatsuhiko; Yonehara, Hidenori; Kosako, Toshiso; Fujitaka, Kazunobu; Sasaki, Yasuhito

2011-07-01

The International Commission on Radiological Protection has recommended that cosmic radiation exposure of crew in commercial jet aircraft be considered as occupational exposure. In Japan, the Radiation Council of the government has established a guideline that requests domestic airlines to voluntarily keep the effective dose of cosmic radiation for aircraft crew below 5 mSv y(-1). The guideline also gives some advice and policies regarding the method of cosmic radiation dosimetry, the necessity of explanation and education about this issue, a way to view and record dose data, and the necessity of medical examination for crew. The National Institute of Radiological Sciences helps the airlines to follow the guideline, particularly for the determination of aviation route doses by numerical simulation. The calculation is performed using an original, easy-to-use program package called 'JISCARD EX' coupled with a PHITS-based analytical model and a GEANT4-based particle tracing code. The new radiation weighting factors recommended in 2007 are employed for effective dose determination. The annual individual doses of aircraft crew were estimated using this program.

[How to assess clinical practice guidelines with AGREE II: The example of neonatal jaundice].

PubMed

Renesme, L; Bedu, A; Tourneux, P; Truffert, P

2016-03-01

Neonatal jaundice is a very frequent condition that occurs in approximately 50-70% of term or near-term (>35 GA) babies in the 1st week of life. In some cases, a high bilirubin blood level can lead to kernicterus. There is no consensus for the management of neonatal jaundice and few countries have published national clinical practice guidelines for the management of neonatal jaundice. The aim of this study was to assess the quality of these guidelines. We conducted a systematic review of the literature for national clinical practice guidelines for the management of neonatal jaundice in term or near-term babies. Four independent reviewers assessed the quality of each guideline using the AGREE II evaluation. For each of the clinical practice guidelines, the management modalities were analyzed (screening, treatment, follow-up, etc.). Seven national clinical practice guidelines were found (South Africa, USA AAP, UK NICE, Canada, Norway, Switzerland, and Israel). The AGREE II score showed widespread variation regarding the quality of these national guidelines. There was no major difference between the guidelines concerning the clinical management of these babies. The NICE guideline is the most valuable guideline regarding the AGREE II score. NICE showed that, despite a strong and rigorous methodology, there is no evidenced-based recommended code of practice (RCP). Comparing RCPs, we found no major differences. The NICE guideline showed the best quality. The AGREE II instrument should be used as a framework when developing clinical practice guidelines to improve the quality of the future guideline. In France, a national guideline is needed for a more standardized management of neonatal jaundice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Severe Sepsis and Septic Shock Cases Meeting Guidelines Among Patients in a University Hospital Setting.

PubMed

Charrier, J A; Steen, C L; Borrero, E

2017-01-01

A diagnosis of severe sepsis or septic shock has been shown to significantly increase mortality rate independent of other factors. Research has revealed all cause hospital case fatality rates have declined yet the percentage of severe sepsis cases continues to increase and age-adjusted mortality rates from severe sepsis and septic shock has significantly increased during the same time period. Patients with severe sepsis demonstrate ongoing mortality rate increases for up to 2 years following hospitalization when compared to aged matched controls of nonseptic patients. International guidelines with mortality benefit for the management of severe sepsis and septic shock have been illustrated in the latest surviving sepsis campaign. The objective of this study was to increase the percentage of patients admitted to the hospital with a diagnosis of severe sepsis or septic shock who met guidelines based on surviving sepsis campaign. A retrospective chart review was conducted for patients admitted to UHC from January 2016 to present to identify cases with a diagnosis of severe sepsis or septic shock, and whether they met guidelines set forth by surviving sepsis campaign both before and after an intervention program which included interviews with providers failing to meet protocol, educational sessions on guidelines to meet protocol, resident led quality improvement workshops to address barriers to meeting protocol, and development of an EMR power plan to assist providers on meeting protocol. 139 cases with a diagnosis, or meeting criteria for, severe sepsis or septic shock were identified during the period of 1/1/2016-9/30/2016 with an average of 43 percent of total cases which met guidelines. Trend analysis revealed increased compliance following resident lead intervention program with 31 percent and 49 percent before and after intervention, respectively. ICU data is currently being analyzed for meeting guidelines and have not been included in current data. The most common reason for failing guidelines was failure to obtain or repeat lactic acid on time (46 percent ); and failure to give timely antibiotics (22 percent );. The percentage of patients admitted to the hospital with a diagnosis of severe sepsis or septic shock at UHC meeting guidelines set forth by surviving sepsis campaign has improved following resident lead intervention program. Intervention strategies to further improve compliance with guidelines with a goal >60 percent are currently being analyzed.

Reduction of Broad-Spectrum Antimicrobial Use in a Tertiary Children's Hospital Post Antimicrobial Stewardship Program Guideline Implementation.

PubMed

Lee, Kelley R; Bagga, Bindiya; Arnold, Sandra R

2016-03-01

The core strategies recommended for antimicrobial stewardship programs, formulary restriction with preauthorization and prospective audit and feedback, can be difficult to implement with limited resources; therefore, we took an approach of guideline development and education with the goal of reducing overall antibiotic use and unwarranted use of broad-spectrum antimicrobials. Retrospective chart review before and after intervention. Le Bonheur Children's Hospital pediatric, neonatal, and cardiac ICUs. All patients in our pediatric, neonatal, and cardiac ICUs within the time frame of the study. Baseline review in our ICUs revealed excessive use of broad-spectrum antibiotics and inconsistency in managing common pediatric infections. Guidelines were developed and implemented using cycles of education, retrospective review, and feedback. Purchasing and antibiotic use data were obtained to assess changes before and after guideline implementation. Unit-specific days of therapy were measured using periodic chart audit. Segmented regression analysis was used to assess changes in purchasing and broad-spectrum antibiotic days of therapy. The change in median monthly purchases was assessed using 2-tail Student t test. Hospital-wide targeted broad-spectrum antibiotic days of therapy/1,000 patient-days during the preimplementation year averaged 105 per month and decreased 33% to 70 per month during the postimplementation year. The overall antibiotic days of therapy decreased 41%, 21%, and 18%, and targeted broad-spectrum antibiotic days of therapy decreased by 99%, 75%, and 61% in the cardiac, pediatric, and neonatal ICUs, respectively, after guideline implementation. Yearly purchases of our most common broad-spectrum antibiotics decreased 62% from $230,059 to $86,887 after guideline implementation. Median monthly purchases of these drugs before implementation were $19,389 and $11,043 after implementation (p < 0.001). Guideline implementation was successful in reducing targeted broad-spectrum antibiotic use and acquisition cost. Programs with very limited resources may find similar implementation of guidelines effective to provide initial success, so that putting into practice one of the more resource intensive core strategies, such as prospective audit and feedback, may be feasible.

[Evaluating the effectiveness of a disease management program diabetes in the German Statutory Health Insurance: first results and methodological considerations].

PubMed

Drabik, Anna; Graf, Christian; Büscher, Guido; Stock, Stephanie

2012-01-01

Disease management programs (DMPs) were implemented in the German Statutory Health Insurance (SHI) in a nationwide rollout in 2002. The explicit goal of the programs is to improve coordination and quality of care for the chronically ill (Sect. 137f, SGB V). To reach this goal extensive quality assurance measures in the programs are mandatory, enrolment and coordination of care rests with the primary care or DMP physician, treatment is based on evidence-based care guidelines, and patients are offered diabetes education classes to support self-management. The present study evaluates the DMP diabetes mellitus type II, a nationwide program offered by the BARMER, a German health insurance company. To minimize selection bias we formed a control group of administrative data using a propensity score matching approach. In comparison to the control group DMP participants have a significantly lower mortality rate, and their average drug and hospital costs are reduced. Enrolled patients also had a lower mean number of hospital stays and shorter hospital stays. These results indicate that the programs meet the initial goal of improving the quality of care for the chronically ill. Copyright © 2011. Published by Elsevier GmbH.

[Methodological fundamentals for the development of the guideline].

