APNEA/WIT system nondestructive assay capability evaluation plan for select accessibly stored INEL RWMC waste forms

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

Becker, G.K.

1997-01-01

Bio-Imaging Research Inc. (BIR) and Lockheed Martin Speciality Components (LMSC) are engaged in a Program Research and Development Agreement and a Rapid Commercialization Initiative with the Department of Energy, EM-50. The agreement required BIR and LMSC to develop a data interpretation method that merges nondestructive assay and nondestructive examination (NDA/NDE) data and information sufficient to establish compliance with applicable National TRU Program (Program) waste characterization requirements and associated quality assurance performance criteria. This effort required an objective demonstration of the BIR and LMSC waste characterization systems in their standalone and integrated configurations. The goal of the test plan is tomore » provide a mechanism from which evidence can be derived to substantiate nondestructive assay capability and utility statement for the BIT and LMSC systems. The plan must provide for the acquisition, compilation, and reporting of performance data thereby allowing external independent agencies a basis for an objective evaluation of the standalone BIR and LMSC measurement systems, WIT and APNEA respectively, as well as an expected performance resulting from appropriate integration of the two systems. The evaluation is to be structured such that a statement regarding select INEL RWMC waste forms can be made in terms of compliance with applicable Program requirements and criteria.« less

A comprehensive inventory of radiological and nonradiological contaminants in waste buried or projected to be buried in the subsurface disposal area of the INEL RWMC during the years 1984-2003, Volume 3

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

NONE

1995-05-01

This is the third volume of this comprehensive report of the inventory of radiological and nonradiological contaminants in waste buried or projected to be buried in the subsurface disposal area of the Idaho National Engineering Laboratory. Appendix B contains a complete printout of contaminant inventory and other information from the CIDRA Database and is presented in volumes 2 and 3 of the report.

Transport of Carbon Tetrachloride in a Fractured Vadose Zone due to Atmospheric Pressure Fluctuations, Diffusion, and Vapor Density

NASA Astrophysics Data System (ADS)

McCray, J. E.; Downs, W.; Falta, R. W.; Housley, T.

2005-12-01

DNAPL sources of carbon tetrachloride (CT) vapors are of interest at the Radioactive Waste Management Complex (RWMC) at the Idaho National Engineering and Environmental Laboratory (INEEL). The site is underlain by thick fractured basalt that includes sedimentary interbeds, each are a few meters thick. Daily atmospheric pressure fluctuations serve as driving forces for CT vapor transport in the subsurface. Other important transport processes for vapor movement include gas-phase diffusion and density-driven transport. The objective of this research is to investigate the influence and relative importance of these processes on gaseous transport of CT. Gas pressure and vapor concentration measurements were conducted at various depths in two wells. A numerical multiphase flow model (TOUGH2), calibrated to field pressure data, is used to conduct sensitivity analyses to elucidate the importance of the different transport mechanisms. Results show that the basalt is highly permeable to vertical air flow. The pressure dampening occurs mainly in the sedimentary interbeds. Model-calibrated permeability values for the interbeds are similar to those obtained in a study by the U.S. Geological Survey for shallow sediments, and an order of magnitude higher than column-scale values obtained by previous studies conducted by INEEL scientists. The transport simulations indicate that considering the effect of barometric pressure changes is critical to simulating transport of pollutants in the vadose zone above the DNAPL source. Predicted concentrations can be orders of magnitude smaller than actual concentrations if the effect is not considered. Below the DNAPL vapor source, accounting for density and diffusion alone would yield acceptable results provided that a 20% error in concentrations are acceptable, and that simulating concentrations trends (and not actual concentrations) is the primary goal.

Evapotranspiration Cover for the 92-Acre Area Retired Mixed Waste Pits:Interim CQA Report

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

The Delphi Groupe, Inc., and J. A. Cesare and Associates, Inc.

This Interim Construction Quality Assurance (CQA) Report is for the 92-Acre Evapotranspiration Cover, Area 5 Waste Management Division (WMD) Retired Mixed Waste Pits, Nevada National Security Site, Nevada for the period of January 20, 2011 to May 12, 2011. This Interim Construction Quality Assurance (CQA) Report is for the 92-Acre Evapotranspiration Cover, Area 5 Waste Management Division (WMD) Retired Mixed Waste Pits, Nevada National Security Site, Nevada for the period of January 20, 2011 to May 12, 2011. Construction was approved by the Nevada Division of Environmental Protection (NDEP) under the Approval of Corrective Action Decision Document/Corrective Action Plan (CADD/CAP)more » for Corrective Action Unit (CAU) 111: Area 5 WMD Retired Mixed Waste Pits, Nevada National Security Site, Nevada, on January 6, 2011, pursuant to Subpart XII.8a of the Federal Facility Agreement and Consent Order. The project is located in Area 5 of the Radioactive Waste Management Complex (RWMC) at the Nevada National Security Site (NNSS), formerly known as the Nevada Test Site, located in southern Nevada, approximately 65 miles northwest of Las Vegas, Nevada, in Nye County. The project site, in Area 5, is located in a topographically closed basin approximately 14 additional miles north of Mercury Nevada, in the north-central part of Frenchman Flat. The Area 5 RWMS uses engineered shallow-land burial cells to dispose of packaged waste. The 92-Acre Area encompasses the southern portion of the Area 5 RWMS, which has been designated for the first final closure operations. This area contains 13 Greater Confinement Disposal (GCD) boreholes, 16 narrow trenches, and 9 broader pits. With the exception of two active pits (P03 and P06), all trenches and pits in the 92-Acre Area had operational covers approximately 2.4 meters thick, at a minimum, in most areas when this project began. The units within the 92-Acre Area are grouped into the following six informal categories based on physical location, waste types and regulatory requirements: (1) Pit 3 Mixed Waste Disposal Unit (MWDU); (2) Corrective Action Unit (CAU) 111; (3) CAU 207; (4) Low-level waste disposal units; (5) Asbestiform low-level waste disposal units; and (6) One transuranic (TRU) waste trench.« less

An update of hydrologic conditions and distribution of selected constituents in water, eastern Snake River Plain aquifer and perched groundwater zones, Idaho National Laboratory, Idaho, emphasis 2009–11

USGS Publications Warehouse

Davis, Linda C.; Bartholomay, Roy C.; Rattray, Gordon W.

2013-01-01

Since 1952, wastewater discharged to infiltration ponds (also called percolation ponds) and disposal wells at the Idaho National Laboratory (INL) has affected water quality in the eastern Snake River Plain (ESRP) aquifer and perched groundwater zones underlying the INL. The U.S. Geological Survey (USGS), in cooperation with the U.S. Department of Energy, maintains groundwater monitoring networks at the INL to determine hydrologic trends, and to delineate the movement of radiochemical and chemical wastes in the aquifer and in perched groundwater zones. This report presents an analysis of water-level and water-quality data collected from aquifer, multilevel monitoring system (MLMS), and perched groundwater wells in the USGS groundwater monitoring networks during 2009–11. Water in the ESRP aquifer primarily moves through fractures and interflow zones in basalt, generally flows southwestward, and eventually discharges at springs along the Snake River. The aquifer primarily is recharged from infiltration of irrigation water, infiltration of streamflow, groundwater inflow from adjoining mountain drainage basins, and infiltration of precipitation. From March–May 2009 to March–May 2011, water levels in wells generally declined in the northern part of the INL. Water levels generally rose in the central and eastern parts of the INL. Detectable concentrations of radiochemical constituents in water samples from aquifer wells or MLMS equipped wells in the ESRP aquifer at the INL generally decreased or remained constant during 2009–11. Decreases in concentrations were attributed to radioactive decay, changes in waste-disposal methods, and dilution from recharge and underflow. In 2011, concentrations of tritium in groundwater from 50 of 127 aquifer wells were greater than or equal to the reporting level and ranged from 200±60 to 7,000±260 picocuries per liter. Tritium concentrations from one or more discrete zones from four wells equipped with MLMS were greater than or equal to reporting levels in water samples collected at various depths. Tritium concentrations in water from wells completed in shallow perched groundwater at the Advanced Test Reactor Complex (ATR Complex) were less than the reporting levels. Tritium concentrations in deep perched groundwater at the ATR Complex equaled or exceeded the reporting level in 12 wells during at least one sampling event during 2009–11 at the ATR Complex. Concentrations of strontium-90 in water from 20 of 76 aquifer wells sampled during April or October 2011 exceeded the reporting level. Strontium-90 was not detected within the ESRP aquifer beneath the ATR Complex. During at least one sampling event during 2009–11, concentrations of strontium-90 in water from 10 wells completed in deep perched groundwater at the ATR Complex equaled or exceeded the reporting levels. During 2009–11, concentrations of plutonium-238, and plutonium-239, -240 (undivided), and americium-241 were less than the reporting level in water samples from all aquifer wells and in all wells equipped with MLMS. Concentrations of cesium-137 were equal to or slightly above the reporting level in 8 aquifer wells and from 2 wells equipped with MLMS. The concentration of chromium in water from one well south of the ATR Complex was 97 micrograms per liter (μg/L) in April 2011, just less than the maximum contaminant level (MCL) of 100 μg/L. Concentrations of chromium in water samples from 69 other wells sampled ranged from 0.8 μg/L to 25 μg/L. During 2009–11, dissolved chromium was detected in water from 15 wells completed in perched groundwater at the ATR Complex. In 2011, concentrations of sodium in water from most wells in the southern part of the INL were greater than the background concentration of 10 milligrams per liter (mg/L); the highest concentrations were at or near the Idaho Nuclear Engineering and Technology Center (INTEC). After the newpercolation ponds were put into service in 2002 southwest of the INTEC, concentrations of sodium in water samples from the Rifle Range well rose steadily until 2008, when the concentrations generally began decreasing. The increases and decreases were attributed to disposal variability in the new percolation ponds. Concentrations of sodium in most wells equipped with MLMS generally were consistent with depth. During 2011, dissolved sodium concentrations in water from 17 wells completed in deep perched groundwater at the ATR Complex ranged from 6 to 146 mg/L. In 2011, concentrations of chloride in most water samples from aquifer wells south of the INTEC and at the Central Facilities Area exceeded the background concentrations of 15 mg/L, but were less than the secondary MCL of 250 mg/L. Chloride concentrations in water from wells south of the INTEC have generally increased because of increased chloride disposal to the old percolation ponds since 1984 when discharge of wastewater to the INTEC disposal well was discontinued. After the new percolation ponds were put into service in 2002 southwest of the INTEC, concentrations of chloride in water samples from one well rose steadily until 2008 then began decreasing. Chloride concentrations in water from all but one well completed in the ESRP aquifer at or near the ATR Complex were less than background and ranged between 10 and 14 mg/L during 2011, similar to concentrations detected during the 2006–08 reporting period. During 2011, chloride concentrations in water from two aquifer wells at the Radioactive Waste Management Complex (RWMC) were slightly greater than concentrations detected during the 2006–08 reporting period. The vertical distribution of chloride concentrations in wells equipped with MLMS were generally consistent within zones during 2009–11 and ranged from about 8 to 20 mg/L. During April 2011, dissolved chloride concentrations in shallow perched groundwater at the ATR Complex ranged from 7 to 13 mg/L in water from three wells. Dissolved chloride concentrations in deep perched groundwater at the ATR Complex during 2011 ranged from 4 to 54 mg/L. In 2011, sulfate concentrations in water samples from 11 aquifer wells in the south-central part of the INL equaled or exceeded the background concentration of sulfate and ranged from 40 to 167 mg/L. The greater-than-background concentrations in water from these wells probably resulted from sulfate disposal at the ATR Complex infiltration ponds or the old INTEC percolation ponds. In 2011, sulfate concentrations in water samples from two wells near the RWMC were greater than background levels and could have resulted from well construction techniques and (or) waste disposal at the RWMC. The vertical distribution of sulfate concentrations in three wells near the southern boundary of the INL was generally consistent with depth, and ranged between 19 and 25 mg/L. The maximum dissolved sulfate concentration in shallow perched groundwater near the ATR Complex was 400 mg/L in well CWP 1 in April 2011. During 2009–11, the maximum concentration of dissolved sulfate in deep perched groundwater at the ATR Complex was 1,550 mg/L in a well located west of the chemical-waste pond. In 2011, concentrations of nitrate in water from most wells at and near the INTEC exceeded the regional background concentrations of 1 mg/L and ranged from 1.6 to 5.95 mg/L. Concentrations of nitrate in wells south of INTEC and farther away from the influence of disposal areas and the Big Lost River show a general decrease in nitrate concentrations through time. During 2009–11, water samples from 30 wells were collected and analyzed for volatile organic compounds (VOCs). Six VOCs were detected. At least one and up to five VOCs were detected in water samples from 10 wells. The primary VOCs detected include carbon tetrachloride, chloroform, tetrachloroethylene, 1,1,1-trichloroethane, and trichloroethylene. In 2011, concentrations for all VOCs were less than their respective MCL for drinking water, except carbon tetrachloride in water from two wells. During 2009–11, variability and bias were evaluated from 56 replicate and 16 blank quality-assurance samples. Results from replicate analyses were investigated to evaluate sample variability. Constituents with acceptable reproducibility were stable isotope ratios, major ions, nutrients, and VOCs. All radiochemical constituents and trace metals had acceptable reproducibility except for gross beta-particle radioactivity, aluminum, antimony, and cobalt. Bias from sample contamination was evaluated from equipment, field, container, and source-solution blanks. No detectable constituent concentrations were reported for equipment blanks of the thief samplers and sampling pipes or for the source-solution and field blanks. Equipment blanks of bailers had detectable concentrations of strontium-90, sodium, chloride, and sulfate, and the container blank had a detectable concentration of dichloromethane.

Complexity theory in the management of communicable diseases.

PubMed

Simmons, Mike

2003-06-01

In nature, apparently complex behavioural patterns are the result of repetitive simple rules. Complexity science studies the application of these rules and looks for applications in society. Complexity management opportunities have developed from this science and are providing a revolutionary approach in the constantly changing workplace. This article discusses how complexity management techniques have already been applied to communicable disease management in Wales and suggests further developments. A similar approach is recommended to others in the field, while complexity management probably has wider applications in the NHS, not least in relation to the developing managed clinical networks.

Biologically-Inspired Concepts for Self-Management of Complexity

NASA Technical Reports Server (NTRS)

Sterritt, Roy; Hinchey, G.

2006-01-01

Inherent complexity in large-scale applications may be impossible to eliminate or even ameliorate despite a number of promising advances. In such cases, the complexity must be tolerated and managed. Such management may be beyond the abilities of humans, or require such overhead as to make management by humans unrealistic. A number of initiatives inspired by concepts in biology have arisen for self-management of complex systems. We present some ideas and techniques we have been experimenting with, inspired by lesser-known concepts in biology that show promise in protecting complex systems and represent a step towards self-management of complexity.

Understanding the Data Complexity continuum to reduce data management costs and increase data usability through partnerships with the National Centers for Environmental Information

NASA Astrophysics Data System (ADS)

Mesick, S.; Weathers, K. W.

2017-12-01

Data complexity can be seen as a continuum from complex to simple. The term data complexity refers to data collections that are disorganized, poorly documented, and generally do not follow best data management practices. Complex data collections are challenging and expensive to manage. Simplified collections readily support automated archival processes, enhanced discovery and data access, as well as production of services that make data easier to reuse. In this session, NOAA NCEI scientific data stewards will discuss the data complexity continuum. This talk will explore data simplification concepts, methods, and tools that data managers can employ which may offer more control over data management costs and processes, while achieving policy goals for open data access and ready reuse. Topics will include guidance for data managers on best allocation of limited data management resources; models for partnering with NCEI to accomplish shared data management goals; and will demonstrate through case studies the benefits of investing in documentation, accessibility, and services to increase data value and return on investment.

The Stryker Mobile Gun System: A Case Study on Managing Complexity

DTIC Science & Technology

2009-06-01

In his article Managing Innovation in Complex Product Systems, Howard Rush (1997) identified three “hotspot” categories: 1) requirements... Managing innovation in complex product systems. The Institution for Electrical Engineers. Retrieved February 2, 2009, from http

Complexity: A Frontier for Management Education

ERIC Educational Resources Information Center

Axley, Stephen R.; McMahon, Timothy R.

2006-01-01

This article critiques the mechanistic grounding of traditional management education and proposes complexity science as a fitting explanatory model for an age of complexity, contributing timely and important educational content and instructional processes to management education. It highlights some of those contributions and reviews instructional…

Nurse manager cognitive decision-making amidst stress and work complexity.

PubMed

Shirey, Maria R; Ebright, Patricia R; McDaniel, Anna M

2013-01-01

  The present study provides insight into nurse manager cognitive decision-making amidst stress and work complexity.   Little is known about nurse manager decision-making amidst stress and work complexity. Because nurse manager decisions have the potential to impact patient care quality and safety, understanding their decision-making processes is useful for designing supportive interventions.   This qualitative descriptive study interviewed 21 nurse managers from three hospitals to answer the research question: What decision-making processes do nurse managers utilize to address stressful situations in their nurse manager role? Face-to-face interviews incorporating components of the Critical Decision Method illuminated expert-novice practice differences. Content analysis identified one major theme and three sub-themes.   The present study produced a cognitive model that guides nurse manager decision-making related to stressful situations. Experience in the role, organizational context and situation factors influenced nurse manager cognitive decision-making processes.   Study findings suggest that chronic exposure to stress and work complexity negatively affects nurse manager health and their decision-making processes potentially threatening individual, patient and organizational outcomes.   Cognitive decision-making varies based on nurse manager experience and these differences have coaching and mentoring implications. This present study contributes a current understanding of nurse manager decision-making amidst stress and work complexity. © 2012 Blackwell Publishing Ltd.

Aligning population-based care management with chronic disease complexity.

PubMed

Hewner, Sharon; Seo, Jin Young; Gothard, Sandra E; Johnson, Barbara J

2014-01-01

Risk-stratified care management requires knowledge of the complexity of chronic disease and comorbidity, information that is often not readily available in the primary care setting. The purpose of this article was to describe a population-based approach to risk-stratified care management that could be applied in primary care. Three populations (Medicaid, Medicare, and privately insured) at a regional health plan were divided into risk-stratified cohorts based on chronic disease and complexity, and utilization was compared before and after the implementation of population-specific care management teams of nurses. Risk-stratified care management was associated with reductions in hospitalization rates in all three populations, but the opportunities to avoid admissions were different. Knowledge of population complexity is critical to the development of risk-stratified care management in primary care, and a complexity matrix can help nurses identify gaps in care and align interventions to cohort and population needs. Copyright © 2014 Elsevier Inc. All rights reserved.

Managing Programmatic Risk for Complex Space System Developments

NASA Technical Reports Server (NTRS)

Panetta, Peter V.; Hastings, Daniel; Brumfield, Mark (Technical Monitor)

2001-01-01

Risk management strategies have become a recent important research topic to many aerospace organizations as they prepare to develop the revolutionary complex space systems of the future. Future multi-disciplinary complex space systems will make it absolutely essential for organizations to practice a rigorous, comprehensive risk management process, emphasizing thorough systems engineering principles to succeed. Project managers must possess strong leadership skills to direct high quality, cross-disciplinary teams for successfully developing revolutionary space systems that are ever increasing in complexity. Proactive efforts to reduce or eliminate risk throughout a project's lifecycle ideally must be practiced by all technical members in the organization. This paper discusses some of the risk management perspectives that were collected from senior managers and project managers of aerospace and aeronautical organizations by the use of interviews and surveys. Some of the programmatic risks which drive the success or failure of projects are revealed. Key findings lead to a number of insights for organizations to consider for proactively approaching the risks which face current and future complex space systems projects.

Medicaid's Complex Goals: Challenges for Managed Care and Behavioral Health

PubMed Central

Gold, Marsha; Mittler, Jessica

2000-01-01

The Medicaid program has become increasingly complex as policymakers use it to address various policy objectives, leading to structural tensions that surface with Medicaid managed care. In this article, we illustrate this complexity by focusing on the experience of three States with behavioral health carveouts—Maryland, Oregon, and Tennessee. Converting to Medicaid managed care forces policymakers to confront Medicaid's competing policy objectives, multiplicity of stakeholders, and diverse patients, many with complex needs. Emerging Medicaid managed care systems typically represent compromises in which existing inequities and fragmentation are reconfigured rather than eliminated. PMID:12500322

Managing Schools as Complex Adaptive Systems: A Strategic Perspective

ERIC Educational Resources Information Center

Fidan, Tuncer; Balci, Ali

2017-01-01

This conceptual study examines the analogies between schools and complex adaptive systems and identifies strategies used to manage schools as complex adaptive systems. Complex adaptive systems approach, introduced by the complexity theory, requires school administrators to develop new skills and strategies to realize their agendas in an…

Managing inherent complexity for sustainable walleye fisheries in Lake Erie

USGS Publications Warehouse

Roseman, Edward F.; Drouin, Richard; Gaden, Marc; Knight, Roger; Tyson, Jeff; Zhao, Yingming; Taylor, William W.; Lynch, Abigail J.; Léonard, Nancy J.

2012-01-01

In Lake Erie, Walleye (Sander vitreus vitreus) is king. The naturally occurring species is the foundation of commercial fishing operations on the Canadian side of the lake and is a much-prized sport fish on the American side. Management of Lake Erie walleye fisheries is complex and takes place in an inter-jurisdictional setting composed of resource agencies from the states of Michigan (MDNR), Ohio (ODNR), Pennsylvania (PFBC), and New York (NYDEC) and the province of Ontario (OMNR). The complexity of walleye management is exacerbated by interactions among environmental and ecological changes in Lake Erie, complex life-history characteristics of the species, public demand for walleye, and cultural/governance differences among managing groups and their respective constituents. Success of future management strategies will largely hinge upon our ability to understand these inherent complexities and to employ tactics that successfully accommodate stock productivity and human demand in a highly dynamic environment. In this report, we review the history of Lake Erie walleye management, outline the multi-jurisdictional process for international management of walleye, and discuss strategies to address challenges facing managers.

Heuristics in Managing Complex Clinical Decision Tasks in Experts’ Decision Making

PubMed Central

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2016-01-01

Background Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. Objective The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. Method After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. Results We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Conclusion Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Application Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design. PMID:27275019

Heuristics in Managing Complex Clinical Decision Tasks in Experts' Decision Making.

PubMed

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2014-09-01

Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design.

When weight management lasts. Lower perceived rule complexity increases adherence.

PubMed

Mata, Jutta; Todd, Peter M; Lippke, Sonia

2010-02-01

Maintaining behavior change is one of the major challenges in weight management and long-term weight loss. We investigated the impact of the cognitive complexity of eating rules on adherence to weight management programs. We studied whether popular weight management programs can fail if participants find the rules too complicated from a cognitive perspective, meaning that individuals are not able to recall or process all required information for deciding what to eat. The impact on program adherence of participants' perceptions of eating rule complexity and other behavioral factors known to influence adherence (including previous weight management, self-efficacy, and planning) was assessed via a longitudinal online questionnaire given to 390 participants on two different popular weight management regimens. As we show, the regimens, Weight Watchers and a popular German recipe diet (Brigitte), strongly differ in objective rule complexity and thus their cognitive demands on the dieter. Perceived rule complexity was the strongest factor associated with increased risk of quitting the cognitively demanding weight management program (Weight Watchers); it was not related to adherence length for the low cognitive demand program (Brigitte). Higher self-efficacy generally helped in maintaining a program. The results emphasize the importance of considering rule complexity to promote long-term weight management. 2009 Elsevier Ltd. All rights reserved.

Developing an instrument to measure heart failure disease management program intensity and complexity.

PubMed

Riegel, Barbara; Lee, Christopher S; Sochalski, Julie

2010-05-01

Comparing disease management programs and their effects is difficult because of wide variability in program intensity and complexity. The purpose of this effort was to develop an instrument that can be used to describe the intensity and complexity of heart failure (HF) disease management programs. Specific composition criteria were taken from the American Heart Association (AHA) taxonomy of disease management and hierarchically scored to allow users to describe the intensity and complexity of the domains and subdomains of HF disease management programs. The HF Disease Management Scoring Instrument (HF-DMSI) incorporates 6 of the 8 domains from the taxonomy: recipient, intervention content, delivery personnel, method of communication, intensity/complexity, and environment. The 3 intervention content subdomains (education/counseling, medication management, and peer support) are described separately. In this first test of the HF-DMSI, overall intensity (measured as duration) and complexity were rated using an ordinal scoring system. Possible scores reflect a clinical rationale and differ by category, with zero given only if the element could potentially be missing (eg, surveillance by remote monitoring). Content validity was evident as the instrument matches the existing AHA taxonomy. After revision and refinement, 2 authors obtained an inter-rater reliability intraclass correlation coefficient score of 0.918 (confidence interval, 0.880 to 0.944, P<0.001) in their rating of 12 studies. The areas with most variability among programs were delivery personnel and method of communication. The HF-DMSI is useful for describing the intensity and complexity of HF disease management programs.

Self-organization versus self-management: two sides of the same coin?

PubMed

Clancy, Thomas R

2009-03-01

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the eighth in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, the author explores self-organization as it relates to self-management in complex social organizations.

A resource management architecture based on complex network theory in cloud computing federation

NASA Astrophysics Data System (ADS)

Zhang, Zehua; Zhang, Xuejie

2011-10-01

Cloud Computing Federation is a main trend of Cloud Computing. Resource Management has significant effect on the design, realization, and efficiency of Cloud Computing Federation. Cloud Computing Federation has the typical characteristic of the Complex System, therefore, we propose a resource management architecture based on complex network theory for Cloud Computing Federation (abbreviated as RMABC) in this paper, with the detailed design of the resource discovery and resource announcement mechanisms. Compare with the existing resource management mechanisms in distributed computing systems, a Task Manager in RMABC can use the historical information and current state data get from other Task Managers for the evolution of the complex network which is composed of Task Managers, thus has the advantages in resource discovery speed, fault tolerance and adaptive ability. The result of the model experiment confirmed the advantage of RMABC in resource discovery performance.

Appreciating the Complexity of Project Management Execution: Using Simulation in the Classroom

ERIC Educational Resources Information Center

Hartman, Nathan S.; Watts, Charles A.; Treleven, Mark D.

2013-01-01

As the popularity and importance of project management increase, so does the need for well-prepared project managers. This article discusses our experiences using a project management simulation in undergraduate and MBA classes to help students better grasp the complexity of project management. This approach gives students hands-on experience with…

Complex Adaptive Systems as Metaphors for Organizational Management

ERIC Educational Resources Information Center

Palmberg, Klara

2009-01-01

Purpose: The purpose of this paper is to explore the concept of complex adaptive systems (CAS) from the perspective of managing organizations, to describe and explore the management principles in a case study of an organization with unconventional ways of management and to present a tentative model for managing organizations as CAS--system…

Learning to manage complexity through simulation: students' challenges and possible strategies.

PubMed

Gormley, Gerard J; Fenwick, Tara

2016-06-01

Many have called for medical students to learn how to manage complexity in healthcare. This study examines the nuances of students' challenges in coping with a complex simulation learning activity, using concepts from complexity theory, and suggests strategies to help them better understand and manage complexity.Wearing video glasses, participants took part in a simulation ward-based exercise that incorporated characteristics of complexity. Video footage was used to elicit interviews, which were transcribed. Using complexity theory as a theoretical lens, an iterative approach was taken to identify the challenges that participants faced and possible coping strategies using both interview transcripts and video footage.Students' challenges in coping with clinical complexity included being: a) unprepared for 'diving in', b) caught in an escalating system, c) captured by the patient, and d) unable to assert boundaries of acceptable practice.Many characteristics of complexity can be recreated in a ward-based simulation learning activity, affording learners an embodied and immersive experience of these complexity challenges. Possible strategies for managing complexity themes include: a) taking time to size up the system, b) attuning to what emerges, c) reducing complexity, d) boundary practices, and e) working with uncertainty. This study signals pedagogical opportunities for recognizing and dealing with complexity.

Application of NASA management approach to solve complex problems on earth

NASA Technical Reports Server (NTRS)

Potate, J. S.

1972-01-01

The application of NASA management approach to solving complex problems on earth is discussed. The management of the Apollo program is presented as an example of effective management techniques. Four key elements of effective management are analyzed. Photographs of the Cape Kennedy launch sites and supporting equipment are included to support the discussions.

Matrix management in hospitals: testing theories of matrix structure and development.

PubMed

Burns, L R

1989-09-01

A study of 315 hospitals with matrix management programs was used to test several hypotheses concerning matrix management advanced by earlier theorists. The study verifies that matrix management involves several distinctive elements that can be scaled to form increasingly complex types of lateral coordinative devices. The scalability of these elements is evident only cross-sectionally. The results show that matrix complexity is not an outcome of program age, nor does matrix complexity at the time of implementation appear to influence program survival. Matrix complexity, finally, is not determined by the organization's task diversity and uncertainty. The results suggest several modifications in prevailing theories of matrix organization.

GBA manager: an online tool for querying low-complexity regions in proteins.

PubMed

Bandyopadhyay, Nirmalya; Kahveci, Tamer

2010-01-01

Abstract We developed GBA Manager, an online software that facilitates the Graph-Based Algorithm (GBA) we proposed in our earlier work. GBA identifies the low-complexity regions (LCR) of protein sequences. GBA exploits a similarity matrix, such as BLOSUM62, to compute the complexity of the subsequences of the input protein sequence. It uses a graph-based algorithm to accurately compute the regions that have low complexities. GBA Manager is a user friendly web-service that enables online querying of protein sequences using GBA. In addition to querying capabilities of the existing GBA algorithm, GBA Manager computes the p-values of the LCR identified. The p-value gives an estimate of the possibility that the region appears by chance. GBA Manager presents the output in three different understandable formats. GBA Manager is freely accessible at http://bioinformatics.cise.ufl.edu/GBA/GBA.htm .

Enhanced Systemic Understanding of the Information Environment in Complex Crisis Management - Analytical Concept, Version 1.0

DTIC Science & Technology

2010-10-22

4. TITLE AND SUBTITLE Enhanced Systemic Understanding of the Information Environment in Complex Crisis Management Analytical Concept, Version 1.0...Email: schmidtb@iabg.de UNCLASSIFIED FOR PUBLIC RELEASE – Enhanced Systemic Understanding of the Information Environment in Complex Crisis ...multinational crisis management and the security sector about the significance and characteristics of the information environment. The framework is

If you take stand, how can you manage an ecosystem? The complex art of raising a forest.

Treesearch

Sally Duncan

2000-01-01

Managing whole ecosystem is a concept gaining considerable acceptance among forest managers throughout the Northwest, but it does not have a clear or simple definition. Terminology and definitions can be confusing. Forests are complex places, formed by complex processes, and the moment we try to simplify, we are likely to damage the healthy functioning of...

PROGRAM-ORIENTED INFORMATION--A MANAGEMENT SYSTEMS COMPLEX FOR STATE EDUCATION AGENCIES. PART II, MANUAL OF ACCOUNTING AND RELATED FINANCIAL PROCEDURES.

ERIC Educational Resources Information Center

FRIEDMAN, BURTON DEAN; AND OTHERS

THIS DOCUMENT IS THE SECOND PART OF A REPORT, PROGRAM-ORIENTED INFORMATION--A MANAGEMENT SYSTEMS COMPLEX FOR STATE EDUCATION AGENCIES. PART 1, EA 001 170, SUBTITLED "ANALYSIS AND PROPOSALS," CONTAINS AN OUTLINE OF THE NEED FOR A MANAGEMENT SYSTEMS COMPLEX WITHIN EACH STATE EDUCATION AGENCY. THIS DOCUMENT IS A MANUAL PRESENTING THE…

How Project Managers Really Manage: An Indepth Look at Some Managers of Large, Complex NASA Projects

NASA Technical Reports Server (NTRS)

Mulenburg, Gerald M.; Impaeilla, Cliff (Technical Monitor)

2000-01-01

This paper reports on a research study by the author that examined ten contemporary National Aeronautics and Space Administration (NASA) complex projects. In-depth interviews with the project managers of these projects provided qualitative data about the inner workings of the project and the methodologies used in establishing and managing the projects. The inclusion of a variety of space, aeronautics, and ground based projects from several different NASA research centers helped to reduce potential bias in the findings toward any one type of project, or technical discipline. The findings address the participants and their individual approaches. The discussion includes possible implications for project managers of other large, complex, projects.

Trajectory-Oriented Approach to Managing Traffic Complexity: Trajectory Flexibility Metrics and Algorithms and Preliminary Complexity Impact Assessment

NASA Technical Reports Server (NTRS)

Idris, Husni; Vivona, Robert A.; Al-Wakil, Tarek

2009-01-01

This document describes exploratory research on a distributed, trajectory oriented approach for traffic complexity management. The approach is to manage traffic complexity based on preserving trajectory flexibility and minimizing constraints. In particular, the document presents metrics for trajectory flexibility; a method for estimating these metrics based on discrete time and degree of freedom assumptions; a planning algorithm using these metrics to preserve flexibility; and preliminary experiments testing the impact of preserving trajectory flexibility on traffic complexity. The document also describes an early demonstration capability of the trajectory flexibility preservation function in the NASA Autonomous Operations Planner (AOP) platform.

Exploring the Complexity of Classroom Management: 8 Components of Managing a Highly Productive, Safe, and Respectful Urban Environment

ERIC Educational Resources Information Center

Jones, Karrie A.; Jones, Jennifer L.; Vermette, Paul J.

2013-01-01

Creating a learning environment where all students can thrive academically requires an understanding of the complexities of classroom management. The notions of "discipline," "conformity" and "obedience" that have littered discussions of classroom management in the past are no longer sufficient to describe the diverse…

Methods Used to Support a Life Cycle of Complex Engineering Products

NASA Astrophysics Data System (ADS)

Zakharova, Alexandra A.; Kolegova, Olga A.; Nekrasova, Maria E.; Eremenko, Andrey O.

2016-08-01

Management of companies involved in the design, development and operation of complex engineering products recognize the relevance of creating systems for product lifecycle management. A system of methods is proposed to support life cycles of complex engineering products, based on fuzzy set theory and hierarchical analysis. The system of methods serves to demonstrate the grounds for making strategic decisions in an environment of uncertainty, allows the use of expert knowledge, and provides interconnection of decisions at all phases of strategic management and all stages of a complex engineering product lifecycle.

Implementing complex innovations: factors influencing middle manager support.

PubMed

Chuang, Emmeline; Jason, Kendra; Morgan, Jennifer Craft

2011-01-01

Middle manager resistance is often described as a major challenge for upper-level administrators seeking to implement complex innovations such as evidence-based protocols or new skills training. However, factors influencing middle manager support for innovation implementation are currently understudied in the U.S. health care literature. This article examined the factors that influence middle managers' support for and participation in the implementation of work-based learning, a complex innovation adopted by health care organizations to improve the jobs, educational pathways, skills, and/or credentials of their frontline workers. We conducted semistructured interviews and focus groups with 92 middle managers in 17 health care organizations. Questions focused on understanding middle managers' support for work-based learning as a complex innovation, facilitators and barriers to the implementation process, and the systems changes needed to support the implementation of this innovation. Factors that emerged as influential to middle manager support were similar to those found in broader models of innovation implementation within the health care literature. However, our findings extend previous research by developing an understanding about how middle managers perceived these constructs and by identifying specific strategies for how to influence middle manager support for the innovation implementation process. These findings were generally consistent across different types of health care organizations. Study findings suggest that middle manager support was highest when managers felt the innovation fit their workplace needs and priorities and when they had more discretion and control over how it was implemented. Leaders seeking to implement innovations should consider the interplay between middle managers' control and discretion, their narrow focus on the performance of their own departments or units, and the dedication of staff and other resources for empowering their managers to implement these complex innovations.

Managing Complex Problems in Rangeland Ecosystems

USDA-ARS?s Scientific Manuscript database

Management of rangelands, and natural resources in general, has become increasingly complex. There is an atmosphere of increasing expectations for conservation efforts associated with a variety of issues from water quality to endangered species. We argue that many current issues are complex by their...

Complexity Theory, School Leadership and Management: Questions for Theory and Practice

ERIC Educational Resources Information Center

Morrison, Keith

2010-01-01

Complexity theory (CT) has had a meteoric rise in management literature and the social sciences. Its fledgling importation into school leadership and management raises several questions and concerns. This article takes one view of CT and argues that, though its key elements have much to offer school leadership and management, caution has to be…

Simplifying the complexity surrounding ICU work processes--identifying the scope for information management in ICU settings.

PubMed

Munir, Samina K; Kay, Stephen

2005-08-01

A multi-site study, conducted in two English and two Danish intensive care units, investigates the complexity of work processes in intensive care, and the implications of this complexity for information management with regards to clinical information systems. Data were collected via observations, shadowing of clinical staff, interviews and questionnaires. The construction of role activity diagrams enabled the capture of critical care work processes. Upon analysing these diagrams, it was found that intensive care work processes consist of 'simplified-complexity', these processes are changed with the introduction of information systems for the everyday use and management of all clinical information. The prevailing notion of complexity surrounding critical care clinical work processes was refuted and found to be misleading; in reality, it is not the work processes that cause the complexity, the complexity is rooted in the way in which clinical information is used and managed. This study emphasises that the potential for clinical information systems that consider integrating all clinical information requirements is not only immense but also very plausible.

Trajectory-Oriented Approach to Managing Traffic Complexity: Operational Concept and Preliminary Metrics Definition

NASA Technical Reports Server (NTRS)

Idris, Husni; Vivona, Robert; Garcia-Chico, Jose L.

2008-01-01

This document describes preliminary research on a distributed, trajectory-oriented approach for traffic complexity management. The approach is to manage traffic complexity in a distributed control environment, based on preserving trajectory flexibility and minimizing constraints. In particular, the document presents an analytical framework to study trajectory flexibility and the impact of trajectory constraints on it. The document proposes preliminary flexibility metrics that can be interpreted and measured within the framework.

Identifying behaviour patterns of construction safety using system archetypes.

PubMed

Guo, Brian H W; Yiu, Tak Wing; González, Vicente A

2015-07-01

Construction safety management involves complex issues (e.g., different trades, multi-organizational project structure, constantly changing work environment, and transient workforce). Systems thinking is widely considered as an effective approach to understanding and managing the complexity. This paper aims to better understand dynamic complexity of construction safety management by exploring archetypes of construction safety. To achieve this, this paper adopted the ground theory method (GTM) and 22 interviews were conducted with participants in various positions (government safety inspector, client, health and safety manager, safety consultant, safety auditor, and safety researcher). Eight archetypes were emerged from the collected data: (1) safety regulations, (2) incentive programs, (3) procurement and safety, (4) safety management in small businesses (5) production and safety, (6) workers' conflicting goals, (7) blame on workers, and (8) reactive and proactive learning. These archetypes capture the interactions between a wide range of factors within various hierarchical levels and subsystems. As a free-standing tool, they advance the understanding of dynamic complexity of construction safety management and provide systemic insights into dealing with the complexity. They also can facilitate system dynamics modelling of construction safety process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Habitat complexity influences fine scale hydrological processes and the incidence of stormwater runoff in managed urban ecosystems.

PubMed

Ossola, Alessandro; Hahs, Amy Kristin; Livesley, Stephen John

2015-08-15

Urban ecosystems have traditionally been considered to be pervious features of our cities. Their hydrological properties have largely been investigated at the landscape scale and in comparison with other urban land use types. However, hydrological properties can vary at smaller scales depending upon changes in soil, surface litter and vegetation components. Management practices can directly and indirectly affect each of these components and the overall habitat complexity, ultimately affecting hydrological processes. This study aims to investigate the influence that habitat components and habitat complexity have upon key hydrological processes and the implications for urban habitat management. Using a network of urban parks and remnant nature reserves in Melbourne, Australia, replicate plots representing three types of habitat complexity were established: low-complexity parks, high-complexity parks, and high-complexity remnants. Saturated soil hydraulic conductivity in low-complexity parks was an order of magnitude lower than that measured in the more complex habitat types, due to fewer soil macropores. Conversely, soil water holding capacity in low-complexity parks was significantly higher compared to the two more complex habitat types. Low-complexity parks would generate runoff during modest precipitation events, whereas high-complexity parks and remnants would be able to absorb the vast majority of rainfall events without generating runoff. Litter layers on the soil surface would absorb most of precipitation events in high-complexity parks and high-complexity remnants. To minimize the incidence of stormwater runoff from urban ecosystems, land managers could incrementally increase the complexity of habitat patches, by increasing canopy density and volume, preserving surface litter and maintaining soil macropore structure. Copyright © 2015 Elsevier Ltd. All rights reserved.

Development of Innovative Business Model of Modern Manager's Qualities

ERIC Educational Resources Information Center

Yashkova, Elena V.; Sineva, Nadezda L.; Shkunova, Angelika A.; Bystrova, Natalia V.; Smirnova, Zhanna V.; Kolosova, Tatyana V.

2016-01-01

The paper defines a complex of manager's qualities based on theoretical and methodological analysis and synthesis methods, available national and world literature, research papers and publications. The complex approach methodology was used, which provides an innovative view of the development of modern manager's qualities. The methodological…

Policy experimentation and innovation as a response to complexity in China's management of health reforms.

PubMed

Husain, Lewis

2017-08-03

There are increasing criticisms of dominant models for scaling up health systems in developing countries and a recognition that approaches are needed that better take into account the complexity of health interventions. Since Reform and Opening in the late 1970s, Chinese government has managed complex, rapid and intersecting reforms across many policy areas. As with reforms in other policy areas, reform of the health system has been through a process of trial and error. There is increasing understanding of the importance of policy experimentation and innovation in many of China's reforms; this article argues that these processes have been important in rebuilding China's health system. While China's current system still has many problems, progress is being made in developing a functioning system able to ensure broad population access. The article analyses Chinese thinking on policy experimentation and innovation and their use in management of complex reforms. It argues that China's management of reform allows space for policy tailoring and innovation by sub-national governments under a broad agreement over the ends of reform, and that shared understandings of policy innovation, alongside informational infrastructures for the systemic propagation and codification of useful practices, provide a framework for managing change in complex environments and under conditions of uncertainty in which 'what works' is not knowable in advance. The article situates China's use of experimentation and innovation in management of health system reform in relation to recent literature which applies complex systems thinking to global health, and concludes that there are lessons to be learnt from China's approaches to managing complexity in development of health systems for the benefit of the poor.

Fuzzy Entropy Method for Quantifying Supply Chain Networks Complexity

NASA Astrophysics Data System (ADS)

Zhang, Jihui; Xu, Junqin

Supply chain is a special kind of complex network. Its complexity and uncertainty makes it very difficult to control and manage. Supply chains are faced with a rising complexity of products, structures, and processes. Because of the strong link between a supply chain’s complexity and its efficiency the supply chain complexity management becomes a major challenge of today’s business management. The aim of this paper is to quantify the complexity and organization level of an industrial network working towards the development of a ‘Supply Chain Network Analysis’ (SCNA). By measuring flows of goods and interaction costs between different sectors of activity within the supply chain borders, a network of flows is built and successively investigated by network analysis. The result of this study shows that our approach can provide an interesting conceptual perspective in which the modern supply network can be framed, and that network analysis can handle these issues in practice.

Application of Complex Adaptive Systems in Portfolio Management

ERIC Educational Resources Information Center

Su, Zheyuan

2017-01-01

Simulation-based methods are becoming a promising research tool in financial markets. A general Complex Adaptive System can be tailored to different application scenarios. Based on the current research, we built two models that would benefit portfolio management by utilizing Complex Adaptive Systems (CAS) in Agent-based Modeling (ABM) approach.…

The Role of Mental Models in Dynamic Decision-Making

DTIC Science & Technology

2009-03-01

Humansystems® Incorporated 111 Farquhar St., Guelph, ON N1H 3N4 Project Manager : Lisa A. Rehak PWGSC Contract No.: W7711-078110/001/TOR Call...simulate the processes that people use to manage complex systems. These analogies, moreover, represent one way to help people to form more accurate...make complex decisions. Control theory’s primary emphasis is on the role of feedback while managing a complex system. What is common to all of these

Some thoughts on the management of large, complex international space ventures

NASA Technical Reports Server (NTRS)

Lee, T. J.; Kutzer, Ants; Schneider, W. C.

1992-01-01

Management issues relevant to the development and deployment of large international space ventures are discussed with particular attention given to previous experience. Management approaches utilized in the past are labeled as either simple or complex, and signs of efficient management are examined. Simple approaches include those in which experiments and subsystems are developed for integration into spacecraft, and the Apollo-Soyuz Test Project is given as an example of a simple multinational approach. Complex approaches include those for ESA's Spacelab Project and the Space Station Freedom in which functional interfaces cross agency and political boundaries. It is concluded that individual elements of space programs should be managed by individual participating agencies, and overall configuration control is coordinated by level with a program director acting to manage overall objectives and project interfaces.

Complex and open fractures: a straightforward approach to management in the cat.

PubMed

Corr, Sandra

2012-01-01

Cats often present with traumatic injuries of the limbs, including complex and open fractures, frequently as a result of road traffic accidents. On initial assessment, complex and open fractures may appear to require expertise beyond the experience of the general practitioner and, in some cases, referral to a specialist may be indicated or amputation should be considered. Many cases, however, can be managed using straightforward principles. This review describes a logical and practical approach to treating such injuries. It discusses general principles of fracture management, highlights the treatment of open fractures, and describes the use of external skeletal fixation for stabilisation of both open and complex fractures. Most fractures can be stabilised using equipment and expertise available in general practice if the basic principles of fracture fixation are understood and rigorously applied. Many textbooks and journal articles have been published on the management of fractures in companion animals, presenting case studies, case series and original biomechanical research. The simple strategy for managing complex injuries that is provided in this review is based on the published literature and the author's clinical experience.

76 FR 56770 - Food and Drug Administration/Xavier University Global Outsourcing Conference

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

..., Pharma Case Study on How to Manage a Global Complex Supply Chain, USP : Good Storage and Distribution... through topics such as Strategic Procurement, End-to-End lifecycle product management, Managing Global Complex Supply Chains, and other topics. The experience level of our audience has fostered engaged dialog...

Complexity in Nature and Society: Complexity Management in the Age of Globalization

NASA Astrophysics Data System (ADS)

Mainzer, Klaus

The theory of nonlinear complex systems has become a proven problem-solving approach in the natural sciences from cosmic and quantum systems to cellular organisms and the brain. Even in modern engineering science self-organizing systems are developed to manage complex networks and processes. It is now recognized that many of our ecological, social, economic, and political problems are also of a global, complex, and nonlinear nature. What are the laws of sociodynamics? Is there a socio-engineering of nonlinear problem solving? What can we learn from nonlinear dynamics for complexity management in social, economic, financial and political systems? Is self-organization an acceptable strategy to handle the challenges of complexity in firms, institutions and other organizations? It is a main thesis of the talk that nature and society are basically governed by nonlinear and complex information dynamics. How computational is sociodynamics? What can we hope for social, economic and political problem solving in the age of globalization?.

Remediation management of complex sites using an adaptive site management approach.

