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Sample records for management danish experience

  1. Reducing abortion: the Danish experience.

    PubMed

    Risor, H

    1989-01-01

    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.

  2. Do managers experience more stress than employees? Results from the Intervention Project on Absence and Well-being (IPAW) study among Danish managers and their employees.

    PubMed

    Skakon, Janne; Kristensen, Tage S; Christensen, Karl Bang; Lund, Thomas; Labriola, Merete

    2011-01-01

    To examine whether managers' perceived stress and work strain is higher than perceived stress and work strain among employees. The study is based on questionnaire responses from 2052 respondents (128 managers and 1924 employees) at 48 worksites. Bi-variate and multivariate analyses were used to explain possible differences in stress levels and related mediators. Managers experienced higher demands, higher level of conflicts, and lower degree of social support from peers. They tended to experience significantly lower emotional stress, whereas this trend was insignificant with regards to behavioural, somatic and cognitive stress. The difference was partly explained by higher scores in the psychosocial work environment factors; job satisfaction, perceived management quality from their managers, influence, degrees of freedom at work, possibilities for development and meaning of work. For behavioural stress, 41% of the difference was explained by the preventive factors, 20% for somatic stress, 39% for emotional stress and 56% for cognitive stress. This study indicates that the preventive psychosocial factors explain parts of the managers' lower stress level. These results contradict the lay perception of managers being under higher pressure and experiencing more stress than employees. Interventions aiming at reducing employee stress levels, especially regarding behavioural and cognitive stress, could benefit from focussing on psychosocial work environment exposures such as skill discretion, meaning of work, psychological demands, information flow and management quality.

  3. Danish guidelines on management of otitis media in preschool children.

    PubMed

    Heidemann, C H; Lous, J; Berg, J; Christensen, J J; Håkonsen, S J; Jakobsen, M; Johansen, C J; Nielsen, L H; Hansen, M P; Poulsen, A; Schousboe, L P; Skrubbeltrang, C; Vind, A B; Homøe, P

    2016-08-01

    Otitis media is one of the most common diseases in small children. This underlines the importance of optimizing diagnostics and treatment of the condition. Recent literature points toward a stricter approach to diagnosing acute otitis media (AOM). Moreover, ventilating tube treatment for recurrent AOM (RAOM) and chronic otitis media with effusion (COME) has become the most frequently performed surgical procedure in pre-school children. Therefore, the Danish Health and Medicines Authority and the Danish Society of Otorhinolaryngology, Head and Neck Surgery deemed it necessary to update the Danish guidelines regarding the diagnostic criteria for acute otitis media and surgical treatment of RAOM and COME. The GRADE system (The Grading of Recommendations Assessment, Development and Evaluation) was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted between July and December 2014. The quality of the existing literature was assessed using AGREE II (Appraisal of Guidelines for Research & Evaluation), AMSTAR (assessing the Methodological Quality of Systematic Reviews), QUADAS-2 (Quality of Diagnostic Accuracy Studies), Cochrane Risk of Bias Tool for randomized trials and ACROBAT-NRSI (A Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies). The working group consisted of otolaryngologists, general practitioners, pediatricians, microbiologists and epidemiologists. Recommendations for AOM diagnosis, surgical management for RAOM and COME, including the role of adenoidectomy and treatment of ventilating tube otorrhea, are proposed in the guideline. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Medical informatic research management in academia - the Danish setting.

    PubMed

    Kjær Andersen, Stig

    2011-01-01

    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.

  5. Danish heathland manipulation experiment data in Model-Data-Fusion

    NASA Astrophysics Data System (ADS)

    Thum, Tea; Peylin, Philippe; Ibrom, Andreas; Van Der Linden, Leon; Beier, Claus; Bacour, Cédric; Santaren, Diego; Ciais, Philippe

    2013-04-01

    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

  6. Exploring User Experience of a Telehealth System for the Danish TeleCare North Trial.

    PubMed

    Lilholt, Pernille Heyckendorff; Hæsum, Lisa Korsbakke Emtekær; Hejlesen, Ole Kristian

    2015-01-01

    The aim was to explore user experiences of using a telehealth system (Telekit) designed for the Danish TeleCare North trial. Telekit is designed for patients diagnosed with chronic obstructive pulmonary disease (COPD) in order to manage the disease and support patient empowerment. This article sums up COPD-participants' user experiences in terms of increased sense of freedom, of security, of control, and greater awareness of COPD symptoms. A consecutive sample of sixty participants (27 women, 33 men) were recruited from the TeleCare North trial. At home the participants completed a non-standardised questionnaire while a researcher was present. The questionnaire identified their health status, their use of specific technologies, and their user experiences with the telehealth system. Results from the questionnaire indicate that the majority of participants (88%) considered the Telekit system as easy to use. 43 (72%) participants felt increased sense of security, and 37 (62%) participants felt increased sense of control by using the system. 30 (50%) participants felt greater awareness of their COPD symptoms, but only 16 (27%) participants felt increased freedom. The study has provided a general picture of COPD participants' user experiences which is important to emphasise as it has a bearing on whether a given implementation will be successful or not.

  7. Change Management at a Danish University: The Introduction of a Common Market for Education

    ERIC Educational Resources Information Center

    Bundgaard, Helle

    2012-01-01

    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…

  8. Change Management at a Danish University: The Introduction of a Common Market for Education

    ERIC Educational Resources Information Center

    Bundgaard, Helle

    2012-01-01

    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…

  9. Thrombopoietin-receptor agonists in haematological disorders: the Danish experience.

    PubMed

    Gudbrandsdottir, Sif; Frederiksen, Henrik; Hasselbalch, Hans

    2012-01-01

    The objective of this study was to investigate the use of thrombopoietin-receptor agonists (TPO-ra) in patients with refractory primary immune thrombocytopenia (ITP) as well as off-label use of TPO-ra in Danish haematology departments. Hospital medical records from 32 of the 39 patients having received TPO-ra from 2009 to 1 May 2011 were available for data collection and included in the study. Of these patients, 15 received TPO-ra for refractory primary ITP, 7 for secondary ITP (chronic lymphatic leukaemia, systemic lupus erythematosus, Evans syndrome, human immunodeficiency virus and celiac disease) and 10 were treated for non-ITP (chemotherapy-induced, acute myeloid leukaemia, myelodysplastic syndrome, hereditary spherocytosis and suspected chemically induced thrombocytopenia). Initial response to TPO-ra defined as platelet counts >30 × 10(9)/l after 4 weeks of treatment was found in 59% of primary ITP patients, 57% of patients with secondary ITP and 40% of patients with non-ITP. There were four deaths in the cohort, three of which were related to pre-existing medical conditions. Otherwise adverse effects were in general mild. This Danish retrospective registration study has demonstrated that in the off-protocol setting, the use of TPO-ra is associated with response rates largely similar to those seen in previous protocol-monitored studies and no new adverse events were reported.

  10. Educational Testing as an Accountability Measure: Drawing on Twentieth-Century Danish History of Education Experiences

    ERIC Educational Resources Information Center

    Ydesen, Christian

    2013-01-01

    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…

  11. Educational Testing as an Accountability Measure: Drawing on Twentieth-Century Danish History of Education Experiences

    ERIC Educational Resources Information Center

    Ydesen, Christian

    2013-01-01

    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…

  12. Danish Health Professionals' Experiences of Being Coached: A Pilot Study

    ERIC Educational Resources Information Center

    Ammentorp, Jette; Jensen, Hanne Irene; Uhrenfeldt, Lisbeth

    2013-01-01

    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…

  13. Danish Health Professionals' Experiences of Being Coached: A Pilot Study

    ERIC Educational Resources Information Center

    Ammentorp, Jette; Jensen, Hanne Irene; Uhrenfeldt, Lisbeth

    2013-01-01

    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…

  14. Ruxolitinib is manageable in patients with myelofibrosis and severe thrombocytopenia: a report on 12 Danish patients.

    PubMed

    Bjørn, Mads Emil; Holmström, Morten Orebo; Hasselbalch, Hans Carl

    2016-01-01

    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.

  15. Male and female transsexualism: the Danish experience with 37 patients.

    PubMed

    Sørensen, T; Hertoft, P

    1982-04-01

    Since the first sex-reassignment operation in Denmark at the Rigshospitalet in 1951, a total of 37 patients, 29 males and 8 females, have had sex-modifying surgery and a change in legal status. In our experience a basic insecure gender identity is a predominant trait in transsexuals, dating back to earliest childhood. This insecurity and a concomitant anxiety are overcome differently by the two transsexual sexes. In male transsexualism, the most outstanding characteristic is a narcissistic withdrawal to a condition marked by submission and pseudofeminity. Anxiety and insecurity are basic to the gender dysphoria but are subdued by means of fantasy escape and gratification in aestheticized ego-ideals with suppression of aggressive and sexual feelings. This results in the often observed pseudofeminity in the male transsexual. A core group of transsexual males are marked by a persistent pseudofeminine narcissism. They have stable ego strength, are agenital in sexual attitude, and have an intact sense of reality. This group is expected to remain so after sex reassignment. The transsexual female assumes a narcissistic, phallic attitude displaying outer activities and caricatured masculine manners in an attempt to subdue her insecurity. Examples are given of the characteristic splitting of these persons' phenomenological ego-experiences and how different their reality testing is from that of psychotic persons with a desire for sex change. Transsexual females are much more sexually active than transsexual males. We find a closer connection between female homosexuality and transsexualism than between male homosexuality and transsexualism.

  16. Sensemaking, Sensegiving and Strategic Management in Danish Higher Education

    ERIC Educational Resources Information Center

    Degn, Lise

    2015-01-01

    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…

  17. Sensemaking, Sensegiving and Strategic Management in Danish Higher Education

    ERIC Educational Resources Information Center

    Degn, Lise

    2015-01-01

    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…

  18. Cryogenic fluid management experiment

    NASA Technical Reports Server (NTRS)

    Eberhardt, R. N.; Bailey, W. J.; Fester, D. A.

    1981-01-01

    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.

  19. Experiences with global trigger tool reviews in five Danish hospitals: an implementation study.

    PubMed

    von Plessen, Christian; Kodal, Anne Marie; Anhøj, Jacob

    2012-01-01

    To describe experiences with the implementation of global trigger tool (GTT) reviews in five Danish hospitals and to suggest ways to improve the performance of GTT review teams. Retrospective observational study. The measurement and monitoring of harms are crucial to campaigns to improve the safety of patients. Increasingly, teams use the GTT to review patient records and measure harms in English and non-English-speaking countries. Meanwhile, it is not clear as to how the method performs in such diverse settings. Review teams from five Danish pilot hospitals of the national Danish Safer Hospital Programme. We collected harm rates, background and anecdotal information and reported patient safety incidents (PSIs) from five pilot hospitals currently participating in the Danish Safer Hospital Programme. Experienced reviewers categorised harms by type. We plotted harm rates as run-charts and applied rules for the detection of patterns of non-random variation. The hospitals differed in size but had similar patient populations and activity. PSIs varied between 3 and 12 per 1000 patient-days. The average harm rate for all hospitals was 60 per 1000 patient-days ranging from 34 to 84. The percentage of harmed patients was 25 and ranged from 18 to 33. Overall, 96% of harms were temporary. Infections, pressure ulcers procedure-related and gastrointestinal problems were common. Teams reported differences in training and review procedures such as the role of the secondary reviewer. We found substantial variation in harm rates. Differences in training, review procedures and documentation in patient records probably contributed to these variations. Training reviewers as teams, specifying the roles of the different reviewers, training records and a database for findings of reviews may improve the application of the GTT.

  20. Experiences with global trigger tool reviews in five Danish hospitals: an implementation study

    PubMed Central

    von Plessen, Christian; Kodal, Anne Marie; Anhøj, Jacob

    2012-01-01

    Objectives To describe experiences with the implementation of global trigger tool (GTT) reviews in five Danish hospitals and to suggest ways to improve the performance of GTT review teams. Design Retrospective observational study. Setting The measurement and monitoring of harms are crucial to campaigns to improve the safety of patients. Increasingly, teams use the GTT to review patient records and measure harms in English and non-English-speaking countries. Meanwhile, it is not clear as to how the method performs in such diverse settings. Participants Review teams from five Danish pilot hospitals of the national Danish Safer Hospital Programme. Primary and secondary outcome measures We collected harm rates, background and anecdotal information and reported patient safety incidents (PSIs) from five pilot hospitals currently participating in the Danish Safer Hospital Programme. Experienced reviewers categorised harms by type. We plotted harm rates as run-charts and applied rules for the detection of patterns of non-random variation. Results The hospitals differed in size but had similar patient populations and activity. PSIs varied between 3 and 12 per 1000 patient-days. The average harm rate for all hospitals was 60 per 1000 patient-days ranging from 34 to 84. The percentage of harmed patients was 25 and ranged from 18 to 33. Overall, 96% of harms were temporary. Infections, pressure ulcers procedure-related and gastrointestinal problems were common. Teams reported differences in training and review procedures such as the role of the secondary reviewer. Conclusions We found substantial variation in harm rates. Differences in training, review procedures and documentation in patient records probably contributed to these variations. Training reviewers as teams, specifying the roles of the different reviewers, training records and a database for findings of reviews may improve the application of the GTT. PMID:23065451

  1. "It's not very feminine to have a mustache": Experiences of Danish women with polycystic ovary syndrome.

    PubMed

    Pfister, Gertrud; Rømer, Kristine

    2017-02-01

    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.

  2. [The National Danish Survey of Patient Experiences has a small positive bias].

    PubMed

    Rosenstjerne Andersen, Angelo; Fuglsang, Marie; Kyed, Daisy

    2012-10-01

    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.

  3. The First-Year Experience of Non-Traditional Students in Danish Science and Engineering University Programmes

    ERIC Educational Resources Information Center

    Ulriksen, Lars; Madsen, Lene Møller; Holmegaard, Henriette Tolstrup

    2017-01-01

    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…

  4. The First-Year Experience of Non-Traditional Students in Danish Science and Engineering University Programmes

    ERIC Educational Resources Information Center

    Ulriksen, Lars; Madsen, Lene Møller; Holmegaard, Henriette Tolstrup

    2017-01-01

    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…

  5. Petascale system management experiences.

    SciTech Connect

    Desai, N.; Bradshaw, R.; Lueninghoener, C.; Cherry, A.; Coghlan, S.; Scullin, W.

    2008-01-01

    National Laboratory, and a 504 TF Opteron-based system has been deployed at Texas Advanced Computing Center (TACC). Intrepid is comprised of 40,960 nodes with a total of 163,840 cores. While systems like these are uncommon now, we expect them to become more widespread in the coming years. The scale of these large systems impose several requirements upon system architecture. The need for scalability is obvious, however, power efficiency and density constraints have become increasingly important in recent years. At the same time, because the size of administrative staff cannot grow linearly with the system size, more efficient system management techniques are needed. In this paper we will describe our experiences administering Intrepid. Over the last year, we have experienced a number of interesting challenges in this endeavor. Our initial expectation was for scalability to be the dominant system issue. This expectation was not accurate. Several issues expected to have minor impact have played a much greater role in system operations. Debugging, due to the large numbers of components used in scalable system operations, has become a much more difficult endeavor. The system has a sophisticated monitoring system, however, the analysis of this data has been problematic. These issues are not specific to HPC workloads in any way, so we expect them to be of general interest. This paper consists of three major parts. First, we will provide a detailed overview of several important aspects of Intrepid's hardware and software. In this, we will highlight aspects that have featured prominently in our system management experiences. Next, we will describe our administration experiences in detail. Finally, we will draw some conclusions based on these experiences. In particular, we will discuss the implications for the non-HPC world, system managers, and system software developers.

  6. Danish women's experiences of the rebozo technique during labour: A qualitative explorative study.

    PubMed

    Iversen, Mette Langeland; Midtgaard, Julie; Ekelin, Maria; Hegaard, Hanne Kristine

    2017-03-01

    The study aimed to explore women's experiences of the rebozo technique during labour. This was a qualitative study based on individual telephone interviews, analysed by means of qualitative content analysis and inspired by interpretive description. 17 participants were recruited from two different-sized Danish hospitals and identified by applying a purposeful sample strategy. The main theme expressed the women's overall experience with the rebozo: "Joined movements in a harmless effort towards a natural birth". The women experienced that the technique created bodily sensations, which reduced their pain, and furthermore they expressed that it interrelated the labour process and produced mutual involvement and psychological support from the midwife and the women's partner. The rebozo technique was in most situations carried out because the midwife suspected a foetus malposition. The experiences of the rebozo technique were overall positive and both of a physical and psychological nature. The results indicate that health professionals should view rebozo as an easy accessible clinical tool with high user acceptance and possible positive psychological and clinical implications. The study contributes with a deeper and more nuanced understanding of a topic where only limited knowledge exists, however, efficacy studies are warranted. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  7. Comparison of the organic waste management systems in the Danish-German border region using life cycle assessment (LCA).

    PubMed

    Jensen, Morten Bang; Møller, Jacob; Scheutz, Charlotte

    2016-03-01

    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.

  8. A managed multidisciplinary programme on multi-resistant Klebsiella pneumoniae in a Danish university hospital.

    PubMed

    Andersen, Stig Ejdrup; Knudsen, Jenny Dahl

    2013-11-01

    Bacteria-producing extended spectrum β-lactamase (ESBL) enzymes are resistant to commonly used antimicrobials. In 2008, routine monitoring revealed a clonal hospital outbreak of ESBL-producing Klebsiella pneumoniae (ESBL-KP). At a 510-bed Danish university hospital, a multidisciplinary change project inspired by Kotter's Eight Steps of Change was designed. In addition to revision of antimicrobial guidelines and restriction of selected antimicrobials, the complex, managed, multi-faceted intervention comprised training and education, enhanced isolation precautions, and a series of actions to improve the infection control measures and standardise procedures across the hospital. A prospective interrupted time series design was used to analyse data collected at hospital level from January 2008 through December 2011. Though overall antimicrobial consumption remained unaffected, the intervention led to intended, immediate and sustained reduction in the use of cefuroxime, and an increase in the use of ertapenem, piperacillin/tazobactam and β-lactamase sensitive penicillin. Moreover, a postintervention reduction in the rate of ESBL-KP in diagnostic samples and in the incidence of ESBL-KP infections was observed. The intervention may also have reduced the need for isolation precautions and may have shortened each isolation period. The results indicate that an immediate and sustained change in the antimicrobial consumption and a decreasing rate of ESBL-KP are achievable through the application of a managed, multi-faceted intervention that does not require ongoing antibiotic stewardship.

  9. First Danish experience with ex vivo lung perfusion of donor lungs before transplantation.

    PubMed

    Henriksen, Ian Sune Iversen; Møller-Sørensen, Hasse; Møller, Christian Holdfold; Zemtsovski, Mikhail; Nilsson, Jens Christian; Seidelin, Casper Tobias; Perch, Michael; Iversen, Martin; Steinbrüchel, Daniel

    2014-03-01

    The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its introduction. The study was conducted by prospective registration of donor offers and lung transplantations in Denmark from 1 May 2012 to 30 April 2013. Donor lungs without any contraindications were transplanted in the traditional manner. Taken for EVLP were donor lungs that were otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test. In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died of non-EVLP-related causes, but all other recipients were alive with normal graft function at the end of our registration period. All lungs showed an improved PaO2/FiO2 ratio from a median 23.1 kPa (8.8-38.9) within the donor to 58.8 kPa (34.9-76.5) (FiO2 = 1.0) after EVLP, which corresponds to a 155% improved oxygenation. The median time to extubation, time in intensive care unit and the admission period were 1, 7 and 39 days, respectively. In the first year after the introduction of EVLP in Denmark, seven pairs of donor lungs that previously would have been rejected have been transplanted as a result of their improved function. EVLP seems to be a safe way to increase the use of marginal donor lungs. no funding was granted for the present paper. not relevant.

  10. The Danish Fracture Database can monitor quality of fracture-related surgery, surgeons' experience level and extent of supervision.

    PubMed

    Andersen, Morten Jon; Gromov, Kiril; Brix, Michael; Troelsen, Anders

    2014-06-01

    The importance of supervision and of surgeons' level of experience in relation to patient outcome have been demonstrated in both hip fracture and arthroplasty surgery. The aim of this study was to describe the surgeons' experience level and the extent of supervision for: 1) fracture-related surgery in general; 2) the three most frequent primary operations and reoperations; and 3) primary operations during and outside regular working hours. A total of 9,767 surgical procedures were identified from the Danish Fracture Database (DFDB). Procedures were grouped based on the surgeons' level of experience, extent of supervision, type (primary, planned secondary or reoperation), classification (AO Müller), and whether they were performed during or outside regular hours. Interns and junior residents combined performed 46% of all procedures. A total of 90% of surgeries by interns were performed under supervision, whereas 32% of operations by junior residents were unsupervised. Supervision was absent in 14-16% and 22-33% of the three most frequent primary procedures and reoperations when performed by interns and junior residents, respectively. The proportion of unsupervised procedures by junior residents grew from 30% during to 40% (p < 0.001) outside regular hours. Interns and junior residents together performed almost half of all fracture-related surgery. The extent of supervision was generally high; however, a third of the primary procedures performed by junior residents were unsupervised. The extent of unsupervised surgery performed by junior residents was significantly higher outside regular hours. not relevant. The Danish Fracture Database ("Dansk Frakturdatabase") was approved by the Danish Data Protection Agency ID: 01321.

  11. Barriers to cancer pain management in Danish and Lithuanian patients treated in pain and palliative care units.

    PubMed

    Jacobsen, Ramune; Samsanaviciene, Jurgita; Liubarskiene, Zita; Sjøgren, Per; Møldrup, Claus; Christrup, Lona; Sciupokas, Arunas; Hansen, Ole Bo

    2014-03-01

    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.

  12. A prospective evaluation of the Chronic Pain Self-Management Programme in a Danish population of chronic pain patients.

    PubMed

    Mehlsen, Mimi; Heegaard, Lea; Frostholm, Lisbeth

    2015-05-01

    This study evaluates the feasibility and changes in pain, pain cognition, and distress during a patient education course and a 5-month follow-up period. The Chronic Pain Self-Management Programme (CPSMP) is a lay-led patient education consisting of six manualized sessions. A Danish adaptation of the CPSMP was tested in four municipalities. The sample consisted of 74 women and 13 men between 26 and 80 years with a long pain history (+10 years). Participants completed questionnaires before the CPSMP, immediately after and 5 months after the program. The study showed that the Danish version of the CPSMP was feasible. The sample was heterogeneous with respect to age, education, duration and causes of pain but all participants reported serious pain and most experienced high levels of distress and disability. Participants evaluated the CPSMP as satisfying and more than 75% would recommend the program to other patients. Participants showed significant improvements on pain, disability, catastrophizing, depression, anxiety, and health worry, and changes were stable through the follow-up period. A consistent pattern of stable improvements in pain, pain cognition and distress was observed but the scope of changes was modest. The Danish version of the CPSMP is feasible. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Assessment of blue mussel Mytilus edulis fisheries and waterbird shellfish-predator management in the Danish Wadden Sea.

    PubMed

    Laursen, Karsten; Kristensen, Per Sand; Clausen, Preben

    2010-11-01

    We assessed the blue mussel Mytilus edulis fishery management scheme introduced in 1994 in the Danish Wadden Sea that regulate fishing vessels, fishery quota, set-aside for mussel-eating birds and established zones closed to mussel fishery. The results showed (i) a reduction in the blue mussel biomass and mussel bed areas in zones closed to fishery, (ii) decrease in eiders Somateria mollissima numbers and increase or stable numbers for oystercatcher Haematopus ostralegus and herring gull Larus argentatus and (iii) that energy estimations based on ecological food requirements for the mussel-eating birds should be at least three times larger, than the amount set-aside in the mussel management scheme. It is concluded that the mussel management scheme had been unable to stabilize or increase the blue mussel stocks and to secure stable or increasing numbers for all target bird species. Thus, it is recommended to revise the present blue mussel management scheme in the Danish Wadden Sea, to continue and improve mussel stock and bird surveys, and to consider novel studies of the mussel-eating birds' energetics for improved set-aside estimates and future assessments.

  14. Different effects of BCG strains - A natural experiment evaluating the impact of the Danish and the Russian BCG strains on morbidity and scar formation in Guinea-Bissau.

    PubMed

    Frankel, H; Byberg, S; Bjerregaard-Andersen, M; Martins, C L; Aaby, P; Benn, C S; Fisker, A B

    2016-08-31

    Different Bacillus Calmette-Guerin (BCG) vaccine strains may have different non-specific effects. We assessed the effect of two BCG strains (Danish and Russian) on childhood morbidity and BCG scarification in Guinea-Bissau. During 2011-2013, infants in the Bandim Health Project's urban study area received the Danish or Russian BCG in a natural experiment. Health center consultations were registered at point of care and scar status and size at age 4½ months. We assessed the effect of strain on consultation rates between vaccination and age 45days in Cox proportional hazards models. Scar prevalence and size were compared using binomial regression and ranksum tests. Among 1206 children, 18% received Danish BCG (n=215) and 82% Russian BCG (n=991). The adjusted hazard ratio (aHR) for consultations was 0.94 (95% CI 0.60-1.46) for Danish BCG compared with Russian BCG. Girls vaccinated with Danish BCG tended to have lower consultation rates compared with girls vaccinated with Russian BCG (aHR 0.56 (0.25-1.24)), whereas the effect was opposite for boys (aHR 1.24 (0.74-2.11)), p=0.09. Children vaccinated with Danish BCG were more likely to develop a scar (97%) than children vaccinated with Russian BCG (87%), the relative risk (RR) being 1.11 (1.06-1.16). The effect was stronger in girls, and BCG scar size was larger among infants vaccinated with the Danish strain. BCG strain influences scar prevalence and scar size, and may have sex differential effects on morbidity. BCG strains are currently used interchangeably, but BCG scarring has been linked to subsequent survival. Hence, more research into the health effects of different BCG strains is warranted. Small adjustments of BCG production could potentially lower childhood morbidity and mortality at low cost. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Activity Theories and the Ontology of Psychology: Learning from Danish and Russian Experiences.

    PubMed

    Mammen, Jens; Mironenko, Irina

    2015-12-01

    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.

  16. Public-Private Partnerships in the health sector: the Danish experience.

    PubMed

    Vrangbaek, Karsten

    2008-04-01

    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.

  17. Thermal energy management process experiment

    NASA Technical Reports Server (NTRS)

    Ollendorf, S.

    1984-01-01

    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.

  18. Assessing atmospheric nitrogen deposition to natural and semi-natural ecosystems - Experience from Danish studies using the DAMOS

    NASA Astrophysics Data System (ADS)

    Hertel, Ole; Geels, Camilla; Frohn, Lise Marie; Ellermann, Thomas; Skjøth, Carsten Ambelas; Løfstrøm, Per; Christensen, Jesper H.; Andersen, Helle Vibeke; Peel, Robert George

    2013-02-01

    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

  19. Japanese experiences of environmental management.

    PubMed

    Matsuo, T

    2003-01-01

    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.

  20. User satisfaction and experience with a telehealth system for the Danish TeleCare North Trial: a think-aloud study.

    PubMed

    Lilholt, Pernille Heyckendorff; Heiden, Sisse; Hejlesen, Ole K

    2014-01-01

    The aim was to evaluate a redesigned version of Telekit--a telehealth system developed for the Danish TeleCare North Trial. Telekit is used in the management of care in patients diagnosed with chronic obstructive pulmonary disease (COPD). This paper summarises the experience and the feedback received from six COPD-participants in terms of usability and satisfaction. Participants were asked to think-aloud while performing some system specific tasks. After each session, participants completed a post-test questionnaire. The think-aloud test was recorded, and notes from the tests were categorised and analysed. All tasks were completed by participants. Difficulties were observed concerning monitoring of measurements and use of the touchscreen. User feedback was mainly positive, and nearly all participants perceived Telekit as very easy to use. The study provides important insight regarding use of Telekit by patients suffering from a chronic illness and increased understanding about, how similar systems can more effectively be used in such home health initiatives.

  1. Recruitment of ethnic minorities for public health research: An interpretive synthesis of experiences from six interlinked Danish studies.

    PubMed

    Nielsen, Annemette Ljungdalh; Jervelund, Signe Smith; Villadsen, Sarah Fredsted; Vitus, Kathrine; Ditlevsen, Kia; TØrslev, Mette Kirstine; Kristiansen, Maria

    2017-03-01

    This paper examines the importance of recruitment site in relation to the recruitment of ethnic minorities into health research. It presents a synthesis of experiences drawn from six interlinked Danish studies which applied different methods and used healthcare facilities and educational settings as sites for recruitment. Inspired by interpretive reviewing, data on recruitment methods from the different studies were synthesized with a focus on the various levels of recruitment success achieved. This involved an iterative process of comparison, analysis and discussion of experiences among the researchers involved. Success in recruitment seemed to depend partly on recruitment site. Using healthcare facilities as the recruitment site and healthcare professionals as gatekeepers was less efficient than using schools and employees from educational institutions. Successful study designs also depended on the possibility of singling out specific locations with a high proportion of the relevant ethnic minority target population. The findings, though based on a small number of cases, indicate that health professionals and healthcare institutions, despite their interest in high-quality health research into all population groups, fail to facilitate research access to some of the most disadvantaged groups, who need to be included in order to understand the mechanisms behind health disparities. This happens despite the genuine wish of many healthcare professionals to help facilitate such research. In this way, the findings indirectly emphasize the specific challenge of accessing more vulnerable and sick groups in research studies.

  2. Adaptive grazing management experiment: The new frontier of grazing management

    USDA-ARS?s Scientific Manuscript database

    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...

  3. Software Acquisition Management Practical Experience

    DTIC Science & Technology

    2009-04-23

    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

  4. NASA cryogenic fluid management space experiment efforts

    NASA Technical Reports Server (NTRS)

    Glover, Daniel

    1991-01-01

    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.

  5. Wilderness visitors, experiences, and visitor management

    Treesearch

    David N. Cole; Stephen F. McCool

    2000-01-01

    This paper provides an overview of the Wilderness science in a time of change conference-Volume 4: Wilderness visitors, experiences, and visitor management. Wilderness areas are managed to protect their wilderness character, but they also provide opportunities for recreation use. Decades ago, relatively few people sought wilderness experiences, and...

  6. Engineering data management: Experience and projections

    NASA Technical Reports Server (NTRS)

    Jefferson, D. K.; Thomson, B.

    1978-01-01

    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.

  7. Engineering data management: Experience and projections

    NASA Technical Reports Server (NTRS)

    Jefferson, D. K.; Thomson, B.

    1978-01-01

    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.

  8. Assessment of management-related risk factors for paratuberculosis in Danish dairy herds using Bayesian mixture models.

    PubMed

    Nielsen, S S; Toft, N

    2007-10-16

    Transmission of Mycobacterium avium subsp. paratuberculosis (Map) to susceptible animals is primarily considered to occur via faeces and milk originating from infectious cows. However, studies of factors resulting in increased transmission of Map are difficult to perform due to a long and unpredictable incubation period and inaccurate diagnostic tests. A multi-level Bayesian mixture model has been shown to predict the infection status of an individual cow more precisely than traditional cut-off based methods used for interpretation of diagnostic test-information, thereby increasing the precision of the diagnostic information. The objective of our study was to assess management-related risk factors for within-herd transmission of Map. Management-related risk factors were recorded in 97 Danish dairy herds. Twenty-six months following that recording, the antibody status of all lactating cows (n=7,410) in the same herds was measured by the use of an ELISA. A multi-level Bayesian mixture model was used to assess the association between the probability of infection of individual cows and 41 herd-level management-related risk factors using univariable analyses. In this model, the continuous OD value was used to estimate the probability of infection, corrected for known animal covariates and laboratory factors. The statistical significance of the potential risk factors was assessed by calculating odds ratios and their 95% credibility posterior intervals. Four significant risk factors were identified: housing of cows in bed stalls compared to housing in tie stalls; low level of hygiene in the feeding area of calving areas; low amounts of straw in the bedding of the calving area; high animal density among young stock >12 months of age. Surprisingly, the hygiene level in the calving area was not found to affect the odds of infection.

  9. Managing the Fruit Fly Experiment.

    ERIC Educational Resources Information Center

    Jeszenszky, Arleen W.

    1997-01-01

    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)

  10. Managing the Fruit Fly Experiment.

    ERIC Educational Resources Information Center

    Jeszenszky, Arleen W.

    1997-01-01

    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)

  11. The benefit of meeting a stranger: experiences with emotional support provided by nurses among Danish-born and migrant cancer patients.

    PubMed

    Kristiansen, M; Tjørnhøj-Thomsen, T; Krasnik, A

    2010-07-01

    Research among cancer patients has shown that emotional support in informal relationships may be difficult to access because of a fear or lack of knowledge about cancer. Consequently, formal relationships with healthcare professionals may be important sources of support. This study explores needs for and experiences with emotional support provided by nurses as well as prerequisites for the provision of support among Danish-born and migrant cancer patients. We conducted narrative interviews with 18 adult Danish-born and migrant cancer patients. Patients were recruited from a variety of places in a purposive strategic sampling process. Analysis was inspired by phenomenological methods and Simmel's theoretical concept of "the stranger". Both Danish-born and migrant patients perceived the support delivered by healthcare professionals as available, empathic and valuable. Prerequisites for providing emotional support were 1) setting aside time for the patient to feel safe and able to verbalise emotional concerns, 2) continuity in relationships with healthcare professionals, and 3) nurses' ability to understand the patient's emotional reactions without creating additional distress. Being positioned as a stranger to the patient gives nurses a unique position from which to provide emotional support during cancer treatment. Thus, formal relationships with healthcare professionals are of great importance for many cancer patients.

  12. Cryptosporidium and Giardia in different age groups of Danish cattle and pigs--occurrence and management associated risk factors.