PubMed

Bernardy, K; Klose, P; Uçeyler, N; Kopp, I; Häuser, W

2008-06-01

The guideline was developed by 10 scientific societies and 2 patient self-help organizations and coordinated by the German Association of Pain Therapy (DIVS). The guideline was approved by the Association of the Scientific Medical Societies in Germany AWMF (AWMF number 041/004), april 17, 2008. No direct or indirect financial support by pharmaceutical companies was involved and there were no potential conflicts of interest for any of the 58 participants of the guideline group. The results of a systematic search of the literature (Cochrane Library [1993-12/2006], Medline [1980-12/2006], PsychInfo [1966-12/2006] and Scopus [1980-12/2006]) were analyzed by 8 working groups. A balanced composition of the working groups as to sex, level of medical care and position in medical or scientific hierarchy of their members was realized. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine. Grading of the strengths of recommendations was done according to the German program for disease management guidelines. Standardized, formal procedures to reach a consensus on recommendations were used. The guideline was reviewed by the board of directors of the societies engaged in the development of the guideline. The guideline will be published in complete and short scientific versions, clinical practice and patient versions.

Adherence to management guidelines for childhood asthma in Australia.

PubMed

Bereznicki, Bonnie J; Beggs, Sean; Duff, Caitlin; Bereznicki, Luke

2015-12-01

Little is known about doctors' treatment preferences for childhood asthma. The aim of this study was to investigate adherence to management guidelines for childhood asthma. One thousand general practitioners (GPs) and paediatric specialists in Australia were invited to take part in a survey, which collected demographic details and explored their familiarity with and adherence to childhood asthma management guidelines. Two hundred doctors (20% response rate) responded and were eligible for inclusion in the survey. Approximately half (54.5%) of the respondents were very familiar with at least one of the childhood asthma management guidelines. The majority of respondents (86.8%) followed guideline recommendations when prescribing initial maintenance therapy for childhood asthma, while 89.2% and 68.0% followed guideline recommendations regarding step-up and step-down therapy respectively. Overall familiarity with childhood asthma management guidelines could be improved. There is scope for improvement in the adherence to these guidelines when prescribing medication in childhood asthma, particularly for step-down therapy.

Peripartum management of bipolar disorder: what do the latest guidelines recommend?

PubMed

Sharma, Verinder; Sharma, Sapna

2017-04-01

Many women with bipolar disorder experience significant morbidity during pregnancy and the postpartum period. The use of evidence-based and up-to-date guidelines has the potential to improve maternal and neonatal care. We review the latest clinical practice guidelines to gather recommendations for the peripartum management of bipolar disorder. Areas covered: Three electronic databases, MEDLINE/PubMed, the Cochrane Library, and the National Guidelines Clearinghouse were searched using various combinations of the following terms: bipolar disorder, pregnancy, postpartum, peripartum, puerperal, antenatal, postnatal, and guidelines. All guidelines retrieved were published, revised, or reaffirmed during the period from November 2010-June 2016. Expert commentary: To date there are no exclusive guidelines for the peripartum management of bipolar disorder. Currently available guidelines do not provide sufficient guidance for clinicians to deliver optimal care to women before, during, and after pregnancy. The guidelines reflect the paucity of available literature on the peripartum management of bipolar disorder. Further research is urgently needed to strengthen the evidence supporting the guidelines recommendations.

41 CFR 105-54.304 - Cost guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Cost guidelines. 105-54.304 Section 105-54.304 Public Contracts and Property Management Federal Property Management... Administration 54-ADVISORY COMMITTEE MANAGEMENT 54.3-Advisory Committee Procedures § 105-54.304 Cost guidelines...

Using standardized patients to teach disease management skills to preclinical students: a pilot project.

PubMed

Brown, Amanda; Anderson, Delia; Szerlip, Harold M

2003-01-01

Physician adherence to practice guidelines has been poor. Exposure to such guidelines is not a routine part of medical school curricula. This study was designed to determine whether standardized patients could be used to teach preclinical students the skills to manage a patient with newly diagnosed diabetes mellitus. Students were assigned a standardized patient with hyperglycemia. The students were given guidelines on the management of diabetes and told to manage the patient appropriately. Patients' charts were reviewed to determine if all cardiovascular risks were managed appropriately. Students successfully managed all cardiovascular risks according to published guidelines. Participants overwhelmingly believed this methodology was a valuable way to teach disease management. Second-year students can use practice guidelines to successfully manage patients with diabetes. The students' performance exceeded the standards of care found in the published literature. This problem-based approach may be an ideal way to teach disease management.

Storage management in Ada. Three reports. Volume 1: Storage management in Ada as a risk to the development of reliable software. Volume 2: Relevant aspects of language. Volume 3: Requirements of the language versus manifestations of current implementations

NASA Technical Reports Server (NTRS)

Auty, David

1988-01-01

The risk to the development of program reliability is derived from the use of a new language and from the potential use of new storage management techniques. With Ada and associated support software, there is a lack of established guidelines and procedures, drawn from experience and common usage, which assume reliable behavior. The risk is identified and clarified. In order to provide a framework for future consideration of dynamic storage management on Ada, a description of the relevant aspects of the language is presented in two sections: Program data sources, and declaration and allocation in Ada. Storage-management characteristics of the Ada language and storage-management characteristics of Ada implementations are differentiated. Terms that are used are defined in a narrow and precise sense. The storage-management implications of the Ada language are described. The storage-management options available to the Ada implementor and the implications of the implementor's choice for the Ada programmer are also described.

78 FR 71715 - Amendments to Highway Safety Program Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-29

... promulgate uniform guidelines for State highway safety programs. This notice revises five of the existing... successful and are based on sound science and program administration. The revised guidelines are Guideline No... become effective as of the date of publication of this document in the Federal Register. FOR FURTHER...

Development and Application of a Message Metric for NOAA NWS Tsunami Warnings and Recommended Guidelines for the NWS TsunamiReady Program

NASA Astrophysics Data System (ADS)

Gregg, C. E.; Johnston, D. M.; Ricthie, L.; Meinhold, S.; Johnson, V.; Scott, C.; Farnham, C.; Houghton, B. F.; Horan, J.; Gill, D.

2012-12-01

Improving the quality and effectiveness of tsunami warning messages and the TsunamiReady community preparedness program of the US National Oceanic and Atmospheric Administration, National Weather Service's (NWS), Tsunami Program are two key objectives of a three year project (Award NA10NWS4670015) to help integrate social science into the NWS' Tsunami Program and improve the preparedness of member states and territories of the National Tsunami Hazard Mitigation Program (NTHMP). Research was conducted in collaboration with state and local emergency managers. Based on findings from focus group meetings with a purposive sample of local, state and Federal stakeholders and emergency managers in six states (AK, WA, OR, CA, HI and NC) and two US Territories (US Virgin Islands and American Samoa), and upon review of research literature on behavioral response to warnings, we developed a warning message metric to help guide revisions to tsunami warning messages issued by the NWS' West Coast/Alaska Tsunami Warning Center, Alaska and Pacific Tsunami Warning Center, Hawaii. The metric incorporates factors that predict response to warning information, which are divided into categories of Message Content, Style, Order and Formatting and Receiver Characteristics. A message is evaluated by cross-referencing the message with the meaning of metric factors and assigning a maximum score of one point per factor. Findings are then used to guide revisions of the message until the characteristics of each factor are met. From focus groups that gathered information on the usefulness and achievability of tsunami preparedness actions, we developed recommendations for revisions to the proposed draft guidelines of the TsunamiReady Improvement Program. Proposed key revisions include the incorporation of community vulnerability to distant (far-field) versus local (near-field) tsunamis as a primary determinant of mandatory actions, rather than community population. Our team continues to work with NWS personnel, including a NWS Tsunami Warning Improvement Team, and the focus group participants to finalize and pilot test prototype warning products and the draft TsunamiReady guidelines.

Manned space flight nuclear system safety. Volume 6: Space base nuclear system safety plan

NASA Technical Reports Server (NTRS)

1972-01-01

A qualitative identification of the steps required to assure the incorporation of radiological system safety principles and objectives into all phases of a manned space base program are presented. Specific areas of emphasis include: (1) radiological program management, (2) nuclear system safety plan implementation, (3) impact on program, and (4) summary of the key operation and design guidelines and requirements. The plan clearly indicates the necessity of considering and implementing radiological system safety recommendations as early as possible in the development cycle to assure maximum safety and minimize the impact on design and mission plans.

Play for All Guidelines: Planning, Design and Management of Outdoor Play Settings for All Children. Second Edition.

ERIC Educational Resources Information Center

Moore, Robin C., Ed.; Goltsman, Susan M., Ed.; Iacofano, Daniel S., Ed.