PubMed

Price, John; Spreng, Carl; Hawley, Elisabeth L; Deeb, Rula

2017-12-15

Complex sites require a disproportionate amount of resources for environmental remediation and long timeframes to achieve remediation objectives, due to their complex geologic conditions, hydrogeologic conditions, geochemical conditions, contaminant-related conditions, large scale of contamination, and/or non-technical challenges. A recent team of state and federal environmental regulators, federal agency representatives, industry experts, community stakeholders, and academia worked together as an Interstate Technology & Regulatory Council (ITRC) team to compile resources and create new guidance on the remediation management of complex sites. This article summarizes the ITRC team's recommended process for addressing complex sites through an adaptive site management approach. The team provided guidance for site managers and other stakeholders to evaluate site complexities and determine site remediation potential, i.e., whether an adaptive site management approach is warranted. Adaptive site management was described as a comprehensive, flexible approach to iteratively evaluate and adjust the remedial strategy in response to remedy performance. Key aspects of adaptive site management were described, including tools for revising and updating the conceptual site model (CSM), the importance of setting interim objectives to define short-term milestones on the journey to achieving site objectives, establishing a performance model and metrics to evaluate progress towards meeting interim objectives, and comparing actual with predicted progress during scheduled periodic evaluations, and establishing decision criteria for when and how to adapt/modify/revise the remedial strategy in response to remedy performance. Key findings will be published in an ITRC Technical and Regulatory guidance document in 2017 and free training webinars will be conducted. More information is available at www.itrc-web.org. Copyright © 2017 Elsevier Ltd. All rights reserved.

Recording information on protein complexes in an information management system

PubMed Central

Savitsky, Marc; Diprose, Jonathan M.; Morris, Chris; Griffiths, Susanne L.; Daniel, Edward; Lin, Bill; Daenke, Susan; Bishop, Benjamin; Siebold, Christian; Wilson, Keith S.; Blake, Richard; Stuart, David I.; Esnouf, Robert M.

2011-01-01

The Protein Information Management System (PiMS) is a laboratory information management system (LIMS) designed for use with the production of proteins in a research environment. The software is distributed under the CCP4 licence, and so is available free of charge to academic laboratories. Like most LIMS, the underlying PiMS data model originally had no support for protein–protein complexes. To support the SPINE2-Complexes project the developers have extended PiMS to meet these requirements. The modifications to PiMS, described here, include data model changes, additional protocols, some user interface changes and functionality to detect when an experiment may have formed a complex. Example data are shown for the production of a crystal of a protein complex. Integration with SPINE2-Complexes Target Tracker application is also described. PMID:21605682

Recording information on protein complexes in an information management system.

PubMed

Savitsky, Marc; Diprose, Jonathan M; Morris, Chris; Griffiths, Susanne L; Daniel, Edward; Lin, Bill; Daenke, Susan; Bishop, Benjamin; Siebold, Christian; Wilson, Keith S; Blake, Richard; Stuart, David I; Esnouf, Robert M

2011-08-01

The Protein Information Management System (PiMS) is a laboratory information management system (LIMS) designed for use with the production of proteins in a research environment. The software is distributed under the CCP4 licence, and so is available free of charge to academic laboratories. Like most LIMS, the underlying PiMS data model originally had no support for protein-protein complexes. To support the SPINE2-Complexes project the developers have extended PiMS to meet these requirements. The modifications to PiMS, described here, include data model changes, additional protocols, some user interface changes and functionality to detect when an experiment may have formed a complex. Example data are shown for the production of a crystal of a protein complex. Integration with SPINE2-Complexes Target Tracker application is also described. Copyright © 2011 Elsevier Inc. All rights reserved.

Applying Best Business Practices from Corporate Performance Management to DoD

DTIC Science & Technology

2013-01-01

leading or governing large, complex corporations and are experienced in creating reliable solutions to complex management issues guided by best business ...recommendations and effective solutions aimed at improving DoD. Defense Business Board Corporate Performance Management REPORT FY13-03 Task...Group 1 Applying Best Business Practices from Corporate Performance Management to DoD TASK The Deputy Secretary of Defense (DEPSECDEF

Improving Care for Children With Complex Needs

ClinicalTrials.gov

2017-10-10

Medically Complex Children; Care Coordination; Case Manager; Care Manager; Collaborative Care; Disease Management; Patient Care Team or Organization; Managed Care; Children With Chronic Conditions; Children With Special Health Care Needs; Shared Care Plan; Patient Care Plan; Health Care and Resource Utilization; Adherence to Care; Functional Status and Productivity; Health Related Quality of Life; Satisfaction With Care; Care Coordinator; Family Experience of Care; Quality Health Care

Planning and management of the Nido Reef Complex Oil Field development, Philippines

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

Harry, R.Y.

1981-01-01

As Operator for the Northeast Palawan consortium, Philippines-Cities Service, Inc., commenced the Philippines first commercial offshore oil production from the Nido Reef Complex Oil Field on February 1, 1979, some 11 months after a decision by management to start development. The relative speed at which design, fabrication, and construction were accomplished is attributed to the use of the concepts of project planning, task force approach, and project management. This paper presents the above concepts as applied to the Nido Complex.

Medication Management: The Macrocognitive Workflow of Older Adults With Heart Failure.

PubMed

Mickelson, Robin S; Unertl, Kim M; Holden, Richard J

2016-10-12

Older adults with chronic disease struggle to manage complex medication regimens. Health information technology has the potential to improve medication management, but only if it is based on a thorough understanding of the complexity of medication management workflow as it occurs in natural settings. Prior research reveals that patient work related to medication management is complex, cognitive, and collaborative. Macrocognitive processes are theorized as how people individually and collaboratively think in complex, adaptive, and messy nonlaboratory settings supported by artifacts. The objective of this research was to describe and analyze the work of medication management by older adults with heart failure, using a macrocognitive workflow framework. We interviewed and observed 61 older patients along with 30 informal caregivers about self-care practices including medication management. Descriptive qualitative content analysis methods were used to develop categories, subcategories, and themes about macrocognitive processes used in medication management workflow. We identified 5 high-level macrocognitive processes affecting medication management-sensemaking, planning, coordination, monitoring, and decision making-and 15 subprocesses. Data revealed workflow as occurring in a highly collaborative, fragile system of interacting people, artifacts, time, and space. Process breakdowns were common and patients had little support for macrocognitive workflow from current tools. Macrocognitive processes affected medication management performance. Describing and analyzing this performance produced recommendations for technology supporting collaboration and sensemaking, decision making and problem detection, and planning and implementation.

77 FR 14567 - Draft General Management Plan/Environmental Impact Statement for the Ice Age Complex at Cross...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-12

... Impact Statement for the Ice Age Complex at Cross Plains, Cross Plains, Wisconsin AGENCY: National Park... General Management Plan/Environmental Impact Statement for the Ice Age Complex at Cross Plains, Wisconsin... also send comments to Superintendent, Ice Age National Scenic Trail, 700 Rayovac Drive, Suite 100...

Language Students Learning to Manage Complex Pedagogic Situations in a Technology-Rich Environment

ERIC Educational Resources Information Center

Tumelius, Riikka; Kuure, Leena

2017-01-01

Being a language teacher in the modern world requires sensitivity to complexity, which may pose challenges for student teachers and teachers in the field accustomed to classroom-based learning and teaching. This study examines how language students are managing complex pedagogic situations in a technologyrich environment while exploring new ways…

The Acquisition Process as a Vehicle for Enabling Knowledge Management in the Lifecycle of Complex Federal Systems

NASA Technical Reports Server (NTRS)

Stewart, Helen; Spence, Matt Chew; Holm, Jeanne; Koga, Dennis (Technical Monitor)

2001-01-01

This white paper explores how to increase the success and operation of critical, complex, national systems by effectively capturing knowledge management requirements within the federal acquisition process. Although we focus on aerospace flight systems, the principles outlined within may have a general applicability to other critical federal systems as well. Fundamental design deficiencies in federal, mission-critical systems have contributed to recent, highly visible system failures, such as the V-22 Osprey and the Delta rocket family. These failures indicate that the current mechanisms for knowledge management and risk management are inadequate to meet the challenges imposed by the rising complexity of critical systems. Failures of aerospace system operations and vehicles may have been prevented or lessened through utilization of better knowledge management and information management techniques.

Case Management for Patients with Complex Multimorbidity: Development and Validation of a Coordinated Intervention between Primary and Hospital Care

PubMed Central

Giménez-Campos, María Soledad; Villar-López, Julia; Faubel-Cava, Raquel; Donat-Castelló, Lucas; Valdivieso-Martínez, Bernardo; Soriano-Melchor, Elisa; Bahamontes-Mulió, Amparo; García-Gómez, Juan M.

2017-01-01

In the past few years, healthcare systems have been facing a growing demand related to the high prevalence of chronic diseases. Case management programs have emerged as an integrated care approach for the management of chronic disease. Nevertheless, there is little scientific evidence on the impact of using a case management program for patients with complex multimorbidity regarding hospital resource utilisation. We evaluated an integrated case management intervention set up by community-based care at outpatient clinics with nurse case managers from a telemedicine unit. The hypothesis to be tested was whether improved continuity of care resulting from the integration of community-based and hospital services reduced the use of hospital resources amongst patients with complex multimorbidity. A retrospective cohort study was performed using a sample of 714 adult patients admitted to the program between January 2012 and January 2015. We found a significant decrease in the number of emergency room visits, unplanned hospitalizations, and length of stay, and an expected increase in the home care hospital-based episodes. These results support the hypothesis that case management interventions can reduce the use of unplanned hospital admissions when applied to patients with complex multimorbidity. PMID:28970745

Chapter 4: Use of fire to manage populations of nonnative invasive plants

Treesearch

Peter M. Rice; Jane Kapler Smith

2008-01-01

It may be impossible to overstate the complexity of relationships among wildland ecosystems, fires, and nonnative invasives. Strategies for managing these relationships are similarly complex; they require information on local plant phenology, ability to produce various levels of fire severity within burns, willingness to combine fire with other management techniques,...

Progression in Complexity: Contextualizing Sustainable Marine Resources Management in a 10th Grade Classroom

ERIC Educational Resources Information Center

Bravo-Torija, Beatriz; Jimenez-Aleixandre, Maria-Pilar

2012-01-01

Sustainable management of marine resources raises great challenges. Working with this socio-scientific issue in the classroom requires students to apply complex models about energy flow and trophic pyramids in order to understand that food chains represent transfer of energy, to construct meanings for sustainable resources management through…

76 FR 28328 - Fisheries of the Northeastern United States; Northeast Skate Complex Fishery; Framework Adjustment 1

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-17

... alternatives for each of three principal management measures: (1) The primary possession limit affecting the... measures in Framework Adjustment 1 to the Northeast Skate Complex Fishery Management Plan (Skate FMP). Framework Adjustment 1 was developed by the New England Fishery Management Council (Council) to adjust the...

Health care organizations as complex systems: new perspectives on design and management.

PubMed

McDaniel, Reuben R; Driebe, Dean J; Lanham, Holly Jordan

2013-01-01

We discuss the impact of complexity science on the design and management of health care organizations over the past decade. We provide an overview of complexity science issues and their impact on thinking about health care systems, particularly with the rising importance of information systems. We also present a complexity science perspective on current issues in today's health care organizations and suggest ways that this perspective might help in approaching these issues. We review selected research, focusing on work in which we participated, to identify specific examples of applications of complexity science. We then take a look at information systems in health care organizations from a complexity viewpoint. Complexity science is a fundamentally different way of understanding nature and has influenced the thinking of scholars and practitioners as they have attempted to understand health care organizations. Many scholars study health care organizations as complex adaptive systems and through this perspective develop new management strategies. Most important, perhaps, is the understanding that attention to relationships and interdependencies is critical for developing effective management strategies. Increased understanding of complexity science can enhance the ability of researchers and practitioners to develop new ways of understanding and improving health care organizations. This analysis opens new vistas for scholars and practitioners attempting to understand health care organizations as complex adaptive systems. The analysis holds value for those already familiar with this approach as well as those who may not be as familiar.

Quality data collection and management technology of aerospace complex product assembly process

NASA Astrophysics Data System (ADS)

Weng, Gang; Liu, Jianhua; He, Yongxi; Zhuang, Cunbo

2017-04-01

Aiming at solving problems of difficult management and poor traceability for discrete assembly process quality data, a data collection and management method is proposed which take the assembly process and BOM as the core. Data collection method base on workflow technology, data model base on BOM and quality traceability of assembly process is included in the method. Finally, assembly process quality data management system is developed and effective control and management of quality information for complex product assembly process is realized.

Using complexity theory to analyse the organisational response to resurgent tuberculosis across London.

PubMed

Trenholm, Susan; Ferlie, Ewan

2013-09-01

We employ complexity theory to analyse the English National Health Service (NHS)'s organisational response to resurgent tuberculosis across London. Tennison (2002) suggests that complexity theory could fruitfully explore a healthcare system's response to this complex and emergent phenomenon: we explore this claim here. We also bring in established New Public Management principles to enhance our empirical analysis, which is based on data collected between late 2009 and mid-2011. We find that the operation of complexity theory based features, especially self-organisation, are significantly impacted by the macro context of a New Public Management-based regime which values control, measurement and risk management more than innovation, flexibility and lateral system building. We finally explore limitations and suggest perspectives for further research. Copyright © 2012 Elsevier Ltd. All rights reserved.

Medication Management: The Macrocognitive Workflow of Older Adults With Heart Failure

PubMed Central

2016-01-01

Background Older adults with chronic disease struggle to manage complex medication regimens. Health information technology has the potential to improve medication management, but only if it is based on a thorough understanding of the complexity of medication management workflow as it occurs in natural settings. Prior research reveals that patient work related to medication management is complex, cognitive, and collaborative. Macrocognitive processes are theorized as how people individually and collaboratively think in complex, adaptive, and messy nonlaboratory settings supported by artifacts. Objective The objective of this research was to describe and analyze the work of medication management by older adults with heart failure, using a macrocognitive workflow framework. Methods We interviewed and observed 61 older patients along with 30 informal caregivers about self-care practices including medication management. Descriptive qualitative content analysis methods were used to develop categories, subcategories, and themes about macrocognitive processes used in medication management workflow. Results We identified 5 high-level macrocognitive processes affecting medication management—sensemaking, planning, coordination, monitoring, and decision making—and 15 subprocesses. Data revealed workflow as occurring in a highly collaborative, fragile system of interacting people, artifacts, time, and space. Process breakdowns were common and patients had little support for macrocognitive workflow from current tools. Conclusions Macrocognitive processes affected medication management performance. Describing and analyzing this performance produced recommendations for technology supporting collaboration and sensemaking, decision making and problem detection, and planning and implementation. PMID:27733331

Efficient methods and readily customizable libraries for managing complexity of large networks.

PubMed

Dogrusoz, Ugur; Karacelik, Alper; Safarli, Ilkin; Balci, Hasan; Dervishi, Leonard; Siper, Metin Can

2018-01-01

One common problem in visualizing real-life networks, including biological pathways, is the large size of these networks. Often times, users find themselves facing slow, non-scaling operations due to network size, if not a "hairball" network, hindering effective analysis. One extremely useful method for reducing complexity of large networks is the use of hierarchical clustering and nesting, and applying expand-collapse operations on demand during analysis. Another such method is hiding currently unnecessary details, to later gradually reveal on demand. Major challenges when applying complexity reduction operations on large networks include efficiency and maintaining the user's mental map of the drawing. We developed specialized incremental layout methods for preserving a user's mental map while managing complexity of large networks through expand-collapse and hide-show operations. We also developed open-source JavaScript libraries as plug-ins to the web based graph visualization library named Cytsocape.js to implement these methods as complexity management operations. Through efficient specialized algorithms provided by these extensions, one can collapse or hide desired parts of a network, yielding potentially much smaller networks, making them more suitable for interactive visual analysis. This work fills an important gap by making efficient implementations of some already known complexity management techniques freely available to tool developers through a couple of open source, customizable software libraries, and by introducing some heuristics which can be applied upon such complexity management techniques to ensure preserving mental map of users.

Economic Decision Making: Application of the Theory of Complex Systems

NASA Astrophysics Data System (ADS)

Kitt, Robert

In this chapter the complex systems are discussed in the context of economic and business policy and decision making. It will be showed and motivated that social systems are typically chaotic, non-linear and/or non-equilibrium and therefore complex systems. It is discussed that the rapid change in global consumer behaviour is underway, that further increases the complexity in business and management. For policy making under complexity, following principles are offered: openness and international competition, tolerance and variety of ideas, self-reliability and low dependence on external help. The chapter contains four applications that build on the theoretical motivation of complexity in social systems. The first application demonstrates that small economies have good prospects to gain from the global processes underway, if they can demonstrate production flexibility, reliable business ethics and good risk management. The second application elaborates on and discusses the opportunities and challenges in decision making under complexity from macro and micro economic perspective. In this environment, the challenges for corporate management are being also permanently changed: the balance between short term noise and long term chaos whose attractor includes customers, shareholders and employees must be found. The emergence of chaos in economic relationships is demonstrated by a simple system of differential equations that relate the stakeholders described above. The chapter concludes with two financial applications: about debt and risk management. The non-equilibrium economic establishment leads to additional problems by using excessive borrowing; unexpected downturns in economy can more easily kill companies. Finally, the demand for quantitative improvements in risk management is postulated. Development of the financial markets has triggered non-linearity to spike in prices of various production articles such as agricultural and other commodities that has added market risk management to the business model of many companies.

A practical approach for comparing management strategies in complex forest ecosystems using meta-modelling toolkits

Treesearch

Andrew Fall; B. Sturtevant; M.-J. Fortin; M. Papaik; F. Doyon; D. Morgan; K. Berninger; C. Messier

2010-01-01

The complexity and multi-scaled nature of forests poses significant challenges to understanding and management. Models can provide useful insights into process and their interactions, and implications of alternative management options. Most models, particularly scientific models, focus on a relatively small set of processes and are designed to operate within a...

Exploring Use of Climate Information in Wildland Fire Management: A Decision Calendar Study

Treesearch

Thomas W. Corringham; Anthony L. Westerling; Barbara J. Morehouse

2006-01-01

Wildfire management is an institutionally complex process involving a complex budget and appropriations cycle, a variety of objectives, and a set of internal and external political constraints. Significant potential exists for enhancing the use of climate information and long-range climate forecasts in wildland fire management in the Western U.S. Written surveys and...

Wildland fire management policy: Learning from the past and present and responding to future challenges

Treesearch

Tom Zimmerman

2009-01-01

Since its origin as a defined functional activity, wildland fire management has been the natural resource management program with the highest risk, complexity, and greatest potential for serious negative outcomes. During this time, this program has continually grown in temporal and spatial extent, operational complexity, ecological significance, social, economic, and...

Internet of Things technology-based management methods for environmental specimen banks.

PubMed

Peng, Lihong; Wang, Qian; Yu, Ang

2015-02-01

The establishment and management of environmental specimen banks (ESBs) has long been a problem worldwide. The complexity of specimen environment has made the management of ESB likewise complex. Through an analysis of the development and management of ESBs worldwide and in light of the sophisticated Internet of Things (IOT) technology, this paper presents IOT technology-based ESB management methods. An IOT technology-based ESB management system can significantly facilitate ESB ingress and egress management as well as long-term storage management under quality control. This paper elaborates on the design of IOT technology-based modules, which can be used in ESB management to achieve standardized, smart, information-based ESB management. ESB management has far-reaching implications for environmental management and for research in environmental science.

Bayesian inference and decision theory - A framework for decision making in natural resource management

USGS Publications Warehouse

Dorazio, R.M.; Johnson, F.A.

2003-01-01

Bayesian inference and decision theory may be used in the solution of relatively complex problems of natural resource management, owing to recent advances in statistical theory and computing. In particular, Markov chain Monte Carlo algorithms provide a computational framework for fitting models of adequate complexity and for evaluating the expected consequences of alternative management actions. We illustrate these features using an example based on management of waterfowl habitat.

Balancing Management and Leadership in Complex Health Systems Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

PubMed

Kwamie, Aku

2015-08-14

Health systems, particularly those in low- and middle-income countries (LMICs), need stronger management and leadership capacities. Management and leadership are not synonymous, yet should be considered together as there can be too much of one and not enough of the other. In complex adaptive health systems, the multiple interactions and relationships between people and elements of the system mean that management and leadership, so often treated as domains of the individual, are additionally systemic phenomena, emerging from these relational interactions. This brief commentary notes some significant implications for how we can support capacity strengthening interventions for complex management and leadership. These would necessarily move away from competency-based models focused on training for individuals, and would rather encompass longer-term initiatives explicitly focused on systemic goals of accountability, innovation, and learning. © 2015 by Kerman University of Medical Sciences.

Modeling wildfire incident complexity dynamics.

PubMed

Thompson, Matthew P

2013-01-01

Wildfire management in the United States and elsewhere is challenged by substantial uncertainty regarding the location and timing of fire events, the socioeconomic and ecological consequences of these events, and the costs of suppression. Escalating U.S. Forest Service suppression expenditures is of particular concern at a time of fiscal austerity as swelling fire management budgets lead to decreases for non-fire programs, and as the likelihood of disruptive within-season borrowing potentially increases. Thus there is a strong interest in better understanding factors influencing suppression decisions and in turn their influence on suppression costs. As a step in that direction, this paper presents a probabilistic analysis of geographic and temporal variation in incident management team response to wildfires. The specific focus is incident complexity dynamics through time for fires managed by the U.S. Forest Service. The modeling framework is based on the recognition that large wildfire management entails recurrent decisions across time in response to changing conditions, which can be represented as a stochastic dynamic system. Daily incident complexity dynamics are modeled according to a first-order Markov chain, with containment represented as an absorbing state. A statistically significant difference in complexity dynamics between Forest Service Regions is demonstrated. Incident complexity probability transition matrices and expected times until containment are presented at national and regional levels. Results of this analysis can help improve understanding of geographic variation in incident management and associated cost structures, and can be incorporated into future analyses examining the economic efficiency of wildfire management.

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

Deeb, Rula A.; Hawley, Elisabeth L.

The goal of United States (U.S.) Department of Energy's (DOE)'s environmental remediation programs is to restore groundwater to beneficial use, similar to many other Federal and state environmental cleanup programs. Based on past experience, groundwater remediation to pre-contamination conditions (i.e., drinking water standards or non-detectable concentrations) can be successfully achieved at many sites. At a subset of the most complex sites, however, complete restoration is not likely achievable within the next 50 to 100 years using today's technology. This presentation describes several approaches used at complex sites in the face of these technical challenges. Many complex sites adopted a long-termmore » management approach, whereby contamination was contained within a specified area using active or passive remediation techniques. Consistent with the requirements of their respective environmental cleanup programs, several complex sites selected land use restrictions and used risk management approaches to accordingly adopt alternative cleanup goals (alternative endpoints). Several sites used long-term management designations and approaches in conjunction with the alternative endpoints. Examples include various state designations for groundwater management zones, technical impracticability (TI) waivers or greater risk waivers at Superfund sites, and the use of Monitored Natural Attenuation (MNA) or other passive long-term management approaches over long time frames. This presentation will focus on findings, statistics, and case studies from a recently-completed report for the Department of Defense's Environmental Security Technology Certification Program (ESTCP) (Project ER-0832) on alternative endpoints and approaches for groundwater remediation at complex sites under a variety of Federal and state cleanup programs. The primary objective of the project was to provide environmental managers and regulators with tools, metrics, and information needed to evaluate alternative endpoints for groundwater remediation at complex sites. A statistical analysis of Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) sites receiving TI waivers will be presented as well as case studies of other types of alternative endpoints and alternative remedial strategies that illustrate the variety of approaches used at complex sites and the technical analyses used to predict and document cost, time frame, and potential remedial effectiveness. This presentation is intended to inform DOE program managers, state regulators, practitioners and other stakeholders who are evaluating technical cleanup challenges within their own programs, and establishing programmatic approaches to evaluating and implementing long-term management approaches. Case studies provide examples of long-term management designations and strategies to manage and remediate groundwater at complex sites. At least 13 states consider some designation for groundwater containment in their corrective action policies, such as groundwater management zones, containment zones, and groundwater classification exemption areas. Long-term management designations are not a way to 'do nothing' or walk away from a site. Instead, soil and groundwater within the zone is managed to be protective of human health and the environment. Understanding when and how to adopt a long-term management approach can lead to cost savings and the more efficient use of resources across DOE and at numerous other industrial and military sites across the U.S. This presentation provides context for assessing the use and appropriate role of alternative endpoints and supporting long-term management designations in final remedies. (authors)« less

Risk management integration into complex project organizations

NASA Technical Reports Server (NTRS)

Fisher, K.; Greanias, G.; Rose, J.; Dumas, R.

2002-01-01

This paper describes the approach used in designing and adapting the SIRTF prototype, discusses some of the lessons learned in developing the SIRTF prototype, and explains the adaptability of the risk management database to varying levels project complexity.

Digital subtraction angiography-guided esophagography, intraluminal drainage, and endoscopic clipping-complex managements for intrathoracic esophagogastric anastomotic leak.

PubMed

Xu, Kai; Chen, Shaomu; Bian, Wen; Xie, Hongya; Ma, Haitao; Ni, Bin

2016-07-01

Intrathoracic esophagogastric anastomotic leak is a critical complication after esophagectomy. Recently, novel complex diagnostic and therapeutic managements for intrathoracic esophagogastric anastomotic leak have been performed at our institution. Sixty-seven consecutive patients with intrathoracic esophagogastric anastomotic leak after esophagectomy from January 2009 to May 2015 at our institution were reviewed. Thirty-nine patients received conventional managements (conventional group), in which they were diagnosed via contrast swallow when there was a suspicion of anastomotic leak and were subsequently treated with a metallic stent. Twenty-eight patients received complex managements (complex group), in which they were diagnosed using digital subtraction angiography, an intraluminal drainage tube was placed, and clips were subsequently performed under an endoscope. The outcomes of the two groups were retrospectively analyzed. There were no significant differences (P > 0.05) between the two groups in the preoperative general clinical data, whereas the postoperative data exhibited some differences. Compared with the conventional group, the confirmation time and recovery time are significantly decreased in the complex group (P < 0.01 and P < 0.01, respectively), and the incidence of severe complications is also lower (P < 0.01); however, there were no significant differences in the mortality rate between the two groups (P > 0.05). Complex managements may represent a useful therapeutic option for postoperative esophagogastric anastomotic leak. Copyright © 2016 Elsevier Inc. All rights reserved.

Microsurgical management of basilar artery apex aneurysms: a single surgeon's experience from Louisiana State University, Shreveport.

PubMed

Nanda, Anil; Sonig, Ashish; Banerjee, Anirban Deep; Javalkar, Vijay Kumar

2014-01-01

Basilar artery apex aneurysms continue to generate technical challenges and management controversy. Endovascular intervention is becoming the mainstay in the management of these formidable aneurysms, but it has limitations, especially with large/giant or wide neck basilar apex aneurysms. There is paucity of data in the available literature pertaining to the successful management of large/giant, wide neck, and calcified/thrombosed basilar apex aneurysms. We present our experience with consecutively operated complex basilar apex aneurysms so as to present the role of microneurosurgery as a viable management option for these aneurysms. Ours is a retrospective analysis of case-records for operated cases of basilar artery aneurysms spanning 18 years. Basilar apex aneurysms >10 cm, calcified or thrombosed, neck ≥4 mm posterior direction, and retro/subsellar were considered as complex anatomy aneurysms. Basilar apex aneurysms with favorable anatomy were included in the study as a reference group for statistical analysis. Patient demographics, complex features of aneurysms, clinical grade, and outcomes were analyzed. A total of 33 (53.2%) patients had complex anatomy: large (>10 mm) in eight (24.2%); giant aneurysms (>25 mm) in seven (21.2%); wide-neck in 22 (66.7%); and calcified/thrombosed morphology in five (15.1%). The mean age was 48.5 years, and 22 (66.67%) were women. All aneurysms were clipped by the use of various skull base approaches. A total of 71.9% of patients harboring complex aneurysm had good outcomes. If only unruptured and good grade complex aneurysms also are considered, then 86.9% (n = 20) patients had good outcomes. Statistically there was no significant difference in the outcomes of complex and noncomplex aneurysm. Although concerning, the management of large/giant, wide neck, and calcified/thrombosed aneurysms with microneurosurgery is still a competitive alternative to endovascular therapy. After careful selection of appropriate skull base approaches based on the complexity of the basilar apex aneurysm, microneurosurgery can achieve acceptable results. Copyright © 2014 Elsevier Inc. All rights reserved.

Utility and Scope of Rapid Prototyping in Patients with Complex Muscular Ventricular Septal Defects or Double-Outlet Right Ventricle: Does it Alter Management Decisions?

PubMed

Bhatla, Puneet; Tretter, Justin T; Ludomirsky, Achi; Argilla, Michael; Latson, Larry A; Chakravarti, Sujata; Barker, Piers C; Yoo, Shi-Joon; McElhinney, Doff B; Wake, Nicole; Mosca, Ralph S

2017-01-01

Rapid prototyping facilitates comprehension of complex cardiac anatomy. However, determining when this additional information proves instrumental in patient management remains a challenge. We describe our experience with patient-specific anatomic models created using rapid prototyping from various imaging modalities, suggesting their utility in surgical and interventional planning in congenital heart disease (CHD). Virtual and physical 3-dimensional (3D) models were generated from CT or MRI data, using commercially available software for patients with complex muscular ventricular septal defects (CMVSD) and double-outlet right ventricle (DORV). Six patients with complex anatomy and uncertainty of the optimal management strategy were included in this study. The models were subsequently used to guide management decisions, and the outcomes reviewed. 3D models clearly demonstrated the complex intra-cardiac anatomy in all six patients and were utilized to guide management decisions. In the three patients with CMVSD, one underwent successful endovascular device closure following a prior failed attempt at transcatheter closure, and the other two underwent successful primary surgical closure with the aid of 3D models. In all three cases of DORV, the models provided better anatomic delineation and additional information that altered or confirmed the surgical plan. Patient-specific 3D heart models show promise in accurately defining intra-cardiac anatomy in CHD, specifically CMVSD and DORV. We believe these models improve understanding of the complex anatomical spatial relationships in these defects and provide additional insight for pre/intra-interventional management and surgical planning.

Historical and current fire management practices in two wilderness areas in the southwestern United States: The Saguaro Wilderness Area and the Gila-Aldo Leopold Wilderness Complex

Treesearch

Molly E. Hunter; Jose M. Iniguez; Calvin A. Farris

2014-01-01

Fire suppression has been the dominant fire management strategy in the West over the last century. However, managers of the Gila and Aldo Leopold Wilderness Complex in New Mexico and the Saguaro Wilderness Area in Arizona have allowed fire to play a more natural role for decades. This report summarizes the effects of these fire management practices on key resources,...

Implementation of behavioral health interventions in real world scenarios: Managing complex change.

PubMed

Clark, Khaya D; Miller, Benjamin F; Green, Larry A; de Gruy, Frank V; Davis, Melinda; Cohen, Deborah J

2017-03-01

A practice embarks on a radical reformulation of how care is designed and delivered when it decides to integrate medical and behavioral health care for its patients and success depends on managing complex change in a complex system. We examined the ways change is managed when integrating behavioral health and medical care. Observational cross-case comparative study of 19 primary care and community mental health practices. We collected mixed methods data through practice surveys, observation, and semistructured interviews. We analyzed data using a data-driven, emergent approach. The change management strategies that leadership employed to manage the changes of integrating behavioral health and medical care included: (a) advocating for a mission and vision focused on integrated care; (b) fostering collaboration, with a focus on population care and a team-based approaches; (c) attending to learning, which includes viewing the change process as continuous, and creating a culture that promoted reflection and continual improvement; (d) using data to manage change, and (e) developing approaches to finance integration. This paper reports the change management strategies employed by practice leaders making changes to integrate care, as observed by independent investigators. We offer an empirically based set of actionable recommendations that are relevant to a range of leaders (policymakers, medical directors) and practice members who wish to effectively manage the complex changes associated with integrated primary care. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A Phenomenological Study of Urban Search and Rescue Members Who Responded to a Disaster

ERIC Educational Resources Information Center

Kerns, Terry L.

2012-01-01

The complicated world of disaster management requires urban search and rescue (US&R) members to be well trained to respond to complex, unpredictable, and difficult to manage disasters anywhere in the world on short notice. Disasters are becoming more complex and difficult to manage as was witnessed by the multi-faceted disaster in Japan in…

Assessing risks to multiple resources affected by wildfire and forest management using an integrated probabilistic framework

Treesearch

Steven P. Norman; Danny C. Lee; Sandra Jacobson; Christine Damiani

2010-01-01

The tradeoffs that surround forest management are inherently complex, often involving multiple temporal and spatial scales. For example, conflicts may result when fuel treatments are designed to mediate long-term fuel hazards, but activities could impair sensitive aquatic habitat or degrade wildlife habitat in the short term. This complexity makes it hard for managers...

School Crisis Management: A Model of Dynamic Responsiveness to Crisis Life Cycle

ERIC Educational Resources Information Center

Liou, Yi-Hwa

2015-01-01

Purpose: This study aims to analyze a school's crisis management and explore emerging aspects of its response to a school crisis. Traditional linear modes of analysis often fail to address complex crisis situations. The present study applied a dynamic crisis life cycle model that draws on chaos and complexity theory to a crisis management case,…

Ecological sites: Organizational tool for outcome-based land management

USDA-ARS?s Scientific Manuscript database

Managing for sustained ecosystem services from rangelands involves complex interactions among soils, plant communities, topography and the prevailing environmental conditions across different land forms from local patches to entire landscapes. This complexity has contributed to prior difficulties in...

Management of complex dynamical systems

NASA Astrophysics Data System (ADS)

MacKay, R. S.

2018-02-01

Complex dynamical systems are systems with many interdependent components which evolve in time. One might wish to control their trajectories, but a more practical alternative is to control just their statistical behaviour. In many contexts this would be both sufficient and a more realistic goal, e.g. climate and socio-economic systems. I refer to it as ‘management’ of complex dynamical systems. In this paper, some mathematics for management of complex dynamical systems is developed in the weakly dependent regime, and questions are posed for the strongly dependent regime.

Improving processes through evolutionary optimization.

PubMed

Clancy, Thomas R

2011-09-01

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies on complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 18th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, I discuss methods to optimize complex healthcare processes through learning, adaptation, and evolutionary planning.

Lungs in TSC

MedlinePlus

... Complex Consensus Group.* Tuberous Sclerosis Complex Surveillance and Management: Recommendations of the 2012 International Tuberous Sclerosis Complex Consensus Conference. (2013) Pediatric Neurology, ...

Anticipative management for coral reef ecosystem services in the 21st century.

PubMed

Rogers, Alice; Harborne, Alastair R; Brown, Christopher J; Bozec, Yves-Marie; Castro, Carolina; Chollett, Iliana; Hock, Karlo; Knowland, Cheryl A; Marshell, Alyssa; Ortiz, Juan C; Razak, Tries; Roff, George; Samper-Villarreal, Jimena; Saunders, Megan I; Wolff, Nicholas H; Mumby, Peter J

2015-02-01

Under projections of global climate change and other stressors, significant changes in the ecology, structure and function of coral reefs are predicted. Current management strategies tend to look to the past to set goals, focusing on halting declines and restoring baseline conditions. Here, we explore a complementary approach to decision making that is based on the anticipation of future changes in ecosystem state, function and services. Reviewing the existing literature and utilizing a scenario planning approach, we explore how the structure of coral reef communities might change in the future in response to global climate change and overfishing. We incorporate uncertainties in our predictions by considering heterogeneity in reef types in relation to structural complexity and primary productivity. We examine 14 ecosystem services provided by reefs, and rate their sensitivity to a range of future scenarios and management options. Our predictions suggest that the efficacy of management is highly dependent on biophysical characteristics and reef state. Reserves are currently widely used and are predicted to remain effective for reefs with high structural complexity. However, when complexity is lost, maximizing service provision requires a broader portfolio of management approaches, including the provision of artificial complexity, coral restoration, fish aggregation devices and herbivore management. Increased use of such management tools will require capacity building and technique refinement and we therefore conclude that diversification of our management toolbox should be considered urgently to prepare for the challenges of managing reefs into the 21st century. © 2014 John Wiley & Sons Ltd.

Positive deviance: an elegant solution to a complex problem.

PubMed

Lindberg, Curt; Clancy, Thomas R

2010-04-01

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 13th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. This article provides one example of how concepts taken from complex systems theory can be applied to real-world problems facing nurses today.

Sustainable System Management with Fisher Information based Objectives

EPA Science Inventory

Sustainable ecosystem management that integrates ecological, economic and social perspectives is a complex task where simultaneous persistence of human and natural components of the system must be ensured. Given the complexity of this task, systems theory approaches based on soun...

COPD self-management supportive care: chaos and complexity theory.

PubMed

Cornforth, Amber

This paper uses the emergent theories of chaos and complexity to explore the self-management supportive care of chronic obstructive pulmonary disease (COPD) patients within the evolving primary care setting. It discusses the concept of self-management support, the complexity of the primary care context and consultations, smoking cessation, and the impact of acute exacerbations and action planning. The author hopes that this paper will enable the acquisition of new insight and better understanding in this clinical area, as well as support meaningful learning and facilitate more thoughtful, effective and high quality patient-centred care within the context of primary care.

Using complexity science and negotiation theory to resolve boundary-crossing water issues

NASA Astrophysics Data System (ADS)

Islam, Shafiqul; Susskind, Lawrence

2018-07-01

Many water governance and management issues are complex. The complexity of these issues is related to crossing of multiple boundaries: political, social and jurisdictional, as well as physical, ecological and biogeochemical. Resolution of these issues usually requires interactions of many parties with conflicting values and interests operating across multiple boundaries and scales to make decisions. The interdependence and feedback among interacting variables, processes, actors and institutions are hard to model and difficult to forecast. Thus, decision-making related to complex water problems needs be contingent and adaptive. This paper draws on a number of ideas from complexity science and negotiation theory that may make it easier to cope with the complexities and difficulties of managing boundary crossing water disputes. It begins with the Water Diplomacy Framework that was developed and tested over the past several years. Then, it uses three key ideas from complexity science (interdependence and interconnectedness; uncertainty and feedback; emergence and adaptation) and three from negotiation theory (stakeholder identification and engagement; joint fact finding; and value creation through option generation) to show how application of these ideas can help enhance effectiveness of water management.

Supplement Analysis for the Transmission System Vegetation Management Program FEIS (DOE/EIS-0285/SA-117 - Ross Complex)

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

Stratton, Elaine

2003-01-16

Vegetation Management for the non-electric portions of the Bonneville Power Administration’s Ross Complex. BPA proposes to manage and maintain grounds and landscaping in the non-electrical portions of the Ross Facility. Vegetation management at the Facility shall include: 1) bare ground management of graveled storage areas, perimeter roads and parking areas; 2) mechanical and/or spot herbicide control of some broad leafs and noxious weeds; 3) mowing, fertilizing, and broadleaf control of landscaped lawn areas; 4) weed control in ornamental shrub areas; and 4) areas requiring only mechanical control to manage unwanted grasses, and shrubs.

University management nurse: a grounded theory.

PubMed

Cunha, Kamylla Santos da; Andrade, Selma Regina de; Erdmann, Alacoque Lorenzini

2018-03-08

to understand the meaning of the university management performed by nurses managers of the nursing undergraduate course of a public university. this is a qualitative research, based on the grounded theory. Data collection took place between May and September 2016, with open interviews, in the scenario of a federal public university. The technique of constant comparative analysis of the data was followed, obtaining a theoretical sample with 19 nurses, in two sample groups. there were three categories emerged that shaped the phenomenon: Articulating complex collectives through university management for the qualified training of new nurses. The categories included: a) conditions, defined by perceiving the commitment to the collective, previous experiences, and training for health management, as motivations to be a teacher manager; b) actions/interactions, delimited by Knowing and recognizing, in practice, the university management process, limits and possibilities in the coordination of complex collective subjects; and, c) consequences, such as Improving teaching work and taking responsibility for university education. the nurses teaching managers to explain university management as a set of individual and collective actions that, articulated in a complex social environment, promote conditions for the training of critical and reflexive nurses with the demands of society.

Tuberous sclerosis complex surveillance and management: recommendations of the 2012 International Tuberous Sclerosis Complex Consensus Conference.

PubMed

Krueger, Darcy A; Northrup, Hope

2013-10-01

Tuberous sclerosis complex is a genetic disorder affecting every organ system, but disease manifestations vary significantly among affected individuals. The diverse and varied presentations and progression can be life-threatening with significant impact on cost and quality of life. Current surveillance and management practices are highly variable among region and country, reflective of the fact that last consensus recommendations occurred in 1998 and an updated, comprehensive standard is lacking that incorporates the latest scientific evidence and current best clinical practices. The 2012 International Tuberous Sclerosis Complex Consensus Group, comprising 79 specialists from 14 countries, was organized into 12 separate subcommittees, each led by a clinician with advanced expertise in tuberous sclerosis complex and the relevant medical subspecialty. Each subcommittee focused on a specific disease area with important clinical management implications and was charged with formulating key clinical questions to address within its focus area, reviewing relevant literature, evaluating the strength of data, and providing a recommendation accordingly. The updated consensus recommendations for clinical surveillance and management in tuberous sclerosis complex are summarized here. The recommendations are relevant to the entire lifespan of the patient, from infancy to adulthood, including both individuals where the diagnosis is newly made as well as individuals where the diagnosis already is established. The 2012 International Tuberous Sclerosis Complex Consensus Recommendations provide an evidence-based, standardized approach for optimal clinical care provided for individuals with tuberous sclerosis complex. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

New public management in Iran's health complex: a management framework for primary health care system.

PubMed

Tabrizi, Jafar Sadegh; HaghGoshayie, Elaheh; Doshmangir, Leila; Yousefi, Mahmood

2018-05-01

New public management (NPM) was developed as a management reform to improve the efficiency and effectiveness in public organizations, especially in health sector. Using the features of private sector management, the managers of health organizations may try to implement the elements of NPM with the hope to improve the performance of their systems.AimsOur aim in the present study was to identify the elements and infrastructures suitable for implementing NPM in the Iranian health complex. In this qualitative study with conventional content analysis approach, we tried to explore the NPM elements and infrastructures in Iranian public health sector. A series of semi-structured interviews (n=48) were conducted in 2016 with a managers in public and private health complex. Three focus group discussions with nine faculty members were also conducted. A data collection form was used to collect the demographic characteristics and perspectives of the participants.FindingsFrom the perspective of managers, managerialism, decentralization, using market mechanism, performance management, customer orientation and performance budgeting were the main elements of NPM in the Iranian context. The most important infrastructures for implementing this reform were as follows: education and training, information technology, the proper use of human resources, decision support systems, top management commitment, organizational culture, flexibility of rules, rehabilitating of the aging infrastructures, and expanding the coverage of services. The NPM was generally identified to be an effective replacement for the traditional administration method. These reforms may be helpful in strengthening the public health complex and the management capacity, as well. NPM also seems to be useful in interacting the public health sector with the private sector in terms of personnel and resources, performance, reward structure, and methods of doing business.

Participatory approaches to understanding practices of flood management across borders

NASA Astrophysics Data System (ADS)

Bracken, L. J.; Forrester, J.; Oughton, E. A.; Cinderby, S.; Donaldson, A.; Anness, L.; Passmore, D.

2012-04-01

The aim of this paper is to outline and present initial results from a study designed to identify principles of and practices for adaptive co-management strategies for resilience to flooding in borderlands using participatory methods. Borderlands are the complex and sometimes undefined spaces existing at the interface of different territories and draws attention towards messy connections and disconnections (Strathern 2004; Sassen 2006). For this project the borderlands concerned are those between professional and lay knowledge, between responsible agencies, and between one nation and another. Research was focused on the River Tweed catchment, located on the Scottish-English border. This catchment is subject to complex environmental designations and rural development regimes that make integrated management of the whole catchment difficult. A multi-method approach was developed using semi-structured interviews, Q methodology and participatory GIS in order to capture wide ranging practices for managing flooding, the judgements behind these practices and to 'scale up' participation in the study. Professionals and local experts were involved in the research. The methodology generated a useful set of options for flood management, with research outputs easily understood by key management organisations and the wider public alike. There was a wide endorsement of alternative flood management solutions from both managers and local experts. The role of location was particularly important for ensuring communication and data sharing between flood managers from different organisations and more wide ranging stakeholders. There were complex issues around scale; both the mismatch between communities and evidence of flooding and the mismatch between governance and scale of intervention for natural flood management. The multi-method approach was essential in capturing practice and the complexities around governance of flooding. The involvement of key flood management organisations was integral to making the research of relevance to professionals.

Social networks as embedded complex adaptive systems.

PubMed

Benham-Hutchins, Marge; Clancy, Thomas R

2010-09-01

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 15th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, the authors discuss healthcare social networks as a hierarchy of embedded complex adaptive systems. The authors further examine the use of social network analysis tools as a means to understand complex communication patterns and reduce medical errors.

Luring anglers to enhance fisheries

USGS Publications Warehouse

Martin, Dustin R.; Pope, Kevin L.

2011-01-01

Current fisheries management is, unfortunately, reactive rather than proactive to changes in fishery characteristics. Furthermore, anglers do not act independently on waterbodies, and thus, fisheries are complex socio-ecological systems. Proactive management of these complex systems necessitates an approach-adaptive fisheries management-that allows learning to occur simultaneously with management. A promising area for implementation of adaptive fisheries management is the study of luring anglers to or from specific waterbodies to meet management goals. Purposeful manipulation of anglers, and its associated field of study, is nonexistent in past management. Evaluation of different management practices (i.e., hypotheses) through an iterative adaptive management process should include both a biological and sociological survey to address changes in fish populations and changes in angler satisfaction related to changes in management. We believe adaptive management is ideal for development and assessment of management strategies targeted at angler participation. Moreover these concepts and understandings should be applicable to other natural resource users such as hunters and hikers.

Ecosystem services and cooperative fisheries research to address a complex fishery problem

EPA Science Inventory

The St. Louis River represents a complex fishery management problem. Current fishery management goals have to be developed taking into account bi-state commercial, subsistence and recreational fisheries which are valued for different characteristics by a wide range of anglers, as...

Managing Complex Dynamical Systems

ERIC Educational Resources Information Center

Cox, John C.; Webster, Robert L.; Curry, Jeanie A.; Hammond, Kevin L.

2011-01-01

Management commonly engages in a variety of research designed to provide insight into the motivation and relationships of individuals, departments, organizations, etc. This paper demonstrates how the application of concepts associated with the analysis of complex systems applied to such data sets can yield enhanced insights for managerial action.

Managing Multiple Tasks in Complex, Dynamic Environments

NASA Technical Reports Server (NTRS)

Freed, Michael; Null, Cynthia H. (Technical Monitor)

1998-01-01

Sketchy planners are designed to achieve goals in realistically complex, time-pressured, and uncertain task environments. However, the ability to manage multiple, potentially interacting tasks in such environments requires extensions to the functionality these systems typically provide. This paper identifies a number of factors affecting how interacting tasks should be prioritized, interrupted, and resumed, and then describes a sketchy planner called APEX that takes account of these factors when managing multiple tasks.

Management Aspects of Software Maintenance.

