In 1987, 20,830 legal abortions were performed in Denmark. 2,845 involved women below the age of 20, and 532 involved women terminating pregnancy after the 12th week. Danish law permits all of its female citizens to have an abortion free-of-charge before the 12th week of pregnancy. After the 12th week, the abortion must be applied for through a committee of 3 members, and all counties in Denmark have a committee. It is felt in Denmark that a woman has a right to an abortion if she decides to have one. It she makes that choice, doctors and nurses are supportive. Since 1970, sex education has been mandatory in Danish schools. Teachers often collaborate closely with school doctors and nurses in this education. All counties are required to have at least 1 clinic that provides contraceptive counselling. It was recently found that the lowest number of pregnancies among teenaged girls was found in a county in Jutland where all 9th grade students visit the county clinic to learn about contraceptives, pregnancy, and abortion. Within 1 year after Copenhagen had adopted this practice, the number of abortions among teenagers declined by 20%. One fourth of all pharmacies also collaborate with schools to promote sex education, instructing students about contraceptives and pregnancy tests. The Danish Family Planning Association has produced a film on abortion, and plans to produce videos on abortion for use in schools. The organization also holds training programs for health care personnel on contraception, pregnancy, and abortion. By means of the practices described above, it is hoped that the number of abortions and unwanted pregnancies in Denmark will be reduced.
Kjær Andersen, Stig
The condition that the Danish universities have been subject to severe changes through the last decade has had huge consequences for management of research at the level of a discipline as Medical Informatics. The presentation pinpoints some of the instruments, which is on top of the management agenda in the new academic reality in Denmark. Performance contracts, organizational structure, general management, research constraints, ranking and performance issues, economy linked to production, ownership, and incitements are issues affecting the way research are done. The issue of effective research management is to navigate in this reality, ensure inspiration and influx from other environments dealing with medical informatics problems, in theory as well as in praxis - and shield the individual researcher from emerging bureaucracy, leaving room for creativity.
Thum, Tea; Peylin, Philippe; Ibrom, Andreas; Van Der Linden, Leon; Beier, Claus; Bacour, Cédric; Santaren, Diego; Ciais, Philippe
In ecosystem manipulation experiments (EMEs) the ecosystem is artificially exposed to different environmental conditions that aim to simulate circumstances in future climate. At Danish EME site Brandbjerg the responses of a heathland to drought, warming and increased atmospheric CO2 concentration are studied. The warming manipulation is realized by passive nighttime warming. The measurements include control plots as well as replicates for each three treatment separately and in combination. The Brandbjerg heathland ecosystem is dominated by heather and wavy hairgrass. These experiments provide excellent data for validation and development of ecosystem models. In this work we used a generic vegetation model ORCHIDEE with Model-Data-Fusion (MDF) approach. ORCHIDEE model is a process-based model that describes the exchanges of carbon, water and energy between the atmosphere and the vegetation. It can be run at different spatial scales from global to site level. Different vegetation types are described in ORCHIDEE as plant functional types. In MDF we are using observations from the site to optimize the model parameters. This enables us to assess the modelling errors and the performance of the model for different manipulation treatments. This insight will inform us whether the different processes are adequately modelled or if the model is missing some important processes. We used a genetic algorithm in the MDF. The data available from the site included measurements of aboveground biomass, heterotrophic soil respiration and total ecosystem respiration from years 2006-2008. The biomass was measured six times doing this period. The respiration measurements were done with manual chamber measurements. For the soil respiration we used results from an empirical model that has been developed for the site. This enabled us to have more data for the MDF. Before the MDF we performed a sensitivity analysis of the model parameters to different data streams. Fifteen most influential
This article discusses the approach to the management of change taken by a Danish university when introducing a university-wide market for education and it explores the different positions taken by some of the central stakeholders in one of the faculties involved. I argue that neither the inadequacies of a popular management model nor insufficient…
This article reveals perspectives based on experiences from twentieth-century Danish educational history by outlining contemporary, test-based accountability regime characteristics and their implications for education policy. The article introduces one such characteristic, followed by an empirical analysis of the origins and impacts of test-based…
Ammentorp, Jette; Jensen, Hanne Irene; Uhrenfeldt, Lisbeth
Introduction: In recent years, coaching, as a supplement to professional development, has received increased attention, especially in nursing. Still, only little is known about how health professionals experience participating in coaching sessions. The purpose of this pilot study was to describe and analyze health professionals' experiences from…
Eberhardt, R. N.; Bailey, W. J.; Fester, D. A.
The cryogenic fluid management experiment (CFME), designed to characterize subcritical liquid hydrogen storage and expulsion in the low-q space environment, is discussed. The experiment utilizes a fine mesh screen fluid management device to accomplish gas-free liquid expulsion and a thermodynamic vent system to intercept heat leak and control tank pressure. The experiment design evolved from a single flight prototype to provision for a multimission (up to 7) capability. A detailed design of the CFME, a dynamic test article, and dedicated ground support equipment were generated. All materials and parts were identified, and components were selected and specifications prepared. Long lead titanium pressurant spheres and the flight tape recorder and ground reproduce unit were procured. Experiment integration with the shuttle orbiter, Spacelab, and KSC ground operations was coordinated with the appropriate NASA centers, and experiment interfaces were defined. Phase 1 ground and flight safety reviews were conducted. Costs were estimated for fabrication and assembly of the CFME, which will become the storage and supply tank for a cryogenic fluid management facility to investigate fluid management in space.
Bjørn, Mads Emil; Holmström, Morten Orebo; Hasselbalch, Hans Carl
We report 12 Danish myelofibrosis patients who have been treated successfully with ruxolitinib despite having low platelet counts (< 50 × 10(9)/L) during their treatment-course. The majority of the patients experienced marked clinical improvement. Serious side effects were only recorded in a single patient. It is concluded that JAK-inhibition with ruxolitinib is manageable in patients with low platelet counts and should be considered in symptomatic patients who otherwise might not be candidates for treatment.
Strategic management and leadership has been a vital catchphrase in most European higher education reforms over the past decade, and has in many countries resulted in a strengthening of the top level management tiers. Rectors and Deans are increasingly tasked with the responsibility of turning HEIs into more active, entrepreneurial actors in…
Rosenstjerne Andersen, Angelo; Fuglsang, Marie; Kyed, Daisy
The response rate in The National Danish Survey of Patient Experiences in 2009 was 54%. In order to evaluate bias due to non-responders, The Unit of Patient-perceived Quality merged survey data and data on patient background from Statistics Denmark. The relationships between the responding patients' background and their answers to six questions in the survey questionnaire are estimated with logistic regression analysis and subsequently used for predicting the answers of the non-responders. Results indicate a small positive bias in four of the questions and no bias in the remaining two.
Pfister, Gertrud; Rømer, Kristine
This article explores women's lived experiences with polycystic ovary syndrome (PCOS) on the basis of semistructured interviews with 21 Danish women. It provides insights about the problems that they experienced and how they coped with PCOS. The interviews revealed that they were highly influenced by society's femininity norms. Many of them perceived their bodies as "different" because of the symptoms of PCOS, namely, hirsutism. They used different strategies to live up to body ideals and cope with the symptoms. However, hirsutism had a decisive negative influence on the women's everyday lives, particularly with regard to male partners and sexual relations.
Ulriksen, Lars; Madsen, Lene Møller; Holmegaard, Henriette Tolstrup
To understand student drop-out from university, research must explore students' first-year experiences and the challenges they encounter. This article analyses the first-year experiences of non-traditional students in Danish science and engineering university programmes. Focusing on identity theory and the framework of integration processes…
Jensen, Morten Bang; Møller, Jacob; Scheutz, Charlotte
This study assessed the management of the organic household waste in the Danish-German border region and points out major differences between the systems and their potential effects on the environment using life cycle assessment (LCA). The treatment of organic waste from households in the Danish-German border region is very different on each side of the border; the Danish region only uses incineration for the treatment of organic household waste while the German region includes combined biogas production and composting, mechanical and biological treatment (MBT) and incineration. Data on all parts of the organic waste treatment was collected including waste composition data and data from treatment facilities and their respective energy systems. Based on that the organic waste management systems in the border region were modelled using the EASETECH waste management LCA-model. The main output is a life cycle assessment showing large differences in the environmental performance of the two different regions with the Danish region performing better in 10 out of 14 impact categories. Furthermore, the importance of the substituted district heating systems was investigated showing an impact up to 34% of the entire system for one impact category and showing large difference between each heating system substituted, e.g. in "Global Warming" the impact was from -16 to -1.1 milli person equivalent/tonne treated waste from substitution of centralised hard coal and decentralised natural gas, respectively.
Jacobsen, Ramune; Samsanaviciene, Jurgita; Liubarskiene, Zita; Sjøgren, Per; Møldrup, Claus; Christrup, Lona; Sciupokas, Arunas; Hansen, Ole Bo
The prevalence of cancer-related pain is high despite available guidelines for the effective assessment and management of that pain. Barriers to the use of opioid analgesics partially cause undertreatment of cancer pain. The aim of this study was to compare pain management outcomes and patient-related barriers to cancer pain management in patient samples from Denmark and Lithuania. Thirty-three Danish and 30 Lithuanian patients responded to, respectively, Danish and Lithuanian versions of the Brief Pain Inventory pain scale, the Barriers Questionnaire II, the Hospital Anxiety and Depression Scale, the Specific Questionnaire On Pain Communication, and the Medication Adherence Report Scale. Emotional distress and patient attitudes toward opioid analgesics in cancer patient samples from both countries explained pain management outcomes in the multivariate regression models. Pain relief and pain medication adherence were better in Denmark, and the country of origin significantly explained the difference in the regression models for these outcomes. In conclusion, interventions in emotional distress and patient attitudes toward opioid analgesics may result in better pain management outcomes generally, whereas poor adherence to pain medication and poor pain relief appear to be more country-specific problems.
The thermal energy management processes experiment (TEMP) will demonstrate that through the use of two-phase flow technology, thermal systems can be significantly enhanced by increasing heat transport capabilities at reduced power consumption while operating within narrow temperature limits. It has been noted that such phenomena as excess fluid puddling, priming, stratification, and surface tension effects all tend to mask the performance of two-phase flow systems in a 1-g field. The flight experiment approach would be to attack the experiment to an appropriate mounting surface with a 15 to 20 meter effective length and provide a heat input and output station in the form of heaters and a radiator. Using environmental data, the size, location, and orientation of the experiment can be optimized. The approach would be to provide a self-contained panel and mount it to the STEP through a frame. A small electronics package would be developed to interface with the STEP avionics for command and data handling. During the flight, heaters on the evaporator will be exercised to determine performance. Flight data will be evaluated against the ground tests to determine any anomalous behavior.
Mammen, Jens; Mironenko, Irina
Psychology has permanent problems of theoretical coherence and practical, analytic and critical efficiency. It is claimed that Activity Theory (AT) with roots in a long European philosophical tradition and continued in Russian AT is a first step to remedy this. A Danish version of AT may have a key to exceed some, mostly implicit, ontological restrictions in traditional AT and free it from an embracement of functionalism and mechanicism, rooted in Renaissance Physics. The analysis goes back to Aristotle's understanding of the freely moving animal in its ecology and introduces some dualities in the encounter between subject and object which replace the dualistic dichotomies traditionally splitting Psychology in Naturwissenschaft vs. Geisteswissenshaft. This also implies a "Copernican turn" of Cartesian dualism. The perspectives are to give place for a phenomenology of meaning without cutting human psyche out of Nature and to open Psychology to its domain.
This article investigates the current use of Public-Private Partnerships (PPP) in the Danish health sector based on an initial discussion of theoretical approaches that analyze PPP. The empirical analysis concludes that PPP has been used very sparsely in the Danish health sector. There are few examples of large-scale partnership projects with joint investment and risk taking, but a number of smaller partnerships such as jointly owned companies at the regional level. When defining PPP more broadly, we can identify a long tradition for various types of collaboration between public and private actors in health care in Denmark. An analysis of the regulatory environment is offered as an explanation for the limited use of PPPs in Denmark. Major political and institutional actors at the central level differ in their enthusiasm for the PPP concept, and the regulatory framework is somewhat uncertain. A number of general issues and concerns related to PPPs are also discussed. It is suggested that a risk-based framework can be useful for mapping the potential and challenges for both private and public partners. Such a framework can be used to feed into game theoretical models of pros and cons for PPP projects. In general terms, it is concluded that more empirical research is needed for the assessment of the various risk factors involved in using PPPs in health care. Most PPPs are still very young, and the evidence on performance and broader governance issues is only just emerging. Ideally, such assessments should include comparisons with a purely public alternative.
Japan experienced a very rapid industrialization and economic growth in the era of income doubling in 1960s and at the same time Japan experienced very severe damage from various types of environmental pollution. In this paper, historical development of population, GNP, energy consumption with classification of petroleum, coal and electric power, and CO2 emission are introduced as basic background data on Japanese development. The tragic experience of Minamata disease and Itai-itai disease caused by methyl mercury and cadmium, respectively, are introduced. In two tables, historical development of water pollution and air pollution are summarized. Regarding solid wastes management, the total mass balance in Japan and recent development in legislation framework for enhancement of recycling of wastes are introduced briefly.
Hertel, Ole; Geels, Camilla; Frohn, Lise Marie; Ellermann, Thomas; Skjøth, Carsten Ambelas; Løfstrøm, Per; Christensen, Jesper H.; Andersen, Helle Vibeke; Peel, Robert George
Local agricultural emissions contribute significantly to the atmospheric reactive nitrogen loads of Danish terrestrial ecosystems. In the vicinity of the sources this may be up to 6-8 kg N ha-1 yr-1 depending on location and ecosystem type. This contribution arises from dry deposition of gas phase ammonia derived from local livestock production. Long-range transport, however, often constitutes the largest contribution to the overall atmospheric terrestrial reactive nitrogen loadings in Denmark. This is often in the range 10-15 kg N ha-1 yr-1 and consists mainly of aerosol phase nitrate and ammonium (reaction products of nitrogen oxides and ammonia), but also dry deposition of other reactive nitrogen compounds (mainly nitrogen oxides in the form of gas phase nitric acid and nitrogen dioxide). In Denmark's environmental management of the sensitive terrestrial ecosystems modelling tools are required that account for both the local and the long-range transported contributions. This motivated development of the Danish Ammonia MOdelling System (DAMOS) that has been successfully applied to the assessment of atmospheric nitrogen loadings to sensitive Danish ecosystems. We present here three different examples of such assessments. Our results show that ecosystems located in Western Denmark (Case 1) receive the highest loads of atmospheric nitrogen depositions which generally exceed the critical load. This part of the country has the highest livestock density. In the Eastern part of the country, the atmospheric loadings are often below or close to the lower end of the interval for critical load values. These lower loads in Eastern Denmark (Case 2) are due to lower density of agricultural activities, as well as, lower precipitation rates, which leads to less wet deposition of reactive nitrogen. In general there is a gradient in atmospheric deposition over the country, with the highest depositions in the South-Western part of Denmark (Case 3) due to long-range transport
The Adaptive Grazing Management experiment at the USDA-ARS Central Plains Experimental Range addresses important gaps in our current understanding of grazing management including: 1) lack of management-science partnerships to more fully understand the effect of management decisions, 2) need for mana...
June 1975. EVMS 2002 American National Standards Institute / Electrical Industries Association, Earned Value Management System ( EIA - 748 -A...Prediction, Application, McGraw-Hill, 1987. NDIA 2005 National Defense Industrial Association (NDIA) Program Management Systems Committee (PMSC) ANSI/ EIA ... 748 -A Standard for Earned Value Management Systems Intent Guide OIG 1998 Office of Inspection General, Audit Report, Advance Automation System
A history of technological development for subcritical cryogenic fluid management (CFM) through space experiments is given for the period 1960 to 1990. Space experiments with liquid hydrogen were conducted in the early 1960s. Efforts since then have consisted of studies and designs of potential space experiments. A chronology of CFM space experiments and design efforts is included.
Jefferson, D. K.; Thomson, B.
Experiences in developing a large engineering data management system are described. Problems which were encountered are presented and projected to future systems. Business applications involving similar types of data bases are described. A data base management system architecture proposed by the business community is described and its applicability to engineering data management is discussed. It is concluded that the most difficult problems faced in engineering and business data management can best be solved by cooperative efforts.
Jeszenszky, Arleen W.
Describes a sophisticated version of the fruit fly experiment for teaching concepts about genetics to biology students. Provides students with the opportunity to work with live animals over an extended period. (JRH)
Sekhri, N. K.
This article provides an overview of managed health care in the USA--what has been achieved and what has not--and some lessons for policy-makers in other parts of the world. Although the backlash by consumers and providers makes the future of managed care in the USA uncertain, the evidence shows that it has had a positive effect on stemming the rate of growth of health care spending, without a negative effect on quality. More importantly, it has spawned innovative technologies that are not dependent on the US market environment, but can be applied in public and private systems globally. Active purchasing tools that incorporate disease management programmes, performance measurement report cards, and alignment of incentives between purchasers and providers respond to key issues facing health care reform in many countries. Selective adoption of these tools may be even more relevant in single payer systems than in the fragmented, voluntary US insurance market where they can be applied more systematically with lower transaction costs and where their effects can be measured more precisely. PMID:10916920
Maddox-Hyttel, Charlotte; Langkjaer, Rikke B; Enemark, Heidi L; Vigre, Håkan
To obtain information both about the prevalence of Giardia and Cryptosporidium in Danish cattle and pigs as well as the possible influence of different management systems on the occurrence and intensity of infection, we conducted an epidemiological survey comprising 50 randomly selected dairy and sow herds, respectively. Each herd was visited once for the collection of faecal samples and registration of basic management parameters. Faecal samples were collected from three different age groups of animals, i.e. 5 sows/cows, 10 nursing piglets/calves less than 1 month, and 10 weaner pigs 8-45 kg/calves 1-12 months. The faecal samples were purified and the number of (oo)cysts quantified. The study revealed an age-specific herd prevalence of Cryptosporidium of 16, 31 and 100% for sows, piglets and weaners, respectively, and of 14, 96 and 84% for cows, young calves and older calves, respectively. For Giardia the age-specific herd prevalence was 18, 22 and 84% for the sows, piglets and weaners, while for cattle herds the prevalence was 60, 82 and 100% for cows, young calves and older calves, correspondingly. The (oo)cyst excretion levels varied considerably both within and between herds for all age groups. Risk factors were evaluated by using proportional odds models with (oo)cyst excretion levels divided into four categories as response. Among the numerous risk factors examined, only a few were demonstrated to have a statistically significant influence, e.g. the use of an empty period in the calf pen between introduction of calves for both parasites had a protective effect in young calves. For weaners, use of straw in the pen and high pressure cleaning between batches of weaners had a preventive effect against higher Cryptosporidium oocyst excretion levels.
The methods and techniques for experiment development and integration that evolved during the Skylab Program are described to facilitate transferring this experience to experimenters in future manned space programs. Management responsibilities and the sequential process of experiment evolution from initial concept through definition, development, integration, operation and postflight analysis are outlined and amplified, as appropriate. Emphasis is placed on specific lessons learned on Skylab that are worthy of consideration by future programs.
Synthesis of the Danish Experience with Combating Nutrient Pollution of Surface Waters: The Old Regulatory Approach and a New Targeted Approach Utilising the Natural Attenuation Capacity in Landscapes
Kronvang, Brian; Windolf, Jørgen; Blicher-Mathiesen, Gitte; Tornbjerg, Henrik; Højberg, Anker; Rieman, Bo
Excess nitrogen (N) and phosphorus (P) emissions to surface waters are a high priority environmental problem worldwide for protection of water resources in times of population growth and climate change. As clean water is a scarce resource the struggle for reducing nutrient emissions are an ongoing issue for many countries and regions. Since the mid1980s a wide range of national regulatory general measures have been implemented to reduce land based nitrogen (N) and phosphorus (P) loadings of the Danish aquatic environment. These measures have addressed both point source emissions and emissions from diffuse sources especially from agricultural production. Following nearly 4 decades of combating nutrient pollution our surface waters such as lakes and estuaries are only slowly responding on the 50% reduction in N and 56% reduction in P. Therefore, the implementation of the EU Water Framework Directive in Danish surface waters still call for further reductions of N and P loadings. Introduction of a new paradigm of targeted implemented measures was the proposed outcome of a Commission on Nature and Agriculture established by the Danish Government in 2013. Their White Book points to the need of increased growth and better environment through more targeted and efficient regulation using advanced technological mitigation methods that are implemented intelligently according to the local natural attenuation capacity for nutrients in the landscape. As a follow up a national consensus model for N was established chaining existing leaching, 3D groundwater and surface water models. The new model concept enables a calculation of the N dynamics and attenuation capacity within a scale of 15 km2. Moreover, several research projects have been conducted to investigate the effect of a suite of targeted mitigation measures such as restored natural wetlands, constructed wetlands, controlled drainage and intelligent buffer zones. The outcome of six Danish management plans for nutrient load
Nielsen, S S; Toft, N
A voluntary risk-based control program on paratuberculosis in dairy cattle was initiated in Denmark in 2006. Cows were categorized as high-risk (antibody-positive at least once within the last 3 tests) or low-risk animals based on the results of 3 to 4 annual milk ELISA detecting Mycobacterium avium ssp. paratuberculosis (MAP)-specific antibodies. High-risk animals require management practices aimed at decreasing calf exposure to MAP-contaminated colostrum and milk, and feces originating from these cows. Moreover, repeated test-positive cows are recommended for slaughter before next calving. The objective was to assess the effect of different management practices on the prevalence of MAP-specific antibodies. A questionnaire on management practices was distributed to 1,261 participating herds in December 2008. A total of 1,092 (87%) herd managers returned the questionnaire. Repeated prevalence data from 1,081 herds were available for a period up to 4.25 yr after the first test round. The changes in the prevalence of MAP-specific antibodies from the start of interventions were assessed using a hierarchical logistic model, where different management practices were assessed: a) culling of repeated test-positive cows, b) separation of high-risk from low-risk cows in calving areas, c) cleaning of calving areas after high-risk cows calved, d) removal of calves born to high-risk dams within 2h after calving, e) use of colostrum for feeding of heifer calves from low-risk cows only, f) use of waste milk for feeding of heifer calves from low-risk cows only, g) herd size, and h) proportion of purchased animals. Multivariable analyses suggested that only the proportion of purchased animals (>15% purchased animals as well as 0 to 15% purchased animals compared with no purchased animals in the herd), culling of repeated test-positive animals, and use of waste milk from specific cow groups influenced the decrease in prevalence of MAP-specific antibodies. The control program has
Keiser, Ken; Tanner, Steve; Hatcher, Danny; Graves, Sara
What do you get when you cross rocket scientists with computer geeks? It is an interactive, distributed computing web of tools and services providing a more productive environment for propulsion research and development. The Rocket Engine Advancement Program 2 (REAP2) project involves researchers at several institutions collaborating on propulsion experiments and modeling. In an effort to facilitate these collaborations among researchers at different locations and with different specializations, researchers at the Information Technology and Systems Center,' University of Alabama in Huntsville, are creating a prototype web-based interactive information system in support of propulsion research. This system, to be based on experience gained in creating similar systems for NASA Earth science field experiment campaigns such as the Convection and Moisture Experiments (CAMEX), will assist in the planning and analysis of model and experiment results across REAP2 participants. The initial version of the Propulsion Experiment Project Management Environment (PExPM) consists of a controlled-access web portal facilitating the drafting and sharing of working documents and publications. Interactive tools for building and searching an annotated bibliography of publications related to REAP2 research topics have been created to help organize and maintain the results of literature searches. Also work is underway, with some initial prototypes in place, for interactive project management tools allowing project managers to schedule experiment activities, track status and report on results. This paper describes current successes, plans, and expected challenges for this project.
Hammitt, William E.; McDonald, Cary D.; Noe, Francis P.
Deer hunter satisfaction is investigated from two perspectives, (1) satisfaction with the hunt/harvest and (2) satisfaction with the overall hunting trip experience. Regression analysis is used to determine what variables best predict satisfaction with the hunt and the hunting experience. Results indicate that animal population variables (number of deer seen, shot at, bagged) are the best determinants of a quality deer hunt, while environmental (outdoors) and social (crowding and hunter behavior) are the best predictors of a quality hunting trip experience. Wildlife managers and researchers need to realize that deer hunters view the hunt/harvest as different from the hunting trip experience and need to manage for both aspects of hunter satisfaction.
Willard-Grace, Rachel; Dubé, Kate; Hessler, Danielle; O'Brien, Bridget; Earnest, Gillian; Gupta, Reena; Shunk, Rebecca; Grumbach, Kevin
Burnout and professional dissatisfaction are threats to the primary care workforce. We investigated the relationship between panel management capability, team culture, cynicism, and perceived "do-ability" of primary care among primary care providers (PCPs) and staff in primary care practices. We surveyed 326 PCPs and 142 staff members in 10 county-administered, 6 university-run, and 3 Veterans Affairs primary care clinics in a large urban area in 2013. Predictor variables included capability for performing panel management and perception of team culture. Outcome variables included 2 work experience measures--the Maslach Burnout Inventory cynicism scale and a 1-item measure of the "do-ability" of primary care this year compared with last year. Generalized Estimation Equation (GEE) models were used to account for clustering at the clinic level. Greater panel management capability and higher team culture were associated with lower cynicism among PCPs and staff and higher reported "do-ability" of primary care among PCPs. Panel management capability and team culture interacted to predict the 2 work experience outcomes. Among PCPs and staff reporting high team culture, there was little association between panel management capability and the outcomes, which were uniformly positive. However, there was a strong relationship between greater panel management capability and improved work experience outcomes for PCPs and staff reporting low team culture. Team-based processes of care such as panel management may be an important strategy to protect against cynicism and dissatisfaction in primary care, particularly in settings that are still working to improve their team culture.
Defelice, David M.
Since its foundation, NASA has excelled in the study and development of microgravity fluid management technology. With the advent of space-based vehicles and systems, the use of and the ability to efficiently manage subcritical cryogens in the space environment has become necessary to our growing space program. The NASA Lewis Research Center is responsible for the planning and execution of a program which will provide advanced in-space cryogenic fluid management technology. A number of future space missions have been identified that will require or could benefit from this technology. These technology needs have been prioritized and the Cryogenic Fluid Management Flight Experiment (CFMFE) is being designed to provide the experimental data necessary for the technological development effort.
Bailey, W. J.; Fester, D. A.; Toth, J. M., Jr.; Kasper, H. J.
A subcritical liquid hydrogen orbital storage and transfer experiment was designed for flight in the Shuttle cargo bay. The Cryogenic Fluid Management Experiment (CFME) includes a liquid hydrogen tank supported in a vacuum jacket by two fiberglass epoxy trunnion mounts. This composite material was selected for the trunnions since it provides desirable strength, weight and thermal characteristics for supporting cryogenic tankage. An experimental program was conducted to provide material property and fatigue data for S-glass epoxy composite materials at ambient and liquid hydrogen temperatures and to verify structural integrity of the CFME trunnion supports.
Vaarst, Mette; Sørensen, Jan Tind
Calf mortality has remained at a high (risk approximately 7%) in Denmark, despite much knowledge disseminated to farmers. We conducted a qualitative interview to explore calf managers' perception of their own management and working situation, and how this related to calf mortality problems in their herds. Twenty-eight calf managers from herds with either no (NO) or high (HI; 17-31%) calf mortality in 2004 were included in the study. We used our judgement to create a model of the inter-relationships among the attitudes that seemed most different between the two groups of farmers. 'Flexible time,' (for activities such as management of crisis or unexpected events) was crucial; it allowed the farmer to intervene immediately at first sign of a crisis. Our interpretation suggests that focus on the farmers time planning and structure of everyday activities is, therefore, a key to understanding and solving problems related to calf disease and mortality. An important distinction between the groups was whether the calf manager had a basic belief that calf mortality is a permanent crisis that has to be expected to be present on a dairy farm. Previous experience in solving disease and mortality problems in calves had a strong positive influence on this belief. We suggest that the issues of empowerment and flexible time management be explored further to assist dairy-calf raisers.
Wiebe, E.; Janssen, P.
OBJECTIVE: To describe women's experiences with expectant management of spontaneous abortions. DESIGN: Descriptive survey using questionnaires with fixed-choice and open-ended questions. The latter were analyzed for themes, using qualitative methods. SETTING: Urban and suburban private primary care family practices. PARTICIPANTS: A convenience sample of family practice patients (59 of 80 eligible) pregnant for less than 12 weeks who had spontaneous abortions without surgery. Response rate was 84.7%; 50 questionnaires were received from the 59 women. METHOD: Women were asked about their physical experiences, including amount of pain and bleeding; emotional effects; their satisfaction with medical care; and their suggestions for improving care. MAIN FINDINGS: The mean worst pain experienced during a spontaneous abortion on an 11-point scale was 5.9. Bleeding varied, but was often very heavy. Satisfaction rate was 92.9% with family physician care and 84.6% with hospital care. Women described the emotional effect of "natural" spontaneous abortions and made recommendations for improving care. CONCLUSIONS: A better understanding of the physical and emotional experiences of the women in this study might help physicians better prepare and support patients coping with expectant management of spontaneous abortions. PMID:10540695
Bundgaard, K.; Lumborg, U.; Vested, H. J.; Edelvang, K.
In the past years extensive research has been carried out on the effect of dredging in estuarine environments. The environmental impact is often assessed through measurements, dedicated numerical modelling studies and monitoring. However, given the extreme complexity of the dredged sediments, it is often difficult to predict the behaviour of the sediment. This depends on various chemical and physical properties, many of which are still unaccounted for. Several research projects have been carried out in the Danish Wadden Sea in recent years and the sedimentology and hydrodynamic conditions in the area are thus well documented. Many major projects have been carried out over the last decades: the first was in 1971 and the latest was in 2005. Characteristic for these projects was that they were based on extensive data sets and were, therefore able to demonstrate the complex hydrodynamics and sediment dynamics in the area. Further information can be found in the additional information. The area is dominated by the tidal barrier spit of Skallingen and the barrier island of Fanoe. The tidal inlet of Graadyb is responsible by far for most of the water exchange in the area. Only minor water masses are transported over the tidal divide behind Fanoe. The tidal lagoon is about 12 km long and 4 km wide. About 40% is comprised of intertidal flats. Esbjerg harbour, located at the centre of the estuary, carries out maintenance dredging of between 200.000 and 600.000 m3 of fine-grained sediment annually. Most of this sediment is dispersed on two sites located on the sides of the tidal channels, depending on the phase of the tide. The sedimentation of fine-grained sediment in the area is governed by estuarine processes such as settling lag, scour lag and tidal asymmetry. Research shows that slow but significant deposition occurs at the tidal flats consistent with measurements showing a net flux into the area. In this paper, the knowledge gained from various research projects and
Lehman, David H.; Clark, Karla B.; Cook, Beverly A.; Gavit, Sarah A.; Kayali, Sammy A.; McKinney, John C.; Milkovich, David C.; Reh, Kim R.; Taylor, Randall L.; Casani, John R.
Congress authorized NASA?s Prometheus Project in February 2003, with the first Prometheus mission slated to explore the icy moons of Jupiter. The Project had two major objectives: (1) to develop a nuclear reactor that would provide unprecedented levels of power and show that it could be processed safely and operated reliably in space for long-duration, deep-space exploration and (2) to explore the three icy moons of Jupiter - Callisto, Ganymede, and Europa - and return science data that would meet the scientific goals as set forth in the Decadal Survey Report of the National Academy of Sciences. Early in Project planning, it was determined that the development of the Prometheus nuclear powered Spaceship would be complex and require the intellectual knowledge residing at numerous organizations across the country. In addition, because of the complex nature of the Project and the multiple partners, approaches beyond those successfully used to manage a typical JPL project would be needed. This paper1 will describe the key experiences in managing Prometheus that should prove useful for future projects of similar scope and magnitude
Vaarst, M; Bennedsgaard, T W; Klaas, I; Nissen, T B; Thamsborg, S M; Østergaard, S
Promotion of animal health and well-being at the individual animal and herd level is an important goal in organic farming. At the same time, chemical products affecting the natural balance among living organisms are prohibited in all areas of the organic farm. From an animal welfare point of view, however, no animal must suffer. Therefore, veterinary drugs are allowed under the European Union's regulations for organic farming, despite the fact that they are powerful cell toxins affecting both pathogenic and necessary bacteria, and as such in organic terminology, are regarded as "chemical" or "artificial" products. In this article, we present and discuss interviews with 12 Danish organic dairy producers who claim that minimized use or nonuse of antimicrobial drugs is an explicit goal. The dairy producers were at different levels with regard to reduced antimicrobial treatment. An explicit strategy of no antimicrobial treatments is based primarily on a long-term effort to improve herd health, and secondarily, on finding alternative treatments for diseased animals. Improved hygiene, outdoor access, use of nursing cows, and blinding of chronic mastitis quarters were the main techniques in developing a strategy of not using antimicrobial treatments in the herd by dairy producers. Producers' perception of disease changed from something unavoidable to a disturbing break in the daily rhythm that often could have been avoided. Change toward a nonantimicrobial strategy was gradual and stepwise. All dairy producers in this study desired to preserve the possibility of using antimicrobial drugs in emergencies.
A history of technological development for subcritical cryogenic fluid management (CFM) through space experiments is given for the period 1960 to 1990. Space experiments with liquid hydrogen were conducted in the early 1960's. Efforts since then have consisted of studies and designs of potential space experiments. A chronology of CFM space experiments and design efforts is included.
Abiodun-Oyebanji, Olayemi; Olaleye, F.
This study examined women in university management in Nigeria. It was a descriptive research of the survey type. The population of the study comprised all the public universities in southwest Nigeria, out of which three were selected through the stratified random sampling technique. Three hundred respondents who were in management positions were…
Ryan, Leo V.; Coover, Thomas A.
St. Viator High School, through a Business Management Seminar, converted job experiences into learning experiences by acknowledging the real value of the job as a laboratory for the study of principles of management and their application to the job. (Author/BP)
The Adaptive Grazing Management experiment (2013-2023) in shortgrass steppe of Colorado addresses a critical gap in grazing management: lack of management-science partnerships to more fully understand the effect of management decisions for multiple ecosystem goods and services at ranch-scales. A Sta...
Elkjær, K; Ancker, M-L; Gustafsson, H; Friggens, N C; Waldmann, A; Mølbak, L; Callesen, H
The overall aim of this study was to describe uterine bacterial flora during the postpartum period in Danish Holstein cows using the Terminal Restriction Fragment Length Polymorphism (T-RFLP) method. This method produces a pattern of nucleic acid fragments from the microorganisms present, reflecting the "fingerprint" of the actual microbial flora. As well as characterizing changes in flora with time from calving and between herds, data were examined for strong relations between uterine bacterial flora, calving management and uterine condition. In total 125 Holstein cows from five herds were included, and for each cow calving management was recorded. Cows were clinically examined on average 8 (range 0-19) and 28 (range 22-38) days after calving, and a uterine sample was taken for bacterial identification using T-RFLP. Milk samples were taken weekly for progesterone analysis. Bacteria were found in all cows at both examinations, and the flora was composed of many species, including species not traditionally reported to be present in the bovine uterus. The bacterial composition differed according to days from calving and herd. In all five herds Fusobacterium necrophorum, Pseudomonas/Acinetobacter and Bacteroides/Sphingobacterium/Prevotellaceae were among the most common at both examinations. In four herds there was a percentage decrease of F. necrophorum from first to second examination, and in all herds there was a percentage increase of Pseudomonas/Acinetobacter from first to second examination. No differences in bacterial flora were found between cows with different uterine scores, which were influenced by herd, calving difficulty and retained placenta.
Background There has been an increased interest in recruiting health professionals with a clinical background to management positions in health care. We know little about the factors that influence individuals’ decisions to engage in management. The aim of this study is to explore clinicians’ journeys towards management positions in hospitals, in order to identify potential drivers and barriers to management recruitment and development. Methods We did a qualitative study which included in-depth interviews with 30 clinicians in middle and first-line management positions in Norwegian hospitals. In addition, participant observation was conducted with 20 of the participants. The informants were recruited from medical and surgical departments, and most had professional backgrounds as medical doctors or nurses. Interviews were analyzed by systemic text condensation. Results We found that there were three phases in clinicians’ journey into management; the development of leadership awareness, taking on the manager role and the experience of entering management. Participants’ experiences suggest that there are different journeys into management, in which both external and internal pressure emerged as a recurrent theme. They had not anticipated a career in clinical management, and experienced that they had been persuaded to take the position. Being thrown into the position, without being sufficiently prepared for the task, was a common experience among participants. Being left to themselves, they had to learn management “on the fly”. Some were frustrated in their role due to increasing administrative workloads, without being able to delegate work effectively. Conclusions Path dependency and social pressure seems to influence clinicians’ decisions to enter into management positions. Hospital organizations should formalize pathways into management, in order to identify, attract, and retain the most qualified talents. Top managers should make sure that necessary
Serowik, Kristin L; Bellamy, Chyrell D; Rowe, Michael; Rosen, Marc I
A large proportion of people diagnosed with mental illnesses have difficulty managing their money, and therefore many psychiatric treatments involve providing money management assistance. However, little is known about the subjective experience of having a money manager, and extant literature is restricted to people forced to work with a representative payee or conservator. In this study, fifteen people were interviewed about their experience receiving a voluntary money management intervention designed to minimize substance use. Clients emphasized the importance of trusting the money manager, financial mindfulness (an enhanced awareness of the financial transactions in clients' day-to-day lives), agency over their own affairs, and addiction. In contrast to evaluations of people assigned representative payees and/or conservators, there was little mention of feeling coerced. These findings suggest that money management programs can address client concerns by building trust, relating budgeting to clients' day-to-day lives, and encouraging clients' control over their own affairs.
The author's experience with a Nunavut business management education program illustrates how to develop culturally relevant organizational behavior curriculum. The process initially involved interviews with Inuit Elders about culturally appropriate responses to scenarios of cultural conflicts in the workplace identified by Inuit managers. The…
Kaspersen, Bjarke Stoltze; Christensen, Thomas Budde; Fredenslund, Anders Michael; Møller, Henrik Bjarne; Butts, Michael Brian; Jensen, Niels H; Kjaer, Tyge
The interest in sustainable bioenergy solutions has gained great importance in Europe due to the need to reduce GHG emissions and to meet environmental policy targets, not least for the protection of groundwater and surface water quality. In the Municipality of Solrød in Denmark, a novel bioenergy concept for anaerobic co-digestion of food industry residues, manure and beach-cast seaweed has been developed and tested in order to quantify the potential for synergies between climate change mitigation and coastal eutrophication management in the Køge Bay catchment. The biogas plant, currently under construction, was designed to handle an annual input of up to 200,000 t of biomass based on four main fractions: pectin wastes, carrageenan wastes, manure and beach-cast seaweed. This paper describes how this bioenergy concept can contribute to strengthening the linkages between climate change mitigation strategies and Water Framework Directive (WFD) action planning. Our assessments of the projected biogas plant indicate an annual reduction of GHG emissions of approx. 40,000 t CO2 equivalents, corresponding to approx. 1/3 of current total GHG emissions in the Municipality of Solrød. In addition, nitrogen and phosphorous loads to Køge Bay are estimated to be reduced by approx. 63 t yr.(-1) and 9 tyr.(-1), respectively, contributing to the achievement of more than 70% of the nutrient reduction target set for Køge Bay in the first WFD river basin management plan. This study shows that anaerobic co-digestion of the specific food industry residues, pig manure and beach-cast seaweed is feasible and that there is a very significant, cost-effective GHG and nutrient loading mitigation potential for this bioenergy concept. Our research demonstrates how an integrated planning process where considerations about the total environment are integrated into the design and decision processes can support the development of this kind of holistic bioenergy solutions.
Angelici, Gary; Popovici, Lidia; Skiles, J. W.
The ability of investigators of an interdisciplinary science project to properly manage the data that are collected during the experiment is critical to the effective conduct of science. When the project becomes large, possibly including several scenes of large-format remotely sensed imagery shared by many investigators requiring several services, the data management effort can involve extensive staff and computerized data inventories. The OTTER (Oregon Transect Ecosystem Research) project was supported by the PLDS (Pilot Land Data System) with several data management services, such as data inventory, certification, and publication. After a brief description of these services, experiences in providing them are compared with earlier data management efforts and some conclusions regarding data management in support of interdisciplinary science are discussed. In addition to providing these services, a major goal of this data management capability was to adopt characteristics of a pro-active attitude, such as flexibility and responsiveness, believed to be crucial for the effective conduct of active, interdisciplinary science. These are also itemized and compared with previous data management support activities. Identifying and improving these services and characteristics can lead to the design and implementation of optimal data management support capabilities, which can result in higher quality science and data products from future interdisciplinary field experiments.
Bent, John M; Kroiss, Ryan R; Torrez, Alfred; Wingate, Meghan
Experiment management in any domain is challenging. There is a perpetual feedback loop cycling through planning, execution, measurement, and analysis. The lifetime of a particular experiment can be limited to a single cycle although many require myriad more cycles before definite results can be obtained. Within each cycle, a large number of subexperiments may be executed in order to measure the effects of one or more independent variables. Experiment management in high performance computing (HPC) follows this general pattern but also has three unique characteristics. One, computational science applications running on large supercomputers must deal with frequent platform failures which can interrupt, perturb, or terminate running experiments. Two, these applications typically integrate in parallel using MPI as their communication medium. Three, there is typically a scheduling system (e.g. Condor, Moab, SGE, etc.) acting as a gate-keeper for the HPC resources. In this paper, we introduce LANL Experiment Management (LEM), an experimental management framework simplifying all four phases of experiment management. LEM simplifies experiment planning by allowing the user to describe their experimental goals without having to fully construct the individual parameters for each task. To simplify execution, LEM dispatches the subexperiments itself thereby freeing the user from remembering the often arcane methods for interacting with the various scheduling systems. LEM provides transducers for experiments that automatically measure and record important information about each subexperiment; these transducers can easily be extended to collect additional measurements specific to each experiment. Finally, experiment analysis is simplified by providing a general database visualization framework that allows users to quickly and easily interact with their measured data.
Urban, Mary Elizabeth
Risk is a factor, element, constraint, or course of action that introduces an uncertainty of outcome that could impact project objectives. Risk is an inherent part of all activities, whether the activity is simple and small, or large and complex. Risk management is a process that identifies, evaluates, handles, and monitors risks that have the potential to affect project success. The risk management process spans the entire project, from its initiation to its successful completion and closeout, including both technical and programmatic (non-technical) risks. This Risk Management Plan (RMP) defines the process to be used for identifying, evaluating, handling, and monitoring risks as part of the overall management of the Enhanced Capabilities for Subcritical Experiments (ECSE) ‘Project’. Given the changing nature of the project environment, risk management is essentially an ongoing and iterative process, which applies the best efforts of a knowledgeable project staff to a suite of focused and prioritized concerns. The risk management process itself must be continually applied throughout the project life cycle. This document was prepared in accordance with DOE O 413.3B, Program and Project Management for the Acquisition of Capital Assets, its associated guide for risk management DOE G 413.3-7, Risk Management Guide, and LANL ADPM AP-350-204, Risk and Opportunity Management.
Valett, Jon D.
To effectively manage a software development project, the software manager must have access to key information concerning a project's status. This information includes not only data relating to the project of interest, but also, the experience of past development efforts within the environment. This paper describes the concepts and functionality of a software management tool designed to provide this information. This tool, called the Software Management Environment (SME), enables the software manager to compare an ongoing development effort with previous efforts and with models of the 'typical' project within the environment, to predict future project status, to analyze a project's strengths and weaknesses, and to assess the project's quality. In order to provide these functions the tool utilizes a vast corporate memory that includes a data base of software metrics, a set of models and relationships that describe the software development environment, and a set of rules that capture other knowledge and experience of software managers within the environment. Integrating these major concepts into one software management tool, the SME is a model of the type of management tool needed for all software development organizations.
The objective of this report is to provide an assessment of the current light water reactor experience regarding accident management programs and associated technology developments. This assessment for light water reactor (LWR) designs is provided as a resource and reference for the development of accident management capabilities for the production reactors at the Savannah River Site. The specific objectives of this assessment are as follows: 1. Perform a review of the NRC, utility, and industry (NUMARC, EPRI) accident management programs and implementation experience. 2. Provide an assessment of the problems and opportunities in developing an accident management program in conjunction or following the Individual Plant Examination process. 3. Review current NRC, utility, and industry technological developments in the areas of computational tools, severe accident predictive tools, diagnostic aids, and severe accident training and simulation.
Lanham, C. C., Jr.
A data management system study is presented that defines, in functional terms, the most cost effective ground data management system to support Advanced Technology Laboratory (ATL) flights of the space shuttle. Results from each subtask performed and the recommended system configuration for reformatting the experiment instrumentation tapes to computer compatible tape are examined. Included are cost factors for development of a mini control center for real-time support of the ATL flights.
Bouchard, C E
In healthcare, as in any other field, work can become dehumanizing, meaningless drudgery. But good managers can transform their organizations and renew the experience of work. Good management demands not only good business skills, but character, rooted in truthfulness and vision. Three virtues are particularly important: prudence, justice and fortitude. The moral skill of prudence enables healthcare managers to know what is to be done; justice creates honest relationships; and fortitude enables managers to seek a good that is difficult to achieve--to do the right thing. Businesses must also explore their potential for sacramentality and find ways in which employees--and employers--can become better, holier people through their work. Organizations should strive to achieve subsidiarity and keep employees well-informed of their missions. Establishing a sense of connectedness is important, as is open and honest communication. Finally, managers-and healthcare organizations-must always work for the common good.
Sørensen, Sarah Mejer; Bjørn, Signe Frahm; Jochumsen, Kirsten Marie; Jensen, Pernille Tine; Thranov, Ingrid Regitze; Hare-Bruun, Helle; Seibæk, Lene; Høgdall, Claus
Aim of database The Danish Gynecological Cancer Database (DGCD) is a nationwide clinical cancer database and its aim is to monitor the treatment quality of Danish gynecological cancer patients, and to generate data for scientific purposes. DGCD also records detailed data on the diagnostic measures for gynecological cancer. Study population DGCD was initiated January 1, 2005, and includes all patients treated at Danish hospitals for cancer of the ovaries, peritoneum, fallopian tubes, cervix, vulva, vagina, and uterus, including rare histological types. Main variables DGCD data are organized within separate data forms as follows: clinical data, surgery, pathology, pre- and postoperative care, complications, follow-up visits, and final quality check. DGCD is linked with additional data from the Danish “Pathology Registry”, the “National Patient Registry”, and the “Cause of Death Registry” using the unique Danish personal identification number (CPR number). Descriptive data Data from DGCD and registers are available online in the Statistical Analysis Software portal. The DGCD forms cover almost all possible clinical variables used to describe gynecological cancer courses. The only limitation is the registration of oncological treatment data, which is incomplete for a large number of patients. Conclusion The very complete collection of available data from more registries form one of the unique strengths of DGCD compared to many other clinical databases, and provides unique possibilities for validation and completeness of data. The success of the DGCD is illustrated through annual reports, high coverage, and several peer-reviewed DGCD-based publications. PMID:27822089
Yuxiang, Li; Lingjun, Zhou; Lu, Tang; Mengjie, Liu; Xing, Ming; Fengping, Shen; Jing, Cui; Xianli, Meng; Jijun, Zhao
Pain is a major problem after burns and researchers continue to report that pain from burns remains undertreated. The inadequate pain control results in adverse sequalae physically and psychologically in the burn victims. A better understanding of a burn patient's experience is important in identifying the factors responsible for undertreated pain and establishing effective pain management guidelines or recommendation in the practice of pain relief for burn injuries. This study sought to explore and describe the experience that patients have about pain related to burn-injury during hospitalization. Semi-structured interviews were conducted on eight patients with moderate to severe pain from burn injuries recruited from a Burn Centre in Northwest China. Data was collected by in-depth interviews and qualitative description after full transcription of each interview. Analysis involved the identification of themes and the development of a taxonomy of patients' experience of burn pain and its management. Three themes were indentified: (1) patients' experience of pain control, (2) patients' perception on burn pain management, and (3) patients' expectation of burn pain management. Findings from this study suggested that patients experience uncontrolled pain both physically and psychologically which may serve as an alert for awareness of health professionals to recognize and establish a multidisciplinary pain management team for burn victims, including surgeons, critical care specialists, anesthesiologists, nurses, psychologists, and social workers to accomplish safe and effective strategies for pain control to reach an optimal level of pain management in burn patients. It also provides insights and suggestions for future research directions to address this significant clinical problem.
Purcell, Laura; Milner, Brigid
Purpose--The purpose of this paper is to investigate the dramatic reforms in the health service in recent years. Design/methodology/approach--Examines management development in health care, and explores the experiences of clinical nurse managers. Findings--Duplication of agencies and multiplication of roles have led to tensions in terms of both…
Townsend, Peter; Regan, Padraic; Li, Liang Liang
Purpose: The purpose of this paper is to evaluate cultural experience as a learning strategy for developing international managers. Design/methodology/approach: Using an integrated framework, two quantitative studies, based on empirical methodology, are conducted. Study 1, with an undergraduate sample situated in the Asia Pacific, aimed to examine…
Johnson, Taya C.; Stoner, Gary; Green, Susan K.
Demonstrates the experimenting society model using data-based decision making and collaborative consultation to evaluate behavior-management intervention strategies in 25 seventh graders. Each intervention results in improved behavior, but active teaching of classroom rules was determined to be most effective. (Author/JDM)
Yuen, Allan; Fox, Robert; Sun, Angie; Deng, Liping
Purpose: The course management system (CMS), as an evolving tool and innovation, is increasingly used to promote the quality, efficiency and flexibility of teaching and learning in higher education. This paper aims to examine students' experiences of CMSs across faculties at a comprehensive university in Hong Kong. Design/methodology/approach:…
This paper identifies and describes experience with ‘green’ stormwater management practices in Germany. It provides the context in which developments took place and extracts lessons learned to inform efforts of other countries in confronting urban stormwater challenges. Our findi...
Tran, Trang Thi Thu; Moni, Karen
This study investigated EFL students' and teachers' perspectives and experiences of managing foreign language anxiety (FLA). Data were obtained from 49 student autobiographies, 18 student interviews, 8 teacher interviews and 351 student responses to an open-ended question. Content analysis was used to analyse the data with the use of NVivo. A…
Temple, Paul; Callender, Claire; Grove, Lyn; Kersh, Natasha
This research report, prepared between January 2014 and July 2014, assesses how the management of the undergraduate student experience in English higher education (HE) is changing as a result of a more competitive environment, and in particular the impact of the new tuition fee regime introduced in 2012. Summary of respondent categories by…
Mehdinezhad, Vali; Sardarzahi, Zaid
This paper aims at studying the leadership behaviors reported by principals and observed by teachers and its relationship with management experience of principals. A quantitative method was used in this study. The target population included all principals and teachers of guidance schools and high schools in the Dashtiari District, Iran. A sample…
Stevens, Robert; Zhao, Jun; Goble, Carole
This article offers a briefing in one of the knowledge management issues of in silico experimentation in bioinformatics. Recording of the provenance of an experiment-what was done; where, how and why, etc. is an important aspect of scientific best practice that should be extended to in silico experimentation. We will do this in the context of eScience which has been part of the move of bioinformatics towards an industrial setting. Despite the computational nature of bioinformatics, these analyses are scientific and thus necessitate their own versions of typical scientific rigour. Just as recording who, what, why, when, where and how of an experiment is central to the scientific process in laboratory science, so it should be in silico science. The generation and recording of these aspects, or provenance, of an experiment are necessary knowledge management goals if we are to introduce scientific rigour into routine bioinformatics. In Silico experimental protocols should themselves be a form of managing the knowledge of how to perform bioinformatics analyses. Several systems now exist that offer support for the generation and collection of provenance information about how a particular in silico experiment was run, what results were generated, how they were generated, etc. In reviewing provenance support, we will review one of the important knowledge management issues in bioinformatics.
Noronha, Ernesto; D'Cruz, Premilla
This paper presents the findings of a phenomenological study, which describes the experiences of human resource (HR) managers implementing a downsizing program in a steel manufacturing organization in India. Data were collected through conversational interviews. Following van Manens sententious analytic approach, the core theme of a necessary…
Hölmich, Lisbet Rosenkrantz; Klausen, Siri; Spaun, Eva; Schmidt, Grethe; Gad, Dorte; Svane, Inge Marie; Schmidt, Henrik; Lorentzen, Henrik Frank; Ibfelt, Else Helene
Aim of database The aim of the database is to monitor and improve the treatment and survival of melanoma patients. Study population All Danish patients with cutaneous melanoma and in situ melanomas must be registered in the Danish Melanoma Database (DMD). In 2014, 2,525 patients with invasive melanoma and 780 with in situ tumors were registered. The coverage is currently 93% compared with the Danish Pathology Register. Main variables The main variables include demographic, clinical, and pathological characteristics, including Breslow’s tumor thickness, ± ulceration, mitoses, and tumor–node–metastasis stage. Information about the date of diagnosis, treatment, type of surgery, including safety margins, results of lymphoscintigraphy in patients for whom this was indicated (tumors > T1a), results of sentinel node biopsy, pathological evaluation hereof, and follow-up information, including recurrence, nature, and treatment hereof is registered. In case of death, the cause and date are included. Currently, all data are entered manually; however, data catchment from the existing registries is planned to be included shortly. Descriptive data The DMD is an old research database, but new as a clinical quality register. The coverage is high, and the performance in the five Danish regions is quite similar due to strong adherence to guidelines provided by the Danish Melanoma Group. The list of monitored indicators is constantly expanding, and annual quality reports are issued. Several important scientific studies are based on DMD data. Conclusion DMD holds unique detailed information about tumor characteristics, the surgical treatment, and follow-up of Danish melanoma patients. Registration and monitoring is currently expanding to encompass even more clinical parameters to benefit both patient treatment and research. PMID:27822097
Bell, R. S.; Vento, D. M.; Hanna, G. J.
An overview of the CONE program is presented which includes a definition of the technology addressed by CONE and a baseline experiment set, a description of the experimental and support subsystems, interface requirements between the STS and the experiment carrier (Hitchhiker M), and the reusability and expansion capacity for additional experiment flights. CONE evaluates three primary technologies: the active thermodynamic vent system, the passive thermodynamic vent system, and liquid acquisition device performance. The cryogenic fluid management technology database that the system offers will allow for efficient subcritical cryogenic system designs for operation in a low-gravity environment. This system maximizes the balance between existing component technology and the need for the development of a cryogenic-fluid-management (CFM) test bed to investigate and demonstrate methods of storage and handling arenas.