    PubMed

    Maddox-Hyttel, Charlotte; Langkjaer, Rikke B; Enemark, Heidi L; Vigre, Håkan

    2006-10-10

    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.

  13. Managed care: the US experience.

    PubMed Central

    Sekhri, N. K.

    2000-01-01

    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

  14. Experiences with Recruitment of Marginalized Groups in a Danish Health Promotion Program: A Document Evaluation Study

    PubMed Central

    Kristiansen, Tine Mechlenborg; Bak, Carsten Kronborg

    2016-01-01

    Background Studies have found that marginalized groups living in deprived neighborhoods are less likely to participate in health programs compared to the majority of society. This study evaluates recruitment approaches conducted during a national government-funded project in 12 deprived neighborhoods across Denmark between 2010 and 2014. The aim of this study was to understand how recruitment approaches could promote participation in health programs within deprived neighborhoods to reach marginalized groups. Method Documents from all 12 of the included municipalities were collected to conduct a document evaluation. The collected documents consisted of 1,500 pages of written material with 12 project descriptions, three midterm and 10 final evaluations. The collected data were analyzed through a qualitative content analysis. Results The results are based on the fact that only 10 municipalities have developed evaluations related to recruitment, and only three evaluations provided a description of which marginalized groups were recruited. Challenges related to recruitment consist of difficulties involving the target group, including general distrust, language barriers and a lack of ability to cope with new situations and strangers. Additional geographical challenges emerged, especially in rural areas. Positive experiences with recruitment approaches were mainly related to relationship building and trust building, especially through face-to-face contact and the project employees’ presence in the neighborhood. Additionally, adjusting some of the interventions and the recruitment strategy increased participation. Conclusion This study found that relation and trust between the residents and the project employees is an important factor in the recruitment of marginalized groups in deprived neighborhoods as well as adjusting the health interventions or recruitment strategy to the target groups. In future research, it is necessary to examine which recruitment approaches are

  15. Experiences with Recruitment of Marginalized Groups in a Danish Health Promotion Program: A Document Evaluation Study.

    PubMed

    Rasmussen, Marianne; Poulsen, Eva Kanstrup; Rytter, Anne Stoffersen; Kristiansen, Tine Mechlenborg; Bak, Carsten Kronborg

    2016-01-01

    Studies have found that marginalized groups living in deprived neighborhoods are less likely to participate in health programs compared to the majority of society. This study evaluates recruitment approaches conducted during a national government-funded project in 12 deprived neighborhoods across Denmark between 2010 and 2014. The aim of this study was to understand how recruitment approaches could promote participation in health programs within deprived neighborhoods to reach marginalized groups. Documents from all 12 of the included municipalities were collected to conduct a document evaluation. The collected documents consisted of 1,500 pages of written material with 12 project descriptions, three midterm and 10 final evaluations. The collected data were analyzed through a qualitative content analysis. The results are based on the fact that only 10 municipalities have developed evaluations related to recruitment, and only three evaluations provided a description of which marginalized groups were recruited. Challenges related to recruitment consist of difficulties involving the target group, including general distrust, language barriers and a lack of ability to cope with new situations and strangers. Additional geographical challenges emerged, especially in rural areas. Positive experiences with recruitment approaches were mainly related to relationship building and trust building, especially through face-to-face contact and the project employees' presence in the neighborhood. Additionally, adjusting some of the interventions and the recruitment strategy increased participation. This study found that relation and trust between the residents and the project employees is an important factor in the recruitment of marginalized groups in deprived neighborhoods as well as adjusting the health interventions or recruitment strategy to the target groups. In future research, it is necessary to examine which recruitment approaches are effective under which circumstances to

  16. Effect of management practices on paratuberculosis prevalence in Danish dairy herds.

    PubMed

    Nielsen, S S; Toft, N

    2011-04-01

    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

  17. 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

    NASA Astrophysics Data System (ADS)

    Kronvang, Brian; Windolf, Jørgen; Blicher-Mathiesen, Gitte; Tornbjerg, Henrik; Højberg, Anker; Rieman, Bo

    2016-04-01

    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

  18. Network Analysis as a tool for assessing environmental sustainability: applying the ecosystem perspective to a Danish Water Management System.

    PubMed

    Pizzol, Massimo; Scotti, Marco; Thomsen, Marianne

    2013-03-30

    New insights into the sustainable use of natural resources in human systems can be gained through comparison with ecosystems via common indices. In both kinds of system, resources are processed by a number of users within a network, but we consider ecosystems as the only ones displaying sustainable patterns of growth and development. This study aims at using Network Analysis (NA) to move such "ecosystem perspective" from theory into practice. A Danish municipal Water Management System (WMS) is used as case study to test the NA methodology and to discuss its generic applicability. We identified water users within the WMS and represented their interactions as a network of water flows. We computed intensive and extensive indices of system-level performance for seven different network configurations illustrating past conditions (2004-2008) and future scenarios (2015 and 2020). We also computed the same indices for other 24 human systems and for 12 ecosystems, by using information from the existing scientific literature on NA. The comparison of these results reveals that the WMS is similar to the other human systems and that human systems generally differ from ecosystems. The WMS is highly efficient at processing the water resource, but the rigid and almost linear structure makes it vulnerable in situations of stress such as heavy rain events. The analysis of future scenarios showed a trend towards increased sustainability, but differences between past and expected future performance of the WMS are marginal. We argue that future interventions should create alternative pathways for reusing rainwater within the WMS, increasing its potential to withstand the occurrence of flooding. We discuss advantages, limitations, and general applicability of NA as a tool for assessing environmental sustainability in human systems. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Experimenters' reference based upon Skylab experiment management

    NASA Technical Reports Server (NTRS)

    1974-01-01

    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.

  20. Management system for the SND experiments

    NASA Astrophysics Data System (ADS)

    Pugachev, K.; Korol, A.

    2017-09-01

    A new management system for the SND detector experiments (at VEPP-2000 collider in Novosibirsk) is developed. We describe here the interaction between a user and the SND databases. These databases contain experiment configuration, conditions and metadata. The new system is designed in client-server architecture. It has several logical layers corresponding to the users roles. A new template engine is created. A web application is implemented using Node.js framework. At the time the application provides: showing and editing configuration; showing experiment metadata and experiment conditions data index; showing SND log (prototype).

  1. Building a Propulsion Experiment Project Management Environment

    NASA Technical Reports Server (NTRS)

    Keiser, Ken; Tanner, Steve; Hatcher, Danny; Graves, Sara

    2004-01-01

    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.

  2. Wildlife management: Managing the hunt versus the hunting experience

    NASA Astrophysics Data System (ADS)

    Hammitt, William E.; McDonald, Cary D.; Noe, Francis P.

    1989-07-01

    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.

  3. Panel management, team culture, and worklife experience.

    PubMed

    Willard-Grace, Rachel; Dubé, Kate; Hessler, Danielle; O'Brien, Bridget; Earnest, Gillian; Gupta, Reena; Shunk, Rebecca; Grumbach, Kevin

    2015-09-01

    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. (c) 2015 APA, all rights reserved).

  4. Cryogenic Fluid Management Flight Experiment (CFMFE)

    NASA Technical Reports Server (NTRS)

    Defelice, David M.

    1987-01-01

    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.

  5. Danish dairy farmers' perceptions and attitudes related to calf-management in situations of high versus no calf mortality.

    PubMed

    Vaarst, Mette; Sørensen, Jan Tind

    2009-05-01

    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.

  6. Cryogenic fluid management experiment trunnion fatigue verification

    NASA Technical Reports Server (NTRS)

    Bailey, W. J.; Fester, D. A.; Toth, J. M., Jr.; Kasper, H. J.

    1983-01-01

    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.

  7. Cryogenic fluid management experiment trunnion fatigue verification

    NASA Technical Reports Server (NTRS)

    Bailey, W. J.; Fester, D. A.; Toth, J. M., Jr.; Kasper, H. J.

    1983-01-01

    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.

  8. Flight experience with flight control redundancy management

    NASA Technical Reports Server (NTRS)

    Szalai, K. J.; Larson, R. R.; Glover, R. D.

    1980-01-01

    Flight experience with both current and advanced redundancy management schemes was gained in recent flight research programs using the F-8 digital fly by wire aircraft. The flight performance of fault detection, isolation, and reconfiguration (FDIR) methods for sensors, computers, and actuators is reviewed. Results of induced failures as well as of actual random failures are discussed. Deficiencies in modeling and implementation techniques are also discussed. The paper also presents comparison off multisensor tracking in smooth air, in turbulence, during large maneuvers, and during maneuvers typical of those of large commercial transport aircraft. The results of flight tests of an advanced analytic redundancy management algorithm are compared with the performance of a contemporary algorithm in terms of time to detection, false alarms, and missed alarms. The performance of computer redundancy management in both iron bird and flight tests is also presented.

  9. Classification and coding of commercial fishing injuries by work processes: an experience in the Danish fresh market fishing industry.

    PubMed

    Jensen, O C; Stage, S; Noer, P

    2005-06-01

    Work-related injuries in commercial fishing are of concern internationally. To better identify the causes of injury, this study coded occupational injuries by working processes in commercial fishing for fresh market fish. A classification system of the work processes was developed by participation in fishing vessel trips where observations and video recordings of the work operations on board were collected. Subsequently the system was pilot tested using the Danish Maritime Authority injury reports. The developed classification system contains 17 main categories and up to 13 sub-categories of the work processes for each of the five different types of fishing. A total of 620 injury reports were reviewed and coded. Five percent (n = 33) of these were fatal injuries. The working processes were identified and coded according to the developed classification system for 553 (89%) injury reports: Danish seiner (n = 83), gill-netter (n = 122), beam trawler (n = 71), twin-trawler 2-T (n = 96), single/pair trawler 1-T (n = 181). Sixty-seven (11%) of the reports were unclassifiable due to lack of information. Preparing, shooting, and hauling of the gear and nets accounted for 50% of the injuries; they were most serious type of injuries such as fractures and sprains. Walking about the ship, in particular embarking and disembarking, climbing and descending ladders accounted for nearly one-fifth of the injuries. We found that the working processes related to working with the gear and nets vary greatly in the different fishing methods. Coding of the injuries to the specific working processes allows for targeted prevention efforts.

  10. Applying State-of-the-art, Unstructured mesh Models on Estuary Management in the Danish Wadden Sea

    NASA Astrophysics Data System (ADS)

    Bundgaard, K.; Lumborg, U.; Vested, H. J.; Edelvang, K.

    2006-12-01

    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

  11. Experience with the use of LCA-modelling (EASEWASTE) in waste management.

    PubMed

    Christensen, Thomas H; Bhander, Gurbakhash; Lindvall, Hanna; Larsen, Anna W; Fruergaard, Thilde; Damgaard, Anders; Manfredi, Simone; Boldrin, Alessio; Riber, Christian; Hauschild, Michael

    2007-06-01

    Life-cycle assessment (LCA) models are becoming the principal decision support tools of waste management systems. This paper describes our experience with the use of EASEWASTE (Environmental Assessment of Solid Waste Systems and Technologies), a new computerized LCA-based model for integrated waste management. Our findings provide a quantitative understanding of waste management systems and may reveal consistent approaches to improve their environmental performances. EASEWASTE provides a versatile system modelling facility combined with a complete life-cycle impact assessment and in addition to the traditional impact categories addresses toxicity-related categories. New categories dealing with stored ecotoxicity and spoiled groundwater resources have been introduced. EASEWASTE has been applied in several studies, including full-scale assessments of waste management in Danish municipalities. These studies led to numerous modelling issues: the need of combining process-specific and input-specific emissions, the choice of a meaningful time horizon, the way of accounting for biological carbon emissions, the problem of stored ecotoxicity and aspects of crediting the waste management system with the savings inherent in avoided production of energy and materials. Interpretation of results showed that waste management systems can be designed in an environmentally sustainable manner where energy recovery processes lead to substantial avoidance of emissions and savings of resources.

  12. Conservative management of spontaneous abortions. Women's experiences.

    PubMed Central

    Wiebe, E.; Janssen, P.

    1999-01-01

    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

  13. An experience on wheelchair bank management.

    PubMed

    Lau, Hongyin; Tam, Eric W C; Cheng, Jack C Y

    2008-11-01

    In this article, we described the wheelchair bank program at a local hospital and our experiences in managing the service over the past 10 years from 1996 to 2005. This article also reported statistical information related to the acquisitions of wheelchairs and adaptive components, including body support and pressure relief systems. The cost benefit of recycling seating and mobility equipments for use by children with neuromuscular diseases was revealed. With the reference of the reported data, the demands on specific types of wheelchairs and adaptive parts were disclosed to facilitate budget planning of similar services.

  14. Experiences in managing the Prometheus Project

    NASA Technical Reports Server (NTRS)

    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.

    2006-01-01

    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

  15. Experiences in managing the Prometheus Project

    NASA Technical Reports Server (NTRS)

    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.

    2006-01-01

    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

  16. ATHLET validation using accident management experiments

    SciTech Connect

    Teschendorff, V.; Glaeser, H.; Steinhoff, F.

    1995-09-01

    The computer code ATHLET is being developed as an advanced best-estimate code for the simulation of leaks and transients in PWRs and BWRs including beyond design basis accidents. The code has features that are of special interest for applications to small leaks and transients with accident management, e.g. initialisation by a steady-state calculation, full-range drift-flux model, and dynamic mixture level tracking. The General Control Simulation Module of ATHLET is a flexible tool for the simulation of the balance-of-plant and control systems including the various operator actions in the course of accident sequences with AM measures. The systematic validation of ATHLET is based on a well balanced set of integral and separate effect tests derived from the CSNI proposal emphasising, however, the German combined ECC injection system which was investigated in the UPTF, PKL and LOBI test facilities. PKL-III test B 2.1 simulates a cool-down procedure during an emergency power case with three steam generators isolated. Natural circulation under these conditions was investigated in detail in a pressure range of 4 to 2 MPa. The transient was calculated over 22000 s with complicated boundary conditions including manual control actions. The calculations demonstrations the capability to model the following processes successfully: (1) variation of the natural circulation caused by steam generator isolation, (2) vapour formation in the U-tubes of the isolated steam generators, (3) break-down of circulation in the loop containing the isolated steam generator following controlled cool-down of the secondary side, (4) accumulation of vapour in the pressure vessel dome. One conclusion with respect to the suitability of experiments simulating AM procedures for code validation purposes is that complete documentation of control actions during the experiment must be available. Special attention should be given to the documentation of operator actions in the course of the experiment.

  17. Development and daily management of an explicit strategy of nonuse of antimicrobial drugs in twelve Danish organic dairy herds.

    PubMed

    Vaarst, M; Bennedsgaard, T W; Klaas, I; Nissen, T B; Thamsborg, S M; Østergaard, S

    2006-05-01

    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.

  18. Management of testicular seminoma. Our experience.

    PubMed

    Sperlongano, P; Pisaniello, D; Di Mauro, U; Pone, D; Casoli, E

    2000-01-01

    The authors report their experience in the management of seminomas. They examine 12 cases of seminoma among a series of 19 patients with testicular germ cell tumours observed at the Second Surgical Department of the Second University of Naples. Their results showed a better prognosis for patients in early stage of the disease who underwent surgery and adjuvant prophylactic radiotherapy; good survival rates for patients in advanced stages of the disease were achieved by the combined use of surgery, adjuvant radiotherapy and chemotherapy. The authors discuss risk factors, clinical and diagnostic features of seminomas, relating their prognosis with the combined use of both surgery and adjuvant therapies. They consider total orchiectomy, followed by prophylactic radiotherapy, the treatment of choice, especially in stages IA and IIA. They don't perform the routine retroperitoneal lymphadenectomy, differently from American authors, who always achieve it to stage the disease. The authors stress the improvement in the prognosis of seminoma, which has actually reached the 98% of five-year survival rate, for stages I and II.

  19. Implementing managed care and case management: the neuroscience experience.

    PubMed

    Marr, J A; Reid, B

    1992-10-01

    The case management model for patient care in the neuroscience area was recently implemented in the neurosciences area at a tertiary care hospital. Understanding of the concepts of case management and managed care were essential to the implementation process. Clustering of case types and appointment of group leaders made the development of individual care maps a manageable task. Case management of 2 case types, Parkinson's disease and Guillain Barré syndrome are described, including the rationale for selection, care map development and education. The process of continuing education focused on operational issues regarding utilization of the map and professional issues such as health teaching responsibilities.

  20. NASA cryogenic fluid management space experiment efforts, 1960-1990

    NASA Technical Reports Server (NTRS)

    Glover, Daniel

    1991-01-01

    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.

  1. Women in University Management: The Nigerian Experience

    ERIC Educational Resources Information Center

    Abiodun-Oyebanji, Olayemi; Olaleye, F.

    2011-01-01

    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…

  2. Uterine bacterial flora in postpartum Danish Holstein dairy cows determined using DNA-based fingerprinting: correlation to uterine condition and calving management.

    PubMed

    Elkjær, K; Ancker, M-L; Gustafsson, H; Friggens, N C; Waldmann, A; Mølbak, L; Callesen, H

    2013-04-01

    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. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Integrating Work Experience and Management for College Bound Students

    ERIC Educational Resources Information Center

    Ryan, Leo V.; Coover, Thomas A.

    1975-01-01

    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)

  4. The US JGOFS data management experience

    NASA Astrophysics Data System (ADS)

    Glover, David M.; Chandler, Cynthia L.; Doney, Scott C.; Buesseler, Ken O.; Heimerdinger, George; Bishop, J. K. B.; Flierl, Glenn R.

    2006-03-01

    The US Joint Global Ocean Flux Study (JGOFS) database management system is an online, oceanographic database assembled from the research activities of the US JGOFS field and Synthesis and Modeling Program (SMP). It is based on modern, object-oriented programming, with a web-based user interface ( http://usjgofs.whoi.edu/jg/dir/jgofs) that gives all users, regardless of the computer platform being used, equal access to the data and metadata. It is populated with an extensive set of biogeochemical data from the US JGOFS community along with the attendant metadata. This article summarizes the lessons learned that may serve as a primer for future oceanographic and earth science research programs. Good data management requires devoted resources, about 5-10% of the total cost of the program. A data management office should be established at the initiation of the program, conventions for standard methods, names, and units need to be established before the field program begins, and an agreed-to list of metadata must be collected systematically along with the data. Open and accessible data management depends upon investigators agreeing to share their data with each other, leading to more rapid scientific discovery. Data management should support data distribution and archival; interactions between the data managers and the principal investigators make the database a living database. Innovative use of commercial products in information technology can save time and money in scientific database management. Technology allows access to the database to be transparent in location and intuitive in use. Finally, the most important investments in data management are the people hired.

  5. Bridging the management-science partnership gap: Adaptive grazing management experiment in shortgrass steppe

    USDA-ARS?s Scientific Manuscript database

    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...

  6. Clinicians’ experiences of becoming a clinical manager: a qualitative study

    PubMed Central

    2012-01-01

    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

  7. Linking climate change mitigation and coastal eutrophication management through biogas technology: Evidence from a new Danish bioenergy concept.

    PubMed

    Kaspersen, Bjarke Stoltze; Christensen, Thomas Budde; Fredenslund, Anders Michael; Møller, Henrik Bjarne; Butts, Michael Brian; Jensen, Niels H; Kjaer, Tyge

    2016-01-15

    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.

  8. Subjective Experiences of Clients in a Voluntary Money Management Program

    PubMed Central

    Serowik, Kristin L.; Bellamy, Chyrell D.; Rowe, Michael; Rosen, Marc I.

    2013-01-01

    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. PMID:24605071

  9. Subjective Experiences of Clients in a Voluntary Money Management Program.

    PubMed

    Serowik, Kristin L; Bellamy, Chyrell D; Rowe, Michael; Rosen, Marc I

    2013-01-01

    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.

  10. Managing recreation areas for quality user experiences: a theoretical framework

    Treesearch

    Thomas A. More; Gregory J. Buhyoff

    1979-01-01

    The production of opportunities for high-quality visitor experiences is a basic goal of recreation management. Recreation quality can be interpreted using concepts from psychological field theory to relate emotion to the strength of motivation. Applications to on-site management for recreation quality and use regulation are suggested.

  11. Culturally Relevant Management Education: Insights from Experience in Nunavut

    ERIC Educational Resources Information Center

    Wihak, Christine

    2005-01-01

    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…

  12. Integrated vector management: the Zambian experience.

    PubMed

    Chanda, Emmanuel; Masaninga, Fred; Coleman, Michael; Sikaala, Chadwick; Katebe, Cecilia; Macdonald, Michael; Baboo, Kumar S; Govere, John; Manga, Lucien

    2008-08-27

    The Zambian Malaria Control Programme with the Roll Back Malaria (RBM) partners have developed the current National Malaria Strategic Plan (NMSP 2006-2011) which focuses on prevention based on the Integrated Vector Management (IVM) strategy. The introduction and implementation of an IVM strategy was planned in accordance with the World Health Organization (WHO) steps towards IVM implementation namely Introduction Phase, Consolidation Phase and Expansion Phase. IVM has created commitment for Legal and Regulatory policy review, monitoring, Research and a strong stewardship by the chemical suppliers. It has also leveraged additional resources, improved inter-sectoral collaboration, capacity building and enhanced community participation which facilitated a steady scaling up in coverage and utilisation of key preventive interventions. Thus, markedly reducing malaria incidence and case fatalities in the country. Zambia has successfully introduced, consolidated and expanded IVM activities. Resulting in increased coverage and utilization of interventions and markedly reducing malaria-related morbidity and mortality while ensuring a better protection of the environment.

  13. Frameworks for defining and managing the wilderness experience

    Treesearch

    Robert E. Manning

    2012-01-01

    A large and growing body of research on outdoor recreation and the wilderness experience has been conducted over the nearly 50 years since passage of the Wilderness Act of 1964. A number of conceptual and empirical frameworks have emerged from this body of knowledge that can be used to help define and manage the wilderness experience.

  14. Defining and managing the quality of wilderness recreation experiences

    Treesearch

    Robert E. Manning; David W. Lime

    2000-01-01

    There is a substantial body of scientific literature on defining and managing the quality of wilderness experiences. Two conceptual frameworks derived from this literature—carrying capacity and the Recreation Opportunity Spectrum (ROS)—suggest that wilderness recreation experiences can be defined through indicators and standards of quality, and that wilderness...

  15. Student Engagement and the College Experience in Hospitality Management

    ERIC Educational Resources Information Center

    Wray, Michael L.

    2010-01-01

    Student perceptions of competency in Hospitality Management, (HM) and the level of engagement in the college experience were compared between two programs to verify engagement as a construct consisting of three domains; classroom, campus, and off-campus. Administrator and student descriptions of engagement in the college experience described the…

  16. Data management for interdisciplinary field experiments: OTTER project support

    NASA Technical Reports Server (NTRS)

    Angelici, Gary; Popovici, Lidia; Skiles, J. W.

    1993-01-01

    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.

  17. Perspectives and experiences of elective surgery patients regarding pain management.

    PubMed

    Rejeh, Nahid; Vaismoradi, Mojtaba

    2010-03-01

    The purpose of this study was to explore the perspectives and experiences of elective surgery patients regarding pain management. A qualitative design, based on the content analysis approach, was used to collect and analyze the experience of 20 elective surgery patients who all had abdominal surgery in surgical wards in two teaching hospitals in Tehran, Iran. After employing purposeful sampling for the selection of the participants, semistructured interviews were held for data collection. During the data analysis, three main themes emerged: "perceptions of pain management goals", "patients' views of nurses' role in pain management", and "interaction in pain management". It was concluded that understanding the factors that influence pain management after surgery from the patients' viewpoint will contribute to the body of knowledge of nurses in order to promote the quality of nursing care.

  18. Management of acid burns: experience from Bangladesh.

    PubMed

    Das, Kishore Kumar; Olga, Loren; Peck, Michael; Morselli, Paolo G; Salek, A J M

    2015-05-01

    Acid burn injuries in Bangladesh primarily occur as a result of intentional attacks although there are incidences of accidental acid burns in industry, on the street, and at home. A total of 126 patients with acid burns, 95 from attacks and 31 from accidents, were studied from July 2004 to December 2012. A diagnosis of acid burn was made from history, physical examination and in some cases from chemical analysis of the patients' clothing. Alkali burns were excluded from the study. In the burn unit of Dhaka Medical College Hospital, we applied a slightly different protocol for management of acid burns, beginning with plain water irrigation of the wound, which effectively reduced burn depth and the requirement of surgical treatment. Application of hydrocolloid dressing for 48-72 h helped with the assessment of depth and the course of treatment. Early excision and grafting gives good results but resultant acid trickling creates a marble cake-like appearance of the wound separated by the vital skin. Excision with a scalpel and direct stitching of the wounds are often a good option. Observation of patients on follow-up revealed that wounds showed a tendency for hypertrophy. Application of pressure garments and other scar treatments were given in all cases unless the burn was highly superficial.

  19. End-to-end experiment management in HPC

    SciTech Connect

    Bent, John M; Kroiss, Ryan R; Torrez, Alfred; Wingate, Meghan

    2010-01-01

    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.

  20. Danish Gynecological Cancer Database

    PubMed Central

    Sørensen, Sarah Mejer; Bjørn, Signe Frahm; Jochumsen, Kirsten Marie; Jensen, Pernille Tine; Thranov, Ingrid Regitze; Hare-Bruun, Helle; Seibæk, Lene; Høgdall, Claus

    2016-01-01

    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

  1. Managing psychogenic pseudosyncope: Facts and experiences.

    PubMed

    Tannemaat, Martijn R; Thijs, Roland D; van Dijk, J Gert

    2014-01-01

    Psychogenic pseudosyncope (PPS) is a common cause of apparent transient loss of consciousness (TLOC) with a dramatic impact on the quality of life. This review aims to give an overview of the definition, incidence, etiology, diagnosis, treatment, and prognosis of PPS based on a combination of literature data and personal experience. The limited literature on the subject suggests that PPS is relatively common but insufficiently recognized. PPS is probably similar to psychogenic nonepiteptic seizures (PNES), in which a long delay to diagnosis worsens the prognosis. A detailed history is of paramount importance for the diagnosis. The key feature in the history of patients with PPS is the occurrence of frequent, long attacks of apparent TLOC with closed eyes. The diagnosis is certain when a typical event is recorded during a tilt-table test with simultaneous blood pressure (BP), heart rate and video-electroencephalographic recordings. Home video and BP recording during an attack can be very useful. The diagnosis should be communicated to the patient in a way that is clear, understandable and does not cause offense. Although treatment options have not been investigated formally, the literature on PNES suggests that cognitive behavioral therapy is beneficial.

  2. The Danish Melanoma Database

    PubMed Central

    Hölmich, Lisbet Rosenkrantz; Klausen, Siri; Spaun, Eva; Schmidt, Grethe; Gad, Dorte; Svane, Inge Marie; Schmidt, Henrik; Lorentzen, Henrik Frank; Ibfelt, Else Helene

    2016-01-01

    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

  3. Automated support for experience-based software management

    NASA Technical Reports Server (NTRS)

    Valett, Jon D.

    1992-01-01

    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.

  4. Enhanced Capabilities for Subcritical Experiments (ECSE) Risk Management Plan

    SciTech Connect

    Urban, Mary Elizabeth

    2016-05-02

    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.

  5. Assessment of light water reactor accident management programs and experience

    SciTech Connect

    Hammersley, R.J.

    1992-03-01

    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.

  6. Langley applications experiments data management system study. [for space shuttles

    NASA Technical Reports Server (NTRS)

    Lanham, C. C., Jr.

    1975-01-01

    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.

  7. The virtuous manager. Renewing the experience of work.

    PubMed

    Bouchard, C E

    1997-01-01

    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.

  8. Retrivability in The Danish National Hospital Registry of HIV and hepatitis B and C coinfection diagnoses of patients managed in HIV centers 1995–2004

    PubMed Central

    Obel, Niels; Reinholdt, Hanne; Omland, Lars H; Engsig, Frederik; Sørensen, Henrik T; Hansen, Ann-Brit E

    2008-01-01

    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

  9. Patient Experience Shows Little Relationship with Hospital Quality Management Strategies

    PubMed Central

    Groene, Oliver; Arah, Onyebuchi A.; Klazinga, Niek S.; Wagner, Cordula; Bartels, Paul D.; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A.; Pfaff, Holger; DerSarkissian, Maral; Sunol, Rosa

    2015-01-01

    Objectives Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. Materials and Methods We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Results Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute

  10. The effect of a lay-led, group-based self-management program for patients with chronic pain: a randomized controlled trial of the Danish version of the Chronic Pain Self-Management Programme.

    PubMed

    Mehlsen, Mimi; Hegaard, Lea; Ørnbøl, Eva; Jensen, Jens Søndergaard; Fink, Per; Frostholm, Lisbeth

    2017-08-01

    The Stanford Chronic Pain Self-Management Programme (CPSMP) consists of 6 2½-hour weekly workshops focusing on how to manage pain in daily life. The workshops are facilitated by 2 workshop leaders of whom at least 1 must suffer from a long-term pain condition. The program is highly structured and manualized. Only few controlled trials testing the effect of CPSMP exist. Enrolled in the study were 424 adults from 19 Danish municipalities, (72% women; age: 25-93 years) with pain of any etiology and great variation in pain history (0-50 yrs). Of these, 216 were randomized to a lay-led version of the CPSMP. The primary outcome was pain-related disability. Secondary outcomes were pain, pain catastrophizing, self-efficacy, emotional distress, physical symptoms, and illness worry. Outcomes were measured before randomization, immediately after the CPSMP (response rate: 94%), and at 3-month follow-up (response rate: 92%). National register data on health expenditure were obtained to examine effects on health care use. ClinicalTrials.gov Identifier: NCT01306747. The CPSMP had no effect on the primary outcome pain-related disability or on health expenditure during intervention and follow-up period. Small positive effects on emotional distress and illness worry 3 months after CPSMP were observed. Lay-led CPSMP is not recommended as treatment for chronic pain-related disability. This heterogeneous group of patients with pain did not benefit from the CPSMP except for a small, but clinically insignificant improvement in psychological well-being.

  11. The effect of a lay-led, group-based self-management program for patients with chronic pain: a randomized controlled trial of the Danish version of the Chronic Pain Self-Management Programme

    PubMed Central

    Mehlsen, Mimi; Hegaard, Lea; Ørnbøl, Eva; Jensen, Jens Søndergaard; Fink, Per; Frostholm, Lisbeth

    2017-01-01

    Abstract The Stanford Chronic Pain Self-Management Programme (CPSMP) consists of 6 2½-hour weekly workshops focusing on how to manage pain in daily life. The workshops are facilitated by 2 workshop leaders of whom at least 1 must suffer from a long-term pain condition. The program is highly structured and manualized. Only few controlled trials testing the effect of CPSMP exist. Enrolled in the study were 424 adults from 19 Danish municipalities, (72% women; age: 25-93 years) with pain of any etiology and great variation in pain history (0-50 yrs). Of these, 216 were randomized to a lay-led version of the CPSMP. The primary outcome was pain-related disability. Secondary outcomes were pain, pain catastrophizing, self-efficacy, emotional distress, physical symptoms, and illness worry. Outcomes were measured before randomization, immediately after the CPSMP (response rate: 94%), and at 3-month follow-up (response rate: 92%). National register data on health expenditure were obtained to examine effects on health care use. ClinicalTrials.gov Identifier: NCT01306747. The CPSMP had no effect on the primary outcome pain-related disability or on health expenditure during intervention and follow-up period. Small positive effects on emotional distress and illness worry 3 months after CPSMP were observed. Lay-led CPSMP is not recommended as treatment for chronic pain-related disability. This heterogeneous group of patients with pain did not benefit from the CPSMP except for a small, but clinically insignificant improvement in psychological well-being. PMID:28644822

  12. The effect of a lay-led, group-based self-management program for patients with chronic pain: A randomized controlled trial of the Danish version of the Chronic Pain Self-Management Programme.

    PubMed

    Mehlsen, Mimi; Hegaard, Lea; Ørnbøl, Eva; Jensen, Jens Søndergaard; Fink, Per; Frostholm, Lisbeth

    2017-06-22

    The Stanford Chronic Pain Self-Management Programme (CPSMP) consists of six 2½-hour weekly workshops focusing on how to manage pain in daily life. The workshops are facilitated by two workshop leaders of whom at least one must suffer from a long-term pain condition. The program is highly structured and manualized. Only few controlled trials testing the effect of CPSMP exist.Enrolled in the study were 424 adults from 19 Danish municipalities, (72% women; age: 25-93 years) with pain of any etiology and great variation in pain history (0-50 yrs). Of these, 216 were randomized to a lay-led version of the CPSMP. The primary outcome was pain-related disability. Secondary outcomes were pain, pain catastrophizing, self-efficacy, emotional distress, physical symptoms, and illness worry. Outcomes were measured before randomization, immediately after the CPSMP (response rate: 94%), and at 3-month follow-up (response rate: 92%). National register data on health expenditure were obtained to examine effects on health care use. ClinicalTrials.gov Identifier: NCT01306747.The CPSMP had no effect on the primary outcome pain-related disability or on health expenditure during intervention and follow-up period. Small positive effects on emotional distress and illness worry 3 months after CPSMP were observed.Lay-led CPSMP is not recommended as treatment for chronic pain-related disability. This heterogeneous group of pain patients did not benefit from the CPSMP except for a small, but clinically insignificant improvement in psychological well-being.