DTIC Science & Technology

1984-09-01

educated in * the complex nature of software maintenance to be able to properly evaluate and manage the software maintenance effort. In this...maintenance and improvement may be called "software evolution". The soft- ware manager must be Educated in the complex nature cf soft- Iware maintenance to be...complaint of error or request for modification is also studied in order to determine what action needs tc be taken. 2. Define Objective and Approach :

Research Management and Administration: A Reflection of Where We Are and Where We Need to Go as a Profession

ERIC Educational Resources Information Center

Langley, David

2012-01-01

In this article, the author reflects on research management and administration (RMA) as a profession. RMA arose from the need to manage growth in the number and complexity of research awards over the last fifty years, and is an activity and profession that continues to mature. It has grown in parallel with the increasing complexity of research…

Bronchoscopic Treatment in the Management of Benign Tracheal Stenosis: Choices for Simple and Complex Tracheal Stenosis.

PubMed

Dalar, Levent; Karasulu, Levent; Abul, Yasin; Özdemir, Cengiz; Sökücü, Sinem Nedime; Tarhan, Merve; Altin, Sedat

2016-04-01

Bronchoscopic treatment is 1 of the treatment choices for both palliative and definitive treatment of benign tracheal stenosis. There is no consensus on the management of these patients, however, especially patients having complex stenoses. The aim of the present study was to assess, in the largest group of patients with complex stenoses yet reported, which types of tracheal stenosis are amenable to optimal management by bronchoscopic treatment. The present study was a retrospective cohort study including 132 consecutive patients with benign tracheal stenoses diagnosed between August 2005 and January 2013. The mean age of the study population was 52 ± 18 years; 62 (47%) were women and 70 (53%) were men. Their lesions were classified as simple and complex stenoses. Simple stenoses (n = 6) were treated with 12 rigid and flexible bronchoscopic procedures (mean of 2 per patient); 5 stents were placed. The total success rate was 100%. Among the 124 complex stenoses, 4 were treated directly with surgical intervention. In total, 481 rigid and 487 flexible bronchoscopic procedures were performed in these patients. In this group, the success rate was 69.8%. From the present study, we propose that after accurate classification, interventional bronchoscopic management may have an important role in the treatment of benign tracheal stenosis. Bronchoscopic treatment should be considered as first-line therapy for simple stenoses, whereas complex stenoses need a multidisciplinary approach and often require surgical intervention. However, bronchoscopic treatment may be a valid conservative approach in the management of patients with complex tracheal stenosis who are not eligible for operative treatment. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Everyday value conflicts and integrative complexity of thought.

PubMed

Myyry, Liisa

2002-12-01

This study examined the value pluralism model in everyday value conflicts, and the effect of issue context on complexity of thought. According to the cognitive manager model we hypothesized that respondents would obtain a higher level of integrative complexity on personal issues that on professional and general issues. We also explored the relations of integrative complexity to value priorities, measured by the Schwartz Value Survey, and to emotional empathy. The value pluralism model was not supported by the data collected from 126 university students from social science, business and technology. The cognitive manager model was partially confirmed by data from females but not from males. Concerning value priorities, more complex respondents had higher regard for self-transcendence values, and less complex respondents for self-enhancement values Emotional empathy was also significantly related to complexity score.

Enabling long-term oceanographic research: Changing data practices, information management strategies and informatics

NASA Astrophysics Data System (ADS)

Baker, Karen S.; Chandler, Cynthia L.

2008-09-01

Interdisciplinary global ocean science requires new ways of thinking about data and data management. With new data policies and growing technological capabilities, datasets of increasing variety and complexity are being made available digitally and data management is coming to be recognized as an integral part of scientific research. To meet the changing expectations of scientists collecting data and of data reuse by others, collaborative strategies involving diverse teams of information professionals are developing. These changes are stimulating the growth of information infrastructures that support multi-scale sampling, data repositories, and data integration. Two examples of oceanographic projects incorporating data management in partnership with science programs are discussed: the Palmer Station Long-Term Ecological Research program (Palmer LTER) and the United States Joint Global Ocean Flux Study (US JGOFS). Lessons learned from a decade of data management within these communities provide an experience base from which to develop information management strategies—short-term and long-term. Ocean Informatics provides one example of a conceptual framework for managing the complexities inherent to sharing oceanographic data. Elements are introduced that address the economies-of-scale and the complexities-of-scale pertinent to a broader vision of information management and scientific research.

Role of Ketamine and Methadone as Adjunctive Therapy in Complex Pain Management: A Case Report and Literature Review

PubMed Central

Faisal, Wasek; Jacques, Judith

2017-01-01

Assessment and management of complex cancer pain always remains a major challenge for any palliative care team, given its heterogeneity of underlying pathophysiology and limitations of any pharmacotherapy. Here, we present a case of complex pain management in a young patient with a life-limiting illness, highlighting the issues of organic and nonorganic contributors of pain and provide some insight into the role of ketamine and methadone as adjunctive therapy to opioid analgesics. A brief literature review is also done to provide the context of use of these adjunctive drugs in this setting. PMID:28216871

Knowledge Management for the Analysis of Complex Experimentation.

ERIC Educational Resources Information Center

Maule, R.; Schacher, G.; Gallup, S.

2002-01-01

Describes a knowledge management system that was developed to help provide structure for dynamic and static data and to aid in the analysis of complex experimentation. Topics include quantitative and qualitative data; mining operations using artificial intelligence techniques; information architecture of the system; and transforming data into…

Development of an Inter-Service Complex Wound and Limb Salvage Center within the DoD (Briefing charts)

DTIC Science & Technology

2010-10-15

CWLSC Patient Growth: 2008-2010  Complex soft-tissue wound management in austere settings  NPWT/VAC application and management  Ostomy , fistula, and...acute and chronic wounds Complex Wound Limb Salvage Program WRAMC/NNMC Inpatient Care Wound and Ostomy NNMC and WRAMC Outpatient Care 2 Clinics...Standardization Ostomy Wound care Skin Care Cleansers Research / EBP Pressure ulcer protocol CPG development Wound education research grant WRNMMC

Risk Management in Complex Construction Projects that Apply Renewable Energy Sources: A Case Study of the Realization Phase of the Energis Educational and Research Intelligent Building

NASA Astrophysics Data System (ADS)

Krechowicz, Maria

2017-10-01

Nowadays, one of the characteristic features of construction industry is an increased complexity of a growing number of projects. Almost each construction project is unique, has its project-specific purpose, its own project structural complexity, owner’s expectations, ground conditions unique to a certain location, and its own dynamics. Failure costs and costs resulting from unforeseen problems in complex construction projects are very high. Project complexity drivers pose many vulnerabilities to a successful completion of a number of projects. This paper discusses the process of effective risk management in complex construction projects in which renewable energy sources were used, on the example of the realization phase of the ENERGIS teaching-laboratory building, from the point of view of DORBUD S.A., its general contractor. This paper suggests a new approach to risk management for complex construction projects in which renewable energy sources were applied. The risk management process was divided into six stages: gathering information, identification of the top, critical project risks resulting from the project complexity, construction of the fault tree for each top, critical risks, logical analysis of the fault tree, quantitative risk assessment applying fuzzy logic and development of risk response strategy. A new methodology for the qualitative and quantitative risk assessment for top, critical risks in complex construction projects was developed. Risk assessment was carried out applying Fuzzy Fault Tree analysis on the example of one top critical risk. Application of the Fuzzy sets theory to the proposed model allowed to decrease uncertainty and eliminate problems with gaining the crisp values of the basic events probability, common during expert risk assessment with the objective to give the exact risk score of each unwanted event probability.

The value of information for woodland management: Updating a state–transition model

USGS Publications Warehouse

Morris, William K.; Runge, Michael C.; Vesk, Peter A.

2017-01-01

Value of information (VOI) analyses reveal the expected benefit of reducing uncertainty to a decision maker. Most ecological VOI analyses have focused on population models rarely addressing more complex community models. We performed a VOI analysis for a complex state–transition model of Box-Ironbark Forest and Woodland management. With three management alternatives (limited harvest/firewood removal (HF), ecological thinning (ET), and no management), managing the system optimally (for 150 yr) with the original information would, on average, increase the amount of forest in a desirable state from 19% to 35% (a 16-percentage point increase). Resolving all uncertainty would, on average, increase the final percentage to 42% (a 19-percentage point increase). However, only resolving the uncertainty for a single parameter was worth almost two-thirds the value of resolving all uncertainty. We found the VOI to depend on the number of management options, increasing as the management flexibility increased. Our analyses show it is more cost-effective to monitor low-density regrowth forest than other states and more cost-effective to experiment with the no-management alternative than the other management alternatives. Importantly, the most cost-effective strategies did not include either the most desired forest states or the least understood management strategy, ET. This implies that managers cannot just rely on intuition to tell them where the most VOI will lie, as critical uncertainties in a complex system are sometimes cryptic.

Is management still a science?

PubMed

Freedman, D H

1992-01-01

New technologies are transforming products, markets, and entire industries. Yet the more science and technology reshape the essence of business, the less useful the concept of management itself as a science seems to be. On reflection, this paradox is not so surprising. The traditional scientific approach to management promised to provide managers with the capacity to analyze, predict, and control the behavior of the complex organizations they led. But the world most managers currently inhabit often appears to be unpredictable, uncertain, and even uncontrollable. In the face of this more volatile business environment, the old-style mechanisms of "scientific management" seem positively counterproductive. And science itself appears less and less relevant to the practical concerns of managers. In this article, science journalist David Freedman argues that the problem lies less in the shortcomings of a scientific approach to management than in managers' understanding of science. What most managers think of as scientific management is based on a conception of science that few current scientists would defend. What's more, just as managers have become more preoccupied with the volatility of the business environment, scientists have also become preoccupied with the inherent volatility--the "chaos" and "complexity"--of nature. They are developing new rules for complex behavior in physical systems that have intriguing parallels to the kind of organizational behaviors companies are trying to encourage. In fact, science, long esteemed by business as a source of technological innovation, may ultimately prove of greatest value to managers as a source of something else: useful ways of looking at the world.

Complexity Management Using Metrics for Trajectory Flexibility Preservation and Constraint Minimization

NASA Technical Reports Server (NTRS)

Idris, Husni; Shen, Ni; Wing, David J.

2011-01-01

The growing demand for air travel is increasing the need for mitigating air traffic congestion and complexity problems, which are already at high levels. At the same time new surveillance, navigation, and communication technologies are enabling major transformations in the air traffic management system, including net-based information sharing and collaboration, performance-based access to airspace resources, and trajectory-based rather than clearance-based operations. The new system will feature different schemes for allocating tasks and responsibilities between the ground and airborne agents and between the human and automation, with potential capacity and cost benefits. Therefore, complexity management requires new metrics and methods that can support these new schemes. This paper presents metrics and methods for preserving trajectory flexibility that have been proposed to support a trajectory-based approach for complexity management by airborne or ground-based systems. It presents extensions to these metrics as well as to the initial research conducted to investigate the hypothesis that using these metrics to guide user and service provider actions will naturally mitigate traffic complexity. The analysis showed promising results in that: (1) Trajectory flexibility preservation mitigated traffic complexity as indicated by inducing self-organization in the traffic patterns and lowering traffic complexity indicators such as dynamic density and traffic entropy. (2)Trajectory flexibility preservation reduced the potential for secondary conflicts in separation assurance. (3) Trajectory flexibility metrics showed potential application to support user and service provider negotiations for minimizing the constraints imposed on trajectories without jeopardizing their objectives.

Built structure identification in wildland fire decision support

Treesearch

David E. Calkin; Jon D. Rieck; Kevin D. Hyde; Jeffrey D. Kaiden

2011-01-01

Recent ex-urban development within the wildland interface has significantly increased the complexity and associated cost of federal wildland fire management in the United States. Rapid identification of built structures relative to probable fire spread can help to reduce that complexity and improve the performance of incident management teams. Approximate structure...

Managing Construction Operations Visually: 3-D Techniques for Complex Topography and Restricted Visibility

ERIC Educational Resources Information Center

Rodriguez, Walter; Opdenbosh, Augusto; Santamaria, Juan Carlos

2006-01-01

Visual information is vital in planning and managing construction operations, particularly, where there is complex terrain topography and salvage operations with limited accessibility and visibility. From visually-assessing site operations and preventing equipment collisions to simulating material handling activities to supervising remotes sites…

Value of the Morgan-Monroe-Yellowwood State Forest Complex

Treesearch

William L. Hoover

2013-01-01

As publicly owned forest land, the Morgan-Monroe and Yellowwood State Forests (Indiana), referred to herein as the Morgan-Monroe Yellowwood Complex (MMYC), have many stakeholders with differing management expectations. The Hardwood Ecosystem Experiment (HEE) within the MMYC will significantly increase the science-based information available for forest management...

Chapter 6: Managing forests for wildlife communities

Treesearch

M North; P. Manley

2012-01-01

Forest management to maintain native wildlife communities is an important, yet complex objective. The complexities stem from two primary sources: habitat requirements for native species are diverse and span multiple spatial scales and seral stages, and habitat is a species-specific concept making multispecies community response difficult to predict. Given these...

NREL Leads Energy Systems Integration - Continuum Magazine | NREL

Science.gov Websites

performance data to manage and optimize campus energy use. Integrated Solutions for a Complex Energy World 03 Integrated Solutions for a Complex Energy World Energy systems integration optimizes the design and efficient data centers in the world. Sustainability through Dynamic Energy Management Sustainability through

Mergers and acquisitions in professional organizations: a complex adaptive systems approach.

PubMed

Walls, M E; McDaniel, R R

1999-09-01

Nurse managers face unique challenges as they cope with mergers and acquisitions among health care organizations. These challenges can be better understood if it is recognized that health care institutions are professional organizations and that the transformations required are extremely difficult. These difficulties are caused, in part, by the institutionalized nature of professional organizations, and this nature is explicated. Professional organizations are stubborn. They are repositories of expertise and values that are societal in origin and difficult to change. When professional organizations are understood as complex adaptive systems, complexity theory offers insight that provide strategies for managing mergers and acquisitions that may not be apparent when more traditional conceptualizations of professional organizations are used. Specific managerial techniques consistent with both the institutionalized characteristics and the complex adaptive systems characteristics of professional organizations are offered to nurse managers.

Older Patients’ Perspectives on Managing Complexity in CKD Self-Management

PubMed Central

Vandenberg, Ann E.; Phillips, Lawrence S.; McClellan, William M.; Johnson, Theodore M.; Echt, Katharina V.

2017-01-01

Background and objectives Patients with CKD are asked to perform self-management tasks including dietary changes, adhering to medications, avoiding nephrotoxic drugs, and self-monitoring hypertension and diabetes. Given the effect of aging on functional capacity, self-management may be especially challenging for older patients. However, little is known about the specific challenges older adults face maintaining CKD self-management regimens. Design, setting, participants, & measurements We conducted an exploratory qualitative study designed to understand the relationship among factors facilitating or impeding CKD self-management in older adults. Six focus groups (n=30) were held in August and September of 2014 with veterans≥70 years old with moderate-to-severe CKD receiving nephrology care at the Atlanta Veterans Affairs Medical Center. Grounded theory with a constant comparative method was used to collect, code, and analyze data. Results Participants had a mean age (range) of 75.1 (70.1–90.7) years, 60% were black, and 96.7% were men. The central organizing concept that emerged from these data were managing complexity. Participants typically did not have just one chronic condition, CKD, but a number of commonly co-occurring conditions. Recommendations for CKD self-management therefore occurred within a complex regimen of recommendations for managing other diseases. Participants identified overtly discordant treatment recommendations across chronic conditions (e.g., arthritis and CKD). Prioritization emerged as one effective strategy for managing complexity (e.g., focusing on BP control). Some patients arrived at the conclusion that they could group concordant recommendations to simplify their regimens (e.g., protein restriction for both gout and CKD). Conclusions Among older veterans with moderate-to-severe CKD, multimorbidity presents a major challenge for CKD self-management. Because virtually all older adults with CKD have multimorbidity, an integrated treatment approach that supports self-management across commonly occurring conditions may be necessary to meet the needs of these patients. PMID:28389529

Older Patients' Perspectives on Managing Complexity in CKD Self-Management.

PubMed

Bowling, C Barrett; Vandenberg, Ann E; Phillips, Lawrence S; McClellan, William M; Johnson, Theodore M; Echt, Katharina V

2017-04-03

Patients with CKD are asked to perform self-management tasks including dietary changes, adhering to medications, avoiding nephrotoxic drugs, and self-monitoring hypertension and diabetes. Given the effect of aging on functional capacity, self-management may be especially challenging for older patients. However, little is known about the specific challenges older adults face maintaining CKD self-management regimens. We conducted an exploratory qualitative study designed to understand the relationship among factors facilitating or impeding CKD self-management in older adults. Six focus groups ( n =30) were held in August and September of 2014 with veterans≥70 years old with moderate-to-severe CKD receiving nephrology care at the Atlanta Veterans Affairs Medical Center. Grounded theory with a constant comparative method was used to collect, code, and analyze data. Participants had a mean age (range) of 75.1 (70.1-90.7) years, 60% were black, and 96.7% were men. The central organizing concept that emerged from these data were managing complexity. Participants typically did not have just one chronic condition, CKD, but a number of commonly co-occurring conditions. Recommendations for CKD self-management therefore occurred within a complex regimen of recommendations for managing other diseases. Participants identified overtly discordant treatment recommendations across chronic conditions ( e.g., arthritis and CKD). Prioritization emerged as one effective strategy for managing complexity ( e.g. , focusing on BP control). Some patients arrived at the conclusion that they could group concordant recommendations to simplify their regimens ( e.g. , protein restriction for both gout and CKD). Among older veterans with moderate-to-severe CKD, multimorbidity presents a major challenge for CKD self-management. Because virtually all older adults with CKD have multimorbidity, an integrated treatment approach that supports self-management across commonly occurring conditions may be necessary to meet the needs of these patients. Copyright © 2017 by the American Society of Nephrology.

Management intensity and vegetation complexity affect web-building spiders and their prey.

PubMed

Diehl, Eva; Mader, Viktoria L; Wolters, Volkmar; Birkhofer, Klaus

2013-10-01

Agricultural management and vegetation complexity affect arthropod diversity and may alter trophic interactions between predators and their prey. Web-building spiders are abundant generalist predators and important natural enemies of pests. We analyzed how management intensity (tillage, cutting of the vegetation, grazing by cattle, and synthetic and organic inputs) and vegetation complexity (plant species richness, vegetation height, coverage, and density) affect rarefied richness and composition of web-building spiders and their prey with respect to prey availability and aphid predation in 12 habitats, ranging from an uncut fallow to a conventionally managed maize field. Spiders and prey from webs were collected manually and the potential prey were quantified using sticky traps. The species richness of web-building spiders and the order richness of prey increased with plant diversity and vegetation coverage. Prey order richness was lower at tilled compared to no-till sites. Hemipterans (primarily aphids) were overrepresented, while dipterans, hymenopterans, and thysanopterans were underrepresented in webs compared to sticky traps. The per spider capture efficiency for aphids was higher at tilled than at no-till sites and decreased with vegetation complexity. After accounting for local densities, 1.8 times more aphids were captured at uncut compared to cut sites. Our results emphasize the functional role of web-building spiders in aphid predation, but suggest negative effects of cutting or harvesting. We conclude that reduced management intensity and increased vegetation complexity help to conserve local invertebrate diversity, and that web-building spiders at sites under low management intensity (e.g., semi-natural habitats) contribute to aphid suppression at the landscape scale.

Surgical Management of Complex Lower-Extremity Trauma With a Long Hindfoot Fusion Nail: A Case Report.

PubMed

Jain, Nickul S; Lopez, Gregory D; Bederman, S Samuel; Wirth, Garrett A; Scolaro, John A

2016-08-01

High-energy injuries can result in complete or partial loss of the talus. Ipsilateral fractures to the lower limb increase the complexity of surgical management, and treatment is guided by previous case reports of similar injuries. A case of complex lower-extremity trauma with extruded and missing talar body and ipsilateral type IIIB open tibia fracture is presented. Surgical limb reconstruction and salvage was performed successfully with a single orthopaedic implant in a manner not described previously in the literature. The purpose of this case report is to present the novel use of a single orthopaedic implant for treatment of a complex, open traumatic injury. Previous case reports in the literature have described the management of complete or partial talar loss. We describe the novel use of a long hindfoot fusion nail and staged bone grafting to achieve tibiocalcaneal arthrodesis for the treatment of complex lower-extremity trauma. Therapeutic, Level IV: Case study. © 2015 The Author(s).

Accounting for the Impact of Management Scenarios on Typha Domingensis (Cattail) in an Everglades Wetland

NASA Astrophysics Data System (ADS)

Lagerwall, Gareth; Kiker, Gregory; Muñoz-Carpena, Rafael; Wang, Naiming

2017-01-01

The coupled regional simulation model, and the transport and reaction simulation engine were recently adapted to simulate ecology, specifically Typha domingensis (Cattail) dynamics in the Everglades. While Cattail is a native Everglades species, it has become invasive over the years due to an altered habitat over the last few decades, taking over historically Cladium jamaicense (Sawgrass) areas. Two models of different levels of algorithmic complexity were developed in previous studies, and are used here to determine the impact of various management decisions on the average Cattail density within Water Conservation Area 2A in the Everglades. A Global Uncertainty and Sensitivity Analysis was conducted to test the importance of these management scenarios, as well as the effectiveness of using zonal statistics. Management scenarios included high, medium and low initial water depths, soil phosphorus concentrations, initial Cattail and Sawgrass densities, as well as annually alternating water depths and soil phosphorus concentrations, and a steadily decreasing soil phosphorus concentration. Analysis suggests that zonal statistics are good indicators of regional trends, and that high soil phosphorus concentration is a pre-requisite for expansive Cattail growth. It is a complex task to manage Cattail expansion in this region, requiring the close management and monitoring of water depth and soil phosphorus concentration, and possibly other factors not considered in the model complexities. However, this modeling framework with user-definable complexities and management scenarios, can be considered a useful tool in analyzing many more alternatives, which could be used to aid management decisions in the future.

Accounting for the Impact of Management Scenarios on Typha Domingensis (Cattail) in an Everglades Wetland.

PubMed

Lagerwall, Gareth; Kiker, Gregory; Muñoz-Carpena, Rafael; Wang, Naiming

2017-01-01

The coupled regional simulation model, and the transport and reaction simulation engine were recently adapted to simulate ecology, specifically Typha domingensis (Cattail) dynamics in the Everglades. While Cattail is a native Everglades species, it has become invasive over the years due to an altered habitat over the last few decades, taking over historically Cladium jamaicense (Sawgrass) areas. Two models of different levels of algorithmic complexity were developed in previous studies, and are used here to determine the impact of various management decisions on the average Cattail density within Water Conservation Area 2A in the Everglades. A Global Uncertainty and Sensitivity Analysis was conducted to test the importance of these management scenarios, as well as the effectiveness of using zonal statistics. Management scenarios included high, medium and low initial water depths, soil phosphorus concentrations, initial Cattail and Sawgrass densities, as well as annually alternating water depths and soil phosphorus concentrations, and a steadily decreasing soil phosphorus concentration. Analysis suggests that zonal statistics are good indicators of regional trends, and that high soil phosphorus concentration is a pre-requisite for expansive Cattail growth. It is a complex task to manage Cattail expansion in this region, requiring the close management and monitoring of water depth and soil phosphorus concentration, and possibly other factors not considered in the model complexities. However, this modeling framework with user-definable complexities and management scenarios, can be considered a useful tool in analyzing many more alternatives, which could be used to aid management decisions in the future.

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

PubMed

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

2013-12-01

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

The Characteristics of Project Managers: An Exploration of Complex Projects in the National Aeronautics and Space Administration

NASA Technical Reports Server (NTRS)

Mulenburg, Gerald M.

2000-01-01

Study of characteristics and relationships of project managers of complex projects in the National Aeronautics and Space Administration. Study is based on Research Design, Data Collection, Interviews, Case Studies, and Data Analysis across varying disciplines such as biological research, space research, advanced aeronautical test facilities, aeronautic flight demonstrations, and projects at different NASA centers to ensure that findings were not endemic to one type of project management, or to one Center's management philosophies. Each project is treated as a separate case with the primary data collected during semi-structured interviews with the project manager responsible for the overall project. Results of the various efforts show some definite similarities of characteristics and relationships among the project managers in the study. A model for how the project managers formulated and managed their projects is included.

Complex ambulatory settings demand scheduling systems.

PubMed

Ross, K M

1998-01-01

Practice management systems are becoming more and more complex, as they are asked to integrate all aspects of patient and resource management. Although patient scheduling is a standard expectation in any ambulatory environment, facilities and equipment resource scheduling are additional functionalities of scheduling systems. Because these functions were not typically managed in manual patient scheduling, often the result was resource mismanagement, along with a potential negative impact on utilization, patient flow and provider productivity. As ambulatory organizations have become more seasoned users of practice management software, the value of resource scheduling has become apparent. Appointment scheduling within a fully integrated practice management system is recognized as an enhancement of scheduling itself and provides additional tools to manage other information needs. Scheduling, as one component of patient information management, provides additional tools in these areas.

A novel scene management technology for complex virtual battlefield environment

NASA Astrophysics Data System (ADS)

Sheng, Changchong; Jiang, Libing; Tang, Bo; Tang, Xiaoan

2018-04-01

The efficient scene management of virtual environment is an important research content of computer real-time visualization, which has a decisive influence on the efficiency of drawing. However, Traditional scene management methods do not suitable for complex virtual battlefield environments, this paper combines the advantages of traditional scene graph technology and spatial data structure method, using the idea of management and rendering separation, a loose object-oriented scene graph structure is established to manage the entity model data in the scene, and the performance-based quad-tree structure is created for traversing and rendering. In addition, the collaborative update relationship between the above two structural trees is designed to achieve efficient scene management. Compared with the previous scene management method, this method is more efficient and meets the needs of real-time visualization.

The role of personal models in clinical management: Exploring health care providers' beliefs about psoriasis.

PubMed

Chisholm, Anna; Nelson, Pauline A; Pearce, Christina J; Keyworth, Chris; Griffiths, Christopher E M; Cordingley, Lis; Bundy, Christine

2016-02-01

Individuals' illness representations, including beliefs about psoriasis (a complex immune-mediated condition), and their emotional responses to the condition guide self-management behaviour. It is also plausible that health care providers' illness representations guide their own management of psoriasis. Patients commonly report poor health care experiences related to psoriasis, and the role of health care providers' beliefs, emotions, as well as their knowledge, experiences and behaviours ('personal models') in this is unexplored. This study aimed explore health care providers' personal models of psoriasis. Qualitative analysis of 23 semi-structured interviews with health care professionals providing care for psoriasis patients was performed. Purposive sampling achieved maximum variation regarding participant discipline, level of experience, gender and age. The self-regulatory/common sense model informed data collection and initial data analysis. Principles of framework analysis were used to generate predetermined and emergent key issues related to practitioners' personal models. Three types of personal model emerged. Sophisticated-Linear Model: 70% of practitioners recognized psoriasis as a complex condition but managed it as a skin condition. Mixed Model: 17% of practitioners recognized/managed some elements of psoriasis as complex and some as a skin condition. Sophisticated-Sophisticated Model: 13% recognized and managed psoriasis as a complex condition. Across the data set, five themes emerged illustrating key patterns underpinning these different models including (1) Recognising complexity, (2) Putting skin first, (3) Taking on the complexities of psoriasis with the patient, (4) Aiming for clearance, and (5) Affective experiences within psoriasis consultations. Health care providers recognized psoriasis as a complex condition but commonly reported managing psoriasis as a simple skin condition. Providers' beliefs and management approaches varied in the extent to which they were consistent with one another; and their emotional experiences during consultations may vary depending upon their personal model. Findings could inform future dermatology training programmes by highlighting the role of health care providers' illness representations in clinical management of the condition. What is already known on this subject? Health behaviour is predicted by underlying beliefs and emotions associated with an illness and its treatment. Few studies have examined health care providers' beliefs and emotions about the illnesses they manage in clinical practice. Many patients are dissatisfied with dermatology consultations and wish to be treated holistically. What does this study add? Qualitative exploration of health care providers' beliefs/emotions revealed their personal models of psoriasis. Providers' personal models of psoriasis vary in coherence and are often skin rather than whole person focused. Further investigation of health care providers' models of psoriasis and their impact on health outcomes is needed. © 2015 The British Psychological Society.

Managing and Querying Image Annotation and Markup in XML.

PubMed

Wang, Fusheng; Pan, Tony; Sharma, Ashish; Saltz, Joel

2010-01-01

Proprietary approaches for representing annotations and image markup are serious barriers for researchers to share image data and knowledge. The Annotation and Image Markup (AIM) project is developing a standard based information model for image annotation and markup in health care and clinical trial environments. The complex hierarchical structures of AIM data model pose new challenges for managing such data in terms of performance and support of complex queries. In this paper, we present our work on managing AIM data through a native XML approach, and supporting complex image and annotation queries through native extension of XQuery language. Through integration with xService, AIM databases can now be conveniently shared through caGrid.

Managing and Querying Image Annotation and Markup in XML

PubMed Central

Wang, Fusheng; Pan, Tony; Sharma, Ashish; Saltz, Joel

2010-01-01

Proprietary approaches for representing annotations and image markup are serious barriers for researchers to share image data and knowledge. The Annotation and Image Markup (AIM) project is developing a standard based information model for image annotation and markup in health care and clinical trial environments. The complex hierarchical structures of AIM data model pose new challenges for managing such data in terms of performance and support of complex queries. In this paper, we present our work on managing AIM data through a native XML approach, and supporting complex image and annotation queries through native extension of XQuery language. Through integration with xService, AIM databases can now be conveniently shared through caGrid. PMID:21218167

Application fields for the new Object Management Group (OMG) Standards Case Management Model and Notation (CMMN) and Decision Management Notation (DMN) in the perioperative field.

PubMed

Wiemuth, M; Junger, D; Leitritz, M A; Neumann, J; Neumuth, T; Burgert, O

2017-08-01

Medical processes can be modeled using different methods and notations. Currently used modeling systems like Business Process Model and Notation (BPMN) are not capable of describing the highly flexible and variable medical processes in sufficient detail. We combined two modeling systems, Business Process Management (BPM) and Adaptive Case Management (ACM), to be able to model non-deterministic medical processes. We used the new Standards Case Management Model and Notation (CMMN) and Decision Management Notation (DMN). First, we explain how CMMN, DMN and BPMN could be used to model non-deterministic medical processes. We applied this methodology to model 79 cataract operations provided by University Hospital Leipzig, Germany, and four cataract operations provided by University Eye Hospital Tuebingen, Germany. Our model consists of 85 tasks and about 20 decisions in BPMN. We were able to expand the system with more complex situations that might appear during an intervention. An effective modeling of the cataract intervention is possible using the combination of BPM and ACM. The combination gives the possibility to depict complex processes with complex decisions. This combination allows a significant advantage for modeling perioperative processes.

Laparoscopic management of a large ovarian cyst in the neonate.

PubMed

Mahomed, A; Jibril, A; Youngson, G

1998-10-01

Laparotomy has become the preferred approach to the excision of large, complex abdominal cysts in the neonate. We describe a laparoscopic-assisted decapsulation of an antenatally diagnosed abdominal cyst that was noted on postnatal ultrasound scan to have a complex echo pattern. This limited procedure allows for accurate verification of the diagnosis, institution of appropriate therapy, and organ salvage. It represents a superior management option that obviates the significant complications associated with conservative management.

Making Sense of Education Change at Thistle College: The Existence of Witchcraft, Witches and Shamans.

ERIC Educational Resources Information Center

Grant, Kevin

2003-01-01

Discusses a complex and charged change program and its management at a Scottish higher education institution. Discusses the difficulties of the educational change process in higher education, the complexities surrounding notions of organizational cultures and communities of practice, and issues of power and management including the new…

Setting and measuring team goals and objectives for improved management of forestry research

Treesearch

Scott J. Josiah

1999-01-01

As our world becomes more complex and diverse, many forestry research organizations are responding by adopting more interdisciplinary and collaborative research programs. Our rapidly increasing knowledge of the ecological, social, and economic factors affecting forestry and natural resource management makes it simply untenable to expect that complex problems can be...

Creating a Shared Context for Value-Based Collaboration & Decision Making

ERIC Educational Resources Information Center

Guckert, Donald J.; King, Jeri Ripley

2012-01-01

How does one succinctly communicate the breadth, complexity, and forward-thinking approaches that are necessary for facilities management organizations to operate in today's complex and ever-changing environment? Recently, the authors were asked to do just that at the University of Iowa Department of Facilities Management. In this article, they…

Navigating the Turbulent Waters of Academia: The Leadership Role of Programme Managers

ERIC Educational Resources Information Center

Vilkinas, Tricia; Cartan, Greg

2015-01-01

The focus of our paper is the leadership role of programme managers in the higher education sector. In particular, we highlight the complex and paradoxical nature of the programme leader's role, and provide an insight into leadership in this challenging and dynamic environment. We identify cognitive and behavioural complexity as necessary…

The Use of Complexity Theory and Strange Attractors to Understand and Explain Information System Development

ERIC Educational Resources Information Center

Tomasino, Arthur P.

2013-01-01

In spite of the best efforts of researchers and practitioners, Information Systems (IS) developers are having problems "getting it right". IS developments are challenged by the emergence of unanticipated IS characteristics undermining managers ability to predict and manage IS change. Because IS are complex, development formulas, best…

The Effectiveness of an Electronic Security Management System in a Privately Owned Apartment Complex

ERIC Educational Resources Information Center

Greenberg, David F.; Roush, Jeffrey B.

2009-01-01

Poisson and negative binomial regression methods are used to analyze the monthly time series data to determine the effects of introducing an integrated security management system including closed-circuit television (CCTV), door alarm monitoring, proximity card access, and emergency call boxes to a large privately-owned complex of apartment…

Using DCOM to support interoperability in forest ecosystem management decision support systems

Treesearch

W.D. Potter; S. Liu; X. Deng; H.M. Rauscher

2000-01-01

Forest ecosystems exhibit complex dynamics over time and space. Management of forest ecosystems involves the need to forecast future states of complex systems that are often undergoing structural changes. This in turn requires integration of quantitative science and engineering components with sociopolitical, regulatory, and economic considerations. The amount of data...

Care for a Patient With Cancer As a Project: Management of Complex Task Interdependence in Cancer Care Delivery.

PubMed

Trosman, Julia R; Carlos, Ruth C; Simon, Melissa A; Madden, Debra L; Gradishar, William J; Benson, Al B; Rapkin, Bruce D; Weiss, Elisa S; Gareen, Ilana F; Wagner, Lynne I; Khan, Seema A; Bunce, Mikele M; Small, Art; Weldon, Christine B

2016-11-01

Cancer care is highly complex and suffers from fragmentation and lack of coordination across provider specialties and clinical domains. As a result, patients often find that they must coordinate care on their own. Coordinated delivery teams may address these challenges and improve quality of cancer care. Task interdependence is a core principle of rigorous teamwork and is essential to addressing the complexity of cancer care, which is highly interdependent across specialties and modalities. We examined challenges faced by a patient with early-stage breast cancer that resulted from difficulties in understanding and managing task interdependence across clinical domains involved in this patient's care. We used team science supported by the project management discipline to discuss how various task interdependence aspects can be recognized, deliberately designed, and systematically managed to prevent care breakdowns. This case highlights how effective task interdependence management facilitated by project management methods could markedly improve the course of a patient's care. This work informs efforts of cancer centers and practices to redesign cancer care delivery through innovative, practical, and patient-centered approaches to management of task interdependence in cancer care. Future patient-reported outcomes research will help to determine optimal ways to engage patients, including those who are medically underserved, in managing task interdependence in their own care.

Managing today's complex healthcare business enterprise: reflections on distinctive requirements of healthcare management education.

PubMed

Welton, William E

2004-01-01

In early 2001, the community of educational programs offering master's-level education in healthcare management began an odyssey to modernize its approach to the organization and delivery of healthcare management education. The community recognized that cumulative long-term changes within healthcare management practice required a careful examination of healthcare management context and manpower requirements. This article suggests an evidence-based rationale for defining the distinctive elements of healthcare management, thus suggesting a basis for review and transformation of master's-level healthcare management curricula. It also suggests ways to modernize these curricula in a manner that recognizes the distinctiveness of the healthcare business enterprise as well as the changing management roles and careers within these complex organizations and systems. Through such efforts, the healthcare management master's-level education community would be better prepared to meet current and future challenges, to increase its relevance to the management practice community, and to allocate scarce faculty and program resources more effectively.

USDA Forest Service watershed analyses: A lesson in interdisciplinary natural resource management

Treesearch

Anthony S. DeFalco

1999-01-01

Abstract - Recent thinking in natural resource management has led federal land management agencies such as the U.S. Department of Agriculture's Forest Service (Forest Service) to adopt ecosystem management as its official land management policy. A pivotal aspect of ecosystem management is interdisciplinary analysis of complex land management problems....

Assessing the compatibility of the management of standardized procedures with the complexity of a sociotechnical system: case study of a control room in an oil refinery.

PubMed

Saurin, Tarcisio Abreu; Gonzalez, Santiago Sosa

2013-09-01

Although the need for the management of complex socio-technical systems (STS) to be compatible with the nature of those systems is widely recognized, there are few guidelines on how to determine the actual extent of this compatibility. The purpose of this study is to assess how compatible the management of standardized procedures (SPs) is with the nature of a complex STS. To this end, a case study was made of a control room in an oil refinery, involving the following stages: (a) delimitation of the investigated STS; (b) description of the STS according to a set of characteristics of complex STS; (c) application of two types of questionnaires to thirty workers - one of them to assess their perceptions about the applicability of seven principles of SPs management in complex STS and the other to determine their perceptions about the actual use of these principles; and (d) a feedback meeting with workers to discuss the results of the assessment. The assessment is discussed in terms of its limitations, usefulness and ease of use of the data collection and analysis tools. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

DETERMINANTS OF NETWORK OUTCOMES: THE IMPACT OF MANAGEMENT STRATEGIES

PubMed Central

YSA, TAMYKO; SIERRA, VICENTA; ESTEVE, MARC

2014-01-01

The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more influence on network dynamics than previously theorized. PMID:25520529

DETERMINANTS OF NETWORK OUTCOMES: THE IMPACT OF MANAGEMENT STRATEGIES.

PubMed

Ysa, Tamyko; Sierra, Vicenta; Esteve, Marc

2014-09-01

The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more influence on network dynamics than previously theorized.

Systems fragility: The sociology of chaos.

PubMed

Hodges, Lori R

2016-01-01

This article examines the concept of community fragility in emergency management from a systems perspective. Using literature that addresses fragility in four areas of complex systems, including ecosystems, social systems, sociotechnical systems, and complex adaptive systems, a theoretical framework focused on the emergency management field is created. These findings illustrate how community fragility factors can be used in the emergency management field to not only improve overall outcomes after disaster but also build less fragile systems and communities in preparation for future disasters.

Safety management of a complex R and D ground operating system

NASA Technical Reports Server (NTRS)

Connors, J. F.; Maurer, R. A.

1975-01-01

A perspective on safety program management was developed for a complex R&D operating system, such as the NASA-Lewis Research Center. Using a systems approach, hazardous operations are subjected to third-party reviews by designated-area safety committees and are maintained under safety permit controls. To insure personnel alertness, emergency containment forces and employees are trained in dry-run emergency simulation exercises. The keys to real safety effectiveness are top management support and visibility of residual risks.

Safety management of a complex R&D ground operating system

NASA Technical Reports Server (NTRS)

Connors, J. F.; Maurer, R. A.

1975-01-01

A perspective on safety program management has been developed for a complex R&D operating system, such as the NASA-Lewis Research Center. Using a systems approach, hazardous operations are subjected to third-party reviews by designated area safety committees and are maintained under safety permit controls. To insure personnel alertness, emergency containment forces and employees are trained in dry-run emergency simulation exercises. The keys to real safety effectiveness are top management support and visibility of residual risks.

Complex bile duct injuries: management

PubMed Central

Ardiles, V.; Pekolj, J.

2008-01-01

Background. Laparoscopic cholecystectomy is the present treatment of choice for patients with gallbladder stones, despite its being associated with a higher incidence of biliary injuries compared with the open procedure. Injuries occurring during the laparoscopic approach seem to be more complex. A complex biliary injury is a disease that is difficult to diagnose and treat. We considered complex injuries: 1) injuries that involve the confluence; 2) injuries in which repair attempts have failed; 3) any bile duct injury associated with a vascular injury; 4) or any biliary injury in association with portal hypertension or secondary biliary cirrhosis. The present review is an evaluation of our experience in the treatment of these complex biliary injuries and an analysis of the international literature on the management of patients. PMID:18695753

12 CFR 615.5133 - Investment management.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Investment management. 615.5133 Section 615... POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Investment Management § 615.5133 Investment management. (a... management information systems that are appropriate for the level and complexity of your investment...

System complexity as a measure of safe capacity for the emergency department.

PubMed

France, Daniel J; Levin, Scott

2006-11-01

System complexity is introduced as a new measure of system state for the emergency department (ED). In its original form, the measure quantifies the uncertainty of demands on system resources. For application in the ED, the measure is being modified to quantify both workload and uncertainty to produce a single integrated measure of system state. Complexity is quantified using an information-theoretic or entropic approach developed in manufacturing and operations research. In its original form, complexity is calculated on the basis of four system parameters: 1) the number of resources (clinicians and processing entities such as radiology and laboratory systems), 2) the number of possible work states for each resource, 3) the probability that a resource is in a particular work state, and 4) the probability of queue changes (i.e., where a queue is defined by the number of patients or patient orders being managed by a resource) during a specified time period. An example is presented to demonstrate how complexity is calculated and interpreted for a simple system composed of three resources (i.e., emergency physicians) managing varying patient loads. The example shows that variation in physician work states and patient queues produces different scores of complexity for each physician. It also illustrates how complexity and workload differ. System complexity is a viable and technically feasible measurement for monitoring and managing surge capacity in the ED.

Management of severe asthma: targeting the airways, comorbidities and risk factors.

PubMed

Gibson, Peter G; McDonald, Vanessa M

2017-06-01

Severe asthma is a complex heterogeneous disease that is refractory to standard treatment and is complicated by multiple comorbidities and risk factors. In mild to moderate asthma, the burden of disease can be minimised by inhaled corticosteroids, bronchodilators and self-management education. In severe asthma, however, management is more complex. When patients with asthma continue to experience symptoms and exacerbations despite optimal management, severe refractory asthma (SRA) should be suspected and confirmed, and other aetiologies ruled out. Once a diagnosis of SRA is established, patients should undergo a systematic and multidimensional assessment to identify inflammatory endotypes, risk factors and comorbidities, with targeted and individualised management initiated. We describe a practical approach to assessment and management of patients with SRA. © 2017 Royal Australasian College of Physicians.

Assessing Complex Emergency Management with Clinical Case-Vignettes: A Validation Study

PubMed Central

2015-01-01

Objective To evaluate whether responses to dynamic case-vignettes accurately reflect actual practices in complex emergency situations. We hypothesized that when obstetricians were faced with vignette of emergency situation identical to one they previously managed, they would report the management strategy they actually used. On the other hand, there is no reason to suppose that their response to a vignette based on a source case managed by another obstetrician would be the same as the actual management. Methods A multicenter vignette-based study was used in 7 French maternity units. We chose the example of severe postpartum hemorrhage (PPH) to study the use of case-vignettes for assessing the management of complex situations. We developed dynamic case-vignettes describing incidents of PPH in several steps, using documentation in patient files. Vignettes described the postpartum course and included multiple-choice questions detailing proposed clinical care. Each participating obstetrician was asked to evaluate 4 case-vignettes: 2 directly derived from cases they previously managed and 2 derived from other obstetricians’ cases. We compared the final treatment decision in vignette responses to those documented in the source-case by the overall agreement and the Kappa coefficient, both for the cases the obstetricians previously managed and the cases of others. Results Thirty obstetricians participated. Overall agreement between final treatment decisions in case-vignettes and documented care for cases obstetricians previously managed was 82% (Kappa coefficient: 0.75, 95% CI [0.62–0.88]). Overall agreement between final treatment decisions in case-vignettes and documented care in vignettes derived from other obstetricians’ cases was only 48% (Kappa coefficient: 0.30, 95% CI [0.12–0.48]). Final agreement with documented care was significantly better for cases based on their own previous cases than for others (p<0.001). Conclusions Dynamic case-vignettes accurately reflect actual practices in complex emergency situations. Therefore, they can be used to assess the quality of management in these situations. PMID:26383261

Brainlab: A Python Toolkit to Aid in the Design, Simulation, and Analysis of Spiking Neural Networks with the NeoCortical Simulator.

PubMed

Drewes, Rich; Zou, Quan; Goodman, Philip H

2009-01-01

Neuroscience modeling experiments often involve multiple complex neural network and cell model variants, complex input stimuli and input protocols, followed by complex data analysis. Coordinating all this complexity becomes a central difficulty for the experimenter. The Python programming language, along with its extensive library packages, has emerged as a leading "glue" tool for managing all sorts of complex programmatic tasks. This paper describes a toolkit called Brainlab, written in Python, that leverages Python's strengths for the task of managing the general complexity of neuroscience modeling experiments. Brainlab was also designed to overcome the major difficulties of working with the NCS (NeoCortical Simulator) environment in particular. Brainlab is an integrated model-building, experimentation, and data analysis environment for the powerful parallel spiking neural network simulator system NCS.

Brainlab: A Python Toolkit to Aid in the Design, Simulation, and Analysis of Spiking Neural Networks with the NeoCortical Simulator

PubMed Central

Drewes, Rich; Zou, Quan; Goodman, Philip H.

2008-01-01

Neuroscience modeling experiments often involve multiple complex neural network and cell model variants, complex input stimuli and input protocols, followed by complex data analysis. Coordinating all this complexity becomes a central difficulty for the experimenter. The Python programming language, along with its extensive library packages, has emerged as a leading “glue” tool for managing all sorts of complex programmatic tasks. This paper describes a toolkit called Brainlab, written in Python, that leverages Python's strengths for the task of managing the general complexity of neuroscience modeling experiments. Brainlab was also designed to overcome the major difficulties of working with the NCS (NeoCortical Simulator) environment in particular. Brainlab is an integrated model-building, experimentation, and data analysis environment for the powerful parallel spiking neural network simulator system NCS. PMID:19506707

Integrated System Health Management Development Toolkit

NASA Technical Reports Server (NTRS)

Figueroa, Jorge; Smith, Harvey; Morris, Jon

2009-01-01

This software toolkit is designed to model complex systems for the implementation of embedded Integrated System Health Management (ISHM) capability, which focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, and predict future anomalies), and to provide data, information, and knowledge (DIaK) to control systems for safe and effective operation.

A Logically Centralized Approach for Control and Management of Large Computer Networks

ERIC Educational Resources Information Center

Iqbal, Hammad A.

2012-01-01

Management of large enterprise and Internet service provider networks is a complex, error-prone, and costly challenge. It is widely accepted that the key contributors to this complexity are the bundling of control and data forwarding in traditional routers and the use of fully distributed protocols for network control. To address these…

Visualizing land-use and management complexity within biogeochemical cycles of an agricultural landscape

Treesearch

Kai Nils Nitzsche; Gernot Verch; Katrin Premke; Arthur Gessler; Zachary Kayler

2016-01-01

Crop fields are cultivated across continuities of soil, topography, and local climate that drive biological processes and nutrient cycling at the landscape scale; yet land management and agricultural research are often performed at the field scale, potentially neglecting the context of the surrounding landscape. Adding to this complexity is the overlap of ecosystems...