Obel, Niels; Reinholdt, Hanne; Omland, Lars H; Engsig, Frederik; Sørensen, Henrik T; Hansen, Ann-Brit E
Background Hospital-based discharge registries are used increasingly for longitudinal epidemiological studies of HIV. We examined completeness of registration of HIV infections and of chronic hepatitis B (HBV) and hepatitis C (HCV) coinfections in the Danish National Hospital Registry (DNHR) covering all Danish hospitals. Methods The Danish HIV Cohort Study (DHCS) encompasses all HIV-infected patients treated in Danish HIV clinics since 1 January 1995. All 2,033 Danish patients in DHCS diagnosed with HIV-1 during the 10-year period from 1 January 1995 to 31 December 2004 were included in the current analysis. We used the DHCS as a reference to examine the completeness of HIV and of HBV and HCV coinfections recorded in DNHR. Cox regression analysis was used to estimate hazard ratios of time to diagnosis of HIV in DNHR compared to DHCS. Results Of the 2,033 HIV patients in DHCS, a total of 2,006 (99%) were registered with HIV in DNHR. Of these, 1,888 (93%) were registered in DNHR within one year of their first positive HIV test. A CD4 < 200 cells/μl, a viral load >= 100,000 copies/ml and being diagnosed after 1 January 2000, were associated with earlier registration in DNHR, both in crude and adjusted analyses. Thirty (23%) HIV patients registered with chronic HBV (n = 129) in DHCS and 126 (48%) of HIV patients with HCV (n = 264) in DHCS were registered with these diagnoses in the DNHR. Further 17 and 8 patients were registered with HBV and HCV respectively in DNHR, but not in DHCS. The positive predictive values of being registered with HBV and HCV in DHCS were thereby estimated to 0.88 and 0.97 and in DNHR to 0.32 and 0.54. Conclusion The study demonstrates that secondary data from national hospital databases may be reliable for identification of patients diagnosed with HIV infection. However, the predictive value of co-morbidity data may be low. PMID:18439245
The minimum number of standardized (common) module concepts that will satisfy the experiment program for manned space stations at least cost is investigated. The module interfaces with other elements such as the space shuttle, ground stations, and the experiments themselves are defined. The total experiment module program resource and test requirements are also considered. The minimum number of common module concepts that will satisfy the program at least cost is found to be three, plus a propulsion slice and certain experiment-peculiar integration hardware. The experiment modules rely on the space station for operational, maintenance, and logistic support. They are compatible with both expendable and shuttle launch vehicles, and with servicing by shuttle, tug, or directly from the space station. A total experiment module program cost of approximately $2319M under the study assumptions is indicated. This total is made up of $838M for experiment module development and production, $806M for experiment equipment, and $675M for interface hardware, experiment integration, launch and flight operations, and program management and support.
Bjerrum, Andreas; Andersen, Ole; Fischer, Anders; Lindebjerg, Jan; Lynge, Elsebeth
Background In Denmark, colorectal cancer (CRC) is the third most frequent cancer. Randomised trials have shown that guaiac faecal occult blood test (gFOBT) screening can reduce CRC mortality, but a recent large randomised study from Finland did not find any effect. A feasibility study was carried out in Denmark in 2005–2006 where residents aged 50–74 years in 2 Danish counties were invited once to participate in gFOBT screening. We used the unique Danish registers to assess the impact of gFOBT screening in this group on CRC incidence and mortality. Methods In this cohort study, we followed a group comprising 166 277 individuals invited to screening and a reference group comprising the remaining 1 240 348 Danes of the same age. We linked the Danish population and health service registers to obtain information about colonoscopies, polypectomies, incident CRC and cause of death. Results After a median follow-up time of 8.9 years, the CRC mortality was significantly lower in the screening group than in the reference group with an adjusted HR (aHR) of 0.92 (95% CI 0.86 to 0.99), while the aHR for all-cause mortality was 0.95 (95% CI 0.94 to 0.96). For screening participants, the aHR for CRC mortality and all-cause mortality was 0.72 (0.64 to 0.80) and 0.59 (0.57 to 0.60), respectively. Conclusions About 10 years after a single round of gFOBT screening, we found a significant 8% deficit in CRC mortality in the screening group compared with other Danes. We found almost the same deficit in all-cause mortality, and on this basis, it is not possible to conclude that one screening round had an effect on CRC mortality. Our study indicated that close monitoring of the outcome of CRC screening is warranted. PMID:28074150
Schuster, J. R.; Wachter, J. P.; Vento, D. M.
Future national space transportation missions will depend on the use of cryogenic fluid management technology development needs for these missions. In-space testing will be conducted in order to show low gravity cryogenic fluid management concepts and to acquire a technical data base. Liquid H2 is the preferred test fluid due to its propellant use. The design of COLD-SAT (Cryogenic On-orbit Liquid Depot Storage, Acquisition, and Transfer Satellite), an Expendable Launch Vehicle (ELV) launched orbital spacecraft that will perform subcritical liquid H2 storage and transfer experiments under low gravity conditions is studied. An Atlas launch vehicle will place COLD-SAT into a circular orbit, and the 3-axis controlled spacecraft bus will provide electric power, experiment control, and data management, attitude control, and propulsive accelerations for the experiments. Low levels of acceleration will provide data on the effects that low gravity might have on the heat and mass transfer processes used. The experiment module will contain 3 liquid H2 tanks; fluid transfer, pressurization and venting equipment; and instrumentation.
Whitehead, John S.
The paper is a supplement to an earlier paper in the same series which reviews Danish higher education until 1977. Expansion in higher education in the last 20 years, approaching the scale of mass higher education, culminated in a crisis in 1977. At that time, a trend toward self-government and participatory governing boards was seen as the end of…
Johnsen, Søren Paaske; Ingeman, Annette; Hundborg, Heidi Holmager; Schaarup, Susanne Zielke; Gyllenborg, Jesper
Aim of database The aim of the Danish Stroke Registry is to monitor and improve the quality of care among all patients with acute stroke and transient ischemic attack (TIA) treated at Danish hospitals. Study population All patients with acute stroke (from 2003) or TIA (from 2013) treated at Danish hospitals. Reporting is mandatory by law for all hospital departments treating these patients. The registry included >130,000 events by the end of 2014, including 10,822 strokes and 4,227 TIAs registered in 2014. Main variables The registry holds prospectively collected data on key processes of care, mainly covering the early phase after stroke, including data on time of delivery of the processes and the eligibility of the individual patients for each process. The data are used for assessing 18 process indicators reflecting recommendations in the national clinical guidelines for patients with acute stroke and TIA. Patient outcomes are currently monitored using 30-day mortality, unplanned readmission, and for patients receiving revascularization therapy, also functional level at 3 months poststroke. Descriptive data Sociodemographic, clinical, and lifestyle factors with potential prognostic impact are registered. Conclusion The Danish Stroke Registry is a well-established clinical registry which plays a key role for monitoring and improving stroke and TIA care in Denmark. In addition, the registry is increasingly used for research. PMID:27843349
Nagel, L. M.; Swanston, C.; Janowiak, M.
Three common forest adaptation options discussed in the context of an uncertain future climate are: creating resistance, promoting resilience, and enabling forests to respond to change. Though there is consensus on the broad management goals addressed by each of these options, translating these concepts into management plans specific for individual forest types that vary in structure, composition, and function remains a challenge. We will describe a decision-making framework that we employed within a manager-scientist partnership to develop a suite of adaptation treatments for two contrasting forest types as part of a long-term forest management experiment. The first, in northern Minnesota, is a red pine-dominated forest with components of white pine, aspen, paper birch, and northern red oak, with a hazel understory. The second, in southwest Colorado, is a warm-dry mixed conifer forest dominated by ponderosa pine, white fir, and Douglas-fir, with scattered aspen and an understory of Gambel oak. The current conditions at both sites are characterized by overstocking with moderate-to-high fuel loading, vulnerability to numerous forest health threats, and are generally uncharacteristic of historic structure and composition. The desired future condition articulated by managers for each site included elements of historic structure and natural range of variability, but were greatly tempered by known vulnerabilities and projected changes to climate and disturbance patterns. The resultant range of treatments we developed are distinct for each forest type, and address a wide range of management objectives.
Ezell, Matthew A; Maxwell, Don E; Beer, David
High performance computing resources utilize batch systems to manage the user workload. Cray systems are uniquely different from typical clusters due to Cray s Application Level Placement Scheduler (ALPS). ALPS manages binary transfer, job launch and monitoring, and error handling. Batch systems require special support to integrate with ALPS using an XML protocol called BASIL. Previous versions of Adaptive Computing s TORQUE and Moab batch suite integrated with ALPS from within Moab, using PERL scripts to interface with BASIL. This would occasionally lead to problems when all the components would become unsynchronized. Version 4.1 of the TORQUE Resource Manager introduced new features that allow it to directly integrate with ALPS using BASIL. This paper describes production experiences at Oak Ridge National Laboratory using the new TORQUE software versions, as well as ongoing and future work to improve TORQUE.
Konrad, Christopher P.; Olden, Julian D.; Lytle, David A.; Melis, Theodore S.; Schmidt, John C.; Bray, Erin N.; Freeman, Mary C.; Gido, Keith B.; Hemphill, Nina P.; Kennard, Mark J.; McMullen, Laura E.; Mims, Meryl C.; Pyron, Mark; Robinson, Christopher T.; Williams, John G.
Experimental manipulations of streamflow have been used globally in recent decades to mitigate the impacts of dam operations on river systems. Rivers are challenging subjects for experimentation, because they are open systems that cannot be isolated from their social context. We identify principles to address the challenges of conducting effective large-scale flow experiments. Flow experiments have both scientific and social value when they help to resolve specific questions about the ecological action of flow with a clear nexus to water policies and decisions. Water managers must integrate new information into operating policies for large-scale experiments to be effective. Modeling and monitoring can be integrated with experiments to analyze long-term ecological responses. Experimental design should include spatially extensive observations and well-defined, repeated treatments. Large-scale flow manipulations are only a part of dam operations that affect river systems. Scientists can ensure that experimental manipulations continue to be a valuable approach for the scientifically based management of river systems.
Able Site is located 24 km northwest of Mercury on the Nevada Test Site. The Nevada Test Site is approximately 105 km northwest of Las Vegas, NV. Major facilities at Able Site include Buildings 5100,5180, and 5191. Significant external interfaces for the JASPER site include the electrical system, wastewater system, communications systems, and water supply system, which provides both potable and fire-protection water. Support services, which are provided on the Nevada Test Site, include medical, emergency response (NTS Fire Department), radiation protection, industrial hygiene, and waste management. Although JASPER will ultimately be used for actinide research, the start-up process requires system demonstration using surrogates in place of the actinide targets. LLNL Nevada Experiments and Operations (N) Program has established a Management Prestart Review (MPR) team to determine the readiness of the JASPER personnel and facilities to initiate surrogate-material experiments. A second MPR will be conducted before actinide experiments are executed. This document addresses implementation requirements for only the first MPR. This first review coincides with the completion of authorization-basis documents and physical subsystems, which have undergone appropriate formal engineering design reviews. This MPR will affirm the quality of those reviews, their findings/resolutions, and will look most closely at systems integration requirements and demonstrations that will have undergone technical acceptance reviews before this formal MPR action. Closure of MPR findings will finalize requirements for a DOE/NV Real Estate/Operations Permit (REOP) for surrogate-material experiments. Upon completion of that experiment series and the establishment of capabilities for incorporating special nuclear material (SNM) into future experiments, the team will convene again as part of the process of authorizing those activities. A summary of the review schedule is provided.
Kumar, Jatinder; Kumar, Vikas; Bhatia, Vijaylakshmi; Dabadghao, Preeti; Chaturvedi, Samit; Kapoor, Rakesh; Ansari, M. S.
Introduction: Ambiguous genitalia are a major cause of parental anxiety and create psychological and social problems to patient, if not managed properly. Here we present our experience in managing patients with ambiguous genitalia. Material and Methods: We retrospectively reviewed clinical records of all patients with ambiguous genitalia managed surgically at out institute between December 1989 and January 2011. Relevant history, clinical examination, investigations and surgical procedures performed were analyzed and results were evaluated in terms of anatomical, functional and psychosexual outcomes. Results: Female pseudohermaphroditism was the most common cause of genital ambiguity in our patients. Male and female genitoplasty was done according to gender of rearing, genital anatomy and parental choice. Twenty six patients (86.6%) reported satisfactory cosmetic outcome and 22 (73.3%) satisfactory functional outcome on long term follow-up. Among the 24 patients diagnosed as male pseudohermaphroditism 14 (82.3%) patient have reported satisfactory cosmetic outcome and 13 (76.4%) have reported satisfactory functional outcome. In patients with mixed gonadal dysgenesis and true hermaphroditism satisfactory cosmetic and functional outcome was seen in 70% patient. Conclusion: Managing patients of genital ambiguity according to gender of rearing, genital anatomy and parental choice carries good prognosis in terms of anatomical, functional and psychosexual outcome. PMID:23204656
Schuster, J. R.; Wachter, J. P.; Vento, D. M.
The COLD-SAT spacecraft design experiments are described. COLD-SAT will be placed into an initial 1300 km circular orbit by an Atlas commercial launch vehicle. Electric power, experiment control and data management, attitude control, and propulsive accelarations for the experiments will be provided by the three-axis-controlled spacecraft bus. To provide data on the effects that low gravity levels might have on the heat and mass transfer processes involved, low levels of accelaration will be created. The COLD-SAT experiment will be configured into a module. The spacecraft experiment module will include three liquid hydrogen tanks; fluid transfer, pressurization and venting equipment; and instrumentation. Since the largest tank has helium-purged MLI to prevent ingress and freezing of air on the launchpad, it will contain all the liquid hydrogen at the point of launching. The hydrogen tanking system used for the Centaur upper stage of the Atlas will load and top off this tank. Atlas, with its liquid hydrogen upper stage, large payload fairing, and large launch margin, simplifies COLD-SAT design and integration.
Lambrechts, T.; Bryce, J.; Orinda, V.
The strategy of Integrated Management of Childhood Illness (IMCI) aims to reduce child mortality and morbidity in developing countries by combining improved management of common childhood illnesses with proper nutrition and immunization. The strategy includes interventions to improve the skills of health workers, the health system, and family and community practices. This article describes the experience of the first countries to adopt and implement the IMCI interventions, the clinical guidelines dealing with the major causes of morbidity and mortality in children, and the training package on these guidelines for health workers in first-level health facilities. The most relevant lessons learned and how these lessons have served as a basis for developing a broader IMCI strategy are described. PMID:10444882
Famà, Fausto; Beccaria, Antonio; Malara, Consolato; Placanica, Pantaleone; Cucinotta, Francesco; Caruso, Antonino; Estollere, Concetta; Versace, Giuseppina; Latorre, Nadia; Foti, Donatella; Falzea, Roberto; De Ponte, Francesco; Gioffrè-Florio, Maria Antonietta
Maxillofacial injuries are relatively frequent. These may be complicated by cranioencephalic injuries or large facial wounds. We report our experience with the initial management of these lesions in an emergency unit setting. In 2007, we observed 105 patients with maxillofacial injuries. Maxillofacial injuries were associated with cranio-encephalic injuries in 69 patients (65.7%) and with polytrauma in 31(29.5%), while in 5 cases (4.8%) they were isolated. The main causes of trauma were motorcycle accidents (60%). All patients were treated in accordance with the Advanced Trauma Life Support guidelines and assessed by computed tomography. No mortality was observed after diagnosis in the emergency unit or in the month following the trauma. Seventy-seven patients (73.3%) were admitted and 28 (26.7%) were treated and discharged. Accurate diagnosis and appropriate initial management yield good clinical outcomes with functional restoration and fewer aesthetic complications.
Liu, Xin; Wirtz, Kai W.
In many coastal regions, oil spills can be considered as one of the most important and certainly the most noticeable forms of marine pollution. Efficient contingency management responding to oil spills on waters, which aims at minimizing pollution effects on coastal resources, turns out to be critically important. Such a decision making highly depends on the importance attributed to different coastal economic and ecological resources. Economic uses can, in principal, be addressed by standard measures such as value added. However, there is a missing of market in the real world for natural goods. Coastal resources such as waters and beach cannot be directly measured in money terms, which increases the risk of being neglected in a decision making process. This paper evaluates these natural goods of coastal environment in a hypothetical market by employing stated choice experiments. Oil spill management practice in German North Sea is used as an example. Results from a pilot survey show that during a combat process, beach and eider ducks are of key concerns for households. An environmental friendly combat option has to be a minor cost for households. Moreover, households with less children, higher monthly income and a membership of environmental organization are more likely to state that they are willing to pay for combat option to prevent coastal resources from an oil pollution. Despite that choice experiments require knowledge of designing questionnaire and statistical skills to deal with discrete choices and conducting a survey is time consumed, the results have important implications for oil spill contingency management. Overall, such a stated preference method can offer useful information for decision makers to consider coastal resources into a decision making process and can further contribute to finding a cost-effective oil preventive measure, also has a wide application potential in the field of Integrated Coastal Zone Management (ICZM).
Danish auroral science history begins with the early auroral observations made by the Danish astronomer Tycho Brahe during the years from 1582 to 1601 preceding the Maunder minimum in solar activity. Included are also the brilliant observations made by another astronomer, Ole Rømer, from Copenhagen in 1707, as well as the early auroral observations made from Greenland by missionaries during the 18th and 19th centuries. The relations between auroras and geomagnetic variations were analysed by H. C. Ørsted, who also played a vital role in the development of Danish meteorology that came to include comprehensive auroral observations from Denmark, Iceland and Greenland as well as auroral and geomagnetic research. The very important auroral investigations made by Sophus Tromholt are outlined. His analysis from 1880 of auroral observations from Greenland prepared for the significant contributions from the Danish Meteorological Institute, DMI, (founded in 1872) to the first International Polar Year 1882/83, where an expedition headed by Adam Paulsen was sent to Greenland to conduct auroral and geomagnetic observations. Paulsen's analyses of the collected data gave many important results but also raised many new questions that gave rise to auroral expeditions to Iceland in 1899 to 1900 and to Finland in 1900 to 1901. Among the results from these expeditions were 26 unique paintings of the auroras made by the artist painter, Harald Moltke. The expedition to Finland was headed by Dan la Cour, who later as director of the DMI came to be in charge of the comprehensive international geomagnetic and auroral observations made during the Second International Polar Year in 1932/33. Finally, the article describes the important investigations made by Knud Lassen during, among others, the International Geophysical Year 1957/58 and during the International Quiet Sun Year (IQSY) in 1964/65. With his leadership the auroral and geomagnetic research at DMI reached a high international
Kantak, A. V.
This collection of programs comprises The UNIX Based Data Management System for the Pilot Field Experiment (PiFEx) which is an attempt to mimic the Mobile Satellite (MSAT) scenario. The major purposes of PiFEx are to define the mobile communications channels and test the workability of new concepts used to design various components of the receiver system. The results of the PiFex experiment are large amounts of raw data which must be accessed according to a researcher's needs. This package provides a system to manage the PiFEx data in an interactive way. The system not only provides the file handling necessary to retrieve the desired data, but also several FORTRAN programs to generate some standard results pertaining to propagation data. This package assumes that the data file initially generated from the experiment has been already converted from binary to ASCII format. The Data Management system described here consists of programs divided into two categories: those programs that handle the PiFEx generated files and those that are used for number-crunching of these files. Five FORTRAN programs and one UNIX shell script file are used for file manipulation purposes. These activities include: calibration of the acquired data; and parsing of the large data file into datasets concerned with different aspects of the experiment such as the specific calibrated propagation data, dynamic and static loop error data, statistical data, and temperature and spatial data on the hardware used in the experiment. The five remaining FORTRAN programs are used to generate usable information about the data. Signal level probability, probability density of the signal fitting the Rician density function, frequency of the data's fade duration, and the Fourier transform of the data can all be generated from these data manipulation programs. In addition, a program is provided which generates a downloadable file from the signal levels and signal phases files for use with the plotting routine
Danish as a second language textbooks published over the last 15 years have presented the Danish cultural identity as a homogenous and purely national phenomenon. Research into teaching theory, on the other hand, has been more broad-minded, and is based on interactivity. The aim of this paper is to explain this divergence. (Contains 2 notes.)
Green, Tommy; Stevens, Keith; Heaney, John; Murray, Alan; Warwick, Phil; Croudace, Ian
Available in abstract form only. Full text of publication follows: This paper provides an account of the tritium management experience of a UK decommissioning and remediation contracting organisation (NUKEM Limited), supported by a specialist radio-analysis organisation (GAU-Radioanalytical). This experience was gained during the execution of projects which involved the characterisation and remediation of facilities which had previously been used for tritium work and were contaminated with tritium. The emphasis of the paper is on the characterisation (sampling and analysis) of tritium. An account is given of the development of a methodology to improve the accuracy of tritium characterisation. The improved methodology evolved from recognition of the need to minimise tritium losses during sampling, storage, transport and preparation for analysis. These improvements were achieved in a variety of ways, including use of cold and dry sampling techniques in preference to hot or wet ones and freezing relevant samples during storage and transport. The major benefit was an improvement in the accuracy and reliability of the analyses results, essential for proper categorisation, sentencing and future management of tritiated waste. (authors)
Sivagnanam, Subhashini; Majumdar, Amit; Yoshimoto, Kenneth; Astakhov, Vadim; Bandrowski, Anita; Martone, MaryAnn; Carnevale, Nicholas. T.
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
In 1996, Glen Canyon Dam Adaptive Management (GCDAMP) program was established to provide input on Glen Canyon Dam operations and their affect on the Colorado Ecosystem in Grand Canyon. The GCDAMP is a bold experiment in federal resource management that features a governing partnership with all relevant stakeholders sitting at the same table. It is a complicated, difficult process where stakeholder-derived management actions must balance resource protection with water and power delivery compacts, the Endangered Species Act, the National Historical Preservation Act, the Grand Canyon Protection Act, National Park Service Policy, and other stakeholder concerns. The program consists of four entities: the Adaptive Management Workgroup (AMWG), the Technical Workgroup (TWG), the Grand Canyon Monitoring and Research Center (GCMRC), and independent review panels. The AMWG and TWG are federal advisory committees that consists of federal and state resource managers, Native American tribes, power, environmental and recreation interests. The AMWG is develops, evaluates and recommends alternative dam operations to the Secretary. The TWG translates AMWG policy and goals into management objectives and information needs, provides questions that serve as the basis for long-term monitoring and research activities, interprets research results from the GCMRC, and prepares reports as required for the AMWG. The GCMRC is an independent science center that is responsible for all GCDAMP monitoring and research activities. The GCMRC utilizes proposal requests with external peer review and an in-house staff that directs and synthesizes monitoring and research results. The GCMRC meets regularly with the TWG and AMWG and provides scientific information on the consequences of GCDAMP actions. Independent review panels consist of external peer review panels that provide reviews of scientific activities and the program in general, technical advice to the GCMRC, TWG and AMWG, and play a critical
Russell, J M; Cracknell, M; Barton, S E; Catalan, J
OBJECTIVE--To determine the variation in management of genital herpes by genitourinary physicians, and whether their duration of experience or gender influence their clinical management. METHODS--A postal questionnaire was sent to UK consultant genitourinary physicians with detailed questions about management of primary and recurrent herpes. The gender and duration of genitourinary medicine experience of the physicians were also recorded. RESULTS--One hundred and eighty two questionnaires were sent, 112 (62%) returned. Eighty-one (72%) physicians treat all patients with primary genital herpes, but physicians with more than 20 years experience were significantly (p < 0.05) more likely to treat only "severe" primary attacks. Most experienced physicians were also most likely (p < 0.05) to prescribe topical acyclovir. Prescription of suppressive acyclovir was also influenced by the experience of the physician, the least experienced physicians being more likely to prescribe to patients who were HIV antibody positive or to those entering new relationships, whereas the more experienced prescribed to those patients who were particularly anxious (p < 0.05 for each of these). Male physicians were significantly more likely to agree with the proposition that men cope better with genital herpes (54%) than female physicians (24%, p < 0.01). CONCLUSION--The response to the questionnaire illustrates that management of genital herpes is influenced by the duration of the physicians clinical experience. Gender of the physician may have an indirect role to play as we have shown that physicians differ in their perception of how the sexes cope with genital herpes. PMID:8509090
Azevedo, S; Casey, A; Beeler, R; Bettenhausen, R; Bond, E; Chandrasekaran, H; Foxworthy, C; Hutton, M; Krammen, J; Liebman, J; Marsh, A; Pannell, T; Rhodes, J; Tappero, J; Warrick, A
Experiments, or 'shots', conducted at the National Ignition Facility (NIF) are discrete events that occur over a very short time frame (tens of nanoseconds) separated by many hours. Each shot is part of a larger campaign of shots to advance scientific understanding in high-energy-density physics. In one campaign, scientists use energy from the 192-beam, 1.8-Megajoule pulsed laser in the NIF system to symmetrically implode a hydrogen-filled target, thereby creating conditions similar to the interior of stars in a demonstration of controlled fusion. Each NIF shot generates gigabytes of data from over 30 diagnostics that measure optical, x-ray, and nuclear phenomena from the imploding target. We have developed systems to manage all aspects of the shot cycle. Other papers will discuss the control of the lasers and targets, while this paper focuses on the setup and management of campaigns and diagnostics. Because of the low duty cycle of shots, and the thousands of adjustments for each shot (target type, composition, shape; laser beams used, their power profiles, pointing; diagnostic systems used, their configuration, calibration, settings) it is imperative that we accurately define all equipment prior to the shot. Following the shot, and capture of the data by the automatic control system, it is equally imperative that we archive, analyze and visualize the results within the required 30 minutes post-shot. Results must be securely archived, approved, web-visible and downloadable in order to facilitate subsequent publication. To-date NIF has successfully fired over 2,500 system shots, as well as thousands of test firings and dry-runs. We will present an overview of the highly-flexible and scalable campaign management systems and tools employed at NIF that control experiment configuration of the facility all the way through presentation of analyzed results.
Maul, William A.; Chicatelli, Amy K.; Fulton, Christopher E.
The Propulsion Integrated Vehicle Health Management (IVHM) Technology Experiment (PITEX) is a continuing NASA effort being conducted cooperatively by the NASA Glenn Research Center, the NASA Ames Research Center, and the NASA Kennedy Space Center. It was a key element of a Space Launch Initiative risk-reduction task performed by the Northrop Grumman Corporation in El Segundo, California. PITEX's main objectives are the continued maturation of diagnostic technologies that are relevant to second generation reusable launch vehicle (RLV) subsystems and the assessment of the real-time performance of the PITEX diagnostic solution. The PITEX effort has considerable legacy in the NASA IVHM Technology Experiment for X-vehicles (NITEX) that was selected to fly on the X-34 subscale RLV that was being developed by Orbital Sciences Corporation. NITEX, funded through the Future-X Program Office, was to advance the technology-readiness level of selected IVHM technologies within a flight environment and to begin the transition of these technologies from experimental status into RLV baseline designs. The experiment was to perform realtime fault detection and isolation and suggest potential recovery actions for the X-34 main propulsion system (MPS) during all mission phases by using a combination of system-level analysis and detailed diagnostic algorithms.
High-throughput sequencing assays are now routinely used to study different aspects of genome organization. As decreasing costs and widespread availability of sequencing enable more laboratories to use sequencing assays in their research projects, the number of samples and replicates in these experiments can quickly grow to several dozens of samples and thus require standardized annotation, storage and management of preprocessing steps. As a part of the STATegra project, we have developed an Experiment Management System (EMS) for high throughput omics data that supports different types of sequencing-based assays such as RNA-seq, ChIP-seq, Methyl-seq, etc, as well as proteomics and metabolomics data. The STATegra EMS provides metadata annotation of experimental design, samples and processing pipelines, as well as storage of different types of data files, from raw data to ready-to-use measurements. The system has been developed to provide research laboratories with a freely-available, integrated system that offers a simple and effective way for experiment annotation and tracking of analysis procedures. PMID:25033091
The Lawrence Livermore National Laboratory (LLNL) Joint Actinide Shock Physics Experimental Research (JASPER) Facility is being developed at the Nevada Test Site (NTS) to conduct shock physics experiments on special nuclear material and other actinide materials. JASPER will use a two-stage, light-gas gun to shoot projectiles at actinide targets. Projectile velocities will range from 1 to 8 km/s, inducing pressures in the target material up to 6 Mbar. The JASPER gas gun has been designed to match the critical dimensions of the two-stage, light-gas gun in Building 341 of LLNL. The goal in copying the LLNL gun design is to take advantage of the extensive ballistics database that exists and to minimize the effort spent on gun characterization in the initial facility start-up. A siting study conducted by an inter-Laboratory team identified Able Site in Area 27 of the NTS as the best location for the JASPER gas gun. Able Site consists of three major buildings that had previously been used to support the nuclear test program. In April 1999, Able Site was decommissioned as a Nuclear Explosive Assembly Facility and turned back to the DOE for other uses. Construction and facility modifications at Able Site to support the JASPER project started in April 1999 and were completed in September 1999. The gas gun and the secondary confinement chamber (SCC) were installed in early 2000. During the year, all facility and operational systems were brought on line. Initial system integration demonstrations were completed in September 2000. The facility is anticipated to be operational by August 2001, and the expected life cycle for the facility is 10 years. LLNL Nevada Experiments and Operations (N) Program has established a Management Prestart Review (MPR) team to determine the readiness of the JASPER personnel and facilities to initiate surrogate-material experiments. The review coincides with the completion of authorization-basis documents and physical subsystems, which have
Cooper, W E
The Lawrence Livermore National Laboratory (LLNL) Joint Actinide Shock Physics Experimental Research (JASPER) Facility is being developed at the Nevada Test Site (NTS) to conduct shock physics experiments on special nuclear material and other actinide materials. JASPER will use a two-stage, light-gas gun to shoot projectiles at actinide targets. Projectile velocities will range from 1 to 8 km/s, inducing pressures in the target material up to 6 Mbar. The JASPER gas gun has been designed to match the critical dimensions of the two-stage, light-gas gun in Building 341 of LLNL. The goal in copying the LLNL gun design is to take advantage of the extensive ballistics database that exists and to minimize the effort spent on gun characterization in the initial facility start-up. A siting study conducted by an inter-Laboratory team identified Able Site in Area 27 of the NTS as the best location for the JASPER gas gun. Able Site consists of three major buildings that had previously been used to support the nuclear test program. In April 1999, Able Site was decommissioned as a Nuclear Explosive Assembly Facility and turned back to the DOE for other uses. Construction and facility modifications at Able Site to support the JASPER project started in April 1999 and were completed in September 1999. The gas gun and the secondary confinement chamber (SCC) were installed in early 2000. During the year, all facility and operational systems were brought on line. Initial system integration demonstrations were completed in September 2000. The facility is anticipated to be operational by August 2001, and the expected life cycle for the facility is 10 years. LLNL Nevada Experiments and Operations (N) Program has established a Management Prestart Review (MPR) team to determine the readiness of the JASPER personnel and facilities to initiate surrogate-material experiments. The review coincides with the completion of authorization-basis documents and physical subsystems, which have
Oppenheimer, R.W.; Krespi, Y.P.; Einhorn, R.K.
Radiation necrosis of the laryngeal cartilages is an uncommon complication of radiotherapy for laryngeal carcinoma. It is a devastating process for which there is no one acceptable treatment. Medical management offers only temporary, symptomatic relief, which further necessitates surgical treatment. Surgical management may start with a tracheotomy; however, it often ends with a total laryngectomy. Physiologically, the necrotic cartilages are the source of the problem. It is a general surgical principle that nonviable tissue must be excised to promote healing. Therefore, if the affected laryngeal cartilages were removed, the larynx should heal. Total or near total removal of the thyroid and cricoid cartilages with preservation of the endolaryngeal soft tissues has not been reported in the literature. Theoretically, if the entire cartilaginous framework is removed, there would be no structural support for the airway. We have found using animal models, that submucosal resection of the laryngeal cartilages, leaving the perichondrium and endolaryngeal soft tissues intact can result in a competent airway. Animal and clinical experience will be presented.
Madden, Michael M.; Sugden, Paul C.
In modern transport aircraft, the flight management computer (FMC) has evolved from a flight planning aid to an important hub for pilot information and origin-to-destination optimization of flight performance. Current trends indicate increasing roles of the FMC in aviation safety, aviation security, increasing airport capacity, and improving environmental impact from aircraft. Related research conducted at the Langley Research Center (LaRC) often requires functional extension of a modern, full-featured FMC. Ideally, transport simulations would include an FMC simulation that could be tailored and extended for experiments. However, due to the complexity of a modern FMC, a large investment (millions of dollars over several years) and scarce domain knowledge are needed to create such a simulation for transport aircraft. As an intermediate alternative, the Flight Research Services Directorate (FRSD) at LaRC created a set of reusable software products to extend flight management functionality upstream of a Boeing-757 FMC, transparently simulating or sharing its operator interfaces. The paper details the design of these products and highlights their use on NASA projects.
Reiss, M; Reiss, G
A good reference management program should make it easy to record the elements of a reference: author's name, year of publication, title of article, etc. It should offer tools that let you find and retrieve references quickly, and it should be able to produce the bibliography in the format required for a particular publication. There are many computer programs, but very few stand out as truly useful, time saving, and work enhancing. One of them is EndNote-EndLink. We want to report our experience with this database manager. The functions and the use of the software package EndNote 2.3 for Windows are described. You can create your database or you can download batches of references from one of the popular searching services (e.g. MEDLINE). When you want to cite a reference you simply paste the reference wherever you want your in-text citation to appear. To prepare the bibliography, EndNote scans your article, replaces the place holders with citations and prints the list of references at the end of the manuscript, according with the style that you have chosen. Altogether EndNote provides an excellent combination of features and ease of use.
Bailey, W. J.; Fester, D. A.
The Cryogenic Fluid Management Experiment (CFME) was designed to characterize subcritical liquid hydrogen storage and expulsion in the low-g space environment. The CFME has now become the storage and supply tank for the Cryogenic Fluid Management Facility, which includes transfer line and receiver tanks, as well. The liquid hydrogen storage and supply vessel is supported within a vacuum jacket to two fiberglass/epoxy composite trunnions which were analyzed and designed. Analysis using the limited available data indicated the trunnion was the most fatigue critical component in the storage vessel. Before committing the complete storage tank assembly to environmental testing, an experimental assessment was performed to verify the capability of the trunnion design to withstand expected vibration and loading conditions. Three tasks were conducted to evaluate trunnion integrity. The first determined the fatigue properties of the trunnion composite laminate materials. Tests at both ambient and liquid hydrogen temperatures showed composite material fatigue properties far in excess of those expected. Next, an assessment of the adequacy of the trunnion designs was performed (based on the tested material properties).
Bailey, W. J.; Fester, D. A.
The Cryogenic Fluid Management Experiment (CFME) was designed to characterize subcritical liquid hydrogen storage and expulsion in the low-g space environment. The CFME has now become the storage and supply tank for the Cryogenic Fluid Management Facility, which includes transfer line and receiver tanks, as well. The liquid hydrogen storage and supply vessel is supported within a vacuum jacket to two fiberglass/epoxy composite trunnions which were analyzed and designed. Analysis using the limited available data indicated the trunnion was the most fatigue critical component in the storage vessel. Before committing the complete storage tank assembly to environmental testing, an experimental assessment was performed to verify the capability of the trunnion design to withstand expected vibration and loading conditions. Three tasks were conducted to evaluate trunnion integrity. The first determined the fatigue properties of the trunnion composite laminate materials. Tests at both ambient and liquid hydrogen temperatures showed composite material fatigue properties far in excess of those expected. Next, an assessment of the adequacy of the trunnion designs was performed (based on the tested material properties).
Kørnøv, Lone; Hill, Amanda Louise; Busck, Ole; Løkke, Søren
The push for creating a more competitive and liberalized system for traditional public services, including waste management, has been on the European agenda since the late 1980s. In 2008, changes were made in EU waste legislation allowing source-separated industrial/commercial waste that is suitable for incineration to be traded within the European market. This change has had broad implications for the Danish waste sector, which is characterized by institutionalized municipal control with all streams of waste and municipal ownership of the major treatment facilities allowing the municipal sector to integrate combustible waste in local heat and power generation. This article, applying an institutional approach, maps the institutions and actors of the Danish waste sector and analyses how the regulatory as well as normative pressure to liberalize has been met and partly neutralized in the institutional and political context. The new Danish regulation of 2010 has thus accommodated the specific requirement for liberalization, but in fact only represents a very small step towards a market-based waste management system. On the one hand, by only liberalizing industrial/commercial waste, the Danish Government chose to retain the main features of the established waste system favouring municipal control and hence the institutionalized principles of decentralized enforcement of environmental legislation as well as welfare state considerations. On the other hand, this has led to a technological and financial deadlock, particularly when it comes to reaching the recycling targets of EU, which calls for further adjustments of the Danish waste sector.
Tuğcu, Volkan; Şahin, Selçuk; Yiğitbaşı, İsmail; Şener, Nevzat Can; Akbay, Fatih Gökhan; Taşçı, Ali İhsan
Objective To present our experience with laparoscopic donor nephrectomy (LDN), our complications and management modalities. Material and methods: Fifty-one transperitoneal LDNs performed in our clinic between the years 2011, and 2015, were evaluated retrospectively. Demographic characteristics of the patients, operative and postoperative data and complications were evaluated. Results Nineteen female and 32 male patients with ages ranging from 24 to 65 years underwent left- (n=44), and right-sided (n=7) LDNs. Six patients had two, and one patient three renal arteries. Mean operation time was 115±11 (min–max: 90–150) minutes, and mean warm ischemia time 111±9 (min–max: 90–140 sec) seconds. Mean hospital stay was found to be 2.5±0.5 days. No patient needed to switch to open surgery. In one patient, lumbar vein was ruptured, and hemostatic control was achieved laparoscopically. Postoperative paralytic ileus developed in two patients. Three patients had postoperative atelectasis, and a febrile (38.1°C) episode. Conclusion LDN is a minimally invasive method with advantages of short hospital stay, less analgesic requirement, and better cosmetic results. However it should be performed by surgeons with advanced laparoscopic experience. PMID:28270958
Middle managers in higher education hold diverse titles and perform a variety of roles. Women represent a large portion of this midlevel management, but there is limited research exploring their experiences. As a result, little is known about women middle managers' career trajectories and what effect their experiences have on their future career…
Christiansen, Peer; Ejlertsen, Bent; Jensen, Maj-Britt; Mouridsen, Henning
Aim of database Danish Breast Cancer Cooperative Group (DBCG), with an associated database, was introduced as a nationwide multidisciplinary group in 1977 with the ultimate aim to improve the prognosis in breast cancer. Since then, the database has registered women diagnosed with primary invasive nonmetastatic breast cancer. The data reported from the departments to the database included details of the characteristics of the primary tumor, of surgery, radiotherapy, and systemic therapies, and of follow-up reported on specific forms from the departments in question. Descriptive data From 1977 through 2014, ~110,000 patients are registered in the nationwide, clinical database. The completeness has gradually improved to more than 95%. DBCG has continuously prepared evidence-based guidelines on diagnosis and treatment of breast cancer and conducted quality control studies to ascertain the degree of adherence to the guidelines in the different departments. Conclusion Utilizing data from the DBCG database, a long array of high-quality DBCG studies of various designs and scope, nationwide or in international collaboration, have contributed to the current updating of the guidelines, and have been an instrumental resource in the improvement of management and prognosis of breast cancer in Denmark. Thus, since the establishment of DBCG, the prognosis in breast cancer has continuously improved with a decrease in 5-year mortality from ~37% to 15%. PMID:27822082
Özcan, Cengiz; Juel, Knud; Flensted Lassen, Jens; von Kappelgaard, Lene Mia; Mortensen, Poul Erik; Gislason, Gunnar
Aim The Danish Heart Registry (DHR) seeks to monitor nationwide activity and quality of invasive diagnostic and treatment strategies in patients with ischemic heart disease as well as valvular heart disease and to provide data for research. Study population All adult (≥15 years) patients undergoing coronary angiography (CAG), percutaneous coronary intervention (PCI), coronary artery bypass grafting, and heart valve surgery performed across all Danish hospitals were included. Main variables The DHR contains a subset of the data stored in the Eastern and Western Denmark Heart Registries (EDHR and WDHR). For each type of procedure, up to 70 variables are registered in the DHR. Since 2010, the data quality protocol encompasses fulfillment of web-based validation rules of daily-submitted records and yearly approval of the data by the EDHR and WDHR. Descriptive data The data collection on procedure has been complete for PCI and surgery since 2000, and for CAG as of 2006. From 2000 to 2014, the number of CAG, PCI, and surgical procedures changed by 231%, 193%, and 99%, respectively. Until the end of 2014, a total of 357,476 CAG, 131,309 PCI, and 60,831 surgical procedures had been performed, corresponding to 249,445, 100,609, and 55,539 first-time patients, respectively. The DHR generally has a high level of completeness (1–missing) of each procedure (>90%) when compared to the National Patient Registry. Variables important for assessing the quality of care have a high level of completeness for surgery since 2000, and for CAG and PCI since 2010. Conclusion The DHR contains valuable data on cardiac invasive procedures, which makes it an important national monitoring and quality system and at the same time serves as a platform for research projects in the cardiovascular field. PMID:27822091
Jørgensen, Peter Holmberg; Lausten, Gunnar Schwarz; Pedersen, Alma B
Aim The aim of the database is to gather information about sarcomas treated in Denmark in order to continuously monitor and improve the quality of sarcoma treatment in a local, a national, and an international perspective. Study population Patients in Denmark diagnosed with a sarcoma, both skeletal and ekstraskeletal, are to be registered since 2009. Main variables The database contains information about appearance of symptoms; date of receiving referral to a sarcoma center; date of first visit; whether surgery has been performed elsewhere before referral, diagnosis, and treatment; tumor characteristics such as location, size, malignancy grade, and growth pattern; details on treatment (kind of surgery, amount of radiation therapy, type and duration of chemotherapy); complications of treatment; local recurrence and metastases; and comorbidity. In addition, several quality indicators are registered in order to measure the quality of care provided by the hospitals and make comparisons between hospitals and with international standards. Descriptive data Demographic patient-specific data such as age, sex, region of living, comorbidity, World Health Organization’s International Classification of Diseases – tenth edition codes and TNM Classification of Malignant Tumours, and date of death (after yearly coupling to the Danish Civil Registration System). Data quality and completeness are currently secured. Conclusion The Danish Sarcoma Database is population based and includes sarcomas occurring in Denmark since 2009. It is a valuable tool for monitoring sarcoma incidence and quality of treatment and its improvement, postoperative complications, and recurrence within 5 years follow-up. The database is also a valuable research tool to study the impact of technical and medical interventions on prognosis of sarcoma patients. PMID:27822116
Voldstedlund, M; Haarh, M; Mølbak, K
The Danish Microbiology Database (MiBa) is a national database that receives copies of reports from all Danish departments of clinical microbiology. The database was launched in order to provide healthcare personnel with nationwide access to microbiology reports and to enable real-time surveillance of communicable diseases and microorganisms. The establishment and management of MiBa has been a collaborative process among stakeholders, and the present paper summarises lessons learned from this nationwide endeavour which may be relevant to similar projects in the rapidly changing landscape of health informatics.
Paternoster, R.; Butterfield, K.
The Los Alamos Critical Experiments Facility (LACEF) currently operates two burst reactors (Godiva-IV and Skua), one solution assembly [the Solution High-Energy Burst Assembly (SHEBA)], two fast-spectrum benchmark assemblies (Flattop and Big Ten), and five general-purpose remote assembly machines that may be configured with nuclear materials and assembled by remote control. Special nuclear materials storage vaults support these and other operations at the site. With this diverse set of operations, several approaches are possible in the analysis and management of risk. The most conservative approach would be to write a safety analysis report (SAR) for each assembly and experiment. A more cost-effective approach is to analyze the probability and consequences of several classes of operations representative of operations on each critical assembly machine and envelope the bounding case accidents. Although the neutron physics of these machines varies widely, the operations performed at LACEF fall into four operational modes: steady-state mode, approach-to-critical mode, prompt burst mode, and nuclear material operations, which can include critical assembly fuel loading. The operational sequences of each mode are very nearly identical, whether operated on one assembly machine or another. The use of an envelope approach to accident analysis is facilitated by the use of classes of operations and the use of bounding case consequence analysis. A simple fault tree analysis of operational modes helps resolve which operations are sensitive to human error and which are initiated by hardware of software failures. Where possible, these errors and failures are blocked by TSR LCOs. Future work will determine the probability of accidents with various initiators.
Schlosser, G.J.; Krebs, W.; Urban, P. )
Germany has adopted the strategy of a closed fuel cycle using reprocessing and recycling. The central issue today is plutonium recycling by the use of U-Pu mixed oxide (MOX) in pressurized water reactors (PWRs) and boiling water reactors (BWRs). The design of MOX fuel assemblies and fuel management in MOX-containing cores are strongly influenced by the nuclear properties of the plutonium isotopes. Optimized MOX fuel assembly designs for PWRs currently use up to three types of MOX fuel rods having different plutonium contents with natural uranium or uranium tailings as carrier material but without burnable absorbers. The MOX fuel assembly designs for BWRs use four to six rod types with different plutonium contents and Gd[sub 2]O[sub 3]/UO[sub 2] burnable absorber rods. Both the PWR and the BWR designs attain good burnup equivalence and compatibility with uranium fuel assemblies. High flexibility exists in the loading schemes relative to the position and number of MOX fuel assemblies in the reloads and in the core as a whole. The Siemens experience with MOX fuel assemblies is based on the insertion of 318 MOX fuel assemblies in eight PWRs and 168 in BWRs and pressurized heavy water reactors so far. The primary operating results include information on the cycle length, power distribution, reactivity coefficients, and control rod worth of cores containing MOX fuel assemblies.
Snowden, Alicia; Hayden, Ingrid; Dixon, Joanna; Gregory, Gareth
Patients with chronic lymphocytic leukaemia (CLL) are typically diagnosed at an advanced age and may have multiple co-existing conditions, augmenting the challenges of treating their CLL. Aggressive cytotoxic therapies are often poorly tolerated in this patient population. Obinutuzumab is a glycoengineered type II anti-CD20 monoclonal antibody indicated in combination with chlorambucil for previously untreated CLL. The approval of this drug was based on the pivotal CLL11 trial, which demonstrated longer progression-free survival vs. rituximab/chlorambucil and chlorambucil alone in patients with significant co-existing medical conditions and/or poor renal function. However, a higher risk of infusion-related reactions (IRRs) was demonstrated with obinutuzumab-based therapy. We highlight important nursing care considerations to help prevent and successfully manage IRRs and other important adverse events, to improve the treatment experience of patients receiving obinutuzumab infusions and to enable them to complete their treatment and receive optimal benefit. Premedication, drug handling, dosing, administration, monitoring and documentation are discussed.
Boccanelli, A; Spandonaro, F
In most Italian hospitals, sanitary reform is being applied, while at the same time a new organization of the National Health System is being planned. The director of the medical hospital (head doctor) is becoming more and more involved in management and this aspect has modified his professional attributes. Cardiology is a branch of medicine that, through its scientific preparatory work consisting in debates, management courses, ethics, and production of managerial software, is closer to applying the reform without risking improper administrative aspects. This, obviously, comes about after thoroughly reviewing past work methods and the need to have an administrative organization, which allocates efficient use of manpower and materials, helping to eliminate any sources of inefficiency. The logical procedure foresees an actual analysis in terms of sanitary needs and availability of resources, and so attempting to better balance and harmonize both aspects of the problem. Certainly, the acquisition of theoretical norms and practices, which today are present because of the upsurge in training courses for doctors, is not enough to guarantee the achievement of optimal results. Furthermore, we find that theoretical models need to be validated and adapted to real work situations in the public hospital sector. This paper proposes, therefore, to explain the managerial experiences achieved in actual work situations at the Cardiology Department Unit of the San Giovanni Addolorata Hospital in Rome. In particular, it shows that in order to reach its clinical and economical objectives, it is essential to make available correct informative support for strategic and operational decisions. We can observe that there is a continuing lack of computer support systems being integrated into the present organization of most cardiology units. The use of software distributed to cardiology units from the Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) has enabled us to partially
Viljoen, John; And Others
Interviews with a sample of 18 first-year Master's of Business Administration students elicited their conceptions of management in terms of attributes, roles, and choices. Comparisons with major management theories showed that, although participants view management as an amalgam of highly personal choices, theories underplay the importance of…
In 1992 the Baltimore City Public School District (Maryland) entered into a 5-year contract with Education Alternatives, Incorporated (EAI), to manage 9 of its schools. Baltimore's private-management model differed significantly from that of Dade County, Florida, in that EAI was given overall management responsibility. Data were gathered through a…
Bouchard, Veronique; del Forno, Leon
Purpose: Management practices and education are presently in a stage of reappraisal and a growing number of scholars and experts are suggesting that managers should be taught and adopt the approach and methodologies of designers. The purpose of this paper is to imagine the impact of this move and to try and foresee whether "management as design"…
Chowdhury, Forhad Hossain; Haque, Mohammod Raziul; Sarker, Mainul Haque
Objectives: An intracranial epidermoid tumor is relatively a rare tumor, accounting for approximately 0.1% of all intracranial space occupying lesions. These are also known as pearly tumor due to their pearl like appearance. In this series, the localization of the tumor, presenting age and symptoms, imaging criteria for diagnosis, surgical management strategy with completeness of excision and overall outcome were studied prospectively. Here, we report our short experience of intracranial epidermoid as a whole. Materials and Methods: Between January 2006 to December 2010, 23 cases of intracranial epidermoid were diagnosed preoperatively with almost certainty by computed tomography (CT) and magnetic resonance imaging (MRI) of brain in plain, contrast and other relevant studies. All of them underwent operation in Dhaka Medical College Hospital and in some Private Hospital in Dhaka, Bangladesh. All patients were followed-up routinely by clinical examination and neuroimaging. Average follow-up was 39 (range-71-11months) months. Patients of the series were prospectively studied. Results: Supratentorial epidermoids were 04 cases and infratemporal epidermoids were 19 cases. Clinical features and surgical strategy varies according to the location and extension of the tumors. Age range was 19-71 years (37.46 years). Common clinical features were headache, cerebellar features, seizure, vertigo, hearing impairment and features of raised intracranial pressure (ICP). Investigation was CT scan or/+ MRI of brain in all cases. Pre-operative complete excision was 20 cases, but post-operative images showed complete excision in 17 cases. Content of tumor was pearly white/white material in all cases except one, where content was putty material. Re-operation for residual/recurrent tumor was nil. Complications included pre-operative mortality one case, persisted sixth nerve palsy in one case, transient memory disturbance one case, and extra dural hematoma one case. One senior patient
Van Heek, Aliki; Metz, Bert; Janssen, Bas; Groothuis, Ron
Most radioactive waste emerges as well-defined waste streams from operating power reactors. The management of this is an on-going practice, based on comprehensive (IAEA) guidelines. A special waste category however consists of the historical waste from research reactors, mostly originating from various experiments in the early years of the nuclear era. Removal of the waste from the research site, often required by law, raises challenges: the waste packages must fulfill the acceptance criteria from the receiving storage site as well as the criteria for nuclear transports. Often the aged waste containers do not fulfill today's requirements anymore, and their contents are not well documented. Therefore removal of historical waste requires advanced characterization, sorting, sustainable repackaging and sometimes conditioning of the waste. This paper describes the Dutch experience of a historical waste removal campaign from the Petten High Flux research reactor. The reactor is still in operation, but Dutch legislation asks for central storage of all radioactive waste at the COVRA site in Vlissingen since the availability of the high- and intermediate-level waste storage facility HABOG in 2004. In order to comply with COVRA's acceptance criteria, the complex and mixed inventory of intermediate and low level waste must be characterized and conditioned, identifying the relevant nuclides and their activities. Sorting and segregation of the waste in a Hot Cell offers the possibility to reduce the environmental footprint of the historical waste, by repackaging it into different classes of intermediate and low level waste. In this way, most of the waste volume can be separated into lower level categories not needing to be stored in the HABOG, but in the less demanding LOG facility for low-level waste instead. The characterization and sorting is done on the basis of a combination of gamma scanning with high energy resolution of the closed waste canister and low
Johnson, L.A.; Foote, A.L.
Structural marsh management and nutria herbivory are both believed to strongly influence plant production in the brackish, deltaic marshes of coastal Louisiana, USA. Previous studies have tested the effects of structural management on aboveground biomass after implementing management, but very few studies have collected data before and after management. Thus, to test the effects of structural marsh management on Spartina patens (Ait.) Muhl. and Scirpus americanus Pers., the aboveground biomass of both species was estimated before and after the construction of shallow, leveed impoundments. The water level in each impoundment was managed with a single flap-gated culvert fitted with a variable crest weir. Additionally, the influence of nutria grazing on aboveground biomass was measured by nondestructively sampling fenced (ungrazed) and unfenced (grazed) plots in both managed and unmanaged areas. While there was no significant difference in S. patens production between managed and unmanaged areas, marsh management negatively affected Sc. americanus production the two species also differed in their responses to grazing. Grazing dramatically reduced the sedge, Sc. americanus, while the grass, S. patens, remained at similar biomass levels in grazed and ungrazed plant stands. These findings support the belief that herbivory has a strong influence on plant production, but do not support the claim that management increases plant production in the deltaic marshes of Louisiana.
Cronin, G M; Rault, J L; Glatz, P C
The main impetus for 'modern' intensive animal production occurred after the Second World War, when Western governments developed policies to increase the availability of cheap, safe food for their populations. Livestock benefit under intensive husbandry by protection from environmental extremes and predators, and better nutritional and health management. Nevertheless, there are costs to the animal, such as impaired social behaviour, limited choice of living environment or pen mates, poor environmental stimulation and behavioural restrictions. The rapid progress in genetic selection of production traits has also, in some cases, adversely affected welfare by creating anatomical and metabolic problems. Above all, the intensively housed animal is heavily reliant on the stockperson and, therefore, inadequate care and husbandry practices by the stockperson may be the largest welfare risk. In a future in which the food supply may be limited as the world's population grows and land availability shrinks, intensive animal production is likely to expand. At the same time, ethical considerations surrounding intensive farming practices may also become more prominent. Novel technologies provide the opportunity to enhance both the productivity and welfare of intensively kept animals. Developing countries are also establishing more intensive commercial systems to meet their growing need for animal protein. Intensive livestock production in such countries has the potential for major expansion, particularly if such developments address the key constraints of poor welfare, inadequate nutrition, poor reproduction, poor housing, and high mortality often seen with traditional systems, and if farmer access to emerging market opportunities is improved. However, as shown by previous experience, inadequate regulation and staff who lack the appropriate training to care for the welfare of intensively housed livestock can be major challenges to overcome.
Hansen, Ulla Darling; Gradel, Kim Oren; Larsen, Michael Due
The Danish Urogynaecological Database is established in order to ensure high quality of treatment for patients undergoing urogynecological surgery. The database contains details of all women in Denmark undergoing incontinence surgery or pelvic organ prolapse surgery amounting to ~5,200 procedures per year. The variables are collected along the course of treatment of the patient from the referral to a postoperative control. Main variables are prior obstetrical and gynecological history, symptoms, symptom-related quality of life, objective urogynecological findings, type of operation, complications if relevant, implants used if relevant, 3–6-month postoperative recording of symptoms, if any. A set of clinical quality indicators is being maintained by the steering committee for the database and is published in an annual report which also contains extensive descriptive statistics. The database has a completeness of over 90% of all urogynecological surgeries performed in Denmark. Some of the main variables have been validated using medical records as gold standard. The positive predictive value was above 90%. The data are used as a quality monitoring tool by the hospitals and in a number of scientific studies of specific urogynecological topics, broader epidemiological topics, and the use of patient reported outcome measures. PMID:27826217
proceeds. A major task in project risk management is to assure that the ex- pected value of the projected outcome area does not materially deviate...Description of the bidder’s risk management plan covering cost, scheduling, and technical risks, together with the details of procedures and system for...Implementing the risk management plan. 4. As part of the bid evaluation, the government should compare the bidder’s risk analysis results with the
Zambia like all other countries in the world is faced with environmental problems brought about by a variety of human activities. In Zambia the major environmental issues as identified by Nation Environmental Action Plan (NEAP) of 1994 are water pollution, poor sanitation, land degradation, air pollution, poor waste management, misuse of chemicals, wildlife depletion and deforestation. Zambian has been using a lot of radioactive materials in its various industries. The country has taken several projects with help of external partners. These partners however left these projects in the hands of the Zambians without developing their capacities to manage these radioactive sources. The Government recognized the need to manage these sources and passed legislation governing the management of radioactive materials. The first act of Parliament on Radiation Protection work was passed in 1975 to legislate the use of ionizing radiation. However, because of financial constraints the Country is facing, these regulations have remained unimplemented. Fortunately the international Community has been working in partnership with the Zambian Government in the Management of Radioactive Material. Therefore this paper will present the following aspects of radioactive waste management in Zambia: review Existing Legislation in Zambia regarding management of spent/radioactive sources; capacity building in the field of management of radioactive waste; management of spent and disused radiation sources; existing disposal systems in Zambia regarding spent/orphaned sources; existing stocks of radioactive sources in the Zambian industries.