  13. The Danish Stroke Registry

    PubMed Central

    Johnsen, Søren Paaske; Ingeman, Annette; Hundborg, Heidi Holmager; Schaarup, Susanne Zielke; Gyllenborg, Jesper

    2016-01-01

    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

  14. Spoken Danish. Book Two.

    ERIC Educational Resources Information Center

    Dearden, Jeannette; Stig-Nielsen, Karin

    This is one of a series of self-teaching textbooks initially prepared for the Armed Forces and now offered to the public. The text is designed to be used with a native speaker of Danish or with the accompanying recordings. The textbook is divided into three major sections, each consisting of five learning units and one unit for review. Each unit…

  15. The Danish System Revisited.

    ERIC Educational Resources Information Center

    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…

  16. Burn patients' experience of pain management: a qualitative study.

    PubMed

    Yuxiang, Li; Lingjun, Zhou; Lu, Tang; Mengjie, Liu; Xing, Ming; Fengping, Shen; Jing, Cui; Xianli, Meng; Jijun, Zhao

    2012-03-01

    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.

  17. Influences on parents' fever management: beliefs, experiences and information sources.

    PubMed

    Walsh, Anne; Edwards, Helen; Fraser, Jenny

    2007-12-01

    To identify parents' knowledge, beliefs, management and sources of information about fever management. Despite numerous studies exploring parents' management of childhood fever; negative beliefs about fever and overuse of antipyretics and health services for mild fevers and self-limiting viral illnesses continue to be reported. Qualitative design using semi-structured interviews and discussions. Fifteen metropolitan parents whose children were aged six months to five years, volunteered to participate in individual interviews or group discussions. Recruitment was through Playgroup Queensland's online newsletter and letters from two childcare centres to all parents. Verbatim and audio data were collected by an experienced moderator using a semi-structured interview guide. Two transcripts were independently analysed by two researchers; categories, sub-headings and codes were independently developed, crosschecked and found comparable. Remaining transcripts were analysed using developed categories and codes. Fever, determined through behavioural changes, was perceived as 'good', a warning that something was wrong. High fever, reported as 38.0-39.1 degrees C, was considered harmful; it must be prevented or reduced irrespective of concerns about antipyretics. Positive febrile experiences reduced concern about fever. Negative experiences such as febrile convulsions, media reports of harm, not receiving a definitive diagnosis, inaccessibility to regular doctors and receiving conflicting information about fever management increased the concerns. Parents seek information about fever from multiple sources such as doctors, books and other parents. Parents' experiences with and information sources about fever and fever management influenced their knowledge, beliefs and practices. Positive experiences reduce concerns, health service usage and sometimes antipyretic usage. Negative experiences increase concerns, monitoring and antipyretic and health service usage. Health

  18. Colorectal cancer mortality 10 years after a single round of guaiac faecal occult blood test (gFOBT) screening: experiences from a Danish screening cohort

    PubMed Central

    Bjerrum, Andreas; Andersen, Ole; Fischer, Anders; Lindebjerg, Jan; Lynge, Elsebeth

    2016-01-01

    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

  19. Management Development in Health Care: Exploring the Experiences of Clinical Nurse Managers

    ERIC Educational Resources Information Center

    Purcell, Laura; Milner, Brigid

    2005-01-01

    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…

  20. [The Experience of Fluid Management in Hemodialysis Patients].

    PubMed

    Kim, Yoonsoo; Kim, Miyoung

    2015-10-01

    The purpose of this study was to explore the experience of fluid management in hemodialysis patients by describing how they manage fluid intake and what affects fluid management. Purposive sampling yielded 11 patients who have received hemodialysis for one year or longer in one general hospital. Data were collected through in-depth interviews and analysed using Giorgi's phenomenological method. Data collection and analysis were performed concurrently. The findings regarding how hemodialysis patients manage fluid intake were classified into four constituents: 'recognizing the need for fluid control', 'observing the status of fluid accumulation', 'controlling fluid intake and output', 'getting used to fluid management'. The factors that affect fluid management of hemodialysis patients were revealed as 'willpower', 'change in the mindset', 'support system', and 'emotional state'. The study results show that hemodialysis patients manage fluid intake through food and exercise as well as interpersonal relationships. These findings suggest that strategies in the development of nursing interventions for hemodialysis patients should be directed at assisting them in familiarization with fluid management based on an understanding of their sociocultural contexts.

  1. Managing Diversity: The City of San Diego Experience.

    ERIC Educational Resources Information Center

    Sannwald, William

    1999-01-01

    Considers how libraries can build and manage a work force that is sensitive to and mirrors the increasingly diverse population they serve. Defines diversity; describes the experiences of the city of San Diego (California) in developing its "Diversity Commitment" and the involvement of the public library in the program; and provides…

  2. A Necessary Evil: The Experiences of Managers Implementing Downsizing Programmes

    ERIC Educational Resources Information Center

    Noronha, Ernesto; D'Cruz, Premilla

    2006-01-01

    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…

  3. Managing the Student Experience in a Shifting Higher Education Landscape

    ERIC Educational Resources Information Center

    Temple, Paul; Callender, Claire; Grove, Lyn; Kersh, Natasha

    2014-01-01

    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…

  4. Management of Foreign Language Anxiety: Insiders' Awareness and Experiences

    ERIC Educational Resources Information Center

    Tran, Trang Thi Thu; Moni, Karen

    2015-01-01

    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…

  5. Using provenance to manage knowledge of in silico experiments.

    PubMed

    Stevens, Robert; Zhao, Jun; Goble, Carole

    2007-05-01

    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.

  6. Developing International Managers: The Contribution of Cultural Experience to Learning

    ERIC Educational Resources Information Center

    Townsend, Peter; Regan, Padraic; Li, Liang Liang

    2015-01-01

    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…

  7. Demonstrating the Experimenting Society Model with Classwide Behavior Management Interventions.

    ERIC Educational Resources Information Center

    Johnson, Taya C.; Stoner, Gary; Green, Susan K.

    1996-01-01

    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)

  8. Managing the Student Experience in a Shifting Higher Education Landscape

    ERIC Educational Resources Information Center

    Temple, Paul; Callender, Claire; Grove, Lyn; Kersh, Natasha

    2014-01-01

    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…

  9. German experience in managing stormwater with green infrastructure

    EPA Science Inventory

    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...

  10. Course Management Systems in Higher Education: Understanding Student Experiences

    ERIC Educational Resources Information Center

    Yuen, Allan; Fox, Robert; Sun, Angie; Deng, Liping

    2009-01-01

    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:…

  11. Developing International Managers: The Contribution of Cultural Experience to Learning

    ERIC Educational Resources Information Center

    Townsend, Peter; Regan, Padraic; Li, Liang Liang

    2015-01-01

    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…

  12. A Necessary Evil: The Experiences of Managers Implementing Downsizing Programmes

    ERIC Educational Resources Information Center

    Noronha, Ernesto; D'Cruz, Premilla

    2006-01-01

    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…

  13. German experience in managing stormwater with green infrastructure

    EPA Science Inventory

    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...

  14. Leadership Behaviors and Its Relation with Principals' Management Experience

    ERIC Educational Resources Information Center

    Mehdinezhad, Vali; Sardarzahi, Zaid

    2016-01-01

    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…

  15. Electric power management for the International Space Station experiment racks

    SciTech Connect

    Burcham, M.; Darty, M.A.; Thibodeau, P.E.; Coe, R.; Dunn, M.

    1995-12-31

    An intelligent, all solid state, electric power management system for International Space Station experiment racks is described. This power system is implemented via redundant internal microcomputers, controlling hybridized solid state power controllers in response to 1553B data bus commands. The solid state power controllers are programmable for current trip level and for normally-open or normally-closed operation.

  16. CONE - An STS-based cryogenic fluid management experiment

    NASA Technical Reports Server (NTRS)

    Bell, R. S.; Vento, D. M.; Hanna, G. J.

    1992-01-01

    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.

  17. [The firing of nurse managers: literature and experiences].

    PubMed

    Palese, Alvisa; Scarsini, Sara; Marin, Meri; Saiani, Luisa

    2012-01-01

    The firing of a nursing manager was first documented in the 80' in US. To describe the involuntary turnover according to the literature and a case-story. Literature review and interview to a key informant. The involuntary turnover is preceded by a hard time with indicators of a difficult relationships with the management; it initiates a profound crisis comparable to the loss of a significant person and feelings of failure prevail, self esteem and self confidence decrease. If the manager is fired, external help may be necessary - included psychological counseling - to overcome the traumatic experience. Before effectively facing the future, some time may be needed to deal with the loss effectively. The firing of a nursing manager is not an exception in Italy but the literature and discussion on the problem is lacking.

  18. Experiment module concepts study. Volume 1: Management summary

    NASA Technical Reports Server (NTRS)

    1970-01-01

    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.

  19. A pediatric residency experience with surgical co-management.

    PubMed

    Carr, Anna Marie; Irigoyen, Matilde; Wimmer, Robert Samuel; Arbeter, Allan Myron

    2013-04-01

    Acquisition of knowledge and skills in the care of surgical patients is defined as an essential element of training by the Pediatric Residency Review Committee. The pediatric-surgical comanagement model of care is increasingly utilized, yet its impact on residency training has not been described. The goal of this study was to describe a 5-year experience with a co-management model in a pediatric residency program. We describe the planning and implementation of a surgical co-management model in a pediatric residency program and report on case volume and diversity from 2005 to 2010. We assessed the experience of pediatric residents and faculty through rotation evaluations, program leadership meetings, and an anonymous online survey. In the survey, residents rated the value of their exposure on knowledge and skills in selected perioperative domains and their experience with interprofessional teamwork. The volume of co-managed patients increased threefold from 2005 to 2010; most (79%) had concurrent medical conditions, and one-third (36%) were children with special health care needs (CYSHCN). Residents reported that co-management helped them gain knowledge and skills in pain management, fluid and electrolytes, respiratory, and nutritional support, as well as in interprofessional teamwork. Other strengths included greater exposure to CYSHCN and subspecialty faculty, and preparedness for critical care rotations. Challenges included clarity of roles and responsibilities between pediatric and surgery residents and interservice communication. A surgical co-management model in pediatric residency training presented important opportunities for development of residents' knowledge and skills in perioperative care and interprofessional teamwork.

  20. The COLD-SAT Experiment for Cryogenic Fluid Management Technology

    NASA Technical Reports Server (NTRS)

    Schuster, J. R.; Wachter, J. P.; Vento, D. M.

    1990-01-01

    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.

  1. Nevada Experiments and Operations Program (N Program) Management Plan

    SciTech Connect

    Nattrass, L.; Anastasio, M.R.

    2000-02-01

    This plan briefly describes the Lawrence Livermore National Laboratory (LLNL) institutional structure and how Nevada Experiments and Operations Program (N Program's) organization fits within this structure, roles and responsibilities, and management processes that govern N Program activities. This plan also serves as the Integrated Safety Management (ISM) Implementation Plan for N Program work. This plan applies to all work performed by and for LLNL that falls under the oversight of DOE/NV except LLNL activities in support of the Yucca Mountain Project Office (YMPO).

  2. The Danish Adoption Register.

    PubMed

    Petersen, Liselotte; Sørensen, Thorkild I A

    2011-07-01

    The Danish Adoption Register was established in 1963-1964 to explore the genetic and environmental contribution to familial aggregation of schizophrenia. The register encompass information on all 14,425 non-familial adoptions of Danish children legally granted in Denmark 1924-1947. It includes name and date of birth of each adoptee and his or her biological and adoptive parents, date of transfer to adoptive parents and date of formal adoption. The linkage to biological and adoptive parents is close to complete, even biological fathers are registered for 91.4% of the adoptees. Adoption registers are a unique source allowing disentangling of genetic and familial environmental influences on traits, risk of diseases, and mortality.

  3. Designing Forest Adaptation Experiments through Manager-Scientist Partnerships

    NASA Astrophysics Data System (ADS)

    Nagel, L. M.; Swanston, C.; Janowiak, M.

    2014-12-01

    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.

  4. NASA integrated vehicle health management technology experiment for X-37

    NASA Astrophysics Data System (ADS)

    Schwabacher, Mark; Samuels, Jeff; Brownston, Lee

    2002-07-01

    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 an unpiloted vehicle designed to 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 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.

  5. Loss of Financial Management Independence After Brain Injury: Survivors' Experiences.

    PubMed

    Koller, Kathryn; Woods, Lindsay; Engel, Lisa; Bottari, Carolina; Dawson, Deirdre R; Nalder, Emily

    2016-01-01

    This pilot study explored the experiences of brain injury survivors after a change in financial management (FM) independence. Using a qualitative descriptive design, 6 participants with acquired brain injury were recruited from a community brain injury organization and participated in semistructured interviews. Data were analyzed using thematic analysis. Three themes emerged from the interviews: (1) trajectory of FM change, involving family members as key change agents; (2) current FM situation, involving FM strategies such as automatic deposits and restricted budgets; and (3) the struggle for control, in which survivors desired control while also accepting supports for FM. This study identifies some of the challenges brain injury survivors face in managing their finances and the adjustment associated with a loss of FM independence. Occupational therapists should be aware of clients' experiences when supporting them through a change in independence. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  6. Production Experiences with the Cray-Enabled TORQUE Resource Manager

    SciTech Connect

    Ezell, Matthew A; Maxwell, Don E; Beer, David

    2013-01-01

    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.

  7. Governance Experiments in Water Management: From Interests to Building Blocks.

    PubMed

    Doorn, Neelke

    2016-06-01

    The management of water is a topic of great concern. Inadequate management may lead to water scarcity and ecological destruction, but also to an increase of catastrophic floods. With climate change, both water scarcity and the risk of flooding are likely to increase even further in the coming decades. This makes water management currently a highly dynamic field, in which experiments are made with new forms of policy making. In the current paper, a case study is presented in which different interest groups were invited for developing new water policy. The case was innovative in that stakeholders were invited to identify and frame the most urgent water issues, rather than asking them to reflect on possible solutions developed by the water authority itself. The case suggests that stakeholders can participate more effectively if their contribution is focused on underlying competing values rather than conflicting interests.

  8. Wilderness experiences: what should we be managing for?

    Treesearch

    David N. Cole

    2004-01-01

    The U.S. Wilderness Act gives wilderness managers a challenging stewardship responsibility: to provide and/or protect opportunities for certain types of human experiences. The act states that wilderness “shall be administered for the use and enjoyment of the American people in such manner as will leave them unimpaired for future use and enjoyment as wilderness.” The...

  9. Danish auroral science history

    NASA Astrophysics Data System (ADS)

    Stauning, P.

    2011-01-01

    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

  10. Danish Cultural Identity and the Teaching of Danish to Foreigners

    ERIC Educational Resources Information Center

    Reuter, Hedwig

    2006-01-01

    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.)

  11. Primary Care Physicians' Experience with Disease Management Programs

    PubMed Central

    Fernandez, Alicia; Grumbach, Kevin; Vranizan, Karen; Osmond, Dennis H; Bindman, Andrew B

    2001-01-01

    OBJECTIVE To examine primary care physicians' perceptions of how disease management programs affect their practices, their relationships with their patients, and overall patient care. DESIGN Cross-sectional mailed survey. SETTING The 13 largest urban counties in California. PARTICIPANTS General internists, general pediatricians, and family physicians. MEASUREMENTS AND MAIN RESULTS Physicians' self-report of the effects of disease management programs on quality of patient care and their own practices. Respondents included 538 (76%) of 708 physicians: 183 (34%) internists, 199 (38%) family practitioners, and 156 (29%) pediatricians. Disease management programs were available 285 to (53%) physicians; 178 had direct experience with the programs. Three quarters of the 178 physicians believed that disease management programs increased the overall quality of patient care and the quality of care for the targeted disease. Eighty-seven percent continued to provide primary care for their patients in these programs, and 70% reported participating in major patient care decisions. Ninety-one percent reported that the programs had no effect on their income, decreased (38%) or had no effect (48%) on their workload, and increased (48%)) their practice satisfaction. CONCLUSIONS Practicing primary care physicians have generally favorable perceptions of the effect of voluntary, primary care-inclusive, disease management programs on their patients and on their own practice satisfaction. PMID:11318911

  12. Large-scale flow experiments for managing river systems

    USGS Publications Warehouse

    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.

    2011-01-01

    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.

  13. Visual experiments on the web: design of a web-based visual experiment management system

    NASA Astrophysics Data System (ADS)

    Zuffi, Silvia; Beltrame, Elisa; Scala, Paolo

    2008-01-01

    In psychological research, it is common to perform investigations on the World Wide Web in the form of questionnaires to collect data from a large number of participants. By comparison, visual experiments have been mainly performed in the laboratory, where it is possible to use calibrated devices and controlled viewing conditions. Recently, the Web has been exploited also for "uncontrolled" visual experiments, despite the lack of control on image rendering at the client side, assuming that the large number of participants involved in a Web investigation "averages out" the parameters that the experiments would require to keep fixed if, following a traditional approach, it was performed under controlled conditions. This paper describes the design and implementation of a Web-based visual experiment management system, which acts as a repository of visual experiment, and is designed with the purpose of facilitating the publishing of online investigations.

  14. Managing the negatives of experience in physician teams.

    PubMed

    Hoff, Timothy

    2010-01-01

    Experience is a key shaper of thought and action in the health care workplace and a fundamental component of management and professional policies dealing with improving quality of care. Physicians rely on experience to structure social interaction, to determine authority relations, and to resist organizational encroachments on their work and autonomy. However, an overreliance on experience within physician teams may paradoxically undermine learning, participation, and entrepreneurship, affecting organizational performance. Approximately 100 hours of direct observation of normal workdays for physician teams (n = 17 physicians) in two different work settings in a single academic medical center located in the Northeastern part of the United States. Qualitative data were collected from physician teams in the medical intensive care unit and trauma/general surgery settings. Data were transcribed and computer analyzed through an interactive process of open coding, theoretical sampling, and pattern recognition that proceeded longitudinally. Three particular experience-based schemas were identified that physician teams used to structure social relations and perform work. These schemas involved using experience as a commodity, trump card, and liberator. Each of these schemas consisted of strongly held norms, beliefs, and values that produced team dynamics with the potential for undermining learning, participation, and entrepreneurship in the group. Organizations may move to mitigate the negative impact of an overreliance on experience among physicians by promoting bureaucratic forms of control that enable physicians to engage learning, participation, and entrepreneurship in their work while not usurping existing and difficult-to-change cultural drivers of team behavior.

  15. Implementation Plan: Jasper Management Prestart Review (Surrogate Material Experiments)

    SciTech Connect

    Cooper, W.E.

    2000-09-29

    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.

  16. The COLD-SAT experiment for cryogenic fluid management technology

    NASA Technical Reports Server (NTRS)

    Schuster, J. R.; Wachter, J. P.; Vento, D. M.

    1990-01-01

    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.

  17. Managing disorder of sexual development surgically: A single center experience

    PubMed Central

    Kumar, Jatinder; Kumar, Vikas; Bhatia, Vijaylakshmi; Dabadghao, Preeti; Chaturvedi, Samit; Kapoor, Rakesh; Ansari, M. S.

    2012-01-01

    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

  18. Nurses' Experiences of Managing and Management in a Critical Care Unit.

    PubMed

    Ogle, K Robyn; Glass, Nel

    2014-01-01

    In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses' experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of "junior novice." Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem.

  19. Nurses’ Experiences of Managing and Management in a Critical Care Unit

    PubMed Central

    Ogle, K. Robyn; Glass, Nel

    2014-01-01

    In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses’ experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of “junior novice.” Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem. PMID:28462287

  20. [Management of maxillofacial injuries in an emergency unit: our experience].

    PubMed

    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

    2009-01-01

    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.

  1. Integrated management of childhood illness: a summary of first experiences.

    PubMed Central

    Lambrechts, T.; Bryce, J.; Orinda, V.

    1999-01-01

    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

  2. Managing coastal area resources by stated choice experiments

    NASA Astrophysics Data System (ADS)

    Liu, Xin; Wirtz, Kai W.

    2010-02-01

    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).

  3. Central airways stenoses management--a single institution experience.

    PubMed

    Pereszlenyi, A; Majer, I; Janik, M; Demian, J; Igaz, M; Knappkova, S; Eftimova, P; Benej, R; Harustiak, S

    2004-01-01

    Tracheal stenosis is a serious, life-threatening disease with an increasing tendency. The number of complicated tracheal lesions, where resection and anastomosis can not be performed, still increases and the situation requires solution by endoprosthesis. Consequent the management of such complicated obstructive tracheal lesions is individual and time-consuming. The main objective of this study is to review the single institution experience with central airways stenosis treatment and to define the role of endotracheal stenting in tracheal reconstruction surgery. This study presents the retrospective analysis of tracheal stenosis reconstruction by means of our own modification of Montgomery T-tube. (Tab. 3, Fig. 3, Ref. 12.)

  4. Policy on manager involvement in work re-integration: managers' experiences in a Canadian setting.

    PubMed

    Maiwald, Karin; Meershoek, Agnes; de Rijk, Angelique; Nijhuis, Frans J N

    2014-01-01

    In Canada and other countries, sickness absence among workers is a significant concern. Local return-to-work policies developed by both management and workers' representatives are preferred to tackle the problem. This article examines how managers perceive this local bipartite agreed upon return-to-work policy, wherein a social constructivist view on the policy process is taken. In-depth interviews were held with 10 managers on their experiences with execution of this policy in a Canadian healthcare organization. Interviews were transcribed verbatim and qualitative analyses were completed to gain deep insight into the managers' perspectives. Results show that the managers viewed themselves as a linchpin between the workplace and the worker. They did not feel heard by the other stakeholders, wrestled with worker's limitations, struggled getting plans adjusted and became overextended to meet return-to-work objectives. The study shows that the managers felt unable to meet the responsibilities the policy demanded and got less involved in the return-to-work process than this policy intended. RTW policy needs to balance on the one hand, flexibility to safeguard active involvement of managers and, on the other hand, strictness regarding taking responsibility by stakeholders, particularly the health care and re-integration professionals.

  5. Manager Experiences with the Return to Work Process in a Large, Publically Funded, Hospital Setting: Walking a Fine Line.

    PubMed

    Stochkendahl, Mette Jensen; Myburgh, Corrie; Young, Amanda Ellen; Hartvigsen, Jan

    2015-12-01

    Previous research on the role of managers in the return to work (RTW) process has primarily been conducted in contexts where the workplace has declared organizational responsibility for the process. While this is a common scenario, in some countries, including Denmark, there is no explicit legal obligation on the workplace to accommodate RTW. The aim of this study was to gain knowledge about the potential roles and contributions of managers in supporting returning employees in a context where they have no legal obligation to actively support RTW. Nineteen Danish hospital managers participated in a one-on-one interview or focus group discussions aimed at identifying barriers and facilitators for supporting employees in their RTW. Five individual interviews and two focus group discussions were conducted. Transcripts were analysed using thematic content analysis. Four main themes were identified: (1) 'Coordinator and collaborator'; (2) 'Dilemmas of the RTW policy enforcer'; (3) 'The right to be sick and absent'; and (4) 'Keep the machinery running…'. Our findings indicated that supervisors' capacity to support returning workers was related to individual, communication, organizational, and policy factors. Instances were observed where supervisors faced the dilemma of balancing ethical and managerial principles with requirements of keeping staffing budgets. Although it is not their legislative responsibility, Danish managers play a key role in the RTW process. As has been observed in other contexts, Danish supervisors struggle to balance considerations for the returning worker with those of their teams.

  6. UNIX-BASED DATA MANAGEMENT SYSTEM FOR PROPAGATION EXPERIMENTS

    NASA Technical Reports Server (NTRS)

    Kantak, A. V.

    1994-01-01

    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

  7. UNIX-BASED DATA MANAGEMENT SYSTEM FOR PROPAGATION EXPERIMENTS

    NASA Technical Reports Server (NTRS)

    Kantak, A. V.

    1994-01-01

    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

  8. Perceptions of Health Information Management Educational and Practice Experiences

    PubMed Central

    Bates, Mari; Black, Clarence; Blair, Franchesica; Davis, Laquanda; Ingram, Steven; Lane, DaQuandra; McElderry, Alicia; Peagler, Bianca; Pickett, Jamie; Plettenberg, Cheryl; Hart-Hester, Susan

    2014-01-01

    Introduction Undergraduate students’ progress toward achievement of learning outcomes and entry-level competencies is an essential ingredient in efforts to meet the needs of the evolving national healthcare information infrastructure. Therefore, studies to evaluate variance in outcome assessment methods and perceived adequacy of educational curricula used by health information management (HIM) programs are vital. This study examined perceptions of HIM students, faculty, and individuals employed in healthcare regarding educational experiences and career preparation. Methods A convenience sample of attendees from the American Health Information Management Association (AHIMA) national conference in Atlanta, Georgia, was obtained. A survey was developed on the basis of a review of current literature related to the assessment of HIM educational programming. The authors used a prepared script to describe the study purpose and survey when approaching potential respondents. Completion of the survey was voluntary. Results Of the 100 surveys distributed, 58 were returned. Twenty-six respondents were employed in healthcare, 25 were students, and 7 were HIM faculty members; no respondents were HIM program directors. Ninety-six percent of the student respondents indicated that the programs’ HIM curriculum prepared them for an entry-level position, while 86 percent of the faculty respondents and 70 percent of the respondents employed in healthcare agreed with this statement. More than half (56 percent) of the respondents who were employed in healthcare indicated that they needed additional training when they entered their first entry-level position. The majority of the respondents indicated that they were not matched with a mentor during their educational experience. Conclusions This research supports the complementary roles that educational coursework and practical experiences provide individuals within the HIM field. However, additional research is needed to assess the

  9. UK contractors' experience of management of tritium during decommissioning projects

    SciTech Connect

    Green, Tommy; Stevens, Keith; Heaney, John; Murray, Alan; Warwick, Phil; Croudace, Ian

    2007-07-01

    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)

  10. The Glen Canyon Dam Adaptive Management Program: An experiment in science-based resource management

    NASA Astrophysics Data System (ADS)

    kaplinski, m

    2001-12-01

    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

  11. Republished error management: Descriptions of verbal communication errors between staff. An analysis of 84 root cause analysis-reports from Danish hospitals.

    PubMed

    Rabøl, Louise Isager; Andersen, Mette Lehmann; Ostergaard, Doris; Bjørn, Brian; Lilja, Beth; Mogensen, Torben

    2011-11-01

    Poor teamwork and communication between healthcare staff are correlated to patient safety incidents. However, the organisational factors responsible for these issues are unexplored. Root cause analyses (RCA) use human factors thinking to analyse the systems behind severe patient safety incidents. The objective of this study is to review RCA reports (RCAR) for characteristics of verbal communication errors between hospital staff in an organisational perspective. Two independent raters analysed 84 RCARs, conducted in six Danish hospitals between 2004 and 2006, for descriptions and characteristics of verbal communication errors such as handover errors and error during teamwork. Raters found description of verbal communication errors in 44 reports (52%). These included handover errors (35 (86%)), communication errors between different staff groups (19 (43%)), misunderstandings (13 (30%)), communication errors between junior and senior staff members (11 (25%)), hesitance in speaking up (10 (23%)) and communication errors during teamwork (8 (18%)). The kappa values were 0.44-0.78. Unproceduralized communication and information exchange via telephone, related to transfer between units and consults from other specialties, were particularly vulnerable processes. With the risk of bias in mind, it is concluded that more than half of the RCARs described erroneous verbal communication between staff members as root causes of or contributing factors of severe patient safety incidents. The RCARs rich descriptions of the incidents revealed the organisational factors and needs related to these errors.

  12. Early experiences in developing and managing the neuroscience gateway

    PubMed Central

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

    2015-01-01

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

  13. Early experiences in developing and managing the neuroscience gateway.

    PubMed

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

    2015-02-01

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

  14. Parental experiences of scoliosis management in Rett syndrome.

    PubMed

    Ager, Sarah; Downs, Jenny; Fyfe, Sue; Leonard, Helen

    2009-01-01

    Scoliosis is the most common orthopaedic complication of Rett syndrome. Parents of affected individuals are vital partners in the clinical management of scoliosis and this study explored parental experiences of various aspects of different management options. Publicly available Rettnet postings informed the development of an online questionnaire about scoliosis and its management in Rett syndrome. Parents of subjects who met the criteria for Rett syndrome participated in a survey using this questionnaire. One hundred and eighty families participated in this study with scoliosis having developed in 135 (75.4%) of subjects. Eighty-four (62.2% of subjects with scoliosis) had received specific treatment for scoliosis while 51 (37.8%) had not. Surgery was perceived as improving the scoliosis in the majority of subjects but had considerable emotional effects for families of subjects who were less severely affected (p = 0.055) or older (p = 0.063). Physiotherapy and bracing were perceived as not reducing the progression of the curve, but physiotherapy was frequently reported to be beneficial to the subject's quality of life and bracing was frequently associated with side effects such as decreased mobility and problems with pressure. Only half of respondents felt that information about scoliosis provided by clinicians was adequate. The perspectives of parents provided useful insights into the complexities of decision-making regarding scoliosis treatment in Rett syndrome. The provision of scoliosis information by clinicians should be more family-centred.

  15. Recognising and Managing Refractory Coeliac Disease: A Tertiary Centre Experience.

    PubMed

    Nasr, Ikram; Nasr, Iman; Beyers, Carl; Chang, Fuju; Donnelly, Suzanne; Ciclitira, Paul J

    2015-12-01

    Refractory coeliac disease (RCD) is a rare complication of coeliac disease (CD) and involves malabsorption and villous atrophy despite adherence to a strict gluten-free diet (GFD) for at least 12 months in the absence of another cause. RCD is classified based on the T-cells in the intra-epithelial lymphocyte (IEL) morphology into type 1 with normal IEL and type 2 with aberrant IEL (clonal) by PCR (polymerase chain reaction) for T cell receptors (TCR) at the β/γ loci. RCD type 1 is managed with strict nutritional and pharmacological management. RCD type 2 can be complicated by ulcerative jejunitis or enteropathy associated lymphoma (EATL), the latter having a five-year mortality of 50%. Management options for RCD type 2 and response to treatment differs across centres and there have been debates over the best treatment option. Treatment options that have been used include azathioprine and steroids, methotrexate, cyclosporine, campath (an anti CD-52 monoclonal antibody), and cladribine or fluadribine with or without autologous stem cell transplantation. We present a tertiary centre's experience in the treatment of RCD type 2 where treatment with prednisolone and azathioprine was used, and our results show good response with histological recovery in 56.6% of treated individuals.

  16. Recognising and Managing Refractory Coeliac Disease: A Tertiary Centre Experience

    PubMed Central

    Nasr, Ikram; Nasr, Iman; Beyers, Carl; Chang, Fuju; Donnelly, Suzanne; Ciclitira, Paul J.

    2015-01-01

    Refractory coeliac disease (RCD) is a rare complication of coeliac disease (CD) and involves malabsorption and villous atrophy despite adherence to a strict gluten-free diet (GFD) for at least 12 months in the absence of another cause. RCD is classified based on the T-cells in the intra-epithelial lymphocyte (IEL) morphology into type 1 with normal IEL and type 2 with aberrant IEL (clonal) by PCR (polymerase chain reaction) for T cell receptors (TCR) at the β/γ loci. RCD type 1 is managed with strict nutritional and pharmacological management. RCD type 2 can be complicated by ulcerative jejunitis or enteropathy associated lymphoma (EATL), the latter having a five-year mortality of 50%. Management options for RCD type 2 and response to treatment differs across centres and there have been debates over the best treatment option. Treatment options that have been used include azathioprine and steroids, methotrexate, cyclosporine, campath (an anti CD-52 monoclonal antibody), and cladribine or fluadribine with or without autologous stem cell transplantation. We present a tertiary centre’s experience in the treatment of RCD type 2 where treatment with prednisolone and azathioprine was used, and our results show good response with histological recovery in 56.6% of treated individuals. PMID:26633478

  17. Management of genital herpes by genitourinary physicians: does experience or doctor's gender influence clinical management?

    PubMed Central

    Russell, J M; Cracknell, M; Barton, S E; Catalan, J

    1993-01-01

    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

  18. Management Of Experiments And Data At The National Ignition Facility

    SciTech Connect

    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

    2011-03-18

    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.

  19. Propulsion Integrated Vehicle Health Management Technology Experiment (PITEX) Conducted

    NASA Technical Reports Server (NTRS)

    Maul, William A.; Chicatelli, Amy K.; Fulton, Christopher E.

    2004-01-01

    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.

  20. Propulsion Integrated Vehicle Health Management Technology Experiment (PITEX) Conducted

    NASA Technical Reports Server (NTRS)

    Maul, William A.; Chicatelli, Amy K.; Fulton, Christopher E.

    2004-01-01

    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.

  1. Danish Breast Cancer Cooperative Group

    PubMed Central

    Christiansen, Peer; Ejlertsen, Bent; Jensen, Maj-Britt; Mouridsen, Henning

    2016-01-01

    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

  2. The Danish Nephrology Registry

    PubMed Central

    Heaf, James

    2016-01-01

    Aim of database The Danish Nephrology Registry’s (DNR) primary function is to support the Danish public health authorities’ quality control program for patients with end-stage renal disease in order to improve patient care. DNR also supplies epidemiological data to several international organizations and supports epidemiological and clinical research. Study population The study population included patients treated with dialysis or transplantation in Denmark from January 1, 1990 to January 1, 2016, with retrospective data since 1964. Main variables DNR registers patient data (eg, age, sex, renal diagnosis, and comorbidity), predialysis specialist treatment, details of eight dialysis modalities (three hemodialysis and five peritoneal dialysis), all transplantation courses, dialysis access at first dialysis, treatment complications, and biochemical variables. The database is complete (<1% missing data). Patients are followed until death or emigration. Descriptive data DNR now contains 18,120 patients, and an average of 678 is added annually. Data for each transplantation course include donor details, tissue type, time to onset of graft function, and cause of graft loss. Registered complications include peritonitis in peritoneal dialysis patients, causes of peritoneal dialysis technique failure, and transplant rejections. Fifteen biochemical variables are registered, mainly describing anemia control, mineral and bone disease, nutritional and uremia status. Date and cause of death are also included. Six quality indicators are published annually, and have been associated with improvements in patient results, eg, a reduction in dialysis patient mortality, improved graft survival, and earlier referral to specialist care. Approximately, ten articles, mainly epidemiological, are published each year. Conclusion DNR contains a complete description of end-stage renal disease patients in Denmark, their treatment, and prognosis. The stated aims are fulfilled. PMID:27843345

  3. The Danish Heart Registry

    PubMed Central

    Özcan, Cengiz; Juel, Knud; Flensted Lassen, Jens; von Kappelgaard, Lene Mia; Mortensen, Poul Erik; Gislason, Gunnar

    2016-01-01

    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

  4. STATegra EMS: an Experiment Management System for complex next-generation omics experiments

    PubMed Central

    2014-01-01

    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

  5. STATegra EMS: an Experiment Management System for complex next-generation omics experiments.

    PubMed

    Hernández-de-Diego, Rafael; Boix-Chova, Noemi; Gómez-Cabrero, David; Tegner, Jesper; Abugessaisa, Imad; Conesa, Ana

    2014-01-01

    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.