These guidelines assist professional designers, park and recreation managers, and community groups when making decisions about the planning, design, and ongoing management of children's public play environments. The guidelines are updated to meet or exceed the requirements of the Americans with Disabilities Act Guidelines (July 26, 1991) and the…

40 CFR 60.35e - Waste management guidelines.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 7 2012-07-01 2012-07-01 false Waste management guidelines. 60.35e... Hospital/Medical/Infectious Waste Incinerators § 60.35e Waste management guidelines. For approval, a State plan shall include the requirements for a waste management plan at least as protective as those...

40 CFR 60.35e - Waste management guidelines.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 6 2011-07-01 2011-07-01 false Waste management guidelines. 60.35e... Hospital/Medical/Infectious Waste Incinerators § 60.35e Waste management guidelines. For approval, a State plan shall include the requirements for a waste management plan at least as protective as those...

40 CFR 60.35e - Waste management guidelines.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 7 2013-07-01 2013-07-01 false Waste management guidelines. 60.35e... Hospital/Medical/Infectious Waste Incinerators § 60.35e Waste management guidelines. For approval, a State plan shall include the requirements for a waste management plan at least as protective as those...

40 CFR 60.35e - Waste management guidelines.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 7 2014-07-01 2014-07-01 false Waste management guidelines. 60.35e... Hospital/Medical/Infectious Waste Incinerators § 60.35e Waste management guidelines. For approval, a State plan shall include the requirements for a waste management plan at least as protective as those...

Rethinking Heat Injury in the SOF Multipurpose Canine: A Critical Review.

PubMed

Baker, Janice L; Hollier, Paul J; Miller, Laura; Lacy, Ward A

2012-01-01

Heat injury is a significant concern of the Special Operations Forces Multipurpose Canine (SOF MPC). The unique athletic abilities and working environment of the SOF MPC differ from that of companion dogs or even conventional military working dogs. This should be considered in the prevention, diagnosis, and treatment of heat injury of the SOF MPC. A critical review of the literature on canine heat injury as it pertains to working dogs demonstrates limited scientific evidence on best practices for immediate clinical management of heat injury in SOF MPCs. A majority of management guidelines for heat injury in veterinary reference books and journals are based on review articles or professional opinion of the author vs. evidence from original research. In addition, guidelines are written primarily for companion animal populations vs. SOF MPCs and focus on measures to be undertaken in a clinical setting vs. point of injury. The phenomenon of ?circular referencing? is also prevalent in the heat injury literature. Current guidelines supported by review articles and textbooks often provide no citation or cite other review articles for clinical standards such as normal temperature ranges, treatment methods, and recurrence of heat injury. This ?circular referencing? phenomenon misrepresents anecdotal evidence and professional opinion as scientifically validated, reinforcing concepts and recommendations that are not truly supported by the evidence. Further study is needed to fully understand heat injury in SOF MPCs and how this applies to prevention, diagnosis and treatment guidelines. In order to provide SOF canine programs with best clinical advice and care, SOF Veterinarians must make clinical judgments based on evaluation of the most accurate and valid information possible. Clinical guidelines are fluid and should be reviewed regularly for relevance to the defined population in question. Clinical Guidelines should also be utilized as guiding principles in conjunction with clinical judgment vs. dictate a clinical protocol. SOF veterinarians as the veterinary support asset to SOF MPC programs should be clinically competent as well as versed in evidence based medicine practices to provide the cutting edge clinical support that is required to keep SOF MPCs operating in modern warfare environments. 2012.

Systematic review of guidelines for management of intermediate hepatocellular carcinoma using the Appraisal of Guidelines Research and Evaluation II instrument.

PubMed

Holvoet, Tom; Raevens, Sarah; Vandewynckel, Yves-Paul; Van Biesen, Wim; Geboes, Karen; Van Vlierberghe, Hans

2015-10-01

Hepatocellular carcinoma is the second leading cause of cancer-related mortality worldwide. Multiple guidelines have been developed to assist clinicians in its management. We aimed to explore methodological quality of these guidelines focusing on treatment of intermediate hepatocellular carcinoma by transarterial chemoembolization. A systematic search was performed for Clinical Practice Guidelines and Consensus statements for hepatocellular carcinoma management. Guideline quality was appraised using the Appraisal of Guidelines Research and Evaluation II instrument, which rates guideline development processes across 6 domains: 'Scope and purpose', 'Stakeholder involvement', 'Rigour of development', 'Clarity of presentation', 'Applicability' and 'Editorial independence'. Thematic analysis of guidelines was performed to map differences in recommendations. Quality of 21 included guidelines varied widely, but was overall poor with only one guideline passing the 50% mark on all domains. Key recommendations as (contra)indications and technical aspects were inconsistent between guidelines. Aspects on side effects and health economics were mainly neglected. Methodological quality of guidelines on transarterial chemoembolization in hepatocellular carcinoma management is poor. This results in important discrepancies between guideline recommendations, creating confusion in clinical practice. Incorporation of the Appraisal of Guidelines Research and Evaluation II instrument in guideline development may improve quality of future guidelines by increasing focus on methodological aspects. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

28 CFR 42.306 - Guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Guidelines. 42.306 Section 42.306... PROCEDURES Equal Employment Opportunity Program Guidelines § 42.306 Guidelines. (a) Recipient agencies are... guidelines under their equal employment opportunity program which will correct, in a timely manner, any...

Medicare managed care. How physicians can make it better.

PubMed

Roggin, G M

1997-12-01

The federal government is attempting to control anticipated, increased Medicare health care costs by providing the senior population with incentives to encourage their movement into managed care programs. For-profit corporate HMOs that currently dominate the managed care arena are coming under increased competitive pressure at a time when their perception of profiteering is undergoing increased public scrutiny. If physicians are to take advantage of this window of opportunity and successfully enter the Medicare managed care marketplace, they must identify the major deficiencies existing in the current model, and fashion a new product that divests itself of the profit orientation of current corporate HMOs. A nonprofit version of a highly integrated, multispecialty provider service organization (PSO) provides an appropriate model to effectively compete with the corporate HMO. The ideal physician-controlled managed care model must: develop a responsive policy board structure; create practice guidelines that decrease variation in physician practice; achieve an appropriate balance between primary and specialty medical care; and adopt a quality-assurance program that effectively addresses both process and outcome data.

Guidelines for the Podiatrist in the School Health Program.

ERIC Educational Resources Information Center

Pigg, R. Morgan, Jr.

1978-01-01

These guidelines were compiled to provide a model for integrating the services of the podiatrist into the health program of the school. The guidelines are intended to enable the podiatrist to supplement or complement the services of other medical specialists involved in the school health program. The scope of the guidelines encompasses the…

Surgical Management of Osteoarthritis of the Knee: Evidence-based Guideline.

PubMed

McGrory, Brian J; Weber, Kristy L; Jevsevar, David S; Sevarino, Kaitlyn

2016-08-01

Surgical Management of Osteoarthritis of the Knee: Evidence-based Guideline is based on a systematic review of the current scientific and clinical research. The guideline contains 38 recommendations pertaining to the preoperative, perioperative, and postoperative care of patients with osteoarthritis (OA) of the knee who are considering surgical treatment. The purpose of this clinical practice guideline is to help improve surgical management of patients with OA of the knee based on current best evidence. In addition to guideline recommendations, the work group highlighted the need for better research on the surgical management of OA of the knee.

Diabetes mellitus disease management in a safety net hospital system: translating evidence into practice.

PubMed

Butler, Michael K; Kaiser, Michael; Johnson, Jolene; Besse, Jay; Horswell, Ronald

2010-12-01

The Louisiana State University Health Care Services Division system assessed the effectiveness of implementing a multisite disease management program targeting diabetes mellitus in an indigent patient population. A population-based disease management program centered on evidence-based clinical care guidelines was applied from the system level. Specific clinic modifications and models were used, as well as ancillary services such as medication assistance and equipment subsidies. Marked improvement in process goals led to improved clinical outcomes. From 2001 to 2008, the percentage of patients with a hemoglobin A1c < 7.0 increased from 45% to 55% on the system level, with some sites experiencing a more dramatic shift. Results were similar across sites, which included both small provider groups and academic health centers. In order to achieve these results, the clinical environment changed to promote those evidence-based interventions. Even in complex environments such as academic health centers with several provider levels, or those environments with limited care resources, disease management programs can be successfully implemented and achieve statistically significant results.