Yakubu, Mariama Bisongu
Ghana is highly vulnerable and threatened by several hazards and has sought ways of minimizing impacts of hazards events over time including demonstrating an interest in developing an emergency management training and an higher education degree program. Yet, as of 2013, the country has not developed a disaster management training program or a…
Management training in ELT organizations is often inadequate. New managers are in severe need of training, especially for tasks which are non-pedagogical, yet they operate in a milieu where there are few opportunities for support compared with colleagues in mainstream education. The purpose of this case study, a rare evidence-based contribution to…
Mulholland, D. R.; Reller, J. O., Jr.; Neel, C. B.; Haughney, L. C.
Airborne research management and shuttle sortie planning at the Ames Research Center are reported. Topics discussed include: basic criteria and procedures for the formulation and approval of airborne missions; ASO management structure and procedures; experiment design, development, and testing aircraft characteristics and experiment interfaces; information handling for airborne science missions; mission documentation requirements; and airborne science methods and shuttle sortie planning.
Mulholland, D. R.; Reller, J. O., Jr.; Neel, C. B.; Haughney, L. C.
The management concepts and operating procedures are documented as they apply to the planning of shuttle spacelab operations. Areas discussed include: airborne missions; formulation of missions; management procedures; experimenter involvement; experiment development and performance; data handling; safety procedures; and applications to shuttle spacelab planning. Characteristics of the airborne science experience are listed, and references and figures are included.
Holt, Chuck; Hargrove, Pauline; Harris, Sandra
The purpose of this study was to investigate the life experiences and beliefs of highly effective teachers exhibiting effective classroom management. This study explores the beliefs, background, and experiences of exemplary teachers in the area of classroom management. The goal of this study was to develop a deeper understanding of how individuals…
San Mateo Union High School District, CA.
The General and Vocational Work Experience Education Programs management system is designed to assist the local school teacher/coordinator in the organization and management of the programs. The system defines and describes the accountability line from the Work Experience Education teacher/coordinator, through the Career Planning and Placement…
The article analyzes the practice and experience of faculty management at the University of Pennsylvania and its implications for Chinese universities from the perspective of management systems and operation mechanisms. Recent reforms and innovation of faculty management at Sichuan University are described.
Literary Analyses of the Danish, the Greenlandic, and the Turkish Stories Used in the "Folktale Project." Folktale: A Cross-Cultural, Interdisciplinary Study of the Experience of Literature. Paper 12.
Dollerup, Cay; And Others
As part of the Folktale project, which explores similarities and dissimilarities in the response to literature from and in different cultures, advanced undergraduate students in classes on literary interpretation or literary history analyzed a Danish, a Greenlandic, and a Turkish folk tale. Two male and two female students in classes on literary…
Groenvold, Mogens; Adsersen, Mathilde; Hansen, Maiken Bang
Aims The aim of the Danish Palliative Care Database (DPD) is to monitor, evaluate, and improve the clinical quality of specialized palliative care (SPC) (ie, the activity of hospital-based palliative care teams/departments and hospices) in Denmark. Study population The study population is all patients in Denmark referred to and/or in contact with SPC after January 1, 2010. Main variables The main variables in DPD are data about referral for patients admitted and not admitted to SPC, type of the first SPC contact, clinical and sociodemographic factors, multidisciplinary conference, and the patient-reported European Organisation for Research and Treatment of Cancer Quality of Life Questionaire-Core-15-Palliative Care questionnaire, assessing health-related quality of life. The data support the estimation of currently five quality of care indicators, ie, the proportions of 1) referred and eligible patients who were actually admitted to SPC, 2) patients who waited <10 days before admission to SPC, 3) patients who died from cancer and who obtained contact with SPC, 4) patients who were screened with European Organisation for Research and Treatment of Cancer Quality of Life Questionaire-Core-15-Palliative Care at admission to SPC, and 5) patients who were discussed at a multidisciplinary conference. Descriptive data In 2014, all 43 SPC units in Denmark reported their data to DPD, and all 9,434 cancer patients (100%) referred to SPC were registered in DPD. In total, 41,104 unique cancer patients were registered in DPD during the 5 years 2010–2014. Of those registered, 96% had cancer. Conclusion DPD is a national clinical quality database for SPC having clinically relevant variables and high data and patient completeness. PMID:27822111
Daire, Judith; Gilson, Lucy
In South Africa, as elsewhere, Primary Health Care (PHC) facilities are managed by professional nurses. Little is known about the dimensions and challenges of their job, or what influences their managerial practice. Drawing on leadership and organizational theory, this study explored what the job of being a PHC manager entails, and what factors influence their managerial practice. We specifically considered whether the appointment of professional nurses as facility managers leads to an identity transition, from nurse to manager. The overall intention was to generate ideas about how to support leadership development among PHC facility managers. Adopting case study methodology, the primary researcher facilitated in-depth discussions (about their personal history and managerial experiences) with eight participating facility managers from one geographical area. Other data were collected through in-depth interviews with key informants, document review and researcher field notes/journaling. Analysis involved data triangulation, respondent and peer review and cross-case analysis. The experiences show that the PHC facility manager's job is dominated by a range of tasks and procedures focused on clinical service management, but is expected to encompass action to address the population and public health needs of the surrounding community. Managing with and through others, and in a complex system, requiring self-management, are critical aspects of the job. A range of personal, professional and contextual factors influence managerial practice, including professional identity. The current largely facility-focused management practice reflects the strong nursing identity of managers and broader organizational influences. However, three of the eight managers appear to self-identify an emerging leadership identity and demonstrate related managerial practices. Nonetheless, there is currently limited support for an identity transition towards leadership in this context. Better
Johnson, Fred A.; Madsen, Jesper
This document describes progress to date on the development of an adaptive harvest management strategy for maintaining the Svalbard population of pink‐footed geese (Anser brachyrhynchus) near their agreed target level (60,000) by providing for sustainable harvests in Norway and Denmark. This report provides an assessment of the most recent monitoring information (1991-2015) and its implications for the harvest management strategy. By combining varying hypotheses about survival and reproduction, a suite of nine models have been developed that represent a wide range of possibilities concerning the extent to which demographic rates are density dependent or independent. These results suggest that the pink‐footed goose population may have recently experienced a release from density‐dependent mechanisms, corresponding to the period of most rapid growth in population size. Beginning with the 2016 hunting season, harvest quotas will be prescribed on an annual basis rather than every three years because of the potential to better meet population management objectives. Based on updated model weights, the recent observations of population size (74,800), the proportion of the population comprised of one-year-old birds (0.138), and temperature days in Svalbard (20), the optimal harvest quota for the 2016 hunting season is 25,000. The large increase in quota compared to that during first three years of AHM reflects stakeholders’ desire to reduce population size to the goal of 60,000, recognizing that population size remains relatively high and above-average production is expected in 2016 due to a warm spring.
Daire, Judith; Gilson, Lucy
In South Africa, as elsewhere, Primary Health Care (PHC) facilities are managed by professional nurses. Little is known about the dimensions and challenges of their job, or what influences their managerial practice. Drawing on leadership and organizational theory, this study explored what the job of being a PHC manager entails, and what factors influence their managerial practice. We specifically considered whether the appointment of professional nurses as facility managers leads to an identity transition, from nurse to manager. The overall intention was to generate ideas about how to support leadership development among PHC facility managers. Adopting case study methodology, the primary researcher facilitated in-depth discussions (about their personal history and managerial experiences) with eight participating facility managers from one geographical area. Other data were collected through in-depth interviews with key informants, document review and researcher field notes/journaling. Analysis involved data triangulation, respondent and peer review and cross-case analysis. The experiences show that the PHC facility manager’s job is dominated by a range of tasks and procedures focused on clinical service management, but is expected to encompass action to address the population and public health needs of the surrounding community. Managing with and through others, and in a complex system, requiring self-management, are critical aspects of the job. A range of personal, professional and contextual factors influence managerial practice, including professional identity. The current largely facility-focused management practice reflects the strong nursing identity of managers and broader organizational influences. However, three of the eight managers appear to self-identify an emerging leadership identity and demonstrate related managerial practices. Nonetheless, there is currently limited support for an identity transition towards leadership in this context. Better
Niu, Hongxia; Liang, Junxue; Lin, Zhaowen; Ma, Yan
Future network is a complex resources pool including multiple physical resources and virtual resources. Establishing experiment on future network is complicate and tedious. That achieving the automated management of future network experiments is so important. This paper brings forward the way for researching and managing the life cycle of experiment based on the description language. The description language uses the framework, which couples with a low hierarchical structure and a complete description of the network experiment. In this way, the experiment description template can be generated by this description framework accurately and completely. In reality, we can also customize and reuse network experiment by modifying the description template. The results show that this method can achieve the aim for managing the life cycle of network experiment effectively and automatically, which greatly saves time, reduces the difficulty, and implements the reusability of services.
In this paper, I shall discuss Danish perspectives on nature, showing the interdependence of conceptions of "nature" and "nationhood" in the formations of a particular cultural community. Nature, thus construed, is never innocent of culture and cannot therefore simply be "restored" to some pristine, pre-lapsarian…
Johnson, Anya M.; Jackson, Paul R.
We examined the effect of career transition support and three other situational variables--financial reserves, social inclusion, and a partner--on the psychological strain of unemployed managers. We extended the theories of unemployment by investigating the mechanisms by which these four situational variables affect psychological strain. After…
Reiff, M G; Sperling, K L
In a leap of faith, Citibank in 1989 designed a point-of-service plan aimed at containing health care costs in the long term without sacrificing quality of care. In 1994 a study was undertaken to empirically evaluate whether these goals had been achieved. The study supported Citibank's overall managed care strategy, providing objective, quantifiable data that can lead to greater efficiencies.
Askarkyzy, Samal; Toibayev, Adlet; Algozhaeva, Nursulu; Rimantas, Zelvys; Iskakova, Guldariya; Arynova, Aigul
The present article outlines the main principles and peculiarities of the result-oriented university management on the basis of the Development strategy of the Kazakh State Women's Pedagogical University for 2013-2020. The relevance of the investigated issue is conditioned by the fact that in the context of a highly competitive market of research…
Dworkin, Daniel S.; Lyddon, William J.
Describes the development of a time-limited and managed care treatment policy at the university counseling center at Colorado State University. It is offered as one agency's attempt to become more proactive in defining its responsibilities and limits regarding emerging challenges and changes on college campuses. (Author/LLL)
Lindberg, Erik; Wilson, Timothy L.
Purpose: This paper seeks to explore how managing by objectives (MBO) has been adopted in Swedish schools and to reflect on some of the consequences in a longitudinal study. Results relate to whether introduction has increased student performance and whether it works as a tool for the principals to create more effective schools.…
Franz-Balsen, Angela; Heinrichs, Harald
Purpose: Sustainability communication is evolving as a new interdisciplinary field of research and professional practice. The purpose of this paper is to point out the advantage of applying theoretical frameworks and related research instruments for an adequate sustainability communication management on campus. It also aims to highlight the…
Although sustainable land management (SLM) is widely promoted to prevent and mitigate land degradation and desertification, its monitoring and assessment has received much less attention. This paper compiles methodological approaches which to date have been little reported in literature. It draws le...
Spruell, James; Hawkins, Al; Vicknair, David
The study explores the development and management of a rich learning environment that extends the traditional classroom to include significant co-curricular programs. Learning enrichment is guided by the individual mission of the business school, accreditation agency (AACSB), and in our case, the Jesuit mission. That central framework provides a…
Personal stories of illness give depth to otherwise clinical descriptions of diagnoses. This article offers an autobiographical narrative of complications after total knee replacement surgery. Diagnosis and nursing management of acute compartment syndrome, nociceptive and neuropathic origins of pain, pharmacologic and nursing interventions for pain, the use of prayer in illness, and compassionate caring from a Christian perspective are discussed.
Agasisti, Tommaso; Arnaboldi, Michela; Azzone, Giovanni
This paper presents an investigation of management accounting in four major Italian universities, which have been struggling to build their strategy in a context of significant change. Following many OECD countries the Italian government has been changing its higher education system by giving more autonomy to universities. These changes pose a…
Element Number I Project No. Task -- Work Unit Accession No. 11 Title (Include Security Classification) LESSONS LEARNED FROM EXPERIMENTS CONDUCTED ON...firmly established, an analysis of the experiment can be conducted. The experimental plan and report will be analyzed in Chapter III . 16 III . ANALYSIS...equipped with an ATS and when not, are expected. However, whether or not the ATS eliminates valid air targets remains to be seen. 23 iii 4) :4 I... U C
Fenger, N; Broberg, M
The physician's liability in Danish law is based on negligence, which is assessed by the courts largely on the basis of expert opinions. Such opinions are provided primarily by the Medico-Legal Council rather than by experts selected by the parties. The evaluation of negligence is based on a "reasonable man" standard and the performance expected of a competent colleague; a hospital will be responsible for the negligence of its employees. The burden of proof generally lies with the plaintiff; negligence will not be presumed and the assessment of the evidence of negligence will be adapted to the individual situation, e.g. factors such as the degree of specialization involved, the time which the physician had at his disposal to make his decision and the resources available to him will be taken into consideration. The courts have shown themselves willing to allow for the fact that doctors differ, i.e. recognizing that there must be scope for reasonable discretion. Because the culpa principle is central, the standard applied to medical knowledge will be that which pertained at the time of the treatment. Where a non-specialist is confronted with a problem which may go beyond the knowledge of his limits and experience, he is under an obligation to refer the patient. The principle of informed consent to treatment is accepted in Danish law, but such consent will readily be considered to have been given tacitly.
Toft, Gunnar; Flyvbjerg, Allan; Bonde, Jens Peter
Background From animal studies it is known that currently used pesticides can disturb thyroid function. Methods In the present study we investigated the thyroid function in 122 Danish greenhouse workers, to evaluate if greenhouse workers classified as highly exposed to pesticides experiences altered thyroid levels compared to greenhouse workers with lower exposure. Serum samples from the greenhouse workers were sampled both in the spring and the fall to evaluate if differences in pesticide use between seasons resulted in altered thyroid hormone levels. Results We found a moderate reduction of free thyroxine (FT4) (10–16%) among the persons working in greenhouses with a high spraying load both in samples collected in the spring and the fall, but none of the other measured thyroid hormones differed significantly between exposure groups in the cross-sectional comparisons. However, in longitudinal analysis of the individual thyroid hormone level between the spring and the fall, more pronounced differences where found with on average 32% higher thyroid stimulating hormone (TSH) level in the spring compared to the fall and at the same time a 5–9% lower total triiodthyroxin (TT3), free triiodthyroxine (FT3) and FT4. The difference between seasons was not consistently more pronounced in the group classified as high exposure compared to the low exposure groups. Conclusion The present study indicates that pesticide exposure among Danish greenhouse workers results in only minor disturbances of thyroid hormone levels. PMID:17147831
Since 1987 Long Island Sound (LIS) has been part of EPA’s National Estuary Program, and since 1994 it has been governed by a Comprehensive Conservation and Management Plan that provided for a strategic relationship between science and management. The Management Conference ...
Internationally, it is agreed that pain management is a central component of nursing care. Although much has been written about pain prevalence among patients after surgery, research is scant on patients' experiences of nursing pain management and factors involved. This study explores patients' experiences of nursing pain management in Jordan and identifies contributing factors. A qualitative research design was used. Data were collected through focus group discussions (n = 4). A total of 31 patients were purposively selected. Two main themes emerged. The first theme was living in pain and comprised two categories: from sleep disturbances to the fear of addiction and from dependence to uncertainty. The second theme was about barriers that affect nursing pain management. Patients' experiences of nursing pain management were not up to their expectations; their needs were largely ignored and were dealt with in a mechanistic way. Barriers precipitating this situation were referred to in this study as the three "nots," including not being well-informed, not being believed, and not being privileged. The study concluded that patients' experiences of nursing pain management are a complex world that goes beyond medically orientated care. Nurses, therefore, are urged to look beyond standardized assessment tools and use patients' experiences and voices as valuable evidence contributing to more effective pain management. Unless this occurs in their daily encounters with patients, another decade will pass with little change in the practice of pain management.
van der Velde, J; Linehan, L; Cusack, S
We conducted a survey of Irish Coast Guard Search and Rescue Helicopter winchmen to establish if their pain management scope of practice was adequate for their working environment. We surveyed 17 SAR personnel. 88% of winchmen have experienced scenarios where they were unable to reduce pain scores below 6/10. In seeking solutions within current Irish Prehospital Clinical Practice Guidelines, repeated descriptions of operations in extreme weather and sea conditions were given which were entirely incompatible with the dexterity required to break a glass ampoule and draw up solution, let alone site an intravenous (IV) line or administer a drug via intramuscular (IM) injection. Irish Coast Guard Search and Rescue Helicopter winchmen encounter polytrauma patients in extreme pain in uniquely challenging environments. Novel solutions to pain management within this tightly governed system are urgently required.
Foster, G. B., Jr.
The Apollo management of data for postflight engineering evaluation is described. The sources of Apollo telemetry data, the control of data processing by a single data team, the data techniques used to assist in evaluation of the large quantity of data, and the operation of the data team before the mission and during the evaluation phase are described. The techniques used to ensure the output of valid data and to determine areas in which data were of questionable quality are also included.
Cooper, Lynne P.
This study was conducted to better understand how New Product Development (NPD) team members apply their experiences to meet the task needs of their project. Although "experience" is highly valued in team members, little research has looked specifically at experiences as a type of knowledge, and how this knowledge is used in work settings. This research evaluated nearly 200 instances where team members referenced past experiences during team meetings. During these experience exchanges, team members structured the sharing of their experiences to include three common elements: the source of the experience, the nature of the experience, and the degree of relevance to the current work of the team. The experiences fell into four categories: people (relationships), process, product, and politics. This paper describes how team members structured, applied, and integrated their individual experiences and presents the resulting implications for knowledge management systems that wish to exploit experience knowledge.
Maddux, Gary A.; Provancha, Anna; Chattam, David
The Microgravity Projects Office identified a need to develop a software package that will lead experiment developers through the development planning process, obtain necessary information, establish an electronic data exchange avenue, and allow easier manipulation/reformatting of the collected information. An MS-DOS compatible software package called the Automated Payload Experiment Tool (APET) has been developed and delivered. The objective of this task is to expand on the results of the APET work previously performed by UAH and provide versions of the software in a Macintosh and Windows compatible format.
Maddux, Gary A.; Provancha, Anna; Chattam, David
The Microgravity Projects Office identified a need to develop a software package that will lead experiment developers through the development planning process, obtain necessary information, establish an electronic data exchange avenue, and allow easier manipulation/reformatting of the collected information. An MS-DOS compatible software package called the Automated Payload Experiment Tool (APET) has been developed and delivered. The objective of this task is to expand on the results of the APET work previously performed by University of Alabama in Huntsville (UAH) and provide versions of the software in a Macintosh and Windows compatible format. Appendix 1 science requirements document (SRD) Users Manual is attached.
An encouraging trend of reductions in accidents and fatalities in the Danish construction industry, brought about by the combined sustained efforts of unions, management, and government, is suffering a reverse. While some large construction companies have achieved excellent safety records through effective internal programs combining rewards and penalties as incentives, the overall picture is worsening as government eases pressures on small and medium-sized enterprises by relaxing occupational health and safety regulations.
The author is a reference and instruction librarian at Iowa State University with collection development and liaison responsibilities for chemistry, biochemistry, entomology, and natural resource ecology. She recently came to librarianship with an education and three years' experience in biochemistry and biotechnology. During the last four years…
Bäck, Leif; Oinas, Minna; Pietarinen-Runtti, Petra; Saarilahti, Kauko; Vuola, Jyrki; Saat, Riste; Öhman, Juha; Haglund, Caj; Niemelä, Mika; Leivo, Ilmo; Hagström, Jaana; Mäkitie, Antti A
Esthesioneuroblastoma remains a challenging disease because of its rarity, the complexity of surrounding structures, missing opinions of optimal treatment protocol, and complications associated with necessary surgery. Our objective was to analyse the management and outcome of a cohort of patients with esthesioneuroblastoma from 1990 to 2009 in a tertiary medical centre. There were 17 eligible patients (8 males and 9 females) with the median age of 53 years (range 20-75 years). An obvious inconsistency was noted in the management of the various tumours of the present series during the two decades due to a lack of a uniform treatment protocol. The median follow-up time was 57.5 months (range 3-158 months). Nine patients (seven with curative treatment intent) died of the disease with the median time from diagnosis to death of 60 months (range 3-161 months). Eight patients had no evidence of the disease at last follow-up visit (median 76 months, range 24-119 months). Recurrences were documented in seven of the patients. The median time from end of primary treatment to a recurrence was 57 months (range 6-110 months). The 5-year overall survival and disease-free survival was 68 and 62%, respectively. The management of ENB should be planned by an experienced head and neck surgeon as part of a multidisciplinary team in a tertiary referral setting. Multimodality therapy with long-term follow-up is preferable and should be set based on the available disease-specific classifications for clinical staging and histopathological grading.
Glad, A.; Drobnis, D.; McHarg, B.
Present-day fusion research requires extensive support for the large amount of scientific data generated, bringing about three distinct problems computer systems must solve: (1) the processing of large amounts of data in very small time frames; (2) the archiving, analyzing and managing of the entire data output for the project's lifetime; (3) the standardization of data for the exchange of information between laboratories. The computer system supporting General Atomic's Doublet III tokamak, a project funded by the United States Department of Energy, is the first to encounter and address these problems through a system-wide data base structure.
Lewis, V; Lawler, K
A review of the findings from a 1996 survey of women visiting a Planned Parenthood clinic reveals that some members of managed care organizations (MCOs) may not be receiving appropriate preventive services and information from their primary care providers. This article details the results of a survey of 115 women who attended a Planned Parenthood of New York City clinic for reproductive health services. Based on these survey findings, the authors provide recommendations for MCOs and traditional providers of reproductive health to improve service delivery.
Dornan, Tim; Brown, Martin; Powley, Dan; Hopkins, Mike
The aim was to establish how ICT could apply feedback principles to experience based learning. Based on a survey of student and staff requirements, we developed a personalized educational technology ('iSUS') that: (1) Made students clear what they should learn; (2) Helped them meet appropriate real patients; (3) Encouraged reflective feedback; (4) Calculated benchmarks from accumulated feedback; (5) Compared individual students' feedback against those benchmarks; (6) Matched clinical activities to curriculum objectives; (7) Gave feedback to teachers and course leads. Bench testing proved the system usable. During seven weeks of real time use, a whole year group of 111 students feedback on 1183 learning episodes. Five hundred and forty-one (46%) of feedback episodes were self initiated. We have successfully prototyped an application of feedback principles to experience based learning that students seem to find useful.
Mujtaba, Bahaudin G.; Cavico, Frank J.; McCartney, Timothy O.; DiPaolo, Peter T.
Ethical maturity and behavior are of great concern to all educators, firms, and investors, and even more so in a recession. This research surveyed managers and employees in the retail environment to measure their Personal Business Ethics Scores (PBES) to see if age, education, and management experience makes a difference in making more ethical…
Bajunid, Ibrahim Ahmad
Articulates the need to understand and seek indigenous perspectives of educational management, using Malaysia's experience as an example. To differentiate culture-free and culture-bound content in educational management, the field's core corpus of theories, concepts, and terminology must be identified; the culture-specific ways of knowing must be…
Larson, Karl L.
Purpose: The purpose of the study was to document the stages of learning reflected through student journaling during a self-directed experience in stress management, and the relationship of those stages to a historical model. Methods: College students participating in a full-semester course in stress management theory were required to select a…
deGroh, Henry C., III; Johnston, J. Christopher; Wei, Bingbo
The second flight of NASA's Shuttle Flight experiment program known as MEPHISTO suffered from a void in the liquid portion of the sample, even though a piston arrangement was in place to keep the ampoule filled. In preparations for the next flight of the MEPHISTO furnace an animated computer program, called MEPHISTO Volume Visualizer (MVV), was written to help avoid the formation of unwanted voids. A piston system on MEPHISTO has the ability to move approximately 5 mm in compression, to accommodate expansion of the solid during heating; then from the completely compressed position, the piston can move up to 25 mm in towards the sample, effectively making the ampoule smaller and hopefully eliminating any voids. Due to the nature of the piston design and ampoule and sample arrangement, the piston has gotten stuck during normal directional solidification; this creates the risk of a void. To eliminate such a void, the liquid in the hot zones of the furnace can be heated, thereby expanding the liquid and consuming any void. The problem with this approach is that if the liquid is heated too much an overpressure could result, breaking the ampoule and ending the experiment catastrophically. The MVV has been found to be a useful tool in the assessment of the risks associated with the formation of a void and the additional heating of the liquid in the hot zone of this Bridgman type furnace. The MVV software will be discussed and copies available; it is written in the Delphi 2 programming language and runs under Windows 95 and NT. The strategies used in other flight experiments, such as the Isothermal Dendritic Growth Experiment, will also be presented.
Thacker, Rick L
The National Ignition Facility at Lawrence Livermore National Laboratory is the world's largest and most energetic laser system for inertial confinement fusion and experiments studying high energy density science. Many experiments performed at the National Ignition Facility involve radioactive materials; these may take the form of tritium and small quantities of depleted uranium used in targets, activation products created by neutron-producing fusion experiments, and fission products produced by the fast fissioning of the depleted uranium. While planning for the introduction of radioactive material, it was recognized that some of the standard institutional processes would need to be customized to accommodate aspects of NIF operations, such as surface contamination limits, radiological postings, airborne tritium monitoring protocols, and personnel protective equipment. These customizations were overlaid onto existing work practices to accommodate the new hazard of radioactive materials. This paper will discuss preparations that were made prior to the introduction of radioactive material, the types of radiological work activities performed, and the hazards and controls encountered. Updates to processes based on actual monitoring results are also discussed.
... or experience in administration and management. 21.51 Section 21.51 Public Health PUBLIC HEALTH... Appointment of officers having specialized training or experience in administration and management. The... specialized training or experience in administration and management relating to the functions of the...
Hirst, E.; Armstrong, J. R.
The development and operation of energy conservation programs in the Minnesota Energy Agency (MEA) are discussed. The MEA has responsibility for voluntary conservation efforts, regulating energy efficient devices, and grant programs to audit and retrofit public buildings. The MEA has developed the plan under which the Minnesota utilities will provide conservation services to residential customers, including an on-site home energy audit. The relation between the Department of Energy (DOE) and state energy offices in implementing programs is considered. The DOE has provided technical assistance to the states through the development of a model audit. Steps are discussed to reduce the burdens imposed on the states by program planning, funding, and management responsibilities, including the consolidation of several existing state conservation programs. Improved policy analysis is suggested to correct inefficiencies in government programs.
Management of malignant pleural mesothelioma (MPM) remains a clinical challenge and the incidence of the disease will continue to increase worldwide. Several aspects of mesothelioma treatment are discussed controversially, in particular, regarding extent and best type of surgery, radiotherapy, and the role of neoadjuvant or adjuvant treatment. However, best survival data is reported from groups using multimodality treatment including macroscopic complete resection (MCR) achieved by either extrapleural pneumonectomy (EPP) or (extended) pleurectomy/decortication for patients qualifying from the tumor biology, stage, and patient’s performance status and comorbidities. Several aspects have to be considered during surgery but morbidity and mortality have been reduced at experienced centres. The final analysis of extended selection algorithms is pending. PMID:24868442
Lunar dust will present significant challenges to NASA's Lunar Exploration Missions. The challenges can be overcome by using best practices in system engineering design. For successful lunar surface missions, all systems that come into contact with lunar dust must consider the effects throughout the entire design process. Interfaces between all these systems with other systems also must be considered. Incorporating dust management into Concept of Operations and Requirements development are the best place to begin to mitigate the risks presented by lunar dust. However, that is only the beginning. To be successful, every person who works on NASA's Constellation lunar missions must be mindful of this problem. Success will also require fiscal responsibility. NASA must learn from Apollo the root cause of problems caused by dust, and then find the most cost-effective solutions to address each challenge. This will require a combination of common sense existing technologies and promising, innovative technical solutions
Helm, Caitlin; Huschart, Emily; Kaul, Rajat; Bhumbra, Samina; Blackwood, R. Alexander; Mukundan, Deepa
Osteomyelitis is an infection of the bone; proper management requires prolonged antibiotic treatment. Controversy exists as to when a patient should transition from intravenous to oral antibiotics. However, due to the high bioavailability of some oral antibiotics, optimal time to transition from high to low bioavailability antibiotics is a more valid consideration. Additionally, there are questions surrounding the efficacy of certain antibiotics, specifically trimethoprim-sulfamethoxazole (TMP-SMX), in treating osteomyelitis. After obtaining Institutional Review Board approval from both universities, a retrospective chart review was conducted, utilizing an author-created severity scale, on all patients seen by Pediatric Infectious Diseases at the Universities of Michigan and Toledo with an acute osteomyelitis diagnosis from 2002-2012. There were 133 patients, 106 treated successfully. Success was defined in this study specifically as treatment of <14 weeks without recurrence within 30 days of stopping antibiotics or permanent site disability. Seventeen patients were treated with TMP-SMX at comparable cure rates. Patients with pre-existing bone defects (noted in radiological reports), initial erythrocyte sedimentation rate (ESR)≥70, hematogenous osteomyelitis with soft tissue extension, and skull osteomyelitis were associated with increased failure rate. Switch to low bioavailability antibiotics occurred, on average, at 3.5 weeks; however, switching before then was not associated with decreased cure rate. As prevalence of methicillin-resistant Staphylococcus aureus (MRSA), especially clindamycin-resistant MRSA, increases, TMP-SMX appears to be an acceptable antibiotic. There does not appear to be a minimum length of high bioavailability treatment required for cure. Prior bone defect, extensive infection, ESR≥70, or skull osteomyelitis may be indications for more aggressive management.
Pimenta Mourao, R.
The Centro de Desenvolvimento da Tecnologia Nuclear (Center for the Development of Nuclear Technology) - CDTN - has been actively engaged in cooperation programs for disused source management throughout the Latin American and the Caribbean region since 1996. The CDTN source conditioning team participated in the preparation of the technical procedures established for the different tasks involved in the radium sources conditioning operations, like preparation of the packaging for conditioning; sources conditioning; capsule welding; leak test in radium-containing capsule; and radiation protection planning for the conditioning of disused radium sources. The team also carried out twelve radium sources conditioning operation in the region, besides in-house operations, which resulted in a total conditioned activity of approximately 525 GBq, or 14,200 mg of radium. Additionally, one operation was carried out in Nicaragua to safely condition three Cobalt teletherapy heads stored under very precarious conditions in the premises of an old hospital. More recently, the team started its participation in an IAEA- and US State Department-sponsored program for the repatriation of disused or excess transuranic sources presently stored at users' premises or under regulatory control in different countries in the region. In September 2007 the team attended a theoretical and practical training in transuranic sources management, including the participation in the conditioning of different neutron sources in certified packages. It is expected that the trained team will carry out similar operations in other Latin American countries. Finally, the team is expected be involved in the near future in the repatriation of US-origin teletherapy heads and industrial gauges. (authors)
Caprioli, M.; Trizzino, R.; Mazzone, F.; Scarano, M.
In this paper the results of some surveys carried out in an area of Apulian territory affected by serious environmental hazard are presented. Unmanned Aerial Vehicles (UAV) are emerging as a key engineering tool for future environmental survey tasks. UAVs are increasingly seen as an attractive low-cost alternative or supplement to aerial and terrestrial photogrammetry due to their low cost, flexibility, availability and readiness for duty. In addition, UAVs can be operated in hazardous or temporarily inaccessible locations, that makes them very suitable for the assessment and management of environmental risk conditions. In order to verify the reliability of these technologies an UAV survey and A LIDAR survey have been carried outalong about 1 km of coast in the Salento peninsula, near the towns of San Foca, Torre dellOrso and SantAndrea( Lecce, Southern Italy). This area is affected by serious environmental risks due to the presence of dangerous rocky cliffs named falesie. The UAV platform was equipped with a photogrammetric measurement system that allowed us to obtain a mobile mapping of the fractured fronts of dangerous rocky cliffs. UAV-images data have been processed using dedicated software (AgisoftPhotoscan). The point clouds obtained from both the UAV and LIDAR surveys have been processed using Cloud Compare software, with the aim of testing the UAV results with respect to the LIDAR ones. The total error obtained was of centimeter-order that is a very satisfactory result. The environmental information has been arranged in an ArcGIS platform in order to assess the risk levels. The possibility to repeat the survey at time intervals more or less close together depending on the measured levels of risk and to compare the output allows following the trend of the dangerous phenomena. In conclusion, for inaccessible locations of dangerous rocky bodies the UAV survey coupled with GIS methodology proved to be a key engineering tool for the management of environmental
Murphy, James J.; Cardenas, Juan-Camilo
Managing local environmental resources with moderately enforced government regulations can often be counterproductive, whereas nonbinding communications can be remarkably effective. The authors describe a classroom experiment that illustrates these points. The experiment is rich in its institutional settings and highlights the challenges that…
Kozma, Chris M
Any attempt to widely disperse smallpox vaccinations will necessitate educating people about the risks and benefits of vaccination. Most disease management programs have extensive experience in distributing educational materials and programs to health care workers and patients as well as in tracking response to interventions. Can this experience lend a hand in the event of widespread vaccination?
Background Pubic diastasis, a result of high energy antero-posterior compression (APC) injury, has been managed based on the Young and Burguess classification system. The mode of fixation in APC II injury has, however, been a subject of controversy and some authors have proposed a need to address the issue of partial breach of the posterior pelvic ring elements in these injuries. Methods The study included a total of 19 patients with pubic diastasis managed by us from May 2006 to December 2007. There was a single patient with type I APC injury who treated conservatively. Type II APC injuries (13 patients) were treated surgically with symphyseal plating using single anterior/superior plates or double perpendicularly placed plates. Type III injuries (5 patients) in addition underwent posterior fixation using plates or percutaneous sacro-iliac screws. The outcome was assessed clinically (Majeed score) and radiologically. Results The mean follow-up was for 2.9 years (6 months to 4.5 years). Among the 13 patients with APC II injuries, the clinical scores were excellent in one (7.6%), good in 6 (46.15%), fair in 4 (30.76%) and poor in 2 (15.38%). Radiological scores were excellent in 2 (15.38%), good in 8 (61.53%), fair in 2 (15.38%) and poor in one patient (7.6%). Among the 5 patients with APC III injuries, there were 2 patients each with good (50%) and fair (50%) clinical scores while one patient was lost on long term follow up. The radiological outcomes were also similar in these. Complications included implant failure in 3 patients, postoperative infection in 2 patients, deep venous thrombosis in one patient and bladder herniation in one of the patients with implant failure. Conclusions There is no observed dissimilarity in outcomes between isolated anterior and combined symphyseal (perpendicular) plating techniques in APC II injuries. Single anterior symphyseal plating along with posterior stabilisation provides a stable fixation in type III APC injuries. Limited
Manjiri, S; Padmalatha, SK; Shetty, J
Aims: To analyse the clinical presentation, clinicopathological correlation and management of complex ovarian cysts in newborn and infants. Materials and Methods: Over a period of 6 years (2009-2015), 25 newborns who were diagnosed to have ovarian cyst on antenatal ultrasound, were followed up. We collected data in the form of clinical features, radiological findings, pathology and mode of treatment. Results: Of the 25 fetuses who were diagnosed to have ovarian cysts, fourteen (56%) underwent spontaneous regression by 6-8 months. Eight were operated in newborn period while 3 were operated in early infancy. Seven had ovarian cyst on right side, 4 had on left side. Eight babies underwent laparoscopy while 3 underwent laparotomy. Histopathology showed varied features of hemorrhagic cyst with necrosis and calcification, serous cystadenoma with hemorrhage, benign serous cyst with hemorrhage and simple serous cyst. Post-operative recovery was uneventful in all. Conclusion: All the ovarian cysts detected antenatally in female fetuses need close follow-up after birth. Since spontaneous regression is known, only complex or larger cysts need surgical intervention, preferably by laparoscopy. Majority of the complex cysts show atrophic ovarian tissue hence end up in oophorectomy but simple cysts can be removed preserving normal ovarian tissue whenever possible. PMID:28083489
Pandey, Anand; Gangopadhyay, Ajay Narayan; Sharma, Shiv Prasad; Kumar, Vijayendra; Gopal, Saroj Chooramani; Gupta, Dinesh Kumar
Ulceration is the most common complication of haemangioma and occurs in 5-15% of cases. The present study was carried out to evaluate the clinical features of ulcerated haemangioma and efficacy of the management protocol adopted by us over a period of 20 years. All patients with ulcerated haemangioma were evaluated on the basis of age at presentation, sex, rural or urban distribution and site of haemangioma. Treatment included application of topical antibiotic and systemic antibiotic and analgesic for pain. The total number of patients was 608. The male to female ratio was 1: 2.28. The rural:urban distribution was 2.43:1. The most common site of involvement was head and neck. Mean age of patients was 5.60 +/- 2.44 months. Mean size of haemangioma and ulceration was 47.30 +/- 20.67 cm(2) and 7.49 +/- 4.52 cm(2), respectively. The mean time for ulcer healing was 40.06 +/- 19.41 days. Ulcer size of more than 10 cm(2) took more time to heal. Response to treatment was satisfactory. Ulcerated haemangioma usually occurs before completion of 1 year of age; hence, every patient with haemangioma needs careful attention. Adequate treatment and regular follow up brings satisfactory response in the patients.
Didion, Jeffrey R.
The Electrically Driven Single Phase Thermal Management: STP-H5 iEHDS Experiment is a technology demonstration of prototype proof of concept hardware to establish the feasilibilty and long term operation of this hardware. This is a structural thermal plate that will operate continuous as part of the STP-H5 ISEM experiment for up to 18 months. This presentation discusses the design, fabrication and environmental operational paramertes of the experiment hardware.
In 1967, the problem of occupational lead exposure came to public attention in Korea. Since then, regular progress has been made in lowering workplace lead exposures, instituting new workplace controls, and implementing health examinations of exposed workers. Past serious lead poisoning episodes made it possible to introduce biological monitoring programs on a voluntary basis in high-lead-exposure facilities in Korea. Industry-specific occupational health services for lead workers in Korea during the last 22 years can be categorized into three phases. During the first phase (1988-1993), efforts were directed at increasing awareness among workers about the hazards of lead exposure, biological monitoring of blood zinc protoporphyrin began, and a respiratory protection program was introduced. During the second phase (1994-1997), a computerized health management system for lead workers was developed, blood-lead measurement was added to biologic monitoring, and engineering controls were introduced in the workplace to lower air-lead levels to comply with air-lead regulations. Finally, during the third phase (1998-present), a new biomarker, bone-lead measurement by X-ray fluorescence, was introduced. Bone-lead measurement proved to be useful for assessing body burden and to demonstrate past lead exposure in retired workers. Occupational health service practice for lead workers, including the industry-specific group occupational health system, has brought considerable success in the prevention of lead poisoning and in reducing the lead burden in Korean lead workers during the last several decades. The successful achievement of prevention of lead poisoning in Korea was a result of the combined efforts of lead workers, employers, relevant government agencies, and academic institutes. PMID:22953192
Conventional wisdom in the US is that firms face a trade-off between environmental efforts and profit because of the belief that environmental protection invariably involves costs that reduce profits. Firms, therefore, generally perceive environmental protection as an impediment to their goal of profit maximization. Environmental efforts are viewed as an added hurdle in producing a product, rather than an as intrinsic part of well-designed operations. From this perspective, firms have no incentive to engage in environmental protection efforts, and will do so only if they are forced (or are given incentives) by government or if they perceive in advance potential profits from their efforts (e.g., a market for environmental products). The concept of a trade-off between the environment and profit, however, has been challenged recently. A common argument raised for questioning this trade-off is that efforts directed at environmental protection will lead to the development of new technologies and will give US firms a competitive advantage in the emerging environmental industry. It is argued that opportunities available within this growth field outweigh costs of entry and research. Recent publications (World Wildlife Fund, 1992; Resources for the Future, 1993) have proposed that government actions, may encourage the development of the environmental industry and, thus, improve both economic and environmental performance. Suggested governmental actions include using market incentives rather than command and control regulation to achieve environmental goals, integrating environmental values into governmental policy analysis, and supporting investments in environmental technologies. This paper details the economics and benefits of various waste management efforts.
Lamberg, Anna Lei; Sølvsten, Henrik; Lei, Ulrikke; Vinding, Gabrielle Randskov; Stender, Ida Marie; Jemec, Gregor Borut Ernst; Vestergaard, Tine; Thormann, Henrik; Hædersdal, Merete; Dam, Tomas Norman; Olesen, Anne Braae
Aim of database The Danish Nonmelanoma Skin Cancer Dermatology Database was established in 2008. The aim of this database was to collect data on nonmelanoma skin cancer (NMSC) treatment and improve its treatment in Denmark. NMSC is the most common malignancy in the western countries and represents a significant challenge in terms of public health management and health care costs. However, high-quality epidemiological and treatment data on NMSC are sparse. Study population The NMSC database includes patients with the following skin tumors: basal cell carcinoma (BCC), squamous cell carcinoma, Bowen’s disease, and keratoacanthoma diagnosed by the participating office-based dermatologists in Denmark. Main variables Clinical and histological diagnoses, BCC subtype, localization, size, skin cancer history, skin phototype, and evidence of metastases and treatment modality are the main variables in the NMSC database. Information on recurrence, cosmetic results, and complications are registered at two follow-up visits at 3 months (between 0 and 6 months) and 12 months (between 6 and 15 months) after treatment. Descriptive data In 2014, 11,522 patients with 17,575 tumors were registered in the database. Of tumors with a histological diagnosis, 13,571 were BCCs, 840 squamous cell carcinomas, 504 Bowen’s disease, and 173 keratoakanthomas. Conclusion The NMSC database encompasses detailed information on the type of tumor, a variety of prognostic factors, treatment modalities, and outcomes after treatment. The database has revealed that overall, the quality of care of NMSC in Danish dermatological clinics is high, and the database provides the necessary data for continuous quality assurance. PMID:27822110
LONGHEU, A.; MEDAS, F.; CORRIAS, F.; FARRIS, S.; TATTI, A.; PISANO, G.; ERDAS, E.; CALÒ, P.G.
Aim Gynecomastia is a common finding in male population of all ages. The aim of our study was to present our experience and goals in surgical treatment of gynecomastia. Patients and Methods Clinical records of patients affected by gynecomastia referred to our Department of Surgery between September 2008 and January 2015 were analyzed. 50 patients were included in this study. Results Gynecomastia was monolateral in 12 patients (24%) and bilateral in 38 (76%); idiopathic in 41 patients (82%) and secondary in 9 (18%). 39 patients (78%) underwent surgical operation under general anaesthesia, 11 (22%) under local anaesthesia. 3 patients (6%) presented recurrent disease. Webster technique was performed in 28 patients (56%), Davidson technique in 16 patients (32%); in 2 patients (4%) Pitanguy technique was performed and in 4 patients (8%) a mixed surgical technique was performed. Mean surgical time was 80.72±35.14 minutes, median postoperative stay was 1.46±0.88 days. 2 patients (4%) operated using Davidson technique developed a hematoma, 1 patient (2%) operated with the same technique developed hypertrophic scar. Conclusions Several surgical techniques are described for surgical correction of gynecomastia. If performed by skilled general surgeons surgical treatment of gynecomastia is safe and permits to reach satisfactory aesthetic results. PMID:27938530
Municipal waste charges in Spain are very widespread, although their application varies significantly among different municipalities. Most commonly, waste charges are implemented as a flat rate, but some of them depend on indicators such as household water consumption, the land area of the property or the value of the real estate. Only one residential pay-as-you-throw scheme has been applied so far. It was a pay-per-bag scheme implemented in Torrelles de Llobregat, Barcelona. A number of other systems focussing only on commercial waste have been implemented in Spain. Several factors suggest that new pay-as-you-throw schemes will be adopted in the near future. In 2000 no municipalities had door-to-door collection schemes; since then over 70 municipalities have implemented them. In addition to this, some regions encourage the separate collection of commercial waste, by means of doorstep schemes. In all of these areas, variable charging systems could be easily adopted. Additionally, regarding waste charges, the National Waste Plan (2000-2006) advocated for the implementation of "pilot experiences for the quantitative application of the polluter-pays-principle". The tendency towards these variable charging systems in Europe will also favour their introduction in Spain.
Mesolella, M; Cimmino, M; Cantone, E; Marino, A; Cozzolino, M; Della Casa, R; Parenti, G; Iengo, M
Mucopolysaccharidoses (MPSs) are lysosomal storage disorders caused by deficiency of enzymes involved in the degradation of glycosaminoglycans (GAGs). These disorders are associated with the accumulation of GAGs in tissues with organomegaly, mental retardation and short stature. Otologic and upper respiratory tract pathologies are among the earliest clinical manifestations. We analyzed 20 patients (13 male and 7 female, median age at the beginning of the observation 6 years) with MPS (35% type I, 30% type II, 20% type III, 5% type IV, 10% type VI), focusing on their otorhinolaryngologic problems and the impact of surgery on quality of life. We found ear, nose and throat manifestations in all types of MPS; in particular, recurrent otitis media was present in 30% of cases, hearing loss in 75% (mixed in 43.33%, conductive in 43.33%, sensorineural in 13.33%), adenotonsillar hypertrophy in 75%, frequent infections of the upper airway in 75% and obstructive sleep apnoea syndrome in 45% of cases. Fifty percent of patients required surgical therapy (adenotonsillectomy, adenoidectomy with insertion of middle ear ventilation tubes, tonsillectomy, tracheotomy and exeresis of vocal cord polyps). In our experience the ENT surgery reduced the frequency and severity of ear infections and relieved symptoms related to upper airway obstruction, thereby improving the quality of life in affected patients.
Faced with liberalisation proposals and an increasing internationalisation of water resource management, the question arises as to how a change of the regulatory framework would affect the market structure and the supply conditions in this area. While the term "privatisation" relates to the ownership structure of the providers, the term "liberalisation" implies extensive free market ideas. Privatisation involves the outsourcing of public services from the public authorities to a privately organised organisation. Through this, however, nothing needs to change in terms of the market or the intensity of competition for the commodity in question. Within the framework of privatisation it can also occur that the public monopoly is only transferred to a private monopoly. The term "liberalisation" in addition refers to the basic regulatory constraints: liberalisation signifies the cessation of limitations to competition and supply monopolies, and open competition between several suppliers for the consumers. In the EU-15, the only country where the provision of operational services in the water supply has been totally passed to the private sector is the UK, but this is only true for UK and Wales. Another singular case is France, where there is a mix of mainly private operating companies and municipalities which have divided the regional supply areas among themselves. In six other EU-15 countries where some privatisation took place, either the municipalities or (majority) publicly owned companies are controlling water supply. In the remaining seven countries, the water supply is organised by municipality companies only. In an international comparison, there are three basic models for the regulation of natural monopolies in the public water supply: the Anglo-Saxon, the French and the German model. The delimitation between supervisory bodies and operations in the water supply is strongest in the first model and weakest in the last. This has led to three basic types of
Furuie, Sergio S; Rebelo, Marina S; Moreno, Ramon A; Santos, Marcelo; Bertozzo, Nivaldo; Motta, Gustavo H M B; Pires, Fabio A; Gutierrez, Marco A
Patients usually get medical assistance in several clinics and hospitals during their lifetime, archiving vital information in a dispersed way. Clearly, a proper patient care should take into account that information in order to check for incompatibilities, avoid unnecessary exams, and get relevant clinical history. The Heart Institute (InCor) of São Paulo, Brazil, has been committed to the goal of integrating all exams and clinical information within the institution and other hospitals. Since InCor is one of the six institutes of the University of São Paulo Medical School and each institute has its own information system, exchanging information among the institutes is also a very important aspect that has been considered. In the last few years, a system for transmission, archiving, retrieval, processing, and visualization of medical images integrated with a hospital information system has been successfully created and constitutes the InCor's electronic patient record (EPR). This work describes the experience in the effort to develop a functional and comprehensive EPR, which includes laboratory exams, images (static, dynamic, and three dimensional), clinical reports, documents, and even real-time vital signals. A security policy based on a contextual role-based access control model was implemented to regulate user's access to EPR. Currently, more than 10 TB of digital imaging and communications in medicine (DICOM) images have been stored using the proposed architecture and the EPR stores daily more than 11 GB of integrated data. The proposed storage subsystem allows 6 months of visibility for rapid retrieval and more than two years for automatic retrieval using a jukebox. This paper addresses also a prototype for the integration of distributed and heterogeneous EPR.
Twycross, Alison; Parker, Roslyn; Williams, Anna; Gibson, Faith
Advances in treatment mean children are increasingly cared for by their parents at home, leading to a shift in responsibility from health care professionals to parents. Little is known about parents' pain management experiences and the etiology of pain experienced by children with cancer especially when at home. A rapid review of the literature was undertaken investigating children's cancer-related pain, with emphasis on the management of pain outside the health care setting. Electronic databases were searched and a quality assessment was conducted. Forty-two articles were included. Despite advances in pain management techniques, children with cancer regularly cite pain as the most prevalent symptom throughout the cancer trajectory. The source of pain is usually treatment side effects or painful procedures. Parents find dealing with their child's pain distressing and demanding and may hold misconceptions about pain management. Findings indicate a need for more robust research into parental pain management leading to the development of effective pain management resources for parents.
The agency director sought to create a systematically coordinated department that utilizes knowledge management strategies to promote evidence-informed practice. In his view, the organization was not providing needed information or organizational supports for practitioners to use knowledge effectively. To address this issue, he created a Director of Development and Operational Planning (DDOP) position with the responsibility to build structures and facilitate processes that support knowledge management. The DDOP oversees research and planning, government relations, legislative development and support, Board of Supervisors communications, staff development and training, community contracts, public information and in-house communication. The DDOP is reorganizing units under her supervision to create a knowledge management matrix that will implement new knowledge sharing strategies related to evaluation, contracts, legislation, organizational development, policy and planning, and staff development. The case study describes challenges and strategies related to: government regulations, size and complexity of the agency, staff resistance, and the developmental nature of the process.
Squance, Marline L.; Reeves, Glenn E. M.; Bridgman, Howard
Individuals living with lupus commonly experience daily backgrounds of symptoms managed to acceptable tolerance levels to prevent organ damage. Despite management, exacerbation periods (flares) still occur. Varied clinical presentations and unpredictable symptom exacerbation patterns provide management and assessment challenges. Patient perceptions of symptoms vary with perceived impact, lifestyles, available support, and self-management capacity. Therefore, to increase our understanding of lupus' health impacts and management, it was important to explore lupus flare characteristics from the patient viewpoint. Lupus flares in 101 Australian female patients were retrospectively explored with the use of a novel flare definition. Qualitative methods were used to explore patient-perceived flare symptoms, triggers, and management strategies adopted to alleviate symptom exacerbations. A mean of 29.9 flare days, with 6.8 discrete flares, was experienced. The study confirmed that patients perceive stress, infection, and UV light as flare triggers and identified new potential triggers of temperature and weather changes, work, and chemical exposure from home cleaning. The majority of flares were self-managed with patients making considered management choices without medical input. Barriers to seeking medical support included appointment timings and past negative experiences reflecting incongruence between clinician and patient views of symptom impact, assessment, and ultimately flare occurrence. PMID:26464865
Neighbors, A. K.
The Gravity Probe-B (GP-B) experiment is one of the most sophisticated and challenging developments to be undertaken by NASA. Its objective is to measure the relativistic drift of gyroscopes in orbit about the earth. In this paper, the experiment is described, and the strategy of phased procurements for accomplishing the engineering development of the hardware is discussed. The microcomputer is a very convenient and powerful tool in the management of GP-B. It is used in creating and monitoring such project data as schedules, budgets, hardware procurements and technical and interface requirements. Commercially available software in word processing, database management, communications, spreadsheet, graphics and program management are used. Examples are described of the efficacy of the application of the computer by the management team.
Kantak, Anil V.
A new method is presented for handling data resulting from Mobile Satellite propagation experiments such as the Pilot Field Experiment (PiFEx) conducted by JPL. This method uses the UNIX operating system and C programming language. The data management system is implemented on a VAX minicomputer. The system automatically divides the large data file housing data from various experiments under a predetermined format into various individual files containing data from each experiment. The system also has a number of programs written in C and FORTRAN languages to allow the researcher to obtain meaningful quantities from the data at hand.
Van Bogaert, Peter; Peremans, Lieve; de Wit, Marlinde; Van heusden, Danny; Franck, Erik; Timmermans, Olaf; Havens, Donna S.
Aim: To study nurse managers' perceptions and experiences of staff nurse structural empowerment and its impact on the nurse manager leadership role and style. Background: Nurse managers' leadership roles may be viewed as challenging given the complex needs of patients and staff nurses' involvement in both clinical and organizational decision-making processes in interdisciplinary care settings. Design: Qualitative phenomenological study. Methods: Individual semi-structured interviews were conducted with 8 medical or surgical nurse managers in a 600-bed Belgian university hospital between December 2013 and June 2014. This hospital was undergoing conversion from a classical hierarchical, departmental structure to a flat, interdisciplinary model. Results: Nurse managers were found to be familiar with the structural empowerment of clinical nurses in the hospital and to hold positive attitudes toward it. They confirmed the positive impact of empowerment on their staff nurses, as evidenced by increased responsibility, autonomy, critical reflection and enhanced communication skills that in turn improved the quality and safety of patient care. Structural empowerment was being supported by several change initiatives at both the unit and hospital levels. Nurse managers' experiences with these initiatives were mixed, however, because of the changing demands with regard to their manager role and leadership style. In addition, pressure was being experienced by both staff nurses and nurse managers as a result of direct patient care priorities, tightly scheduled projects and miscommunication. Conclusion: Nurse managers reported that structural empowerment was having a favorable impact on staff nurses' professional attitudes and the safety and quality of care in their units. However, they also reported that the empowerment process had led to changes in the managers' roles as well as daily practice dilemmas related to the leadership styles needed. Clear organizational goals and
Gundtoft, Per Hviid; Varnum, Claus; Pedersen, Alma Becic; Overgaard, Søren
Aim of database The aim of the Danish Hip Arthroplasty Register (DHR) is to continuously monitor and improve the quality of treatment of primary and revision total hip arthroplasty (THA) in Denmark. Study population The DHR is a Danish nationwide arthroplasty register established in January 1995. All Danish orthopedic departments – both public and private – report to the register, and registration is compulsory. Main variables The main variables in the register include civil registration number, indication for primary and revision surgery, operation date and side, and postoperative complications. Completeness of primary and revision surgery is evaluated annually and validation of a number of variables has been carried out. Descriptive data A total of 139,525 primary THAs and 22,118 revisions have been registered in the DHR between January 1, 1995 and December 31, 2014. Since 1995, completeness of procedure registration has been high, being 97.8% and 92.0% in 2014 for primary THAs and revisions, respectively. Several risk factors, such as comorbidity, age, specific primary diagnosis and fixation types for failure of primary THAs, and postoperative complications, have been identified through the DHR. Approximately 9,000 primary THAs and 1,500 revisions are reported to the register annually. Conclusion The DHR is important for monitoring and improvement of treatment with THA and is a valuable tool for research in THA surgery due to the high quality of prospective collected data with long-term follow-up and high completeness. The register can be used for population-based epidemiology studies of THA surgery and can be linked to a range of other national databases. PMID:27822092
The scotopticometer is a small, light and handy instrument from 1935, which was developed in Denmark by Carsten Edmund Zeuthen (1897-1973) and Hans Ulrik Møller (1894-1954) for the measurement of dark vision without the use of a dark chamber. The prerequisites are Jannik Bjerrum's contrast letters from 1889 and Marius Tscherning's photometric neutral-gray filter-glasses with a logaritmic scale (Ph 1-8); both Bjerrum (1851-1920) and Tscherning (1854-1939) were Danish ophthalmologists. Tescherning's basic experiments and theories are reported, based on a study of his scientific publications, scientific protocols, letters and scrapbook. Tscherning inspired many young Danish scientists to further studies of dark adaptation, which is still an important topic (traffic, military, art, illumination, gerontology).
