Individual Stress Management Coursework in Canadian Teacher Preparation Programs

ERIC Educational Resources Information Center

Harris, Gregory E.

2011-01-01

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

Current best management practices for harvesting and storing dry hay: a research review

USDA-ARS?s Scientific Manuscript database

The production of high-quality grass or legume hays in humid environments is complicated by slower drying rates, and increased probability of rainfall events compared to hay produced under arid climatic conditions. As a result, hay producers in humid environments often face the management dilemma of...

Development of a web-based tool for projecting costs of managing emerald ash borer in municipal forests

Treesearch

Clifford S. Sadof

2009-01-01

City managers faced with the invasion of emerald ash borer into their urban forests need to plan for the invasion in order to obtain the resources they need to protect the public from harm caused by dying ash trees. Currently, city...

Occurrence detection and selection procedures in healthcare facilities: a comparison across Canada and Brazil.

PubMed

Morita, Plinio P; Burns, Catherine M

2011-01-01

Healthcare institutions face high levels of risk on a daily basis. Efforts have been made to address these risks and turn this complex environment into a safer environment for patients, staff, and visitors. However, healthcare institutions need more advanced risk management tools to achieve the safety levels currently seen in other industries. One of these potential tools is occurrence investigation systems. In order to be investigated, occurrences must be detected and selected for investigation, since not all institutions have enough resources to investigate all occurrences. A survey was conducted in healthcare institutions in Canada and Brazil to evaluate currently used risk management tools, the difficulties faced, and the possibilities for improvement. The findings include detectability difficulties, lack of resources, lack of support, and insufficient staff involvement.

Current issues and challenges in the management of bariatric patients.

PubMed

Bell, Sue Ellen

2005-01-01

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

Micro-Scale Avionics Thermal Management

NASA Technical Reports Server (NTRS)

Moran, Matthew E.

2001-01-01

Trends in the thermal management of avionics and commercial ground-based microelectronics are converging, and facing the same dilemma: a shortfall in technology to meet near-term maximum junction temperature and package power projections. Micro-scale devices hold the key to significant advances in thermal management, particularly micro-refrigerators/coolers that can drive cooling temperatures below ambient. A microelectromechanical system (MEMS) Stirling cooler is currently under development at the NASA Glenn Research Center to meet this challenge with predicted efficiencies that are an order of magnitude better than current and future thermoelectric coolers.

Changing Forest Values and Ecosystem Management

Treesearch

David N. Bengston

1994-01-01

There is substantial evidence that we are currently in a period of rapid and significant change in forest values. Some have charged that managing forests in ways that are responsive to diverse and changing forest values is the main challenge faced by public forest managers. To tackle this challenge, we need to address the following questions: (1) What is the nature of...

Non-face-to-face consultations and communications in primary care: the role and perspective of general practice managers in Scotland.

PubMed

Hanna, Lisa; May, Carl; Fairhurst, Karen

2011-01-01

Practice managers play an important role in the organisation and delivery of primary care, including uptake and implementation of technologies. Little is currently known about practice managers' attitudes to the use of information and communication technologies, such as email or text messaging, to communicate or consult with patients. To investigate practice managers' attitudes to non-face-to-face consultation/communication technologies in the routine delivery of primary care and their role in the introduction and normalisation of these technologies. We carried out a mixed-methods study in Scotland, UK. We invited all practice managers in Scotland to take part in a postal questionnaire survey. A maximum variation sample of 20 survey respondents participated subsequently in in-depth qualitative interviews. Practice managers supported the use of new technologies for routine tasks to manage workload and maximise convenience for patients, but a range of contextual factors such as practice list size, practice deprivation area and geographical location affected whether managers would pursue the introduction of these technologies in the immediate future. The most common objections were medico-legal concerns and lack of perceived patient demand. Practice managers are likely to play a central role in the introduction of new consultation/communication technologies within general practice. They hold varying views on the appropriateness of these technologies, influenced by a complex mix of contextual characteristics. Managers from areas in which the ethos of the practice prioritises personalised care in service delivery are less enthusiastic about the adoption of remote consultation/communication technologies.

Implementing a Nurse Manager Profile to Improve Unit Performance.

PubMed

Krugman, Mary E; Sanders, Carolyn L

2016-06-01

Nurse managers face significant pressures in the rapidly changing healthcare environment. Staying current with multiple sources of data, including reports that detail institutional and unit performance outcomes, is particularly challenging. A Nurse Manager Customized Profile was developed at a western academic hospital to provide a 1-page visual of pertinent data to help managers and director supervisors focus coaching to improve unit performance. Use of the Decisional Involvement Scale provided new insights into measuring manager performance.

Project management of life-science research projects: project characteristics, challenges and training needs.

PubMed

Beukers, Margot W

2011-02-01

Thirty-four project managers of life-science research projects were interviewed to investigate the characteristics of their projects, the challenges they faced and their training requirements. A set of ten discriminating parameters were identified based on four project categories: contract research, development, discovery and call-based projects--projects set up to address research questions defined in a call for proposals. The major challenges these project managers are faced with relate to project members, leadership without authority and a lack of commitment from the respective organization. Two-thirds of the project managers indicated that they would be interested in receiving additional training, mostly on people-oriented, soft skills. The training programs that are currently on offer, however, do not meet their needs. Copyright © 2010 Elsevier Ltd. All rights reserved.

Integrated pest management of coffee berry borer in Hawaii and Puerto Rico: current status and prospects

USDA-ARS?s Scientific Manuscript database

The coffee berry borer (CBB), Hypothenemus hampei, is the most significant insect pest of coffee worldwide. Since CBB was detected in Puerto Rico in 2007 and Hawaii in 2010, coffee growers from these islands are facing increased costs, reduced coffee quality, and increased pest management challenges...

Integration of Flux-Based Methods and Triad Principles for DNAPL Site Management, Part II: Review of Flux Measurement Methods

EPA Science Inventory

Managing dense nonaqueous phase liquid (DNAPL) contaminated sites continues to be among the most pressing environmental problems currently faced. One approach that has recently been investigated for use in DNAPL site characterization and remediation is mass flux (mass per unit ar...

Water management: Current and future challenges and research directions

NASA Astrophysics Data System (ADS)

Cosgrove, William J.; Loucks, Daniel P.

2015-06-01

Water distinguishes our planet compared to all the others we know about. While the global supply of available freshwater is more than adequate to meet all current and foreseeable water demands, its spatial and temporal distributions are not. There are many regions where our freshwater resources are inadequate to meet domestic, economic development and environmental needs. In such regions, the lack of adequate clean water to meet human drinking water and sanitation needs is indeed a constraint on human health and productivity and hence on economic development as well as on the maintenance of a clean environment and healthy ecosystems. All of us involved in research must find ways to remove these constraints. We face multiple challenges in doing that, especially given a changing and uncertain future climate, and a rapidly growing population that is driving increased social and economic development, globalization, and urbanization. How best to meet these challenges requires research in all aspects of water management. Since 1965, the journal Water Resources Research has played an important role in reporting and disseminating current research related to managing the quantity and quality and cost of this resource. This paper identifies the issues facing water managers today and future research needed to better inform those who strive to create a more sustainable and desirable future.

[Management and new current French recommendations for tetanus care].

PubMed

Nicolai, Dominique; Farcet, Anaïs; Molines, Catherine; Delalande, Géraldine; Retornaz, Frédérique

2015-06-01

Tetanus is an acute severe disease induced by an exotoxin, often lethal. All cases occur in untreated or inadequately vaccinated patients and mainly in elderly patients who accumulate many risk factors. The current management of wounds faced difficulties in the assessment of immunization status and wound risks status. Indeed, all injuries can potentially lead to tetanus. Minor risks and chronic wounds are mainly found as tetanus cause. Vaccination remains the key element in reducing the morbidity and mortality associated with tetanus. It is estimated that the vaccine's coverage is fairly good, but decreases with age. To improve tetanus prevention, new vaccine recommendations have been established which recommend vaccine's injections at fixed age, but their impact seems to be limited especially in the elderly. The immunochromatographic tests have demonstrated cost-effectiveness in the Emergency department settings. They are currently not available outside hospital while general practionners also face a significant risk. Effectiveness of these tests should be studied in outpatients population including cost-effectiveness.

Integrating Academic Management with Business Planning Activities: The Case of University of Education, Winneba (UEW), Ghana

ERIC Educational Resources Information Center

Owusu-Ansah, Collins; Afful, Deborah

2015-01-01

Currently, public universities are facing chronic problem of underfunding. In a bid to explore more alternative and innovative ways of addressing such underfunding challenges, authorities of universities have sought to inject business activities into the management of the universities. They are now forced to search for additional sources of income…

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

ERIC Educational Resources Information Center

Baumgartner, Mindy S.; Schneider, David E.

2010-01-01

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

Soil Quality Standards Monitoring Program administration and implementation

Treesearch

Randy L. Davis; Felipe Sanchez; Sharon DeHart

2010-01-01

Forest managers and resource scientists and specialists are engaged in a partnership to sustain the natural resource value of our national forests. Managers are faced with deciding which activities provide the best resource benefits with the least resource damage. Many, but not all, aspects of the decision process must be based on the science supporting our current...

Addressing Bullying Problems in Irish Schools and in Cyberspace: A Challenge for School Management

ERIC Educational Resources Information Center

Corcoran, Lucie; Mc Guckin, Conor

2014-01-01

Background: School management, in Ireland and also internationally, are currently faced with the problem of peer aggression among students both in a traditional school context and in a cyber context. Although Irish school principals are obliged to implement policy and procedures to counter bullying among students, there is a need for guidance that…

Skill sets required for the management of military head, face and neck trauma: a multidisciplinary consensus statement.

PubMed

Breeze, John; Blanch, R; Baden, J; Monaghan, A M; Evriviades, D; Harrisson, S E; Roberts, S; Gibson, A; MacKenzie, N; Baxter, D; Gibbons, A J; Heppell, S; Combes, J G; Rickard, R F

2018-05-01

The evolution of medical practice is resulting in increasing subspecialisation, with head, face and neck (HFN) trauma in a civilian environment usually managed by a combination of surgical specialties working as a team. However, the full combination of HFN specialties commonly available in the NHS may not be available in future UK military-led operations, necessitating the identification of a group of skill sets that could be delivered by one or more deployed surgeons. A systematic review was undertaken to identify those surgical procedures performed to treat acute military head, face, neck and eye trauma. A multidisciplinary consensus group was convened following this with military HFN trauma expertise to define those procedures commonly required to conduct deployed, in-theatre HFN surgical combat trauma management. Head, face, neck and eye damage control surgical procedures were identified as comprising surgical cricothyroidotomy, cervico-facial haemorrhage control and decompression of orbital haemorrhage through lateral canthotomy. Acute in-theatre surgical skills required within 24 hours consist of wound debridement, surgical tracheostomy, decompressive craniectomy, intracranial pressure monitor placement, temporary facial fracture stabilisation for airway management or haemorrhage control and primary globe repair. Delayed in-theatre procedures required within 5 days prior to predicted evacuation encompass facial fracture fixation, delayed lateral canthotomy, evisceration, enucleation and eyelid repair. The identification of those skill sets required for deployment is in keeping with the General Medical Council's current drive towards credentialing consultants, by which a consultant surgeon's capabilities in particular practice areas would be defined. Limited opportunities currently exist for trainees and consultants to gain experience in the management of traumatic head, face, neck and eye injuries seen in a kinetic combat environment. Predeployment training requires that the surgical techniques described in this paper are covered and should form the curriculum of future military-specific surgical fellowships. Relevant continued professional development will be necessary to maintain required clinical competency. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Exploring current and potential roles of Australian community pharmacists in gout management: a qualitative study.

PubMed

Counsell, Allyce B; Nguyen, Amy D; Baysari, Melissa T; Kannangara, Diluk R W; McLachlan, Andrew J; Day, Richard O

2018-05-09

Gout is an increasingly prevalent form of inflammatory arthritis. Although effective treatments for gout exist, current management is suboptimal due to low medication adherence rates and treatments that are non-concordant with guidelines. Medications are the mainstay and most effective form of gout management. Thus, there is potential for community pharmacists to play an important primary health care role in gout management, however their current role and their potential to improve management of gout treatment is currently unclear. The purpose of the study is to explore the views of Australian pharmacists on their roles in gout management and to identify factors influencing their involvement in gout management. A convenience sample of community pharmacists were invited to participate using a snowballing recruitment strategy. Semi-structured, face-to-face interviews were conducted with 15 pharmacists of varying age, gender and pharmacy experience. Interviews focused on pharmacists' experiences of managing gout, interactions with people living with gout and their perceived roles and responsibilities in gout management. Interviews were transcribed verbatim and independently analysed by two reviewers to identify themes. The main role of pharmacists reported in gout management was providing patient education. The greatest facilitator to pharmacists involvement in gout management was identified to be pharmacists' good understanding of gout and its management. Barriers to pharmacists involvement were identified to be difficulties in monitoring adherence to gout medications, low priority given to gout in the pharmacy compared to other chronic health conditions, and lack of specific training and/or continuing education in gout prevention and management. Pharmacists can expand their primary health care role in gout management, particularly in the area of ongoing provision of education to people living with gout and in monitoring medication adherence in patients. However, a number of barriers need to be overcome including difficulties in monitoring patient adherence to medications, ensuring a higher priority is given to chronic gout management and providing continuing training to community pharmacists about gout. Implications for pharmacist practice include initiating conversations about medication adherence and education when dispensing medications and undertaking continuing education in gout.

Orientation and mobility training for adults with low vision: a new standardized approach

PubMed Central

Ballemans, Judith; Kempen, Gertrudis IJM

2013-01-01

Background: Orientation and mobility training aims to facilitate independent functioning and participation in the community of people with low vision. Objective: (1) To gain insight into current practice regarding orientation and mobility training, and (2) to develop a theory-driven standardized version of this training to teach people with low vision how to orientate and be safe in terms of mobility. Study of current practice: Insight into current practice and its strengths and weaknesses was obtained via reviewing the literature, observing orientation and mobility training sessions (n = 5) and interviewing Dutch mobility trainers (n = 18). Current practice was mainly characterized by an individual, face-to-face orientation and mobility training session concerning three components: crystallizing client’s needs, providing information and training skills. A weakness was the lack of a (structured) protocol based on evidence or theory. New theory-driven training: A new training protocol comprising two face-to-face sessions and one telephone follow-up was developed. Its content is partly based on the components of current practice, yet techniques from theoretical frameworks (e.g. social-cognitive theory and self-management) are incorporated. Discussion: A standardized, tailor-made orientation and mobility training for using the identification cane is available. The new theory-driven standardized training is generally applicable for teaching the use of every low-vision device. Its acceptability and effectiveness are currently being evaluated in a randomized controlled trial. PMID:22734105

Challenges in the management of community pharmacies in Malaysia

PubMed Central

2017-01-01

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

Development of Human Face Literature Database Using Text Mining Approach: Phase I.

PubMed

Kaur, Paramjit; Krishan, Kewal; Sharma, Suresh K

2018-06-01

The face is an important part of the human body by which an individual communicates in the society. Its importance can be highlighted by the fact that a person deprived of face cannot sustain in the living world. The amount of experiments being performed and the number of research papers being published under the domain of human face have surged in the past few decades. Several scientific disciplines, which are conducting research on human face include: Medical Science, Anthropology, Information Technology (Biometrics, Robotics, and Artificial Intelligence, etc.), Psychology, Forensic Science, Neuroscience, etc. This alarms the need of collecting and managing the data concerning human face so that the public and free access of it can be provided to the scientific community. This can be attained by developing databases and tools on human face using bioinformatics approach. The current research emphasizes on creating a database concerning literature data of human face. The database can be accessed on the basis of specific keywords, journal name, date of publication, author's name, etc. The collected research papers will be stored in the form of a database. Hence, the database will be beneficial to the research community as the comprehensive information dedicated to the human face could be found at one place. The information related to facial morphologic features, facial disorders, facial asymmetry, facial abnormalities, and many other parameters can be extracted from this database. The front end has been developed using Hyper Text Mark-up Language and Cascading Style Sheets. The back end has been developed using hypertext preprocessor (PHP). The JAVA Script has used as scripting language. MySQL (Structured Query Language) is used for database development as it is most widely used Relational Database Management System. XAMPP (X (cross platform), Apache, MySQL, PHP, Perl) open source web application software has been used as the server.The database is still under the developmental phase and discusses the initial steps of its creation. The current paper throws light on the work done till date.

Interdisciplinary transportation education and workforce development modules (ITEWDM).

DOT National Transportation Integrated Search

2014-01-01

The transportation industry will face a shortage of skilled workforce to manage future advanced transportation systems as the current workforce begins to retire. Education and training of future transportation professionals is critical in view of the...

A systematic review of the evidence for 'myths and misconceptions' in acne management: diet, face-washing and sunlight.

PubMed

Magin, Parker; Pond, Dimity; Smith, Wayne; Watson, Alan

2005-02-01

Lay perceptions that diet, hygiene and sunlight exposure are strongly associated with acne causation and exacerbation are common but at variance with the consensus of current dermatological opinion. The objective of this study was to carry out a review of the literature to assess the evidence for diet, face-washing and sunlight exposure in acne management. Original studies were identified by searches of the Medline, EMBASE, AMED (Allied and Complementary Medicine), CINAHL, Cochrane, and DARE databases. Methodological information was extracted from identified articles but, given the paucity of high quality studies found, no studies were excluded from the review on methodological grounds. Given the prevalence of lay perceptions, and the confidence of dermatological opinion in rebutting these perceptions as myths and misconceptions, surprisingly little evidence exists for the efficacy or lack of efficacy of dietary factors, face-washing and sunlight exposure in the management of acne. Much of the available evidence has methodological limitations. Based on the present state of evidence, clinicians cannot be didactic in their recommendations regarding diet, hygiene and face-washing, and sunlight to patients with acne. Advice should be individualized, and both clinician and patient cognizant of its limitations.

Adaptive Management: From More Talk to Real Action

NASA Astrophysics Data System (ADS)

Williams, Byron K.; Brown, Eleanor D.

2014-02-01

The challenges currently facing resource managers are large-scale and complex, and demand new approaches to balance development and conservation goals. One approach that shows considerable promise for addressing these challenges is adaptive management, which by now is broadly seen as a natural, intuitive, and potentially effective way to address decision-making in the face of uncertainties. Yet the concept of adaptive management continues to evolve, and its record of success remains limited. In this article, we present an operational framework for adaptive decision-making, and describe the challenges and opportunities in applying it to real-world problems. We discuss the key elements required for adaptive decision-making, and their integration into an iterative process that highlights and distinguishes technical and social learning. We illustrate the elements and processes of the framework with some successful on-the-ground examples of natural resource management. Finally, we address some of the difficulties in applying learning-based management, and finish with a discussion of future directions and strategic challenges.

Evaluation of an imaging protocol using ultrasound as the primary diagnostic modality in pediatric patients with superficial soft tissue infections of the face and neck.

PubMed

Sethia, Rishabh; Mahida, Justin B; Subbarayan, Rahul A; Deans, Katherine J; Minneci, Peter C; Elmaraghy, Charles A; Essig, Garth F

2017-05-01

To determine the clinical impact of an initiative to use ultrasound (US) as the primary diagnostic modality for children with superficial face and neck infections versus use of computed tomography (CT). Children with a diagnosis of lymphadenitis, face or neck abscess, or face and neck cellulitis were retrospectively evaluated by the otolaryngology service. Patients were separated into two groups based on implementation of a departmental initiative to use US as the primary diagnostic modality. The pre-implementation cohort consisted of patients treated prior to the initiative (2006-2009) and the current protocol cohort consisted of patients treated after the initiative was started (2010-2013). Demographics, use of US or CT, necessity of surgical intervention, and failure of medical management were compared. Three hundred seventy three children were evaluated; 114 patients were included in the pre-implementation cohort and 259 patients were included in the current protocol cohort for comparison. Patients presenting during the current protocol period were more likely to undergo US (pre-implementation vs. current protocol, p-value) (12% vs. 49%, p < 0.0001) and less likely to undergo CT (66% vs. 41%, p < 0.0001) for their initial evaluation. There were no differences in the percentage of children who underwent prompt surgical drainage, prompt discharge without surgery, or trial inpatient observation. There were also no differences in the rate of treatment failure for patients undergoing prompt surgery or prompt discharge on antibiotics. For those patients who underwent repeat evaluation following trial medical management, US was used more frequently in the current protocol period (4% vs. 20%, p = 0.002) with no difference in CT use, selected treatment strategy, or treatment failure rates. Increased use of US on initial evaluation of children with superficial face and neck infections resulted in decreased CT utilization, without negatively impacting outcome. Decreasing pediatric radiation exposure and potential long-term effects is of primary importance. Copyright © 2017. Published by Elsevier B.V.

Challenges to Successful Total Quality Management Implementation in Public Secondary Schools: A Case Study of Kohat District, Pakistan

ERIC Educational Resources Information Center

Suleman, Qaiser; Gul, Rizwana

2015-01-01

The current study explores the challenges faced by public secondary schools in successful implementation of total quality management (TQM) in Kohat District. A sample of 25 heads and 75 secondary school teachers selected from 25 public secondary schools through simple random sampling technique was used. Descriptive research designed was used and a…

Effects of Sudden Oak Death on the crown fire ignition potential of tanoak (Lithocarpus densiflorus)

Treesearch

Howard Kuljian; J. Morgan Varner

2010-01-01

In the face of the sudden oak death (SOD) epidemic, decreasing foliar moisture content (FMC) of tanoak (Lithocarpus densiflorus) has land managers, fire managers, and property owners concerned with the increased possibility of crown fire in affected areas. A need exists to link local SOD-affected foliar moisture content (FMC) values and current FMC...

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

ERIC Educational Resources Information Center

Ravenhall, Mark; Kenway, Mike

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

The Last 100 Days of a Presidency: What Boards Need to Know and Do

ERIC Educational Resources Information Center

Johnson, Sandra S.; Eckel, Peter

2013-01-01

Many boards will find themselves hiring a new president in the near future, as higher education faces unprecedented turnover in its top leaders. Not only must they manage the transition of a new president into the institution, but they must also manage the transition of the current president out. Best practices for the transition are discussed in…

Towards Increasing Business Students' Confidence in Facing an Ethically Confusing Business Environment: A Strategic Management Approach

ERIC Educational Resources Information Center

Fox-Wolfgramm, Susan J.

2010-01-01

This paper presentation will focus on the application of self leadership and strategic management concepts to help make sense of the current global financial crisis and its critical connection with our future business professionals' perceptions of ethical behavior. The author will explore ideas that lead to the strengthening of business students'…

Facilitating the improved management of waste in South Africa through a national waste information system

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

Godfrey, Linda

2008-07-01

Developing a waste information system (WIS) for a country is more than just about collecting routine data on waste; it is about facilitating the improved management of waste by providing timely, reliable information to the relevant role-players. It is a means of supporting the waste governance challenges facing South Africa - challenges ranging from strategic waste management issues at national government to basic operational challenges at local government. The paper addresses two hypotheses. The first is that the identified needs of government can provide a platform from which to design a national WIS framework for a developing country such asmore » South Africa, and the second is that the needs for waste information reflect greater, currently unfulfilled challenges in the sustainable management of waste. Through a participatory needs analysis process, it is shown that waste information is needed by the three spheres of government, to support amongst others, informed planning and decision-making, compliance monitoring and enforcement, community participation through public access to information, human, infrastructure and financial resource management and policy development. These needs for waste information correspond closely with key waste management challenges currently facing the country. A shift in governments approach to waste, in line with national and international policy, is evident from identified current and future waste information needs. However, the need for information on landfilling remains entrenched within government, possibly due to the poor compliance of landfill sites in South Africa and the problems around the illegal disposal of both general and hazardous waste.« less

Progress and challenges to the global waste management system.

PubMed

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

2014-09-01

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

An introduction to global carbon cycle management

USGS Publications Warehouse

Sundquist, Eric T.; Ackerman, Katherine V.; Parker, Lauren; Huntzinger, Deborah N.

2009-01-01

Past and current human activities have fundamentally altered the global carbon cycle. Potential future efforts to control atmospheric CO2 will also involve significant changes in the global carbon cycle. Carbon cycle scientists and engineers now face not only the difficulties of recording and understanding past and present changes but also the challenge of providing information and tools for new management strategies that are responsive to societal needs. The challenge is nothing less than managing the global carbon cycle.

Translating Policy into Practice for Community-Based Management of Rheumatoid Arthritis: Targeting Professional Development Needs among Physiotherapists.

PubMed

Fary, Robyn E; Slater, Helen; Chua, Jason; Briggs, Andrew M

2012-01-01

Introduction. Contemporary health policy promotes delivery of community-based health services to people with musculoskeletal conditions, including rheumatoid arthritis (RA). This emphasis requires a skilled workforce to deliver safe, effective care. We aimed to explore physiotherapy workforce readiness to co-manage consumers with RA by determining the RA-specific professional development (PD) needs in relation to work and educational characteristics of physiotherapists in Western Australia (WA). Methods. An e-survey was sent to physiotherapists regarding their confidence in co-managing people with RA and their PD needs. Data including years of clinical experience, current RA clinical caseload, professional qualifications, and primary clinical area of practice were collected. Results. 273 physiotherapists completed the survey. Overall confidence in managing people with RA was low (22.7-58.2%) and need for PD was high (45.1-95.2%). Physiotherapists with greater years of clinical experience, a caseload of consumers with RA, postgraduate qualifications in musculoskeletal physiotherapy, or who worked in the musculoskeletal area were more confident in managing people with RA and less likely to need PD. Online and face-to-face formats were preferred modes of PD delivery. Discussion. To enable community-based RA service delivery to be effectively established, subgroups within the current physiotherapy workforce require upskilling in the evidence-based management of consumers with RA.

Stormwater quality management in rail transportation--past, present and future.

PubMed

Vo, Phuong Tram; Ngo, Huu Hao; Guo, Wenshan; Zhou, John L; Listowski, Andrzej; Du, Bin; Wei, Qin; Bui, Xuan Thanh

2015-04-15

Railways currently play an important role in sustainable transportation systems, owing to their substantial carrying capacity, environmental friendliness and land-saving advantages. Although total pollutant emissions from railway systems are far less than that of automobile vehicles, the pollution from railway operations should not be underestimated. To date, both scientific and practical papers dealing with stormwater management for rail tracks have solely focused on its drainage function. Unlike roadway transport, the potential of stormwater pollution from railway operations is currently mishandled. There have been very few studies into the impact of its operations on water quality. Hence, upon the realisation on the significance of nonpoint source pollution, stormwater management priorities should have been re-evaluated. This paper provides an examination of past and current practices of stormwater management in the railway industry, potential sources of stormwater pollution, obstacles faced in stormwater management and concludes with strategies for future management directions. Copyright © 2015 Elsevier B.V. All rights reserved.

E-waste: a problem or an opportunity? Review of issues, challenges and solutions in Asian countries.

PubMed

Herat, Sunil; Agamuthu, P

2012-11-01

Safe management of electronic and electrical waste (e-waste/WEEE) is becoming a major problem for many countries around the world. In particular, developing countries face a number of issues with the generation, transboundary movement and management of e-waste. It is estimated that the world generates around 20-50 million tonnes of e-waste annually, most of it from Asian countries. Improper handling of e-waste can cause harm to the environment and human health because of its toxic components. Several countries around the world are now struggling to deal with this emerging threat. Although the current emphasis is on end-of-life management of e-waste activities, such as reuse, servicing, remanufacturing, recycling and disposal, upstream reduction of e-waste generation through green design and cleaner production is gaining much attention. Environmentally sound management (ESM) of e-waste in developing countries is absent or very limited. Transboundary movement of e-waste is a major issue throughout the region. Dealing with the informal recycling sector is a complex social and environmental issue. There are significant numbers of such challenges faced by these countries in achieving ESM of e-waste. This article aims to present a review of challenges and issues faced by Asian countries in managing their e-waste in a sustainable way.

A Survey of the Current Situation of Clinical Biobanks in China.

PubMed

Li, Haiyan; Ni, Mingyu; Wang, Peng; Wang, Xiaomin

2017-06-01

The development of biomedical research urgently needs the support of a large number of high-quality clinical biospecimens. Therefore, human biobanks at different levels have been established successively in China and other countries at a significantly increasing pace in recent years. To better understand the general current state of clinical biobanks in China, we surveyed 42 clinical biobanks based in hospitals and collected information involving their management systems, sharing mechanisms, quality control systems, and informational management systems using closed questionnaire methods. Based on our current information, there has not been such a large-scale survey in China. An understanding of the status and challenges current clinical biobanks face will provide valuable insights for the construction and sustainable development of higher quality clinical biobanks.

Intelligent Transportation Systems (ITS) in the NPS : 2005 baseline inventory and preliminary program assessment

DOT National Transportation Integrated Search

2006-01-19

This report presents the current status of Intelligent Transportation Systems (ITS) within the 398 national parks managed by the National Park Service (NPS), discusses the potential of ITS to address the often unique transportation challenges faced b...

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

EPA Science Inventory

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

Change at Work.

ERIC Educational Resources Information Center

Cappelli, Peter; Bassi, Laurie; Katz, Harry; Knoke, David; Osterman, Paul; Useem, Michael

This book estimates and analyzes the changes currently under way in the U.S. workplace. The book's seven chapters are: (1) "The Pressures To Restructure Employment" (effects of labor law and public policy, increased competitiveness, new markets, financial restructuring, investor pressures, new management techniques, faces and effects of…

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

PubMed

Jeong, Yong Sun; Kim, Jin Sun

2014-01-01

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

EU Water Governance: Striking the Right Balance between Regulatory Flexibility and Enforcement?

EPA Science Inventory

Considering the challenges and threats currently facing water management and the exacerbation of uncertainty by climate change, the need for flexible yet robust and legitimate environmental regulation is evident. The European Union took a novel approach toward sustainable water r...

Wealth from Health: an incentive program for disease and population management: a 12-year project.

PubMed

Ratner, D; Louria, D; Sheffet, A; Fain, R; Curran, J; Saed, N; Bhaskar, S; Quereshi, M; Cable, G

2001-01-01

The future of healthcare is linked with its ability to face the challenges of consumerism. Disease and population management will represent the dominant style of healthcare delivery in the future. This article describes the Wealth from Health programs which utilize current and future technologies to help the healthcare system become a leader in healthcare delivery and to assist many communities at an affordable cost.

Development of a training program to support health care professionals to deliver the SPACE for COPD self-management program

PubMed Central

Blackmore, Claire; Johnson-Warrington, Vicki L; Williams, Johanna EA; Apps, Lindsay D; Young, Hannah ML; Bourne, Claire LA; Singh, Sally J

2017-01-01

Background With the growing burden of COPD and associated morbidity and mortality, a need for self-management has been identified. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed to support self-management in COPD patients. Currently, there is no literature available regarding health care professionals’ training needs when supporting patients with COPD on self-management. Aim This study sought to identify these needs to inform, design and develop a training program for health care professionals being trained to deliver a self-management program in COPD. Methods Fourteen health care professionals from both primary and secondary care COPD services participated in face-to-face semistructured interviews. Thematic analysis was used to produce a framework and identify training needs and views on delivery of the SPACE for COPD self-management program. Components of training were web-based knowledge training, with pre-and posttraining knowledge questionnaires, and a 1-day program to introduce the self-management manual. Feedback was given after training to guide the development of the training program. Results Health care professionals were able to identify areas where they required increased knowledge to support patients. This was overwhelming in aspects of COPD seen to be outside of their current clinical role. Skills in goal setting and behavioral change were not elicited as a training need, suggesting a lack of understanding of components of supporting self-management. An increase in knowledge of COPD was demonstrated following the training program. Conclusion Both knowledge and skill gaps existed in those who would deliver self-management. Analysis of this has enabled a training program to be designed to address these gaps and enable health care professionals to support patients in self-management. PMID:28652720

Development of a training program to support health care professionals to deliver the SPACE for COPD self-management program.

PubMed

Blackmore, Claire; Johnson-Warrington, Vicki L; Williams, Johanna Ea; Apps, Lindsay D; Young, Hannah Ml; Bourne, Claire LA; Singh, Sally J

2017-01-01

With the growing burden of COPD and associated morbidity and mortality, a need for self-management has been identified. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed to support self-management in COPD patients. Currently, there is no literature available regarding health care professionals' training needs when supporting patients with COPD on self-management. This study sought to identify these needs to inform, design and develop a training program for health care professionals being trained to deliver a self-management program in COPD. Fourteen health care professionals from both primary and secondary care COPD services participated in face-to-face semistructured interviews. Thematic analysis was used to produce a framework and identify training needs and views on delivery of the SPACE for COPD self-management program. Components of training were web-based knowledge training, with pre-and posttraining knowledge questionnaires, and a 1-day program to introduce the self-management manual. Feedback was given after training to guide the development of the training program. Health care professionals were able to identify areas where they required increased knowledge to support patients. This was overwhelming in aspects of COPD seen to be outside of their current clinical role. Skills in goal setting and behavioral change were not elicited as a training need, suggesting a lack of understanding of components of supporting self-management. An increase in knowledge of COPD was demonstrated following the training program. Both knowledge and skill gaps existed in those who would deliver self-management. Analysis of this has enabled a training program to be designed to address these gaps and enable health care professionals to support patients in self-management.

Comparison of computing capability and information system abilities of state hospitals owned by Ministry of Labor and Social Security and Ministry of Health.

PubMed

Tengilimoğlu, Dilaver; Celik, Yusuf; Ulgü, Mahir

2006-08-01

The main purpose of this study is to give an idea to the readers about how big and important the computing and information problems that hospital managers as well as policy makers will face with after collecting the Ministry of Labor and Social Security (MoLSS) and Ministry of Health (MoH) hospitals under single structure in Turkey by comparing the current level of computing capability of hospitals owned by two ministries. The data used in this study were obtained from 729 hospitals that belong to both ministries by using a data collection tool. The results indicate that there have been considerable differences among the hospitals owned by the two ministries in terms of human resources and information systems. The hospital managers and decision makers making their decisions based on the data produced by current hospital information system (HIS) would more likely face very important difficulties after merging MoH and MoLSS hospitals in Turkey. It is also possible to claim that the level and adequacy of computing abilities and devices do not allow the managers of public hospitals to use computer technology effectively in their information management practices. Lack of technical information, undeveloped information culture, inappropriate management styles, and being inexperienced are the main reasons of why HIS does not run properly and effectively in Turkish hospitals.

Putting Climate Adaptation on the Map: Developing Spatial Management Strategies for Whitebark Pine in the Greater Yellowstone Ecosystem.

PubMed

Ireland, Kathryn B; Hansen, Andrew J; Keane, Robert E; Legg, Kristin; Gump, Robert L

2018-06-01

Natural resource managers face the need to develop strategies to adapt to projected future climates. Few existing climate adaptation frameworks prescribe where to place management actions to be most effective under anticipated future climate conditions. We developed an approach to spatially allocate climate adaptation actions and applied the method to whitebark pine (WBP; Pinus albicaulis) in the Greater Yellowstone Ecosystem (GYE). WBP is expected to be vulnerable to climate-mediated shifts in suitable habitat, pests, pathogens, and fire. We spatially prioritized management actions aimed at mitigating climate impacts to WBP under two management strategies: (1) current management and (2) climate-informed management. The current strategy reflected management actions permissible under existing policy and access constraints. Our goal was to understand how consideration of climate might alter the placement of management actions, so the climate-informed strategies did not include these constraints. The spatial distribution of actions differed among the current and climate-informed management strategies, with 33-60% more wilderness area prioritized for action under climate-informed management. High priority areas for implementing management actions include the 1-8% of the GYE where current and climate-informed management agreed, since this is where actions are most likely to be successful in the long-term and where current management permits implementation. Areas where climate-informed strategies agreed with one another but not with current management (6-22% of the GYE) are potential locations for experimental testing of management actions. Our method for spatial climate adaptation planning is applicable to any species for which information regarding climate vulnerability and climate-mediated risk factors is available.

Putting Climate Adaptation on the Map: Developing Spatial Management Strategies for Whitebark Pine in the Greater Yellowstone Ecosystem

NASA Astrophysics Data System (ADS)

Ireland, Kathryn B.; Hansen, Andrew J.; Keane, Robert E.; Legg, Kristin; Gump, Robert L.

2018-06-01

Natural resource managers face the need to develop strategies to adapt to projected future climates. Few existing climate adaptation frameworks prescribe where to place management actions to be most effective under anticipated future climate conditions. We developed an approach to spatially allocate climate adaptation actions and applied the method to whitebark pine (WBP; Pinus albicaulis) in the Greater Yellowstone Ecosystem (GYE). WBP is expected to be vulnerable to climate-mediated shifts in suitable habitat, pests, pathogens, and fire. We spatially prioritized management actions aimed at mitigating climate impacts to WBP under two management strategies: (1) current management and (2) climate-informed management. The current strategy reflected management actions permissible under existing policy and access constraints. Our goal was to understand how consideration of climate might alter the placement of management actions, so the climate-informed strategies did not include these constraints. The spatial distribution of actions differed among the current and climate-informed management strategies, with 33-60% more wilderness area prioritized for action under climate-informed management. High priority areas for implementing management actions include the 1-8% of the GYE where current and climate-informed management agreed, since this is where actions are most likely to be successful in the long-term and where current management permits implementation. Areas where climate-informed strategies agreed with one another but not with current management (6-22% of the GYE) are potential locations for experimental testing of management actions. Our method for spatial climate adaptation planning is applicable to any species for which information regarding climate vulnerability and climate-mediated risk factors is available.

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

PubMed

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

2013-01-01

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

Physicians' Practice, Attitudes Toward, and Knowledge of Cancer Pain Management in China.

PubMed

Zhang, Qiongwen; Yu, Chunhua; Feng, Shijian; Yao, Wenxiu; Shi, Huashan; Zhao, Yuwei; Wang, Yongsheng

2015-11-01

To evaluate physicians' current practice, attitudes toward, and knowledge of cancer pain management in China. We conducted a face-to-face survey of physicians (oncologists, internists, hematologists) who are responsible for the care of cancer patient of 11 general hospitals in Sichuan, China between December 2011 and December 2013. Statistical analyses were performed using SPSS (SPSS, Chicago, IL) software. A 23-item questionnaire was designed and distributed to 550 physicians in 11 medical facilities in China. Five hundred (90.90%) physicians responded. About one-third (32.6%) of physicians assessed patients' pain rarely, and 85.5% never or occasionally treated patients' cancer pain together with psychologists. More than half of physicians indicated that opioid dose titration in patients with poor pain control and assessment of the cause and severity of pain were urgently needed knowledge for cancer pain management. Inadequate assessment of pain and pain management (63.0%), patients' reluctance to take opioids (62.2%), and inadequate staff knowledge of pain management (61.4%) were the three most frequently cited barriers to physicians' pain management. Physicians' positive attitudes toward cancer pain management need to be encouraged, and active professional analgesic education programs are needed to improve pain management in China. Wiley Periodicals, Inc.

Coping with Computing Success.

ERIC Educational Resources Information Center

Breslin, Richard D.

Elements of computing success of Iona College, the challenges it currently faces, and the strategies conceived to cope with future computing needs are discussed. The college has mandated computer literacy for students and offers nine degrees in the computerized information system/management information system areas. Since planning is needed in…

An Air Force Guide for Effective Meeting Management

DTIC Science & Technology

2011-05-01

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

Evidence-based practice and research utilization activities among rural nurses.

PubMed

Olade, Rosaline A

2004-01-01

To identify the extent to which rural nurses utilize evidence-based practice guidelines from scientific research in their practice; to describe both previous and current research utilization activities in which they have participated, and to identify the specific barriers they face in their practice settings. Data for this descriptive study were collected through questionnaires with open-ended questions focused on (a) current utilization of nursing research findings, (b) previous involvement in nursing research activities, and (c) participation in medical research activities. The participants were 106 nurses from various practice areas in six rural counties of a southwestern state in the United States. Results revealed that only 20.8% of the participants stated they were currently involved in research utilization, and they were mostly nurses with bachelor's degrees. The two most common areas of current research utilization were pain management and pressure ulcer prevention and management. Barriers to research utilization, such as rural isolation and lack of nursing research consultants, were identified. The types of research utilization activities identified by these nurses indicate how much the facilities in which these nurses work in the rural areas are striving with the utilization of available scientific evidence. Rural nurses face unique barriers related to situational and geographic factors, with implications for nursing administrators, researchers, and educators.

My46: a web-based tool for self-guided management of genomic test results in research and clinical settings

PubMed Central

Tabor, Holly K.; Jamal, Seema M.; Yu, Joon-Ho; Crouch, Julia M.; Shankar, Aditi G.; Dent, Karin M.; Anderson, Nick; Miller, Damon A.; Futral, Brett T.; Bamshad, Michael J.

2016-01-01

A major challenge to implementing precision medicine is the need for an efficient and cost-effective strategy for returning individual genomic test results that is easily scalable and can be incorporated into multiple models of clinical practice. My46 is a web-based tool for managing the return of genetic results that was designed and developed to support a wide range of approaches to results disclosure, ranging from traditional face-to-face disclosure to self-guided models. My46 has five key functions: set and modify results return preferences, return results, educate, manage return of results, and assess return of results. These key functions are supported by six distinct modules and a suite of features that enhance the user experience, ease site navigation, facilitate knowledge sharing, and enable results return tracking. My46 is a potentially effective solution for returning results and supports current trends toward shared decision-making between patient and provider and patient-driven health management. PMID:27632689

Study of nonparticipation in an employee diabetes program.

PubMed

Brna, Stephanie A; Ruisinger, Janelle F; Howard, Patricia A; Barnes, Brian J; Hare, Sarah E

2012-01-01

To determine factors that affect nonparticipation in an employee diabetes program and factors that may increase participation in future employee health programs. Participants in this cross-sectional study were adults with type 1 or type 2 diabetes, 18 to 80 years of age, who were covered by employer insurance but chose not to participate in an employer-sponsored diabetes program. Potential factors affecting program participation were assessed through a face-to-face or mailed survey. Of 204 employees or their dependents eligible for the diabetes program, 75 (37%) chose not to participate. Among the nonparticipants, 46 (61%) were eligible for this study. A total of 22 surveys were collected for a 48% response rate. The majority of those individuals surveyed (91%) were aware of the diabetes program and had been notified by mail (42%) or phone (29%). Of those surveyed, 33% did not believe that program incentives had been sufficiently explained to them. Work schedule was not found to be a determinant of participation. More than one-half (52%) of responders identified satisfaction with their current diabetes management as the most notable reason for nonparticipation in the employee diabetes program. This study demonstrated that the primary reason for program nonparticipation was patient satisfaction with current physician management of their diabetes. In the future, companies offering health programs should emphasize that the program is being offered to supplement and complement current disease state management, not to replace it.

Managing the demands of the preregistration mental health nursing programme: The views of students with mental health conditions.

PubMed

Ramluggun, Pras; Lacy, Mary; Cadle, Martha; Anjoyeb, Mahmood

2018-05-30

An increasing number of students with a pre-existing mental health condition are enrolling on preregistration mental health nursing programmes. The challenges faced by these students in managing the demands of the programme have not been fully explored. Mental health and well-being is an integral part of providing a healthy university in which students can flourish. The purpose of the study was to explore how students with an underlying mental health issue manage the demands of the mental health nursing programme. The outcomes of the study are aimed at informing inclusive teaching and learning and current student support provision. Ethics approval was given. Students from two universities in South East England who met the criterion of having a pre-existing mental health condition when enrolling on the mental health preregistration nursing programme were invited to take part. Nine students took part in the study. Using an interpretative descriptive design, 1:1 face-to-face, audio-taped, semistructured interviews were undertaken. The data were analysed using a framework approach, and this revealed four main themes: timing of disclosure; managing lived experience in learning environments; students' coping mechanisms, and experience of support. Recommendations for practice was that approved education institutes (AEIs) should ensure they have a robust, inclusive practice by implementing strategies to develop these students' resilience, and enhance their learning and the current support provisions. This will ensure the barriers to disclosing their mental health conditions are recognized and minimized to enable these students to fully contribute to their own learning and teaching experience. © 2018 Australian College of Mental Health Nurses Inc.

Education and training initiatives for crisis management in the European Union: a web-based analysis of available programs.

PubMed

Ingrassia, Pier Luigi; Foletti, Marco; Djalali, Ahmadreza; Scarone, Piercarlo; Ragazzoni, Luca; Corte, Francesco Della; Kaptan, Kubilay; Lupescu, Olivera; Arculeo, Chris; von Arnim, Gotz; Friedl, Tom; Ashkenazi, Michael; Heselmann, Deike; Hreckovski, Boris; Khorram-Manesh, Amir; Khorrram-Manesh, Amir; Komadina, Radko; Lechner, Kostanze; Patru, Cristina; Burkle, Frederick M; Fisher, Philipp

2014-04-01

Education and training are key elements of disaster management. Despite national and international educational programs in disaster management, there is no standardized curriculum available to guide the European Union (EU) member states. European- based Disaster Training Curriculum (DITAC), a multiple university-based project financially supported by the EU, is charged with developing a holistic and highly-structured curriculum and courses for responders and crisis managers at a strategic and tactical level. The purpose of this study is to qualitatively assess the prevailing preferences and characteristics of disaster management educational and training initiatives (ETIs) at a postgraduate level that currently exist in the EU countries. An Internet-based qualitative search was conducted in 2012 to identify and analyze the current training programs in disaster management. The course characteristics were evaluated for curriculum, teaching methods, modality of delivery, target groups, and funding. The literature search identified 140 ETIs, the majority (78%) located in United Kingdom, France, and Germany. Master level degrees were the primary certificates granted to graduates. Face-to-face education was the most common teaching method (84%). Approximately 80% of the training initiatives offered multi- and cross-disciplinary disaster management content. A competency-based approach to curriculum content was present in 61% of the programs. Emergency responders at the tactical level were the main target group. Almost all programs were self-funded. Although ETIs currently exist, they are not broadly available in all 27 EU countries. Also, the curricula do not cover all key elements of disaster management in a standardized and competency-based structure. This study has identified the need to develop a standardized competency-based educational and training program for all European countries that will ensure the practice and policies that meet both the standards of care and the broader expectations for professionalization of the disaster and crisis workforce.

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

NASA Astrophysics Data System (ADS)

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

2018-02-01

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

In the face of increasing subspecialisation, how does the specialty ensure that the management of ENT emergencies is timely, appropriate and safe?

PubMed

Rouhani, M J

2016-06-01

The field of ENT surgery is one of the most varied specialties, with numerous subspecialties and continuing divergence. With this evolution there comes, however, a risk that specialists become de-skilled in certain areas. In the case of ENT emergencies, this can be particularly dangerous. Current guidance from relevant UK professional membership bodies regarding emergency surgery provision was inspected and a literature search was performed to identify studies relating to management of ENT emergencies in the context of increasing subspecialisation. The specialty currently has provisions in place to ensure timely, appropriate and safe management of emergencies, in the form of guidelines and emergency clinics; however, there is scope for improvement of the system.

How do older people with sight loss manage their general health? A qualitative study.

PubMed

Burton, Amy E; Gibson, Jonathan M; Shaw, Rachel L

2016-11-01

Older people with sight loss experience a number of barriers to managing their health. The purpose of this qualitative study was to explore how older people with sight loss manage their general health and explore the techniques used and strategies employed for health management. Semi-structured face-to-face interviews were conducted with 30 participants. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Health management challenges experienced included: managing multiple health conditions; accessing information; engaging in health behaviours and maintaining wellbeing. Positive strategies included: joining support groups, clubs and societies; using low vision aids; seeking support from family and friends and accessing support through health and social care services. Healthcare professionals need to be more aware of the challenges faced by older people with sight loss. Improved promotion of group support and charity services which are best placed to share information, provide fora to learn about coping techniques and strategies, and give older people social support to prevent isolation is needed. Rehabilitation and support services and equipment can only be beneficial if patients know what is available and how to access them. Over-reliance on self-advocacy in current healthcare systems is not conducive to patient-centred care. Implications for Rehabilitation Sight loss in older people can impact on many factors including health management. This study identifies challenges to health management and highlights strategies used by older people with sight loss to manage their health. Access to support often relies on patients seeking information for themselves. However, self-advocacy is challenging due to information accessibility barriers. Informal groups and charities play an important role in educating patients about their condition and advising on available support to facilitate health management.

The influence of Thai culture on diabetes perceptions and management.

PubMed

Sowattanangoon, Napaporn; Kotchabhakdi, Naipinich; Petrie, Keith J

2009-06-01

To explore the way Thai patients perceive and manage their diabetes. Using a focused ethnographic approach, face-to-face interviews were conducted at two public hospitals in Bangkok. All interviews (n=27) were audio-taped and transcribed verbatim. Analysis of the interview transcripts was completed thematically. The findings showed that Thai patients manage their diabetes according to their beliefs about diabetes. These beliefs are constructed using both modern and traditional knowledge. For example, some patients explained the cause of their illness as being due to biomedical factors such as genetics, and also cultural factors such as karma from either previous or current lifetimes. The analysis also revealed that some aspects of Thai life facilitate diabetes self-management while other aspects hamper good control of the illness. For example, Buddhist values of moderation contribute positively to dietary change, while, on the other hand, the importance of rice in the Thai diet can impede successful self-management strategies. The results of this research indicate that Thai culture influences diabetes perceptions and management. Culturally appropriate treatment guidelines should be established for diabetes management that give special consideration to the significance and meaning of food and to Buddhist beliefs.

Moving upstream or muddying the waters? Incentives for managing for health.