Review of A critique of silviculture: managing for complexity

Treesearch

Brian R. Lockhart

2010-01-01

Klaus Puettmann, K. David Coates, and Christian Messier have written a timely book. One of a few books specifically about American silviculture outside of the standard textbooks by Daniel et al. (1979), Smith et al. (1997), and Nyland (2002), and going beyond the regional focus of many of the other silviculture books, Critique of Silviculture: Managing for Complexity...

Managing interoperability and complexity in health systems.

PubMed

Bouamrane, M-M; Tao, C; Sarkar, I N

2015-01-01

In recent years, we have witnessed substantial progress in the use of clinical informatics systems to support clinicians during episodes of care, manage specialised domain knowledge, perform complex clinical data analysis and improve the management of health organisations' resources. However, the vision of fully integrated health information eco-systems, which provide relevant information and useful knowledge at the point-of-care, remains elusive. This journal Focus Theme reviews some of the enduring challenges of interoperability and complexity in clinical informatics systems. Furthermore, a range of approaches are proposed in order to address, harness and resolve some of the many remaining issues towards a greater integration of health information systems and extraction of useful or new knowledge from heterogeneous electronic data repositories.

Hypercompetitive Environments: An Agent-based model approach

NASA Astrophysics Data System (ADS)

Dias, Manuel; Araújo, Tanya

Information technology (IT) environments are characterized by complex changes and rapid evolution. Globalization and the spread of technological innovation have increased the need for new strategic information resources, both from individual firms and management environments. Improvements in multidisciplinary methods and, particularly, the availability of powerful computational tools, are giving researchers an increasing opportunity to investigate management environments in their true complex nature. The adoption of a complex systems approach allows for modeling business strategies from a bottom-up perspective — understood as resulting from repeated and local interaction of economic agents — without disregarding the consequences of the business strategies themselves to individual behavior of enterprises, emergence of interaction patterns between firms and management environments. Agent-based models are at the leading approach of this attempt.

Collaborative adaptive rangeland management fosters management-science partnerships

USDA-ARS?s Scientific Manuscript database

Rangelands of the western Great Plains of North America are complex social-ecological systems where management objectives for livestock production, grassland bird conservation and vegetation structure and composition converge. The Collaborative Adaptive Rangeland Management (CARM) experiment is a 10...

Managing Conflict in Temporary Management Systems

ERIC Educational Resources Information Center

Wilemon, David L.

1973-01-01

As organizational tasks have grown more complex, several innovative temporary management systems such as matrix management have been developed. The Apollo space program has been an important contribution to the development of matrix management techniques. Discusses the role of conflict within the matrix, its determinants, and the process of…

Preparing for Complexity and Wicked Problems through Transformational Learning Approaches

ERIC Educational Resources Information Center

Yukawa, Joyce

2015-01-01

As the information environment becomes increasingly complex and challenging, Library and Information Studies (LIS) education is called upon to nurture innovative leaders capable of managing complex situations and "wicked problems." While disciplinary expertise remains essential, higher levels of mental complexity and adaptive…

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

NASA Astrophysics Data System (ADS)

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

2007-12-01

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

Exploring representations and experiences of case-management users: towards difficulties and solutions to leading qualitative interviews with older people with complex living conditions.

PubMed

Balard, Frédéric; Corre, Stéphanie Pin Le; Trouvé, Hélène; Saint-Jean, Olivier; Somme, Dominique

2013-01-01

By matching needs to resource services, case management could be a useful tool for improving the care of older people with complex living conditions. Collecting and analysing the users' experiences represents a good way to evaluate the effectiveness and efficiency of a case-management service. However, in the literature, fieldwork is very rarely considered and the users included in qualitative research seem to be the most accessible. This study was undertaken to describe the challenges of conducting qualitative research with older people with complex living conditions in order to understand their experiences with case-management services. Reflective analysis was applied to describe the process of recruiting and interviewing older people with complex living conditions in private homes, describing the protocol with respect to fieldwork chronology. The practical difficulties inherent in this type of study are addressed, particularly in terms of defining a sample, the procedure for contacting the users and conducting the interview. The users are people who suffer from a loss of autonomy because of cognitive impairment, severe disease and/or psychiatric or social problems. Notably, most of them refuse care and assistance. Reflective analysis of our protocol showed that the methodology and difficulties encountered constituted the first phase of data analysis. Understanding the experience of users of case management to analyse the outcomes of case-management services requires a clear methodology for the fieldwork.

Alertness management : strategic naps in operational settings

DOT National Transportation Integrated Search

1995-01-01

Managing fatigue in complex operational settings requires attention to multiple factors, including hours of service, scheduling, education and training, countermeasures, technology, and research. Alertness-management strategies can be used to promote...

Staffing levels in endoscopy units.

PubMed

Ott, B J; Igo, M; Shields, N

1994-04-01

Staffing the endoscopy area has become increasingly complex. Growth in procedure volumes, changes in technology, and the application of endoscopy in the diagnosis and treatment of disease contribute to the complexities. The manager must deal with these changes, maintain costs, and still provide adequate staffing to ensure patient safety and quality care. The purpose of this article is to present the results of a laboratory manager survey conducted in 1990. Of 51 laboratory managers who responded, those who rated their laboratories to be adequately staffed averaged 4.2 hr per procedure. The survey results may be useful to laboratory managers seeking to calculate staff needs in a typical endoscopy area.

Current trends in pharmacy benefit designs: a threat to disease management in chronic complex diseases.

PubMed

Owens, Gary; Emons, Matthew F; Christian-Herman, Jennifer; Lawless, Grant

2007-04-01

With a focus on those patients who are candidates for treatment with biologic agents, we review the impact that current pharmacy benefit trends have on patients with chronic complex diseases and how they affect opportunities for disease management in this unique patient population. Dramatic increases in health care costs have led to a variety of strategies to manage cost. Many of these strategies either limit access to care or increase the patient's responsibility for choosing and paying for care, especially for medications. These strategies have a disproportionate impact on patients with chronic complex diseases, particularly those who require the use of biologic medications. A fundamental prerequisite of disease management has been coverage of disease-modifying therapies. If current pharmacy benefit trends continue, unintended consequences will likely occur including lost opportunities for disease management. Current pharmacy benefit trends could adversely impact disease management, particularly for patients requiring the use of biologic agents. Health plans should consider innovative benefit designs that reflect an appropriate level of cost sharing across all key stake-holders, ensuring appropriate access to needed therapies. Additional research is needed to clarify the value of newer approaches to therapies or benefit design changes.

Rescheduling nursing shifts: scoping the challenge and examining the potential of mathematical model based tools.

PubMed

Clark, Alistair; Moule, Pam; Topping, Annie; Serpell, Martin

2015-05-01

To review research in the literature on nursing shift scheduling / rescheduling, and to report key issues identified in a consultation exercise with managers in four English National Health Service trusts to inform the development of mathematical tools for rescheduling decision-making. Shift rescheduling is unrecognised as an everyday time-consuming management task with different imperatives from scheduling. Poor rescheduling decisions can have quality, cost and morale implications. A systematic critical literature review identified rescheduling issues and existing mathematic modelling tools. A consultation exercise with nursing managers examined the complex challenges associated with rescheduling. Minimal research exists on rescheduling compared with scheduling. Poor rescheduling can result in greater disruption to planned nursing shifts and may impact negatively on the quality and cost of patient care, and nurse morale and retention. Very little research examines management challenges or mathematical modelling for rescheduling. Shift rescheduling is a complex and frequent management activity that is more challenging than scheduling. Mathematical modelling may have potential as a tool to support managers to minimise rescheduling disruption. The lack of specific methodological support for rescheduling that takes into account its complexity, increases the likelihood of harm for patients and stress for nursing staff and managers. © 2013 John Wiley & Sons Ltd.

Implementation Characteristics of Organizational Innovations: Limits and Opportunities for Management Strategies.

ERIC Educational Resources Information Center

Leonard-Barton, Dorothy

1988-01-01

Examines the effects of a technology's implementation characteristics (its transferability, organizational complexity, and divisibility) on tactics managers use to implement an innovation, such as: involving users, managing sponsorship, and managing organizational change in concert with technical change. (SR)

Management of adult blunt hepatic trauma.

PubMed

Kozar, Rosemary A; McNutt, Michelle K

2010-12-01

To review the nonoperative and operative management of blunt hepatic injury in the adult trauma population. Although liver injury scale does not predict need for surgical intervention, a high-grade complex liver injury should alert the physician to a patient at increased risk of hepatic complications following nonoperative management. Blunt hepatic injury remains a frequent intraabdominal injury in the adult trauma population. The management of blunt hepatic injury has undergone a major paradigm shift from mandatory operative exploration to nonoperative management. Hemodynamic instability with a positive focused abdominal sonography for trauma and peritonitis are indications for emergent operative intervention. Although surgical intervention for blunt hepatic trauma is not as common as in years past, it is imperative that the current trauma surgeon be familiar with the surgical skill set to manage complex hepatic injuries. This study represents a review of both nonoperative and operative management of blunt hepatic injury.

Outdoor Recreation Management

ERIC Educational Resources Information Center

Jubenville, Alan

The complex problems facing the manager of an outdoor recreation area are outlined and discussed. Eighteen chapters cover the following primary concerns of the manager of such a facility: (1) an overview of the management process; (2) the basic outdoor recreation management model; (3) the problem-solving process; (4) involvement of the public in…

Mindful Organizing as a Paradigm to Develop Managers

ERIC Educational Resources Information Center

Gebauer, Annette

2013-01-01

How can managers prepare for extreme but exceptional events and for the challenge of managing complexity and uncertainty in their daily business? Confronted with the challenge of achieving high and reliable performance in risk-prone, fast-paced, and unpredictable environments, managers and management scholars can learn a lot from the organizing…

Care for a Patient With Cancer As a Project: Management of Complex Task Interdependence in Cancer Care Delivery

PubMed Central

Carlos, Ruth C.; Simon, Melissa A.; Madden, Debra L.; Gradishar, William J.; Benson, Al B.; Rapkin, Bruce D.; Weiss, Elisa S.; Gareen, Ilana F.; Wagner, Lynne I.; Khan, Seema A.; Bunce, Mikele M.; Small, Art; Weldon, Christine B.

2016-01-01

Cancer care is highly complex and suffers from fragmentation and lack of coordination across provider specialties and clinical domains. As a result, patients often find that they must coordinate care on their own. Coordinated delivery teams may address these challenges and improve quality of cancer care. Task interdependence is a core principle of rigorous teamwork and is essential to addressing the complexity of cancer care, which is highly interdependent across specialties and modalities. We examined challenges faced by a patient with early-stage breast cancer that resulted from difficulties in understanding and managing task interdependence across clinical domains involved in this patient’s care. We used team science supported by the project management discipline to discuss how various task interdependence aspects can be recognized, deliberately designed, and systematically managed to prevent care breakdowns. This case highlights how effective task interdependence management facilitated by project management methods could markedly improve the course of a patient’s care. This work informs efforts of cancer centers and practices to redesign cancer care delivery through innovative, practical, and patient-centered approaches to management of task interdependence in cancer care. Future patient-reported outcomes research will help to determine optimal ways to engage patients, including those who are medically underserved, in managing task interdependence in their own care. PMID:27577619

Transportation risk management : international practices for program development and project delivery.

DOT National Transportation Integrated Search

2012-08-01

Managing transportation networks, including agency : management, program development, and project : delivery, is extremely complex and fraught with : uncertainty. Administrators, planners, and engineers : coordinate a multitude of organizational and ...

Distributed Traffic Complexity Management by Preserving Trajectory Flexibility

NASA Technical Reports Server (NTRS)

Idris, Husni; Vivona, Robert A.; Garcia-Chico, Jose-Luis; Wing, David J.

2007-01-01

In order to handle the expected increase in air traffic volume, the next generation air transportation system is moving towards a distributed control architecture, in which groundbased service providers such as controllers and traffic managers and air-based users such as pilots share responsibility for aircraft trajectory generation and management. This paper presents preliminary research investigating a distributed trajectory-oriented approach to manage traffic complexity, based on preserving trajectory flexibility. The underlying hypotheses are that preserving trajectory flexibility autonomously by aircraft naturally achieves the aggregate objective of avoiding excessive traffic complexity, and that trajectory flexibility is increased by collaboratively minimizing trajectory constraints without jeopardizing the intended air traffic management objectives. This paper presents an analytical framework in which flexibility is defined in terms of robustness and adaptability to disturbances and preliminary metrics are proposed that can be used to preserve trajectory flexibility. The hypothesized impacts are illustrated through analyzing a trajectory solution space in a simple scenario with only speed as a degree of freedom, and in constraint situations involving meeting multiple times of arrival and resolving conflicts.

Automated complex for research of electric drives control

NASA Astrophysics Data System (ADS)

Avlasko, P. V.; Antonenko, D. A.

2018-05-01

In the article, the automated complex intended for research of various control modes of electric motors including the inductor motor of double-way feed is described. As a basis of the created complex, the National Instruments platform is chosen. The operating controller built in a platform is delivered with an operating system of real-time for creation of systems of measurement and management. The software developed in the environment of LabVIEW consists of several connected modules which are in different elements of a complex. Besides the software for automated management by experimental installation, the program complex is developed for modelling of processes in the electric drive. As a result there is an opportunity to compare simulated and received experimentally transitional characteristics of the electric drive in various operating modes.

Decade-long bird community response to the spatial pattern of variable retention harvesting in red pine (Pinus resinosa) forests

Treesearch

Eddie L. Shea; Lisa A. Schulte; Brian J. Palik

2017-01-01

Structural complexity is widely recognized as an inherent characteristic of unmanaged forests critical to their function and resilience, but often reduced in their managed counterparts. Variable retention harvesting (VRH) has been proposed as a way to restore or enhance structural complexity in managed forests, and thereby sustain attendant biodiversity and ecosystem...

Describing wildland surface fuel loading for fire management: A review of approaches, methods and systems

Treesearch

Robert E. Keane

2013-01-01

Wildland fuelbeds are exceptionally complex, consisting of diverse particles of many sizes, types and shapes with abundances and properties that are highly variable in time and space. This complexity makes it difficult to accurately describe, classify, sample and map fuels for wildland fire research and management. As a result, many fire behaviour and effects software...

Aspects of transport system management within mining complex using information and telecommunication systems

NASA Astrophysics Data System (ADS)

Semykina, A. S.; Zagorodniy, N. A.; Konev, A. A.; Duganova, E. V.

2018-05-01

The paper considers aspects of transport system management within the mining complex. It indicates information and telecommunication systems that are used to increase transportation efficiency. It also describes key advantages and disadvantages. It is found that software products of the Modular Company used in pits allow increasing transport performance, minimizing losses and ensuring efficient transportation of minerals.

Supporting the Role of Associate Dean in Universities: An Alternative Approach to Management Development

ERIC Educational Resources Information Center

Preston, Diane; Floyd, Alan

2016-01-01

Located between senior management and academic staff, the role of the Associate Dean in universities appears to be growing in number, complexity and importance in recent years. A role arguably fraught with complexity, it remains largely undefined and under-researched. While little is known about the role in general, less still is known about their…

Recreation visitor attitudes towards management-ignited prescribed fires in the Bob Marshall Wilderness Complex, Montana

Treesearch

Katie Knotek; Alan E. Watson; William T. Borrie; Joshua G. Whitmore; David Turner

2008-01-01

Research at the Bob Marshall Wilderness Complex in Montana explored differences in recreation visitors' attitudes towards the use of management-ignited prescribed fires in the wilderness. A mail-back survey of visitors (n = 291) during the 2004 season revealed that over half of visitors would accept prescribed fires in wilderness. This support did not vary by...

What can complexity do for diabetes management? Linking theory to practice.

PubMed

Cooper, Helen C; Geyer, Robert

2009-08-01

Diabetes presents a multifaceted picture with its rapidly rising prevalence associated with changing demographics and increasing levels of obesity in the developed world. Deaths from diabetes are predicted to rise by 25% over the next 10 years. The enormity of this public health challenge has been recognized the world over, but little attention has been paid to the theoretical frameworks underpinning practical management. This paper aims to introduce complexity theory and discuss its practical application to diabetes, focusing on a single 'tool' to provide an example of how theory can be linked to practice. Critics have questioned the all inclusive nature of complexity seeing it as an intangible concept that fails to offer anything new to health care. However, few have appraised its practical application to a chronic disease that is currently managed using an outdated, linear, reduce and resolve model which fails to address the multiple interacting systems inherent within this condition. This article proposes that complexity theory provides an interprofessional perspective for describing and understanding the processes involved, and provides working 'tools' for patients, carers and practitioners that capture the reality of managing this chronic disease in modern life.

Nurse manager orientation.

PubMed

Hawkins, Anne; Carter, Kelly; Nugent, Mary

2009-01-01

On the basis of the principles of management and leadership, our organization has worked over the years to formalize the orientation program for new nurse managers. This program meets the needs of new nurse managers and responds to today's complex health care system needs. This article describes the components of a nurse manager orientation program for the novice nurse manager and methods for evaluating nurse manager effectiveness.

Office managers: nobody knows the trouble they see.

PubMed

Marrone, S

1995-09-01

Computers, code revisions, and patients' changing expectations have added responsibility and a new level of complexity to the job of medical office manager. How are you and your office manager coping? Some experienced managers relay their views of this rapidly changing field.

An update of the distribution of selected radiochemical and chemical constituents in perched ground water, Idaho National Laboratory, Idaho, Emphasis 1999-2001

USGS Publications Warehouse

Davis, Linda C.

2006-01-01

Radiochemical and chemical wastes generated at facilities at the Idaho National Laboratory (INL) were discharged since 1952 to infiltration ponds at the Reactor Technology Complex (RTC) (known as the Test Reactor Area [TRA] until 2005), and the Idaho Nuclear Technology and Engineering Center (INTEC) and buried at the Radioactive Waste Management Complex (RWMC). Disposal of wastewater to infiltration ponds and infiltration of surface water at waste burial sites resulted in formation of perched ground water in basalts and in sedimentary interbeds above the Snake River Plain aquifer. Perched ground water is an integral part of the pathway for waste-constituent migration to the aquifer. The U.S. Geological Survey (USGS), in cooperation with the U.S. Department of Energy, maintains ground-water monitoring networks at the INL to determine hydrologic trends, and to monitor the movement of radiochemical and chemical constituents in wastewater discharged from facilities to both perched ground water and the aquifer. This report presents an analysis of water-quality and water-level data collected from wells completed in perched ground water at the INL during 1999-2001, and summarizes historical disposal data and water-level-and water-quality trends. At the RTC, tritium, strontium-90, cesium-137, dissolved chromium, chloride, sodium, and sulfate were monitored in shallow and deep perched ground water. In shallow perched ground water, no tritium was detected above the reporting level. In deep perched ground water, tritium concentrations generally decreased or varied randomly during 1999-2001. During October 2001, tritium concentrations ranged from less than the reporting level to 39.4?1.4 picocuries per milliliter (pCi/mL). Reportable concentrations of tritium during July-October 2001 were smaller than the reported concentrations measured during July-December 1998. Tritium concentrations in water from wells at the RTC were likely affected by: well's distance from the radioactive-waste infiltration ponds (commonly referred to as the warm-waste ponds); water depth below the ponds; the amount of tritium discharged to radioactive-waste infiltration ponds in the past; discontinued use of radioactive-waste infiltration ponds; radioactive decay; and dilution from disposal of nonradioactive water. During 1999-2001, the strontium-90 concentrations in two wells completed in shallow perched water near the RTC exceeded the reporting level. Strontium-90 concentrations in water from wells completed in deep perched ground water at the RTC varied randomly with time. During October 2001, concentrations in water from five wells exceeded the reporting level and ranged from 2.8?0.7 picocuries per liter (pCi/L) in well USGS 63 to 83.8?2.1 pCi/L in well USGS 54. No reportable concentrations of cesium-137, chromium-51, or cobalt-60 were present in water samples from any of the shallow or deep wells at the RTC during 1999-2001. Dissolved chromium was not detected in shallow perched ground water at the RTC during 1999-2001. Concentrations of dissolved chromium during July-October 2001 in deep perched ground water near the RTC ranged from 10 micrograms per liter (?g/L) in well USGS 61 to 82 ?g/L in well USGS 55. The largest concentrations were in water from wells north and west of the radioactive-waste infiltration ponds. During July-October 2001, dissolved sodium concentrations ranged from 7 milligrams per liter (mg/L) in well USGS 78 to 20 mg/L in all wells except well USGS 68 (413 mg/L). Dissolved chloride concentrations in shallow perched ground water ranged from 10 mg/L in wells CWP 1, 3, and 4 to 53 mg/L in well TRA A 13 during 1999-2001. Dissolved chloride concentrations in deep perched ground water ranged from 5 mg/L in well USGS 78 to 91 mg/L in well USGS 73. The maximum dissolved sulfate concentration in shallow perched ground water was 419 mg/L in well CWP 1 during July 2000. Concentrations of dissolved sulfate in water from wells USGS 54, 60

Management Knowledge and Skills Required in the Health Care System of the Federation Bosnia and Herzegovina

PubMed Central

Slipicevic, Osman; Masic, Izet

2012-01-01

Extremely complex health care organizations, by their structure and organization, operate in a constantly changing business environment, and such situation implies and requires complex and demanding health management. Therefore, in order to manage health organizations in a competent manner, health managers must possess various managerial skills and be familiar with problems in health care. Research, identification, analysis, and assessment of health management education and training needs are basic preconditions for the development and implementation of adequate programs to meet those needs. Along with other specific activities, this research helped to determine the nature, profile, and level of top-priority needs for education. The need for knowledge of certain areas in health management, as well as the need for mastering concrete managerial competencies has been recognized as top-priorities requiring additional improvement and upgrading. PMID:23922519

Variable speed limit strategies analysis with mesoscopic traffic flow model based on complex networks

NASA Astrophysics Data System (ADS)

Li, Shu-Bin; Cao, Dan-Ni; Dang, Wen-Xiu; Zhang, Lin

As a new cross-discipline, the complexity science has penetrated into every field of economy and society. With the arrival of big data, the research of the complexity science has reached its summit again. In recent years, it offers a new perspective for traffic control by using complex networks theory. The interaction course of various kinds of information in traffic system forms a huge complex system. A new mesoscopic traffic flow model is improved with variable speed limit (VSL), and the simulation process is designed, which is based on the complex networks theory combined with the proposed model. This paper studies effect of VSL on the dynamic traffic flow, and then analyzes the optimal control strategy of VSL in different network topologies. The conclusion of this research is meaningful to put forward some reasonable transportation plan and develop effective traffic management and control measures to help the department of traffic management.

Bringing Technology to the Resource Manager ... and Not the Reverse

Treesearch

Daniel L. Schmoldt

1992-01-01

Many natural resource managers envision their jobs as pressed between the resources that they have a mandate to manage and the technological aides that are essential tools to conduct those management activities. On the one hand, managers are straining to understand an extremely complex array of natural systems and the management pressures placed on those systems. Then...

78 FR 20661 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-05

... Category: For a food additive petition without complex chemistry, manufacturing, efficacy, or safety issues...) Complex Category: For a food additive petition with complex chemistry, manufacturing, efficacy, and/or... additive file without complex chemistry, manufacturing, efficacy, or safety issues, the estimated time...

Have we been successful? Monitoring horizontal forest complexity for forest restoration projects

Treesearch

Yvette L. Dickinson; Kristen A. Pelz; Emma Giles; Josh Howie

2016-01-01

Forest management today often seeks to restore ecological integrity and enhance human well-being by increasing forest complexity, resilience, and functionality. However, effective and financially expedient monitoring of forest complexity is challenging. In this study, we developed a practical and inexpensive technique to measure horizontal forest complexity....

Management Strategies for Complex Adaptive Systems: Sensemaking, Learning, and Improvisation

ERIC Educational Resources Information Center

McDaniel, Reuben R., Jr.

2007-01-01

Misspecification of the nature of organizations may be a major reason for difficulty in achieving performance improvement. Organizations are often viewed as machine-like, but complexity science suggests that organizations should be viewed as complex adaptive systems. I identify the characteristics of complex adaptive systems and give examples of…

Assessing Complexity in Learning Outcomes--A Comparison between the SOLO Taxonomy and the Model of Hierarchical Complexity

ERIC Educational Resources Information Center

Stålne, Kristian; Kjellström, Sofia; Utriainen, Jukka

2016-01-01

An important aspect of higher education is to educate students who can manage complex relationships and solve complex problems. Teachers need to be able to evaluate course content with regard to complexity, as well as evaluate students' ability to assimilate complex content and express it in the form of a learning outcome. One model for evaluating…

Ixcatec ethnoecology: plant management and biocultural heritage in Oaxaca, Mexico.

PubMed

Rangel-Landa, Selene; Casas, Alejandro; Rivera-Lozoya, Erandi; Torres-García, Ignacio; Vallejo-Ramos, Mariana

2016-07-20

Studying motives of plant management allows understanding processes that originated agriculture and current forms of traditional technology innovation. Our work analyses the role of native plants in the Ixcatec subsistence, management practices, native plants biocultural importance, and motivations influencing management decisions. Cultural and ecological importance and management complexity may differ among species according with their use value and availability. We hypothesized that decreasing risk in availability of resources underlies the main motives of management, but curiosity, aesthetic, and ethical values may also be determinant. Role of plants in subsistence strategies, forms of use and management was documented through 130 semi-structured interviews and participant observation. Free listing interviews to 38 people were used to estimate the cognitive importance of species used as food, medicine, fuel, fodder, ornament and ceremonial. Species ecological importance was evaluated through sampling vegetation in 22 points. Principal Components Analysis were performed to explore the relation between management, cultural and ecological importance and estimating the biocultural importance of native species. We recorded 627 useful plant species, 589 of them native. Livelihood strategies of households rely on agriculture, livestock and multiple use of forest resources. At least 400 species are managed, some of them involving artificial selection. Management complexity is the main factor reflecting the biocultural importance of plant species, and the weight of ecological importance and cultural value varied among use types. Management strategies aim to ensure resources availability, to have them closer, to embellish human spaces or satisfying ethical principles. Decisions about plants management are influenced by perception of risk to satisfy material needs, but immaterial principles are also important. Studying such relation is crucial for understanding past and present technological innovation processes and understand the complex process of developing biocultural legacy.

DeMAID: A Design Manager's Aide for Intelligent Decomposition user's guide

NASA Technical Reports Server (NTRS)

Rogers, James L.

1989-01-01

A design problem is viewed as a complex system divisible into modules. Before the design of a complex system can begin, the couplings among modules and the presence of iterative loops is determined. This is important because the design manager must know how to group the modules into subsystems and how to assign subsystems to design teams so that changes in one subsystem will have predictable effects on other subsystems. Determining these subsystems is not an easy, straightforward process and often important couplings are overlooked. Moreover, the planning task must be repeated as new information become available or as the design specifications change. The purpose of this research is to develop a knowledge-based tool called the Design Manager's Aide for Intelligent Decomposition (DeMAID) to act as an intelligent advisor for the design manager. DeMaid identifies the subsystems of a complex design problem, orders them into a well-structured format, and marks the couplings among the subsystems to facilitate the use of multilevel tools. DeMAID also provides the design manager with the capability of examining the trade-offs between sequential and parallel processing. This type of approach could lead to a substantial savings or organizing and displaying a complex problem as a sequence of subsystems easily divisible among design teams. This report serves as a User's Guide for the program.

Optimization of protocol design: a path to efficient, lower cost clinical trial execution

PubMed Central

Malikova, Marina A

2016-01-01

Managing clinical trials requires strategic planning and efficient execution. In order to achieve a timely delivery of important clinical trials’ outcomes, it is useful to establish standardized trial management guidelines and develop robust scoring methodology for evaluation of study protocol complexity. This review will explore the challenges clinical teams face in developing protocols to ensure that the right patients are enrolled and the right data are collected to demonstrate that a drug is safe and efficacious, while managing study costs and study complexity based on proposed comprehensive scoring model. Key factors to consider when developing protocols and techniques to minimize complexity will be discussed. A methodology to identify processes at planning phase, approaches to increase fiscal return and mitigate fiscal compliance risk for clinical trials will be addressed. PMID:28031939

PANORAMA: An approach to performance modeling and diagnosis of extreme-scale workflows

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

Deelman, Ewa; Carothers, Christopher; Mandal, Anirban

Here we report that computational science is well established as the third pillar of scientific discovery and is on par with experimentation and theory. However, as we move closer toward the ability to execute exascale calculations and process the ensuing extreme-scale amounts of data produced by both experiments and computations alike, the complexity of managing the compute and data analysis tasks has grown beyond the capabilities of domain scientists. Therefore, workflow management systems are absolutely necessary to ensure current and future scientific discoveries. A key research question for these workflow management systems concerns the performance optimization of complex calculation andmore » data analysis tasks. The central contribution of this article is a description of the PANORAMA approach for modeling and diagnosing the run-time performance of complex scientific workflows. This approach integrates extreme-scale systems testbed experimentation, structured analytical modeling, and parallel systems simulation into a comprehensive workflow framework called Pegasus for understanding and improving the overall performance of complex scientific workflows.« less

PANORAMA: An approach to performance modeling and diagnosis of extreme-scale workflows

DOE PAGES

Deelman, Ewa; Carothers, Christopher; Mandal, Anirban; ...

2015-07-14

Here we report that computational science is well established as the third pillar of scientific discovery and is on par with experimentation and theory. However, as we move closer toward the ability to execute exascale calculations and process the ensuing extreme-scale amounts of data produced by both experiments and computations alike, the complexity of managing the compute and data analysis tasks has grown beyond the capabilities of domain scientists. Therefore, workflow management systems are absolutely necessary to ensure current and future scientific discoveries. A key research question for these workflow management systems concerns the performance optimization of complex calculation andmore » data analysis tasks. The central contribution of this article is a description of the PANORAMA approach for modeling and diagnosing the run-time performance of complex scientific workflows. This approach integrates extreme-scale systems testbed experimentation, structured analytical modeling, and parallel systems simulation into a comprehensive workflow framework called Pegasus for understanding and improving the overall performance of complex scientific workflows.« less

Addressing the conundrum of multimorbidity in heart failure: Do we need a more strategic approach to improve health outcomes?

PubMed

Stewart, Simon; Riegel, Barbara; Thompson, David R

2016-02-01

There is clear evidence across the globe that the clinical complexity of patients presenting to hospital with the syndrome of heart failure is increasing - not only in terms of the presence of concurrent disease states, but with additional socio-demographic risk factors that complicate treatment. Management strategies that treat heart failure as the main determinant of health outcomes ignores the multiple and complex issues that will inevitably erode the efficacy and efficiency of current heart failure management programmes. This complex problem (or conundrum) requires a different way of thinking around the complex interactions that underpin poor outcomes in heart failure. In this context, we present the COordinated NUrse-led inteNsified Disease management for continuity of caRe for mUltiMorbidity in Heart Failure (CONUNDRUM-HF) matrix that may well inform future research and models of care to achieve better health outcomes in this rapidly increasing patient population. © The European Society of Cardiology 2015.

Neil Snyder | NREL

Science.gov Websites

Photo of Neil Snyder Neil Snyder Manager III-Program Management Research Neil.Snyder@nrel.gov management. He has chiefly focused on developing complex systems and his specific expertise is leadership. As has acquired familiarity level expertise in many technical fields including environmental management

An Integration of a GIS with Peatland Management

NASA Technical Reports Server (NTRS)

Hoshal, J. C.; Johnson, R. L.

1982-01-01

The complexities of peatland management in Minnesota and the use of a geographic information system, the Minnesota Land Management Information System (MLMIS) in the management process are examined. General information on the nature of peat and it quantity and distribution in Minnesota is also presented.

The relationship between work complexity and nurses' participation in decision making in hospitals.

PubMed

Bacon, Cynthia Thornton; Lee, Shoou-Yih Daniel; Mark, Barbara

2015-04-01

The aim of this study is to examine the relationship between work complexity and nurses' participation in decision making in hospital nursing units. Increasing nurses' participation in decision making has been used as a way to manage work complexity; however, the work of nurses in acute care hospitals has become highly complex, and strategies used to manage this complexity have not been fully explored. The relationship between work complexity and nurse participation in decision making was examined using data from the Outcomes Research in Nursing Administration project. The sample included 3,718 RNs in 278 medical-surgical units in 143 hospitals. When work complexity increased, nurses' participation in decision making decreased. When nurses have limited input into decision making, the information available to the care team may be incomplete. Barriers to nurses' participation in decision making should be explored and interventions developed so that nurses may be full participants in decision making affecting both patients and the work environment.

Improvement of the F-Perceptory Approach Through Management of Fuzzy Complex Geographic Objects

NASA Astrophysics Data System (ADS)

Khalfi, B.; de Runz, C.; Faiz, S.; Akdag, H.

2015-08-01

In the real world, data is imperfect and in various ways such as imprecision, vagueness, uncertainty, ambiguity and inconsistency. For geographic data, the fuzzy aspect is mainly manifested in time, space and the function of objects and is due to a lack of precision. Therefore, the researchers in the domain emphasize the importance of modeling data structures in GIS but also their lack of adaptation to fuzzy data. The F-Perceptory approachh manages the modeling of imperfect geographic information with UML. This management is essential to maintain faithfulness to reality and to better guide the user in his decision-making. However, this approach does not manage fuzzy complex geographic objects. The latter presents a multiple object with similar or different geographic shapes. So, in this paper, we propose to improve the F-Perceptory approach by proposing to handle fuzzy complex geographic objects modeling. In a second step, we propose its transformation to the UML modeling.

Grounding explanations in evolving, diagnostic situations

NASA Technical Reports Server (NTRS)

Johannesen, Leila J.; Cook, Richard I.; Woods, David D.

1994-01-01

Certain fields of practice involve the management and control of complex dynamic systems. These include flight deck operations in commercial aviation, control of space systems, anesthetic management during surgery or chemical or nuclear process control. Fault diagnosis of these dynamic systems generally must occur with the monitored process on-line and in conjunction with maintaining system integrity.This research seeks to understand in more detail what it means for an intelligent system to function cooperatively, or as a 'team player' in complex, dynamic environments. The approach taken was to study human practitioners engaged in the management of a complex, dynamic process: anesthesiologists during neurosurgical operations. The investigation focused on understanding how team members cooperate in management and fault diagnosis and comparing this interaction to the situation with an Artificial Intelligence(AI) system that provides diagnoses and explanations. Of particular concern was to study the ways in which practitioners support one another in keeping aware of relevant information concerning the state of the monitored process and of the problem solving process.

A user's guide to coping with estuarine management bureaucracy: An Estuarine Planning Support System (EPSS) tool.

PubMed

Lonsdale, Jemma; Nicholson, Rose; Weston, Keith; Elliott, Michael; Birchenough, Andrew; Sühring, Roxana

2018-02-01

Estuaries are amongst the most socio-economically and ecologically important environments however, due to competing and conflicting demands, management is often challenging with a complex legislative framework managed by multiple agencies. To facilitate the understanding of this legislative framework, we have developed a GISbased Estuarine Planning Support System tool. The tool integrates the requirements of the relevant legislation and provides a basis for assessing the current environmental state of an estuary as well as informing and assessing new plans to ensure a healthy estuarine state. The tool ensures that the information is easily accessible for regulators, managers, developers and the public. The tool is intended to be adaptable, but is assessed using the Humber Estuary, United Kingdom as a case study area. The successful application of the tool for complex socio-economic and environmental systems demonstrates that the tool can efficiently guide users through the complex requirements needed to support sustainable development. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

A PBOM configuration and management method based on templates

NASA Astrophysics Data System (ADS)

Guo, Kai; Qiao, Lihong; Qie, Yifan

2018-03-01

The design of Process Bill of Materials (PBOM) holds a hinge position in the process of product development. The requirements of PBOM configuration design and management for complex products are analysed in this paper, which include the reuse technique of configuration procedure and urgent management need of huge quantity of product family PBOM data. Based on the analysis, the function framework of PBOM configuration and management has been established. Configuration templates and modules are defined in the framework to support the customization and the reuse of configuration process. The configuration process of a detection sensor PBOM is shown as an illustration case in the end. The rapid and agile PBOM configuration and management can be achieved utilizing template-based method, which has a vital significance to improve the development efficiency for complex products.

Proceedings of the symposium on the management of prairie dog complexes for the reintroduction of the black-footed ferret

USGS Publications Warehouse

Oldemeyer, John L.; Biggins, Dean E.; Miller, Brian J.; Crete, Ronald

1993-01-01

The workshop featured a review of current knowledge in the biology of prairie dogs in the context of managing black-footed ferret habitat. The review addressed two main components. The first consisted of a series of papers on prairie dog habitat and biology. The second component of the workshop was a summary of the participants' discussion about managing prairie dog complexes. This discussion was based on the previously identified papers and profited from the participants' expertise on the ecology of black-footed ferrets and prairie dogs. The report provides current and comprehensive information about management of habitat for prairie dogs and black-footed ferrets and is a useful guide for agencies and individuals that manage black-footed ferrets.

Managing Contextual Complexity in an Experiential Learning Course: A Dynamic Systems Approach through the Identification of Turning Points in Students' Emotional Trajectories

PubMed Central

Nogueiras, Gloria; Kunnen, E. Saskia; Iborra, Alejandro

2017-01-01

This study adopts a dynamic systems approach to investigate how individuals successfully manage contextual complexity. To that end, we tracked individuals' emotional trajectories during a challenging training course, seeking qualitative changes–turning points—and we tested their relationship with the perceived complexity of the training. The research context was a 5-day higher education course based on process-oriented experiential learning, and the sample consisted of 17 students. The students used a five-point Likert scale to rate the intensity of 16 emotions and the complexity of the training on 8 measurement points. Monte Carlo permutation tests enabled to identify 30 turning points in the 272 emotional trajectories analyzed (17 students * 16 emotions each). 83% of the turning points indicated a change of pattern in the emotional trajectories that consisted of: (a) increasingly intense positive emotions or (b) decreasingly intense negative emotions. These turning points also coincided with particularly complex periods in the training as perceived by the participants (p = 0.003, and p = 0.001 respectively). The relationship between positively-trended turning points in the students' emotional trajectories and the complexity of the training may be interpreted as evidence of a successful management of the cognitive conflict arising from the clash between the students' prior ways of meaning-making and the challenging demands of the training. One of the strengths of this study is that it provides a relatively simple procedure for identifying turning points in developmental trajectories, which can be applied to various longitudinal experiences that are very common in educational and developmental contexts. Additionally, the findings contribute to sustaining that the assumption that complex contextual demands lead unfailingly to individuals' learning is incomplete. Instead, it is how individuals manage complexity which may or may not lead to learning. Finally, this study can also be considered a first step in research on the developmental potential of process-oriented experiential learning training. PMID:28515703

Managing Complex Change in Clinical Study Metadata

PubMed Central

Brandt, Cynthia A.; Gadagkar, Rohit; Rodriguez, Cesar; Nadkarni, Prakash M.

2004-01-01

In highly functional metadata-driven software, the interrelationships within the metadata become complex, and maintenance becomes challenging. We describe an approach to metadata management that uses a knowledge-base subschema to store centralized information about metadata dependencies and use cases involving specific types of metadata modification. Our system borrows ideas from production-rule systems in that some of this information is a high-level specification that is interpreted and executed dynamically by a middleware engine. Our approach is implemented in TrialDB, a generic clinical study data management system. We review approaches that have been used for metadata management in other contexts and describe the features, capabilities, and limitations of our system. PMID:15187070

Software Schedules Missions, Aids Project Management

NASA Technical Reports Server (NTRS)

2008-01-01

NASA missions require advanced planning, scheduling, and management, and the Space Agency has worked extensively to develop the programs and software suites necessary to facilitate these complex missions. These enormously intricate undertakings have hundreds of active components that need constant management and monitoring. It is no surprise, then, that the software developed for these tasks is often applicable in other high-stress, complex environments, like in government or industrial settings. NASA work over the past few years has resulted in a handful of new scheduling, knowledge-management, and research tools developed under contract with one of NASA s partners. These tools have the unique responsibility of supporting NASA missions, but they are also finding uses outside of the Space Program.

University of San Francisco Institutional-Level Financial Indicators, FY 1968-1969 to FY 1972-1973.

ERIC Educational Resources Information Center

Counelis, James S.; Rizzo, Claude J.

To manage effectively the higher education enterprise is a complex matter. Part of the problem of managing complexity is the need for monitoring data in time series such that the on-going enterprise is viewed at comparable times in comparable terms. Part of the answer at the University of San Francisco is the development of time series data on…

Understanding Complexity and Self-Organization in a Defense Program Management Organization (Experimental Design)

DTIC Science & Technology

2016-03-18

SPONSORED REPORT SERIES Understanding Complexity and Self - Organization in a Defense Program Management Organization (Experimental Design...experiment will examine the decision-making process within the program office and the self - organization of key program office personnel based upon formal...and informal communications links. Additionally, we are interested in the effects of this self - organizing process on the organization’s shared

Biology, taxonomy, and IPM strategies of Bactrocera tau Walker and complex species (Diptera; Tephritidae) in Asia: a comprehensive review.

PubMed

Jaleel, Waqar; Lu, Lihua; He, Yurong

2018-06-02

Bactrocera flies are the serious pests of fruit, vegetables, and nuts over the world. Bactrocera tau Walker is an economically important pest of agricultural crops. In Asia, approximately 30-40% losses of agricultural products are caused by B. tau infestation every year. In Asia, the B. tau contains a complex of sibling species that called the tau complex. However, the basic studies of B. tau and complex species are very important for integrated management. A comprehensive review of the B. tau and complex species has not been provided elsewhere. So, considering the importance of B. tau and complex species, this study provides the published information on ecology, nomenclature, identification tools, geographical distribution, potential invasion, and IPM tactics of B. tau and complex species, which would be more informative for publication facilitating related to integrated pest management (IPM) strategies of B. tau and complex species. In IPM of B. tau and complex species, the phytochemical and biological controls have not been applied successfully in Asia; there is an urgent need to study and applications of these two mentioned control techniques against the B. tau and complex species in Asia.

Integrating research tools to support the management of social-ecological systems under climate change

USGS Publications Warehouse

Miller, Brian W.; Morisette, Jeffrey T.

2014-01-01

Developing resource management strategies in the face of climate change is complicated by the considerable uncertainty associated with projections of climate and its impacts and by the complex interactions between social and ecological variables. The broad, interconnected nature of this challenge has resulted in calls for analytical frameworks that integrate research tools and can support natural resource management decision making in the face of uncertainty and complex interactions. We respond to this call by first reviewing three methods that have proven useful for climate change research, but whose application and development have been largely isolated: species distribution modeling, scenario planning, and simulation modeling. Species distribution models provide data-driven estimates of the future distributions of species of interest, but they face several limitations and their output alone is not sufficient to guide complex decisions for how best to manage resources given social and economic considerations along with dynamic and uncertain future conditions. Researchers and managers are increasingly exploring potential futures of social-ecological systems through scenario planning, but this process often lacks quantitative response modeling and validation procedures. Simulation models are well placed to provide added rigor to scenario planning because of their ability to reproduce complex system dynamics, but the scenarios and management options explored in simulations are often not developed by stakeholders, and there is not a clear consensus on how to include climate model outputs. We see these strengths and weaknesses as complementarities and offer an analytical framework for integrating these three tools. We then describe the ways in which this framework can help shift climate change research from useful to usable.

41 CFR 101-5.000 - Scope of part.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Scope of part. 101-5.000 Section 101-5.000 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 5-CENTRALIZED SERVICES IN FEDERAL BUILDINGS AND COMPLEXES...

41 CFR 101-5.000 - Scope of part.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Scope of part. 101-5.000 Section 101-5.000 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 5-CENTRALIZED SERVICES IN FEDERAL BUILDINGS AND COMPLEXES...

41 CFR 101-5.000 - Scope of part.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Scope of part. 101-5.000 Section 101-5.000 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 5-CENTRALIZED SERVICES IN FEDERAL BUILDINGS AND COMPLEXES...

Sustainability, Complexity and Learning: Insights from Complex Systems Approaches

ERIC Educational Resources Information Center

Espinosa, A.; Porter, T.

2011-01-01

Purpose: The purpose of this research is to explore core contributions from two different approaches to complexity management in organisations aiming to improve their sustainability,: the Viable Systems Model (VSM), and the Complex Adaptive Systems (CAS). It is proposed to perform this by summarising the main insights each approach offers to…

Shifting conceptions of complexity in forest management and silviculture

Treesearch

Robert T. Fahey; Brandon C. Alveshere; Julia I. Burton; Anthony W. D' Amato; Yvette L. Dickinson; William S. Keeton; Christel C. Kern; Andrew J. Larson; Brian J. Palik; Klaus J. Puettmann; Michael R. Saunders; Christopher R. Webster; Jeff W. Atkins; Christopher M. Gough; Brady S. Hardiman

2018-01-01

In the past several decades, a trend in forestry and silviculture has been toward promoting complexity in forest ecosystems, but how complexity is conceived and described has shifted over time as new ideas and terminology have been introduced. Historically, ecologically-focused silviculture has focused largely on manipulation of structural complexity, but often with...

Understanding Complex Adaptive Systems by Playing Games

ERIC Educational Resources Information Center

van Bilsen, Arthur; Bekebrede, Geertje; Mayer, Igor

2010-01-01

While educators teach their students about decision making in complex environments, managers have to deal with the complexity of large projects on a daily basis. To make better decisions it is assumed, that the latter would benefit from better understanding of complex phenomena, as do students as the professionals of the future. The goal of this…

Operational performance management of priced facilities

DOT National Transportation Integrated Search

2011-03-01

The Texas Department of Transportation and its agency partners have implemented various forms of lane management and pricing over the past three decades, including HOV lanes, managed lanes, and toll roads. As more of these complex transportation faci...

Instream wood recruitment, channel complexity, and their relationship to stream ecology in forested headwater streams under alternative stable states

NASA Astrophysics Data System (ADS)

Livers, B.; Wohl, E.

2015-12-01

Human alteration to forests has had lasting effects on stream channels worldwide. Such land use changes affect how wood enters and is stored in streams as individual pieces and as logjams. Changes in wood recruitment affect the complexity and benefits wood can provide to the stream environment, such as zones of flow separation that store fine sediment and organic matter, increased nutrient processing, and greater habitat potential, which can enhance biota and cascade through stream-riparian ecosystems. Previous research in our study area shows that modern headwater streams flowing through old-growth, unmanaged forests have more wood than streams in young, managed forests, but does not explicitly evaluate how wood affects channel complexity or local ecology. 'Managed' refers to forests previously or currently exposed to human alteration. Alteration has long since ceased in some areas, but reduced wood loads in managed streams persist. Our primary objective was to quantify stream complexity metrics, with instream wood as a mediator, on streams across a gradient of management and disturbance histories in order to examine legacy effects of human alteration to forests. Data collected in the Southern Rocky Mountains include 24 2nd to 3rd order subalpine streams categorized into: old-growth unmanaged; younger, naturally disturbed unmanaged; and younger managed. We assessed instream wood loads and logjams and evaluated how they relate to channel complexity using a number of metrics, such as standard deviation of bed and banks, volume of pools, ratios of stream to valley lengths and stream to valley area, and diversity of substrate, gradient, and morphology. Preliminary results show that channel complexity is directly related to instream wood loads and is greatest in streams in old-growth. Related research in the field area indicates that streams with greater wood loads also have increased nutrient processing and greater abundance and diversity of aquatic insect predators.