Keen, Meg . E-mail: firstname.lastname@example.org; Sullivan, Marjorie
Aid agencies, like commercial businesses, are increasingly concerned with incorporating sound environmental management into their operations. Different approaches are being used to integrate sustainability into development assistance to ensure that environmental impacts are assessed and managed. One approach being used by AusAID, the Australian aid agency, is to implement an environmental management system (EMS) across program and project areas. This paper examines how AusAID has adapted the EMS approach to suit aid agency operations, and some of the lessons from the Australian experience.
Shishko, Robert; Matijevic, Jacob R.
On 4 July 1997, the Mars Pathfinder landed on the surface of Mars carrying the first planetary rover, known as the Sojourner. Formally known as the Microrover Flight Experiment (MFEX), the Sojourner was a low cost, high-risk technology demonstration, in which new risk management techniques were tried. This paper summarizes the activities and results of the effort to conduct a low-cost, yet meaningful risk management program for the MFEX. The specific activities focused on cost, performance, schedule, and operations risks. Just as the systems engineering process was iterative and produced successive refinements of requirements, designs, etc., so was the risk management process. Qualitative risk assessments were performed first to gain some insights for refining the microrover design and operations concept. These then evolved into more quantitative analyses. Risk management lessons from the manager's perspective is presented for other low-cost, high-risk space missions.
Bookout, Michelle L; Staffileno, Beth A; Budzinsky, Christine M
Patient-centered care is a key driver for the nation's health system, yet patient experience surveys indicate that hospitals are far from achieving favorable outcomes. Partnering with patients and families through a patient and family advisory council (PFAC) advances the practice of patient-centered care to improve outcomes and experiences. This article describes the process of implementing a PFAC and presents outcomes related to patients' perception of pain management in the acute care hospital setting.
Unal, Zafer; Unal, Aslihan
This study provided a basis for answering the following essential question: Does the years of experience affect teachers' classroom management approaches? Data were collected from 268 primary school teachers. The findings of this study demonstrated that experienced teachers are more likely to prefer to be in control in their classrooms than…
Husky, Mathilde M.; Mazure, Carolyn M.; Carroll, Kathleen M.; Barry, Danielle; Petry, Nancy M.
Contingency management (CM) treatments have been shown to be effective in reducing substance use. This manuscript illustrates how the experience sampling method (ESM) can depict behavior and behavior change and can be used to explore CM treatment mechanisms. ESM characterizes idiosyncratic patterns of behavior and offers the potential to determine…
Zanjani, Mellissia M.
The purpose of this research study was to enhance understanding of successful conflict management by community college Presidents through highlighting and describing conflict experiences with the faculty union or the board of trustees in a community college context. The following questions guided the research: (a) How do community college…
Wolf, Kattlyn J.; Foster, Daniel D.; Birkenholz, Robert J.
Beginning agriculture teachers often cite classroom management as the most important problem they face in their careers. The purpose of this study was to assess the effect of leadership experience on self-perceived teacher efficacy among agricultural education student teachers. The three dimensions of teacher efficacy addressed in this study…
Coulet, O; Kraemer, P; Leyral, G; Cloatre, G
Based on their experience in managing Grave's disease at the Bouffard Army Hospital Center within the local health care context in Djibouti, the authors advocate surgery as the first line treatment. Medical and economical factors supporting this preference are discussed so that readers can adapt them to his own local context.
Fukuzawa, Ryoko; Joho, Hideo; Maeshiro, Tetsuya
This paper reports the results of a survey that investigated the practice and experience of task management of university students. A total of 202 tasks identified by 24 university students were analyzed. The results suggest that participants had a reasonable sense of priority of tasks, that they tend to perceive a task as a big chunk, not a…
Safioleas, M; Stamatakos, M; Spyrakos, C; Safioleas, P; Chatzikonstantinou, C; Iannescu, R; Safioleas, C
Gallstone ileus representing 1-4% of all bowel obstructions cholelithiasis. Impaction of a gallstone in the human of the bowel is a surgical emergency. Relief of the obstruction is the treatment of choice, but controversy exists regarding the repair of the fistula and cholecystectomy. Our experience in the management of gallstone ileus is presented in the following article.
Lawrence, Heather; Shafer, Duane
When Hurricane Katrina hit the Gulf Coast in August 2005, Southeastern Louisiana University was spared the brunt of the storm and was fortunate that most structures on campus remained intact. However, the storm still affected the campus for weeks. This article reflects on the experiences of university leaders and facility managers as they provided…
Ruhe Marsh, Linda
The purpose of this qualitative narrative inquiry was to explore the perceptions and lived experiences of Illinois Parents as Teachers (PAT) program leaders managing a multigenerational workforce. Supervisors state that leading a multigenerational staff possesses challenges that affect overall productivity (Bell, 2008). PAT stakeholders including…
Cunningham, George B.; Sagas, Michael
Building from Mever, Allen, & Smith's (1993) work in organizational psychology, the purpose of this study was to examine the relationships among work experiences, affective occupational commitment, and intent to enter the sport management profession among college seniors completing their internship requirements. Results indicate that intent to…
Reid, Eric Justin
This qualitative study explored the perceptions and experiences of IT Managers in publicly traded companies within the San Antonio, Texas area about outsourced data centers. Narrative data was collected using open-ended questions and face-to-face interviews within semi-structured environments. The research questions guided the study: (1)…
Kakyo, Tracy Alexis; Xiao, Lily Dongxia
Ensuring safe and quality care for patients in hospitals is an important part of a nurse manager's role. Continuous quality improvement has been identified as one approach that leads to the delivery of quality care services to patients and is widely used by nurse managers to improve patient care. Nurse managers' experiences in initiating continuous quality improvement activities in resource-poor healthcare settings remain largely unknown. Research evidence is highly demanded in these settings to address disease burden and evidence-based practice. This interpretive qualitative study was conducted to gain an understanding of nurse managers' Continuous Quality Improvement experiences in rural hospitals in Uganda. Nurse managers in rural healthcare settings used their role to prioritize quality improvement activities, monitor the Continuous Quality Improvement process, and utilize in-service education to support continuous quality improvement. The nurse managers in our sample encountered a number of barriers during the implementation of Continuous Quality Improvement, including: limited patient participation, lack of materials, and limited human resources. Efforts to address the challenges faced through good governance and leadership development require more attention.
Oxley, Rebecca; Macnaughton, Jane
Purpose of review Breathlessness can be debilitating for those with chronic conditions, requiring continual management. Yet, the meaning of breathlessness for those who live with it is poorly understood in respect of its subjective, cultural, and experiential significance. This article discusses a number of current issues in understanding the experience of breathlessness. Recent findings Effective communication concerning the experience of breathlessness is crucial for diagnosis, to identify appropriate treatment, and to provide patients with the capacity to self-manage their condition. However, there is an evident disconnect between the way breathlessness is understood between clinical and lay perspectives, in terms of awareness of breathlessness, the way symptoms are expressed, and acknowledgement of how it affects the daily lives of patients. Summary The review highlights the need for integrated multidisciplinary work on breathlessness, and suggests that effective understanding and management of breathlessness considers its wider subjective and social significance. PMID:27490147
Lassnig, Mario; Garonne, Vincent; Molfetas, Angelos; Beermann, Thomas; Dimitrov, Gancho; Canali, Luca; Zang, Donal; Azzurra Chinzer, Lisa
The distributed data management system of the high-energy physics experiment ATLAS has a critical dependency on the Oracle Relational Database Management System. Recently however, the increased appearance of data warehouselike workload in the experiment has put considerable and increasing strain on the Oracle database. In particular, the analysis of archived data, and the aggregation of data for summary purposes has been especially demanding. For this reason, structured storage systems were evaluated to offload the Oracle database, and to handle processing of data in a non-transactional way. This includes distributed file systems like HDFS that support parallel execution of computational tasks on distributed data, as well as non-relational databases like HBase, Cassandra, or MongoDB. In this paper, the most important analysis and aggregation use cases of the data management system are presented, and how structured storage systems were established to process them.
Smith, Lindsay F; Frost, Julia; Levitas, Ruth; Bradley, Harriet; Garcia, Jo
Background Miscarriage affects around one in six pregnancies. Much research has taken place identifying the consequences of this for parents but is mainly quantitative. Of the limited qualitative studies, none have explored women's experiences of the methods of miscarriage management received. Aim To assess the social and personal impact of different management methods (expectant, medical and surgical) on women's experience of first trimester miscarriage. Design of study Qualitative interviews using a topic guide with a purposive cohort of four categories of women (each management method plus non-participants) 6 months to 1 year after first trimester miscarriage. Focus groups with both research participants and health workers. Setting Women from three hospitals in the South West of England that participated in the Miscarriage Treatment (MIST) trial. Method Seventy-two interviews were undertaken between September 1999 and June 2000. There were also five focus groups (47 participants) and two feedback sessions (8 participants) with written feedback from 12 women. Interviews lasted 0.5–2.5 hours generating over 2000 A4 pages of transcripts. The transcripts were analysed for common themes, using standard proformas, which were filled in by individual team members and then discussed by the whole research team. Iterative readings in the light of new emerging issues ensured that new themes could be identified throughout the analytical process. All transcripts were then encoded for the identified themes using NUDIST. Results Common themes emerged across all management options although some were specific to just one or two management options. The five major themes arising out of the data analysis were: intervention; experiences of care; finality; the ‘baby’; and pain and bleeding. Conclusions Women's experiences and beliefs vary widely and their preferences need to be considered in their early miscarriage management. The three methods have different benefits and
Kwa, B H
Eleven cases of chest trauma managed in the Intensive Care Unit (ICU), Alexandra Hospital were reviewed. Common manifestations were: rib fractures, haemothorax, pneumothorax, pulmonary contusion and flail chest. Nine patients had fractures on other sites of the body and three patients had associated abdominal injuries requiring laparotomy. Patients were referred to the ICU only when they were in respiratory distress. Transfer to the ICU occurred one to three days after admission to the hospital. Eight patients subsequently had to be ventilated. Two patients died. Respiratory failure in chest trauma is often the result of damage to the parenchyma, atelectasis and infection. Whilst the extent of parenchyma lung damage is dependent upon the severity of the injury and therefore not medically preventable, atelectasis and infection can be avoided. Patients with significant chest trauma should therefore be admitted directly to the Intensive Care Unit and the 'Expectant Therapy' instituted.
Lyons, J.E.; Laskowski, H.P.; Runge, M.C.; Lor, S.; Kendall, W.L.; Talbott, S.
Managed wetlands provide a broad spectrum of resources to migratory waterbirds (shorebirds, wading birds, and waterfowl) throughout the annual cycle. Successful conservation and management of waterbirds depends on integrated approaches that (1) incorporate larger spatial and temporal scales than traditional approaches to wetland management, and (2) use experimental designs to reduce uncertainty about the response of the systems to management. In a previous experiment on USFWS National Wildlife Refuges in the Northeast, we explored the effects of water-level management on migratory shorebirds in spring. We documented regional patterns of shorebird use of Refuge wetlands and showed that across the region, a slow drawdown was superior to 2 alternatives. USGS and USFWS have now cooperatively undertaken an expanded study focusing on 3 waterbird guilds in the context of the complete annual cycle and over a larger spatial extent. For this 3-yr study, now in its first year, 2 impoundments were selected at each of 23 NWRs across the Northeast and Upper Midwest Regions. Two experimental treatments (annual water regimes focused on early-season or late-season drawdowns) are being applied each year in a cross-over design. This experimental design will increase our understanding of cross-seasonal interactions which result from specific hydrologic regimes aimed at a particular waterbird guild. Monitoring will allow waterbird responses to be linked with direct effects of water management on plant and invertebrate populations. Results of this large-scale experiment will be used to motivate formal adaptive management of wetlands and waterbirds at refuges following completion of this experiment.
Martin, C; Bonas, S; Shepherd, L; Hedges, E
Burns can have both physical and psychological effects on individuals. Pressure garments and silicone gels are used to improve the aesthetic appearance and functions of the skin, but these treatments have been associated with various physical, emotional, sexual and social difficulties. Interpretative phenomenological analysis (IPA) was used to explore participants' experiences of scar management. IPA examines individual experiences before comparing results across cases, and is suited to capture the different ways in which individuals experience a phenomena as well as cautiously looking at patterns across cases. Eight burn patients who had experienced scar management, including pressure garments, were interviewed. Two superordinate themes were identified: Assimilation of Pressure Garment Identity, and Psychosocial Functions of the Pressure Garments. The findings offered insight into the positive and negative experiences of scar management, describing the diverse personal and social functions of the pressure garments and how they became integrated into participants' identities. By understanding the individual nature of these experiences, healthcare professionals can enhance support around these issues and potentially aid adherence to treatment. Further research with different demographic groups as well as for other burn treatments would be useful to develop and contextualise these findings.
Moore, J.L.; Berger, D.A.; Rubin, C.B.; Hutchinson, P.A. Sr.; Griggs, H.M.
The report provides local officials and staff with information on lessons from the audit, projection, and general planning experiences of the Comprehensive Community Energy Management Program (CCEMP) communities and provides ANL and US DOE with information useful to the further development of local energy management planning methods. In keeping with the objectives, the report is organized into the following sections: Section II presents the evaluation issues and key findings based on the communities' experiences from Spring of 1979 to approximately March of 1980; Section III gives an organized review of experience of communities in applying the detailed audit methodology for estimating current community energy consumption and projecting future consumption and supply; Section IV provides a preliminary assessment of how audit information is being used in other CCEMP tasks; Section V presents an organized review of preliminary lessons from development of the community planning processes; and Section VI provides preliminary conclusions on the audit and planning methodology. (MCW)
Metzelaar, P. N.
Five typical AMPS experiments were formulated to allow simulation studies to verify data management concepts. Design studies were conducted to analyze these experiments in terms of the applicable procedures, data processing and displaying functions. Design concepts for AMPS data management system are presented which permit both automatic repetitive measurement sequences and experimenter-controlled step-by-step procedures. Extensive use is made of a cathode ray tube display, the experimenters' alphanumeric keyboard, and the computer. The types of computer software required by the system and the possible choices of control and display procedures available to the experimenter are described for several examples. An electromagnetic wave transmission experiment illustrates the methods used to analyze data processing requirements.
Tronchin, Daisy Maria Rizatto; Peres, Heloisa Helena Ciqueto; Lima, Antônio Fernandes Costa; Alavarce, Débora Cristina; Prata, Ana Paula; Santos, Margarida Reis; Aroldi, Juscilynne Barros da Costa
Objective To describe the experience of planning and developing online refresher courses in nursing management for nurses in the contexts of Brazil and Portugal. Method The instructional design was based on meaningful learning theory, andragogy, and dialectical methodology, so it valued interaction between the actors, emphasizing the scenarios of practice and applying the concepts covered. The course structure is divided into nine theoretical units, four case studies, and an essay exam. Results The course was positively evaluated by the participants, who reported opportunities for acquisition of new knowledge, interaction and exchange of experiences, motivation to study the topics, and self-learning. Conclusion It is expected that description of this experience will stimulate proposals for new courses and programs in distance education modalities, improving the processes of teaching and learning so as to give support to future analyses of their impact on the development and enhancement of management skills in nursing.
Brito, Maria José Menezes; Montenegro, Lívia Cozer; Alves, Marília
Influenced by increased technology and globalization, Brazilian hospitals are undergoing significant changes. The managerial models focused on the male model are being slowly and gradually replaced, with an expressive participation of female nurses in management positions. Thus, we aimed to uncover some aspects of the relational experiences of power and gender of nine female nurse-managers working in four large and medium-sized private hospitals in Belo Horizonte, MG, Brazil, through a qualitative case study. The results show that management discourses value a managerial style focused on the organizations' humanized aspects, where authoritative styles have no space. In this scenario, the work of female nurse-managers strengthens teamwork, which improves their image and contributes to forming their identity.
Mølhave, L.; Schneider, T.; Kjærgaard, S. K.; Larsen, L.; Norn, S.; Jørgensen, O.
Floor dust from Danish offices was collected and analyzed. The dust was to be used in an exposure experiment. The dust was analyzed to show the composition of the dust which can be a source of airborne dust indoors. About 11 kg of dust from vacuum cleaner bags from seven Danish office buildings with about 1047 occupants (12 751 m 2) was processed according to a standardized procedure yielding 5.5 kg of processed bulk dust. The bulk dust contained 130.000-160.000 CFU g -1 microorganisms and 71.000-90.000 CFU g -1 microfungi. The content of culturable microfungi was 65-123 CFU 30 g -1 dust. The content of endotoxins ranged from 5.06-7.24 EU g -1 (1.45 ng g -1 to 1.01 ng g -1). Allergens (ng g -1) were from 147-159 (Mite), 395-746 (dog) and 103-330 (cat). The macro molecular organic compounds (the MOD-content) varied from 7.8-9.8 mg g -1. The threshold of release of histamine from basophil leukocytes provoked by the bulk dust was between 0.3 and 1.0 mg ml -1. The water content was 2% (WGT) and the organic fraction 33%. 6.5-5.9% (dry) was water soluble. The fiber content was less than 0.2-1.5% (WGT) and the desorbable VOCs was 176-319 μg g -1. Most of the VOC were aldehydes. However, softeners for plastic (DBP and DEHP) were present. The chemical composition includes human and animal skin fragments, paper fibers, glass wool, wood and textilefibers and inorganic and metal particles. The sizes ranged from 0.001-1 mm and the average specific density was 1.0 g m -3. The bulk dust was resuspended and injected into an exposure chamber. The airborne dust was sampled and analyzed to illustrate the exposures that can result from sedimented dirt and dust. The airborne dust resulting from the bulk dust reached concentrations ranging from 0.26-0.75 mg m -3 in average contained 300-170 CFU m -3. The organic fraction was from 55-70% and the water content about 2.5% (WGT). The content of the dust was compared to the similar results reported in the literature and its toxic potency is
Ingeholm, Peter; Gögenur, Ismail; Iversen, Lene H
Aim of database The aim of the database, which has existed for registration of all patients with colorectal cancer in Denmark since 2001, is to improve the prognosis for this patient group. Study population All Danish patients with newly diagnosed colorectal cancer who are either diagnosed or treated in a surgical department of a public Danish hospital. Main variables The database comprises an array of surgical, radiological, oncological, and pathological variables. The surgeons record data such as diagnostics performed, including type and results of radiological examinations, lifestyle factors, comorbidity and performance, treatment including the surgical procedure, urgency of surgery, and intra- and postoperative complications within 30 days after surgery. The pathologists record data such as tumor type, number of lymph nodes and metastatic lymph nodes, surgical margin status, and other pathological risk factors. Descriptive data The database has had >95% completeness in including patients with colorectal adenocarcinoma with >54,000 patients registered so far with approximately one-third rectal cancers and two-third colon cancers and an overrepresentation of men among rectal cancer patients. The stage distribution has been more or less constant until 2014 with a tendency toward a lower rate of stage IV and higher rate of stage I after introduction of the national screening program in 2014. The 30-day mortality rate after elective surgery has been reduced from >7% in 2001–2003 to <2% since 2013. Conclusion The database is a national population-based clinical database with high patient and data completeness for the perioperative period. The resolution of data is high for description of the patient at the time of diagnosis, including comorbidities, and for characterizing diagnosis, surgical interventions, and short-term outcomes. The database does not have high-resolution oncological data and does not register recurrences after primary surgery. The Danish
Grevsen, Jørgen V; Kruse, Edith; Kruse, Poul R
The article series provides a written and pictorial account of the Danish pharmaceutical industry's products from their introduction until about 1950. Part 6 deals with products from A/S Pharmacia. A/S Pharmacia was established in Copenhagen in 1922 as a Danish limited company by the enterprising pharmacist Edward Jacobsen. Pharmacia was not Jacobsen's first pharmaceutical company as previously he had established a pharmaceutical agency already in 1913 which in 1919 was reorganized to a limited company by the name of A/S Edward Jacobsen. This agency was later extended to include a production of generics. Jacobsen remained the co-owner and manager of Pharmacia until 1934 where he resigned and established another company, A/S Ejco, for the manufacture of generics. It is worth mentioning that already in 1911 a Swedish pharmaceutical company was established named AB Pharmacia. Today we do not know whether Edward Jacobsen knew about this Swedish company. Later on in 1936 AB Pharmacia and A/S Pharmacia made a contract concerning mutual market sharing, and a research cooperation was brought about between the two companies which resulted in an increase of turnover for A/S Pharmacia. In 1955 the cooperation between the two companies was increased as the Swedish company joined as principal shareholder with the purpose of continuing and developing the Danish company as an independent pharmaceutical company with its own research and development as well as manufacture, control and marketing. Therefore Pharmacia in Denmark was able to establish a synthesis factory in Koge and move the domicile to new premises in Hillered. In 1993 Pharmacia was presented in a printed matter as "The largest Nordic pharmaceutical company" as a result of the merger between the Swedish Kabi Pharmacia, formerly established by a merger between Kabi Vitrum and AB Pharmacia, and the Italian Farmitalia Carlo Erba. Only two years later in 1995 Pharmacia merged with the American pharmaceutical company The
Wibbenmeyer, Matthew J; Hand, Michael S; Calkin, David E; Venn, Tyron J; Thompson, Matthew P
Federal policy has embraced risa management as an appropriate paradigm for wildfire management. Economic theory suggests that over repeated wildfire events, potential economic costs and risas of ecological damage are optimally balanced when management decisions are free from biases, risa aversion, and risa seeking. Of primary concern in this article is how managers respond to wildfire risa, including the potential effect of wildfires (on ecological values, structures, and safety) and the likelihood of different fire outcomes. We use responses to a choice experiment questionnaire of U.S. federal wildfire managers to measure attitudes toward several components of wildfire risa and to test whether observed risa attitudes are consistent with the efficient allocation of wildfire suppression resources. Our results indicate that fire managers' decisions are consistent with nonexpected utility theories of decisions under risa. Managers may overallocate firefighting resources when the likelihood or potential magnitude of damage from fires is low, and sensitivity to changes in the probability of fire outcomes depends on whether probabilities are close to one or zero and the magnitude of the potential harm.
Ritchie, David J; Yen, Margaret L
This study reports on an analysis of 17 postgraduate programs in health services management. Public information was collected from websites in February 2010. Data analysed included core subject abstracts, admission requirements and length and aims of each course. Findings indicate that only three out of 16 subjects identified as core are common to more than 50% of the programs, with the eight most common individual subjects appearing in only a third of programs. This suggests diversity in what is deemed core foundational knowledge in managing health services and the approach taken to management development. We believe there should be greater consensus on core subjects in a specialist health services management qualification. WHAT IS KNOWN ABOUT THE TOPIC? With changes in the organisational structure of health organisations in Australia over the past two decades, managerial positions and roles have also changed. The educational preparation for those managerial roles would also be expected to have changed but core foundational knowledge should remain similar between the various academic institutions.WHAT DOES THIS PAPER ADD? This paper indicates greater diversity in core knowledge areas in health services management education than expected despite a similar target audience.WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? There are differences in what are deemed to be core foundational areas of knowledge required in specialist management development between academic programs. Management development requires a balance between knowledge, skills and experience and intending st
Schuett, Michael A.; Pierskalla, Chad D.
Fee-fishing involves paying a fee for the privilege of fishing a body of water where fish populations are enhanced by stocking fish. Past literature on this activity has focused more on the operation of the enterprise and management of the fish than the people and site characteristics. The objectives of the study were to profile anglers and describe their site/management preferences. This study utilized an on-site interview and mail-back questionnaire at fee-fishing establishments in West Virginia ( n = 212). Factor analysis of desired recreation experiences yielded five factors: Experience nature & adventure, Stress release & relaxation, Trophy fishing, Escape, and Family time. Cluster analysis showed that these anglers can be segmented into two distinct clusters, differing by sociodemographic characteristics, fishing behavior, and site/management preferences. The findings from this study provide baseline data to aid public resource managers and fee-fishing business owners in determining how to provide satisfying outdoor experiences and deliver desired services on-site. Future research will be needed from additional fee-fishing sites to obtain more detail about this outdoor recreation cohort and be able to generalize to a larger population of participants.
The characteristics, detection, and emergency management of nuclear criticality accidents outside reactors has been an important component of criticality safety for as long as the need for this specialized safety discipline has been recognized. The general interest and importance of such topics receives special emphasis because of the potentially lethal, albeit highly localized, effects of criticality accidents and because of heightened public and regulatory concerns for any undesirable event in nuclear and radiological fields. This bibliography lists references which are potentially applicable to or interesting for criticality alarm, detection, and warning systems; criticality accident emergency management; and their associated programs. The lists are annotated to assist bibliography users in identifying applicable: industry and regulatory guidance and requirements, with historical development information and comments; criticality accident characteristics, consequences, experiences, and responses; hazard-, risk-, or safety-analysis criteria; CAS design and qualification criteria; CAS calibration, maintenance, repair, and testing criteria; experiences of CAS designers and maintainers; criticality accident emergency management (planning, preparedness, response, and recovery) requirements and guidance; criticality accident emergency management experience, plans, and techniques; methods and tools for analysis; and additional bibliographies.
Lu, Ching-Hui; Huang, Chu-Yu; Park, Jeong-Hwan; Lin, Hung-Ru; Lee, Ya-Ling; Cheng, Su-Fen
Neuroblastoma is a common malignant tumor among children. Seventy percent of children with neuroblastoma have metastatic disease when the diagnosis is established. The aim of this study was to understand the main caregivers' lived experiences in managing pain for children with neuroblastoma. A descriptive qualitative design was used. Twelve main caregivers of children with neuroblastoma were interviewed. Two themes evolved: experiences of pain and coping with pain. Three subthemes were found under the theme "experience of pain": pain assessment based on language expressions and behavioral observations, tendency of misdiagnosing tumor metastasis-related pain, and unique manifestations of pain at various phases. Four subthemes evolved under the theme "coping with pain": utilization of pharmacological and nonpharmacological modalities for pain management, learning to confront pain, seeking mental and emotional support, and adjustment of family lifestyle. The results provide a description regarding the expression of pain in children with neuroblastoma and the pain management modalities used by the main caregivers. The findings serve as a reference for health care providers in Taiwan as they manage pain for children with neuroblastoma and seek to understand the needs of the main caregivers.
Hansen, Erik; Larsson, Heidi; Nørgaard, Mette; Thind, Peter; Jensen, Jørgen Bjerggaard
Aim of database The aim of the Danish Bladder Cancer Database (DaBlaCa-data) is to monitor the treatment of all patients diagnosed with invasive bladder cancer (BC) in Denmark. Study population All patients diagnosed with BC in Denmark from 2012 onward were included in the study. Results presented in this paper are predominantly from the 2013 population. Main variables In 2013, 970 patients were diagnosed with BC in Denmark and were included in a preliminary report from the database. A total of 458 (47%) patients were diagnosed with non-muscle-invasive BC (non-MIBC) and 512 (53%) were diagnosed with muscle-invasive BC (MIBC). A total of 300 (31%) patients underwent cystectomy. Among the 135 patients diagnosed with MIBC, who were 75 years of age or younger, 67 (50%) received neoadjuvent chemotherapy prior to cystectomy. In 2013, a total of 147 patients were treated with curative-intended radiation therapy. Descriptive data One-year mortality was 28% (95% confidence interval [CI]: 15–21). One-year cancer-specific mortality was 25% (95% CI: 22–27%). One-year mortality after cystectomy was 14% (95% CI: 10–18). Ninety-day mortality after cystectomy was 3% (95% CI: 1–5) in 2013. One-year mortality following curative-intended radiation therapy was 32% (95% CI: 24–39) and 1-year cancer-specific mortality was 23% (95% CI: 16–31) in 2013. Conclusion This preliminary DaBlaCa-data report showed that the treatment of MIBC in Denmark overall meet high international academic standards. The database is able to identify Danish BC patients and monitor treatment and mortality. In the future, DaBlaCa-data will be a valuable data source and expansive observational studies on BC will be available. PMID:27822081
Nguyen-Nielsen, Mary; Høyer, Søren; Friis, Søren; Hansen, Steinbjørn; Brasso, Klaus; Jakobsen, Erik Breth; Moe, Mette; Larsson, Heidi; Søgaard, Mette; Nakano, Anne; Borre, Michael
Aim of database The Danish Prostate Cancer Database (DAPROCAdata) is a nationwide clinical cancer database that has prospectively collected data on patients with incident prostate cancer in Denmark since February 2010. The overall aim of the DAPROCAdata is to improve the quality of prostate cancer care in Denmark by systematically collecting key clinical variables for the purposes of health care monitoring, quality improvement, and research. Study population All Danish patients with histologically verified prostate cancer are included in the DAPROCAdata. Main variables The DAPROCAdata registers clinical data and selected characteristics for patients with prostate cancer at diagnosis. Data are collected from the linkage of nationwide health registries and supplemented with online registration of key clinical variables by treating physicians at urological and oncological departments. Main variables include Gleason scores, cancer staging, prostate-specific antigen values, and therapeutic measures (active surveillance, surgery, radiotherapy, endocrine therapy, and chemotherapy). Descriptive data In total, 22,332 patients with prostate cancer were registered in DAPROCAdata as of April 2015. A key feature of DAPROCAdata is the routine collection of patient-reported outcome measures (PROM), including data on quality-of-life (pain levels, physical activity, sexual function, depression, urine and fecal incontinence) and lifestyle factors (smoking, alcohol consumption, and body mass index). PROM data are derived from questionnaires distributed at diagnosis and at 1-year and 3-year follow-up. Hitherto, the PROM data have been limited by low completeness (26% among newly diagnosed patients in 2014). Conclusion DAPROCAdata is a comprehensive, yet still young clinical database. Efforts to improve data collection, data validity, and completeness are ongoing and of high priority. PMID:27843346
Bilardi, Jade; Walker, Sandra; McNair, Ruth; Mooney-Somers, Julie; Temple-Smith, Meredith; Bellhouse, Clare; Fairley, Christopher; Chen, Marcus; Bradshaw, Catriona
Background Few data are available on how women manage recurring bacterial vaginosis (BV) and their experiences of the clinical care of this condition. This study aimed to explore women’s recurrent BV management approaches and clinical care experiences, with a view to informing and improving the clinical management of BV. Methods A descriptive, social constructionist approach was chosen as the framework for the study. Thirty-five women of varying sexual orientation who had experienced recurrent BV in the past 5 years took part in semi-structured interviews. Results The majority of women reported frustration and dissatisfaction with current treatment regimens and low levels of satisfaction with the clinical management of BV. Overall, women disliked taking antibiotics regularly, commonly experienced adverse side effects from treatment and felt frustrated at having symptoms recur quite quickly after treatment. Issues in clinical care included inconsistency in advice, misdiagnosis and inappropriate diagnostic approaches and insensitive or dismissive attitudes. Women were more inclined to report positive clinical experiences with sexual health physicians than primary care providers. Women’s frustrations led most to try their own self-help remedies and lifestyle modifications in an attempt to treat symptoms and prevent recurrences, including well-known risk practices such as douching. Conclusion In the face of considerable uncertainty about the cause of BV, high rates of recurrence, unacceptable treatment options and often insensitive and inconsistent clinical management, women are trying their own self-help remedies and lifestyle modifications to prevent recurrences, often with little effect. Clinical management of BV could be improved through the use of standardised diagnostic approaches, increased sensitivity and understanding of the impact of BV, and the provision of evidence based advice about known BV related risk factors. PMID:27010725
Burgarella, Sarah; Cattaneo, Dario; Pinciroli, Francesco; Masseroli, Marco
Background Improvements of bio-nano-technologies and biomolecular techniques have led to increasing production of high-throughput experimental data. Spotted cDNA microarray is one of the most diffuse technologies, used in single research laboratories and in biotechnology service facilities. Although they are routinely performed, spotted microarray experiments are complex procedures entailing several experimental steps and actors with different technical skills and roles. During an experiment, involved actors, who can also be located in a distance, need to access and share specific experiment information according to their roles. Furthermore, complete information describing all experimental steps must be orderly collected to allow subsequent correct interpretation of experimental results. Results We developed MicroGen, a web system for managing information and workflow in the production pipeline of spotted microarray experiments. It is constituted of a core multi-database system able to store all data completely characterizing different spotted microarray experiments according to the Minimum Information About Microarray Experiments (MIAME) standard, and of an intuitive and user-friendly web interface able to support the collaborative work required among multidisciplinary actors and roles involved in spotted microarray experiment production. MicroGen supports six types of user roles: the researcher who designs and requests the experiment, the spotting operator, the hybridisation operator, the image processing operator, the system administrator, and the generic public user who can access the unrestricted part of the system to get information about MicroGen services. Conclusion MicroGen represents a MIAME compliant information system that enables managing workflow and supporting collaborative work in spotted microarray experiment production. PMID:16351755
Blakeslee, Richard; Hall, John; Goodman, Michael; Parker, Philip; Freudinger, Larry; He, Matt
The NASA Real Time Mission Monitor (RTMM) is a situational awareness tool that integrates satellite, airborne and surface data sets; weather information; model and forecast outputs; and vehicle state data (e.g., aircraft navigation, satellite tracks and instrument field-of-views) for field experiment management RTMM optimizes science and logistic decision-making during field experiments by presenting timely data and graphics to the users to improve real time situational awareness of the experiment's assets. The RTMM is proven in the field as it supported program managers, scientists, and aircraft personnel during the NASA African Monsoon Multidisciplinary Analyses experiment during summer 2006 in Cape Verde, Africa. The integration and delivery of this information is made possible through data acquisition systems, network communication links and network server resources built and managed by collaborators at NASA Dryden Flight Research Center (DFRC) and Marshall Space Flight Center (MSFC). RTMM is evolving towards a more flexible and dynamic combination of sensor ingest, network computing, and decision-making activities through the use of a service oriented architecture based on community standards and protocols.
Haymann-Haber, Guido; Colombano, Silvano P.; Groleau, Nicolas; Rosenthal, Don; Szolovits, Peter; Young, Laurence R.
Perhaps the scarcest resource for manned flight experiments - on Spacelab or on the Space Station Freedom - will continue to be crew time. To maximize the efficiency of the crew and to make use of their abilities to work as scientist collaborators as well as equipment operators, normally requires more training in a wide variety of disciplines than is practical. The successful application of on-board expert systems, as envisioned by the Principal Investigator in a Box program, should alleviate the training bottleneck and provide the astronaut with the guidance and coaching needed to permit him or her to operate an experiment according to the desires and knowledge of the PI, despite changes in conditions. The Protocol Manager module of the system is discussed. The Protocol Manager receives experiment data that has been summarized and categorized by the other modules. The Protocol Manager acts on the data in real-time, by employing expert system techniques. Its recommendations are based on heuristics provided by the Principal Investigator in charge of the experiment. This prototype was developed on a Macintosh II by employing CLIPS, a forward-chaining rule-based system, and HyperCard as an object-oriented user interface builder.
Aaronson, W E; West, D J; Heshmat, S; Ramirez, B
AUPHA faculty members have had the opportunity to provide health care executive training and to work in partnership with academic institutions in Central and Eastern Europe and in the New Independent States of the former Soviet Union. This article presents some observations on health management education that demonstrate the similarity in issues faced by programs in the U.S. and in CEE. The health management educational partnership program was designed to provide technical assistance to emerging health management programs in the CEE. The partnership program has been mutually beneficial for several reasons. The role of physicians in leadership and the management educational needs that result provide one example of an issue that health management educational programs must address. The emergence of the roles of other health professions and growing contribution that they will make has its parallel in the American ascendance of the role of interdisciplinary team in clinical decision making. The partnership and executive training experiences have caused U.S. partners to focus consciously on pedagogical methods. The nature of the issues faced by emerging CEE health management programs suggests that mutual support among programs in the region after the partnership program is necessary in order to provide a forum for debate. The focus of the debate should continue to be on the role of management in health reform, content of curriculum, research focus and pedagogical methods appropriate for health care management undergraduate and graduate programs. The result will be a strengthening of the health management academic discipline in the region. The future of the AUPHA should predicated on the same principles, the roots from which it has grown.
Chowdhury, Arif Tahjibul
This manuscript presents the author's engineering and management experience during his internship in the Materials and Pavements (M&P) Division at the Texas A&M Transportation Institute (TTI), and is a record of study for the Doctor of Engineering at Texas A&M University. Through this internship, he met his established internship objectives of gaining technical knowledge as well as knowledge and skills in project management, organizational communication, and quality management of pavement condition data, and of attaining professional development. In meeting these objectives, the author describes the history, mission, and organizational structure of his workplace. He also presents his experience of developing and delivering a two-week training course on pavement design and construction in Kosovo. Participating in a number of professional development training courses and other activities prepared him for working as an engineering manager. These activities include Delta-T leadership training, an instructor development course, a time management and organizational skills course, and the M&P Division lecture series. Leadership and skills learned through the Delta-T program were beneficial for the employee as well as the employer. For the class project, the author and his teammates performed a study dealing with improving TTI's deliverables. The Delta-T team composed a report summarizing their efforts of examining the current state of TTI's project deliverables, the deliverables' shortcomings, and potential enhancements to expand the deliverables' appeal to additional types of potential users outside the traditional research community. The team also developed a prototype web-based model of deliverables and presented some implementation recommendations. Participating in the Texas Department of Transportation's (TxDOT's) pavement surface distress data collection program enabled the author to become familiar with pavement distress data quality management and thus attain the
as a natural consequence of being a co-founder of the United Nations, focused on promoting peace and stability in the world, as a relatively large...Soviet invasion to a more expeditionary course of deploying forces to promote peace and stability around the globe. As a result, Danish defense policy...Danish government including the armed forces. As a consequence Defense Agreement 2010 – 2014 was replaced by Defense Agreement 2013 – 2017 including
Vassilev, Ivaylo; Rogers, Anne; Todorova, Elka; Kennedy, Anne; Roukova, Poli
The shift from social democratic to a neoliberal consensus in modern welfare capitalist states is characterised by an emphasis on individual responsibility, consumer choice, market rationality and growing social inequalities. There has been little exploration of how neoliberalism has shaped the environment within which chronic illness is experienced and managed. This article explores the different articulations of neoliberalism manifest in the arena of personal illness management in Bulgaria and the UK. People with type 2 diabetes discussed their experiences in terms of struggling with diet, diabetes as a personal failure, integrating illness management and valued activities, and the trustworthiness of the healthcare system. The UK narratives were framed within an individual responsibility discourse while in Bulgaria lack of resources dominated discussions, which were framed as structurally generated and unrelated to individual capabilities and choices. Respondents faced personal management challenges related to consumer and healthcare market failures in both countries. Differences in market regulation and emerging stakeholder and interest coalitions influenced users' expectations and their navigation and adaption to market failures in managing their everyday illnesses. The UK and Bulgarian articulations of neoliberalism can be described differently: the first as a logic of managed choice and the second as a logic of unmanaged consumerism.
Schultz, Carl H; Koenig, Kristi L; Alassaf, Wajdan
As Ebola has spread beyond West Africa, the challenges confronting health care systems with no experience in managing such patients are enormous. Not only is Ebola a significant threat to a population's health, it can infect the medical personnel trying to treat it. As such, it represents a major challenge to those in public health, emergency medical services (EMS), and acute care hospitals. Our academic medical center volunteered to become an Ebola Treatment Center as part of the US effort to manage the threat. We developed detailed policies and procedures for Ebola patient management at our university hospital. Both the EMS system and county public health made significant contributions during the development process. This article shares information about this process and the outcomes to inform other institutions facing similar challenges of preparing for an emerging threat with limited resources. The discussion includes information about management of (1) patients who arrive by ambulance with prior notification, (2) spontaneous walk-in patients, and (3) patients with confirmed Ebola who are interfacility transfers. Hospital management includes information about Ebola screening procedures, personal protective equipment selection and personnel training, erection of a tent outside the main facility, establishing an Ebola treatment unit inside the facility, and infectious waste and equipment management. Finally, several health policy considerations are presented.
Chato, David J.; Kassemi, Mohammad
The Zero Boil-Off Technology (ZBOT) Experiment involves performing a small scale ISS experiment to study tank pressurization and pressure control in microgravity. The ZBOT experiment consists of a vacuum jacketed test tank filled with an inert fluorocarbon simulant liquid. Heaters and thermo-electric coolers are used in conjunction with an axial jet mixer flow loop to study a range of thermal conditions within the tank. The objective is to provide a high quality database of low gravity fluid motions and thermal transients which will be used to validate Computational Fluid Dynamic (CFD) modeling. This CFD can then be used in turn to predict behavior in larger systems with cryogens. This paper will discuss the current status of the ZBOT experiment as it approaches its flight to installation on the International Space Station, how its findings can be scaled to larger and more ambitious cryogenic fluid management experiments, as well as ideas for follow-on investigations using ZBOT like hardware to study other aspects of cryogenic fluid management.
Schwabacher, Mark; Samuels, Jeff; Brownston, Lee; Clancy, Daniel (Technical Monitor)
The NASA Integrated Vehicle Health Management (IVHM) Technology Experiment for X-37 was intended to run IVHM software on-board the X-37 spacecraft. The X-37 is intended to be an unpiloted vehicle that would orbit the Earth for up to 21 days before landing on a runway. The objectives of the experiment were to demonstrate the benefits of in-flight IVHM to the operation of a Reusable Launch Vehicle, to advance the Technology Readiness Level of this IVHM technology within a flight environment, and to demonstrate that the IVHM software could operate on the Vehicle Management Computer. The scope of the experiment was to perform real-time fault detection and isolation for X-37's electrical power system and electro-mechanical actuators. The experiment used Livingstone, a software system that performs diagnosis using a qualitative, model-based reasoning approach that searches system-wide interactions to detect and isolate failures. Two of the challenges we faced were to make this research software more efficient so that it would fit within the limited computational resources that were available to us on the X-37 spacecraft, and to modify it so that it satisfied the X-37's software safety requirements. Although the experiment is currently unfunded, the development effort had value in that it resulted in major improvements in Livingstone's efficiency and safety. This paper reviews some of the details of the modeling and integration efforts, and some of the lessons that were learned.
Phillips, Amy M; Large, Erin; Bird, T Mac; Hitt, W C; Eastham, Donna G; Pulley, Leavonne; Hutchins, David A
The objective of this survey was to determine the level of experience OB/GYN (Obstetrics & Gynecology) physicians in the state of Arkansas have in seeing and managing patients with vulvar pain, commonly known as vulvodynia. The 8 question, anonymous survey was mailed to Arkansas OB/GYN physicians. The survey assessed the experience of the providers, the age range of their patients, and whether or not they treat and/or refer. Thirty of 182 surveys were returned for a rate of 16.4%. The survey revealed that physicians are moderately comfortable treating vulvodynia within their practice and refer mostly for treatment failure.
Haozous, Emily A.; Doorenbos, Ardith Z.; Stoner, Susan
Purpose The purpose of this project was to explore the chronic pain experience and establish cultural appropriateness of cognitive behavioral pain management (CBPM) techniques in American Indians and Alaska Natives (AI/ANs). Design A semistructured interview guide was used with three focus groups of AI/AN patients in the U.S. Southwest and Pacific Northwest regions to explore pain and CBPM in AI/ANs. Findings The participants provided rich qualitative data regarding chronic pain and willingness to use CBPM. Themes included empty promises and health care insufficiencies, individuality, pain management strategies, and suggestions for health care providers. Conclusion Results suggest that there is room for improvement in chronic pain care among AI/ANs and that CBPM would likely be a viable and culturally appropriate approach for chronic pain management. Implications This research provides evidence that CBPM is culturally acceptable and in alignment with existing traditional AI/AN strategies for coping and healing. PMID:25403169
In recent decades, most states' Medicaid programs have introduced disease management programs for chronically ill beneficiaries. Interventions assist beneficiaries and their health care providers to appropriately manage chronic health condition(s) according to established clinical guidelines. Cost containment has been a key justification for the creation of these programs despite mixed evidence they actually save money. This study evaluates the effects of a disease management program in Georgia by exploiting a natural experiment that delayed the introduction of high-intensity services for several thousand beneficiaries. Expenditures for medical claims decreased an average of $89 per person per month for the high- and moderate-risk groups, but those savings were not large enough to offset the total costs of the program. Impacts varied by the intensity of interventions, over time, and across disease groups. Heterogeneous treatment effect analysis indicates that decreases in medical expenditures were largest at the most expensive tail of the distribution.
Lacking a coordinated effort in utilizing data and tracking program outcomes, one agency developed a Quality Management (QM) division to facilitate and manage more effective data use. To support this process, the agency sought to develop a collective, agency-wide understanding and investment in improving and measuring client outcomes. Similarly, the agency also focused efforts on creating a culture of transparency and accountability, with goals of improving service, increasing agency integrity, meeting regulatory compliance, and engaging in effective risk management. Operationalizing the QM initiative involved developing procedures, systems, and guidelines that would facilitate the generation of reliable and accurate data that could be used to inform program change and decision-making. This case study describes this agency's experience in successfully creating and implementing a QM initiative aimed at engaging in greater knowledge sharing.
Olden, Julian D.; Konrad, Christopher P.; Melis, Theodore S.; Kennard, Mark J.; Freeman, Mary C.; Mims, Meryl C.; Bray, Erin N.; Gido, Keith B.; Hemphill, Nina P.; Lytle, David A.; McMullen, Laura E.; Pyron, Mark; Robinson, Christopher T.; Schmidt, John C.; Williams, John G.
Greater scientific knowledge, changing societal values, and legislative mandates have emphasized the importance of implementing large-scale flow experiments (FEs) downstream of dams. We provide the first global assessment of FEs to evaluate their success in advancing science and informing management decisions. Systematic review of 113 FEs across 20 countries revealed that clear articulation of experimental objectives, while not universally practiced, was crucial for achieving management outcomes and changing dam-operating policies. Furthermore, changes to dam operations were three times less likely when FEs were conducted primarily for scientific purposes. Despite the recognized importance of riverine flow regimes, four-fifths of FEs involved only discrete flow events. Over three-quarters of FEs documented both abiotic and biotic outcomes, but only one-third examined multiple taxonomic responses, thus limiting how FE results can inform holistic dam management. Future FEs will present new opportunities to advance scientifically credible water policies.
Hincks, A. D.; Shaw, J. R.; Chime Collaboration
The Canadian Hydrogen Intensity Mapping Experiment (CHIME) is an ambitious new radio telescope project for measuring cosmic expansion and investigating dark energy. Keeping good records of both physical configuration of its 1280 antennas and their analogue signal chains as well as the ˜100 TB of data produced daily from its correlator will be essential to the success of CHIME. In these proceedings we describe the database-driven software we have developed to manage this complexity.
Farías Torbidoni, Estela Inés
Planning and management for recreational activities in protected areas involves an understanding of many complex factors. Segmentation of recreation demand and of the main physical or sporting activities can contribute to the design of more efficient management strategies, which may help to maintain or significantly enhance satisfaction with the recreation experience, and this in turn could improve the interest in and appreciation of the natural environment. The current study examined the motivations of hikers in three small Natura 2000 protected areas. It establishes a typology or categorization as a contribution to better management based on a survey conducted through on-site personal interviews with a representative sample of 569 hikers. Through an analysis of the principal intervening components by means of cluster analysis, we identified three groups of hikers based on three motivational dimensions: (1) nature-minded hikers, (2) sporting hikers and (3) general-purpose hikers. The most striking results were the significant differences among group variables related to visit behaviour (frequency and duration of visits and number of people per group), previous knowledge (protection status of the areas) and recreational frequentation (trail categories and protected areas visited). A positive correlation between the degree of sympathy for nature and the degree of satisfaction with the recreational experience (including positive evaluation of the public facilities, signposting and services offered) was also observed. The results are discussed in terms of their applicability and implications in hiking management in protected natural areas such as those of Natura 2000.
Farías Torbidoni, Estela Inés
Planning and management for recreational activities in protected areas involves an understanding of many complex factors. Segmentation of recreation demand and of the main physical or sporting activities can contribute to the design of more efficient management strategies, which may help to maintain or significantly enhance satisfaction with the recreation experience, and this in turn could improve the interest in and appreciation of the natural environment. The current study examined the motivations of hikers in three small Natura 2000 protected areas. It establishes a typology or categorization as a contribution to better management based on a survey conducted through on-site personal interviews with a representative sample of 569 hikers. Through an analysis of the principal intervening components by means of cluster analysis, we identified three groups of hikers based on three motivational dimensions: (1) nature-minded hikers, (2) sporting hikers and (3) general-purpose hikers. The most striking results were the significant differences among group variables related to visit behaviour (frequency and duration of visits and number of people per group), previous knowledge (protection status of the areas) and recreational frequentation (trail categories and protected areas visited). A positive correlation between the degree of sympathy for nature and the degree of satisfaction with the recreational experience (including positive evaluation of the public facilities, signposting and services offered) was also observed. The results are discussed in terms of their applicability and implications in hiking management in protected natural areas such as those of Natura 2000.
Strobino, D.; Zumbrunen, E.; Putzu, R.; Pontelandolfo, P.
This paper is about the further analysis of an experiment named CAESAR (stands for Capillarity-based Experiment for Spatial Advanced Research): a sounding rocket experiment carried out by students of hepia within the REXUS program. The authors have launched on REXUS-14 a propellant management experiment based on capillarity to reliably confirm other ground-based cxperiments. In the framework of the present work, the authors present the comparison of CAESAR experimental data with theoretical profiles provided in literature. The objective of this flight was to place several Propellant Management Devices (PMD) in a microgravity environment and acquire images of the fluid distribution around them. The main element of the experiment, called a sponge, is a PMD for space vehicles, often used in satellites. This radial panel shaped device can be used at the bottom of a satellite tank to keep the propellant near the outlet. It is designed to work even if the vehicle undergoes small accelerations, for example during station-keeping maneuvers. The fluid is eccentric but stays on the sponge and near the outlet, so the injection system of the motor is continuously supplied with the propellant. As previously published, the authors have created a buoyancy test bench and have designed another system by magnetic levitation to perform the same experiment on earth. These systems are easier to use and less expensive than a sounding rocket, a parabolic flight or a drop tower (i.e. other system to obtain microgravity on earth), so they will be very useful to make progress in this particular domain of science. They will also allow universities with small funds to work within this spatial field. A previous publication showed, from a qualitative point of view, a good agreement between experiments and theory; however in this paper quantitative comparisons are given. With this demonstrated, hepia can validate its buoyancy test facility with real flight tests.
Despite relatively generous coverage of the over-65 population, Danish home help services receive regular criticism in the media and public opinion polls. Perhaps as a consequence, reforms of Danish home care policy for senior citizens have placed a strong emphasis on quality since the 1990s. This reform strategy represents a shift from the welfare state modernisation programme of the 1980s, which built mainly on economic strategies of cost-efficiency and New Public Management principles, including contract management and performance management. Recent reforms have instead attempted to increase the overall quality of care by increasing the transparency at the political, administrative and user levels. However, reforms have revolved around the conflicting principles of standardisation and the individualisation of care provision. This approach has succeeded in increasing the political and administrative control over home help at the expense of the control by users, care workers and case managers.
A retrospective analysis of a societal experiment among the Danish population suggests that exposure to extra doses of vitamin A during fetal development may lower type 2 diabetes mellitus (T2DM) risk later in life.
Keller, Amélie; Ängquist, Lars; Jacobsen, Ramune; Vaag, Allan; Heitmann, Berit L
Vitamin A deficiency has been associated with impaired fetal pancreatic development and increased risk of developing type 2 diabetes mellitus (T2DM). In 1962, mandatory margarine fortification with vitamin A was increased by 25 % in Denmark. We aimed to determine whether offspring of mothers who had been exposed to the extra vitamin A from fortification during pregnancy had a lower risk of developing T2DM in adult life, compared with offspring of mothers exposed to less vitamin A. Individuals from birth cohorts with the higher prenatal vitamin A exposure (born 1 December 1962-31 March 1964) and those with lower prenatal exposure (born 1 September 1959-31 December 1960) were followed up with regard to development of T2DM before 31 December 2012 in the Danish National Diabetes Registry and National Patient Register. Logistic and Cox regression analyses were performed to determine the risk of T2DM by vitamin A exposure level. A total of 193 803 individuals were followed up until midlife. Our results showed that individuals exposed prenatally to extra vitamin A from fortified margarine had a lower risk of developing T2DM than those exposed to lower levels: OR 0·88; 95 % CI 0·81, 0·95, P=0·001, after adjustment for sex. Fetal exposure to small, extra amounts of vitamin A from food fortification may reduce the risk of T2DM. These results may have public health relevance, as they demonstrate that one of the most costly chronic diseases may be prevented by food fortification - a simple and affordable public health nutrition intervention.
Coulon, Frédéric; Jones, Kevin; Li, Hong; Hu, Qing; Gao, Jingyang; Li, Fasheng; Chen, Mengfang; Zhu, Yong-Guan; Liu, Rongxia; Liu, Ming; Canning, Kate; Harries, Nicola; Bardos, Paul; Nathanail, Paul; Sweeney, Rob; Middleton, David; Charnley, Maggie; Randall, Jeremy; Richell, Martin; Howard, Trevor; Martin, Ian; Spooner, Simon; Weeks, Jason; Cave, Mark; Yu, Fang; Zhang, Fang; Jiang, Ying; Longhurst, Phil; Prpich, George; Bewley, Richard; Abra, Jonathan; Pollard, Simon
There are a number of specific opportunities for UK and China to work together on contaminated land management issues as China lacks comprehensive and systematic planning for sustainable risk based land management, encompassing both contaminated soil and groundwater and recycling and reuse of soil. It also lacks comprehensive risk assessment systems, structures to support risk management decision making, processes for verification of remediation outcome, systems for record keeping and preservation and integration of contamination issues into land use planning, along with procedures for ensuring effective health and safety considerations during remediation projects, and effective evaluation of costs versus benefits and overall sustainability. A consequence of the absence of these overarching frameworks has been that remediation takes place on an ad hoc basis. At a specific site management level, China lacks capabilities in site investigation and consequent risk assessment systems, in particular related to conceptual modelling and risk evaluation. There is also a lack of shared experience of practical deployment of remediation technologies in China, analogous to the situation before the establishment of the independent, non-profit organisation CL:AIRE (Contaminated Land: Applications In Real Environments) in 1999 in the UK. Many local technology developments are at lab-scale or pilot-scale stage without being widely put into use. Therefore, a shared endeavour is needed to promote the development of technically and scientifically sound land management as well as soil and human health protection to improve the sustainability of the rapid urbanisation in China.
McDonnell, Diana D; Graham, Carrie L
In 2011 California began transitioning approximately 340,000 seniors and people with disabilities from Medicaid fee-for-service (FFS) to Medicaid managed care plans. When beneficiaries did not actively choose a managed care plan, the state assigned them to one using an algorithm based on their previous FFS primary and specialty care use. When no clear link could be established, beneficiaries were assigned by default to a managed care plan based on weighted randomization. In this article we report the results of a telephone survey of 1,521 seniors and people with disabilities enrolled in Medi-Cal (California Medicaid) and who were recently transitioned to a managed care plan. We found that 48 percent chose their own plan, 11 percent were assigned to a plan by algorithm, and 41 percent were assigned to a plan by default. People in the latter two categories reported being similarly less positive about their experiences compared to beneficiaries who actively chose a plan. Many states in addition to California are implementing mandatory transitions of Medicaid-only beneficiaries to managed care plans. Our results highlight the importance of encouraging beneficiaries to actively choose their health plan; when beneficiaries do not choose, states should employ robust intelligent assignment algorithms.
This article analyses the relationship between time and subjectification, focusing on the temporal structures created within Danish asylum centres and politics, and on children's experiences of and reactions to open-ended waiting. Such waiting leads to existential boredom which manifests in the children as restlessness, fatigue and despair. The…
Christensen, Mette Krogh; Sorensen, Jan Kahr
Today's young semi-professional football players are expected to continue their education while honing their talents as footballers. This means they must balance the contradictory demands that come from their education establishments and their football clubs. The present study explores how young Danish male football talents experience and describe…
Pederson, B. M.