PubMed

Marks, Linda; Hunter, David J

2005-11-01

The objective of this study was to identify factors influencing the capacity of NHS managers to 'manage for health'. Semi-structured interviews (32) were carried out over the telephone or face to face with national stakeholders (15) and NHS senior managers (17) from four Strategic Health Authorities (SHAs) and five Primary Care Trusts (PCTs) in England. Interviews were transcribed and a qualitative analysis carried out. The current system of targets and incentives prioritised access to acute services, public health skills were too thinly spread, baseline data were inadequate, decision-making for public health investment was fragmented and evidence for effective interventions was scanty. Health improvement targets should be plausible, longer term and locally owned, but key factors in creating a proactive public health organisation were a strong public health ethos, and effective management and leadership skills. Strengthening the NHS's role in managing for health was welcomed, but enthusiasm was tempered by concurrent NHS policy initiatives and incentives pulling in opposing directions. Key NHS policy initiatives have been developed in isolation from each other. While their combined effect remains unpredictable, they may serve to threaten the welcome shift towards managing for health improvement.

Prehospital airway management on rescue helicopters in the United Kingdom.

PubMed

Schmid, M; Mang, H; Ey, K; Schüttler, J

2009-06-01

Adequate equipment is one prerequisite for advanced, out of hospital, airway management. There are no data on current availability of airway equipment on UK rescue helicopters. An internet search revealed all UK rescue helicopters, and a questionnaire was sent to the bases asking for available airway management items. We identified 27 helicopter bases and 26 (96%) sent the questionnaire back. Twenty-four bases (92%) had at least one supraglottic airway device; 16 (62%) helicopters had material for establishing a surgical airway (e.g. a cricothyroidotomy set); 88% of the helicopters had CO(2) detection; 25 (96%) helicopters carried automatic ventilators; among these, four (15%) had sophisticated ventilators and seven (27%) helicopters carried special face masks suitable for non-invasive ventilation. We found a wide variation in the advanced airway management equipment that was carried routinely on air ambulances. Current guidelines for airway management are not met by all UK air ambulances.

Instructional Design Issues for Current and Future Interactive Video Media.

ERIC Educational Resources Information Center

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

2003-01-01

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

Women's Health USA, 2003.

ERIC Educational Resources Information Center

Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Bureau of Maternal and Child Health and Resources Development.

This book provides a collection of current and historical data on some of the most pressing health challenges facing women, their families, and their communities. It is intended to be a concise reference for policymakers and program managers at the federal, state, and local levels. The book brings together the latest available data from various…

Current Issues in Chinese Higher Education. Education and Skills.

ERIC Educational Resources Information Center

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

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

The Implications of Real Options on ERP-Enabled Adoption

ERIC Educational Resources Information Center

Nwankpa, Joseph K.

2012-01-01

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

Gamma irradiation inactivates honey bee fungal, microsporidian, and viral pathogens and parasites

USDA-ARS?s Scientific Manuscript database

Managed honey bee (Apis mellifera) populations are currently facing unsustainable losses due to a variety of factors. Colonies are challenged with brood pathogens, such as the fungal agent of chalkbrood disease, the microsporidian gut parasite Nosema sp., and several viruses. These pathogens may be ...

The Evolution of Teleophthalmology Programs in the United Kingdom: Beyond Diabetic Retinopathy Screening.

PubMed

Sim, Dawn A; Mitry, Danny; Alexander, Philip; Mapani, Adam; Goverdhan, Srini; Aslam, Tariq; Tufail, Adnan; Egan, Catherine A; Keane, Pearse A

2016-02-01

Modern ophthalmic practice in the United Kingdom is faced by the challenges of an aging population, increasing prevalence of systemic pathologies with ophthalmic manifestations, and emergent treatments that are revolutionary but dependent on timely monitoring and diagnosis. This represents a huge strain not only on diagnostic services but also outpatient management and surveillance capacity. There is an urgent need for newer means of managing this surge in demand and the socioeconomic burden it places on the health care system. Concurrently, there have been exponential increases in computing power, expansions in the strength and ubiquity of communications technologies, and developments in imaging capabilities. Advances in imaging have been not only in terms of resolution, but also in terms of anatomical coverage, allowing new inferences to be made. In spite of this, image analysis techniques are still currently superseded by expert ophthalmologist interpretation. Teleophthalmology is therefore currently perfectly placed to face this urgent and immediate challenge of provision of optimal and expert care to remote and multiple patients over widespread geographical areas. This article reviews teleophthalmology programs currently deployed in the United Kingdom, focusing on diabetic eye care but also discussing glaucoma, emergency eye care, and other retinal diseases. We examined current programs and levels of evidence for their utility, and explored the relationships between screening, teleophthalmology, disease detection, and monitoring before discussing aspects of health economics pertinent to diabetic eye care. The use of teleophthalmology presents an immense opportunity to manage the steadily increasing demand for eye care, but challenges remain in the delivery of practical, viable, and clinically proven solutions. © 2016 Diabetes Technology Society.

The Evolution of Teleophthalmology Programs in the United Kingdom

PubMed Central

Sim, Dawn A.; Mitry, Danny; Alexander, Philip; Mapani, Adam; Goverdhan, Srini; Aslam, Tariq; Tufail, Adnan; Egan, Catherine A.; Keane, Pearse A.

2016-01-01

Modern ophthalmic practice in the United Kingdom is faced by the challenges of an aging population, increasing prevalence of systemic pathologies with ophthalmic manifestations, and emergent treatments that are revolutionary but dependent on timely monitoring and diagnosis. This represents a huge strain not only on diagnostic services but also outpatient management and surveillance capacity. There is an urgent need for newer means of managing this surge in demand and the socioeconomic burden it places on the health care system. Concurrently, there have been exponential increases in computing power, expansions in the strength and ubiquity of communications technologies, and developments in imaging capabilities. Advances in imaging have been not only in terms of resolution, but also in terms of anatomical coverage, allowing new inferences to be made. In spite of this, image analysis techniques are still currently superseded by expert ophthalmologist interpretation. Teleophthalmology is therefore currently perfectly placed to face this urgent and immediate challenge of provision of optimal and expert care to remote and multiple patients over widespread geographical areas. This article reviews teleophthalmology programs currently deployed in the United Kingdom, focusing on diabetic eye care but also discussing glaucoma, emergency eye care, and other retinal diseases. We examined current programs and levels of evidence for their utility, and explored the relationships between screening, teleophthalmology, disease detection, and monitoring before discussing aspects of health economics pertinent to diabetic eye care. The use of teleophthalmology presents an immense opportunity to manage the steadily increasing demand for eye care, but challenges remain in the delivery of practical, viable, and clinically proven solutions. PMID:26830492

Review: the use of sodium hypochlorite in endodontics--potential complications and their management.

PubMed

Spencer, H R; Ike, V; Brennan, P A

2007-05-12

Aqueous sodium hypochlorite (bleach) solution is widely used in dental practice during root canal treatment. Although it is generally regarded as being very safe, potentially severe complications can occur when it comes into contact with soft tissue. This paper discusses the use of sodium hypochlorite in dental treatment, reviews the current literature regarding hypochlorite complications, and considers the appropriate management for a dental practitioner when faced with a potentially adverse incident with this agent.

Trans-disciplinary community groups: an initiative for improving healthcare.

PubMed

Sideras, James Demetri

2016-01-01

In the context of budget constraints and the current quality crisis facing UK healthcare, the purpose of this paper is to examine the use of trans-disciplinary community groups (TCG)--an innovative and inexpensive initiative for improving patient care. Using an action research study, TCG was implemented within a private healthcare firm for vulnerable adults. Qualitative data were gathered over 12 months from 33 participants using depth interviews and focus groups. TCG led to improved patient activities and increased patient decision-making and confidence in self-advocacy. Key prerequisites were top management commitment, democratic leadership and employee empowerment. However, staff nurses resisted TCG because they were inclined to using managerial control and their own independent clinical judgements. Whilst the findings from this study should not be generalized across all healthcare sectors, its results could be replicated in contexts where there is wide commitment to TCG and where managers adopt a democratic style of leadership. Researchers could take this study further by exploring the applicability of TCG in public healthcare organizations or other multi-disciplinary service contexts. The findings of this research paper provide policy makers and healthcare managers with practical insights on TCG and the factors that are likely to obstruct and facilitate its implementation. Adopting TCG could enable healthcare managers to ameliorate their services with little or no extra cost, which is especially important in a budget constraint context and the current quality crisis facing UK healthcare.

Glycemic Control in a Clinic-Based Sample of Diabetics in M'Bour Senegal

ERIC Educational Resources Information Center

BeLue, Rhonda; Ndiaye, Khadidiatou; NDao, Fatou; Ba, Fatou Niass Niang; Diaw, Mor

2016-01-01

Background: Sub-Saharan Africa (SSA) including Senegal is faced with a significant and increasing burden of type 2 diabetes. However, little information is available about diabetes management among Senegalese diabetics. Purpose: The current study aims to describe the level of glycemic control among a convenience sample of diabetics who receive…

Five Recession-Driven Strategies for Planning and Managing Campus Facilities

ERIC Educational Resources Information Center

Rudden, Michael S.

2010-01-01

Colleges and universities continue to face significant fiscal challenges in the current recession. A review of ongoing campus facilities planning projects, coupled with a review of more than 30 recent campus master planning requests for proposals and the relevant literature, indicates that colleges and universities are finding innovative ways to…

University and E-Learning Classes in Italy

ERIC Educational Resources Information Center

Capogna, Stefania

2012-01-01

The article explores the use of e-learning in Italian universities. The aim is to understand how the university system has faced this problem or opportunity to date and what weaknesses or developing perspectives may result from multimedia technologies applied to academic teaching management. After a brief review of the current position of Italian…

Teaching the Google-Eyed YouTube Generation

ERIC Educational Resources Information Center

Ashraf, Bill

2009-01-01

Purpose: The purpose of this paper is to report on how the University sector in the UK has undertaken a massive transformation over recent years, resulting in a current mass market. Institutions (and their managers) are facing enormous challenges to establish competitive advantages whilst attending to customer need and focus. A smarter,…

Stakeholder views of management and decision support tools to integrate climate change into Great Lakes Lake Whitefish management

USGS Publications Warehouse

Lynch, Abigail J.; Taylor, William W.; McCright, Aaron M.

2016-01-01

Decision support tools can aid decision making by systematically incorporating information, accounting for uncertainties, and facilitating evaluation between alternatives. Without user buy-in, however, decision support tools can fail to influence decision-making processes. We surveyed fishery researchers, managers, and fishers affiliated with the Lake Whitefish Coregonus clupeaformis fishery in the 1836 Treaty Waters of Lakes Huron, Michigan, and Superior to assess opinions of current and future management needs to identify barriers to, and opportunities for, developing a decision support tool based on Lake Whitefish recruitment projections with climate change. Approximately 64% of 39 respondents were satisfied with current management, and nearly 85% agreed that science was well integrated into management programs. Though decision support tools can facilitate science integration into management, respondents suggest that they face significant implementation barriers, including lack of political will to change management and perceived uncertainty in decision support outputs. Recommendations from this survey can inform development of decision support tools for fishery management in the Great Lakes and other regions.

General concepts in the management of a kidney transplant.

PubMed

Ortiz-Heredia, Luis; Cangiano, Jose L

2011-01-01

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

A Comprehensive Analysis of the Current Status and Unmet Needs in Kidney Transplantation in Southeast Asia

PubMed Central

Chan-on, Chitranon; Sarwal, Minnie M.

2017-01-01

To address the unmet needs in the face of a growing demand for end-stage renal failure management and kidney transplantation in Asia, we have conducted a critical analysis of published literature and national registries to evaluate clinical outcomes and the rates of organ donation in Southeast Asia and the challenges facing these regions with regards to regulation, choice of donor source, and funding. Based on the available data, suggestions are proposed for an advancement of rates of organ donation and access, with emphasis on improved regulation and public education. PMID:28691007

Factoring quality laboratory diagnosis into the malaria control agenda for sub-Saharan Africa.

PubMed

Aidoo, Michael

2013-09-01

Recent progress in malaria control in sub-Saharan Africa has been achieved primarily through provision of insecticide-treated nets, indoor residual spraying, and antimalarial drugs. Although these interventions are important, proper case identification and accurate measurement of their impact depend on quality diagnostic testing. Current availability of diagnostic testing for malaria in sub-Saharan Africa is inadequate to support disease management, prevention programs, and surveillance needs. Challenges faced include a dearth of skilled workforce, inadequate health systems infrastructure, and lack of political will. A coordinated approach to providing pre-service clinical and laboratory training together with systems that support a scale-up of laboratory services could provide means not only for effective malaria case management but also, management of non-malaria febrile illnesses, disease surveillance, and accurate control program evaluation. A synthesis of the challenges faced in ensuring quality malaria testing and how to include this information in the malaria control and elimination agenda are presented.

Women's work. Maintaining a healthy body weight.

PubMed

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

2009-08-01

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

Does the private sector have a role in Canadian healthcare?

PubMed

McGowan, Tom

2004-01-01

The current system of public pay with primarily public management for essential healthcare services has largely been successful. The Romanow and Kirby reports have made compelling arguments for expanding the definition of essential healthcare services to include, among other things, medications. The problem facing Canadians is that expanding services is not feasible under the current structure, as it is not affordable. The rigid adherence to a 45-year-old definition of system structure is hampering our ability to innovate. In an increasingly unresponsive system, the introduction of private management, through the judicious use of private contracts, can improve efficiency and increase accountability, while maintaining the important principle of public funding.

Evaluation of Water Rights to Reveal Hidden Patterns and Trends in Water Resources Management

NASA Astrophysics Data System (ADS)

Grantham, T.; Viers, J. H.

2013-12-01

California's current water management challenges are strongly influenced by the legacy of 19th century legal doctrines, which aim to maximize the appropriation of available water for human uses and benefits. As a consequence and over time, most of the water flowing through the state's rivers and streams has been dedicated through water rights to human uses, limiting potential for sustainable water management and climate change adaptation. This history is recorded in a database of water rights, which contains approximately 50,000 records of diversion and storage projects dating from the early 19th century to the present day. Although water rights records are rarely considered in regional water budgeting, information on the location, age, purpose, and face values of water rights offer insight into the spatial and temporal dimensions of water-use pressures and can be used to identify opportunities for management interventions. Using the state water rights database, we calculated cumulative face-value rights at the HUC12-watershed scale and compared water appropriation volumes with modeled predictions of surface water availability. Total annual allocations of current water rights exceed 340 million-acre feet (4 x 1011 m3), approximately five times the state's mean annual runoff. The total volume of face-value water rights is 25 to 1,000% of annual water availability in major river basins (greater than 400 km2), with the greatest degree of appropriation observed in tributaries to the Sacramento and San Joaquin Rivers and coastal streams in southern California. Trends in water rights appropriation since 1900 indicate periods of rapid demand growth between 1925-1940, 1950-1960, and 1975-1985, which mirror major dam building eras. We illustrate how information on the spatial distribution of water rights, appropriation volumes, and priority of use, can guide strategic planning for re-allocating water for environmental benefits and other management objectives. We also describe how this effort can improve reporting and processing of, and access to, state water rights data for improved decision-making and management of water resources.

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

PubMed

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

2007-01-01

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

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

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

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

1999-07-01

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

Mitigating cyanobacterial harmful algal blooms in aquatic ecosystems impacted by climate change and anthropogenic nutrients.

PubMed

Paerl, Hans W; Gardner, Wayne S; Havens, Karl E; Joyner, Alan R; McCarthy, Mark J; Newell, Silvia E; Qin, Boqiang; Scott, J Thad

2016-04-01

Mitigating the global expansion of cyanobacterial harmful blooms (CyanoHABs) is a major challenge facing researchers and resource managers. A variety of traditional (e.g., nutrient load reduction) and experimental (e.g., artificial mixing and flushing, omnivorous fish removal) approaches have been used to reduce bloom occurrences. Managers now face the additional effects of climate change on watershed hydrologic and nutrient loading dynamics, lake and estuary temperature, mixing regime, internal nutrient dynamics, and other factors. Those changes favor CyanoHABs over other phytoplankton and could influence the efficacy of control measures. Virtually all mitigation strategies are influenced by climate changes, which may require setting new nutrient input reduction targets and establishing nutrient-bloom thresholds for impacted waters. Physical-forcing mitigation techniques, such as flushing and artificial mixing, will need adjustments to deal with the ramifications of climate change. Here, we examine the suite of current mitigation strategies and the potential options for adapting and optimizing them in a world facing increasing human population pressure and climate change. Copyright © 2015 Elsevier B.V. All rights reserved.

A complex case of congenital cystic renal disease

PubMed Central

Cordiner, David S; Evans, Clair A; Brundler, Marie-Anne; McPhillips, Maeve; Murio, Enric; Darling, Mark; Taheri, Sepideh

2012-01-01

This case outlines the potential complexity of autosomal recessive polycystic kidney disease (ARPKD). It highlights the challenges involved in managing this condition, some of the complications faced and areas of uncertainty in the decision making process. With a paucity of published paediatric cases on this subject, this should add to the pool of information currently available. PMID:22605879

Improving Forsyth Technical Community College's Ability to Develop and Maintain Partnerships: Leveraging Technology to Develop Partnerships

ERIC Educational Resources Information Center

Murdock, Alan K.

2017-01-01

Forsyth Technical Community College (FTCC) face a shortage of funding to meet the demands of students, faculty, staff and businesses. Through this practitioner research, the utilization of the college's current customer relationship management (CRM) database advanced. By leveraging technology, the researcher assisted the college in meeting the…

Large-Scale Innovation and Change in UK Higher Education

ERIC Educational Resources Information Center

Brown, Stephen

2013-01-01

This paper reflects on challenges universities face as they respond to change. It reviews current theories and models of change management, discusses why universities are particularly difficult environments in which to achieve large scale, lasting change and reports on a recent attempt by the UK JISC to enable a range of UK universities to employ…

Getting People Involved: The Benefit of Intellectual Capital Management for Addressing HR Challenges

ERIC Educational Resources Information Center

Pook, Katja

2011-01-01

Purpose: This paper aims to explore the benefits of intellectual capital assessment for facing current challenges of human resources work and organizational development. Design/methodology/approach: The paper takes findings of studies on challenges in HR work and maps them with features of intellectual capital assessment methods. It is thus a…

The Effectiveness of "Knowledge Management System" in Research Mentoring Using Knowledge Engineering

ERIC Educational Resources Information Center

Sriwichai, Puangpet; Meksamoot, Komsak; Chakpitak, Nopasit; Dahal, Keshav; Jengjalean, Anchalee

2014-01-01

Currently, many old universities in Thailand have been facing the occurrence of lecturer massive retirement. This leads to the large amount of newly Ph. D. graduate recruitment for taking immediate responsibilities to teach and conduct research without mentoring by senior staff as well as in new universities. Therefore, this paper aims to propose…

Researcher Identity in Transition: Signals to Identify and Manage Spheres of Activity in a Risk-Career

ERIC Educational Resources Information Center

Castelló, Montserrat; Kobayashi, Sofie; McGinn, Michelle K.; Pechar, Hans; Vekkaila, Jenna; Wisker, Gina

2015-01-01

Within the current higher education context, early career researchers (ECRs) face a "risk-career" in which predictable, stable academic careers have become increasingly rare. Traditional milestones to signal progress toward a sustainable research career are disappearing or subject to reinterpretation, and ECRs need to attend to new or…

Teachers' Sensemaking about Implementation of an Innovative Science Curriculum across the Settings of Professional Development and Classroom Enactment

ERIC Educational Resources Information Center

de los Santos, Xeng

2017-01-01

Designing professional development that effectively supports teachers in learning new and often challenging practices remains a dilemma for teacher educators. Within the context of current reform efforts in science education, such as the "Next Generation Science Standards," teacher educators are faced with managing the dilemma of how to…

Experiences of Families with Relatives with Intellectual and Developmental Disabilities in a Consumer-Directed Support Program

ERIC Educational Resources Information Center

Caldwell, Joe

2007-01-01

The current study explores the experiences of families with relatives with intellectual and developmental disabilities participating in a consumer-directed support program in the USA. The Illinois Home Based Support Services Program provides a limited budget to purchase and manage services. However, within recent years the program has faced cuts…

Implementing principles of the integrated control concept 50 years later – current challenges in IPM for arthropod pests

USDA-ARS?s Scientific Manuscript database

Pest management theory and concepts developed fifty years ago as part of the integrated control concept remain at the foundation of IPM today. Implementation of integrated control and subsequently IPM has always been faced with the challenge of carrying out their principles in a rigorous, disciplin...

Photonics industry in China: from current status and trends to the importance of innovation

NASA Astrophysics Data System (ADS)

Fan, Chongcheng

2011-12-01

Current status and trends in various sectors of photonics industry in Mainland China are reviewed, which includes optical fiber communication, optical preform, fiber and cable, photonic devices and chips, LED illumination and display, and photovoltaics. Then, from the challenges and risks they are facing, critical importance of innovation is discussed. In the evolving Innovation Economy, the core competence of a company, an industry or a country is its innovation power and the capability to grab (and manage) talented people.

[Endorsement of risk management and patient safety by certification of conformity in health care quality assessment].

PubMed

Waßmuth, Ralf

2015-01-01

Certification of conformity in health care should provide assurance of compliance with quality standards. This also includes risk management and patient safety. Based on a comprehensive definition of quality, beneficial effects on the management of risks and the enhancement of patient safety can be expected from certification of conformity. While these effects have strong face validity, they are currently not sufficiently supported by evidence from health care research. Whether this relates to a lack of evidence or a lack of investigation remains open. Advancing safety culture and "climate", as well as learning from adverse events rely in part on quality management and are at least in part reflected in the certification of healthcare quality. However, again, evidence of the effectiveness of such measures is limited. Moreover, additional factors related to personality, attitude and proactive action of healthcare professionals are crucial factors in advancing risk management and patient safety which are currently not adequately reflected in certification of conformity programs.

Important, misunderstood, and challenging: a qualitative study of nurses' and allied health professionals' perceptions of implementing self-management for patients with COPD.

PubMed

Young, Hannah M L; Apps, Lindsay D; Harrison, Samantha L; Johnson-Warrington, Vicki L; Hudson, Nicky; Singh, Sally J

2015-01-01

In light of the growing burden of COPD, there is increasing focus on the role of self-management for this population. Currently, self-management varies widely. Little is known either about nurses' and allied health professionals' (AHPs') understanding and provision of self-management in clinical practice. This study explores nurses' and AHPs' understanding and implementation of supported COPD self-management within routine clinical practice. Nurses and AHPs participated in face-to-face semistructured interviews to explore their understanding and provision of COPD self-management, as well as their perceptions of the challenges to providing such care. Purposive sampling was used to select participants from a range of professions working within primary, community, and secondary care settings. Three researchers independently analyzed each transcript using a thematic approach. A total of 14 participants were interviewed. Nurses and AHPs viewed self-management as an important aspect of COPD care, but often misunderstood what it involved, leading to variation in practice. A number of challenges to supporting self-management were identified, which related to lack of time, lack of insight regarding training needs, and assumptions regarding patients' perceived self-management abilities. Nurses and AHPs delivering self-management require clear guidance, training in the use of effective self-management skills, and education that challenges their preconceptions regarding patients. The design of health care services also needs to consider the practical barriers to COPD self-management support for the implementation of such interventions to be successful.

Medicare Disease Management in Policy Context

PubMed Central

Linden, Ariel; Adler-Milstein, Julia

2008-01-01

Interim results of the Medicare health support (MHS) demonstration projects suggest that commercial disease management (DM) is unable to deliver short-term medical cost savings. This is not surprising given the current DM program focus on compliance with process measures that may only lead to cost savings in the long term. A program focused on reducing near-term hospitalizations is more likely to deliver savings during the initial 3-year phase of MHS. If the early trends in MHS are indicative of the final results, CMS will face the decision of whether to abandon commercial DM in favor of other chronic care management strategies. This article supports the upcoming assessment by describing the characteristics of the current commercial DM model that limit its ability to deliver short-term medical cost savings and the changes required to overcome these limitations. PMID:18567239

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

USGS Publications Warehouse

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

2008-01-01

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

Sustainable water future with global implications: everyone's responsibility.

PubMed

Kuylenstierna, J L; Bjorklund, G; Najlis, P

1997-01-01

The current use and management of freshwater is not sustainable in many countries and regions of the world. If current trends are maintained, about two-thirds of the world's population will face moderate to severe water stress by 2025 compared to one-third at present. This water stress will hamper economic and social development unless action is taken to deal with the emerging problems. The Comprehensive Assessment of the Freshwater Resources of the World, prepared by the UN and the Stockholm Environment Institute, calls for immediate action to prevent further deterioration of freshwater resources. Although most problems related to water quantity and quality require national and regional solutions, only a global commitment can achieve the necessary agreement on principles, as well as financial means to attain sustainability. Due to the central and integrated role played by water in human activities, any measures taken need to incorporate a wide range of social, ecological and economic factors and needs. The Assessment thus addresses the many issues related to freshwater use, such as integrated land and water management at the watershed level, global food security, water supply and sanitation, ecosystem requirements, pollution, strengthening of major groups, and national water resource assessment capabilities and monitoring networks. Governments are urged to work towards a consensus regarding global principles and guidelines for integrated water management, and towards their implementation in local and regional water management situations. The alternative development options available to countries facing water stress, or the risk thereof, needs to be considered in all aspects of development planning.

Animal Health and Welfare Issues Facing Organic Production Systems

PubMed Central

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

2013-01-01

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

Homeland Security. Management Challenges Facing Federal Leadership

DTIC Science & Technology

2002-12-01

Security Management Challenges Facing Federal Leadership 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...including attention to management practices and key success factors. HOMELAND SECURITY Management Challenges Facing Federal Leadership www.gao.gov/cgi...significant management and coordination challenges if it is to provide this leadership and be successful in preventing and responding to any future

A case study of the knowledge transfer practices from the perspectives of highly experienced engineers in the aerospace industry

NASA Astrophysics Data System (ADS)

Martin, Deloris

Purpose. The purpose of this study was to describe the existing knowledge transfer practices in selected aerospace companies as perceived by highly experienced engineers retiring from the company. Specifically it was designed to investigate and describe (a) the processes and procedures used to transfer knowledge, (b) the systems that encourage knowledge transfer, (c) the impact of management actions on knowledge transfer, and (d) constraining factors that might impede knowledge transfer. Methodology. A descriptive case study was the methodology applied in this study. Qualitative data were gathered from highly experienced engineers from 3 large aerospace companies in Southern California. A semistructured interview was conducted face-to-face with each participant in a private or semiprivate, non-workplace setting to obtain each engineer's perspectives on his or her company's current knowledge transfer practices. Findings. The participants in this study preferred to transfer knowledge using face-to-face methods, one-on-one, through actual troubleshooting and problem-solving scenarios. Managers in these aerospace companies were observed as having knowledge transfer as a low priority; they tend not to promote knowledge transfer among their employees. While mentoring is the most common knowledge transfer system these companies offer, it is not the preferred method of knowledge transfer among the highly experienced engineers. Job security and schedule pressures are the top constraints that impede knowledge transfer between the highly experienced engineers and their coworkers. Conclusions. The study data support the conclusion that the highly experienced engineers in the study's aerospace companies would more likely transfer their knowledge to those remaining in the industry if the transfer could occur face-to-face with management support and acknowledgement of their expertise and if their job security is not threatened. The study also supports the conclusion that managers should be responsible for the leadership in developing a knowledge-sharing culture and rewarding those who do share. Recommendations. It is recommended that a quantitative study of highly experienced engineers in aerospace be conducted to determine the degree to which knowledge-sharing methods, processes, and procedures may be effective in capturing their knowledge. It is also recommended that a replication of this study be undertaken to include the perspectives of first-line managers on developing a knowledge-sharing culture for the aerospace industry.

Supported self-management for cancer survivors to address long-term biopsychosocial consequences of cancer and treatment to optimize living well.

PubMed

Howell, Doris D

2018-03-01

As individuals are living longer with cancer as a chronic disease, they face new health challenges that require the application of self-management behaviors and skills that may not be in their usual repertoire of self-regulatory health behaviors. Increasing attention is focused on supported self-management (SSM) programs to enable survivors in managing the long-term biopsychosocial consequences and health challenges of survivorship. This review explores current directions and evidence for SSM programs that enable survivors to manage these consequences and optimize health. Cancer survivors face complex health challenges that affect daily functioning and well being. Multiple systematic reviews show that SSM programs have positive effects on health outcomes in typical chronic diseases. However, the efficacy of these approaches in cancer survivors are in their infancy; and the 'one-size' fits all approach for chronic disease self-management may not be adequate for cancer as a complex chronic illness. This review suggests that SSM has promising potential for improving health and well being of cancer survivors, but there is a need for standardizing SSM for future research. Although there is increasing enthusiasm for SSM programs tailored to cancer survivors, there is a need for further research of their efficacy on long-term health outcomes.

Psychosocial working conditions and diabetes self-management at work: A qualitative study.

PubMed

Loerbroks, Adrian; Nguyen, Xuan Quynh; Vu-Eickmann, Patricia; Krichbaum, Michael; Kulzer, Bernhard; Icks, Andrea; Angerer, Peter

2018-06-01

We conducted a qualitative study to expand our current understanding of the potential link between psychosocial working conditions and diabetes self-management at work. Thirty employed adults with diabetes mellitus living in Germany (n = 19 with type 1, n = 11 with type 2, 57% female, aged 24-64 years) were recruited. Using a topic guide, we carried out in-depth interviews in face-to-face contact or by telephone. Interviews were transcribed and content-analyzed using MaxQDA. Psychosocial working conditions perceived to detrimentally affect self-management activities included, amongst others, a high workload, poor job control, unhygienic working environments, the requirement to work under high or fluctuating temperature, perceived social norms at the workplace, and the attitude to prioritize work-related demands as opposed to diabetes-related demands. The types of self-management activities considered to be adversely affected related to glucose monitoring, insulin injections, dietary control, the ability to recognize hypoglycemia and health care use. Various types of occupational psychosocial factors may determine diabetes self-management practices at the workplace. Quantitative studies are needed to confirm our observations. Subsequently, interventions could be developed and evaluated to improve opportunities to adequately engage into diabetes self-management at work. Copyright © 2018 Elsevier B.V. All rights reserved.

One Northwest community - People, salmon, rivers, and the sea: Towards sustainable salmon fisheries

USGS Publications Warehouse

MacDonald, Donald D.; Steward, Cleveland R.; Knudsen, E. Eric; Knudsen, E. Eric; Steward, Cleveland R.; MacDonald, Donald; Williams, Jack E.; Reiser, Dudley W.

1999-01-01

Pacific salmon management is in crisis. Throughout their range, salmon and steelhead populations are being adversely affected by human activities. Without coordinated, effective, and timely action, the future of the Pacific salmon resource is most certainly in doubt. To address the challenges that are currently facing salmon management, concerned citizens representing a diverse array of government agencies and non-governmental organizations have agreed to cooperate in the development of a Sustainable Fisheries Strategy for west coast salmon and steelhead populations. The Strategy builds on the contents of this book, resulting from the Sustainable Fisheries Conference and subsequent community- and watershed-based citizen forums. This chapter presents the key elements of the Strategy including a common vision for the future, a series of guiding principles, and specific strategies for supporting sustainable fisheries. As such, the Strategy embraces an ecosystem-based approach to managing human activities, rather than the traditional egocentric approach to managing salmonid populations and associated habitats. A system of community-based, watershed-oriented councils, including all stakeholders and agency representatives, is proposed for effective transition to ecosystem-based salmon and steelhead management. It is our hope that everyone involved in Pacific salmon management will embrace both the spirit and the specific elements of the Sustainable Fisheries Strategy as we face the difficult challenges ahead.

Engineering for reliability in at-home chronic disease management

PubMed Central

Kendall, Logan; Eschler, Jordan; Lozano, Paula; McClure, Jennifer B.; Vizer, Lisa M.; Ralston, James D.; Pratt, Wanda

2014-01-01

Individuals with chronic conditions face challenges with maintaining lifelong adherence to self-management activities. Although reminders can help support the cognitive demands of managing daily and future health tasks, we understand little of how they fit into people’s daily lives. Utilizing a maximum variation sampling method, we interviewed and compared the experiences of 20 older adults with diabetes and 19 mothers of children with asthma to understand reminder use for at-home chronic disease management. Based on our participants’ experiences, we contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance. Furthermore, we identify key principles from reliability engineering that both explain current behavior and suggest strategies to improve patient reminder systems. PMID:25954384

Engineering for reliability in at-home chronic disease management.

PubMed

Kendall, Logan; Eschler, Jordan; Lozano, Paula; McClure, Jennifer B; Vizer, Lisa M; Ralston, James D; Pratt, Wanda

2014-01-01

Individuals with chronic conditions face challenges with maintaining lifelong adherence to self-management activities. Although reminders can help support the cognitive demands of managing daily and future health tasks, we understand little of how they fit into people's daily lives. Utilizing a maximum variation sampling method, we interviewed and compared the experiences of 20 older adults with diabetes and 19 mothers of children with asthma to understand reminder use for at-home chronic disease management. Based on our participants' experiences, we contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance. Furthermore, we identify key principles from reliability engineering that both explain current behavior and suggest strategies to improve patient reminder systems.

Weight management for adolescents with intellectual and developmental disabilities: Rationale and design for an 18month randomized trial.

PubMed

Donnelly, J E; Ptomey, L T; Goetz, J R; Sullivan, D K; Gibson, C A; Greene, J L; Lee, R H; Mayo, M S; Honas, J J; Washburn, R A

2016-11-01

Adolescents with intellectual and developmental disabilities (IDD) are an underserved group in need of weight management. However, information regarding effective weight management for this group is limited, and is based primarily on results from small, non-powered, non-randomized trials that were not conducted in accordance with current weight management guidelines. Additionally, the comparative effectiveness of emerging dietary approaches, such as portion-controlled meals (PCMs) or program delivery strategies such as video chat using tablet computers have not been evaluated. Therefore, we will conduct an 18month trial to compare weight loss (6months) and maintenance (7-18months) in 123 overweight/obese adolescents with mild to moderate IDD, and a parent, randomized to a weight management intervention delivered remotely using FaceTime™ on an iPad using either a conventional meal plan diet (RD/CD) or a Stop Light diet enhanced with PCMs (RD/eSLD), or conventional diet delivered during face-to-face home visits (FTF/CD). This design will provide an adequately powered comparison of both diet (CD vs. eSLD) and delivery strategy (FTF vs. RD). Exploratory analyses will examine the influence of behavioral session attendance, compliance with recommendations for diet (energy intake), physical activity (min/day), self-monitoring of diet and physical activity, medications, and parental variables including diet quality, physical activity, baseline weight, weight change, and beliefs and attitudes regarding diet and physical activity on both weight loss and maintenance. We will also complete a cost and contingent valuation analysis to compare costs between RD and FTF delivery. Copyright © 2016. Published by Elsevier Inc.

Navy Occupational Health Information Management System (NOHIMS). Environmental Exposure Module. Operators’ Guide

DTIC Science & Technology

1987-01-01

be recorded. Obviously, without the close transaction the module cannot maintain the current status of each boundary. 4-1 0% Sle.t SOUNDARY tD NUMBER...HOp: 134 (MIMS) ... 0KI YES//-.. (YES) ARE YOU ADDING A NEW EMPLOYEE (THE 11TH FOR THIS IOUNDARY)9 Y (YES) RESPIRATOR TYPE: 1r~PF HALF FACE, DUST FUME

Current trends in the management of aspen and mixed aspen forests for sustainable production

Treesearch

A. J. David; John C. Zasada; D. W. Gilmore; S. M. Landhausser

2001-01-01

Quaking aspen (Populus tremuloides Michx.) is a remarkable species that performs several significant ecological roles throughout its range while at the same time is facing ever-increasing harvesting pressure. Although its full product potential remains untapped, aspen utilization has increased noticeably in the past 15 years as it has become a desired species for...

Schools as Architecture for Newcomers and Strangers: The Perfect School as Public School?

ERIC Educational Resources Information Center

Masschelein, Jan; Simons, Maarten

2010-01-01

Background/Context: The article reflects on the public role of education on the occasion of the 50th anniversary of the publication of Hannah Arendt's essay, "The Crisis in Education" and in facing the current transformation of public policy into "new public management." Purpose/Objective/Research Question/Focus of Study: Based on Arendt's essay,…

The Effects of a Strengths-Based Assessment and Development Program on First-Term Masters of Business Administration Students and Future Academic Success

ERIC Educational Resources Information Center

Hohn, Michael C.

2009-01-01

Adults returning to graduate school to acquire a master of business administration (MBA) degree face a myriad of challenges as they attempt to manage academic responsibilities, work, family, and social obligations. Currently, a number of educational professionals only look to identify and remediate student deficiencies. Developing existing…

A perspective on laboratory utilization management from Canada.

PubMed

Naugler, Christopher

2014-01-01

Utilization, particularly in chemistry and molecular testing, is growing rapidly in Canada at a time when laboratory budgets are shrinking. Canadian laboratories face particular challenges as the prevailing funding model limits the scope for new revenue generation. Aggressive and coordinated interventions to reduce over-utilization will be necessary to ensure the long-term viability of the current system. © 2013.

An alternative incentive structure for wildfire management on national forest land.

Treesearch

Geoffrey H. Donovan; Thomas C. Brown

2005-01-01

Wildfire suppression expenditures on national forest land have increased over the last 35 years, exceeding US $l billion in 2000 and 2002. These increases in expenditure have been attributed, in part, to a century of aggressive wildfire suppression, resulting in a buildup of fuel on the nation's forests. The efficiency of the current incentive structure faced by...

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

ERIC Educational Resources Information Center

Williamson, Charles E.

2010-01-01

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

A Study of the Impact of a Leadership Development Program on a Community College's Front-Line and Middle Managers

ERIC Educational Resources Information Center

Adcock-Shantz, Jennifer K.

2011-01-01

Current research indicates that community colleges are facing what has been termed a "leadership crisis" due to the high number of Baby Boomers retiring and those planning to retire in the next several years (McCall, 2006; Bagnato, 2004; Shults, 2001). In 2006, the American Association of Community Colleges recommended community colleges…

Pearls and pitfalls of deformity correction and limb lengthening via monolateral external fixation.

PubMed Central

Noonan, K. J.; Price, C. T.

1996-01-01

In conclusion, monolateral external fixation can be effectively utilized in the management of limb length discrepancy and angular deformity. This manuscript outlines the pertinent theory, application and problems important in these cases. When faced with specific congenital conditions the surgeon is encouraged to reference relevant literature that is more focused than the current paper. PMID:9129275

Tapping the Principal Pipeline: Identifying Talent for Future School Leadership in the Absence of Formal Succession Management Programs

ERIC Educational Resources Information Center

Myung, Jeannie; Loeb, Susanna; Horng, Eileen

2011-01-01

Purpose: In light of the difficulty many districts face finding quality principal candidates, this article explores an informal recruitment mechanism of teachers to become principals, which the authors call tapping. The authors assess the extent to which current teachers are being approached by school leaders to consider leadership and whether…

Teaching a Cognitive Behavioral Strategy to Manage Emotions Rational Emotive Behavior Therapy in an Educational Setting

ERIC Educational Resources Information Center

Banks, Tachelle; Zionts, Paul

2009-01-01

The academic and social challenges facing public schools are enormous. For example, the pressure to meet the demands of the current high-stakes testing environment and reach adequate yearly progress (AYP) goals has arguably never been greater (Luna & Turner, 2001; Sanders, 2003). The energy devoted to academics has supplanted the little time spent…

Strategies Used by Intellectually Gifted Students to Cope with Stress during Their Participation in a High School International Baccalaureate Program

ERIC Educational Resources Information Center

Shaunessy, Elizabeth; Suldo, Shannon M.

2010-01-01

Individuals respond to threats to affiliation and achievement needs through drawing on a repertoire of coping strategies specific to a given situation. Gifted adolescents in college-preparatory high school programs may be faced with novel stressors, and may have unique coping strategies to manage these challenges. The current study considers…

Linking Science and Management in an Interactive Geospatial, Mutli-Criterion, Structured Decision Support Framework: Use Case Studies of the "Future Forests Geo-visualization and Decision Support Tool

NASA Astrophysics Data System (ADS)

Pontius, J.; Duncan, J.

2017-12-01

Land managers are often faced with balancing management activities to accomplish a diversity of management objectives, in systems faced with many stress agents. Advances in ecosystem modeling provide a rich source of information to inform management. Coupled with advances in decision support techniques and computing capabilities, interactive tools are now accessible for a broad audience of stakeholders. Here we present one such tool designed to capture information on how climate change may impact forested ecosystems, and how that impact varies spatially across the landscape. This tool integrates empirical models of current and future forest structure and function in a structured decision framework that allows users to customize weights for multiple management objectives and visualize suitability outcomes across the landscape. Combined with climate projections, the resulting products allow stakeholders to compare the relative success of various management objectives on a pixel by pixel basis and identify locations where management outcomes are most likely to be met. Here we demonstrate this approach with the integration of several of the preliminary models developed to map species distributions, sugar maple health, forest fragmentation risk and hemlock vulnerability to hemlock woolly adelgid under current and future climate scenarios. We compare three use case studies with objective weightings designed to: 1) Identify key parcels for sugarbush conservation and management, 2) Target state lands that may serve as hemlock refugia from hemlock woolly adelgid induced mortality, and 3) Examine how climate change may alter the success of managing for both sugarbush and hemlock across privately owned lands. This tool highlights the value of flexible models that can be easily run with customized weightings in a dynamic, integrated assessment that allows users to hone in on their potentially complex management objectives, and to visualize and prioritize locations across the landscape. It also demonstrates the importance of including climate considerations for long-term management. This merging of scientific knowledge with the diversity of stakeholder needs is an important step towards using science to inform management and policy decisions.

A Comparison of the Effectiveness of a Game Informed Online Learning Activity and Face to Face Teaching in Increasing Knowledge about Managing Aggression in Health Settings

ERIC Educational Resources Information Center

McKenzie, Karen

2013-01-01

The present study compared the impact of face to face teaching with a short online game informed learning activity on health participants' knowledge about, and confidence in, managing aggressive situations. Both forms of teaching resulted in a significant increase in participants' knowledge and confidence. Face to face training led to…

Innovations in the Use of Interactive Technology to Support Weight Management

PubMed Central

Spruijt-Metz, D.; Wen, C.K.F.; O’Reilly, G.; Li, M.; Lee, S; Emken, B.A.; Mitra, U.; Annavaram, M.; Ragusa, G.; Narayanan, S.

2015-01-01

New and emerging mobile technologies are providing unprecedented possibilities for understanding and intervening on obesity-related behaviors in real time. However, the mobile health (mHealth) field has yet to catch up with the fast-paced development of technology. Current mHealth efforts in weight management still tend to focus mainly on short message systems (SMS) interventions, rather than taking advantage of real-time sensing to develop Just-In-Time, Adaptive Interventions (JITAIs). This paper will give an overview of the current technology landscape for sensing and intervening on three behaviors that are central to weight management; diet, physical activity, and sleep. Then five studies that really dig into the possibilities that these new technologies afford will be showcased. We conclude with a discussion of hurdles that mHealth obesity research has yet to overcome, and a future-facing discussion. PMID:26364308

Chronic disease management and the development of virtual communities.

PubMed

Smith, Alan D

2007-01-01

The current volume and expected increases in the number of patients with chronic diseases are concerned significant and substantial. Patients with chronic diseases have a great need to personally manage their health-related behaviour, such as food consumption, and its impact on their health indicators, like blood pressure, body weight, blood sugar, cholesterol, to name a few. Current healthcare systems are unable to meet the needs of patients with chronic diseases for management, due to the need for acute care. An analysis of the needs was performed and recommendations for virtual communities were made to help patients with chronic diseases monitor and manage their health. Virtual communities have the potential to meet the need to assist with monitoring activities, education, community membership, and the sale of products and services. However, they also face risks inherent to accepting and storing any form of personal health information, and of remaining in compliance with the Health Insurance Portability and Accessibility Act of 2001.

FaceTOON: a unified platform for feature-based cartoon expression generation

NASA Astrophysics Data System (ADS)

Zaharia, Titus; Marre, Olivier; Prêteux, Françoise; Monjaux, Perrine

2008-02-01

This paper presents the FaceTOON system, a semi-automatic platform dedicated to the creation of verbal and emotional facial expressions, within the applicative framework of 2D cartoon production. The proposed FaceTOON platform makes it possible to rapidly create 3D facial animations with a minimum amount of user interaction. In contrast with existing commercial 3D modeling softwares, which usually require from the users advanced 3D graphics skills and competences, the FaceTOON system is based exclusively on 2D interaction mechanisms, the 3D modeling stage being completely transparent for the user. The system takes as input a neutral 3D face model, free of any facial feature, and a set of 2D drawings, representing the desired facial features. A 2D/3D virtual mapping procedure makes it possible to obtain a ready-for-animation model which can be directly manipulated and deformed for generating expressions. The platform includes a complete set of dedicated tools for 2D/3D interactive deformation, pose management, key-frame interpolation and MPEG-4 compliant animation and rendering. The proposed FaceTOON system is currently considered for industrial evaluation and commercialization by the Quadraxis company.

Pollution exposure on marine protected areas: A global assessment.

PubMed

Partelow, Stefan; von Wehrden, Henrik; Horn, Olga

2015-11-15

Marine protected areas (MPAs) face many challenges in their aim to effectively conserve marine ecosystems. In this study we analyze the extent of pollution exposure on the global fleet of MPAs. This includes indicators for current and future pollution and the implications for regionally clustered groups of MPAs with similar biophysical characteristics. To cluster MPAs into characteristic signature groups, their bathymetry, baseline biodiversity, distance from shore, mean sea surface temperature and mean sea surface salinity were used. We assess the extent at which each signature group is facing exposure from multiple pollution types. MPA groups experience similar pollution exposure on a regional level. We highlight how the challenges that MPAs face can be addressed through governance at the appropriate scale and design considerations for integrated terrestrial and marine management approaches within regional level networks. Furthermore, we present diagnostic social-ecological indicators for addressing the challenges facing unsuccessful MPAs with practical applications. Copyright © 2015 Elsevier Ltd. All rights reserved.

Examining differences between recovered and declining endangered species

USGS Publications Warehouse

Abbitt, Robbyn J.F.; Scott, J. Michael

2001-01-01

Between 1973 and 1999, 43 species in the United States were reclassified from endangered to threatened or removed entirely from the Endangered Species List. Of these, 23 were identified as recovered. In 1999 the U.S. Fish and Wildlife Service ( USFWS) published a list of 33 additional species for possible reclassification and/or delisting. We initiated this study to examine why some endangered species recover but others continue to decline and to identify differences in management activities between these two groups. We defined recovered/recovering species as previously recovered species and the additional recovered/recovering species listed by the USFWS. We defined declining species as those identified as declining in the most recent USFWS Report to Congress. Information on recovered/recovering and declining species was gathered from relevant literature, recovery plans, U.S. Federal Register documents, and individuals responsible for the recovery management of each species. We used this information to examine (1) the percentage of current and historic range covered by management activities; (2) threats affecting the species; (3) population sizes at the time of listing; (4) current versus historic range size; and (5) percentage of recovery management objectives completed. Although few statistical analyses provided significant results, those that did suggest the following differences between recovered/recovering and declining species: (1) recovered/recovering species face threats that are easier to address; (2) recovered/recovering species occupy a greater percentage of their historic range; and (3) recovered/recovering species have a greater percentage of their recovery management objectives completed. Those species with threats easier to address and that occupy a greater percentage of their historic range are recovered/recovering. In contrast, declining species face threats more difficult to address and occupy significantly less of their historic range. If this remains true, future species recovery may require more time and resources.

Improving Posthospital Discharge Telephone Reach Rates Through Prehospital Discharge Face-to-Face Meetings.

PubMed

Vergara, Franz H; Sheridan, Daniel J; Sullivan, Nancy J; Budhathoki, Chakra

The purpose of this study was to determine whether a face-to-face meeting with patients by a telephonic case manager prehospital discharge would result in increased telephone follow-up (TFU) reach rates posthospital discharge. Acute care adult medicine inpatient units. A quasiexperimental design was utilized. Two adult inpatient medicine units were selected as the intervention and comparison groups. The framework of the study is the transitions theory. A convenience sampling technique was used, whereby 88 eligible patients on the intervention unit received face-to-face meetings prehospital discharge whereas 123 patients on the comparison unit received standard care (no face-to-face meetings). Cross-tabulation and chi-square tests were employed to examine the association of face-to-face meeting intervention and TFU reach rates. Implementing brief (<10 min) face-to-face meetings by a telephonic case manager prehospital discharge resulted in a TFU reach rate of 87% on the intervention unit, whereas the comparison unit only had a 58% TFU reach rate (p < .001). Increasing reach rates by a telephonic case manager facilitates communication with more patients posthospital discharge. A brief prehospital discharge face-to-face meeting with patients assisted them to understand the reasons for a posthospital discharge telephone call, identified the best times to call using accurate telephone numbers, and taught patients how best to prepare for the call. In addition, by meeting patients face-to-face, the telephonic case manager was no longer an unknown person on the telephone asking them questions about their medical condition. These factors combined may have significantly helped to increase TFU reach rates.

Critical thinking in nurse managers.