Canadian Schizophrenia Guidelines: Schizophrenia and Other Psychotic Disorders with Coexisting Substance Use Disorders.

PubMed

Crockford, David; Addington, Donald

2017-09-01

Persons with schizophrenia and other psychotic disorders frequently have coexisting substance use disorders that require modifications to treatment approaches for best outcomes. The objectives of this review were to identify evidence-based practices best practices that improve outcomes for individuals with schizophrenia and substance used disorders. We reviewed guidelines that were published in the last 5 years and that included systematic reviews or meta-analyses. Most of our recommendations came from 2 publications from the National Institute for Health and Care Excellence (NICE): the 2011 guidance titled Coexisting Severe Mental Illness (Psychosis) and Substance Misuse: Assessment and Management in Healthcare Settings and the 2014 guidance titled Psychosis and Schizophrenia in Adults: Prevention and Management. We placed these recommendations into the Canadian context to create this guideline. Evidence supports the inclusion of individuals with coexisting substance use disorders in first-episode psychosis programs. The programs should integrate psychosis and substance use treatments, emphasizing ongoing monitoring of both substance use and patterns and symptoms. The best outcomes are achieved with combined use of antipsychotic medications and addiction-based psychosocial interventions. However, limited evidence is available to recommend using one antipsychotic medication over another or one psychosocial intervention over another for persons with schizophrenia and other psychotic disorders with coexisting substance use disorders. Treating persons who have schizophrenia and other psychotic disorders with coexisting substance use disorders can present clinical challenges, but modifications in practice can help engage and retain people in treatment, where significant improvements over time can be expected.

Guidelines on the management of atrial fibrillation in the emergency department: a critical appraisal.

PubMed

Costantino, Giorgio; Podda, Gian Marco; Falsetti, Lorenzo; Iannone, Primiano; Lages, Ana; Marra, Alberto M; Masala, Maristella; Reiakvam, Olaug Marie; Savva, Florentia; Schovanek, Jan; van Bree, Sjoerd; da Silva Chora, Inês João; Privitera, Graziella; Ragozzino, Silvio; von Rotz, Matthias; Woittiez, Lycke; Davidson, Christopher; Montano, Nicola

2017-08-01

Several guidelines often exist on the same topic, sometimes offering divergent recommendations. For the clinician, it can be difficult to understand the reasons for this divergence and how to select the right recommendations. The aim of this study is to compare different guidelines on the management of atrial fibrillation (AF), and provide practical and affordable advice on its management in the acute setting. A PubMed search was performed in May 2014 to identify the three most recent and cited published guidelines on AF. During the 1-week school of the European School of Internal Medicine, the attending residents were divided in five working groups. The three selected guidelines were compared with five specific questions. The guidelines identified were: the European Society of Cardiology guidelines on AF, the Canadian guidelines on emergency department management of AF, and the American Heart Association guidelines on AF. Twenty-one relevant sub-questions were identified. For five of these, there was no agreement between guidelines; for three, there was partial agreement; for three data were not available (issue not covered by one of the guidelines), while for ten, there was complete agreement. Evidence on the management of AF in the acute setting is largely based on expert opinion rather than clinical trials. While there is broad agreement on the management of the haemodynamically unstable patient and the use of drugs for rate-control strategy, there is less agreement on drug therapy for rhythm control and no agreement on several other topics.

Correcting Blindness In the Nerve Center: How To Improve Situational Awareness

DTIC Science & Technology

2015-12-01

Civil Defence Emergency Management released the Response Management, Director’s Guideline for CDEM Group and Local Controllers document in October...Defence & Emergency Management, Response Management: Director’s Guideline for CDEM Group and Local Controllers (Wellington, New Zealand: Ministry of...Response Management: Director’s Guideline for CDEM Group and Local Controllers . Wellington, New Zealand: Ministry of Civil Defence & Emergency

Towards an improved global understanding of treatment and outcomes in people with type 2 diabetes: Rationale and methods of the DISCOVER observational study program.

PubMed

Ji, Linong; Bonnet, Fabrice; Charbonnel, Bernard; Gomes, Marilia B; Kosiborod, Mikhail; Khunti, Kamlesh; Nicolucci, Antonio; Pocock, Stuart; Rathmann, Wolfgang; Shestakova, Marina V; Shimomura, Iichiro; Watada, Hirotaka; Fenici, Peter; Hammar, Niklas; Hashigami, Kiyoshi; Macaraeg, Greg; Surmont, Filip; Medina, Jesús

2017-07-01

Contemporary global real-world data on the management of type 2 diabetes are scarce. The global DISCOVER study program aims to describe the disease management patterns and a broad range of associated outcomes in patients with type 2 diabetes initiating a second-line glucose-lowering therapy in routine clinical practice. The DISCOVER program comprises two longitudinal observational studies involving more than 15,000 patients in 38 countries across six continents. Study sites have been selected to be representative of type 2 diabetes management in each country. Data will be collected at baseline (initiation of second-line therapy), at 6months, and yearly during a 3-year follow-up period. The DISCOVER program will record patient, healthcare provider, and healthcare system characteristics, treatment patterns, and factors influencing changes in therapy. In addition, disease control (e.g. achievement of glycated hemoglobin target), management of associated risk factors (e.g. hypercholesterolemia and hypertension), and healthcare resource utilization will be recorded. Microvascular and macrovascular complications, incidence of hypoglycemic events, and patient-reported outcomes will also be captured. The DISCOVER program will provide insights into the current management of patients with type 2 diabetes worldwide, which will contribute to informing future clinical guidelines and improving patient care. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Diabetic Dyslipidemia Review: An Update on Current Concepts and Management Guidelines of Diabetic Dyslipidemia.

PubMed

Dake, Andrew W; Sora, Nicoleta D

2016-04-01

Cardiovascular disease is the most common cause of morbidity and mortality in patients with diabetes and the major source of cost in the care of diabetes. Treatment of dyslipidemia with cholesterol-lowering medications has been shown to decrease cardiovascular events. However, available guidelines for the treatment of dyslipidemia often contain significant differences in their recommendations. Lipid guidelines from National Cholesterol Education Program Adult Treatment Panel III, American Association of Clinical Endocrinologists, American Diabetes Association and American Heart Association/American College of Cardiology were reviewed. In addition a literature review was performed using PubMed to research diabetic peculiarities to the topic of lipids. Summarized within this article are the aforementioned, commonly-used guidelines as they relate to diabetes, as well as information regarding the diabetic phenotype of dislipidemia and the association between statins and new-onset diabetes. While the multitude of guidelines and the differences between them may contribute to confusion for practitioners, they are best viewed as tools to help tailor appropriate treatment plans for individual patients. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Clinical Practice Guidelines for Delirium Management: Potential Application in Palliative Care

PubMed Central

Bush, Shirley H.; Bruera, Eduardo; Lawlor, Peter G.; Kanji, Salmaan; Davis, Daniel H.J.; Agar, Meera; Wright, David; Hartwick, Michael; Currow, David C.; Gagnon, Bruno; Simon, Jessica; Pereira, José L.

2014-01-01

Context Delirium occurs in patients across a wide array of health care settings. The extent to which formal management guidelines exist or are adaptable to palliative care is unclear. Objectives This review aims to 1) source published delirium management guidelines with potential relevance to palliative care settings, 2) discuss the process of guideline development, 3) appraise their clinical utility, and 4) outline the processes of their implementation and evaluation and make recommendations for future guideline development. Methods We searched PubMed (1990–2013), Scopus, U.S. National Guideline Clearinghouse, Google, and relevant reference lists to identify published guidelines for the management of delirium. This was supplemented with multidisciplinary input from delirium researchers and other relevant stakeholders at an international delirium study planning meeting. Results There is a paucity of high-level evidence for pharmacological and non-pharmacological interventions in the management of delirium in palliative care. However, multiple delirium guidelines for clinical practice have been developed, with recommendations derived from “expert opinion” for areas where research evidence is lacking. In addition to their potential benefits, limitations of clinical guidelines warrant consideration. Guidelines should be appraised and then adapted for use in a particular setting before implementation. Further research is needed on the evaluation of guidelines, as disseminated and implemented in a clinical setting, focusing on measurable outcomes in addition to their impact on quality of care. Conclusion Delirium clinical guidelines are available but the level of evidence is limited. More robust evidence is required for future guideline development. PMID:24766743

Programming Deep Brain Stimulation for Tremor and Dystonia: The Toronto Western Hospital Algorithms.