A brief description of the Danish wind energy program and its present status is given. Results and experiences from tests on the Gedser windmill (200 kW) are presented. The key results are presented from the preliminary design study and detailed design of two new WECS (630 kW each) is described.
Rawson, Timothy M; Moore, Luke S P; Hernandez, Bernard; Castro-Sanchez, Enrique; Charani, Esmita; Georgiou, Pantelis; Ahmad, Raheelah; Holmes, Alison H
Objective To understand patient engagement with decision-making for infection management in secondary care and the consequences associated with current practices. Design A qualitative investigation using in-depth focus groups. Participants Fourteen members of the public who had received antimicrobials from secondary care in the preceding 12 months in the UK were identified for recruitment. Ten agreed to participate. All participants had experience of infection management in secondary care pathways across a variety of South-East England healthcare institutes. Study findings were subsequently tested through follow-up focus groups with 20 newly recruited citizens. Results Participants reported feelings of disempowerment during episodes of infection in secondary care. Information is communicated in a unilateral manner with individuals ‘told’ that they have an infection and will receive an antimicrobial (often unnamed), leading to loss of ownership, frustration, anxiety and ultimately distancing them from engaging with decision-making. This poor communication drives individuals to seek information from alternative sources, including online, which is associated with concerns over reliability and individualisation. Failures in communication and information provision by clinicians in secondary care influence individuals’ future ideas about infections and their management. This alters their future actions towards antimicrobials and can drive prescription non-adherence and loss to follow-up. Conclusions Current infection management and antimicrobial prescribing practices in secondary care fail to engage patients with the decision-making process. Secondary care physicians must not view infection management episodes as discrete events, but as cumulative experiences which have the potential to shape future patient behaviour and understanding of antimicrobial use. PMID:27799238
Burgarella, Sarah; Cattaneo, Dario; Masseroli, Marco
We developed MicroGen, a multi-database Web based system for managing all the information characterizing spotted microarray experiments. It supports information gathering and storing according to the Minimum Information About Microarray Experiments (MIAME) standard. It also allows easy sharing of information and data among all multidisciplinary actors involved in spotted microarray experiments. PMID:17238488
Burgarella, Sarah; Cattaneo, Dario; Masseroli, Marco
We developed MicroGen, a multi-database Web based system for managing all the information characterizing spotted microarray experiments. It supports information gathering and storing according to the Minimum Information About Microarray Experiments (MIAME) standard. It also allows easy sharing of information and data among all multidisciplinary actors involved in spotted microarray experiments.
Brooks, Erica A; Unruh, Anita; Lynch, Mary E
BACKGROUND: Chronic noncancer pain (CNCP) and prescription opioid use is a highly complex and growing health care issue in Canada. Many quantitative research studies have investigated the effectiveness of opioids for chronic pain; however, gaps remain in the literature regarding the personal experience of using opioids and their impact on those experiencing CNCP. OBJECTIVE: To explore the lived experience of adults using prescription opioids to manage CNCP, focusing on how opioid medication affected their daily lives. METHODS: In-depth qualitative interviews were conducted with nine adults between 40 and 68 years of age who were using prescription opioids daily for CNCP. Interviews were audiorecorded and transcribed, and subsequently analyzed using interpretive phenomenological analysis. RESULTS: Six major themes identified positive and negative aspects of opioid use associated with social, physical, emotional and psychological dimensions of pain management. These themes included the process of decision making, and physical and psychosocial consequences of using opioids including pharmacological side effects, feeling stigmatized, guilt, fears, ambivalence, self-protection and acceptance. CONCLUSION: Although there were many negative aspects to using opioids daily, the positive effects outweighed the negative for most participants and most of the negative aspects were socioculturally induced rather than caused by the drug itself. The present study highlighted the complexities involved in using prescription opioids daily for management of CNCP for individuals living with pain. PMID:25562838
Yon, Katherine; Walters, Kate; Lamahewa, Kethakie; Buszewicz, Marta
Objectives To explore junior doctors’ knowledge about and experiences of managing patients with medically unexplained symptoms (MUS) and to seek their recommendations for improved future training on this important topic about which they currently receive little education. Design Qualitative study using in-depth interviews analysed using the framework method. Setting Participants were recruited from three North Thames London hospitals within the UK. Participants Twenty-two junior doctors undertaking the UK foundation two-year training programme (FY1/FY2). Results The junior doctors interviewed identified a significant gap in their training on the topic of MUS, particularly in relation to their awareness of the topic, the appropriate level of investigations, possible psychological comorbidities, the formulation of suitable explanations for patients’ symptoms and longer term management strategies. Many junior doctors expressed feelings of anxiety, frustration and a self-perceived lack of competency in this area, and spoke of over-investigating patients or avoiding patient contact altogether due to the challenging nature of MUS and a difficulty in managing the accompanying uncertainty. They also identified the negative attitudes of some senior clinicians and potential role models towards patients with MUS as a factor contributing to their own attitudes and management choices. Most reported a need for more training during the foundation years, and recommended interactive case-based group discussions with a focus on providing meaningful explanations to patients for their symptoms. Conclusions There is an urgent need to improve postgraduate training about the topics of MUS and avoiding over-investigation, as current training does not equip junior doctors with the necessary knowledge and skills to effectively and confidently manage patients in these areas. Training needs to focus on practical skill development to increase clinical knowledge in areas such as delivering
Tsai, Laura Cordisco
This study explores the causal impact of independent management of household finances upon women's experiences of intimate partner violence (IPV) in the Philippines. Propensity score matching is used to generate a casual estimate of the impact of women's roles as household financial managers on their experiences of IPV. Findings demonstrate that managing household finances independently significantly increased the severity of IPV women experienced from their partners compared with women who managed finances jointly with partners. Findings reinforce the importance of explicit attention to intrahousehold power dynamics and gender norms in the implementation of microfinance interventions intended to empower women.
Leathwick, D M; Besier, R B
In many countries the presence of anthelmintic resistance in nematodes of small ruminants, and in some cases also in those infecting cattle and horses, has become the status quo rather than the exception. It is clear that consideration of anthelmintic resistance, and its management, should be an integral component of anthelmintic use regardless of country or host species. Many years of research into understanding the development and management of anthelmintic resistance in nematodes of small ruminants has resulted in an array of strategies for minimising selection for resistance and for dealing with it once it has developed. Importantly, many of these strategies are now supported by empirical science and some have been assessed and evaluated on commercial farms. In sheep the cost of resistance has been measured at about 10% of the value of the lamb at sale which means that losses due to undetected resistance far outweigh the cost of testing anthelmintic efficacy. Despite this many farmers still do not test for anthelmintic resistance on their farm. Many resistance management strategies have been developed and some of these have been tailored for specific environments and/or nematode species. However, in general, most strategies can be categorised as either; identify and mitigate high risk management practices, maintain an anthelmintic-susceptible population in refugia, choose the optimal anthelmintic (combinations and formulations), or prevent the introduction of resistant nematodes. Experiences with sheep farmers in both New Zealand and Australia indicate that acceptance and implementation of resistance management practices is relatively easy as long as the need to do so is clear and the recommended practices meet the farmer's criteria for practicality. A major difference between Australasia and many other countries is the availability and widespread acceptance of combination anthelmintics as a resistance management tool. The current situation in cattle and horses
Jacobson, R. B.; Gaeuman, D. A.; Elliott, C. M.; Johnson, H. E.; Laustrup, M. S.
Morphology of the highly engineered Lower Missouri River (Sioux City, Iowa to St. Louis, Missouri) is nearly independent of flow regime because channelization has greatly reduced opportunity for channel adjustment. Rehabilitation efforts have therefore focused on altering channel form directly rather than altering flow regime. Rehabilitation sites offer the potential for experimental studies to address geomorphic adjustments and tradeoffs in form and flow in river recovery. Implementation of experiments remains a challenge, however, because increased scientific understanding is not universally valued by all stakeholders participating in the adaptive management process. Nevertheless, some rehabilitation sites have been utilized for opportunistic geomorphic experiments. Engineered rehabilitation projects typically seek to increase diversity of habitats, with emphasis on increasing areas of shallow, slow current velocity that are much diminished from their historical extent and which are thought to be especially important to recovering ecological processes. Projects fall into two broad categories: those that increase width of the channel or diversity of habitats between the high banks, and those that create or re-create side-channel chutes. Early results from two contrasting experiments in side-channel chute development indicate that a) the experimentally uncontrolled sequence and magnitude of hydroclimatic events have a substantial effect on morphogenesis, and b) geomorphic and ecological responses are highly influenced by reach-scale spatial patterns of sediment and large-woody debris transport that determine fluxes into chutes. After less than a year of monitoring of channel-widening experiments, we have only preliminary results, but we have developed a keen appreciation for experimental approaches in an extremely dynamic and spatially diverse river. Particular challenges are developing robust, cost-effective, geomorphic performance metrics and designing
Campbell, Claudia R; Lomperis, Ana Maria Turner; Gillespie, Kathleen N; Arrington, Barbara
As a follow up to a school-wide initiative to create a common set of competencies for all degree programs in the Saint Louis University School of Public Health, in January 2000 the Department of Health Management and Policy (HMP, renamed from the Department of Health Administration in 2002) began a process to develop a competency-based curriculum for its Master of Health Administration (MHA) degree program with the goal of establishing a foundation for systematically measuring the learning outcomes of its students as they progressed through the program. This article describes how the department developed a set of competencies most appropriate for graduate training in healthcare management, how it incorporated these into its overall MHA program curriculum and content, and how effective this approach has been in measuring student progress in mastering these competencies over the first two years of this initiative. The problems and challenges encountered during this process are discussed, as are the next steps for effectively using competencies to assess healthcare management program learning outcomes. Our experience provides a model for other healthcare management programs considering using an outcomes approach for curriculum development and assessment.
Peltonen, Lasse; Sairinen, Rauno
The article examines the interlinkages between recent developments in conflict management and impact assessment procedures in the context of urban planning in Finland. It sets out by introducing the fields of impact assessment and conflict mediation. It then proceeds to discuss the development of impact assessment practices and the status of conflict mediation in Finnish land use planning. The case of Korteniitty infill development plan in Jyvaeskylae is used to demonstrate how the Finnish planning system operates in conflict situations - and how social impact assessment can contribute to managing planning conflicts. The authors ask how the processes of impact assessment contribute to conflict management. Based on the Finnish experience, it is argued that social impact assessment of land use plans can contribute to conflict management, especially in the absence of institutionalised conflict mediation processes. In addition, SIA may acquire features of conflict mediation, depending on extent and intensity of stakeholder participation in the process, and the quality of linkages it between knowledge production and decision-making. Simultaneously, conflict mediation practices and theoretical insights can inform the application of SIA to help it address land use conflicts more consciously.
Swift, J. A.; Pearce, J.; Jethwa, P. H.; Taylor, M. A.; Ellis, S.; McMullen, S.
The current emphasis on obstetric risk management helps to frame gestational weight gain as problematic and encourages intervention by healthcare professionals. However pregnant women have reported confusion, distrust, and negative effects associated with antenatal weight management interactions. The MAGIC study (MAnaging weiGht In pregnanCy) sought to examine women's self-reported experiences of usual-care antenatal weight management in early pregnancy and consider these alongside weight monitoring behaviours and future expectations. 193 women (18 yrs+) were recruited from routine antenatal clinics at the Nottingham University Hospital NHS Trust. Self-reported gestation was 10–27 weeks, with 41.5% (n = 80) between 12 and 14 and 43.0% (n = 83) between 20 and 22 weeks. At recruitment 50.3% of participants (n = 97) could be classified as overweight or obese. 69.4% of highest weight women (≥30 kg/m2) did not report receiving advice about weight, although they were significantly more likely compared to women with BMI < 30 kg/m2. The majority of women (regardless of BMI) did not express any barriers to being weighed and 40.8% reported weighing themselves at home. Women across the BMI categories expressed a desire for more engagement from healthcare professionals on the issue of bodyweight. Women are clearly not being served appropriately in the current situation which simultaneously problematizes and fails to offer constructive dialogue. PMID:27843648
Jaglal, Susan B.; Carroll, June; Hawker, Gillian; McIsaac, Warren J.; Jaakkimainen, Liisa; Cadarette, Suzanne M.; Cameron, Cathy; Davis, Dave
OBJECTIVE: To explore family physicians' experiences and perceptions of osteoporosis and to identify their educational needs in this area. DESIGN: Qualitative study using focus groups. SETTING: Four Ontario sites: one each in Thunder Bay and Timmins, and two in Toronto, chosen to represent a range of practice sizes, populations, locations, and use of bone densitometry. PARTICIPANTS: Thirty-two FPs participated in four focus groups. Physicians were identified by investigators or local contacts to provide maximum variation sampling. METHOD: Focus groups using a semistructured interview guide were audiotaped and transcribed. The constant comparative method of data analysis was used to identify key words and concepts until saturation of themes was reached. MAIN FINDINGS: Family physicians order bone densitometry and try to manage osteoporosis appropriately, but lack a rationale for testing and are confused about management. Participants' main concern was clinical management, followed by disease prevention and their educational needs. CONCLUSION: Family physicians are confused about how to manage osteoporosis. To reduce the burden of illness due to osteoporosis, educational interventions should be tailored to family physicians' needs. PMID:12729242
Zamanzadeh, Vahid; Ahmadi, Fazlollah; Behshid, Mozhgan; Irajpoor, Alireza; Zakeri-Milani, Parvin
Despite the effectiveness of pharmacotherapy for pain management in patients with osteoarthritis (OA), personal biases in the selection, administration, and continuation of pharmacotherapy challenge the proper management of symptoms and the effectiveness of the therapy. This study was conducted to carry out an in-depth examination of the experiences of patients with OA about their use of pharmacotherapy for the OA pain management and the existing challenges. The present qualitative study was conducted on 17 patients with OA, 5 of their family members and 8 healthcare personnel using a conventional content analysis approach. Data were collected through 35 interviews, which were unstructured at first but became semi-structured later on. Data collection continued until data saturation and analyzed simultaneously. The criteria used to determine the rigor of the study included the credibility, transferability, dependability and conformability of the data. The analysis of the data revealed 3 main categories and 8 subcategories. The main categories including preference for non-pharmacological modalities, preference for symptomatic slow-acting drugs for osteoarthritis (SySADOAs) and preference for vitamins and minerals. Briefing the patients on the therapeutic goals, participating them in the clinical decision-making process, modifying drug administration patterns through prescribing the minimum effective dosage and substituting alternative therapies whenever possible, consistently monitoring the therapeutic responses and any unexpected complications and use of complementary treatments, makes up strategies that can help improve OA pain management.
Nakatani, T.; Inamura, Y.; Moriyama, K.; Ito, T.; Muto, S.; Otomo, T.
Neutron scattering can be a powerful probe in the investigation of many phenomena in the materials and life sciences. The Materials and Life Science Experimental Facility (MLF) at the Japan Proton Accelerator Research Complex (J-PARC) is a leading center of experimental neutron science and boasts one of the most intense pulsed neutron sources in the world. The MLF currently has 18 experimental instruments in operation that support a wide variety of users from across a range of research fields. The instruments include optical elements, sample environment apparatus and detector systems that are controlled and monitored electronically throughout an experiment. Signals from these components and those from the neutron source are converted into a digital format by the data acquisition (DAQ) electronics and recorded as time-tagged event data in the DAQ computers using "DAQ-Middleware". Operating in event mode, the DAQ system produces extremely large data files (˜GB) under various measurement conditions. Simultaneously, the measurement meta-data indicating each measurement condition is recorded in XML format by the MLF control software framework "IROHA". These measurement event data and meta-data are collected in the MLF common storage and cataloged by the MLF Experimental Database (MLF EXP-DB) based on a commercial XML database. The system provides a web interface for users to manage and remotely analyze experimental data.
The assessment and management of wounds forms a large proportion of community nurses' workload, often requiring judgment and decision-making in complex, challenging and uncertain circumstances. The processes through which nurses form judgments and make decisions within this context are reviewed in this article against existing theories on these subjects. There is variability in wound assessment and management practice which may be attributed to uncertainties within the context, a lack of knowledge in appropriate treatment choices and the inability to correctly value the importance of the clinical information presented. Nurses may be required to draw on intuition to guide their judgments and decision-making by association with experience and expertise. In addition, a step-by-step analytical approach underpinned by an evidence base may be required to ensure accuracy in practice. Developing an understanding of the different theories of judgment and decision-making may facilitate nurses' abilities to reflect on their own decision tasks, thereby enhancing the care provided.
Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne; Foghmar, Sussie; Eichhorst, Regina; Prescott, Eva; Cerqueira, Charlotte; Soja, Anne Merete Boas; Gislason, Gunnar H; Larsen, Mogens Lytken; Andersen, Ulla Overgaard; Gustafsson, Ida; Thomsen, Kristian K; Boye Hansen, Lene; Hammer, Signe; Viggers, Lone; Christensen, Bo; Kvist, Birgitte; Lindström Egholm, Cecilie; May, Ole
Aim of database The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). Study population Hospitalized patients with CHD with stenosis on coronary angiography treated with percutaneous coronary intervention, coronary artery bypass grafting, or medication alone. Reporting is mandatory for all hospitals in Denmark delivering CR. The database was initially implemented in 2013 and was fully running from August 14, 2015, thus comprising data at a patient level from the latter date onward. Main variables Patient-level data are registered by clinicians at the time of entry to CR directly into an online system with simultaneous linkage to other central patient registers. Follow-up data are entered after 6 months. The main variables collected are related to key outcome and performance indicators of CR: referral and adherence, lifestyle, patient-related outcome measures, risk factor control, and medication. Program-level online data are collected every third year. Descriptive data Based on administrative data, approximately 14,000 patients with CHD are hospitalized at 35 hospitals annually, with 75% receiving one or more outpatient rehabilitation services by 2015. The database has not yet been running for a full year, which explains the use of approximations. Conclusion The DHRD is an online, national quality improvement database on CR, aimed at patients with CHD. Mandatory registration of data at both patient level as well as program level is done on the database. DHRD aims to systematically monitor the quality of CR over time, in order to improve the quality of CR throughout Denmark to benefit patients. PMID:27822083
Bleses, Dorthe; Vach, Werner; Slott, Malene; Wehberg, Sonja; Thomsen, Pia; Madsen, Thomas O.; Basboll, Hans
This paper presents a large-scale cross-sectional study of Danish children's early language acquisition based on the Danish adaptation of the "MacArthur-Bates Communicative Development Inventories" (CDI). Measures of validity and reliability imply that the Danish adaptation of the American CDI has been adjusted linguistically and culturally in…
Sarter, Nadine B.; Woods, David D.
Results are presented of two studies on the potential effect of cockpit automation on the pilot's performance, which provide data on pilots' difficulties with understanding and operating one of the core systems of cockpit automation, the Flight Management System (FMS). The results of both studies indicate that, although pilots do become proficient in standard FMS operations through ground training and subsequent flight experience, they still have difficulties tracking the FMS status and behavior in certain flight contexts and show gaps in the understanding of the functional structure of the system. The results suggest that design-related factors such as opaque interfaces contribute to these difficulties, which can affect the pilot's situation awareness.
Sundin, George W; Castiblanco, Luisa F; Yuan, Xiaochen; Zeng, Quan; Yang, Ching-Hong
Plant diseases caused by bacterial pathogens place major constraints on crop production and cause significant annual losses on a global scale. The attainment of consistent effective management of these diseases can be extremely difficult, and management potential is often affected by grower reliance on highly disease-susceptible cultivars because of consumer preferences, and by environmental conditions favouring pathogen development. New and emerging bacterial disease problems (e.g. zebra chip of potato) and established problems in new geographical regions (e.g. bacterial canker of kiwifruit in New Zealand) grab the headlines, but the list of bacterial disease problems with few effective management options is long. The ever-increasing global human population requires the continued stable production of a safe food supply with greater yields because of the shrinking areas of arable land. One major facet in the maintenance of the sustainability of crop production systems with predictable yields involves the identification and deployment of sustainable disease management solutions for bacterial diseases. In addition, the identification of novel management tactics has also come to the fore because of the increasing evolution of resistance to existing bactericides. A number of central research foci, involving basic research to identify critical pathogen targets for control, novel methodologies and methods of delivery, are emerging that will provide a strong basis for bacterial disease management into the future. Near-term solutions are desperately needed. Are there replacement materials for existing bactericides that can provide effective disease management under field conditions? Experience should inform the future. With prior knowledge of bactericide resistance issues evolving in pathogens, how will this affect the deployment of newer compounds and biological controls? Knowledge is critical. A comprehensive understanding of bacterial pathosystems is required to not
Cwiok, Mikolaj; Mankiewicz, Lech; Nawrocki, Krzysztof; Sokolowski, Marcin; Wrochna, Grzegorz
This paper describes PiMan, a CORBA based system manager of the "Pi of the Sky" experiment. The "Pi of the Sky" experiment, located at Las Campanas Observatory in Chile searches for rapidly changing optical objects such as Gamma Ray Bursts (GRB). The system is composed of two CCD cameras located on paralactic mount and operated by a PC, equipped with the dedicated software. The software, divided into modules that correspond to hardware or logical components, controls all aspects of data collection and on-line data analysis. The PiMan assures communication between modules, coordinates their behavior and gives possibility to operate the system automatically and to control it remotely over low bandwidth and unstable link.
Richter, D., Jr.
In a few decades, managers of Earth's Critical Zones (biota, humans, land, and water) will be challenged to double food and fiber production and diminish adverse effects of management on the wider environment. To meet these challenges, an array of scientific approaches is being used to increase understanding of Critical Zone functioning and evolution, and one amongst these approaches needs to be long-term soil field studies to move us beyond black boxing the belowground Critical Zone, i.e., to further understanding of processes driving changes in the soil environment. Long-term soil experiments (LTSEs) provide direct observations of soil change and functioning across time scales of decades, data critical for biological, biogeochemical, and environmental assessments of sustainability; for predictions of soil fertility, productivity, and soil-environment interactions; and for developing models at a wide range of temporal and spatial scales. Unfortunately, LTSEs globally are not in a good state, and they take years to mature, are vulnerable to loss, and even today remain to be fully inventoried. Of the 250 LTSEs in a web-based network, results demonstrate that soils and belowground Critical Zones are highly dynamic and responsive to human management. The objective of this study is to review the contemporary state of LTSEs and consider how they contribute to three open questions: (1) can soils sustain a doubling of food production in the coming decades without further impinging on the wider environment, (2) how do soils interact with the global C cycle, and (3) how can soil management establish greater control over nutrient cycling. While LTSEs produce significant data and perspectives for all three questions, there is on-going need and opportunity for reviews of the long-term soil-research base, for establishment of an efficiently run network of LTSEs aimed at sustainability and improving management control over C and nutrient cycling, and for research teams that
Roussel-Dupre, Diane C.; Bloch, Jeffrey J.; Ciskowski, Doug; Dingler, Robert; Little, Cindy; Kennison, Meg; Priedhorsky, William C.; Ryan, Sean; Warner, Richard
The Array of Low Energy X-ray Imaging Sensors (ALEXIS) satellite is Los Alamos' first attempt at building and flying a small, low cost, rapid development, technology demonstration and scientific space mission. The ALEXIS satellite contains the two experiments: the ALEXIS telescope array, (which consists of six EUV/ultrasoft x-ray telescopes utilizing multilayer mirrors, each with a 33 degree field-of-view), and VHF ionospheric experiment called BLACKBEARD. The spacecraft is controlled exclusively from a ground station located at Los Alamos. The 113-kg ALEXIS satellite was launched by a Pegasus booster into a 750 X 850 km, 70 degree inclination orbit on April 25, 1993. Due to damage sustained at the time of launch, ground controllers did not make contact with the satellite until late June. By late July, full satellite operations had been restored through the implementation of new procedures for attitude control. Science operations with the two onboard experiments began at that time. This paper will discuss our experience gained in launching and managing this small scientific and technology demonstration satellite.
Tseng, Chien-Ning; Huang, Guey-Shiun; Yu, Po-Jui; Lou, Meei-Fang
Background Incontinence is a common problem faced by family caregivers that is recognized as a major burden and predictor of institutionalization. However, few studies have evaluated the experiences of family caregivers caring for stroke survivors with incontinence. Purpose To describe experiences of caregivers managing incontinence in stroke survivors. Design This qualitative descriptive study employed a grounded-theory approach. Methods Semi-structured in-depth interviews with ten family caregivers of stroke survivors with incontinence were conducted during 2011. Audiotaped interviews were transcribed and analyzed using content analysis. Findings Data analysis identified four themes: chaos, hypervigilance, exhaustion, and creating a new life. There were nine related subcategories: fluster, dirtiness, urgency, fear of potential health-hazard, physically demanding and time-consuming, mentally draining, financial burden, learning by doing, and attitude adjustment. Together, these described a process of struggling to cope with the care of stroke survivors with urinary/fecal incontinence. Of the four categories, “creating a new life” developed gradually over time to orient caregivers to their new life, while the other three categories occurred in a chronological order. Conclusion The research highlighted unique caring experiences of family caregivers of stroke patients, which focused solely on the ‘incontinence issue’. Understanding these experiences may help nurses provide better support and resources for family caregivers when caring for stroke survivors with incontinence. PMID:26066345
Emis, Larry; Dillingham, John
Texas's online career portfolio management tool for high school students participating in supervised agricultural experience programs (SAEPs) was developed in 1998 by a committee of Texas high school teachers of agriscience and Texas Education Agency personnel. The career portfolio management tool reflects General Accepted Accounting Principles…
Estep, Leland; Spruce, Joseph P.
The central aim of this RPC (Rapid Prototyping Capability) experiment is to demonstrate the use of VIIRS (Visible/Infrared Imager/ Radiometer Suite and LDCM (Landsat Data Continuity Mission) sensors as key input to the RSM (Regional Sediment Management) GIS (geographic information system) DSS (Decision Support System). The project affects the Coastal Management National Application.
Deane, Frank P.; Tweedie, Rosemarie; van der Weyden, Chantelle; Cowlin, Feona
Unlicensed boarding houses provide low cost accommodation for many people who have mental health and/or alcohol or other drug problems. The present study explored the needs and experiences of owners and managers of unlicensed boarding houses who have residents with MH and AOD problems. Twenty-three boarding house managers (BHMs) from Illawarra and…
Foddai, Alessandro; Nielsen, Liza Rosenbaum; Krogh, Kaspar; Alban, Lis
Tuberculosis is a zoonosis caused by Mycobacterium spp. International trade in cattle is regulated with respect to Mycobacterium bovis (M. bovis) but not Mycobacterium tuberculosis (M. tuberculosis), despite that cattle can become infected with both species. In this study we estimated the annual probability (PIntro) of introducing M. tuberculosis into the Danish cattle population, by the import of cattle and/or by immigrants working in Danish cattle herds. Data from 2013 with date, number, and origin of imported live cattle were obtained from the Danish cattle database. Information on immigrants working in Danish cattle herds was obtained through a questionnaire sent to Danish cattle farmers. The gained inputs were fed into three stochastic scenario trees to assess the PIntro for the current and alternative test-and-manage strategies, such as testing of imported animals and/or testing immigrant workers with the tuberculin skin test. We considered the population of Danish farmers and practitioners free of tuberculosis, because in Denmark, the incidence of the disease in humans is low and primarily related to immigrants and socially disadvantaged people. The median annual probability of introducing M. tuberculosis into the Danish cattle population due to imported live cattle was 0.008% (90% P.I.: 0.0007%; 0.03%), while the probability due to immigrant workers was 4.1% (90% P.I.: 0.8%; 12.1%). The median combined probability (PIntro) due to imported cattle plus workers was 4.1% (90% P.I.: 0.8%; 12.6%). Hence, on average at least one introduction each 24 (90% P.I.: 8; 125) years could be expected. Imported live cattle appeared to play a marginal role on the overall annual PIntro, because they represented only approximately 0.2% of the median annual probability. By testing immigrant workers the overall annual PIntro could be reduced to 0.2% (90% P.I.: 0.04%; 0.7%). Thus, testing of immigrant workers could be considered as a risk mitigation strategy to markedly reduce
Sandberg, Jonathan; Trief, Paula M; Izquierdo, Roberto; Goland, Robin; Morin, Philip C; Palmas, Walter; Larson, Carly D; Strait, James G; Shea, Steven; Weinstock, Ruth S
Telehealth interventions are feasible and efficacious. While patients are the focus of both quantitative and qualitative studies that assess their response to telehealth, little is known about the view of providers of telehealth services. The purpose of this study was to better understand the experiences of providers and the factors that they perceive to contribute to the success of telehealth interventions as well as to their own satisfaction. Face-to-face or telephone interviews were conducted with 10 diabetes educators (nurses and dietitians) who served as providers of a telemedicine case management intervention for older adults who have diabetes. Qualitative analyses revealed that providers were very satisfied with their experience and felt their efforts with patients were generally successful. Providers also identified a number of unique benefits to telehealth interventions. These included opportunities for more frequent contact with patients, greater relaxation and information due to the ability to interact with the patients in their own homes, increased ability to reach the underserved, more timely and accurate medical monitoring, and improved management of data. The primary disadvantages of telehealth they identified were technology problems and a concern about the lack of physical contact with patients. Findings illustrate providers' perspectives on the unique advantages of telehealth and offer insight as to how to make telehealth interventions more effective, as well as more satisfying for those who do the day-to-day work of providing the interventions.
Zizzi, Sam; Kadushin, Peter; Michel, Jesse; Abildso, Christiaan
Compared with randomized trials, community-based interventions are delivered by a wider variety of professionals with varied training backgrounds. When evidence-based programs are scaled into larger formats and disseminated to a wider audience, little is understood about how clients experience these interventions. To understand the experience of clients after meetings with nutrition, exercise, and health behavior professionals, researchers surveyed participants after 6 months in a weight management program. A total of 958 participants were recruited in monthly cohorts beginning September 2011 to complete a program evaluation survey. Qualitative inductive analysis was completed on several open-text items querying respondents as to what they found helpful from meetings with a registered dietitian, personal trainer, and health behavior counselor. Results indicate participants benefitted from gaining knowledge, learning new behavioral skills, or from interpersonal interactions. Findings suggest that the various professional services are valued by clients and that professionals appear to stay within their scope of practice. Implications for those working in weight management are discussed.
Odemene, Glory C.
The Niger Delta crises escalated beyond the borders of the Nigerian nation to become an issue that affected individuals and corporations around the world. This study led to the discovery of how the local crises escalated with international implications. This discovery was accomplished by addressing how the Niger Delta crises escalated from villages to international scenes, with notable impacts on the environment, health, safety, security, and financial segments of local, international, private, and corporate entities. Using Sweeny's crisis decision theory and Lazarus and Folkman's coping theory, the study considered the coping strategies of community members, the decisions, and actions they took in response to the management approaches of the government and the oil and gas companies (OGCs). This qualitative study utilized historical narrative to collect data by interviewing 4 participants who lived and worked in the region during the crises. NVivo was used for manual and automatic coding of data, as well as for categorization and connection of codes. Content analysis of identified codes and categories revealed the themes and trends in the experiences narrated by participants. Findings include the root causes, trend of escalation, and management strategies of the government and the OGCs that influenced the crises. These findings will help to influence policies and practices in the region and enhance effective management of current and emerging conflicts, with possibilities of restoring stability and security in the areas and in the nation at large.
Hatzidakis, Adam A.; Alexandrakis, George; Kouroumalis, Helias; Gourtsoyiannis, Nicholas C.
Purpose: To present our experience performing percutaneous cholangioscopy in the management of 25 patients with biliary disease.Methods: During the last 3 years, 26 percutaneous cholangioscopies were performed in 25 patients with common bile duct disease (n = 16), intrahepatic ducts disease (n = 6), and gallbladder disease (n = 4). Our patient population group included seven with common bile duct stones, three with intrahepatic lithiasis, and eight with benign strictures (six iatrogenic and two postinflammatory). In four patients malignancy was to be excluded, in two the tumor extent was to be evaluated, whereas in one case the correct placement of a metallic stent needed to be controlled. A 9.9 Fr flexible endoscope URF-P (Olympus, 1.2 mm working channel, 70-cm length) was used.Results: In total, percutaneous cholangioscopy answered 30 diagnostic questions, was technically helpful in 19 cases (performing lithotripsy or biopsy or guiding a wire), and of therapeutic help in 12 (performing stone retrieval). In 24 of 26 cases the therapeutic decision and the patient management changed because of the findings or because of the help of the method. In two cases biliary intervention failed to treat the cause of the disease. No major complication due to the use of the endoscopy was noted.Conclusions: Percutaneous cholangioscopy is a very useful tool in the management of patients with biliary disease. The method can help in diagnosis, in performing complex interventional procedures, and in making or changing therapeutic decisions.
Posada, Rafael; Nascimento, Domingos; Neto, Francisco Osvaldo S.; Riede, Jens; Kaspar, Frank
The knowledge on climate variability in parts of Southern Africa is limited because of the low availability of historic and present-day ground-based observations (Niang et al., 2014). However, there is an increased need of climate information for research, climate adaptation measures and climate services. To respond to the challenges of climate change and related issues, Angola, Botswana, Germany, Namibia, South Africa and Zambia have initiated the interdisciplinary regional competence centre SASSCAL, the "Southern African Science Service Centre for Climate Change and Adaptive Land Management". As part of the initiative, Germany's national meteorological service (Deutscher Wetterdienst, DWD) cooperates with the meteorological services of Angola, Botswana and Zambia in order to improve the management and availability of historical and present-day climate data in these countries. The first results of the cooperation between the German and the Angolan Meteorological Services are presented here. International assessments have shown that improvements of the data management concepts are needed in several countries. The experience of this cooperation can therefore provide hints for comparable activities in other regions.
Efunkoya, Akinwale Adeyemi; Omeje, Kelvin Uchenna; Amole, Ibiyinka Olushola; Osunde, Otasowie Daniel; Akpasa, Izegboya Olohitae
Background: Cleft lip (CL) and palate (CLP) management is multidisciplinary. A cleft team was formed in a Nigerian Tertiary Hospital to address the health needs of cleft patients in the centre. Aim: This paper aims at documenting the Aminu Kano Teaching Hospital (AKTH) management protocol for orofacial clefts and also to review our experience with CLP surgeries performed at AKTH since our partnering with Smile Train. Materials and Methods: A retrospective review of all the cleft patients surgically treated from January 2006 to December 2014 under Smile Train sponsorship was undertaken. A descriptive narrative of the cleft team protocol was also given. Results: One hundred and fifty-five patients (80 males, 75 females) had surgical repairs of either the lip or palate. CL patients were 83 (53.55%), while CLP patients were 45 (29.03%) and isolated cleft palate patients were 27 (17.42%). Conclusion: The inclusion of various specialities in the cleft team is highly desirable. Poverty level amongst our patients frequently limits our management to surgical treatment sponsored by the Smile Train, despite the presence of other residual problems. PMID:26712291
Rogers, A; Kennedy, A; Nelson, E; Robinson, A
Background: Improving access is a key policy issue in improving quality of care and extending patient choice and participation. People's experience of changing from fixed outpatient appointments to more flexible direct access arrangements for chronic disease has been underexplored. Objectives: To examine patients' views on using an open system of access compared with fixed outpatient appointments as part of a guided self-management intervention for inflammatory bowel disease (IBD). Design: Embedded qualitative study undertaken alongside a randomised controlled trial. Semi-structured interviews were undertaken to obtain an in depth understanding of patients' experience of the change in access arrangements. Participants: A purposive sample (n = 30) was drawn from the intervention group (n = 700) according to a range of responses to the trial baseline and follow up quantitative measures. Results: 28 interviews were included in the analysis. Compared with the previous system of fixed appointments, preference for the new open access system was based on enhanced personal control in contacting services and the view that it fitted better with everyday routine management and the requirement for urgent medical contact when symptoms fail to respond to medication. Preference for retaining fixed appointments was based on a sense of security from gaining access which did not require the individual to initiate the request for medical help. Conclusions: Open access may fit better with patients' self-management of their condition and everyday routines, roles and responsibilities. Ensuring that outpatient organisational arrangements and personnel are responsive to patient initiated requests for appointments is likely to impact on the acceptability of this type of access arrangement. Some people may continue to prefer the fixed appointment system which should be retained if patient choice is to be respected. PMID:15465941
Nielsen, Mandy; Corbière, Marc; Franche, Reneé-Louise
Background Physical therapists have an active role in the rehabilitation of injured workers. However, regulations in Queensland, Australia, do not afford them the opportunity to participate in return-to-work (RTW) decisions in a standardized way. No prior research has explored the experiences and perceptions of therapists in determining work capacity. Objectives The aim of this study was to investigate physical therapists' experiences with and perspectives on their role in determining readiness for RTW and work capacity for patients receiving workers' compensation in Queensland. Design A qualitative design was used. Participants were physical therapists who manage injured workers. Methods Novice (n=5) and experienced (n=20) therapists managing patients receiving workers' compensation were selected through purposeful sampling to participate in a focus group or semistructured telephone interviews. Data obtained were audio-recorded and transcribed verbatim. Transcripts were thematically analyzed. Physical therapists' confidence in making RTW decisions was determined with 1 question scored on a 0 to 10 scale. Results Themes identified were: (1) physical therapists believe they are important in RTW, (2) physical therapists use a variety of methods to determine work capacity, and (3) physical therapists experience a lack of role clarity. Therapists made recommendations for RTW using clinical judgment informed by subjective and objective information gathered from the injured worker. Novice therapists were less confident in making RTW decisions. Conclusion Therapists are well situated to gather and interpret the information necessary to make RTW recommendations. Strategies targeting the Australian Physiotherapy Association, physical therapists, and the regulators are needed to standardize assessment of readiness for RTW, improve role clarity, and assist novice practitioners. PMID:22745200
Anderson, Bernhard H.; Miller, Daniel N.; Gridley, Marvin C.; Agrell, Johan
It is the purpose of this study to demonstrate the viability and economy of Design-of-Experiments methodologies to arrive at microscale secondary flow control array designs that maintain optimal inlet performance over a wide range of the mission variables and to explore how these statistical methods provide a better understanding of the management of flow in compact air vehicle inlets. These statistical design concepts were used to investigate the robustness properties of low unit strength micro-effector arrays. Low unit strength micro-effectors are micro-vanes set at very low angles-of-incidence with very long chord lengths. They were designed to influence the near wall inlet flow over an extended streamwise distance, and their advantage lies in low total pressure loss and high effectiveness in managing engine face distortion. The term robustness is used in this paper in the same sense as it is used in the industrial problem solving community. It refers to minimizing the effects of the hard-to-control factors that influence the development of a product or process. In Robustness Engineering, the effects of the hard-to-control factors are often called noise , and the hard-to-control factors themselves are referred to as the environmental variables or sometimes as the Taguchi noise variables. Hence Robust Optimization refers to minimizing the effects of the environmental or noise variables on the development (design) of a product or process. In the management of flow in compact inlets, the environmental or noise variables can be identified with the mission variables. Therefore this paper formulates a statistical design methodology that minimizes the impact of variations in the mission variables on inlet performance and demonstrates that these statistical design concepts can lead to simpler inlet flow management systems.
Health care organization in French hospitals has become an increasingly important issue, as efforts to ensure better cost control have increased financial constraints, as patients have demanded ever better results and quality, and as nurses' expectations for better working conditions have grown. Organizing a health care unit requires an articulation between individual efforts--necessary both for gathering accurate information on each patient and for providing patients with personalized care--as well as an integrated system of various logistics, specialized services such as nursing care, custodial care, technical examinations, and administrative procedures. Coordination between these different components continues to be a significant challenge to hospitals, as each category has developed independently its own specialty and sense of autonomy, resulting in different professional rationalities, cultures, approaches, and sometimes conflicting behaviour. Pointing out these difficulties is not sufficient to solve the problem, however, and since the management tools currently in use (activity measurements, procedures used to develop choices and judgements) are often kept in place for external reasons, they may actually perpetuate these behaviours. This paper is a set of reflections derived from a long period of experience and research in the management of French hospitals and health management institutions. It reports that the financial reforms implemented in budgeting procedures for French hospitals, and the efforts to control costs better in the national health insurance system, have resulted in new types of behaviour in physicians, nurses and health care managers, as well as the need for information that deals not only with health care activities but also with quality.
Recent Danish government proposals to increase the national and international mobility of scientists are reviewed, including a formalized sabbatical system in the universities, new rules for obtaining leaves of absence with or without salary, and plans for increased mobility between public and private sectors. (MSE)
Hansen, B.; Thorling, L.; Dalgaard, T.; Erlandsen, M.
This presentation assesses the long-term development in the oxic groundwater nitrate concentration and nitrogen (N) loss due to intensive farming in Denmark. Firstly, up to 20-year time-series from the national groundwater monitoring network enable a statistically systematic analysis of distribution, trends and trend reversals in the groundwater nitrate concentration. Secondly, knowledge about the N surplus in Danish agriculture since 1950 is used as an indicator of the potential loss of N. Thirdly, groundwater recharge CFC (Chlorofluorocarbon) age determination allows linking of the first two dataset. The development in the nitrate concentration of oxic groundwater clearly mirrors the development in the national agricultural N surplus, and a corresponding trend reversal is found in groundwater. Regulation and technical improvements in the intensive farming in Denmark have succeeded in decreasing the N surplus by 40% since the mid 1980s while at the same time maintaining crop yields and increasing the animal production of especially pigs. Trend analyses prove that the youngest (0-15 years old) oxic groundwater shows more pronounced significant downward nitrate trends (44%) than the oldest (25-50 years old) oxic groundwater (9%). This amounts to clear evidence of the effect of reduced nitrate leaching on groundwater nitrate concentrations in Denmark. Are the Danish groundwater monitoring strategy obtimal for detection of nitrate trends? Will the nitrate concentrations in Danish groundwater continue to decrease or are the Danish nitrate concentration levels now appropriate according to the Water Framework Directive?
Brostrom, Stig; Hansen, Ole Henrik
This article seeks to identify the relation between policy and lived life, for the small child in the Danish creche. To accomplish this, the article integrates demography, traditions, national curriculum and psychological, educational, and recent developments in research. It is an attempt to reveal knowledge and consequences, by conducting the…
Olsen, Tore Vincents
The Danish free school tradition has entailed a large degree of associational freedom for non-governmental schools, religious as well as non-religious. Until the late 1990s, the non-governmental schools were under no strict ideological or pedagogical limitations; they could recruit teachers and students according to their own value base, and were…
Martin, Nancy K.; Yin, Zenong; Mayall, Hayley
This study represents a continuation of research efforts to further refine the Attitudes and Beliefs on Classroom Control (ABCC) Inventory. The purposes of this study were to investigate the: (1) impact of classroom management training on classroom management style; (2) differences in attitudes toward classroom management between novice and…
Tomic, Stefan T; Janata, Petr
We provide a description of Ensemble, a suite of Web-integrated modules for managing and analyzing data associated with psychology experiments in a small research lab. The system delivers interfaces via a Web browser for creating and presenting simple surveys without the need to author Web pages and with little or no programming effort. The surveys may be extended by selecting and presenting auditory and/or visual stimuli with MATLAB and Flash to enable a wide range of psychophysical and cognitive experiments which do not require the recording of precise reaction times. Additionally, one is provided with the ability to administer and present experiments remotely. The software technologies employed by the various modules of Ensemble are MySQL, PHP, MATLAB, and Flash. The code for Ensemble is open source and available to the public, so that its functions can be readily extended by users. We describe the architecture of the system, the functionality of each module, and provide basic examples of the interfaces.
Bennike, S; Wikman, J M; Ottesen, L S
This article explores a new Danish football-based activity for health called Football Fitness (FF). Data are from quantitative and qualitative methods, and the theoretical framework for the analysis of the organizational form of FF is the theory of path dependency (Mahoney) and first- and second-order change (Watzlawick et al.). Theories of Pestoff concerning differences between state, market, and the civil society and theories of voluntary associations in a Danish context (Kaspersen & Ottesen; Ibsen & Seippel) are applied. This article indicates how FF is a result of the changing landscape of sport and argues that it can be beneficial to target sports organizations and include the expertise of non-profit sports clubs if the goal is to raise the physical activity level of the local community and make these long lasting. But the organizations need to consider how this is to be done. FF, established by the Danish Football Association (FA) and managed by the voluntary clubs, is one example in a Danish context. Data indicate that FF is beneficial to the clubs involved in a number of ways. Among other things, it attracts new user groups and improves the club environment, including social activities and parental environment.
Jensen, F P; Fenger, J
The Danish air pollution abatement is based by and large on emission control. Since the ratification of the international sulfur protocol of 1985, there has been a continuous tightening of the permissible sulfur content in fuels and of the maximum emissions from power plants. As a consequence, the total annual emission of sulfur dioxide (SO2) has been reduced from 450,000 tons in the seventies to 180,000 tons in 1990. This has had a pronounced effect on the SO2 levels in Danish urban areas. Thus, in Copenhagen, the yearly averages have fallen to about 25%. For nitrogen oxides emitted from the power plants, similar regulations are in force. With this legislation, the most important and crucial source of air pollution in Danish urban areas is road traffic. The contribution of nitrogen oxides from national traffic accounts for nearly half the total Danish emission and is increasing steadily; this is consistent with an observed increase of nitrogen oxides in ambient air. The permissible levels of lead in petrol has been reduced drastically. After an introduction of reduced tax on lead-free petrol, it now accounts for more than two-thirds of the total consumption. As a result, the concentration of lead in urban ambient air has been reduced to less than one-sixth. The introduction of 3-way catalytic converters from October 1990 will result in reductions in the emission of a series of pollutants, e.g., lead, volatile organic compounds, carbon monoxide, and nitrogen oxides. In 1980, a Danish air quality monitoring program was established as a cooperative effort between the authorities, the Government, the countries, the municipalities, and the Greater Copenhagen Council.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7821296
Gimsing, Peter; Holmström, Morten O; Klausen, Tobias Wirenfelt; Andersen, Niels Frost; Gregersen, Henrik; Pedersen, Robert Schou; Plesner, Torben; Pedersen, Per Trøllund; Frederiksen, Mikael; Frølund, Ulf; Helleberg, Carsten; Vangsted, Annette; de Nully Brown, Peter; Abildgaard, Niels
Aim The Danish National Multiple Myeloma Registry (DMMR) is a population-based clinical quality database established in January 2005. The primary aim of the database is to ensure that diagnosis and treatment of plasma cell dyscrasia are of uniform quality throughout the country. Another aim is to support research. Patients are registered with their unique Danish personal identification number, and the combined use of DMMR, other Danish National registries, and the Danish National Cancer Biobank offers a unique platform for population-based translational research. Study population All newly diagnosed patients with multiple myeloma (MM), smoldering MM, solitary plasmacytomas, and plasma cell leukemia in Denmark are registered annually; ~350 patients. Amyloid light-chain amyloidosis, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome), monoclonal gammopathy of undetermined significance and monoclonal gammopathy of undetermined significance with polyneuropathy have been registered since 2014. Main variables The main registered variables at diagnosis are patient demographics, baseline disease characteristics, myeloma-defining events, clinical complications, prognostics, first- and second-line treatments, treatment responses, progression free, and overall survival. Descriptive data Up to June 2015, 2,907 newly diagnosed patients with MM, 485 patients with smoldering MM, 64 patients with plasma cell leukemia, and 191 patients with solitary plasmacytomas were registered. Registration completeness of new patients is ~100%. A data validation study performed in 2013–2014 by the Danish Myeloma Study Group showed >95% data correctness. Conclusion The DMMR is a population-based data validated database eligible for clinical, epidemiological, and translational research. PMID:27822103
Background In the last decade, a large amount of microarray gene expression data has been accumulated in public repositories. Integrating and analyzing high-throughput gene expression data have become key activities for exploring gene functions, gene networks and biological pathways. Effectively utilizing these invaluable microarray data remains challenging due to a lack of powerful tools to integrate large-scale gene-expression information across diverse experiments and to search and visualize a large number of gene-expression data points. Results Gene Expression Browser is a microarray data integration, management and processing system with web-based search and visualization functions. An innovative method has been developed to define a treatment over a control for every microarray experiment to standardize and make microarray data from different experiments homogeneous. In the browser, data are pre-processed offline and the resulting data points are visualized online with a 2-layer dynamic web display. Users can view all treatments over control that affect the expression of a selected gene via Gene View, and view all genes that change in a selected treatment over control via treatment over control View. Users can also check the changes of expression profiles of a set of either the treatments over control or genes via Slide View. In addition, the relationships between genes and treatments over control are computed according to gene expression ratio and are shown as co-responsive genes and co-regulation treatments over control. Conclusion Gene Expression Browser is composed of a set of software tools, including a data extraction tool, a microarray data-management system, a data-annotation tool, a microarray data-processing pipeline, and a data search & visualization tool. The browser is deployed as a free public web service (http://www.ExpressionBrowser.com) that integrates 301 ATH1 gene microarray experiments from public data repositories (viz. the Gene
Merino, F.; Oneill, R. F.
The Cryogenic Fluid Management Experiment (CFME) was analyzed to assess the feasibility and advisability of deleting the vapor cooled shield (VCS) from the baseline CFME insulation and pressure control system. Two alternate concepts of CFME insulation and pressure control, neither of which incorporated the VCS, were investigated. The first concept employed a thermodynamic vent system (TVS) to throttle the flow through an internal wall mounted heat exchanger (HX) within the pressure vessel to decrease boiloff and pressure rise rate, while the second concept utilized a TVS without an internal heat exchanger. Only the first concept was viable. Its performance was assessed for a seven day mission and found to be satisfactory. It was also concluded that VCS development costs would be greater than for an internal HX installation. Based upon the above comparisons, the HX was recommended as a replacement for the VCS.
Kääriäinen, Jukka; Välimäki, Antti
In this paper we present an industrial study about the history of Application Lifecycle Management (ALM) improvement in a case company. The study is part of broader research with the aim to improve global development in a company. The improvement of ALM started three years ago when the company decided to acquire a commercial ALM solution. Two SW teams developing different kinds of SW products started to pilot the solution and after various steps ended up with fairly different ALM solutions. This paper concludes the history and experiences of ALM improvement and discusses the reasons why two teams ended up with different solutions. The improvement of ALM solutions has been facilitated with the use of an ALM framework.
Gowing, Alice; Dickinson, Claire; Gorman, Tom; Robinson, Louise; Duncan, Rachel
Objectives To explore the views and experiences of patients on the care they have received while enrolled on the Northumberland High Risk Patient Programme (NHRPP). This programme involved case finding of frail patients using a multidisciplinary team (MDT)-led community case management programme, and support of patients through care planning and regular reviews using primary, community, secondary and social care professionals. Design A qualitative study using semistructured interviews, which were digitally recorded, transcribed and subject to thematic analysis. Setting Community patients receiving primary care in the county of Northumberland, England. Participants 23 participants took part, of which 16 were patients enrolled on the NHRPP, and 7 carers. GP practices were selected purposively by size, deprivation and location, and patients identified and invited by General Practitioners to participate. Results 4 main themes emerged from the data: awareness and understanding of the NHRPP, confidence in the primary healthcare team, limitations of home care and the active role of being a patient. Despite having a low level of awareness of the details of the NHRPP, participants did think that its broad aim made sense. Participants discussed their high level of satisfaction with their care and access to team members. However, some limitations of alternatives to hospital care were identified, including the need to consider psychological as well as medical needs, the importance of overnight care and the needs of those without informal carers. Finally, participants discussed the active nature of being a patient under the NHRPP if they were to contribute fully to planning and managing their own care. Conclusions This study has identified that a programme of MDT-led case management was generally very well received by patients and their families. However, a number of factors were identified that could improve the implementation of the programme and further research needs to be
Noble, Adam J; Snape, Darlene; Goodacre, Steve; Jackson, Mike; Sherratt, Frances C; Pearson, Mike; Marson, Anthony
Objectives The UK ambulance service is expected to now manage more patients in the community and avoid unnecessary transportations to hospital emergency departments (ED). Most people it attends who have experienced seizures have established epilepsy, have experienced uncomplicated seizures and so do not require the full facilities of an ED. Despite this, most are transported there. To understand why, we explored paramedics’ experiences of managing seizures. Design and setting Semistructured interviews were conducted with a purposive sample of paramedics from the English ambulance service. Interviews were transcribed and thematically analysed. Participants A diverse sample of 19 professionals was recruited from 5 different ambulance NHS trusts and the College of Paramedics. Results Participants’ confirmed how most seizure patients attended to do not clinically require an ED. They explained, however, that a number of factors influence their care decisions and create a momentum for these patients to still be taken. Of particular importance was the lack of access paramedics have to background medical information on patients. This, and the limited seizure training paramedics receive, meant paramedics often cannot interpret with confidence the normality of a seizure presentation and so transport patients out of precaution. The restricted time paramedics are expected to spend ‘on scene’ due to the way the ambulance services’ performance is measured and that are few alternative care pathways which can be used for seizure patients also made conveyance likely. Conclusions Paramedics are working within a system that does not currently facilitate non-conveyance of seizure patients. Organisational, structural, professional and educational factors impact care decisions and means transportation to ED remains the default option. Improving paramedics access to medical histories, their seizure management training and developing performance measures for the service that
Marvin-DiPasquale, M. C.; Windham-Myers, L.; Fleck, J.; McQuillen, H.
Wetlands are important areas for methylmercury (MeHg) production and export to adjacent water bodies, and yet are also critical for wildlife and healthy ecosystem function. Thus, preserving or restoring wetland habitat, while limiting MeHg export, provides a unique challenge to wetland managers. This study examined how wetland design and the use of strategically located deep cells could reduce MeHg export. The study area consisted of eight ~10 hectare leveed fields, annually flooded (4-20 cm) during mid-September thru late April to promote waterfowl habitat. In four 'treatment' fields, 20% of the area (~2 hectare) at the outflow end was excavated to a depth of ~1 m, while no elevation adjustments were made in the four remaining 'control' fields. We examined 3 potential mechanisms of MeHg removal in the deep cell areas of the treatment fields (particulate flux to the benthos, benthic demethylation, and photo-demethylation), and compared MeHg export between control and treatment fields. Particulate depositional flux was high across all deep cells (3.5-8.9 g particles/m2/d dry wt.; 25-75% quartile, n=211), as assessed with deposition pads deployed prior to and retrieved after flooding. This compared well to three separate short-term (24 hr) deposition experiments (1.6-4.7 g particles/m2/d dry wt.; 25-75% quartile, n=48) used to assess particulate MeHg depositional flux (7.6-25.5 ng MeHg/m2/d dry wt.; 25-75% quartile, n=48). With additional results pending, this presentation will describe the relative contribution of the above three MeHg removal processes, the MeHg export from treatment vs control fields, and the overall effectiveness of this wetland management option using deep water cells for reducing MeHg export from managed wetlands to adjacent water bodies.
The assessment and management of wounds forms a large proportion of community nurses' workload, often requiring judgment and decision-making in complex, challenging and uncertain circumstances. The processes through which nurses form judgments and make decisions within this context are reviewed in this article against existing theories on these on these subjects. There is variability in wound assessment and management practice which may be attributed to uncertainties within the context, a lack of knowledge in appropriate treatment choices and the inability to correctly value the importance of the clinical information presented. Nurses may be required to draw on intuition to guide their judgments and decision-making by association with experience and expertise. In addition, a step-by-step analytical approach underpinned by an evidence base may be required to ensure accuracy in practice. Developing an understanding of the different theories of judgment and decision-making may facilitate nurses' abilities to reflect on their own decision tasks, thereby enhancing the care provided.