Predictive Analytics to Support Real-Time Management in Pathology Facilities.

PubMed

Lessard, Lysanne; Michalowski, Wojtek; Chen Li, Wei; Amyot, Daniel; Halwani, Fawaz; Banerjee, Diponkar

2016-01-01

Predictive analytics can provide valuable support to the effective management of pathology facilities. The introduction of new tests and technologies in anatomical pathology will increase the volume of specimens to be processed, as well as the complexity of pathology processes. In order for predictive analytics to address managerial challenges associated with the volume and complexity increases, it is important to pinpoint the areas where pathology managers would most benefit from predictive capabilities. We illustrate common issues in managing pathology facilities with an analysis of the surgical specimen process at the Department of Pathology and Laboratory Medicine (DPLM) at The Ottawa Hospital, which processes all surgical specimens for the Eastern Ontario Regional Laboratory Association. We then show how predictive analytics could be used to support management. Our proposed approach can be generalized beyond the DPLM, contributing to a more effective management of pathology facilities and in turn to quicker clinical diagnoses.

Predictive Analytics to Support Real-Time Management in Pathology Facilities

PubMed Central

Lessard, Lysanne; Michalowski, Wojtek; Chen Li, Wei; Amyot, Daniel; Halwani, Fawaz; Banerjee, Diponkar

2016-01-01

Predictive analytics can provide valuable support to the effective management of pathology facilities. The introduction of new tests and technologies in anatomical pathology will increase the volume of specimens to be processed, as well as the complexity of pathology processes. In order for predictive analytics to address managerial challenges associated with the volume and complexity increases, it is important to pinpoint the areas where pathology managers would most benefit from predictive capabilities. We illustrate common issues in managing pathology facilities with an analysis of the surgical specimen process at the Department of Pathology and Laboratory Medicine (DPLM) at The Ottawa Hospital, which processes all surgical specimens for the Eastern Ontario Regional Laboratory Association. We then show how predictive analytics could be used to support management. Our proposed approach can be generalized beyond the DPLM, contributing to a more effective management of pathology facilities and in turn to quicker clinical diagnoses. PMID:28269873

Developing predictive systems models to address complexity and relevance for ecological risk assessment.

PubMed

Forbes, Valery E; Calow, Peter

2013-07-01

Ecological risk assessments (ERAs) are not used as well as they could be in risk management. Part of the problem is that they often lack ecological relevance; that is, they fail to grasp necessary ecological complexities. Adding realism and complexity can be difficult and costly. We argue that predictive systems models (PSMs) can provide a way of capturing complexity and ecological relevance cost-effectively. However, addressing complexity and ecological relevance is only part of the problem. Ecological risk assessments often fail to meet the needs of risk managers by not providing assessments that relate to protection goals and by expressing risk in ratios that cannot be weighed against the costs of interventions. Once more, PSMs can be designed to provide outputs in terms of value-relevant effects that are modulated against exposure and that can provide a better basis for decision making than arbitrary ratios or threshold values. Recent developments in the modeling and its potential for implementation by risk assessors and risk managers are beginning to demonstrate how PSMs can be practically applied in risk assessment and the advantages that doing so could have. Copyright © 2013 SETAC.

Complex socio-technical systems: Characterization and management guidelines.

PubMed

Righi, Angela Weber; Saurin, Tarcisio Abreu

2015-09-01

Although ergonomics has paid increasing attention to the perspective of complexity, methods for its operationalization are scarce. This study introduces a framework for the operationalization of the "attribute view" of complexity, which involves: (i) the delimitation of the socio-technical system (STS); (ii) the description of four complexity attributes, namely a large number of elements in dynamic interactions, a wide diversity of elements, unexpected variability, and resilience; (iii) the assessment of six management guidelines, namely design slack, give visibility to processes and outcomes, anticipate and monitor the impacts of small changes, monitor the gap between prescription and practice, encourage diversity of perspectives when making decisions, and create an environment that supports resilience; and (iv) the identification of leverage points for improving the STS design, based on both the analysis of relationships among the attributes and their classification as irreducible/manageable complexity, and liability/asset. The use of the framework is illustrated by the study of an emergency department of a University hospital. Data collection involved analysis of documents, observations of work at the front-line, interviews with employees, and the application of questionnaires. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Putting it altogether: improving performance in heart failure outcomes, part 2.

PubMed

Clancy, Thomas R

2009-09-01

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 10th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. As follow-up to the case study in this column's June 2009 article, this article highlights the interventions and outcomes of the study.

Contribution of the Multi Attribute Value Theory to conflict resolution in groundwater management. Application to the Mancha Oriental groundwater system, Spain

NASA Astrophysics Data System (ADS)

Apperl, B.; Andreu, J.; Karjalainen, T. P.; Pulido-Velazquez, M.

2014-09-01

The implementation of the EU Water Framework Directive demands participatory water resource management approaches. Decision making in groundwater quantity and quality management is complex because of the existence of many independent actors, heterogeneous stakeholder interests, multiple objectives, different potential policies, and uncertain outcomes. Conflicting stakeholder interests have been often identified as an impediment to the realization and success of water regulations and policies. The management of complex groundwater systems requires clarifying stakeholders' positions (identifying stakeholders preferences and values), improving transparency with respect to outcomes of alternatives, and moving the discussion from the selection of alternatives towards definition of fundamental objectives (value-thinking approach), what facilitates negotiation. The aims of the study are to analyse the potential of the multi attribute value theory for conflict resolution in groundwater management and to evaluate the benefit of stakeholder incorporation in the different stages of the planning process to find an overall satisfying solution for groundwater management. The research was conducted in the Mancha Oriental groundwater system (Spain), subject to an intensive use of groundwater for irrigation. A complex set of objectives and attributes were defined, and the management alternatives were created by a combination of different fundamental actions, considering different implementation stages and future changes in water resources availability. Interviews were conducted with representative stakeholder groups using an interactive platform, showing simultaneously the consequences of changes of preferences to the alternative ranking. Results show that the acceptation of alternatives depends strongly on the combination of measures and the implementation stages. Uncertainties of the results were notable but did not influence heavily on the alternative ranking. The expected reduction of future groundwater resources by climate change increases the conflict potential. The implementation of the method to a very complex case study, with many conflicting objectives and alternatives and uncertain outcomes, including future scenarios under water limiting conditions, illustrate the potential of the method for supporting management decisions.

Contribution of the multi-attribute value theory to conflict resolution in groundwater management - application to the Mancha Oriental groundwater system, Spain

NASA Astrophysics Data System (ADS)

Apperl, B.; Pulido-Velazquez, M.; Andreu, J.; Karjalainen, T. P.

2015-03-01

The implementation of the EU Water Framework Directive demands participatory water resource management approaches. Decision making in groundwater quantity and quality management is complex because of the existence of many independent actors, heterogeneous stakeholder interests, multiple objectives, different potential policies, and uncertain outcomes. Conflicting stakeholder interests have often been identified as an impediment to the realisation and success of water regulations and policies. The management of complex groundwater systems requires the clarification of stakeholders' positions (identifying stakeholder preferences and values), improving transparency with respect to outcomes of alternatives, and moving the discussion from the selection of alternatives towards the definition of fundamental objectives (value-thinking approach), which facilitates negotiation. The aims of the study are to analyse the potential of the multi-attribute value theory for conflict resolution in groundwater management and to evaluate the benefit of stakeholder incorporation into the different stages of the planning process, to find an overall satisfying solution for groundwater management. The research was conducted in the Mancha Oriental groundwater system (Spain), subject to intensive use of groundwater for irrigation. A complex set of objectives and attributes was defined, and the management alternatives were created by a combination of different fundamental actions, considering different implementation stages and future changes in water resource availability. Interviews were conducted with representative stakeholder groups using an interactive platform, showing simultaneously the consequences of changes in preferences to the alternative ranking. Results show that the approval of alternatives depends strongly on the combination of measures and the implementation stages. Uncertainties in the results were notable, but did not influence the alternative ranking heavily. The expected reduction in future groundwater resources by climate change increases the conflict potential. The implementation of the method in a very complex case study, with many conflicting objectives and alternatives and uncertain outcomes, including future scenarios under water limiting conditions, illustrates the potential of the method for supporting management decisions.

An Evolutionary Complex Systems Decision-Support Tool for the Management of Operations

NASA Astrophysics Data System (ADS)

Baldwin, J. S.; Allen, P. M.; Ridgway, K.

2011-12-01

This research aimed to add both to the development of complex systems thinking in the subject area of Operations and Production Management and to the limited number of applications of computational models and simulations from the science of complex systems. The latter potentially offer helpful decision-support tools for operations and production managers. A mechanical engineering firm was used as a case study where a combined qualitative and quantitative methodological approach was employed to extract the required data from four senior managers. Company performance measures as well as firm technologies, practices and policies, and their relation and interaction with one another, were elicited. The data were subjected to an evolutionary complex systems model resulting in a series of simulations. The findings included both reassuring and some unexpected results. The simulation based on the CEO's opinions led the most cohesive and synergistic collection of practices describing the firm, closely followed by the Marketing and R&D Managers. The Manufacturing Manager's responses led to the most extreme evolutionary trajectory where the integrity of the entire firm came into question particularly when considering how employees were utilised. By drawing directly from the opinions and views of managers rather than from logical 'if-then' rules and averaged mathematical representations of agents that characterise agent-based and other self-organisational models, this work builds on previous applications by capturing a micro-level description of diversity and a learning effect that has been problematical not only in terms of theory but also in application. This approach can be used as a decision-support tool for operations and other managers providing a forum with which to explore a) the strengths, weaknesses and consequences of different decision-making capacities within the firm; b) the introduction of new manufacturing technologies, practices and policies; and, c) the different evolutionary trajectories that a firm can take.

25 CFR 1200.16 - What criteria will be used in evaluating the management plan?

Code of Federal Regulations, 2010 CFR

2010-04-01

... performance record for funds management, and the ability to compensate the tribe if the entity is found liable for failing to comply with the tribe's management plan (i.e., its assets, bonding, and insurance). (b... complexity of the proposed management plan to determine whether the tribe has the experience to manage its...

25 CFR 1200.16 - What criteria will be used in evaluating the management plan?

Code of Federal Regulations, 2011 CFR

2011-04-01

... performance record for funds management, and the ability to compensate the tribe if the entity is found liable for failing to comply with the tribe's management plan (i.e., its assets, bonding, and insurance). (b... complexity of the proposed management plan to determine whether the tribe has the experience to manage its...

Managing Communications with Experts in Geographically Distributed Collaborative Networks

DTIC Science & Technology

2009-03-01

agent architectures, and management of sensor-unmanned vehicle decision maker self organizing environments . Although CENETIX has its beginnings...understanding how everything in a complex system is interconnected. Additionally, environmental factors that impact the management of communications with...unrestricted warfare environment . In “Unconventional Insights for Managing Stakeholder Trust”, Pirson, et al. (2008) emphasizes the challenges of managing

Evaluation of fleet management techniques for timber highway bridges

Treesearch

Brent M. Phares; Travis K. Hosteng; Justin Dahlberg; Michael A. Ritter

2011-01-01

The general condition of the nation's bridges presents a complex management issue when considering cost, safety, and time. Consequently, the management of those bridges can become an overwhelming task. The need for a management system that is specific to rural systems may help to improve the management of this significant number of bridges. Although individual...

A multi-criteria decisionmaking approach to management indicator species selection for the Monongahela National Forest, West Virginia.

Treesearch

Kurtis R. Moseley; W.Mark Ford; John W. Edwards; Michael P. Strager

2010-01-01

The management indicator species concept is useful for land managers charged with monitoring and conserving complex biological diversity over large landscapes with limited available resources. We used the analytical hierarchy process (AHP) to determine the best management indicator species (MIS) for three...

Data Management Consulting at the Johns Hopkins University

ERIC Educational Resources Information Center

Varvel, Virgil E., Jr.; Shen, Yi

2013-01-01

As research data complexity and quantity grows and funding agency requirements for data management are articulated, there is a growing need for data management services (DMS). Within these services, one important role emerging is that of data management consultant (DMC). Roles were analyzed that these professionals play through case study analysis…

Social acceptability of forest conditions and management practices: a problem analysis.

Treesearch

Bruce A. Shindler; Mark Brunson; George H. Stankey

2002-01-01

The purpose of this report is to improve understanding of the complex sociopolitical processes related to resource management and to help structure management response to conflict and contentiousness, misunderstanding among participants, and failed citizen-agency interactions. Public acceptance is essential to every resource management decision public agencies must...

Designing monitoring programs in an adaptive management context for regional multiple species conservation plans

USGS Publications Warehouse

Atkinson, A.J.; Trenham, P.C.; Fisher, R.N.; Hathaway, S.A.; Johnson, B.S.; Torres, S.G.; Moore, Y.C.

2004-01-01

critical management uncertainties; and 3) implementing long-term monitoring and adaptive management. Ultimately, the success of regional conservation planning depends on the ability of monitoring programs to confront the challenges of adaptively managing and monitoring complex ecosystems and diverse arrays of sensitive species.

77 FR 50523 - Texas Mid-Coast National Wildlife Refuge Complex, Brazoria, Fort Bend, Matagorda, and Wharton...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-21

... principles of fish and wildlife management, conservation, legal mandates, and our policies. In addition to outlining broad management direction on conserving wildlife and their habitats, CCPs identify wildlife... past management, future management, and issues common to both agencies. Additional public scoping for...

Synthesis and summary: land use decisions and fire risk

Treesearch

Theodore E. Jr. Adams

1989-01-01

Rapidly chancing land use patterns are having a significant impact on watershed management and the included elements of fuel management and fire protection. The complexity of watershed management was defined in the Watershed Management Council's publication prepared for the first conference. This publication, California's Watersheds, emphasized that all land...

Spares Management : Optimizing Hardware Usage for the Space Shuttle Main Engine

NASA Technical Reports Server (NTRS)

Gulbrandsen, K. A.

1999-01-01

The complexity of the Space Shuttle Main Engine (SSME), combined with mounting requirements to reduce operations costs have increased demands for accurate tracking, maintenance, and projections of SSME assets. The SSME Logistics Team is developing an integrated asset management process. This PC-based tool provides a user-friendly asset database for daily decision making, plus a variable-input hardware usage simulation with complex logic yielding output that addresses essential asset management issues. Cycle times on critical tasks are significantly reduced. Associated costs have decreased as asset data quality and decision-making capability has increased.

Journey to the Nevada Test Site Radioactive Waste Management Complex

ScienceCinema

None

2018-01-16

Journey to the Nevada Test Site Radioactive Waste Management Complex begins with a global to regional perspective regarding the location of low-level and mixed low-level waste disposal at the Nevada Test Site. For decades, the Nevada National Security Site (NNSS) has served as a vital disposal resource in the nation-wide cleanup of former nuclear research and testing facilities. State-of-the-art waste management sites at the NNSS offer a safe, permanent disposal option for U.S. Department of Energy/U.S. Department of Defense facilities generating cleanup-related radioactive waste.

Innovations in clinical trials informatics.

PubMed

Summers, Ron; Vyas, Hiten; Dudhal, Nilesh; Doherty, Neil F; Coombs, Crispin R; Hepworth, Mark

2008-01-01

This paper will investigate innovations in information management for use in clinical trials. The application typifies a complex, adaptive, distributed and information-rich environment for which continuous innovation is necessary. Organisational innovation is highlighted as well as the technical innovations in workflow processes and their representation as an integrated set of web services. Benefits realization uncovers further innovations in the business strand of the work undertaken. Following the description of the development of this information management system, the semantic web is postulated as a possible solution to tame the complexity related to information management issues found within clinical trials support systems.

Systems approach provides management control of complex programs

NASA Technical Reports Server (NTRS)

Dudek, E. F., Jr.; Mc Carthy, J. F., Jr.

1970-01-01

Integrated program management process provides management visual assistance through three interrelated charts - system model that identifies each function to be performed, matrix that identifies personnel responsibilities for these functions, process chart that breaks down the functions into discrete tasks.

Adaptive management for ecosystem services (j/a)

EPA Science Inventory

Management of natural resources for the production of ecosystem services, which are vital for human well-being, is necessary even when there is uncertainty regarding system response to management action. This uncertainty is the result of incomplete controllability, complex intern...

Assessing the likely effectiveness of multispecies management for imperiled desert fishes with niche overlap analysis

USGS Publications Warehouse

Laub, P; Budy, Phaedra

2015-01-01

A critical decision in species conservation is whether to target individual species or a complex of ecologically similar species. Management of multispecies complexes is likely to be most effective when species share similar distributions, threats, and response to threats. We used niche overlap analysis to assess ecological similarity of 3 sensitive desert fish species currently managed as an ecological complex. We measured the amount of shared distribution of multiple habitat and life history parameters between each pair of species. Habitat use and multiple life history parameters, including maximum body length, spawning temperature, and longevity, differed significantly among the 3 species. The differences in habitat use and life history parameters among the species suggest they are likely to respond differently to similar threats and that most management actions will not benefit all 3 species equally. Habitat restoration, frequency of stream dewatering, non-native species control, and management efforts in tributaries versus main stem rivers are all likely to impact each of the species differently. Our results demonstrate that niche overlap analysis provides a powerful tool for assessing the likely effectiveness of multispecies versus single-species conservation plans.

Primary care managers' perceptions of their capability in providing care planning to patients with complex needs.

PubMed

Larsson, Lena Gunvor; Bäck-Pettersson, Siv; Kylén, Sven; Marklund, Bertil; Carlström, Eric

2017-01-01

The aim of this study was to investigate primary care managers' perceptions of their capability in providing care planning to patients with complex needs. Care planning is defined as a process where the patient, family and health professionals engage in dialogue about the patient's care needs and plan care interventions together. Semi-structured interviews with 18 primary care managers in western Sweden were conducted using Westrin's theoretical cooperation model. Data were analysed using a qualitative deductive method. Results reveal that the managers' approach to care planning was dominated by non-cooperation and separation. The managers were permeated by uncertainty about the meaning of the task of care planning as such. They did not seem to be familiar with the national legislation stipulating that every healthcare provider must meet patients' need for care interventions and participate in the care planning. To accomplish care planning, the process needs to cross - and overcome - both professional and organisational boundaries. There is also a need for incentives to develop working methods that promote local cooperation in order to facilitate optimal care for patients with complex needs. Copyright © 2016. Published by Elsevier Ireland Ltd.

Community participation in natural resources management: reality or rhetoric? Lessons learnt from the Kasanka Game Management Area (GMA) communities, Serenje District, Zambia.

PubMed

Mutamba, Emmanuel

2004-12-01

In the developing world, the term 'participation' has in recent years become a household word in the same way that 'democracy' or 'gender' have. Development agencies are demanding increased participation in their programmes. The use of the word or its application has become a centre of debate. Due to the difficulties involved in measuring 'participation' or indeed determining levels at which participation should take place, who participates and when, many 'doubting Thomases' have questioned its effectiveness. It has, however been acknowledged in many areas that popular participation changes policies and enhances management and governance. In complex issues of natural resources management, participatory techniques have helped communities develop collective responsibilities towards management of their resources and projects. This paper discusses the complexities of community participation in natural resources management, ranging from interrelations among stakeholders to resource ownership based on the experiences in the Kasanka Game Management Area (KGMA).

Using integrated research and interdisciplinary science: Potential benefits and challenges to managers of parks and protected areas

USGS Publications Warehouse

van Riper, Charles; Powell, Robert B.; Machlis, Gary; van Wagtendonk, Jan W.; van Riper, Carena J.; von Ruschkowski, Eick; Schwarzbach, Steven E.; Galipeau, Russell E.

2012-01-01

Our purpose in this paper is to build a case for utilizing interdisciplinary science to enhance the management of parks and protected areas. We suggest that interdisciplinary science is necessary for dealing with the complex issues of contemporary resource management, and that using the best available integrated scientific information be embraced and supported at all levels of agencies that manage parks and protected areas. It will take the commitment of park managers, scientists, and agency leaders to achieve the goal of implementing the results of interdisciplinary science into park management. Although such calls go back at least several decades, today interdisciplinary science is sporadically being promoted as necessary for supporting effective protected area management(e.g., Machlis et al. 1981; Kelleher and Kenchington 1991). Despite this history, rarely has "interdisciplinary science" been defined, its importance explained, or guidance provided on how to translate and then implement the associated research results into management actions (Tress et al. 2006; Margles et al. 2010). With the extremely complex issues that now confront protected areas (e.g., climate change influences, extinctions and loss of biodiversity, human and wildlife demographic changes, and unprecedented human population growth) information from more than one scientific discipline will need to be brought to bear in order to achieve sustained management solutions that resonate with stakeholders (Ostrom 2009). Although interdisciplinary science is not the solution to all problems, we argue that interdisciplinary research is an evolving and widely supported best practice. In the case of park and protected area management, interdisciplinary science is being driven by the increasing recognition of the complexity and interconnectedness of human and natural systems, and the notion that addressing many problems can be more rapidly advanced through interdisciplinary study and analysis.

A combined nurse-pharmacist managed pain clinic: joint venture of public and private sectors.

PubMed

Hadi, Muhammad Abdul; Alldred, David Phillip; Briggs, Michelle; Closs, S José

2012-02-01

Chronic pain has become one of the most prevalent problems in primary care. The management of chronic pain is complex and often requires a multidisciplinary approach. The limited capacity of general practitioners to manage chronic pain and long waiting time for secondary care referrals further add to the complexity of chronic pain management. Restricted financial and skilled human capital make it hard for healthcare systems across the world to establish and maintain multidisciplinary pain clinics, in spite of their documented effectiveness. Affordability and accessibility to such multidisciplinary pain clinics is often problematic for patients. The purpose of this paper is to share our experience and relevant research evidence of a community based combined nurse-pharmacist managed pain clinic. The pain clinic serves as an example of public-private partnership in healthcare.

Birds of a Feather: Supporting Secure Systems

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

Braswell III, H V

2006-04-24

Over the past few years Lawrence Livermore National Laboratory has begun the process of moving to a diskless environment in the Secure Computer Support realm. This movement has included many moving targets and increasing support complexity. We would like to set up a forum for Security and Support professionals to get together from across the Complex and discuss current deployments, lessons learned, and next steps. This would include what hardware, software, and hard copy based solutions are being used to manage Secure Computing. The topics to be discussed include but are not limited to: Diskless computing, port locking and management,more » PC, Mac, and Linux/UNIX support and setup, system imaging, security setup documentation and templates, security documentation and management, customer tracking, ticket tracking, software download and management, log management, backup/disaster recovery, and mixed media environments.« less

Bridging the gap between uncertainty analysis for complex watershed models and decision-making for watershed-scale water management

NASA Astrophysics Data System (ADS)

Zheng, Y.; Han, F.; Wu, B.

2013-12-01

Process-based, spatially distributed and dynamic models provide desirable resolutions to watershed-scale water management. However, their reliability in solving real management problems has been seriously questioned, since the model simulation usually involves significant uncertainty with complicated origins. Uncertainty analysis (UA) for complex hydrological models has been a hot topic in the past decade, and a variety of UA approaches have been developed, but mostly in a theoretical setting. Whether and how a UA could benefit real management decisions remains to be critical questions. We have conducted a series of studies to investigate the applicability of classic approaches, such as GLUE and Markov Chain Monte Carlo (MCMC) methods, in real management settings, unravel the difficulties encountered by such methods, and tailor the methods to better serve the management. Frameworks and new algorithms, such as Probabilistic Collocation Method (PCM)-based approaches, were also proposed for specific management issues. This presentation summarize our past and ongoing studies on the role of UA in real water management. Challenges and potential strategies to bridge the gap between UA for complex models and decision-making for management will be discussed. Future directions for the research in this field will also be suggested. Two common water management settings were examined. One is the Total Maximum Daily Loads (TMDLs) management for surface water quality protection. The other is integrated water resources management for watershed sustainability. For the first setting, nutrients and pesticides TMDLs in the Newport Bay Watershed (Orange Country, California, USA) were discussed. It is a highly urbanized region with a semi-arid Mediterranean climate, typical of the western U.S. For the second setting, the water resources management in the Zhangye Basin (the midstream part of Heihe Baisn, China), where the famous 'Silk Road' came through, was investigated. The Zhangye Basin has a Gobi-oasis system typical of the western China, with extensive agriculture in its oasis.

Bovine pasteurellosis and other bacterial infections of the respiratory tract.

PubMed

Griffin, Dee

2010-03-01

Despite technological, biologic, and pharmacologic advances the bacterial component of the bovine respiratory disease (BRD) complex continues to have a major adverse effect on the health and wellbeing of stocker and feeder cattle. Overlooked in this disappointing assessment is evaluation of the effects that working with younger, lighter-weight cattle have on managing the bacterial component of the BRD complex. Most problems associated with BRD come from cattle taken from and comingled with cattle operations that have inconsistent or nonexistent cattle health management. This article reviews the biologic, clinical, and management aspects of Pasteurella multocida, Mannheimia haemolytica, Histophilus somni, and Mycoplasma bovis, primarily as related to current production management considerations of stocker and feeder cattle. Copyright 2010 Elsevier Inc. All rights reserved.

An evidence-based algorithm for the management of common peroneal nerve injury associated with traumatic knee dislocation

PubMed Central

Samson, Deepak; Ng, Chye Yew; Power, Dominic

2016-01-01

Traumatic knee dislocation is a complex ligamentous injury that may be associated with simultaneous vascular and neurological injury. Although orthopaedic surgeons may consider CPN exploration at the time of ligament reconstruction, there is no standardised approach to the management of this complex and debilitating complication. This review focusses on published evidence of the outcomes of common peroneal nerve (CPN) injuries associated with knee dislocation, and proposes an algorithm for the management. Cite this article: Deepak Samson, Chye Yew Ng, Dominic Power. An evidence-based algorithm for the management of common peroneal nerve injury associated with traumatic knee dislocation. EFORT Open Rev 2016;1:362-367. DOI: 10.1302/2058-5241.160012. PMID:28461914

The BioIntelligence Framework: a new computational platform for biomedical knowledge computing.

PubMed

Farley, Toni; Kiefer, Jeff; Lee, Preston; Von Hoff, Daniel; Trent, Jeffrey M; Colbourn, Charles; Mousses, Spyro

2013-01-01

Breakthroughs in molecular profiling technologies are enabling a new data-intensive approach to biomedical research, with the potential to revolutionize how we study, manage, and treat complex diseases. The next great challenge for clinical applications of these innovations will be to create scalable computational solutions for intelligently linking complex biomedical patient data to clinically actionable knowledge. Traditional database management systems (DBMS) are not well suited to representing complex syntactic and semantic relationships in unstructured biomedical information, introducing barriers to realizing such solutions. We propose a scalable computational framework for addressing this need, which leverages a hypergraph-based data model and query language that may be better suited for representing complex multi-lateral, multi-scalar, and multi-dimensional relationships. We also discuss how this framework can be used to create rapid learning knowledge base systems to intelligently capture and relate complex patient data to biomedical knowledge in order to automate the recovery of clinically actionable information.

Multifaceted Modelling of Complex Business Enterprises

PubMed Central

2015-01-01

We formalise and present a new generic multifaceted complex system approach for modelling complex business enterprises. Our method has a strong focus on integrating the various data types available in an enterprise which represent the diverse perspectives of various stakeholders. We explain the challenges faced and define a novel approach to converting diverse data types into usable Bayesian probability forms. The data types that can be integrated include historic data, survey data, and management planning data, expert knowledge and incomplete data. The structural complexities of the complex system modelling process, based on various decision contexts, are also explained along with a solution. This new application of complex system models as a management tool for decision making is demonstrated using a railway transport case study. The case study demonstrates how the new approach can be utilised to develop a customised decision support model for a specific enterprise. Various decision scenarios are also provided to illustrate the versatility of the decision model at different phases of enterprise operations such as planning and control. PMID:26247591

Multifaceted Modelling of Complex Business Enterprises.

PubMed

Chakraborty, Subrata; Mengersen, Kerrie; Fidge, Colin; Ma, Lin; Lassen, David

2015-01-01

We formalise and present a new generic multifaceted complex system approach for modelling complex business enterprises. Our method has a strong focus on integrating the various data types available in an enterprise which represent the diverse perspectives of various stakeholders. We explain the challenges faced and define a novel approach to converting diverse data types into usable Bayesian probability forms. The data types that can be integrated include historic data, survey data, and management planning data, expert knowledge and incomplete data. The structural complexities of the complex system modelling process, based on various decision contexts, are also explained along with a solution. This new application of complex system models as a management tool for decision making is demonstrated using a railway transport case study. The case study demonstrates how the new approach can be utilised to develop a customised decision support model for a specific enterprise. Various decision scenarios are also provided to illustrate the versatility of the decision model at different phases of enterprise operations such as planning and control.

Intelligent building system for airport

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

Ancevic, M.

1997-11-01

The Munich airport uses a state-of-the-art intelligent building management system to control systems such as HVAC, runway lights, baggage handling, etc. Planning the new Munich II international airport provided a unique opportunity to use the latest state-of-the-art technical systems, while integrating their control through a single intelligent building management system. Opened in 1992, the airport is Germany`s second-largest airport after Frankfurt. The airport is staffed by 16,000 employees and can handle 17 million passengers a year. The sprawling site encompasses more than 120 buildings. The airport`s distributed control system is specifically designed to optimize the complex`s unique range of functions,more » while providing a high degree of comfort, convenience and safety for airport visitors. With the capacity to control 200,000 points, this system controls more than 112,000 points and integrates 13 major subsystems from nine different vendors. It provides convenient, accessible control of everything including the complex`s power plant, HVAC Control, the terminal`s people-moving functions, interior lighting controls, runway lights, baggage forwarding systems, elevators, and boarding bridges. The airport was named 1993 intelligent building of the year by the Intelligent Buildings Institute Foundation. Its building management system is a striking example of the degree to which a building complex`s functions can be integrated for greater operational control and efficiency.« less

A Process Model of Small Business Owner-Managers' Learning in Peer Networks

ERIC Educational Resources Information Center

Zhang, Jing; Hamilton, Eleanor

2009-01-01

Purpose: The purpose of this study is to explore how owner-managers of small businesses can learn in peer networks to improve their management skills. It aims to offer a new way of understanding owner-managers' learning as part of a social process, by highlighting the complex, interactive relationship that exists between the owner-manager, his or…

How Does a Project Manager's Level of Development Influence Conceptualizations of Project Management and the Project Development Environment?

ERIC Educational Resources Information Center

Lynch, Margaret M.

2013-01-01

This study explores the meaning project managers (PMs) make of their project environment, how they lead their teams and have incorporate complexity into their project management approach. The exploration of the PM's developmental level and meaning making offers a different angle on the project management and leadership literature. The study…

An approach to improve management visibility within the procurement and financial group at Goldstone

NASA Technical Reports Server (NTRS)

Maiocco, F. R.; Rozek, J. B.

1976-01-01

Improvements in the operational efficiency of the data management systems at the Goldstone Deep Space Communications Complex (GDSCC) are discussed. This addresses the existing procurement and financial management data system at GDSCC, identifies management requirements for better visibility, describes a proposed computerized data management system, summarizes results to data, and identifies plans for future development.

Management of Corporate Culture through Local Managers' Training in Foreign Companies in China: A Qualitative Analysis

ERIC Educational Resources Information Center

Zhao, Crystal L.

2005-01-01

Corporate culture is a complex phenomenon in foreign companies located in the People's Republic of China. For the management team of an international enterprise, it is a challenging task to manage cultural differences. Education and training provided to local managers might be one of the important solutions. Therefore, this study explores the…

25 CFR 1200.16 - What criteria will be used in evaluating the management plan?

Code of Federal Regulations, 2014 CFR

2014-04-01

... evaluate the individuals or entities that will manage the funds to be withdrawn, or that will advise the... experience to manage the funds. Among the elements we will evaluate are: the number of years in business, the... complexity of the proposed management plan to determine whether the tribe has the experience to manage its...

25 CFR 1200.16 - What criteria will be used in evaluating the management plan?

Code of Federal Regulations, 2012 CFR

2012-04-01

... evaluate the individuals or entities that will manage the funds to be withdrawn, or that will advise the... experience to manage the funds. Among the elements we will evaluate are: the number of years in business, the... complexity of the proposed management plan to determine whether the tribe has the experience to manage its...

25 CFR 1200.16 - What criteria will be used in evaluating the management plan?

Code of Federal Regulations, 2013 CFR

2013-04-01

... evaluate the individuals or entities that will manage the funds to be withdrawn, or that will advise the... experience to manage the funds. Among the elements we will evaluate are: the number of years in business, the... complexity of the proposed management plan to determine whether the tribe has the experience to manage its...

Decision making in a human population living sustainably.

PubMed

Hicks, John S; Burgman, Mark A; Marewski, Julian N; Fidler, Fiona; Gigerenzer, Gerd

2012-10-01

The Tiwi people of northern Australia have managed natural resources continuously for 6000-8000 years. Tiwi management objectives and outcomes may reflect how they gather information about the environment. We qualitatively analyzed Tiwi documents and management techniques to examine the relation between the social and physical environment of decision makers and their decision-making strategies. We hypothesized that principles of bounded rationality, namely, the use of efficient rules to navigate complex decision problems, explain how Tiwi managers use simple decision strategies (i.e., heuristics) to make robust decisions. Tiwi natural resource managers reduced complexity in decision making through a process that gathers incomplete and uncertain information to quickly guide decisions toward effective outcomes. They used management feedback to validate decisions through an information loop that resulted in long-term sustainability of environmental use. We examined the Tiwi decision-making processes relative to management of barramundi (Lates calcarifer) fisheries and contrasted their management with the state government's management of barramundi. Decisions that enhanced the status of individual people and their attainment of aspiration levels resulted in reliable resource availability for Tiwi consumers. Different decision processes adopted by the state for management of barramundi may not secure similarly sustainable outcomes. ©2012 Society for Conservation Biology.

Exploring managers' views on span of control: more than a headcount.

PubMed

Wong, Carol A; Elliott-Miller, Pat; Laschinger, Heather; Cuddihy, Michael; Meyer, Raquel M; Keatings, Margaret; Burnett, Camille; Szudy, Natalie

2014-03-01

The purpose of this qualitative study was to explore front-line managers' (FLMs') perceptions of their span of control (SOC) and how they manage it. As part of a larger quantitative study examining relationships between FLMs' SOC and performance outcomes, 10 manager focus groups were conducted by teleconference, involving 48 managers from 14 academic healthcare organizations. Themes and subthemes were identified according to (a) perceptions of the size and scope of SOC; (b) factors influencing the complexity of SOC; (c) supports needed to manage SOC; (d) changing leadership style; and (e) ways of coping with role overload. Participants described system demands as a significant contributor to their work responsibilities and a sense of role overload. About half of managers stated their SOC was unreasonable and that they lacked the necessary supports to manage it. Many managers who described their SOC as reasonable still expressed concerns about internal and external workload pressures that contributed to changing leadership style and role overload. Findings reinforce the importance of organizational strategies to create regular dialogue with FLMs regarding the size, complexity and appropriateness of current spans and to provide the resource supports necessary to ensure they can manage their SOC effectively.

The science of decisionmaking: applications for sustainable forest and grassland management in the National Forest System

Treesearch

Matthew P. Thompson; Bruce G. Marcot; Frank R. Thompson; Steven McNulty; Larry A. Fisher; Michael C. Runge; David Cleaves; Monica Tomosy

2013-01-01

Sustainable management of national forests and grasslands within the National Forest System (NFS) often requires managers to make tough decisions under considerable uncertainty, complexity, and potential conflict. Resource decisionmakers must weigh a variety of risks, stressors, and challenges to sustainable management, including climate change, wildland fire, invasive...

Inventory-based landscape-scale simulation of management effectiveness and economic feasibility with BioSum

Treesearch

Jeremy S. Fried; Larry D. Potts; Sara M. Loreno; Glenn A. Christensen; R. Jamie Barbour

2017-01-01

The Forest Inventory and Analysis (FIA)-based BioSum (Bioregional Inventory Originated Simulation Under Management) is a free policy analysis framework and workflow management software solution. It addresses complex management questions concerning forest health and vulnerability for large, multimillion acre, multiowner landscapes using FIA plot data as the initial...

76 FR 18505 - Fisheries of the Northeastern United States; Northeast Skate Complex Fishery; Framework Adjustment 1

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-04

... alternatives for each of three principal management measures: (1) The primary possession limit affecting the... Management Plan (Skate FMP). Framework Adjustment 1 was developed by the New England Fishery Management... (IRFA), are available on request from Paul J. Howard, Executive Director, New England Fishery Management...

Detecting the fingerprints of complex land management practices in a tallgrass prairie site using phenocam and satellite images, and the eddy covariance technique

USDA-ARS?s Scientific Manuscript database

Burning, grazing, and baling (hay harvesting) are common management practices for tallgrass prairie. However, the impacts of these management practices on grassland phenology and carbon uptake are not well understood. Utilizing multiple observations to detect fingerprints of various management pract...

Best Practices for Real Property Management

DTIC Science & Technology

2016-04-21

organizations and are experienced in creating reliable and actionable solutions to complex management issues guided by proven best business practices...DEFENSE BUSINESS BOARD For the Secretary of Defense Best Practices for Real Property Management DBB...FY16-02 Recommendations on the best practices for management of Department of Defense real property assets Defense Business

Risk preferences, probability weighting, and strategy tradeoffs in wildfire management

Treesearch

Michael S. Hand; Matthew J. Wibbenmeyer; Dave Calkin; Matthew P. Thompson

2015-01-01

Wildfires present a complex applied risk management environment, but relatively little attention has been paid to behavioral and cognitive responses to risk among public agency wildfire managers. This study investigates responses to risk, including probability weighting and risk aversion, in a wildfire management context using a survey-based experiment administered to...

Forest management for mitigation and adaptation: insights from long-term silvicultural experiments

Treesearch

Anthony W. D' Amato; John B. Bradford; Shawn Fraver; Brian J. Palik

2011-01-01

Developing management strategies for addressing global climate change has become an increasingly important issue influencing forest management around the globe. Currently, management approaches are being proposed that intend to (1) mitigate climate change by enhancing forest carbon stores and (2) foster adaptation by maintaining compositionally and structurally complex...

Scope Complexity Options Risks Excursions (SCORE) Version 3.0 Mathematical Description.

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

Gearhart, Jared Lee; Samberson, Jonell Nicole; Shettigar, Subhasini

The purpose of the Scope, Complexity, Options, Risks, Excursions (SCORE) model is to estimate the relative complexity of design variants of future warhead options. The results of this model allow those considering these options to understand the complexity tradeoffs between proposed warhead options. The core idea of SCORE is to divide a warhead option into a well- defined set of scope elements and then estimate the complexity of each scope element against a well understood reference system. The uncertainty associated with estimates can also be captured. A weighted summation of the relative complexity of each scope element is used tomore » determine the total complexity of the proposed warhead option or portions of the warhead option (i.e., a National Work Breakdown Structure code). The SCORE analysis process is a growing multi-organizational Nuclear Security Enterprise (NSE) effort, under the management of the NA- 12 led Enterprise Modeling and Analysis Consortium (EMAC), that has provided the data elicitation, integration and computation needed to support the out-year Life Extension Program (LEP) cost estimates included in the Stockpile Stewardship Management Plan (SSMP).« less

Cellular Decomposition Based Hybrid-Hierarchical Control Systems with Applications to Flight Management Systems

NASA Technical Reports Server (NTRS)

Caines, P. E.

1999-01-01

The work in this research project has been focused on the construction of a hierarchical hybrid control theory which is applicable to flight management systems. The motivation and underlying philosophical position for this work has been that the scale, inherent complexity and the large number of agents (aircraft) involved in an air traffic system imply that a hierarchical modelling and control methodology is required for its management and real time control. In the current work the complex discrete or continuous state space of a system with a small number of agents is aggregated in such a way that discrete (finite state machine or supervisory automaton) controlled dynamics are abstracted from the system's behaviour. High level control may then be either directly applied at this abstracted level, or, if this is in itself of significant complexity, further layers of abstractions may be created to produce a system with an acceptable degree of complexity at each level. By the nature of this construction, high level commands are necessarily realizable at lower levels in the system.

Airway management through submental derivation: a safe and easily reproduced alternative for patients with complex facial trauma

PubMed Central

2018-01-01

Objectives Airway management in patients with panfacial trauma is complicated. In addition to involving facial lesions, such trauma compromises the airway, and the use of intermaxillary fixation makes it difficult to secure ventilation by usual approaches (nasotracheal or endotracheal intubation). Submental airway derivation is an alternative to tracheostomy and nasotracheal intubation, allowing a permeable airway with minimal complications in complex patients. Materials and Methods This is a descriptive, retrospective study based on a review of medical records of all patients with facial trauma from January 2003 to May 2015. In total, 31 patients with complex factures requiring submental airway derivation were included. No complications such as bleeding, infection, vascular, glandular, or nervous lesions were presented in any of the patients. Results The use of submental airway derivation is a simple, safe, and easy method to ensure airway management. Moreover, it allows an easier reconstruction. Conclusion Based on these results, we concluded that, if the relevant steps are followed, the use of submental intubation in the treatment of patients with complex facial trauma is a safe and effective option. PMID:29535964

Attributes of advanced practice registered nurse care coordination for children with medical complexity.

PubMed

Cady, Rhonda G; Kelly, Anne M; Finkelstein, Stanley M; Looman, Wendy S; Garwick, Ann W

2014-01-01

Care coordination is an essential component of the pediatric health care home. This study investigated the attributes of relationship-based advanced practice registered nurse care coordination for children with medical complexity enrolled in a tertiary hospital-based health care home. Retrospective review of 2,628 care coordination episodes conducted by telehealth over a consecutive 3-year time period for 27 children indicated that parents initiated the majority of episodes and the most frequent reason was acute and chronic condition management. During this period, care coordination episodes tripled, with a significant increase (p < .001) between years 1 and 2. The increased episodes could explain previously reported reductions in hospitalizations for this group of children. Descriptive analysis of a program-specific survey showed that parents valued having a single place to call and assistance in managing their child's complex needs. The advanced practice registered nurse care coordination model has potential for changing the health management processes for children with medical complexity. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

Clotrimazole-cyclodextrin based approach for the management and treatment of Candidiasis - A formulation and chemistry-based evaluation.

PubMed

Mohammed, Noorullah Naqvi; Pandey, Pankaj; Khan, Nayaab S; Elokely, Khaled M; Liu, Haining; Doerksen, Robert J; Repka, Michael A

2016-08-01

Clotrimazole (CT) is a poorly soluble antifungal drug that is most commonly employed as a topical treatment in the management of vaginal candidiasis. The present work focuses on a formulation approach to enhance the solubility of CT using cyclodextrin (CD) complexation. A CT-CD complex was prepared by a co-precipitation method. Various characterization techniques such as differential scanning calorimetry, infrared (IR) and X-ray spectroscopy, scanning electron microscopy and nuclear magnetic resonance (NMR) spectroscopy were performed to evaluate the complex formation and to understand the interactions between CT and CD. Computational molecular modeling was performed using the Schrödinger suite and Gaussian 09 program to understand structural conformations of the complex. The phase solubility curve followed an AL-type curve, indicating formation of a 1:1 complex. Molecular docking studies supported the data obtained through NMR and IR studies. Enthalpy changes confirmed that complexation was an exothermic and enthalpically favorable phenomenon. The CT-CD complexes were formulated in a gel and evaluated for release and antifungal activity. The in vitro release studies performed using gels demonstrated a sustained release of CT from the CT-CD complex with the complex exhibiting improved release relative to the un-complexed CT. Complexed CT-CD exhibited better fungistatic activity toward different Candida species than un-complexed CT.

Adaptive management: a paradigm for remediation of public facilities

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

Janecky, David R; Whicker, Jeffrey J; Doerr, Ted B

2009-01-01

Public facility restoration planning traditionally focused on response to natural disasters and hazardous materials accidental releases. These plans now need to integrate response to terrorist actions. Therefore, plans must address a wide range of potential vulnerabilities. Similar types of broad remediation planning are needed for restoration of waste and hazardous material handling areas and facilities. There are strong similarities in damage results and remediation activities between unintentional and terrorist actions; however, the uncertainties associated with terrorist actions result in a re-evaluation of approaches to planning. Restoration of public facilities following a release of a hazardous material is inherently far moremore » complex than in confined industrial settings and has many unique technical, economic, social, and political challenges. Therefore, they arguably involve a superset of drivers, concerns and public agencies compared to other restoration efforts. This superset of conditions increases complexity of interactions, reduces our knowledge of the initial conditions, and even condenses the timeline for restoration response. Therefore, evaluations of alternative restoration management approaches developed for responding to terrorist actions provide useful knowledge for large, complex waste management projects. Whereas present planning documents have substantial linearity in their organization, the 'adaptive management' paradigm provides a constructive parallel operations paradigm for restoration of facilities that anticipates and plans for uncertainty, multiple/simUltaneous public agency actions, and stakeholder participation. Adaptive management grew out of the need to manage and restore natural resources in highly complex and changing environments with limited knowledge about causal relationships and responses to restoration actions. Similarities between natural resource management and restoration of a facility and surrounding area(s) after a disruptive event suggest numerous advantages over preset linearly-structured plans by incorporating the flexibility and overlap of processes inherent in effective facility restoration. We discuss three restoration case studies (e.g., the Hart Senate Office Building anthrax restoration, Rocky Flats actinide remediation, and hurricane destruction restoration), that implement aspects of adaptive management but not a formal approach. We propose that more formal adoption of adaptive management principles could be a basis for more flexible standards to improve site-specific remediation plans under conditions of high uncertainty.« less

Complex Systems Simulation and Optimization | Computational Science | NREL

Science.gov Websites

account. Stochastic Optimization and Control: Formulation and implementation of advanced optimization and account uncertainty. Contact Wesley Jones Group Manager, Complex Systems Simulation and Optimiziation

Climate change, carbon, and forestry in northwestern North America: proceedings of a workshop November 14-15, 2001 Orcas Island, Washington.

Treesearch

David L. Peterson; John L. Innes; Kelly O’Brian

2004-01-01

Interactions between forests, climatic change and the Earth’s carbon cycle are complex and represent a challenge for forest managers – they are integral to the sustainable management of forests. In this volume, a number of papers are presented that describe some of the complex relationships between climate, the global carbon cycle and forests. Research has demonstrated...

Some aspects on kinetic modeling of evacuation dynamics. Comment on "Human behaviours in evacuation crowd dynamics: From modelling to "big data" toward crisis management" by Nicola Bellomo et al.

NASA Astrophysics Data System (ADS)

Calvo, Juan; Nieto, Juanjo

2016-09-01

The management of human crowds in extreme situations is a complex subject which requires to take into account a variety of factors. To name a few, the understanding of human behaviour, the psychological and behavioural features of individuals, the quality of the venue and the stress level of the pedestrian need to be addressed in order to select the most appropriate action during an evacuation process on a complex venue. In this sense, the mathematical modeling of such complex phenomena can be regarded as a very useful tool to understand and predict these situations. As presented in [4], mathematical models can provide guidance to the personnel in charge of managing evacuation processes, by means of helping to design a set of protocols, among which the most appropriate during a given critical situation is then chosen.

Managing complexity in simulations of land surface and near-surface processes

DOE PAGES

Coon, Ethan T.; Moulton, J. David; Painter, Scott L.