PubMed

Picillo, Marina; Lozano, Andres M; Kou, Nancy; Munhoz, Renato Puppi; Fasano, Alfonso

2016-01-01

Deep brain stimulation (DBS) is an effective treatment for essential tremor (ET) and dystonia. After surgery, a number of extensive programming sessions are performed, mainly relying on neurologist's personal experience as no programming guidelines have been provided so far, with the exception of recommendations provided by groups of experts. Finally, fewer information is available for the management of DBS in ET and dystonia compared with Parkinson's disease. Our aim is to review the literature on initial and follow-up DBS programming procedures for ET and dystonia and integrate the results with our current practice at Toronto Western Hospital (TWH) to develop standardized DBS programming protocols. We conducted a literature search of PubMed from inception to July 2014 with the keywords "balance", "bradykinesia", "deep brain stimulation", "dysarthria", "dystonia", "gait disturbances", "initial programming", "loss of benefit", "micrographia", "speech", "speech difficulties" and "tremor". Seventy-six papers were considered for this review. Based on the literature review and our experience at TWH, we refined three algorithms for management of ET, including: (1) initial programming, (2) management of balance and speech issues and (3) loss of stimulation benefit. We also depicted algorithms for the management of dystonia, including: (1) initial programming and (2) management of stimulation-induced hypokinesia (shuffling gait, micrographia and speech impairment). We propose five algorithms tailored to an individualized approach to managing ET and dystonia patients with DBS. We encourage the application of these algorithms to supplement current standards of care in established as well as new DBS centers to test the clinical usefulness of these algorithms in supplementing the current standards of care. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality management in home care: models for today's practice.

PubMed

Verhey, M P

1996-01-01

In less than a decade, home care providers have been a part of two major transitions in health care delivery. First, because of the advent of managed care and a shift from inpatient to community-based services, home care service delivery systems have experienced tremendous growth. Second, the principles and practices of total quality management and continuous quality improvement have permeated the organization, administration, and practice of home health care. Based on the work of Deming, Juran, and Crosby, the basic tenets of the new quality management philosophy involve a focus on the following five key areas: (1) systems and processes rather than individual performance; (2) involvement, collaboration, and empowerment; (3) internal and external "customers"; (4) data and measurement; and (5) standards, guidelines, and outcomes of care. Home care providers are among those in the forefront who are developing and implementing programs that integrate these foci into the delivery of quality home care services. This article provides a summary of current home care programs that address these five key areas of quality management philosophy and provide models for innovative quality management practice in home care. For further information about each program, readers are referred to the original reports in the home care and quality management journal literature, as cited herein.

Summary of the British Transplantation Society Guidelines for Management of the Failing Kidney Transplant.

PubMed

Andrews, Peter A

2014-12-15

The British Transplantation Society "Guideline for Transplantation Management of the Failing Kidney Transplant" was published in May 2014. This is the first national guideline in this field. In line with previous guidelines published by the British Transplantation Society, the guideline has used the GRADE system to rate the strength of evidence and recommendations.This article summarizes the Statements of Recommendation contained in the guideline, which provide a framework for the management of the failing kidney graft in the United Kingdom and may be of wide international interest. It is recommended that the full guideline document is consulted for details of the relevant references and evidence base. This may be accessed at: http://www.bts.org.uk/MBR/Clinical/Guidelines/Current/Member/Clinical/Current_Guidelines.aspx.

Investigacion Participativa y Gestion de Sistemas Educativos. (Participatory Research and the Management of Educational Systems).

ERIC Educational Resources Information Center

Valle, Victor M.

Elements which, when put in harmony, might generate powerful tools for social change and educational development are (1) the ever present need of the educational systems to evaluate their performance; (2) the universal acceptance of the life-long education concept as a major guideline to design educational programs; (3) the trend toward a…

The Fire and Fire Surrogates Study: Providing guidelines for fire in future forest watershed management decisions

Treesearch

Carleton B. Edminster; C. Phillip Weatherspoon; Daniel G. Neary

2000-01-01

As part of the 1998 Joint USDA/USDI Fire Science Program, the Fire and Fire Surrogates Study was proposed to establish and evaluate cross-comparisons of fuels treatment practices and techniques to reduce wildfire risk. This study evaluates prescribed fire, thinning, and various mechanical treatment methods for treating, removing, or using woody biomass. Site-specific...

Fundamentals of Day Camping. An Ideal Reference for Administrators of Day Camps and School-Age Day Care Programs. Revised.

ERIC Educational Resources Information Center

Mitchell, Grace; And Others

This revised edition of a 1961 publication outlines the steps involved in establishing a new day camp, and presents guidelines for day camp operation. Four chapters cover: (1) preliminary decisions and planning for a new camp; (2) site selection, legal and regulatory considerations, and property management; (3) deciding on buildings and equipment…

Goal-Setting: Guidelines for Diagnosis and Rehabilitation Program Development: Trainer's Guide. Advanced Facilitative Case Management Series, Training Package II.

ERIC Educational Resources Information Center

Roessler, Richard T.; Rubin, Stanford E.

This guide is the introductory volume for the second in a series of instructor-assisted training modules for rehabilitation counselors, supervisors, and graduate students. This trainer's guide for the second module focuses on the counseling skills needed for rehabilitation of the severely disabled and provides the trainer with the information and…

Professional Dress for the 80's. Marketing and Distributive Education Program, Professional Dress Unit. Instructor's Guide.

ERIC Educational Resources Information Center

Holmes, Wally; And Others

This guide for an adult marketing education course provides instructors with the necessary materials to present a seminar about "image management to project professionalism." General teaching suggestions are provided as well as a course outline and a time chart that provides guidelines for the minimum and maximum time to be spent on each…

Alternatives to the Fish Early Life-Stage Test: A Research Strategy for Discovering and Annotating Adverse Outcome Pathways During Fish Development

EPA Science Inventory

The OECD 210 fish early life]stage (FELS) test is the primary guideline test used to estimate chronic fish toxicity, as well as support ecological risk assessments and chemical management programs around the world. As a step toward developing alternatives to the FELS test, a HES...

Implementation of a patient blood management monitoring and feedback program significantly reduces transfusions and costs.

PubMed

Mehra, Tarun; Seifert, Burkhardt; Bravo-Reiter, Silvina; Wanner, Guido; Dutkowski, Philipp; Holubec, Tomas; Moos, Rudolf M; Volbracht, Jörk; Manz, Markus G; Spahn, Donat R

2015-12-01

Patient blood management (PBM) measures have been shown to be effective in reducing transfusions while maintaining patient outcome. The issuance of transfusion guidelines is seen as being key to the success of PBM programs. As the introduction of guidelines alone did not visibly reduce transfusions in our center, a monitoring and feedback program was established. The aim of our study was to show the effectiveness of such measures in reducing transfusions and cost. We designed a prospective, interventional cohort study with a 3-year time frame (January 1, 2012 to December 31, 2014). In total, 101,794 patients aged 18 years or older were included. The PBM monitoring and feedback program was introduced on January 1, 2014, with the subsequent issuance of quarterly reporting. Within the first year of introduction, transfusion of all allogeneic blood products per 1000 patients was reduced by 27% (red blood cell units, -24%; platelet units, -25%; and fresh-frozen plasma units, -37%; all p < 0.001) leading to direct allogeneic blood product related savings of more than 2 million USD. The number of blood products transfused per case was significantly reduced from 9 ± 19 to 7 ± 14 (p < 0.001). With an odds ratio of 0.86 (95% confidence interval, 0.82-0.91), the introduction of our PBM monitoring and feedback program was a significant independent factor in the reduction of transfusion probability (p < 0.001). Our PBM monitoring and feedback program was highly efficacious in reducing the transfusion of allogeneic blood products and transfusion-related costs. © 2015 AABB.

Adapting evidence-based clinical practice guidelines at university teaching hospitals: A model for the Eastern Mediterranean Region.