Trimpl, M.; Deptuch, G.; Gingu, C.; Yarema, R.; Holt, R.; Weber, M.; Kierstead, J.; Lynn, D.; /Brookhaven
Serial powering is one viable and very efficient way to distribute power to future high energy physics (HEP) experiments. One promising way to realize serial powering is to have a power management device on the module level that provides the necessary voltage levels and features monitoring functionality. The SPi (Serial Powering Interface) chip is such a power manager and is designed to meet the requirements imposed by current SLHC upgrade plans. It incorporates a programmable shunt regulator, two linear regulators, current mode ADCs to monitor the current distribution on the module, over-current detection, and also provides module power-down capabilities. Compared to serially powered setups that use discrete components, the SPi offers a higher level of functionality in much less real estate and is designed to be radiation tolerant. Bump bonding techniques are used for chip on board assembly providing the most reliable connection at lowest impedance. This paper gives an overview of the SPi and outlines the main building blocks of the chip. First stand alone tests are presented showing that the chip is ready for operation in serially powered setups.
Mohamed, Sara; Favrod, Vincent; Philippe, Roberta Antonini; Hauw, Denis
The aim of this study was to determine how risks associated with skydiving can be managed within acceptable limits. Using “Course-of-Action” theory described by Theureau, four experienced skydivers viewed recordings of their jumps, from preparation to landing, to elicit their perceptions of these experiences. The sequences dealing with safety concerns were then extracted. Data analysis revealed seven typical sequences of activity to manage safety, labeled “To check the material during preparation,” “To feel prepared and safe for the jump as the plane gains altitude,” “To use the time of freefall,” “To deploy the parachute,” “To fly safely,” “To ensure a safe landing” and “To organize the structured packing of the parachute.” These results showed how the skydivers mitigated safety risks through a heightened awareness of critical elements in the unfolding jump activity and sequences of distributed and timed concerns and actions. The implications for accident analysis, prevention and education for training in risky sports activity are provided. Key points The skydivers’ activity could be broken down into seven safety sequences. Each safety sequence was defined by specific involvements and directions at the very moment of the situation. Skydivers’ safety concerns are embedded in the succession of two types of temporal horizon organization: immediate and short-term. PMID:25983583
Sarasua, Irene; Clausen, Christina; Frunchak, Valerie
The purpose of this study was to examine the experiences on mothers with regard to the breastfeeding support and management provided by healthcare professionals on an acute care postpartum unit in a multiethnic obstetrical referral center in Montreal, Canada. The study survey was largely based on the UNICEF/World Health Organization's (1998) ten steps to successful breastfeeding. The convenience sample included 60 recently-delivered mothers. Findings indicated that primiparous women and women who delivered by caesarean section consistently received more information about breastfeeding management than multiparous women and women who delivered vaginally. However, the study does suggest that all women, regardless of parity or type of delivery, have information and support needs related to breastfeeding. A total of 29 mothers (67%), who intended to breastfeed exclusively, supplemented with artificial baby milk. Of these mothers, 16 (55%) stated 'milk insufficiency' as their primary reasons for supplementing. Overall, respondents perceived healthcare professionals to be encouraging of breastfeeding, and 48 mothers (80%) were 'moderately' to 'very' satisfied with the breastfeeding education and support received. These findings suggest that overall adherence to breastfeeding best practices in the current study hospital are below targets set by the World Health Organization for 'Baby Friendly' status. Results from the study can be used to target areas for improvement.
Mohamed, Sara; Favrod, Vincent; Philippe, Roberta Antonini; Hauw, Denis
The aim of this study was to determine how risks associated with skydiving can be managed within acceptable limits. Using "Course-of-Action" theory described by Theureau, four experienced skydivers viewed recordings of their jumps, from preparation to landing, to elicit their perceptions of these experiences. The sequences dealing with safety concerns were then extracted. Data analysis revealed seven typical sequences of activity to manage safety, labeled "To check the material during preparation," "To feel prepared and safe for the jump as the plane gains altitude," "To use the time of freefall," "To deploy the parachute," "To fly safely," "To ensure a safe landing" and "To organize the structured packing of the parachute." These results showed how the skydivers mitigated safety risks through a heightened awareness of critical elements in the unfolding jump activity and sequences of distributed and timed concerns and actions. The implications for accident analysis, prevention and education for training in risky sports activity are provided. Key pointsThe skydivers' activity could be broken down into seven safety sequences.Each safety sequence was defined by specific involvements and directions at the very moment of the situation.Skydivers' safety concerns are embedded in the succession of two types of temporal horizon organization: immediate and short-term.
Choudhury, S.; Duerr, R. E.; Mayernik, M. S.; DiLauro, T.; Metsger, E.; Rippin, M.; Pralle, B.
The Data Conservancy is a growing community organized around data curation research, technology development, and community building. Initially funded by the National Science Foundation's DataNet program, the Data Conservancy is headquartered at the Sheridan Libraries, Johns Hopkins University. Data Conservancy community members include university libraries, national data centers, national research labs, and information science research and education programs. The Data Conservancy Community is driven by a common theme: the need for Institutional solutions to digital research data collection, curation and preservation challenges. While firmly convinced that data curation solutions for research institutions must address both technical and organizational challenges, a significant activity within the community is the shared development of curation cyberinfrastructure. Despite many challenges, an alpha release of the Data Conservancy software (DCS) stack was publicly released at the end of August this year. While components of the DCS stack are being used by other projects, this first instantiation of the DCS is in use at two institutions, as the technical underpinnings of the Johns Hopkins University Data Management Services (JHU DMS) and at the National Snow and Ice Data Center (NSIDC) where it is being used to manage data from the Exchange for Local and Traditional Knowledge of the Arctic (ELOKA). Here we briefly provide an overview of the DCS system, describe our early experiences with the two instances of the DCS, and discuss our plans and the roadmap for the future of the Data Conservancy.
Yohannes, Abebaw Mengistu
Up to 40% of patients with chronic obstructive pulmonary disease (COPD) suffer from comorbid depression. However, there is little data available on the perceptions and experiences of general practitioners (GPs) on the management of depression in patients with COPD. The study investigated GPs' views about recognizing and treating depression in patients with COPD. A postal survey of 3957 GPs in England about their views on recognizing and treating depression in patients with COPD was conducted. Participants were drawn from the General Medical Services statistics database maintained by the Department of Health. A total of 3957 GPs were mailed. Of these, 857 (22%) complete responses were received. Seventy two percent of the GPs reported screening for depression regularly in patients with COPD. Over 95% of the GPs' views were that depression interferes with the self-management of COPD and 584 (67%) thought that it exacerbates the symptoms of COPD. However, over two-fifths of GPs were concerned that convincing COPD patients with comorbid depression to receive appropriate treatment was a challenge. Barriers for treatment of comorbid depression in patients with COPD include lack of adequate provision of psychological services and long waiting times for psychological treatment. It is encouraging that most GPs were vigilant and proactively screening for depression. However, there is limited immediate access and provision to psychological therapies to refer COPD patients for treatment in the primary care setting. Further study is required.
Lecoanet, André; Sellier, Elodie; Carpentier, Françoise; Maignan, Maxime; Seigneurin, Arnaud; François, Patrice
Objective Emergency departments are high-risk structures. The objective was to analyse the functioning of an experience feedback committee (EFC), a security management tool for the analysis of incidents in a medical department. Methods We conducted a descriptive study based on the analysis of the written documents produced by the EFC between November 2009 and May 2012. We performed a double analysis of all incident reports, meeting minutes and analysis reports. Results During the study period, there were 22 meetings attended by 15 professionals. 471 reported incidents were transmitted to the EFC. Most of them (95%) had no consequence for the patients. Only one reported incident led to the patient's death. 12 incidents were analysed thoroughly and the committee decided to set up 14 corrective actions, including eight guideline writing actions, two staff trainings, two resource materials provisions and two organisational changes. Conclusions The staff took part actively in the EFC. Following the analysis of incidents, the EFC was able to set up actions at the departmental level. Thus, an EFC seems to be an appropriate security management tool for an emergency department. PMID:23964063
Naftz, D. L.; Yahnke, J.; Miller, J.; Noyes, S.
Constructed and natural wetlands can accumulate elevated levels of selenium (Se); however, few data are available on cost-effective methods for remobilization and removal of Se from these areas. The experiment was conducted at Stewart Lake Waterfowl Management Area (SLWMA), a Se-contaminated wetland in northeastern Utah. The purpose of the experiment was to assess the effectiveness of flooding on the removal of Se from surface sediments and transport to the chemically reducing ground water 1.8 meters (m) below land surface. The 84-m2 flood-experiment plot contained 10 monitoring wells, a water-quality minimonitor (continuous measurement of pH, specific conductance, water temperature, and dissolved oxygen), a down-hole bromide (Br) electrode, and 2 pressure transducers. Flooding was initiated on August 27, 2002, and a Br tracer was added to water delivered through a pipeline to the flood plot. Standing water depth in the flood plot was maintained at 0.3 m through September 1, 2002. Mean vertical water velocities were estimated to range from 0.3 to 1.3 centimeters per hour. Dissolved (less than 0.45 micron) Se increased from pre-flood concentrations of less than 10 micrograms per liter (ug/L) to greater than 800 ug/L during flooding in samples from deep (1.8 m below land surface) ground water. Se concentrations exceeded 5,500 ug/L in samples from shallow (0.8 m below land surface) ground water. Ratios of Se to Br in water samples indicate that Se moved conservatively during the experiment and was derived from leaching of near-surface sediments. Cumulative Se flux to the deep ground water during the experiment ranged from 54.9 to 172 milligrams per square meter (mg/m2). Pre- and post-flood surface soil sampling indicated a mean Se flux of 750 mg/m2 through the top 15 centimeters of soil. Measurable Se flux to the deep ground water would have increased if the flood experiment had continued beyond September 1, 2002. Water samples from the deep ground water collected in
Background Coronary heart disease is an incurable condition. The only approach known to slow its progression is healthy lifestyle change and concordance with cardio-protective medicines. Few people fully succeed in these daily activities so potential health improvements are not fully realised. Little is known about peoples’ experiences of managing lifestyle change. The aim of this study was to synthesise qualitative research to explain how participants make lifestyle change after a cardiac event and explore this within the wider illness experience. Methods A qualitative synthesis was conducted drawing upon the principles of meta-ethnography. Qualitative studies were identified through a systematic search of 7 databases using explicit criteria. Key concepts were identified and translated across studies. Findings were discussed and diagrammed during a series of audiotaped meetings. Results The final synthesis is grounded in findings from 27 studies, with over 500 participants (56% male) across 8 countries. All participants experienced a change in their self-identity from what was ‘familiar’ to ‘unfamiliar’. The transition process involved ‘finding new limits and a life worth living’ , ‘finding support for self’ and ‘finding a new normal’. Analyses of these concepts led to the generation of a third order construct, namely an ongoing process of ‘reassessing past, present and future lives’ as participants considered their changed identity. Participants experienced a strong urge to get back to ‘normal’. Support from family and friends could enable or constrain life change and lifestyle changes. Lifestyle change was but one small part of a wider ‘life’ change that occurred. Conclusions The final synthesis presents an interpretation, not evident in the primary studies, of a person-centred model to explain how lifestyle change is situated within ‘wider’ life changes. The magnitude of individual responses to a changed health status
Gilliam, Eric; Thompson, Megan; Griend, Joseph Vande
Objective. To develop a community pharmacy-based medication therapy management (MTM) advanced pharmacy practice experience (APPE) that provides students with skills and knowledge to deliver entry-level pharmacy MTM services. Design. The University of Colorado Skaggs School of Pharmacy & Pharmaceutical Sciences (SSPPS) partnered with three community pharmacy chains to establish this three-week, required MTM APPE. Students completed the American Pharmacists Association MTM Certificate Course prior to entering the APPE. Students were expected to spend 90% or more of their time at this experience working on MTM interventions, using store MTM platforms. Assessment. All 151 students successfully completed this MTM APPE, and each received a passing evaluation from their preceptor. Preceptor evaluations of students averaged above four (entry-level practice) on a five-point Likert scale. The majority of students reported engagement in MTM services for more than 80% of the time on site. Students’ self-reporting of their ability to perform MTM interventions improved after participation in the APPE. Conclusion. The SSPPS successfully implemented a required MTM APPE, preparing students for entry-level delivery of MTM services. PMID:28381896
Baxley, Brian T.; Wilson, Sara R.; Swieringa, Kurt A.; Roper, Roy D.
Interval Management Alternative Clearances (IMAC) was a human-in-the-loop simulation experiment conducted to explore the efficacy and acceptability of three IM operations: CAPTURE, CROSS, and MAINTAIN. Two weeks of data collection were conducted, with each week using twelve subject pilots and four subject controllers flying ten high-density arrival scenarios into the Denver International Airport. Overall, both the IM operations and procedures were rated very favorably by the flight crew in terms of acceptability, workload, and pilot head down time. However, several critical issues were identified requiring resolution prior to real-world implementation, including the high frequency of IM speed commands, IM speed commands requiring changes to aircraft configuration, and ambiguous IM cockpit displays that did not trigger the intended pilot reaction. The results from this experiment will be used to prepare for a flight test in 2017, and to support the development of an advanced IM concept of operations by the FAA (Federal Aviation Agency) and aviation industry.
Donno, F.; Abadie, L.; Badino, P.; Baud, J.-P.; Corso, E.; Witt, S. D.; Fuhrmann, P.; Gu, J.; Koblitz, B.; Lemaitre, S.; Litmaath, M.; Litvintsev, D.; Presti, G. L.; Magnoni, L.; McCance, G.; Mkrtchan, T.; Mollon, R.; Natarajan, V.; Perelmutov, T.; Petravick, D.; Shoshani, A.; Sim, A.; Smith, D.; Tedesco, P.; Zappi, R.
Storage Services are crucial components of the Worldwide LHC Computing Grid Infrastructure spanning more than 200 sites and serving computing and storage resources to the High Energy Physics LHC communities. Up to tens of Petabytes of data are collected every year by the four LHC experiments at CERN. To process these large data volumes it is important to establish a protocol and a very efficient interface to the various storage solutions adopted by the WLCG sites. In this work we report on the experience acquired during the definition of the Storage Resource Manager v2.2 protocol. In particular, we focus on the study performed to enhance the interface and make it suitable for use by the WLCG communities. At the moment 5 different storage solutions implement the SRM v2.2 interface: BeStMan (LBNL), CASTOR (CERN and RAL), dCache (DESY and FNAL), DPM (CERN), and StoRM (INFN and ICTP). After a detailed inside review of the protocol, various test suites have been written identifying the most effective set of tests: the S2 test suite from CERN and the SRM-Tester test suite from LBNL. Such test suites have helped verifying the consistency and coherence of the proposed protocol and validating existing implementations. We conclude our work describing the results achieved.
Bernacki, Edward J; Tsai, Shan P
This work presents 10 years of experience using an Integrated Workers' Compensation Claims Management System that allows safety professionals, adjusters, and selected medical and nursing providers to collaborate in a process of preventing accidents and expeditiously assessing, treating, and returning individuals to productive work. The hallmarks of the program involve patient advocacy and customer service, steerage of injured employees to a small network of physicians, close follow-up, and the continuous dialogue between parties regarding claims management. The integrated claims management system was instituted in fiscal year 1992 servicing a population of approximately 21,000 individuals. The system was periodically refined and by the 2002 fiscal year, 39,000 individuals were managed under this paradigm. The frequency of lost-time and medical claims rate decreased 73% (from 22 per 1000 employees to 6) and 61% (from 155 per 1000 employees to 61), respectively, between fiscal year 1992 and fiscal year 2002. The number of temporary/total days paid per 100 insureds decreased from 163 in fiscal year 1992 to 37 in fiscal year 2002, or 77%. Total workers' compensation expenses including all medical, indemnity and administrative, decreased from $0.81 per $100 of payroll in fiscal year 1992 to $0.37 per $100 of payroll in fiscal year 2002, a 54% decrease. More specifically, medical costs per $100 of payroll decreased 44% (from $0.27 to $0.15), temporary/total, 61% (from $0.18 to $0.07), permanent/partial, 63% (from $0.19 to $0.07) and administrative costs, 48% ($0.16 to $0.09). These data suggests that workers' compensation costs can be reduced over a multi-year period by using a small network of clinically skilled health care providers who address an individual workers' psychological, as well as physical needs and where communication between all parties (e.g., medical care providers, supervisors, and injured employees) is constantly maintained. Furthermore, these results
Nevo, Alessandro Del; D'Auria, Francesco; Mazzini, Marino; Bykov, Michael; Elkin, Ilya V.; Suslov, Alexander
Experimental programs carried-out in integral test facilities are relevant for validating the best estimate thermal-hydraulic codes(1), which are used for accident analyses, design of accident management procedures, licensing of nuclear power plants, etc. The validation process, in fact, is based on well designed experiments. It consists in the comparison of the measured and calculated parameters and the determination whether a computer code has an adequate capability in predicting the major phenomena expected to occur in the course of transient and/or accidents. University of Pisa was responsible of the numerical design of the 12 experiments executed in PSB-VVER facility (2), operated at Electrogorsk Research and Engineering Center (Russia), in the framework of the TACIS 2.03/97 Contract 3.03.03 Part A, EC financed (3). The paper describes the methodology adopted at University of Pisa, starting form the scenarios foreseen in the final test matrix until the execution of the experiments. This process considers three key topics: a) the scaling issue and the simulation, with unavoidable distortions, of the expected performance of the reference nuclear power plants; b) the code assessment process involving the identification of phenomena challenging the code models; c) the features of the concerned integral test facility (scaling limitations, control logics, data acquisition system, instrumentation, etc.). The activities performed in this respect are discussed, and emphasis is also given to the relevance of the thermal losses to the environment. This issue affects particularly the small scaled facilities and has relevance on the scaling approach related to the power and volume of the facility.
Foster care children who experience placement disruption and foster care instability are at elevated risk for a host of poor outcomes, yet little work considers what these unstable foster care careers look like or what causes them. In this article, I start by using previous studies on foster care drift, instability, and placement disruptions to define the unstable foster care career as a subset of foster care careers. I then use administrative data on 30,239 Danish children born 1982-1987 who entered foster care to generate nine foster care careers, two of which meet the criteria for an unstable career. Children with a high number of risk factors associated with foster care entry were also the most likely to enter an unstable career. I end by discussing implications for recent studies of the effect of foster care on children's later life outcomes and the relevance of the findings for practitioners.
This short paper mentioned the medical treatment using the 'holy' springs, the first 'eye doctor' in Denmark, the first picture of spectacles which was found in Viborg Cathedral of the high priest before he performs circumcisio praeputii on Jesus Christ, further cataract reclination in Denmark from around year zero and cataract extraction in 1667 in Denmark on a goose by Francisco Borri and on humans by the Danish Georg Heuermann in 1755. Epidemic military eye diseases in 1807, 1856 and 1865 are also described in this study. From 1856, a new ophthalmological period started in Denmark with the first eye hospital (lazaret only for eye diseases), and in 1864, patients with eye diseases were transported from the few beds in the surgical departments in the municipal hospital to the first civil eye department in Denmark, the eye hospital Sct. Annae in Copenhagen. The new scientific period started with Jacob Christian Bentz (ophthalmia granulosa, joint editor of the Danish Medical Journal) and Heinrich Lehmann.
Danish sperm donors face a particular kind of kinship trouble: they find themselves in a cultural and organizational context that offers different and contrary ways of how to make connections to donor-conceived individuals meaningful. Whereas Danish sperm banks and Danish law want sperm donors to regard these connections as contractual issues, the dominant kinship narrative in Denmark asks sperm donors to also consider them as family and kinship relations. Based on interviews with Danish sperm donors and participant observation at Danish sperm banks, I argue that Danish sperm donors make sense of connections to donor-conceived individuals as a particular kind of relatedness that cannot be reduced to either contractual or kinship relations. Making sense of these connections, sperm donors negotiate their social significance and thereby participate in opening a space which offers avenues for new kinds of sociality.
Ullrich, Robert A.
A professor of management looks at university management development programs and finds that, despite increasing enrollments in management seminars, both the organizations purchasing the educational services and the universities selling them are often dissatisfied. He offers suggestions for improving management development programs. (MF)
Andersson, Charlotte Brix; Flems, Christina; Kesmodel, Ulrik Schiøler
Aim of the database The aim of the Danish National Quality Database for Births (DNQDB) is to measure the quality of the care provided during birth through specific indicators. Study population The database includes all hospital births in Denmark. Main variables Anesthesia/pain relief, continuous support for women in the delivery room, lacerations (third and fourth degree), cesarean section, postpartum hemorrhage, establishment of skin-to-skin contact between the mother and the newborn infant, severe fetal hypoxia (proportion of live-born children with neonatal hypoxia), delivery of a healthy child after an uncomplicated birth, and anesthesia in case of cesarean section. Descriptive data Data have been collected since 2010. As of August 2015, data on women and children representing 269,597 births and 274,153 children have been collected. All data for the DNQDB is collected from the Danish Medical Birth Registry. Registration to the Danish Medical Birth Registry is mandatory for all maternity units in Denmark. During the 5 years, performance has improved in the areas covered by the process indicators and for some of the outcome indicators. Conclusion Measuring quality of care during childbirth has inspired and enabled staff to attend to the quality of the care they provide and has led to improvements in most of the areas covered. PMID:27822105
Aim of database The Danish Neuro-Oncology Registry (DNOR) was established by the Danish Neuro-Oncology Group as a national clinical database. It was established for the purpose of supporting research and development in adult patients with primary brain tumors in Denmark. Study population DNOR has registered clinical data on diagnostics and treatment of all adult patients diagnosed with glioma since January 1, 2009, which numbers approximately 400 patients each year. Main variables The database contains information about symptoms, presurgical magnetic resonance imaging (MRI) characteristics, performance status, surgical procedures, residual tumor on postsurgical MRI, postsurgical complications, diagnostic and histology codes, radiotherapy, and chemotherapy. Descriptive data DNOR publishes annual reports on descriptive data. During the period of registration, postoperative MRI is performed in a higher proportion of the patients (Indicator II), and a higher proportion of patients have no residual tumor after surgical resection of the primary tumor (Indicator IV). Further data are available in the annual reports. The indicators reflect only minor elements of handling brain tumor patients. Another advantage of reporting indicators is the related multidisciplinary discussions giving a better understanding of what actually is going on, thereby facilitating the work on adjusting the national guidelines in the Danish Neuro-Oncology Group. Conclusion The establishment of DNOR has optimized the quality in handling primary brain tumor patients in Denmark by reporting indicators and facilitating a better multidisciplinary collaboration at a national level. DNOR provides a valuable resource for research. PMID:27822109
McGuirk, S P; Griselli, M; Stumper, O F; Rumball, E M; Miller, P; Dhillon, R; de Giovanni, J V; Wright, J G; Barron, D J; Brawn, W J
Objective To describe a 12 year experience with staged surgical management of the hypoplastic left heart syndrome (HLHS) and to identify the factors that influenced outcome. Methods Between December 1992 and June 2004, 333 patients with HLHS underwent a Norwood procedure (median age 4 days, range 0–217 days). Subsequently 203 patients underwent a bidirectional Glenn procedure (stage II) and 81 patients underwent a modified Fontan procedure (stage III). Follow up was complete (median interval 3.7 years, range 32 days to 11.3 years). Results Early mortality after the Norwood procedure was 29% (n = 95); this decreased from 46% (first year) to 16% (last year; p < 0.05). Between stages, 49 patients died, 27 before stage II and 22 between stages II and III. There were one early and three late deaths after stage III. Actuarial survival (SEM) was 58% (3%) at one year and 50% (3%) at five and 10 years. On multivariable analysis, five factors influenced early mortality after the Norwood procedure (p < 0.05). Pulmonary blood flow supplied by a right ventricle to pulmonary artery (RV‐PA) conduit, arch reconstruction with pulmonary homograft patch, and increased operative weight improved early mortality. Increased periods of cardiopulmonary bypass and deep hypothermic circulatory arrest increased early mortality. Similar factors also influenced actuarial survival after the Norwood procedure. Conclusion This study identified an improvement in outcome after staged surgical management of HLHS, which was primarily attributable to changes in surgical technique. The RV‐PA conduit, in particular, was associated with a notable and independent improvement in early and actuarial survival. PMID:15939721
Baxley, Brian T.; Swieringa, Kurt A.; Capron, William R.
An area in aviation operations that may offer an increase in efficiency is the use of continuous descent arrivals (CDA), especially during dependent parallel runway operations. However, variations in aircraft descent angle and speed can cause inaccuracies in estimated time of arrival calculations, requiring an increase in the size of the buffer between aircraft. This in turn reduces airport throughput and limits the use of CDAs during high-density operations, particularly to dependent parallel runways. The Interval Management with Spacing to Parallel Dependent Runways (IMSPiDR) concept uses a trajectory-based spacing tool onboard the aircraft to achieve by the runway an air traffic control assigned spacing interval behind the previous aircraft. This paper describes the first ever experiment and results of this concept at NASA Langley. Pilots flew CDAs to the Dallas Fort-Worth airport using airspeed calculations from the spacing tool to achieve either a Required Time of Arrival (RTA) or Interval Management (IM) spacing interval at the runway threshold. Results indicate flight crews were able to land aircraft on the runway with a mean of 2 seconds and less than 4 seconds standard deviation of the air traffic control assigned time, even in the presence of forecast wind error and large time delay. Statistically significant differences in delivery precision and number of speed changes as a function of stream position were observed, however, there was no trend to the difference and the error did not increase during the operation. Two areas the flight crew indicated as not acceptable included the additional number of speed changes required during the wind shear event, and issuing an IM clearance via data link while at low altitude. A number of refinements and future spacing algorithm capabilities were also identified.
Al Dohayan, A
Primary palmar hyperhydrosis is a functionally and socially disabling problem of unknown etiology, affecting adolescents and young adults, especially in hot climates. Thoracoscopic sympathectomy is the most effective treatment for palmar hyperhydrosis. Postsympathectomy rebound hyperhydrosis may limit its success, especially in hot climates. The aim of this study is to report experience with thoracoscopic sympathectomy in a hot climate, managing the dominant hand (unilateral), followed by the other hand at a later date, based on the patient's choice. One hundred twenty patients were operated on during a 3 year period. The mean operative time was 25 minutes. The procedure was successfully completed in 169 operated limbs and was abandoned in one limb because of severe pleural adhesions. The procedure was done for the dominant hand (unilateral) in 120 patients. Fifty patients returned for contralateral thoracoscopic sympathectomy. There were 18 postoperative complications. Most of the patients (95%) were discharged after an overnight stay. The early observed cure rate was high (97%). During the mean follow-up period of 300 days, there was no recurrence of the original symptoms, except for one patient in whom the nerve of Kuntz was found and diathermized on the second thoracoscopy with symptomatic relief. Rebound hyperhydrosis occurred in 40 patients (33% of the total; 21% in the unilateral group and 42% in the bilateral group). In conclusion, it seems that transaxillary endoscopic sympathectomy of the dominant hand is an alternative method of treatment for patients with hyperhydrosis. Managing the dominant hand first and giving the patient the chance to observe the severity of the rebound hyperhydrosis may facilitate the decision for contralateral sympathectomy.
Kendigelen, Pinar; Tunali, Yusuf; Tutuncu, Ayse; Ashyralyyeva, Gulruh; Emre, Senol; Kaya, Guner
The mucopolysaccharidosis (MPS) is a rare lysosomal storage disease. Glycosaminoglycans (GAG) accumulate in musculoskeletal system, connective tissues. Enlarged tongue, short immobile neck, and limited mobility of the cervical spine and temporomandibular joints render the airway management potentially risky. MPS children have high anesthetic risks, especially in airway management of emergency situations. The foreign-body aspiration requiring intervention with rigid bronchoscopy is an urgent and risky clinical situation. We present our experience with a challenging airway management with a three-year-old child with MPS who needed emergency bronchoscopy due to peanut aspiration.
Pornak, S; Meyer, T; Raspe, H
Priority setting in medicine helps to achieve a fair and transparent distribution of health-care resources. The German discussion about priority setting is still in its infancy and may benefit from other countries' experiences. This paper aims to analyse the Danish priority setting debate in order to stimulate the German discussion. The methods used are a literature analysis and a document analysis as well as expert interviews. The Danish debate about priority setting in medicine began in the 1970s, when a government committee was constituted to evaluate health-care priorities at the national level. In the 1980s a broader debate arose in politics, ethics, medicine and health economy. The discussions reached a climax in the 1990s, when many local activities - always involving the public - were initiated. Some Danish counties tried to implement priority setting in the daily routine of health care. The Council of Ethics was a major player in the debate of the 1990s and published a detailed statement on priority setting in 1996. With the new century the debate about priority setting seemed to have come to an end, but in 2006 the Technology Council and the Danish Regions resumed the discussion. In 2009 the Medical Association called for a broad debate in order to achieve equity among all patients. The long lasting Danish debate on priority setting has entailed only very little practical consequences on health care. The main problems seem to have been the missing effort to bundle the various local initiatives on a national level and the lack of powerful players to put results of the discussion into practice. Nevertheless, today the attitude towards priority setting is predominantly positive and even politicians talk freely about it.
A successful landslide risk reduction program requires that the society is aware and understand the landslide problems within the geographic area involved. Central organizations that manage national landslide risks should: a) create and systematically applied natural hazard laws/national landslide strategies, where roles and limits of responsibilities of federal, state, provincial, municipal and private entities are well defined; c) establish fruitful multidisciplinary and interinstitutional collaboration among scientists; d) provide good risk assessments in which landslide experts report transparently what is really known and the limitations of methods and tools used; e) share and systematically communicate their knowledge more effectively with all private and public stakeholders involved, paying attention to providing balanced information about risks and addressing inevitable uncertainties; f) support the mass-media in spreading correct scientific information; g) perform serious risk and cost-benefit analyses before mitigation measures are realized; h) assist local authorities in the application of land-use planning policies and g) built trust and confidence by means of a continuous contact and communication with the public and local authorities. However, this is not yet achieved, not even in developed countries where, in theory, more economical resources are available and people are better educated then in developing countries. Herein I make some observations on how national landslide prevention efforts are being organized in two countries (Nicaragua and Norway), where I have been worked at governmental agencies as landslide expert in the last 10 years. I start describing similarities and differences between the countries and try to compare practices and experiences. The analysis was motivated by the following questions: Why after so many years of landslide mapping and investigations, landslide prevention is not good and effective as it should be? Is this
Porro, Ivan; Torterolo, Livia; Corradi, Luca; Fato, Marco; Papadimitropoulos, Adam; Scaglione, Silvia; Schenone, Andrea; Viti, Federica
Several systems have been presented in the last years in order to manage the complexity of large microarray experiments. Although good results have been achieved, most systems tend to lack in one or more fields. A Grid based approach may provide a shared, standardized and reliable solution for storage and analysis of biological data, in order to maximize the results of experimental efforts. A Grid framework has been therefore adopted due to the necessity of remotely accessing large amounts of distributed data as well as to scale computational performances for terabyte datasets. Two different biological studies have been planned in order to highlight the benefits that can emerge from our Grid based platform. The described environment relies on storage services and computational services provided by the gLite Grid middleware. The Grid environment is also able to exploit the added value of metadata in order to let users better classify and search experiments. A state-of-art Grid portal has been implemented in order to hide the complexity of framework from end users and to make them able to easily access available services and data. The functional architecture of the portal is described. As a first test of the system performances, a gene expression analysis has been performed on a dataset of Affymetrix GeneChip® Rat Expression Array RAE230A, from the ArrayExpress database. The sequence of analysis includes three steps: (i) group opening and image set uploading, (ii) normalization, and (iii) model based gene expression (based on PM/MM difference model). Two different Linux versions (sequential and parallel) of the dChip software have been developed to implement the analysis and have been tested on a cluster. From results, it emerges that the parallelization of the analysis process and the execution of parallel jobs on distributed computational resources actually improve the performances. Moreover, the Grid environment have been tested both against the possibility of
Hammitzsch, Martin; Necmioglu, Ocal; Lendholt, Matthias; Reißland, Sven; Schulz, Jana; Aksari, Dogan; Koseoglu, Aysegul; Ozer, Ceren; Comoglu, Mustafa; Meral Ozel, Nurcan; Wächter, Joachim
On November 27-28, 2012, the Kandilli Observatory and Earthquake Research Institute (KOERI) joined other countries in the North-eastern Atlantic, the Mediterranean and Connected Seas (NEAM) region as participants in an international tsunami response exercise. The exercise, titled NEAMWave12, simulated widespread Tsunami Watch situations throughout the NEAM region. It is the first international exercise as such, in this region, where the UNESCO-IOC ICG/NEAMTWS tsunami warning chain has been tested to a full scale for the first time with different systems. One of the systems is developed in the project Collaborative, Complex, and Critical Decision-Support in Evolving Crises (TRIDEC) and has been validated in this exercise among others by KOERI. KOERI, representing the Tsunami National Contact (TNC) and Tsunami Warning Focal Point (TWFP) for Turkey, is one of the key partners in TRIDEC. KOERI is responsible for the operation of a National Tsunami Warning Centre (NTWC) for Turkey and establishes candidate Tsunami Watch Provider (TWP) responsibilities for the Eastern Mediterranean, Aegean, Marmara and Black Seas. Based on this profound experience KOERI is contributing valuable requirements to the overall TRIDEC system and is responsible for the definition and development of feasible tsunami-related scenarios in the context of UNESCO-IOC ICG/NEAMTWS activities. However, KOERI's, most important input focuses on testing and evaluating the TRIDEC system according to specified evaluation and validation criteria in order to meet ICG/NEAMTWS requirements. The TRIDEC system will be implemented in three phases, each with a demonstrator. Successively, the demonstrators are addressing related challenges. The first and second phase system demonstrator, deployed at KOERI's crisis management room has been designed and implemented, firstly, to support plausible scenarios for the Turkish NTWC to demonstrate the treatment of simulated tsunami threats with an essential subset of a NTWC
Aabenhus, Rune; Hallas, Peter
Health-care workers may experience uncertainty regarding legal matters when attending to medical needs of undocumented migrants. This paper applies a pragmatic focus when addressing the legal aspects involved in providing health-care services to undocumented migrants with examples from the Danish Health Act and international conventions. The delivery of medical care to vulnerable groups such as pregnant women and children is described.
Athanasiadis, Georgios; Jørgensen, Frank G.; Cheng, Jade Y.; Kjærgaard, Peter C.; Schierup, Mikkel H.; Mailund, Thomas
Scientific outreach delivers science to the people. But it can also deliver people to the science. In this work, we report our experience from a large-scale public engagement project promoting genomic literacy among Danish high school students with the additional benefit of collecting data for studying the genetic makeup of the Danish population. Not only did we confirm that students have a great interest in their genetic past, but we were also gratified to see that, with the right motivation, adolescents can provide high-quality data for genetic studies. PMID:27571202
Ronen-Eliraz, Gefen; Russak, Amos; Nitzan, Ido; Guttman, Joseph; Kurtzman, Daniel
Managed aquifer recharge (MAR) events are occasionally carried out with surplus desalinated seawater that has been post-treated with CaCO3 in infiltration ponds overlying the northern part of the Israeli Coastal Aquifer. This water's chemical characteristics differ from those of any other water recharged to the aquifer and of the natural groundwater. As the MAR events are short (hours to weeks), the sediment under the infiltration ponds will intermittently host desalinated and natural groundwater. As part of comprehensive research on the influence of those events, column experiments were designed to simulate the alternation of the two water types: post-treated desalinated seawater (PTDES) and natural groundwater (GW). Each experiment included three stages: (i) saturation with GW; (ii) inflow of PTDES; (iii) inflow of GW. Three runs were conducted, each with different sediments extracted from the field and representing a different layer below the infiltration pond: (i) sand (<1% CaCO3), (ii) sand containing 7% CaCO3, and (iii) crushed calcareous sandstone (35% CaCO3). The results from all columns showed enrichment of K(+) and Mg(2+) (up to 0.4meq/L for 20 pore volumes) when PTDES replaced GW, whereas an opposite trend of Ca(2+) depletion (up to 0.5meq/L) was observed only in the columns that contained a high percentage of CaCO3. When GW replaced PTDES, depletion of Mg(2+) and K(+) was noted. The results indicated that adsorption/desorption of cations are the main processes causing the observed enrichment/depletion. It was concluded that the high concentration of Ca(2+) (relative to the total concentration of cations) and the low concentration of Mg(2+) in the PTDES relative to natural GW are the factors controlling the main sediment-water interaction. The enrichment of PTDES with Mg(2+) may be viewed as an additional post-treatment.
Paternoster, R.; Butterfield, K.
The Los Alamos Critical Experiments Facility (LACEF) currently operates two burst reactors (Godiva-IV and Skua), one solution assembly (SHEBA 2--Solution high-Energy Burst Assembly), two fast-spectrum benchmark assemblies (Flattop and Big Ten), and five general-purpose remote assembly machines which may be configured with nuclear materials and assembled by remote control. SNM storage vaults support these and other operations at the site. With this diverse set of operations, several approaches are possible in the analysis and management of risk. The most conservative approach would be to write a safety analysis report (SAR) for each assembly and experiment. A more cost-effective approach is to analyze the probability and consequences of several classes of operations representative of operations on each critical assembly machine and envelope the bounding case accidents. Although the neutron physics of these machines varies widely, the operations performed at LACEF fall into four operational modes: steady-state mode, approach-to-critical mode, prompt burst mode, and nuclear material operations which can include critical assembly fuel loading. The operational sequences of each mode are very nearly the same, whether operated on one assembly machine or another. The use of an envelope approach to accident analysis is facilitated by the use of classes of operations and the use of bounding case consequence analysis. A simple fault tree analysis of operational modes helps resolve which operations are sensitive to human error and which are initiated by hardware of software failures. Where possible, these errors and failures are blocked by TSR LCOs.
Holm, Signe A; Sörensen, Camilla R L; Thamsborg, Stig M; Enemark, Heidi L
The prevalence of gastrointestinal parasites in Danish goats and the presence of anthelmintic resistance (AR) in 10 selected herds were investigated during April-September 2012. All Danish herds (n = 137) with 10 or more adult goats were invited to participate, and of these 27 herds met the inclusion criterion of more than 10 young kids never treated with anthelmintics. Questionnaire data on management were collected, and faecal samples from 252 kids were analysed by the McMaster technique. From all herds with a mean faecal egg count (FEC) above 300 eggs per g of faeces, pooled samples were stained with peanut agglutinin (PNA) for specific detection of Haemonchus contortus. Strongyle eggs were detected with an individual prevalence of 69%, including Nematodirus battus (3.6%) and other Nematodirus species (15.0%). Eimeria spp. were observed in 99.6% of the kids. H. contortus was found in 11 of 12 (92%) tested herds. Anthelmintics were used in 89% of the herds with mean treatment frequencies of 0.96 and 0.89 treatments per year for kids and adults, respectively. In 2011, new animals were introduced into 44% of the herds of which 25% practised quarantine anthelmintic treatments. In 10 herds the presence of AR was analysed by egg hatch assay and FEC reduction tests using ivermectin (0.3 mg/kg) or fenbendazole (10.0 mg/kg). AR against both fenbendazole and ivermectin was detected in seven herds; AR against fenbendazole in one herd, and AR against ivermectin in another herd. In conclusion, resistance to the most commonly used anthelmintics is widespread in larger goat herds throughout Denmark.
Holm, Signe A.; Sörensen, Camilla R. L.; Thamsborg, Stig M.; Enemark, Heidi L.
The prevalence of gastrointestinal parasites in Danish goats and the presence of anthelmintic resistance (AR) in 10 selected herds were investigated during April–September 2012. All Danish herds (n = 137) with 10 or more adult goats were invited to participate, and of these 27 herds met the inclusion criterion of more than 10 young kids never treated with anthelmintics. Questionnaire data on management were collected, and faecal samples from 252 kids were analysed by the McMaster technique. From all herds with a mean faecal egg count (FEC) above 300 eggs per g of faeces, pooled samples were stained with peanut agglutinin (PNA) for specific detection of Haemonchus contortus. Strongyle eggs were detected with an individual prevalence of 69%, including Nematodirus battus (3.6%) and other Nematodirus species (15.0%). Eimeria spp. were observed in 99.6% of the kids. H. contortus was found in 11 of 12 (92%) tested herds. Anthelmintics were used in 89% of the herds with mean treatment frequencies of 0.96 and 0.89 treatments per year for kids and adults, respectively. In 2011, new animals were introduced into 44% of the herds of which 25% practised quarantine anthelmintic treatments. In 10 herds the presence of AR was analysed by egg hatch assay and FEC reduction tests using ivermectin (0.3 mg/kg) or fenbendazole (10.0 mg/kg). AR against both fenbendazole and ivermectin was detected in seven herds; AR against fenbendazole in one herd, and AR against ivermectin in another herd. In conclusion, resistance to the most commonly used anthelmintics is widespread in larger goat herds throughout Denmark. PMID:25076056
Rahkila, Sakari; Stenberg, Susanne
The integration of the two recognized network management protocol standards, common management information protocol, and simple network management protocol, and common object request broker architecture (CORBA) technology, allows management applications to take advantage of distributed object computing as well as the standardized network management protocols. This paper describes the distributed computing platform (DCP) prototype developed at the Nokia Research Center. The DCP prototype is a framework, including tools, compilers and gateways, built to support both Internet and open systems interconnection management through a CORBA infrastructure.
Munyewende, Pascalia O.; Rispel, Laetitia C.
Background South Africa is on the brink of another wave of major health system reforms that underscore the centrality of primary health care (PHC). Nursing managers will play a critical role in these reforms. Objective The aim of the study was to explore the work experiences of PHC clinic nursing managers through the use of reflective diaries, a method hitherto under-utilised in health systems research in low- and middle-income countries. Design During 2012, a sub-set of 22 PHC nursing managers was selected randomly from a larger nurses’ survey in two South African provinces. After informed consent, participants were requested to keep individual diaries for a period of 6 weeks, using a clear set of diary entry guidelines. Reminders consisted of weekly short message service reminders and telephone calls. Diary entries were analysed using thematic content analysis. A diary feedback meeting was held with all the participants to validate the findings. Results Fifteen diaries were received, representing a 68% response rate. The majority of respondents (14/15) were female, each with between 5 and 15 years of nursing experience. Most participants made their diary entries at home. Diaries proved to be cathartic for individual nursing managers. Although inter-related and not mutually exclusive, the main themes that emerged from the diary analysis were health system deficiencies; human resource challenges; unsupportive management environment; leadership and governance; and the emotional impact of clinic management. Conclusions Diaries are an innovative method of capturing the work experiences of managers at the PHC level, as they allow for confidentiality and anonymity, often not possible with other qualitative research methods. The expressed concerns of nursing managers must be addressed to ensure the success of South Africa's health sector reforms, particularly at the PHC level. PMID:25537937
Ravn, Iben M; Frederiksen, Kirsten; Beedholm, Kirsten
This article reports on the results of a Fairclough-inspired critical discourse analysis aiming to clarify how chronically ill patients are presented in contemporary Danish chronic care policies. Drawing on Fairclough's three-dimensional framework for analyzing discourse, and using Dean's concepts of governmentality as an interpretative lens, we analyzed and explained six policies published by the Danish Health and Medicines Authority between 2005 and 2013. The analysis revealed that discourses within the policy vision of chronic care consider chronically ill patients' active role, lifestyle, and health behavior to be the main factors influencing susceptibility to chronic diseases. We argue that this discursive construction naturalizes a division between people who can actively manage responsible self-care and those who cannot. Such discourses may serve the interests of those patients who are already activated, while others remain subjugated to certain roles. For example, they may be labeled as "vulnerable."
Despite intense critique from various parts of the medical professions, Danish hospitals have been subjected to a mandatory accreditation system known as the Danish Quality Model (Den Danske Kvalitetsmodel, DDKM) since 2009. The notion of government assemblage is employed to understand how and why, in the face of these obstacles, DDKM was ultimately implemented. It is argued that DDKM is the result of the emergence of hospital quality management assemblage in 1980s and 1990s made up by new methods of categorizing disease treatments, computerization of such treatments, concerns over cost-effectiveness, complaint registration, the availability of international hospital quality assessment systems, the mobilization of organized medical interest groups, and a tradition of consultative policymaking procedures. This assemblage was crucial for identifying quality as a problem in need of administrative intervention and for shaping the political struggle over how best to assure the quality of hospital services.
Kitts, Christopher Adam
This research program consists of an experimental study of model-based reasoning methods for detecting, diagnosing and resolving anomalies that occur when operating a comprehensive space system. Using a first principles approach, several extensions were made to the existing field of model-based fault detection and diagnosis in order to develop a general theory of model-based anomaly management. Based on this theory, a suite of algorithms were developed and computationally implemented in order to detect, diagnose and identify resolutions for anomalous conditions occurring within an engineering system. The theory and software suite were experimentally verified and validated in the context of a simple but comprehensive, student-developed, end-to-end space system, which was developed specifically to support such demonstrations. This space system consisted of the Sapphire microsatellite which was launched in 2001, several geographically distributed and Internet-enabled communication ground stations, and a centralized mission control complex located in the Space Technology Center in the NASA Ames Research Park. Results of both ground-based and on-board experiments demonstrate the speed, accuracy, and value of the algorithms compared to human operators, and they highlight future improvements required to mature this technology.
Liu, Dan; Zhou, Jingjing; Zhang, Wenjing; Huan, Ying; Yu, Xipeng; Li, Fulin; Chen, Xuequn
Colloids act as vectors for pollutants in groundwater, thereby creating a series of environmental problems. While managed aquifer recharge plays an important role in protecting groundwater resources and controlling land subsidence, it has a significant effect on the transport of colloids. In this study, particle size and zeta potential of colloidal humic acid (HA) have been measured to determine the effects of different hydrochemistry conditions. Column experiments were conducted to examine the effects on the transport of colloidal HA under varying conditions of pH (5, 7, 9), ionic strength (<0.0005, 0.02, 0.05 M), cation valence (Na+, Ca2+) and flow rate (0.1, 0.2, 0.4 ml/min) through collectors (glass beads) to model the properties and quality of artificial recharge water and changes in the hydrodynamic field. Breakthrough curves showed that the behavior of colloidal HA being transported varied depending on the conditions. Colloid transport was strongly influenced by hydrochemical and hydrodynamic conditions. With decreasing pH or increasing ionic strength, a decrease in the peak effluent concentration of colloidal HA and increase in deposition could be clearly seen. Comparison of different cation valence tests indicated that changes in transport and deposition were more pronounced with divalent Ca2+ than with monovalent Na+. Changes in hydrodynamic field (flow rate) also had an impact on transportation of colloidal HA. The results of this study highlight the need for further research in this area.
Chato, David J.
The Vented Tank Resupply Experiment (VTRE) flown on STS-77 confirmed the design approaches presently used in the development of vane-type propellant management devices (PMD) for use in resupply and tank-venting situations, and it provided the first practical demonstration of an autonomous fluid transfer system. All the objectives were achieved. Transfers were more stable than drop tower testing indicated. Liquid was retained successfully at the highest flow rate tested (2.73 gal/min), demonstrating that rapid fills could be achieved. Liquid-free vents were achieved for two different tanks, although the flow rate was higher for the spherical tank (0.1591 cu ft/min) than for the tank with a short barrel section (0.0400 cu ft/min). Recovery from a thruster firing, which moved the liquid to the opposite end of the tank from the PMD, was achieved in 30 sec, showing that liquid rewicked more quickly into the PMD after thruster firing than pretest projections had predicted. In addition, researchers obtained great insights into the PMD behavior from the video footage provided, and discovered new considerations for future PMD designs that would not have been seen without this flight test.
Narendorf, Sarah Carter; Small, Eusebius; Cardoso, Jodi A. Berger; Wagner, Richard W.; Jennings, Sheara Williams
Support from research assistants (RAs) is often framed as a resource to facilitate faculty research productivity, yet most assistant professors have received minimal training on how to effectively make use of this resource. This study collected data from a national sample of assistant professors to examine tasks RAs are asked to perform, satisfaction with RA work, challenges in working with RAs, and lessons learned to be successful. Authors used a sequential mixed-methods design, first conducting a Web-based survey with 109 assistant professors in social work schools with doctoral programs, then qualitative interviews with a subset of 13 respondents who volunteered to talk more about their experiences. Evidence indicated low levels of satisfaction regarding the preparation of students for RA work, particularly among those assistant professors working with first-year doctoral students. Primary challenges included lack of student skills and commitment and sufficient time to supervise and train students. Recommendations include careful assessment of student skills at the start of the relationship and setting clear expectations. Social work programs can improve faculty–RA relationships by training new assistant professors on how to support and manage RAs and training incoming students on basic research skills for their work as RAs. PMID:27257354
Douvere, Fanny; Ehler, Charles N
Increased development pressures on the marine environment and the potential for multiple use conflicts, arising as a result of the current expansion of offshore wind energy, fishing and aquaculture, dredging, mineral extraction, shipping, and the need to meet international and national commitments to biodiversity conservation, have led to increased interest in sea use planning with particular emphasis on marine spatial planning. Several European countries, on their own initiative or driven by the European Union's Marine Strategy and Maritime Policy, the Bergen Declaration of the North Sea Conference, and the EU Recommendation on Integrated Coastal Zone Management, have taken global leadership in implementing marine spatial planning. Belgium, The Netherlands, and Germany in the North Sea, and the United Kingdom in the Irish Sea, have already completed preliminary sea use plans and zoning proposals for marine areas within their national jurisdictions. This paper discusses the nature and context of marine spatial planning, the international legal and policy framework, and the increasing need for marine spatial planning in Europe. In addition, the authors review briefly three marine spatial planning initiatives in the North Sea and conclude with some initial lessons learned from these experiences.
McKee, M.; Torres-Rua, A. F.; ELarab, M.; Hassan Esfahani, L.; Jensen, A.
Remote sensing applications for precision agriculture depend on acquiring actionable information at high spatial resolution and at a temporal frequency appropriate for timely responses. Unmanned aerial systems (UAS) are capable of providing such imagery for use in various applications for precision agriculture (yield estimation, evapotranspiration, etc.). AggieAirTM, a UAS platform and sensory array, was designed and developed at Utah State University to acquire high-resolution imagery (0.15m -0.6 m) in the visual, near infrared, red edge, and thermal infrared spectra. Spectral data obtained from AggieAir are used to develop soil moisture, plant chlorophyll, leaf nitrogen and actual evapotranspiration estimates to support management in precision agriculture. This presentation will focus on experience in using the AggieAir system to provide information products of possible interest in precision agriculture. The discussion will include information about the direction and rate of development of UAS technology and the current and anticipated future state of the regulatory environment for use of these systems in the U.S.
Martins, Carlos; Almeida, Paulo; Castelobranco, Orlanda; Romero, Madalena; Cabral, Gonçalo; Dinis da Gama, A
The authors report a series of 26 consecutive patients, 20 men and 6 women, age range 47-80 years, average age of 66 years, who underwent conventional surgery for the treatment of carotid reestenosis. The surgical management consisted in the resection of a segment of the common carotid-internal carotid arteries and interposition of a prosthetic graft, followed by ligation of the external carotid, in 3 patients; in the remainder 23 cases a venous bypass graft was interposed from the common carotid to the internal carotid artery, above the lesion, with preservation of the external carotid artery flow and ligation of the internal carotid, just below the anastomosis. There was no operative mortality and the significant morbility consisted in a cervical hematoma in one patient, transient disphonia in two cases and transient disphagia in one patient. During the mean follow up time of 43 months, one patient developed a significant reestenosis of the venous graft and another patient developed an aneurysm of the venous graft, both conditions requiring surgical repair. Based on the early and late results of this experience, the authors elect the open conventional surgery as the method of choice for the treatment of carotid reestenosis.
Giudice, Giuseppe; Maggio, Giulio; Bufano, Loredana; Memeo, Giuseppe
Background: The management of toxic epidermal necrolysis (TEN) is controversial and there is no uniform strategy. Objective: To share our 10 years’ experience in treating severe TEN with a novel protocol based on the association of cyclosporine A and plasmapheresis. Methods: In this case series, we retrospectively collected and assessed the 12 cases of severe TEN treated from 2005 to 2015 at the Burn Unit of the University of Bari Policlinico hospital. Results: Average body surface area was 77; average SCORETEN was 4.3. The 12 patients had been treated with culprit drug withdrawal, systemic corticosteroids, and/or cyclosporine A with no response. The protocol was successfully administered in all 12 cases. Average time to response from protocol start was 4.9 days. Average time to remission from protocol start was 22 days; average hospital stay at our unit was 24.8 days. Four patients developed severe complications; 1 patient died. No complications linked to the protocol therapeutic measures were observed. The relatively small number of cases given the rarity of the condition is a limitation of this report. Conclusion: Our protocol based on the association of cyclosporine A and plasmapheresis is safe and efficacious in treating severe TEN. PMID:28280663
Sasso, Francesco; Vittori, Matteo; D'Addessi, Alessandro; Bassi, Pier Francesco
Our aim was to review the literature and discuss about penile curvature in order to have an update for management after 20 years experience in the field.Penile curvature may be congenital or acquired. Congenital penile curvature is a relatively uncommon condition that may present in late adolescent or early adult life. The incidence is estimated to be 0.6 %. On the other side, acquired penile curvature has an overall prevalence of 0.5-13%. Three main factors seem to increase the risk of developing an acquired penile curvature, often related to Peyronie's disease: penile traumatism, genetic and familiar conditions and a history of diseases of the genital tract. In treating Peyronie's disease, no medical therapy is fully effective, and surgery remains the gold standard in cases of severe deformity and/or erectile disfunction. Peyronie's disease is associated with significant psychological stress for patients and their partners. Appropriate treatment should be individualized and tailored to the patient's goals and expectations. There is not the 'best' surgical technique and outcomes are satisfactory when proper treatment decisions are made.