PubMed

Zori, Susan; Morrison, Barbara

2009-01-01

Formal education and support is needed for nurse managers to effectively function in their role in the current health care environment. Many nurse managers assume their positions based on expertise in a clinical role with little expertise in managerial and leadership skills. Operating as a manager and leader requires ongoing development of critical thinking skills and the inclination to use those skills. Critical thinking can have a powerful influence on the decision making and problem solving that nurse managers are faced with on a daily basis. The skills that typify critical thinking include analysis, evaluation, inference, and deductive and inductive reasoning. It is intuitive that nurse managers require both the skills and the dispositions of critical thinking to be successful in this pivotal role at a time of transformation in health care. Incorporating critical thinking into education and support programs for the nurse manager is necessary to position the nurse manager for success.

New management structure at headquarters

NASA Astrophysics Data System (ADS)

On July 1, 1987, AGU Executive Director Fred Spilhaus informed the AGU staff that Judy C. Holoviak has been promoted to the position of Group Director. This is a new management position with responsibility for more than one division. Both the Publications Division and the newly formed Public Information and Marketing Division will report to Holoviak, as will the new Special Assistant for Nonprint Publications.Spilhaus explained that this new position will permit the headquarters management staff to be responsive to the current AGU growth. A stronger management structure is needed to take advantage of the many opportunities facing the Union. In pointing to the initiatives identified by the Planning Committee, he stated that continued growth is the only likely course for AGU.

ECS Resignations Raise Questions of Fiscal Health: Leader of State Policy Group Says Problems Can Be Fixed

ERIC Educational Resources Information Center

Hoff, David J.

2006-01-01

Kathy Christie, senior vice president at the Education Commission of the States (ECS), resigned on May 1, 2006, saying that the Denver-based group faces a financial crisis, and that she doubts the current ECS president can fix it. By the end of the week, the accounting manager had also resigned, expressing similar concerns, and two policy analysts…

Managing e-Learning: What Are the Real Implications for Schools?

ERIC Educational Resources Information Center

Boulton, Helen

2008-01-01

This paper is concerned with the use of e-learning in secondary education. It is based on research that has taken place over a period of two years with students aged 14-16 (Key Stage 4). The paper considers the current research in e-learning and identifies the challenges faced by students, the changing role of the learner, and the impact elearning…

Major Management Challenges and Program Risks. Department of Agriculture

DTIC Science & Technology

2001-01-01

environment, ensure food safety , improve the well-being of rural America, promote domestic marketing and the export of food and farm products, conduct...meat and poultry. USDA must also determine if foreign countries have implemented equivalent food safety and inspection systems before those countries...continuing fundamental problem facing USDA, namely, that the current food safety system is highly fragmented with as many as 12 different federal

Proceedings of a Symposium on the Kings River Sustainable Forest Ecosystem Project: Progress and Current Status

Treesearch

Jared Verner

2002-01-01

Ecosystem management aligns different uses of the land with ecological parameters and goals of environmental quality. An important USDA Forest Service mission is to balance the multiple uses of its lands in an ecologically sustainable way. This objective has been particularly challenging for National Forests of the Sierra Nevada in the face of heated controversies over...

Imaging assessment of penetrating injury of the neck and face.

PubMed

Offiah, Curtis; Hall, Edward

2012-10-01

Penetrating trauma of the neck and face is a frequent presentation to acute emergency, trauma and critical care units. There remains a steady incidence of both gunshot penetrating injury to the neck and face as well as non-missile penetrating injury-largely, but not solely, knife-related. Optimal imaging assessment of such injuries therefore remains an on-going requirement of the general and specialised radiologist. The anatomy of the neck and face-in particular, vascular, pharyngo-oesophageal, laryngo-tracheal and neural anatomy-demands a more specialised and selective management plan which incorporates specific imaging techniques. The current treatment protocol of injuries of the neck and face has seen a radical shift away from expectant surgical exploration in the management of such injuries, largely as a result of advances in the diagnostic capabilities of multi-detector computed tomography angiography (MDCTA), which is now the first-line imaging modality of choice in such cases. This review aims to highlight ballistic considerations, differing imaging modalities, including MDCTA, that might be utilised to assist in the accurate assessment of these injuries as well as the specific radiological features and patterns of specific organ-system injuries that should be considered and communicated to surgical and critical care teams. TEACHING POINTS : • MDCTA is the first-line imaging modality in penetrating trauma of the neck and, often, of the face • The inherent deformability of a bullet is a significant factor in its tissue-damaging capabilities • MDCTA can provide accurate assessment of visceral injury of the neck as well as vascular injury • Penetrating facial trauma warrants radiological assessment of key adjacent anatomical structures • In-driven fragments of native bone potentiate tissue damage in projectile penetrating facial trauma.

The Proposed MACRA/MIPS Threshold for Patient-Facing Encounters: What It Means for Radiologists.

PubMed

Rosenkrantz, Andrew B; Hirsch, Joshua A; Allen, Bibb; Wang, Wenyi; Hughes, Danny R; Nicola, Gregory N

2017-03-01

In implementing the Merit-Based Incentive Payment System (MIPS), CMS will provide special considerations to physicians with infrequent face-to-face patient encounters by reweighting MIPS performance categories to account for the unique circumstances facing these providers. The aim of this study was to determine the impact of varying criteria on the fraction of radiologists who are likely to receive special considerations for performance assessment under MIPS. Data from the 2014 Medicare Physician and Other Supplier file for 28,710 diagnostic radiologists were used to determine the fraction of radiologists meeting various proposed criteria for receiving special considerations. For each definition, the fraction of patient-facing encounters among all billed codes was determined for those radiologists not receiving special considerations. When using the criterion proposed by CMS that physicians will receive special considerations if billing ≤25 evaluation and management services or surgical codes, 72.0% of diagnostic radiologists would receive special considerations, though such encounters would represent only 2.1% of billed codes among remaining diagnostic radiologists without special considerations. If CMS were to apply an alternative criterion of billing ≤100 evaluation and management codes exclusively, 98.8% of diagnostic radiologists would receive special considerations. At this threshold, patient-facing encounters would represent approximately 10% of billed codes among remaining radiologists without special considerations. The current CMS proposed criterion for special considerations would result in a considerable fraction of radiologists being evaluated on the basis of measures that are not reflective of their practice and beyond their direct control. Alternative criteria could help ensure that radiologists are provided a fair opportunity for success in performance review under the MIPS. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Panel workload assessment in US primary care: accounting for non-face-to-face panel management activities.

PubMed

Arndt, Brian; Tuan, Wen-Jan; White, Jennifer; Schumacher, Jessica

2014-01-01

An understanding of primary care provider (PCP) workload is an important consideration in establishing optimal PCP panel size. However, no widely acceptable measure of PCP workload exists that incorporates the effort involved with both non-face-to-face patient care activities and face-to-face encounters. Accounting for this gap is critical given the increase in non-face-to-face PCP activities that has accompanied electronic health records (EHRs) (eg, electronic messaging). Our goal was to provide a comprehensive assessment of perceived PCP workload, accounting for aspects of both face-to-face and non-face-to-face encounters. Internal medicine, family medicine, and pediatric PCPs completed a self-administered survey about the perceived workload involved with face-to-face and non-face-to-face panel management activities as well as the perceived challenge associated with caring for patients with particular biomedical, demographic, and psychosocial characteristics (n = 185). Survey results were combined with EHR data at the individual patient and PCP service levels to assess PCP panel workload, accounting for face-to-face and non-face-to-face utilization. Of the multiple face-to-face and non-face-to-face activities associated with routine primary care, PCPs considered hospital admissions, obstetric care, hospital discharges, and new patient preventive health visits to be greater workload than non-face-to-face activities such as telephone calls, electronic communication, generating letters, and medication refills. Total workload within PCP panels at the individual patient level varied by overall health status, and the total workload of non-face-to-face panel management activities associated with routine primary care was greater than the total workload associated with face-to-face encounters regardless of health status. We used PCP survey results coupled with EHR data to assess PCP workload associated with both face-to-face as well as non-face-to-face panel management activities in primary care. The non-face-to-face workload was an important contributor to overall PCP workload for all patients regardless of overall health status. This is an important consideration for PCP workload assessment given the changing nature of primary care that requires more non-face-to-face effort, resulting in an overall increase in PCP workload. © Copyright 2014 by the American Board of Family Medicine.

The role of Confucianism in South Korea's emergency management system.

PubMed

Ha, Kyoo-Man

2018-03-26

Numerous Western researchers have examined the influence of Confucianism on development in Asia, but almost no South Korean researchers have studied the topic in regard to emergency management in their own country. This study begins by considering Confucianism as a social culture. Next, it goes on to evaluate its role in South Korea's emergency management system, contributing, ultimately, to efficiencies in emergency management. Drawing on a literature review and a case study, the paper assesses the double- and single-faced approaches, using four major Confucian components: destiny; family; ritual; and relation. The double-faced approach includes the positive and negative aspects of emergency management, whereas the single-faced approach incorporates only its positive aspects. This paper provides, for the first time, a systematic analysis of the relationship between Confucianism and emergency management in South Korea. Its key finding is that the double-faced approach needs to be transformed into a single-faced approach through active facilitation of behavioural change. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Effectiveness of online and face-to-face fatigue self-management programmes for adults with neurological conditions.

PubMed

Ghahari, Setareh; Packer, Tanya

2012-01-01

To evaluate effectiveness of a face-to-face and an online fatigue self-management programme and to compare these to two control groups (information-only and no-intervention) in a sample of adults (n = 115) with neurological conditions reporting extreme fatigue. Non-equivalent pre-test post-test control group design using the Fatigue Impact Scale, Personal Wellbeing Index and Activity Card Sort as primary outcome measures. Participants in the two intervention groups and the information-only group showed clinically significant improvements in fatigue over time (p < 0.05). When compared to the no-intervention group, face-to-face participants showed significantly greater improvement in overall and cognitive fatigue, while participants in the online group showed significant improvement in self-efficacy and stress. Participation in either the online or face-to-face programme appears to result in improved self-management, however, with different potency depending on outcomes. The improvement in the online information only group further complicates the understanding of the results. With few other comparisons of online and face-to-face self-management protocols available, further research is needed to understand differential impacts which may be related to the delivery format, the rural versus urban split of participants or other unknown factors.

Pharmacy executives: leadership issues and associated skills, knowledge, and abilities in the U.S. Department of Defense.

PubMed

Meadows, Andrew B; Finstuen, Kenn; Hudak, Ronald P

2003-01-01

To identify the issues or problems that current and aspiring U.S. Department of Defense (DoD) pharmacy executives will face in the future and to define the skills, knowledge, and abilities (SKAs) required to successfully address these issues. Delphi method for executive decision making. DoD. Ninety-three pharmacists serving in the military grades of lieutenant colonel/commander and colonel/captain, as well as pharmacists selected for promotion to those grades. iterations of the Delphi method for executive decision making separated by an expert panel content analysis. Round 1--participants identified five major issues believed to be of greatest importance to pharmacy executives and reported specific SKAs that might be needed to successfully manage those issues. An expert panel sorted these issues into meaningful domains, then provided an appropriate title for each domain. Round 2--on a 7-point scale, respondents rated the SKA items according to their assessment of how much a future DoD pharmacy executive would need each SKA. Response rates were 44.1% and 46.2% for Delphi rounds 1 and 2, respectively. The first round generated 62 unique issues facing pharmacy executives. The expert panel reviewed and sorted the issues into eight domains and selected an appropriate title for each domain. The domains identified by the panel were human resources, pharmacy operations/business practices, information management and technology, financial resources, formulary management, drug therapy management, pharmacy benefit management, and leadership. During round 2, 73.3% of the top 15 rated SKAs came from the drug therapy management, leadership, and formulary management domains. The three highest-rated SKAs were "ability to see the big picture," "ability to build strong relations with medical staffs," and "skills in both writing and verbal communication." The issues facing future DoD pharmacy executives will require them to expand their clinical abilities as well as their ability to collaborate and communicate with other professionals.

Computer-mediated mobile messaging as collaboration support for nurses.

PubMed

Karpati, Peter; Toussaint, Pieter Jelle; Nytrø, Oystein

2009-01-01

Collaboration in hospitals is coordinated mainly by communication, which currently happens by face-to-face meetings, phone calls, pagers, notes and the electronic patient record. These habits raise problems e.g., delayed notifications and unnecessary interruptions. Dealing with these problems could save time and improve the care. Therefore we designed and prototyped a mobile messaging solution based on two specific scenarios coming from observations at a cardiology department of a Norwegian hospital. The main focus was on supporting the work of nurses. One prototype supported patient management while another one dealt with messages related to medication planning. The evaluation of the prototypes suggested that messaging-based collaboration support is worth to explore and also gave ideas for improvement.

How Mode of Delivery Affects Comprehension of an Operations Management Simulation: Online vs Face-to-Face Classrooms

ERIC Educational Resources Information Center

Riley, Jason M.; Ellegood, William A.; Solomon, Stanislaus; Baker, Jerrine

2017-01-01

Purpose: This study aims to understand how mode of delivery, online versus face-to-face, affects comprehension when teaching operations management concepts via a simulation. Conceptually, the aim is to identify factors that influence the students' ability to learn and retain new concepts. Design/methodology/approach: Leveraging Littlefield…

Impression Management in Kindergarten Classrooms: An Analysis of Children's Face-Work in Peer Interactions.

ERIC Educational Resources Information Center

Hatch, J. Amos

A systematic analysis was made of the communications of 5- and 6-year-old children in two kindergarten classrooms to discover whether children's face-to-face interactions with peers included "face work" components (rituals through which individuals manage impressions when it becomes difficult to maintain a social situation) and, if so,…

Prominent Constraints Faced by Government Managers.

DTIC Science & Technology

1983-06-01

A A t-32 412 PROMINENT CONSTRAINTS FACED BY GOVERNMENT MANAGERS (U) JUN 83NAVAL POSTGRADUATE SCHOOL MONTEREY CA R I NIEDERMULLER7N.LASSI FIED F/G ,5...STANDARS-963A- ’ I It I Uf NAVAL POSTGRADUATE SCHOOL Monterey, California co IA THESIS PROMINENT CONSTRAINTS FACED BY GOVERNMENT MANAGERS by Robert T...Government Managers June 1983 S. PERFORMING ORO. REPORT NUMsER 7. AUTNOR(s) .COtAC R03 GRANT NUNSER(W.) Robert T. Niedermuller I. PERPORMIXG OROANIZATIIOM

Managing and Evaluating Digital Repositories

ERIC Educational Resources Information Center

Zuccala, Alesia; Oppenheim, Charles; Dhiensa, Rajveen

2008-01-01

Introduction: We examine the role of the digital repository manager, discuss the future of repository management and evaluation and suggest that library and information science schools develop new repository management curricula. Method: Face-to-face interviews were carried out with managers of five different types of repositories and a Web-based…

Efficient Bulk Data Replication for the Earth System Grid

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

Sim, Alex; Gunter, Dan; Natarajan, Vijaya

2010-03-10

The Earth System Grid (ESG) community faces the difficult challenge of managing the distribution of massive data sets to thousands of scientists around the world. To move data replicas efficiently, the ESG has developed a data transfer management tool called the Bulk Data Mover (BDM). We describe the performance results of the current system and plans towards extending the techniques developed so far for the up- coming project, in which the ESG will employ advanced networks to move multi-TB datasets with the ulti- mate goal of helping researchers understand climate change and its potential impacts on world ecology and society.

Aquaculture and food crisis: opportunities and constraints.

PubMed

Liao, I Chiu; Chao, Nai-Hsien

2009-01-01

Fish farming, now well known as aquaculture, has been well recognized since the ancient era. The first written document on fish culture was published in China in 475 BC, and the first koi pond was constructed at the Japanese Imperial Palace grounds during 71-130 AD. In recent years, aquaculture has progressively played an important role in the provision of: animal protein and gourmet cuisines, job opportunities, and foreign currency for developing countries. Asian countries produce around 91 percent of the world's total aquaculture production. Among the top ten aquaculture-producing countries, nine are from Asia. The current global population consist of more than 6.5 billion individuals; over one billion of which face hunger problem. In the highly populated Asia-Pacific region with moderately high-productivity, 642 million people are still facing hunger. Being a proficient and potential source of animal protein, aquaculture will play an increasing and important role in solving the world food problem in the future. This paper discusses both the opportunities and constraints in the aquaculture industry, specifically in the Asia-Pacific region, and its possible role in solving the current global food crisis. Strategies including promotion and adoption of traceability and HACCP systems for food safety, and marketing management for aquaculture products are also suggested. It is hoped that traditional administration of aquaculture management for survival, profit, as well as food safety will successfully match sustainability management to meet the urgent global need for food.

Identifying professionals' needs in integrating electronic pain monitoring in community palliative care services: An interview study.

PubMed

Taylor, Sally; Allsop, Matthew J; Bekker, Hilary L; Bennett, Michael I; Bewick, Bridgette M

2017-07-01

Poor pain assessment is a barrier to effective pain control. There is growing interest internationally in the development and implementation of remote monitoring technologies to enhance assessment in cancer and chronic disease contexts. Findings describe the development and testing of pain monitoring systems, but research identifying the needs of health professionals to implement routine monitoring systems within clinical practice is limited. To inform the development and implementation strategy of an electronic pain monitoring system, PainCheck, by understanding palliative care professionals' needs when integrating PainCheck into routine clinical practice. Qualitative study using face-to-face interviews. Data were analysed using framework analysis Setting/participants: Purposive sample of health professionals managing the palliative care of patients living in the community Results: A total of 15 interviews with health professionals took place. Three meta-themes emerged from the data: (1) uncertainties about integration of PainCheck and changes to current practice, (2) appraisal of current practice and (3) pain management is everybody's responsibility Conclusion: Even the most sceptical of health professionals could see the potential benefits of implementing an electronic patient-reported pain monitoring system. Health professionals have reservations about how PainCheck would work in practice. For optimal use, PainCheck needs embedding within existing electronic health records. Electronic pain monitoring systems have the potential to enable professionals to support patients' pain management more effectively but only when barriers to implementation are appropriately identified and addressed.

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

PubMed

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

2009-05-01

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

Measurement and Diagnosis of Student Attitudes Toward a Career in Advertising. Working Paper Series, Center for Marketing Studies Paper No. 19.

ERIC Educational Resources Information Center

Lutz, Richard J.

A problem currently facing many advertising agencies is the recruitment of top quality business school graduates as potential account managers. Viewing the problem from a marketing perspective, a career in advertising is seen as a product competing with other careers for the market of new graduates. Then it is possible to use one of the…

Market value: an underused financial planning tool.

PubMed

Harris, J P; Schimmel, V E

1987-04-01

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

GAR Global Risk Assessment

NASA Astrophysics Data System (ADS)

Maskrey, Andrew; Safaie, Sahar

2015-04-01

Disaster risk management strategies, policies and actions need to be based on evidence of current disaster loss and risk patterns, past trends and future projections, and underlying risk factors. Faced with competing demands for resources, at any level it is only possible to priorities a range of disaster risk management strategies and investments with adequate understanding of realised losses, current and future risk levels and impacts on economic growth and social wellbeing as well as cost and impact of the strategy. The mapping and understanding of the global risk landscape has been greatly enhanced by the latest iteration of the GAR Global Risk Assessment and the objective of this submission is to present the GAR global risk assessment which contributed to Global Assessment Report (GAR) 2015. This initiative which has been led by UNISDR, was conducted by a consortium of technical institutions from around the world and has covered earthquake, cyclone, riverine flood, and tsunami probabilistic risk for all countries of the world. In addition, the risks associated with volcanic ash in the Asia-Pacific region, drought in various countries in sub-Saharan Africa and climate change in a number of countries have been calculated. The presentation will share thee results as well as the experience including the challenges faced in technical elements as well as the process and recommendations for the future of such endeavour.

Practice of laryngectomy rehabilitation interventions: a perspective from Hong Kong.

PubMed

Chan, Jimmy Y W

2013-06-01

To review the current practice of rehabilitation for laryngectomees in Hong Kong. Factors affecting the quality of life of laryngectomees include their performance in speech restoration, the presence of complications of treatment, as well as the availability of psycho-social support. In Hong Kong, more than 90% of laryngectomees have speech restoration by various means, the commonest of which being tracheo-oesophageal puncture and electrolaryngeal speech. However, they face special problems in communication using the current alaryngeal speech modalities, as it is difficult to produce variation in tones, which is important to express different meanings in Cantonese. The responsibility of surgeons to follow-up patients after surgery and the practice of management of common complications after laryngectomy are also discussed. The New Voice Club of Hong Kong promotes self-help and mutual help between laryngectomees, with the aim of helping new members to regain normal speech and to re-integrate into society. Quality-of-life study in Hong Kong shows that although the mean global health score is satisfactory, the social functioning domain is most severely affected after surgery. Cantonese-speaking laryngectomees in Hong Kong are facing unique challenges in speech restoration and re-integration into society after surgery. Surgeons should take the leading role in the multidisciplinary management of these patients.

A historical forest management conundrum: do social and biophysical mix?

Treesearch

Heidi Bigler-Cole

2005-01-01

Forest managers face an array of prickly, seemingly intractable environmental problems. They have traditionally turned to the biophysical sciences to help gauge potential management effects, weigh alternatives, and set priorities. Over the past several decades, forest managers have watched management plans disintegrate in the face of grassroots-level protests, quarrels...

What’s in a Face? How Face Gender and Current Affect Influence Perceived Emotion

PubMed Central

Harris, Daniel A.; Hayes-Skelton, Sarah A.; Ciaramitaro, Vivian M.

2016-01-01

Faces drive our social interactions. A vast literature suggests an interaction between gender and emotional face perception, with studies using different methodologies demonstrating that the gender of a face can affect how emotions are processed. However, how different is our perception of affective male and female faces? Furthermore, how does our current affective state when viewing faces influence our perceptual biases? We presented participants with a series of faces morphed along an emotional continuum from happy to angry. Participants judged each face morph as either happy or angry. We determined each participant’s unique emotional ‘neutral’ point, defined as the face morph judged to be perceived equally happy and angry, separately for male and female faces. We also assessed how current state affect influenced these perceptual neutral points. Our results indicate that, for both male and female participants, the emotional neutral point for male faces is perceptually biased to be happier than for female faces. This bias suggests that more happiness is required to perceive a male face as emotionally neutral, i.e., we are biased to perceive a male face as more negative. Interestingly, we also find that perceptual biases in perceiving female faces are correlated with current mood, such that positive state affect correlates with perceiving female faces as happier, while we find no significant correlation between negative state affect and the perception of facial emotion. Furthermore, we find reaction time biases, with slower responses for angry male faces compared to angry female faces. PMID:27733839

Water management, purification, and conservation in arid climates. Volume 3: Water conservation

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

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

1999-07-01

Arid regions are already feeling the severe restraining effects of potable water shortages. In coming years, humid and sub-humid regions of the world will also have to face many of these same problems. In the future, serious conflicts may arise not because of a lack of oil, but due to water shortages. Are there solutions to these problems? Aside from increasing public awareness about the importance of water, society needs to take a three pronged approach: water needs to be effectively managed, it needs to be economically purified, and it needs to be conserved. Only by doing these three thingsmore » in unison can they hope to alleviate the water problems faced by arid regions of the world. This book presents information valuable to seeking, finding and using current technologies to help solve these problems now. Volume 3 addresses aspects of water conservation and includes rainwater harvesting and wastewater reuse and reclamation.« less

Water management, purification, and conservation in arid climates. Volume 2: Water purification

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

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

1999-10-01

Arid regions are already feeling the severe restraining effects of potable water shortages. In coming years, humid and sub-humid regions of the world will also have to face many of these same problems. In the future, serious conflicts may arise not because of a lack of oil, but due to water shortages. Are there solutions to these problems? Aside from increasing public awareness about the importance of water, society needs to take a three pronged approach: water needs to be effectively managed, it needs to be economically purified, and it needs to be conserved. Only by doing these three thingsmore » in unison can they hope to alleviate the water problems faced by arid regions of the world. This book presents information valuable to seeking, finding and using current technologies to help solve these problems now. Volume 2 presents various methods of purifying water, and includes membrane processes and alternative techniques such as solar desalination.« less

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

PubMed

Johnson, Brian R

2013-01-01

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

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

PubMed

Chen, Chun-Yu

2004-06-01

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

An evaluation of the telehealth facilitation of diabetes and cardiovascular care in remote Australian Indigenous communities: - protocol for the telehealth eye and associated medical services network [TEAMSnet] project, a pre-post study design.

PubMed

Brazionis, Laima; Jenkins, Alicia; Keech, Anthony; Ryan, Chris; Bursell, Sven-Erik

2017-01-05

Despite substantial investment in detection, early intervention and evidence-based treatments, current management strategies for diabetes-associated retinopathy and cardiovascular disease are largely based on real-time and face-to-face approaches. There are limited data re telehealth facilitation in type 2 diabetes management. Therefore, we aim to investigate efficacy of telehealth facilitation of diabetes and cardiovascular disease care in high-risk vulnerable Aboriginal and Torres Strait Islanders in remote/very remote Australia. Using a pre-post intervention design, 600 Indigenous Australians with type 2 diabetes will be recruited from three primary-care health-services in the Northern Territory. Diabetes status will be based on clinical records. There will be four technological interventions: 1. Baseline retinal imaging [as a real-time patient education/engagement tool and telehealth screening strategy]. 2. A lifestyle survey tool administered at ≈ 6-months. 3. At ≈ 6- and 18-months, an electronic cardiovascular disease and diabetes decision-support tool based on current guidelines in the Standard Treatment Manual of the Central Australian Rural Practitioner's Association to generate clinical recommendations. 4. Mobile tablet technology developed to enhance participant engagement in self-management. Data will include: Pre-intervention clinical and encounter-history data, baseline retinopathy status, decision-support and survey data/opportunistic mobile tablet encounter data. The primary outcome is increased participant adherence to clinical appointments, a marker of engagement and self-management. A cost-benefit analysis will be performed. Remoteness is a major barrier to provision and uptake of best-practice chronic disease management. Telehealth, beyond videoconferencing of consultations, could facilitate evidence-based management of diabetes and cardiovascular disease in Indigenous Australians and serve as a model for other conditions. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN 12616000370404 was retrospectively registered on 22/03/2016.

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

PubMed

Cao, Wenzhi; Wong, Ming H

2007-10-01

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

Update on clinical attire requirements in dental hygiene programs.

PubMed

Foley, E S

1994-01-01

Many changes have occurred in the clinical appearance of dental hygienists in the past few years because of increased emphasis on infection control and disease prevention. The purpose of this study was to assess dental hygiene program clinical attire requirements in 1993 and to compare them with requirements as described by a 1988 survey. Checklist questionnaires were mailed to the directors of all 211 dental hygiene programs in the United States and Puerto Rico in October 1993. Questions were asked regarding clinical attire requirements for students and faculty, including uniforms, gowns, lab coats, masks, protective eyewear, shoes, hair coverings, laundry management, and changes under consideration. Percentages were calculated by region and for all responding programs. Of 211 questionnaires mailed, 178 were returned, for a response rate of 84%. Results indicated that students and faculty are currently wearing more colorful uniforms and scrubs than in 1988. Long-sleeved lab coats, disposable gowns, and washable surgical gowns are increasing in use. Glasses and face masks were required for all students and faculty in both surveys, but chin-length face shields are increasing in use as optional face protection. In most instances, face shields are worn with face masks. Laundry services are being provided for faculty (employees); however, most students continue to be responsible for their own laundry after being instructed to follow stringent guidelines taught by the faculty. Increasing emphasis on personal and patient protection is moving clinical attire requirements toward a more surgical appearance. Dental hygiene educators continue to monitor and to stay current with federal infection control recommendations, regulations, and guidelines.

The different faces of one’s self: an fMRI study into the recognition of current and past self-facial appearances

PubMed Central

Apps, Matthew A. J.; Tajadura-Jiménez, Ana; Turley, Grainne; Tsakiris, Manos

2013-01-01

Mirror self-recognition is often considered as an index of self-awareness. Neuroimaging studies have identified a neural circuit specialised for the recognition of one’s own current facial appearance. However, faces change considerably over a lifespan, highlighting the necessity for representations of one’s face to continually be updated. We used fMRI to investigate the different neural circuits involved in the recognition of the childhood and current, adult, faces of one’s self. Participants viewed images of either their own face as it currently looks morphed with the face of a familiar other or their childhood face morphed with the childhood face of the familiar other. Activity in areas which have a generalised selectivity for faces, including the inferior occipital gyrus, the superior parietal lobule and the inferior temporal gyrus, varied with the amount of current self in an image. Activity in areas involved in memory encoding and retrieval, including the hippocampus and the posterior cingulate gyrus, and areas involved in creating a sense of body ownership, including the temporo-parietal junction and the inferior parietal lobule, varied with the amount of childhood self in an image. We suggest that the recognition of one’s own past or present face is underpinned by different cognitive processes in distinct neural circuits. Current self-recognition engages areas involved in perceptual face processing, whereas childhood self-recognition recruits networks involved in body ownership and memory processing. PMID:22940117

The different faces of one's self: an fMRI study into the recognition of current and past self-facial appearances.

PubMed

Apps, Matthew A J; Tajadura-Jiménez, Ana; Turley, Grainne; Tsakiris, Manos

2012-11-15

Mirror self-recognition is often considered as an index of self-awareness. Neuroimaging studies have identified a neural circuit specialised for the recognition of one's own current facial appearance. However, faces change considerably over a lifespan, highlighting the necessity for representations of one's face to continually be updated. We used fMRI to investigate the different neural circuits involved in the recognition of the childhood and current, adult, faces of one's self. Participants viewed images of either their own face as it currently looks morphed with the face of a familiar other or their childhood face morphed with the childhood face of the familiar other. Activity in areas which have a generalised selectivity for faces, including the inferior occipital gyrus, the superior parietal lobule and the inferior temporal gyrus, varied with the amount of current self in an image. Activity in areas involved in memory encoding and retrieval, including the hippocampus and the posterior cingulate gyrus, and areas involved in creating a sense of body ownership, including the temporo-parietal junction and the inferior parietal lobule, varied with the amount of childhood self in an image. We suggest that the recognition of one's own past or present face is underpinned by different cognitive processes in distinct neural circuits. Current self-recognition engages areas involved in perceptual face processing, whereas childhood self-recognition recruits networks involved in body ownership and memory processing. Copyright © 2012 Elsevier Inc. All rights reserved.

Reconstructive Management of Devastating Electrical Injuries to the Face.

PubMed

Janis, Jeffrey E; Khansa, Ibrahim; Lehrman, Craig R; Orgill, Dennis P; Pomahac, Bohdan

2015-10-01

Devastating fourth-degree electrical injuries to the face and head pose significant reconstructive challenges. To date, there have been few peer-reviewed articles in the literature that describe those reconstructive challenges. The authors present the largest case series to date that describes the management of these injuries, including the incorporation of face transplantation. A retrospective case series was conducted of patients with devastating electrical injuries to the face who were managed at two level-1 trauma centers between 2007 and 2011. Data describing patient injuries, initial management, and reconstructive procedures were collected. Five patients with devastating electrical injuries to the face were reviewed. After initial stabilization and treatment of life-threatening injuries, all five underwent burn excision and microsurgical reconstruction using distant flaps. Two of the patients eventually underwent face transplantation. The authors describe differences in management between the two trauma centers, one of which had the availability for composite tissue allotransplantation; the other did not. Also described is how initial attempts at traditional reconstruction affected the eventual face transplantation. The care of patients with complex electrical burns must be conducted in a multidisciplinary fashion. As with all other trauma, the initial priority should be management of the airway, breathing, and circulation. Additional considerations include cardiac arrhythmias and renal impairment attributable to myoglobinuria. Before embarking on aggressive reconstruction attempts, it is advisable to determine early whether the patient is a candidate for face transplantation in order to avoid antigen sensitization, loss of a reconstructive "lifeboat," surgical plane disruption, and sacrifice of potential recipient vessels. Therapeutic, V.

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

PubMed

Brigley, Stephen; Hosein, Ian; Myemba, Irnei

2009-04-01

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

Assignment of Grades and Student Performance in a Hybrid Operations Management Course: What Works and Ideas for Improvements

ERIC Educational Resources Information Center

Houts, Lisa M.; Taylor, James C.

2008-01-01

The production and operations management class offered at California State University, Fresno underwent a transformation from being a four-unit, face-to-face course to a hybrid course. This hybrid course, which is required for all students in the Craig School of Business, includes two units of face-to-face instruction each week, with some coverage…

Iterative development of Stand Up Australia: a multi-component intervention to reduce workplace sitting

PubMed Central

2014-01-01

Background Sitting, particularly in prolonged, unbroken bouts, is widespread within the office workplace, yet few interventions have addressed this newly-identified health risk behaviour. This paper describes the iterative development process and resulting intervention procedures for the Stand Up Australia research program focusing on a multi-component workplace intervention to reduce sitting time. Methods The development of Stand Up Australia followed three phases. 1) Conceptualisation: Stand Up Australia was based on social cognitive theory and social ecological model components. These were operationalised via a taxonomy of intervention strategies and designed to target multiple levels of influence including: organisational structures (e.g. via management consultation), the physical work environment (via provision of height-adjustable workstations), and individual employees (e.g. via face-to-face coaching). 2) Formative research: Intervention components were separately tested for their feasibility and acceptability. 3) Pilot studies: Stand Up Comcare tested the integrated intervention elements in a controlled pilot study examining efficacy, feasibility and acceptability. Stand Up UQ examined the additional value of the organisational- and individual-level components over height-adjustable workstations only in a three-arm controlled trial. In both pilot studies, office workers’ sitting time was measured objectively using activPAL3 devices and the intervention was refined based on qualitative feedback from managers and employees. Results Results and feedback from participants and managers involved in the intervention development phases suggest high efficacy, acceptance, and feasibility of all intervention components. The final version of the Stand Up Australia intervention includes strategies at the organisational (senior management consultation, representatives consultation workshop, team champions, staff information and brainstorming session with information booklet, and supportive emails from managers to staff), environmental (height-adjustable workstations), and individual level (face-to-face coaching session and telephone support). Stand Up Australia is currently being evaluated in the context of a cluster-randomised controlled trial at the Department of Human Services (DHS) in Melbourne, Australia. Conclusions Stand Up Australia is an evidence-guided and systematically developed workplace intervention targeting reductions in office workers’ sitting time. PMID:24559162

Identifying challenges for academic leadership in medical universities in Iran.

PubMed

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

2010-05-01

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

The Multiple Sclerosis Self-Management Scale

PubMed Central

Ghahari, Setareh; Khoshbin, Lana S.

2014-01-01

Background: The Multiple Sclerosis Self-Management Scale (MSSM) is currently the only measure that was developed specifically to address self-management among individuals with multiple sclerosis (MS). While good internal consistency (α = 0.85) and construct validity have been demonstrated, other psychometric properties have not been established. This study was undertaken to evaluate the criterion validity, test-retest reliability, and face validity of the MSSM. Methods: Thirty-one individuals with MS who met the inclusion criteria were recruited to complete a series of questionnaires at two time points. At Time 1, participants completed the MSSM and two generic self-management tools—the Partners in Health (PIH-12) and the Health Education Impact Questionnaire (heiQ)—as well as a short questionnaire to capture participants' opinions about the MSSM. At Time 2, approximately 2 weeks after Time 1, participants completed the MSSM again. Results: The available MSSM factors showed moderate to high correlations with both PIH-12 and heiQ and were deemed to have satisfactory test-retest reliability. Face validity pointed to areas of the MSSM that need to be revised in future work. As indicated by the participants, some dimensions of MS self-management are missing in the MSSM and some items such as medication are redundant. Conclusions: This study provides evidence for the reliability and validity of the MSSM; however, further changes are required for both researchers and clinicians to use the tool meaningfully in practice. PMID:25061429

Management challenges faced by managers of New Zealand long-term care facilities.

PubMed

Madas, E; North, N

2000-01-01

This article reports on a postal survey of 78 long-term care managers in one region of New Zealand, of whom 45 (58%) responded. Most long-term care managers (73.2%) were middle-aged females holding nursing but not management qualifications. Most long-term care facilities (69%) tended to be stand-alone facilities providing a single type of care (rest home or continuing care hospital). The most prominent issues facing managers were considered to be inadequate funding to match the growing costs of providing long-term care and occupancy levels. Managers believed that political/regulatory, economic and social factors influenced these issues. Despite a turbulent health care environment and the challenges facing managers, long-term care managers reported they were coping well and valued networking.

The changing nature of ICU charge nurses' decision making: from supervision of care delivery to unit resource management.

PubMed

Miller, Anne; Buerhaus, Peter I

2013-01-01

Recent findings that variations in nursing workload may affect inpatient outcomes now highlight nurse workload management and the need for an updated analysis of the role of the charge nurse (CN). Observational data for eight CNs, each at one of eight ICUs in a not-for-profit Level 1 Trauma Center, coded to capture interprofessional interactions, decision making, team coordination phases, and support tools. A researcher shadowed each participant for 12 hours. Each shift began and ended with a face-to-face handoff that included summaries of each patient's condition; the current bed census; anticipated admissions, discharges, and transfers; and the number of nurses available to work the current and coming two shifts. The researcher, using a notebook, recorded the substantive content of all work conversations initiated by or directed to the CN from physicians, staff nurses, allied health workers, other employees, and patients/families. The tools used to support conversations were collected as blank forms or computer screen prints and annotated to describe how they were used, when, and for what purpose. Statistically significant three-way interactions suggest that CNs' conversations with colleagues depend on the team coordination phase and the decision-making level, and that the support tools that CNs use when talking to colleagues depend on the decision-making level and the team coordination phase. The role of ICU CNs appears to be continuing to evolve, now encompassing unit resource management in addition to supervising care delivery. Effective support tools, together with education that would enhance communication and resource management skills, will be essential to CNs' ability to support unit resilience and adaptability in an increasingly complex environment.

[From personnel administration to human resource management : demographic risk management in hospitals].

PubMed

Schmidt, C E; Gerbershagen, M U; Salehin, J; Weib, M; Schmidt, K; Wolff, F; Wappler, F

2011-06-01

The healthcare market is facing a serious shortage of qualified personnel in 2020. Aging of staff members is one important driver of this human resource deficit but current planning periods of 1-2 years cannot compensate the demographic effects on staff portfolio early enough. Therefore, prospective human resource planning is important to avoid loss of competence. The long range development (10 years) of human resources in the hospitals of the City of Cologne was analyzed. The basis for the analysis was a simulation model that included fluctuation of staff, retirement, maternity leave, status of employee illness, partial retirement and fresh engagements per department and profession. The model was matched with the staff requirements for each department. The results showed a capacity analysis which was used to convey strategic measures for staff recruitment and retention. The greatest risk for shortage of qualified staff was found in the fluctuation of doctors and in the aging work force. Without strategic human resource management the hospitals would face a 50% reduction of the work force within 10 years and after 2 years there would be a 25% deficit of anesthesiologists with impact on the function of operation rooms (OR) and intensive care units. Qualification and continuous training of staff members as well as process optimization are the most important spheres of activity for human resource management in order to recruit and retain qualified staff members. Prospective human resource planning for the OR and intensive care units can help to detect shortage of staff and loss of competence early enough to apply effective personnel development measures. A growing number of companies have started to plan ahead of the current demand of human resources. Hospitals should follow this example because the competition for qualified staff members is increasing rapidly.

Animal Health and Welfare Issues Facing Organic Production Systems.

PubMed

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

2013-10-31

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

Proactive conservation management of an island-endemic bird species in the face of global change

USGS Publications Warehouse

Morrison, S.A.; Sillett, T. Scott; Ghalambor, Cameron K.; Fitzpatrick, J.W.; Graber, D.M.; Bakker, V.J.; Bowman, R.; Collins, C.T.; Collins, P.W.; Delaney, K.S.; Doak, D.F.; Koenig, Walter D.; Laughrin, L.; Lieberman, A.A.; Marzluff, J.M.; Reynolds, M.D.; Scott, J.M.; Stallcup, J.A.; Vickers, W.; Boyce, W.M.

2011-01-01

Biodiversity conservation in an era of global change and scarce funding benefits from approaches that simultaneously solve multiple problems. Here, we discuss conservation management of the island scrub-jay (Aphelocoma insularis), the only island-endemic passerine species in the continental United States, which is currently restricted to 250-square-kilometer Santa Cruz Island, California. Although the species is not listed as threatened by state or federal agencies, its viability is nonetheless threatened on multiple fronts. We discuss management actions that could reduce extinction risk, including vaccination, captive propagation, biosecurity measures, and establishing a second free-living population on a neighboring island. Establishing a second population on Santa Rosa Island may have the added benefit of accelerating the restoration and enhancing the resilience of that island's currently highly degraded ecosystem. The proactive management framework for island scrub-jays presented here illustrates how strategies for species protection, ecosystem restoration, and adaptation to and mitigation of climate change can converge into an integrated solution. ?? 2011 by American Institute of Biological Sciences. All rights reserved.

Hope for the Forests? Habitat Resiliency Illustrated in the Face of Climate Change Using Fine-Scale Modeling

NASA Astrophysics Data System (ADS)

Flint, L. E.; Flint, A. L.; Weiss, S. B.; Micheli, E. R.

2010-12-01

In the face of rapid climate change, fine-scale predictions of landscape change are of extreme interest to land managers that endeavor to develop long term adaptive strategies for maintaining biodiversity and ecosystem services. Global climate model (GCM) outputs, which generally focus on estimated increases in air temperature, are increasingly applied to species habitat distribution models. For sensitive species subject to climate change, habitat models predict significant migration (either northward or towards higher elevations), or complete extinction. Current studies typically rely on large spatial scale GCM projections (> 10 km) of changes in precipitation and air temperature: at this scale, these models necessarily neglect subtleties of topographic shading, geomorphic expression of the landscape, and fine-scale differences in soil properties - data that is readily available at meaningful local scales. Recent advances in modeling take advantage of available soils, geology, and topographic data to construct watershed-scale scenarios using GCM inputs and result in improved correlations of vegetation distribution with temperature. For this study, future climate projections were downscaled to 270-m and applied to a physically-based hydrologic model to calculate future changes in recharge, runoff, and climatic water deficit (CWD) for basins draining into the northern San Francisco Bay. CWD was analyzed for mapped vegetation types to evaluate the range of CWD for historic time periods in comparison to future time periods. For several forest communities (including blue oak woodlands, montane hardwoods, douglas-fir, and coast redwood) existing landscape area exhibiting suitable CWD diminishes by up 80 percent in the next century, with a trend towards increased CWD throughout the region. However, no forest community loses all suitable habitat, with islands of potential habitat primarily remaining on north facing slopes and deeper soils. Creation of new suitable habitat is also predicted throughout the region. Results have direct application to management issues of habitat connectivity, forest land protection and acquisition, and active management solutions such as transplanting or assisted migration. Although this analysis considers only one driver of forest habitat distribution, consideration of hydrologic derivatives at a fine scale explains current forest community distributions and provides a far more informed perspective on potential future forest distributions. Results demonstrate the utility of fine-scale modeling and provide landscape managers and conservation agencies valuable management tools in fine-scale future forest scenarios and a framework for evaluating forest resiliency in a changing climate.

The FaceBase Consortium: A comprehensive program to facilitate craniofacial research

PubMed Central

Hochheiser, Harry; Aronow, Bruce J.; Artinger, Kristin; Beaty, Terri H.; Brinkley, James F.; Chai, Yang; Clouthier, David; Cunningham, Michael L.; Dixon, Michael; Donahue, Leah Rae; Fraser, Scott E.; Hallgrimsson, Benedikt; Iwata, Junichi; Klein, Ophir; Marazita, Mary L.; Murray, Jeffrey C.; Murray, Stephen; de Villena, Fernando Pardo-Manuel; Postlethwait, John; Potter, Steven; Shapiro, Linda; Spritz, Richard; Visel, Axel; Weinberg, Seth M.; Trainor, Paul A.

2012-01-01

The FaceBase Consortium consists of ten interlinked research and technology projects whose goal is to generate craniofacial research data and technology for use by the research community through a central data management and integrated bioinformatics hub. Funded by the National Institute of Dental and Craniofacial Research (NIDCR) and currently focused on studying the development of the middle region of the face, the Consortium will produce comprehensive datasets of global gene expression patterns, regulatory elements and sequencing; will generate anatomical and molecular atlases; will provide human normative facial data and other phenotypes; conduct follow up studies of a completed genome-wide association study; generate independent data on the genetics of craniofacial development, build repositories of animal models and of human samples and data for community access and analysis; and will develop software tools and animal models for analyzing and functionally testing and integrating these data. The FaceBase website (http://www.facebase.org) will serve as a web home for these efforts, providing interactive tools for exploring these datasets, together with discussion forums and other services to support and foster collaboration within the craniofacial research community. PMID:21458441

New Clinical and Research Trends in Lower Extremity Management for Ambulatory Children with Cerebral Palsy

PubMed Central

Damiano, Diane L.; Alter, Katharine E.; Chambers, Henry

2010-01-01

Synopsis Cerebral palsy is the most prevalent physical disability in childhood and includes a group of disorders with varying manifestations and levels of capability in individuals given this diagnosis. This chapter will focus on current and future intervention strategies for improving mobility and participation over the lifespan for ambulatory children with cerebral palsy (CP). The provision and integration of physical therapy, medical and orthopedic surgery management focused primarily on the lower extremities will be discussed here. Some of the newer trends are: more intense and task-related exercise strategies, greater precision in tone identification and management, and a shift towards musculoskeletal surgery that focuses more on promoting dynamic bony alignment and less on releasing or lengthening tendons. Advances in basic and clinical science and technology development are changing existing paradigms and offering renewed hope for improved functioning for children with CP who are currently facing a lifelong disability with unique challenges at each stage in life. PMID:19643348

Guide for developing an information technology investment road map for population health management.

PubMed

Hunt, Jacquelyn S; Gibson, Richard F; Whittington, John; Powell, Kitty; Wozney, Brad; Knudson, Susan

2015-06-01

Many health systems recovering from a massive investment in electronic health records are now faced with the prospect of maturing into accountable care organizations. This maturation includes the need to cooperate with new partners, involve substantially new data sources, require investment in additional information technology (IT) solutions, and become proficient in managing care from a new perspective. Adding to the confusion, there are hundreds of population health management (PHM) vendors with overlapping product functions. This article proposes an organized approach to investing in PHM IT. The steps include assessing the organization's business and clinical goals, establishing governance, agreeing on business requirements, evaluating the ability of current IT systems to meet those requirements, setting time lines and budgets, rationalizing current and future needs and capabilities, and installing the new systems in the context of a continuously learning organization. This article will help organizations chart their position on the population health readiness spectrum and enhance their chances for a successful transition from volume-based to value-based care.

A review of the key genetic tools to assist imperiled species conservation: analyzing West Indian manatee populations

USGS Publications Warehouse

Bonde, Robert K.; McGuire, Peter M.; Hunter, Margaret E.

2012-01-01

Managers faced with decisions on threatened and endangered wildlife populations often are lacking detailed information about the species of concern. Integration of genetic applications will provide management teams with a better ability to assess and monitor recovery efforts on imperiled species. The field of molecular biology continues to progress rapidly and many tools are currently available. Presently, little guidance is available to assist researchers and managers with the appropriate selection of genetic tools to study the status of wild manatee populations. We discuss several genetic tools currently employed in the application of conservation genetics, and address the utility of using these tools to determine population status to aid in conservation efforts. As an example, special emphasis is focused on the endangered West Indian manatee (Order Sirenia). All four extant species of sirenians are imperiled throughout their range, predominately due to anthropogenic sources; therefore, the need for genetic information on their population status is direly needed.

Marketers don't wear plaid: marketing and health care administration in the Canadian context.

PubMed

Rigby, J M; Backman, A M

1997-01-01

Marketing has a bad reputation among Canadian health managers, even though marketing solutions may address many of their problems. This article provides an overview of current understandings of marketing and how they may be applied to health care situations. Marketing should be considered an ongoing process. This is particularly helpful if we understand the root task of health managers as creating and promoting exchanges--with governments, physicians, nurses, other health workers and client groups. Exchanges that are desirable to the health care community will more likely occur if the true costs and benefits of health services are analyzed, understood and imaginatively communicated. The public constantly evaluates the health system. Constant evaluation implies a need for marketing directed internally at staff and those within the health system, and externally at constituents outside the system. Properly understood and practiced, marketing can be part of the innovative solutions health care managers develop and apply as they deal with the difficult challenges facing them in Canada's current health care environment.

Targeted gene flow for conservation.

PubMed

Kelly, Ella; Phillips, Ben L

2016-04-01

Anthropogenic threats often impose strong selection on affected populations, causing rapid evolutionary responses. Unfortunately, these adaptive responses are rarely harnessed for conservation. We suggest that conservation managers pay close attention to adaptive processes and geographic variation, with an eye to using them for conservation goals. Translocating pre-adapted individuals into recipient populations is currently considered a potentially important management tool in the face of climate change. Targeted gene flow, which involves moving individuals with favorable traits to areas where these traits would have a conservation benefit, could have a much broader application in conservation. Across a species' range there may be long-standing geographic variation in traits or variation may have rapidly developed in response to a threatening process. Targeted gene flow could be used to promote natural resistance to threats to increase species resilience. We suggest that targeted gene flow is a currently underappreciated strategy in conservation that has applications ranging from the management of invasive species and their impacts to controlling the impact and virulence of pathogens. © 2015 Society for Conservation Biology.