PubMed

Amer, Yasser S; Wahabi, Hayfaa A; Abou Elkheir, Manal M; Bawazeer, Ghada A; Iqbal, Shaikh M; Titi, Maher A; Ekhzaimy, Aishah; Alswat, Khalid A; Alzeidan, Rasmieh A; Al-Ansary, Lubna A

2018-04-24

Clinical practice guidelines (CPGs) are significant tools for evidence-based health care quality improvement. The CPG program at King Saud University was launched as a quality improvement program to fulfil the international accreditation standards. This program was a collaboration between the Research Chair for Evidence-Based Healthcare and Knowledge Translation and the Quality Management Department. This study aims to develop a fast-track method for adaptation of evidence-based CPGs and describe results of the program. Twenty-two clinical departments participated in the program. Following a CPGs awareness week directed to all health care professionals (HCPs), 22 teams were trained to set priorities, search, screen, assess, select, and customize the best available CPGs. The teams were technically supported by the program's CPG advisors. To address the local health care context, a modified version of the ADAPTE was used where recommendations were either accepted or rejected but not changed. A strict peer-review process for clinical content and methodology was employed. In addition to raising awareness and building capacity, 35 CPGs were approved for implementation by March 2018. These CPGs were integrated with other existing projects such as accreditation, electronic medical records, performance management, and training and education. Preliminary implementation audits suggest a positive impact on patient outcomes. Leadership commitment was a strength, but the high turnover of the team members required frequent and extensive training for HCPs. This model for CPG adaptation represents a quick, practical, economical method with a sense of ownership by staff. Using this modified version can be replicated in other countries to assess its validity. © 2018 John Wiley & Sons, Ltd.

Utah Publications Depository Program. Manual of Guidelines for State Agencies, Revised [and] Manual of Guidelines for Depository Libraries, Revised.

ERIC Educational Resources Information Center

Utah State Library, Salt Lake City.

Two manuals provide guidelines for users of the Utah Publications Depository Program. The first, "Guidelines for State Agencies," is designed to assist agencies in complying with the depository law. The program is designed to collect Utah State Governmental publications and to make them available through libraries. State publications…

Guidelines for the management of people with foot health problems related to rheumatoid arthritis: a survey of their use in podiatry practice.

PubMed

Williams, Anita E; Graham, Andrea S; Davies, Samantha; Bowen, Catherine J

2013-06-18

In the last decade there has been a significant expansion in the body of knowledge on the effects of rheumatoid arthritis (RA) on the foot and the management of these problems. Aligned with this has been the development of specialist clinical roles for podiatrists. However, despite being recommended by national guidelines, specialist podiatrists are scarce. In order to inform non-specialist podiatrists of the appropriate interventions for these foot problems, management guidelines have been developed and disseminated by a group of specialist podiatrists. The aim of this survey was to investigate the use of these guidelines in clinical practice. Following ethical approval an online questionnaire survey was carried out. The questions were formulated from a focus group and comprised fixed response and open response questions. The survey underwent cognitive testing with two podiatrists before being finalised. An inductive approach using thematic analysis was used with the qualitative data. 245 questionnaires were completed (128-non-specialist working in the private sector, 101 non-specialists working in the NHS and 16 specialist podiatrists). Overall, 97% of the non-specialists (n = 222) had not heard of the guidelines. The non-specialists identified other influences on their management of people with RA, such as their undergraduate training and professional body branch meetings. Three main themes emerged from the qualitative data: (i) the benefits of the foot health management guidelines, (ii) the barriers to the use of guidelines generally and (iii) the features of useable clinical guidelines. This study has revealed some crucial information about podiatrists' level of engagement with the foot health management guidelines and the use of guidelines in general. Specifically, the non-specialist podiatrists were less likely to use the foot health management guidelines than the specialist podiatrists. The positive aspects were that for the specialist practitioners, the guidelines helped them to identify their professional development needs and for the few non-specialists that did use them, they enabled appropriate referral to the rheumatology team for foot health management. The barriers to their use included a lack of understanding of the risk associated with managing people with RA and that guidelines can be too long and detailed for use in clinical practice. Suggestions are made for improving the implementation of foot health guidelines.

Some guidance on preparing validation plans for the DART Full System Models.

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

Gray, Genetha Anne; Hough, Patricia Diane; Hills, Richard Guy

2009-03-01

Planning is an important part of computational model verification and validation (V&V) and the requisite planning document is vital for effectively executing the plan. The document provides a means of communicating intent to the typically large group of people, from program management to analysts to test engineers, who must work together to complete the validation activities. This report provides guidelines for writing a validation plan. It describes the components of such a plan and includes important references and resources. While the initial target audience is the DART Full System Model teams in the nuclear weapons program, the guidelines are generallymore » applicable to other modeling efforts. Our goal in writing this document is to provide a framework for consistency in validation plans across weapon systems, different types of models, and different scenarios. Specific details contained in any given validation plan will vary according to application requirements and available resources.« less

[Interpretation of 2018 guidelines for the early management of patients with acute ischemic stroke].

PubMed

Wang, Gang; Fang, Bangjiang; Yu, Xuezhong; Li, Zhijun

2018-04-01

In 2018, the American Heart Association/American Stroke Association (AHA/ASA) has developed the latest 2018 guidelines for the early management of patients with acute ischemic stroke (AIS), based on the latest evidences. The 2018 guidelines including recommendations on pre-hospital and in-hospital management treatment, has revised and add new recommendations from 2013 guideline. The major changes in 2018 guideline involve applications of brain imaging in early stage, intravenous thrombolysis and mechanical thrombectomy, et al. This review interprets the 2018 guidelines for clinicians to improve the clinical diagnosis, treatment and outcome of patients with AIS.

Managing asthma in primary care through imperative outcomes.

PubMed

du Plessis, Jesslee M; Gerber, Jan J; Brand, Linda

2013-04-01

To evaluate asthma management and control in primary care clinics so as to design improvements based on guideline-directed outcomes. In this study, all medical records of asthma-diagnosed patients (children as well as adults, entire lifespan, asthma-related visits or not) were retrospectively reviewed as a basis for assessing the level of guideline adherence and asthma control. Six primary health care clinics were visited in the Dr Kenneth Kaunda Municipal District, Potchefstroom, South Africa during May to July 2008, 2009 and 2010. A total of 323 asthma patient records were reviewed over the three time slots, resulting in 125, 87, and 111 patients respectively. A suboptimal clinical asthma control picture, with a mere 16% (n = 20) of females and 2% (n = 3) of males with Peak Expiratory Flow (PEF) percentages above 60%, were observed in the initial assessment. Improvement in control was observed during the following time slot, but with an end result in 2010 of no PEF percentages above 60% for males and only 9% (n = 7) for females. Over all three of the data collection periods adherence to effectively applied management of asthma guidelines proved to be below the minimum recommended clinical evaluation work-up as set out by the Expert Panel Report 3 (EPR3) of the National Asthma Education and Prevention Program (NAEPP). Applying a greater focus on essential outcomes through different disease management documents resulted in an improved quality of managed care, but still requires dedicated and continuous education and motivation. (NWU-0052-08-A5). © 2012 Blackwell Publishing Ltd.

Do United States' teachers know and adhere to the national guidelines on asthma management in the classroom? A systematic review.

PubMed

Jaramillo, Yudilyn; Reznik, Marina

2015-01-01

Proper asthma management in schools is important in achieving optimum asthma control in children with asthma. The National Heart, Lung, and Blood Institute (NHLBI) has developed guidelines on classroom asthma management. We conducted a systematic review to examine teacher knowledge of the NHLBI guidelines on asthma management in the classroom. We searched PubMed and EMBASE using search terms "asthma management," "teacher(s)," "school teacher," and "public school." The inclusion criteria were articles published in English from 1994 to May 2014 that focus on schools in the United States (US). From 535 titles and abstracts, 9 studies met inclusion criteria. All studies reported that school teachers did not know the policies and procedures of asthma management. Teachers relied on school nurses to handle medical emergencies. Some studies identified that lack of full-time school nurses was a barrier to asthma management. Only one study showed directly that classroom teachers were not following the NHLBI guidelines on asthma management. Our literature review revealed that US teachers do not know the NHLBI guidelines on asthma management in the classroom. Future research should focus on interventions targeted toward training classroom teachers on asthma management as per NHLBI guidelines to ultimately improve asthma management in schools.

Implementation of a diabetes self-management education program in primary care for adults using shared medical appointments.