  6. Management of Rett syndrome: a ten year experience.

    PubMed

    Budden, S S

    1995-04-01

    Over the past 10 years (1983-1993) multidisciplinary team at the Child Development and Rehabilitation Center has diagnosed and evaluated 60 females with Rett syndrome aged 13 months to 43 years. Experience with comprehensive management is discussed with focus on feeding difficulties, communication needs, hand function, scoliosis, and deformities. Clinical and radiological assessment of feeding problems is important in deciding whether therapy will allay symptoms or a gastrostomy is indicated. Hand use can be facilitated with appropriate intervention, and a coordinated effort with a communication specialist can develop systems for environmental access. Aggressive physical therapy has been very effective in preventing progression of scoliosis and avoiding surgery. Asymmetrical function is commonly recognized in ambulatory females, and is of neurogenic origin. Psychosocial support and educational plan attempts to collaborate with community services and resources.

  7. The Danish Microbiology Database (MiBa) 2010 to 2013.

    PubMed

    Voldstedlund, M; Haarh, M; Mølbak, K

    2014-01-09

    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.

  8. Plan of Action: JASPER Management Prestart Review (Surrogate Material Experiments)

    SciTech Connect

    Cooper, W.E.

    2000-09-29

    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

  9. Plan of Action: JASPER Management Prestart Review (Surrogate Material Experiment)

    SciTech Connect

    Cooper, W E

    2000-12-05

    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

  10. Laparoscopic management of CBD stones: an Indian experience.

    PubMed

    Chander, Jagdish; Vindal, Anubhav; Lal, Pawanindra; Gupta, Nikhil; Ramteke, Vinod Kumar

    2011-01-01

    Common bile duct stones (CBDS) that are seen in the Asian population are very different from those seen in the west. It is not infrequent to see multiple, large, and impacted stones and a hugely dilated CBD. Many of these patients have been managed by open CBD exploration (OCBDE), even after the advent of laparoscopic cholecystectomy (LC), because these large stones pose significant challenges for extraction by endoscopic retrograde cholangiopancreatography. This series presents the largest experience of managing CBDS using a laparoscopic approach from Indian subcontinent. Between 2003 and 2009, 150 patients with documented CBDS were treated laparoscopically at a tertiary care hospital in New Delhi. Of these, 4 patients were managed through transcystic route and 140 through the transcholedochal route. There were 34 men and 116 women patients with age ranging from 15 to 72 years. The mean size of the CBD on ultrasound was 11.7 ± 3.7 mm and on MRCP 13.8 ± 4.7 mm. The number of stones extracted varied from 1 to 70 and the size of the extracted stones from 5 to 30 mm. The average duration of surgery was 139.9 ± 26.3 min and the mean intraoperative blood loss was 103.4 ± 85.9 ml. There were 6 conversions to open procedures, 1 postoperative death (0.7%), and 23 patients (15%) had nonfatal postoperative complications. Three patients had retained stones (2%) and one developed recurrent stone (0.7%). Even in patients with multiple, large, and impacted CBDS, there is scope for a minimally invasive procedure with its attendant benefits in the form of laparoscopic CBD exploration (LCBDE).

  11. Defining chronic cancer: patient experiences and self-management needs.

    PubMed

    Harley, Clare; Pini, Simon; Bartlett, Yvonne Kiera; Velikova, Galina

    2012-09-01

    Chronic cancer is poorly defined and strategies for supporting patients during this disease phase are lacking. This research defines chronic cancer, explores patient experiences and reviews patients' support needs against those described in the 2007 Department of Health Generic Choice Model for Long-term Conditions (DoH-GCM). Semistructured interviews were audio recorded, transcribed and data explored for emergent themes. The a priori themes from DoH-GCM were applied: clinical support; self-care and self-management; supporting independence; psychological support; and social and economic factors. 56 patients >12 months postdiagnosis of advanced cancer were recruited from five clinics at a Yorkshire cancer centre: breast (n=11); renal (n=11); colorectal/gastrointestinal (n=12); gynaecological (n=12); and prostate (n=10). Most patients aspired to living normal lives. Challenges included frequent and lengthy hospital appointments, long-term symptom control and uncertainty. Only renal and prostate patients reported routine access to specialist nursing. Uptake of support services was varied and there was generally poor understanding of support pathways for non-medical problems and issues occurring when patients were not receiving active treatment. There was variation in coping strategies and ability of patients to attain a positive outlook on life. For patients to do well in this cancer phase requires good self-management of symptoms plus taking an active role in accessing appropriate services as needed. Care planning at the point of transition to the chronic phase of cancer should focus on evaluating patients' needs, clarifying support pathways, increasing the profile and involvement of community services and organisations, and supporting patients and families develop effective self-management skills.

  12. Defining chronic cancer: patient experiences and self-management needs.

    PubMed

    Harley, Clare; Pini, Simon; Bartlett, Yvonne Kiera; Velikova, Galina

    2015-12-01

    Chronic cancer is poorly defined and strategies for supporting patients during this disease phase are lacking. This research defines chronic cancer, explores patient experiences and reviews patients' support needs against those described in the 2007 Department of Health Generic Choice Model for Long-term Conditions (DoH-GCM). Semistructured interviews were audio recorded, transcribed and data explored for emergent themes. The a priori themes from DoH-GCM were applied: clinical support; self-care and self-management; supporting independence; psychological support; and social and economic factors. 56 patients >12 months postdiagnosis of advanced cancer were recruited from five clinics at a Yorkshire cancer centre: breast (n=11); renal (n=11); colorectal/gastrointestinal (n=12); gynaecological (n=12); and prostate (n=10). Most patients aspired to living normal lives. Challenges included frequent and lengthy hospital appointments, long-term symptom control and uncertainty. Only renal and prostate patients reported routine access to specialist nursing. Uptake of support services was varied and there was generally poor understanding of support pathways for non-medical problems and issues occurring when patients were not receiving active treatment. There was variation in coping strategies and ability of patients to attain a positive outlook on life. For patients to do well in this cancer phase requires good self-management of symptoms plus taking an active role in accessing appropriate services as needed. Care planning at the point of transition to the chronic phase of cancer should focus on evaluating patients' needs, clarifying support pathways, increasing the profile and involvement of community services and organisations, and supporting patients and families develop effective self-management skills. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Cryogenic Fluid Management Experiment (CFME) trunnion verification testing

    NASA Technical Reports Server (NTRS)

    Bailey, W. J.; Fester, D. A.

    1983-01-01

    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).

  14. Improving agricultural knowledge management: The AgTrials experience

    PubMed Central

    Hyman, Glenn; Espinosa, Herlin; Camargo, Paola; Abreu, David; Devare, Medha; Arnaud, Elizabeth; Porter, Cheryl; Mwanzia, Leroy; Sonder, Kai; Traore, Sibiry

    2017-01-01

    Background: Opportunities to use data and information to address challenges in international agricultural research and development are expanding rapidly. The use of agricultural trial and evaluation data has enormous potential to improve crops and management practices. However, for a number of reasons, this potential has yet to be realized. This paper reports on the experience of the AgTrials initiative, an effort to build an online database of agricultural trials applying principles of interoperability and open access. Methods: Our analysis evaluates what worked and what did not work in the development of the AgTrials information resource. We analyzed data on our users and their interaction with the platform. We also surveyed our users to gauge their perceptions of the utility of the online database. Results: The study revealed barriers to participation and impediments to interaction, opportunities for improving agricultural knowledge management and a large potential for the use of trial and evaluation data.  Conclusions: Technical and logistical mechanisms for developing interoperable online databases are well advanced.  More effort will be needed to advance organizational and institutional work for these types of databases to realize their potential. PMID:28580127

  15. Extending a Flight Management Computer for Simulation and Flight Experiments

    NASA Technical Reports Server (NTRS)

    Madden, Michael M.; Sugden, Paul C.

    2005-01-01

    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.

  16. Cryogenic Fluid Management Experiment (CFME) trunnion verification testing

    NASA Astrophysics Data System (ADS)

    Bailey, W. J.; Fester, D. A.

    1983-12-01

    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).

  17. Management of laryngeal radionecrosis: Animal and clinical experience

    SciTech Connect

    Oppenheimer, R.W.; Krespi, Y.P.; Einhorn, R.K.

    1989-05-01

    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.

  18. [Experience with the reference manager EndNote-EndLink].

    PubMed

    Reiss, M; Reiss, G

    1998-09-01

    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.

  19. Surgical management of urethral prolapse in girls: 13 years' experience.

    PubMed

    Holbrook, Charlotte; Misra, Devesh

    2012-07-01

    conservative measures. In our practice, this involves the use of Sitz baths. More importantly, the study shows that in cases with more symptomatic prolapse or with evidence of vascular compromise, there is an alternative to a surgical procedure and its potential complications. We have found reducing the prolapse under a GA to be beneficial. Complete reduction was achieved in 3/7 patients, with no recurrence. The remaining four patients with partial reduction had improvement in symptoms, allowing conservative therapy to continue and resulting in complete or almost complete resolution of prolapse at follow-up. This approach has not been described previously in published literature on UP. To review our experience of managing urethral prolapse (UP) in girls. A total of 21 girls, all of whom were Black and whose age range was 2-15 years, were diagnosed with UP between 1995 and 2008. Case notes were reviewed for age, symptoms, clinical findings, predisposing factors, management and outcomes. Presenting symptoms were: mass (n= 8), bleeding (n= 6), dysuria/straining at micturition (n= 6), discharge (n= 1) and constipation (n= 1). In all, 13 patients were managed conservatively because their symptoms were mild. Seven patients underwent prolapse reduction under general anaesthetic (GA). In one patient, an examination under anesthesia was done to confirm the diagnosis as bedside examination was not possible. Prolapse reduction was complete in only three patients. Two patients had partial reduction, which resolved over the next 3 months. Two patients continue to have minimal residual prolapse. A causative/precipitating factor was found in only one patient (severe chronic constipation). She had a recurrence 2 years after reduction. There were no other recurrences. UP in girls can be diagnosed clinically in most cases. Girls with mild symptoms can be managed conservatively. For girls with more significant symptoms, we recommend a simple reduction under GA. This may be curative, or may

  20. Laparoscopic donor nephrectomy, complications and management: a single center experience

    PubMed Central

    Tuğcu, Volkan; Şahin, Selçuk; Yiğitbaşı, İsmail; Şener, Nevzat Can; Akbay, Fatih Gökhan; Taşçı, Ali İhsan

    2017-01-01

    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

  1. Experience with Self-Management and Participation in United States Industry

    ERIC Educational Resources Information Center

    Brower, Michael

    1975-01-01

    Examines examples of pure cases of self-management, considers recent experiments by large capitalist firms in which management has delegated a share of authority to workers, and looks at the question of whether such experiments may move the country slowly toward more fully self-managed institutions in the future. (Author)

  2. Understanding the Work-Life Experiences and Goals of Women Middle Managers in Higher Education

    ERIC Educational Resources Information Center

    Hankinson, Marie

    2013-01-01

    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…

  3. Subjectless sentences in child Danish.

    PubMed

    Hamann, C; Plunkett, K

    1998-11-01

    Three alternative accounts of subject omission, pragmatic, processing and grammatical, are considered from the perspective of child Danish. Longitudinal data for two Danish children are analyzed for subject omission, finite and infinitival verb usage and discourse anchorage of sentence subjects (overt and missing). The data exhibit a well-defined phase of subject omission which coincides with a well-defined phase of infinitival verbal utterances. No evidence is found for input driven accounts of subject omission. Danish adults rarely omit subjects from utterance initial position. Neither is there any evidence to support the claim that omitted subjects are anchored in previous discourse. Evidence supporting a processing constraint explanation of missing subjects is equivocal. The pattern of subject omission, infinitival usage and third person pronoun and past tense usage points to a grammatical explanation of the phenomenon. However, current grammatical accounts have difficulty accommodating several aspects of the data reported. Contrary to structure building theories, the Danish children do not exhibit a phase of development where only uninflected verb forms are used. Danish children also omit subjects from finite utterances. Furthermore, the decline of subject omissions in finite utterances coincides with decline in usage of infinitival utterances. These findings challenge tense-based accounts of children's subject omission. Finally, Danish children exhibit an asymmetry in subject omission according to verb type; subjects are omitted from main verb utterances more frequently than from copula utterances. Given the language typology associated with Danish, this asymmetry is difficult to accommodate within truncation and tense or number-based accounts of subject omission. We suggest that a proper treatment of child subject omission will involve an integration of grammatical and discourse-based approaches.

  4. Danish Urogynaecological Database

    PubMed Central

    Hansen, Ulla Darling; Gradel, Kim Oren; Larsen, Michael Due

    2016-01-01

    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

  5. Risk management for operations of the LANL Critical Experiments Facility

    SciTech Connect

    Paternoster, R.; Butterfield, K.

    1998-12-31

    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.

  6. Public participation in wilderness and backcountry litter control: a review of research and management experience.

    Treesearch

    Robert M. Muth; Roger N. Clark

    1978-01-01

    This paper describes the application of the Incentive System for Litter Control to wilderness and backcountry environments. Based on research, observation, and management experience, a set of procedures was developed and is presented here. Additional management considerations are discussed.

  7. Experience in PWR and BWR mixed-oxide fuel management

    SciTech Connect

    Schlosser, G.J.; Krebs, W.; Urban, P. )

    1993-04-01

    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.

  8. Prevention and management of obinutuzumab-associated toxicities: Australian experience.

    PubMed

    Snowden, Alicia; Hayden, Ingrid; Dixon, Joanna; Gregory, Gareth

    2015-12-01

    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.

  9. [Management control of cardiology: the experience of a departmental unit].

    PubMed

    Boccanelli, A; Spandonaro, F

    2000-01-01

    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

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

    ERIC Educational Resources Information Center

    Bouchard, Veronique; del Forno, Leon

    2012-01-01

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

  11. The MBA Experience: Participants' Entry Level Conceptions of Management.

    ERIC Educational Resources Information Center

    Viljoen, John; And Others

    1990-01-01

    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…

  12. The Private Management of Public Schools: The Baltimore, Maryland, Experience.

    ERIC Educational Resources Information Center

    Doughty, Sherri

    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…

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

    ERIC Educational Resources Information Center

    Bouchard, Veronique; del Forno, Leon

    2012-01-01

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

  14. Danish Palliative Care Database

    PubMed Central

    Groenvold, Mogens; Adsersen, Mathilde; Hansen, Maiken Bang

    2016-01-01

    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

  15. Management of Carotid Bifurcation Tumors: 30-Year Experience.

    PubMed

    Torrealba, Jose Ignacio; Valdés, Francisco; Krämer, Albrecht H; Mertens, Renato; Bergoeing, Michel; Mariné, Leopoldo

    2016-07-01

    The carotid bifurcation can host a variety of tumors requiring complex surgical management. Treatment requires resection and, in some cases, vascular reconstruction that may compromise the cerebral circulation. The most frequent lesion at this location is the carotid body tumor (CBT). CBT are classified according to Shamblin in 3 types depending on the degree of carotid vessels encasement. Our main objective was to report our clinical experience managing carotid bifurcation tumors throughout the last 30 years. Between 1984 and 2014, we treated 30 patients with 32 carotid bifurcation tumors. There were 21 women and 9 men (2.3:1), with a mean age of 45.5 years (18-75). The most frequent presentation was an asymptomatic neck swelling or palpable mass localized at the carotid triangle (86.7%). Thirty of 32 tumors were resected. Since 1994, computed tomography scan has been the most frequently used diagnostic imaging tool (80%), followed by magnetic resonance imaging. Angiography was used mainly during the first 10 years of the study period. Mean size of the tumor was 44.6 mm (20-73 mm). Nineteen (63%) were classified as Shamblin II and 6 (20%) as Shamblin's III. All specimens were analyzed by a pathologist; 28 tumors (93%) were confirmed as paragangliomas, 2 (7%) were diagnosed as schwannomas. Two patients underwent preoperative embolization of the CBT; 5 patients (17%) required simultaneous carotid revascularization, all of them Shamblin III. Mean hospitalization time was 4.5 days (1-35 days). Transient extracranial nerve deficit was observed in 7 patients (23.3%). Three patients (Shamblin III) required red blood cells transfusion. One patient (Shamblin III) underwent a planned en bloc excision of the vagus nerve. There was no perioperative mortality or procedure-related stroke. No malignancy or tumor recurrence were observed during follow-up. CBTs can be diagnosed on clinical grounds requiring vascular imaging confirmation. These infrequent lesions are

  16. Intracranial epidermoid tumor; microneurosurgical management: An experience of 23 cases

    PubMed Central

    Chowdhury, Forhad Hossain; Haque, Mohammod Raziul; Sarker, Mainul Haque

    2013-01-01

    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

  17. The Danish PEP Registry: Experience with the use of post-exposure prophylaxis following blood exposure to HIV from 1999-2012.

    PubMed

    Lunding, Suzanne; Katzenstein, Terese L; Kronborg, Gitte; Storgaard, Merete; Pedersen, Court; Mørn, Birgitte; Lindberg, Jens Å; Kronborg, Thit M; Jensen, Janne

    2016-01-01

    The risk of occupational exposures to blood cannot be eliminated completely and access to post-exposure prophylaxis (PEP) to prevent HIV transmission is important. However, PEP administration has been associated with frequent adverse effects, low compliance and difficulties to ensure a proper risk assessment. This nationwide study describes 14 years of experience with the use of PEP following blood exposure in Denmark. A descriptive study of all PEP cases following non-sexual exposure to HIV in Denmark from 1999-2012. A total of 411 cases of PEP were described. There was a mean of 29.4 cases/year, increasing from 23 cases in 1999 to 49 cases in 2005 and then decreasing to 16 cases in 2012. Overall 67.2% of source patients were known to be HIV-positive at the time of PEP initiation, with no significant change over time. The median time to initiation of PEP was 2.5 h (0.15-28.5) following occupational exposure. Adverse effects were reported by 50.9% with no significant difference according to PEP regimen. In 85.1% of cases with available data, either a full course of PEP was completed or PEP was stopped because the source was tested HIV-negative. Only 6.6% stopped PEP early due to adverse effects. PEP in Denmark is generally prescribed according to the guidelines and the annual number of cases has declined since 2005. Adverse effects were common regardless of PEP regimens used and new drug regimens should be considered.

  18. Management of historical waste from research reactors: the Dutch experience

    SciTech Connect

    Van Heek, Aliki; Metz, Bert; Janssen, Bas; Groothuis, Ron

    2013-07-01

    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

  19. 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.

    ERIC Educational Resources Information Center

    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…

  20. 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.

    ERIC Educational Resources Information Center

    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…

  1. Lessons learned from past experience with intensive livestock management systems.

    PubMed

    Cronin, G M; Rault, J L; Glatz, P C

    2014-04-01

    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.

  2. Management of Cushing's disease: a single-center experience.

    PubMed

    Solak, Mirsala; Kraljevic, Ivana; Dusek, Tina; Melada, Ante; Kavanagh, Marcel Marjanovic; Peterkovic, Vjerislav; Ozretic, David; Kastelan, Darko

    2016-03-01

    The purpose of this study was to review therapeutic outcomes and comorbidities of patients with Cushing's disease (CD) in a single center. We conducted a retrospective study of 33 patients with CD undergoing transsphenoidal surgery from January 2007 to February 2014 (27 females and 6 males, median age 38 years, range 18-71 years). The diagnosis of Cushing's syndrome was established on the basis of the patient's history, characteristic clinical features, and laboratory data including an elevated 24-h urinary free cortisol level, lack of serum cortisol suppression after dexamethasone suppression tests and an elevated midnight cortisol level. In 28/33 patients, the tumor was visualized on MR of the sellar region, while in 5 it was diagnosed using an inferior petrosal sinus sampling. Out of the 33 patients, 10 had macroadenoma and the remaining 23 had microadenoma. Twenty-one patients (63.6%) had hypertension, 17 (51.5%) dyslipidemia, and 7 (21.2%) had type 2 diabetes or impaired glucose tolerance. The median follow-up period was 28 months. Remission after transsphenoidal surgery was achieved in 78.8% of patients, while 7 patients failed to achieve disease remission. Those patients were treated with second-line treatment modalities (second operation, radiotherapy, bilateral adrenalectomy, and/or ketoconazole). One patient rejected all the treatment modalities after surgery. Cumulative remission after all the treatment modalities was achieved in 87.9% patients. Patients with Cushing's disease should be managed in centers with much experience due to high patient load. In our Center, the remission of the disease has been achieved in 78.8% of the patients following transsphenoidal surgery. Multimodal treatment which included radiotherapy and medical treatment led to biochemical remission of the disease in 87.9% of patients.

  3. [Surgical management of gallstone ileus: fourteen year experience].

    PubMed

    Mondragón Sánchez, Alejandro; Berrones Stringel, Guillermo; Tort Martínez, Alejandro; Soberanes Fernández, Carlos; Domínguez Camacho, Leticia; Mondragón Sánchez, Ricardo

    2005-01-01

    The aim of this study is to describe our experience in the diagnosis and treatment of gallstone ileus, as well as the morbility and mortality associated to this pathology. The first description of gallstone ileus was made by Bartholin in 1645 during a post-mortem study. It is a rare pathology, the preoperative diagnosis is difficult and controversy exists in the management that should be carried out on first instance, whether the extraction of the gallstone or the correction of the fistula which can affect outcome. We made a case series study in which we studied a total of 25 patients in a 14 years period (1989-2003) with diagnosis of gallstone ileus, patients excluded were those with cholecystoduodenal fistula without gallstone ileus. The variables analyzed were: age, sex, preoperative and postoperative diagnosis, treatment and postoperative morbidity and mortality. Twenty, five patients were studied with diagnosis of gallstone ileus (20 women and 5 men) The median age was 64 (rage 41 to 99). The cholecystoenteric fistula is the most frequently was the cholecystoduodenal in 23. cases (92%) one coledocoduodenal (4%) and one cholecystogastric (4%). The most common site of obstruction was the terminal ileon in 96%. There was a morbility of 20% and the mortality in 7%. Gallstone ileus is a rare entity, with only 25 cases reported in a 14 years period in our hospitals. Initial surgical treatment should be guided to the correction of the obstruction and should be considered in a second stage the correction of the fistula, if the patient does not develop symptoms it is not necessary, decreasing morbidity and mortality.

  4. Strengthening health management: experience of district teams in The Gambia.

    PubMed

    Conn, C P; Jenkins, P; Touray, S O

    1996-03-01

    The lack of basic management skills of district-level health teams is often described as a major constraint to implementation of primary health care in developing countries. To improve district-level management in The Gambia, a 'management strengthening' project was implemented in two out of the three health regions. Against a background of health sector decentralization policy the project had two main objectives: to improve health team management skills and to improve resources management under specially-trained administrators. The project used a problem-solving and participatory strategy for planning and implementing activities. The project resulted in some improvements in the management of district-level health services, particularly in the quality of team planning and coordination, and the management of the limited available resources. However, the project demonstrated that though health teams had better management skills and systems, their effectiveness was often limited by the policy and practice of the national level government and donor agencies. In particular, they were limited by the degree to which decision making was centralized on issues of staffing, budgeting, and planning, and by the extent to which national level managers have lacked skills and motivation for management change. They were also limited by the extent to which donor-supported programmes were still based on standardized models which did not allow for varying and complex environments at district level. These are common problems despite growing advocacy for more devolution of decision making to the local level.

  5. Vertebrate herbivory in managed coastal wetlands: A manipulative experiment

    USGS Publications Warehouse

    Johnson, L.A.; Foote, A.L.

    1997-01-01

    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.

  6. The Danish Nonmelanoma Skin Cancer Dermatology Database.

    PubMed

    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

    2016-01-01

    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. 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. 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. 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. 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.

  7. Experiences and Lessons Learned in Project Risk Management

    DTIC Science & Technology

    1983-07-15

    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

  8. Management of Spent and Disused Radiation Sources - The Zambian Experience

    SciTech Connect

    Chabala, F.

    2002-02-26

    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.

  9. An experience of virtual leadership development for human resource managers.

    PubMed

    Sherk, Karen E; Nauseda, Fiona; Johnson, Sarah; Liston, Delphine

    2009-01-08

    Strong leadership and management skills are crucial to finding solutions to the human resource crisis in health. Health professionals and human resource (HR) managers worldwide who are in charge of addressing HR challenges in health systems often lack formal education in leadership and management. Management Sciences for Health (MSH) developed the Virtual Leadership Development Program (VLDP) with support from the United States Agency for International Development (USAID). The VLDP is a Web-based leadership development programme that combines face-to-face and distance-learning methodologies to strengthen the capacity of teams to identify and address health challenges and produce results. The USAID-funded Leadership, Management and Sustainability (LMS) Program, implemented by MSH, and the USAID-funded Capacity Project, implemented by IntraHealth, adapted the VLDP for HR managers to help them identify and address HR challenges that ministries of health, other public-sector organizations and nongovernmental organizations are facing. LOCAL SETTINGS: Three examples illustrate the results of the VLDP for teams of HR managers: 1. the Uganda Protestant and Catholic Medical Bureaus 2. the Christian Health Association of Malawi 3. the Developing Human Resources for Health Project in Uganda. The VLDP is an effective programme for developing the management and leadership capacity of HR managers in health.

  10. An experience of virtual leadership development for human resource managers

    PubMed Central

    Sherk, Karen E; Nauseda, Fiona; Johnson, Sarah; Liston, Delphine

    2009-01-01

    Problem Strong leadership and management skills are crucial to finding solutions to the human resource crisis in health. Health professionals and human resource (HR) managers worldwide who are in charge of addressing HR challenges in health systems often lack formal education in leadership and management. Approach Management Sciences for Health (MSH) developed the Virtual Leadership Development Program (VLDP) with support from the United States Agency for International Development (USAID). The VLDP is a Web-based leadership development programme that combines face-to-face and distance-learning methodologies to strengthen the capacity of teams to identify and address health challenges and produce results. Relevant changes The USAID-funded Leadership, Management and Sustainability (LMS) Program, implemented by MSH, and the USAID-funded Capacity Project, implemented by IntraHealth, adapted the VLDP for HR managers to help them identify and address HR challenges that ministries of health, other public-sector organizations and nongovernmental organizations are facing. Local settings Three examples illustrate the results of the VLDP for teams of HR managers: 1. the Uganda Protestant and Catholic Medical Bureaus 2. the Christian Health Association of Malawi 3. the Developing Human Resources for Health Project in Uganda. Lessons learnt The VLDP is an effective programme for developing the management and leadership capacity of HR managers in health. PMID:19133140

  11. Adaptive harvest management for the Svalbard population of pink‐footed geese: 2016 progress summary: Technical Report from DCE – Danish Centre for Environment and Energy, No. 86

    USGS Publications Warehouse

    Johnson, Fred A.; Madsen, Jesper

    2016-01-01

    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.

  12. The Experience of Initial Management Training in ELT

    ERIC Educational Resources Information Center

    Rimmer, Wayne

    2016-01-01

    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…

  13. Developing Higher Education Programs in Emergency Management: Ghana's Experience

    ERIC Educational Resources Information Center

    Yakubu, Mariama Bisongu

    2013-01-01

    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…

  14. Developing Higher Education Programs in Emergency Management: Ghana's Experience

    ERIC Educational Resources Information Center

    Yakubu, Mariama Bisongu

    2013-01-01

    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…

  15. The Experience of Initial Management Training in ELT

    ERIC Educational Resources Information Center

    Rimmer, Wayne

    2016-01-01

    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…

  16. An Investigation into the Life Experiences and Beliefs of Teachers Exhibiting Highly Effective Classroom Management Behaviors

    ERIC Educational Resources Information Center

    Holt, Chuck; Hargrove, Pauline; Harris, Sandra

    2011-01-01

    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…

  17. General and Vocational Work Experience Education Programs Management System: Career Development Programs.

    ERIC Educational Resources Information Center

    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…

  18. Study of airborne science experiment management concepts for application to space shuttle. Volume 1: Executive summary

    NASA Technical Reports Server (NTRS)

    Mulholland, D. R.; Reller, J. O., Jr.; Neel, C. B.; Haughney, L. C.

    1973-01-01

    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.

  19. Study of airborne science experiment management concepts for application to space shuttle, volume 2

    NASA Technical Reports Server (NTRS)

    Mulholland, D. R.; Reller, J. O., Jr.; Neel, C. B.; Haughney, L. C.

    1973-01-01

    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.

  20. An Investigation into the Life Experiences and Beliefs of Teachers Exhibiting Highly Effective Classroom Management Behaviors

    ERIC Educational Resources Information Center

    Holt, Chuck; Hargrove, Pauline; Harris, Sandra

    2011-01-01

    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…

  1. Liberalization in the Danish waste sector: an institutional perspective.

    PubMed

    Kørnøv, Lone; Hill, Amanda Louise; Busck, Ole; Løkke, Søren

    2016-12-01

    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. © The Author(s) 2016.

  2. Building a First-Class Faculty Based on the Management Experience of the University of Pennsylvania

    ERIC Educational Resources Information Center

    Luo, Zhongshu

    2014-01-01

    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.

  3. The Effects of Clinical Experiences on the Understanding of Classroom Management Techniques

    ERIC Educational Resources Information Center

    Cushman, Carey Anne Aycock; Kempy, Andrew

    2012-01-01

    For teacher educators, classroom management education is one of the least researched aspects of the profession. The purpose of this study was to determine if classroom management was most effectively learned through textbook analysis coupled with classroom discussion, or the experience of observing and practicing classroom management in the…

  4. Six Data Base Management Systems: Feature Analysis and User Experiences. Technical Note 887.

    ERIC Educational Resources Information Center

    Fong, Elizabeth; And Others

    This report presents an objective overview of features of six selected data-base management systems and federal user experiences with these systems. Application criteria were developed in order to aid in the evaluation and selection of data-base management systems. The advantages of generalized data-base management systems over traditional methods…

  5. Building a First-Class Faculty Based on the Management Experience of the University of Pennsylvania

    ERIC Educational Resources Information Center

    Luo, Zhongshu

    2014-01-01

    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.

  6. Thyroid function in Danish greenhouse workers

    PubMed Central

    Toft, Gunnar; Flyvbjerg, Allan; Bonde, Jens Peter

    2006-01-01

    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

  7. The physician's civil liability under Danish law.

    PubMed

    Fenger, N; Broberg, M

    1991-01-01

    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.

  8. Patients' experiences managing cardiovascular disease and risk factors in prison.

    PubMed

    Thomas, Emily H; Wang, Emily A; Curry, Leslie A; Chen, Peggy G

    Despite greater risk of cardiovascular disease (CVD) mortality in patients with a history of incarceration, little is known about how prisons manage CVD risk factors (CVD-RF) to mitigate this risk. We conducted in-depth interviews with individuals with CVD-RF who had been recently released from prison (n = 26). These individuals were recruited through community flyers and a primary care clinic in Connecticut. Using a grounded theory approach and the constant comparative method, we inductively generated themes about CVD-RF care in prisons. Data collection and analysis occurred iteratively to refine and unify emerging themes. Four themes emerged about care in prison: (1) Participants perceive that their CVD-RFs are managed through acute, rather than chronic, care processes; (2) Prison providers' multiple correctional and medical roles can undermine patient-centered care; (3) Informal support systems can enhance CVD-RF self-management education and skills; and (4) The trade-off between prisoner security and patient autonomy influences opportunities for self-management. Patients develop self-management skills through complex processes that may be compromised by the influence of correctional policies on medical care. Our findings support interventions to engage peers, medical providers, care delivery systems, and correctional staff in cultivating effective self-management strategies tailored to prison settings.

  9. Struggles for health and safety in the Danish construction industry.

    PubMed

    Nielsen, Jesper

    2007-01-01

    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.

  10. Postgraduate Study and Managers' Subsequent Work Experience: An Exploratory Evaluation

    ERIC Educational Resources Information Center

    Andrews, Jane; Harris, Margaret

    2009-01-01

    Drawing on an exploratory qualitative study, this article considers the link between business school teaching at graduate level and subsequent work behaviour and experiences of former students. It evaluates the student experience some time "after" graduation. The findings of the retrospective evaluation point to the value of classroom…

  11. Does identity shape leadership and management practice? Experiences of PHC facility managers in Cape Town, South Africa

    PubMed Central

    Daire, Judith; Gilson, Lucy

    2014-01-01

    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

  12. Automated management of life cycle for future network experiment based on description language

    NASA Astrophysics Data System (ADS)

    Niu, Hongxia; Liang, Junxue; Lin, Zhaowen; Ma, Yan

    2016-12-01

    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.