2016-01-12

Increasing computing power and the growing role of simulation in Earth systems science have led to an increase in the number and complexity of processes in modern simulators. We present a multiphysics framework that specifies interfaces for coupled processes and automates weak and strong coupling strategies to manage this complexity. Process management is enabled by viewing the system of equations as a tree, where individual equations are associated with leaf nodes and coupling strategies with internal nodes. A dynamically generated dependency graph connects a variable to its dependencies, streamlining and automating model evaluation, easing model development, and ensuring models aremore » modular and flexible. Additionally, the dependency graph is used to ensure that data requirements are consistent between all processes in a given simulation. Here we discuss the design and implementation of these concepts within the Arcos framework, and demonstrate their use for verification testing and hypothesis evaluation in numerical experiments.« less

Coastal resource complexes of South India: options for sustainable management.

PubMed

Damodaran, A

2006-04-01

India's coastal resource complexes were traditionally characterized by a continuum of 'common property resources' or 'commons' that stretched from the shores to the seas. The continuum aided the existence of sustainable livelihood systems for local communities. Today, fragmented policy approaches and economic welfare schemes have caused the disintegration of community control over the continuum. As a consequence, livelihood systems of local communities have declined. The introduction of coastal management guidelines in the 1990s has exacerbated the situation. With reference to a coastal village located in the State of Kerala in South West India, the paper describes the trajectory of unsustainable change that has taken place in the coastal area resource complexes of the country. The paper argues for restoring the continuum of commons in the study area through community driven systems of natural resource management that are based on networks of nested institutions.

Paradigms of Canadian nurse managers: lenses for viewing leadership and management.

PubMed

King, T

2000-01-01

To an extent unprecedented in history, healthcare is a complex and human enterprise. Generating the complexity are stakeholders with more diverse perspectives, needs, and agendas, and greater knowledge and vested interest than ever before. Given their pivotal position between the direct-care environment and external stakeholders, nurse managers can no longer rely on the hierarchy, authority, and linear thinking afforded by traditional management; in order to accomplish they must lead people by working through them. Ironically, when needed most, there is a lack of consensus in the literature about what leadership is. In this paper I describe the paradigms for leadership and management held by six Canadian nurse managers who participated in a phenomenological study of leadership. Thinking leaders worked through people to enhance their growth, potential, and accomplishment, participants did so by creating and sustaining inclusive environments, influencing people, and acting in a manner that reflected and supported integrity. Participants thought managers did not focus on people; instead, they carried out routine, procedure-driven tasks to run departmental business. Included in this paper are suggestions about how participants' paradigms might benefit the nursing profession, consumers of care, and healthcare organizations. Although organizations are markedly interested in the development of managers and leaders as decision makers behind accomplishment (Beyers, 1991), managed or pushed organizations will fall behind those that are "led and stretched" (Batten, 1989, p. 3). According to Bennis and Nanus (1985), whereas managers are concerned about efficiency as it relates to set routines, leaders try to be effective by doing what is right. These authors also posited that although management alone may have sufficed in our more predictable past, today's intricate world is not well served by management's linear thinking; its lack of attention to people's diversity; and its dangerous assumptions that problems, goals, alternatives, and consequences are always clear, known, and/or certain, and that necessary information is always on hand and reliable. Perhaps to an extent unprecedented in history healthcare is a human enterprise. Within its dynamic context myriad stakeholders with increasingly diverse perspectives, needs, and agendas, and growing levels of knowledge and vested interest, are involved in unpredictable and uniquely complex situations with uncertain outcomes. These factors orchestrate the intangible mist that healthcare organizations must contend with today. These factors also render traditional how-to manuals obsolete and suggest, instead, that contemporary decision makers in healthcare must be leaders who are comfortable with ambiguity, deftly sensitive and responsive to complexity, and continually looking for ways to work with people to enhance organizational success. Ironically, when we need it most, leadership retains its enigmatic and complex nature (Beyers, 1991); perhaps that is why management is the prevalent practice in organizations (Bennis & Nanus, 1985). Results of one project identified insufficient nursing leadership as a major cause of dissatisfaction among registered nurses (Registered Nurses Association of British Columbia (RNABC), 1989). Hence, our need to grapple with the elusive nature of leadership. In this paper I share the paradigms for leadership and management held by six Canadian nurse managers, and suggest how their paradigms might benefit the nursing profession, and healthcare consumers and organizations.

Complexity and valued landscapes

Treesearch

Michael M. McCarthy

1979-01-01

The variable "complexity," or "diversity," has received a great deal of attention in recent research efforts concerned with visual resource management, including the identification of complexity as one of the primary evaluation measures. This paper describes research efforts that support the hypothesis that the landscapes we value are those with...

RAFCON: A Graphical Tool for Engineering Complex, Robotic Tasks

DTIC Science & Technology

2016-10-09

Robotic tasks are becoming increasingly complex, and with this also the robotic systems. This requires new tools to manage this complexity and to...execution of robotic tasks, called RAFCON. These tasks are described in hierarchical state machines supporting concurrency. A formal notation of this concept

Managing Complexity in the MSL/Curiosity Entry, Descent, and Landing Flight Software and Avionics Verification and Validation Campaign

NASA Technical Reports Server (NTRS)

Stehura, Aaron; Rozek, Matthew

2013-01-01

The complexity of the Mars Science Laboratory (MSL) mission presented the Entry, Descent, and Landing systems engineering team with many challenges in its Verification and Validation (V&V) campaign. This paper describes some of the logistical hurdles related to managing a complex set of requirements, test venues, test objectives, and analysis products in the implementation of a specific portion of the overall V&V program to test the interaction of flight software with the MSL avionics suite. Application-specific solutions to these problems are presented herein, which can be generalized to other space missions and to similar formidable systems engineering problems.

Challenges of Developing New Classes of NASA Self-Managing Mission

NASA Technical Reports Server (NTRS)

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

2005-01-01

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

Management of complex glottic stenosis in children with recurrent respiratory papillomatosis.

PubMed

Siegel, Bianca; Smith, Lee P

2013-10-01

To describe our management of complex glottic stenosis in tracheotomy dependent children with severe recurrent respiratory papillomatosis. Retrospective chart review at a tertiary care children's hospital. Three children with complex glottic stenosis secondary to severe recurrent respiratory papillomatosis were treated at our institution since 2011. Two patients had complete stenosis, and the third had near-complete stenosis. Two patients were managed using balloon dilation alone, and the third also underwent laryngotracheal reconstruction with posterior costal cartilage grafting. Two patients have been successfully decannulated and the third has been tolerating continuous tracheotomy capping for greater than twelve months. All three patients underwent aggressive debridement of papillomatosis and balloon dilation every 4-6 weeks until their burden of disease was controlled. In two patients, the glottic airway was patent, and the third continued to have complete restenosis between procedures and required laryngotracheoplasty with multiple post-operative dilation procedures to establish an adequate glottic airway. Severe laryngeal stenosis is a well-described complication of recurrent respiratory papillomatosis, but its management is not well-defined. Aggressive management of papillomatosis with frequent debridement is critical in successfully managing laryngeal stenosis. Balloon dilation alone may be surprisingly effective in these patients, and laryngotracheoplasty can be used as an adjunct procedure in those patients who fail balloon dilation. Given the quality of life issues and concerns regarding distal spread of disease with tracheotomies in these patients, we feel that aggressive management and early decannulation is in the patient's best interest. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Management of metastatic retroperitoneal sarcoma: a consensus approach from the Trans-Atlantic Retroperitoneal Sarcoma Working Group (TARPSWG).

PubMed

2018-04-01

Retroperitoneal sarcoma (RPS) is a rare disease accounting for 0.1%-0.2% of all malignancies. Management of RPS is complex and requires multidisciplinary, tailored treatment strategies at all stages, but especially in the context of metastatic or multifocal recurrent disease. Due to the rarity and heterogeneity of this family of diseases, the literature to guide management is limited. The Trans-Atlantic Retroperitoneal Sarcoma Working Group (TARPSWG) is an international collaboration of sarcoma experts from all disciplines convened in an effort to overcome these limitations. The TARPSWG has compiled the available evidence surrounding metastatic and multifocally recurrent RPS along with expert opinion in an iterative process to generate a consensus document regarding the complex management of this disease. The objective of this document is to guide sarcoma specialists from all disciplines in the diagnosis and treatment of multifocal recurrent or metastatic RPS. All aspects of patient assessment, diagnostic processes, local and systemic treatments, and palliation are reviewed in this document, and consensus recommendations provided accordingly. Recommendations were guided by available evidence, in conjunction with expert opinion where evidence was lacking. This consensus document combines the available literature regarding the management of multifocally recurrent or metastastic RPS with the practical expertise of high-volume sarcoma centers from multiple countries. It is designed as a tool for decision making in the complex multidisciplinary management of this condition and is expected to standardize management across centers, thereby ensuring that patients receive the highest quality care.

Experience and management of chronic pain among patients with other complex chronic conditions.

PubMed

Butchart, Amy; Kerr, Eve A; Heisler, Michele; Piette, John D; Krein, Sarah L

2009-05-01

Managing multiple chronic health conditions is a significant challenge. The purpose of this study was to examine the experience and management of chronic pain among adult patients with other complex chronic conditions, specifically diabetes and heart failure (HF). We surveyed 624 US Department of Veterans Affairs primary care patients in 3 study groups: 184 with HF, 221 with diabetes, and 219 general primary care users. We compared health status and function between those with and without chronic pain within the 3 study groups. Among those with chronic pain, we compared pain location, severity, and treatment across groups. More than 60% in each group reported chronic pain, with the majority reporting pain in the back, hip, or knee. In all groups, patients with chronic pain were more likely to report fair or poor health than those without pain (P<0.05). In the HF and diabetes groups, a higher percentage of patients with pain were not working because of health reasons. Of those with pain, more than 70% in each group took medications for pain; more than one-half managed pain with rest or sedentary activities; and less than 50% used exercise for managing their pain. Chronic pain is a prevalent problem that is associated with poor functioning among multimorbid patients. Better management of chronic pain among complex patients could lead to significant improvements in health status, functioning, and quality of life and possibly also improve the management of their other major chronic health conditions.

Beyond the short term : transportation asset management for long-term sustainability, accountability and performance

DOT National Transportation Integrated Search

2010-01-01

Transportation Asset Management (TAM) has long been recognized as a sound, long-term approach to managing infrastructure. It provides decision makers with a rational, long-term systematic process for making difficult and complex decisions about how t...

Benefits and challenges of using LCA to advance sustainable wasteand materials management

EPA Science Inventory

MSW management can be complex and involve many unit processes that can vary based on needs of urban, rural, and suburbia to safely manage waste and to optimize energy and resource recovery while considering local infrastructure and priorities.

Designing a complex intervention for dementia case management in primary care

PubMed Central

2013-01-01

Background Community-based support will become increasingly important for people with dementia, but currently services are fragmented and the quality of care is variable. Case management is a popular approach to care co-ordination, but evidence to date on its effectiveness in dementia has been equivocal. Case management interventions need to be designed to overcome obstacles to care co-ordination and maximise benefit. A successful case management methodology was adapted from the United States (US) version for use in English primary care, with a view to a definitive trial. Medical Research Council guidance on the development of complex interventions was implemented in the adaptation process, to capture the skill sets, person characteristics and learning needs of primary care based case managers. Methods Co-design of the case manager role in a single NHS provider organisation, with external peer review by professionals and carers, in an iterative technology development process. Results The generic skills and personal attributes were described for practice nurses taking up the case manager role in their workplaces, and for social workers seconded to general practice teams, together with a method of assessing their learning needs. A manual of information material for people with dementia and their family carers was also created using the US intervention as its source. Conclusions Co-design produces rich products that have face validity and map onto the complexities of dementia and of health and care services. The feasibility of the case manager role, as described and defined by this process, needs evaluation in ‘real life’ settings. PMID:23865537

Human resource management practices in a medical complex in the Eastern Cape, South Africa: assessing their impact on the retention of doctors.

PubMed

Longmore, Bruce; Ronnie, Linda

2014-03-26

Human resource management (HRM) practices have the potential to influence the retention of doctors in the public health sector. To explore the key human resource (HR) practices affecting doctors in a medical complex in the Eastern Cape, South Africa. We used an open-ended questionnaire to gather data from 75 doctors in this setting. The most important HR practices were paying salaries on time and accurately, the management of documentation, communication, HR staff showing that they respected and valued the doctors, and reimbursement for conferences and special leave requests. All these practices were judged to be poorly administered. Essential HR characteristics were ranked in the following order: task competence of HR staff, accountability, general HR efficiency, occupation-specific dispensation adjustments and performance management and development system efficiency, and availability of HR staff. All these characteristics were judged to be poor. HRM practices in this Eastern Cape medical complex were inadequate and a source of frustration. This lack of efficiency could lead to further problems with regard to retaining doctors in public sector service.

Facilitating the Evaluation of Complexity in the Public Sector: Learning from the NHS in Scotland

ERIC Educational Resources Information Center

Connolly, John; Reid, Garth; Mooney, Allan

2015-01-01

It is necessary for public managers to be able to evaluate programmes in the context of complexity. This article offers key learning and reflections based on the experience of facilitating the evaluation of complexity with a range of public sector partners in Scotland. There have been several articles that consider evaluating complexity and…

Change management in an environment of ongoing primary health care system reform: A case study of Australian primary health care services.

PubMed

Javanparast, Sara; Maddern, Janny; Baum, Fran; Freeman, Toby; Lawless, Angela; Labonté, Ronald; Sanders, David

2018-01-01

Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers. As part of a 5-year project, we interviewed PHC practitioners and managers of services in 7 Australian PHC services. Our findings revealed a policy shift away from the principles of comprehensive PHC including health promotion and action on social determinants of health to one-to-one disease management during the course of study. Analysis of the process of change shows that overall, rapid, and top-down radical reforms of policies and directions were the main characteristic of changes with minimal communication with practitioners and service managers. The study showed that services with community-controlled model of governance had more autonomy to use an emergent model of change and to maintain their comprehensive PHC services. Change is an inevitable feature of PHC systems continually trying to respond to health care demand and cost pressures. The implementation of change in complex settings such as PHC requires appropriate change management strategies to ensure that the proposed reforms are understood, accepted, and implemented successfully. Copyright © 2017 John Wiley & Sons, Ltd.

[Refusal of care faced by case manager from elderly persons in complex situation: cross perspectives].

PubMed

Corvol, A; Balard, F; Moutel, G; Somme, D

2014-01-01

Case management is a new professional field in France. It is addressed to elderly persons living in community whose situation is regarded as particularly complex. Case managers have to assess needs and coordinate necessary services. One common criteria of complexity is refusal of care. The objective of this study is to compare the words of users with those of case managers about refusal of care, in order to understand its meaning, professionals' attitudes and ethical challenges. Two researchers have cooperated on this qualitative research: the first one, anthropologist, interviewed 19 individuals, and 11 of their caregivers. The second one, geriatrician and researcher in medical ethics, lead four focus groups gathering a total of 18 case managers. Refusal of care often is the result of the will of preserving one's identity, compromised by illness. Individuals seek control on their life. Facing this behaviour, case managers try to secure the individual, by establishing a personal relationship that respects their choices, even if care has to be delayed. Refusal of care may sometimes disclose a desire to vanish, in front of which professionals meet their own limits. To recognise an elderly person that refuses care as a unique individual who can make choices secure his identity, and allow him to change. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

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

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

Diduck, A.

1999-10-01

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

Competencies for the new postdoctoral Oral Medicine graduate in the United States.

PubMed

Whitney, Eli M; Stoopler, Eric; Brennan, Michael T; DeRossi, Scott S; Treister, Nathaniel S

2015-09-01

Oral Medicine is primarily a nonsurgical dental discipline that includes management of (1) oral mucosal and salivary gland diseases; (2) temporomandibular disorders and orofacial pain; (3) oral complications of systemic disease; and (4) dental management of medically complex patients within its scope of practice. In the United States, the American Academy of Oral Medicine (AAOM) is the professional organization that primarily supports Oral Medicine education, research, and patient care. This document informs the knowledge, skills, and behaviors of beginning Oral Medicine graduates in the United States in three domains: Diagnosis and primarily nonsurgical management of oral mucosal and salivary gland disorders. Diagnosis and primarily nonsurgical management of temporomandibular, orofacial pain, and neurosensory disorders. Management of the medically complex patient. Each domain is subsequently expanded with major competencies and supporting competencies. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Editorial [Special issue on software defined networks and infrastructures, network function virtualisation, autonomous systems and network management

DOE PAGES

Biswas, Amitava; Liu, Chen; Monga, Inder; ...

2016-01-01

For last few years, there has been a tremendous growth in data traffic due to high adoption rate of mobile devices and cloud computing. Internet of things (IoT) will stimulate even further growth. This is increasing scale and complexity of telecom/internet service provider (SP) and enterprise data centre (DC) compute and network infrastructures. As a result, managing these large network-compute converged infrastructures is becoming complex and cumbersome. To cope up, network and DC operators are trying to automate network and system operations, administrations and management (OAM) functions. OAM includes all non-functional mechanisms which keep the network running.

Fixed orthodontic appliances in the management of severe dental trauma in mixed dentition: a case report.

PubMed

Ebrahim, Fouad-Hassan; Kulkarni, Gajanan

2013-01-01

We describe a case of complex trauma to the early mixed dentition in which tooth avulsion, intrusion, extrusion and lateral luxation were managed effectively using a fixed, non-rigid orthodontic splint after treatment with a traditional wire-composite splint had failed. The use of orthodontic brackets and flexible wires provided several advantages, such as the ability to splint severely malpositioned teeth; easy assessment without removing the splint; slow, gentle repositioning of traumatized teeth; and gradual reestablishment of the arch form allowing for ease of future prosthodontic rehabilitation. Therefore, orthodontic appliances should be considered as a viable option for managing complex dental trauma.

An emerging crisis across northern prairie refuges: Prevalence of invasive plants and a plan for adaptive management

USGS Publications Warehouse

Grant, T.A.; Flanders-Wanner, B.; Shaffer, T.L.; Murphy, R.K.; Knutsen, G.A.

2009-01-01

In the northern Great Plains, native prairies managed by the U.S. Fish and Wildlife Service (Service) can be pivotal in conservation of North America's biological diversity. From 2002 to 2006, we surveyed 7,338 belt transects to assess the general composition of mixed-grass and tallgrass prairie vegetation across five "complexes" (i.e., administrative groupings) of national wildlife refuges managed by the Service in North Dakota and South Dakota. Native grasses and forbs were common (mean frequency of occurrence 47%-54%) on two complexes but uncommon (4%-13%) on two others. Conversely, an introduced species of grass, smooth brome (Bromus inermis), accounted for 45% to 49% of vegetation on two complexes and another species, Kentucky bluegrass (Poa pratensis) accounted for 27% to 36% of the vegetation on three of the complexes. Our data confirm prior suspicions of widespread invasion by introduced species of plants on Service-owned tracts of native prairie, changes that likely stem in part from a common management history of little or no disturbance (e.g., defoliation by grazing or fire). However, variability in the degree and type of invasion among prairie tracts suggests that knowledge of underlying causes (e.g., edaphic or climatic factors, management histories) could help managers more effectively restore prairies. We describe an adaptive management approach to acquire such knowledge while progressing with restoration. More specifically, we propose to use data from inventories of plant communities on Service-owned prairies to design and implement, as experiments, optimal restoration strategies. We will then monitor these experiments and use the results to refine future strategies. This comprehensive, process-oriented approach should yield reliable and robust recommendations for restoration and maintenance of native prairies in the northern Great Plains. 2009 by the Board of Regents of the University of Wisconsin System.

12 CFR 250.412 - Interlocking relationships between member bank and insurance company-mutual fund complex.

Code of Federal Regulations, 2014 CFR

2014-01-01

... and insurance company-mutual fund complex. 250.412 Section 250.412 Banks and Banking FEDERAL RESERVE... between member bank and insurance company-mutual fund complex. (a) The Board has been asked whether... fund's incorporated investment manager-advisor, (3) the insurance company sponsoring and apparently...

12 CFR 250.412 - Interlocking relationships between member bank and insurance company-mutual fund complex.

Code of Federal Regulations, 2013 CFR

2013-01-01

... and insurance company-mutual fund complex. 250.412 Section 250.412 Banks and Banking FEDERAL RESERVE... between member bank and insurance company-mutual fund complex. (a) The Board has been asked whether... fund's incorporated investment manager-advisor, (3) the insurance company sponsoring and apparently...

12 CFR 250.412 - Interlocking relationships between member bank and insurance company-mutual fund complex.

Code of Federal Regulations, 2012 CFR

2012-01-01

... and insurance company-mutual fund complex. 250.412 Section 250.412 Banks and Banking FEDERAL RESERVE... between member bank and insurance company-mutual fund complex. (a) The Board has been asked whether... fund's incorporated investment manager-advisor, (3) the insurance company sponsoring and apparently...

Leading and Managing in Complexity: The Case of South African Deans

ERIC Educational Resources Information Center

Seale, Oliver; Cross, Michael

2016-01-01

In recent years, deanship in universities has become more complex and challenging. Deans in South African universities take up their positions without appropriate training and prior executive experience, and with no clear understanding of the ambiguity and complexity of their roles. This paper calls for appropriate leadership development…

Mobilising Knowledge in Complex Health Systems: A Call to Action

ERIC Educational Resources Information Center

Holmes, Bev J.; Best, Allan; Davies, Huw; Hunter, David; Kelly, Michael P.; Marshall, Martin; Rycroft-Malone, Joanne

2017-01-01

Worldwide, policymakers, health system managers, practitioners and researchers struggle to use evidence to improve policy and practice. There is growing recognition that this challenge relates to the complex systems in which we work. The corresponding increase in complexity-related discourse remains primarily at a theoretical level. This paper…

The Influence of Cultural Factors on Trust in Automation

ERIC Educational Resources Information Center

Chien, Shih-Yi James

2016-01-01

Human interaction with automation is a complex process that requires both skilled operators and complex system designs to effectively enhance overall performance. Although automation has successfully managed complex systems throughout the world for over half a century, inappropriate reliance on automation can still occur, such as the recent…

Managing Tipping Point Dynamics in Single Development Projects

DTIC Science & Technology

2006-04-30

Journal of Product Innovation Management , 22(2005), 177-192. Lyneis, F., Cooper, K., & Els, S. (2001). Strategic management of complex projects: A case...new product development. Journal of Product Innovation Management ,18(2001), 265-300. Richardson, G.P., & Pugh, A.L. (1981). Introduction to... Product Innovation Management , 17(2000), 128- 142. United States General Accounting Office (USGAO). (1996). Department of Energy: Opportunity to improve

Conceptions of Software Development by Project Managers: A Study of Managing the Outsourced Development of Software Applications for United States Federal Government Agencies

ERIC Educational Resources Information Center

Eisen, Daniel

2013-01-01

This study explores how project managers, working for private federal IT contractors, experience and understand managing the development of software applications for U.S. federal government agencies. Very little is known about how they manage their projects in this challenging environment. Software development is a complex task and only grows in…

TU-FG-201-10: Quality Management of Accelerated Partial Breast Irradiation (APBI) Plans

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

Ji, H; Lorio, V; Cernica, G

2016-06-15

Purpose: Since 2008, over 700 patients received high dose rate (HDR) APBI treatment at Virginia Hospital Center. The complexity involved in the planning process demonstrated a broad variation between patient geometry across all applicators, in relation to anatomical regions of interest. A quality management program instituting various metrics was implemented in March 2013 with the goal of ensuring an optimal plan is achieved for each patient. Methods: For each plan, an in-house complexity index, geometric conformity index, and plan quality index were defined. These indices were obtained for all patients treated. For patients treated after the implementation, the conformity indexmore » and quality index were maximized while other dosimetric limits, such as maximum skin and rib doses, were strictly kept. Subsequently, all evaluation parameters and applicator information were placed in a database for cross-evaluation with similar complexity. Results: Both the conformity and quality indices show good correlation with the complexity index. They decrease as complexity increases for all applicators. Multi lumen type balloon applicators demonstrate a minimal advantage over single lumen applicators in increasingly complex patient geometries, as compared to SAVI applicators which showed considerably greater advantage in these circumstances. After the implementation of the in-house planning protocol, there is a direct improvement of quality for SAVI plans. Conclusion: Due to their interstitial nature, SAVI devices show a better conformity in comparison to balloon-based devices regardless of the number of lumens, especially in complex cases. The quality management program focuses on optimizing indices by utilizing prior planning knowledge based on complexity levels. The database of indices assists in decision making and has subsequently aided in balancing the experience level among planners. This approach has made APBI planning more robust for patient care, with a measurable improvement in the plan quality.« less

FRIEDA: Flexible Robust Intelligent Elastic Data Management Framework

DOE PAGES

Ghoshal, Devarshi; Hendrix, Valerie; Fox, William; ...

2017-02-01

Scientific applications are increasingly using cloud resources for their data analysis workflows. However, managing data effectively and efficiently over these cloud resources is challenging due to the myriad storage choices with different performance, cost trade-offs, complex application choices and complexity associated with elasticity, failure rates in these environments. The different data access patterns for data-intensive scientific applications require a more flexible and robust data management solution than the ones currently in existence. FRIEDA is a Flexible Robust Intelligent Elastic Data Management framework that employs a range of data management strategies in cloud environments. FRIEDA can manage storage and data lifecyclemore » of applications in cloud environments. There are four different stages in the data management lifecycle of FRIEDA – (i) storage planning, (ii) provisioning and preparation, (iii) data placement, and (iv) execution. FRIEDA defines a data control plane and an execution plane. The data control plane defines the data partition and distribution strategy, whereas the execution plane manages the execution of the application using a master-worker paradigm. FRIEDA also provides different data management strategies, either to partition the data in real-time, or predetermine the data partitions prior to application execution.« less

FRIEDA: Flexible Robust Intelligent Elastic Data Management Framework

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

Ghoshal, Devarshi; Hendrix, Valerie; Fox, William

Scientific applications are increasingly using cloud resources for their data analysis workflows. However, managing data effectively and efficiently over these cloud resources is challenging due to the myriad storage choices with different performance, cost trade-offs, complex application choices and complexity associated with elasticity, failure rates in these environments. The different data access patterns for data-intensive scientific applications require a more flexible and robust data management solution than the ones currently in existence. FRIEDA is a Flexible Robust Intelligent Elastic Data Management framework that employs a range of data management strategies in cloud environments. FRIEDA can manage storage and data lifecyclemore » of applications in cloud environments. There are four different stages in the data management lifecycle of FRIEDA – (i) storage planning, (ii) provisioning and preparation, (iii) data placement, and (iv) execution. FRIEDA defines a data control plane and an execution plane. The data control plane defines the data partition and distribution strategy, whereas the execution plane manages the execution of the application using a master-worker paradigm. FRIEDA also provides different data management strategies, either to partition the data in real-time, or predetermine the data partitions prior to application execution.« less

Managing thrips and tospoviruses in tomato

USDA-ARS?s Scientific Manuscript database

Tomato spotted wilt virus and more recently emerged Tomato chlorotic spot virus and Groundnut ringspot virus are all transmitted by thrips, making managment complex. All three viruses and the thrips vector are major pests of tomato in Florida. Current management tools for these viruses and the th...

Organizational Cultural Theory and Research Administration Knowledge Management

ERIC Educational Resources Information Center

Lehman, Dwayne W.

2017-01-01

The administration and management of sponsored projects spans many levels within an institution of higher education. Research administration professionals require an operational understanding of a complex and intertwined set of disciplines that include project management, finance, legal, ethics, communication, and business acumen. The explicit…

75 FR 10759 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-09

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... exclusive economic zone (EEZ). Recommendations from this group will be brought to the full Council for... complex using updated survey data; review the Ecosystem-Based Fishery Management draft policy paper and...

50 CFR 600.315 - National Standard 2-Scientific Information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... sources to improve understanding and management of the resource, marine ecosystem, and the fishery... any stock or stock complex is approaching the minimum stock size threshold. (ii) Any management..., social, and ecological information pertinent to the success of management or the achievement of...

50 CFR 600.315 - National Standard 2-Scientific Information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... sources to improve understanding and management of the resource, marine ecosystem, and the fishery... any stock or stock complex is approaching the minimum stock size threshold. (ii) Any management..., social, and ecological information pertinent to the success of management or the achievement of...

ENVIRONMENTAL SYSTEMS MANAGEMENT AS APPLIED TO WATERSHEDS, UTILIZING REMOTE SENSING, DECISION SUPPORT AND VISUALIZATION

EPA Science Inventory

Environmental Systems Management as a conceptual framework and as a set of interdisciplinary analytical approaches will be described within the context of sustainable watershed management, within devergent complex ecosystems. A specific subset of integrated tools are deployed to...

Framing the issues of resistance management in soybean

USDA-ARS?s Scientific Manuscript database

The soybean insect-pest complex consists of both long-established and new invasive pests. Management of these pests has been achieved by various means, but often relies heavily on the application of insecticides and the development of insect-resistant soybean varieties. Pest management practitione...

BCG Approaches for Improved Management of Estuaries

EPA Science Inventory

Estuaries and other complex aquatic systems are exposed to a variety of stressors that act at several scales, but are managed piecemeal - - often resulting in a “death by 1000 cuts” caused by cumulative impacts to these valued resources. To address this, managers need tools that...

Software Development Management: Empirical and Analytical Perspectives

ERIC Educational Resources Information Center

Kang, Keumseok

2011-01-01

Managing software development is a very complex activity because it must deal with people, organizations, technologies, and business processes. My dissertation consists of three studies that examine software development management from various perspectives. The first study empirically investigates the impacts of prior experience with similar…

Leveraging electronic health records to support chronic disease management: the need for temporal data views.

PubMed

Samal, Lipika; Wright, Adam; Wong, Bang T; Linder, Jeffrey A; Bates, David W

2011-01-01

The ageing population worldwide is increasingly acquiring multiple chronic diseases. The complex management of chronic diseases could be improved with electronic health records (EHRs) tailored to chronic disease care, but most EHRs in use today do not adequately support longitudinal data management. A key aspect of chronic disease management is that it takes place over long periods, but the way that most EHRs display longitudinal data makes it difficult to trend changes over time and slows providers as they review each patient's unique course. We present five clinical scenarios illustrating longitudinal data needs in complex chronic disease management. These scenarios may function as example cases for software development. For each scenario, we describe and illustrate improvements in temporal data views. Two potential solutions are visualisation for numerical data and disease-oriented text summaries for non-numerical data. We believe that development and widespread implementation of improved temporal data views in EHRs will improve the efficiency and quality of chronic disease management in primary care.

Pathology and failure in the design and implementation of adaptive management

USGS Publications Warehouse

Allen, Craig R.; Gunderson, Lance H.

2011-01-01

The conceptual underpinnings for adaptive management are simple; there will always be inherent uncertainty and unpredictability in the dynamics and behavior of complex ecological systems as a result non-linear interactions among components and emergence, yet management decisions must still be made. The strength of adaptive management is in the recognition and confrontation of such uncertainty. Rather than ignore uncertainty, or use it to preclude management actions, adaptive management can foster resilience and flexibility to cope with an uncertain future, and develop safe to fail management approaches that acknowledge inevitable changes and surprises. Since its initial introduction, adaptive management has been hailed as a solution to endless trial and error approaches to complex natural resource management challenges. However, its implementation has failed more often than not. It does not produce easy answers, and it is appropriate in only a subset of natural resource management problems. Clearly adaptive management has great potential when applied appropriately. Just as clearly adaptive management has seemingly failed to live up to its high expectations. Why? We outline nine pathologies and challenges that can lead to failure in adaptive management programs. We focus on general sources of failures in adaptive management, so that others can avoid these pitfalls in the future. Adaptive management can be a powerful and beneficial tool when applied correctly to appropriate management problems; the challenge is to keep the concept of adaptive management from being hijacked for inappropriate use.

The Harvest and Management of Migratory Bird Eggs by Inuit in Nunatsiavut, Labrador

NASA Astrophysics Data System (ADS)

Natcher, David; Felt, Larry; Chaulk, Keith; Procter, Andrea

2012-12-01

This paper presents the results of collaborative research conducted in 2007 on the harvest of migratory bird eggs by Inuit households of Nunatsiavut, Labrador. Harvest variability between communities and species is examined, as is the social and ecological factors affecting the 2007 Inuit egg harvest. Representing the first comprehensive account of Inuit egg use in Labrador, this information should be valuable to agencies responsible for managing migratory bird populations in North America and will contribute to a more informed understanding of the complexity and temporal variability in subsistence harvesting among Labrador Inuit. It is argued that the recognition of this complexity will be critical as the Nunatsiavut Government and other wildlife management agencies formulate management policies that are supportive rather, than constraining, to Inuit resource use in the future.

The clinical management of diabetic foot in the elderly and medico-legal implications.

PubMed

Terranova, Claudio; Bruttocao, Andrea

2013-10-01

Diabetic foot is a complex and challenging pathological state, characterized by high complexity of management, morbidity and mortality. The elderly present peculiar problems which interfere on one hand with the patient's compliance and on the other with their diagnostic-therapeutic management. Difficult clinical management may result in medico-legal problems, with criminal and civil consequences. In this context, the authors present a review of the literature, analysing aspects concerning the diagnosis and treatment of diabetic foot in the elderly which may turn out to be a source of professional responsibility. Analysis of these aspects provides an opportunity to discuss elements important not only for clinicians and medical workers but also experts (judges, lawyers, medico-legal experts) who must evaluate hypotheses of professional responsibility concerning diabetic foot in the elderly.

Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association.

PubMed

Canobbio, Mary M; Warnes, Carole A; Aboulhosn, Jamil; Connolly, Heidi M; Khanna, Amber; Koos, Brian J; Mital, Seema; Rose, Carl; Silversides, Candice; Stout, Karen

2017-02-21

Today, most female children born with congenital heart disease will reach childbearing age. For many women with complex congenital heart disease, carrying a pregnancy carries a moderate to high risk for both the mother and her fetus. Many such women, however, do not have access to adult congenital heart disease tertiary centers with experienced reproductive programs. Therefore, it is important that all practitioners who will be managing these women have current information not only on preconception counseling and diagnostic evaluation to determine maternal and fetal risk but also on how to manage them once they are pregnant and when to refer them to a regional center with expertise in pregnancy management. © 2017 American Heart Association, Inc.

Saudi lung cancer management guidelines 2017

PubMed Central

Jazieh, Abdul Rahman; Al Kattan, Khaled; Bamousa, Ahmed; Al Olayan, Ashwaq; Abdelwarith, Ahmed; Ansari, Jawaher; Al Twairqi, Abdullah; Al Fayea, Turki; Al Saleh, Khalid; Al Husaini, Hamed; Abdelhafiez, Nafisa; Mahrous, Mervat; Faris, Medhat; Al Omair, Ameen; Hebshi, Adnan; Al Shehri, Salem; Al Dayel, Foad; Bamefleh, Hanaa; Khalbuss, Walid; Al Ghanem, Sarah; Loutfi, Shukri; Khankan, Azzam; Al Rujaib, Meshael; Al Ghamdi, Majed; Ibrahim, Nagwa; Swied, Abdulmonem; Al Kayait, Mohammad; Datario, Marie

2017-01-01

BACKGROUND: Lung cancer management is getting more complex due to the rapid advances in all aspects of diagnostic and therapeutic options. Developing guidelines is critical to help practitioners provide standard of care. METHODS: The Saudi Lung Cancer Guidelines Committee (SLCGC) multidisciplinary members from different specialties and from various regions and healthcare sectors of the country reviewed and updated all lung cancer guidelines with appropriate labeling of level of evidence. Supporting documents to help healthcare professionals were developed. RESULTS: Detailed lung cancer management guidelines were finalized with appropriate resources for systemic therapy and short reviews highlighting important issues. Stage based disease management recommendation were included. A summary explanation for complex topics were included in addition to tables of approved systemic therapy. CONCLUSION: A multidisciplinary lung cancer guidelines was developed and will be disseminated across the country. PMID:29118855

Saudi lung cancer management guidelines 2017.

PubMed

Jazieh, Abdul Rahman; Al Kattan, Khaled; Bamousa, Ahmed; Al Olayan, Ashwaq; Abdelwarith, Ahmed; Ansari, Jawaher; Al Twairqi, Abdullah; Al Fayea, Turki; Al Saleh, Khalid; Al Husaini, Hamed; Abdelhafiez, Nafisa; Mahrous, Mervat; Faris, Medhat; Al Omair, Ameen; Hebshi, Adnan; Al Shehri, Salem; Al Dayel, Foad; Bamefleh, Hanaa; Khalbuss, Walid; Al Ghanem, Sarah; Loutfi, Shukri; Khankan, Azzam; Al Rujaib, Meshael; Al Ghamdi, Majed; Ibrahim, Nagwa; Swied, Abdulmonem; Al Kayait, Mohammad; Datario, Marie

2017-01-01

Lung cancer management is getting more complex due to the rapid advances in all aspects of diagnostic and therapeutic options. Developing guidelines is critical to help practitioners provide standard of care. The Saudi Lung Cancer Guidelines Committee (SLCGC) multidisciplinary members from different specialties and from various regions and healthcare sectors of the country reviewed and updated all lung cancer guidelines with appropriate labeling of level of evidence. Supporting documents to help healthcare professionals were developed. Detailed lung cancer management guidelines were finalized with appropriate resources for systemic therapy and short reviews highlighting important issues. Stage based disease management recommendation were included. A summary explanation for complex topics were included in addition to tables of approved systemic therapy. A multidisciplinary lung cancer guidelines was developed and will be disseminated across the country.

Training Middle Managers of South African Public Schools in Leadership and Management Skills

ERIC Educational Resources Information Center

Mampane, Sharon Thabo

2017-01-01

The purpose of this conceptual explanatory research is to highlight the importance of training of Middle Managers or Heads of Department (HoDs) in leadership and management in South African public schools. Leadership responsibilities in schools are becoming more complex to the extent that principals can no longer be sole leaders in schools. The…

Writing syntheses for managers: Lessons from the Rainbow Series and Fire Effects Information System

Treesearch

Jane Kapler Smith; Kristin L. Zouhar; Janet Fryer

2009-01-01

Scientific knowledge is essential for sound wildland management, but this knowledge is a complex, ever-expanding resource. Managers often request syntheses or reviews of available knowledge, and scientists have responded with an increasing number of syntheses for managers. Unfortunately, little guidance is available for this kind of writing. While most scientists have...

Demography: a tool for understanding the wildland-urban interface fire problems

Treesearch

James B. Davis

1989-01-01

Fire managers across the nation are confronting the rapidly developing problem created by movement of people into wildland areas, increasing what has been termed the wildland-urban interface. The problem is very complex from the standpoint of fire planning and management. To plan and manage more effectively, fire managers should identify three types of interface areas...

Integrative complexity of wildfire management: development of a scale

Treesearch

Joshua Carroll; Alan Bright

2007-01-01

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

Seeing the future impacts of climate change and forest management: a landscape visualization system for forest managers

Treesearch

Eric J. Gustafson; Melissa Lucash; Johannes Liem; Helen Jenny; Rob Scheller; Kelly Barrett; Brian R. Sturtevant

2016-01-01

Forest managers are increasingly considering how climate change may alter forests' capacity to provide ecosystem goods and services. But identifying potential climate change effects on forests is difficult because interactions among forest growth and mortality, climate change, management, and disturbances are complex and uncertain. Although forest landscape models...

A national cohesive wildland fire management strategy

Treesearch

Forest Service U.S. Department of Agriculture; Office of Wildland Fire Coordination Department of the Interior

2011-01-01

Addressing wildfire is not simply a fire management, fire operations, or wildland-urban interface problem - it is a larger, more complex land management and societal issue. The vision for the next century is to: Safely and effectively extinguish fire, when needed; use fire where allowable; manage our natural resources; and as a Nation, live with wildland fire. Three...

Setting the stage to enhance ecological site description appplications to wildlife management in sagebrush ecosystems: A 2007 society for range management workshop

USDA-ARS?s Scientific Manuscript database

Widespread loss, alteration and degradation of sagebrush ecosystems have created complex challenges for managers seeking to conserve dependent wildlife species. A half century of range and wildlife research has generated an extensive and diverse base of information to assist managers in making land ...

Managing wildfire events: risk-based decision making among a group of federal fire managers

Treesearch

Robyn S. Wilson; Patricia L. Winter; Lynn A. Maguire; Timothy Ascher

2011-01-01

Managing wildfire events to achieve multiple management objectives involves a high degree of decision complexity and uncertainty, increasing the likelihood that decisions will be informed by experience-based heuristics triggered by available cues at the time of the decision. The research reported here tests the prevalence of three risk-based biases among 206...

Complexity analysis of the Next Gen Air Traffic Management System: trajectory based operations.

PubMed

Lyons, Rhonda

2012-01-01

According to Federal Aviation Administration traffic predictions currently our Air Traffic Management (ATM) system is operating at 150 percent capacity; forecasting that within the next two decades, the traffic with increase to a staggering 250 percent [17]. This will require a major redesign of our system. Today's ATM system is complex. It is designed to safely, economically, and efficiently provide air traffic services through the cost-effective provision of facilities and seamless services in collaboration with multiple agents however, contrary the vision, the system is loosely integrated and is suffering tremendously from antiquated equipment and saturated airways. The new Next Generation (Next Gen) ATM system is designed to transform the current system into an agile, robust and responsive set of operations that are designed to safely manage the growing needs of the projected increasingly complex, diverse set of air transportation system users and massive projected worldwide traffic rates. This new revolutionary technology-centric system is dynamically complex and is much more sophisticated than it's soon to be predecessor. ATM system failures could yield large scale catastrophic consequences as it is a safety critical system. This work will attempt to describe complexity and the complex nature of the NextGen ATM system and Trajectory Based Operational. Complex human factors interactions within Next Gen will be analyzed using a proposed dual experimental approach designed to identify hazards, gaps and elicit emergent hazards that would not be visible if conducted in isolation. Suggestions will be made along with a proposal for future human factors research in the TBO safety critical Next Gen environment.

Management of disasters and complex emergencies in Africa: The challenges and constraints.

PubMed

Aliyu, Alhaji

2015-01-01

Natural and man-made catastrophes have caused significant destruction and loss of lives throughout human history. Disasters accompany a wide variety of events with multiple causes and consequences often leading to a cascade of related events. African continent has not been spared of these events. A new phenomenon in the continent is terrorism that is fuelled by globalization of arms trade and has contributed significantly to escalation of conflicts in sub-Saharan Africa (SSA) resulting in complex emergencies and destruction of socioeconomic structures. The aim of this paper is to review relevant papers on management of disasters and complex emergencies in Africa and the challenges and constraints against the background of a weakened health system. Systematic search of published literature was conducted between 1990 and 2013. Grey literature (technical reports, government documents), published peer review journals, abstracts, relevant books and internet articles were reviewed. The review revealed that the frequency of both natural and man-made disasters in Africa is escalating. Complex emergencies are also on the increase since the Rwandan crisis in 1994. The impact of these events has overstretched and overwhelmed the health care system that is least prepared to handle and cope with the surge capacity and also render normal services. In conclusion, there is an urgent need for national emergency agencies/departments across Africa to develop a robust emergency preparedness and response plan. Every hospital most have a disaster management committee with flexible disaster management plan to respond to these catastrophes. There is a need for curriculum review in tertiary institutions across SSA to introduce and or expand training in disaster management.

Group Policy Reference Systems and Network Attack Center (SNAC)

DTIC Science & Technology

2001-03-02

Policy Snap-in for a given Active Directory container . It is hoped that this map will alleviate some of the complexity in managing and understanding...help the reader locate specific policies within the Group Policy Snap-in for a given Active Directory container . It is hoped that this map will alleviate...Policy Snap-in for a given Active Directory container . It is hoped that this map will alleviate some of the complexity in managing and

Safety management of complex research operators

NASA Technical Reports Server (NTRS)

Brown, W. J.

1981-01-01

Complex research and technology operations present varied potential hazards which are addressed in a disciplined, independent safety review and approval process. Potential hazards vary from high energy fuels to hydrocarbon fuels, high pressure systems to high voltage systems, toxic chemicals to radioactive materials and high speed rotating machinery to high powered lasers. A Safety Permit System presently covers about 600 potentially hazardous operations. The Safety Management Program described is believed to be a major factor in maintaining an excellent safety record.

Surgical management of spontaneous in-the-bag intraocular lens and capsular tension ring complex dislocation.

PubMed

Gunenc, Uzeyir; Kocak, Nilufer; Ozturk, A Taylan; Arikan, Gul

2014-08-01

We describe a technique to manage late spontaneous intraocular lens (IOL) and capsular tension ring (CTR) dislocation within the intact capsular bag. The subluxated IOL and CTR complex can be positioned in a closed chamber and fixed to the pars plana at both 3 and 9 o'clock quadrants with the presented ab externo direct scleral suturation technique which provides an easy, safe and effective surgical option for such cases.

Early experiences in developing and managing the neuroscience gateway.

PubMed

Sivagnanam, Subhashini; Majumdar, Amit; Yoshimoto, Kenneth; Astakhov, Vadim; Bandrowski, Anita; Martone, MaryAnn; Carnevale, Nicholas T

2015-02-01

The last few decades have seen the emergence of computational neuroscience as a mature field where researchers are interested in modeling complex and large neuronal systems and require access to high performance computing machines and associated cyber infrastructure to manage computational workflow and data. The neuronal simulation tools, used in this research field, are also implemented for parallel computers and suitable for high performance computing machines. But using these tools on complex high performance computing machines remains a challenge because of issues with acquiring computer time on these machines located at national supercomputer centers, dealing with complex user interface of these machines, dealing with data management and retrieval. The Neuroscience Gateway is being developed to alleviate and/or hide these barriers to entry for computational neuroscientists. It hides or eliminates, from the point of view of the users, all the administrative and technical barriers and makes parallel neuronal simulation tools easily available and accessible on complex high performance computing machines. It handles the running of jobs and data management and retrieval. This paper shares the early experiences in bringing up this gateway and describes the software architecture it is based on, how it is implemented, and how users can use this for computational neuroscience research using high performance computing at the back end. We also look at parallel scaling of some publicly available neuronal models and analyze the recent usage data of the neuroscience gateway.

Early experiences in developing and managing the neuroscience gateway

PubMed Central

Sivagnanam, Subhashini; Majumdar, Amit; Yoshimoto, Kenneth; Astakhov, Vadim; Bandrowski, Anita; Martone, MaryAnn; Carnevale, Nicholas. T.

2015-01-01

SUMMARY The last few decades have seen the emergence of computational neuroscience as a mature field where researchers are interested in modeling complex and large neuronal systems and require access to high performance computing machines and associated cyber infrastructure to manage computational workflow and data. The neuronal simulation tools, used in this research field, are also implemented for parallel computers and suitable for high performance computing machines. But using these tools on complex high performance computing machines remains a challenge because of issues with acquiring computer time on these machines located at national supercomputer centers, dealing with complex user interface of these machines, dealing with data management and retrieval. The Neuroscience Gateway is being developed to alleviate and/or hide these barriers to entry for computational neuroscientists. It hides or eliminates, from the point of view of the users, all the administrative and technical barriers and makes parallel neuronal simulation tools easily available and accessible on complex high performance computing machines. It handles the running of jobs and data management and retrieval. This paper shares the early experiences in bringing up this gateway and describes the software architecture it is based on, how it is implemented, and how users can use this for computational neuroscience research using high performance computing at the back end. We also look at parallel scaling of some publicly available neuronal models and analyze the recent usage data of the neuroscience gateway. PMID:26523124

Education research: a case-based bioethics curriculum for neurology residents.