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2016-09-01

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

Challenges Facing Managers in Managing Conflict in Schools in the South and South Central Regions of Botswana

ERIC Educational Resources Information Center

Morake, Nnior Machomi; Monobe, Ratau John; Dingwe, Stephonia

2011-01-01

The purpose of this study was to examine the challenges facing managers in managing conflict in schools of South and South Central Regions of Botswana. In this study, the schedule of interview was used to collect empirical data. A random sample of 50 school managers and deputy school managers was selected for interviews. Major findings of the…

The role of peer support in diabetes care and self-management.

PubMed

Brownson, Carol A; Heisler, Michele

2009-03-01

In light of the growing prevalence and healthcare costs of diabetes mellitus, it is critically important for healthcare providers to improve the efficiency and effectiveness of their diabetes care. A key element of effective disease management for diabetes is support for patient self-management. Barriers to care exist for both patients and healthcare systems. As a result, many people with diabetes do not get the care and support needed to successfully manage their diabetes.Disease management approaches that incorporate peer support may be a promising way to help provide self-management support to patients with diabetes. Trained peers provide emotional support, instrumental (tangible or material) support, education, and skills training to those they serve, and outreach and care coordination for provider systems. They play a unique role that complements and supports clinical care.To describe how peers are currently supporting diabetes care, a number of databases were searched for studies describing the roles of peers using relevant key words. This paper reviews current literature that describes the roles and duties of peers in interventions to improve diabetes care, with a focus on their contributions to six essential elements of self-management support: (i) access to regular, high-quality clinical care; (ii) an individualized approach to assessment and treatment; (iii) patient-centered collaborative goal setting; (iv) education and skills training; (v) ongoing follow-up and support; and (vi) linkages to community resources.Peers worked under a variety of titles, which did not define their duties. The scope of their work ranged from assisting health professionals to playing a central role in care. Providing education and follow-up support were the two most common roles. In all but one study, these roles were carried out during face-to-face contact, most frequently in community sites.A growing body of literature supports the value of peer models for diabetes management. Additional research can answer remaining questions related to such issues as cost effectiveness, sustainability, integration of peers into health and social service delivery systems, and recruitment, training, and support of peers. Continuing to develop and evaluate innovative models for more effectively mobilizing and integrating peers into diabetes care has great potential for improving diabetes outcomes worldwide.

DOT's budget : management and performance issues facing the department in fiscal year 1999

DOT National Transportation Integrated Search

1998-02-12

This testimony discusses key resource management issues and performance challenges facing the Department of Transportation in 1999 and beyond. 1. There is a need for increased management attention to highway, transit, and rail programs - which accoun...

Smokey comes of age: Unmanned aerial systems for fire management

USGS Publications Warehouse

Twidwell, Dirac; Allen, Craig R.; Detweiler, Carrick; Higgins, James; Laney, Christian; Elbaum, Sebastian

2016-01-01

During the past century, fire management has focused on techniques both to protect human communities from catastrophic wildfire and to maintain fire-dependent ecological systems. However, despite a large and increasing allocation of resources and personnel to achieve these goals, fire management objectives at regional to global scales are not being met. Current fire management techniques are clearly inadequate for the challenges faced by fire managers, and technological innovations are needed. Advances in unmanned aerial systems (UAS) technology provide opportunities for innovation in fire management and science. In many countries, fire management organizations are beginning to explore the potential of UAS for monitoring fires. We have taken the next step and developed a prototype that can precisely ignite fires as part of wildfire suppression tactics or prescribed fires (fire intentionally ignited within predetermined conditions to reduce hazardous fuels, improve habitat, or mitigate for large wildfires). We discuss the potential for these technologies to benefit fire management activities, while acknowledging the sizeable sociopolitical barriers that prevent their immediate broad application.

A comparison of the effectiveness of a game informed online learning activity and face to face teaching in increasing knowledge about managing aggression in health settings.

PubMed

McKenzie, Karen

2013-12-01

The present study compared the impact of face to face teaching with a short online game informed learning activity on health participants' knowledge about, and confidence in, managing aggressive situations. Both forms of teaching resulted in a significant increase in participants' knowledge and confidence. Face to face training led to significantly greater increases in knowledge but was equivalent in terms of confidence. Both forms of teaching were rated positively, but face to face teaching received significantly higher ratings than the online activity. The study suggests that short online game informed learning activities may offer an effective alternative for health professional training where face to face training is not possible. Further research is needed on the longer term impact of both types of training on practice.

Clinical leadership: the elephant in the room.

PubMed

Edmonstone, John

2009-01-01

The article explores the concept of clinical leadership in the National Health Service in the UK by seeking to establish a workable definition and by contrasting it with managerial leadership, focussing on the 'disconnected hierarchy' in professional organizations. It proposes that the problems faced by clinical leadership relate to the current nature of general management in the NHS and concludes by suggesting that clinical leadership is the 'elephant in the room'-often ignored or unaddressed.

Big Data Challenges for Large Radio Arrays

NASA Technical Reports Server (NTRS)

Jones, Dayton L.; Wagstaff, Kiri; Thompson, David; D'Addario, Larry; Navarro, Robert; Mattmann, Chris; Majid, Walid; Lazio, Joseph; Preston, Robert; Rebbapragada, Umaa

2012-01-01

Future large radio astronomy arrays, particularly the Square Kilometre Array (SKA), will be able to generate data at rates far higher than can be analyzed or stored affordably with current practices. This is, by definition, a "big data" problem, and requires an end-to-end solution if future radio arrays are to reach their full scientific potential. Similar data processing, transport, storage, and management challenges face next-generation facilities in many other fields.

Is management still a science?

PubMed

Freedman, D H

1992-01-01

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

Research on spatio-temporal database techniques for spatial information service

NASA Astrophysics Data System (ADS)

Zhao, Rong; Wang, Liang; Li, Yuxiang; Fan, Rongshuang; Liu, Ping; Li, Qingyuan

2007-06-01

Geographic data should be described by spatial, temporal and attribute components, but the spatio-temporal queries are difficult to be answered within current GIS. This paper describes research into the development and application of spatio-temporal data management system based upon GeoWindows GIS software platform which was developed by Chinese Academy of Surveying and Mapping (CASM). Faced the current and practical requirements of spatial information application, and based on existing GIS platform, one kind of spatio-temporal data model which integrates vector and grid data together was established firstly. Secondly, we solved out the key technique of building temporal data topology, successfully developed a suit of spatio-temporal database management system adopting object-oriented methods. The system provides the temporal data collection, data storage, data management and data display and query functions. Finally, as a case study, we explored the application of spatio-temporal data management system with the administrative region data of multi-history periods of China as the basic data. With all the efforts above, the GIS capacity of management and manipulation in aspect of time and attribute of GIS has been enhanced, and technical reference has been provided for the further development of temporal geographic information system (TGIS).

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

PubMed

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

2012-05-01

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

DOT's Budget: Safety, Management, and Other Issues Facing the Department in Fiscal Year 1998 and Beyond

DOT National Transportation Integrated Search

1997-03-06

This testimony discusses key resource management issues and performance challenges facing the Department of Transportation in 1998 and beyond. 1. Increased safety and security concerns prompted by accidents and maintenance issues. 2. Important manage...

Managing Ada development

NASA Technical Reports Server (NTRS)

Green, James R.

1986-01-01

The Ada programming language was developed under the sponsorship of the Department of Defense to address the soaring costs associated with software development and maintenance. Ada is powerful, and yet to take full advantage of its power, it is sufficiently complex and different from current programming approaches that there is considerable risk associated with committing a program to be done in Ada. There are also few programs of any substantial size that have been implemented using Ada that may be studied to determine those management methods that resulted in a successful Ada project. The items presented are the author's opinions which have been formed as a result of going through an experience software development. The difficulties faced, risks assumed, management methods applied, and lessons learned, and most importantly, the techniques that were successful are all valuable sources of management information for those managers ready to assume major Ada developments projects.

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

PubMed Central

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

2011-01-01

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

Facing Ethical Dilemmas in the Workplace: A Qualitative Study of HR Managers' Perceptions of the Influences on Their Behavior and the Implications for Building an Ethical Culture in Organizations

ERIC Educational Resources Information Center

LaMontagne, Ramona Marie

2012-01-01

This qualitative study examined the perceptions of human resource managers who had faced ethical dilemmas in the workplace, to gain an understanding of how they felt their life experiences shaped their values in making ethical decisions. The experiences of ten human resource managers who believed they chose a right course of action when faced with…

Developing management capacity building package to district health manager in northwest of Iran: A sequential mixed method study.

PubMed

Tabrizi, Jafar Sadegh; Gholipour, Kamal; Farahbakhsh, Mostafa; Jahanbin, Hasan; Karamuz, Majid

2016-11-01

To assess districts health managers educational needs and develop management training programmes. This mixed-method study was carried out between August 2014 and August 2015 in Tabriz, Iran. Four focus group discussion sessions and three semi-structured face-to-face interviews were conducted among district health managers and experts of a health centre. Besides, 52 questionnaires were completed to weigh and finalise management education module and courses. Interviews and focus group discussions were tape-recorded, transcribed and analysed using content analysis method. Data was analysed using SPSS17. There were 52 participants, of whom 40(78.8%) were men and 12(21.2%) were women. All of the subjects (100%) took part in the quantitative phase, while 25(48.08%) participated in the qualitative phase. In the qualitative section, 11(44%) participants were heads of unit/departments in provincial health centre and 14(56%) were district health managers. In the quantitative phase, 30(57.7%) participants were district health managers and 8(28.8%) were heads of units/departments. Moreover, 33(63.4%) participants had medical education. The job experience of 3(5.8%) participants in the current position was below five years. Districts health management training programme consisted of 10modules with 53 educational topics. The normalised score out of a total of 100 for rules and ethics was 75.51, health information management 71.19, management and leadership 69.27, district management 68.08, human resources and organisational creativity 67.58,quality improvement 66.6, health resources management 62.37, planning and evaluation 61.87, research in health system 59.15, and community participation was 53.15. Considering district health managers' qualification in health and medicine, they had not been trained in basic management. Almost all the management and leadership courses were prioritised as most necessary.

A Virtual World Versus Face-to-Face Intervention Format to Promote Diabetes Self-Management Among African American Women: A Pilot Randomized Clinical Trial

PubMed Central

Heyden, Robin; Mejilla, Roanne; Capelson, Roberta; Chalmers, Karen A; Rizzo DePaoli, Maria; Veerappa, Chetty; Wiecha, John M

2014-01-01

Background Virtual world environments have the potential to increase access to diabetes self-management interventions and may lower cost. Objective We tested the feasibility and comparative effectiveness of a virtual world versus a face-to-face diabetes self-management group intervention. Methods We recruited African American women with type 2 diabetes to participate in an 8-week diabetes self-management program adapted from Power to Prevent, a behavior-change in-person group program for African Americans with diabetes or pre-diabetes. The program is social cognitive theory–guided, evidence-based, and culturally tailored. Participants were randomized to participate in the program via virtual world (Second Life) or face-to-face, both delivered by a single intervention team. Blinded assessors conducted in-person clinical (HbA1c), behavioral, and psychosocial measurements at baseline and 4-month follow-up. Pre-post differences within and between intervention groups were assessed using t tests and chi-square tests (two-sided and intention-to-treat analyses for all comparisons). Results Participants (N=89) were an average of 52 years old (SD 10), 60% had ≤high school, 82% had household incomes

FORT Molecular Ecology Laboratory

USGS Publications Warehouse

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

2011-01-01

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

Evaluation of sediment transport at a fetch-limited beach from spring to neap tide

NASA Astrophysics Data System (ADS)

Carrasco, Ana Rita; Ferreira, Óscar; Matias, Ana; Freire, Paula; Alveirinho Dias, João.

2010-05-01

Sediment transport studies are useful tools for the determination of sediment budgets, important in the definition of management policies, in particular in environments not fully understood like fetch-limited beaches. Only a few studies have been made with respect to these beaches, and research efforts need to be continued to correctly quantify the main factors governing morphological changes. The present study provides new insights on sediment transport at a fetch-limited backbarrier beach located at the Peninsula do Ancão (Ria Formosa, South of Portugal). The field site extends over ~150 m and includes a sandy beach with a low and narrow reflective morphology, and an external sand bank at the seaward edge of the sub-aerial beach profile. Fluorescent tracers were used to measure the short-term sediment transport (rates and directions) from spring to neap tides, for fair-weather conditions. The experiment was set at two beach morphologies: beach face and sand bank. Tracer was released on 20th March 2008 at both sites, and sampling was conducted at low tide, each 24h, during 7 days. In situ fluorescent tracer detection was performed with UV light. Currents were obtained with a portable single-axis electromagnetic current meter located at the beach face, and an Aquadopp Profiler located at the sand bank. Local waves were obtained by numerical modelling for the study area, based on prevailing winds (measured by a nearby meteorological station), and using available bathymetric surveys. Tracer trends, tidal currents, wind conditions and waves were integrative in order to determine to which forcing mechanism the beach morphology was more responsive. Daily wind intensities were, in average, close to 5 m/s, and maximum estimated significant wave height (Hs) did not exceed 0.045 m. Daily mean wave period ranged from 0.5 s to 0.7 s. The maximum tidal range was 2.8 m. Currents were of higher magnitude at the sand bank than at the beach face, with the maximum during ebb tide (0.50 m/s). At the beach face, maximum velocities are very similar for both ebb and flood tide, with a maximum of 0.26 m/s. Tracer displacement was greater at the beach face, indicating that this is the most active part of the profile during the experiment. At the sand bank, tracer dispersion was greater, but tracer advection was shorter. Tracer isopachs illustrate a relatively independency of both analysed morphologies, without significant exchange across the profile. At both morphologies, the residual transport is dominated by the longshore component, and mostly directed towards the ebb. Ebb directed transport agrees with ebb dominance on tidal currents at this location. Results suggest a tidal and current dominance. Tidal range assumes particular importance at beach face.

A new perspective on optimal care for patients with COPD.

PubMed

Postma, Dirkje; Anzueto, Antonio; Calverley, Peter; Jenkins, Christine; Make, Barry J; Sciurba, Frank C; Similowski, Thomas; van der Molen, Thys; Eriksson, Göran

2011-06-01

Worldwide, clinicians face the task of providing millions of patients with the best possible treatment and management of COPD. Currently, management primarily involves short-term 'here-and-now' goals, targeting immediate patient benefit. However, although there is considerable knowledge available to assist clinicians in minimising the current impact of COPD on patients, relatively little is known about which dominant factors predict future risks. These predictors may vary for different outcomes, such as exacerbations, mortality, co-morbidities, and the long-term consequences of COPD. We propose a new paradigm to achieve 'optimal COPD care' based on the concept that here-and-now goals should be integrated with goals to improve long-term outcomes and reduce future risks. Whilst knowledge on risk factors for poorer outcomes in COPD is growing and some data exist on positive effects of pharmacological interventions, information on defining the benefits of all commonly used interventions for reducing the risk of various future disease outcomes is still scarce. Greater insight is needed into the relationships between the two pillars of optimal COPD care: 'best current control' and 'future risk reduction'. This broader approach to disease management should result in improved care for every COPD patient now and into the future.

Managing Programmatic Risk for Complex Space System Developments

NASA Technical Reports Server (NTRS)

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

2001-01-01

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

Towards Sustainable Ambon Bay: Evaluation of Solid Waste Management in Ambon City

NASA Astrophysics Data System (ADS)

Maryati, S.; Miharja, M.; Iscahyono, A. F.; Arsallia, S.; Humaira, AN S.

2017-07-01

Ambon Bay is a strategic area in the context of regional economic development, however it also faced environmental problems due to economic development and the growth of population. One of the environmental problems in the Ambon Bay is the growing solid waste which in turn lowers the quality of the water. The purpose of this study is to evaluate solid waste management in the Ambon City and propose recommendation in order to reduce solid waste in the Ambon Bay. The analytical method used is descriptive analysis by comparing a number of criteria based on the concept of solid waste management in coastal region with the current conditions of solid waste management in Ambon City. Criteria for waste management are divided into generation, storage, collection, transport, transfer and disposal. From the results of analysis, it can be concluded that the components of solid waste management at transport, transfer, and disposal level are generally still adequate, but solid waste management at source, storage and collection level have to be improved.

Water Resources Management and Hydrologic Design Under Uncertain Climate Change Scenarios

NASA Astrophysics Data System (ADS)

Teegavarapu, R. S.

2008-05-01

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

Feasibility of an online and a face-to-face version of a self-management program for young adults with a rheumatic disease: experiences of young adults and peer leaders

PubMed Central

2014-01-01

Background Based on the self-efficacy theory, an online and a face-to-face self-management programs ‘Challenge your Arthritis’ for young adults with a rheumatic disease have recently been developed. These two courses are led by young peer leaders. The objective of this study was to test the feasibility of the online and face-to-face self-management program. Methods Feasibility was evaluated on items of perceived usefulness, perceived ease of use, user-acceptance, and adherence to both programs in young adults and peer leaders. Additional analyses of interactions on the e-Health applications, discussion board and chat board, were conducted. Results Twenty-two young adults with a diagnosed rheumatic disease participated in the study: 12 young adults followed the online program and 10 followed the face-to-face program. Both programs appeared to be feasible, especially in dealing with problems in daily life, and the participants indicated the time investment as ‘worthwhile’. In using the online program, no technical problems occurred. Participants found the program easy to use, user friendly, and liked the ‘look and feel’ of the program. Conclusions Both the online and the face-to-face versions of a self-management program. ‘Challenge your arthritis’ were found to be feasible and well appreciated by young adults with a rheumatic disease. Because these programs are likely to be a practical aid to health practices, a randomized controlled study to investigate the effects on patient outcomes is planned. PMID:24666817

Feasibility of an online and a face-to-face version of a self-management program for young adults with a rheumatic disease: experiences of young adults and peer leaders.

PubMed

Ammerlaan, Judy; van Os-Medendorp, Harmieke; Scholtus, Lieske; de Vos, André; Zwier, Matthijs; Bijlsma, Hans; Kruize, Aike A

2014-03-25

Based on the self-efficacy theory, an online and a face-to-face self-management programs 'Challenge your Arthritis' for young adults with a rheumatic disease have recently been developed. These two courses are led by young peer leaders. The objective of this study was to test the feasibility of the online and face-to-face self-management program. Feasibility was evaluated on items of perceived usefulness, perceived ease of use, user-acceptance, and adherence to both programs in young adults and peer leaders. Additional analyses of interactions on the e-Health applications, discussion board and chat board, were conducted. Twenty-two young adults with a diagnosed rheumatic disease participated in the study: 12 young adults followed the online program and 10 followed the face-to-face program. Both programs appeared to be feasible, especially in dealing with problems in daily life, and the participants indicated the time investment as 'worthwhile'. In using the online program, no technical problems occurred. Participants found the program easy to use, user friendly, and liked the 'look and feel' of the program. Both the online and the face-to-face versions of a self-management program. 'Challenge your arthritis' were found to be feasible and well appreciated by young adults with a rheumatic disease. Because these programs are likely to be a practical aid to health practices, a randomized controlled study to investigate the effects on patient outcomes is planned.

Using alternatives to face-to-face consultations: a survey of prevalence and attitudes in general practice.

PubMed

Brant, Heather; Atherton, Helen; Ziebland, Sue; McKinstry, Brian; Campbell, John L; Salisbury, Chris

2016-07-01

The ubiquitous use of communication technologies has led to an expectation that a similar approach should extend to health care. Despite considerable rhetoric about the need for general practices to offer alternatives to face-to-face consultations, such as telephone, email, and internet video consultations, the extent to which such technologies are actually used at present is unclear. The aim of the survey was to identify the frequency and range of ways in which general practices are providing (or planning) alternatives to face-to-face consultations. A postal survey of practices around Bristol, Oxford, Lothian, the Highlands, and the Western Isles of Scotland. A postal questionnaire survey was sent to each of the GPs and practice managers of 421 practices between January and May 2015. A response was received from 319/421 practices (76%). Although the majority of the practices reported that they were conducting telephone consultations frequently (n = 211/318, 66%), fewer were implementing email consultations (n = 18/318, 6%), and most (n = 169/318, 53%) had no plans to introduce this. None were currently using internet video, and 86% (n = 273/318) had no plans to introduce internet video consultations. These findings were repeated in the reported use of alternatives to face-to-face consultations at an individual GP level. Optional free text responses were completed by 28% of responders, and offered an explanation for the (often perceived) barriers and incentives for implementation. Despite policy pressure to introduce consultations by email and internet video, there is a general reluctance among GPs to implement alternatives to face-to-face consultations. This identifies a substantial gap between rhetoric and reality in terms of the likelihood of certain alternatives (email, video) changing practice in the near future. © British Journal of General Practice 2016.

Reputation Management: The New Face of Corporate Public Relations?

ERIC Educational Resources Information Center

Hutton, James G.; Goodman, Michael B.; Alexander, Jill B.; Genest, Christina M.

2001-01-01

Presents an empirical study of the Fortune 500 companies suggesting that "reputation management" is gaining ground as a driving philosophy behind corporate public relations. Finds some interesting correlations between reputation and specific categories of spending. Concludes that if reputation management is the new face of corporate…

14 CFR 6 - Objective Classification of Balance Sheet Elements

Code of Federal Regulations, 2012 CFR

2012-01-01

...] Current Liabilities 2000Current Maturities of Long-term Debt. Record here the face value or principal... not properly classifiable as current. 2005Notes Payable—Banks. Record here the face value of all notes... should be included in account 2000. 2015Notes Payable—Other. Record here the face value of all notes...

14 CFR Section 6 - Objective Classification of Balance Sheet Elements

Code of Federal Regulations, 2014 CFR

2014-01-01

...] Current Liabilities 2000Current Maturities of Long-term Debt. Record here the face value or principal... not properly classifiable as current. 2005Notes Payable—Banks. Record here the face value of all notes... should be included in account 2000. 2015Notes Payable—Other. Record here the face value of all notes...

14 CFR Section 6 - Objective Classification of Balance Sheet Elements

Code of Federal Regulations, 2013 CFR

2013-01-01

...] Current Liabilities 2000Current Maturities of Long-term Debt. Record here the face value or principal... not properly classifiable as current. 2005Notes Payable—Banks. Record here the face value of all notes... should be included in account 2000. 2015Notes Payable—Other. Record here the face value of all notes...

Examining the structural challenges to communication as experienced by nurse managers in two US hospital settings.

PubMed

Marx, Marcia

2014-11-01

This study examined the structural barriers to communication for first-line nurse managers with their staff nurses. The delivery of quality care depends on effective communication in hospital units. First-line nurse managers are central figures in networks whose responsibility is to communicate information from the senior management to staff nurses. The data were collected using face-to-face interviews with first-line managers at two US hospitals The interviews were transcribed and coded with limited use of the qualitative software atlas Interview questions focused on work experiences of managers with special emphases on communication. Structural barriers that influenced managers' communication included the amount of face-to-face interaction with nurses, the amount of information to communicate, levels of formalization, outreach to all nurses, time constraints and nurses' subcultural networks These factors compromised managers' ability to communicate effectively with nurses. Managers should carefully examine how structure affects communication recognizing that some dynamics of structure cannot be changed but that they can influence others, such as formalization and communication networks. Managers should examine their own positioning within nurses' networks and demonstrate to nurses that their expertise contributes to the collaborative capital upon which nursing practice depends. © 2013 John Wiley & Sons Ltd.

"Dropbox" Brings Course Management Back to Teachers

ERIC Educational Resources Information Center

Niles, Thaddeus M.

2013-01-01

Course management software (CMS) allows teachers to deliver content electronically and manage collaborative coursework, either blending with face-to-face interactions or as the core of an entirely virtual classroom environment. CMS often takes the form of an electronic storehouse of course materials with which students can interact, a virtual…

Business---Education: Parallels in Management.

ERIC Educational Resources Information Center

Speer, Edgar B.

1976-01-01

Administrators of higher education are facing a challenge and opportunity that parallels those faced by managers in American business. The economic situation presents a struggle to make ends meet as well as an opportunity to sharpen its role in society, to redefine its goals. Administrators in both fields are using management-by-objective theories…

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

PubMed

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

2017-09-01

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

Knowledge of hypertension and its management among hypertensive patients on chronic medicines at primary health care public sector facilities in South Africa; findings and implications.

PubMed

Rampamba, Enos M; Meyer, Johanna C; Helberg, Elvera; Godman, Brian

2017-08-01

There are high growing prevalence rates of hypertension in South Africa. Consequently, there is a need to assess knowledge and management among hypertensive patients receiving chronic medication from primary health care (PHC) facilities in South Africa as a basis for improving future management. This is important as South Africa seeks to improve its management of chronic diseases. Descriptive, quantitative study amongst chronic hypertensive patients in the chronic disease programme. Patients were interviewed face-to-face by trained pharmacists using a structured questionnaire. Data analysis included descriptive and inferential statistics. Half (53.7%) of the patients had uncontrolled blood pressure (BP). Less than a third of patients (27.7%) knew what hypertension is, the meaning of recorded BP numbers (4.5%), and what normal BP should be (19.9%). All patients who knew the meaning of BP numbers had formal education (p = 0.047). Only 15.6% of the 56.0% patients, who received hypertension information, received it on antihypertensive medicines specifically. The majority of the patients lacked hypertension specific knowledge and only half had controlled BP. Interventions to improve the control of high BP should be targeted at closing knowledge gaps as part of the current chronic treatment initiatives in South Africa to ensure the benefits of increased access to care are realized.

Hospital Management Between The Modern Image And Aging

NASA Astrophysics Data System (ADS)

Dadulescu, Ana-Maria

2015-09-01

Hospital management has experienced significant progress with the evolution of the Romanian health system reform, it has made strides in terms of resource allocation and cost control, new systems for classification, evaluation and monitoring (DRGs, SIUI, CaPeSaRo) were implemented, some taken from other countries and adapted to local conditions, but not always integrated with the other components and sometimes incompletely implemented and developed. This material does not offer definite solutions to current problems. It only briefly addresses the main aspects of hospital activity, and points out some failures with whom hospital managers are presently faced. Once the problems are identified it creates prerequisites for solving them, it opens channels of research and development of new methodologies or correlation of the existing deficient workflows that can be corrected.

Management of aspen in a changing environment

USGS Publications Warehouse

Shinneman, Douglas; Halford, Anne S.; Howell, Cheri; Krasnow, Kevin D.; Strand, Eva K.; Chambers, Jeanne

2015-01-01

Aspen communities are biologically rich and ecologically valuable, yet they face myriad threats, including changing climate, altered fire regimes, and excessive browsing by domestic and wild ungulates. Recognizing the different types of aspen communities that occur in the Great Basin, and being able to distinguish between seral and stable aspen stands, can help managers better identify restoration needs and objectives. Identifying key threats to aspen regeneration and persistence in a given stand or landscape is important to designing restoration plans, and to selecting appropriate treatment types. Although some aspen stands will need intensive treatment (e.g., use of fire) to persist or remain healthy, other stands may only require the modification of current management practices (e.g., reducing livestock browsing) or may not require any action at all (e.g., self-replacing stable aspen communities).

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

PubMed

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

2013-01-01

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

Commentary on the reimbursement paradox.

PubMed

Reaven, Nancy L; Rosenbloom, Judy

2009-07-01

Reimbursement policies are a critical step in the incorporation of new technologies and therapies into the clinical armamentarium. Reimbursement is an umbrella concept describing the process to manage and pay for healthcare services, including benefit coverage, coding, and payment processes. The technologies and services used in therapeutic temperature management are not directly reimbursed, leading to challenges by hospitals and physicians that the services are too expensive to use. The reimbursement models used in the United States make it increasingly difficult for new technologies and therapies to gain direct reimbursement, part of a strategy by insurers, including Medicare and private insurance companies, to manage access to health care services. Insurers, physicians, hospitals, and other providers face conflicting financial incentives in current reimbursement systems. Aligning the financial incentives underlying reimbursement systems is necessary to adequately support new technologies of merit.

Future implications of eHealth interventions for chronic pain management in underserved populations.

PubMed

DeMonte, Colette M; DeMonte, William D; Thorn, Beverly E

2015-01-01

Many underserved communities, especially those in rural settings, face unique challenges that make high quality healthcare less accessible. The implementation of eHealth technologies has become a potentially valuable option to disseminate interventions. The authors' work in rural Alabama Federally Qualified Health Centers provide insights into the access to technology as well as the likelihood of utilizing eHealth technology in underserved communities. This paper will review current challenges related to digital dissemination of behavioral health interventions for chronic pain. Two major concerns are the lack of technological resources and the lack of appropriate materials for patients who may have low levels of reading, health and/or digital literacy. We will propose some recommendations to address common barriers faced by those providing care.

Project Overview: A Reef Manager's Guide to Coral Bleaching ...

EPA Pesticide Factsheets

The purpose of this report is to provide the latest scientific knowledge and discuss available management options to assist local and regional managers in responding effectively to mass coral bleaching events. Background A Reef Manager’s Guide to Coral Bleaching is the result of a collaborative effort by over 50 scientists and managers to: (1) share the best available scientific information on climate-related coral bleaching; and (2) compile a tool kit of currently available strategies for adaptive management of coral reefs in a changing climate. The result is a compendium of current information, tools, and practical suggestions to aid managers in their efforts to protect reefs in a way that maximizes reef resilience in the face of continuing climate change. The Guide is a joint publication of the National Oceanic and Atmospheric Administration, the Great Barrier Reef Marine Park Authority, and The World Conservation Union, with author contributions from a variety of international partners from government agencies, non-governmental organizations, and academic institutions. EPA’s Office of Research and Development was a major contributor to the Guide through authorship and participation in the final review and editing process for the entire report. A Reef Manager’s Guide to Coral Bleaching is the result of a collaborative effort by over 50 scientists and managers to: (1) share the best available scientific information on climate-related coral blea

Alaskan North Slope Oil & Gas Transportation Support

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

Lilly, Michael Russell

North Slope oil and gas resources are a critical part of US energy supplies and their development is facing a period of new growth to meet increasing national energy needs. While this growth is taking place in areas active in development for more than 20 years, there are many increasing environmental challenges facing industry and management agencies. A majority of all exploration and development activities, pipeline maintenance and other field support activities take place in the middle of winter, when the fragile tundra surface is more stable. The window for the critical oil and gas winter operational season has beenmore » steadily decreasing over the last 25 years. The number of companies working on the North Slope is increasing. Many of these companies are smaller and working with fewer resources than the current major companies. The winter operations season starts with the tundra-travel opening, which requires 15 cm of snow on the land surface in the coastal management areas and 23 cm in the foothills management areas. All state managed areas require -5°C soil temperatures at a soil depth of 30 cm. Currently there are no methods to forecast this opening date, so field mobilization efforts are dependent on agency personnel visiting field sites to measure snow and soil temperature conditions. Weeks can be easily lost in the winter operating season due to delays in field verification of tundra conditions and the resulting mobilization. After the season is open, a significant percentage of exploration, construction, and maintenance do not proceed until ice roads and pads can be built. This effort is dependent on access to lake ice and under-ice water. Ice chipping is a common ice-road construction technique used to build faster and stronger ice roads. Seasonal variability in water availability and permitting approaches are a constant constraint to industry. At the end of the winter season, projects reliant on ice-road networks are often faced with ending operations early or risk being caught on ice roads with flooded stream crossings, or unusable sections of ice road due to local melt. These challenges result in higher oil and gas field exploration and operational costs. Much of the scientific understanding to address transportation issues for oil and gas development on the North Slope exists, but has not been placed into a set of tools and data sets useful for industry and management agencies. Optimizing North Slope transportation networks during winter operation seasons is critical in managing increasing resource development and will provide a framework for environmentally-responsive development. Understanding the physical environment (such as snow, water, ice, soils) is necessary to ensure protection of fisheries and other natural resources on the sensitive tundra landscape. Solutions also have to do more than just describe current conditions, they need the ability to forecast short-term conditions. This will allow management agencies to respond to future variability in snow cover, soil temperature, and water availability more effectively. In turn, industry will then have more time to plan the significant mobilization taking place every winter season.« less

Using decision analysis to choose phosphorus targets for Lake Erie.

PubMed

Anderson, R M; Hobbs, B F; Koonce, J F; Locci, A B

2001-02-01

Lake Erie water quality has improved dramatically since the degraded conditions of the 1960s. Additional gains could be made, but at the expense of further investment and reductions in fishery productivity. In facing such cross-jurisdictional issues, natural resource managers in Canada and the United States must grapple with conflicting objectives and important uncertainties, while considering the priorities of the public that live in the basin. The techniques and tools of decision analysis have been used successfully to deal with such decision problems in a range of environmental settings, but infrequently in the Great Lakes. The objective of this paper is to illustrate how such techniques might be brought to bear on an important, real decision currently facing Lake Erie resource managers and stakeholders: the choice of new phosphorus loading targets for the lake. The heart of our approach is a systematic elicitation of stakeholder preferences and an investigation of the degree to which different phosphorus-loading policies might satisfy ecosystem objectives. Results show that there are potential benefits to changing the historical policy of reducing phosphorus loads in Lake Erie. Copyright 2001 Springer-Verlag

Automating Individualized Formative Feedback in Large Classes Based on a Directed Concept Graph

PubMed Central

Schaffer, Henry E.; Young, Karen R.; Ligon, Emily W.; Chapman, Diane D.

2017-01-01

Student learning outcomes within courses form the basis for course completion and time-to-graduation statistics, which are of great importance in education, particularly higher education. Budget pressures have led to large classes in which student-to-instructor interaction is very limited. Most of the current efforts to improve student progress in large classes, such as “learning analytics,” (LA) focus on the aspects of student behavior that are found in the logs of Learning Management Systems (LMS), for example, frequency of signing in, time spent on each page, and grades. These are important, but are distant from providing help to the student making insufficient progress in a course. We describe a computer analytical methodology which includes a dissection of the concepts in the course, expressed as a directed graph, that are applied to test questions, and uses performance on these questions to provide formative feedback to each student in any course format: face-to-face, blended, flipped, or online. Each student receives individualized assistance in a scalable and affordable manner. It works with any class delivery technology, textbook, and learning management system. PMID:28293202

Trade-off between light availability and soil fertility determine refugial conditions for the relict light-demanding species in lowland forests

NASA Astrophysics Data System (ADS)

Kiedrzyński, Marcin; Kurowski, Józef Krzysztof; Kiedrzyńska, Edyta

2017-11-01

Identifying potential refugial habitats in the face of rapid environmental change is a challenge faced by scientists and nature conservation managers. Relict populations and refugial habitats are the model objects in those studies. Based on the example of Actaea europaea from Central Poland, we analyse the habitat factors influencing relict populations of continental, light-demanding species in lowland forests and examine which habitats of studied species corresponding most closely to ancient vegetation. Our results indicate that the current refugial habitats of Actaea europaea include not only communities which are very similar to ancient open forest but also forests with a closed canopy. Although the populations are influenced by nitrogen and light availability, the co-occurrence of these two factors in forest communities is limited by dense canopy formation by hornbeam and beech trees on fertile soils and in more humid conditions. Our findings indicate that the future survival of relict, light-demanding communities in lowland forests requires low-intensity disturbances to be performed in tree-stands, according to techniques, which imitate traditional forests management.

[Face presentation: retrospective study of 32 cases at term].

PubMed

Ducarme, G; Ceccaldi, P-F; Chesnoy, V; Robinet, G; Gabriel, R

2006-05-01

To determine the etiologic factors, circumstances of diagnosis, obstetrical management and complications of face presentation and to value the maternal and foetal prognosis of this presentation. Thirty-two cases of face presentation have been observed in the maternity wards of Reims and Troyes over the last 12 years. The incidence of face presentation was 0.7 per 1000 deliveries. Spontaneous vaginal delivery occurred with mento-anterior presentation 73% of the time and caesarean section was performed in 100% of mento-posterior presentation. There was no increasing rate of foetal or maternal mortality and morbidity with vaginal delivery. Face presentation is an unusual complication of pregnancy with obstetric factors that predispose the foetus to face presentation. The low foetal and maternal mortality and morbidity substantiate the effectiveness of conservative management in face presentation.

Addressing current and future challenges for the NHS: the role of good leadership.

PubMed

Elton, Lotte

2016-10-03

Purpose This paper aims to describe and analyse some of the ways in which good leadership can enable those working within the National Health Service (NHS) to weather the changes and difficulties likely to arise in the coming years, and takes the format of an essay written by the prize-winner of the Faculty of Medical Leadership and Management's Student Prize. The Faculty of Medical Leadership and Management ran its inaugural Student Prize in 2015-2016, which aimed at medical students with an interest in medical leadership. In running the Prize, the Faculty hoped to foster an enthusiasm for and understanding of the importance of leadership in medicine. Design/methodology/approach The Faculty asked entrants to discuss the role of good leadership in addressing the current and future challenges faced by the NHS, making reference to the Leadership and Management Standards for Medical Professionals published by the Faculty in 2015. These standards were intended to help guide current and future leaders and were grouped into three categories, namely, self, team and corporate responsibility. Findings This paper highlights the political nature of health care in the UK and the increasing impetus on medical professionals to navigate debates on austerity measures and health-care costs, particularly given the projected deficit in NHS funding. It stresses the importance of building organisational cultures prizing transparency to prevent future breaches in standards of care and the value of patient-centred approaches in improving satisfaction for both patients and staff. Identification of opportunities for collaboration and partnership is emphasised as crucial to assuage the burden that lack of appropriate social care places on clinical services. Originality/value This paper offers a novel perspective - that of a medical student - on the complex issues faced by the NHS over the coming years and utilises a well-regarded set of standards in conceptualising the role that health professionals have to play in leading the NHS.

Identification of Patients With Diabetes Who Benefit Most From a Health Coaching Program in Chronic Disease Management, Sydney, Australia, 2013.

PubMed

Delaney, Grace; Newlyn, Neroli; Pamplona, Elline; Hocking, Samantha L; Glastras, Sarah J; McGrath, Rachel T; Fulcher, Gregory R

2017-03-02

Chronic disease management programs (CDMPs) that include health coaching can facilitate and coordinate diabetes management. The aim of this study was to assess changes in patients' general knowledge of diabetes, self-reported health status, diabetes distress, body mass index (BMI), and glycemic control after enrollment in a face-to-face CDMP group health coaching session (with telephone follow-up) compared with participation in telephone-only health coaching, during a 12-month period. Patients with diabetes were enrolled in a health coaching program at Royal North Shore Hospital, Sydney, Australia, in 2013. Questionnaires were administered at baseline and at 3, 6, and 12 months, and the results were compared with baseline. Glycemic control, measured with glycated hemoglobin A 1c (HbA 1c ) and BMI, were measured at baseline and 12 months. Overall, 238 patients attended a face-to-face CDMP session with telephone follow-up (n = 178) or participated in telephone-only health coaching (n = 60). We found no change in BMI in either group; however, HbA 1c levels in patients with baseline above the current recommended target (>7%) decreased significantly from 8.5% (standard deviation [SD], 1.0%) to 7.9% (SD, 1.0%) (P = .03). Patients with the lowest self-reported health status at baseline improved from 4.4 (SD, 0.5) to 3.7 (SD, 0.9) (P = .001). Diabetes knowledge improved in all patients (24.4 [SD, 2.4] to 25.2 [SD, 2.4]; P < .001), and diabetes distress decreased among those with the highest levels of distress at baseline (3.0 [SD, 0.4] vs 3.8 [SD, 0.6]; P = .003). Diabetes health coaching programs can improve glycemic control and reduce diabetes distress in patients with high levels of these at baseline.

Can we manage for biological diversity in the absence of science?

USGS Publications Warehouse

Trauger, D.L.; Hall, R.J.

1995-01-01

Conservation of biological diversity is dependent on sound scientific information about underlying ecological processes. Current knowledge of the composition, distribution, abundance and life cycles of most species of plants and animals is incomplete, insufficient, unreliable, or nonexistent. Contemporary managers are also confronted with additional levels of complexity related to varying degrees of knowledge and understanding about interactions of species and ecosystems. Consequently, traditional species-oriented management schemes may have unintended consequences and ecosystem-oriented management initiatives may fail in the face of inadequate or fragmentary information on the structure, function, and dynamics of biotic communities and ecological systems. Nevertheless, resource managers must make decisions and manage based on the best biological information currently available. Adaptive resource management may represent a management paradigm that allows managers to learn something about the species or systems that they are managing while they are managing, but potential pitfalls lurk for such approaches. In addition to lack of control over the primary physical, chemical, and ecological processes, managers also lack control over social, economic, and political parameters affecting resource management options. Moreover, appropriate goals may be difficult to identify and criteria for determining success may be elusive. Some management responsibilities do not lend themselves to adaptive strategies. Finally, the lessons learned from adaptive management are usually obtained from a highly situational context that may limit applicability in a wider range of situations or undermine confidence that problems and solutions were properly diagnosed and addressed. Several scenarios are critically examined where adaptive management approaches may be inappropriate or ineffective and where management for biological diversity may be infeasible or inefficient without a sound scientific basis. Whereas some level of management must exist to meet agency responsibilities, more research is needed to conserve biological diversity.

A call for tiger management using "reserves" of genetic diversity.

PubMed

Bay, Rachael A; Ramakrishnan, Uma; Hadly, Elizabeth A

2014-01-01

Tigers (Panthera tigris), like many large carnivores, are threatened by anthropogenic impacts, primarily habitat loss and poaching. Current conservation plans for tigers focus on population expansion, with the goal of doubling census size in the next 10 years. Previous studies have shown that because the demographic decline was recent, tiger populations still retain a large amount of genetic diversity. Although maintaining this diversity is extremely important to avoid deleterious effects of inbreeding, management plans have yet to consider predictive genetic models. We used coalescent simulations based on previously sequenced mitochondrial fragments (n = 125) from 5 of 6 extant subspecies to predict the population growth needed to maintain current genetic diversity over the next 150 years. We found that the level of gene flow between populations has a large effect on the local population growth necessary to maintain genetic diversity, without which tigers may face decreases in fitness. In the absence of gene flow, we demonstrate that maintaining genetic diversity is impossible based on known demographic parameters for the species. Thus, managing for the genetic diversity of the species should be prioritized over the riskier preservation of distinct subspecies. These predictive simulations provide unique management insights, hitherto not possible using existing analytical methods.

Implementing the work disability prevention paradigm among therapists in Hong Kong: facilitators and barriers.

PubMed

Szeto, Grace P Y; Cheng, Andy S K; Lee, Edwin W C; Schonstein, Eva; Gross, Douglas P

2011-03-01

This is a discussion paper to examine the issues surrounding management of work-related injuries by physiotherapists and occupational therapists in Hong Kong. Therapists working in public hospitals are faced with managing injured workers with limited resources and this frequently results in suboptimal outcomes. In this paper, five experienced therapists critically reviewed the current practices in the physiotherapy and occupational therapy professions in Hong Kong, with regard to managing patients with work injuries. In many hospitals, therapists still practice with a disease-based model focusing on symptom relief and restoration of general physical function. We collated information about current programs initiated by physiotherapists and occupational therapists to provide more strategic intervention strategies for early screening of high-risk patients and adaptive biopsychosocial interventions targeting return-to-work outcomes. Clinical and system-level barriers and facilitators of a major paradigm shift towards work disability prevention are discussed. Physiotherapists and occupational therapists need to develop more strategic collaborations and actively voice out the need for major systematic changes within the local healthcare system, in order to provide a more effective management approach in line with the concept of Work Disability Prevention.

Simultaneous personnel and vehicle shift scheduling in the waste management sector.

PubMed

Ghiani, Gianpaolo; Guerriero, Emanuela; Manni, Andrea; Manni, Emanuele; Potenza, Agostino

2013-07-01

Urban waste management is becoming an increasingly complex task, absorbing a huge amount of resources, and having a major environmental impact. The design of a waste management system consists in various activities, and one of these is related to the definition of shift schedules for both personnel and vehicles. This activity has a great incidence on the tactical and operational cost for companies. In this paper, we propose an integer programming model to find an optimal solution to the integrated problem. The aim is to determine optimal schedules at minimum cost. Moreover, we design a fast and effective heuristic to face large-size problems. Both approaches are tested on data from a real-world case in Southern Italy and compared to the current practice utilized by the company managing the service, showing that simultaneously solving these problems can lead to significant monetary savings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Chronic disease management and the home-care alternative in Ontario, Canada.

PubMed

Tsasis, Peter

2009-08-01

The pressure on our health-care system to deliver efficient, quality and cost-effective care is increasing. The debate on its sustainability is also expanding. These challenges can be managed with revisions to our health-care policy frameworks governing how and what public health-care services are delivered. Chronic disease management and home care can together ease many of the present and future pressures facing the health-care system. However, the current level of investment and the present policy are not effectively supporting movement in this direction. Updating the Canada Health Act to reflect the realities of our health-care system, and developing policies to support the areas of interdisciplinary teamwork and system integration are needed to facilitate chronic disease management and home care in Canada. This article lays out the challenges, highlights the impending issues and suggests a framework for moving forward.

A review of Integrated Vehicle Health Management tools for legacy platforms: Challenges and opportunities

NASA Astrophysics Data System (ADS)

Esperon-Miguez, Manuel; John, Philip; Jennions, Ian K.

2013-01-01

Integrated Vehicle Health Management (IVHM) comprises a set of tools, technologies and techniques for automated detection, diagnosis and prognosis of faults in order to support platforms more efficiently. Specific challenges are faced when IVHM tools are to be retrofitted into legacy vehicles since major modifications are much more challenging than with platforms whose design can still be modified. The topics covered in this Review Paper include the state of the art of IVHM tools and how their characteristics match the requirements of legacy aircraft, a summary of problems faced in the past trying to retrofit IVHM tools both from a technical and organisational perspective and the current level of implementation of IVHM in industry. Although the technology has not reached the level necessary to implement IVHM to its full potential on every kind of component, significant progress has been achieved on rotating equipment, structures or electronics. Attempts to retrofit some of these tools in the past faced both technical difficulties and opposition by some stakeholders, the later being responsible for the failure of technically sound projects in more than one occasion. Nevertheless, despite these difficulties, products and services based on IVHM technology have started to be offered by the manufacturers and, what is more important, demanded by the operators, providing guidance on what the industry would demand from IVHM on legacy aircraft.

77 FR 69913 - Self-Regulatory Organizations; Fixed Income Clearing Corporation; Notice of Filing of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

... to enhance the NOS for SPTs by no longer requiring the current face value submitted on each member's NOS to exactly match the current face value of the SPT. Instead, members will have the ability to submit and match multiple NOS to reduce the SPT current face until it is fully settled. For example, if a...

Drought vulnerability assessment: The case of wheat farmers in Western Iran

NASA Astrophysics Data System (ADS)

Zarafshani, Kiumars; Sharafi, Lida; Azadi, Hossein; Hosseininia, Gholamhossein; De Maeyer, Philippe; Witlox, Frank

2012-12-01

Drought, as a natural and slow-onset phenomenon, creates numerous damages to agricultural communities. As a drought prone area in the Middle East, Iran has currently launched a crisis management approach to mitigate the harmful impacts of drought. However, thus far studies indicate that effective drought management strategies should be designed based upon vulnerability management which can increase farmers' ability to challenge the impacts. The purpose of this study was to assess drought vulnerability across three drought intensities (very high, extremely high, and critical) areas in Western Iran. Accordingly, a survey study was applied and 370 wheat farmers who all experienced drought during 2007-2009 were selected through a multi-stage stratified random sampling method. Face to face interviews were used to collect data on vulnerability indices from the farmers. Me-Bar and Valdez's vulnerability formula was applied to assess the vulnerability of wheat farmers during drought. Results revealed that the farmers' vulnerability is influenced mainly by economic, socio-cultural, psychological, technical, and infrastructural factors. The results also indicated that the farmers in Sarpole-Zahab township were most vulnerable compared to those in the Kermanshah township as the least vulnerable. Accordingly, some conclusions and recommendations are drawn for both policy-makers and practitioners who often must prioritize limited resources in the design vulnerability-reducing interventions.

Expert consensus paper on the use of Vedolizumab for the management of patients with moderate-to-severe Inflammatory Bowel Disease.

PubMed

Armuzzi, Alessandro; Gionchetti, Paolo; Daperno, Marco; Danese, Silvio; Orlando, Ambrogio; Lia Scribano, Maria; Vecchi, Maurizio; Rizzello, Fernando

2016-04-01

Crohn's Disease (CD) and Ulcerative Colitis (UC) are chronic, relapsing conditions resulting from uncontrolled inflammation of the intestinal mucosa. Both conditions are associated with significant disability and patients with CD face higher mortality rates compared to the general population. The increasing understanding of the immunological basis of the disease led to the introduction of biologic therapies targeting key pathways of the natural and adaptive immune response such as Tumor Necrosis Factor α (TNF-α) inhibitors and, more recently, integrin-receptor antagonists. Treatment with TNF-α inhibitors improved clinical and patient-reported outcomes for many patients who did not benefit from conventional therapy. However, a sizeable share of patients still face suboptimal outcomes due to primary or secondary therapy failure. With the introduction of VDZ, a biologic treatment targeting novel IBD-relevant biologic pathways, it is crucial to understand how to integrate such innovations into current clinical practice. To this end, a panel of 14 Italian experts in the management of IBD met for a roundtable discussion. Recommendations concerning the management of moderate-to-severe IBD based on experts' opinions and literature review are discussed in the present report. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Educational technology integration and distance learning in respiratory care: practices and attitudes.