  13. Experience of a low-maintenance distributed data management system

    NASA Astrophysics Data System (ADS)

    Takase, Wataru; Matsumoto, Yoshimi; Hasan, Adil; Di Lodovico, Francesca; Watase, Yoshiyuki; Sasaki, Takashi

    2014-06-01

    In this paper we report on the setup, deployment and operation of a low-maintenance, policy-driven distributed data management system for scientific data based on the integrated Rule Oriented Data System (iRODS). The system is located at KEK, Tsukuba, Japan with a satellite system at QMUL, London, UK. The system has been running stably in production for more than two years with minimal management overhead. The management tool that was developed to support the production system is also described. In addition we describe a simple XOR-based approach to file backup that reduces the amount of storage space consumed. In situations of large data volumes this approach can be of great benefit.

  14. Elaborating on theory with middle managers' experience implementing healthcare innovations in practice.

    PubMed

    Birken, Sarah A; DiMartino, Lisa D; Kirk, Meredith A; Lee, Shoou-Yih D; McClelland, Mark; Albert, Nancy M

    2016-01-04

    The theory of middle managers' role in implementing healthcare innovations hypothesized that middle managers influence implementation effectiveness by fulfilling the following four roles: diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. The theory also suggested several activities in which middle managers might engage to fulfill the four roles. The extent to which the theory aligns with middle managers' experience in practice is unclear. We surveyed middle managers (n = 63) who attended a nursing innovation summit to (1) assess alignment between the theory and middle managers' experience in practice and (2) elaborate on the theory with examples from middle managers' experience overseeing innovation implementation in practice. Middle managers rated all of the theory's hypothesized four roles as "extremely important" but ranked diffusing and synthesizing information as the most important and selling innovation implementation as the least important. They reported engaging in several activities that were consistent with the theory's hypothesized roles and activities such as diffusing information via meetings and training. They also reported engaging in activities not described in the theory such as appraising employee performance. Middle managers' experience aligned well with the theory and expanded definitions of the roles and activities that it hypothesized. Future studies should assess the relationship between hypothesized roles and the effectiveness with which innovations are implemented in practice. If evidence supports the theory, the theory should be leveraged to promote the fulfillment of hypothesized roles among middle managers, doing so may promote innovation implementation.

  15. Lessons Learned from Experiments Conducted on Radar Data Management System

    DTIC Science & Technology

    1994-06-01

    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

  16. Result-Oriented Management: The Experience of Kazakhstani Universities

    ERIC Educational Resources Information Center

    Askarkyzy, Samal; Toibayev, Adlet; Algozhaeva, Nursulu; Rimantas, Zelvys; Iskakova, Guldariya; Arynova, Aigul

    2016-01-01

    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…

  17. The Experience of Intense Pain: Nursing Management and Interventions.

    PubMed

    Kiser-Larson, Norma

    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.

  18. Managing coastal recreation impacts and visitor experience using GIS

    Treesearch

    Anna M. T. Gajda; Judson Brown; Grant Peregoodoff; Patrick Bartier

    2000-01-01

    A campsite monitoring program was initiated in Gwaii Haanas National Park Reserve/Haida Heritage Site to determine baseline levels of visitor impacts. These data were necessary to evaluate visitor management strategies and to act as reference points to measure changes in impacts over time. Using GIS, survey data were integrated with an ecological land classification,...

  19. Managing Learning Experiences in an AACSB Environment: Beyond the Classroom

    ERIC Educational Resources Information Center

    Spruell, James; Hawkins, Al; Vicknair, David

    2009-01-01

    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…

  20. Managing Sustainability Communication on Campus: Experiences from Luneburg

    ERIC Educational Resources Information Center

    Franz-Balsen, Angela; Heinrichs, Harald

    2007-01-01

    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…

  1. Managing Demands on Counseling Services: The Colorado State University Experience.

    ERIC Educational Resources Information Center

    Dworkin, Daniel S.; Lyddon, William J.

    1991-01-01

    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)

  2. Managing Information Technology in Academic Medical Centers: A "Multicultural" Experience.

    ERIC Educational Resources Information Center

    Friedman, Charles P.; Corn, Milton; Krumrey, Arthur; Perry, David R.; Stevens, Ronald H.

    1998-01-01

    Examines how beliefs and concerns of academic medicine's diverse professional cultures affect management of information technology. Two scenarios, one dealing with standardization of desktop personal computers and the other with publication of syllabi on an institutional intranet, form the basis for an exercise in which four prototypical members…

  3. Management Development Experiences and Expectations: Informal vs Formal Learning

    ERIC Educational Resources Information Center

    Becker, Karen; Bish, Adelle

    2017-01-01

    Purpose: Many organisations are reconsidering their investment in formal education and training, in favour of more informal approaches to learning such as mentoring, temporary assignments, stretch assignments, and job rotation. The purpose of this paper is to explore the ways in which managers have developed capabilities for their roles thus far…

  4. Management by Objectives: The Swedish Experience in Upper Secondary Schools

    ERIC Educational Resources Information Center

    Lindberg, Erik; Wilson, Timothy L.

    2011-01-01

    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.…

  5. Where does the US experience of managed care currently stand?

    PubMed

    Simonet, D

    2005-01-01

    After an historical review of the advent of managed care in the USA, this article presents cost-control mechanisms, changes in the medical practice and consequences on patient health. The article also explains the development of the HMO using the transaction costs theory and the subsequent orientations of the US health care system.

  6. Experiences in monitoring and assessment of sustainable land management

    USDA-ARS?s Scientific Manuscript database

    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...

  7. Golden Parachutes: Changing the Experience of Unemployment for Managers

    ERIC Educational Resources Information Center

    Johnson, Anya M.; Jackson, Paul R.

    2012-01-01

    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…

  8. Managing Sustainability Communication on Campus: Experiences from Luneburg

    ERIC Educational Resources Information Center

    Franz-Balsen, Angela; Heinrichs, Harald

    2007-01-01

    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…

  9. Measuring the savings from managed care: experience at Citibank.

    PubMed

    Reiff, M G; Sperling, K L

    1995-01-01

    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.

  10. Work Experience (Money Management and Social Involvement). Course Outline: 8769.

    ERIC Educational Resources Information Center

    Dade County Public Schools, Miami, FL.

    A course was designed to help students develop traits which have worthwhile carry-over values which will prove useful in the continuation or completion of their formal education. The proper methods used in wise money management, covering those areas of earnings, savings, spending, budgeting and calculations of deductions are discussed and…

  11. Golden Parachutes: Changing the Experience of Unemployment for Managers

    ERIC Educational Resources Information Center

    Johnson, Anya M.; Jackson, Paul R.

    2012-01-01

    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…

  12. Management of Epistaxis - A Single Centre Experience and Economic Considerations.

    PubMed

    Keane, E; Subramaniam, T; Khan, A H; Patil, N

    2016-06-10

    Epistaxis represents the most common ENT emergency and its management has been a focus of audit recently, with consideration given to the associated economic burden. The aim of our study is to evaluate the management of epistaxis in terms of treatments used, duration of stay, recurrence and cost. A retrospective review of hospital inpatient enquiry (HIPE) data from a single secondary referral centre was undertaken during a four year period. Four hundrefd and thirty-four patients were identified. The majority (n= 262, 60.3%) were male and the average age was 64.2 years. The vast majority (n=362, 83.4%) were managed non-operatively. Only 15 patients (3.4%) were managed surgically. The average length of stay was 2.5 days and did not vary greatly between the treatment groups. The recurrence rate was 8.2% (n=36). Approximate costs of packing vs EUA and cautery suggest that packing alone is more economical but more data is needed to fully compare the options.

  13. Strategic Management Accounting in Universities: The Italian Experience

    ERIC Educational Resources Information Center

    Agasisti, Tommaso; Arnaboldi, Michela; Azzone, Giovanni

    2008-01-01

    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…

  14. Strategic Management Accounting in Universities: The Italian Experience

    ERIC Educational Resources Information Center

    Agasisti, Tommaso; Arnaboldi, Michela; Azzone, Giovanni

    2008-01-01

    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…

  15. Parents and pediatric weight management attrition: experiences and recommendations.

    PubMed

    Sallinen Gaffka, Bethany J; Frank, Maura; Hampl, Sarah; Santos, Melissa; Rhodes, Erinn T

    2013-10-01

    One of the most frequently cited challenges faced by pediatric weight management programs/clinics is attrition, with many studies reporting rates greater than 50%. Few studies have evaluated parental perspectives on recommendations for weight-management treatment enhancement. The aim of this study was to elicit perspectives on areas for improvement, discussions with staff about discontinuation, and potentially modifiable aspects of attrition from parents who prematurely discontinued stage 3 pediatric weight management treatment. This study was performed as a semistructured interview as part of a telephone survey assessing reasons for attrition. Interviews were performed with 147 parents of children who attended programs/clinics at 13 children's hospitals participating in the National Association of Children's Hospitals and Related Institutions (now Children's Hospital Association) FOCUS on a Fitter Future II collaborative. The majority of parents (65%) denied talking to staff about their decisions to stop coming. When describing what could have been done to retain families, parents most frequently discussed changing logistics (e.g., hours and locations). Parents described changes in logistics and components (i.e., nutrition education, exercise, and behavior education/support) when asked what would work best for their family for pediatric weight management. Parental responses appeared to express frustration about flexibility with appointment times and treatment locations. The most frequently desired components were those traditionally offered by stage 3 pediatric weight management programs/clinics, and this may suggest a need for treatment delivery of these components to be more individualized. Additional discussion with families about their desire to discontinue treatment may provide a timely opportunity to address this need.

  16. An Early Danish Computer Game

    NASA Astrophysics Data System (ADS)

    Jørgensen, Anker Helms

    This paper reports on the development of Nimbi, which is an early computer game implemented at the Danish Computer Company Regnecentralen in 1962-63. Nimbi is a variant of the ancient game Nim. The paper traces the primary origins of the development of Nimbi. These include a mathematical analysis from 1901 of Nim that “killed the game” as the outcome could be predicted quite easily; the desire of the Danish inventor Piet Hein to make a game that eluded such analyses; and the desire of Piet Hein to have computers play games against humans. The development of Nimbi was successful in spite of considerable technical obstacles. However, it seems that the game was not used for publicizing the capabilities of computers - at least not widely - as was the case with earlier Nim implementations, such as the British Nim-playing computer Nimrod in 1951.

  17. The Danish Testicular Cancer database.

    PubMed

    Daugaard, Gedske; Kier, Maria Gry Gundgaard; Bandak, Mikkel; Mortensen, Mette Saksø; Larsson, Heidi; Søgaard, Mette; Toft, Birgitte Groenkaer; Engvad, Birte; Agerbæk, Mads; Holm, Niels Vilstrup; Lauritsen, Jakob

    2016-01-01

    The nationwide Danish Testicular Cancer database consists of a retrospective research database (DaTeCa database) and a prospective clinical database (Danish Multidisciplinary Cancer Group [DMCG] DaTeCa database). The aim is to improve the quality of care for patients with testicular cancer (TC) in Denmark, that is, by identifying risk factors for relapse, toxicity related to treatment, and focusing on late effects. All Danish male patients with a histologically verified germ cell cancer diagnosis in the Danish Pathology Registry are included in the DaTeCa databases. Data collection has been performed from 1984 to 2007 and from 2013 onward, respectively. The retrospective DaTeCa database contains detailed information with more than 300 variables related to histology, stage, treatment, relapses, pathology, tumor markers, kidney function, lung function, etc. A questionnaire related to late effects has been conducted, which includes questions regarding social relationships, life situation, general health status, family background, diseases, symptoms, use of medication, marital status, psychosocial issues, fertility, and sexuality. TC survivors alive on October 2014 were invited to fill in this questionnaire including 160 validated questions. Collection of questionnaires is still ongoing. A biobank including blood/sputum samples for future genetic analyses has been established. Both samples related to DaTeCa and DMCG DaTeCa database are included. The prospective DMCG DaTeCa database includes variables regarding histology, stage, prognostic group, and treatment. The DMCG DaTeCa database has existed since 2013 and is a young clinical database. It is necessary to extend the data collection in the prospective database in order to answer quality-related questions. Data from the retrospective database will be added to the prospective data. This will result in a large and very comprehensive database for future studies on TC patients.

  18. Science in Support of Management, Management in Support of Science - the Long Island Sound Experience

    EPA Science Inventory

    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 ...

  19. Science in Support of Management, Management in Support of Science - the Long Island Sound Experience

    EPA Science Inventory

    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 ...

  20. "Sleepless nights and sore operation site": patients' experiences of nursing pain management after surgery in Jordan.

    PubMed

    Shoqirat, Noordeen

    2014-09-01

    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.

  1. Experience of health-system pharmacy administration residents in a longitudinal human resource management program.

    PubMed

    Amerine, Lindsey B Poppe; Granko, Robert P; Savage, Scott W; Daniels, Rowell; Eckel, Stephen F

    2014-12-15

    The experience of health-system pharmacy administration (HSPA) residents in a longitudinal human resource (HR) management program is described. The subsequent benefits to the residents, department, and profession are also discussed. Postgraduate year 2 HSPA residents at an academic medical center desired more responsibility for managing an operational area. To this end, a program was created in which these residents directly manage a small group of pharmacy technicians and report to a clinical manager or assistant director with oversight responsibility. These "resident managers" are responsible, under the direction of the area's clinical manager, for the personnel, schedule, time and attendance, and HR activities of the area. Resident managers have led and sustained operational improvement projects in their areas. In addition to providing learning experiences to residents, the HSPA residency program has also improved the operations of the areas in which these residents work. Benefits to the residents include conducting annual performance evaluations for employees with whom they have a relationship as it is a task every administrator completes. Resident managers at UNC have consistently stated that this longitudinal HR experience is one of the most rewarding and most challenging experiences offered in the two-year HSPA residency. The involvement of HSPA residents in longitudinal management responsibilities furthers residents' leadership success by providing trained managers who are ready to immerse themselves into practice postresidency, having employee engagement and HR skills as well as experiences with leading operational improvements. A longitudinal HR management experience was successfully incorporated into an HSPA residency combined Master of Science degree program. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  2. Helicopter winchmens' experiences with pain management in challenging environments.

    PubMed

    van der Velde, J; Linehan, L; Cusack, S

    2013-02-01

    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.

  3. Experience as Knowledge in a New Product Development Team: Implications for Knowledge Management

    NASA Technical Reports Server (NTRS)

    Cooper, Lynne P.

    2009-01-01

    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.

  4. Experience as Knowledge in a New Product Development Team: Implications for Knowledge Management

    NASA Technical Reports Server (NTRS)

    Cooper, Lynne P.

    2009-01-01

    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.

  5. Apollo experience report: Data management for postflight engineering evaluation

    NASA Technical Reports Server (NTRS)

    Foster, G. B., Jr.

    1974-01-01

    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.

  6. The Apollo Experience Lessons Learned for Constellation Lunar Dust Management

    NASA Technical Reports Server (NTRS)

    Wagner, Sandra

    2008-01-01

    In 2008, NASA was embarking on its Exploration Vision, knowing that many technical challenges would be encountered. For lunar exploration missions, one challenge was to learn to manage lunar dust. References to problems associated with lunar dust during the Apollo Program were found on many of pages of the mission reports and technical debriefs. All engineers designing hardware that would come into contact with lunar dust had to mitigate its effects in the design.

  7. Conservative management of staghorn calculi: a single-centre experience.

    PubMed

    Deutsch, Peter G; Subramonian, Kesavapilla

    2016-09-01

    To evaluate the outcomes of conservatively managed staghorn calculi, specifically looking at morbidity and mortality, incidence of infections and progressive changes in renal function. A total of 22 patients with unilateral or bilateral staghorn calculi, who were treated conservatively, were included in the study. Patients were reviewed yearly with symptom assessment, urine culture and measurement of estimated glomerular filtration rate. The presentations to the urology department of staghorn calculi were incidental (41%), haematuria (36%), abdominal discomfort (5%) and recurrent urinary tract infections (UTIs; 18%). The reasons for conservative management in the cohort were comorbidities (59%), patient choice (36%) or poor access/anatomy (5%). In the whole cohort the rate of recurrent UTIs was 50%, the progressive renal failure rate was 14%, the disease-specific mortality rate was 9%, the dialysis dependence rate was 9% and the rate of hospital attendances attributable to stone-related morbidity was 27%. Comparison of outcome measures between the unilateral and bilateral staghorn stones showed statistically significant differences in disease-specific mortality (0 vs 40%) and morbidity (12 vs 80%) in favour of the unilateral group. Although there was a lower incidence of UTIs (41 vs 80%), renal deterioration (6 vs 40%) and dialysis requirement (6 vs 20%) in the unilateral group, these findings were not statistically significant. From the results, we conclude that conservative management of staghorn calculi is not as unsafe as previously thought. Careful patient selection to include unilateral asymptomatic stones with minimal infection, and thorough counselling with regard to the risks, could make conservative management a suitable option for specific patient groups. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

  8. Software engineering and data management for automated payload experiment tool

    NASA Technical Reports Server (NTRS)

    Maddux, Gary A.; Provancha, Anna; Chattam, David

    1994-01-01

    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.

  9. Software engineering and data management for automated payload experiment tool

    NASA Technical Reports Server (NTRS)

    Maddux, Gary A.; Provancha, Anna; Chattam, David

    1994-01-01

    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.

  10. Conflicting goals of wilderness management: natural conditions vs. natural experiences

    Treesearch

    Alan E. Watson; Michael J. Niccolucci

    1995-01-01

    Beliefs and attitudes underlying wilderness visitors’ support for use restrictions were studied. Some evidence shows that in overused places visitors cite both protection of the resource and the wilderness experience as reasons for supporting restrictions. The research reported here provides the opportunity to assess the relative contribution of each of these reasons,...

  11. [Paliative managment of oesophageal carcinomas--our experience].

    PubMed

    Polanecký, O; Pazdro, A; Tvrdon, J; Tersíp, T; Smejkal, P; Smejkal, M; Hladík, P; Pafko, P

    2006-04-01

    The authors of this presentation explain their experience with methods of paliative care of oesophagus carcinoma. The indication criteria are described and compared advantages and disadvantages of those methods. There is an accent in most frequent method--oesophagus stent implementation. The results in the group of patients after the stent implementation are described, also complications and other solutions.

  12. Learning the Collection: A New Librarian's Experience in Collection Management

    ERIC Educational Resources Information Center

    Lewin, Heather

    2010-01-01

    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…

  13. Learning the Collection: A New Librarian's Experience in Collection Management

    ERIC Educational Resources Information Center

    Lewin, Heather

    2010-01-01

    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…

  14. The Danish Nonmelanoma Skin Cancer Dermatology Database

    PubMed Central

    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

    2016-01-01

    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

  15. The developing management of esthesioneuroblastoma: a single institution experience.

    PubMed

    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

    2012-01-01

    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.

  16. Data management in a fusion energy research experiment

    SciTech Connect

    Glad, A.; Drobnis, D.; McHarg, B.

    1981-07-01

    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.

  17. The transition to managed care: experiences of planned parenthood patients.

    PubMed

    Lewis, V; Lawler, K

    1998-11-01

    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.

  18. Integrating management concepts into licensed practical nurse and associate degree in nursing student clinical experiences.

    PubMed

    Cummings, J E; Nugent, L

    1997-01-01

    In an associate degree nursing program in which students have the option to take the practical nurse licensing examination at the end of the first year, management concepts and experiences are introduced during the second semester. Many students work as licensed practical nurses and are expected to manage care for groups of clients. Using this model, students work together to practice time management and leadership skills.

  19. Preliminary Explorations of Indigenous Perspectives of Educational Management: The Evolving Malaysian Experience.

    ERIC Educational Resources Information Center

    Bajunid, Ibrahim Ahmad

    1996-01-01

    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…

  20. Stages of Learning during a Self-Directed Stress Management Experience

    ERIC Educational Resources Information Center

    Larson, Karl L.

    2015-01-01

    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…

  1. Ethics and Retail Management Professionals: An Examination of Age, Education, and Experience Variables

    ERIC Educational Resources Information Center

    Mujtaba, Bahaudin G.; Cavico, Frank J.; McCartney, Timothy O.; DiPaolo, Peter T.

    2009-01-01

    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…

  2. Career-Self Management and Entrepreneurship: An Experience with PhD Students

    ERIC Educational Resources Information Center

    Pinto, Joana Carneiro; do Ceu Taveira, Maria; Sa, Elisabete

    2012-01-01

    Introduction: This study presents an experience developed with PhD students aimed to analyze the extent to which career self-management should be approached along with entrepreneurship issues to promote students' career development. Method: An intervention group who attended a Career Self-Management Seminar (EG1), a comparison group who attended…

  3. Preliminary Explorations of Indigenous Perspectives of Educational Management: The Evolving Malaysian Experience.

    ERIC Educational Resources Information Center

    Bajunid, Ibrahim Ahmad

    1996-01-01

    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…

  4. Toward Full Participation in Management Consulting Practice: Experiences of Recent College Graduates

    ERIC Educational Resources Information Center

    Chao, Chia-an

    2005-01-01

    Purpose - This study seeks to understand the college-to-work transition process from the perspectives of a group of new management consultants. Design/methodology/approach - This study focuses on the experience of a group of management consultants, how they construct meaning in their work, and the workplace itself. Participants in this study…

  5. A technology using feedback to manage experience based learning.

    PubMed

    Dornan, Tim; Brown, Martin; Powley, Dan; Hopkins, Mike

    2004-12-01

    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.

  6. Void Management in MEPHISTO and Other Space Experiments

    NASA Technical Reports Server (NTRS)

    deGroh, Henry C., III; Johnston, J. Christopher; Wei, Bingbo

    1998-01-01

    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.

  7. Experiences managing radioactive material at the National Ignition Facility.

    PubMed

    Thacker, Rick L

    2013-06-01

    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.

  8. 42 CFR 21.51 - Appointment of officers having specialized training or experience in administration and management.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 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...

  9. Does identity shape leadership and management practice? Experiences of PHC facility managers in Cape Town, South Africa.

    PubMed

    Daire, Judith; Gilson, Lucy

    2014-09-01

    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

  10. Parents' experiences of managing their child's postoperative pain at home: an exploratory qualitative study.

    PubMed

    Longard, Julie; Twycross, Alison; Williams, Anna M; Hong, Paul; Chorney, Jill

    2016-09-01

    To understand parents' experiences of managing their child's postoperative pain at home. Recent changes in children's health care services often shift the responsibility of managing children's postoperative pain to parents. Although pain management is important for good postoperative outcomes, it can be a challenging task for families, and children's pain is often under-managed. This qualitative study used semi-structured interviews to explore parents' experiences of managing their child's postoperative pain at home. Participants were parents of 10 typically developing 5- and 6-year olds, who underwent (adeno)tonsillectomy, and experienced no complications leading to hospitalisation in the postoperative period. One-on-one interviews were conducted with parents within three months of their child's surgery. Interviews were transcribed verbatim and content analysis was used to identify themes in parents' experiences. All children experienced some postoperative pain. Parents' experiences of managing their child's pain were impacted by balancing the pros and cons of administering analgesic medications, managing the emotional and psychological effects of their child's pain, as well as parents' information needs. Most parents' information needs were met yet they still struggled to manage their child's pain. These findings provide insight into some of the barriers that make this process challenging for many families, and what health care centres can do to help support parents manage their child's postoperative pain at home. The results of this study may aid in the design of interventions that will support parents when managing their child's postoperative pain at home and thus improve children's experiences. © 2016 John Wiley & Sons Ltd.

  11. The Apollo Experience Lessons Learned for Constellation Lunar Dust Management

    NASA Technical Reports Server (NTRS)

    Wagner, Sandra

    2006-01-01

    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

  12. A purchaser experience of managing new expensive drugs: interferon beta.

    PubMed Central

    Rous, E.; Coppel, A.; Haworth, J.; Noyce, S.

    1996-01-01

    Interferon beta is a new and expensive drug for treating multiple sclerosis. One published trial has shown that it reduces the exacerbation rate in patients who have relapsing-remitting disease without important disability. This paper describes the development of a strategy for purchasing the drug in one region of England before its licensing. Purchasers felt unable to decline funding for this marginally effective drug and thereby undertake explicit rationing. To ensure prescribing was within the guidelines, a vast communication network had to be sustained with managers, general practitioners, neurologists, the Multiple Sclerosis Society, and professional advisers in all the purchasing authorities. The workload involved was considerable. The dilemma of rationing in a public service with a high political profile is demonstrated. PMID:8916757

  13. Management of malignant pleural mesothelioma—The European experience

    PubMed Central

    2014-01-01

    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

  14. Managing state energy conservation programs - The Minnesota experience

    NASA Astrophysics Data System (ADS)

    Hirst, E.; Armstrong, J. R.

    1980-11-01

    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.

  15. Managing information technology in academic medical centers: a "multicultural" experience.

    PubMed

    Friedman, C P; Corn, M; Krumrey, A J; Perry, D R; Stevens, R H

    1998-09-01

    Based on a session at the 1997 conference on Information Resources and Academic Medicine sponsored by the Association of American Medical Colleges, this article illustrates how the beliefs and concerns of academic medicine's diverse professional cultures affect the management of information technology. Two scenarios--one dealing with the standardization of desktop PCs, the other with publication of syllabi on an institutional intranet--form the basis of this exercise. Four prototypical members of a hypothetical medical center community--the chairman of surgery, a senior basic scientist, the chief information officer of an affiliated hospital, and the chief administrative officer--offer their perspectives on each scenario. Their statements illustrate many of the challenges of planning, deploying, and maintaining effective information technology in the "multicultural" environment of academic medical centers.

  16. Experiences of Uav Surveys Applied to Environmental Risk Management

    NASA Astrophysics Data System (ADS)

    Caprioli, M.; Trizzino, R.; Mazzone, F.; Scarano, M.

    2016-06-01

    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

  17. Experience of disused source management in Latin America

    SciTech Connect

    Pimenta Mourao, R.

    2008-07-01

    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)

  18. Management of Acute Osteomyelitis: A Ten-Year Experience

    PubMed Central

    Helm, Caitlin; Huschart, Emily; Kaul, Rajat; Bhumbra, Samina; Blackwood, R. Alexander; Mukundan, Deepa

    2016-01-01

    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.

  19. Surgical Management of Intracranial Neuroenteric Cysts: The UCSF Experience

    PubMed Central

    Breshears, Jonathan D.; Rutkowski, Martin J.; McDermott, Michael W.; Cha, Soonmee; Tihan, Tarik; Theodosopoulos, Philip V.

    2015-01-01

    Objective Modern surgical experience with intracranial neuroenteric cysts is limited in the literature. We review our 15-year institutional experience with these rare lesions. Design Single-institution retrospective study. Setting Large North American tertiary care center. Participants Histologically confirmed cases of intracranial neuroenteric cyst from January 2000 to September 2014. Main Outcome Measures Pre- and postoperative modified Rankin Scale (mRS) scores, extent of resection, and postoperative complications are reported. Clinical presentation, imaging features, pathology, and operative approach are discussed. Results Five spinal and six intracranial neuroenteric cysts were surgically treated over a 15-year period. Median age at presentation for the intracranial cysts was 38.5 years. Mean cyst diameter was 3.8 cm. Five cysts were located in the pre-pontomedullary cistern, and one was located in the third ventricle. Gross total resection was achieved in four of the five posterior fossa cysts through a far lateral transcondylar approach. Postoperative complications included aseptic meningitis (one), transient abducens palsy (one), and pseudomeningocele requiring reoperation (three). Postoperative mRS scores improved to ≤1 by 6.5 months median follow-up. Conclusions Intracranial neuroenteric cysts are rare lesions with a variable imaging appearance. Complete surgical resection through a far lateral transcondylar approach is possible and usually results in symptom improvement or resolution. PMID:26682127

  20. Surgical Management of Intracranial Neuroenteric Cysts: The UCSF Experience.

    PubMed

    Breshears, Jonathan D; Rutkowski, Martin J; McDermott, Michael W; Cha, Soonmee; Tihan, Tarik; Theodosopoulos, Philip V

    2015-12-01

    Objective Modern surgical experience with intracranial neuroenteric cysts is limited in the literature. We review our 15-year institutional experience with these rare lesions. Design Single-institution retrospective study. Setting Large North American tertiary care center. Participants Histologically confirmed cases of intracranial neuroenteric cyst from January 2000 to September 2014. Main Outcome Measures Pre- and postoperative modified Rankin Scale (mRS) scores, extent of resection, and postoperative complications are reported. Clinical presentation, imaging features, pathology, and operative approach are discussed. Results Five spinal and six intracranial neuroenteric cysts were surgically treated over a 15-year period. Median age at presentation for the intracranial cysts was 38.5 years. Mean cyst diameter was 3.8 cm. Five cysts were located in the pre-pontomedullary cistern, and one was located in the third ventricle. Gross total resection was achieved in four of the five posterior fossa cysts through a far lateral transcondylar approach. Postoperative complications included aseptic meningitis (one), transient abducens palsy (one), and pseudomeningocele requiring reoperation (three). Postoperative mRS scores improved to ≤1 by 6.5 months median follow-up. Conclusions Intracranial neuroenteric cysts are rare lesions with a variable imaging appearance. Complete surgical resection through a far lateral transcondylar approach is possible and usually results in symptom improvement or resolution.

  1. One park, many experiences: socially-explicit improvements to recreation management frameworks with application to Taiwan

    Treesearch

    James D. Absher

    2010-01-01

    Park management frameworks developed in the US (e.g., VERP, etc.) are being applied in other countries, notably Taiwan. The social forces that drive visitor experiences and how they are reflected in practice are very important in these new contexts. The diversity of meanings, types of experiences desired or expected, and the ways to gauge "success"...

  2. An Experiment on Enforcement Strategies for Managing a Local Environment Resource

    ERIC Educational Resources Information Center

    Murphy, James J.; Cardenas, Juan-Camilo

    2004-01-01

    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…

  3. Can smallpox response teams use the experience of disease management programs?

    PubMed

    Kozma, Chris M

    2003-02-01

    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?

  4. An Experiment on Enforcement Strategies for Managing a Local Environment Resource

    ERIC Educational Resources Information Center

    Murphy, James J.; Cardenas, Juan-Camilo

    2004-01-01

    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…

  5. General and Vocational Work Experience Education Programs Management System. Career Development Programs. Revised Edition.

    ERIC Educational Resources Information Center

    Larson, C. G.; And Others

    The guide was designed to serve dual functions: (1) as the plan for the administration and operation of a work experience program for the San Mateo Union High School District for 1975-80, and (2) to assist the staff at all levels in the daily organization and management of work experience programs. The system defines the lines of accountability at…

  6. Management outcomes in pubic diastasis: our experience with 19 patients

    PubMed Central

    2011-01-01

    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

  7. The Danish Hip Arthroplasty Register

    PubMed Central

    Gundtoft, Per Hviid; Varnum, Claus; Pedersen, Alma Becic; Overgaard, Søren

    2016-01-01

    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

  8. Danish Colorectal Cancer Group Database.

    PubMed

    Ingeholm, Peter; Gögenur, Ismail; Iversen, Lene H

    2016-01-01

    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. All Danish patients with newly diagnosed colorectal cancer who are either diagnosed or treated in a surgical department of a public Danish hospital. 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. 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. 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 Colorectal Cancer Group provides high-quality data and has been documenting an

  9. Qualifications and experience: how well prepared are nurse managers compared to health service executives?

    PubMed

    Duffield, Christine; Franks, Helen

    2002-01-01

    The purpose of the paper was to compare the demographic details, educational qualifications, professional support and career guidance experiences of two groups of health managers as reported in previous research. One group comprised nurse managers (Duffield et al 2001) and the other comprised senior health administrators (Harris, Maddern & Pegg 1998). Employment and education data from self-administered questionnaires were compared. Nurse managers were predominantly female (88%), while the administrators were 50% female. The nurse managers, although with a relatively equal rate of managerial qualifications as their health service counterparts, had not attained as many senior positions in health care administration. Over half had not had a mentor. Nurse managers have skills attained through their academic studies and experience that cause them to be as capable as (if not in some cases better than) health service administrators. Increased use of mentoring may provide opportunities for professional advancement in wider administrative areas.

  10. Laparoscopic managment of common bile duct stones: our initial experience.

    PubMed

    Aroori, S; Bell, J C

    2002-05-01

    The management of choledocholithiasis has changed radically since the introduction of laparoscopic cholecystectomy. However, perceived technical difficulties have deterred many surgeons from treating common bile duct stones laparoscopically at the time of cholecystectomy. This has lead to reliance on endoscopic retrograde cholangiopancreatography followed by endoscopic sphincterotomy to deal with common bile duct stones. We retrospectively reviewed the charts of patients who had laparoscopic common bile duct exploration at Downe Hospital between December 1999 and August 2001. Among 149 laparoscopic cholecystectomies done by our group in this period, 10 patients (6.7%) underwent laparoscopic CBD exploration, three by the transcystic technique and seven by choledochotomy. Three patients (2%) had unsuspected stones found on routine per- operative cholangiogram. The mean operative time was 2.34hrs (range 1.50-3.30hrs). The mean hospital post- operative stay was 3 days (range 1-6 days). Post-operative morbidity was zero. Stone clearance was achieved in all cases. We conclude, laparoscopic exploration of the common bile duct is relatively safe and straightforward method. The key skill required is the ability to perform laparoscopic suturing with confidence.

  11. Laparoscopic managment of common bile duct stones: our initial experience.

    PubMed Central

    Aroori, S.; Bell, J. C.