PubMed

Tolchin, Benjamin; Willey, Joshua Z; Prager, Kenneth

2015-03-31

In 2012, the American Academy of Neurology (AAN) updated and expanded its ethics curriculum into Practical Ethics in Clinical Neurology, a case-based ethics curriculum for neurologists. We piloted a case-based bioethics curriculum for neurology residents using the framework and topics recommended by the AAN, matched to clinical cases drawn from Columbia's neurologic services. Our primary outcome was residents' ability to analyze and manage ethically complex cases as measured on precurriculum and postcurriculum multiple-choice quizzes. Secondary outcomes included precurriculum and postcurriculum self-assessed comfort in discussing and managing ethically complex cases, as well as attendance at ethics discussion sessions as compared to attendance at other didactic sessions. Resident performance on quizzes improved from 75.8% to 86.7% (p = 0.02). Comfort in discussing ethically complex cases improved from 6.4 to 7.4 on a 10-point scale (p = 0.03). Comfort in managing such cases trended toward improvement but did not reach statistical significance. Attendance was significantly better at ethics discussions (73.5%) than at other didactic sessions (61.7%, p = 0.04). Our formal case-based ethics curriculum for neurology residents, based on core topics drawn from the AAN's published curricula, was successfully piloted. Our study showed a statistically significant improvement in residents' ability to analyze and manage ethically complex cases as measured by multiple-choice tests and self-assessments. © 2015 American Academy of Neurology.

Results from 10 Years of a CBT Pain Self-Management Outpatient Program for Complex Chronic Conditions.

PubMed

Boschen, Kathryn A; Robinson, Edward; Campbell, Kent A; Muir, Sarah; Oey, Elvina; Janes, Kristen; Fashler, Samantha R; Katz, Joel

2016-01-01

Background. Traditional unimodal interventions may be insufficient for treating complex pain, as they do not address cognitive and behavioural contributors to pain. Cognitive Behavioural Therapy (CBT) and physical exercise (PE) are empirically supported treatments that can reduce pain and improve quality of life. Objectives. To examine the outcomes of a pain self-management outpatient program based on CBT and PE at a rehabilitation hospital in Toronto, Ontario. Methods. The pain management group (PMG) consisted of 20 sessions over 10 weeks. The intervention consisted of four components: education, cognitive behavioural skills, exercise, and self-management strategies. Outcome measures included the sensory, affective, and intensity of pain experience, depression, anxiety, pain disability, active and passive coping style, and general health functioning. Results. From 2002 to 2011, 36 PMGs were run. In total, 311 patients entered the program and 214 completed it. Paired t -tests showed significant pre- to posttreatment improvements in all outcomes measured. Patient outcomes did not differ according to the number or type of diagnoses. Both before and after treatment, women reported more active coping than men. Discussion. The PMGs improved pain self-management for patients with complex pain. Future research should use a randomized controlled design to better understand the outcomes of PMGs.

A conceptual framework for addressing complexity and unfolding transition dynamics when developing sustainable adaptation strategies in urban water management.

PubMed

Fratini, C F; Elle, M; Jensen, M B; Mikkelsen, P S

2012-01-01

To achieve a successful and sustainable adaptation to climate change we need to transform the way we think about change. Much water management research has focused on technical innovation with a range of new solutions developed to achieve a 'more sustainable and integrated urban water management cycle'. But Danish municipalities and utility companies are struggling to bring such solutions into practice. 'Green infrastructure', for example, requires the consideration of a larger range of aspects related to the urban context than the traditional urban water system optimization. There is the need for standardized methods and guidelines to organize transdisciplinary processes where different types of knowledge and perspectives are taken into account. On the basis of the macro-meso-micro pattern inspired by complexity science and transition theory, we developed a conceptual framework to organize processes addressing the complexity characterizing urban water management in the context of climate change. In this paper the framework is used to organize a research process aiming at understanding and unfolding urban dynamics for sustainable transition. The final goal is to enable local authorities and utilities to create the basis for managing and catalysing the technical and organizational innovation necessary for a sustainable transition towards climate change adaptation in urban areas.

Linking Local Scale Ecosystem Science to Regional Scale Management

NASA Astrophysics Data System (ADS)

Shope, C. L.; Tenhunen, J.; Peiffer, S.

2012-04-01

Ecosystem management with respect to sufficient water yield, a quality water supply, habitat and biodiversity conservation, and climate change effects requires substantial observational data at a range of scales. Complex interactions of local physical processes oftentimes vary over space and time, particularly in locations with extreme meteorological conditions. Modifications to local conditions (ie: agricultural land use changes, nutrient additions, landscape management, water usage) can further affect regional ecosystem services. The international, inter-disciplinary TERRECO research group is intensively investigating a variety of local processes, parameters, and conditions to link complex physical, economic, and social interactions at the regional scale. Field-based meteorology, hydrology, soil physics, plant production, solute and sediment transport, economic, and social behavior data were measured in a South Korean catchment. The data are used to parameterize suite of models describing local to landscape level water, sediment, nutrient, and monetary relationships. We focus on using the agricultural and hydrological SWAT model to synthesize the experimental field data and local-scale models throughout the catchment. The approach of our study was to describe local scientific processes, link potential interrelationships between different processes, and predict environmentally efficient management efforts. The Haean catchment case study shows how research can be structured to provide cross-disciplinary scientific linkages describing complex ecosystems and landscapes that can be used for regional management evaluations and predictions.

Who to Blame: Irrational Decision-Makers or Stupid Modelers? (Arne Richter Award for Outstanding Young Scientists Lecture)

NASA Astrophysics Data System (ADS)

Madani, Kaveh

2016-04-01

Water management benefits from a suite of modelling tools and techniques that help simplifying and understanding the complexities involved in managing water resource systems. Early water management models were mainly concerned with optimizing a single objective, related to the design, operations or management of water resource systems (e.g. economic cost, hydroelectricity production, reliability of water deliveries). Significant improvements in methodologies, computational capacity, and data availability over the last decades have resulted in developing more complex water management models that can now incorporate multiple objectives, various uncertainties, and big data. These models provide an improved understanding of complex water resource systems and provide opportunities for making positive impacts. Nevertheless, there remains an alarming mismatch between the optimal solutions developed by these models and the decisions made by managers and stakeholders of water resource systems. Modelers continue to consider decision makers as irrational agents who fail to implement the optimal solutions developed by sophisticated and mathematically rigours water management models. On the other hand, decision makers and stakeholders accuse modelers of being idealist, lacking a perfect understanding of reality, and developing 'smart' solutions that are not practical (stable). In this talk I will have a closer look at the mismatch between the optimality and stability of solutions and argue that conventional water resources management models suffer inherently from a full-cooperation assumption. According to this assumption, water resources management decisions are based on group rationality where in practice decisions are often based on individual rationality, making the group's optimal solution unstable for individually rational decision makers. I discuss how game theory can be used as an appropriate framework for addressing the irrational "rationality assumption" of water resources management models and for better capturing the social aspects of decision making in water management systems with multiple stakeholders.

32 CFR 552.88 - Responsibilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Area Access Section of their entry onto, and departure from, the range complex. (d) DPCA. Manage the Installation Hunting, Fishing, and Trapping programs in conjunction with DEH Wildlife. Manage those picnic and...

32 CFR 552.88 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Area Access Section of their entry onto, and departure from, the range complex. (d) DPCA. Manage the Installation Hunting, Fishing, and Trapping programs in conjunction with DEH Wildlife. Manage those picnic and...

32 CFR 552.88 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Area Access Section of their entry onto, and departure from, the range complex. (d) DPCA. Manage the Installation Hunting, Fishing, and Trapping programs in conjunction with DEH Wildlife. Manage those picnic and...

32 CFR 552.88 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Area Access Section of their entry onto, and departure from, the range complex. (d) DPCA. Manage the Installation Hunting, Fishing, and Trapping programs in conjunction with DEH Wildlife. Manage those picnic and...

32 CFR 552.88 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Area Access Section of their entry onto, and departure from, the range complex. (d) DPCA. Manage the Installation Hunting, Fishing, and Trapping programs in conjunction with DEH Wildlife. Manage those picnic and...

NATIONAL CONFERENCE ON RETROFIT OPPORTUNITIES ...

EPA Pesticide Factsheets

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

41 CFR 101-5.306 - Economic feasibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Economic feasibility. 101-5.306 Section 101-5.306 Public Contracts and Property Management Federal Property Management... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.306 Economic feasibility. (a) The studies...

41 CFR 101-5.306 - Economic feasibility.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Economic feasibility. 101-5.306 Section 101-5.306 Public Contracts and Property Management Federal Property Management... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.306 Economic feasibility. (a) The studies...

41 CFR 101-5.306 - Economic feasibility.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true Economic feasibility. 101-5.306 Section 101-5.306 Public Contracts and Property Management Federal Property Management... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.306 Economic feasibility. (a) The studies...

41 CFR 101-5.306 - Economic feasibility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Economic feasibility. 101-5.306 Section 101-5.306 Public Contracts and Property Management Federal Property Management... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.306 Economic feasibility. (a) The studies...

41 CFR 101-5.306 - Economic feasibility.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false Economic feasibility. 101-5.306 Section 101-5.306 Public Contracts and Property Management Federal Property Management... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.306 Economic feasibility. (a) The studies...

A Comprehensive Approach to Managed Care for Mental Health.

ERIC Educational Resources Information Center

Langman-Dorwart, Nancy; Peebles, Thomas

1988-01-01

Asserts that managing mental health and substance abuse utilization in a complex network health maintenance organization (HMO) can be accomplished through comprehensive approach. Describes prescreening of admissions and preferred provider contracts of one HMO's managed care system. Explains savings resulting from averting unnecessary admissions.…

48 CFR 970.1504-1-4 - Types of contracts and fee arrangements.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-based management contract, those contract types which incentivize performance and cost control are... performance result or outcome. (e) Because the nature and complexity of the work performed under a management... AGENCY SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Contracting by Negotiation 970...

RISK COMMUNICATION AS A RISK MANAGEMENT TOOL: A RISK COMMUNICATION WORKBOOK

EPA Science Inventory

Communicating information about environmental risk to the people most affected by it is one of the major challenges faced by risk managers and community decision makers. Changing human behavior is a far more complex task than designing water retention systems or managing storm wa...

Training Manager Competencies: The Standards. Third Edition.

ERIC Educational Resources Information Center

Foxon, Marguerite; Richey, Rita C.; Roberts, Robert C.; Spannaus, Timothy W.

In this third edition of "Training Manager Competencies: The Standards," the International Board of Standards for Training, Performance and Instruction (IBSTPI) presents an updated definition and discussion of the competencies of training managers. It is an expanded view that reflects the complexities and pressures of current practice…

Integrating Collaboration, Adaptive Management, and Scenario-Planning to Address Rapid Change: Experiences at Las Cienegas National Conservation Area

NASA Astrophysics Data System (ADS)

Caves, J. K.; Bodner, G.; Simms, K.; Fisher, L.; Robertson, T.

2012-12-01

There is growing recognition that public lands cannot be managed as islands; rather, land management must address the ecological, social, and temporal complexity that often spans jurisdictions and traditional planning horizons. Collaborative decision-making and adaptive management (CAM) have been promoted as methods to reconcile competing societal demands and respond to complex ecosystem dynamics. We present the experiences of land managers and stakeholders in using CAM at Las Cienegas National Conservation Area (LCNCA), a highly valued site under the jurisdiction of the Bureau of Land Management (BLM). The CAM process at Las Cienegas is marked by strong stakeholder engagement, with four core elements: 1) shared watershed goals with measurable resource objectives; 2) mechanisms to incorporate new information into decision-making; 3) efforts to make information increasingly relevant and reliable; and 4) shared learning to improve both the process and management actions. The combination of stakeholder engagement and adaptive management has led to agreement on contentious issues, more innovative solutions, and more effective land management. Yet the region is now experiencing rapid changes outside managers' control—including climate change, human population growth, and reduced federal budgets—with large but unpredictable impacts on natural resources. While CAM experience provides a strong foundation for making the difficult and contentious management decisions that such changes are likely to require, neither collaboration nor adaptive management provides a sufficient structure for addressing uncontrollable and unpredictable change. As a result, LCNCA is exploring two specific modifications to CAM that may better address emerging challenges, including: 1) Creating nested resource objectives to distinguish between those objectives which may be crucial from those which may hinder a flexible response to climate change, and 2) Incorporating scenario planning into CAM to explore how climate change may interact with other drivers and alter options for the future, to identify robust management, and to prioritize ecological monitoring efforts. The experiences at LCNCA demonstrate how collaboration and adaptive management can be used to improve social and environmental outcomes and, with a few modifications, may help address the complexity and change that threatens to overwhelm even the best efforts to sustain public lands.

Stabilizing Group Treatment for Complex Posttraumatic Stress Disorder Related to Childhood Abuse Based on Psycho-Education and Cognitive Behavioral Therapy: A Pilot Study

ERIC Educational Resources Information Center

Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H.; van Balkom, Anton J. L. M.; van Dyck, Richard; Veltman, Dick J.; Draijer, Nel

2010-01-01

Objective: This study tests a Stabilizing Group Treatment protocol, designed for the management of the long-term sequelae of child abuse, that is, Complex Posttraumatic Stress Disorder (Complex PTSD). Evidence-based treatment for this subgroup of PTSD patients is largely lacking. This stabilizing treatment aims at improving Complex PTSD using…

[Algorithms for treatment of complex hand injuries].

PubMed

Pillukat, T; Prommersberger, K-J

2011-07-01

The primary treatment strongly influences the course and prognosis of hand injuries. Complex injuries which compromise functional recovery are especially challenging. Despite an apparently unlimited number of injury patterns it is possible to develop strategies which facilitate a standardized approach to operative treatment. In this situation algorithms can be important guidelines for a rational approach. The following algorithms have been proven in the treatment of complex injuries of the hand by our own experience. They were modified according to the current literature and refer to prehospital care, emergency room management, basic strategy in general and reconstruction of bone and joints, vessels, nerves, tendons and soft tissue coverage in detail. Algorithms facilitate the treatment of severe hand injuries. Applying simple yes/no decisions complex injury patterns are split into distinct partial problems which can be managed step by step.

[The constitution of competences in mental health nursing education and practice].

PubMed

Lucchese, Roselma; Barros, Sônia

2009-03-01

This qualitative study had the purpose to increase the discussions about the constitution of competences in the education of nurses so that they can work in the mental healthcare area. to analyze the representations of the research subjects about mental healthcare competences. qualitative research. The nursing department in a public university in the state of São Paulo. Professors and healthcare nurses working in the same area. The mobilization of testimonies happened in focus groups, followed by discourse analysis. The building of competences and promotion of complex situations in the students' learning process were discussed, and the discourse analysis yielded the following empirical categories: The concept of competence, What is a complex situation, Which knowledge is necessary to manage complex situations in psychiatric nursing and mental healthcare, Competence: knowing how to manage a complex situation.

Clinical application of three-dimensional printing to the management of complex univentricular hearts with abnormal systemic or pulmonary venous drainage.

PubMed

McGovern, Eimear; Kelleher, Eoin; Snow, Aisling; Walsh, Kevin; Gadallah, Bassem; Kutty, Shelby; Redmond, John M; McMahon, Colin J

2017-09-01

In recent years, three-dimensional printing has demonstrated reliable reproducibility of several organs including hearts with complex congenital cardiac anomalies. This represents the next step in advanced image processing and can be used to plan surgical repair. In this study, we describe three children with complex univentricular hearts and abnormal systemic or pulmonary venous drainage, in whom three-dimensional printed models based on CT data assisted with preoperative planning. For two children, after group discussion and examination of the models, a decision was made not to proceed with surgery. We extend the current clinical experience with three-dimensional printed modelling and discuss the benefits of such models in the setting of managing complex surgical problems in children with univentricular circulation and abnormal systemic or pulmonary venous drainage.

Role of robotics in managing mesh and suture complications of prior pelvic organ prolapse surgery.

PubMed

Wilkinson, Michael N; O'Sullivan, Orfhlaith E; O'Reilly, Barry A

2017-03-01

Robotic surgery is proving essential in providing a minimally invasive approach to complex urogynaecological cases. This video highlights the diversity and complexity of cases performed using the robot-assisted approach. The robot-assisted approach was utilised for excellent effect in two complex urogynaecological cases. In the first case the entire left arm of an intravesically placed TVT was removed using a combined vaginal and robotic approach. The second case involved removing four paravaginal sutures, one of which breeched the bladder and was encrusted with calculus. These were placed during a laparoscopic paravaginal repair 2 years previously. She had a concomitant vaginal hysterectomy, Mc Calls culdoplasty and anterior wall repair. The robot-assisted approach allows for excellent access to the pelvis and retropubic space facilitating the surgical management of complex urogynaecology cases.

Alternative Endpoints and Approaches Selected for the Remediation of Contaminated Groundwater at Complex Sites

NASA Astrophysics Data System (ADS)

Deeb, R. A.; Hawley, E.

2011-12-01

This presentation will focus on findings, statistics, and case studies from a recently-completed report for the Department of Defense's Environmental Security Technology Certification Program (ESTCP) (Project ER-0832) on alternative endpoints and alternative remedial strategies for groundwater remediation under a variety of Federal and state cleanup programs, including technical impracticability (TI) and other Applicable or Relevant and Appropriate Requirement (ARAR) waivers, state and local designations such as groundwater management zones, Alternate Concentration Limits (ACLs), use of monitored natural attenuation (MNA) over long timeframes, and more. The primary objective of the project was to provide environmental managers and regulators with tools, metrics, and information needed to evaluate alternative endpoints for groundwater remediation at complex sites. A statistical analysis of Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) sites receiving TI waivers will be presented as well as case studies of other types of alternative endpoints and alternative remedial strategies to illustrate the variety of approaches used at complex sites and the technical analyses used to predict and document cost, timeframe, and potential remedial effectiveness. Case studies provide examples of the flexible, site-specific, application of alternative endpoints and alternative remedial strategies that have been used in the past to manage and remediate groundwater contamination at complex sites. For example, at least 13 states consider some designation for groundwater containment in their corrective action policies, such as groundwater management zones, containment zones, and groundwater classification exemption areas. These designations typically indicate that groundwater contamination is present above permissible levels. Soil and groundwater within these zones are managed to protect human health and the environment. Lesson learned for the analyses conducted and the case studies evaluated allow for a more careful consideration of alternative, beneficial, and cost-effective cleanup objectives and metrics that can be achieved over the short-term (while eventually meeting long-term cleanup objectives or demonstrating the applicability of alternative endpoints), thus improving the site cleanup process at complex sites where appropriate.

What we know about the purpose, theoretical foundation, scope and dimensionality of existing self-management measurement tools: A scoping review.

PubMed

Packer, Tanya L; Fracini, America; Audulv, Åsa; Alizadeh, Neda; van Gaal, Betsie G I; Warner, Grace; Kephart, George

2018-04-01

To identify self-report, self-management measures for adults with chronic conditions, and describe their purpose, theoretical foundation, dimensionality (multi versus uni), and scope (generic versus condition specific). A search of four databases (8479 articles) resulted in a scoping review of 28 self-management measures. Although authors identified tools as measures of self-management, wide variation in constructs measured, purpose, and theoretical foundations existed. Subscales on 13 multidimensional tools collectively measure domains of self-management relevant to clients, however no one tool's subscales cover all domains. Viewing self-management as a complex, multidimensional whole, demonstrated that existing measures assess different, related aspects of self-management. Activities and social roles, though important to patients, are rarely measured. Measures with capacity to quantify and distinguish aspects of self-management may promote tailored patient care. In selecting tools for research or assessment, the reason for development, definitions, and theories underpinning the measure should be scrutinized. Our ability to measure self-management must be rigorously mapped to provide comprehensive and system-wide care for clients with chronic conditions. Viewing self-management as a complex whole will help practitioners to understand the patient perspective and their contribution in supporting each individual patient. Copyright © 2017 Elsevier B.V. All rights reserved.

12 CFR 250.412 - Interlocking relationships between member bank and insurance company-mutual fund complex.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and insurance company-mutual fund complex. 250.412 Section 250.412 Banks and Banking FEDERAL RESERVE... and insurance company-mutual fund complex. (a) The Board has been asked whether section 32 of the... investment manager-advisor, (3) the insurance company sponsoring and apparently controlling the fund. (b) X...

12 CFR 250.412 - Interlocking relationships between member bank and insurance company-mutual fund complex.

Code of Federal Regulations, 2011 CFR

2011-01-01

... and insurance company-mutual fund complex. 250.412 Section 250.412 Banks and Banking FEDERAL RESERVE... and insurance company-mutual fund complex. (a) The Board has been asked whether section 32 of the... investment manager-advisor, (3) the insurance company sponsoring and apparently controlling the fund. (b) X...

Rethinking Traditional Behaviour Management to Better Support Complex Trauma-Surviving Students

ERIC Educational Resources Information Center

Howard, Judith

2016-01-01

Children and adolescents who have survived complex trauma have suffered the type of ongoing and repeated traumatic experience that includes factors such as physical, sexual, and/or emotional abuse, significant neglect, and/or family violence. Complex childhood trauma (sometimes referred to as paediatric or child maltreatment-related post traumatic…

A Simulation for Managing Complexity in Sales and Operations Planning Decisions

ERIC Educational Resources Information Center

DuHadway, Scott; Dreyfus, David

2017-01-01

Within the classroom it is often difficult to convey the complexities and intricacies that go into making sales and operations planning decisions. This article describes an in-class simulation that allows students to gain hands-on experience with the complexities in making forecasting, inventory, and supplier selection decisions as part of the…

Flash crashes, bursts, and black swans: parallels between financial markets and healthcare systems.

PubMed

West, Bruce J; Clancy, Thomas R

2010-11-01

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 16th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, Dr Clancy, the editor of this column, and co-author, Dr West, discuss how the collapse of global financial markets in 2008 may provide valuable insight into mechanisms of complex system behavior in healthcare. Dr West, a physicist and expert in the field of complex systems and network science, is author of a chapter in the book, On the Edge: Nursing in the Age of Complexity (Lindberg C, Nash S, Linberg C. Bordertown, NJ: Plexus Press; 2008) and his most recent book, Disrupted Networks: From Physics to Climate Change (West BJ, Scafetta N. Singapore: Disrupted Networks, World Scientific Publishing; 2010).

Scope Complexity Options Risks Excursions (SCORE) Factor Mathematical Description.

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

Gearhart, Jared Lee; Samberson, Jonell Nicole; Shettigar, Subhasini

The purpose of the Scope, Complexity, Options, Risks, Excursions (SCORE) model is to estimate the relative complexity of design variants of future warhead options, resulting in scores. SCORE factors extend this capability by providing estimates of complexity relative to a base system (i.e., all design options are normalized to one weapon system). First, a clearly defined set of scope elements for a warhead option is established. The complexity of each scope element is estimated by Subject Matter Experts (SMEs), including a level of uncertainty, relative to a specific reference system. When determining factors, complexity estimates for a scope element canmore » be directly tied to the base system or chained together via comparable scope elements in a string of reference systems that ends with the base system. The SCORE analysis process is a growing multi-organizational Nuclear Security Enterprise (NSE) effort, under the management of the NA-12 led Enterprise Modeling and Analysis Consortium (EMAC). Historically, it has provided the data elicitation, integration, and computation needed to support the out-year Life Extension Program (LEP) cost estimates included in the Stockpile Stewardship Management Plan (SSMP).« less

To manage inland fisheries is to manage at the social-ecological watershed scale.

PubMed

Nguyen, Vivian M; Lynch, Abigail J; Young, Nathan; Cowx, Ian G; Beard, T Douglas; Taylor, William W; Cooke, Steven J

2016-10-01

Approaches to managing inland fisheries vary between systems and regions but are often based on large-scale marine fisheries principles and thus limited and outdated. Rarely do they adopt holistic approaches that consider the complex interplay among humans, fish, and the environment. We argue that there is an urgent need for a shift in inland fisheries management towards holistic and transdisciplinary approaches that embrace the principles of social-ecological systems at the watershed scale. The interconnectedness of inland fisheries with their associated watershed (biotic, abiotic, and humans) make them extremely complex and challenging to manage and protect. For this reason, the watershed is a logical management unit. To assist management at this scale, we propose a framework that integrates disparate concepts and management paradigms to facilitate inland fisheries management and sustainability. We contend that inland fisheries need to be managed as social-ecological watershed system (SEWS). The framework supports watershed-scale and transboundary governance to manage inland fisheries, and transdisciplinary projects and teams to ensure relevant and applicable monitoring and research. We discuss concepts of social-ecological feedback and interactions of multiple stressors and factors within/between the social-ecological systems. Moreover, we emphasize that management, monitoring, and research on inland fisheries at the watershed scale are needed to ensure long-term sustainable and resilient fisheries. Copyright © 2016. Published by Elsevier Ltd.

Development of the Andalusian Registry of Patients Receiving Community Case Management, for the follow-up of people with complex chronic diseases.

PubMed

Morales-Asencio, Jose M; Kaknani-Uttumchandani, Shakira; Cuevas-Fernández-Gallego, Magdalena; Palacios-Gómez, Leopoldo; Gutiérrez-Sequera, José L; Silvano-Arranz, Agustina; Batres-Sicilia, Juan Pedro; Delgado-Romero, Ascensión; Cejudo-Lopez, Ángela; Trabado-Herrera, Manuel; García-Lara, Esteban L; Martin-Santos, Francisco J; Morilla-Herrera, Juan C

2015-10-01

Complex chronic diseases are a challenge for the current configuration of health services. Case management is a service frequently provided for people with chronic conditions, and despite its effectiveness in many outcomes, such as mortality or readmissions, uncertainty remains about the most effective form of team organization, structures and the nature of the interventions. Many processes and outcomes of case management for people with complex chronic conditions cannot be addressed with the information provided by electronic clinical records. Registries are frequently used to deal with this weakness. The aim of this study was to generate a registry-based information system of patients receiving case management to identify their clinical characteristics, their context of care, events identified during their follow-up, interventions developed by case managers and services used. The study was divided into three phases, covering the detection of information needs, the design and its implementation in the health care system, using literature review and expert consensus methods to select variables that would be included in the registry. A total of 102 variables representing structure, processes and outcomes of case management were selected for their inclusion in the registry after the consensus phase. A web-based registry with modular and layered architecture was designed. The framework follows a pattern based on the model-view-controller approach. In its first 6 months after the implementation, 102 case managers have introduced an average number of 6.49 patients each one. The registry permits a complete and in-depth analysis of the characteristics of the patients who receive case management, the interventions delivered and some major outcomes as mortality, readmissions or adverse events. © 2015 John Wiley & Sons, Ltd.

Managing TIAA-CREF Contracts

ERIC Educational Resources Information Center

Bastable, C. W.; Brady, Gerald P.

1976-01-01

Complexities in managing TIAA-CREF contracts are reviewed. Attention is directed toward participation, period considerations, selection of retirement age, retirement income transition, estate considerations and beneficiaries, voluntary additional contributions, and supplemental retirement annuity contracts. (LBH)

User group attitudes toward forest management treatments on the Shawnee National Forest: application of a photo-evaluation technique

Treesearch

Jonathan M. Cohen; Jean C. Mangun; Mae A. Davenport; Andrew D. Carver

2008-01-01

Diverse public opinions, competing management goals, and polarized interest groups combine with problems of scale to create a complex management arena for managers in the Central Hardwood Forest region. A mixed-methods approach that incorporated quantitative analysis of data from a photo evaluation-attitude scale survey instrument was used to assess attitudes toward...

Addressing the human and technical dimensions of potato IPM using farmer field schools (FFS): CIP and partners' experience on late blight management

USDA-ARS?s Scientific Manuscript database

Starting in the 1990’s, the International Potato Center (CIP)’s integrated pest management team for potato late blight (IPM-LB) realized the importance of addressing the management of this complex potato disease by combining crop protection and management sciences, with social and behavioral science...

The complex nature of informal care in home-based heart failure management.

PubMed

Clark, Alexander M; Reid, Margaret E; Morrison, Caroline E; Capewell, Simon; Murdoch, David L; McMurray, John J

2008-02-01

This paper is a report of a study to examine the complexities of informal caregiving for people with chronic heart failure. Little is known of the activities involved and underlying informal care. Heart failure is a common and burdensome condition in which carers play an important management role. Semi-structured interviews were carried out with 30 informal carers nominated by patients with mild-to-moderate heart failure (24 spouses, four children, one sibling and one neighbour). Interviews examined knowledge of heart failure, its effects, reported management practices and concerns, decision making and support. The data were collected in 2001. The management of heart failure was a shared and ongoing responsibility between the carer and patient. Carers' clinical knowledge of the condition and management was often limited, but they developed extensive knowledge of its personal effects on the patient. Invisible care activities included monitoring signs of symptom exacerbation and energy boundaries against perceived current and future demands and priorities. Visible care activities included medication management, dressing, bathing and help-seeking. Carers responded to patients' capacities, and adopted philosophies that sought to foster independence while facilitating as normal a life for the patient as was possible and safe. Interventions for informal carers around effective chronic heart failure management should address both visible and invisible informal caring. Future research is needed to develop interventions with carers to improve quality of care, reduce costs and improve patient quality of life. More research is needed to explore the complexities of lay caregiving and to explore the invisible dimensions of informal care further.

JMS: An Open Source Workflow Management System and Web-Based Cluster Front-End for High Performance Computing.

PubMed

Brown, David K; Penkler, David L; Musyoka, Thommas M; Bishop, Özlem Tastan

2015-01-01

Complex computational pipelines are becoming a staple of modern scientific research. Often these pipelines are resource intensive and require days of computing time. In such cases, it makes sense to run them over high performance computing (HPC) clusters where they can take advantage of the aggregated resources of many powerful computers. In addition to this, researchers often want to integrate their workflows into their own web servers. In these cases, software is needed to manage the submission of jobs from the web interface to the cluster and then return the results once the job has finished executing. We have developed the Job Management System (JMS), a workflow management system and web interface for high performance computing (HPC). JMS provides users with a user-friendly web interface for creating complex workflows with multiple stages. It integrates this workflow functionality with the resource manager, a tool that is used to control and manage batch jobs on HPC clusters. As such, JMS combines workflow management functionality with cluster administration functionality. In addition, JMS provides developer tools including a code editor and the ability to version tools and scripts. JMS can be used by researchers from any field to build and run complex computational pipelines and provides functionality to include these pipelines in external interfaces. JMS is currently being used to house a number of bioinformatics pipelines at the Research Unit in Bioinformatics (RUBi) at Rhodes University. JMS is an open-source project and is freely available at https://github.com/RUBi-ZA/JMS.

Gastrointestinal surgery in cystic fibrosis: a 20-year review.

PubMed

Farrelly, Paul J; Charlesworth, Caroline; Lee, Sophie; Southern, Kevin W; Baillie, Colin T

2014-02-01

The purpose of this study was to evaluate outcomes of the surgical management for meconium ileus (MI) and Distal Intestinal Obstruction Syndrome (DIOS) in Cystic Fibrosis (CF). Children born between 1990 and 2010 were identified using a regional CF database. Retrospective case note analysis was performed. Outcome measures for MI were mortality, relaparotomy rate, length of stay (LOS), time on parental nutrition (TP), and time to full feeds (TFF). Outcome measures for DIOS were: age of onset, number of episodes, and need for laparotomy. Seventy-five of 376 neonates presented with MI. Fifty-four (92%) required laparotomy. Contrast enema decompression was attempted in nineteen. There were no post-operative deaths. Thirty-nine (72%) neonates with MI were managed with stomas. LOS was longer in those managed with stomas (p=0.001) and in complex MI (p=0.002). Thirty-five patients were treated for DIOS. Twenty-five patients were managed with gastrograffin. Ten patients underwent surgical management of DIOS. Overall, MI did not predispose to later development of DIOS. There was a significantly greater incidence of laparotomy for DIOS in children who had MI. The proportion of neonates with complex meconium ileus was high (49%) and may explain the infrequent utilisation of radiological decompression. Complex MI or management with stomas both significantly increase LOS. Re-laparotomy rate is high (22%) in MI irrespective of the type of management. DIOS is not a benign condition, particularly when the child has had previous abdominal surgery. Early referral to a surgical team is essential in these children. Copyright © 2014 Elsevier Inc. All rights reserved.

JMS: An Open Source Workflow Management System and Web-Based Cluster Front-End for High Performance Computing

PubMed Central

Brown, David K.; Penkler, David L.; Musyoka, Thommas M.; Bishop, Özlem Tastan

2015-01-01

Complex computational pipelines are becoming a staple of modern scientific research. Often these pipelines are resource intensive and require days of computing time. In such cases, it makes sense to run them over high performance computing (HPC) clusters where they can take advantage of the aggregated resources of many powerful computers. In addition to this, researchers often want to integrate their workflows into their own web servers. In these cases, software is needed to manage the submission of jobs from the web interface to the cluster and then return the results once the job has finished executing. We have developed the Job Management System (JMS), a workflow management system and web interface for high performance computing (HPC). JMS provides users with a user-friendly web interface for creating complex workflows with multiple stages. It integrates this workflow functionality with the resource manager, a tool that is used to control and manage batch jobs on HPC clusters. As such, JMS combines workflow management functionality with cluster administration functionality. In addition, JMS provides developer tools including a code editor and the ability to version tools and scripts. JMS can be used by researchers from any field to build and run complex computational pipelines and provides functionality to include these pipelines in external interfaces. JMS is currently being used to house a number of bioinformatics pipelines at the Research Unit in Bioinformatics (RUBi) at Rhodes University. JMS is an open-source project and is freely available at https://github.com/RUBi-ZA/JMS. PMID:26280450

The intersection of trust and recreation management

Treesearch

Patricia L. Winter; George T. Cvetkovich

2013-01-01

The management of public land as venues for a wide variety of outdoor recreation interests is a highly complex professional field. Understanding of the relationship between the visitor, general public values, the natural resource base and the politics of management policies requires training, experience and savvy. Recreation planning for forest, park, preserve,...

Estimating US federal wildland fire managers' preferences toward competing strategic suppression objectives

Treesearch

David E. Calkin; Tyron Venn; Matthew Wibbenmeyer; Matthew P. Thompson

2012-01-01

Wildfire management involves significant complexity and uncertainty, requiring simultaneous consideration of multiple, non-commensurate objectives. This paper investigates the tradeoffs fire managers are willing to make among these objectives using a choice experiment methodology that provides three key advancements relative to previous stated-preference studies...

The Pacific Northwest Research Station biodiversity initiative: collaborating for biodiversity management.

Treesearch

Peter Nelson; Rachel White; Randy Molina

2006-01-01

The Pacific Northwest Research Station launched a biodiversity initiative to assist natural resource professionals in integrating complex biodiversity concepts into natural resource management processes. We canvassed clients from various affiliations to determine the main challenges they face in biodiversity management, to define their information needs, and to...

ArcFuels10 system overview

Treesearch

Nicole M. Vaillant; Alan A. Ager; John Anderson

2013-01-01

Fire behavior modeling and geospatial analyses can provide tremendous insight for land managers as they grapple with the complex problems frequently encountered in wildfire risk assessments and fire and fuels management planning. Fuel management often is a particularly complicated process in which the benefits and potential impacts of fuel treatments need to be...

Public Debates Shaping Forestry's Future: An Analysis.

Treesearch

David Fan; David Bengston

1997-01-01

The job of forest managers and policy makers is growing increasingly complex because of rapid change in the social, political, economic, and scientific environments in which forest management is carried out. Managing public lands in ways that are responsive to changing social conditions requires continuous monitoring and assessment. But traditional methods for...

Saving Face: Managing Rapport in a Problem-Based Learning Group

ERIC Educational Resources Information Center

Robinson, Leslie; Harris, Ann; Burton, Rob

2015-01-01

This qualitative study investigated the complex social aspects of communication required for students to participate effectively in Problem-Based Learning and explored how these dynamics are managed. The longitudinal study of a group of first-year undergraduates examined interactions using Rapport Management as a framework to analyse communication…

The Management of Integrated Educational Environment Resources: The Factors to Be Considered

ERIC Educational Resources Information Center

Stukalina, Yulia

2010-01-01

Today, as educational organisations have become large and complex systems, education managers play a greater role in developing the most efficient educational environment. This article analyses the strategic background for educational management in relation to creating a constructive educational environment aimed at supporting a sustainable…

Enrollment Management: An Introduction to Concepts and Structures

ERIC Educational Resources Information Center

Bontrager, Bob

2004-01-01

In the increasingly complex world of managing enrollments, success or failure hinges on building a solid foundation of concepts, structures, and strategies. This first of a two-part series reviews the core concepts and structural considerations that underlie successful enrollment management organizations. The purpose of this article is to…

Biodiversity in the city: key challenges for urban green space management

Treesearch

Myla F.J. Aronson; Christopher A. Lepczyk; Karl L. Evans; Mark A. Goddard; Susannah B. Lerman; J. Scott MacIvor; Charles H. Nilon; Timothy Vargo

2017-01-01

Cities play important roles in the conservation of global biodiversity, particularly through the planning and management of urban green spaces (UGS). However, UGS management is subject to a complex assortment of interacting social, cultural, and economic factors, including governance, economics, social networks, multiple stakeholders, individual preferences, and social...

Positive Management Education: Creating Creative Minds, Passionate Hearts, and Kindred Spirits

ERIC Educational Resources Information Center

Karakas, Fahri

2011-01-01

The goal of this article is to explore positive management education, a practice-based teaching and learning model centered on positive organizational scholarship. Six signs of transformation in organizations are presented: complexity, community, creativity, spirituality, flexibility, and positivity. A model for positive management education is…

75 FR 6872 - Aransas National Wildlife Refuge Complex, Aransas, Calhoun, and Refugio Counties, TX

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-12

... and freshwater marshes. Management efforts focus on protecting, enhancing, and restoring Refuge habitats and water management for the benefit of important fish and wildlife resources. Aransas NWRC was... the system is ``for use as an inviolate sanctuary, or any other management purpose, for migratory...

A Collaborative Protocol for Encopresis Management in School-Aged Children.

ERIC Educational Resources Information Center

Chaney, Carol A.

1995-01-01

Encopresis affects a small percentage of children, but most parents are unaware of the condition and react punitively. The lengthy, complex management program usually includes physiological and behavioral approaches. The collaborative management protocol focuses on medical clinicians, families, children, school nurses, and teachers, and can help…

Use of family management styles in family intervention research.

PubMed

Alderfer, Melissa A

2006-01-01

Family management styles (FMSs) explain some of the complexities embedded in a family with a child who has chronic illness. The FMS typologies provide descriptions of family adjustment and management of care. These 5 distinct patterns may be valuable in tailoring and evaluating family interventions in research.

Development of a Procurement Management Framework in Ghana: A New Paradigm for Interdisciplinary Postgraduate Education

ERIC Educational Resources Information Center

Owusu-Manu, D.; Badu, E.; Edwards, D. J.

2011-01-01

Procurement in the corporate world is increasingly complex, multi-faceted and interdisciplinary. This paper explores existing knowledge specifications relating to procurement management competencies and proposes a new procurement management competency framework (PMCF) and a competency-based postgraduate programme for postgraduate students in…

Postgraduate Programmes on Environmental Water Resources Engineering and Management in Greek Universities

ERIC Educational Resources Information Center

Latinopoulos, Pericles; Angelidis, Panagiotis

2014-01-01

The management of complex water problems is nowadays being practised through new ways and approaches. Therefore, water engineers, planners and managers should be appropriately educated through modern undergraduate curricula and by well-designed postgraduate specialisation programmes. Within this framework, a study of the specific characteristics…

78 FR 26616 - Pacific Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... Pacific Fishery Management Council's (Pacific Council) Groundfish Management Team (GMT) will hold a... will be held via webinar. To attend the GMT meeting, please reserve your seat by visiting: https://www2... reorganization of groundfish stock complexes. The GMT is tentatively scheduled to report their findings to the...

Evolution of Management Thought in the Medieval Times.

ERIC Educational Resources Information Center

Sharma, C. L.

The medieval times witnessed progress toward the growth of larger and more complex organizations and the application of increasingly sophisticated management techniques. Feudalism contributed the concept of decentralization. The concepts evolved by the Catholic Church can scarcely be improved on and are very much pertinent to the management of…

Data management in the mission data system

NASA Technical Reports Server (NTRS)

Wagner, David A.

2005-01-01

As spacecraft evolve from simple embedded devices to become more sophisticated computing platforms with complex behaviors it is increasingly necessary to model and manage the flow of data, and to provide uniform models for managing data that promote adaptability, yet pay heed to the physical limitations of the embedded and space environments.

Neuropathic pain in people with cancer (part 2): pharmacological and non-pharmacological management.

PubMed

Taverner, Tarnia

2015-08-01

The aim of this paper is to provide an overview of the management of neuropathic pain associated with cancer and to provide helpful clinical advice for nurses working with patients who may have neuropathic pain. While cancer pain is a mixed-mechanism pain, this article will focus only on neuropathic pain management. The impact of neuropathic pain on patients' quality of life is great and while many patients recover from their cancer, a significant number continue to suffer from a neuropathic pain syndrome. Management of neuropathic pain is significantly different from management of nociceptive pain with respect to pharmacological and non-pharmacological strategies. Neuropathic pain is complex, and as such requires complex management using pharmacological as well as non-pharmacological approaches. Specific drugs for neuropathic pain may be effective for some patients, but not all; therefore, ongoing and comprehensive assessment and management are required. Furthermore, these patients may require trials of several drugs before they find one that works for them. It is important for nurses to understand neuropathic pain, its manifestation, impact on quality of life and management when nursing patients with neuropathic pain associated with cancer.

Use of Antibiotic-Impregnated Absorbable Beads and Tissue Coverage of Complex Wounds.

PubMed

White, Terris L; Culliford, Alfred T; Zomaya, Martin; Freed, Gary; Demas, Christopher P

2016-11-01

The treatment of complex wounds is commonplace for plastic surgeons. Standard management is debridement of infected and devitalized tissue and systemic antibiotic therapy. In cases where vital structures are exposed within the wound, coverage is obtained with the use of vascularized tissue using both muscle and fasciocutaneous flaps. The use of nondissolving polymethylmethacrylate and absorbable antibiotic-impregnated beads has been shown to deliver high concentrations of antibiotics with low systemic levels of the same antibiotic. We present a multicenter retrospective review of all cases that used absorbable antibiotic-impregnated beads for complex wound management from 2003 to 2013. A total of 104 cases were investigated, flap coverage was used in 97 cases (93.3%). Overall, 15 patients (14.4%) required reoperation with the highest groups involving orthopedic wounds and sternal wounds. The advantages of using absorbable antibiotic-impregnated beads in complex infected wounds have been demonstrated with minimal disadvantages. The utilization of these beads is expanding to a variety of complex infectious wounds requiring high concentrations of local antibiotics.

The BioIntelligence Framework: a new computational platform for biomedical knowledge computing

PubMed Central

Farley, Toni; Kiefer, Jeff; Lee, Preston; Von Hoff, Daniel; Trent, Jeffrey M; Colbourn, Charles

2013-01-01

Breakthroughs in molecular profiling technologies are enabling a new data-intensive approach to biomedical research, with the potential to revolutionize how we study, manage, and treat complex diseases. The next great challenge for clinical applications of these innovations will be to create scalable computational solutions for intelligently linking complex biomedical patient data to clinically actionable knowledge. Traditional database management systems (DBMS) are not well suited to representing complex syntactic and semantic relationships in unstructured biomedical information, introducing barriers to realizing such solutions. We propose a scalable computational framework for addressing this need, which leverages a hypergraph-based data model and query language that may be better suited for representing complex multi-lateral, multi-scalar, and multi-dimensional relationships. We also discuss how this framework can be used to create rapid learning knowledge base systems to intelligently capture and relate complex patient data to biomedical knowledge in order to automate the recovery of clinically actionable information. PMID:22859646

Modeling social crowds. Comment on "Human behaviours in evacuation crowd dynamics: From modelling to "big data" toward crisis management" by Nicola Bellomo et al.

NASA Astrophysics Data System (ADS)

Poyato, David; Soler, Juan

2016-09-01

The study of human behavior is a complex task, but modeling some aspects of this behavior is an even more complicated and exciting idea. From crisis management to decision making in evacuation protocols, understanding the complexity of humans in stress situations is more and more demanded in our society by obvious reasons [5,6,8,12]. In this context, [4] deals with crowd dynamics with special attention to evacuation.

CALFED--An experiment in science and decisionmaking

USGS Publications Warehouse

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

2003-01-01

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

Hardware Specific Integration Strategy for Impedance-Based Structural Health Monitoring of Aerospace Systems

NASA Technical Reports Server (NTRS)

Owen, Robert B.; Gyekenyesi, Andrew L.; Inman, Daniel J.; Ha, Dong S.

2011-01-01

The Integrated Vehicle Health Management (IVHM) Project, sponsored by NASA's Aeronautics Research Mission Directorate, is conducting research to advance the state of highly integrated and complex flight-critical health management technologies and systems. An effective IVHM system requires Structural Health Monitoring (SHM). The impedance method is one such SHM technique for detection and monitoring complex structures for damage. This position paper on the impedance method presents the current state of the art, future directions, applications and possible flight test demonstrations.

Laboratory complex for simulation of navigation signals of pseudosatellites

NASA Astrophysics Data System (ADS)

Ratushniak, V. N.; Gladyshev, A. B.; Sokolovskiy, A. V.; Mikhov, E. D.

2018-05-01

In the article, features of the organization, structure and questions of formation of navigation signals of pseudosatellites of the short - range navigation system based on the hardware-software complex National Instruments are considered. A software model that performs the formation and management of a pseudo-random sequence of a navigation signal and the formation and management of the format transmitted pseudosatellite navigation information is presented. The variant of constructing the transmitting equipment of the pseudosatellite base stations is provided.

The Huaihe Basin Water Resource and Water Quality Management Platform Implemented with a Spatio-Temporal Data Model

NASA Astrophysics Data System (ADS)

Liu, Y.; Zhang, W.; Yan, C.

2012-07-01

Presently, planning and assessment in maintenance, renewal and decision-making for watershed hydrology, water resource management and water quality assessment are evolving toward complex, spatially explicit regional environmental assessments. These problems have to be addressed with object-oriented spatio-temporal data models that can restore, manage, query and visualize various historic and updated basic information concerning with watershed hydrology, water resource management and water quality as well as compute and evaluate the watershed environmental conditions so as to provide online forecasting to police-makers and relevant authorities for supporting decision-making. The extensive data requirements and the difficult task of building input parameter files, however, has long been an obstacle to use of such complex models timely and effectively by resource managers. Success depends on an integrated approach that brings together scientific, education and training advances made across many individual disciplines and modified to fit the needs of the individuals and groups who must write, implement, evaluate, and adjust their watershed management plans. The centre for Hydro-science Research, Nanjing University, in cooperation with the relevant watershed management authorities, has developed a WebGIS management platform to facilitate this complex process. Improve the management of watersheds over the Huaihe basin through the development, promotion and use of a web-based, user-friendly, geospatial watershed management data and decision support system (WMDDSS) involved many difficulties for the development of this complicated System. In terms of the spatial and temporal characteristics of historic and currently available information on meteorological, hydrological, geographical, environmental and other relevant disciplines, we designed an object-oriented spatiotemporal data model that combines spatial, attribute and temporal information to implement the management system. Using this system, we can update, query and analyze environmental information as well as manage historical data, and a visualization tool was provided to help the user interpret results so as to provide scientific support for decision-making. The utility of the system has been demonstrated its values by being used in watershed management and environmental assessments.