PubMed

Hopper, Keith B; Johns, Carol L

2007-11-01

Educational technologies have had an important role in respiratory care. Distance learning via postal correspondence has been used extensively in respiratory care, and Internet-based distance learning is now used in the training of respiratory therapists (RTs), clinical continuing education, and in baccalaureate degree and higher programs for RTs and educators. To describe the current scope of respiratory care educational technology integration, including distance learning. To investigate online research potential in respiratory care. A probabilistic online survey of United States respiratory care program directors was conducted on educational technology practices and attitudes, including distance learning. A parallel exploratory study of United States respiratory care managers was conducted. One-hundred seventy-seven (53%) program directors participated. One-hundred twenty-eight respiratory care managers participated. For instructional purposes, the respiratory care programs heavily use office-productivity software, the Internet, e-mail, and commercial respiratory care content-based computer-based instruction. The programs use, or would use, online resources provided by text publishers, but there is a paucity. Many program directors reported that their faculty use personal digital assistants (PDAs), often in instructional roles. 74.6% of the programs offer no fully online courses, but 61.0% reported at least one course delivered partially online. The managers considered continuing education via online technologies appropriate, but one third reported that they have not/will not hire RTs trained via distance learning. Neither group considered fully online courses a good match for RT training, nor did they consider training via distance learning of comparable quality to on-campus programs. Both groups rated baccalaureate and higher degrees via distance learning higher if the program included face-to-face instruction. Online distance-learning participatory experience generally improved attitudes toward distance learning. There was a good match between manager RT expectations in office-productivity software and program instructional practices. Educational technologies have an important role in respiratory care. Online distance learning for baccalaureate and higher degrees in respiratory care is promising. Online distance learning in respiratory care must include face-to-face instruction. Distance-learning deployment in respiratory care will require resources. A follow-up probabilistic survey of United States respiratory care managers is needed. Online surveys conducted for respiratory care are promising, but neither less expensive nor easier than conventional means.

Web-based stress management for newly diagnosed cancer patients (STREAM-1): a randomized, wait-list controlled intervention study.

PubMed

Grossert, Astrid; Urech, Corinne; Alder, Judith; Gaab, Jens; Berger, Thomas; Hess, Viviane

2016-11-03

Being diagnosed with cancer causes major psychological distress, yet the majority of newly diagnosed cancer patients lack psychological support. Internet interventions overcome many barriers for seeking face-to-face support and allow for independence in time and place. We assess efficacy and feasibility of the first web-based stress management intervention (STREAM: STREss-Aktiv-Mindern) for newly diagnosed, German-speaking cancer patients. In a prospective, wait-list controlled trial 120 newly diagnosed cancer patients will be included within 12 weeks of starting anti-cancer treatment and randomized between an immediate (intervention group) or delayed (control group) 8-week, web-based intervention. The intervention consists of eight modules with weekly written feedback by a psychologist ("minimal-contact") based on well-established stress management manuals including downloadable audio-files and exercises. The aim of this study is to evaluate efficacy in terms of improvement in quality of life (FACT-F), as well as decrease in anxiety and depression (HADS), as compared to patients in the wait-list control group. A sample size of 120 patients allows demonstrating a clinically relevant difference of nine points in the FACT score after the intervention (T2) with a two-sided alpha of 0.05 and 80 % power. As this is the first online stress management intervention for German-speaking cancer patients, more descriptive outcomes are equally important to further refine the group of patients with the largest potential for benefit who then will be targeted more specifically in future trials. These descriptive endpoints include: patients' characteristics (type of cancer, type of treatment, socio-demographic factors), dropout rate and dropout reasons, adherence and satisfaction with the program. New technologies open new opportunities: minimal-contact psychological interventions are becoming standard of care in several psychological disorders, where their efficacy is often comparable to face-to-face interventions. With our study we open this field to the population of newly diagnosed cancer patients. We will not only assess clinical efficacy but also further refine the target population who has the most potential to benefit. An internet-based minimal-contact stress management program might be an attractive, time- and cost-effective way to effectively deliver psychological support to newly diagnosed cancer patients and an opportunity to include those who currently are not reached by conventional support. ClinicalTrials.gov NCT02289014 .

Opportunities and challenges of cloud computing to improve health care services.

PubMed

Kuo, Alex Mu-Hsing

2011-09-21

Cloud computing is a new way of delivering computing resources and services. Many managers and experts believe that it can improve health care services, benefit health care research, and change the face of health information technology. However, as with any innovation, cloud computing should be rigorously evaluated before its widespread adoption. This paper discusses the concept and its current place in health care, and uses 4 aspects (management, technology, security, and legal) to evaluate the opportunities and challenges of this computing model. Strategic planning that could be used by a health organization to determine its direction, strategy, and resource allocation when it has decided to migrate from traditional to cloud-based health services is also discussed.

A student manual for promoting mental health among high school students.

PubMed

Gigantesco, Antonella; Del Re, Debora; Cascavilla, Isabella

2013-01-01

We describe a school program based on a student manual for promoting mental health and preventing mental illness. A preliminary version of the manual was assessed for face validity by two focus groups. The final version was evaluated for acceptability among 253 students in 10 high schools and 1 middle school in Italy. The manual included 18 chapters (or "units") which address skills for enabling students to cope with their daily lives: communication skills, problem-solving, assertive skills, negotiation, stress management, anger management and conflict resolution. The manual was found to have been acceptable by high school students. The effectiveness of the manual in actually promoting mental health and preventing mental illness is currently being evaluated.

Principal-agent theory: a framework for improving health care reform in Tennessee.

PubMed

Sekwat, A

2000-01-01

Using a framework based on principal-agent theory, this study examines problems faced by managed care organizations (MCOs) and major health care providers under the state of Tennessee's current capitation-based managed care programs called TennCare. Based on agency theory, the study proposes a framework to show how an effective collaborative relationship can be forged between the state of Tennessee and participating MCOs which takes into account the major concerns of third-party health care providers. The proposed framework further enhances realization of the state's key health care reform goals which are to control the rising costs of health care delivery and to expand health care coverage to uninsured and underinsured Tennesseans.

How can we help family carers manage pain medicines for patients with advanced cancer? A systematic review of intervention studies.

PubMed

Latter, Sue; Hopkinson, Jane B; Richardson, Alison; Hughes, Jane A; Lowson, Elizabeth; Edwards, Deborah

2016-09-01

Family carers play a significant role in managing pain and associated medicines for people with advanced cancer. Research indicates that carers often feel inadequately prepared for the tasks involved, which may impact on carers' and patients' emotional state as well as the achievement of optimal pain control. However, little is known about effective methods of supporting family carers with cancer pain medicines. To systematically identify and review studies of interventions to help carers manage medicines for pain in advanced cancer. To identify implications for practice and research. A systematic literature search of databases (MEDLINE, CINAHL, PsycINFO and AMED) was carried out to identify studies of pain medication management interventions that involved family carers of patients with advanced cancer, and reported specific outcomes for family carers. Patient pain outcomes were also sought. Studies were quality appraised; key aspects of study design, interventions and outcomes were compared and a narrative synthesis of findings developed. 8 studies were included; all had significant methodological limitations. The majority reported improvements in family carer knowledge and/or self-efficacy for managing pain medicines; no effect on patient pain outcomes; and no adverse effects. It was not possible to discern any association between particular intervention characteristics and family carer outcomes. Current evidence is limited, but overall suggests face-to-face educational interventions supported by written and/or other resources have potential to improve carers' knowledge and self-efficacy for pain management. Further research is needed to identify how best to help family carers manage pain medicines for patients with advanced cancer. 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/

How can we help family carers manage pain medicines for patients with advanced cancer? A systematic review of intervention studies

PubMed Central

Latter, Sue; Hopkinson, Jane B; Richardson, Alison; Hughes, Jane A; Lowson, Elizabeth; Edwards, Deborah

2016-01-01

Background Family carers play a significant role in managing pain and associated medicines for people with advanced cancer. Research indicates that carers often feel inadequately prepared for the tasks involved, which may impact on carers’ and patients’ emotional state as well as the achievement of optimal pain control. However, little is known about effective methods of supporting family carers with cancer pain medicines. Aims To systematically identify and review studies of interventions to help carers manage medicines for pain in advanced cancer. To identify implications for practice and research. Method A systematic literature search of databases (MEDLINE, CINAHL, PsycINFO and AMED) was carried out to identify studies of pain medication management interventions that involved family carers of patients with advanced cancer, and reported specific outcomes for family carers. Patient pain outcomes were also sought. Studies were quality appraised; key aspects of study design, interventions and outcomes were compared and a narrative synthesis of findings developed. Results 8 studies were included; all had significant methodological limitations. The majority reported improvements in family carer knowledge and/or self-efficacy for managing pain medicines; no effect on patient pain outcomes; and no adverse effects. It was not possible to discern any association between particular intervention characteristics and family carer outcomes. Conclusions Current evidence is limited, but overall suggests face-to-face educational interventions supported by written and/or other resources have potential to improve carers’ knowledge and self-efficacy for pain management. Further research is needed to identify how best to help family carers manage pain medicines for patients with advanced cancer. PMID:27150294

Development of practice and consensus-based strategies including a treat-to-target approach for the management of moderate and severe juvenile dermatomyositis in Germany and Austria.

PubMed

Hinze, Claas H; Oommen, Prasad T; Dressler, Frank; Urban, Andreas; Weller-Heinemann, Frank; Speth, Fabian; Lainka, Elke; Brunner, Jürgen; Fesq, Heike; Foell, Dirk; Müller-Felber, Wolfgang; Neudorf, Ulrich; Rietschel, Christoph; Schwarz, Tobias; Schara, Ulrike; Haas, Johannes-Peter

2018-06-25

Juvenile dermatomyositis (JDM) is the most common inflammatory myopathy in childhood and a major cause of morbidity among children with pediatric rheumatic diseases. The management of JDM is very heterogeneous. The JDM working group of the Society for Pediatric Rheumatology (GKJR) aims to define consensus- and practice-based strategies in order to harmonize diagnosis, treatment and monitoring of JDM. The JDM working group was established in 2015 consisting of 23 pediatric rheumatologists, pediatric neurologists and dermatologists with expertise in the management of JDM. Current practice patterns of management in JDM had previously been identified via an online survey among pediatric rheumatologists and neurologists. Using a consensus process consisting of online surveys and a face-to-face consensus conference statements were defined regarding the diagnosis, treatment and monitoring of JDM. During the conference consensus was achieved via nominal group technique. Voting took place using an electronic audience response system, and at least 80% consensus was required for individual statements. Overall 10 individual statements were developed, finally reaching a consensus of 92 to 100% regarding (1) establishing a diagnosis, (2) case definitions for the application of the strategies (moderate and severe JDM), (3) initial diagnostic testing, (4) monitoring and documentation, (5) treatment targets within the context of a treat-to-target strategy, (6) supportive therapies, (7) explicit definition of a treat-to-target strategy, (8) various glucocorticoid regimens, including intermittent intravenous methylprednisolone pulse and high-dose oral glucocorticoid therapies with tapering, (9) initial glucocorticoid-sparing therapy and (10) management of refractory disease. Using a consensus process among JDM experts, statements regarding the management of JDM were defined. These statements and the strategies aid in the management of patients with moderate and severe JDM.

Closing the loop in person-centered care: patient experiences of a chronic kidney disease self-management intervention.

PubMed

Havas, Kathryn; Douglas, Clint; Bonner, Ann

2017-01-01

The provision of self-management support (SMS) for people with earlier stages (1-4) of chronic kidney disease (CKD) can improve patient outcomes and extend time to dialysis. However, attempts to deliver such support have often not taken patient preferences into account. After the development, implementation, and quantitative evaluation of the person-centered CKD-SMS intervention, the aim of this study was to investigate participant experiences and perceptions of the program, as well as to seek suggestions to improve future SMS attempts. Semi-structured, face-to-face interviews were conducted with almost all (63/66) participants in the CKD-SMS. Deductive categories were derived from previous research into self-management from the CKD patient's perspective, and this was supplemented by categories that emerged inductively during multiple readings of interview transcripts. Content analysis was used to analyze interview data. Participants recognized self-management of CKD as complex and multifaceted. They felt that the CKD-SMS helped them develop skills to engage in necessary self-management tasks, as well as their knowledge about their condition and confidence to take an active role in their healthcare. These participants experience a healthcare environment that is characterized by complexity and inconsistency, and participation in the intervention helped them to navigate it. The benefit of participating in this research to contribute to the scientific literature was also recognized by participants. Overall, participants found the CKD-SMS useful in its current format, and made some suggestions for future interventions. People with CKD must engage in self-management behavior within a complex health environment. Individualized SMS such as the CKD-SMS provides an opportunity to support patients to manage their health effectively.

Systems identification and the adaptive management of waterfowl in the United States

USGS Publications Warehouse

Williams, B.K.; Nichols, J.D.

2001-01-01

Waterfowl management in the United States is one of the more visible conservation success stories in the United States. It is authorized and supported by appropriate legislative authorities, based on large-scale monitoring programs, and widely accepted by the public. The process is one of only a limited number of large-scale examples of effective collaboration between research and management, integrating scientific information with management in a coherent framework for regulatory decision-making. However, harvest management continues to face some serious technical problems, many of which focus on sequential identification of the resource system in a context of optimal decision-making. The objective of this paper is to provide a theoretical foundation of adaptive harvest management, the approach currently in use in the United States for regulatory decision-making. We lay out the legal and institutional framework for adaptive harvest management and provide a formal description of regulatory decision-making in terms of adaptive optimization. We discuss some technical and institutional challenges in applying adaptive harvest management and focus specifically on methods of estimating resource states for linear resource systems.

Data Management Support for Faculty Facing New Funding Mandates: The Case of The U. S. Department of Agriculture's National Institute of Food and Agriculture

ERIC Educational Resources Information Center

Exner, Nina

2018-01-01

Data management is a way for liaison librarians to support faculty research. American liaison librarians face new demands in data management due to expanding public access guidelines. This article gives advice for librarians new to data management, with the specific case of agriculture. For librarians supporting agriculture, the United States…

Development of Methodologies for Technology Deployment for Advanced Outage Control Centers that Improve Outage Coordination, Problem Resolution and Outage Risk Management

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

Shawn St. Germain; Ronald Farris; Heather Medeman

2013-09-01

This research effort is a part of the Light-Water Reactor Sustainability (LWRS) Program, which is a research and development (R&D) program sponsored by Department of Energy (DOE) and performed in close collaboration with industry R&D programs that provides the technical foundations for licensing and managing the long-term, safe, and economical operation of current nuclear power plants. The LWRS program serves to help the U.S. nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. The long term viability of existing nuclear power plants in the U.S.more » will depend upon maintaining high capacity factors, avoiding nuclear safety issues and reducing operating costs. The slow progress in the construction on new nuclear power plants has placed in increased importance on maintaining the output of the current fleet of nuclear power plants. Recently expanded natural gas production has placed increased economic pressure on nuclear power plants due to lower cost competition. Until recently, power uprate projects had steadily increased the total output of the U.S. nuclear fleet. Errors made during power plant upgrade projects have now removed three nuclear power plants from the U.S. fleet and economic considerations have caused the permanent shutdown of a fourth plant. Additionally, several utilities have cancelled power uprate projects citing economic concerns. For the past several years net electrical generation from U.S. nuclear power plants has been declining. One of few remaining areas where significant improvements in plant capacity factors can be made is in minimizing the duration of refueling outages. Managing nuclear power plant outages is a complex and difficult task. Due to the large number of complex tasks and the uncertainty that accompanies them, outage durations routinely exceed the planned duration. The ability to complete an outage on or near schedule depends upon the performance of the outage management organization. During an outage, the outage control center (OCC) is the temporary command center for outage managers and provides several critical functions for the successful execution of the outage schedule. Essentially, the OCC functions to facilitate information inflow, assist outage management in processing information and to facilitate the dissemination of information to stakeholders. Currently, outage management activities primarily rely on telephone communication, face to face reports of status and periodic briefings in the OCC. Much of the information displayed in OCCs is static and out of date requiring an evaluation to determine if it is still valid. Several advanced communication and collaboration technologies have shown promise for facilitating the information flow into, across and out of the OCC. Additionally, advances in the areas of mobile worker technologies, computer based procedures and electronic work packages can be leveraged to improve the availability of real time status to outage managers.« less

Rural roads and bridges : management issues facing local highway officials

DOT National Transportation Integrated Search

1996-09-01

The report documents management practices used by, and issues facing, local transportation administrators. Data are drawn from a national survey of county and town highway officials, in Fall 1994 and Spring 1995, which provided usable information fro...

Assessing the current state of dental informatics in saudi arabia: the new frontier.

PubMed

Al-Nasser, Lubna; Al-Ehaideb, Ali; Househ, Mowafa

2014-01-01

Dental informatics is an emerging field that has the potential to transform the dental profession. This study aims to summarize the current applications of dental informatics in Saudi Arabia and to identify the challenges facing expansion of dental informatics in the Saudi context. Search for published articles and specialized forum entries was conducted, as well as interviews with dental professionals familiar with the topic. Results indicated that digital radiography/analysis and administrative management of dental practice are the commonest applications used. Applications in Saudi dental education included: web-based learning systems, computer-based assessments and virtual technology for clinical skills' teaching. Patients' education software, electronic dental/oral health records and the potential of dental research output from electronic databases are yet to be achieved in Saudi Arabia. Challenges facing Saudi dental informatics include: lack of IT infrastructure/support, social acceptability and financial cost. Several initiatives are taken towards the research in dental informatics. Still, more investments are needed to fully achieve the potential of various application of informatics in dental education, practice and research.

Wilderness management planning in an Alaskan national park: last chance to do it right?

Treesearch

Michael J. Tranel

2000-01-01

Like many wilderness areas, Denali National Park and Preserve faces a variety of challenges in its wilderness management planning. As an Alaska conservation unit that has been significantly expanded by the Alaska National Interest Lands Conservation Act of 1980 (ANILCA), Denali faces the additional responsibility of acknowledging that its management of controversial...

College Students' Conceptions of Learning Management: The Difference between Traditional (Face-to-Face) Instruction and Web-Based Learning Environments

ERIC Educational Resources Information Center

Lin, Hung-Ming; Tsai, Chin-Chung

2011-01-01

This study investigates the differences between students' conceptions of learning management via traditional instruction and Web-based learning environments. The Conceptions of Learning Management Inventory (COLM) was administered to 259 Taiwanese college students majoring in Business Administration. The COLM has six factors (categories), namely,…

Learning Management Systems in Traditional Face-to-Face Courses: A Narrative Inquiry Study

ERIC Educational Resources Information Center

Washington, Gloria

2017-01-01

The purpose of the qualitative narrative inquiry study was to explore accounts of individual higher education instructors' experiences utilizing LMSs as a potential platform for teaching and learning in the traditional face-to-face classroom environment. The pedagogical use of LMSs in traditional face-to-face courses from real life experiences of…

Implementing blended learning in emergency airway management training: a randomized controlled trial.

PubMed

Kho, Madeleine Huei Tze; Chew, Keng Sheng; Azhar, Muhaimin Noor; Hamzah, Mohd Lotfi; Chuah, Kee Man; Bustam, Aida; Chan, Hiang Chuan

2018-01-15

While emergency airway management training is conventionally conducted via face-to-face learning (F2FL) workshops, there are inherent cost, time, place and manpower limitations in running such workshops. Blended learning (BL) refers to the systematic integration of online and face-to-face learning aimed to facilitate complex thinking skills and flexible participation at a reduced financial, time and manpower cost. This study was conducted to evaluate its effectiveness in emergency airway management training. A single-center prospective randomised controlled trial involving 30 doctors from Sarawak General Hospital, Malaysia was conducted from September 2016 to February 2017 to compare the effectiveness of BL versus F2FL for emergency airway management training. Participants in the BL arm were given a period of 12 days to go through the online materials in a learning management system while those in the F2FL arm attended a-day of face-to-face lectures (8 h). Participants from both arms then attended a day of hands-on session consisting of simulation skills training with airway manikins. Pre- and post-tests in knowledge and practical skills were administered. E-learning experience and the perception towards BL among participants in the BL arm were also assessed. Significant improvements in post-test scores as compared to pre-test scores were noted for participants in both BL and F2FL arms for knowledge, practical, and total scores. The degree of increment between the BL group and the F2FL arms for all categories were not significantly different (total scores: 35 marks, inter-quartile range (IQR) 15.0 - 41.0 vs. 31 marks, IQR 24.0 - 41.0, p = 0.690; theory scores: 18 marks, IQR 9 - 24 vs. 19 marks, IQR 15 - 20, p = 0.992; practical scores: 11 marks, IQR 5 -18 vs. 10 marks, IQR 9 - 20, p = 0.461 respectively). The overall perception towards BL was positive. Blended learning is as effective as face-to-face learning for emergency airway management training of junior doctors, suggesting that blended learning may be a feasible alternative to face-to-face learning for such skill training in emergency departments. Malaysian National Medical Research NMRR-16-696-30190 . Registered 28 April 2016.

Impacts of Potential Changes in Land Use, Climate, and Water Use on Water Availability, Coastal Carolinas Region, Southeastern United States

NASA Astrophysics Data System (ADS)

Gurley, L. N.; Garcia, A. M.

2017-12-01

Sustainable growth in coastal areas with rapidly increasing populations, such as the coastal regions of North and South Carolina, relies on an understanding of the current state of coastal natural resources coupled with the ability to assess future impacts of changing coastal communities and resources. Changes in climate, water use, population, and land use (e.g. urbanization) will place additional stress on societal and ecological systems that are already competing for water resources. The potential effects of these stressors on water availability are not fully known. To meet societal and ecological needs, water resources management and planning efforts require estimates of likely impacts of population growth, land-use, and climate. Two Soil and Water Assessment (SWAT) hydrologic models were developed to help address the challenges that water managers face in the Carolinas: the (1) Cape Fear and (2) Pee Dee drainage basins. SWAT is a basin-scale, process-based watershed model with the capability of simulating water-management scenarios. Model areas were divided into two square mile sub-basins to evaluate ecological response at headwater streams. The sub-basins were subsequently divided into smaller, discrete hydrologic response units based on land use, slope, and soil type. Monthly and annual water-use data were used for 2000 to 2014 and included estimates of municipal, industrial, agricultural, and commercial water use. Models were calibrated for 2000 to 2014 and potential future streamflows were estimated through 2060 based on a suite of scenarios that integrated land use change projections, climate projections and water-use forecasts. The approaches and new techniques developed as part of this research could be applied to other coastal areas that face similar current and future water availability demands.

Current status and future options for trauma and emergency surgery in Turkey.

PubMed

Taviloğlu, Korhan; Ertekin, Cemalettin

2008-01-01

The number of trauma victims in Turkey is expected to increase as a consequence of the increasing vehicular traffic, potential for earthquakes, and risk of terrorist attacks. The Turkish Association for Trauma and Emergency Surgery monitors trauma cases, publishes a quarterly journal, organizes trauma courses and seminars for various health personnel nationwide. It is also extending efforts to improve in-hospital care by establishing trauma and emergency surgery fellowships and trauma and emergency surgery centers nationwide, which is run by General Surgeons currently. Turkey faces the same dilemma as the rest of the developed world regarding the future of trauma surgeons in the current era of nonoperative trauma management. We suggest that the field of trauma and emergency surgery be redefined to include emergency general surgery and cavitary trauma.

Lighting system with heat distribution face plate

DOEpatents

Arik, Mehmet; Weaver, Stanton Earl; Stecher, Thomas Elliot; Kuenzler, Glenn Howard; Wolfe, Jr., Charles Franklin; Li, Ri

2013-09-10

Lighting systems having a light source and a thermal management system are provided. The thermal management system includes synthetic jet devices, a heat sink and a heat distribution face plate. The synthetic jet devices are arranged in parallel to one and other and are configured to actively cool the lighting system. The heat distribution face plate is configured to radially transfer heat from the light source into the ambient air.

Is this what you need? Direct feedback help climate change information exchange

NASA Astrophysics Data System (ADS)

Bachelet, D. M.; Brown, M.; Gough, M.; Basin, D.

2015-12-01

The combination of projected climate change and land use adds uncertainty to the long-term effectiveness of current management strategies. Managers need reliable information to adjust their strategies as population density increases. However they are currently overwhelmed by the diversity of available information and the multiplicity of sources. CBI's goal is to centralize and package effectively the usable information for land managers and for the general public in order to increase awareness and promote preparation for the challenges ahead. We are designing conservation planning atlases in Data Basin for a number of landscape conservation cooperatives to address this need. We are adding some user-friendly tools to specifically serve the available climate projections and land use data in a meaningful way. By working closely with a group of managers, our goal is to understand how consideration of these projections figures into the decision-making process and refine the ways we can deliver relevant metrics. We have been holding interviews to gather information and critical feedback on existing climate-related web pages and tools, providing us with benchmarks for improvement. As it turned out, the student-manager dialogue added a component of climate change education and awareness of available tools to the project. Through an iterative process we plan to continue this exchange and address the variety of issues managers continually have to face to maintain healthy ecosystems.

System and method of adjusting the equilibrium temperature of an inductively-heated susceptor

DOEpatents

Matsen, Marc R; Negley, Mark A; Geren, William Preston

2015-02-24

A system for inductively heating a workpiece may include an induction coil, at least one susceptor face sheet, and a current controller coupled. The induction coil may be configured to conduct an alternating current and generate a magnetic field in response to the alternating current. The susceptor face sheet may be configured to have a workpiece positioned therewith. The susceptor face sheet may be formed of a ferromagnetic alloy having a Curie temperature and being inductively heatable to an equilibrium temperature approaching the Curie temperature in response to the magnetic field. The current controller may be coupled to the induction coil and may be configured to adjust the alternating current in a manner causing a change in at least one heating parameter of the susceptor face sheet.

Medium Moderates the Message. How Users Adjust Their Communication Trajectories to Different Media in Collaborative Task Solving.

PubMed

Lisiecka, Karolina; Rychwalska, Agnieszka; Samson, Katarzyna; Łucznik, Klara; Ziembowicz, Michał; Szóstek, Agnieszka; Nowak, Andrzej

2016-01-01

Rapid development of information and communications technologies (ICT) has triggered profound changes in how people manage their social contacts in both informal and professional contexts. ICT mediated communication may seem limited in possibilities compared to face-to-face encounters, but research shows that puzzlingly often it can be just as effective and satisfactory. We posit that ICT users employ specific communication strategies adapted to particular communication channels, which results in a comparable effectiveness of communication. In order to maintain a satisfactory level of conversational intelligibility they calibrate the content of their messages to a given medium's richness and adjust the whole conversation trajectory so that every stage of the communication process runs fluently. In the current study, we compared complex task solving trajectories in chat, mobile phone and face-to-face dyadic conversations. Media conditions did not influence the quality of decision outcomes or users' perceptions of the interaction, but they had impact on the amount of time devoted to each of the identified phases of decision development. In face-to-face contacts the evaluation stage of the discussion dominated the conversation; in the texting condition the orientation-evaluation-control phases were evenly distributed; and the phone condition provided a midpoint between these two extremes. The results show that contemporary ICT users adjust their communication behavior to the limitations and opportunities of various media through the regulation of attention directed to each stage of the discussion so that as a whole the communication process remains effective.

Consumer Mobile Health Apps: Current State, Barriers, and Future Directions.

PubMed

Kao, Cheng-Kai; Liebovitz, David M

2017-05-01

This paper discusses the current state, barriers, and future directions of consumer-facing applications (apps). There are currently more than 165,000 mobile health apps publicly available in major app stores, the vast majority of which are designed for patients. The top 2 categories are wellness management and disease management apps, whereas other categories include self-diagnosis, medication reminder, and electronic patient portal apps. Apps specific to physical medicine and rehabilitation also are reviewed. These apps have the potential to provide low-cost, around-the-clock access to high-quality, evidence-based health information to end users on a global scale. However, they have not yet lived up to their potential due to multiple barriers, including lack of regulatory oversight, limited evidence-based literature, and concerns of privacy and security. The future directions may consist of improving data integration into the health care system, an interoperable app platform allowing access to electronic health record data, cloud-based personal health record across health care networks, and increasing app prescription by health care providers. For consumer mobile health apps to fully contribute value to health care delivery and chronic disease management, all stakeholders within the ecosystem must collaborate to overcome the significant barriers. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Managing chronic orofacial pain: A qualitative study of patients', doctors', and dentists' experiences.

PubMed

Peters, Sarah; Goldthorpe, Joanna; McElroy, Cheryl; King, Elizabeth; Javidi, Hanieh; Tickle, Martin; Aggarwal, Vishal R

2015-11-01

Persistent pain in the face, mouth, and jaws is a common presentation to dental and medical services. The aetiology remains unclear, but a growing evidence base recognizes the effectiveness of psychological rather than biomedical interventions. To understand how this approach might be implemented into clinical practice, knowledge is needed of patients' and clinicians' experience of chronic orofacial pain (COFP). The aim of this study was to explore the experience and understanding of COFP by patients and primary and secondary care medical and dental practitioners. Qualitative interview study. Audio-recorded semi-structured interviews with a purposive sample of 12 dentists, 11 general practitioners, and seven patients were thematically analysed. Clinicians and patients recognized the role that psychological factors could play in the development and maintenance of COFP, yet management and self-management strategies were largely limited to biomedical interventions. Achieving a diagnosis proved problematic but largely functional for both parties. GPs and dentists viewed COFP as a non-dental problem and felt inadequately equipped to manage the condition. GPs, unlike dentists, felt obligated to support patients using techniques for managing patients with other long-term conditions. Frustration at the current inadequacy of COFP management often led to conflict with (or disengagement from) the clinician-patient relationship. Current management of COFP is ineffective and unsatisfactory for patients and practitioners, which impacts on their relationship. Fundamental barriers to accessing and implementing psychological interventions for COFP arise from ineffective communication between physicians and patients, and between medical and dental practitioners. Statement of contribution What is already known on this subject? COFP is characterized by persistent pain in the face, mouth, or jaws that are not the result of organic disease or physical trauma. Patients with COFP present to both medical and dental services and receive sub-optimal care. No studies have examined the experiences of managing this problem from the perspectives of dentists, general practitioners and patients. What does this study add? Patients, dentists, and GPs recognize the role that psychological factors have in maintaining and addressing facial pain symptoms, yet principally manage it through biomedical interventions. Challenges exist over arriving at a diagnosis and managing the problem, and challenges are exacerbated by poor communication between doctors and medical services. Improvements are needed in liaison between medical and dental services and further training to support primary care clinicians to facilitate a stepped care approach to managing COFP. © 2015 The British Psychological Society.

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-to-face, in-depth interviews, guided by a topic list, along service users with BD I or II (n = 16) in three specialised community care clinics across the Netherlands. Interviews were digitally recorded and transcribed verbatim prior to analysis in Atlas.ti 7. Unlike existing studies, which suggest that individual abilities of service users determine outcomes in self-management of BD, the current study found that self-management of BD is a learning process that takes place in a collaborative network. We identified five categories: acknowledgment of having BD, processing the information load, illness management, reflecting on living with BD, and self-management of BD. The success of self-management depends on the acknowledgment of individual limitations in learning to cope with BD and willingness to use a social network as a back-up instead. Especially, the dormant fear of a recurrent episode is a hampering factor in this learning process. © 2015 John Wiley & Sons Ltd.

Perspectives on mealtime management in residential aged care: insights from a cross-disciplinary investigation.

PubMed

Bennett, Michelle K; Ward, Elizabeth; Scarinci, Nerina; Waite, Monique

2014-01-01

Meeting the medical, nutritional, and psychosocial mealtime needs of aged care residents requires a holistic, multidisciplinary approach. To date the perspectives of this multidisciplinary team have not been adequately explored. The aim of this study was to explore the perspectives of a range of service providers involved in mealtime management in residential aged care. In-depth semistructured interviews were conducted with 61 participants from five service disciplines. Four themes emerged: ( 1 ) mealtimes are highly valued; ( 2 ) service providers face common barriers to mealtime management; ( 3 ) communication among service providers is challenging; and ( 4 ) education in mealtime management is limited. Data indicated service providers acknowledge the importance of mealtimes but recognize numerous shortfalls in current care. The need for interdisciplinary training and increased communication and collaboration among providers was emphasized, including the need for clarification of provider roles. Limited consideration of mealtimes in policy and funding documents was identified as a primary barrier in further prioritizing mealtime management and advancing mealtime care.

Survey of business process management: challenges and solutions

NASA Astrophysics Data System (ADS)

Alotaibi, Youseef; Liu, Fei

2017-09-01

The current literature shows that creating a good framework on business process model (PM) is not an easy task. A successful business PM should have the ability to ensure accurate alignment between business processes (BPs) and information technology (IT) designs, provide security protection, manage the rapidly changing business environment and BPs, manage customer power, be flexible for reengineering and ensure that IT goals can be easily derived from business goals and hence an information system (IS) can be easily implemented. This article presents an overview of research in the business PM domain. We have presented a review of the challenges facing business PMs, such as misalignment between business and IT, difficulty of deriving IT goals from business goals, creating secured business PM, reengineering BPs, managing the rapidly changing BP and business environment and managing customer power. Also, it presents the limitations of existing business PM frameworks. Finally, we outline several guidelines to create good business PM and the possible further research directions in the business PM domain.

Facilitating adaptive management in a government program: A household energy efficiency case study.

PubMed

Curtis, Jim; Graham, Alex; Ghafoori, Eraj; Pyke, Susan; Kaufman, Stefan; Boulet, Mark

2017-02-01

Interim evaluations of government programs can sometimes reveal lower than expected outcomes, leading to the question of how adjustments can be made while the program is still underway. Although adaptive management frameworks can provide a practical roadmap to address this question, a lack of successful learnings and poor implementation have hampered the progress and wider application of adaptive management. Using a case study involving an energy efficiency government program targeting low-income households, this article provides supporting evidence on how adaptive management can be facilitated and applied. Factors such as proactive and responsive leadership, establishing a research-practice interface, and recognizing the skills, expertise, and contributions of multiple stakeholders guided adjustments to the program, and later paved the way for longer-term organizational learning that impacted how other programs are delivered. Implications for knowledge and practice, and a discussion of the challenges faced in the program, advance current thinking in adaptive management. Copyright © 2016 Elsevier Ltd. All rights reserved.

Does having a "brand" help you lead others?

PubMed

Davidhizar, Ruth

Managing expertly requires many qualities one of which is managing a personal brand. The manager must manage the brand with clarity, consistency, the right technologies, skillful human resources, and clear vision in order for the message to be heard and for effectiveness to soar. Where as technology is valuable it is just as important to talk to people face to face to clearly as effectively sell a personal brand and a personal vision (Noonan, 1991).

The Management Of Intellectual Property In A Romanian State University Where Research Represents A Strength

NASA Astrophysics Data System (ADS)

Tîţu, Aurel Mihail; Oprean, Constantin; Răulea, Andreea Simina

2015-07-01

The transition to the knowledge-based economy and society requires adaptation to constant change that implies intellectual property as a multidimensional concept that continually leaves its mark on generations contributing to their well-being in obvious and undeniable ways. The main objective of this article was to assess the present level of the management of intellectual property in a state university in Romania displaying their strengths and weaknesses. The overall objective of the work is to analyze the state of the art in a Romanian state university in order to find solutions to the current problems that the Romanian scientific environment is facing. The conclusions drawn in the study converge in directions and proposals for improving the way in which the intellectual property is regarded and its management in the state universities of Romania.

Development of the INEEL Site Wide Vadose Zone Roadmap

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

Yonk, Alan Keith

2001-09-01

The INEEL Vadose Zone Roadmap was developed to identify inadquacies in current knowledge, to assist in contaminant management capabilities relative to the INEEL vadose zone, and to ensure that ongoing and planned Science and Technology developments will meet the risk management challenges facing the INEEL in coming years. The primary objective of the Roadmap is to determine the S&T needs that will facilitate monitoring, characterization, prediction, and assessment activities necessary to support INEEL risk management decisions and to ensure that long-term stewardship of contaminated sites at the INEEL is achieved. The mission of the Roadmap is to insure that themore » long-term S&T strategy is aligned with site programs, that it takes advantage of progress made to date, and that it can assist in meeting the milestones and budgets of operations.« less

Pilot Study of Low-Income Parents' Perspectives of Managing Asthma In High-Risk Infants and Toddlers

PubMed Central

Koenig, Karel

2009-01-01

This pilot study describes the challenges low-income parents face in managing asthma in their infants and toddlers who are at high risk of morbidity due to asthma. Five families of children younger than 3 years and recently hospitalized for asthma were interviewed from 1 to 5 times and asked to give narratives about the everyday management of asthma in their high risk infants and toddlers. Interpretive phenomenology was used as the method to describe parents' perspectives on managing the illness. The parents, all single mothers, struggled to manage asthma in crowded conditions, with limited transportation for frequently needed emergency care, and in face of the complicating needs of other children and family members. Not knowing then knowing the diagnosis, and provider availability and lack of availability were two dichotomous challenges mothers faced when managing asthma in their very young children. PMID:17708181

Conflict management in online relationships.

PubMed

Ishii, Kumi

2010-08-01

With the diffusion of networked technology, personal relationships can be easily formed and maintained online today. Similar to a face-to-face situation, conflict is also seen in these online relationships. Early theories suggested that computer-mediated communication (CMC) tends to increase conflicts because of the lack of social-context cues, and CMC is not rich enough to manage conflict. As CMC has become part of our daily life, we often face conflict online, and thus we need to understand how people manage conflict online. This study explored how online users manage interpersonal conflict. Self-report survey data from 159 university students were analyzed to examine their conflict-management styles in association with the perceived closeness of the online relationship and a future intention toward the relationship. The results indicated that online users select cooperative management styles to handle conflict in their close relationships. In addition, online users avoid less cooperative styles when they want to continue the relationship.

Remote monitoring of cardiac implantable electronic devices in Europe: results of the European Heart Rhythm Association survey.

PubMed

Hernández-Madrid, Antonio; Lewalter, Thorsten; Proclemer, Alessandro; Pison, Laurent; Lip, Gregory Y H; Blomstrom-Lundqvist, Carina

2014-01-01

The aim of this European Heart Rhythm Association survey was to provide an insight into the current use of remote monitoring for cardiac implantable electronic devices in Europe. The following topics were explored: use of remote monitoring, infrastructure and organization, patient selection and benefits. Centres using remote monitoring reported performing face-to-face visits less frequently. In many centres (56.9%), a nurse reviews all the data and forwards them to the responsible physician. The majority of the centres (91.4%) stated that remote monitoring is best used in patients with implantable cardioverter-defibrillators and those live far from the hospital (76.6% top benefit). Supraventricular and ventricular arrhythmias were reported to be the major events detected earlier by remote monitoring. Remote monitoring will have a significant impact on device management.

Why Don't They Just Give Us Money? Project Cost Estimating and Cost Reporting

NASA Technical Reports Server (NTRS)

Comstock, Douglas A.; Van Wychen, Kristin; Zimmerman, Mary Beth

2015-01-01

Successful projects require an integrated approach to managing cost, schedule, and risk. This is especially true for complex, multi-year projects involving multiple organizations. To explore solutions and leverage valuable lessons learned, NASA's Virtual Project Management Challenge will kick off a three-part series examining some of the challenges faced by project and program managers when it comes to managing these important elements. In this first session of the series, we will look at cost management, with an emphasis on the critical roles of cost estimating and cost reporting. By taking a proactive approach to both of these activities, project managers can better control life cycle costs, maintain stakeholder confidence, and protect other current and future projects in the organization's portfolio. Speakers will be Doug Comstock, Director of NASA's Cost Analysis Division, Kristin Van Wychen, Senior Analyst in the GAO Acquisition and Sourcing Management Team, and Mary Beth Zimmerman, Branch Chief for NASA's Portfolio Analysis Branch, Strategic Investments Division. Moderator Ramien Pierre is from NASA's Academy for Program/Project and Engineering Leadership (APPEL).

Fault Management Metrics

NASA Technical Reports Server (NTRS)

Johnson, Stephen B.; Ghoshal, Sudipto; Haste, Deepak; Moore, Craig

2017-01-01

This paper describes the theory and considerations in the application of metrics to measure the effectiveness of fault management. Fault management refers here to the operational aspect of system health management, and as such is considered as a meta-control loop that operates to preserve or maximize the system's ability to achieve its goals in the face of current or prospective failure. As a suite of control loops, the metrics to estimate and measure the effectiveness of fault management are similar to those of classical control loops in being divided into two major classes: state estimation, and state control. State estimation metrics can be classified into lower-level subdivisions for detection coverage, detection effectiveness, fault isolation and fault identification (diagnostics), and failure prognosis. State control metrics can be classified into response determination effectiveness and response effectiveness. These metrics are applied to each and every fault management control loop in the system, for each failure to which they apply, and probabilistically summed to determine the effectiveness of these fault management control loops to preserve the relevant system goals that they are intended to protect.

Concept of sustainable waste management in the city of Zagreb: Towards the implementation of circular economy approach.

PubMed

Ribić, Bojan; Voća, Neven; Ilakovac, Branka

2017-02-01

Improvement of the current waste management is one of the main challenges for most municipalities in Croatia, mainly due to legal obligations set in different European Union (EU) directives regarding waste management, such as reduction of waste generation and landfilling, or increase of separately collected waste and recycling rates. This paper highlights the current waste management in the city of Zagreb by analyzing the waste generation, collection, and disposal scenario along with the regulatory and institutional framework. Since the present waste management system mainly depends upon landfilling, with the rate of separate waste collection and recycling far from being adequate, it is necessary to introduce a new system that will take into account the current situation in the city as well as the obligations imposed by the EU. Namely, in the coming years, the Waste Framework and Landfill Directives of the European Union will be a significant driver of change in waste management practices and governance of the city of Zagreb. At present, the yearly separate waste collection makes somewhat less than 5 kg per capita of various waste fractions, i.e., far below the average value for the (28) capital cities of the EU, which is 108 kg per capita. This is possible to achieve only by better and sustainable planning of future activities and facilities, taking into account of environmental, economic, and social aspects of waste management. This means that the city of Zagreb not only will have to invest in new infrastructure to meet the targets, but also will have to enhance public awareness in diverting this waste at the household level. The solution for the new waste management proposed in this paper will certainly be a way of implementing circular economy approach to current waste management practice in the city of Zagreb. Municipal waste management in the developing countries in the EU (new eastern EU members) is often characterized by its limited utilization of recycling activities, inadequate management of nonindustrial hazardous waste, and inadequate landfill disposal. Many cities in Eastern Europe and Zagreb as well are facing serious problems in managing municipal wastes due to the existing solid waste management system that is found to be highly inefficient. The proposed scenario for city of Zagreb in the paper is an innovative upgrading of municipal waste management based on the waste management hierarchy and circular economy approach.

Perspectives of healthcare providers on the nutritional management of patients on haemodialysis in Australia: an interview study

PubMed Central

Tong, Allison; Campbell, Katrina L; Craig, Jonathan C; Lee, Vincent W

2018-01-01

Objective To describe the perspectives of healthcare providers on the nutritional management of patients on haemodialysis, which may inform strategies for improving patient-centred nutritional care. Design Face-to-face semistructured interviews were conducted until data saturation, and thematic analysis based on principles of grounded theory. Setting 21 haemodialysis centres across Australia. Participants 42 haemodialysis clinicians (nephrologists and nephrology trainees (15), nurses (12) and dietitians (15)) were purposively sampled to obtain a range of demographic characteristics and clinical experiences. Results Six themes were identified: responding to changing clinical status (individualising strategies to patient needs, prioritising acute events, adapting guidelines), integrating patient circumstances (assimilating life priorities, access and affordability), delineating specialty roles in collaborative structures (shared and cohesive care, pivotal role of dietary expertise, facilitating access to nutritional care, perpetuating conflicting advice and patient confusion, devaluing nutritional specialty), empowerment for behaviour change (enabling comprehension of complexities, building autonomy and ownership, developing self-efficacy through engagement, tailoring self-management strategies), initiating and sustaining motivation (encountering motivational hurdles, empathy for confronting life changes, fostering non-judgemental relationships, emphasising symptomatic and tangible benefits, harnessing support networks), and organisational and staffing barriers (staffing shortfalls, readdressing system inefficiencies). Conclusions Organisational support with collaborative multidisciplinary teams and individualised patient care were seen as necessary for developing positive patient–clinician relationships, delivering consistent nutrition advice, and building and sustaining patient motivation to enable change in dietary behaviour. Improving service delivery and developing and delivering targeted, multifaceted self-management interventions may enhance current nutritional management of patients on haemodialysis. PMID:29523567

The Happy Life Club™ study protocol: a cluster randomised controlled trial of a type 2 diabetes health coach intervention.

PubMed

Browning, Colette; Chapman, Anna; Cowlishaw, Sean; Li, Zhixin; Thomas, Shane A; Yang, Hui; Zhang, Tuohong

2011-02-09

The Happy Life Club™ is an intervention that utilises health coaches trained in behavioural change and motivational interviewing techniques to assist with the management of type 2 diabetes mellitus (T2DM) in primary care settings in China. Health coaches will support participants to improve modifiable risk factors and adhere to effective self-management treatments associated with T2DM. A cluster randomised controlled trial involving 22 Community Health Centres (CHCs) in Fengtai District of Beijing, China. CHCs will be randomised into a control or intervention group, facilitating recruitment of at least 1320 individual participants with T2DM into the study. Participants in the intervention group will receive a combination of both telephone and face-to-face health coaching over 18 months, in addition to usual care received by the control group. Health coaching will be performed by CHC doctors and nurses certified in coach-assisted chronic disease management. Outcomes will be assessed at baseline and again at 6, 12 and 18 months by means of a clinical health check and self-administered questionnaire. The primary outcome measure is HbA1c level. Secondary outcomes include metabolic, physiological and psychological variables. This cluster RCT has been developed to suit the Chinese health care system and will contribute to the evidence base for the management of patients with T2DM. With a strong focus on self-management and health coach support, the study has the potential to be adapted to other chronic diseases, as well as other regions of China. Current Controlled Trials ISRCTN01010526.

Personal Distress and Sympathy Differentially Influence Health Care Professional and Parents' Estimation of Child Procedure-Related Pain.

PubMed

Caes, Line; Goubert, Liesbet; Devos, Patricia; Verlooy, Joris; Benoit, Yves; Vervoort, Tine

2017-02-01

Caregivers’ pain estimations may have important implications for pediatric pain management decisions. Affective responses elicited by facing the child in pain are considered key in understanding caregivers’ estimations of pediatric pain experiences. Theory suggests differential influences of sympathy versus personal distress on pain estimations; yet empirical evidence on the impact of caregivers’ feelings of sympathy versus distress upon estimations of pediatric pain experiences is lacking. The current study explored the role of caregiver distress versus sympathy in understanding caregivers’ pain estimates of the child’s pain experience. Using a prospective design in 31 children undergoing consecutive lumbar punctures and/or bone marrow aspirations at Ghent University Hospital, caregivers’ (i.e., parents, physicians, nurses, and child life specialists) distress and sympathy were assessed before each procedure; estimates of child pain were obtained immediately following each procedure. Results indicated that the child’s level of pain behavior in anticipation of the procedure had a strong influence on all caregivers’ pain estimations. Beyond the impact of child pain behavior, personal distress explained parental and physician’s estimates of child pain, but not pain estimates of nurses and child life specialists. Specifically, higher level of parental and physician’s distress was related to higher child pain estimates. Caregiver sympathy was not associated with pain estimations. The current findings highlight the important role of caregivers’ felt personal distress when faced with child pain, rather than sympathy, in influencing their pain estimates. Potential implications for pain management are discussed.

Insights, attitudes, and perceptions about asthma and its treatment: findings from a multinational survey of patients from Latin America.

PubMed

Maspero, Jorge F; Jardim, Jose R; Aranda, Alvaro; Tassinari C, Paolo; Gonzalez-Diaz, Sandra N; Sansores, Raul H; Moreno-Cantu, Jorge J; Fish, James E

2013-11-04

In 2011 the Latin America Asthma Insight and Management (LA AIM) survey explored the realities of living with asthma. We investigated perception, knowledge, and attitudes related to asthma among Latin American asthma patients. Asthma patients aged ≥12 years from four Latin American countries (Argentina, Brazil, Mexico, Venezuela) and the Commonwealth of Puerto Rico responded to questions during face-to-face interviews. A sample size of 2,169 patients (approximately 400 patients/location) provided an accurate representation of asthma patients' opinions. Questions probed respondents' views on topics such as levels of asthma control, frequency and duration of exacerbations, and current and recent use of asthma medications. A total of 2,169 adults or parents of children with asthma participated in the LA AIM survey. At least 20% of respondents experienced symptoms every day or night or most days or nights. Although 60% reported their disease as well or completely controlled, only 8% met guideline criteria for well-controlled asthma. 47% of respondents reported episodes when their asthma symptoms were more frequent or severe than normal, and 44% reported seeking acute care for asthma in the past year. Asthma patients in Latin America overestimated their degree of asthma control. The LA AIM survey demonstrated the discrepancy between patient perception of asthma control and guideline-mandated criteria. Additional education is required to teach patients that, by more closely following asthma management strategies outlined by current guidelines more patients can achieve adequate asthma control.

'The right direction'. Primary-care docs see promise in CMS' proposed pay for non face-to-face work.

PubMed

Robeznieks, Andis

2013-07-15

The CMS has proposed paying physicians for managing patients apart from face-to-face office visits. Among the details under consideration are requiring practices to use an electronic health-record system that supports access to care, care coordination, care management and communications. "It's a step in the right direction. The devil will be in the details and, if the burden of documentation is so high, people may choose not to spend their time doing it," says Dr. Matt Handley, physician and medical director for quality at the Group Health Cooperative.

A face a mother could love: depression-related maternal neural responses to infant emotion faces.