    2002-01-01

    The management of choledocholithiasis has changed radically since the introduction of laparoscopic cholecystectomy. However, perceived technical difficulties have deterred many surgeons from treating common bile duct stones laparoscopically at the time of cholecystectomy. This has lead to reliance on endoscopic retrograde cholangiopancreatography followed by endoscopic sphincterotomy to deal with common bile duct stones. We retrospectively reviewed the charts of patients who had laparoscopic common bile duct exploration at Downe Hospital between December 1999 and August 2001. Among 149 laparoscopic cholecystectomies done by our group in this period, 10 patients (6.7%) underwent laparoscopic CBD exploration, three by the transcystic technique and seven by choledochotomy. Three patients (2%) had unsuspected stones found on routine per- operative cholangiogram. The mean operative time was 2.34hrs (range 1.50-3.30hrs). The mean hospital post- operative stay was 3 days (range 1-6 days). Post-operative morbidity was zero. Stone clearance was achieved in all cases. We conclude, laparoscopic exploration of the common bile duct is relatively safe and straightforward method. The key skill required is the ability to perform laparoscopic suturing with confidence. PMID:12137159

  12. Management of childhood splenic trauma--the Jos experience.

    PubMed

    Ugwu, B T; Kidmas, A T; Obekpa, P O; Momoh, J T

    1997-11-01

    We studied retrospectively 22 children who were managed for splenic injuries at Jos University Teaching Hospital between September 1988 and October 1995. Sixteen were males and six were females (M:F = 2.7:1) with their ages between five and 15 years and a mean of 10.3 years. Eleven were knocked down by vehicles while crossing the freeway, playing or hawking goods; seven fell from slippery mango trees after a downpour of rain while two were passengers in a vehicle that was involved in a head-on collision and another two were kicked in the abdomen as a result of assault. All had surgery. Four sustained Uphadhyaya and Simpson's Type 1 injuries while six sustained Type IV injuries. Twelve had total splenectomy, seven had total splenectomy with heterotopic autotransplantation of splenic wafers while three had splenorrhaphy augmented with omentoplasty. An average of 1.5 units of blood per patient were transfused. There was only one death. Considering that the majority (18) of these children sustained their splenic injuries while crossing the freeway (playing or hawking goods) and from falls from mango trees after the rains, we believe that there are preventable causes. Mandatory primary and junior secondary school education as well as legislature against child labour will help keep these children safe out of harm's way and thus drastically reduce the incidence of childhood splenic injuries in our environment.

  13. Management of Complex Ovarian Cysts in Newborns – Our Experience

    PubMed Central

    Manjiri, S; Padmalatha, SK; Shetty, J

    2017-01-01

    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

  14. Conservative management of ulcerated haemangioma--twenty years experience.

    PubMed

    Pandey, Anand; Gangopadhyay, Ajay Narayan; Sharma, Shiv Prasad; Kumar, Vijayendra; Gopal, Saroj Chooramani; Gupta, Dinesh Kumar

    2009-02-01

    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.

  15. [Dark visions and adaptation in Danish ophthalmology 1889-1940].

    PubMed

    Norn, Mogens

    2004-01-01

    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).

  16. Electrically Driven Single Phase Thermal Management: STP-H5 EHD Experiment

    NASA Technical Reports Server (NTRS)

    Didion, Jeffrey R.

    2016-01-01

    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.

  17. Implications of pollution prevention experience for environmental management

    SciTech Connect

    Schramm, W.

    1993-06-01

    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.

  18. Occupational health management in the lead industry: the korean experience.

    PubMed

    Lee, Byung-Kook

    2011-06-01

    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.

  19. Occupational Health Management in the Lead Industry: The Korean Experience

    PubMed Central

    2011-01-01

    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

  20. Male first-line managers' experiences of the work situation in elderly care: an empowerment perspective.

    PubMed

    Hagerman, Heidi; Engström, Maria; Häggström, Elisabeth; Wadensten, Barbro; Skytt, Bernice

    2015-09-01

    To describe male first-line managers' experiences of their work situation in elderly care. First-line managers' work is challenging. However, less attention has been paid to male managers' work situation in health care. Knowledge is needed to empower male managers. Fourteen male first-line managers were interviewed. The interview text was subjected to qualitative content analysis. Work situations were described as complex and challenging; challenges were the driving force. They talked about 'Being on one's own but not feeling left alone', 'Having freedom within set boundaries', 'Feeling a sense of satisfaction and stimulation', 'Feeling a sense of frustration' and 'Having a feeling of dejection and resignation'. Although the male managers report deficiencies in the support structure, they largely experience their work as a positive challenge. To meet increasing challenges, male first-line managers need better access to supportive structural conditions. Better access to resources is needed in particular, allowing managers to be more visible for staff and to work with development and quality issues instead of administrative tasks. Regarding organisational changes and the scrutiny of management and the media, they lack and thus need support and information from superiors. © 2013 John Wiley & Sons Ltd.

  1. Management of pituitary apoplexy: clinical experience with 40 patients.

    PubMed

    Lubina, A; Olchovsky, D; Berezin, M; Ram, Z; Hadani, M; Shimon, I

    2005-02-01

    Pituitary apoplexy is a rare major clinical event with neurological, neuro-ophthalmological, cardiovascular and hormonal consequences, resulting from an acute infarction of pituitary adenoma. We report our experience with a series of 40 patients presenting with pituitary apoplexy. Forty patients (27 males, 13 females; mean age, 51.2 yr) were admitted to our medical center between years 1985-2002 with acute presentation of pituitary apoplexy. Visual field defects occurred in 61% and ocular paresis in 40% of subjects. Sixty-three percent of adenomas were nonfunctional, and prolactinomas comprised 31%. Thirty-four patients underwent transsphenoidal pituitary decompression. Visual fields and ophthalmoplegia improved in 81% and 71%, respectively. During follow-up (4.5+/-5.4 yr), 79% of patients developed hypogonadotrophic hypogonadism, central hypothyroidism appeared in 54% and hypocortisolism--in 40% of patients. Permanent diabetes insipidus was diagnosed in 8%. Serial sellar MRI showed disappearance of pituitary tumor in 63% of operated subjects. Six patients (3 with PRL-secreting and 3 nonfunctional adenomas) were treated medically (corticosteroids, dopamine agonists), two patients (out of three) with visual deficits improved, and tumor shrinkage was noted in four. We present a large series of patients with pituitary apoplexy. Most subjects were operated, but six were treated conservatively. Almost all patients improved clinically, including those who were not operated, but hormonal deficiencies are very common.

  2. Charging systems and PAYT experiences for waste management in Spain.

    PubMed

    Puig-Ventosa, I

    2008-12-01

    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.

  3. Surgical management of gynecomastia: experience of a general surgery center

    PubMed Central

    LONGHEU, A.; MEDAS, F.; CORRIAS, F.; FARRIS, S.; TATTI, A.; PISANO, G.; ERDAS, E.; CALÒ, P.G.

    2016-01-01

    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

  4. [Experience in the management of severe inhalation injury].

    PubMed

    Chen, B; Jia, C; Su, Y

    1999-11-01

    To summarize our clinical experiences in the treatment of severe inhalation injury accompanying extensive burn. Retrospective analysis of 30 cases of inhalation injury (1980-1996) was done, the cure rate, mortality, effective treatments and lessons of failure were summarized. As soon as the diagnosis was defined, tracheostomy should be done immediately, followed by oxygen therapy, tracheo-bronchial lavage, aspiration, and clearance of airway secretion. If there was pulmonary edema or severe bronchospasm, cortical hormone was used for a short time, in addition, the patients were encouraged to cough, breathe deeply, and change postures, as well as patted on the back and also positioned to facilitate posture drainage, etc. These measures were effective. In this series, there were thirty cases of severe inhalation injury. Fourteen patients(46.6%) were cured, sixteen patients died(53.3%). The result was basically satisfactory. It is possible to increase the cure rate of severe inhalation injury, and the treatment should be carried out conscientiously as early as possible, and great attention should be paid to prevent various complications.

  5. Management of otolaryngological manifestations in mucopolysaccharidoses: our experience.

    PubMed

    Mesolella, M; Cimmino, M; Cantone, E; Marino, A; Cozzolino, M; Della Casa, R; Parenti, G; Iengo, M

    2013-08-01

    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.

  6. Why did Danish women's life expectancy stagnate? The influence of interwar generations' smoking behaviour.

    PubMed

    Lindahl-Jacobsen, Rune; Oeppen, Jim; Rizzi, Silvia; Möller, Sören; Zarulli, Virginia; Christensen, Kaare; Vaupel, James W

    2016-12-01

    The general health status of a population changes over time, generally in a positive direction. Some generations experience more unfavourable conditions than others. The health of Danish women in the interwar generations is an example of such a phenomenon. The stagnation in their life expectancy between 1977 and 1995 is thought to be related to their smoking behaviour. So far, no study has measured the absolute effect of smoking on the mortality of the interwar generations of Danish women and thus the stagnation in Danish women's life expectancy. We applied a method to estimate age-specific smoking-attributable number of deaths to examine the effect of smoking on the trends in partial life expectancy of Danish women between age 50 and 85 from 1950 to 2012. We compared these trends to those for women in Sweden, where there was no similar stagnation in life expectancy. When smoking-attributable mortality was excluded, the gap in partial life expectancy at age 50 between Swedish and Danish women diminished substantially. The effect was most pronounced in the interwar generations. The major reason for the stagnation in Danish women's partial life expectancy at age 50 was found to be smoking-related mortality in the interwar generations.

  7. Public or private water management: Experience from different European Countries

    NASA Astrophysics Data System (ADS)

    Wackerbauer, Johann

    2008-11-01

    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

  8. The management of HIV in pregnancy: A 10-year experience.

    PubMed

    Raffe, Sonia F; Savage, Charlotte; Perry, Louisa A; Patel, Amie; Keith, Tricia; Howell, Richard; Bradley, Robert; Bomont, Rob; Fidler, Katy; Gilleece, Yvonne

    2017-03-01

    The package of care to reduce HIV mother to child transmission (MTCT) has evolved significantly since trials of ante and intrapartum antiretroviral therapy (ART) in 1994. In the UK MTCT rate has fallen from 25.6% in the 1990s to 0.46%. We review the management of HIV in pregnancy in Brighton in the context of evolving guidelines. HIV, obstetric and neonatal notes of all HIV positive women, pregnant between 2003 and 2014, were reviewed. 97 pregnancies in 75 women were identified, resulting in 79 live births. Antenatal HIV diagnosis was made in 22 (28%). The proportion of pregnancies in those with known HIV at conception increased over the time period. At conception 58 (60%) were on ART, 33 (57%) of who continued on their original regimen. 34 (35%) initiated ART following conception: 14 known to be HIV positive, 20 diagnosed during pregnancy. Two did not start ART (1 due to miscarriage, 1 as diagnosed post-delivery) and in three cases ART history was unavailable due to transfer to alternative centres. ART was initiated on average at 22 weeks gestation (range 6-34). 4(5%) received Zidovudine (AZT) monotherapy, all before 2006. Choice of combination ART (cART) varied with time reflecting changing guidelines. Prior to 2008 an AZT containing regimen was used in 83% versus 8% after. Planned mode of delivery was documented in 73: 30(41%) planned a normal vaginal delivery (NVD), 43(59%) a caesarean section (CS). The viral load (VL) was <50copies/mL in 58(76%) at 36 weeks and 64(84%) at delivery. 90% with a detectable VL at 36 weeks delivered via CS. 100% received neonatal post-exposure prophylaxis (PEP): 68(88%) AZT monotherapy, 9(12%) cART. 84% initiated PEP within four hours. 90% completed 28days. 8(10%) babies experienced side effects. In the 10-year review period, one infant (1.3%) was diagnosed HIV positive. Both mother and infant received care in accordance with guidelines, including neonatal PEP within 4hours. Care of the HIV positive pregnant woman in Brighton has

  9. Managing medical images and clinical information: InCor's experience.

    PubMed

    Furuie, Sergio S; Rebelo, Marina S; Moreno, Ramon A; Santos, Marcelo; Bertozzo, Nivaldo; Motta, Gustavo H M B; Pires, Fabio A; Gutierrez, Marco A

    2007-01-01

    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.

  10. [Management of cerebrospinal fluid leaks according to size. Our experience].

    PubMed

    Alobid, Isam; Enseñat, Joaquim; Rioja, Elena; Enriquez, Karla; Viscovich, Liza; de Notaris, Matteo; Bernal-Sprekelsen, Manuel

    2014-01-01

    We present our experience in the reconstruction of cerebrospinal fluid (CSF) leaks according to their size and location. Fifty-four patients who underwent advanced skull base surgery (large defects) and 62 patients with CSF leaks of different origin (small and medium-sized defects) were included. Large defects were reconstructed with a nasoseptal pedicled flap positioned on fat and fascia lata and lumbar drainage was used. In small and medium-sized leaks of other origin, intrathecal fluorescein 5% was applied previously to identify the defect. Fascia lata in an underlay position was used for reconstruction, which was then covered with mucoperiosteum from the turbinate. Perioperative antibiotics were administered for 5-7 days. Nasal packing was removed after 24-48 hours. The most frequent aetiology for small and medium-sized defects was spontaneous (48.4%), followed by trauma (24.2%), iatrogenic (5%) and others. The success rate was of 91% after the first surgery and 98% in large skull base defects and small/medium-sized respectively. After rescue surgery, the rate of closure achieved was 100%. The follow-up was 15.6 ± 12.4 months for large defects and 75.3 ± 51.3 months for small/medium-sized defects without recurrence. Endoscopic surgery for closure of any type of skull base defect is the gold standard approach. Defect size does not play a significant role in the success rate. Fascia lata and mucoperiosteum allow a reconstruction of small/medium-sized defects. For larger skull base defects, a combination of fat, fascia lata and nasoseptal pedicled flaps provide a successful reconstruction. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  11. Cancer-Related Pain and Pain Management: Sources, Prevalence, and the Experiences of Children and Parents.

    PubMed

    Twycross, Alison; Parker, Roslyn; Williams, Anna; Gibson, Faith

    2015-01-01

    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.

  12. Conceptual framework for a Danish human biomonitoring program

    PubMed Central

    Thomsen, Marianne; Knudsen, Lisbeth E; Vorkamp, Katrin; Frederiksen, Marie; Bach, Hanne; Bonefeld-Jorgensen, Eva Cecilie; Rastogi, Suresch; Fauser, Patrik; Krongaard, Teddy; Sorensen, Peter Borgen

    2008-01-01

    The aim of this paper is to present the conceptual framework for a Danish human biomonitoring (HBM) program. The EU and national science-policy interface, that is fundamental for a realization of the national and European environment and human health strategies, is discussed, including the need for a structured and integrated environmental and human health surveillance program at national level. In Denmark, the initiative to implement such activities has been taken. The proposed framework of the Danish monitoring program constitutes four scientific expert groups, i.e. i. Prioritization of the strategy for the monitoring program, ii. Collection of human samples, iii. Analysis and data management and iv. Dissemination of results produced within the program. This paper presents the overall framework for data requirements and information flow in the integrated environment and health surveillance program. The added value of an HBM program, and in this respect the objectives of national and European HBM programs supporting environmental health integrated policy-decisions and human health targeted policies, are discussed. In Denmark environmental monitoring has been prioritized by extensive surveillance systems of pollution in oceans, lakes and soil as well as ground and drinking water. Human biomonitoring has only taken place in research programs and few incidences of e.g. lead contamination. However an arctic program for HBM has been in force for decades and from the preparations of the EU-pilot project on HBM increasing political interest in a Danish program has developed. PMID:18541069

  13. Preferences for managing symptoms of differing severity: a discrete choice experiment.

    PubMed

    Rennie, Lisa; Porteous, Terry; Ryan, Mandy

    2012-12-01

    To design cost-effective health services it is important to understand why people adopt particular symptom management strategies. To establish the relative importance of factors that influence decision making when managing symptoms of differing severity, to establish how people trade between these factors, and to estimate the monetary value placed on different management types. Discrete choice experiment. UK online research panel. Successive members of an online panel were invited to participate until 480 discrete choice experiment questionnaires were completed. Relative preferences for managing three symptom scenarios of varying severity were measured. Symptom management was described by three characteristics (management type, availability, and cost). Preferences for ways of managing symptoms were measured by using conditional logit analysis. A total of 98.5% of the completed questionnaires were valid (473 of 480 respondents). People preferred to manage minor symptoms by self-care or by visiting a pharmacy and were willing to pay £21.58 and £19.06, respectively, to do so. For managing moderately severe symptoms, people preferred to consult a general practitioner and were willing to pay £34.86 for this option. People preferred to manage potentially very severe symptoms by consulting a general practitioner and were willing to pay £73.08 to do so. Respondents were willing to trade between management types; options less preferred became more attractive when waiting time and cost were reduced. People value self-care, supported self-care, and general practitioner consultation differently depending on the type of symptoms. Manipulating costs to users and waiting times for different services could allow policymakers to influence the services people choose when managing symptoms. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. From managed competition to managed cooperation: theory and lessons from the British experience.

    PubMed

    Light, D W

    1997-01-01

    The United Kingdom led the world in transforming the largest single health care system from a publicly administered service to a set of interlocking contracts. Policy lessons that can be adapted by employers, nations, and other large payers are identified. These lessons are drawn from the improvements that the British made over the design of managed competition, the mistakes and problems they experienced, the underlying trends toward privatization and class discrimination, and the limitations to competition that have led the British toward managed cooperation in collaborative purchasing for the health needs of communities. Yet market reform and the rhetoric of efficiency have justified the shrinking of health services, the shift of costs to household budgets, and the use of public moneys to support private services and investors at greater expense by moving properties and services off the public ledger. In these ways, managed competition can Americanize health care and pose fundamental questions about what policy goals are really being pursued.

  15. A senior manager with a knowledge management portfolio: the Santa Clara County experience.

    PubMed

    Lindberg, Arley

    2012-01-01

    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. Copyright © Taylor & Francis Group, LLC

  16. The Lived Experience of Lupus Flares: Features, Triggers, and Management in an Australian Female Cohort

    PubMed Central

    Squance, Marline L.; Reeves, Glenn E. M.; Bridgman, Howard

    2014-01-01

    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

  17. The journey toward shared governance: the lived experience of nurse managers and staff nurses.

    PubMed

    Ott, Joyce; Ross, Carl

    2014-09-01

    The purpose of the study was to explore the lived experience of nurse managers and staff nurses in shared governance. Shared governance refers to systems and services aligned in partnership. The information gained by studying the lived experience of nurse managers and staff nurses in shared governance is valuable for providing knowledge of empowerment. A qualitative design was used. Data were collected through a semi-structured interview using five questions with 11 Registered Nurses. Data were analysed through thematic analysis. Four themes emerged from data analysis. Nurse managers identified the journey of patient satisfaction; journey of empowerment; journey of self-management and journey of wellness. Staff nurses identified the journey of development and implementation of best practice; journey to provide quality patient care, journey to a new culture of nursing; and journey of a variety of challenges. This study supports the idea that collaboration between nurse managers and staff nurses develops a journey toward shared governance. Nursing management can use findings to empower nurses to collaborate with nurse managers toward best practice. This adds to current knowledge that partnership of nurse managers and staff nurses, supports and encourages ownership in shared governance. © 2013 John Wiley & Sons Ltd.

  18. A qualitative insight into self-management experience among Chinese breast cancer survivors.

    PubMed

    Cheng, Huilin; Sit, Janet W H; Cheng, Karis K F

    2017-07-01

    With increasing awareness in the chronic nature of cancer, promoting the engagement of breast cancer survivors in self-management has become a priority of cancer care reform initiatives. This study aimed to reveal Chinese breast cancer survivors' views and experiences of self-management in extended survivorship. Archived interview transcripts from 19 breast cancer survivors (<5 years since diagnosis) were subjected to a secondary analysis. Each transcript was re-examined through qualitative content analysis. Three categories were established to represent the perceptions of the participants on their self-management tasks related to health and well-being, emotions, and roles and relationships. Managing health and well-being covers modifying lifestyle, taking traditional Chinese medicine, attending regular follow-ups, managing symptoms, and adhering to hormonal therapy. Managing emotions involves maintaining a positive attitude and utilizing supportive resources. Managing roles and relationships comprises adjusting to life as cancer survivors, maintaining marital relationships, and performing familial and other social roles. Most participants actively participated in various self-management tasks and behaviors that can help improve their health and prevent cancer recurrence. They may exhibit optimal self-management in their emotions and most health aspects but may exert limited efforts in managing their different roles during survivorship. Copyright © 2016 John Wiley & Sons, Ltd.

  19. Forgotten Reminders: an Experience with Managing 28 Forgotten Double-J Stents and Management of Related Complications.

    PubMed

    Sohrab, Arora; Aneesh, Srivastava; Sureka, Sanjoy Kumar; Varun, Mittal; Nitesh, Patidar; Manoj, Kumar; Rakesh, Kapoor

    2015-12-01

    Combinations of extracorporeal shockwave lithotripsy (ESWL) and endourological and open surgery have been used for management of forgotten double-J (DJ) stents; however, there are only a few case reports or case series in literature. We present our experience of managing 28 cases of forgotten ureteric stents of whom three patients died because of complications after intervention. We retrospectively reviewed the hospital records of 28 cases of forgotten DJ stents from 2000 to 2013. The details reviewed included indications for stent placement, indwelling time, presenting complaints, laboratory, radiographic, nuclear scan findings, management techniques, and complications. Extensive review of literature was done. Mean patient age was 37.7 ± 14 years. Mean indwelling time was 102.9 months. The commonest presenting complaints were irritative voiding symptoms and hematuria. Nineteen (67.8 %) of the stents were complicated. The complicated stents were managed by a combination of endourological techniques and ESWL. Six (21.5 %) patients presented with renal failure. Three patients died of complications. Forgotten DJ stent can be a lethal yet entirely preventable complication. Preoperative imaging with a noncontrast CT is essential especially in long indwelling time, especially to evaluate stone burden at the upper end of the stent. A stepwise approach should be used for management. Where long operative times are expected, the procedure must be staged. Combined endourological procedures are almost always successful in managing these challenging cases.

  20. The personal computer and GP-B management. [Gravity Probe experiment

    NASA Technical Reports Server (NTRS)

    Neighbors, A. K.

    1986-01-01

    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.

  1. UNIX-based data management system for the Mobile Satellite Propagation Experiment (PiFEx)

    NASA Technical Reports Server (NTRS)

    Kantak, Anil V.

    1987-01-01

    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.

  2. Planning and managing the development of the protoMIRAX balloon experiment by using ECSS standards

    NASA Astrophysics Data System (ADS)

    Santiago Júnior, Valdivino; Braga, Joao

    2012-07-01

    In this paper, we present a tailoring of the European Cooperation for Space Standardization (ECSS) standards in order to plan and manage the development of the balloon-borne high energy astrophysics experiment protoMIRAX. ECSS standards are supported and have been used by several space agencies in Europe and also at Instituto Nacional de Pesquisas Espaciais (INPE) in Brazil to develop space applications. Our approach is to develop a balloon system based on a set of standards used for critical satellite applications, aiming to obtain not only the success of the protoMIRAX experiment but also to test in near-space environment several subsystems that can be reused in INPE's satellite missions. We show our tailoring taking into account the main ECSS disciplines related to management, such as project planning and implementation and risk management, and discuss the current status of development of the protoMIRAX experiment.

  3. Nurse managers' perceptions and experiences regarding staff nurse empowerment: a qualitative study

    PubMed Central

    Van Bogaert, Peter; Peremans, Lieve; de Wit, Marlinde; Van heusden, Danny; Franck, Erik; Timmermans, Olaf; Havens, Donna S.

    2015-01-01

    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

  4. Nurse managers' perceptions and experiences regarding staff nurse empowerment: a qualitative study.

    PubMed

    Van Bogaert, Peter; Peremans, Lieve; de Wit, Marlinde; Van Heusden, Danny; Franck, Erik; Timmermans, Olaf; Havens, Donna S

    2015-01-01

    To study nurse managers' perceptions and experiences of staff nurse structural empowerment and its impact on the nurse manager leadership role and style. 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. Qualitative phenomenological study. 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. 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. 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 dedicated support for both clinical nurses and nursing unit

  5. Danish Colorectal Cancer Group Database

    PubMed Central

    Ingeholm, Peter; Gögenur, Ismail; Iversen, Lene H

    2016-01-01

    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

  6. Agility - The Danish Way (Briefing Charts)

    DTIC Science & Technology

    2014-06-01

    Agility - The Danish Way Dr. William Mitchell Dept. for Joint Operations | C2 & Intelligence | Royal Danish Defence College Ryvangs Allé 1...AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Royal Danish Defence College,Dept...Establish presence in Mogadishu and expand with main effort in Southern Somalia. •MD2- Establish small military presence in Somaliland. • P/SD1-ID Clan

  7. House dust in seven Danish offices

    NASA Astrophysics Data System (ADS)

    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

  8. [Early achievements of the Danish pharmaceutical industry-6 Pharmacia].

    PubMed

    Grevsen, Jørgen V; Kruse, Edith; Kruse, Poul R

    2014-01-01

    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

  9. Aiding the environment: the Australian Development Agency's experience of implementing an environmental management system

    SciTech Connect

    Keen, Meg . E-mail: meg.keen@anu.edu.au; Sullivan, Marjorie

    2005-08-15

    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.

  10. Summary of Results from the Risk Management Program for the Mars Microrover Flight Experiment

    NASA Technical Reports Server (NTRS)

    Shishko, Robert; Matijevic, Jacob R.

    2000-01-01

    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.

  11. Summary of Results from the Risk Management Program for the Mars Microrover Flight Experiment

    NASA Astrophysics Data System (ADS)

    Shishko, Robert; Matijevic, Jacob R.

    2000-01-01

    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.

  12. Heart failure patients' attitudes, beliefs, expectations and experiences of self-management strategies: a qualitative synthesis.

    PubMed

    Wingham, Jennifer; Harding, Geoff; Britten, Nicky; Dalal, Hayes

    2014-06-01

    To develop a model of heart failure patients' attitudes, beliefs, expectations, and experiences based on published qualitative research that could influence the development of self-management strategies. A synthesis of 19 qualitative research studies using the method of meta-ethnography. This synthesis offers a conceptual model of the attitudes, beliefs, and expectations of patients with heart failure. Patients experienced a sense of disruption before developing a mental model of heart failure. Patients' reactions included becoming a strategic avoider, a selective denier, a well-intentioned manager, or an advanced self-manager. Patients responded by forming self-management strategies and finally assimilated the strategies into everyday life seeking to feel safe. This conceptual model suggests that there are a range of interplaying factors that facilitate the process of developing self-management strategies. Interventions should take into account patients' concepts of heart failure and their subsequent reactions.

  13. Potential roles of research in enhancing the performance of management in securing high quality visitor experiences in wilderness

    Treesearch

    Stephen F. McCool

    2012-01-01

    Does research help managers provide opportunities for visitors to have high quality experiences in wilderness? Difficulties in applying visitor experience research result from several factors: the nature of wilderness itself, the character of the wilderness visitor experience challenge as a research and management topic, and the paradigm of research applications...

  14. Partnering With a Patient and Family Advisory Council to Improve Patient Care Experiences With Pain Management.

    PubMed

    Bookout, Michelle L; Staffileno, Beth A; Budzinsky, Christine M

    2016-04-01

    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.

  15. The Danish Bladder Cancer Database

    PubMed Central

    Hansen, Erik; Larsson, Heidi; Nørgaard, Mette; Thind, Peter; Jensen, Jørgen Bjerggaard

    2016-01-01

    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

  16. The Danish Prostate Cancer Database

    PubMed Central

    Nguyen-Nielsen, Mary; Høyer, Søren; Friis, Søren; Hansen, Steinbjørn; Brasso, Klaus; Jakobsen, Erik Breth; Moe, Mette; Larsson, Heidi; Søgaard, Mette; Nakano, Anne; Borre, Michael

    2016-01-01

    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

  17. The role of patients' explanatory models and daily-lived experience in hypertension self-management.

    PubMed

    Bokhour, Barbara G; Cohn, Ellen S; Cortés, Dharma E; Solomon, Jeffrey L; Fix, Gemmae M; Elwy, A Rani; Mueller, Nora; Katz, Lois A; Haidet, Paul; Green, Alexander R; Borzecki, Ann M; Kressin, Nancy R

    2012-12-01

    Uncontrolled hypertension remains a significant problem for many patients. Few interventions to improve patients' hypertension self-management have had lasting effects. Previous work has focused largely on patients' beliefs as predictors of behavior, but little is understood about beliefs as they are embedded in patients' social contexts. This study aims to explore how patients' "explanatory models" of hypertension (understandings of the causes, mechanisms or pathophysiology, course of illness, symptoms and effects of treatment) and social context relate to their reported daily hypertension self-management behaviors. Semi-structured qualitative interviews with a diverse group of patients at two large urban Veterans Administration Medical centers. PARTICIPANTS (OR PATIENTS OR SUBJECTS): African-American, white and Latino Veterans Affairs (VA) primary care patients with uncontrolled blood pressure. We conducted thematic analysis using tools of grounded theory to identify key themes surrounding patients' explanatory models, social context and hypertension management behaviors. Patients' perceptions of the cause and course of hypertension, experiences of hypertension symptoms, and beliefs about the effectiveness of treatment were related to different hypertension self-management behaviors. Moreover, patients' daily-lived experiences, such as an isolated lifestyle, serious competing health problems, a lack of habits and routines, barriers to exercise and prioritizing lifestyle choices, also interfered with optimal hypertension self-management. Designing interventions to improve patients' hypertension self-management requires consideration of patients' explanatory models and their daily-lived experience. We propose a new conceptual model - the dynamic model of hypertension self-management behavior - which incorporates these key elements of patients' experiences.

  18. The influence of literacy on patient-reported experiences of diabetes self-management support.

    PubMed

    Wallace, Andrea S; Carlson, John R; Malone, Robb M; Joyner, James; Dewalt, Darren A

    2010-01-01

    Variability in disease-related outcomes may relate to how patients experience self-management support in clinical settings. The purpose of this study was to identify factors associated with experiences of self-management support during primary care encounters. A cross-sectional survey was conducted of 208 patients seen in a multidisciplinary diabetes program in an academic medicine clinic. Multiple regression analysis was used to test associations between patient-rated experiences of self-management support (Patient Assessment of Chronic Illness Care) and race, gender, insurance status, literacy, duration of diabetes, and intensity of care management. The Patient Assessment of Chronic Illness Care ratings decreased with age (r = -.235, p = .001), were higher for women than for men (3.95 vs. 3.65, t = 2.612, p= .010), and were greater for those with more education (F= 3.927, p = .009) and greater literacy skills (t = 3.839, p< .001). The ratings did not vary between racial (t = -1.108, p = .269) or insurance (F = 1.045, p = .374) groups and were unaffected by the duration of diabetes (r= .052, p = .466) and the intensity of care management (F = 1.028, p = .360). In multivariate models, literacy was the only variable contributing significantly to variation in self-management support ratings. Even when considering the objective intensity of health services delivered, literacy was the sole variable contributing to differences in patient ratings of self-management support. Although conclusions are limited by the cross-sectional nature of this study, the results emphasize the need to consider literacy when developing and communicating treatment plans requiring self-management skills.

  19. Experience of hypertensive patients with self-management of health care.

    PubMed

    Balduino, Anice de Fátima Ahmad; Mantovani, Maria de Fátima; Lacerda, Maria Ribeiro; Marin, Maria José Sanches; Wal, Marilene Loewen

    2016-11-01

    The aim of this study was to interpret how hypertensive patients experience health care self-management. Hypertension is one of the most prevalent chronic diseases worldwide. The involvement of individuals in the management of their health care to treat this disease is fundamental, with aid and advice from healthcare professionals, especially nurses, so that hypertensive patients can effectively self-manage their health care. Qualitative study. Hypertensive patients were recruited using theoretical sampling. The study sample consisted of 28 hypertensive patients aged 18-59 years who were registered in the e-Health programme of the Ministry of Health. Data were collected and analyzed between September 2012-October 2014 using a semi-structured interview based on the methodological framework of the constructivist grounded theory. The participants' statements depicted an outline of their experience with the disease: the beginning of the illness; understanding the disease process; incorporating behaviour for self-management of the disease; experiencing attitudes and actions in the control and treatment of the disease; and being treated in the public healthcare system. A central phenomenon emerged, namely hypertensive patients' experience of self-management of health care. This phenomenon has paths, actions and interactions. When patients discover that they have the disease and become aware of the disease process, they assume the identity of being hypertensive and become proactive in their health care and in living with their families and in communities. © 2016 John Wiley & Sons Ltd.

  20. Developing an Environmental Decision Support System for Stream Management: the STREAMES Experience

    NASA Astrophysics Data System (ADS)

    Riera, J.; Argerich, A.; Comas, J.; Llorens, E.; Martí, E.; Godé, L.; Pargament, D.; Puig, M.; Sabater, F.

    2005-05-01

    Transferring research knowledge to stream managers is crucial for scientifically sound management. Environmental decision support systems are advocated as an effective means to accomplish this. STREAMES (STream REAach Management: an Expert System) is a decision tree based EDSS prototype developed within the context of an European project as a tool to assist water managers in the diagnosis of problems, detection of causes, and selection of management strategies for coping with stream degradation issues related mostly to excess nutrient availability. STREAMES was developed by a team of scientists, water managers, and experts in knowledge engineering. Although the tool focuses on management at the stream reach scale, it also incorporates a mass-balance catchment nutrient emission model and a simple GIS module. We will briefly present the prototype and share our experience in its development. Emphasis will be placed on the process of knowledge acquisition, the design process, the pitfalls and benefits of the communication between scientists and managers, and the potential for future development of STREAMES, particularly in the context of the EU Water Framework Directive.