Background and objective The incidence of traumatic hemipelvectomy is rare, but it is a devastating injury. Recently, an increasing number of patients with traumatic hemipelvectomy are admitted to trauma centers alive due to improvements of the pre-hospital care. Successful management requires prompt recognition of the nature of this injury and meticulous surgical technique. We present our successful experiences on four cases of traumatic hemipelvectomy in the past nine years. Patients and methods Four cases with traumatic hemipelvectomy were admited to our hospital from June 21, 2002 to September 3, 2011. All injuries occurred due to vehicle accident and all patients were in a state of severe hypotension, with two of them having anal lacerations. These four cases were treated immediately with resuscitation, control of hemorrhage, early amputation, repeated debridement and closure of the wounds. An angiographic embolization was given to control hemorrhage in two of the cases preoperatively. One case underwent fecal diversion. Wound infection occurred in all of cases which was successfully controlled by repeated debridements, effective anti-biotic regimen, split-thickness skin grafts. Results All four cases were saved successfully with well-healed wounds during follow up from 1 to 7 years. They were able to walk by themself using crutches. Conclusion Adhering to the surgery principles of damage control including appropriate resuscitation, hemorrhage control, coagulopathy correction and multiple debridements and closure of the wounds in reasonable period of time can save the life of cases suffering from severe pelvic ring injury. PMID:23953033
Collinet, P; Stien, L; Vinatier, D; Leroy, J L
Female genital mutilation (FGM) is still performed on 98% of Djiboutian women. Infibulation (FGM type 3) is the most widely used method of FGM in Djibouti. Even though this operation is mutilating, illegal and sometimes results in death, it is still practiced at approximately the same rate as in the past. Mass immigration of African women to Europe, Canada, Australia and the United States in the past decade has brought the problems of FGM to these countries. Female genital mutilation is a problem unfamiliar to most Western obstetrician-gynecologists. A tight infibulation can be a high risk for the mother and fetus if not handled by a skilled operator. It can lead to an unnecessary cesarean section as a result of the fear of handling infibulated women. Therefore, Western physicians need to be informed. The aim of this article was to share our experience of FGM. It will focus on FGM in Djibouti, its types, epidemiology and health consequences. It will present the management of obstetric and gynecologic complications and discuss medico-legal and health service measures to combat these dangerous and unnecessary practices
Jones, Fiona; Kilbride, Cherry; Victor, Christina
Purpose: The utility of self-management with people from minority ethnic backgrounds has been questioned, resulting in the development of culturally specific tools. Yet, the use of stroke specific self-management programmes is underexplored in these high risk groups. This article presents the experience of stroke therapists in using a stroke specific self-management programme with stroke survivors from minority ethnic backgrounds. Methods: 26 stroke therapists with experience of using the self-management programme with stroke survivors from minority ethnic backgrounds participated in semi-structured interviews. These were audio recorded, transcribed verbatim and analysed thematically. Results: Three themes were identified. One questioned perceived differences in stroke survivors interaction with self-management based on ethnicity. The other themes contrasted with this view demonstrating two areas in which ethnic and cultural attributes were deemed to influence the self-management process both positively and negatively. Aspects of knowledge of health, illness and recovery, religion, family and the professionals themselves are highlighted. Conclusions: This study indicates that ethnicity should not be considered a limitation to the use of an individualized stroke specific self-management programme. However, it highlights potential facilitators and barriers, many of which relate to the capacity of the professional to effectively navigate cultural and ethnic differences. Implications for Rehabilitation Stroke therapists suggest that ethnicity should not be considered a barrier to successful engagement with a stroke specific self-management programme. Health, illness and recovery beliefs along with religion and the specific role of the family do however need to be considered to maximize the effectiveness of the programme. A number of the facilitators and barriers identified are not unique to stroke survivors from ethnic minority communities, nor shared by all. The
Van Niekerk, Leesa Micole; Martin, Frances
A survey of 1,015 Australian registered nurses found that those who felt adequately consulted by physicians were significantly more likely to initiate consultation. Nurses dissatisfied with their relationship with physicians were more likely to experience ethical conflicts related to pain management. Level of satisfaction with this relationship…
Uppal, Nishant; Mishra, Sushanta Kumar
The study investigates the relationship between prior job experience and current academic performance among management students in India. It further explores the impact of individual and situational factors on the above relationship. Based on a longitudinal study spanning over nine months in the academic year 2010-11 among a sample of 324…
Roy, Subhadip; Banerjee, Pratyush
In this study, we aimed to understand experience of students about transition from lecture mode to case study pedagogy in business management courses. Indian education system is predominantly a follower of the lecture mode of teaching from the grass-root level till graduation. Hence Indian students are relatively less familiar with the case based…
Kultyshev, A. Yu.; Blagodarev, A. A.; Gladkii, A. V.; Shanturov, D. N.
The experience of developing, implementing, and adapting the Windchill v.10 product lifecycle management (PLM) system intended for the automation of the control processes by the engineering data for the entire lifecycle of the hardware at the ZAO Ural Turbine Works (UTW) is described.
Gawlitza, Gaby; Perels, Franziska
The aim of this study is to analyze changes in beliefs and attitudes to the teaching profession and to classroom management as a result of teaching experience. The structure of this study is based partly on the COACTIV-model of professional competence of teachers. The COACTIV-model is divided into motivational orientations, convictions and basic…
The purpose of this study was to examine differences between intern and non-intern students in terms of their perspectives on sport management internship within the context of field experience. The subjects of the study were a total of 189 students. They were 4th year students who completed their internship and 3rd year students who were yet to…
Saunders, Murray; Sin, Cristina
This paper analyses how middle managers perform and experience their role in enacting policy in Scottish higher education institutions. The policy focus is the quality enhancement framework (QEF) for learning and teaching in higher education, which was launched in 2003. The data-set was collected between 2008 and 2010, during the evaluation of the…
Background Diabetes represents one of the biggest public health challenges facing the UK. It is also associated with increasing costs to the economy due to working days lost as people with diabetes have a sickness absence rate 2–3 times greater than the general population. Workplaces have the potential to support or hinder self- management of diabetes but little research has been undertaken to examine the relationship between work and diabetes in the UK. This paper seeks to go some way to addressing this gap by exploring the perceptions and experiences of employees with diabetes. Methods Forty three people with diabetes were purposively recruited to ascertain ways in which they managed their disease in the workplace. Semi-structured, interviews were undertaken, tape recorded and transcribed. Analysis was conducted using a constant comparative approach. Results Although respondents had informed managers of their diabetic status they felt that their managers had little concept of the effects of the work environment on their ability to manage their disease. They did not expect support from their managers and were concerned about being stigmatised or treated inappropriately. Work requirements took priority. They had to adapt their disease management to fit their job and reported running their blood glucose levels at higher than optimal levels, thereby putting themselves at higher risk of long term complications. Conclusions Little research has examined the way in which employees with diabetes manage their disease in the workplace. This research shows there is a need to increase the awareness of managers of the short and long term economic benefit of supporting employees with diabetes to manage their disease effectively whist at work. Employees may need individually assessed and tailored support on the job in order to manage their disease effectively. PMID:23617727
Thompson, Carol; Wolstencroft, Peter
This article examines the important but under-researched role of the curriculum manager within further education. It reviews managers' perceptions of the role through the lens of the professional-managerial paradigm, with a particular emphasis on the conflict in values experienced by managers trying to implement processes driven by the financial…
Vaccaro, M. J.
The application of the NASA type management approach to achieve objectives in other fields is considered. The NASA management outlook and the influences of the NASA environment are discussed along with project organization and management, and applications to socio-economic projects.
Adult learning theory literature review... 6 1. Defining an adult ........................ 6 2. How adults learn ......................... 6 3. Why...110 3. Change theory .......................... 111 4. Delegation ............................ 114 5. Negotiation...function focuses on initiating action which results in a change. Accomplishing work through people is the objective necessitating the nurse manager to
Mestry, Raj; Bodalina, Kishan
The effective management of physical resources significantly impacts on the quality of teaching and learning in schools. The procurement, utilization and maintenance of physical resources through organized structures, well-designed policies and rigid processes are critical for quality education. According to the South African Schools Act 1996, a…
Kenning, Cassandra; Coventry, Peter A; Gibbons, Chris; Bee, Penny; Fisher, Louise; Bower, Peter
Background. There is a need to better understand the mechanisms which lead to poor outcomes in patients with multimorbidity, especially those factors that might be amenable to intervention. Objective. This research aims to explore what factors predict self-management behaviour and health outcomes in patients with multimorbidity in primary care in the UK. Methods. A prospective study design was used. Questionnaires were mailed out to 1460 patients with multimorbidity. Patients were asked to complete a range of self-report measures including measures of multimorbidity, measures of their experience of multimorbidity and service delivery and outcomes (three measures of self-management: behaviours, Self-monitoring and Insight and medication adherence; and a measure of self-reported health). Results. In total, 36% (n = 499) of patients responded to the baseline survey and 80% of those respondents completed follow-up. Self-management behaviour at 4 months was predicted by illness perceptions around the consequences of individual conditions. Self-monitoring and Insight at 4 months was predicted by patient experience of ‘Hassles’ in health services. Self-reported medication adherence at 4 months was predicted by health status, Self-monitoring and Insight and ‘Hassles’ in health services. Perceived health status at 4 months was predicted by age and patient experience of multimorbidity. Conclusions. This research shows that different factors, particularly around patients’ experiences of health care and control over their treatment, impact on various types of self-management. Patient experience of multimorbidity was not a critical predictor of self-management but did predict health status in the short term. The findings can help to develop and target interventions that might improve outcomes in patients with multimorbidity. PMID:25715962
Lestyánszka Škůrková, Katarína; Kučerová, Marta; Fidlerová, Helena
In corporate practice, the term of Integrated Management System means a system the aim of which is to manage an organization regarding the quality, environment, health and safety at work. In the first phase of the VEGA project No. 1/0448/13 "Transformation of ergonomics program into the company management structure through interaction and utilization QMS, EMS, HSMS", we focused on obtaining information about the way or procedure of implementing the integrated management systems in manufacturing companies in Slovakia. The paper considers characteristics of integrated management system, specifies the possibilities for successive integration of the management systems and also describes the essential aspects of the practical implementation of integrated management systems in companies in Slovakia.
Jensen De Lopez, Kristine; Olsen, Lone Sundahl; Chondrogianni, Vasiliki
This study examines the comprehension and production of subject and object relative clauses (SRCs, ORCs) by children with Specific Language Impairment (SLI) and their typically developing (TD) peers. The purpose is to investigate whether relative clauses are problematic for Danish children with SLI and to compare errors with those produced by TD…
Vezhnovets', T A
The aim of our study was to examine the influence of age and management experience of executives in healthcare institutions at the style of decision-making. The psychological study of 144 executives was conducted. We found out that the age of executives in healthcare institutions does not affect the style of managerial decision making, while experience in leadership position does. Also it was established that the more experienced leader is, the more often he will make decision in authoritative, autonomous, marginal style and the less management experience is, the more likely is the usage of indulgent and situational style. Moreover, the authoritarian style is typical for younger executives, marginal and autonomous is typical for elder executives.
The primary mission of the Molten Salt Reactor Experiment (MSRE) Remediation Project is to effectively implement the risk-reduction strategies and technical plans to stabilize and prevent further migration of uranium within the MSRE facility, remove the uranium and fuel salts from the system, and dispose of the fuel and flush salts by storage in appropriate depositories to bring the facility to a surveillance and maintenance condition before decontamination and decommissioning. This Project Management Plan (PMP) for the MSRE Remediation Project details project purpose; technical objectives, milestones, and cost objectives; work plan; work breakdown structure (WBS); schedule; management organization and responsibilities; project management performance measurement planning, and control; conduct of operations; configuration management; environmental, safety, and health compliance; quality assurance; operational readiness reviews; and training.
The concept of Educational Ambassadors is embedded within the so-called "Danish model" of industrial relations. The Danish industrial relations system is characterised by strong collective organisations with national coverage, which conclude the collective agreements for various industries or sectors and which are mostly grouped under…
Stokes, Stephanie F.; Bleses, Dorthe; Basboll, Hans; Lambertsen, Claus
Purpose: This research explored the impact of neighborhood density (ND), word frequency (WF), and word length (WL) on the vocabulary size of Danish-speaking children. Given the particular phonological properties of Danish, the impact was expected to differ from that reported in studies on English and French. Method: The monosyllabic words in the…
This article explores the parenting practices of wealthy Danish families and offers insight into the workings of dominant parenting norms within contemporary Danish society. Based on ethnographic fieldwork conducted among 15 families living north of Copenhagen, Denmark, this article identifies the parenting strategies of people with ample…
Falase, Bode; Sanusi, Michael; Majekodunmi, Adetinuwe; Ajose, Ifeoluwa; Oke, David
experience suggests that an adequate armamentarium of bronchoscopy equipment is required to increase the chances of complete extraction, speed up the procedure and reduce the risk of complications of Tracheobronchial Foreign Bodies in our environment. Delayed presentation increases the difficulty of the procedure so earlier referral of these patients would help reduce the risk involved in their management.
Ricke, Katharine; Allen, Myles; Ingram, William; Keith, David; Granger Morgan, M.
To date modeling studies suggest that, while significant hydrological anomalies could result from the artificial addition of reflecting aerosols in the stratosphere for the purpose of solar radiation management (SRM), even at the regional level such a geoengineered world would bear a much closer resemblance to a low CO2 world, than to an unmodified high CO2 world. These previous modeling studies have generally compared one or two SRM forcing scenarios to various business-as-usual controls. However, such approaches cannot provide much information about regional sensitivities to the levels of SRM that might realistically result. Should engaging in SRM every be seriously contemplated, such regional analysis of a range of realistic scenarios will be an essential input to any process of geopolitical decision-making. Here we present the results from a large-ensemble experiment that used the HadCM3L GCM, implemented through climateprediction.net. The analysis examines 135 globally-uniform stratospheric optical depth modification scenarios designed to stabilize global temperatures under SRES A1B. Scenarios were tested using ten-member subensembles which made small perturbations to initial conditions. All simulations use identical standard settings of model physics parameters and are initiated from historically-forced runs from 1920-2005. A total of 7,331 simulations of the years 2000-2080 were performed for this experiment using computing resources donated by the general public. Our analysis of regional temperature and precipitation anomalies, normalized to account for variability, shows that SRM compensations for anthropogenic greenhouse gas forcing do generally return regional climates closer to their baseline climate states than the no-geoengineering, business-as-usual scenarios. However, we find that the magnitudes and sensitivities of regional responses to this type of activity, as modeled in HadCM3L, are highly variable. As the amount of SRM increases to compensate
Martinez, Edward; Lindline, Jennifer; Petronis, Michael S.; Pilotti, Maura
The Bureau of Labor Statistics projects an increase in Natural Resource Management (NRM) jobs within the next 10 years due to baby-boomer retirements and a 12% increase in demand for these occupations. Despite this trend, college enrollment in NRM disciplines has declined. Even more critical is the fact that the soon-to-be-majority Hispanic population is underrepresented in NRM disciplines. The goal of the present study was to determine if an in-residence, two-week, summer science program for underrepresented minorities would not only increase interest in science, actual science knowledge, and perceived science knowledge, but also have an overall impact on underrepresented minority students' decisions to attend college, major in a scientific discipline and pursue a career in science. During a four-year period, 76 high school students participated in a Science Agricultural Summer Experience (SASE) in Northern New Mexico. A pre/post science-knowledge exam and satisfaction survey were administered to participants. We demonstrate that participants improved significantly ( p < .05) in all areas measured. In particular, comfort with science field and lab activities, science knowledge and perceived science knowledge were enhanced after exposure to the program. Students not only found science exciting and approachable after participation, but also exhibited increased interest in pursuing a degree and career in science. Of the 76 SASE participants within graduation age ( n = 44), all graduated from high school; and 86% enrolled in college. These findings suggest that the implemented SASE initiative was effective in recruiting and increasing the confidence and abilities of underrepresented minority students in science.
Wade-Vuturo, Ashley E; Mayberry, Lindsay Satterwhite; Osborn, Chandra Y
Background Patient portal use has been associated with favorable outcomes, but we know less about how patients use and benefit from specific patient portal features. Objective Using mixed-methods, we explored how adults with type 2 diabetes (T2DM) use and benefit from secure messaging (SM) within a patient portal. Methods Adults with T2DM who had used a patient portal participated in a focus group and completed a survey (n=39) or completed a survey only (n=15). We performed thematic analysis of focus group transcripts to identify the benefits of and barriers to using SM within a portal. We also examined the association between use of various patient portal features and patients’ glycemic control. Results Participants were on average 57.1 years old; 65% were female; 76% were Caucasian/White, and 20% were African American/Black. Self-reported benefits of SM within a portal included enhanced patient satisfaction, enhanced efficiency and quality of face-to-face visits, and access to clinical care outside traditional face-to-face visits. Self-reported barriers to using SM within a portal included preconceived beliefs or rules about SM and prior negative experiences with SM. Participants’ assumptions about providers’ opinions about SM and providers’ instructions about SM also influenced use. Greater self-reported use of SM to manage a medical appointment was significantly associated with patients’ glycemic control (ρ=−0.29, p=0.04). Conclusion SM within a portal may facilitate access to care, enhance the quality of office visits, and be associated with patient satisfaction and clinical outcomes for patients with diabetes, but provider communication about SM is essential. PMID:23242764
Humphrey, Chloe; Hulme, Richard; Dalbeth, Nicola; Gow, Peter; Arroll, Bruce; Lindsay, Karen
INTRODUCTION The management of gout is challenging and mainly occurs in primary care. This study aims to explore the experience of treating gout among primary care clinicians and understand the perceived barriers to effective therapy. METHODS Fourteen health professionals from primary care practices in South Auckland were recruited. Each participated in a semi-structured interview exploring their experience of treating and managing gout patients were analysed thematically. FINDINGS Participants described the large burden of gout in their communities and the importance of the clinician-patient relationship in gout management. Four themes summarise the perceived barriers to effective urate lowering therapy (ULT); unique gout factors, eg its intermittent nature and potential for stigmatisation; systemic barriers to optimal treatment, or barriers that emerge from working within a certain organisation; uncertainty about ownership, or who should carry responsibility for overcoming barriers to optimal treatment; and cultural barriers to optimal treatment. CONCLUSION Clinicians in primary practice perceive gout management to be mainly acute rather than preventive care. Patients may be stigmatised and management difficult particularly when diet is emphasised over ULT. Practice nurses are a group potentially available and willing to assist in educating patients. These findings may be helpful in planning for and improving healthcare in gout. KEYWORDS Gout; general practice; uric acid; primary health care; allopurinol; primary prevention.
Kumar, Rajesh; Usunier, Jean-Claude
Assesses the challenges posed by the talk of globalization for French management education. Analyzes the strategies adopted by French business schools for coping with the globalization imperative. (DDR)
The efficacy, the ability to confer protection against a target disease and the safety of a vaccine are assessed in great detail before licensure. However, inherent limitations in the prelicensure assessment necessitate continued epidemiological evaluations of efficacy and safety issues after the introduction of vaccines into use. In Denmark, the opportunities available for epidemiological research are unique. In 2001, an initiative was undertaken to take advantage of these opportunities to study the postlicensure epidemiology of childhood vaccination with respect to effectiveness and safety. First, we describe the unique opportunities for postlicensure research in Denmark with respect to the data sources available and the epidemiological and statistical methods used. We then describe a number of recent postlicensure studies of effectiveness and safety that took advantage of these opportunities. Specifically, studies on the effectiveness of Haemophilus influenzae type b vaccination, the effectiveness of pertussis vaccination, the impact of a preschool pertussis booster on infant pertussis, measles-mumps-rubella vaccine and autism, thimerosal-containing vaccine and autism, measles-mumps-rubella vaccine and febrile seizures, childhood vaccination and Type 1 diabetes, and childhood vaccination and nontargeted infectious disease are discussed.
Davis, David Charles
This historical and comparative study examines the folk high school movement in Denmark from the standpoint of the New Humanism as expressed in the writings of Carl Rogers, Abraham Maslow, Sidney Jourard, and others. These schools are unique among the many educational forms and institutions western man has developed. Private, nonprofit residential…
Frederiksen, Karen-Margrete; Laursen, Katja Årosin
This paper presents our reflections on developing the Computer-Assisted Language Learning (CALL) course "Danish for knowledge workers--labour market-related Danish." As defined by Laursen and Frederiksen (2015), knowledge workers are "highly educated people who typically work at universities, at other institutions of higher…
Williams, Laurel Lyn
Objective: This article explores the relevant data regarding teaching psychiatric residents practice management knowledge and skills. This article also introduces a unique program for teaching practice management to residents. Methods: A literature search was conducted through PubMed and "Academic Psychiatry". Additionally residents…
Research finds that, in Japanese-owned plants in America, efforts are made to bring the system around slowly to a Japanese management style through acculturation, communication, and training. Problems engendered by these efforts emerge particularly at the middle management levels. Barriers to corporate unity are far fewer at the plant level. (CT)
Dennison, David A.; Yin, Zenong; Kibbe, Debra; Burns, Susan; Trowbridge, Frederick
Context: The obesity epidemic threatens the present and future health of adolescents in the United States. Yet, health care providers lack specific training for pediatric obesity assessment and management. Purpose: This study examined the adherence of rural Georgia primary care practitioners to an overweight adolescent management protocol. The…
This paper examines the role of reflexivity in supporting middle managers in understanding and facilitating large-scale change management projects in their organisations. Utilising an example from a UK university, it is argued that the development of a conceptual model to fit local circumstances enables deeper understanding and better informed…
Nandi, Santosh; Nandi, Madhavi L.
Mobility has become an important extension to the business strategies of present-day organizations. Thus, organizations are increasingly seeking managers with knowledge of value chain related to mobile-oriented business activities, usually referred to as mobile commerce (m-commerce). Accordingly, business management schools are interesting in…
Tangwanichagapong, Siwaporn; Nitivattananon, Vilas; Mohanty, Brahmanand; Visvanathan, Chettiyappan
Purpose: This paper aims to describe the effects of 3R (reduce, reuse and recycle) waste management initiatives on a campus community. It ascertains the environmental attitudes and opinions of the residents and investigates their behavioral responses to waste management initiatives. Practical implications for enhancing sustainable waste management…
Stratta, Terese M. Peretto
To date, no empirical studies have examined the sport management internship from students' perspectives. Due to this void in the literature, the purpose of this study was to examine the needs and concerns of students when accessing and completing internships. Rather than relying solely on sport management professionals to determine the parameters…
Hiott, Judith; Beasley, Carla
The development of the Internet and the online collections accessed by it has created major adjustments in all library functions, including collection management and budgeting. The authors share how two public libraries have come full circle in electronic collection management, beginning with early selection, followed by current weeding programs…
Isola, Miriam; Polikaitis, Audrius; Laureto, Rose Ann
Recognized as an early leader in clinical information systems, the University of Illinois Medical Center was challenged to meet the ever-increasing demand for information systems. Interviews with key stakeholders revealed unfavorable attitudes toward the Information Services department. Reasons given were that projects often are not aligned with business strategy, projects are delayed, IS itself is a barrier to progress, and a lack of proactive planning precipitates crises. Under the leadership of a new CIO, IS began developing a Project Management Office, or PMO, to better meet medical center business objectives and to more effectively manage technology projects. Successes during the first year included comprehensive IT strategic planning. Collaborative relationships were established with departmental leaders for planning, prioritizing, budgeting, and executing projects. A formal Web-based process for requesting IS projects was implemented, project management training was provided, and elements of standard project management methodology were implemented. While a framework for effective project management was created, significant effort is still required to firmly root these new processes within the organizational culture. Project management office goals for the second year include implementing a project portfolio management tool, refining the benefits methodology, and continuing the advancement of the project management methodology.
Yang, Yun-Peng; Ma, Yu-Xiang; Huang, Yan; Zhao, Yuan-Yuan; Xu, Fei; Tian, Ying; Zou, Ben-Yan; Gao, Rui-Zhen; Zhang, Li
To improve cancer pain management, the Medical Oncology Department of Sun Yat-sen University Cancer Center (SYSUCC) launched the Good Pain Management (GPM) Ward Program, which has been recognized by the Chinese Ministry of Health and promoted throughout the nation. This retrospective case-control study was designed to evaluate the effectiveness of the program. Patients diagnosed with malignant solid tumors with bone metastasis were eligible. Patients who were admitted 6 months before the initiation of the GPM program were used as the control group, and patients admitted 6 months after the initiation of the program were used as the GPM group. The pain-reporting rate and pain management index (PMI) were calculated. The pain levels before and after pain management were compared. A total of 475 patients (244 in the control group and 231 in the GPM group) were analyzed. The pain-reporting rate of the GPM group was significantly higher than that of the control group (62.8% vs. 37.7%, P < 0.001). The PMI of the GPM group was significantly higher than that of the control group (0.083 vs. -0.261, P < 0.001). Therefore, the GPM Ward Program improved the pain management of cancer patients and provided experience for improving cancer pain management in the future. PMID:24874643
Pneumonia, diarrhea, malaria, measles and malnutrition account for over 70% of the 11.5 million deaths and 80-90% of sick child consultations in developing countries. These conditions often occur in combinations requiring a holistic approach of assessment, treatment and caretaker counseling. The Integrated management of Childhood Illness (IMCI) strategy has been developed to address these needs. Ethiopia contributed immensely to the development of IMCI and officially adopted it in 1997. Progress in terms of training and geographic expansion has been limited. This analytical review has been made to identify ways to strengthen and sustain IMCI implementation. Data were collected from published and unpublished information sources relevant to the IMCI strategy in Ethiopia and through key informant interviews with representatives of Federal Ministry of Health and its partners. The rationale for IMCI in Ethiopia, past, present and planned IMCI activities, related policies and strategies, strengths and weaknesses, and priorities have been analyzed and recommendations developed. The review identified that most of the childhood deaths and 40% of all disability-adjusted life years lost are associated with pneumonia, diarrhea, malaria, measles and malnutrition. IMCI has, thus, been adopted in 1997 as the main strategy for improving child health and included in the Health Sector Development Programme of the country. Three regions have piloted the strategy and their experience used to develop plans for expansion to other regions and also to initiate IMCI activities related to family and community practices. Much has been learnt from the pilot phase and from the country's involvement in the initial development of the strategy. There are critical gaps that need to be addressed for the IMCI strategy to exert the desired impact on child health in Ethiopia. The HIV/AIDS algorithm should be validated and included in the IMCI guidelines. There is a need for scaling-up training
Larsen, Lone; Jensen, Michael Dam; Larsen, Michael Due; Nielsen, Rasmus Gaardskær; Thorsgaard, Niels; Vind, Ida; Wildt, Signe; Kjeldsen, Jens
Aim The aims of The Danish National Registry for Biological Therapy in Inflammatory Bowel Disease are to ensure that biological therapy and the clinical management of patients with inflammatory bowel disease (IBD) receiving biological treatment are in accordance with the national clinical guidelines and, second, the database allows register-based clinical epidemiological research. Study population The study population comprises all Danish patients with IBD (both children and adults) with ulcerative colitis, Crohn’s disease, and IBD unclassified who receive biological therapy. Patients will be enrolled consecutively when biological treatment is initiated. Main variables The variables in the database are: diagnosis, time of diagnosis, disease manifestation, indication for biological therapy, previous biological and nonbiological therapy, date of visit, clinical indices, physician’s global assessment, pregnancy and breastfeeding (women), height (children), weight, dosage (current biological agent), adverse events, surgery, endoscopic procedures, and radiology. Descriptive data Eleven clinical indicators have been selected to monitor the quality of biological treatment. For each indicator, a standard has been defined based on the available evidence. National results will be published in an annual report and local results on a quarterly basis. The indicators will be reported as department-specific proportions with 95% confidence intervals, and the national average will be provided for comparison. An estimated 1,200–1,300 new biological therapies are initiated each year in Danish patients with IBD. Conclusion The database will be available for research during 2016. Data will be made available by The Danish Clinical Registries (www.rkkp.dk). PMID:27822107
Rapid economic growth and urbanization in developing countries lead to extensive construction activities that generate a large amount of waste. A challenge is how to manage construction waste in the most sustainable way. In the developing world, research on construction waste management is scarce and such academic knowledge needs to be responsive to actual practices in the industry in order to be implemented. As construction projects involve a number of participants and stakeholders, their participation and commitment can have a major influence on the goals of green and sustainable construction for urban development. This study provides a significant step in conducting a very first research of this kind in Thailand by aiming to investigate the level of construction stakeholders' commitment as well as the achievement of construction waste management in order to improve short-term practices and to establish a long-term strategic construction waste management plan. In this study, a structural equation model was employed to investigate the influence of factors that are related to environmental aspects, social aspects, and economic aspect of construction waste management. Concern about health and safety was found to be the most significant and dominant influence on the achievement of sustainable construction waste management. Other factors affecting the successful management of construction waste in Thai construction projects were also identified. It is perceived that this study has potential to contribute useful guidelines for practitioners both in Thailand and other developing countries with similar contexts.
Aiftimiei, C.; Andreetto, P.; Bertocco, S.; Fina, S. D.; Ronco, S. D.; Dorigo, A.; Gianelle, A.; Marzolla, M.; Mazzucato, M.; Sgaravatto, M.; Verlato, M.; Zangrando, L.; Corvo, M.; Miccio, V.; Sciaba, A.; Cesini, D.; Dongiovanni, D.; Grandi, C.
Modern Grid middleware is built around components providing basic functionality, such as data storage, authentication, security, job management, resource monitoring and reservation. In this paper we describe the Computing Resource Execution and Management (CREAM) service. CREAM provides a Web service-based job execution and management capability for Grid systems; in particular, it is being used within the gLite middleware. CREAM exposes a Web service interface allowing conforming clients to submit and manage computational jobs to a Local Resource Management System. We developed a special component, called ICE (Interface to CREAM Environment) to integrate CREAM in gLite. ICE transfers job submissions and cancellations from the Workload Management System, allowing users to manage CREAM jobs from the gLite User Interface. This paper describes some recent studies aimed at assessing the performance and reliability of CREAM and ICE; those tests have been performed as part of the acceptance tests for integration of CREAM and ICE in gLite. We also discuss recent work towards enhancing CREAM with a BES and JSDL compliant interface.
Chun, Kevin M; Chesla, Catherine A; Kwan, Christine M L
This study examines how acculturation affects type 2 diabetes management and perceived health for Chinese American immigrants in the U.S. Acculturation experiences or cultural adaptation experiences affecting diabetes management and health were solicited from an informant group of immigrant patients and their spouses (N = 40) during group, couple and individual interviews conducted from 2005 to 2008. A separate respondent group of immigrant patients and their spouses (N = 19) meeting inclusion criteria reviewed and confirmed themes generated by the informant group. Using interpretive phenomenology, three key themes in patients' and spouses' acculturation experiences were identified: a) utilizing health care, b) maintaining family relations and roles, and c) establishing community ties and groundedness in the U.S. Acculturation experiences reflecting these themes were broad in scope and not fully captured by current self-report and proxy acculturation measures. In the current study, shifting family roles and evaluations of diabetes care and physical environment in the U.S. significantly affected diabetes management and health, yet are overlooked in acculturation and health investigations. Furthermore, the salience and impact of specific acculturation experiences respective to diabetes management and perceived health varied across participants due to individual, family, developmental, and environmental factors. In regards to salience, maintaining filial and interdependent family relations in the U.S. was of particular concern for older participants and coping with inadequate health insurance in the U.S. was especially distressing for self-described lower-middle to middle-class participants. In terms of impact, family separation and relocating to ethnically similar neighborhoods in the U.S. differentially affected diabetes management and health due to participants' varied family relations and pre-migration family support levels and diverse cultural and linguistic
Shafii, Milad; Hosseini, Seyed Mostafa; Arab, Mohammad; Asgharizadeh, Ezzatollah; Farzianpour, Fereshteh
Background and Objectives: Hospitals are complex organizations that require strong and effective management. The success of such organizations depends on the performance of managers. This study provides a comprehensive set of indicators to assess the performance of hospital managers in Iranian Ministry of Health owned hospitals. Methods: This research was a cross-sectional study. First, reviewing the literature and using experts’ viewpoints and convening a panel of experts, the dimensions of performance have been selected and came in the form of a performance model. Then, using Fuzzy Analytic Hierarchy Process (FAHP), the chosen dimensions were weighted. Finally, based on the weighted performance dimensions, a questionnaire was designed and after confirming the reliability and validity, through a census, 407 senior and middle managers from 10 hospitals in Yazd, Iran completed it and performance of CEOs in these hospitals was evaluated using the Fuzzy Technique for Order Preference by Similarity Ideal Solution (FTOPSIS). Results: To measure the performance of hospital managers, a performance assessment model consisted of 19 sub-dimensions in 5 main dimensions (Functional, Professional, Organizational, Individual and Human) was developed. The functional area had the most weight and the individual area had the least weight, as well. The hospital managers had different performance levels in each category and sub-dimensions. In terms of overall performance, the hospital managers C and H had the best and the worst performance, respectively. Conclusions: The use of appropriate dimensions for performance, prioritizing them and evaluating the performance of hospital managers using appropriate techniques, can play an effective role in the selection of qualified managers, identifying strengths and weaknesses in performance and continuous improvement of them. PMID:26383216
Pearce, Gemma; Pinnock, Hilary; Epiphaniou, Eleni; Parke, Hannah L.; Heavey, Emily; Griffiths, Christopher J.; Greenhalgh, Trish; Sheikh, Aziz; Taylor, Stephanie J. C.
Background Supporting self-management in stroke patients improves psychological and functional outcomes but evidence on how to achieve this is sparse. We aimed to synthesise evidence from systematic reviews of qualitative studies in an overarching meta-review to inform the delivery and development of self-management support interventions. Methods We systematically searched eight electronic databases including MEDLINE, EMBASE and CINAHL for qualitative systematic reviews (published January 1993 to June 2012). We included studies exploring patients’, carers’ or health care professionals’ experiences relevant to self-management support following a stroke, including studies describing the lived experience of surviving a stroke. We meta-synthesised the included review findings using a meta-ethnographic framework. Results Seven reviews, reporting 130 unique studies, were included. Themes emerging from the reviews were pertinent, consistent and showed data saturation; though explicit mention of self-management support was rare. Our meta-review highlighted the devastating impact of stroke on patients’ self-image; the varying needs for self-management support across the trajectory of recovery; the need for psychological and emotional support throughout recovery particularly when physical recovery plateaus; the considerable information needs of patients and carers which also vary across the trajectory of recovery; the importance of good patient-professional communication; the potential benefits of goal-setting and action-planning; and the need for social support which might be met by groups for stroke survivors. Conclusions The observed data saturation suggests that, currently, no further qualitative research simply describing the lived experience of stroke is needed; we propose that it would be more useful to focus on qualitative research informing self-management support interventions and their implementation. Our findings demonstrate both the on-going importance
Spiegel, Heide; Lehtinen, Taru; Schlatter, Norman; Haslmayr, Hans-Peter; Baumgarten, Andreas; ten Berge, Hein
Successful agricultural management practices are required to maintain or enhance soil quality; at the same time climate change mitigation is becoming increasingly important. Within the EU project CATCH-C we analysed the effects of different agricultural practices not only on crop productivity, but also on soil quality indicators (e.g. soil organic carbon (SOC)) and climate change (CC) mitigation indicators (e.g. CO2, CH4, N2O emissions). European data sets and associated literature, mainly from long-term experiments were evaluated. This evaluation of agricultural management practices was carried out comparing a set of improved ("best") and often applied ("current") management practices. Positive and negative effects occurred when best management practices are adopted. As expected, none of the investigated practices could comply with all objectives simultaneously, i.e. maintaining high yields, mitigating climate change and improving chemical, physical and biological soil quality. The studied soil management practices "non-inversion tillage", "organic fertilisation" (application of farm yard manure, slurry, compost) and "incorporation of crop residues" represent important management practices for farmers to increase SOC, thus improving soil quality. However, CO2 and, especially, N2O emissions may rise as well. The evaluation of CC mitigation is often limited by the lack of data from - preferably - continuous GHG emission measurements. Thus, more long-term field studies are needed to better assess the CO2, CH4 and, especially, N2O emissions following the above mentioned favorably rated MPs. Only if SOC and GHG emissions are measured in the same field experiments, it will be possible to compute overall balances of necessary CO2-C equivalent emissions. CATCH-C is funded within the 7th Framework Programme for Research, Technological Development and Demonstration, Theme 2 - Biotechnologies, Agriculture & Food. (Grant Agreement N° 289782).
Hallberg, I; Ranerup, A; Kjellgren, K
Globally, hypertension is poorly controlled and its treatment consists mainly of preventive behavior, adherence to treatment and risk-factor management. The aim of this study was to explore patients' experiences of an interactive mobile phone-based system designed to support the self-management of hypertension. Forty-nine patients were interviewed about their experiences of using the self-management system for 8 weeks regarding: (i) daily answers on self-report questions concerning lifestyle, well-being, symptoms, medication intake and side effects; (ii) results of home blood-pressure measurements; (iii) reminders and motivational messages; and (iv) access to a web-based platform for visualization of the self-reports. The audio-recorded interviews were analyzed using qualitative thematic analysis. The patients considered the self-management system relevant for the follow-up of hypertension and found it easy to use, but some provided insight into issues for improvement. They felt that using the system offered benefits, for example, increasing their participation during follow-up consultations; they further perceived that it helped them gain understanding of the interplay between blood pressure and daily life, which resulted in increased motivation to follow treatment. Increased awareness of the importance of adhering to prescribed treatment may be a way to minimize the cardiovascular risks of hypertension.
Bliss, Mary; Bowyer, Sonya M.; Bryant, Janet L.; Lipton, Mary S.; Wahl, Karen L.
Radiation workers at the Pacific Northwest National Laboratory are divided into two classes based on whether or not they can encounter radioactive contamination in the normal course of their work. Level I workers primarily handle sealed radioactive materials such as those used to calibrate detectors. Level II workers perform benchtop chemistry. The U.S. Department of Energy has strict guidelines on the management of pregnant radiation workers. Staff members may voluntarily notify their line managers of a pregnancy and be subjected to stringent radiation exposure limits for the developing fetus. The staff member and manager develop a plan to limit and monitor radiation dose for the remainder of the pregnancy. Several examples of dose management plans and case examples of the impact of pregnancy on staff member?s technical work and projects will be presented.
Munson, John B.
A summary of Quality Improvement techniques, implementation, and results in the maintenance, management, and modification of large software systems for the Space Shuttle Program's ground-based systems is provided.
Seifman, Marc; Ek, Edmund W; Menezes, Hana; Rozen, Warren M; Whitaker, Iain S; Cleland, Heather J
Mass burn disasters are among the most difficult disasters to manage, with major burns requiring complex management in a multidisciplinary setting and specialist burns services having limited capacity to deal with large numbers of complex patients. There is a paucity of literature addressing health system responses to mass burn disasters resulting from wildfires, with the events of the "Black Saturday" disaster in the state of Victoria, Australia, able to provide a unique opportunity to draw lessons and increase awareness of key management issues arising in mass burn casualty disasters. The event comprised the worst natural disaster in the state's history and one of the worst wildfire disasters in world history, claiming 173 lives and costing more than AUD 4 billion. This article draws on the national burns disaster plan instituted, Australian Mass Casualty Burn Disaster Plan (AUSBURNPLAN), and details the management of mass burn cases through a systems-based perspective.
Wooten, Kevin C; Dann, Sara M; Finnerty, Celeste C; Kotarba, Joseph A
The development of leadership and project management skills is increasingly important to the evolution of translational science and team-based endeavors. Team science is dependent upon individuals at various stages in their careers, inclusive of postdocs. Data from case histories, as well as from interviews with current and former postdocs, and those supervising postdocs, indicate six essential tasks required of project managers in multidisciplinary translational teams, along with eight skill-related themes critical to their success. To optimize the opportunities available and to ensure sequential development of team project management skills, a life cycle model for the development of translational team skills is proposed, ranging from graduate trainees, postdocs, assistant professors, and finally to mature scientists. Specific goals, challenges and project management roles and tasks are recommended for each stage for the life cycle.
Arutiunov, A S; Kitsul, I S; Lebedenko, I Iu; Gazazian, V V
Expericnce of working out of tools of quality management of maxillofacial prosthetics which can be applied in clinical practice of maxillofacial orthopedy is presented. The fragment of the algorithm of maxillofacial prosthetics developed by authors is presented.
Jupiter, Jesse B
This personal series of nonunions of the distal humerus reviews unique features of this problem, categorizes them according to unique anatomic features, and presents pitfalls and pearls in the management of these complex reconstructive problems.
Wooten, Kevin C.; Dann, Sara M.; Finnerty, Celeste C.; Kotarba, Joseph A.
The development of leadership and project management skills is increasingly important to the evolution of translational science and team-based endeavors. Team science is dependent upon individuals at various stages in their careers, inclusive of postdocs. Data from case histories, as well as from interviews with current and former postdocs, and those supervising postdocs, indicate six essential tasks required of project managers in multidisciplinary translational teams, along with eight skill-related themes critical to their success. To optimize the opportunities available and to ensure sequential development of team project management skills, a life cycle model for the development of translational team skills is proposed, ranging from graduate trainees, postdocs, assistant professors, and finally to mature scientists. Specific goals, challenges and project management roles and tasks are recommended for each stage for the life cycle. PMID:25621288
Mashreky, S R; Bari, S; Sen, S L; Rahman, A; Khan, T F; Rahman, F
Although burn disaster is not a frequent event, with urbanisation and industrialisation, burn disaster is becoming an emerging problem in Bangladesh. On 3 June 2010, a fire disaster killed 124 people in Neemtali, Dhaka, Bangladesh. This paper narrates the management of burn patients of this disaster in the burn unit of Dhaka Medical College Hospital. The burn unit managed 192 burn victims of the disaster. Forty-two victims were admitted and 150 of them received primary care at the emergency room and were sent back home. Ten patients among 42 in-patients died. The in-patient mortality was 23.8%. Burn unit in Dhaka Medical College Hospital is the only burn management centre in Bangladesh. Proper planning and coordinated effort by all sectors and persons concerned were the key elements in this successful management.
Araújo, Carmem Emmanuely Leitão; Pontes, Ricardo José Soares
This research deals with the potential and limitations of the strengthening of subjects in health management, based on the experience in Fortaleza in the period from 2005 to 2008. The subject is approached from a historical-cultural standpoint, which considers the dialectical interaction between the individual and the collective in deepening human consciousness on the self and the world. Focus groups were conducted with managers linked to Primary Healthcare and secondary data were utilized. An attempt was made to understand the meaning of the narratives constructed using a hermeneutic dialectic approach. Empirical categories were identified and analyzed as well as co-intentionality of change, political and conceptual drives, human management, reduction of hierarchy, fragmentation of work processes and concentration of decision-making power. Reflections arose on three main strategic policies: co-management, humanization, and continuous health education. It was concluded that, despite the persistence of obstacles, in order to improve the quality of healthcare services it is essential to establish a democratic management system through organizational arrangements and participatory methods that enhance integration and commitment of the Unified Health System players (SUS).
Silverstone, S.; Nelson, M.; Alling, A.; Allen, J. P.
During the years 2002 and 2003, three closed system experiments were carried out in the "Laboratory Biosphere" facility located in Santa Fe, New Mexico. The program involved experimentation of "Hoyt" Soy Beans, (experiment #1) USU Apogee Wheat (experiment #2) and TU-82-155 sweet potato (experiment #3) using a 5.37 m 2 soil planting bed which was 30 cm deep. The soil texture, 40% clay, 31% sand and 28% silt (a clay loam), was collected from an organic farm in New Mexico to avoid chemical residues. Soil management practices involved minimal tillage, mulching, returning crop residues to the soil after each experiment and increasing soil biota by introducing worms, soil bacteria and mycorrhizae fungi. High soil pH of the original soil appeared to be a factor affecting the first two experiments. Hence, between experiments #2 and #3, the top 15 cm of the soil was amended using a mix of peat moss, green sand, humates and pumice to improve soil texture, lower soil pH and increase nutrient availability. This resulted in lowering the initial pH of 8.0-6.7 at the start of experiment #3. At the end of the experiment, the pH was 7.6. Soil nitrogen and phosphorus has been adequate, but some chlorosis was evident in the first two experiments. Aphid infestation was the only crop pest problem during the three experiments and was handled using an introduction of Hyppodamia convergens. Experimentation showed there were environmental differences even in this 1200 cubic foot ecological system facility, such as temperature and humidity gradients because of ventilation and airflow patterns which resulted in consequent variations in plant growth and yield. Additional humidifiers were added to counteract low humidity and helped optimize conditions for the sweet potato experiment. The experience and information gained from these experiments are being applied to the future design of the Mars On Earth ® facility (Silverstone et al., Development and research program for a soil
Schoffstall, Donald G.
Previous researchers have suggested that in order to be successful in the hospitality industry, students need to obtain work experience in addition to completing their degrees. Although the benefit of gaining such experience from the industry viewpoint has been well documented, few studies have assessed the benefits and challenges faced by…
Essakalli, M; Atouf, O; Ouadghiri, S; Bouayad, A; Drissi, A; Sbain, K; Sakri, L; Benseffaj, N; Brick, C
The management by objectives method has become highly used in health management. In this context, the blood transfusion and haemovigilance service has been chosen for a pilot study by the Head Department of the Ibn Sina Hospital in Rabat. This study was conducted from 2009 to 2011, in four steps. The first one consisted in preparing human resources (information and training), identifying the strengths and weaknesses of the service and the identification and classification of the service's users. The second step was the elaboration of the terms of the contract, which helped to determine two main strategic objectives: to strengthen the activities of the service and move towards the "status of reference." Each strategic objective had been declined in operational objectives, then in actions and the means required for the implementation of each action. The third step was the implementation of each action (service, head department) so as to comply with the terms of the contract as well as to meet the deadlines. Based on assessment committees, the last step consisted in the evaluation process. This evaluation was performed using monitoring indicators and showed that management by objectives enabled the Service to reach the "clinical governance level", to optimize its human and financial resources and to reach the level of "national laboratory of reference in histocompatibility". The scope of this paper is to describe the four steps of this pilot study and to explain the usefulness of the management by objectives method in health management.
Muroff, Jordana; Amodeo, Maryann; Larson, Mary Jo; Carey, Margaret; Loftin, Ralph D
This article describes a data management system (DMS) developed to support a large-scale randomized study of an innovative web-course that was designed to improve substance abuse counselors' knowledge and skills in applying a substance abuse treatment method (i.e., cognitive behavioral therapy; CBT). The randomized trial compared the performance of web-course-trained participants (intervention group) and printed-manual-trained participants (comparison group) to determine the effectiveness of the web-course in teaching CBT skills. A single DMS was needed to support all aspects of the study: web-course delivery and management, as well as randomized trial management. The authors briefly reviewed several other systems that were described as built either to handle randomized trials or to deliver and evaluate web-based training. However it was clear that these systems fell short of meeting our needs for simultaneous, coordinated management of the web-course and the randomized trial. New England Research Institute's (NERI) proprietary Advanced Data Entry and Protocol Tracking (ADEPT) system was coupled with the web-programmed course and customized for our purposes. This article highlights the requirements for a DMS that operates at the intersection of web-based course management systems and randomized clinical trial systems, and the extent to which the coupled, customized ADEPT satisfied those requirements. Recommendations are included for institutions and individuals considering conducting randomized trials and web-based training programs, and seeking a DMS that can meet similar requirements.
Fontana, Margherita; Zero, Domenick
Although dentistry recognizes that dental caries management encompasses more than restoring the consequences of the disease, caries risk assessment and management that go beyond traditional restorative care have not always had a strong and organized voice during clinical curriculum development and competency assessment in U.S. dental schools. This has resulted in confusion and great variability between the need for risk-based caries management and prevention and how practitioners apply these concepts in private and community settings. Dental education is in the unique position of being able to help bridge the gap to improve dissemination of new information and to enhance communication between research and the practice of dentistry to accelerate adoption of validated approaches for the diagnosis and management of dental caries. This paper presents one example of how a dental school totally revamped its approach to teaching cariology--from a few lectures scattered throughout the curriculum to a Cariology Management Program that is integrated into all four years of the curriculum, that includes both didactic and clinical components, and that emphasizes critical thinking and problem solving. From its inception, the program was centered on a competency requirement for graduation and the principles of evidence-based practice. The process, competency, and initial programmatic outcomes assessment measures are discussed. Barriers encountered are briefly reviewed from the following perspectives: dental school structure, faculty support/calibration, students, reimbursement, and standard of care/public expectations.
Background Gestational diabetes rates have increased dramatically in the past two decades and this pattern of increase appears to relate primarily to the obesity epidemic, older maternal age and migration from world areas of high GDM risk. Women from disadvantaged and migrant backgrounds are most at risk of developing and of mismanaging this condition. The aim of the study was to explore the factors that facilitated or inhibited gestational diabetes self-management among women in a socially deprived area. Methods Fifteen pregnant women, with a diagnosis of gestational diabetes, were purposively recruited for this study. Qualitative semi structured interviews and 1 focus group were conducted when participants were approximately 28–38 weeks gestation. The study’s theoretical framework was based on interpretative phenomenology and data was analysed using a thematic analysis approach. Results Women in this study identified a number of factors that complicated their task of GDM self-management. Barriers included: (1) time pressures; (2) physical constraints; (3) social constraints; (4) limited comprehension of requirements, and (5) insulin as an easier option. Factors facilitating GDM self-management included: thinking about the baby and psychological support from partners and families. Conclusion Women from low socio economic and migrant backgrounds often struggle to comprehend GDM self-management requirements. To improve adherence to management plans, these women require educational and supportive services that are culturally appropriate and aimed at a low level of literacy. PMID:22988897
Middleton, Beth A.
Land managers are grappling with massive changes in vegetation structure, particularly in protected areas formerly subjected to fire and grazing. The objective of this review was to compare notes on the historical and current management of ecosystems around the world (especially in wet to dry grasslands in the Americas, Australia, Africa, Europe and Asia) with respect to the usage of fire, grazing and cutting to reduce dominance and support the biodiversity of rare species. This review suggests that former disturbances, which are now often lost, may have once kept tall vegetation from pushing out rarer subdominant species. In cases where prehistoric biodiversity depended on fire or large ungulate grazing, traditional agricultural and indigenous practices may have carried biodiversity forward to historical times by mimicking pre-cultural disturbances (e.g., lightning fire and bison grazing). Ironically, biodiversity related to species richness, landscape heterogeneity and function may decline in preserves, especially if traditional management once maintained this biodiversity. Managers can benefit from a cross-continental comparison of the full arsenal of management techniques used to control encroaching vegetation.
Background Coordinated, interdisciplinary services, supported by self-management underpin effective management for chronic low back pain (CLBP). However, a combination of system, provider and consumer-based barriers exist which limit the implementation of such models into practice, particularly in rural areas where unique access issues exist. In order to improve health service delivery for consumers with CLBP, policymakers and service providers require a more in depth understanding of these issues. The objective of this qualitative study was to explore barriers experienced by consumers in rural settings in Western Australia (WA) to accessing information and services and implementing effective self-management behaviours for CLBP. Methods Fourteen consumers with a history of CLBP from three rural sites in WA participated. Maximum variation sampling was employed to ensure a range of experiences were captured. An interviewer, blinded to quantitative pain history data, conducted semi-structured telephone interviews using a standardised schedule to explore individuals’ access to information and services for CLBP, and self-management behaviours. Interviews were digitally recorded and transcribed verbatim. Inductive analysis techniques were used to derive and refine key themes. Results Five key themes were identified that affected individuals’ experiences of managing CLBP in a rural setting, including: 1) poor access to information and services in rural settings; 2) inadequate knowledge and skills among local practitioners; 3) feelings of isolation and frustration; 4) psychological burden associated with CLBP; and 5) competing lifestyle demands hindering effective self-management for CLBP. Conclusions Consumers in rural WA experienced difficulties in knowing where to access relevant information for CLBP and expressed frustration with the lack of service delivery options to access interdisciplinary and specialist services for CLBP. Competing lifestyle demands such as
la Cour, Peter
Patterns in the psychological defenses of medical students may have implications for the way they handle and respond to the pressures and developmental issues they encounter in medical school and beyond. Using the Defense Style Questionnaire (DSQ40) to assess psychological defenses, a sample of first-year Danish medical students was compared with a sample of students at a short-term boarding school for general education. The medical students scored significantly higher on items connected with pseudo-altruism, denial, and undoing. Trends in the data furthermore suggest a greater use of sublimation, rationalization, and dissociation among medical students. When defense mechanisms were labeled into mature, neurotic, and immature categories, there were no differences between the groups or in the total defense scores.
Vaismoradi, Mojtaba; Skär, Lisa; Söderberg, Siv; Bondas, Terese E.
Older people who live in nursing homes commonly suffer from pain. Therefore, relieving suffering among older people that stems from pain demands knowledge improvement through an integration of international knowledge. This study aimed to integrate current international findings and strengthen the understanding of older people's experiences of and perspectives on pain and pain management in nursing homes. A meta-synthesis study using Noblit and Hare's interpretative meta-ethnography approach was conducted. Empirical research papers from journals were collected from various databases. The search process and appraisal determined six articles for inclusion. Two studies were conducted in the US and one each in Iceland, Norway, the UK, and Australia. The older people's experiences of pain as well as perspectives on pain management from all involved (older people, their family members, and healthcare staff) were integrated into a theoretical model using three themes of “identity of pain,” “recognition of pain,” and “response to pain.” The metaphor of “normalizing suffering” was devised to illustrate the meaning of pain experiences and pain management in nursing homes. Society's common attitude that pain is unavoidable and therefore acceptable in old age in society—among older people themselves as well as those who are responsible for reporting, acknowledging, and relieving pain—must change. The article emphasizes that pain as a primary source of suffering can be relieved, provided that older people are encouraged to report their pain. In addition, healthcare staff require sufficient training to take a person-centered approach towards assessment and management of pain that considers all elements of pain. PMID:27173102
Martin, Angela; Jawad, Sena; Davoudianfar, Mina; Locock, Louise; Ziebland, Sue; Powell, John
Objective To determine the feasibility of a randomised controlled trial (RCT) assessing the effects of an experience-based website as a resource for the self-management of chronic asthma. Design and setting Feasibility, single-blind RCT in 2 regions of England. Randomisation used computer-generated random number sequence in a 1:1 ratio, after baseline data collection, to website access for 2 weeks. Participants Adults (age ≥18 years), with clinically diagnosed asthma as coded in their primary care electronic record, prescribed inhaled corticosteroids for at least 3 months in the previous year, were recruited from 9 general practices. Intervention The EXPERT asthma intervention is an interactive PC/laptop/tablet/smartphone compatible website designed with extensive input from adults with asthma. It provides experience-based information and aims to support subjective perception of self-efficacy, self-management and improve health status. Outcome measures Primary outcomes were consent/recruitment, website usage and completion of outcome measures. Secondary outcomes included Partners in Health (PIH) questionnaire, the Chronic Disease Self-Efficacy Scale, the SF36 and the E-Health Impact Questionnaire. Participant blinding postrandomisation was not possible. The analysis was blind to allocation. Results Recruitment target exceeded. 148 participants randomised (73 intervention group). Age range 19–84 years; 59% female. 121 of 148 (84%; 62 intervention group) followed up. The median number of logins was 2 (IQR 2–3, range 1–48). Minimal differences of change from baseline between groups; both showed improvement in health state or management of their condition with no significant differences between arms. No adverse events. Conclusions Recruitment and retention confirmed feasibility. The trends towards improved outcomes suggest that further research on digital interventions based on exposure to others’ personal experiences may be of value in the self-management
Yoshida, Ronald Y.; Meeks, Willis G.
The management of the Ulysses project, a probe which will fly a solar polar orbit, is described. The 5-yr mission will feature a flyby of Jupiter to deflect the spacecraft into a high-inclination orbit. Data on the solar corona, solar wind, the sun-wind interface, the heliospheric magnetic field, solar and nonsolar cosmic rays, etc., will be gathered as a function of the solar latitude. NASA will track and control the probe with the Deep Space Network. JPL provides project management for NASA while the Directorate of Scientific Programs performs ESA management functions. The DOE will provide a radioisotope thermoelectric generator while NASA and ESA each supply half the scientific payload. A NASA-ESA Joint Working Group meets about twice per year to monitor the project and discuss the technical and scientific requirements. Safety issues and measures which are being addressed due to the presence of the Pu-238 heat source for the RTG are discussed.
Hull, J B; Raza, S A; Stockley, I; Elson, R A
Of 56 acetabular fractures treated in Sheffield between 1976 and 1994, 43 fractures in 40 patients underwent open reduction and internal fixation. This paper reviews the surgically managed fractures with emphasis on the quality of operative reduction and outcome, in particular the development of degenerative osteoarthritis leading to total hip replacement. A good clinical result following operative management was seen to correlate closely with a near perfect reduction; in contrast, all cases with a poor reduction underwent joint replacement in the follow-up period. The relatively few cases managed at a major referral centre in this series suggest that either the incidence of acetabular fracture is low in the area or that only a proportion of cases are referred from the surrounding district general hospitals.
Chato, David J.
This paper reviews the history of cryogenic fluid management technology development and infusion into both the Saturn and Centaur vehicles. Ground testing and analysis proved inadequate to demonstrate full scale performance. As a consequence flight demonstration with full scale vehicle was required by both the Saturn and Centaur programs to build confidence that problems were addressed. However; the flight vehicles were highly limited on flight instrumentation and the flight demonstration “locked-in” the design without challenging the function of design elements. Projects reviewed include: the Aerobee Sounding Rocket Cryogenic Fluid Management (CFM) tests which served as a valuable stepping stone to flight demonstration and built confidence in the ability to handle hydrogen in low gravity; the Saturn IVB Fluid Management Qualification flight test; the Atlas Centaur demonstration flights to develop two burn capability; and finally the Titan Centaur two post mission flight tests.
Chato, David J.