PubMed

Sanchez, Iris

2011-01-01

The purpose of this study was to implement diabetes self-management education in primary care using the Chronic Care Model and shared medical appointments (SMA) to provide evidence-based interventions to improve process and measure outcomes. A quality improvement project using the Plan-Do-Check-Act cycle was implemented in a primary care setting in South Texas to provide diabetes self-management education for adults. Biological measures were evaluated in 70 patients at initiation of the project and thereafter based on current practice guidelines. The results of the project were consistent with the literature regarding the benefits, sustainability, and viability of SMA. As compared with that in studies presented in the literature, the patient population who participated in SMA had similar outcomes regarding improvement in A1C, self-management skills, and satisfaction. SMA are an innovative system redesign concept with the potential to provide comprehensive and coordinated care for patients with multiple and chronic health conditions while still being an efficient, effective, financially viable, and sustainable program. As the incidence and prevalence of diabetes increase, innovative models of care can meet the growing demand for access and utilization of diabetes self-management education programs. Programs focusing on chronic conditions to improve outcomes can be replicated by health care providers in primary care settings. SMA can increase revenue and productivity, improve disease management, and increase provider and patient satisfaction.

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

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

Erickson, Beth A.; Demanes, D. Jeffrey; Ibbott, Geoffrey S.

2011-03-01

High-Dose-Rate (HDR) brachytherapy is a safe and efficacious treatment option for patients with a variety of different malignancies. Careful adherence to established standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for HDR brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrists. Review of the leading indications for HDR brachytherapy in the management of gynecologic, thoracic, gastrointestinal,more » breast, urologic, head and neck, and soft tissue tumors is presented. Logistics with respect to the brachytherapy implant procedures and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful HDR brachytherapy program.« less

Antipsychotic-induced hyperprolactinemia: synthesis of world-wide guidelines and integrated recommendations for assessment, management and future research.

PubMed

Grigg, Jasmin; Worsley, Roisin; Thew, Caroline; Gurvich, Caroline; Thomas, Natalie; Kulkarni, Jayashri

2017-11-01

Hyperprolactinemia is a highly prevalent adverse effect of many antipsychotic agents, with potentially serious health consequences. Several guidelines have been developed for the management of this condition; yet, their concordance has not been evaluated. The objectives of this paper were (1) to review current clinical guidelines; (2) to review key systematic evidence for management; and (3) based on our findings, to develop an integrated management recommendation specific to male and female patients who are otherwise clinically stabilised on antipsychotics. We performed searches of Medline and EMBASE, supplemented with guideline-specific database and general web searches, to identify clinical guidelines containing specific recommendations for antipsychotic-induced hyperprolactinemia, produced/updated 01/01/2010-15/09/2016. A separate systematic search was performed to identify emerging management approaches described in reviews and meta-analyses published ≥ 2010. There is some consensus among guidelines relating to baseline PRL screening (8/12 guidelines), screening for differential diagnosis (7/12) and discontinuing/switching PRL-raising agent (7/12). Guidelines otherwise diverge substantially regarding most aspects of screening, monitoring and management (e.g. treatment with dopamine agonists). There is an omission of clear sex-specific recommendations. Systematic literature on management approaches is promising; more research is needed. An integrated management recommendation is presented to guide sex-specific clinical response to antipsychotic-induced hyperprolactinemia. Key aspects include asymptomatic hyperprolactinemia monitoring and fertility considerations with PRL normalisation. Further empirical work is key to shaping robust guidelines for antipsychotic-induced hyperprolactinemia. The integrated management recommendation can assist clinician and patient decision-making, with the goal of balancing effective psychiatric treatment while minimising PRL-related adverse health effects in male and female patients.

32 CFR 310.36 - OMB training guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false OMB training guidelines. 310.36 Section 310.36... PROGRAM DOD PRIVACY PROGRAM Training Requirements § 310.36 OMB training guidelines. The OMB guidelines (OMB Privacy Guidelines, 40 FR 28948 (July 9, 1975) require all agencies additionally to: (a) Instruct...

Review of occupational medicine practice guidelines for interventional pain management and potential implications.

PubMed

Manchikanti, Laxmaiah; Singh, Vijay; Derby, Richard; Helm, Standiford; Trescot, Andrea M; Staats, Peter S; Prager, Joshua P; Hirsch, Joshua A

2008-01-01

In the modern day environment, workers' compensation costs continue to be a challenge, with a need to balance costs, benefits, and quality of medical care. The cost of workers' compensation care affects all stakeholders including workers, employers, providers, regulators, legislators, and insurers. Consequently, a continued commitment to quality, accessibility to care, and cost containment will help ensure that workers are afforded accessible, high quality, and cost-effective care. In 2004, workers' compensation programs in all 50 states, the District of Columbia, and federal programs in the United States combined received an income of $87.4 billion while paying out only $56 billion in medical and cash benefits with $31.4 billion or 37% in administrative expenses and profit. Occupational diseases represented only 8% of the workers' compensation claims and 29% of the cost. The American College of Occupational and Environmental Medicine (ACOEM) has published several guidelines; though widely adopted by WCPs, these guidelines evaluate the practice of medicine of multiple specialties without adequate expertise and expert input from the concerned specialties, including interventional pain management. An assessment of the ACOEM guidelines utilizing Appraisal of Guidelines for Research and Evaluation (AGREE) criteria, the criteria developed by the American Medical Association (AMA), the Institute of Medicine (IOM), and other significantly accepted criteria, consistently showed very low scores (< 30%) in most aspects of the these guidelines. The ACOEM recommendations do not appear to have been based on a careful review of the literature, overall quality of evidence, standard of care, or expert consensus. Based on the evaluation utilizing appropriate and current evidence-based medicine (EBM) principles, the evidence ratings for diagnostic techniques of lumbar discography; cervical, thoracic, and lumbar facet joint nerve blocks and sacroiliac joint nerve blocks; therapeutic cervical and lumbar medial branch blocks and radiofrequency neurolysis; cervical interlaminar epidural steroid injections, caudal epidural steroid injections, and lumbar transforaminal epidural injections; caudal percutaneous adhesiolysis; abd spinal cord stimulation were found to be moderate with strong recommendation applying for most patients in most circumstances. The evidence ratings for intradiscal electrothermal therapy (IDET), an automated percutaneous disc decompression and also deserve further scrutiny and analysis. In conclusion, these ACOEM guidelines for interventional pain management have no applicability in modern patient care due to lack of expertise by the developing organization (ACOEM), lack of utilization of appropriate and current EBM principles, and lack of significant involvement of experts in these techniques resulting in a lack of clinical relevance. Thus, they may result in reduced medical quality of care; may severely hinder access to appropriate, medically needed and essential medical care; and finally, they may increase costs for injured workers, third party payors, and the government by transferring the injured worker into a non-productive disability system.

New guidelines for topical NSAIDs in the osteoarthritis treatment paradigm.

PubMed

Altman, Roy D

2010-12-01

Osteoarthritis (OA), the most common form of arthritis, often affects hands, hips, and knees and involves an estimated 26.9 million US adults. Women have a higher prevalence of OA, and the risk of developing OA increases with age, obesity, and joint malalignment. OA typically presents with pain and reduced function. Therapeutic programs are often multimodal and must take into account pharmaceutical toxicities and patient comorbidities. For example, nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with cardiovascular, gastrointestinal, and renal adverse events. Topical NSAIDs offer efficacy with reduced systemic drug exposure. This is a review of current guideline recommendations regarding the use of topical NSAIDs in OA of the hand and knee. Articles were identified by PubMed search (January 1, 2000 to May 21, 2010). Several current guidelines for management of OA recommend topical NSAIDs, indicating them as a safe and effective treatment. One guideline recommends that topical NSAIDs be considered as first-line pharmacologic therapy. A US guideline for knee OA recommends topical NSAIDs in older patients and in patients with increased gastrointestinal risk. The consensus across US and European OA guidelines is that topical NSAIDs are a safe and effective treatment for OA. Because the research base on topical NSAIDs for OA is small, guidelines will continue to evolve.

Adolescent asthma education programs for teens: review and summary.

PubMed

Srof, Brenda; Taboas, Peggy; Velsor-Friedrich, Barbara

2012-01-01

The purpose of this review is to describe and evaluate education programs for teens with asthma. Although asthma educational programs for children are plentiful, this is not the case for adolescents. The developmental tasks of adolescence require asthma education programs that are uniquely tailored to this age group. Although several well-designed studies appear in the literature, further research is needed to evaluate the efficacy of asthma education programs among teens. Although the quality of research varies, demonstrated program benefits include improved asthma self-management, self-efficacy, family support mechanisms, and quality of life. Practice implications point to the need for education programs in schools and camp settings that are consistent with national asthma guidelines. Copyright © 2012 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

A national survey on the pediatric cardiologist's clinical approach for patients with Kawasaki disease.