  1. Qualitative study of views and experiences of performance management for healthcare-associated infections.

    PubMed

    Brewster, L; Tarrant, C; Dixon-Woods, M

    2016-09-01

    Centrally led performance management regimes using standard setting, monitoring, and incentives have become a prominent feature of infection prevention and control (IPC) in health systems. To characterize views and experiences of regulation and performance management relating to IPC in English hospitals. Two qualitative datasets containing 139 interviews with healthcare workers and managers were analysed. Data directly relevant to performance management and IPC were extracted. Data analysis was based on the constant comparative method. Participants reported that performance management regimes had mobilized action around specific infections. The benefits of establishing organizational structures of accountability were seen in empirical evidence of decreasing infection rates. Performance management was not, however, experienced as wholly benign, and setting targets in one area was seen to involve risks of 'tunnel vision' and the marginalization of other potentially important issues. Financial sanctions were viewed especially negatively; performance management was associated with risks of creating a culture of fearfulness, suppressing learning and disrupting inter-professional relationships. Centrally led performance management may have some important roles in IPC, but identifying where it is appropriate and determining its limits is critical. Persisting with harsh regimes may affect relationships and increase resistance to continued improvement efforts, but leaving all improvement to local teams may also be a flawed strategy. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. [Psychiatric case management. Chronic Disease Management application experience in a public Mental Health Service].

    PubMed

    Pompili, Enrico; Silvestrini, Cristiana; Nicolò, Giuseppe; Pitino, Annalisa; Bernabei, Laura

    2014-01-01

    Aim of this study is to investigate the possible effectiveness of a specific program management needs of patients at high impact health care, case management (CM). The welfare impact is evaluated in terms of the severity of the presented disorder or to other characteristic factors of the individual patient, such as: adherence to the proposed treatments, possible resistance to drug treatment, cognitive structure, the presence of comorbid medical pathologies, abuse/addiction and, more generally, all bio-psycho-social functioning variables that can complicate the treatment of the patient. Twenty five outpatients with chronic schizophrenia (age mean 49,5 yrs) were evaluated through the Camberwell Assessment of Need (CAN20) and Life Skill Profile (LSP) before and after 1 year of CM treatment. General psychopathology was assessed by the Clinical Global Impression (CGI) and the Brief Psychiatric Rating Scale (BPRS). Demographic data were collected, as well as data related to the severity of the disorder: number of hospitalizations and number of switch in drug treatment in the year before the study. Between T0 and T1 there is a significant improvement on CGI-G, BPRS (total and HOST factor), LSP and CAN TOT in patients treated with CM. Moreover, in CM treated patients a 58% reduction of hospitalizations is noted in the year of study. There is a possible effectiveness of CM in improving patient's clinical and social needs in chronic psychiatric diseases. The CM reduces the number of hospitalizations.

  3. The Future of the Danish Army

    DTIC Science & Technology

    2013-03-01

    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

  4. Experience use history and its relationship to management actions and satisfaction

    Treesearch

    Jordan W. Smith; Roger L. Moore; Steven W. Burr

    2010-01-01

    Th is paper analyzes the relationship between recreationists' patterns of prior experience and their preferences for and satisfaction with specific management actions. A mail-back survey was administered to a random sample of 1,500 off-highway vehicle (OHV) owners in Utah, and data for this study come from the 600 owners who completed the questionnaire. The sample...

  5. The influence of wilderness restoration programs on visitor experience and visitor opinions of managers

    Treesearch

    Joseph P. Flood; Leo H. McAvoy

    2000-01-01

    Wilderness campsites heavily damaged by recreational use pose a significant management challenge that threatens the integrity of the wilderness resource and the quality of the visitors’ experience. This study, conducted in the Mission Mountains Wilderness of northwestern Montana, surveyed 293 visitors to determine what influence heavily damaged campsites and site...

  6. Evaluation and surgical management of the gallstone ileus. A single center experience.

    PubMed

    Safioleas, M; Stamatakos, M; Spyrakos, C; Safioleas, P; Chatzikonstantinou, C; Iannescu, R; Safioleas, C

    2008-01-01

    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.

  7. Managing Disaster Recovery Centers on Campus: The Experience of Southeastern Louisiana University

    ERIC Educational Resources Information Center

    Lawrence, Heather; Shafer, Duane

    2007-01-01

    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…

  8. Using the Experience Sampling Method in the Context of Contingency Management for Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Husky, Mathilde M.; Mazure, Carolyn M.; Carroll, Kathleen M.; Barry, Danielle; Petry, Nancy M.

    2008-01-01

    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…

  9. Effect of Leadership Experience on Agricultural Education Student Teacher Self-Efficacy in Classroom Management

    ERIC Educational Resources Information Center

    Wolf, Kattlyn J.; Foster, Daniel D.; Birkenholz, Robert J.

    2009-01-01

    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…

  10. Perceptions and Lived Experiences of Illinois Parents as Teachers Program Leaders While Managing a Multigenerational Staff

    ERIC Educational Resources Information Center

    Ruhe Marsh, Linda

    2012-01-01

    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…

  11. Practice and Experience of Task Management of University Students: Case of University of Tsukuba, Japan

    ERIC Educational Resources Information Center

    Fukuzawa, Ryoko; Joho, Hideo; Maeshiro, Tetsuya

    2015-01-01

    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…

  12. Perceptions and Lived Experiences of Illinois Parents as Teachers Program Leaders While Managing a Multigenerational Staff

    ERIC Educational Resources Information Center

    Ruhe Marsh, Linda

    2012-01-01

    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…

  13. [Management of Grave's disease in the tropics (experience at Bouffard Army Hospital Center in Djibouti].

    PubMed

    Coulet, O; Kraemer, P; Leyral, G; Cloatre, G

    2004-01-01

    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.

  14. Managing Disaster Recovery Centers on Campus: The Experience of Southeastern Louisiana University

    ERIC Educational Resources Information Center

    Lawrence, Heather; Shafer, Duane

    2007-01-01

    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…

  15. An Academic Medical Center's Experience with Mandatory Managed Care for Medicaid Recipients.

    ERIC Educational Resources Information Center

    Hillman, Alan L.; And Others

    1991-01-01

    This paper reports on experiences and concerns of the Hospital of the University of Pennsylvania as a participating primary care site in a Medicaid managed care program (HealthPASS). Discussed are the modification of existing activities to meet increased care demands and administrative demands, and characteristics of HealthPASS that have impeded…

  16. Using Facebook as a Learning Management System: Experiences of Pre-Service Teachers

    ERIC Educational Resources Information Center

    Kalelioglu, Filiz

    2017-01-01

    The purpose of this study was to examine students' experiences using Facebook as a learning management system during a course. The study participants were 18 junior education faculty students attending a compulsory distance education undergraduate course delivered by the Computer Education and Instructional Technology Department at a university in…

  17. Parents' views and experiences of childhood obesity management in primary care: a qualitative study.

    PubMed

    Turner, Katrina M; Salisbury, Chris; Shield, Julian P H

    2012-08-01

    Primary care has been viewed as an appropriate setting for childhood obesity management. Little is known about parents' views and experiences of obesity management within this clinical setting. These views and experiences need to be explored, as they could affect treatment success. To explore parents' views and experiences of primary care as a treatment setting for childhood obesity. In-depth interviews were held with 15 parents of obese children aged 5-10 years, to explore their views and experiences of primary care childhood obesity management. Parents were contacted via a hospital-based childhood obesity clinic, general practices and Mind, Exercise, Nutrition … Do it! (MEND) groups based in Bristol, England. The interviews were audio-taped transcribed verbatim and analysed thematically. Parents viewed primary care as an appropriate setting in which to treat childhood obesity but were reluctant to consult due to a fear of being blamed for their child's weight and a concern about their child's mental well-being. They also questioned whether practitioners had the knowledge, time and resources to effectively manage childhood obesity. Parents varied in the extent to which they had found consulting a practitioner helpful, and their accounts suggested that GPs and school nurses offer different types of support. Parents need to be reassured that practitioners will address their child's weight in a non-judgemental sensitive manner and are able to treat childhood obesity effectively. A multidisciplinary team approach might benefit a child, as different practitioners may vary in the type of care they provide.

  18. The Impact of Years of Teaching Experience on the Classroom Management Approaches of Elementary School Teachers

    ERIC Educational Resources Information Center

    Unal, Zafer; Unal, Aslihan

    2012-01-01

    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…

  19. Practice and Experience of Task Management of University Students: Case of University of Tsukuba, Japan

    ERIC Educational Resources Information Center

    Fukuzawa, Ryoko; Joho, Hideo; Maeshiro, Tetsuya

    2015-01-01

    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…

  20. Managing for wilderness experiences in the 21st Century: Responding to the recent wilderness critique

    Treesearch

    Joseph W. Roggenbuck

    2012-01-01

    This essay describes five major critiques of the wilderness idea and how wilderness managers might shape experience opportunities in wilderness in response. These challenges include the notions that the wilderness idea separates people from nature, that it denies the human story in "pristine" lands, that it privileges a kind of recreation favored by elites...

  1. Effect of Leadership Experience on Agricultural Education Student Teacher Self-Efficacy in Classroom Management

    ERIC Educational Resources Information Center

    Wolf, Kattlyn J.; Foster, Daniel D.; Birkenholz, Robert J.

    2009-01-01

    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…

  2. The Experiences of Teacher-Assistant Principals in Catholic Elementary Schools: Boundary Spanners and Player Managers

    ERIC Educational Resources Information Center

    Beltramo, J. Luciano

    2014-01-01

    This article presents a phenomenological study of teacher-assistant principals (teacher-APs) in Catholic elementary schools. Drawing from player manager and role theories, this article describes the lived experiences of these individuals, particularly how they perceive the benefits and constraints of their unique role in both faculty and…

  3. Voices of Experience: Understanding and Enhancing Successful Conflict Management by Community College Presidents

    ERIC Educational Resources Information Center

    Zanjani, Mellissia M.

    2012-01-01

    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…

  4. A Qualitative Study of Information Technology Managers' Experiences and Perceptions Regarding Outsourced Data Centers

    ERIC Educational Resources Information Center

    Reid, Eric Justin

    2015-01-01

    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)…

  5. Wilderness visitors, experiences, and management preferences: How they vary with use level and length of stay

    Treesearch

    David N. Cole; Troy E. Hall

    2008-01-01

    We explore the extent to which visitor experiences and management preferences vary between the most heavily used places in wilderness and places that are less popular. We also contrast day and overnight users. The study was conducted in Forest Service administered wildernesses in Oregon and Washington using both on-site and mailback questionnaires. The on-site...

  6. Work Experiences, Occupational Commitment, and Intent to Enter the Sport Management Profession

    ERIC Educational Resources Information Center

    Cunningham, George B.; Sagas, Michael

    2004-01-01

    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…

  7. A Qualitative Study of Information Technology Managers' Experiences and Perceptions Regarding Outsourced Data Centers

    ERIC Educational Resources Information Center

    Reid, Eric Justin

    2015-01-01

    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)…

  8. Supervised Occupational Experience Record Book for Agricultural Resources Conservation, Environmental Management and Forestry: Teacher's Guide.

    ERIC Educational Resources Information Center

    Nickles, Tom

    The guide is designed to aid the instructor in implementing the student guide entitled "Supervised Occupational Experience Record Book For Agricultural Resource Conservation, Environmental Management and Forestry". Intended for use in the secondary level vocational agriculture curriculum, general concepts, student record-keeping skills,…

  9. Work Experiences, Occupational Commitment, and Intent to Enter the Sport Management Profession

    ERIC Educational Resources Information Center

    Cunningham, George B.; Sagas, Michael

    2004-01-01

    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…

  10. Structured storage in ATLAS Distributed Data Management: use cases and experiences

    NASA Astrophysics Data System (ADS)

    Lassnig, Mario; Garonne, Vincent; Molfetas, Angelos; Beermann, Thomas; Dimitrov, Gancho; Canali, Luca; Zang, Donal; Azzurra Chinzer, Lisa

    2012-12-01

    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.

  11. Inspiring change: humanities and social science insights into the experience and management of breathlessness

    PubMed Central

    Oxley, Rebecca; Macnaughton, Jane

    2016-01-01

    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

  12. Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

    PubMed

    Kakyo, Tracy Alexis; Xiao, Lily Dongxia

    2017-03-09

    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.

  13. Are Danish doctors comfortable teaching in English?

    PubMed

    Nilas, L; Løkkegaard, E C; Laursen, J B; Kling, J; Cortes, D

    2016-08-27

    From 2012-2015, the Departments of Obstetrics and Gynecology and of Pediatrics at the University of Copenhagen conducted a project, "Internationalization at Home ", offering clinical teaching in English. The project allowed international students to work with Danish speaking students in a clinical setting. Using semi-quantitative questionnaires to 89 clinicians about use of English and need for training, this paper considers if Danish clinical doctors are prepared to teach in English. The majority self-assessed their English proficiency between seven and eight on a 10 unit visual analogue scale, with 10 equivalent to working in Danish, while 15 % rated five or less. However, one-fourth found teaching and writing in English to be twice as difficult than in Danish, and 12 % rated all teaching tasks in English at four or less compared to Danish. The self-assessed need for additional English skills was perceived low. Teaching in English was rated as 30 % more difficult than in Danish, and a significant subgroup of doctors had difficulties in all forms of communication in English, resulting in challenges when introducing international students in non-native English speaking medical departments.

  14. Women's experiences of three early miscarriage management options a qualitative study

    PubMed Central

    Smith, Lindsay F; Frost, Julia; Levitas, Ruth; Bradley, Harriet; Garcia, Jo

    2006-01-01

    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

  15. Experiences in the management of chest injuries and a review of current management.

    PubMed

    Kwa, B H

    1983-07-01

    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.

  16. PRODIS: a proteomics data management system with support to experiment tracking

    PubMed Central

    2011-01-01

    Background A research area that has greatly benefited from the development of new and improved analysis technologies is Proteomics and large amounts of data have been generated by proteomic analysis as a consequence. Previously, the storage, management and analysis of these data have been done manually. This is, however, incompatible with the volume of data generated by modern proteomic analysis. Several attempts have been made to automate the tasks of data analysis and management. In this work we propose PRODIS (Proteomics Database Integrated System), a system for proteomic experimental data management. The proposed system enables an efficient management of the proteomic experimentation workflow, simplifies controlling experiments and associated data and establishes links between similar experiments through the experiment tracking function. Results PRODIS is fully web based which simplifies data upload and gives the system the flexibility necessary for use in complex projects. Data from Liquid Chromatography, 2D-PAGE and Mass Spectrometry experiments can be stored in the system. Moreover, it is simple to use, researchers can insert experimental data directly as experiments are performed, without the need to configure the system or change their experiment routine. PRODIS has a number of important features, including a password protected system in which each screen for data upload and retrieval is validated; users have different levels of clearance, which allow the execution of tasks according to the user clearance level. The system allows the upload, parsing of files, storage and display of experiment results and images in the main formats used in proteomics laboratories: for chromatographies the chromatograms and lists of peaks resulting from separation are stored; For 2D-PAGE images of gels and the files resulting from the analysis are stored, containing information on positions of spots as well as its values of intensity, volume, etc; For Mass Spectrometry

  17. The experience of scar management for adults with burns: An interpretative phenomenological analysis.

    PubMed

    Martin, C; Bonas, S; Shepherd, L; Hedges, E

    2016-09-01

    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. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  18. The R3/R5 impoundment study: a large-scale management experiment

    USGS Publications Warehouse

    Lyons, J.E.; Laskowski, H.P.; Runge, M.C.; Lor, S.; Kendall, W.L.; Talbott, S.

    2005-01-01

    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.

  19. Development of an online nursing management course: successful experience between Brazil and Portugal.

    PubMed

    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

    2015-12-01

    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.

  20. Community energy auditing: experience with the comprehensive community energy management program

    SciTech Connect

    Moore, J.L.; Berger, D.A.; Rubin, C.B.; Hutchinson, P.A. Sr.; Griggs, H.M.

    1980-09-01

    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)

  1. AMPS data management concepts. [Atmospheric, Magnetospheric and Plasma in Space experiment

    NASA Technical Reports Server (NTRS)

    Metzelaar, P. N.

    1975-01-01

    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.

  2. Relational experiences of power and gender for nurse-managers of private hospitals.

    PubMed

    Brito, Maria José Menezes; Montenegro, Lívia Cozer; Alves, Marília

    2010-01-01

    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.

  3. Airway management of patients with craniofacial abnormalities: 10-year experience at a teaching hospital in Taiwan.

    PubMed

    Chen, Ying-Lun; Wu, Kuo-Hwa

    2009-09-01

    Airway management for patients with craniofacial abnormalities poses many challenges. It potentially has a high rate of morbidity and even mortality. We reviewed our experience in administering anesthesia to patients with a diagnosis of mucopolysaccharidosis or Pierre Robin sequence in the past 10 years (July 1998 to October 2008). The anesthetic procedures, methods of airway management, and events of morbidity and mortality were evaluated. Thirty patients with mucopolysaccharidosis and 53 patients with Pierre Robin sequence were placed under general anesthesia. Although the anesthesiologists always encountered difficulties in managing the airway, most of the anesthetic procedures were performed safely except for 1 case that resulted in mortality. Managing the airway of patients with craniofacial abnormalities can potentially be difficult. It should be carried out by experienced anesthesiologists, with assistance from an otolaryngologist when necessary. A variety of different airway devices should be available if needed.

  4. Health services management development: what formal knowledge should support the skills and experience required?

    PubMed

    Ritchie, David J; Yen, Margaret L

    2013-05-01

    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

  5. The role of practical wisdom in nurse manager practice: why experience matters.

    PubMed

    Cathcart, Eloise Balasco; Greenspan, Miriam

    2013-10-01

    To illustrate through the interpretation of one representative nurse manager's narrative how the methodology of practice articulation gives language to the ways practical wisdom develops in leadership practice and facilitates learning. Patricia Benner's corpus of research has demonstrated that reflection on clinical narratives comes closer than other pedagogical methods to replicating and enhancing the experiential learning required for the development of practical wisdom. Using Benner's methodology of practice articulation, 91 nurse managers wrote and read to a peer group a narrative of their lived experience in the role. The groups interpreted the narratives to extract the skilled knowledge and ethics embedded in the practice of the nurse manager authors. One narrative was chosen for this paper because it is a particularly clear exemplar of how practical wisdom develops in nurse manager practice. Articulating and reflecting on experiential learning led to an understanding of how practical wisdom developed in one nurse manager's practice. Interpretation of the narrative of one nurse manager illustrated how reflection on a complex ethical dilemma was a source of character development for the individual and the peer group. Describing and interpreting how practical wisdom develops for individual nurse managers can be a source of learning for the narrative author and other role incumbents who need to make sound decisions and take prudent action in ethically challenging situations. © 2013 John Wiley & Sons Ltd.

  6. Risk preferences in strategic wildfire decision making: a choice experiment with U.S. wildfire managers.

    PubMed

    Wibbenmeyer, Matthew J; Hand, Michael S; Calkin, David E; Venn, Tyron J; Thompson, Matthew P

    2013-06-01

    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. © 2012 Society for Risk Analysis.

  7. Main caregivers' experiences of managing pain for children with neuroblastoma in Taiwan.

    PubMed

    Lu, Ching-Hui; Huang, Chu-Yu; Park, Jeong-Hwan; Lin, Hung-Ru; Lee, Ya-Ling; Cheng, Su-Fen

    2011-01-01

    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.

  8. Bibliography for nuclear criticality accident experience, alarm systems, and emergency management

    SciTech Connect

    Putman, V.L.

    1995-09-01

    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.

  9. Managing for desired experiences and site preferences: the case of fee-fishing anglers.

    PubMed

    Schuett, Michael A; Pierskalla, Chad D

    2007-02-01

    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.

  10. Managing for Desired Experiences and Site Preferences: The Case of Fee-Fishing Anglers

    NASA Astrophysics Data System (ADS)

    Schuett, Michael A.; Pierskalla, Chad D.

    2007-02-01

    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.

  11. Women's Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study.

    PubMed

    Bilardi, Jade; Walker, Sandra; McNair, Ruth; Mooney-Somers, Julie; Temple-Smith, Meredith; Bellhouse, Clare; Fairley, Christopher; Chen, Marcus; Bradshaw, Catriona

    2016-01-01

    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. 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. 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. 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.

  12. Women’s Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study

    PubMed Central

    Bilardi, Jade; Walker, Sandra; McNair, Ruth; Mooney-Somers, Julie; Temple-Smith, Meredith; Bellhouse, Clare; Fairley, Christopher; Chen, Marcus; Bradshaw, Catriona

    2016-01-01

    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

  13. MicroGen: a MIAME compliant web system for microarray experiment information and workflow management.

    PubMed

    Burgarella, Sarah; Cattaneo, Dario; Pinciroli, Francesco; Masseroli, Marco

    2005-12-01

    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. 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. MicroGen represents a MIAME compliant information system that enables managing workflow and supporting collaborative work in spotted microarray experiment production.

  14. MicroGen: a MIAME compliant web system for microarray experiment information and workflow management

    PubMed Central

    Burgarella, Sarah; Cattaneo, Dario; Pinciroli, Francesco; Masseroli, Marco

    2005-01-01

    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

  15. The Real Time Mission Monitor: A Situational Awareness Tool For Managing Experiment Assets

    NASA Technical Reports Server (NTRS)

    Blakeslee, Richard; Hall, John; Goodman, Michael; Parker, Philip; Freudinger, Larry; He, Matt

    2007-01-01

    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.

  16. An expert system to advise astronauts during experiments: The protocol manager module

    NASA Technical Reports Server (NTRS)

    Haymann-Haber, Guido; Colombano, Silvano P.; Groleau, Nicolas; Rosenthal, Don; Szolovits, Peter; Young, Laurence R.

    1990-01-01

    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.

  17. Managing Meanings of Embodied Experiences Theory: Toward a Discursive Understanding of Becoming Healthier.

    PubMed

    Field-Springer, Kimberly; Margavio Striley, Katie

    2017-04-12

    We advance a new theoretical approach for interpreting health communication from an embodied, intersubjective perspective. We propose individuals experience the world as bodied beings and must make sense of their embodied experiences by managing meanings of who they are in the world (being), the actions they perform (doing), and who they want to become (directed becoming). We call this theory managing meanings of embodied experiences (MMEE). Guided by the philosophies of phenomenology, pragmatism, and feminism, we provide a three-fold framework for exploring individuals' management of health meanings during interactions with others in society. The first layer-being-demonstrates a mutually constituting, intersubjective presence with others, whereby we attend to our own and another's embodied expressions accomplished communicatively. The second layer-doing-appreciates experiences directed by personal and social values both perceived and conceived during the unfolding of coordinated communicative events. The third layer-directed becoming-highlights our ability to mindfully direct changes to our identity and actions through critical reflection; it is the transformative potential of our reflective synthesis of being and doing.

  18. Quality reforms in Danish home care - balancing between standardisation and individualisation.

    PubMed

    Rostgaard, Tine

    2012-05-01

    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.

  19. Management of colon perforation during percutaneous nephrolithotomy: 12 years of experience in a referral center.

    PubMed

    Maghsoudi, Robab-; Etemadian, Massoud; Kashi, Amir Hossein; Mehravaran, Kaveh

    2017-08-09

    The management protocol for colon perforation during percutaneous nephrolithotomy (PNL) is controversial due to the scarcity of reported cases and their management diversity. We present our management experience of colon perforation during PNL. All PNL operations between April 2004 and September 2016 in our center (N=11376) were reviewed for the occurrence and management of colon perforation. We typically performed PNL with insertion of nephrostomy tube before mid 2007. After mid 2007, we typically perform tubeless PNL and inspect access tract for evidence of organ injury especially colon perforation during nephroscope removal. 17 colon perforations happened during the study period. The first 3 cases were diagnosed postoperatively and in 2 patients open surgery was employed for treatment. The next 14 cases were diagnosed intraoperatively (n=12) or in the early postoperative period (n=2) and were managed by broad spectrum antibiotics, bowel rest, and urinary Dj and Foley catheter insertion. Percutaneous retroperitoneal drain was inserted for only one patient after intraoperative diagnosis of colon perforation. The other 13 patients were managed without insertion of such drains. For one patient, postoperative insertion of retroperitoneal drain was attempted due to collection of urine. In other patients (n=12), the management was successful with no need for an operation. Complications according to Clavien-Dindo grade in these 17 patients were grade II, IIIa and IIIb in 13, 1, and 3 patients respectively. Colon perforation during PNL which is diagnosed intraoperatively or in the very early postoperative period can be managed conservatively. It seems possible not to insert colostomy or retroperitoneal drains in stable patients with early or intraoperative diagnosis. In cases of delayed diagnosis, or deterioration of the patient on tubeless management, the standard protocol should be performed including insertion of colonic or retroperitoneal drain or surgery especially

  20. The pillars of health management education: lessons from the CEE experience.

    PubMed

    Aaronson, W E; West, D J; Heshmat, S; Ramirez, B

    1998-01-01

    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.

  1. Engineering and management experience at Texas A&M Transportation Institute

    NASA Astrophysics Data System (ADS)

    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

  2. Self-management experiences among men and women with type 2 diabetes mellitus: a qualitative analysis

    PubMed Central

    2012-01-01

    Background The purpose of this study is to better understand differences in diabetes self-management, specifically needs, barriers and challenges among men and women living with type 2 diabetes mellitus (T2DM). Methods 35 participants were recruited from a diabetes education center (DEC) in Toronto, Canada. Five focus groups and nine individual interviews were conducted to explore men and women's diabetes self-management experiences. Results The average age of participants was 57 years and just over half (51.4%) were female. Analyses revealed five themes: disclosure and identity as a person living with diabetes; self-monitoring of blood glucose (SMBG); diet struggles across varying contexts; utilization of diabetes resources; and social support. Women disclosed their diabetes more readily and integrated management into their daily lives, whereas men were more reluctant to tell friends and family about their diabetes and were less observant of self-management practices in social settings. Men focused on practical aspects of SMBG and experimented with various aspects of management to reduce reliance on medications whereas women focused on affective components of SMBG. Women restricted foods from their diets perceived as prohibited whereas many men moderated their intake of perceived unhealthy foods, except in social situations. Women used socially interactive resources, like education classes and support groups whereas men relied more on self-directed learning but also described wanting more guidance to help navigate the healthcare system. Finally, men and women reported wanting physician support for both affective and practical aspects of self-management. Conclusions Our findings highlight the differences in needs and challenges of diabetes self-management among men and women, which may inform gender-sensitive diabetes, care, counseling and support. PMID:23249410

  3. Children's experiences of managing Type 1 diabetes in everyday life: a thematic synthesis of qualitative studies.

    PubMed

    Rankin, D; Harden, J; Jepson, R; Lawton, J

    2017-08-01

    To explore the everyday experiences of children (aged ≤ 12 years) with Type 1 diabetes to identify factors that help or hinder diabetes self-management practices. Eight databases (Embase, Medline, CINAHL, Web of Science, PsychInfo, ASSIA, ERIC and ProQuest Dissertations) were searched in 2016 to identify qualitative studies exploring children's views about self-managing diabetes. Data were extracted, coded and analysed using thematic synthesis. Eighteen studies from five countries were included in the review. Synthesis of studies' findings resulted in the identification of three overarching analytical themes. The first theme, 'Understandings of diabetes and involvement in self-management', outlines ways in which children understand diabetes and develop self-management responsibilities. The second theme, 'Disruption to life and getting on with it', reports children's frustrations at disruptions to everyday life when managing diabetes, and how attempts to appear normal to family and friends affect self-management practices. The third theme, 'Friends' support', describes how friends' reactions and responses to diabetes affect children's ability to appear normal and willingness to disclose information about diabetes, and support provided by 'informed friends', or peers with diabetes. Although the synthesis has identified how children's everyday life experiences inform ways in which they undertake diabetes self-management, it was not possible to determine new ways to provide support. To help children optimise their glycaemic control, further work should be undertaken to identify their need for support and which takes into account the potential ways in which parents, friends and peers can offer assistance. © 2017 Diabetes UK.

  4. Sport or School? Dreams and Dilemmas for Talented Young Danish Football Players

    ERIC Educational Resources Information Center

    Christensen, Mette Krogh; Sorensen, Jan Kahr

    2009-01-01

    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…

  5. Waiting Time: The De-Subjectification of Children in Danish Asylum Centres

    ERIC Educational Resources Information Center

    Vitus, Kathrine

    2010-01-01

    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…

  6. The Danish large wind turbine program. [feasibility of wind power in a utility grid

    NASA Technical Reports Server (NTRS)

    Pederson, B. M.

    1979-01-01

    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.

  7. Waiting Time: The De-Subjectification of Children in Danish Asylum Centres

    ERIC Educational Resources Information Center

    Vitus, Kathrine

    2010-01-01

    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…

  8. Identifying and describing patients' learning experiences towards self-management of bipolar disorders: a phenomenological study.

    PubMed

    Van den Heuvel, S C G H; Goossens, P J J; Terlouw, C; Van Achterberg, T; Schoonhoven, L

    2015-12-01

    Existing evidence suggest that patient education in promoting self-management strategies of bipolar disorder (BD) is effective. However, results across the full range of service users with BD vary. Learning experiences of service users look to be a crucial factor to take into account when designing, delivering, and evaluating effective interventions that promote self-management in chronic illness. What learning activities service users actually undertake themselves when self-managing BD that might explain varying success rates, and guide future self-management educational programmes has not been examined. Unlike previous studies that suggest that outcomes in self-management depend on individual learning activities, the current study found that learning to self-manage BD takes place in a social network that functions as a learning environment in which it is saved for service users to make mistakes and to learn from these mistakes. Especially, coping with the dormant fear of a recurrent episode and acknowledging the limitations of an individual approach are important factors that facilitate this learning process. Practitioners who provide patient education in order to promote self-management of BD should tailor future interventions that facilitate learning by reflecting on the own experiences of service users. Community psychiatric nurses should keep an open discussion with service users and caregivers, facilitate the use of a network, and re-label problems into learning situations where both play an active role in building mutual trust, thereby enhancing self-management of BD. Existing evidence suggest that self-management education of bipolar disorder (BD) is effective. However, why outcomes differ across the full range of service users has not been examined. This study describes learning experiences of service users in self-managing BD that provide a possible explanation for this varying effectiveness. We have conducted a phenomenological study via face

  9. 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.

    PubMed

    Keller, Amélie; Ängquist, Lars; Jacobsen, Ramune; Vaag, Allan; Heitmann, Berit L

    2017-03-01

    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.

  10. Preparing an Academic Medical Center to Manage Patients Infected With Ebola: Experiences of a University Hospital.

    PubMed

    Schultz, Carl H; Koenig, Kristi L; Alassaf, Wajdan

    2015-10-01

    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.

  11. A concept to empower self-management of psychophysiological wellbeing: preliminary user study experiences.

    PubMed

    Happonen, Antti P; Kaipainen, Kirsikka; Väätänen, Antti; Kinnunen, Marja-Liisa; Myllymäki, Tero; Lappalainen, Päivi; Tuomela, Henna; Rusko, Heikki; Mattila, Elina; Lappalainen, Raimo; Korhonen, Ilkka

    2009-01-01

    In prevention of chronic diseases, health promotion and early interventions based on self-management should be emphasized. Mental health problems and stress cause a significant portion of healthcare costs, and also complicate the management of other chronic conditions. In addition to physical health, psychophysiological and social wellbeing should be equally promoted. Thus, we have previously designed and reported the P4Well or Pervasive Personal and PsychoPhysiological management of WELLness concept for working-age citizens. The concept supports the stress and recovery management on a daily basis through improved health management strategies, and combines psychological methods with personal health technologies. In this paper, we discuss the preliminary user study experiences of ongoing evaluations with two different user groups consisting of: 1) middle-aged men who are using the concept for managing their mental wellbeing or mild depression; and 2) entrepreneurs who are using the concept for coping with stress. Our results provide a preliminary assessment of the role and importance of experts, technologies, and peer-support in the concept.

  12. The articulation of neoliberalism: narratives of experience of chronic illness management in Bulgaria and the UK.

    PubMed

    Vassilev, Ivaylo; Rogers, Anne; Todorova, Elka; Kennedy, Anne; Roukova, Poli

    2017-03-01

    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. © 2016 Foundation for the Sociology of Health & Illness.

  13. The Zero Boil-Off Tank Experiment Contributions to the Development of Cryogenic Fluid Management

    NASA Technical Reports Server (NTRS)

    Chato, David J.; Kassemi, Mohammad

    2015-01-01

    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.

  14. The NASA Integrated Vehicle Health Management Technology Experiment for X-37

    NASA Technical Reports Server (NTRS)

    Schwabacher, Mark; Samuels, Jeff; Brownston, Lee; Clancy, Daniel (Technical Monitor)

    2002-01-01

    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.

  15. Vulvodynia in Arkansas: a survey of Arkansas gynecologists' practice experience and management of vulvar pain.

    PubMed

    Phillips, Amy M; Large, Erin; Bird, T Mac; Hitt, W C; Eastham, Donna G; Pulley, Leavonne; Hutchins, David A

    2013-03-01

    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.

  16. Pharmacy benefit management contracting: an assessment from a recent public sector procurement experience.

    PubMed

    Bae, Jay P; Justice, Paul G

    2002-01-01

    In order to contain the cost of pharmaceuticals while preserving access to medically necessary drugs, Georgia state government competitively selected a single vendor in May of 2000 to manage combined pharmacy benefits under all of the state's health programs. By initiating this procedure, it intended to maximize the state's purchasing power and improve efficiency while streamlining the administrative structure. Synthesizing information from the request for proposal (RFP) and technical proposals submitted by 11 pharmacy benefit managers (PBMs) in response, we describe a model of public sector PBM contracting approach and present an assessment of the industry's service capability and performance statistics. Payers who have been using PBM services may find it interesting to compare their experience with the recent Georgia experience. Those who are considering contracting with a PBM will find the assessment of the PBM industry timely and informative.