This paper reviews the history of cryogenic fluid management technology development and infusion into both the Saturn and Centaur vehicles. Ground testing and analysis proved inadequate to demonstrate full scale performance. As a consequence flight demonstration with a full scale vehicle was required by both the Saturn and Centaur programs to build confidence that problems were addressed. However; the flight vehicles were highly limited on flight instrumentation and the flight demonstration locked-in the design without challenging the function of design elements. Projects reviewed include: the Aerobee Sounding Rocket Cryogenic Fluid Management (CFM) tests which served as a valuable stepping stone to flight demonstration and built confidence in the ability to handle hydrogen in low gravity; the Saturn IVB Fluid Management Qualification flight test; the Atlas Centaur demonstration flights to develop two burn capability; and finally the Titan Centaur two post mission flight tests.
Nkhoma, Bryson G.; Mulwafu, Wapulumuka O.
This study examines the process of irrigation management transfer (IMT) in Malawi using the case studies of Likangala and Domasi irrigation schemes in the lake Chilwa basin. It observes that the concept of irrigation management transfer has been adopted against the background of poor performance of irrigation schemes in Malawi and the desire of the state to conform to global trends and approaches in the management of irrigation schemes. In the context of Malawi, the process of IMT involves rehabilitation of schemes and training of farmers before handing them over. The paper notes that so far the handover process has been fraught with many challenges, not least of which includes lack of adequate funds, delays, lack of public awareness and farmers’ conflicting perceptions on the handover of irrigation schemes. These problems militate against the success of IMT in the Domasi and Likangala irrigation schemes in particular and other schemes in the country as a whole.
Almazrooa, Soulafa A; Woo, Sook-Bin; Mawardi, Hani; Treister, Nathaniel
Exfoliative cheilitis (EC) is a rare inflammatory condition affecting the vermilion of the lips and characterized by production of a thick keratin scale. Given the limited available data, the approach to optimal management of EC remains unclear. The objective of this retrospective study was to characterize the clinical features, management, and outcomes of a series of patients with EC. Fifteen patients with a median age of 59 years and a female-to-male ratio of 2:1 were diagnosed with EC from 2000 to 2010. Parafunctional lip licking (53%) and a history of psychiatric disorders (40%) were common. Ten patients (66%) returned for follow-up, with an overall response rate (partial or complete) of 80% at a median of 2 months, most frequently associated with the use of topical calcineurin inhibitors or moisturizing agents. Management of EC with topical calcineurin inhibitors and moisturizing agents is associated with clinical improvement, but prospective trials are needed.
Links, Amanda E; Draper, David; Lee, Elizabeth; Guzman, Jessica; Valivullah, Zaheer; Maduro, Valerie; Lebedev, Vlad; Didenko, Maxim; Tomlin, Garrick; Brudno, Michael; Girdea, Marta; Dumitriu, Sergiu; Haendel, Melissa A; Mungall, Christopher J; Smedley, Damian; Hochheiser, Harry; Arnold, Andrew M; Coessens, Bert; Verhoeven, Steven; Bone, William; Adams, David; Boerkoel, Cornelius F; Gahl, William A; Sincan, Murat
The National Institutes of Health Undiagnosed Diseases Program (NIH UDP) applies translational research systematically to diagnose patients with undiagnosed diseases. The challenge is to implement an information system enabling scalable translational research. The authors hypothesized that similar complex problems are resolvable through process management and the distributed cognition of communities. The team, therefore, built the NIH UDP integrated collaboration system (UDPICS) to form virtual collaborative multidisciplinary research networks or communities. UDPICS supports these communities through integrated process management, ontology-based phenotyping, biospecimen management, cloud-based genomic analysis, and an electronic laboratory notebook. UDPICS provided a mechanism for efficient, transparent, and scalable translational research and thereby addressed many of the complex and diverse research and logistical problems of the NIH UDP. Full definition of the strengths and deficiencies of UDPICS will require formal qualitative and quantitative usability and process improvement measurement.
Links, Amanda E.; Draper, David; Lee, Elizabeth; Guzman, Jessica; Valivullah, Zaheer; Maduro, Valerie; Lebedev, Vlad; Didenko, Maxim; Tomlin, Garrick; Brudno, Michael; Girdea, Marta; Dumitriu, Sergiu; Haendel, Melissa A.; Mungall, Christopher J.; Smedley, Damian; Hochheiser, Harry; Arnold, Andrew M.; Coessens, Bert; Verhoeven, Steven; Bone, William; Adams, David; Boerkoel, Cornelius F.; Gahl, William A.; Sincan, Murat
The National Institutes of Health Undiagnosed Diseases Program (NIH UDP) applies translational research systematically to diagnose patients with undiagnosed diseases. The challenge is to implement an information system enabling scalable translational research. The authors hypothesized that similar complex problems are resolvable through process management and the distributed cognition of communities. The team, therefore, built the NIH UDP integrated collaboration system (UDPICS) to form virtual collaborative multidisciplinary research networks or communities. UDPICS supports these communities through integrated process management, ontology-based phenotyping, biospecimen management, cloud-based genomic analysis, and an electronic laboratory notebook. UDPICS provided a mechanism for efficient, transparent, and scalable translational research and thereby addressed many of the complex and diverse research and logistical problems of the NIH UDP. Full definition of the strengths and deficiencies of UDPICS will require formal qualitative and quantitative usability and process improvement measurement. PMID:27785453
Jakobsen, Jakob Kristian; Öztürk, Buket; Søgaard, Mette
Aim of database The Danish National Penile Cancer Quality database (DaPeCa-data) aims to improve the quality of cancer care and monitor the diagnosis, staging, and treatment of all incident penile cancer cases in Denmark. The aim is to assure referral practice, guideline adherence, and treatment and development of the database in order to enhance research opportunities and increase knowledge and survival outcomes of penile cancer. Study population The DaPeCa-data registers all patients with newly diagnosed invasive squamous cell carcinoma of the penis in Denmark since June 2011. Main variables Data are systematically registered at the time of diagnosis by a combination of automated data-linkage to the central registries as well as online registration by treating clinicians. The main variables registered relate to disease prognosis and treatment morbidity and include the presence of risk factors (phimosis, lichen sclerosus, and human papillomavirus), date of diagnosis, date of treatment decision, date of beginning of treatment, type of treatment, treating hospital, type and time of complications, date of recurrence, date of death, and cause of death. Descriptive data Registration of these variables correlated to the unique Danish ten-digit civil registration number enables characterization of the cohort, individual patients, and patient groups with respect to age; 1-, 3-, and 5-year disease-specific and overall survival; recurrence patterns; and morbidity profile related to treatment modality. As of August 2015, more than 200 patients are registered with ∼65 new entries per year. Conclusion The DaPeCa-data has potential to provide meaningful, timely, and clinically relevant quality data for quality maintenance, development, and research purposes. PMID:27822104
Overgaard, Jens; Jovanovic, Aleksandar; Godballe, Christian; Grau Eriksen, Jesper
Aim of the database The Danish Head and Neck Cancer database is a nationwide clinical quality database that contains prospective data collected since the early 1960s. The overall aim of this study was to describe the outcome of the national strategy for multidisciplinary treatment of head and neck cancer in Denmark and to create a basis for clinical trials. Study population The study population consisted of all Danish patients referred for treatment of squamous cell carcinoma of the larynx, pharynx, oral cavity, or neck nodes from unknown primary or any histopathological type (except lymphoma) of cancer in the nasal sinuses, salivary glands, or thyroid gland (corresponding to the International Classification of Diseases, tenth revision, classifications C.01–C.11, C.30–C.32, C.73, and C.80). Main variables The main variables used in the study were symptoms and the duration of the symptoms; etiological factors; pretreatment and diagnostic evaluation, including tumor–node–metastasis classification, imaging, histopathology, and laboratory tests; primary treatment with semidetailed information of radiotherapy, surgery, and medical treatment; follow-up registration of tumor status and side effects; registration of relapse and treatment thereof; and registration of death and cause of death. Main results Data from >33,000 patients have been recorded during a period of >45 years. In this period, the outcome of treatment improved substantially, partly due to better treatment as a result of a series of continuous clinical trials and subsequent implementation in national guidelines. The database has furthermore been used to describe the effect of reduced waiting time, changed epidemiology, and influence of comorbidity and socioeconomic parameters. Conclusion Half a century of registration of head and neck cancer treatment and outcome has created the basis for understanding and has substantially contributed to improve the treatment of head and neck cancer at both
Park, Jung Yun; Jung, Sung Min; Kim, Nam-Hoon
Purpose Optimal management of colonoscopic perforation (CP) is controversial because early diagnosis and prompt management play critical roles in morbidity and mortality. Herein, we evaluate the outcomes and clinical characteristics of patients with CP according to treatment modality to help establish guidelines for managing CP. Methods Our retrospective analysis included 40 CP patients from January 1, 2003, to December 31, 2014. Patients with CP were categorized into 2 groups according to therapeutic modality: operation (surgery) and nonoperation (endo-luminal clip application or conservative treatment) groups. Results The postoperative morbidity rate was 40%, and no mortalities were noted. The incidence of abdominal pain and tenderness in patients who received only conservative management was significantly lower than in those who underwent surgery (P < 0.001 and P = 0.004, respectively). Patients tended to undergo surgery more often for diagnosis times longer than 24 hours and for diagnostic CPs. The mean hospital stays for the operation and nonoperation groups were 14.6 ± 7.77 and 5.9 ± 1.62 days, respectively (P < 0.001). Compared to the operation group, the nonoperation group began intake of liquid diets significantly earlier after perforation (3.8 ± 1.32 days vs. 5.6 ± 1.25 days, P < 0.001) and used antibiotics for a shorter duration (4.7 ± 1.29 days vs. 8.7 ± 2.23 days, P < 0.001). Conclusion The time of diagnosis and the injury mechanism may be useful indications for conservative management. Nonoperative management, such as endo-luminal clip application, might be beneficial, when feasible, for the treatment of patients with CP. PMID:27847788
Madsen, Niels; Feekings, Jordan; Lewy, Peter
Plaice (Pleuronectes platessa) plays an important role in the North Sea benthic ecosystem and is by weight the most important commercial flatfish species in the North Sea demersal fishery. There is a high discarding of plaice in the active demersal fisheries in the North Sea. The change in fisheries management towards a more ecosystem based approach, together with a greater focus on sustainability, has caused a severe need for action. Subsequently, the European Commission is preparing regulations to reduce or even ban discards. The trawl fisheries are commercially the most important Danish fishery targeting plaice. Here we analyse discard data collected onboard Danish vessels in the period from 1998 to 2008. We describe the general patterns in these data by dividing them into three mesh size categories: 80-99 mm, 100-119 mm and ≥ 120 mm to reflect implemented technical measures of relevance. We analyse the landed and discarded portions in these mesh size categories and link the discarding to the minimum landing size. We employed a GAM model to assess how discarding of plaice below the minimum landing size is connected to relevant factors that could be of relevance from a management perspective. We identified a statistical significant effect of mesh size category and area. We discuss the results in relation to potential mitigation measures to be implemented in future fisheries management strategies.
UNESCO Bulletin for Libraries, 1978
A summary of a survey conducted in 1973 of Danish library services available to immigrant workers and their families, especially those speaking Arabic, Turkish, Urdu, and the languages used in Yugoslavia. (Author/KP)
Öhrling, Kerstin; Kostenius, Catrine
Living a life with migraine can impair one's sense of feeling well, and migraine is a disorder that is associated with substantial disability. Earlier research on how people manage their migraine has given important insight into these people's preventive actions and how they handle their attacks, but there is still a lack of knowledge of how persons with migraine manage their lives to feel well from a more holistic viewpoint. Therefore, the aim of this study was to explore lived experiences of managing life to feel well while living with migraine. Nineteen persons with migraine were interviewed. A hermeneutic-phenomenological approach was used to explore their lived experiences. The findings reveal that persons with migraine not only used preventive strategies to abort and ease the consequences of migraine but also tried to amplify the good in life through increasing their energy and joy and through reaching peace with being afflicted with migraine. The findings of this study can encourage healthcare providers, as well as persons with migraine, to consider channeling their efforts into strategies aiming to amplify the good in life, including reaching peace of mind despite being afflicted. PMID:23395107
Kirkbride-Smith, Anne E; Wheeler, Philip M; Johnson, Magnus L
Artificial reefs are increasingly used worldwide as a method for managing recreational diving since they have the potential to satisfy both conservation goals and economic interests. In order to help maximize their utility, further information is needed to drive the design of stimulating resources for scuba divers. We used a questionnaire survey to explore divers' perceptions of artificial reefs in Barbados. In addition, we examined reef resource substitution behaviour among scuba divers. Divers expressed a clear preference for large shipwrecks or sunken vessels that provided a themed diving experience. Motives for diving on artificial reefs were varied, but were dominated by the chance of viewing concentrated marine life, increased photographic opportunities, and the guarantee of a 'good dive'. Satisfaction with artificial reef diving was high amongst novices and declined with increasing experience. Experienced divers had an overwhelming preference for natural reefs. As a management strategy, our results emphasize the capacity of well designed artificial reefs to contribute towards the management of coral reef diving sites and highlight a number of important areas for future research. Suggested work should validate the present findings in different marine tourism settings and ascertain support of artificial reefs in relationship to level of diver specialization.
Kirkbride-Smith, Anne E.; Wheeler, Philip M.; Johnson, Magnus L.
Artificial reefs are increasingly used worldwide as a method for managing recreational diving since they have the potential to satisfy both conservation goals and economic interests. In order to help maximize their utility, further information is needed to drive the design of stimulating resources for scuba divers. We used a questionnaire survey to explore divers’ perceptions of artificial reefs in Barbados. In addition, we examined reef resource substitution behaviour among scuba divers. Divers expressed a clear preference for large shipwrecks or sunken vessels that provided a themed diving experience. Motives for diving on artificial reefs were varied, but were dominated by the chance of viewing concentrated marine life, increased photographic opportunities, and the guarantee of a ‘good dive’. Satisfaction with artificial reef diving was high amongst novices and declined with increasing experience. Experienced divers had an overwhelming preference for natural reefs. As a management strategy, our results emphasize the capacity of well designed artificial reefs to contribute towards the management of coral reef diving sites and highlight a number of important areas for future research. Suggested work should validate the present findings in different marine tourism settings and ascertain support of artificial reefs in relationship to level of diver specialization. PMID:23894372
Project #OPE-FY12-0011, February 27, 2012. This memorandum is to notify you that the Office of Inspector General (OIG) is initiating an evaluation on the Alternative Asbestos Control Method (AACM) experiments.
Mace, MD, John D. Ritchie, MD, Kevin K. Chung, MD, Katharine W. Markell, MD, Evan M. Renz, MD, Steven E. Wolf, MD, Lorne H. Blackbourne, MD...345–8. 14. Fabian TC, Croce MA, Pritchard FE, et al. Planned ventral hernia. Staged management for acute abdominal wall de- fects. Ann Surg 1994;219
Bell, Sidney; Lowe, Roger; Edwards, M. Craig
High school students in a forestry and wildlife management course learned the use of global positioning software, geographic information systems, and other computer programs. They applied these skills in a capstone multimedia presentation for the community of maps they had made of a local arboretum. (JOW)
Unal, Zafer; Unal, Aslihan
The goal of this study is to report the results of a comparative usability study conducted in 2008-2009 on two different course management systems (CMS), BlackBoard and Moodle. 135 students enrolled in the fall 2008 and spring 2009 section of Introduction to Educational Technology participated in the study (72 and 63 respectively). At the…
Lampton, Jolene A.
This paper documents the multiplicative benefits from an experiential extracurricular activity--i.e., participation in a Model United Nations (MUN) Club. Management instructors are encouraged to sponsor such activities to give leadership training to students. The benefits are especially rich in liberal-arts institutions, like Park University,…
de Boer, Wim; Collis, Betty
Discusses use of the World Wide Web (WWW) for course management at the University of Twente (Netherlands) and describes the TeleTOP Implementation Model that delineates the change entities that are of importance when an institution plans to implement the World Wide Web in education on a wide scale. (LRW)
Byron, Julie K; Johnson, Susan E; Allen, L Clare V; Brilmyer, Cheryl; Griffiths, Robert P
There is an increasing demand in veterinary education to engage students, teach and reinforce clinical reasoning, and provide access anytime/anywhere to quality learning opportunities. In addition, accrediting bodies are asking for more concrete documentation of essential clinical-skills outcomes. Unfortunately, during the clinical year in a referral hospital setting, students are at the mercy of chance regarding the types of cases they will encounter and the opportunities they will have to participate. Patient- and case-simulation technology is becoming more popular as a way to achieve these objectives in human and veterinary medical education. Many of the current options available to the veterinary medical education community to develop virtual-patient cases are too time-consuming, cost prohibitive, or difficult for the instructor or learner to use. In response, we developed a learning tool, Case Manager, which is low-cost and user-friendly. Case Manager was designed to meet the demands of veterinary education by providing students with an opportunity to cultivate clinical reasoning skills and allowing for real-time student feedback. We launched a pilot test with 37 senior veterinary medical students as part of their Small Animal Internal Medicine clinical rotation. Students reported that Case Manager increased their engagement with the material, improved diagnostic and problem-solving skills, and broadened their exposure to a variety of cases. In addition, students felt that Case Manager was superior to a more traditional, less interactive case presentation format.
This paper presents a qualitative evaluation of seven in-service environmental education teacher training courses conducted in the Czech Republic in 2009-2011. The evaluation applied a grounded theory approach. 14 focus groups, 13 interviews and two post-programme questionnaires were used. The evaluation describes a process of managing cognitive…
Camargo, Maria Eugenia; Jacobi, Pedro Roberto; Ducrot, Raphaele
Role-playing games in natural resource management are currently being tested as research, training, and intervention tools all over the world. Various studies point out their potential to deal with complex issues and to contribute to training processes. The objective of this contribution is to analyze the limits and potentialities of this tool for…
Ambi, Uday S.; Adarsh, E. S.; Hatti, Ramesh; Samalad, Vijaymahantesh
Waardenburg syndrome (WS) is a rare autosomally inherited and genetically heterogeneous disorder of neural crest cell development. Literature regarding the anesthetic management of these cases is limited. We present 2 cases of Shah–Waardenburg syndrome and discuss them in the context of review of previously published cases. PMID:22754447
Onyango, Adelheid W; Pinol, Alain J; de Onis, Mercedes
The World Health Organization (WHO) Multicentre Growth Reference (MGRS) data management protocol was designed to create and manage a large data bank of information collected from multiple sites over a period of several years. Data collection and processing instruments were prepared centrally and used in a standardized fashion across sites. The data management system contained internal validation features for timely detection of data errors, and its standard operating procedures stipulated a method of master file updating and correction that maintained a clear trail for data auditing purposes. Each site was responsible for collecting, entering, verifying, and validating data, and for creating site-level master files. Data from the sites were sent to the MGRS Coordinating Centre every month for master file consolidation and more extensive quality control checking. All errors identified at the Coordinating Centre were communicated to the site for correction at source. The protocol imposed transparency on the sites' data management activities but also ensured access to technical help with operation and maintenance of the system. Through the rigorous implementation of what has been a highly demanding protocol, the MGRS has accumulated a large body of very high-quality data.
Throughout the 1990s, the New Zealand education system was transformed by neo-liberal policies that promoted marketisation, school self-management, local governance and strong centralised forms of control and accountability. The election of a Labour-led "third way" government in 1999 has not only witnessed a continuation of the central…
This paper describes the steps taken and the discoveries made by one school district in its implementation of computer-based education and office management systems. Topics covered include: (1) the formation and responsibilities of the Instructional Technology Committee (ITC) in budgeting, purchasing, and planning staff development programs; (2)…
Dailey, Felecia Ann
Leaving information technology (IT) management positions voluntarily can have adverse effects on productivity and knowledge retention among ethnic minorities. Despite organizational efforts to leverage diversity across leadership positions and to comply with governmental laws that protect ethnic minorities from discriminatory practices, ethnic…
del Barrio Gómez, E; Rodríguez, J M; Martínez, S; García, E; Vargas, M C; Sastre, J A
Left ventricular assist devices have emerged as one of the main therapies of advanced cardiac failure due the increase of this disease and lack of organ supply for cardiac transplantation. The anaesthetic management is described on a patient without cardiac transplantation criteria. The device was successfully implanted as a destination therapy.
Patel, Neil; Jones, Pauline; Adamson, Vikki; Spiteri, Monica; Kinmond, Kathryn
Chronic obstructive pulmonary disease (COPD) is debilitating and costly. Self-management is championed to empower individuals to better manage their condition and also to efficiently utilize health resources. As a multi-disciplinary team, we conducted focus group research with individuals living with COPD who were participating in a longitudinal study to use an electronic "diary" to monitor, record, and transmit their own health status, plus receiving regular nurse visits. The main aims of the focus groups were to investigate how far individuals embraced the electronic diary and experienced it as an aid to the self-management of their condition. We also looked at the importance of the nurse visits to the process. Thematic analysis revealed that patients responded positively to the use of technology (the electronic diary), including psychological benefits of perceived support offered by the remote symptom surveillance. Findings also showed patients' increased awareness and monitoring of personal symptoms together with an improved understanding of disease self-management. Nurse support emerged as an important "human" factor in the process. In addition, a reduction in hospital admission was observed, thus reducing costs to the health service.
Carlos, Lisa; Amsler, Mary
Site-based management (SBM) is an increasingly popular approach to school restructuring. SBM aims to transfer authority from state agencies and school districts to committees based at schools. To garner a consensus supporting reform, these committees are to be representative of educational and community members. SBM plans are characterized by: (1)…
Akan, Obasi Haki
By taking a postmodern ontology that elevates becoming over the modern ontology of being, the author of this article proposes a theory and describes a method that teachers can use to enhance students' cooperative learning of management principles. The author asserts that the social construction of learning groups is an effect of organizing…
Rashid, Omar M.; Schaum, Julia C.; Wolfe, Luke G.; Brinster, Nooshin K.; Neifeld, James P.
Introduction. Cutaneous foot melanoma is rare, challenging to manage, and not adequately examined in the literature. This study evaluated the prognostic variables and surgical management of foot melanoma. Materials and Methods. Foot melanoma cases managed at an academic center from 1985 to 2010 were retrospectively reviewed. Results. 46 patients were identified with a broad range of demographic characteristics. Overall recurrence was 32.6%: 19% acral lentiginous, 57% nodular, 66% superficial spreading, 30% melanoma unspecified, 50% severely atypical; 53% ulcerated, 23% nonulcerated; 29% on the dorsum of the foot, 17% heel, 60% ankle, 22% toe, 50% plantar; 0% <1 mm thick, 47% 1–4 mm, 33% >4 mm. 13 had positive nodes, 4 (31%) of whom recurred. Prognostic factors and recurrence did not correlate, and survival was 96% with a median followup of 91 months. Conclusions. Aggressive management of foot melanoma may result in excellent long-term survival even following disease recurrence. PMID:22363851
Thomas, Olusola A.
This study examined the nature of bureaucracy in Higher Education Institutions (HEIs), and the need for strategic management considering the propelling forces of academic revolution meaning that HEIs must perform better with fewer resources and provide innovative solutions. Three research questions guided this study which followed a…
Martinez, Edward; Lindline, Jennifer; Petronis, Michael S.; Pilotti, Maura
The Bureau of Labor Statistics projects an increase in Natural Resource Management (NRM) jobs within the next 10 years due to baby-boomer retirements and a 12% increase in demand for these occupations. Despite this trend, college enrollment in NRM disciplines has declined. Even more critical is the fact that the soon-to-be-majority Hispanic…
Carey, Mariko; Turon, Heidi; Goergen, Stacy; Sanson-Fisher, Rob; Yoong, Sze Lin; Jones, Kay
Lower back pain is prevalent in the general community. Guidelines recommend against the use of diagnostic imaging unless 'red flags' are present that may indicate a potentially serious cause. This paper reports on a cross-sectional electronic survey to investigate self-reported experiences of lower back pain management among Australian general practice patients. Of the 872 participants, 551 (63%) reported that they had experienced lower back pain in the past 12 months. Approximately 40% of patients who had experienced lower back pain reported that they had consulted their general practitioner (GP) regarding this issue. Among those who sought general practice care, 67% reported being referred for diagnostic imaging. Those who received imaging were more likely to have been prescribed medication by their GP, but received self-management advice at the same rate as those who had not been referred. Rates of self-reported referral for diagnostic imaging were higher than expected, given the low prevalence of potentially serious causes for lower back pain reported in the international literature. However, it remains unclear whether this is due to poor guideline adherence by GPs or lack of specificity in the red flags identified in guidelines. Findings suggest the need for improvements in the provision of evidence-based self-management advice.
Hansen, Birgitte; Thorling, Lærke; Sørensen, Brian; Dalgaard, Tommy; Erlandsen, Mogens
The overall aim of performing nitrate trend analyses in oxic groundwater is to document the effect of regulation of Danish agriculture on N pollution. The design of the Danish Groundwater Monitoring Programme is presented and discussed in relation to performance of statistical consistence nitrate trend analyses. Three types of data are crucial. Firstly, long and continuous time-series from the national groundwater monitoring network enable a statistically systematic analysis of distribution, trends and trend reversals in the groundwater nitrate concentration. Secondly, knowledge about the N surplus in Danish agriculture since 1950 from Denmark Statistics is used as an indicator of the potential loss of N. Thirdly, groundwater recharge age determination are performed in order to allow linking of the first two dataset. Recent results published in Hansen et al. (2011 & 2012) will be presented. Since the 1980s, regulations implemented by Danish farmers have succeeded in optimizing the N (nitrogen) management at farm level. As a result, the upward agricultural N surplus trend has been reversed, and the N surplus has reduced by 30-55% from 1980 to 2007 depending on region. The reduction in the N surplus served to reduce the losses of N from agriculture, with documented positive effects on nature and the environment in Denmark. In groundwater, the upward trend in nitrate concentrations was reversed around 1980, and a larger number of downward nitrate trends were seen in the youngest groundwater compared with the oldest groundwater. However, on average, approximately 48% of the oxic monitored groundwater has nitrate concentrations above the groundwater and drinking water standards of 50 mg/l. Furthermore, trend analyses show that 33% of all the monitored groundwater has upward nitrate trends, while only 18% of the youngest groundwater has upward nitrate trends according to data sampled from 1988-2009. A regional analysis shows a correlation between a high level of N
Kibler, Jennifer L.; Wilson, Sara R.; Hubbs, Clay E.; Smail, James W.
The Interval Management for Near-term Operations Validation of Acceptability (IM-NOVA) experiment was conducted at the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC) in support of the NASA Airspace Systems Program's Air Traffic Management Technology Demonstration-1 (ATD-1). ATD-1 is intended to showcase an integrated set of technologies that provide an efficient arrival solution for managing aircraft using Next Generation Air Transportation System (NextGen) surveillance, navigation, procedures, and automation for both airborne and ground-based systems. The goal of the IMNOVA experiment was to assess if procedures outlined by the ATD-1 Concept of Operations were acceptable to and feasible for use by flight crews in a voice communications environment when used with a minimum set of Flight Deck-based Interval Management (FIM) equipment and a prototype crew interface. To investigate an integrated arrival solution using ground-based air traffic control tools and aircraft Automatic Dependent Surveillance-Broadcast (ADS-B) tools, the LaRC FIM system and the Traffic Management Advisor with Terminal Metering and Controller Managed Spacing tools developed at the NASA Ames Research Center (ARC) were integrated into LaRC's Air Traffic Operations Laboratory (ATOL). Data were collected from 10 crews of current 757/767 pilots asked to fly a high-fidelity, fixed-based simulator during scenarios conducted within an airspace environment modeled on the Dallas-Fort Worth (DFW) Terminal Radar Approach Control area. The aircraft simulator was equipped with the Airborne Spacing for Terminal Area Routes (ASTAR) algorithm and a FIM crew interface consisting of electronic flight bags and ADS-B guidance displays. Researchers used "pseudo-pilot" stations to control 24 simulated aircraft that provided multiple air traffic flows into the DFW International Airport, and recently retired DFW air traffic controllers served as confederate Center, Feeder, Final
Courtenay, Molly; Rowbotham, Samantha; Lim, Rosemary; Deslandes, Rhian; Hodson, Karen; MacLure, Katie; Peters, Sarah; Stewart, Derek
Objective To (1) explore patients' expectations and experiences of nurse and pharmacist non-medical prescriber-led management of respiratory tract infections (RTIs), (2) examine whether patient expectations for antibiotics affect the likelihood of receiving them and (3) understand factors influencing patient satisfaction with RTI consultations. Design Mixed methods. Setting Primary care. Participants Questionnaires from 120 patients and follow-up interviews with 22 patients and 16 nurse and pharmacist non-medical prescribers (NMPs). Results Patients had multiple expectations of their consultation with 43% expecting to be prescribed an antibiotic. There was alignment between self-reported patient expectations and those perceived by NMPs. Patient expectations for non-antibiotic strategies, such as education to promote self-management, were associated with receipt of those strategies, whereas patient expectations for an antibiotic were not associated with receipt of these medications. ‘Patient-centred’ management strategies (including reassurance and providing information) were received by 86.7% of patients. Regardless of patients' expectations or the management strategy employed, high levels of satisfaction were reported for all aspects of the consultation. Taking concerns seriously, conducting a physical examination, communicating the treatment plan, explaining treatment decisions and lack of time restrictions were each reported to contribute to patient satisfaction. Conclusions NMPs demonstrate an understanding of patient expectations of RTI consultations and use a range of non-antibiotic management strategies, particularly those resembling a patient-centred approach. Overall, patients' expectations were met and prescribers were not unduly influenced by patient expectations for an antibiotic. Patients were satisfied with the consultation, indicating that strategies used by NMPs were acceptable. However, the lower levels of satisfaction among patients who
Back, David A.; Behringer, Florian; Haberstroh, Nicole; Ehlers, Jan P.; Sostmann, Kai
Objectives To investigate medical students´ utilization of and problems with a learning management system and its e-learning tools as well as their expectations on future developments. Methods A single-center online survey has been carried out to investigate medical students´ (n = 505) usage and perception concerning the learning management system Blackboard, and provided e-learning tools. Data were collected with a standardized questionnaire consisting of 70 items and analyzed by quantitative and qualitative methods. Results The participants valued lecture notes (73.7%) and Wikipedia (74%) as their most important online sources for knowledge acquisition. Missing integration of e-learning into teaching was seen as the major pitfall (58.7%). The learning management system was mostly used for study information (68.3%), preparation of exams (63.3%) and lessons (54.5%). Clarity (98.3%), teaching-related contexts (92.5%) and easy use of e-learning offers (92.5%) were rated highest. Interactivity was most important in free-text comments (n = 123). Conclusions It is desired that contents of a learning management system support an efficient learning. Interactivity of tools and their conceptual integration into face-to-face teaching are important for students. The learning management system was especially important for organizational purposes and the provision of learning materials. Teachers should be aware that free online sources such as Wikipedia enjoy a high approval as source of knowledge acquisition. This study provides an empirical basis for medical schools and teachers to improve their offerings in the field of digital learning for their students. PMID:27544782
Macdonald, Denis; Bhalla, Pearl; Cass, William; Gollish, Jeff; Brighton, Roger; Gorenstein, Frayda; Vitunjski, Joseph; Ng, Peggy
Objective Evaluation of the safety and potential cost savings of a computerized, laboratory-based program to manage inpatient warfarin thromboprophylaxis after major joint arthroplasty. Design A consecutive-case study of adults. Setting A tertiary care orthopedic institution. Patients Patients requiring joint arthroplasty who had no recent episodes of thromboembolic disease, no mechanical heart valve, atrial fibrillation, severe liver disease or baseline international normalized ratio [INR] greater than 1.3 admitted over a 54-month period (July 1994–December 1998). All patients received a standard regimen of warfarin beginning on the evening after the operation. Four hundred and thirty randomly selected patients managed by the program were followed up by telephone survey 3 months after discharge. Patients exhibiting erratic responses to warfarin were withdrawn from the program and managed individually thereafter. Intervention Major joint arthroplasty with warfarin therapy administered through the computerized program. Main outcome measures Test results maintained within the desired therapeutic range (INR 2.0–3.0), clinically severe bleeding episodes, readmission rates, clinically symptomatic and venographically proven episodes of venous thrombosis or pulmonary embolism. Results Over the study period 5629 patients underwent joint arthroplasty; 5372 patients were considered for the program; 332 patients were ineligible and were managed individually; 311 entered patients did not complete the program. This left 4729 patients who completed the program. In 2932 (62%) patients test results were maintained in the desired therapeutic range. The major bleeding rate was less than 0.5%, the readmission rate was 3.8%, the deep venous thrombosis rate was 3.7% and the pulmonary embolism rate was 0.2% with no thromboembolic related deaths in the small sample cohort. Conclusions The majority of patients requiring warfarin thromboprophylaxis can be safely and effectively managed
de Souza, Luis Eugenio Portela Fernandes
The present text presents a reflection about the author's experience as head of a Health Department of a big city during two and a half years. It presents a systematization of the strategic projects, the political and technical activities and the managerial routine, in which he was involved. It identifies three levels (macro, meso and micro) and four dimensions of management (social-political, institutional, technical-sanitary and administrative in the strict sense). In each dimension, on the three levels, it discusses management strategies designed to contribute to the construction of a universal and equitable Brazilian Health System (SUS). Although it may be premature to evaluate the degree of implantation and the effects of the proposed strategies, their analysis and discussion can be useful for being strongly based on empirical elements. The paper concludes that, even though the consolidation of the SUS is a political struggle that surpasses the management arena, managers are important agents who need to know how to develop strategies able to foster the principles of universality and equity.
Warnes, G M; Norman, R J
As assisted reproductive technology (ART) expanded globally, several countries introduced prescribed requirements for treatment and monitoring of outcomes, as well as a licensing or accreditation requirement. While it is common for ART laboratories to be required to have an effective quality control system, the remainder of the clinic is often under less stringent regulation. Furthermore, when treatment conditions are prescribed, the standards tend to be conservative and clinics may choose to establish their own standards. Total quality management systems are now being used by an increasing number of ART clinics. In Australia and New Zealand, it is now a requirement to have a quality management system in order to be accredited and to help meet customer demand for improved delivery of ART services in these two countries.
Swanson, R Lawrence; Bortman, Marci L; O'Connor, Thomas P; Stanford, Harold M
Development of national policy on sewage sludge management is a classic example of incremental policy formulation [Fiorino, D.J. 1995. Making Environmental Policy. University of California Press. Berkeley, CA. p. 269]. Consequently, policy has developed piecemeal, and results are, in some ways, different than intended. Land application of sewage sludge has not been a panacea. Many of the same types of policy are now being raised about it. We demonstrate this by examining the management of sewage materials by New York City from near the turn of the 20th century, when ocean dumping was viewed as a means to alleviate some of the gross pollution in New York Harbor, to when ocean dumping was banned, and thence to the present when sludge is applied to land as "biosolids." Lessons learned during this long, sometimes contentious history can be applied to present situations--specifically not understanding the long-term consequences of land-based reuse and disposal technologies.
Since 1980, the Agency for International Development (A.I.D.) has invested about $77 million in projects to improve Nepal's natural resource management. The paper reviews the two largest projects; it also describes how USAID/Nepal is supporting multidonor forestry projects. The review identifies several important lessons. USAID/Nepal has been more effective in influencing policymaking and institutional changes when supporting multidonor projects than when acting alone. The reviewed projects underscore the difficulty of implementing large projects that involve technologies far beyond the host country's capabilities. More importantly, they demonstrate that support for resource conservation need not always be technically sophisticated, but sometimes can -- and should -- begin by integrating research and extension activities into existing agricultural and rural development projects. To gain farmer support, such activities should increase livestock and tree production without compromising food crop production. Efforts to decentralize forestry management should not stop at the local government but should involve the affected communities themselves.
Abdoulaye, Bousso; Moussa, Seydi; Daye, Ka; Boubakar, Badiane Seydou; Cor, Sarr Samba; Idrissa, Talla; Mamadou, Ndiaye El Hadj; Oumar, Ba Ibrahima; Tidiane, Ndour Cheikh; Selly, Ly Mamadou; Tacko, Diop Cheikh; Amadou, Diack Papa; Mandiaye, Loume; Mbaye, Diouf; Marie, Coll-Seck Awa
The Ebola virus disease, as a first epidemic in West Africa, stands as the most deadly one throughout history. Guinea, the source of the epidemic, Sierra Leone and Liberia remain the most strongly affected. That epidemic thoroughly destabilized the health system of those countries. Following Nigeria, Senegal received its first imported case from the neighboring Republic of Guinea. In that sub regional psychotic context, such a situation has been handled and managed starting from the potential of a health system that is already suitably structured. The organization of the response, the management of the communication system and the rigorous monitoring of contacts have been decisive in the control of the epidemic. Our countries have to be prepared in order to face health threats, and that is the reason why the need to empower our health systems is important. PMID:26740836
Singh, Rana Gopal; Singh, Shivendra; Rathore, Surendra Singh; Choudhary, Tauhidul Alam
Hemodialysis (HD) is one of the important modalities of renal replacement therapy in acute renal failure (ARF) as well as chronic renal failure (CRF). This study was performed to evaluate the various intradialytic complications that occur during HD and their management. This is a retrospective study performed in patients who underwent conventional HD during the period of 1 January 2000 to 31 December 2011 at our center. Clinical details, various complications faced and their management were retrieved from dialysis case sheets. A total of 2325 patients of renal failure (790 ARF and 1535 CRF patients) were assessed for the intradialytic complications of HD. During the study period, there were 12,785 bicarbonate dialyses performed on these patients. In the ARF patients, the common intradialytic complications were: Hypotension, seen in 1296 sessions (30.4%), nausea and vomiting seen in 1125 sessions (26.4%), fever and chills seen in 818 sessions (19.2%), headache seen in 665 sessions (15.6%), cramps seen in 85 sessions (2.0%), chest pain and back pain seen in 82 sessions (1.92%), hypoglycemia seen in 77 sessions (1.8%), first-use syndrome seen in 72 sessions (1.7%) and femoral hematoma seen in 31 sessions (0.73%). In the CRF group, common complications were hypotension in 2230 sessions (26.1%), nausea and vomiting in 1211 sessions (14.2%), fever and chills in 1228 sessions (14.4%), chest pain and back pain in 1108 cases (13.0%), hypertension in 886 sessions (10.4%), headache in 886 sessions (10.4%), cramps in 256 sessions (3.0%), hematoma in 55 sessions (0.64%), intracerebral hemorrhage in three sessions (0.03%) and catheter tip migration in three sessions (0.03%). There is a need for special attention for the diagnosis and management of intradialytic complications of HD because such complications could be managed successfully without the need for termination of the dialysis procedure.
Reiss, M; Reiss, G
Bibliography database managers are used to manage information recourses: specifically, to maintain a database to references and create bibliographies and reference lists for written works. A good reference management program should make it easy to read and to record the elements that a reference comprises, e.g. authors name, year of publication, title of article etc. It should offer tools that let you find and retrieve references quickly, and it should be able to produce the bibliography in the format required for a particular publication. You can create your database reference by reference or you can download batches of references from one of the popular searching services (e.g. MEDLINE) and you can search in the Internet. When you want to cite a reference you simply paste the reference wherever you want your intext citation to appear. There are many computer programs, but very few stands out as truly useful, time saving, and work enhancing. One of them is EndNote. The reference manager EndNote 5.0 was recently released in Germany. As long-time fans of this excellent program, we upgraded from the previous version. The use of the software package EndNote 5.0 for Windows is described. The main reason for getting EndNote 5.0 is its clearly improved functions and features: especially the co-operation with Microsoft Word (cite while you write) and the spelling examination. Altogether EndNote 5.0 provides also an excellent combination of features and ease of use.
Lynch, A J J; Thackway, R; Specht, A; Beggs, P J; Brisbane, S; Burns, E L; Byrne, M; Capon, S J; Casanova, M T; Clarke, P A; Davies, J M; Dovers, S; Dwyer, R G; Ens, E; Fisher, D O; Flanigan, M; Garnier, E; Guru, S M; Kilminster, K; Locke, J; Mac Nally, R; McMahon, K M; Mitchell, P J; Pierson, J C; Rodgers, E M; Russell-Smith, J; Udy, J; Waycott, M
Mitigating the environmental effects of global population growth, climatic change and increasing socio-ecological complexity is a daunting challenge. To tackle this requires synthesis: the integration of disparate information to generate novel insights from heterogeneous, complex situations where there are diverse perspectives. Since 1995, a structured approach to inter-, multi- and trans-disciplinary(1) collaboration around big science questions has been supported through synthesis centres around the world. These centres are finding an expanding role due to ever-accumulating data and the need for more and better opportunities to develop transdisciplinary and holistic approaches to solve real-world problems. The Australian Centre for Ecological Analysis and Synthesis (ACEAS
Sherrod, Roy Ann; Morrison, Ruby Shaw
Nurse educators need practical, effective methods to help nursing students understand the importance of quality improvement activities and their relationship to the financial viability of organizations. This article describes a project designed to provide students with an opportunity to apply quality improvement principles in a rural, nurse-managed clinic with the ultimate goal of improving potential reimbursement for services through improved documentation. Implications for students, nurse educators, and rural clinics are provided.
Taylor, J. C.; Robertson, M. M.
An airline maintenance department undertook a CRM training program to change its safety and operating culture. In 2 1/2 years this airline trained 2200 management staff and salaried professionals. Participants completed attitude surveys immediately before and after the training, as well as two months, six months, and one year afterward. On-site interviews were conducted to test and confirm the survey results. Comparing managers' attitudes immediately after their training with their pretraining attitudes showed significant improvement for three attitudes. A fourth attitude, assertiveness, improved significantly above the pretraining levels two months after training. The expected effect of the training on all four attitude scales did not change significantly thereafter. Participants' self-reported behaviors and interview comments confirmed their shift from passive to more active behaviors over time. Safety, efficiency, and dependability performance were measured before the onset of the training and for some 30 months afterward. Associations with subsequent performance were strongest with positive attitudes about sharing command (participation), assertiveness, and stress management when those attitudes were measured 2 and 12 months after the training. The two month follow-up survey results were especially strong and indicate that active behaviors learned from the CRM training consolidate and strengthen in the months immediately following training.
Gunnarsson, Kristina; Andersson, Ing-Marie; Rosén, Gunnar
Small-scale enterprises face difficulties in fulfilling the regulations for organising Systematic Work Environment Management. This study compared three groups of small-scale manufacturing enterprises with and without support for implementing the provision. Two implementation methods, supervised and network method, were used. The third group worked according to their own ideas. Twenty-three enterprises participated. The effects of the implementation were evaluated after one year by semi-structured dialogue with the manager and safety representative. Each enterprise was classified on compliance with ten demands concerning the provision. The work environment was estimated by the WEST-method. Impact of the implementation on daily work was also studied. At the follow-up, the enterprises in the supervised method reported slightly more improvements in the fulfilment of the demands in the provision than the enterprises in the network method and the enterprises working on their own did. The effect of the project reached the employees faster in the enterprises with the supervised method. In general, the work environment improved to some extent in all enterprises. Extensive support to small-scale enterprises in terms of advise and networking aimed to fulfil the regulations of Systematic Work Environment Management had limited effect - especially considering the cost of applying these methods.
Edler, Lutz; Pilz, Lothar R
Reliable and correct data capture and safe data management are an inevitable prerequisite to gain valid data in clinical studies. The biostatistical analysis is the basis from which medical consequences about efficacy and safety of the treatment can be driven. The functional role of data capture and data management in relation to the study protocol, development of report forms, data flux between the involved institutions, and the data capture systems will be investigated. Main points of the data capture are the rationale of the study, the protocol, and the statistical analysis plan. Modularity, uniqueness, and reduction on the needs of the study protocol designate a good documentation form. Practical considerations will be given. Prompt and efficient communication between all involved participants is the organizational prerequisite for valid data, independent from the data capture system. Online data capture will displace the classical paper documentation form, however, accurate and careful documentation will remain. Data capture and data management are a crucial and cost-intensive chapter of a clinical study, formed by the technical ability and the team play of clinical principal investigators, biostatisticians, computer scientists, monitors, and the organizers of the study.
Krassovski, M. B.; Riggs, J. S.; Hook, L. A.; ...
Ecosystem-scale manipulation experiments represent large science investments that require well-designed data acquisition and management systems to provide reliable, accurate information to project participants and third party users. The SPRUCE project (Spruce and Peatland Responses Under Climatic and Environmental Change, http://mnspruce.ornl.gov) is such an experiment funded by the Department of Energy's (DOE), Office of Science, Terrestrial Ecosystem Science (TES) Program. The SPRUCE experimental mission is to assess ecosystem-level biological responses of vulnerable, high carbon terrestrial ecosystems to a range of climate warming manipulations and an elevated CO2 atmosphere. SPRUCE provides a platform for testing mechanisms controlling the vulnerability of organisms, biogeochemicalmore » processes, and ecosystems to climatic change (e.g., thresholds for organism decline or mortality, limitations to regeneration, biogeochemical limitations to productivity, and the cycling and release of CO2 and CH4 to the atmosphere). The SPRUCE experiment will generate a wide range of continuous and discrete measurements. In order to successfully manage SPRUCE data collection, achieve SPRUCE science objectives, and support broader climate change research, the research staff has designed a flexible data system using proven network technologies and software components. The primary SPRUCE data system components are the following; 1. data acquisition and control system – set of hardware and software to retrieve biological and engineering data from sensors, collect sensor status information, and distribute feedback to control components; 2. data collection system – set of hardware and software to deliver data to a central depository for storage and further processing; and 3. data management plan – set of plans, policies, and practices to control consistency, protect data integrity, and deliver data. This publication presents our approach to meeting the challenges of
Krassovski, M. B.; Riggs, J. S.; Hook, L. A.; Nettles, W. R.; Hanson, P. J.; Boden, T. A.
Ecosystem-scale manipulation experiments represent large science investments that require well-designed data acquisition and management systems to provide reliable, accurate information to project participants and third party users. The SPRUCE project (Spruce and Peatland Responses Under Climatic and Environmental Change, http://mnspruce.ornl.gov) is such an experiment funded by the Department of Energy's (DOE), Office of Science, Terrestrial Ecosystem Science (TES) Program. The SPRUCE experimental mission is to assess ecosystem-level biological responses of vulnerable, high carbon terrestrial ecosystems to a range of climate warming manipulations and an elevated CO2 atmosphere. SPRUCE provides a platform for testing mechanisms controlling the vulnerability of organisms, biogeochemical processes, and ecosystems to climatic change (e.g., thresholds for organism decline or mortality, limitations to regeneration, biogeochemical limitations to productivity, and the cycling and release of CO2 and CH4 to the atmosphere). The SPRUCE experiment will generate a wide range of continuous and discrete measurements. To successfully manage SPRUCE data collection, achieve SPRUCE science objectives, and support broader climate change research, the research staff has designed a flexible data system using proven network technologies and software components. The primary SPRUCE data system components are the following: 1. data acquisition and control system - set of hardware and software to retrieve biological and engineering data from sensors, collect sensor status information, and distribute feedback to control components; 2. data collection system - set of hardware and software to deliver data to a central depository for storage and further processing; 3. data management plan - set of plans, policies, and practices to control consistency, protect data integrity, and deliver data. This publication presents our approach to meeting
Krassovski, M. B.; Riggs, J. S.; Hook, L. A.; Nettles, W. R.; Hanson, P. J.; Boden, T. A.
Ecosystem-scale manipulation experiments represent large science investments that require well-designed data acquisition and management systems to provide reliable, accurate information to project participants and third party users. The SPRUCE Project (Spruce and Peatland Responses Under Climatic and Environmental Change, http://mnspruce.ornl.gov) is such an experiment funded by the Department of Energy's (DOE), Office of Science, Terrestrial Ecosystem Science (TES) Program. The SPRUCE experimental mission is to assess ecosystem-level biological responses of vulnerable, high carbon terrestrial ecosystems to a range of climate warming manipulations and an elevated CO2 atmosphere. SPRUCE provides a platform for testing mechanisms controlling the vulnerability of organisms, biogeochemical processes, and ecosystems to climatic change (e.g., thresholds for organism decline or mortality, limitations to regeneration, biogeochemical limitations to productivity, the cycling and release of CO2 and CH4 to the atmosphere). The SPRUCE experiment will generate a wide range of continuous and discrete measurements. To successfully manage SPRUCE data collection, achieve SPRUCE science objectives, and support broader climate change research, the research staff has designed a flexible data system using proven network technologies and software components. The primary SPRUCE data system components are: 1. Data acquisition and control system - set of hardware and software to retrieve biological and engineering data from sensors, collect sensor status information, and distribute feedback to control components. 2. Data collection system - set of hardware and software to deliver data to a central depository for storage and further processing. 3. Data management plan - set of plans, policies, and practices to control consistency, protect data integrity, and deliver data. This publication presents our approach to meeting the
Naftz, D.L.; Yahnke, J.; Miller, J.; Noyes, S.
Constructed and natural wetlands can accumulate elevated levels of Se; however, few data are available on cost-effective methods for remobilization and removal of Se from these areas. A field experiment was conducted to assess the effectiveness of flooding on the removal of Se from dry surface sediments. The 83-m2 flood-experiment plot contained 10 monitoring wells, a water-quality minimonitor (continuous measurement of pH, specific conductance, water temperature, and dissolved O2), a down-hole Br electrode, and 2 pressure transducers. Flooding was initiated on August 27, 2002, and a Br tracer was added to water delivered through a pipeline to the flood plot during the first 1.2 h. Standing water depth in the flood plot was maintained at 0.3 m through September 1, 2002. The Br tracer data indicate a dual porosity system that includes fracture (mud cracks) and matrix flow components. Mean vertical water velocities for the matrix flow component were estimated to range from 0.002 to 0.012 m/h. Dissolved (less than 0.45 ??m) Se increased from pre-flood concentrations of less than 10 ??g/L to greater than 800 ??g/L during flooding in samples from deep (2.0 m below land surface) ground water. Selenium concentrations exceeded 5500 ??g/L in samples from shallow (0.8 m below land surface) ground water. Ratios of Se to Br in water samples indicate that Se moved conservatively during the experiment and was derived from leaching of near-surface sediments. Cumulative Se flux to the deep ground water during the experiment ranged from 9.0 to 170 mg/m2. Pre- and post-flood surface soil sampling indicated a mean Se flux of 720 mg/m2 through the top 15 cm of soil. Ground-water samples collected 8 months after termination of the flood experiment contained Se concentrations of less than 20 ??g/L. The minimonitor data indicate a rapid return to chemically reducing conditions in the deep ground water, limiting the mobility of the Se dissolved in the water pulse introduced during the
Argent, A C
The HIV pandemic has affected children throughout the developing world. This article describes the experience of the Paediatric Intensive Care Unit at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa. Over the last 20 years we have improved our management of HIV infected children requiring intensive care admission. In the absence of anti-retroviral therapy, long term outcomes from PICU admission of HIV infected children have not improved significantly, and it is debatable whether PICU admission is justified. Once anti-retroviral therapy is available to children, there may be significant improvements in outcome and possible affected children should be admitted to the PICU if resources are available.
Zamłyński, Jacek; Horzelska, Ewa; Zamłyński, Mateusz; Olszak-Wąsik, Katarzyna; Nowak, Leszek; Bodzek, Piotr; Horzelski, Tomasz; Bablok, Rafał; Olejek, Anita
Myelomeningocele (MMC) is the most frequent congenital defect of the central nervous system for which there is no satisfactory alternative to postnatal treatment. On the contrary prenatal MMC surgery is conducting before birth and is aimed at protecting from Chiari II malformation. The main goal of fetal MMC repair is to improve development and life quality of children with Chiari II malformation. Management of Myelomeningocele Study (MOMS) which was published in 2011 clearly confirmed effectiveness of prenatal surgery. In this paper we compare MOMS results with our own clinical experience. Thanks to high effectiveness and significant improvement in safety of maternal-fetal surgery prenatal MMC surgery become a new standard of treatment.
Municipal governments have attempted to reduce waste disposal and increase recycling rates in Japan. However, it is difficult to get full cooperation from residents. Using experiments in which residents are given an opportunity to choose the components of the waste management system (choice experiments), we measure the cost of each characteristic of the waste collection services. The estimation result reveals that there are trade-offs between the risk, payments, and handling costs. The marginal loss in utility revenues from an increase in the types of waste being separated is almost 200 yen (US$ 1.74) and a 1% increase in the recycling rate raises the cost of service by 53 yen (US$ 0.46). In addition, the results show the need for communications about risks between municipal authorities and residents.
Ruiu, L; Satta, A; Floris, I
The potential of two bioinsecticidal formulations containing Brevibacillus laterosporus spores and azadirachtin, respectively, was assayed in laboratory and in comparative field treatments for the management of immature house flies on dairy farms. As already known for B. laterosporus, preliminary laboratory experiments with azadirachtin evidenced a concentration-dependent effect. Azadirachtin median lethal concentration (LC50) value determined for second instar larvae was 24.5 microg/g diet. Applications in dairy farms were performed at dosages and concentrations predetermined in laboratory experiments, to employ the two formulations at an equal insecticidal potential. Repeated applications on the cow pen caused a significant fly development depression in areas treated with azadirachtin (63%) and B. laterosporus (46%), compared with the control. Formulations were applied at a dosage of 3 liters/m2, and concentrations of 2 x 10(8) B. laterosporus spores/ml and 25 microg azadirachtin/ml, respectively.
Wu, Lihua; Forbes, Angus; While, Alison
We studied the patient experience of a telephone booster intervention, i.e. weekly reinforcement of the clinic advice regarding lifestyle modification advice to support weight loss. Forty six adults with Type 2 diabetes and a body mass index >28 kg/m(2) were randomised into either intervention (n = 25) or control (n = 21) groups. Semi-structured interviews were conducted with the intervention group participants to explore their views and experiences. The patients were satisfied or very satisfied with the telephone calls and most would recommend the intervention to others in a similar situation. The content of the telephone follow-up met their need for on-going support. The benefits arising from the telephone calls included: being reminded to comply with their regimen; prompting and motivating adherence to diabetes self-care behaviours; improved self-esteem; and feeling 'worthy of interest'. The convenience and low cost of telephone support has much potential in chronic disease management.
Ravenna, Jean; Cleaver, Karen
Prevalence of mental health disorder is increasing among young people. It is recognized that early intervention is essential in supporting young people, and care provided within schools to support emotional well-being is recommended as part of this process. A scoping review was undertaken examining school nurses' experiences of supporting the…
Bartkus, Ken; Mills, Robert; Olsen, David
The purpose of this paper is to propose an innovative approach to engaged learning. Founded on the principles of a scholarly think-tank and administered along the lines of a consulting organization, the proposed "Research Group" framework is designed to facilitate effective and efficient undergraduate research experiences in Management…
Gaillard, Janis James
The presence of HIV-positive children in preschool and day care programs is becoming more widespread as medical research discovers new drugs to combat the disease. This paper examines one child's experience in his first 3 years of school in the Bronx, New York. The paper begins with a description of how teachers are becoming more aware of children…
DiMino, John L.; Risler, Robin
This article focuses on the experiences of predoctoral interns supervising the clinical work of less experienced externs in psychology and social work as part of a training program in a large university counseling center. After 4 years of running a relationally based supervision of supervision group, the authors believe that providing supervision…
Slater, Rachel; Veach, Patricia McCarthy; Li, Ziqiu
Teacher countertransference refers to conscious and unconscious, negative or positive emotional reactions to certain students that arise from the teacher's own areas of personal conflict. Our investigation of 14 expert teachers' countertransference experiences in the college classroom, yielded several themes. Countertransference triggers included…
West, Cathie E.
Elementary principal describes experience working with violent-prone children. Describes steps in dealing with violence-prone children: Create a support team, schedule a transition meeting, evaluate risk factors, prepare a transition plan, notify staff members, and create a behavior plan, the components of which include behavior, levels plan,…
Wrench, Alison; Garrett, Robyne; King, Sharron
It is commonly recognised that health and well-being are influenced by social conditions, such as the transition to higher education. This study explored student perceptions and experiences of factors that impacted on health and well-being during the first year of university studies. Data for this study were collected via an online student…