PubMed

Kahwaji, I Y; Connuck, D M; Tafari, N; Dahdah, N S

2002-01-01

In 1994, the American Heart Association (AHA) published the most recent guidelines for long-term cardiovascular management of Kawasaki disease. Since then, recent publications have shed new light on different diagnostic, prognostic, and management issues. We sought the opinion of pediatric cardiologists practicing in U.S. fellowship programs on the subject by means of a multiple-choice survey. Two questions addressed therapy in the acute phase, each preceded by a statement from related literature. Ten duplicate questions addressed the long-term cardiovascular management in five sets of paired questions; each question was first given in reminiscence of a clinical situation and then preceded by a statement from particular publications representative of new information that has become available since the publication of the 1994 AHA guidelines. All questions were provided in the same mailing. Replies were received from 97 participants practicing at 29 institutions. For the acute illness, 21% of respondents do not use high-dose aspirin, and 50% support reassessment of current guidelines. Universal intravenous immune globulin (IVIG) administration is followed by 97%, among whom 20% agree that evaluation of selection criteria is needed. For long-term management, 60-75% advocate regular follow-up of risk level I patients, and 80% favor periodic follow-up, with stress imaging (34-40%), for risk level II. For risk level IV more respondents favor stress echocardiography as opposed to nuclear imaging, in consonance with recent literature. For risk levels III and IV, 36-40% perform coronary angiography on a regular basis, whereas 60% do so when coronary symptoms are present or when stress imaging suggests myocardial ischemia. Finally, 19-25% of respondents do not routinely advise healthy lifestyle to patients free of coronary artery lesions. In conclusion, the guidelines for conventional therapy in the acute phase and long-term cardiovascular management need to be revised.

Age Nutrition Chirugie (ANC) study: impact of a geriatric intervention on the screening and management of undernutrition in elderly patients operated on for colon cancer, a stepped wedge controlled trial.

PubMed

Dupuis, Marine; Kuczewski, Elisabetta; Villeneuve, Laurent; Bin-Dorel, Sylvie; Haine, Max; Falandry, Claire; Gilbert, Thomas; Passot, Guillaume; Glehen, Olivier; Bonnefoy, Marc

2017-01-07

Undernutrition prior to major abdominal surgery is frequent and increases morbidity and mortality, especially in older patients. The management of undernutrition reduces postoperative complications. Nutritional management should be a priority in patient care during the preoperative period. However undernutrition is rarely detected and the guidelines are infrequently followed. Preoperative undernutrition screening should allow a better implementation of the guidelines. The ANC ("Age Nutrition Chirurgie") study is an interventional, comparative, prospective, multicenter, randomized protocol based on the stepped wedge trial design. For the intervention, the surgeon will inform the patient of the establishment of a systematic preoperative geriatric assessment that will allow the preoperative diagnosis of the nutritional status and the implementation of an adjusted nutritional support in accordance with the nutritional guidelines. The primary outcome measure is to determine the impact of the geriatric intervention on the level of perioperative nutritional management, in accordance with the current European guidelines. The implementation of the intervention in the five participating centers will be rolled-out sequentially over six time periods (every six months). Investigators must recommend that all patients aged 70 years or over and who are consulting for a surgery for a colorectal cancer should consider participating in this study. The ANC study is based on an original methodology, the stepped wedge trial design, which is appropriate for evaluating the implementation of a geriatric and nutritional assessment during the perioperative period. We describe the purpose of this geriatric intervention, which is expected to apply the ESPEN and SFNEP recommendations through the establishment of an undernutrition screening and a management program for patients with cancer. This intervention should allow a decrease in patient morbidity and mortality due to undernutrition. This study is registered in ClinicalTrials.gov NCT02084524 on March 11, 2014 (retrospectively registered).

New antiarrhythmic agents for atrial fibrillation and atrial flutter: United States drug market response as an indicator of acceptance.

PubMed

LaPointe, Nancy M Allen; Pamer, Carol A; Kramer, Judith M

2003-10-01

To determine how well dofetilide and Betapace AF (sotalol, approved solely for atrial fibrillation and atrial flutter), with their detailed dosing and monitoring guidelines for safety, were accepted into clinical practice during the 2 calendar years after their introduction. We reviewed the number of new, refill, and total prescriptions of all antiarrhythmic agents in the United States from April 2000-December 2001 to assess use of dofetilide and Betapace AF in the drug market. Both were prescribed very infrequently throughout the study period. In addition, the infrequent reported use of these drugs for patients with atrial fibrillation and flutter indicated poor acceptance of these agents by prescribing physicians. We speculated that the restricted distribution and required educational program for dofetilide, as well as the availability of generic sotalol products, may have discouraged physicians from prescribing both dofetilide and Betapace AE CONCLUSION: A common goal for both the dofetilide risk-management program and the creation of a sotalol product indicated solely for atrial fibrillation and atrial flutter was to provide safer treatment for patients with these arrhythmias. Unfortunately, limited penetration of dofetilide and Betapace AF into the U.S. market suggests that drugs without a risk-management program or detailed dosing guidelines were more likely than dofetilide or Betapace AF to be selected for treatment of atrial fibrillation and atrial flutter.

Perioperative Pain Management in Total Hip Arthroplasty: Korean Hip Society Guidelines

PubMed Central

Kim, Yeesuk; Cho, Hong-Man; Park, Kyung-Soon; Yoon, Pil Whan; Nho, Jae-Hwi; Kim, Sang-Min; Lee, Kyung-Jae; Moon, Kyong-Ho

2016-01-01

Effective perioperative pain management techniques and accelerated rehabilitation programs can improve health-related quality of life and functional status of patients after total hip arthroplasty. Traditionally, postoperative analgesia following arthroplasty was provided by intravenous patient-controlled analgesia or epidural analgesia. Recently, peripheral nerve blockade has emerged alternative analgesic approach. Multimodal analgesia strategy combines analgesics with different mechanisms of action to improve pain management. Intraoperative periarticular injection of multimodal drugs is one of the most important procedures in perioperative pain control for total hip arthroplasty. The goal of this review article is to provide a concise overview of the principles of multimodal pain management regimens as a practical guide for the perioperative pain management for total hip arthroplasty. PMID:27536639

Guidelines on Diabetic Eye Care: The International Council of Ophthalmology Recommendations for Screening, Follow-up, Referral, and Treatment Based on Resource Settings.

PubMed

Wong, Tien Y; Sun, Jennifer; Kawasaki, Ryo; Ruamviboonsuk, Paisan; Gupta, Neeru; Lansingh, Van Charles; Maia, Mauricio; Mathenge, Wanjiku; Moreker, Sunil; Muqit, Mahi M K; Resnikoff, Serge; Verdaguer, Juan; Zhao, Peiquan; Ferris, Frederick; Aiello, Lloyd P; Taylor, Hugh R

2018-05-24

Diabetes mellitus (DM) is a global epidemic and affects populations in both developing and developed countries, with differing health care and resource levels. Diabetic retinopathy (DR) is a major complication of DM and a leading cause of vision loss in working middle-aged adults. Vision loss from DR can be prevented with broad-level public health strategies, but these need to be tailored to a country's and population's resource setting. Designing DR screening programs, with appropriate and timely referral to facilities with trained eye care professionals, and using cost-effective treatment for vision-threatening levels of DR can prevent vision loss. The International Council of Ophthalmology Guidelines for Diabetic Eye Care 2017 summarize and offer a comprehensive guide for DR screening, referral and follow-up schedules for DR, and appropriate management of vision-threatening DR, including diabetic macular edema (DME) and proliferative DR, for countries with high- and low- or intermediate-resource settings. The guidelines include updated evidence on screening and referral criteria, the minimum requirements for a screening vision and retinal examination, follow-up care, and management of DR and DME, including laser photocoagulation and appropriate use of intravitreal anti-vascular endothelial growth factor inhibitors and, in specific situations, intravitreal corticosteroids. Recommendations for management of DR in patients during pregnancy and with concomitant cataract also are included. The guidelines offer suggestions for monitoring outcomes and indicators of success at a population level. Copyright © 2018 American Academy of Ophthalmology. All rights reserved.