PubMed

Laurent, Heidemarie K; Ablow, Jennifer C

2013-01-01

Depressed mothers show negatively biased responses to their infants' emotional bids, perhaps due to faulty processing of infant cues. This study is the first to examine depression-related differences in mothers' neural response to their own infant's emotion faces, considering both effects of perinatal depression history and current depressive symptoms. Primiparous mothers (n = 22), half of whom had a history of major depressive episodes (with one episode occurring during pregnancy and/or postpartum), were exposed to images of their own and unfamiliar infants' joy and distress faces during functional neuroimaging. Group differences (depression vs. no-depression) and continuous effects of current depressive symptoms were tested in relation to neural response to own infant emotion faces. Compared to mothers with no psychiatric diagnoses, those with depression showed blunted responses to their own infant's distress faces in the dorsal anterior cingulate cortex. Mothers with higher levels of current symptomatology showed reduced responses to their own infant's joy faces in the orbitofrontal cortex and insula. Current symptomatology also predicted lower responses to own infant joy-distress in left-sided prefrontal and insula/striatal regions. These deficits in self-regulatory and motivational response circuits may help explain parenting difficulties in depressed mothers.

Influence of socio-economic status on access to different components of SCI management across Indian population.

PubMed

Chhabra, H S; Bhalla, A M

2015-11-01

To assess the influence of financial constraints on access to different components of spinal cord injury (SCI) management in various socio-economic strata of the Indian population. Indian Spinal Injuries Centre (ISIC). One hundred fifty SCI individuals who came for follow-up at ISIC between March 2009 and March 2013 with at least 1 year of community exposure after discharge were included in the study. Socio-economic classification was carried out according to the Kuppuswamy scale, a standard scale for the Indian population. A self-designed questionnaire was administered. No sample was available from the lower group. There was a statistically significant difference (P<0.05) for the levels of difficulty perceived by different socio-economic groups in accessing different components of SCI management. Aided upper lower group was dependent on welfare schemes for in-hospital treatment but could not access other components of management once discharged. Unaided upper lower group either faced severe difficulty or could not access management. Majority of lower middle group faced severe difficulty. Upper middle group was equally divided into facing severe, moderate or no difficulty. Most patients in the upper group faced no difficulty, whereas some faced moderate and a small number of severe difficulty. Financial constraints affected all components of SCI management in all except the upper group. The results of the survey suggest that a very large percentage of the Indian population would find it difficult to access comprehensive SCI management and advocate extension of essential medical coverage to unaided upper lower, lower middle and upper middle groups.

Public participation in environmental management in China: status quo and mode innovation.

PubMed

Chen, Mei; Qian, Xin; Zhang, Longjiang

2015-03-01

Public participation in environmental management is critically important in the development of a healthy environmental governance system. However, public participation has not been well institutionalized in China and the public's role in environmental management is limited. Chinese policy-makers and researchers currently face a dilemma wherein they must determine how to fully and effectively involve the public. This paper aims to contribute an innovative approach that can effectively engage the general public, allowing them to participate more in China's environmental management. In this paper, we first review the current status of environmental management and public participation in China. Based on China's political and socio-cultural-legal dynamics, an Environmental Community Consultative Group (ECCG) was developed to be an innovative means to engage community members. A pilot study of the ECCG was carried out in Yapu village of Changzhou City in Jiangsu Province. The evaluation of the process and outcome of the ECCG showed that the group's effectiveness and influence were significant; the ECCG model was a powerful means by which to promote public environmental awareness, improve public environmental behavior and facilitate public engagement in environmental management. But the ECCG is a small local group that may not function well regarding more complex issues covering a much larger area and has limited impact on environmental policy making. The ECCG experience offers the prospect of grassroots involvement in environmental protection for China's rural areas, while also laying the foundation for further research on community participation in environmental management.

Public Participation in Environmental Management in China: Status Quo and Mode Innovation

NASA Astrophysics Data System (ADS)

Chen, Mei; Qian, Xin; Zhang, Longjiang

2015-03-01

Public participation in environmental management is critically important in the development of a healthy environmental governance system. However, public participation has not been well institutionalized in China and the public's role in environmental management is limited. Chinese policy-makers and researchers currently face a dilemma wherein they must determine how to fully and effectively involve the public. This paper aims to contribute an innovative approach that can effectively engage the general public, allowing them to participate more in China's environmental management. In this paper, we first review the current status of environmental management and public participation in China. Based on China's political and socio-cultural-legal dynamics, an Environmental Community Consultative Group (ECCG) was developed to be an innovative means to engage community members. A pilot study of the ECCG was carried out in Yapu village of Changzhou City in Jiangsu Province. The evaluation of the process and outcome of the ECCG showed that the group's effectiveness and influence were significant; the ECCG model was a powerful means by which to promote public environmental awareness, improve public environmental behavior and facilitate public engagement in environmental management. But the ECCG is a small local group that may not function well regarding more complex issues covering a much larger area and has limited impact on environmental policy making. The ECCG experience offers the prospect of grassroots involvement in environmental protection for China's rural areas, while also laying the foundation for further research on community participation in environmental management.

Using alternatives to face-to-face consultations: a survey of prevalence and attitudes in general practice

PubMed Central

Brant, Heather; Atherton, Helen; Ziebland, Sue; McKinstry, Brian; Campbell, John L; Salisbury, Chris

2016-01-01

Background The ubiquitous use of communication technologies has led to an expectation that a similar approach should extend to health care. Despite considerable rhetoric about the need for general practices to offer alternatives to face-to-face consultations, such as telephone, email, and internet video consultations, the extent to which such technologies are actually used at present is unclear. Aim The aim of the survey was to identify the frequency and range of ways in which general practices are providing (or planning) alternatives to face-to-face consultations. Design and setting A postal survey of practices around Bristol, Oxford, Lothian, the Highlands, and the Western Isles of Scotland. Method A postal questionnaire survey was sent to each of the GPs and practice managers of 421 practices between January and May 2015. Results A response was received from 319/421 practices (76%). Although the majority of the practices reported that they were conducting telephone consultations frequently (n = 211/318, 66%), fewer were implementing email consultations (n = 18/318, 6%), and most (n = 169/318, 53%) had no plans to introduce this. None were currently using internet video, and 86% (n = 273/318) had no plans to introduce internet video consultations. These findings were repeated in the reported use of alternatives to face-to-face consultations at an individual GP level. Optional free text responses were completed by 28% of responders, and offered an explanation for the (often perceived) barriers and incentives for implementation. Conclusion Despite policy pressure to introduce consultations by email and internet video, there is a general reluctance among GPs to implement alternatives to face-to-face consultations. This identifies a substantial gap between rhetoric and reality in terms of the likelihood of certain alternatives (email, video) changing practice in the near future. PMID:27215571

Electrical Stimulation over Bilateral Occipito-Temporal Regions Reduces N170 in the Right Hemisphere and the Composite Face Effect

PubMed Central

Yang, Li-Zhuang; Zhang, Wei; Shi, Bin; Yang, Zhiyu; Wei, Zhengde; Gu, Feng; Zhang, Jing; Cui, Guanbao; Liu, Ying; Zhou, Yifeng; Zhang, Xiaochu; Rao, Hengyi

2014-01-01

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that can modulate cortical excitability. Although the clinical value of tDCS has been advocated, the potential of tDCS in cognitive rehabilitation of face processing deficits is less understood. Face processing has been associated with the occipito-temporal cortex (OT). The present study investigated whether face processing in healthy adults can be modulated by applying tDCS over the OT. Experiment 1 investigated whether tDCS can affect N170, a face-sensitive ERP component, with a face orientation judgment task. The N170 in the right hemisphere was reduced in active stimulation conditions compared with the sham stimulation condition for both upright faces and inverted faces. Experiment 2 further demonstrated that tDCS can modulate the composite face effect, a type of holistic processing that reflects the obligatory attention to all parts of a face. The composite face effect was reduced in active stimulation conditions compared with the sham stimulation condition. Additionally, the current polarity did not modulate the effect of tDCS in the two experiments. The present study demonstrates that N170 can be causally manipulated by stimulating the OT with weak currents. Furthermore, our study provides evidence that obligatory attention to all parts of a face can be affected by the commonly used tDCS parameter setting. PMID:25531112

It is all in the face: carotenoid skin coloration loses attractiveness outside the face.

PubMed

Lefevre, C E; Ewbank, M P; Calder, A J; von dem Hagen, E; Perrett, D I

2013-01-01

Recently, the importance of skin colour for facial attractiveness has been recognized. In particular, dietary carotenoid-induced skin colour has been proposed as a signal of health and therefore attractiveness. While perceptual results are highly consistent, it is currently not clear whether carotenoid skin colour is preferred because it poses a cue to current health condition in humans or whether it is simply seen as a more aesthetically pleasing colour, independently of skin-specific signalling properties. Here, we tested this question by comparing attractiveness ratings of faces to corresponding ratings of meaningless scrambled face images matching the colours and contrasts found in the face. We produced sets of face and non-face stimuli with either healthy (high-carotenoid coloration) or unhealthy (low-carotenoid coloration) colour and asked participants for attractiveness ratings. Results showed that, while for faces increased carotenoid coloration significantly improved attractiveness, there was no equivalent effect on perception of scrambled images. These findings are consistent with a specific signalling system of current condition through skin coloration in humans and indicate that preferences are not caused by sensory biases in observers.

Soil Health Assessment Approaches and the Cornell Framework

NASA Astrophysics Data System (ADS)

van Es, Harold

2016-04-01

Soil health constraints beyond nutrient limitations and excesses currently limit agroecosystem productivity and sustainability, resilience to drought and extreme rainfall, and progress in soil and water conservation. With mounting pressure to produce food, feed, fiber, and even fuel for an increasing population, the concept of soil health is gaining national and international attention. Multiple regional, national, and global efforts are now leveraging that work to reach new stakeholder audiences, so that soil health management is expanding into mainstream agriculture. Each grower is generally faced with a unique situation in the choice of management options to address soil health constraints and each system affords its own set of opportunities or limitations to soil management. A more comprehensive understanding of soil health status can better guide farmers' management decisions. Until recently, there has not been a formalized decision making process for implementing a soil health management system that alleviates field-specific constrains identified through standard measurements and then maintains improved soil health. This presentation will discuss current US-based efforts related to soil health assessment, including efforts to build national consensus on appropriate methods for simple (inexpensive) and comprehensive tests. This includes the Cornell Soil Health Management Planning and Implementation Framework. The most relevant components of the framework are 1) measurement of indicators that represent critical soil processes, 2) scoring of measured values that allows for interpretation, and 3) linkage of identified constraints with management practices. Land managers can monitor changes over time through further assessment, and adapt management practices to achieve chosen goals. We will discuss the full tests and approaches for simplification.

Towards Meaningful Learning through Digital Video Supported, Case Based Teaching

ERIC Educational Resources Information Center

Hakkarainen, Paivi; Saarelainen, Tarja; Ruokamo, Heli

2007-01-01

This paper reports an action research case study in which a traditional lecture based, face to face "Network Management" course at the University of Lapland's Faculty of Social Sciences was developed into two different course versions resorting to case based teaching: a face to face version and an online version. In the face to face…

Knowledge Management and Law Enforcement: An Examination of Knowledge Management Strategies of the Police Information System (POLNET) in the Turkish National Police

ERIC Educational Resources Information Center

Gultekin, Kubra

2009-01-01

This research study explores knowledge management (KM) in law enforcement, focusing on the POLNET system established by the Turkish National Police as a knowledge-sharing tool. This study employs a qualitative case study for exploratory and descriptive purposes. The qualitative data set came from semi-structured face-to-face and telephone…

Terror management theory applied clinically: implications for existential-integrative psychotherapy.

PubMed

Lewis, Adam M

2014-01-01

Existential psychotherapy and Terror Management Theory (TMT) offer explanations for the potential psychological effects of death awareness, although their respective literatures bases differ in clarity, research, and implications for treating psychopathology. Existential therapy is often opaque to many therapists, in part due to the lack of consensus on what constitutes its practice, limited published practical examples, and few empirical studies examining its efficacy. By contrast, TMT has an extensive empirical literature base, both within social psychology and spanning multiple disciplines, although previously unexplored within clinical and counseling psychology. This article explores the implications of a proposed TMT integrated existential therapy (TIE), bridging the gap between disciplines in order to meet the needs of the aging population and current challenges facing existential therapists.

Opportunities and Challenges of Cloud Computing to Improve Health Care Services

PubMed Central

2011-01-01

Cloud computing is a new way of delivering computing resources and services. Many managers and experts believe that it can improve health care services, benefit health care research, and change the face of health information technology. However, as with any innovation, cloud computing should be rigorously evaluated before its widespread adoption. This paper discusses the concept and its current place in health care, and uses 4 aspects (management, technology, security, and legal) to evaluate the opportunities and challenges of this computing model. Strategic planning that could be used by a health organization to determine its direction, strategy, and resource allocation when it has decided to migrate from traditional to cloud-based health services is also discussed. PMID:21937354

The critically ill injured patient.

PubMed

Cereda, Maurizio; Weiss, Yoram G; Deutschman, Clifford S

2007-03-01

Patients admitted to the ICU after severe trauma require frequent procedures in the operating room, particularly in cases where a damage control strategy is used. The ventilatory management of these patients in the operating room can be particularly challenging. These patients often have severely impaired respiratory mechanics because of acute lung injury and abdominal compartment syndrome. Consequently, the pressure and flow generation capabilities of standard anesthesia ventilators may be inadequate to support ventilation and gas exchange. This article presents the problems that may be encountered in patients who have severe abdominal and lung injuries, and the current management concepts used in caring for these patients in the critical care setting, to provide guidelines for the anesthetist faced with these patients in the operating room.

Factors that facilitate registered nurses in their first-line nurse manager role.

PubMed

Cziraki, Karen; McKey, Colleen; Peachey, Gladys; Baxter, Pamela; Flaherty, Brenda

2014-11-01

To determine the factors that attract and retain Registered Nurses in the first-line nurse manager role. The first-line nurse manger role is pivotal in health-care organisations. National demographics suggest that Canada will face a first-line nurse manager shortage because of retirement in the next decade. Determination of factors that attract and retain Registered Nurses will assist organisations and policy makers to employ strategies to address this shortage. The study used an exploratory, descriptive qualitative approach, consisting of semi-structured individual interviews with 11 Registered Nurses in first-line nurse manager roles. The findings revealed a discrepancy between the factors that attract and retain Registered Nurses in the first-line nurse manager role, underscored the importance of the mentor role and confirmed the challenges encountered by first-line nurse managers practicing in the current health-care environment. The first-line nurse manager role has been under studied. Further research is warranted to understand which strategies are most effective in supporting first-line nurse managers. Strategies to support nurses in the first-line nurse manager role are discussed for the individual, programme, organisation and health-care system/policy levels. © 2013 John Wiley & Sons Ltd.

Australian defence requirements and initiatives in smart materials and structures

NASA Astrophysics Data System (ADS)

Wilson, Alan R.; Galea, Stephen C.; Scala, Christine; Wong, Albert

2002-11-01

The Australian Defence Force is increasingly facing escalating costs on through-life support for major platforms (ships, aircraft and land vehicles). The application of smart materials and structures technologies in platform management systems is seen as a very promising approach to reduce these costs and to potentially achieve significant enhancement of platform capability. A new DSTO Key Initiative, 'Smart Materials and Structures', has been recently developed and funded to address these technologies. The Initiative will build on and grow the current activities within DSTO and promote collaboration with external Australian institutes and industry. This paper will present an overview of the Initiative and the generic sensor and system issues inherent in the 'whole-of-platform' and 'whole-of-life' monitoring and management of major defence platforms. Examples for some particular elements of this will be drawn from current work in DSTO. Other presentations in the conference will cover the technical and scientific aspects of these in more detail.

On Farmers’ Ground: Wisconsin Dairy Farm Nutrient Management Survey Questionnaire

USDA-ARS?s Scientific Manuscript database

This questionnaire was used during quarterly, face-to-face interviews with the fifty-four Wisconsin dairy farmers who participated in the ‘On Farmers’ Ground’ nutrient management research project. It was designed to systematically and consistently compile information on herd size and composition, l...

Management of dredge material in the Republic of Ireland - A review.

PubMed

Sheehan, C; Harrington, J

2012-05-01

As an island nation the Republic of Ireland's ports and harbours are key to the economic wellbeing of the country as they are the primary transport link to the United Kingdom, mainland Europe and beyond. This paper examines the main aspects of the Irish dredging industry with comparison to international practice and standards, including the source of the dredge material and volumes generated annually, the dredging plant employed and the management processes currently practised. Relevant European and Irish legislation governing dredging, disposal at sea and waste licensing are presented. The potential impacts of disposal at sea are discussed with the implications for the Irish dredging industry of recently introduced European Directives assessed. Beneficial use rates for dredge material and the techniques implemented in Ireland are examined and compared with international practice. Recent notable beneficial use projects for dredge material and proposed innovative dredge material management techniques for specific dredging projects in Ireland are presented. Proposals to encourage greater beneficial use of dredge material and minimise disposal at sea for Ireland are presented including the introduction of environmental credits, tax breaks and a grant system for pilot schemes. An alternative disposal at sea charge fee structure is also recommended to encourage alternative dredge material management practices. Ireland's management of contaminated sediment is also presented with recent projects described highlighting the current practice of primarily exporting contaminated sediment to mainland Europe. Alternative methods of treatment of contaminated sediment are assessed in an Irish context. Future issues and challenges facing the Irish dredging industry are assessed and a critical analysis of the current approaches to dredge material management is presented. Copyright © 2011 Elsevier Ltd. All rights reserved.

Using Current and Historic Climate Data and Bayesian Belief Networks to Predict Optimum Satellite Image Acquisition Periods for Detecting Cheatgrass on the Snake River Plain, Idaho

NASA Astrophysics Data System (ADS)

Rope, R. C.; Ames, D. P.; Jerry, T. D.; Cherry, S. J.

2005-12-01

Invasive plant species, such as Bromus tectorum (cheatgrass), cost the United States over $36 billion per year and have encroached upon over 100 million acres while impacting range site productivity, disturbing wildlife habitat, altering the wildland fire regime and frequencies, and reducing biodiversity. Because of these adverse impacts, federal, tribal, state, and county land managers are faced with the challenge of prevention, early detection, management, and monitoring of invasive plants. Often these managers rely on the analysis of remotely sensed imagery as part of their management plan. However, it's difficult to predict specific phenological events that allow for the spectral discrimination of invasive species using only remotely sensed imagery. To address this issue tools are being developed to model and view optimal periods to collect high spatial and/or spectral resolution remotely sensed data for refined detection and mapping of invasive species and for use as a decision support tool for land managers. These tools involve the integration of historic and current climate data (cumulative growing days and precipitation) satellite imagery (MODIS) and Bayesian Belief Networks, and a web ArcIMS application to distribute the information. The general approach is to issue an initial forecast early in the year based on the previous years' data. As the year progresses, air temperature, precipitation and newly acquired low resolution MODIS satellite imagery will be used to update the prediction. Updating will be accomplished using a Bayesian Belief Network model that indicates the probabilistic relationships between prior years' conditions and those of the current year. These tools have specific application in providing a means for which land managers can efficiently and effectively detect, map, and monitor invasive plant species, specifically cheatgrass, in western rangelands. This information can then be integrated into management studies and plans to help land managers more accurately and completely determine areas infested with cheatgrass to aid in their eradication practices and future management plans.

A comment on “temporal variation in survival and recovery rates of lesser scaup”

USGS Publications Warehouse

Lindberg, Mark S.; Boomer, G. Scott; Schmutz, Joel A.; Walker, Johann A.

2017-01-01

Concerns about declines in the abundance of lesser scaup (Aythya affinis) have promoted a number of analyses to understand reasons for this decline. Unfortunately, most of these analyses, including that of Arnold et al. (2016 Journal of Wildlife Management 80: 850–861), are based on observational studies leading to weak inference. Although we commend the efforts of Arnold et al. (2016 Journal of Wildlife Management 80: 850–861), we think their conclusions are over-stated given their retrospective analysis. Further, we note a number of inconsistencies in their reasoning and offer alternative conclusions that can be drawn from their analysis. Given the uncertainty still surrounding management of lesser scaup, we do not believe it is prudent to abandon or greatly modify adaptive management approaches designed specifically to make optimal decisions in the face of uncertainty. The current learning-based and recursive approach to management appears to be providing adequate guidance for harvest without punctuated changes to harvest levels, as Arnold et al. (2016 Journal of Wildlife Management 80: 850–861) recommend.

Organization of Biomedical Data for Collaborative Scientific Research: A Research Information Management System

PubMed Central

Myneni, Sahiti; Patel, Vimla L.

2010-01-01

Biomedical researchers often work with massive, detailed and heterogeneous datasets. These datasets raise new challenges of information organization and management for scientific interpretation, as they demand much of the researchers’ time and attention. The current study investigated the nature of the problems that researchers face when dealing with such data. Four major problems identified with existing biomedical scientific information management methods were related to data organization, data sharing, collaboration, and publications. Therefore, there is a compelling need to develop an efficient and user-friendly information management system to handle the biomedical research data. This study evaluated the implementation of an information management system, which was introduced as part of the collaborative research to increase scientific productivity in a research laboratory. Laboratory members seemed to exhibit frustration during the implementation process. However, empirical findings revealed that they gained new knowledge and completed specified tasks while working together with the new system. Hence, researchers are urged to persist and persevere when dealing with any new technology, including an information management system in a research laboratory environment. PMID:20543892

Specialty pharmacy cost management strategies of private health care payers.

PubMed

Stern, Debbie; Reissman, Debi

2006-01-01

The rate of increase in spending on specialty pharmaceuticals is outpacing by far the rate of increase in spending for other drugs. To explore the strategies payers are using in response to challenges related to coverage, cost, clinical management, and access of specialty pharmaceuticals and to describe the potential implications for key stakeholders, including patients, physicians, and health care purchasers. Sources of information were identified in the course of providing consulting services in the subject area of specialty pharmaceuticals to health plans, pharmacy benefit managers, employers, and pharmaceutical manufacturers. Specialty pharmaceuticals represent the fastest growing segment of drug spending due to new product approvals, high unit costs, and increasing use. Health care payers are faced with significant challenges related to coverage, cost, clinical management, and access. A variety of short- and long-term strategies have been employed to address these challenges. Current management techniques for specialty pharmaceuticals often represent a stop-gap approach for controlling rising drug costs. Optimum cost and care management methods will evolve as further research identifies the true clinical and economic value of various specialty pharmaceuticals.

The need for time management training is universal: evidence from Turkey.

PubMed

Kisa, Adnan; Ersoy, Korkut

2005-01-01

In many developing countries, healthcare administrators are currently facing challenges that are representative of those in the United States. Most healthcare administrators here are physicians with no formal training in healthcare administration, and this is perhaps most apparent in their difficulties with time management. The authors' purpose in this study was to characterize the time management difficulties of administrators working in primary healthcare facilities of the Ministry of Healthcare. In the study, 67 healthcare administrators each completed a 31-item time management questionnaire. Of the participants, 79.1% reported that they have never attended time management courses or workshops. Although 76.1% said they were free to choose the priority of their daily tasks, only 44.8% felt they knew how much time they should allow for each activity in their daily life. These and other findings in the study suggest that the need for time management education is a well-defined target for intervention, both in university-based programs for future healthcare administrators and in workplace-based programs, such as in-service training for healthcare administrators who are already working.

Organization of Biomedical Data for Collaborative Scientific Research: A Research Information Management System.

PubMed

Myneni, Sahiti; Patel, Vimla L

2010-06-01

Biomedical researchers often work with massive, detailed and heterogeneous datasets. These datasets raise new challenges of information organization and management for scientific interpretation, as they demand much of the researchers' time and attention. The current study investigated the nature of the problems that researchers face when dealing with such data. Four major problems identified with existing biomedical scientific information management methods were related to data organization, data sharing, collaboration, and publications. Therefore, there is a compelling need to develop an efficient and user-friendly information management system to handle the biomedical research data. This study evaluated the implementation of an information management system, which was introduced as part of the collaborative research to increase scientific productivity in a research laboratory. Laboratory members seemed to exhibit frustration during the implementation process. However, empirical findings revealed that they gained new knowledge and completed specified tasks while working together with the new system. Hence, researchers are urged to persist and persevere when dealing with any new technology, including an information management system in a research laboratory environment.

E-counseling as an emerging preventive strategy for hypertension.

PubMed

Nolan, Robert P; Liu, Sam; Payne, Ada Y M

2014-07-01

Lifestyle counseling that includes exercise training, diet modification, and medication adherence is critical to hypertension management. This article summarizes the efficacy of lifestyle counseling interventions in face-to-face, telehealth, and e-counseling settings. It also discusses the therapeutic potential of e-counseling as a preventive strategy for hypertension. The recent proliferation of telehealth and e-counseling programs increases the reach of preventive counseling for patients with cardiovascular disorders. Blood pressure reduction following these interventions is comparable to face-to-face interventions. However, the effectiveness of e-counseling varies depending on the design features of the core protocol. An evidence-based guideline needs to be established that identifies e-counseling components which are independently associated with blood pressure reduction. As the Internet becomes more sophisticated, e-counseling is demonstrating a therapeutic advantage in comparison with other telehealth interventions. Current evidence supports further development of preventive e-counseling programs for hypertension. A pressing challenge for investigators is to specify key evidence-based components of e-counseling that are essential to the core protocol. In order to achieve this goal, it will be necessary to ensure that e-counseling programs are also clinically organized, in order to guide patients through the process of initiating and sustaining therapeutic behavior change.

Health Professionals Facing Burnout: What Do We Know about Nursing Managers?

PubMed

Heeb, Jean-Luc; Haberey-Knuessi, Véronique

2014-01-01

Objective. To address the degree of burnout in nursing managers in hospitals of Western Switzerland, including comparison with medical managers, and its relationship with personal, work-related, and organizational characteristics. Methods. Statistical analysis of the scores of the Maslach Burnout Inventory-Human Services Survey from 257 nursing managers who answered a standardized electronic questionnaire. Results. Nursing managers showed a low degree of burnout, which was similar to that of medical managers. Most of them had a low level of emotional exhaustion and a low level of depersonalization, while personal accomplishment was contrasted. Only 2.3% had a high degree of burnout. These findings challenge the hypothesis of high stress being associated with high burnout, as nursing managers can be supposed to have a highly demanding job due to their intermediary position within the hospital hierarchy. Variations of burnout by personal, work-related, and organizational characteristics mainly concerned emotional exhaustion. Conclusion. Though nursing managers face a highly demanding job, they may benefit from resources (including coping strategies and empowerment) which help counterbalance job stress. Unequal distribution of resources may play a central role when facing burnout.

Health Professionals Facing Burnout: What Do We Know about Nursing Managers?

PubMed Central

Haberey-Knuessi, Véronique

2014-01-01

Objective. To address the degree of burnout in nursing managers in hospitals of Western Switzerland, including comparison with medical managers, and its relationship with personal, work-related, and organizational characteristics. Methods. Statistical analysis of the scores of the Maslach Burnout Inventory-Human Services Survey from 257 nursing managers who answered a standardized electronic questionnaire. Results. Nursing managers showed a low degree of burnout, which was similar to that of medical managers. Most of them had a low level of emotional exhaustion and a low level of depersonalization, while personal accomplishment was contrasted. Only 2.3% had a high degree of burnout. These findings challenge the hypothesis of high stress being associated with high burnout, as nursing managers can be supposed to have a highly demanding job due to their intermediary position within the hospital hierarchy. Variations of burnout by personal, work-related, and organizational characteristics mainly concerned emotional exhaustion. Conclusion. Though nursing managers face a highly demanding job, they may benefit from resources (including coping strategies and empowerment) which help counterbalance job stress. Unequal distribution of resources may play a central role when facing burnout. PMID:24804090

Emergency responders' critical infrared (ERCI)

NASA Astrophysics Data System (ADS)

Konsin, Larry S.

2004-08-01

Emergency Responders (Fire, Police, Medical, and Emergency Management) face a high risk of injury or death. Even before September 11, 2001, public and private organizations have been driven to better protect Emergency Responders through education, training and improved technology. Recent research on Emergency Responder safety, health risks, and personal protective requirements, shows infrared (IR) imaging as a critical need. Today"s Emergency Responders are increasingly challenged to do more, facing demands requiring technological assistance and/or solutions. Since the introduction of Fire Service IR imaging in the mid 1990s, applications have increased. Emergency response IR is no longer just seeing through smoke to find victims or the seat of a fire. Many more mission critical needs now exist across the broad spectrum of emergency response. At the same time, Emergency Responder injuries and deaths are increasing. The Office of Domestic Preparedness (ODP) has also recognized IR imaging as critical in protecting our communities -- and in preventing many of the injuries and deaths of Emergency Responders. Currently, only 25% of all fire departments (or less than 7% of individual firefighters) have IR imaging. Availability to Police, EMS and Emergency Management is even lower. Without ERCI, Emergency Responders and our communities are at risk.

Growing leaders in a professional membership organization.

PubMed

Shekleton, Maureen E; Preston, John C; Good, Laura E

2010-09-01

This study describes the background, development and delivery of an innovative approach to prepare elected state association leaders for their new leadership roles in their respective state organizations. State-based professional associations face unprecedented threats to scope of practice in the current volatile healthcare environment. In 2009 the American Association of Nurse Anesthetists (AANA) began offering a Leadership Development 'Boot Camp' for all nurse anesthetist state association presidents-elect designed with the intent of providing the participants with information, resources and tools they need in their new role. An organizational assessment examined the philosophy of and need for leadership development across the entire organizational structure. Recommendations from the assessment included the need for intensive leadership development at the state level. A 3-day intensive workshop was designed and implemented. Adult learning theory was used for its development. The success of this programme has lead to its implementation as part of leadership development of the AANA. Nurse managers and elected volunteer leaders in state-based professional associations face similar challenges requiring sound leadership ability. Principles applied to the development of the AANA programme can be applied to leadership development for new nurse managers. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Institutional Governance Framework for Determining Carbon-related Accounting Practices: An Exploratory Study of Electricity Generating Companies in Malaysia

NASA Astrophysics Data System (ADS)

Alrazi, B.; Mat Husin, N.

2016-03-01

Electricity industry is the major contributor of the global carbon emissions which has been scientifically identified as the main cause of climate change. With the various initiatives being implemented at the international, national, and industry levels, companies in the electricity industry are currently facing immense pressure from various stakeholders to demonstrate their policies, initiatives, targets, and performance on climate change. Against this background, accounting system is argued to be able to be play important roles in combating climate change. Using institutional governance as the underlying framework, we have identified several governance mechanisms as the determining factors for companies to have a systematic accounting system related to carbon emissions. The factors include environmental management system certification, environmental organization, publication of stand-alone sustainability reports, the use of GRI guidelines, environmental strategic planning, governance quality, and participation in CDP surveys and emissions trading scheme. We explored this issue in the context of major electricity generating companies in Malaysia and found that except for certified environmental management system, the other governance mechanisms are still lacking. The findings suggest that companies in Malaysia, in particular, from the electricity industry are not well prepared in facing risks related to climate change.

Direct antiviral treatment in patients with hepatitis C virus: Implementation of a nurse telephone consultation.

PubMed

Monllor-Nunell, M Teresa; Sanchez-Lloansí, Meritxell; Dosal-Galguera, Angelina

The treatment of chronic hepatitis C with direct action antivirals has led to a radical change in the management of patients. The elderly or people with morbidities, for whom it was previously contraindicated, are currently candidates for this treatment due to its being well tolerated and safe. The nursing visit at the beginning of treatment is essential to reinforce adherence, to educate on the management of adverse effects, to resolve doubts and to emphasise the importance of pharmacological interactions, in order to promote correct therapeutic compliance. However, due to the new communication tools, it is possible to convey healthcare services without requiring the physical presence of the patient in the medical centre. The telephone has become a routine and indispensable work tool for the nursing professional. This paper describes the pilot test that was performed with 38 patients, previously selected, whose nursing visit at the beginning of treatment was by telephone instead of face-to-face, in order to evaluate the implementation of the telephone nurse consultation, for patients who started treatment with direct antivirals for the hepatitis C virus. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Agent-oriented privacy-based information brokering architecture for healthcare environments.

PubMed

Masaud-Wahaishi, Abdulmutalib; Ghenniwa, Hamada

2009-01-01

Healthcare industry is facing a major reform at all levels-locally, regionally, nationally, and internationally. Healthcare services and systems become very complex and comprise of a vast number of components (software systems, doctors, patients, etc.) that are characterized by shared, distributed and heterogeneous information sources with varieties of clinical and other settings. The challenge now faced with decision making, and management of care is to operate effectively in order to meet the information needs of healthcare personnel. Currently, researchers, developers, and systems engineers are working toward achieving better efficiency and quality of service in various sectors of healthcare, such as hospital management, patient care, and treatment. This paper presents a novel information brokering architecture that supports privacy-based information gathering in healthcare. Architecturally, the brokering is viewed as a layer of services where a brokering service is modeled as an agent with a specific architecture and interaction protocol that are appropriate to serve various requests. Within the context of brokering, we model privacy in terms of the entities ability to hide or reveal information related to its identities, requests, and/or capabilities. A prototype of the proposed architecture has been implemented to support information-gathering capabilities in healthcare environments using FIPA-complaint platform JADE.

The direction of cloud computing for Malaysian education sector in 21st century

NASA Astrophysics Data System (ADS)

Jaafar, Jazurainifariza; Rahman, M. Nordin A.; Kadir, M. Fadzil A.; Shamsudin, Syadiah Nor; Saany, Syarilla Iryani A.

2017-08-01

In 21st century, technology has turned learning environment into a new way of education to make learning systems more effective and systematic. Nowadays, education institutions are faced many challenges to ensure the teaching and learning process is running smoothly and manageable. Some of challenges in the current education management are lack of integrated systems, high cost of maintenance, difficulty of configuration and deployment as well as complexity of storage provision. Digital learning is an instructional practice that use technology to make learning experience more effective, provides education process more systematic and attractive. Digital learning can be considered as one of the prominent application that implemented under cloud computing environment. Cloud computing is a type of network resources that provides on-demands services where the users can access applications inside it at any location and no time border. It also promises for minimizing the cost of maintenance and provides a flexible of data storage capacity. The aim of this article is to review the definition and types of cloud computing for improving digital learning management as required in the 21st century education. The analysis of digital learning context focused on primary school in Malaysia. Types of cloud applications and services in education sector are also discussed in the article. Finally, gap analysis and direction of cloud computing in education sector for facing the 21st century challenges are suggested.

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

PubMed

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

2013-08-01

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

Anticoagulants for secondary prevention after acute myocardial infarction: lessons from the past decade

PubMed Central

Atar, Dan; Bode, Christoph; Stuerzenbecher, André; Verheugt, Freek W A

2014-01-01

The impact of an acute coronary syndrome (ACS) event, such as an acute myocardial infarction (MI), is not limited to the acute management phase; patients face an elevated risk of residual atherothrombotic events that commonly requires chronic management for months or even years. Significant advances have been made in both the acute and chronic management of patients with acute MI over the past decade, resulting in improved prognoses. One of the hallmarks of modern treatment strategies is more aggressive antiplatelet treatment regimens. However, the risks of further ACS events, stroke and premature death remain elevated in these patients, and addressing this residual risk is challenging owing to interpatient variability, differences in management strategies between centres and countries, incomplete understanding of the specific pathophysiology of post-ACS thrombosis and limitations of current therapeutic approaches. The recent approval in Europe of the direct oral anticoagulant rivaroxaban for use in this setting in combination with clopidogrel and acetylsalicylic acid offers another strategy to consider in the management of these patients, and clinical strategies in this area continue to evolve. In this review, we chart the progress made over the past decade in reducing the burden of secondary thromboembolic events after acute MI and discuss the current position of and future perspectives on the inclusion of oral anticoagulants into care pathways in this setting. PMID:24494730

Multi-Institution Research Centers: Planning and Management Challenges

ERIC Educational Resources Information Center

Spooner, Catherine; Lavey, Lisa; Mukuka, Chilandu; Eames-Brown, Rosslyn

2016-01-01

Funding multi-institution centers of research excellence (CREs) has become a common means of supporting collaborative partnerships to address specific research topics. However, there is little guidance for those planning or managing a multi-institution CRE, which faces specific challenges not faced by single-institution research centers. We…

Strategy and Finance in Higher Education. Surviving the '90s.

ERIC Educational Resources Information Center

Massy, William F., Ed.; Meyerson, Joel W., Ed.

This book provides a new look at educational management in the face of mounting financial pressures. The demands for accountability that today's university administrators must face require them to apply the sophistication of modern business and institutional management while preserving the expensive and often difficult-to-measure contributions of…

Online Project Based Learning in Innovation Management.

ERIC Educational Resources Information Center

O'Sullivan, David

2003-01-01

An innovation management course has three strands with face-to-face and online components: (1) seminars with online course notes and slides; (2) assignments (group online case studies, tutorials, in-class presentations); and (3) assessment (online, oral, in-class, written). Students are able to benchmark their work online and teachers use the…

Outsourcing issues for nurse practitioner practices.

PubMed

Mackey, Thomas A; McNiel, Nancy O; Klingensmith, Kenneth

2004-01-01

Nurse practitioner managed practices face multiple business and clinical processes. While most practice managers are prepared as clinicians, they are not well prepared to deal with the daily multiple business infrastructure issues they face. To provide for increased efficiency and effectiveness, nurse practitioner practices should consider outsourcing context business functions.

Implementation of School-Based Management in Indonesia. Monograph

ERIC Educational Resources Information Center

Vernez, Georges; Karam, Rita; Marshall, Jeffery H.

2012-01-01

This study provides a quantitative and qualitative status report on the implementation of school-based management (SBM) in Indonesia, identifies factors associated with the successful practices of SBM, and assesses SBM effects on student achievement eight years after its inception. The authors' findings are based on face-to-face surveys of…

Using Satellite Data to Unpack Causes of Yield Gaps in India's Wheat Belt

NASA Astrophysics Data System (ADS)

Jain, M.; Singh, B.; Srivastava, A.; Malik, R. K.; McDonald, A.; Lobell, D. B.

2016-12-01

India will face significant food security challenges in the coming decades due to climate change, natural resource degradation, and population growth. Yields of wheat, one of India's staple crops, are already stagnating and will be significantly impacted by warming temperatures. Despite these challenges, wheat yields can be enhanced by implementing improved management in regions with existing yield gaps. To identify the magnitude and causes of current yield gaps, we produced 30 m resolution yield maps across India's main wheat belt, the Indo-Gangetic Plains (IGP), from 2000 to 2015. Yield maps were derived using a new method that translates satellite vegetation indices to yield estimates using crop model simulations, bypassing the need for ground calibration data that rarely exist in smallholder systems. We find that yields can be increased by 5% on average and up to 16% in the eastern IGP by improving management to current best practices within a given district. However, if policies and technologies are put in place to improve management to current best practices in Punjab, the highest yielding state, yields can be increased by 29% in the eastern IGP. Considering which factors most influence wheat yields, we find that later sow dates and warmer temperatures are most associated with low yields across the IGP. This suggests that strategies that reduce the negative effects of heat stress, like earlier sowing and planting heat-tolerant wheat varieties, are critical to India's current and future food security.

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

Marshall, Rachael E., E-mail: rmarsh01@uoguelph.ca; Farahbakhsh, Khosrow, E-mail: khosrowf@uoguelph.ca

Highlights: ► Five drivers led developed countries to current solid waste management paradigm. ► Many unique factors challenge developing country solid waste management. ► Limited transferability of developed country approaches to developing countries. ► High uncertainties and decision stakes call for post-normal approaches. ► Systems thinking needed for multi-scale, self-organizing eco-social waste systems. - Abstract: Solid waste management (SWM) has become an issue of increasing global concern as urban populations continue to rise and consumption patterns change. The health and environmental implications associated with SWM are mounting in urgency, particularly in the context of developing countries. While systems analyses largelymore » targeting well-defined, engineered systems have been used to help SWM agencies in industrialized countries since the 1960s, collection and removal dominate the SWM sector in developing countries. This review contrasts the history and current paradigms of SWM practices and policies in industrialized countries with the current challenges and complexities faced in developing country SWM. In industrialized countries, public health, environment, resource scarcity, climate change, and public awareness and participation have acted as SWM drivers towards the current paradigm of integrated SWM. However, urbanization, inequality, and economic growth; cultural and socio-economic aspects; policy, governance, and institutional issues; and international influences have complicated SWM in developing countries. This has limited the applicability of approaches that were successful along the SWM development trajectories of industrialized countries. This review demonstrates the importance of founding new SWM approaches for developing country contexts in post-normal science and complex, adaptive systems thinking.« less

Models for open innovation in the pharmaceutical industry.

PubMed

Schuhmacher, Alexander; Germann, Paul-Georg; Trill, Henning; Gassmann, Oliver

2013-12-01

The nature of the pharmaceutical industry is such that the main driver for its growth is innovation. In view of the vast challenges that the industry has been facing for several years and, in particular, how to manage stagnating research and development (R&D) productivity, pharmaceutical companies have opened their R&D organizations to external innovation. Here, we identify and characterize four new types of open innovator, which we call 'knowledge creator', 'knowledge integrator', 'knowledge translator' and 'knowledge leverager', and which describe current open R&D models. Copyright © 2013 Elsevier Ltd. All rights reserved.

Promoting medical innovation while developing sound social and business policy: a conversation with Thomas G. Roberts. Interview by Barbara J. Culliton.

PubMed

Roberts, Thomas G

2008-01-01

The development of "targeted biologics" as cancer therapy has made the field ripe for investment from the private sector and is changing the face of cancer medicine, while also raising important policy concerns about price, profit, and continued innovation. In this interview Barbara Culliton talks with Thomas Roberts, who sees this world from a unique perspective. Roberts, an oncologist, has practiced at the Massachusetts General Hospital and is currently thinking about innovation as a hedge fund manager.

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

Lucia, M., E-mail: mlucia@pppl.gov; Kaita, R.; Majeski, R.

The Materials Analysis and Particle Probe (MAPP) is a compact in vacuo surface science diagnostic, designed to provide in situ surface characterization of plasma facing components in a tokamak environment. MAPP has been implemented for operation on the Lithium Tokamak Experiment at Princeton Plasma Physics Laboratory (PPPL), where all control and analysis systems are currently under development for full remote operation. Control systems include vacuum management, instrument power, and translational/rotational probe drive. Analysis systems include onboard Langmuir probes and all components required for x-ray photoelectron spectroscopy, low-energy ion scattering spectroscopy, direct recoil spectroscopy, and thermal desorption spectroscopy surface analysis techniques.

The A to Z of healthcare data breaches.

PubMed

Kobus, Theodore J

2012-01-01

There currently exists a myriad of privacy laws that impact a healthcare entity, including more than 47 notification laws that require notification when a data breach occurs, as well as the breach notification requirements of the Health Information Technology for Economic and Clinical Health Act. Given the plethora of issues a healthcare entity faces, there are certain principles that can be built into an organization's philosophy that will comply with the law and help protect it from reputational harm. © 2012 American Society for Healthcare Risk Management of the American Hospital Association.

An educational intervention to reduce pain and improve pain management for Malawian people living with HIV/AIDS and their family carers: study protocol for a randomised controlled trial.

PubMed

Nkhoma, Kennedy; Seymour, Jane; Arthur, Antony

2013-07-13

Many HIV/AIDS patients experience pain often due to advanced HIV/AIDS infection and side effects of treatment. In sub-Saharan Africa, pain management for people with HIV/AIDS is suboptimal. With survival extended as a direct consequence of improved access to antiretroviral therapy, the prevalence of HIV/AIDS related pain is increasing. As most care is provided at home, the management of pain requires patient and family involvement. Pain education is an important aspect in the management of pain in HIV/AIDS patients. Studies of the effectiveness of pain education interventions for people with HIV/AIDS have been conducted almost exclusively in western countries. A randomised controlled trial is being conducted at the HIV and palliative care clinics of two public hospitals in Malawi. To be eligible, patient participants must have a diagnosis of HIV/AIDS (stage III or IV). Carer participants must be the individual most involved in the patient's unpaid care. Eligible participants are randomised to either: (1) a 30-minute face-to-face educational intervention covering pain assessment and management, augmented by a leaflet and follow-up telephone call at two weeks; or (2) usual care. Those allocated to the usual care group receive the educational intervention after follow-up assessments have been conducted (wait-list control group). The primary outcome is pain severity measured by the Brief Pain Inventory. Secondary outcomes are pain interference, patient knowledge of pain management, patient quality of life, carer knowledge of pain management, caregiver motivation and carer quality of life. Follow-up assessments are conducted eight weeks after randomisation by palliative care nurses blind to allocation. This randomised controlled trial conducted in sub-Saharan Africa among people living with HIV/AIDS and their carers will assess whether a pain education intervention is effective in reducing pain and improving pain management, quality of life and carer motivation. Current Controlled Trials ISRCTN72861423.

Impacts, Perceptions and Management of Climate-Related Risks to Cage Aquaculture in the Reservoirs of Northern Thailand.

PubMed

Lebel, Louis; Lebel, Phimphakan; Lebel, Boripat

2016-12-01

Weather is suspected to influence fish growth and survival, and be a factor in mass mortality events in cage aquaculture in reservoirs. The purpose of this study was to identify the important climate-related risks faced by cage aquaculture farms; evaluate how these risks were currently being managed; and explore how farmers might adapt to the effects of climate change. Fish farmers were interviewed across the northern region of Thailand to get information on impacts, perceptions and practices. Drought or low water levels, heat waves, cold spells and periods with dense cloud cover, each caused significant financial losses. Perceptions of climate-related risks were consistent with experienced impacts. Risks are primarily managed in the short-term with techniques like aeration and reducing feed. In the mid-term farmers adjust stocking calendars, take financial measures and seek new information. Farmers also emphasize the importance of maintaining good relations with other stakeholders and reservoir management. Larger farms placed greater importance on risk management than small farms, even though types and levels of risk perceived were very similar. Most fish farms were managed by men alone, or men and women working together. Gender differences in risk perception were not detected, but women judged a few risk management practices as more important than men. Fish farmers perceived that climate is changing, but their perceptions were not strongly associated with recently having suffered impacts from extreme weather. The findings of this study provide important inputs to improving risk management under current and future climate.

Impacts, Perceptions and Management of Climate-Related Risks to Cage Aquaculture in the Reservoirs of Northern Thailand

NASA Astrophysics Data System (ADS)

Lebel, Louis; Lebel, Phimphakan; Lebel, Boripat

2016-12-01

Weather is suspected to influence fish growth and survival, and be a factor in mass mortality events in cage aquaculture in reservoirs. The purpose of this study was to identify the important climate-related risks faced by cage aquaculture farms; evaluate how these risks were currently being managed; and explore how farmers might adapt to the effects of climate change. Fish farmers were interviewed across the northern region of Thailand to get information on impacts, perceptions and practices. Drought or low water levels, heat waves, cold spells and periods with dense cloud cover, each caused significant financial losses. Perceptions of climate-related risks were consistent with experienced impacts. Risks are primarily managed in the short-term with techniques like aeration and reducing feed. In the mid-term farmers adjust stocking calendars, take financial measures and seek new information. Farmers also emphasize the importance of maintaining good relations with other stakeholders and reservoir management. Larger farms placed greater importance on risk management than small farms, even though types and levels of risk perceived were very similar. Most fish farms were managed by men alone, or men and women working together. Gender differences in risk perception were not detected, but women judged a few risk management practices as more important than men. Fish farmers perceived that climate is changing, but their perceptions were not strongly associated with recently having suffered impacts from extreme weather. The findings of this study provide important inputs to improving risk management under current and future climate.

A proposed simulation optimization model framework for emergency department problems in public hospital

NASA Astrophysics Data System (ADS)

Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

2015-12-01

The Emergency Department (ED) is a very complex system with limited resources to support increase in demand. ED services are considered as good quality if they can meet the patient's expectation. Long waiting times and length of stay is always the main problem faced by the management. The management of ED should give greater emphasis on their capacity of resources in order to increase the quality of services, which conforms to patient satisfaction. This paper is a review of work in progress of a study being conducted in a government hospital in Selangor, Malaysia. This paper proposed a simulation optimization model framework which is used to study ED operations and problems as well as to find an optimal solution to the problems. The integration of simulation and optimization is hoped can assist management in decision making process regarding their resource capacity planning in order to improve current and future ED operations.

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.

Treatment of Young Adults with Acute Lymphoblastic Leukemia.

PubMed

Kansagra, Ankit; Litzow, Mark

2017-06-01

Young adults with acute lymphoblastic leukemia are a distinctive category of patients, with substantial difference in disease biology and response to therapy; hence, they pose unique challenges and issues beyond those faced by children and older adults. Despite inferior survival compared to children, there is growing evidence to suggest that young adults have improved outcomes when treated with pediatric-based approaches. With better supportive care and toxicity management and multidisciplinary team and approach, we have made great improvement in outcomes of young adults with ALL. However, despite significant progress, patients with persistence of minimal residual disease have a poor prognosis. This review discusses current controversies in the management of young adults with ALL, outcomes following pediatric and adult protocols, and the role of allogeneic stem cell transplantation. We also explore recent advances in disease monitoring and highlight our approach to incorporation of novel therapies in the management of young adults with ALL.

Analysis of constraints and potentials for wastewater management in the coastal city of Manado, North Sulawesi, Indonesia.