Out-patient management of chronic heart failure.

PubMed

Terrovitis, John V; Anastasiou-Nana, Maria I; Nanas, John N

2005-09-01

Chronic heart failure is a clinical syndrome associated with an ominous long-term prognosis and major economic consequences for Western societies. In recent years, considerable progress has been made in the pharmacological management of heart failure, and several treatments have been confirmed to confer survival and symptomatic benefits. However, pharmaceuticals remain underutilised, and the combination of several different drugs present challenges for their optimal prescription, requiring a thorough knowledge of potential side effects and complex interactions. This article reviews in detail the evidence pertaining to the out-patient pharmacological management of chronic heart failure, and offers recommendations on the use of various drugs in complex clinical conditions, or in areas of ongoing controversy.

Enhancements to the Design Manager's Aide for Intelligent Decomposition (DeMAID)

NASA Technical Reports Server (NTRS)

Rogers, James L.; Barthelemy, Jean-Francois M.

1992-01-01

This paper discusses the addition of two new enhancements to the program Design Manager's Aide for Intelligent Decomposition (DeMAID). DeMAID is a knowledge-based tool used to aid a design manager in understanding the interactions among the tasks of a complex design problem. This is done by ordering the tasks to minimize feedback, determining the participating subsystems, and displaying them in an easily understood format. The two new enhancements include (1) rules for ordering a complex assembly process and (2) rules for determining which analysis tasks must be re-executed to compute the output of one task based on a change in input to that or another task.

Enhancements to the Design Manager's Aide for Intelligent Decomposition (DeMaid)

NASA Technical Reports Server (NTRS)

Rogers, James L.; Barthelemy, Jean-Francois M.

1992-01-01

This paper discusses the addition of two new enhancements to the program Design Manager's Aide for Intelligent Decomposition (DeMAID). DeMAID is a knowledge-based tool used to aid a design manager in understanding the interactions among the tasks of a complex design problem. This is done by ordering the tasks to minimize feedback, determining the participating subsystems, and displaying them in an easily understood format. The two new enhancements include (1) rules for ordering a complex assembly process and (2) rules for determining which analysis tasks must be re-executed to compute the output of one task based on a change in input to that or another task.

A wellness software platform with smart wearable devices and the demonstration report for personal wellness management

NASA Astrophysics Data System (ADS)

Kang, Won-Seok; Son, Chang-Sik; Lee, Sangho; Choi, Rock-Hyun; Ha, Yeong-Mi

2017-07-01

In this paper, we introduce a wellness software platform, called WellnessHumanCare, is a semi-automatic wellness management software platform which has the functions of complex wellness data acquisition(mental, physical and environmental one) with smart wearable devices, complex wellness condition analysis, private-aware online/offline recommendation, real-time monitoring apps (Smartphone-based, Web-based) and so on and we has demonstrated a wellness management service with 79 participants (experimental group: 39, control group: 40) who has worked at experimental group (H Corp.) and control group (K Corp.), Korea and 3 months in order to show the efficiency of the WellnessHumanCare.

Managing Complex Medication Regimens.

PubMed

Harvath, Theresa A; Lindauer, Allison; Sexson, Kathryn

2016-11-01

This article is the first in a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Foundation. Results of focus groups conducted as part of the AARP Foundation's No Longer Home Alone video project supported evidence that family caregivers aren't being given the information they need to manage the complex care regimens of their family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's medications. Each article explains the principles nurses should consider and reinforce with caregivers and is accompanied by a video for the caregiver to watch. The first video can be accessed at http://links.lww.com/AJN/A74.

All-inside, anatomical lateral ankle stabilization for revision and complex primary lateral ankle stabilization: a technique guide.

PubMed

Prissel, Mark A; Roukis, Thomas S

2014-12-01

Lateral ankle instability is a common mechanical problem that often requires surgical management when conservative efforts fail. Historically, myriad open surgical approaches have been proposed. Recently, consideration for arthroscopic management of lateral ankle instability has become popular, with promising results. Unfortunately, recurrent inversion ankle injury following lateral ankle stabilization can occur and require revision surgery. To date, arthroscopic management for revision lateral ankle stabilization has not been described. We present a novel arthroscopic technique combining an arthroscopic lateral ankle stabilization kit with a suture anchor ligament augmentation system for revision as well as complex primary lateral ankle stabilization. © 2014 The Author(s).

Information flow in the pharmaceutical supply chain.

PubMed

Yousefi, Nazila; Alibabaei, Ahmad

2015-01-01

Managing the supply chain plays an important role in creating competitive advantages for companies. Adequate information flow in supply chain is one of the most important issues in SCM. Therefore, using certain Information Systems can have a significant role in managing and integrating data and information within the supply chain. Pharmaceutical supply chain is more complex than many other supply chains, in the sense that it can affect social and political perspectives. On the other hand, managing the pharmaceutical supply chain is difficult because of its complexity and also government regulations in this field. Although, Iran has progressed a lot in pharmaceutical manufacturing, still there are many unsolved issues in managing the information flow in the pharmaceutical supply chain. In this study, we reviewed the benefits of using different levels of an integrated information system in the supply chain and the possible challenges ahead.

Multistability and complex basins in a nonlinear duopoly with price competition and relative profit delegation.

PubMed

Fanti, Luciano; Gori, Luca; Mammana, Cristiana; Michetti, Elisabetta

2016-09-01

In this article, we investigate the local and global dynamics of a nonlinear duopoly model with price-setting firms and managerial delegation contracts (relative profits). Our study aims at clarifying the effects of the interaction between the degree of product differentiation and the weight of manager's bonus on long-term outcomes in two different states: managers behave more aggressively with the rival (competition) under product complementarity and less aggressively with the rival (cooperation) under product substitutability. We combine analytical tools and numerical techniques to reach interesting results such as synchronisation and on-off intermittency of the state variables (in the case of homogeneous attitude of managers) and the existence of chaotic attractors, complex basins of attraction, and multistability (in the case of heterogeneous attitudes of managers). We also give policy insights.

Multistability and complex basins in a nonlinear duopoly with price competition and relative profit delegation

NASA Astrophysics Data System (ADS)

Fanti, Luciano; Gori, Luca; Mammana, Cristiana; Michetti, Elisabetta

2016-09-01

In this article, we investigate the local and global dynamics of a nonlinear duopoly model with price-setting firms and managerial delegation contracts (relative profits). Our study aims at clarifying the effects of the interaction between the degree of product differentiation and the weight of manager's bonus on long-term outcomes in two different states: managers behave more aggressively with the rival (competition) under product complementarity and less aggressively with the rival (cooperation) under product substitutability. We combine analytical tools and numerical techniques to reach interesting results such as synchronisation and on-off intermittency of the state variables (in the case of homogeneous attitude of managers) and the existence of chaotic attractors, complex basins of attraction, and multistability (in the case of heterogeneous attitudes of managers). We also give policy insights.

Spirituality and Religion in Pain and Pain Management

PubMed Central

Dedeli, Ozden; Kaptan, Gulten

2013-01-01

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

Anaesthetic and critical care management of thoracic injuries.

PubMed

Round, J A; Mellor, A J

2010-09-01

Thoracic wounding has been a relatively common presentation of military wounds throughout modern conflict. When civilian casualties are included the incidence has remained constant at around 10%, although the frequency and severity of wounds to combatants has been altered by modern body armour. Whilst thoracic injury has a high initial mortality on the battlefield, those surviving to reach hospital frequently have injuries that only require simple management. In addition to penetrating ballistic injury, blunt chest trauma frequently occurs on operations as a result of road traffic collisions or tertiary blast injury. The physiological impact of thoracic wounds, however, is often great and survivors often require intensive care management and, where available, complex strategies to ensure oxygenation and carbon dioxide removal. This review examines the incidence and patterns of thoracic trauma and looks at therapeutic options for managing these complex cases.

[A reflective case report applied to pain management in a complex care situation].

PubMed

Kinsperger, Laura; Mayrhofer, Stefanie Maria; Pichler, Birgit; Qin, Hong; Rheinfrank, Iris; Schrems, Berta

2015-10-01

This case report deals with the unsatisfying pain management of a 44 year old patient with cardiac arrest and subsequent cardiopulmonary resuscitation. The patient has (1) a reduced consciousness, (2) is isolated due to an infection with multi-resistant germs, (3) has a tracheotomy and (4) contractures of the muscles in fingers and hands. During nursing care he shows facial expressions and body postures that indicate pain which is insufficiently addressed. The case was processed according to the model of reflexive case report by Johns (1995) and interpreted by theoretical expertise and the change of the perspective. Therefore the following questions were answered: Which factors made the nurse who brought the case to the case deliberation feeling dissatisfied with the pain management? Insufficient pain management due to a lack of knowledge, no assessment of the state of consciousness, pain and isolation probably led to unnecessary burden of the patient, next of kin and nurses. Training, systematic pain management and multi-disciplinary case conferences might facilitate dealing with comparable complex situations of caring in the future. The present case report shows that pain can only be treated successfully if pain-triggering factors are recognized, systematically assessed and treated. An adequate external assessment of the pain situation is especially important when dealing with patients who suffer from disorders of consciousness. In complex cases, in which multiple factors influence the pain situation, interdisciplinary case conferences may help to improve the quality of pain management.

[Conceptualization of knowledge management in medium and high complexity health institutions].

PubMed

Arboleda-Posada, Gladys I

2016-06-01

Objective To identify the familiarization, conceptualization and incorporation of employees of medium and high complexity health institutions in the Valle de Aburrá, Colombia into the strategic knowledge management platform in 2011. Methodology Cross sectional study. The study was carried out by applying surveys to 224 employees to assess knowledge management. The population included staff who working in the Health Providing Institutions (IPS) of high (52) and medium complexity (322) in the Valle de Aburrá in 2011. In both the public and private institutions surveyed, 38.8 % of the respondents said they were not familiar with knowledge management. Among those who had administrative training, the ignorance was less than among care workers. It was also noted that as the level of education increased, knowledge of the concept was greater. A high proportion (65.2 % ) of respondents placed the concept in line with the creation, organization, storage, retrieval, transfer and application of knowledge systematically. 78.7 % of respondents from public institutions said that knowledge management was part of the strategic platform of the institution. 58.3 % from private institutions said the same. Conclusions In general terms the concept of knowledge management is not well conceived or familiar to the staff working in these institutions. The study confirmed a lack of empowerment in the field to promote the development of new ideas and to ensure that they become service innovations or processes that contribute to the development of institutional knowledge.

Cross-boundary management between national parks and surrounding lands: A review and discussion

NASA Astrophysics Data System (ADS)

Schonewald-Cox, Christine; Buechner, Marybeth; Sauvajot, Raymond; Wilcox, Bruce A.

1992-03-01

Protecting biodiversity on public lands is difficult, requiring the management of a complex array of factors. This is especially true when the ecosystems in question are affected by, or extend onto, lands outside the boundaries of the protected area. In this article we review recent developments in the cross-boundary management of protected natural resources, such as parks, wildlife reserves, and designated wilderness areas. Five ecological and 11 anthropic techniques have been suggested for use in cross-boundary management. The categories are not mutually exclusive, but each is a distinct and representative approach, suggested by various authors from academic, managerial, and legal professions. The ecological strategies stress the collection of basic data and documentation of trends. The anthropic techniques stress the usefulness of cooperative guidelines and the need to develop a local constituency which supports park goals. However, the situation is complex and the needed strategies are often difficult to implement. Diverse park resources are influenced by events in surrounding lands. The complexity and variability of sources, the ecological systems under protection, and the uncertainty of the effects combine to produce situations for which there are no simple answers. The solution to coexistence of the park and surrounding land depends upon creative techniques and recommendations, many still forthcoming. Ecological, sociological, legal, and economic disciplines as well as the managing agency should all contribute to these recommendations. Platforms for change include legislation, institutional policies, communication, education, management techniques, and ethics.

What does it take to set goals for self-management in primary care? A qualitative study.

PubMed

Lenzen, Stephanie Anna; van Dongen, Jerôme Jean Jacques; Daniëls, Ramon; van Bokhoven, Marloes Amantia; van der Weijden, Trudy; Beurskens, Anna

2016-12-01

There is an increasing number of patients with a chronic illness demanding primary care services. This demands for effective self-management support, including collaborative goal setting. Despite the fact that primary care professionals seem to have difficulties implementing goal setting, little information is available about the factors influencing the complexity of this process in primary care. The aim of this study was to contribute to an understanding of the complexity of self-management goal setting in primary care by exploring experts' and primary care professionals' experiences with self-management goal setting and viewpoints regarding influencing factors. A descriptive qualitative research methodology was adopted. Two focus groups and three individual interviews were conducted (total participants n = 17). Thematic content analysis was used to analyse the data. The findings were categorized into four main themes with subordinated subthemes. The themes focus around the complexity of setting non-medical goals and around professionals' skills and attitudes to negotiate and decide about goals with patients. Furthermore, patients' skills and attitudes for goal setting and the integration of goal setting in the time available were formulated as themes. Setting self-management goals in primary care, especially in family medicine, might require a shift from a medical perspective to a biopsychosocial perspective, with an increasing role set aside for the professional to coach the patient in expressing his self-management goals and to take responsibility for these goals. © The Author 2016. Published by Oxford University Press.

Cynefin as Reference Framework to Facilitate Insight and Decision-Making in Complex Contexts of Biomedical Research.

PubMed

Kempermann, Gerd

2017-01-01

The Cynefin scheme is a concept of knowledge management, originally devised to support decision making in management, but more generally applicable to situations, in which complexity challenges the quality of insight, prediction, and decision. Despite the fact that life itself, and especially the brain and its diseases, are complex to the extent that complexity could be considered their cardinal feature, complex problems in biomedicine are often treated as if they were actually not more than the complicated sum of solvable sub-problems. Because of the emergent properties of complex contexts this is not correct. With a set of clear criteria Cynefin helps to set apart complex problems from "simple/obvious," "complicated," "chaotic," and "disordered" contexts in order to avoid misinterpreting the relevant causality structures. The distinction comes with the insight, which specific kind of knowledge is possible in each of these categories and what are the consequences for resulting decisions and actions. From student's theses over the publication and grant writing process to research politics, misinterpretation of complexity can have problematic or even dangerous consequences, especially in clinical contexts. Conceptualization of problems within a straightforward reference language like Cynefin improves clarity and stringency within projects and facilitates communication and decision-making about them.

Acute Complex Care Model: An organizational approach for the medical care of hospitalized acute complex patients.

PubMed

Pietrantonio, Filomena; Orlandini, Francesco; Moriconi, Luca; La Regina, Micaela

2015-12-01

Chronic diseases are the major cause of death (59%) and disability worldwide, representing 46% of global disease burden. According to the Future Hospital Commission of the Royal College of Physicians, Medical Division (MD) will be responsible for all hospital medical services, from emergency to specialist wards. The Hospital Acute Care Hub will bring together the clinical areas of the MD that focus on the management of acute medical patients. The Chronic Care Model (CCM) places the patient at the center of the care system enhancing the community's social and health support, pathways and structures to keep chronic, frail, poly-pathological people at home or out of the hospital. The management of such patients in the hospital still needs to be solved. Hereby, we propose an innovative model for the management of the hospital's acute complex patients, which is the hospital counterpart of the CCM. The target population are acutely ill complex and poly-pathological patients (AICPPs), admitted to hospital and requiring high technology resources. The mission is to improve the management of medical admissions through pre-defined intra-hospital tracks and a global, multidisciplinary, patient-centered approach. The ACCM leader is an internal medicine specialist (IMS) who summarizes health problems, establishes priorities, and restores health balance in AICPPs. The epidemiological transition leading to a progressive increase in "chronically unstable" and complex patients needing frequent hospital treatment, inevitably enhances the role of hospital IMS in the coordination and delivery of care. ACCM represents a practical response to this epochal change of roles. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

TMT approach to observatory software development process

NASA Astrophysics Data System (ADS)

Buur, Hanne; Subramaniam, Annapurni; Gillies, Kim; Dumas, Christophe; Bhatia, Ravinder

2016-07-01

The purpose of the Observatory Software System (OSW) is to integrate all software and hardware components of the Thirty Meter Telescope (TMT) to enable observations and data capture; thus it is a complex software system that is defined by four principal software subsystems: Common Software (CSW), Executive Software (ESW), Data Management System (DMS) and Science Operations Support System (SOSS), all of which have interdependencies with the observatory control systems and data acquisition systems. Therefore, the software development process and plan must consider dependencies to other subsystems, manage architecture, interfaces and design, manage software scope and complexity, and standardize and optimize use of resources and tools. Additionally, the TMT Observatory Software will largely be developed in India through TMT's workshare relationship with the India TMT Coordination Centre (ITCC) and use of Indian software industry vendors, which adds complexity and challenges to the software development process, communication and coordination of activities and priorities as well as measuring performance and managing quality and risk. The software project management challenge for the TMT OSW is thus a multi-faceted technical, managerial, communications and interpersonal relations challenge. The approach TMT is using to manage this multifaceted challenge is a combination of establishing an effective geographically distributed software team (Integrated Product Team) with strong project management and technical leadership provided by the TMT Project Office (PO) and the ITCC partner to manage plans, process, performance, risk and quality, and to facilitate effective communications; establishing an effective cross-functional software management team composed of stakeholders, OSW leadership and ITCC leadership to manage dependencies and software release plans, technical complexities and change to approved interfaces, architecture, design and tool set, and to facilitate effective communications; adopting an agile-based software development process across the observatory to enable frequent software releases to help mitigate subsystem interdependencies; defining concise scope and work packages for each of the OSW subsystems to facilitate effective outsourcing of software deliverables to the ITCC partner, and to enable performance monitoring and risk management. At this stage, the architecture and high-level design of the software system has been established and reviewed. During construction each subsystem will have a final design phase with reviews, followed by implementation and testing. The results of the TMT approach to the Observatory Software development process will only be preliminary at the time of the submittal of this paper, but it is anticipated that the early results will be a favorable indication of progress.

Management of complex pediatric laryngotracheal stenosis with skin graft reconstruction.

PubMed

Bowe, Sarah N; Wentland, Carissa J; Sandhu, G S; Hartnick, Christopher J

2018-05-01

For pediatric patients with laryngotracheal stenosis, the ultimate goal is creation of a safe, functional airway. Unfortunately, wound healing in a hollow structure can complicate repair attempts, leading to restenosis. Herein, we present our experience using skin-grafting techniques in two complex pediatric laryngotracheal stenosis cases, leading to successful decannulation or speech production. A chart review was performed examining the evaluation and management of two pediatric patients with laryngotracheal stenosis despite prior reconstructive attempts. Patient history, bronchoscopic evaluation, intra-operative technique, post-operative management, treatment outcomes, and complications were noted. Harvesting and preparation of the split-thickness skin grafts (STSG) proceeded in a similar manner for each case. Stenting material varied based on the clinical scenario. Using this technique, our patient with a Type 3 glottic web achieved substantial improvement in exercise tolerance, as well as vocal strength and quality. In addition, our aphonic patient could vocalize for the first time since her laryngotracheal injury. Temporary endoluminal stenting with skin graft lining can reproduce epithelial continuity and provide "biological inhibition" to enhance the wound healing process. When previous reconstructive efforts have failed, use of STSG can be considered in the management of complex pediatric laryngotracheal stenosis. Copyright © 2018. Published by Elsevier B.V.

Pollution characterization of liquid waste of the factory complex Fertial (Arzew, Algeria).

PubMed

Redouane, Fares; Mourad, Lounis

2016-03-01

The industrial development in Algeria has made a worrying situation for all socioeconomic stakeholders. Indeed, this economic growth is marked in recent years by the establishment of factories and industrial plants that discharge liquid waste in marine shorelines. These releases could destabilize the environmental balance in the coming years, hence the need to support the processing of all sources of pollution. Remediation of such discharges requires several steps of identifying the various pollutants to their treatments. Therefore, the authors conducted this first work of characterization of industrial effluents generated by the mineral fertilizer factory complex Fertial (Arzew), and discussed the pollution load generated by this type of industry. This monitoring would establish a tool for reflection and decision support developed by a management system capable of ensuring effective and sustainable management of effluents from industrial activities of Fertial. The authors conducted this first work of characterization of industrial effluents generated by the mineral fertilizer factory complex Fertial (Arzew), and discussed the pollution load generated by this type of industry. This monitoring would establish a tool for reflection and decision support developed by a management system capable of ensuring effective and sustainable management of effluents from industrial activities of Fertial.

Fire Management in the Inter Galatic Interface or 30 Years of Fire Management at Merritt Island National Wildlife Refuge/Kennedy Space Center, Florida

Treesearch

Frederic W. Adrian

2006-01-01

Prescribed burning is essential on Merritt Island National Wildlife Refuge. Not only is it needed to manage the volatile fuels, but also to manage the complex system of fire maintained habitats found here. Fire management on the Refuge presents unique challenges. In addition to the restraints to prescribed burning that are common to many prescribed burning programs,...

Case management: a case study.

PubMed

Stanton, M P; Walizer, E M; Graham, J I; Keppel, L

2000-01-01

This article describes the implementation of a pilot case management program at Walter Reed Army Medical Center. I, it we discuss obvious pitfalls and problems implementing case management in a large multiservice center and the steps and processes implemented to expedite and move case management forward in its early stages. The insights shared may be useful for those implementing case management in a complex medical center situation. Other models used in similar situations are also reviewed.

Leadership and Management in Aesthetic Medicine.

PubMed

Brennan, Connie

2016-01-01

The aesthetic provider is obligated to leverage their leadership, management, and teamwork skills on a daily basis in order to deliver optimum aesthetic outcomes for their clients. This article discusses leadership and motivational theories, leadership and management traits, complexity theory, Gardner's tasks of leadership, and the role of emotional intelligence in leading, managing, and following, so the aesthetic provider can identify and align with a particular leadership and management style that suits their practice philosophy.

The Roles of Chronic Disease Complexity, Health System Integration, and Care Management in Post-Discharge Healthcare Utilization in a Low-Income Population.

PubMed

Hewner, Sharon; Casucci, Sabrina; Castner, Jessica

2016-08-01

Economically disadvantaged individuals with chronic disease have high rates of in-patient (IP) readmission and emergency department (ED) utilization following initial hospitalization. The purpose of this study was to explore the relationships between chronic disease complexity, health system integration (admission to accountable care organization [ACO] hospital), availability of care management interventions (membership in managed care organization [MCO]), and 90-day post-discharge healthcare utilization. We used de-identified Medicaid claims data from two counties in western New York. The study population was 114,295 individuals who met inclusion criteria, of whom 7,179 had index hospital admissions in the first 9 months of 2013. Individuals were assigned to three disease complexity segments based on presence of 12 prevalent conditions. The 30-day inpatient (IP) readmission rates ranged from 6% in the non-chronic segment to 12% in the chronic disease complexity segment and 21% in the organ system failure complexity segment. Rehospitalization rates (both inpatient and emergency department [ED]) were lower for patients in MCOs and ACOs than for those in fee-for-service care. Complexity of chronic disease, initial hospitalization in a facility that was part of an ACO, MCO membership, female gender, and longer length of stay were associated with a significantly longer time to readmission in the first 90 days, that is, fewer readmissions. Our results add to evidence that high-value post-discharge utilization (fewer IP or ED rehospitalizations and early outpatient follow-up) require population-based transitional care strategies that improve continuity between settings and take into account the illness complexity of the Medicaid population. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

A socio-ecological adaptive approach to contaminated mega-site management: from 'control and correct' to 'coping with change'.

PubMed

Schirmer, Mario; Lyon, Ken; Armstrong, James E; Farrell, Katharine N

2012-01-01

Mega-sites have a notable impact on surrounding ecological systems. At such sites there are substantial risks associated with complex socio-ecological interactions that are hard to characterize, let alone model and predict. While the urge to control and clean-up mega-sites (control and correct) is understandable, rather than setting a goal of cleaning up such sites, we suggest a more realistic response strategy is to address these massive and persistent sources of contamination by acknowledging their position as new features of the socio-ecological landscapes within which they are located. As it seems nearly impossible to clean up such sites, we argue for consideration of a 'coping with change' rather than a 'control and correct' approach. This strategy recognizes that the current management option for a mega-site, in light of its physical complexities and due to changing societal preferences, geochemical transformations, hydrogeology knowledge and remedial technology options may not remain optimal in future, and therefore needs to be continuously adapted, as community, ecology, technology and understanding change over time. This approach creates an opportunity to consider the relationship between a mega-site and its human and ecological environments in a different and more dynamic way. Our proposed approach relies on iterative adaptive management to incorporate mega-site management into the overall socio-ecological systems of the site's context. This approach effectively embeds mega-site management planning in a triple bottom line and environmental sustainability structure, rather than simply using single measures of success, such as contaminant-based guidelines. Recognizing that there is probably no best solution for managing a mega-site, we present a starting point for engaging constructively with this seemingly intractable issue. Therefore, we aim to initiate discussion about a new approach to mega-site management, in which the complexity of the problems posed by mega-sites is reflected upon in its entirety. These complexities are associated with uncertainties and unknowns that have to be addressed, as they have an impact on the strategies being developed and applied. We contend that the best that can be hoped for in mega-site management is an acceptable solution for the current state of affairs, with good flexibility to modify strategies as new site conditions, remediation possibilities, community preferences and management objectives develop over time. Copyright © 2011 Elsevier B.V. All rights reserved.

Unprotected Left Main Coronary Artery Disease: Management in the Post NOBLE and EXCEL Era

PubMed Central

Kapadia, Samir R; Ellis, Stephen G

2017-01-01

The optimal management of unprotected left main coronary artery (ULMCA) disease is currently a debated topic. Percutaneous coronary intervention (PCI) has seen an increased adoption for the management of ULMCA disease after numerous small-scale randomised trials and cohort studies showed equipoise with coronary artery bypass grafting (CABG) for low complexity lesions. The recently published NOBLE and EXCEL trials are two of the largest international randomised clinical trials comparing PCI and CABG in patients with ULMCA disease. In lieu of all the available evidence, PCI appears to be equivalent to CABG in regard to mortality in patients with ULMCA disease. In non-diabetic patients with low complexity coronary disease (SYNTAX score ≤32), PCI appears to be a reasonable alternative to CABG, especially for ostial and midshaft left main coronary lesions. CABG is preferable in the presence of diabetes, multivessel coronary disease in addition to ULMCA or complex coronary lesions (SYNTAX score >33) including distal left main lesions. PMID:29588736

Unprotected Left Main Coronary Artery Disease: Management in the Post NOBLE and EXCEL Era.

PubMed

Borges, Nyal; Kapadia, Samir R; Ellis, Stephen G

2017-09-01

The optimal management of unprotected left main coronary artery (ULMCA) disease is currently a debated topic. Percutaneous coronary intervention (PCI) has seen an increased adoption for the management of ULMCA disease after numerous small-scale randomised trials and cohort studies showed equipoise with coronary artery bypass grafting (CABG) for low complexity lesions. The recently published NOBLE and EXCEL trials are two of the largest international randomised clinical trials comparing PCI and CABG in patients with ULMCA disease. In lieu of all the available evidence, PCI appears to be equivalent to CABG in regard to mortality in patients with ULMCA disease. In non-diabetic patients with low complexity coronary disease (SYNTAX score ≤32), PCI appears to be a reasonable alternative to CABG, especially for ostial and midshaft left main coronary lesions. CABG is preferable in the presence of diabetes, multivessel coronary disease in addition to ULMCA or complex coronary lesions (SYNTAX score >33) including distal left main lesions.

Improving the analysis, storage and sharing of neuroimaging data using relational databases and distributed computing.

PubMed

Hasson, Uri; Skipper, Jeremy I; Wilde, Michael J; Nusbaum, Howard C; Small, Steven L

2008-01-15

The increasingly complex research questions addressed by neuroimaging research impose substantial demands on computational infrastructures. These infrastructures need to support management of massive amounts of data in a way that affords rapid and precise data analysis, to allow collaborative research, and to achieve these aims securely and with minimum management overhead. Here we present an approach that overcomes many current limitations in data analysis and data sharing. This approach is based on open source database management systems that support complex data queries as an integral part of data analysis, flexible data sharing, and parallel and distributed data processing using cluster computing and Grid computing resources. We assess the strengths of these approaches as compared to current frameworks based on storage of binary or text files. We then describe in detail the implementation of such a system and provide a concrete description of how it was used to enable a complex analysis of fMRI time series data.

Technical Reference Suite Addressing Challenges of Providing Assurance for Fault Management Architectural Design

NASA Technical Reports Server (NTRS)

Fitz, Rhonda; Whitman, Gerek

2016-01-01

Research into complexities of software systems Fault Management (FM) and how architectural design decisions affect safety, preservation of assets, and maintenance of desired system functionality has coalesced into a technical reference (TR) suite that advances the provision of safety and mission assurance. The NASA Independent Verification and Validation (IVV) Program, with Software Assurance Research Program support, extracted FM architectures across the IVV portfolio to evaluate robustness, assess visibility for validation and test, and define software assurance methods applied to the architectures and designs. This investigation spanned IVV projects with seven different primary developers, a wide range of sizes and complexities, and encompassed Deep Space Robotic, Human Spaceflight, and Earth Orbiter mission FM architectures. The initiative continues with an expansion of the TR suite to include Launch Vehicles, adding the benefit of investigating differences intrinsic to model-based FM architectures and insight into complexities of FM within an Agile software development environment, in order to improve awareness of how nontraditional processes affect FM architectural design and system health management.

Improving the Analysis, Storage and Sharing of Neuroimaging Data using Relational Databases and Distributed Computing

PubMed Central

Hasson, Uri; Skipper, Jeremy I.; Wilde, Michael J.; Nusbaum, Howard C.; Small, Steven L.

2007-01-01

The increasingly complex research questions addressed by neuroimaging research impose substantial demands on computational infrastructures. These infrastructures need to support management of massive amounts of data in a way that affords rapid and precise data analysis, to allow collaborative research, and to achieve these aims securely and with minimum management overhead. Here we present an approach that overcomes many current limitations in data analysis and data sharing. This approach is based on open source database management systems that support complex data queries as an integral part of data analysis, flexible data sharing, and parallel and distributed data processing using cluster computing and Grid computing resources. We assess the strengths of these approaches as compared to current frameworks based on storage of binary or text files. We then describe in detail the implementation of such a system and provide a concrete description of how it was used to enable a complex analysis of fMRI time series data. PMID:17964812

System for decision analysis support on complex waste management issues

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

Shropshire, D.E.

1997-10-01

A software system called the Waste Flow Analysis has been developed and applied to complex environmental management processes for the United States Department of Energy (US DOE). The system can evaluate proposed methods of waste retrieval, treatment, storage, transportation, and disposal. Analysts can evaluate various scenarios to see the impacts to waste slows and schedules, costs, and health and safety risks. Decision analysis capabilities have been integrated into the system to help identify preferred alternatives based on a specific objectives may be to maximize the waste moved to final disposition during a given time period, minimize health risks, minimize costs,more » or combinations of objectives. The decision analysis capabilities can support evaluation of large and complex problems rapidly, and under conditions of variable uncertainty. The system is being used to evaluate environmental management strategies to safely disposition wastes in the next ten years and reduce the environmental legacy resulting from nuclear material production over the past forty years.« less

What Is Case Management? A Scoping and Mapping Review

PubMed Central

Millington, Michael; Salvador-Carulla, Luis

2016-01-01

The description of case management in research and clinical practice is highly variable which impedes quality analysis, policy and planning. Case management makes a unique contribution towards the integration of health care, social services and other sector services and supports for people with complex health conditions. There are multiple components and variations of case management depending on the context and client population. This paper aims to scope and map case management in the literature to identify how case management is described in the literature for key complex health conditions (e.g., brain injury, diabetes, mental health, spinal cord injury). Following literature searches in multiple databases, grey literature and exclusion by health condition, community-based and adequate description, there were 661 potential papers for data extraction. Data from 79 papers (1988–2013) were analysed to the point of saturation (no new information) and mapped to the model, components and activities. The results included 22 definitions, five models, with 69 activities or tasks of case managers mapped to 17 key components (interventions). The results confirm the significant terminological variance in case management which produces role confusion, ambiguity and hinders comparability across different health conditions and contexts. There is an urgent need for an internationally agreed taxonomy for the coordination, navigation and management of care. PMID:28413368

Electronic construction collaboration system -- final phase : [tech transfer summary].

DOT National Transportation Integrated Search

2014-07-01

Construction projects have been growing more complex in terms of : project team composition, design aspects, and construction processes. : To help manage the shop/working drawings and requests for information : (RFIs) for its large, complex projects,...

Structural interaction fingerprints: a new approach to organizing, mining, analyzing, and designing protein-small molecule complexes.

PubMed

Singh, Juswinder; Deng, Zhan; Narale, Gaurav; Chuaqui, Claudio

2006-01-01

The combination of advances in structure-based drug design efforts in the pharmaceutical industry in parallel with structural genomics initiatives in the public domain has led to an explosion in the number of structures of protein-small molecule complexes structures. This information has critical importance to both the understanding of the structural basis for molecular recognition in biological systems and the design of better drugs. A significant challenge exists in managing this vast amount of data and fully leveraging it. Here, we review our work to develop a simple, fast way to store, organize, mine, and analyze large numbers of protein-small molecule complexes. We illustrate the utility of the approach to the management of inhibitor complexes from the protein kinase family. Finally, we describe our recent efforts in applying this method to the design of target-focused chemical libraries.

The Complexity Turn in Studies of Organisations and Leadership: Relevance and Implications

ERIC Educational Resources Information Center

Johannessen, Stig O.

2009-01-01

The widespread experience of complexity is the experience of radical unpredictability and loss of clear connections between cause and effect. The typical response from leaders and researchers is to suggest that more complex contexts require new ways of management control and that particular ways of organising and leading are better than others in…

Managing Complexity: Impact of Organization and Processing Style on Nonverbal Memory in Autism Spectrum Disorders

ERIC Educational Resources Information Center

Tsatsanis, Katherine D.; Noens, Ilse L. J.; Illmann, Cornelia L.; Pauls, David L.; Volkmar, Fred R.; Schultz, Robert T.; Klin, Ami

2011-01-01

The contributions of cognitive style and organization to processing and recalling a complex novel stimulus were examined by comparing the Rey Osterrieth Complex Figure (ROCF) test performance of children, adolescents, and adults with ASD to clinical controls (CC) and non-impaired controls (NC) using the "Developmental Scoring System."…

Evaluating fuel complexes for fire hazard mitigation planning in the southeastern United States

Treesearch

Anne G. Andreu; Dan Shea; Bernard R. Parresol; Roger D. Ottmar

2012-01-01

Fire hazard mitigation planning requires an accurate accounting of fuel complexes to predict potential fire behavior and effects of treatment alternatives. In the southeastern United States, rapid vegetation growth coupled with complex land use history and forest management options requires a dynamic approach to fuel characterization. In this study we assessed...

Learning to manage a complex ecosystem: adaptive management and the Northwest Forest Plan.

Treesearch

George H. Stankey; Roger N. Clark; Bernard T. Bormann

2006-01-01

The Northwest Forest Plan (the Plan) identifies adaptive management as a central strategy for effective implementation. Despite this, there has been a lack of any systematic evaluation of its performance. This study is based on an extensive literature review, 50 interviews with resource managers and scientists involved with the Plan’s implementation, and a survey of...

Integrating fire behavior models and geospatial analysis for wildland fire risk assessment and fuel management planning

Treesearch

Alan A. Ager; Nicole M. Vaillant; Mark A. Finney

2011-01-01

Wildland fire risk assessment and fuel management planning on federal lands in the US are complex problems that require state-of-the-art fire behavior modeling and intensive geospatial analyses. Fuel management is a particularly complicated process where the benefits and potential impacts of fuel treatments must be demonstrated in the context of land management goals...

Managing the Pediatric Facial Fracture

PubMed Central

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

2009-01-01

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

Refueling Strategies for a Team of Cooperating AUVs

DTIC Science & Technology

2011-01-01

manager, and thus the constraint a centrally managed underwater network imposes on the mission. Task management utilizing Robust Decentralized Task ...the computational complexity. A bid based approach to task management has also been studied as a possible means of decentralization of group task ...currently performing another task . In [18], ground robots perform distributed task allocation using the ASyMTRy-D algorithm, which is based on CNP

The Hidden Factors Behind Japan's Highly Productive Management Methods.

ERIC Educational Resources Information Center

Dillon, Linda S.

1984-01-01

Discusses Japanese management from the perspective of the complex relationship between Japanese culture and their practice of lifelong employment, shared authority in decision making, and dissolution of many of the privileges of rank. (Author)

Safe medication management in specialized home healthcare - an observational study.

PubMed

Lindblad, Marléne; Flink, Maria; Ekstedt, Mirjam

2017-08-24

Medication management is a complex, error-prone process. The aim of this study was to explore what constitutes the complexity of the medication management process (MMP) in specialized home healthcare and how healthcare professionals handle this complexity. The study is theoretically based in resilience engineering. Data were collected during the MMP at three specialized home healthcare units in Sweden using two strategies: observation of workplaces and shadowing RNs in everyday work, including interviews. Transcribed material was analysed using grounded theory. The MMP in home healthcare was dynamic and complex with unclear boundaries of responsibilities, inadequate information systems and fluctuating work conditions. Healthcare professionals adapted their everyday clinical work by sharing responsibility and simultaneously being authoritative and preserving patients' active participation, autonomy and integrity. To promote a safe MMP, healthcare professionals constantly re-prioritized goals, handled gaps in communication and information transmission at a distance by creating new bridging solutions. Trade-offs and workarounds were necessary elements, but also posed a threat to patient safety, as these interim solutions were not systematically evaluated or devised learning strategies. To manage a safe medication process in home healthcare, healthcare professionals need to adapt to fluctuating conditions and create bridging strategies through multiple parallel activities distributed over time, space and actors. The healthcare professionals' strategies could be integrated in continuous learning, while preserving boundaries of safety, instead of being more or less interim solutions. Patients' and family caregivers' as active partners in the MMP may be an underestimated resource for a resilient home healthcare.

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

Crolley, R.; Thompson, M.

There has been a need for a faster and cheaper deployment model for information technology (IT) solutions to address waste management needs at US Department of Energy (DOE) complex sites for years. Budget constraints, challenges in deploying new technologies, frequent travel, and increased job demands for existing employees have prevented IT organizations from staying abreast of new technologies or deploying them quickly. Despite such challenges, IT organizations have added significant value to waste management handling through better worker safety, tracking, characterization, and disposition at DOE complex sites. Systems developed for site-specific missions have broad applicability to waste management challenges andmore » in many cases have been expanded to meet other waste missions. Radio frequency identification (RFID) and global positioning satellite (GPS)-enabled solutions have reduced the risk of radiation exposure and safety risks. New web-based and mobile applications have enabled precision characterization and control of nuclear materials. These solutions have also improved operational efficiencies and shortened schedules, reduced cost, and improved regulatory compliance. Collaboration between US Department of Energy (DOE) complex sites is improving time to delivery and cost efficiencies for waste management missions with new information technologies (IT) such as wireless computing, global positioning satellite (GPS), and radio frequency identification (RFID). Integrated solutions developed at separate DOE complex sites by new technology Centers of Excellence (CoE) have increased material control and accountability, worker safety, and environmental sustainability. CoEs offer other DOE sister sites significant cost and time savings by leveraging their technology expertise in project scoping, implementation, and ongoing operations.« less

Peer support of complex health behaviors in prevention and disease management with special reference to diabetes: systematic reviews.

PubMed

Fisher, Edwin B; Boothroyd, Renée I; Elstad, Emily A; Hays, Laura; Henes, Amy; Maslow, Gary R; Velicer, Clayton

2017-01-01

Examine Peer Support (PS) for complex, sustained health behaviors in prevention or disease management with emphasis on diabetes prevention and management. PS was defined as emotional, motivational and practical assistance provided by nonprofessionals for complex health behaviors. Initial review examined 65 studies drawn from 1442 abstracts identified through PubMed, published 1/1/2000-7/15/2011. From this search, 24 reviews were also identified. Extension of the search in diabetes identified 30 studies published 1/1/2000-12/31/2015. In initial review, 54 of all 65 studies (83.1%) reported significant impacts of PS, 40 (61.5%) reporting between-group differences and another 14 (21.5%) reporting significant within-group changes. Across 19 of 24 reviews providing quantifiable findings, a median of 64.5% of studies reviewed reported significant effects of PS. In extended review of diabetes, 26 of all 30 studies (86.7%) reported significant impacts of PS, 17 (56.7%) reporting between-group differences and another nine (30.0%) reporting significant within-group changes. Among 19 of these 30 reporting HbA1c data, average reduction was 0.76 points. Studies that did not find effects of PS included other sources of support, implementation or methodological problems, lack of acceptance of interventions, poor fit to recipient needs, and possible harm of unmoderated PS. Across diverse settings, including under-resourced countries and health care systems, PS is effective in improving complex health behaviors in disease prevention and management including in diabetes.

The Data Management and Communications (DMAC) Strategy for the U.S. Integrated Ocean Observing System (IOOS)

NASA Astrophysics Data System (ADS)

Hankin, S.

2004-12-01

Data management and communications within the marine environment present great challenges due in equal parts to the variety and complexity of the observations that are involved; the rapidly evolving information technology; and the complex history and relationships among community participants. At present there is no coherent Cyberinfrastructure that effectively integrates these data streams across organizations, disciplines and spatial and temporal scales. The resulting lack of integration of data denies US society important benefits, such as improved climate forecasts and more effective protection of coastal marine ecosystems. Therefore, Congress has directed the US marine science communities to come together to plan, design, and implement a sustained Integrated Ocean Observing System (IOOS). Central to the vision of the IOOS is a Data Management and Communications (DMAC) Subsystem that joins Federal, regional, state, municipal, academic and commercial partners in a seamless data sharing framework. The design of the DMAC Subsystem is made particularly challenging by three competing factors: 1) The data types to be integrated are heterogeneous and have complex structure; 2) The holdings are physically distributed and widely ranging in size and complexity; and 3) IOOS is a loose federation of many organizations, large and small, lacking a management hierarchy. Designing the DMAC Subsystem goes beyond solving problems of software engineering; the most demanding aspects of the solution lie in community behavior. An overview of the plan for the DMAC Subsystem and an outline of the next steps forward will be described.

The eClinical Care Pathway Framework: a novel structure for creation of online complex clinical care pathways and its application in the management of sexually transmitted infections.

PubMed

Gibbs, Jo; Sutcliffe, Lorna J; Gkatzidou, Voula; Hone, Kate; Ashcroft, Richard E; Harding-Esch, Emma M; Lowndes, Catherine M; Sadiq, S Tariq; Sonnenberg, Pam; Estcourt, Claudia S

2016-07-22

Despite considerable international eHealth impetus, there is no guidance on the development of online clinical care pathways. Advances in diagnostics now enable self-testing with home diagnosis, to which comprehensive online clinical care could be linked, facilitating completely self-directed, remote care. We describe a new framework for developing complex online clinical care pathways and its application to clinical management of people with genital chlamydia infection, the commonest sexually transmitted infection (STI) in England. Using the existing evidence-base, guidelines and examples from contemporary clinical practice, we developed the eClinical Care Pathway Framework, a nine-step iterative process. Step 1: define the aims of the online pathway; Step 2: define the functional units; Step 3: draft the clinical consultation; Step 4: expert review; Step 5: cognitive testing; Step 6: user-centred interface testing; Step 7: specification development; Step 8: software testing, usability testing and further comprehension testing; Step 9: piloting. We then applied the Framework to create a chlamydia online clinical care pathway (Online Chlamydia Pathway). Use of the Framework elucidated content and structure of the care pathway and identified the need for significant changes in sequences of care (Traditional: history, diagnosis, information versus Online: diagnosis, information, history) and prescribing safety assessment. The Framework met the needs of complex STI management and enabled development of a multi-faceted, fully-automated consultation. The Framework provides a comprehensive structure on which complex online care pathways such as those needed for STI management, which involve clinical services, public health surveillance functions and third party (sexual partner) management, can be developed to meet national clinical and public health standards. The Online Chlamydia Pathway's standardised method of collecting data on demographics and sexual behaviour, with potential for interoperability with surveillance systems, could be a powerful tool for public health and clinical management.

Models of expert assessments and their study in problems of choice and decision-making in management of motor transport processes

NASA Astrophysics Data System (ADS)

Belokurov, V. P.; Belokurov, S. V.; Korablev, R. A.; Shtepa, A. A.

2018-05-01

The article deals with decision making concerning transport tasks on search iterations in the management of motor transport processes. An optimal selection of the best option for specific situations is suggested in the management of complex multi-criteria transport processes.

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

ERIC Educational Resources Information Center

Imam, Abbas H.

2013-01-01

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

Managing Risk on the Final Frontier

NASA Technical Reports Server (NTRS)

Lengyel, David M.; Newman, J. S.

2009-01-01

The National Aeronautics and Space Administration (NASA). Exploration Systems Mission Directorate (ESMD) has combined the Continuous Risk Management (CRM) discipline with innovative knowledge management (KM) practices to more effectively enable the accomplishment of work. CRM enables proactive problem identification and problem solving in the complex world of rocket science. while KM is used to improve this process.

78 FR 49311 - Self-Regulatory Organizations; International Securities Exchange, LLC; Order Approving Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

... to provide market makers with a risk management tool to assist managing the financial exposure of... the management of financial risk exposure could enable market makers to enter quotations with larger... Maker Risk Parameters and Complex Orders August 7, 2013. I. Introduction On June 5, 2013, the...

Methods for evaluating information in managing the enterprise on the basis of a hybrid three-tier system

NASA Astrophysics Data System (ADS)

Vasil'ev, V. A.; Dobrynina, N. V.

2017-01-01

The article presents data on the influence of information upon the functioning of complex systems in the process of ensuring their effective management. Ways and methods for evaluating multidimensional information that reduce time and resources, improve the validity of the studied system management decisions, were proposed.

Closing the gap between research and management

Treesearch

Deborah M. Finch; Marcia Patton-Mallory

1993-01-01

In this paper, we evaluate the reasons for gaps in communication between researchers and natural resource managers and identify methods to close these gaps. Gaps originate from differing patterns of language use, disparities in organizational culture and values, generation of knowledge that is too narrowly-focused to solve complex problems, failure by managers to relay...

Proceedings of the Sierra Nevada Science Symposium

Treesearch

Dennis D. Murphy; Peter A. Stine

2004-01-01

Land and resource management issues in the Sierra Nevada are becoming increasingly complex and controversial. The objective of the Sierra Nevada Science Symposium was to provide a synoptic overview of the current state of scientific knowledge related to key management issues. Attempts were made to tie recent scientific findings to applications in land management and...

23 CFR 971.212 - Federal lands safety management system (SMS).

Code of Federal Regulations, 2011 CFR

2011-04-01

.... (b) The SMS may be based on the guidance in “Safety Management Systems: Good Practices for Development and Implementation.”3 3 “Safety Management Systems: Good Practices for Development and... various levels of complexity depending on the nature of the facility and/or network involved. (e) The SMS...