  17. The Danish Collaborative Bacteraemia Network (DACOBAN) database.

    PubMed

    Gradel, Kim Oren; Schønheyder, Henrik Carl; Arpi, Magnus; Knudsen, Jenny Dahl; Ostergaard, Christian; Søgaard, Mette

    2014-01-01

    The Danish Collaborative Bacteraemia Network (DACOBAN) research database includes microbiological data obtained from positive blood cultures from a geographically and demographically well-defined population serviced by three clinical microbiology departments (1.7 million residents, 32% of the Danish population). The database also includes data on comorbidity from the Danish National Patient Registry, vital status from the Danish Civil Registration System, and clinical data on 31% of nonselected records in the database. Use of the unique civil registration number given to all Danish residents enables linkage to additional registries for specific research projects. The DACOBAN database is continuously updated, and it currently comprises 39,292 patients with 49,951 bacteremic episodes from 2000 through 2011. The database is part of an international network of population-based bacteremia registries from five developed countries on three continents. The main purpose of the DACOBAN database is to study surveillance, risk, and prognosis. Sex- and age-specific data on background populations enables the computation of incidence rates. In addition, the high number of patients facilitates studies of rare microorganisms. Thus far, studies on Staphylococcus aureus, enterococci, computer algorithms for the classification of bacteremic episodes, and prognosis and risk in relation to socioeconomic factors have been published.

  18. Mogens Jansen: An Interview with a Danish Reading Educator.

    ERIC Educational Resources Information Center

    Engberg, Eva

    1985-01-01

    The president of the Danish Association of Reading Teachers discusses the positive effects of international cooperation on reading education, the influence of society's demands on curriculum, and the instinctive features and benefits of Danish Reading instruction. (FL)

  19. Experiences and own management regarding residual symptoms among people with coeliac disease.

    PubMed

    Jacobsson, Lisa Ring; Milberg, Anna; Hjelm, Katarina; Friedrichsen, Maria

    2017-06-01

    Between 7% and 30% of people with treated coeliac disease suffer from residual symptoms, and there is a knowledge gap about their own management of these symptoms. To explore experiences and management concerning residual symptoms despite a gluten-free diet in people with coeliac disease. A qualitative explorative design with semi-structured interviews with 22 adults with coeliac disease in Sweden. Data were analysed using qualitative content analysis. The informants had, at diagnosis, thought that their symptoms would disappear if they followed a gluten-free diet, but the disease was continuing to have a substantial impact on their lives, despite several years of treatment. They experienced cognitive, somatic as well as mental symptoms, including impact on personality (e.g. having a "shorter fuse", being more miserable or tired). However, only a few informants had sought medical care for persistent symptoms. Instead they tried to manage these by themselves, e.g. abstaining from food during periods of more intense symptom, or using distraction. The management of persistent symptoms resembled thorough detective work. To prevent problems related to residual symptoms the informants used withdrawal of social contact as well as acceptance of their situation. People with treated coeliac disease may experience residual symptoms of both a physical and psychological nature, causing major negative impacts on their lives in different ways. In the light of this, healthcare staff should change their practices regarding the follow-up of these people, and in addition to medical care should provide guidance on management strategies to facilitate the daily life. Furthermore, information to newly diagnosed persons should make them aware of the possibility to experience continued symptoms, despite treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Perceptions and experiences underlying self-management and reporting of symptoms in teens with asthma.

    PubMed

    Mammen, Jennifer R; Rhee, Hyekyun; Norton, Sally A; Butz, Arlene M

    2017-03-01

    Teens often have inadequate asthma self-management and control. However, little is known of their perceptions of or rationales for self-management behaviors. To explore how teens self-manage asthma, including experiences, perceptions, responses to and reporting of symptoms. A case-based, qualitative-descriptive design was used. Data were collected from minority and non-minority teens with controlled and uncontrolled asthma and their respective parents (N = 28). There were four data-collection points, including: (1) a primary teen interview; (2) parent interview; (3) 2-week self-management voice-diary; and (4) follow-up teen interview, incorporating symptom-response card-sorting to map symptoms and associated self-management responses. Seventy data sources were included in the analysis. Teens thought of their asthma symptoms as normal or unusual relative to their personal baseline symptom pattern; Those with uncontrolled asthma normalized higher levels of asthma symptoms than their counterparts with controlled asthma. Second, teens' decisions to treat symptoms of asthma with rescue medication were based on perceived benefits, burdens and accessibility of treatment balanced against perceived normalcy of symptoms. Teens with uncontrolled asthma had substantially higher treatment thresholds and delayed responses to symptoms compared to controlled peers. Third, teens never reported perceived normal symptoms of asthma to parents or providers, who were thus only aware of unusual or visible/audible symptoms. Teen's perceptions of symptoms and understanding of what is normal is the basis for self-management decisions. Improving self-management will likely entail modifying perceptions of symptoms and benefits/burdens of treatment to achieve healthier self-management patterns.

  1. Quality management as knowledge sharing: experiences of the Napa County Health and Human Services Agency.

    PubMed

    Harrison, Lindsay

    2012-01-01

    Lacking a coordinated effort in utilizing data and tracking program outcomes, one agency developed a Quality Management (QM) division to facilitate and manage more effective data use. To support this process, the agency sought to develop a collective, agency-wide understanding and investment in improving and measuring client outcomes. Similarly, the agency also focused efforts on creating a culture of transparency and accountability, with goals of improving service, increasing agency integrity, meeting regulatory compliance, and engaging in effective risk management. Operationalizing the QM initiative involved developing procedures, systems, and guidelines that would facilitate the generation of reliable and accurate data that could be used to inform program change and decision-making. This case study describes this agency's experience in successfully creating and implementing a QM initiative aimed at engaging in greater knowledge sharing.

  2. Pain Management Experiences and the Acceptability of Cognitive Behavioral Strategies Among American Indians and Alaska Natives

    PubMed Central

    Haozous, Emily A.; Doorenbos, Ardith Z.; Stoner, Susan

    2014-01-01

    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

  3. Towards emergency management of natural disasters and critical accidents: the Greek experience.

    PubMed

    Nivolianitou, Zoe; Synodinou, Barbara

    2011-10-01

    This paper presents the findings of a prototype study which sought to identify factors that contribute to effective emergency management in Greece and other European states regarding both natural disasters and critical accidents. The parameters for proper action and successful intervention in operational and logistical are identified based on the document analysis and interviews with emergency responders. The interviews are conducted between state-owned and voluntary organizations. They were asked to rate in terms of their importance for effective emergency response efforts. This paper offers useful information of the organization and management of emergency response in Greece, as well as provides interesting responders' opinions data concerning important priorities in the emergency management area. Despite the fact that the data come from the Greek experience, the conclusions may be applied for a broader use in the emergency planning of disasters. The whole study has been undertaken within the European Pre-Emergencies (PreEm) project.

  4. Are large-scale flow experiments informing the science and management of freshwater ecosystems?

    USGS Publications Warehouse

    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.

    2013-01-01

    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.

  5. Managing Hardware Configurations and Data Products for the Canadian Hydrogen Intensity Mapping Experiment

    NASA Astrophysics Data System (ADS)

    Hincks, A. D.; Shaw, J. R.; Chime Collaboration

    2015-09-01

    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.

  6. Care coordination experiences of people with disabilities enrolled in medicaid managed care.

    PubMed

    Bowers, Anne; Owen, Randall; Heller, Tamar

    2017-10-01

    To understand the impact of experience and contacts with care coordinators on Medicaid Managed Care (MMC) enrollees with disabilities. Primary data was collected from a random sample of 6000 out of the 100,000 people with disabilities enrolled in one state's mandatory MMC program. Surveys were conducted through the mail, telephone, and Internet; 1041 surveys were completed. The sample used for analysis included 442 MMC enrollees who received care coordination. Regression analyses were conducted with the outcomes of number of unmet health care needs and enrollee appraisal of the health services they received. Race, age, gender, and disability variables controlled for demographic differences, and the independent variables included enrollee experience with a care coordinator (coordinator knowledge of enrollee medical history and whether the coordinator took into account enrollee wishes and input) and frequency of contact with a care coordinator. Positive enrollee experiences with care coordinators significantly related to more positive enrollee health service appraisals and fewer unmet health care needs; frequency of contact did not have any significant impacts. People with mental health disabilities and intellectual/developmental disabilities had significantly lower health service appraisals. People with mental health disabilities had significantly more unmet needs. Quality of care coordination, but not frequency of contact alone, is associated with better health outcomes for MMC enrollees. Implications for rehabilitation Care coordination is a core component of managed care and facilitates effective healthcare management for people with complex chronic conditions and disabilities. Better experiences with care coordinators is related to fewer unmet healthcare needs and more positive health care service appraisals for Medicaid managed care enrollees. The continuous development of person-centered care coordination strategies and training programs emphasizing quality

  7. An exploration of health professionals' experiences of medicines management in elderly, hospitalised patients in Abu Dhabi.

    PubMed

    Al Shemeili, Saeed; Klein, Susan; Strath, Alison; Fares, Saleh; Stewart, Derek

    2016-02-01

    Given the multiplicity of issues relating to medicines in the elderly, the structures and processes of medicines management should be clearly defined and described to optimise patient outcomes. There is a paucity of research which provides an in-depth exploration of these elements of medicines management for elderly patients. This study explored health professionals’ experiences of medicines management for elderly, hospitalised patients in Abu Dhabi. Setting The research was conducted in five major hospitals in Abu Dhabi, the United Arab Emirates. Responses to an online sampling questionnaire were used to purposively select nurses, pharmacists and physicians for interview. A semi-structured interview schedule was developed with reference to normalization process theory (NPT) and the theoretical domains framework (TDF) to explore issues of medicines management structures, processes and outcomes. Face-to-face interviews of 20–30 min were audio-recorded, transcribed verbatim and analysed using the Framework Approach. Health professionals’ in-depth experiences of structures, processes and outcomes relating to medicines management. Results Saturation of themes was deemed to occur at interview 27 (7 nurses, 13 pharmacists, 7 physicians). Six key themes and several subthemes emerged from the qualitative analysis, which pertained to the need for: appropriate polypharmacy; a systematic approach to medicines history taking; improved communication and documentation; improved patients’ adherence to medicines; guidelines and policies to support medicines selection, and an educated and trained multidisciplinary team. The most dominant TDF behavioural determinants were issues around: professional role and identity; beliefs about capabilities; beliefs about consequences; environmental context and resources; knowledge, and goals. NPT construct identified little evidence of coherence, cognitive participation, collective action and reflexive monitoring. The key themes

  8. Childhood diabetes: parents' experience of home management and the first year following diagnosis.

    PubMed

    Lowes, L; Lyne, P; Gregory, J W

    2004-06-01

    To explore parents' experience of having a child diagnosed with Type 1 diabetes, managed at home, and their first year following diagnosis. A qualitative, longitudinal study based on 40 in-depth interviews with parents of 20 children with newly diagnosed Type 1 diabetes managed at home from diagnosis in South Wales. Many parents were alarmed by the speed of diagnosis following the gradual progress of their child's symptoms. The provision of timely, adequate information was important to all parents. Although five parents had initial concerns about going home, all parents were subsequently pleased their children had not been hospitalized. Home management enabled parents to integrate diabetes management into the family's normal lifestyle from diagnosis. Professional support, particularly accessible telephone advice, was valued by and reassured parents. Parents experienced a loss of spontaneity, a continuing fear of hypoglycaemia and did not want their child to feel different to other children. Acutely aware of the seriousness of diabetes, they did their utmost to achieve optimal glycaemic control but felt that diabetes could not 'dominate' if they were to lead a 'normal' life. The experience of parents in this study suggests that parents of children with newly diagnosed diabetes are able to cope successfully when given the opportunity to start treatment at home. Therefore, if children with diabetes are clinically well at diagnosis, this study supports home management as a system of care from the parents' point of view. These findings are relevant to clinicians, policy makers and health service managers involved in planning and providing paediatric diabetes care.

  9. Conflict management style, supportive work environments and the experience of work stress in emergency nurses.

    PubMed

    Johansen, Mary L; Cadmus, Edna

    2016-03-01

    To examine the conflict management style that emergency department (ED) nurses use to resolve conflict and to determine whether their style of managing conflict and a supportive work environment affects their experience of work stress. Conflict is a common stressor that is encountered as nurses strive to achieve patient satisfaction goals while delivering quality care. How a nurse perceives support may impact work stress levels and how they deal with conflict. A correlational design examined the relationship between supportive work environment, and conflict management style and work stress in a sample of 222 ED nurses using the expanded nurse work stress scale; the survey of perceived organisational support; and the Rahim organisational conflict inventory-II. Twenty seven percent of nurses reported elevated levels of work stress. A supportive work environment and avoidant conflict management style were significant predictors of work stress. Findings suggest that ED nurses' perception of a supportive work environment and their approach to resolving conflict may be related to their experience of work stress. Providing opportunities for ED nurses in skills training in constructive conflict resolution may help to reduce work stress and to improve the quality of patient care. © 2015 John Wiley & Sons Ltd.

  10. Managing for recreational experience opportunities: the case of hikers in protected areas in Catalonia, Spain.

    PubMed

    Farías Torbidoni, Estela Inés

    2011-03-01

    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.

  11. Managing for Recreational Experience Opportunities: The Case of Hikers in Protected Areas in Catalonia, Spain

    NASA Astrophysics Data System (ADS)

    Farías Torbidoni, Estela Inés

    2011-03-01

    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.

  12. Patient's experience with comorbidity management in primary care: a qualitative study of comorbid pain and obesity.

    PubMed

    Janke, E Amy; Ramirez, Michelle L; Haltzman, Brittany; Fritz, Megan; Kozak, Andrea T

    2016-01-01

    The aim of this research is to examine perceptions of those with comorbid chronic pain and obesity regarding their experience of comorbidity management in primary care settings. Chronic pain and obesity are common comorbidities frequently managed in primary care settings. Evidence suggests individuals with this comorbidity may be at risk for suboptimal clinical interactions; however, treatment experiences and preferences of those with comorbid chronic pain and obesity have received little attention. Semi-structured interviews conducted with 30 primary care patients with mean body mass index=36.8 and comorbid persistent pain. The constant comparative method was used to analyze data. Participants discussed frustration with a perceived lack of information tailored to their needs and a desire for a personalized treatment experience. Participants found available medical approaches unsatisfying and sought a more holistic approach to management. Discussions also focused around the need for providers to initiate efforts at education and motivation enhancement and to show concern for and understanding of the unique difficulties associated with comorbidity. Findings suggest providers should engage in integrated communication regarding weight and pain, targeting this multimorbidity using methods aligned with priorities discussed by patients.

  13. Teaching by example: educating medical students through a weight management experience.

    PubMed

    Schmidt, Susan; Rice, Austin; Kolasa, Kathryn

    2013-09-01

    Surgeons General, the Institute of Medicine, and others have called for physicians to be role models for meeting the obesity epidemic. There are few published reports describing undergraduate medical education obesity curriculum elements. Physician experiences, knowledge, and attitudes have been shown to affect patient counseling behavior of physicians. Required and extra credit obesity educational interventions were designed for third-year family medicine clerkship. For extra credit, students completed a personal weight management experience that spanned at least 4 weeks, included calculations of body mass index (BMI), waist circumference, caloric needs, description of eating and physical activity and monitoring plan, and a final report and reflection. During 2011--2012, 72% of the students completed this extra credit activity with almost all losing or maintaining their weight. Most reflected gratitude for this opportunity and their increased empathy for patients as they struggle with weight issues. Medical students completing a weight management experience during their third-year clerkship can see the effects on their own health while developing empathy for and understanding of the weight management struggles of their patients. Minimal faculty time commitment is required.

  14. Propellant Management in Microgravity- Further Analysis of an Experiment Flown on REXUS-14

    NASA Astrophysics Data System (ADS)

    Strobino, D.; Zumbrunen, E.; Putzu, R.; Pontelandolfo, P.

    2015-09-01

    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.

  15. The Danish Cardiac Rehabilitation Database

    PubMed Central

    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

    2016-01-01

    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

  16. The Danish Cardiac Rehabilitation Database.

    PubMed

    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

    2016-01-01

    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). 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. 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. 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. 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.

  17. The Danish Communicative Developmental Inventories: Validity and Main Developmental Trends

    ERIC Educational Resources Information Center

    Bleses, Dorthe; Vach, Werner; Slott, Malene; Wehberg, Sonja; Thomsen, Pia; Madsen, Thomas O.; Basboll, Hans

    2008-01-01

    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…

  18. Managing a work-life balance: the experiences of midwives working in a group practice setting.

    PubMed

    Fereday, Jennifer; Oster, Candice

    2010-06-01

    To explore how a group of midwives achieved a work-life balance working within a caseload model of care with flexible work hours and on-call work. in-depth interviews were conducted and the data were analysed using a data-driven thematic analysis technique. Children, Youth and Women's Health Service (CYWHS) (previously Women's and Children's Hospital), Adelaide, where a midwifery service known as Midwifery Group Practice (MGP) offers a caseload model of care to women within a midwife-managed unit. 17 midwives who were currently working, or had previously worked, in MGP. analysis of the midwives' individual experiences provided insight into how midwives managed the flexible hours and on-call work to achieve a sustainable work-life balance within a caseload model of care. it is important for midwives working in MGP to actively manage the flexibility of their role with time on call. Organisational, team and individual structure influenced how flexibility of hours was managed; however, a period of adjustment was required to achieve this balance. the study findings offer a description of effective, sustainable strategies to manage flexible hours and on-call work that may assist other midwives working in a similar role or considering this type of work setting. Copyright 2008 Elsevier Ltd. All rights reserved.

  19. China's soil and groundwater management challenges: Lessons from the UK's experience and opportunities for China.

    PubMed

    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

    2016-05-01

    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.

  20. Medicaid beneficiaries in california reported less positive experiences when assigned to a managed care plan.

    PubMed

    McDonnell, Diana D; Graham, Carrie L

    2015-03-01

    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. Project HOPE—The People-to-People Health Foundation, Inc.

  1. Experience with the gLite workload management system in ATLAS Monte Carlo production on LCG

    NASA Astrophysics Data System (ADS)

    Campana, S.; Rebatto, D.; Sciaba', A.

    2008-07-01

    The ATLAS experiment has been running continuous simulated events production since more than two years. A considerable fraction of the jobs is daily submitted and handled via the gLite Workload Management System, which overcomes several limitations of the previous LCG Resource Broker. The gLite WMS has been tested very intensively for the LHC experiments use cases for more than six months, both in terms of performance and reliability. The tests were carried out by the LCG Experiment Integration Support team (in close contact with the experiments) together with the EGEE integration and certification team and the gLite middleware developers. A pragmatic iterative and interactive approach allowed a very quick rollout of fixes and their rapid deployment, together with new functionalities, for the ATLAS production activities. The same approach is being adopted for other middleware components like the gLite and CREAM Computing Elements. In this contribution we will summarize the learning from the gLite WMS testing activity, pointing out the most important achievements and the open issues. In addition, we will present the current situation of the ATLAS simulated event production activity on the EGEE infrastructure based on the gLite WMS, showing the main improvements and benefits from the new middleware. Finally, the gLite WMS is being used by many other VOs, including the LHC experiments. In particular, some statistics will be shown on the CMS experience running WMS user analysis via the WMS

  2. A Meta-Synthesis of Children's Experiences of Postoperative Pain Management.

    PubMed

    Sng, Qian Wen; He, Hong-Gu; Wang, Wenru; Taylor, Beverley; Chow, Aloysius; Klainin-Yobas, Piyanee; Zhu, Lixia

    2017-02-01

    Ineffective management of postoperative pain in children has been reported widely. To improve the effectiveness of postoperative pain management for children, it was necessary to conduct a systematic review to better understand the current knowledge of children's experiences of their postoperative pain management. The aim of this review was to update and synthesize current qualitative research of postoperative pain management based on children's experiences. Qualitative studies published between January 1990 and July 2014 were searched from the electronic databases of CINAHL, MEDLINE, MedNar, ProQuest, PsycINFO, Scopus, ScienceDirect, Sociological Abstracts, and Web of Science. A broad range of search keywords and a three-step search strategy were used. Meta-syntheses were used to summarize the findings from the included studies. Nine qualitative studies were included. Three meta-syntheses from 22 categories based on 72 findings were generated: (a) Children experienced various negative emotions related to postoperative pain, and could assess and express their pain but need their parents as advocates; (b) apart from pain medication, various nonpharmacological strategies to relieve children's postoperative pain were employed by children, parents, and nurses; and (c) suggestions from children for their parents and nurses to better relieve postoperative pain. This review provided preliminary support for increasing the provision of information and education for children and their parents about postoperative conditions, pain, and pain relief strategies. Nurses should also be encouraged to employ more nonpharmacological pain-relieving strategies and build rapport with children and their parents. Future intervention studies are needed to improve children's postoperative experiences. © 2016 Sigma Theta Tau International.

  3. Patient engagement with infection management in secondary care: a qualitative investigation of current experiences.

    PubMed

    Rawson, Timothy M; Moore, Luke S P; Hernandez, Bernard; Castro-Sanchez, Enrique; Charani, Esmita; Georgiou, Pantelis; Ahmad, Raheelah; Holmes, Alison H

    2016-10-31

    To understand patient engagement with decision-making for infection management in secondary care and the consequences associated with current practices. A qualitative investigation using in-depth focus groups. 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. 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Patient engagement with infection management in secondary care: a qualitative investigation of current experiences

    PubMed Central

    Rawson, Timothy M; Moore, Luke S P; Hernandez, Bernard; Castro-Sanchez, Enrique; Charani, Esmita; Georgiou, Pantelis; Ahmad, Raheelah; Holmes, Alison H

    2016-01-01

    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

  5. Deficiencies in education and experience in the management of acute kidney injury among Malawian healthcare workers.

    PubMed

    Evans, R; Rudd, P; Hemmila, U; Dobbie, H; Dreyer, G

    2015-09-01

    Acute kidney injury (AKI) is a common but under-recognised disease process, which carries a high risk of mortality or chronic complications, such as chronic kidney disease and other organ dysfunction. Management of AKI, however, is suboptimal, both in developed settings and in Malawi. This is partly because of deficiencies in AKI education and training. To establish current levels of AKI education in a range of healthcare workers in Malawi. An AKI symposium was held in Blantyre in March 2015. Delegates were asked to complete a survey at the start of the symposium to assess their clinical experience and education in the management of AKI. From 100 delegates, 89 nurses, clinical officers, and physicians, originating from 11 different districts, responded to the survey. Twenty-two percent of healthcare workers (including 28% of district workers of the various cadres and 31% of nurses) had never received teaching on any aspect of renal disease, and 50% (including 63% of district workers and 61% of nurses) had never received teaching specifically on AKI. Forty-four percent did not feel confident managing AKI, and 98% wanted more support managing patients with renal disease. Thirty-four percent (including 55% of district workers) were unaware that haemodialysis was available at Queen Elizabeth Central Hospital (QECH) for the treatment of AKI and 53% (74% of district workers) were unaware that peritoneal dialysis was available for the treatment of AKI in children. Only 33% had ever referred a patient with AKI to QECH. There are deficiencies in education about, and clinical experience in, the management of AKI among Malawian healthcare workers, in addition to limited awareness of the renal service available at QECH. Urgent action is required to address these issues in order to prevent morbidity and mortality from AKI in Malawi.

  6. A Web-based multi-database system supporting distributed collaborative management and sharing of microarray experiment information.

    PubMed

    Burgarella, Sarah; Cattaneo, Dario; Masseroli, Marco

    2006-01-01

    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.

  7. A Web-Based Multi-Database System Supporting Distributed Collaborative Management and Sharing of Microarray Experiment Information

    PubMed Central

    Burgarella, Sarah; Cattaneo, Dario; Masseroli, Marco

    2006-01-01

    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

  8. Exploring the lived experience of adults using prescription opioids to manage chronic noncancer pain

    PubMed Central

    Brooks, Erica A; Unruh, Anita; Lynch, Mary E

    2015-01-01

    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

  9. Thai Nurses' experiences of post-operative pain assessment and its' influence on pain management decisions.

    PubMed

    Chatchumni, Manaporn; Namvongprom, Ampaporn; Eriksson, Henrik; Mazaheri, Monir

    2016-01-01

    While many studies have addressed various issues with regards to pain management, there is limited knowledge about how nurses assess pain in surgical wards. This study aimed to describe Thai nurses' experiences of pain assessment in a surgical ward. A cross-sectional explorative study was conducted. Participants were selected through theoretical sampling. Data was collected through interviews with twelve registered nurses working in surgical wards. Qualitative content analysis guided the analysis of the data. Nurses use a double/triple check system, communicated to the healthcare team via records and protocols, and they used their skills and experiences in pain assessment. The results showed that nurses missed the opportunity to include the patients' self-reported pain in their accounts. Though much evidence of pain was collected, this did not seem to benefit the patients. Furthermore, the nurses were not using instruments to measure pain, which illustrates the potential unreliability of professionals who have differing opinions concerning the patients' pain. Thai nurses worked based on a 'patient-evidence' paradigm when assessing patients in pain; this should be shifted to an evidence-based paradigm. Furthermore, by including the patients' self-reported pain in their assessment, nurses would both improve the quality of the pain assessment and empower patients in their pain management. Pain management practices in Thailand should be improved through education, training, supportive innovation, and collegial competence development in order to improve the quality of care in the post-operative field.

  10. Patient-Reported Experience of Diagnosis, Management, and Burden of Neuroendocrine Tumors

    PubMed Central

    Wolin, Edward M.; Leyden, John; Goldstein, Grace; Kolarova, Teodora; Hollander, Ron; Warner, Richard R.P.

    2017-01-01

    Objectives The aim of this survey was to examine the experience of patients with neuroendocrine tumors (NETs) to raise awareness of the NET-related burden and identify unmet needs. Here, we report data from patients in the United States. Methods Patients with NETs participated in a 25-minute anonymous survey, conducted primarily online from February to May 2014. Survey questions captured information on sociodemographics, clinical characteristics, NET diagnostic experience, disease impact/management, interaction with medical teams, and NETs knowledge/awareness. Results Of 1928 patients who participated globally, the largest percentage was from the United States (39%). Approximately 50% of US patients reported being diagnosed with other conditions before receiving their NET diagnosis, which for 34% took 5 years or more. Patients experienced many symptoms on a daily basis as a result of NETs, which had a substantial negative impact on their work and daily lives. Numerous improvements were suggested by patients, including better access to NET-specific treatments and medical teams/centers and better education for the management of disease-related and treatment-related symptoms. Conclusions This survey demonstrated the significant burden of NETs on patients' lives and identified key areas for improvement in diagnosis and long-term management, including better access to NET-specific treatments and specialist medical teams/centers. PMID:28328615

  11. Experience of using an open source clinical trials data management software system in Kenya.

    PubMed

    Ngari, Moses M; Waithira, Naomi; Chilengi, Roma; Njuguna, Patricia; Lang, Trudie; Fegan, Greg

    2014-11-26

    Clinical trials data management (CTDM) remains one of the many challenges in running state of the art trials in resource-poor settings since most trials do not allocate, or have available, sufficient resources for CTDM and because of poor internet connectivity. Open-source software like OpenClinica could be a solution in such scenarios. In 2007, the KEMRI-Wellcome Trust Research Programme (KWTRP) adopted OpenClinica (OC) community edition, an open-source software system and we share our experience and lessons learnt since its adoption. We have used OC in three different modes; direct remote data entry from sites through Global System for Mobile Communications (GSM) modems, a centralized data centre approach where all data from paper records were entered at a central location and an off-line approach where data entry was done from a copy of database hosted on a field-site server laptop, then data uploaded to a centralized server later. We have used OC in eleven trials/studies with a cumulative number of participants in excess of 6000. These include large and complex trials, with multiple sites recruiting in different regions of East Africa. In the process, we have developed substantial local capacity through hands-on training and mentorship, which we have now begun to share with other institutions in the region. Our experience demonstrates that an open source data management system to manage trials' data can be utilized to international industry standards in resource-poor countries.

  12. Assessment of the probability of introducing Mycobacterium tuberculosis into Danish cattle herds.

    PubMed

    Foddai, Alessandro; Nielsen, Liza Rosenbaum; Krogh, Kaspar; Alban, Lis

    2015-11-01

    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

  13. Rheumatology clinicians’ experiences of brief training and implementation of skills to support patient self-management

    PubMed Central

    2014-01-01

    Background Self-management of arthritis requires informed, activated patients to manage its physical and psychosocial consequences. Patient activation and self-management can be enhanced through the use of cognitive-behavioural approaches, which have a strong evidence base and provide insight into the variation in outcome of patients with ostensibly the same degree of disease activity. However, training for rheumatology health professionals in theory and skills underpinning the facilitation of self-management is not widely available. To develop such training, this study explored rheumatology clinicians’ experiences of a variety of brief skills training courses to understand which aspects were helpful or unhelpful, and to identify the barriers and facilitators of applying the skills in clinical practice. Methods 16 clinicians who had previously attended communication and self-management skills training participated in semi-structured interviews: 3 physicians, 3 physiotherapists, 4 nurses, 6 occupational therapists. Transcripts were analysed (ED) using a hybrid inductive and deductive thematic approach, with a subset independently analysed (SH, RG-H, RJ). Results 3 overarching themes captured views about training undertaken and subsequent use of approaches to facilitate self-management. In ‘putting theory into practice’, clinicians felt that generic training was not as relevant as rheumatology-specific training. They wanted a balance between theory and skills practice, and identified the importance of access to ongoing support. In ‘challenging professional identity’, models of care and working cultures influenced learning and implementation. Training often challenged a tendency to problem-solve on behalf of patients and broadened clinicians’ remit from a primary focus on physical symptoms to the mind and body interaction. In ‘enhanced practice’, clinicians viewed consultations as enhanced after training. Focus had shifted from clinicians’ agendas to

  14. Rheumatology clinicians' experiences of brief training and implementation of skills to support patient self-management.

    PubMed

    Dures, Emma; Hewlett, Sarah; Ambler, Nicholas; Jenkins, Remona; Clarke, Joyce; Gooberman-Hill, Rachael

    2014-03-28

    Self-management of arthritis requires informed, activated patients to manage its physical and psychosocial consequences. Patient activation and self-management can be enhanced through the use of cognitive-behavioural approaches, which have a strong evidence base and provide insight into the variation in outcome of patients with ostensibly the same degree of disease activity. However, training for rheumatology health professionals in theory and skills underpinning the facilitation of self-management is not widely available. To develop such training, this study explored rheumatology clinicians' experiences of a variety of brief skills training courses to understand which aspects were helpful or unhelpful, and to identify the barriers and facilitators of applying the skills in clinical practice. 16 clinicians who had previously attended communication and self-management skills training participated in semi-structured interviews: 3 physicians, 3 physiotherapists, 4 nurses, 6 occupational therapists. Transcripts were analysed (ED) using a hybrid inductive and deductive thematic approach, with a subset independently analysed (SH, RG-H, RJ). 3 overarching themes captured views about training undertaken and subsequent use of approaches to facilitate self-management. In 'putting theory into practice', clinicians felt that generic training was not as relevant as rheumatology-specific training. They wanted a balance between theory and skills practice, and identified the importance of access to ongoing support. In 'challenging professional identity', models of care and working cultures influenced learning and implementation. Training often challenged a tendency to problem-solve on behalf of patients and broadened clinicians' remit from a primary focus on physical symptoms to the mind and body interaction. In 'enhanced practice', clinicians viewed consultations as enhanced after training. Focus had shifted from clinicians' agendas to those of patients, and clinicians reported

  15. Household Financial Management and Women's Experiences of Intimate Partner Violence in the Philippines: A Study Using Propensity Score Methods.

    PubMed

    Tsai, Laura Cordisco

    2016-04-27

    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.

  16. Junior doctors’ experiences of managing patients with medically unexplained symptoms: a qualitative study

    PubMed Central

    Yon, Katherine; Walters, Kate; Lamahewa, Kethakie; Buszewicz, Marta

    2015-01-01

    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

  17. The management of anthelmintic resistance in grazing ruminants in Australasia--strategies and experiences.

    PubMed

    Leathwick, D M; Besier, R B

    2014-07-30

    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

  18. Rehabilitation Experiments in the Context of Adaptive Management, Lower Missouri River

    NASA Astrophysics Data System (ADS)

    Jacobson, R. B.; Gaeuman, D. A.; Elliott, C. M.; Johnson, H. E.; Laustrup, M. S.

    2004-12-01

    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

  19. Competency-based healthcare management education: the Saint Louis University experience.

    PubMed

    Campbell, Claudia R; Lomperis, Ana Maria Turner; Gillespie, Kathleen N; Arrington, Barbara

    2006-01-01

    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.

  20. Improving student knowledge in medication management through an advanced pharmacy practice experience.

    PubMed

    Childress, Bc; Bosler, Julie N; Beck, Morgan

    2013-06-01

    To assess the impact of an advanced pharmacy practice rotation on student therapeutic knowledge, confidence in performing medication therapy management (MTM), and ability to use MTM documentation platforms. Pretest/post-test quasi-experiment. This study was conducted at the InterNational Center for Advanced Pharmacy Services (INCAPS), a licensed pharmacy that provides MTM services to geriatric patients in Louisville, Kentucky. This research evaluated 37 advanced pharmacy practice students who participated in the five-week learning rotation at INCAPS between October 1, 2011, and June 30, 2012. Thirty-seven students were tested before (pretest) beginning the rotation. During the rotation, students performed daily MTM consultations and participated in weekly topic discussions pertaining to relevant areas of chronic disease management and geriatric pharmacotherapy. Following the five-week rotation, a post-test was administered to these 37 students to analyze the changes in their knowledge. The primary outcome measure was the test score for the assessment of chronic disease management and geriatric pharmacotherapy. Compared with baseline, post-test scores showed a statistically significant improvement in the areas that were assessed-osteoporosis, hypertension, diabetes, asthma/chronic obstructive pulmonary disease, and inappropriate medication use in the elderly. A post-rotation survey also reflected positive improvements in student confidence when performing MTM consults for geriatric patients. The five-week MTM-focused rotation at INCAPS with weekly topic discussions and daily MTM consults showed a positive impact on students' ability to manage medication therapy for chronically ill and geriatric patients.