PubMed

Lasut, Markus T; Jensen, Kathe R; Shivakoti, Ganesh

2008-09-01

Manado is the largest and most densely populated coastal city in North Sulawesi Province, Indonesia. The city is facing problems of wastewater discharged from various sources. These problems are driven by high population pressure, increasing economic activity, and low household income, in combination with inadequate organizational structure of government institutions for addressing the wastewater problems as well as for law enforcement. There have been no community initiatives to prevent or mitigate wastewater problems. Therefore, a wastewater management plan is urgently needed to prevent and mitigate pollution caused by discharged wastewater. In this paper we analyze the current situation with respect to environmental state, sources and treatment of wastewater, socio-economic and institutional capacities as well as community awareness. Constraints and potentials are discussed to give recommendations for an integrated wastewater management plan for the city of Manado.

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

PubMed

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

2015-04-01

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

Mitigating the Impacts of Climate Nonstationarity on Seasonal Streamflow Predictability in the U.S. Southwest

NASA Astrophysics Data System (ADS)

Lehner, Flavio; Wood, Andrew W.; Llewellyn, Dagmar; Blatchford, Douglas B.; Goodbody, Angus G.; Pappenberger, Florian

2017-12-01

Seasonal streamflow predictions provide a critical management tool for water managers in the American Southwest. In recent decades, persistent prediction errors for spring and summer runoff volumes have been observed in a number of watersheds in the American Southwest. While mostly driven by decadal precipitation trends, these errors also relate to the influence of increasing temperature on streamflow in these basins. Here we show that incorporating seasonal temperature forecasts from operational global climate prediction models into streamflow forecasting models adds prediction skill for watersheds in the headwaters of the Colorado and Rio Grande River basins. Current dynamical seasonal temperature forecasts now show sufficient skill to reduce streamflow forecast errors in snowmelt-driven regions. Such predictions can increase the resilience of streamflow forecasting and water management systems in the face of continuing warming as well as decadal-scale temperature variability and thus help to mitigate the impacts of climate nonstationarity on streamflow predictability.

Web Content Management Systems: An Analysis of Forensic Investigatory Challenges.

PubMed

Horsman, Graeme

2018-02-26

With an increase in the creation and maintenance of personal websites, web content management systems are now frequently utilized. Such systems offer a low cost and simple solution for those seeking to develop an online presence, and subsequently, a platform from which reported defamatory content, abuse, and copyright infringement has been witnessed. This article provides an introductory forensic analysis of the three current most popular web content management systems available, WordPress, Drupal, and Joomla! Test platforms have been created, and their site structures have been examined to provide guidance for forensic practitioners facing investigations of this type. Result's document available metadata for establishing site ownership, user interactions, and stored content following analysis of artifacts including Wordpress's wp_users, and wp_comments tables, Drupal's "watchdog" records, and Joomla!'s _users, and _content tables. Finally, investigatory limitations documenting the difficulties of investigating WCMS usage are noted, and analysis recommendations are offered. © 2018 American Academy of Forensic Sciences.

Challenges in managing freshwater fishery resource through Lebak Lebung Auction approach: a case study in Pangkalan Lampam District Ogan Komering Ilir Regency

NASA Astrophysics Data System (ADS)

Muslimin, B.; Suadi

2018-03-01

Responsible management of fishery resources has been a tradition of Ogan Komering Ilir (OKI) of South Sumatera for generations. It was recorded that since 1630 the Dutch Government had made auction policy for managing water territory in OKI Regency as an effort to preserve nature and to avoid the conflict of inland water ownership. Currently, the community-based management model has been adopted by local governments into formal regulations, known as Regional Regulation on Auction of Flood Water Swamp and Rivers (Lelang Lebak Lebung dan Sungai or L3S). This paper describes the success factors and the threats for the failure of the L3S management model in OKI Regency, based on a case study in Pangkalan Lampam District. The study showed that the management mechanism through the L3S system had been well instituted and become a well-established management practice. The management model is in line with the principle of co-management and the approach has become critical success factor in L3S management. However, ecological, economic and social aspects influence the sustainability of such fishery management model. Besides, L3S management model faces limited data and information related to fish stocks, which result in difficulties in determining the total allowable catch.

Medium Moderates the Message. How Users Adjust Their Communication Trajectories to Different Media in Collaborative Task Solving

PubMed Central

Rychwalska, Agnieszka; Samson, Katarzyna; Łucznik, Klara; Ziembowicz, Michał; Szóstek, Agnieszka; Nowak, Andrzej

2016-01-01

Rapid development of information and communications technologies (ICT) has triggered profound changes in how people manage their social contacts in both informal and professional contexts. ICT mediated communication may seem limited in possibilities compared to face-to-face encounters, but research shows that puzzlingly often it can be just as effective and satisfactory. We posit that ICT users employ specific communication strategies adapted to particular communication channels, which results in a comparable effectiveness of communication. In order to maintain a satisfactory level of conversational intelligibility they calibrate the content of their messages to a given medium’s richness and adjust the whole conversation trajectory so that every stage of the communication process runs fluently. In the current study, we compared complex task solving trajectories in chat, mobile phone and face-to-face dyadic conversations. Media conditions did not influence the quality of decision outcomes or users’ perceptions of the interaction, but they had impact on the amount of time devoted to each of the identified phases of decision development. In face-to-face contacts the evaluation stage of the discussion dominated the conversation; in the texting condition the orientation-evaluation-control phases were evenly distributed; and the phone condition provided a midpoint between these two extremes. The results show that contemporary ICT users adjust their communication behavior to the limitations and opportunities of various media through the regulation of attention directed to each stage of the discussion so that as a whole the communication process remains effective. PMID:27337037

Advances in the Care of Transgender Children and Adolescents

PubMed Central

Shumer, Daniel E; Nokoff, Natalie J; Spack, Norman P

2016-01-01

Children and adolescents with gender dysphoria are presenting for medical attention at increasing rates. Standards of Care have been developed which outline appropriate mental health support and hormonal interventions for transgender youth. This article defines terminology related to gender identity, reviews the history of medical interventions for transgender persons, outlines what is known about gender identity development, and reviews mental health disparities faced by this patient population. We provide an overview of medical management options for transgender adolescents meeting diagnostic criteria for gender dysphoria including pubertal suppression, cross-sex hormones, longitudinal screening and anticipatory guidance. We describe current challenges in the field and provide information about how care is currently being provided in the US and Canada. We conclude with 5 brief case examples. PMID:27426896

High-velocity facial gunshot wounds: multidisciplinary care from prehospital to discharge

PubMed Central

Sinnott, J D; Morris, G; Medland, P J; Porter, K

2016-01-01

A case is presented in which a high velocity rifle (shotgun) was fired into the inferior part of a patient's face in an attempted suicide causing widespread trauma to the inferior and left side of the patient's face. He presented to his general practitioner where an ambulance was called. The patient is followed from prehospital care (air ambulance) to resuscitation in accident and emergency and through the first stages of reconstructive surgery. The article focuses on the multidisciplinary approach to the patient's prehospital care and initial resuscitation at a major trauma centre. CT reconstruction images of the patient's skull allow visualisation of the extent of bone damage at presentation. Medical photography allows visualisation of the extent of the initial damage and shows how reconstructive surgery was undertaken early and in progressive stages. A literature review was performed allowing discussion of the current evidence and best practice in the management of facial gunshot wounds. PMID:26823355

Effects of manifest ethnic identification on employment discrimination.

PubMed

Barron, Laura G; Hebl, Michelle; King, Eden B

2011-01-01

Evidence from recent laboratory experiments suggests that ethnic identification can lead to negative evaluations of ethnic minorities (Kaiser & Pratt-Hyatt, 2009). The current research considers the generalizability of these findings to face-to-face interactions in contexts wherein impression management concerns are salient: the workplace hiring process. In a field experiment, Black, Hispanic, and Irish individuals applied for retail jobs with or without visible display of their ethnic identification. Analysis of indicators of formal (e.g., application offering, interview scheduling) and interpersonal discrimination (e.g., interaction length, nonverbal negativity) suggest store personnel interacting with other-race applicants exhibited greater positivity and longer interactions when applicants displayed ethnic identification than when they did not. The findings suggest that psychologists need to understand not only attitudes or intentions expressed in the lab, but also the behavioral consequences of manifest group identity as they unfold in natural environments.

Western water and climate change

USGS Publications Warehouse

Dettinger, Michael; Udall, Bradley; Georgakakos, Aris P.

2015-01-01

In this context, four iconic river basins offer glimpses into specific challenges that climate change may bring to the West. The Colorado River is a system in which overuse and growing demands are projected to be even more challenging than climate-change-induced flow reductions. The Rio Grande offers the best example of how climate-change-induced flow declines might sink a major system into permanent drought. The Klamath is currently projected to face the more benign precipitation future, but fisheries and irrigation management may face dire straits due to warming air temperatures, rising irrigation demands, and warming waters in a basin already hobbled by tensions between endangered fisheries and agricultural demands. Finally, California's Bay-Delta system is a remarkably localized and severe weakness at the heart of the region's trillion-dollar economy. It is threatened by the full range of potential climate-change impacts expected across the West, along with major vulnerabilities to increased flooding and rising sea levels.

A robust human face detection algorithm

NASA Astrophysics Data System (ADS)

Raviteja, Thaluru; Karanam, Srikrishna; Yeduguru, Dinesh Reddy V.

2012-01-01

Human face detection plays a vital role in many applications like video surveillance, managing a face image database, human computer interface among others. This paper proposes a robust algorithm for face detection in still color images that works well even in a crowded environment. The algorithm uses conjunction of skin color histogram, morphological processing and geometrical analysis for detecting human faces. To reinforce the accuracy of face detection, we further identify mouth and eye regions to establish the presence/absence of face in a particular region of interest.

Management of Primary Adrenal Insufficiency: Review of Current Clinical Practice in a Developed and a Developing Country.

PubMed

Khan, Uzma; Lakhani, Om J

2017-01-01

Treatment of primary adrenal insufficiency (PAI) requires lifelong hormone replacement with glucocorticoids (GCs) and mineralocorticoids. Impaired quality of life and increased standardized mortality ratio in these patients emphasize the importance of tailoring therapy to individual needs. Role of education is paramount in improving patient compliance and in anticipating and preventing adrenal crises. Although discovery of synthetic GCs was a major breakthrough in treatment of patients with this life-threatening condition, management of PAI continues to be challenging. The obstacles for clinicians appear to vary widely across the globe. While optimization and individualization of therapy after diagnosis of PAI remain the main challenges for clinicians in the developed world, doctors in a developing country face problems at almost every stage from the diagnosis to the treatment and follow-up of these patients; cost of therapy, lack of resources, and funding are the main hindrances. Adherence to therapy and patient education are found to be common issues in most parts of the world. This commentary highlights the challenges from both developed and developing country's perspective in treating PAI; it also provides an update on current management scenario and future treatment options.

Energy and water quality management systems for water utility's operations: a review.

PubMed

Cherchi, Carla; Badruzzaman, Mohammad; Oppenheimer, Joan; Bros, Christopher M; Jacangelo, Joseph G

2015-04-15

Holistic management of water and energy resources is critical for water utilities facing increasing energy prices, water supply shortage and stringent regulatory requirements. In the early 1990s, the concept of an integrated Energy and Water Quality Management System (EWQMS) was developed as an operational optimization framework for solving water quality, water supply and energy management problems simultaneously. Approximately twenty water utilities have implemented an EWQMS by interfacing commercial or in-house software optimization programs with existing control systems. For utilities with an installed EWQMS, operating cost savings of 8-15% have been reported due to higher use of cheaper tariff periods and better operating efficiencies, resulting in the reduction in energy consumption of ∼6-9%. This review provides the current state-of-knowledge on EWQMS typical structural features and operational strategies and benefits and drawbacks are analyzed. The review also highlights the challenges encountered during installation and implementation of EWQMS and identifies the knowledge gaps that should motivate new research efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Blending Face-to-Face and Distance Learning Methods in Adult and Career-Technical Education. Practice Application Brief No. 23.

ERIC Educational Resources Information Center

Wonacott, Michael E.

Both face-to-face and distance learning methods are currently being used in adult education and career and technical education. In theory, the advantages of face-to-face and distance learning methods complement each other. In practice, however, both face-to-face and information and communications technology (ICT)-based distance programs often rely…

Examining the Challenging Hindrances facing in the Construction Projects: South India’s Perspective

NASA Astrophysics Data System (ADS)

Subramanyam, K.; Haridharan, M. K.

2017-07-01

Developing countries like India require a huge infrastructure to facilitate needs of the people. Construction industry provides several opportunities to the individuals. Construction manager work is to supervise and organize the construction activities in construction projects. Now a day construction manager facing challenges. This paper aimed to study the challenges facing by the construction manager in the perception of construction professionals. 39 variables were taken from the literature review which found to be severe impact on construction managers’ performance. Construction manager, project manager and site engineers are the respondents for this survey. Using SPSS, regression analysis was done and recognized significant challenges. These challenges were classified into 5 domains. In management challenges, resource availability and allocation, risks and uncertainties existing in the project onsite, top management support and cost constraints are the most significant variables. In skills requirement of a construction manager challenges, technical skills required to learn and adapt new technology in the project, decision making and planning according to the situation in site are the most significant variables. In performance challenges, implementation of tasks according to the plan is the important variable whereas in onsite challenges, manage project risks, develop project policies and procedures are the most important.

6th Annual Earth System Grid Federation Face to Face Conference Report

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

Williams, D. N.

The Sixth Annual Face-to-Face (F2F) Conference of the Earth System Grid Federation (ESGF), a global consortium of international government agencies, institutions, and companies dedicated to the creation, management, analysis, and distribution of extreme-scale scientific data, was held December 5–9, 2016, in Washington, D.C.

Comparative Effectiveness and Student Choice for Online and Face-to-Face Classwork

ERIC Educational Resources Information Center

Nemetz, Patricia Louise; Eager, Wendy M.; Limpaphayom, Wanthanee

2017-01-01

The authors examined learning and task choices made by students when the same interactive course design was used online and face-to-face. A survey was administered in an operations management course covering both conceptual and quantitative topics. Course grades were compared and correlations were measured to determine relevant relationships.…

Soft Tissue Management in Facial Trauma

PubMed Central

Braun, Tara L.; Maricevich, Renata S.

2017-01-01

The management of soft tissue injury after facial trauma poses unique challenges to the plastic surgeon, given the specialized nature of facial tissue and the aesthetic importance of the face. The general principles of trauma management and wound care are applied in all cases. The management of severe injuries to the face is discussed in relation to the location and the mechanism of injury. Facial transplants have arisen in the past decade for the management of catastrophic soft tissue defects, although high morbidity and mortality after these non-life-saving operations must be considered in patient selection. PMID:28496386

The impacts of climate change on the wintering distribution of an endangered migratory bird.

PubMed

Hu, Junhua; Hu, Huijian; Jiang, Zhigang

2010-10-01

There is now ample evidence of the effects of anthropogenic climate change on the distribution and abundance of species. The black-faced spoonbill (Platalea minor) is an endangered migratory species and endemic to East Asia. Using a maximum entropy approach, we predicted the potential wintering distribution for spoonbills and modeled the effects of future climate change. Elevation, human influence index and precipitation during the coldest quarter contributed most to model development. Five regions, including western Taiwan, scattered locations from eastern coastal to central mainland China, coastal areas surrounding the South China Sea, northeastern coastal areas of Vietnam and sites along the coast of Japan, were found to have a high probability of presence and showed good agreement with historical records. Assuming no limits to the spread of this species, the wintering range is predicted to increase somewhat under a changing climate. However, three currently highly suitable regions (northeastern Vietnam, Taiwan and coastal areas surrounding the South China Sea) may face strong reductions in range by 2080. We also found that the center of the predicted range of spoonbills will undergo a latitudinal shift northwards by as much as 240, 450, and 600 km by 2020, 2050 and 2080, respectively. Our findings suggest that species distribution modeling can inform the current and future management of the black-faced spoonbill throughout Asia. It is clear that a strong international strategy is needed to conserve spoonbill populations under a changing climate.

The role of managed care in work-related injuries.

PubMed

Shor, M J; Miller, J C

1996-10-01

Many opportunities exist today for orthopedic surgeons in the treatment and management of work-related injuries. Physicians wishing to enter or participate in this market must realize that the role of the physician in the treatment of the injured worker has expanded from one of being solely the care giver to being a patient manager, a problem solver, and a communicator. A number of years ago, many orthopedic surgeons missed out on managed care contracting for health maintenance organizations because they thought they could survive without it. They soon learned the challenges of sitting on the sidelines. Whether we like it or not, managed care for work-related injuries is here and its likelihood for going away is about zero. If your state has not yet adopted utilization management standards or managed care for workers' compensation-enabling legislation, when you wake up tomorrow they may have done so. Because of its relative embryonic development, there are exceptional opportunities for practitioners to take active roles in shaping the models that will serve employees and employers in the year 2000. Physicians who are interested in the treatment of injured workers have a unique opportunity right now to develop relationships in the managed workers' compensation arena. Payment and patient referrals for workers' compensation may turn out to be more attractive financially than many of the contracts currently in place with health maintenance organizations and other general health plans. Physicians willing to partner with employers and other players in the workers' compensation arena currently face some challenging, rewarding, and exciting opportunities. In the immortal words of Hippocrates, "Healing is a matter of time, but it is sometimes a matter of opportunity."3 It is unclear whether Hippocrates ever imagined our current level of science, practice, and organization, but it is clear the opportunities to be an active participant in the changes occurring in workers' compensation are as real today as they were in 1973 when then President Nixon passed the Health Maintenance Organization Act.

Rethinking the outpatient medication list: increasing patient activation and education while architecting for centralization and improved medication reconciliation.

PubMed

Pandolfe, Frank; Wright, Adam; Slack, Warner V; Safran, Charles

2018-05-17

Identify barriers impacting the time consuming and error fraught process of medication reconciliation. Design and implement an electronic medication management system where patient and trusted healthcare proxies can participate in establishing and maintaining an inclusive and up-to-date list of medications. A patient-facing electronic medication manager was deployed within an existing research project focused on elder care management funded by the AHRQ, InfoSAGE, allowing patients and patients' proxies the ability to build and maintain an accurate and up-to-date medication list. Free and open-source tools available from the U.S. government were used to embed the tenets of centralization, interoperability, data federation, and patient activation into the design. Using patient-centered design and free, open-source tools, we implemented a web and mobile enabled patient-facing medication manager for complex medication management. Patient and caregiver participation are essential to improve medication safety. Our medication manager is an early step towards a patient-facing medication manager that has been designed with data federation and interoperability in mind.

mHealth and the management of chronic conditions in rural areas: a note of caution from southern India.

PubMed

Nahar, Papreen; Kannuri, Nanda Kishore; Mikkilineni, Sitamma; Murthy, G V S; Phillimore, Peter

2017-04-01

This article examines challenges facing implementation of likely mHealth programmes in rural India. Based on fieldwork in Andhra Pradesh in 2014, and taking as exemplars two chronic medical 'conditions' - type 2 diabetes and depression - we look at ways in which people in one rural area currently access medical treatment; we also explore how adults there currently use mobile phones in daily life, to gauge the realistic likelihood of uptake for possible mHealth initiatives. We identify the very different pathways to care for these two medical conditions, and we highlight the importance to the rural population of healthcare outside the formal health system provided by those known as registered medical practitioners (RMP), who despite their title are neither registered nor trained. We also show how limited is the use currently made of very basic mobile phones by the majority of the older adult population in this rural context. Not only may this inhibit mHealth potential in the near future; just as importantly, our data suggest how difficult it may be to identify a clinical partner for patients or their carers for any mHealth application designed to assist the management of chronic ill-health in rural India. Finally, we examine how the promotion of patient 'self-management' may not be as readily translated to a country like India as proponents of mHealth might assume.

The RICORDO approach to semantic interoperability for biomedical data and models: strategy, standards and solutions

PubMed Central

2011-01-01

Background The practice and research of medicine generates considerable quantities of data and model resources (DMRs). Although in principle biomedical resources are re-usable, in practice few can currently be shared. In particular, the clinical communities in physiology and pharmacology research, as well as medical education, (i.e. PPME communities) are facing considerable operational and technical obstacles in sharing data and models. Findings We outline the efforts of the PPME communities to achieve automated semantic interoperability for clinical resource documentation in collaboration with the RICORDO project. Current community practices in resource documentation and knowledge management are overviewed. Furthermore, requirements and improvements sought by the PPME communities to current documentation practices are discussed. The RICORDO plan and effort in creating a representational framework and associated open software toolkit for the automated management of PPME metadata resources is also described. Conclusions RICORDO is providing the PPME community with tools to effect, share and reason over clinical resource annotations. This work is contributing to the semantic interoperability of DMRs through ontology-based annotation by (i) supporting more effective navigation and re-use of clinical DMRs, as well as (ii) sustaining interoperability operations based on the criterion of biological similarity. Operations facilitated by RICORDO will range from automated dataset matching to model merging and managing complex simulation workflows. In effect, RICORDO is contributing to community standards for resource sharing and interoperability. PMID:21878109

Ageing midface: The impact of surgeon's experience on the consistency in the assessment and proposed management.

PubMed

Hazrati, Ali; Izadpanah, Ali; Zadeh, Teanoosh; Gosman, Amanda; Chao, James J; Dobke, Marek K

2011-02-01

An individual's face undergoes numerous changes throughout life. Since mid-face aesthetic units are key areas for rejuvenation procedures, their comprehensive assessment is essential for the development of any aesthetic management plan. Despite the availability of many evaluation criteria for treatment of mid-face ageing, there are discrepancies existing in both assessment and management approaches. The goal of this study was to determine if there are any identifiable profiles of clinical judgements and approaches related to the level of surgeon's experience. Forty seven standardised non-digital and not altered natural size photographic images of patients' faces (front and profile) were presented to eight senior board certified plastic surgeons, eight junior non-board certified plastic surgeons and eight plastic surgery residents from an independent program. Surveyed physicians were 'blinded' from each other and asked to assess five different major features characterising ageing mid-face. An interclass correlation data analysis was performed and the Cronbach coefficient alpha values were computed for each category. Responses obtained from senior plastic surgeons were consistently characterised by higher Cronbach coefficient alpha values indicating higher concordance. The highest agreement levels were obtained for the assessment of rhytids and jowls across all groups and the lowest agreement levels were obtained for the assessment and recommendation of upper lip management. This study illustrated that discrepancies in clinical assessments and surgical management exist among surgeons involved in the aesthetic surgery of the mid-face ageing. It appears that the level of surgeon's experience significantly impacts the inter-rater reliability and consensus in assessment and treatment of mid-face ageing. The most senior plastic surgeons' assessment and recommendations had the highest level of concordance while the junior non-board certified plastic surgeons and the residents group produced variations with less consistency. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

A Business Intelligence Framework for Sustainability Information Management in Higher Education

ERIC Educational Resources Information Center

Scholtz, Brenda; Calitz, Andre; Haupt, Ross

2018-01-01

Purpose: Higher education institutions (HEIs) face a number of challenges in effectively managing and reporting on sustainability information, such as siloes of data and a limited distribution of information. Business intelligence (BI) can assist in addressing the challenges faced by organisations. The purpose of this study was to propose a BI…

Feedlot Nutritionist Boot Camp: An Intensive Short-Course for Commercial Agriculture Graduate Students

ERIC Educational Resources Information Center

Reinhardt, Chris; Hubbert, Mike

2014-01-01

In the digital age, face-to-face meetings combining didactic and experiential learning are valuable. Beef cattle nutrition graduate students (n = 33) from 11 universities attended a 5-day feedlot nutrition and management short-course. Topics included nutrition, veterinary medicine, feedmill maintenance, and management of the financial and human…

Let’s Take it to the Clouds: The Potential of Educational Innovations, Including Blended Learning, for Capacity Building in Developing Countries

PubMed Central

Marrinan, Hannah; Firth, Sonja; Hipgrave, David; Jimenez-Soto, Eliana

2015-01-01

In modern decentralised health systems, district and local managers are increasingly responsible for financing, managing, and delivering healthcare. However, their lack of adequate skills and competencies are a critical barrier to improved performance of health systems. Given the financial and human resource, constraints of relying on traditional face-to-face training to upskill a large and dispersed number of health managers, governments, and donors must look to exploit advances in the education sector. In recent years, education providers around the world have been experimenting with blended learning; that is, amalgamating traditional face-to-face education with web-based learning to reduce costs and enrol larger numbers of students. Access to improved information and communication technology (ICT) has been the major catalyst for such pedagogical innovations. We argue that with many developing countries already improving their ICT systems, the question is not whether but how to employ technology to facilitate the continuous professional development of district and local health managers in decentralised settings. PMID:26340485

Family medicine in Iran: facing the health system challenges.

PubMed

Esmaeili, Reza; Hadian, Mohammad; Rashidian, Arash; Shariati, Mohammad; Ghaderi, Hossien

2014-11-30

In response to the current fragmented context of health systems, it is essential to support the revitalization of primary health care in order to provide a stronger sense of direction and integrity. Around the world, family medicine recognized as a core discipline for strengthening primary health care setting. This study aimed to understand the perspectives of policy makers and decision makers of Iran's health system about the implementation of family medicine in Iran urban areas. This study is a qualitative study with framework analysis. Purposive semi-structured interviews were conducted with Policy and decision makers in the five main organizations of Iran health care system. The codes were extracted using inductive and deductive methods. According to 27 semi-structured interviews were conducted with Policy and decision makers, three main themes and 8 subthemes extracted, including: The development of referral system, better access to health care and the management of chronic diseases. Family medicine is a viable means for a series of crucial reforms in the face of the current challenges of health system. Implementation of family medicine can strengthen the PHC model in Iran urban areas. Attempting to create a general consensus among various stakeholders is essential for effective implementation of the project.

Reforms and emerging noncommunicable disease: some challenges facing a conflict-ridden country--the case of the Syrian Arab Republic.

PubMed

Sen, Kasturi; Al-Faisal, Waleed

2013-01-01

The past year witnessed considerable turbulence in the Arab world-in this case, Syria, a lower middle-income country with a record of a strong public health infrastructure. This paper explores the current challenges facing its health system from reforms, civil strife and international sanctions all of which we argue have serious implications for population health. The health sector in Syria was little known, and until recently, it was well integrated to provide preventive and specialized care when needed. Regionally, it was one of the few countries ready and capable of addressing the challenges of demographic and epidemiologic transition with a long-standing emphasis on primary care and prevention, unlike most countries of the region. This context has changed dramatically through the recent implementation of reforms and the current civil war. Changes to financing, management and the delivery of health service placed access to services in jeopardy, but now, these are compounded by the destruction from an intractable and violent conflict and international sanctions. This paper explores some of the combined effects of reforms, conflict and sanctions on population health. Copyright © 2013 John Wiley & Sons, Ltd.

Proactive and reactive control depends on emotional valence: a Stroop study with emotional expressions and words.

PubMed

Kar, Bhoomika Rastogi; Srinivasan, Narayanan; Nehabala, Yagyima; Nigam, Richa

2018-03-01

We examined proactive and reactive control effects in the context of task-relevant happy, sad, and angry facial expressions on a face-word Stroop task. Participants identified the emotion expressed by a face that contained a congruent or incongruent emotional word (happy/sad/angry). Proactive control effects were measured in terms of the reduction in Stroop interference (difference between incongruent and congruent trials) as a function of previous trial emotion and previous trial congruence. Reactive control effects were measured in terms of the reduction in Stroop interference as a function of current trial emotion and previous trial congruence. Previous trial negative emotions exert greater influence on proactive control than the positive emotion. Sad faces in the previous trial resulted in greater reduction in the Stroop interference for happy faces in the current trial. However, current trial angry faces showed stronger adaptation effects compared to happy faces. Thus, both proactive and reactive control mechanisms are dependent on emotional valence of task-relevant stimuli.

Integrating mobile technology with routine dietetic practice: the case of myPace for weight management.

PubMed

Harricharan, Michelle; Gemen, Raymond; Celemín, Laura Fernández; Fletcher, David; de Looy, Anne E; Wills, Josephine; Barnett, Julie

2015-05-01

The field of Mobile health (mHealth), which includes mobile phone applications (apps), is growing rapidly and has the potential to transform healthcare by increasing its quality and efficiency. The present paper focuses particularly on mobile technology for body weight management, including mobile phone apps for weight loss and the available evidence on their effectiveness. Translation of behaviour change theory into weight management strategies, including integration in mobile technology is also discussed. Moreover, the paper presents and discusses the myPace platform as a case in point. There is little clinical evidence on the effectiveness of currently available mobile phone apps in enabling behaviour change and improving health-related outcomes, including sustained body weight loss. Moreover, it is unclear to what extent these apps have been developed in collaboration with health professionals, such as dietitians, and the extent to which apps draw on and operationalise behaviour change techniques has not been explored. Furthermore, presently weight management apps are not built for use as part of dietetic practice, or indeed healthcare more widely, where face-to-face engagement is fundamental for instituting the building blocks for sustained lifestyle change. myPace is an innovative mobile technology for weight management meant to be embedded into and to enhance dietetic practice. Developed out of systematic, iterative stages of engagement with dietitians and consumers, it is uniquely designed to complement and support the trusted health practitioner-patient relationship. Future mHealth technology would benefit if engagement with health professionals and/or targeted patient groups, and behaviour change theory stood as the basis for technology development. Particularly, integrating technology into routine health care practice, rather than replacing one with the other, could be the way forward.

Defining quality indicators for best-practice management of inflammatory bowel disease in Canada

PubMed Central

Nguyen, Geoffrey C; Devlin, Shane M; Afif, Waqqas; Bressler, Brian; Gruchy, Steven E; Kaplan, Gilaad G; Oliveira, Liliana; Plamondon, Sophie; Seow, Cynthia H; Williams, Chadwick; Wong, Karen; Yan, Brian M; Jones, Jennifer

2014-01-01

BACKGROUND: There is a paucity of published data regarding the quality of care of inflammatory bowel disease (IBD) in Canada. Clinical quality indicators are quantitative end points used to guide, monitor and improve the quality of patient care. In Canada, where universal health care can vary significantly among provinces, quality indicators can be used to identify potential gaps in the delivery of IBD care and standardize the approach to interprovincial management. METHODS: The Emerging Practice in IBD Collaborative (EPIC) group generated a shortlist of IBD quality indicators based on a comprehensive literature review. An iterative voting process was used to select quality indicators to take forward. In a face-to-face meeting with the EPIC group, available evidence to support each quality indicator was presented by the EPIC member aligned to it, followed by group discussion to agree on the wording of the statements. The selected quality indicators were then ratified in a final vote by all EPIC members. RESULTS: Eleven quality indicators for the management of IBD within the single-payer health care system of Canada were developed. These focus on accurate diagnosis, appropriate and timely management, disease monitoring, and prevention or treatment of complications of IBD or its therapy. CONCLUSIONS: These quality indicators are measurable, reflective of the evidence base and expert opinion, and define a standard of care that is at least a minimum that should be expected for IBD management in Canada. The next steps for the EPIC group involve conducting research to assess current practice across Canada as it pertains to these quality indicators and to measure the impact of each of these indicators on patient outcomes. PMID:24839622

Development of a grazing monitoring program for Great Sand Dunes National Park, Colorado

USGS Publications Warehouse

Zeigenfuss, Linda C.; Schoenecker, Kathryn A.

2015-08-07

National parks in the United States face the difficult task of managing natural resources within park boundaries that are influenced to a large degree by historical land uses or by forces outside of the park’s protection and mandate. Among the many challenges faced by parks is management of wildlife populations that occupy larger landscapes than individual park units but that concentrate within park lands both seasonally and opportunistically. Great Sand Dunes National Park and Preserve in south-central Colorado is currently developing an Ungulate Management Plan to address management of elk and bison populations within the park. Execution of the Ungulate Management Plan will require monitoring and assessment of habitat conditions in areas that appear sensitive to ungulate use or heavily used by elk and bison. Several sources of information on the various habitats within the park and their use and response to foraging elk and bison exist from recent and on-going research in Great Sand Dunes National Park and Preserve as well as from studies in other regions of the Intermountain West. All of this data can be used to inform the planning process. This report provides background on vegetation types that make up the primary bison and elk ranges in Great Sand Dunes National Park and Preserve and on the potential effects of ungulate grazing and browsing in these specific vegetation communities (both locally and regionally). The report also provides a review of the elements necessary to develop a long-term monitoring program for Great Sand Dunes National Park and Preserve that addresses both the responses to ungulate herbivory seen in important habitats in the park and the amount and patterns of ungulate habitat use.

What role could community pharmacists in Malaysia play in diabetes self-management education and support? The views of individuals with type 2 diabetes.

PubMed

Lee, E Lyn; Wong, Pei Se; Tan, Ming Yeong; Sheridan, Janie

2018-04-01

This study explored the experiences and views of individuals with type 2 diabetes mellitus (T2D) on their diabetes self-management and potential roles for community pharmacists in diabetes self-management education and support (DSME/S) in Malaysia. A qualitative study, using semi-structured, face-to-face interviews, was conducted with patients with T2D attending a primary care health clinic in Kuala Lumpur, Malaysia. The interviews were audio-recorded, transcribed verbatim and analysed inductively. Fourteen participants with T2D were interviewed. Data were coded into five main themes: experience and perception of diabetes self-management, constraints of the current healthcare system, perception of the community pharmacist and community pharmacies, perceived roles for community pharmacists in diabetes care, and challenges in utilising community pharmacies to provide DSME/S. There were misconceptions about diabetes management that may be attributed to a lack of knowledge. Although participants described potential roles for community pharmacists in education, medication review and continuity of care, these roles were mostly non-clinically oriented. Participants were not confident about community pharmacists making recommendations and changes to the prescribed treatment regimens. While participants recognised the advantages of convenience of a community pharmacy-based diabetes care service, they raised concerns over the retail nature and the community pharmacy environment for providing such services. This study highlighted the need to improve the care provision for people with T2D. Participants with T2D identified potential, but limited roles for community pharmacists in diabetes care. Participants expressed concerns that need to be addressed if effective diabetes care is to be provided from community pharmacies in Malaysia. © 2017 Royal Pharmaceutical Society.

Developing and sustaining human resources in the health supply chain in Ethiopia: barriers and enablers.

PubMed

Kälvemark Sporrong, Sofia; Traulsen, Janine M; Damene Kabtimer, Woynabeba; Mekasha Habtegiorgis, Bitsatab; Teshome Gebregeorgise, Dawit; Essah, Nana Am; Khan, Sara A; Brown, Andrew N

2016-01-01

The health supply chain is often the weakest link in achieving the health-related Millennium Development Goals and universal health coverage, requiring trained professionals who are often unavailable. In Ethiopia there have been recent developments in the area of health supply chain management. The aim of this study was to explore the current status of the development of human resources in health supply chain management in Ethiopia and to identify important factors affecting this development. A series of face-to-face interviews with key stakeholders was carried out in 2014. The interviews were conducted using a semi-structured interview guide. The interview guide comprised 51 questions. A qualitative analysis of transcripts was made. A total of 25 interviews were conducted. Three themes were identified: General changes: recognition, commitment and resources, Education and training, and Barriers and enablers. Results confirm the development of human resources in health supply chain management in many areas. However, several problems were identified including lack of coordination, partly due to the large number of stakeholders; reported high staff mobility; and a lack of overall strategy regarding the job/career structures necessary for maintaining human resources. Rural areas have a particular set of problems, including in transportation of goods and personnel, attracting and keeping personnel, and in communication and access to information. Ethiopia is on the way to developing a nationwide viable system for health supply chain management. However, there are still challenges. Short-term challenges include the importance of highlighting strategies and programs for human resources in health supply chain management. In the long term, commitments to financial support must be obtained. A strategy is needed for the further development and sustainability of human resources in the health supply chain in Ethiopia.

The NASA Planetary Data System Roadmap Study for 2017 - 2026

NASA Astrophysics Data System (ADS)

McNutt, R. L., Jr.; Gaddis, L. R.; Law, E.; Beyer, R. A.; Crombie, M. K.; Ebel, D. S. S.; Ghosh, A.; Grayzeck, E.; Morgan, T. H.; Paganelli, F.; Raugh, A.; Stein, T.; Tiscareno, M. S.; Weber, R. C.; Banks, M.; Powell, K.

2017-12-01

NASA's Planetary Data System (PDS) is the formal archive of >1.2 petabytes of data from planetary exploration, science, and research. Initiated in 1989 to address an overall lack of attention to mission data documentation, access, and archiving, the PDS has evolved into an online collection of digital data managed and served by a federation of six science discipline nodes and two technical support nodes. Several ad hoc mission-oriented data nodes also provide complex data interfaces and access for the duration of their missions. The recent Planetary Data System Roadmap Study for 2017 to 2026 involved 15 planetary science community members who collectively prepared a report summarizing the results of an intensive examination of the current state of the PDS and its organization, management, practices, and data holdings (https://pds.jpl.nasa.gov/roadmap/PlanetaryDataSystemRMS17-26_20jun17.pdf). The report summarizes the history of the PDS, its functions and characteristics, and how it has evolved to its present form; also included are extensive references and documentary appendices. The report recognizes that as a complex, evolving, archive system, the PDS must constantly respond to new pressures and opportunities. The report provides details on the challenges now facing the PDS, 19 detailed findings, suggested remediations, and a summary of what the future may hold for planetary data archiving. The findings cover topics such as user needs and expectations, data usability and discoverability (i.e., metadata, data access, documentation, and training), tools and file formats, use of current information technologies, and responses to increases in data volume, variety, complexity, and number of data providers. In addition, the study addresses the possibility of archiving software, laboratory data, and measurements of physical samples. Finally, the report discusses the current structure and governance of the PDS and its impact on how archive growth, technology, and new developments are enabled and managed within the PDS. The report, with its findings, acknowledges the ongoing and expected challenges to be faced in the future, the need for maintaining an edge in the use of emerging technologies, and represents a guide for evolution of the PDS for the next decade.

An Overview of the Planetary Data System Roadmap Study for 2017 - 2026

NASA Astrophysics Data System (ADS)

Morgan, Thomas H.; McNutt, Ralph L.; Gaddis, Lisa; Law, Emily; Beyer, Ross A.; Crombie, Kate; Ebel, Denton; Ghosh, Amitahba; Grayzeck, Edwin J.; Paganelli, Flora; Raugh, Anne C.; Stein, Thomas; Tiscareno, Matthew S.; Weber, Renee; E Banks, Maria; Powell, Kathryn

2017-10-01

NASA’s Planetary Data System (PDS) is the formal archive of >1.2 petabytes of data from planetary exploration, science, and research. Initiated in 1989 to address an overall lack of attention to mission data documentation, access, and archiving, the PDS has since evolved into an online collection of digital data managed and served by a federation of 6 science discipline nodes and 2 technical support nodes. Several ad-hoc mission-oriented data nodes also provide complex data interfaces and access for the duration of their missions.The new PDS Roadmap Study for 2017-2026 involved 15 planetary science community members who collectively prepared a report summarizing the results of an intensive examination of the current state of the PDS and its organization, management, practices, and data holdings (https://pds.jpl.nasa.gov/roadmap/PlanetaryDataSystemRMS17-26_20jun17.pdf). The report summarizes PDS history, its functions and characteristics, and its present form; also included are extensive references and documentary appendices. The report recognizes that as a complex evolving system, the PDS must respond to new pressures and opportunities. The report provides details on challenges now facing the PDS, 19 detailed findings and suggested remediations that could be used to respond to these findings, and a summary of the potential future of planetary data archiving. These findings cover topics such as user needs and expectations, data usability and discoverability (i.e., metadata, data access, documentation, and training), tools and file formats, use of current information technologies, and responses to increases in data volume, variety, complexity, and number of data providers. In addition, the study addresses the possibility of archiving software, laboratory data, and physical samples. Finally, the report discusses the current structure and governance of PDS and the impact of this on how archive growth, technology, and new developments are enabled and managed within the PDS. The report, with its findings, acknowledges the ongoing and expected challenges to be faced in the future, the need for maintaining an edge on the use of emerging technologies, and represents a guide for evolution of the PDS for the next decade.

The Dynamics of Vulnerability and Implications for Climate Change Adaptation: Lessons from Urban Water Management

NASA Astrophysics Data System (ADS)

Dilling, L.; Daly, M.; Travis, W.; Wilhelmi, O.; Klein, R.; Kenney, D.; Ray, A. J.; Miller, K.

2013-12-01

Recent reports and scholarship have suggested that adapting to current climate variability may represent a "no regrets" strategy for adapting to climate change. Filling "adaptation deficits" and other approaches that rely on addressing current vulnerabilities are of course helpful for responding to current climate variability, but we find here that they are not sufficient for adapting to climate change. First, following a comprehensive review and unique synthesis of the natural hazards and climate adaptation literatures, we advance six reasons why adapting to climate variability is not sufficient for adapting to climate change: 1) Vulnerability is different at different levels of exposure; 2) Coping with climate variability is not equivalent to adaptation to longer term change; 3) The socioeconomic context for vulnerability is constantly changing; 4) The perception of risk associated with climate variability does not necessarily promote adaptive behavior in the face of climate change; 5) Adaptations made to short term climate variability may reduce the flexibility of the system in the long term; and 6) Adaptive actions may shift vulnerabilities to other parts of the system or to other people. Instead we suggest that decision makers faced with choices to adapt to climate change must consider the dynamics of vulnerability in a connected system-- how choices made in one part of the system might impact other valued outcomes or even create new vulnerabilities. Furthermore we suggest that rather than expressing climate change adaptation as an extension of adaptation to climate variability, the research and practice communities would do well to articulate adaptation as an imperfect policy, with tradeoffs and consequences and that decisions be prioritized to preserve flexibility be revisited often as climate change unfolds. We then present the results of a number of empirical studies of decision making for drought in urban water systems in the United States to understand: a) the variety of actions taken; b) the limitations of actions available to water managers; and c) the effectiveness of actions taken to date. Time permitting, we briefly present the results of 3 in-depth case studies of drought response and current perception of preparedness with respect to future drought and climate change among urban water system managers. We examine the role of governance, system connectivity, public perceptions and other factors in driving decision making and outcomes.

[Management programs on diabetes among Chinese adults in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases].

PubMed

Jin, R R; Li, J J; Zhang, J; Li, J L; Bian, F; Deng, G J; Ma, S; Su, X W; Zhao, J; Jiang, Y

2018-04-10

Objective: To understand the current situation on management of diabetes mellitus patients aged 35 and above in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases, in China. Methods: Local residents, aged 18 years and above were randomly selected by a complex, multistage, probability sampling method. Face-to-face questionnaire survey was carried out between November and December 2016. Rates regarding prevalence, treatment and management of diabetes were calculated, and influencing factors of diabetes were analyzed by using the non-conditional logistic regression model. Results: A total of 3 213 residents aged ≥35 years were included in this study, of which 11.48% (369/3 213) reported that they had ever been informed by a doctor or other health worker that their blood sugar level was high or being diabetic. The rate of self-reported treatment among the diabetic patients was 83.20% (307/369). Rates on overall management and standardized management were 69.92% (258/369) and 53.66% (198/369), respectively. Higher rates were seen in residents aged 55 to 64 years, 76.32% for overall management and 59.65% for standardized management. Through multiple logistic regression analysis, we found that standardized management for diabetes was much higher in the Demonstration Areas located in the eastern areas ( OR =2.942, 95% CI : 1.547-5.594), or patients with characteristics including high implementation score ( OR =3.499, 95% CI : 1.865-6.563), already signed family doctors ( OR =5.661, 95% CI : 3.237-9.899), or without hypertension ( OR =1.717, 95% CI : 1.010- 2.920). Residents who were living in the first and second batch areas of implementation or responding to the NCDs with positive attitude were more likely to accept standardized management. Conclusion: Prevention and management programs on diabetes had met the requirements set for the Demonstration Areas which had promoted the specific implementation and further development of standardized management on diabetes.

The neural basis of self-face recognition after self-concept threat and comparison with important others.

PubMed

Guan, Lili; Qi, Mingming; Zhang, Qinglin; Yang, Juan

2014-01-01

The implicit positive association (IPA) theory attributed self-face advantage to the IPA with self-concept. Previous behavioral study has found that self-concept threat (SCT) could eliminate the self-advantage in face recognition over familiar-face, without taking levels of facial familiarity into account. The current event-related potential study aimed to investigate whether SCT could eliminate the self-face advantage over stranger-face. Fifteen participants completed a "self-friend" comparison task in which participants identified the face orientation of self-face and friend-face after SCT and non-self-concept threat (NSCT) priming, and a "self-stranger" comparison task was also completed in which participants identified the face orientation of self-face and stranger-face after SCT and NSCT priming. The results showed that the N2 amplitudes were more negative for processing friend-face than self-face after NSCT priming, but there was no significant difference between them after SCT priming. Moreover, the N2 amplitudes were more negative for processing stranger-face than self-face both after SCT priming and after NSCT priming. Furthermore, SCT manipulated the N2 amplitudes of friend-face rather than self-face. Overall, the present study made a supplementary to the current IPA theory and further indicated that SCT would only eliminate this self-face recognition advantage when comparing with important others.

General practitioners' views and experiences of counselling for physical activity through the New Zealand Green Prescription program.

PubMed

Patel, Asmita; Schofield, Grant M; Kolt, Gregory S; Keogh, Justin W L

2011-11-02

Regular physical activity is beneficial in both the prevention and management of chronic health conditions. A large proportion of adult New Zealanders, however, are insufficiently active. To help increase population levels of physical activity in New Zealand the Green Prescription, a primary care physical activity scripting program, was developed. The primary aim of this study was to identify why general practitioners (GPs) counsel for physical activity and administer Green Prescriptions. A secondary aim was to examine GPs' views and experiences of Green Prescription counselling for the management of depression. Individual face-to-face interviews were conducted with 15 GPs. All interviews were audio-taped and transcribed. Data were analysed using an inductive thematic approach. Several themes and sub-themes emerged from the data. Notably, GPs counselled for physical activity and prescribed Green Prescriptions for both primary preventive (e.g., weight control) and secondary management (e.g., diabetes management) purposes. GPs reported the benefits of the Green Prescription centred around two main themes: (i) a non-medication approach to a healthier lifestyle and (ii) the support benefits of physical activity. Time constraints within the consultation was the only main theme that emerged regarding the barriers GPs perceived to Green Prescription use. Physical activity in general, and physical activity prescribed through the Green Prescription, were also viewed by GPs as beneficial for the management of depression. The results of this study suggest that New Zealand GPs view the Green Prescription program as beneficial for their patients with pre-existing conditions and/or weight problems. While this is encouraging, the Green Prescription may also be used to promote physical activity in currently healthy but low-active and sedentary individuals. Such individuals are currently disease free, but are at risk for future health-related problems because of their inactive lifestyle. It is recommended that time constraints of the consultation in regard to administering Green Prescriptions could be dealt with by delegating the more time consuming tasks to the patient support counsellors that support the Green Prescription program, and having practice nurses assist in the administration of Green Prescriptions. Green Prescription counselling in conjunction with antidepressant medication may be beneficial for the management of depression and warrants further research.

General practitioners' views and experiences of counselling for physical activity through the New Zealand Green Prescription program

PubMed Central

2011-01-01

Background Regular physical activity is beneficial in both the prevention and management of chronic health conditions. A large proportion of adult New Zealanders, however, are insufficiently active. To help increase population levels of physical activity in New Zealand the Green Prescription, a primary care physical activity scripting program, was developed. The primary aim of this study was to identify why general practitioners (GPs) counsel for physical activity and administer Green Prescriptions. A secondary aim was to examine GPs' views and experiences of Green Prescription counselling for the management of depression. Methods Individual face-to-face interviews were conducted with 15 GPs. All interviews were audio-taped and transcribed. Data were analysed using an inductive thematic approach. Results Several themes and sub-themes emerged from the data. Notably, GPs counselled for physical activity and prescribed Green Prescriptions for both primary preventive (e.g., weight control) and secondary management (e.g., diabetes management) purposes. GPs reported the benefits of the Green Prescription centred around two main themes: (i) a non-medication approach to a healthier lifestyle and (ii) the support benefits of physical activity. Time constraints within the consultation was the only main theme that emerged regarding the barriers GPs perceived to Green Prescription use. Physical activity in general, and physical activity prescribed through the Green Prescription, were also viewed by GPs as beneficial for the management of depression. Conclusions The results of this study suggest that New Zealand GPs view the Green Prescription program as beneficial for their patients with pre-existing conditions and/or weight problems. While this is encouraging, the Green Prescription may also be used to promote physical activity in currently healthy but low-active and sedentary individuals. Such individuals are currently disease free, but are at risk for future health-related problems because of their inactive lifestyle. It is recommended that time constraints of the consultation in regard to administering Green Prescriptions could be dealt with by delegating the more time consuming tasks to the patient support counsellors that support the Green Prescription program, and having practice nurses assist in the administration of Green Prescriptions. Green Prescription counselling in conjunction with antidepressant medication may be beneficial for the management of depression and warrants further research. PMID:22044577

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

PubMed Central

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

2017-01-01

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

Knowledge and demand for medicinal plants used in the treatment and management of diabetes in Nyeri County, Kenya.

PubMed

Kamau, Loice N; Mbaabu, Mathiu P; Mbaria, James M; Karuri, Gathumbi P; Kiama, Stephen G

2016-08-02

Non communicable diseases are currently a major health challenge facing humanity. Nyeri County has one of the highest diabetes prevalence in Kenya (12.6%), compared to the country's prevalence of 5.6%. The purpose of the study was to document; diabetes knowledge, medicinal plants and demand for the services of traditional medicine practitioners, in the management and treatment of diabetes. A cross-sectional study was carried out in the six constituencies in Nyeri, using pre-tested semi-structured questionnaires. Thirty practicing traditional medicine practitioners were purposively selected for the study. Field observation and identification was carried out on all plants that were cited during the interview. Plant samples were collected and voucher specimen deposited in the University of Nairobi Herbarium in the - School of Biological Sciences. The study revealed 30 plant species in 28 genera and 23 families that are used by the traditional medicine practitioners to treat and manage diabetes. Demand for traditional medicine practitioners' services in the treatment of diabetes is low and often occurs when conventional drugs fail. Interaction with the TMPs unveiled significant diversity of potential anti diabetic medicinal plants and in-depth ethnobotanical knowledge that they possessed. Preference for traditional herbal medicine was low despite wide ethnobotanical knowledge in the face of high prevalence of diabetes in the locality. The findings form the basis of pharmacological studies for standardization of the documented ethnomedicine used in the treatment and management of diabetes in the study area. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A systematic review of the efficacy of self-management programs for increasing physical activity in community-dwelling adults with acquired brain injury (ABI).

PubMed

Jones, Taryn M; Dean, Catherine M; Hush, Julia M; Dear, Blake F; Titov, Nickolai

2015-04-19

Individuals living with acquired brain injury, typically caused by stroke or trauma, are far less likely to achieve recommended levels of physical activity for optimal health and well-being. With a growing number of people living with chronic disease and disability globally, self-management programs are seen as integral to the management of these conditions and the prevention of secondary health conditions. However, to date, there has been no systematic review of the literature examining the efficacy of self-management programs specifically on physical activity in individuals with acquired brain injury, whether delivered face-to-face or remotely. Therefore, the purpose of this review is to evaluate the efficacy of self-management programs in increasing physical activity levels in adults living in the community following acquired brain injury. The efficacy of remote versus face-to-face delivery was also examined. A systematic review of the literature was conducted. Electronic databases were searched. Two independent reviewers screened all studies for eligibility, assessed risk of bias, and extracted relevant data. Five studies met the inclusion criteria for this review. Studies were widely heterogeneous with respect to program content and delivery characteristics and outcomes, although all programs utilized behavioral change principles. Four of the five studies examined interventions in which physical activity was a component of a multifaceted intervention, where the depth to which physical activity specific content was covered, and the extent to which skills were taught and practiced, could not be clearly established. Three studies showed favorable physical activity outcomes following self-management interventions for stroke; however, risk of bias was high, and overall efficacy remains unclear. Although not used in isolation from face-to-face delivery, remote delivery via telephone was the predominant form of delivery in two studies with support for its inclusion in self-management programs for individuals following stroke. The efficacy of self-management programs in increasing physical activity levels in community-dwelling adults following acquired brain injury (ABI) is still unknown. Research into the efficacy of self-management programs specifically aimed at improving physical activity in adults living in the community following acquired brain injury is needed. The efficacy of remote delivery methods also warrants further investigation. PROSPERO CRD42013006748.

Factors influencing intentions to stay and retention of nurse managers: a systematic review.

PubMed

Brown, Pamela; Fraser, Kimberly; Wong, Carol A; Muise, Melanie; Cummings, Greta

2013-04-01

This systematic review aimed to explore factors known to influence intentions to stay and retention of nurse managers in their current position. Retaining staff nurses and recruiting nurses to management positions are well documented; however, there is sparse research examining factors that influence retention of nurse managers. Thirteen studies were identified through a systematic search of the literature. Eligibility criteria included both qualitative and quantitative studies that examined factors related to nurse manager intentions to stay and retention. Quality assessments, data extraction and analysis were completed on all studies included. Twenty-one factors were categorized into three major categories: organizational, role and personal. Job satisfaction, organizational commitment, organizational culture and values, feelings of being valued and lack of time to complete tasks leading to work/life imbalance, were prominent across all categories. These findings suggest that intentions to stay and retention of nurse managers are multifactoral. However, lack of robust literature highlights the need for further research to develop strategies to retain nurse managers. ImplICATIONS FOR NURSE MANAGEMENT: Health-care organizations and senior decision-makers should feel a responsibility to support front-line managers in relation to workload and span of control, and in understanding work/life balance issues faced by managers. © 2012 Blackwell Publishing Ltd.

Exploring weight loss services in primary care and staff views on using a web-based programme.

PubMed

Ware, Lisa J; Williams, Sarah; Bradbury, Katherine; Brant, Catherine; Little, Paul; Hobbs, F D Richard; Yardley, Lucy

2012-01-01

Demand is increasing for primary care to deliver effective weight management services to patients, but research suggests that staff feel inadequately resourced for such a role. Supporting service delivery with a free and effective web-based weight management programme could maximise primary care resource and provide cost-effective support for patients. However, integration of e-health into primary care may face challenges. To explore primary care staff experiences of delivering weight management services and their perceptions of a web-based weight management programme to aid service delivery. Focus groups were conducted with primary care physicians, nurses and healthcare assistants (n = 36) involved in delivering weight loss services. Data were analysed using inductive thematic analysis. Participants thought that primary care should be involved in delivering weight management, especially when weight was aggravating health problems. However, they felt under-resourced to deliver these services and unsure as to the effectiveness of their input, as routine services were not evaluated. Beliefs that current services were ineffective resulted in staff reluctance to allocate more resources. Participants were hopeful that supplementing practice with a web-based weight management programme would enhance patient services and promote service evaluation. Although primary care staff felt they should deliver weight loss services, low levels of faith in the efficacy of current treatments resulted in provision of under-resourced and 'ad hoc' services. Integration of a web-based weight loss programme that promotes service evaluation and provides a cost-effective option for supporting patients may encourage practices to invest more in weight management services.

Acoustic telemetry observation systems: challenges encountered and overcome in the Laurentian Great Lakes

USGS Publications Warehouse

Krueger, Charles C.; Holbrook, Christopher; Binder, Thomas R.; Vandergoot, Christopher; Hayden, Todd A.; Hondorp, Darryl W.; Nate, Nancy; Paige, Kelli; Riley, Stephen; Fisk, Aaron T.; Cooke, Steven J.

2017-01-01

The Great Lakes Acoustic Telemetry Observation System (GLATOS), organized in 2012, aims to advance and improve conservation and management of Great Lakes fishes by providing information on behavior, habitat use, and population dynamics. GLATOS faced challenges during establishment, including a funding agency-imposed urgency to initiate projects, a lack of telemetry expertise, and managing a flood of data. GLATOS now connects 190+ investigators, provides project consultation, maintains a web-based data portal, contributes data to Ocean Tracking Network’s global database, loans equipment, and promotes science transfer to managers. The GLATOS database currently has 50+ projects, 39 species tagged, 8000+ fish released, and 150+ million tag detections. Lessons learned include (1) seek advice from others experienced in telemetry; (2) organize networks prior to when shared data is urgently needed; (3) establish a data management system so that all receivers can contribute to every project; (4) hold annual meetings to foster relationships; (5) involve fish managers to ensure relevancy; and (6) staff require full-time commitment to lead and coordinate projects and to analyze data and publish results.

An analysis of opinions from veterinarians in South Africa regarding business management skills.

PubMed

Krecek, R C; Tobin, P

2004-03-01

The changing role of veterinarians in the global market is a current topic of debate and discussion. Few countries including South Africa have formally examined the changing dynamics of this profession. Therefore, the present study addressed 2 objectives. The 1st was to examine basic information about veterinarians in South Africa including their age, gender and distribution across provinces, the percentage whose practice was urban, rural or periurban, the numbers working with specific animal species, and the extent of business management and skills previously gained. The 2nd objective was to obtain opinions and insights from veterinarians in South Africa about the challenges and opportunities facing their business practices to better understand what they considered important dynamics to their businesses today. Several areas of business on which they were questioned and which were included in this study were: marketing, vision, human resources, leadership, financial management, ethics, competition, day-to-day operations, interpersonal skills and information management. This is the 1st known survey to employ a questionnaire to gain insights and opinions from veterinarians about business management skills.

Online versus Face-to-Face Training of Critical Time Intervention: A Matching Cluster Randomized Trial

ERIC Educational Resources Information Center

Olivet, Jeffrey; Zerger, Suzanne; Greene, R. Neil; Kenney, Rachael R.; Herman, Daniel B.

2016-01-01

This study examined the effectiveness of online education to providers who serve people experiencing homelessness, comparing online and face-to-face training of Critical Time Intervention (CTI), an evidence-based case management model. The authors recruited 184 staff from nineteen homeless service agencies to participate in one of two training…

Hybrid Structures: Faculty Use and Perception of Web-Based Courseware as a Supplement to Face-to-Face Instruction

ERIC Educational Resources Information Center

Woods, Robert; Baker, Jason D.; Hopper, Dave

2004-01-01

The researchers examined responses from 862 faculty members at 38 institutions nationwide using the blackboard Learning Management System (LMS) to supplement their face-to-face instruction. The four research questions addressed the primary uses that faculty make of blackboard, perceptions that faculty have of how certain blackboard features…

Integrating Physical Actions and Financial Instruments to Manage Environmental Financial Risk

NASA Astrophysics Data System (ADS)

Foster, B.

2016-12-01

Exposure to extreme weather events can be reduced through physical actions (e.g., dams/reservoirs) or mitigated financially (e.g., insurance). Often physical actions involve investments in expensive infrastructure that reduce exposure, but whose benefits are only occasionally realized. Financial risk management does not reduce the impacts of an event, but rather redistributes them temporally, albeit at a cost. Nonetheless, these costs are typically much smaller, at least in the short run, than those incurred for physical actions. Financial strategies are also more flexible than physical ones in the face of an uncertain future. Financial contracts specifically designed to manage extreme environmental risks are becoming more common and can either replace or complement infrastructural investments as part of a risk management portfolio. In order to make optimal decisions as to the relative levels of physical and financial risk mitigation to employ, it is necessary to understand the relative merits of each strategy. This research develops a method for analyzing tradeoffs between physical and financial risk management strategies. We identify the unique cost and benefit properties of each strategy and integrate them into a single model that details the tradeoffs involved in various portfolios of physical and financial strategies. These methods are then applied to evaluate decisions to pursue emergency dredging during drought on the Mississippi River, which is used to mitigate the increased costs and/or reduced revenues barge operators face when water levels are low. Currently the U.S. Army Corps of Engineers funds most emergency dredging operations during major droughts and they are considering more intensive strategies for future droughts. Barge carriers and shippers though could manage at least some portion of their financial risks through a series of existing and experimental financial contracts. This work involves the formulation of these experimental contracts and the development of methods to evaluate integrated portfolios of physical and financial risk management strategies.

Drought processes, modeling, and mitigation

NASA Astrophysics Data System (ADS)

Mishra, Ashok K.; Sivakumar, Bellie; Singh, Vijay P.

2015-07-01

Accurate assessment of droughts is crucial for proper planning and management of our water resources, environment, and ecosystems. The combined influence of increasing water demands and the anticipated impacts of global climate change has already raised serious concerns about worsening drought conditions in the future and their social, economic, and environmental impacts. As a result, studies on droughts are currently a major focal point for a broad range of research communities, including civil engineers, hydrologists, environmentalists, ecologists, meteorologists, geologists, agricultural scientists, economists, policy makers, and water managers. There is, therefore, an urgent need for enhancing our understanding of droughts (e.g. occurrence, modeling), making more reliable assessments of their impacts on various sectors of our society (e.g. domestic, agricultural, industrial), and undertaking appropriate adaptation and mitigation measures, especially in the face of global climate change.

Roles and challenges of the health information management educator: a national HIM faculty survey.

PubMed

Houser, Shannon H; Tesch, Linde; Hart-Hester, Susan; Dixon-Lee, Claire

2009-01-01

Health information technology initiatives created the framework for a national health information infrastructure that concomitantly fostered a need to build intellectual capacity within our current and future health information management (HIM) work force. Results from the 2008 HIM Educator Survey are discussed. Developed for voluntary electronic participation, the survey comprised a series of questions about educators' professional interests and responsibilities. Summary data from the 402 respondents are provided and highlight areas such as academic rank, teaching status, salary range, levels of interest in various issues, and use of virtual learning tools. Data from this survey provide insights into the concerns and challenges many HIM educators face in today's training institutions and suggest implications for future directions in work force training and professional development within the HIM field.

Supporting Teachers in Identifying Students' Learning Styles in Learning Management Systems: An Automatic Student Modelling Approach

ERIC Educational Resources Information Center

Graf, Sabine; Kinshuk; Liu, Tzu-Chien

2009-01-01

In learning management systems (LMSs), teachers have more difficulties to notice and know how individual students behave and learn in a course, compared to face-to-face education. Enabling teachers to know their students' learning styles and making students aware of their own learning styles increases teachers' and students' understanding about…

Lessons Learned from Migrating to an Online Electronic Business Management Course

ERIC Educational Resources Information Center

Walstrom, Kent A.

2014-01-01

This article describes the lessons learned while migrating an Electronic Business Management course from traditional face-to-face delivery to online delivery across a six and a half year time frame. The course under review teaches students how to develop and construct a working information-based online business using free versions of online…

Inclusion or Control? Commissioning and Contracting Services for People with Learning Disabilities

ERIC Educational Resources Information Center

Concannon, Liam

2006-01-01

The rise of new public management has seen the role of the social worker becoming increasingly administrative and less about face to face contact with service users. When commissioning managers seek to help people with learning disabilities plan their services, who actually makes the decisions? Direct payments are proposed as the answer for people…

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)…

Integration of Endnote Online in Information Literacy Instruction Designed for Small and Large Chemistry Courses

ERIC Educational Resources Information Center

Baykoucheva, Svetla; Houck, Joseph D.; White, Natalia

2016-01-01

The blended model for information literacy instruction described in this article introduces students not only to efficient techniques for finding scientific literature and properties of chemical compounds, but also to managing this information with a bibliographic management program (EndNote Online). The model blends face-to-face instruction with…

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

ERIC Educational Resources Information Center

Marwood, Hayley; Hewitt, Olivia

2013-01-01

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

Cost-Effectiveness of Case Management in Substance Abuse Treatment

ERIC Educational Resources Information Center

Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.

2006-01-01

Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…

Reflections on Building and Teaching an Undergraduate Strategic Management Course in a Blended Format

ERIC Educational Resources Information Center

Ross, Douglas N.; Rosenbloom, Al

2011-01-01

This article is a personal reflection on the challenges, frustrations, and rewards of transforming a traditional face-to-face strategic management course into a blended format. The article describes both the discovery process that leads to a significantly redesigned course and the distillation of that experience into six core questions that can…

Database Design Learning: A Project-Based Approach Organized through a Course Management System

ERIC Educational Resources Information Center

Dominguez, Cesar; Jaime, Arturo

2010-01-01

This paper describes an active method for database design learning through practical tasks development by student teams in a face-to-face course. This method integrates project-based learning, and project management techniques and tools. Some scaffolding is provided at the beginning that forms a skeleton that adapts to a great variety of…

Testing Error Management Theory: Exploring the Commitment Skepticism Bias and the Sexual Overperception Bias

ERIC Educational Resources Information Center

Henningsen, David Dryden; Henningsen, Mary Lynn Miller

2010-01-01

Research on error management theory indicates that men tend to overestimate women's sexual interest and women underestimate men's interest in committed relationships (Haselton & Buss, 2000). We test the assumptions of the theory in face-to-face, stranger interactions with 111 man-woman dyads. Support for the theory emerges, but potential boundary…

The Indus basin in the framework of current and future water resources management

NASA Astrophysics Data System (ADS)

Laghari, A. N.; Vanham, D.; Rauch, W.

2012-04-01

The Indus basin is one of the regions in the world that is faced with major challenges for its water sector, due to population growth, rapid urbanisation and industrialisation, environmental degradation, unregulated utilization of the resources, inefficient water use and poverty, all aggravated by climate change. The Indus Basin is shared by 4 countries - Pakistan, India, Afghanistan and China. With a current population of 237 million people which is projected to increase to 319 million in 2025 and 383 million in 2050, already today water resources are abstracted almost entirely (more than 95% for irrigation). Climate change will result in increased water availability in the short term. However in the long term water availability will decrease. Some current aspects in the basin need to be re-evaluated. During the past decades water abstractions - and especially groundwater extractions - have augmented continuously to support a rice-wheat system where rice is grown during the kharif (wet, summer) season (as well as sugar cane, cotton, maize and other crops) and wheat during the rabi (dry, winter) season. However, the sustainability of this system in its current form is questionable. Additional water for domestic and industrial purposes is required for the future and should be made available by a reduction in irrigation requirements. This paper gives a comprehensive listing and description of available options for current and future sustainable water resources management (WRM) within the basin. Sustainable WRM practices include both water supply management and water demand management options. Water supply management options include: (1) reservoir management as the basin is characterised by a strong seasonal behaviour in water availability (monsoon and meltwater) and water demands; (2) water quality conservation and investment in wastewater infrastructure; (3) the use of alternative water resources like the recycling of wastewater and desalination; (4) land use planning and soil conservation as well as flood management, with a focus on the reduction of erosion and resulting sedimentation as well as the restoration of ecosystem services like wetlands and natural floodplains. Water demand management options include: (1) the management of conjunctive use of surface and groundwater; as well as (2) the rehabilitation and modernization of existing infrastructure. Other demand management options are: (3) the increase of water productivity for agriculture; (4) crop planning and diversification including the critical assessment of agricultural export, especially (basmati) rice; (5) economic instruments and (6) changing food demand patterns and limiting post-harvest losses.

Participatory Planning for the improvement of water management in uncertain conditions: Case study of the Souss-Massa basin in Morocco

NASA Astrophysics Data System (ADS)

Imani, Yasmina; Lahlou, Ouiam; Slimani, Imane; Joyce, Brian

2016-04-01

Due to its geographical location and to the natural features of its climate, Morocco is known as a drought prone and water scarce country. However, the country now faces, in the current context of Climate Change, an increasing and alarming water scarcity due to the combined effects of a strong decline of precipitations and a growing pressure on water resources induced by the economic development and demographic growth. Aware of this pressing issue, Morocco implemented a national water strategy based on the decentralization of water management at the river basin level and the establishment of Integrated Water Resources Management master plans for each basin. Unfortunately, these plans often underestimate the impact of uncertainty and this may lead to inefficient and unsustainable water management strategies. In this context, the aim of this study is to develop an innovative approach for robust decision making in uncertain conditions by coupling the WEAP (Water Evaluation and Planning System) model and the "XLRM" robust decision making framework to support the evaluation of management options and promote long-term sustainable integrated water management strategies at the basin level. The Souss-Massa basin, located in the south-western part of the country was retained as a case study because of its strategic importance but also because it now faces, as a consequence of the irrational use of water resources during the last decades significant water resources management challenges mainly due to the overexploitation of ground water resources, the increased of water demand due to the irrigation development, the urban and industrial growth and the expansion of tourism. Thus, in this study, a three step methodology was developed. First, the WEAP model were developed and calibrated for the Souss-Massa basin. In a second step, a XLRM participatory workshop gathering the basin main stakeholders were organized in order to identify the EXogenous factors (key uncertainties confronting water managers in the basin), the Levers (management actions aiming to improve the system outcomes in the face of the identified uncertainties) and a set of Metrics that can be used to evaluate the ability of specific actions to improve water management outcomes in the basin. In a third step, the R (Responses) component of this XLRM framework were given by the WEAP model that were iteratively used to capture the identified uncertainties, represent the identified strategies and produce the identified metrics. Results of this study focuse on water demand, unmet demand and supply delivered under scenarios of increasing drought periods frequencies, full penetration of drip irrigation and use of desalinated water for irrigation.

Assessing and managing stressors in a changing marine environment.

PubMed

Chapman, Peter M

2017-11-30

We are facing a dynamic future in the face of multiple stressors acting individually and in combination: climate change; habitat change/loss; overfishing; invasive species; harmful algal blooms/eutrophication; and, chemical contaminants. Historic assessment and management approaches will be inadequate for addressing risks from climate change and other stressors. Wicked problems (non-linear, complex, competing risks and benefits, not easily solvable), will become increasingly common. We are facing irreversible changes to our planetary living conditions. Agreed protection goals and considering both the negatives (risks) and the positives (benefits) of all any and all actions are required, as is judicious and appropriate use of the Precautionary Principle. Researchers and managers need to focus on: determining tipping points (alternative stable points); maintaining ecosystem services; and, managing competing ecosystem services. Marine (and other) scientists are urged to focus their research on wicked problems to allow for informed decision-making on a planetary basis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Closing the Gap: Supporting Patients’ Transition to Self-Management after Hospitalization

PubMed Central

Pollack, Ari H; Backonja, Uba; Miller, Andrew D.; Mishra, Sonali R.; Khelifi, Maher; Kendall, Logan; Pratt, Wanda

2016-01-01

Patients going home after a hospitalization face many challenges. This transition period exposes patients to unnecessary risks related to inadequate preparation prior to leaving the hospital, potentially leading to errors and patient harm. Although patients engaging in self-management have better health outcomes and increased self-efficacy, little is known about the processes in place to support and develop these skills for patients leaving the hospital. Through qualitative interviews and observations of 28 patients during and after their hospitalizations, we explore the challenges they face transitioning from hospital care to self-management. We identify three key elements in this process: knowledge, resources, and self-efficacy. We describe how both system and individual factors contribute to breakdowns leading to ineffective patient management. This work expands our understanding of the unique challenges faced by patients during this difficult transition and uncovers important design opportunities for supporting crucial yet unmet patient needs. PMID:27500285

The needs of having a paradigm shift from public sector to private sector on funding digitizing management work of historical buildings in Malaysia

NASA Astrophysics Data System (ADS)

Kamarudin, M. K.; Yahya, Z.; Harun, R.; Jaapar, A.

2014-02-01

In Malaysia, the government agencies that handle the management of historical buildings are finding themselves facing a shortage of funds to provide the necessary work on digitalising management works. Due to the rising cost of management, which also covers maintenance and infrastructure works, there is a need for a paradigm shift from public sector to private sector provision on infrastructure and management works. Therefore the government agencies need to find the suitable mechanism to encourage private sector especially the private property and developers to take part in it. This scenario has encouraged the authorities to look new ways of entering into partnership and collaboration with the private sector to secure the continuity of provision and funding. The paper first reviews the different approach to facilitate off-site local management system of historical buildings and then examines options for both private and public funding in digitalising the historical buildings management works by interviewing government officer, conservator and member of nongovernment agencies. It then explores how the current system of management may adopt the shift to avoid any vulnerability and threat to the existing historical buildings. This paper concludes with a short summary of key issues in management works of historical buildings and recommendations.

Time to question diabetes self-management support for Arabic-speaking migrants: exploring a new model of care.

PubMed

Alzubaidi, H; Mc Namara, K; Browning, C

2017-03-01

The objective of this study was to explore a new model for diabetes self-management support in Arabic-speaking migrants. Two qualitative methods were used: face-to-face semi-structured individual interviews and focus groups. Interviews were audio-taped, transcribed verbatim and coded thematically. Arabic-speaking migrants with Type 2 diabetes were recruited from several primary, secondary and tertiary healthcare settings in metropolitan Melbourne, Australia. These settings were purposefully selected to obtain a diverse group of participants. Data collection continued until saturation was reached. This is the first study that involved members of Arabic-speaking communities in Australia in a formal process of consumer and public involvement to inform research design and recruitment in order to provide evidence for a new model of diabetes self-management for Arabic-speaking migrants. No self-management support was offered to Arabic-speaking migrants beyond the initial diagnosis period. Significant knowledge gaps and skills deficits in all self-management domains were evident. The provision of tailored self-management support was considered crucial. When asked about preferred structure and delivery modalities, a strong preference was reported for face-to-face storytelling interactions over telephone- or internet-based interventions. Gender-specific group education and self-management support sessions delivered by Arabic-speaking diabetes health professionals, lay peers or social workers trained in diabetes self-management were highly regarded. A patient and public involvement approach allows genuine engagement with Arabic-speaking migrants with diabetes. There is urgent need for a new model for self-management support among Arabic-speaking migrants. Findings yielded new recommendations for diabetes health professionals working with these migrant communities to support behaviour change. © 2016 Diabetes UK.

A participatory approach to designing and enhancing integrated health information technology systems for veterans: protocol.

PubMed

Haun, Jolie N; Nazi, Kim M; Chavez, Margeaux; Lind, Jason D; Antinori, Nicole; Gosline, Robert M; Martin, Tracey L

2015-02-27

The Department of Veterans Affairs (VA) has developed health information technologies (HIT) and resources to improve veteran access to health care programs and services, and to support a patient-centered approach to health care delivery. To improve VA HIT access and meaningful use by veterans, it is necessary to understand their preferences for interacting with various HIT resources to accomplish health management related tasks and to exchange information. The objective of this paper was to describe a novel protocol for: (1) developing a HIT Digital Health Matrix Model; (2) conducting an Analytic Hierarchy Process called pairwise comparison to understand how and why veterans want to use electronic health resources to complete tasks related to health management; and (3) developing visual modeling simulations that depict veterans' preferences for using VA HIT to manage their health conditions and exchange health information. The study uses participatory research methods to understand how veterans prefer to use VA HIT to accomplish health management tasks within a given context, and how they would like to interact with HIT interfaces (eg, look, feel, and function) in the future. This study includes two rounds of veteran focus groups with self-administered surveys and visual modeling simulation techniques. This study will also convene an expert panel to assist in the development of a VA HIT Digital Health Matrix Model, so that both expert panel members and veteran participants can complete an Analytic Hierarchy Process, pairwise comparisons to evaluate and rank the applicability of electronic health resources for a series of health management tasks. This protocol describes the iterative, participatory, and patient-centered process for: (1) developing a VA HIT Digital Health Matrix Model that outlines current VA patient-facing platforms available to veterans, describing their features and relevant contexts for use; and (2) developing visual model simulations based on direct veteran feedback that depict patient preferences for enhancing the synchronization, integration, and standardization of VA patient-facing platforms. Focus group topics include current uses, preferences, facilitators, and barriers to using electronic health resources; recommendations for synchronizing, integrating, and standardizing VA HIT; and preferences on data sharing and delegation within the VA system. This work highlights the practical, technological, and personal factors that facilitate and inhibit use of current VA HIT, and informs an integrated system redesign. The Digital Health Matrix Model and visual modeling simulations use knowledge of veteran preferences and experiences to directly inform enhancements to VA HIT and provide a more holistic and integrated user experience. These efforts are designed to support the adoption and sustained use of VA HIT to support patient self-management and clinical care coordination in ways that are directly aligned with veteran preferences.

A Participatory Approach to Designing and Enhancing Integrated Health Information Technology Systems for Veterans: Protocol

PubMed Central

Nazi, Kim M; Chavez, Margeaux; Lind, Jason D; Antinori, Nicole; Gosline, Robert M; Martin, Tracey L

2015-01-01

Background The Department of Veterans Affairs (VA) has developed health information technologies (HIT) and resources to improve veteran access to health care programs and services, and to support a patient-centered approach to health care delivery. To improve VA HIT access and meaningful use by veterans, it is necessary to understand their preferences for interacting with various HIT resources to accomplish health management related tasks and to exchange information. Objective The objective of this paper was to describe a novel protocol for: (1) developing a HIT Digital Health Matrix Model; (2) conducting an Analytic Hierarchy Process called pairwise comparison to understand how and why veterans want to use electronic health resources to complete tasks related to health management; and (3) developing visual modeling simulations that depict veterans’ preferences for using VA HIT to manage their health conditions and exchange health information. Methods The study uses participatory research methods to understand how veterans prefer to use VA HIT to accomplish health management tasks within a given context, and how they would like to interact with HIT interfaces (eg, look, feel, and function) in the future. This study includes two rounds of veteran focus groups with self-administered surveys and visual modeling simulation techniques. This study will also convene an expert panel to assist in the development of a VA HIT Digital Health Matrix Model, so that both expert panel members and veteran participants can complete an Analytic Hierarchy Process, pairwise comparisons to evaluate and rank the applicability of electronic health resources for a series of health management tasks. Results This protocol describes the iterative, participatory, and patient-centered process for: (1) developing a VA HIT Digital Health Matrix Model that outlines current VA patient-facing platforms available to veterans, describing their features and relevant contexts for use; and (2) developing visual model simulations based on direct veteran feedback that depict patient preferences for enhancing the synchronization, integration, and standardization of VA patient-facing platforms. Focus group topics include current uses, preferences, facilitators, and barriers to using electronic health resources; recommendations for synchronizing, integrating, and standardizing VA HIT; and preferences on data sharing and delegation within the VA system. Conclusions This work highlights the practical, technological, and personal factors that facilitate and inhibit use of current VA HIT, and informs an integrated system redesign. The Digital Health Matrix Model and visual modeling simulations use knowledge of veteran preferences and experiences to directly inform enhancements to VA HIT and provide a more holistic and integrated user experience. These efforts are designed to support the adoption and sustained use of VA HIT to support patient self-management and clinical care coordination in ways that are directly aligned with veteran preferences. PMID:25803324

Perceptions about traditional and novel methods to learn about postoperative pain management: a qualitative study.

PubMed

Ingadottir, Brynja; Blondal, Katrin; Jaarsma, Tiny; Thylen, Ingela

2016-11-01

The aim of this study was to explore the perceptions of surgical patients about traditional and novel methods to learn about postoperative pain management. Patient education is an important part of postoperative care. Contemporary technology offers new ways for patients to learn about self-care, although face-to-face discussions and brochures are the most common methods of delivering education in nursing practice. A qualitative design with a vignette and semi-structured interviews used for data collection. A purposeful sample of 13 postsurgical patients, who had been discharged from hospital, was recruited during 2013-2014. The patients were given a vignette about anticipated hospital discharge after surgery with four different options for communication (face-to-face, brochure, website, serious game) to learn about postoperative pain management. They were asked to rank their preferred method of learning and thereafter to reflect on their choices. Data were analysed using an inductive content analysis approach. Patients preferred face-to-face education with a nurse, followed by brochures and websites, while games were least preferred. Two categories, each with two sub-categories, emerged from the data. These conceptualized the factors affecting patients' perceptions: (1) 'Trusting the source', sub-categorized into 'Being familiar with the method' and 'Having own prejudgments'; and (2) 'Being motivated to learn' sub-categorized into 'Managing an impaired cognition' and 'Aspiring for increased knowledge'. To implement successfully novel educational methods into postoperative care, healthcare professionals need to be aware of the factors influencing patients' perceptions about how to learn, such as trust and motivation. © 2016 John Wiley & Sons Ltd.

Smart health monitoring systems: an overview of design and modeling.

PubMed

Baig, Mirza Mansoor; Gholamhosseini, Hamid

2013-04-01

Health monitoring systems have rapidly evolved during the past two decades and have the potential to change the way health care is currently delivered. Although smart health monitoring systems automate patient monitoring tasks and, thereby improve the patient workflow management, their efficiency in clinical settings is still debatable. This paper presents a review of smart health monitoring systems and an overview of their design and modeling. Furthermore, a critical analysis of the efficiency, clinical acceptability, strategies and recommendations on improving current health monitoring systems will be presented. The main aim is to review current state of the art monitoring systems and to perform extensive and an in-depth analysis of the findings in the area of smart health monitoring systems. In order to achieve this, over fifty different monitoring systems have been selected, categorized, classified and compared. Finally, major advances in the system design level have been discussed, current issues facing health care providers, as well as the potential challenges to health monitoring field will be identified and compared to other similar systems.

Health Inequalities Associated with Post-Stroke Visual Impairment in the United Kingdom and Ireland: A Systematic Review

PubMed Central

Hanna, K. L.; Rowe, F. J.

2017-01-01

ABSTRACT The aim of this study was to report on the health inequalities facing stroke survivors with visual impairments as described in the current literature. A systemic review of the literature was conducted to investigate the potential health inequalities facing stroke survivors with subsequent visual impairments. A quality-of-evidence and risk-of-bias assessment was conducted for each of the included articles using the appropriate tool dependent on the type of article. Only four articles discussed health inequalities affecting stroke survivors with visual impairment specifically. A further 23 articles identified health inequalities after stroke, and 38 reported on health inequalities within the visually impaired UK or Irish population. Stroke survivors with visual impairment face inconsistency in eye care provision nationally, along with variability in the assessment and management of visual disorders. The subgroups identified as most at risk were females; black ethnicity; lower socioeconomic status; older age; and those with lower education attainment. The issue of inconsistent service provision for this population must be addressed in future research. Further research must be conducted in order to firmly establish whether or not stroke survivors are at risk of the aforementioned sociodemographic and economic inequalities. PMID:28512502

Water Utility Management Strategies in Turkey: The current situation and the challenges

NASA Astrophysics Data System (ADS)

Alp, E.; Aksoy, M. N.; Koçer, B.

2013-12-01

As the effects of climate change becomes more prominent, current challenges related to water and wastewater management is becoming more serious. Providing water that satisfies environmental and safety standards in terms of quantity and quality is needed to maintain human life without compromising the need of future generations. Besides providing safe and affordable water, necessary treatment should be achieved according to several important factors such as receiving body standards, discharge standards, water reuse options. Therefore, management of water becomes more crucial than ever that states have to provide accessibility of safe water with affordable cost to its citizens with the means of effective utility management, including water treatment facilities, wastewater treatment facilities, water supply facilities and water distribution systems. Water utilities encounter with several challenges related to cost, infrastructure, population, legislation, workforce and resource. This study aims to determine the current situation and the necessary strategies to improve utility management in Turkish municipalities in a sustainable manner. US Environment Protection Agency (EPA) has formed a tool on effective utility management that assists utilities to provide a solution for both current and future challenges. In this study, we used EPA's guidelines and developed a survey consists of 60 questions under 10 sub-topics (Product Quality, Employee & Leadership Development, Stakeholder Understanding & Support, Operational Optimization, Infrastructure Stability, Financial Viability, Community Sustainability, Customer Satisfaction, Operational Resiliency, and Water Resource Adequacy). This survey was sent to the managers of 25 metropolitan municipalities in Turkey to assess the current condition of municipalities. After the evaluation of the survey results for each topic, including the importance given by managers, facilities were rated according to their level of achievement. The scores were given for Rate Achievement from 1 to 5 and Rank Importance from 1 to 10 to the survey outcomes for each topic. Then, rating and ranking matrix was constructed according to score ranges. Results show that Product Quality, Stakeholder Understanding & Support, Infrastructure Stability and Customer Satisfaction are the major topics that needs to be improved according to the utility managers in Turkey. According to the outcomes of the study, water losses and unbilled unmetered consumption of water appeared to be the most important issues with the utility management. The utility managers also think there is still room for improvement to satisfy the needs of the users. Even though the rehabilitation of the infrastructure is a costly investment, it can be compensated with the help of the increased revenues as a result of improvement in water loss and unbilled water use. Suggestions given as a result of this study aim to aid decision makers and local authorities to overcome the significant problems faced during management and to achieve a sustainable utility management.

Should pediatric neurosurgeons still manage neurotrauma today?

PubMed

Peter, Jonathan C

2010-02-01

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

Advanced order management in ERM systems: the tic-tac-toe algorithm

NASA Astrophysics Data System (ADS)

Badell, Mariana; Fernandez, Elena; Puigjaner, Luis

2000-10-01

The concept behind improved enterprise resource planning systems (ERP) systems is the overall integration of the whole enterprise functionality into the management systems through financial links. Converting current software into real management decision tools requires crucial changes in the current approach to ERP systems. This evolution must be able to incorporate the technological achievements both properly and in time. The exploitation phase of plants needs an open web-based environment for collaborative business-engineering with on-line schedulers. Today's short lifecycles of products and processes require sharp and finely tuned management actions that must be guided by scheduling tools. Additionally, such actions must be able to keep track of money movements related to supply chain events. Thus, the necessary outputs require financial-production integration at the scheduling level as proposed in the new approach of enterprise management systems (ERM). Within this framework, the economical analysis of the due date policy and its optimization become essential to manage dynamically realistic and optimal delivery dates with price-time trade-off during the marketing activities. In this work we propose a scheduling tool with web-based interface conducted by autonomous agents when precise economic information relative to plant and business actions and their effects are provided. It aims to attain a better arrangement of the marketing and production events in order to face the bid/bargain process during e-commerce. Additionally, management systems require real time execution and an efficient transaction-oriented approach capable to dynamically adopt realistic and optimal actions to support marketing management. To this end the TicTacToe algorithm provides sequence optimization with acceptable tolerances in realistic time.

The most common problem facing by the maintenance department: A case Study between Universiti Tun Hussein Onn Malaysia (UTHM) and Universiti Teknologi Malaysia (UTM)

NASA Astrophysics Data System (ADS)

Norazam Yasin, Mohd; Mohamad Zin, Rosli; Halid Abdullah, Abd; Shafiq Mahmad, Muhammad; Fikri Hasmori, Muhammad

2017-11-01

From time to time, the maintenance works become more challenging due to construction of new building and also aging of the existing buildings. University buildings without any exception require proper maintenance services to support their function requirements and this can be considered as major responsibilities to be fulfilled by the maintenance department in the universities. Maintenance department specifically will face various kinds of problems in their operation works and thus this might influence the maintenance work operations itself. This study purposely to identify the common problem facing by the maintenance department and also to examine the current status of the maintenance department. In addition, this study would also propose any suitable approach that could be implemented to overcome the problem facing by the maintenance department. To achieve the objectives of this study, a combination of deep literature study and carrying out a survey is necessary. Literature study aimed to obtain deeper information about this study, meanwhile a survey aimed at identifying the common problem facing by the maintenance department and also to provide the information of the maintenance department’s organization. Several methods will be used in analyzing the data obtained through the survey, including Microsoft Office Excel and also using mean index formula. This study has identified three categories of problem in the maintenance department, which are management problems, human resource problem, and technical problems. Following the findings, several solutions being proposed which can be implemented as the solution to the problem facing. These suggestions have the potential to improve the maintenance department work efficiency, thus could help to increase the department productivity.

Lessons for outsourcing and interim management relationships.

PubMed

Macko, W; Kostyack, P T

1999-01-01

Few decisions can affect an organization more than the selection of an outsourcing or interim management partner. More and more health care organizations face such decisions in today's competitive market in order to face new business needs. Making these relationships successful can be important for health care organizations seeking competitive advantages or seeking immediately accessible management support. These relationships, however, require careful partner selection and development. Success in outsourcing and interim management relationships is contingent upon a thorough selection process, a strong contract that has clearly and explicitly detailed responsibilities and a culture-sensitive business rapport between the client and selected partner.

China Biobanking.

PubMed

Zhang, Yong; Li, Qiyuan; Wang, Xian; Zhou, Xiaolin

2015-01-01

Biobanks are playing increasingly important roles in clinical and translational research nowadays. China, as a country with the largest population and abundant clinical resources, attaches great importance to the development of biobanks. In recent years, with the increasing support from the Chinese government, biobanks are blooming across the country. This paper provides a detailed overview of China biobanking, which is further divided in the following four parts: (i) general introduction of the number, category and distribution of current biobanks; (ii) summarization of the current development status, and issues that Chinese biobanks are faced with; (iii) international cooperation between China and the global biobanking community; (iv) prospect of the modern twenty-first century Chinese biobanks, which would achieve standardized operation, systematic specimen management, and extensive collaboration, and thus provide support for the robust research discoveries and personalized medicine etc.

Current Status of a NASA High-Altitude Balloon-Based Observatory for Planetary Science

NASA Technical Reports Server (NTRS)

Varga, Denise M.; Dischner, Zach

2015-01-01

Recent studies have shown that progress can be made on over 20% of the key questions called out in the current Planetary Science Decadal Survey by a high-altitude balloon-borne observatory. Therefore, NASA has been assessing concepts for a gondola-based observatory that would achieve the greatest possible science return in a low-risk and cost-effective manner. This paper addresses results from the 2014 Balloon Observation Platform for Planetary Science (BOPPS) mission, namely successes in the design and performance of the Fine Pointing System. The paper also addresses technical challenges facing the new Gondola for High Altitude Planetary Science (GHAPS) reusable platform, including thermal control for the Optical Telescope Assembly, power generation and management, and weight-saving considerations that the team will be assessing in 2015 and beyond.

Anticoagulants for secondary prevention after acute myocardial infarction: lessons from the past decade.

PubMed

Atar, Dan; Bode, Christoph; Stuerzenbecher, André; Verheugt, Freek W A

2014-08-01

The impact of an acute coronary syndrome (ACS) event, such as an acute myocardial infarction (MI), is not limited to the acute management phase; patients face an elevated risk of residual atherothrombotic events that commonly requires chronic management for months or even years. Significant advances have been made in both the acute and chronic management of patients with acute MI over the past decade, resulting in improved prognoses. One of the hallmarks of modern treatment strategies is more aggressive antiplatelet treatment regimens. However, the risks of further ACS events, stroke and premature death remain elevated in these patients, and addressing this residual risk is challenging owing to interpatient variability, differences in management strategies between centres and countries, incomplete understanding of the specific pathophysiology of post-ACS thrombosis and limitations of current therapeutic approaches. The recent approval in Europe of the direct oral anticoagulant rivaroxaban for use in this setting in combination with clopidogrel and acetylsalicylic acid offers another strategy to consider in the management of these patients, and clinical strategies in this area continue to evolve. In this review, we chart the progress made over the past decade in reducing the burden of secondary thromboembolic events after acute MI and discuss the current position of and future perspectives on the inclusion of oral anticoagulants into care pathways in this setting. © 2014 The Authors. Fundamental & Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of Société Française de Pharmacologie et de Thérapeutique.

Sustainability and the local emergency manager.

PubMed

Jensen, Jessica; Chauvet, Regine Laurence

2014-01-01

The objective of this study was to explore how local county emergency managers conceptualize sustainability and apply the concept within their jobs. Qualitative, semistructured telephone and face-to-face interviews were used to collect data from a purposive and convenience sample of local county emergency managers. Interviews were conducted with Florida and North Dakota emergency managers. Twenty-five local county emergency managers participated in this study. The study demonstrated that there is a lack of definitional clarity in emergency manager conceptualizations of sustainability. Nevertheless, emergency managers apply the concept to their jobs in important ways. Emergency management has the opportunity to further define its role vis-à-vis sustainability and how it does so will have implications for the communities it serves, the professionals who will be tasked with it, and the educators who will support the development of future generations of emergency management professionals.

Riparian ecosystem resilience and livelihood strategies under test: lessons from Lake Chilwa in Malawi and other lakes in Africa.

PubMed

Kafumbata, Dalitso; Jamu, Daniel; Chiotha, Sosten

2014-04-05

This paper reviews the importance of African lakes and their management challenges. African inland lakes contribute significantly to food security, livelihoods and national economies through direct exploitation of fisheries, water resources for irrigation and hydropower generation. Because of these key contributions, the ecosystem services provided are under significant stress mainly owing to high demand by increasing populations, negative anthropogenic impacts on lake catchments and high levels of poverty which result in unsustainable use. Climate variability exacerbates the stress on these ecosystems. Current research findings show that the lakes cannot sustain further development activities on the scale seen over the past few decades. Millions of people are at risk of losing livelihoods through impacts on livestock and wildlife. The review further shows that the problems facing these lakes are beyond the purview of current management practices. A much better understanding of the interactions and feedbacks between different components of the lake socio-ecological systems is needed to address the complex challenges of managing these ecosystem services. This review suggests that the three small wetlands of Chad, Chilwa and Naivasha provide an opportunity for testing novel ideas that integrate sustainability of natural resource management with livelihoods in order to inform policy on how future land use and climatic variability will affect both food security and the ecosystem services associated with it.

Minimal Intervention Dentistry (MID) for managing dental caries – a review

PubMed Central

Frencken, Jo E.; Peters, Mathilde C.; Manton, David J.; Leal, Soraya C.; Gordan, Valeria V.; Eden, Ece

2012-01-01

This publication describes the history of Minimal Intervention Dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the ‘surgical’ care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI’s policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing. PMID:23106836

Eye Tracking Reveals a Crucial Role for Facial Motion in Recognition of Faces by Infants

ERIC Educational Resources Information Center

Xiao, Naiqi G.; Quinn, Paul C.; Liu, Shaoying; Ge, Liezhong; Pascalis, Olivier; Lee, Kang

2015-01-01

Current knowledge about face processing in infancy comes largely from studies using static face stimuli, but faces that infants see in the real world are mostly moving ones. To bridge this gap, 3-, 6-, and 9-month-old Asian infants (N = 118) were familiarized with either moving or static Asian female faces, and then their face recognition was…

Waiting Lists for Radiation Therapy: A Case Study

PubMed Central

2001-01-01

Background Why waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list "dynamics" could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions. Methods A case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed. Results The radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula. Conclusion Human resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment. PMID:11319944

A new horizon for the use of non-invasive ventilation in patients with acute respiratory distress syndrome.

PubMed

Carron, Michele

2016-09-01

Non-invasive ventilation (NIV) has assumed an important role in the management of acute respiratory failure (ARF). NIV, compared with standard medical therapy, improves survival and reduces complications in selected patients with ARF. NIV represents the first-line intervention for some forms of ARF, such as chronic obstructive pulmonary disease (COPD) exacerbations and acute cardiogenic pulmonary edema. The use of NIV is also well supported for immunocompromised patients who are at high risk for infectious complications from endotracheal intubation. Selection of appropriate patients is crucial for optimizing NIV success rates. Appropriate ventilator settings, a well-fitting and comfortable interface, and a team skilled and experienced in managing NIV are key components to its success. In a recent issue of the Journal of the American Medical Association , Patel et al . reported the results of their single-center trial of 83 patients with acute respiratory distress syndrome (ARDS) who were randomly assigned to NIV delivered via a helmet or face mask. Patients assigned to the helmet group exhibited a significantly lower intubation rate and were more likely to survive through 90 days. This perspective reviews the findings of this trial in the context of current clinical practice and in light of data from the literature focused on the potential reasons for success of NIV delivered through a helmet compared to face mask. The implications for early management of patients with ARDS are likewise discussed.

Research Driven Policy: Is Financial Capacity Related to Dangerousness?

PubMed

DeLeon, Patrick H; Paxton, Maegan M; Spencer, Tonya; Bajjani-Gebara, Jouhayna E

2018-05-22

Current Veterans administration policy directly links a Veteran's adjudged capacity to manage personal financial resources with their ability to purchase or possess a firearm, pursuant to the regulatory authority of the National Instant Criminal Background Check System (NICS). Preventing Veterans' suicide is a highly laudable public health objective. Effectively utilizing scientific research to "inform" public policy is equally important. The authors should be congratulated for their efforts. However, it is important in utilizing large set population-based data, especially social science data, to evaluate policy alternatives that there be substantial face (i.e., clinical) validity. Correlation does not necessarily represent causation.

Current Management of Neonatal Liver Tumors.

PubMed

Langham, Max R; Furman, Wayne L; Fernandez-Pineda, Israel

2015-01-01

This review is focused on the special issues and challenges confronting physicians and surgeons caring for an unborn child, or a newborn with a liver tumor. Liver tumors at this age are very rare and they make it difficult for pediatric surgeons to gain experience necessary to obtain good results. On the other hand, adult hepatobiliary surgeons faced with a fetus or infant with a liver mass are ill equipped to care for the patient even if they have done a high volume of adult liver surgery and are expert in the field. Often a team approach is the best solution.

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

ERIC Educational Resources Information Center

Pacheco, Regina Silvia; Franzese, Cibele

2017-01-01

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

What Has Happened to Arabs? Identity and Face Management Online

ERIC Educational Resources Information Center

Al Zidjaly, Najma

2012-01-01

In this article, I draw on contemporary theorizing on the concept of face (e.g., Ting-Toomey 1994, 2004; Tracy 2008) and research on Islamic and Arabic cultures and linguistic strategies (e.g., Beeman 1986; Hegland 1998; Wilce 2005; Al Zidjaly 2006) to explore the role that the Internet plays in enabling Muslim Arabs to manage or save their…

Ockham's Razor Makes Me Smile: Managing New Literacy Practices in off Shore University Course Work in the Digital Age

ERIC Educational Resources Information Center

Garrick, Barb

2012-01-01

Managing international cohorts of students who undertake workplace learning in countries other than the country of their host university can be a very complex and difficult process. University academics are accustomed to personal, face to face contact with their students. When students then move offshore, but remain the responsibility of the…

The Application of a Course Management System to Enhance Autonomy in Learning English as a Foreign Language

ERIC Educational Resources Information Center

Sanprasert, Navaporn

2010-01-01

This study investigated the extent to which learner autonomy could be fostered in a blended learning situation involving the integration of a course management system into a traditional face-to-face English class. The purpose was to identify whether there was evidence that such an intervention brought about changes in the students' perception and…

Differences in Learning Styles and Satisfaction between Traditional Face-to-Face and Online Web-Based Sport Management Studies Students

ERIC Educational Resources Information Center

West, Ellen Jo

2010-01-01

Each student has a unique learning style or individual way of perceiving, interacting, and responding to a learning environment. The purpose of this study was to identify and compare the prevalence of learning styles among undergraduate Sport Management Studies (SMS) students at California University of Pennsylvania (Cal U). Learning style…

The Examination and Analysis of the Effects of Elementary Principals' Specific Management Practices on Teacher Morale and Willingness to Embrace Initiative

ERIC Educational Resources Information Center

Reardon, Thomas B.

2012-01-01

The purpose of this study was to determine if there was a relationship between specific principal management practices (as defined in this study as: informal visits to the classroom, face-to-face communication, written communication, visibility throughout the school campus, and a presence at extracurricular activities) and teacher morale. The…

[Ballistic concepts and management of gunshot wounds at members].

PubMed

Fabeck, L; Hock, N; Goffin, J; Ngatchou, W

2017-01-01

Ballistic trauma is not the prerogative of battlefields and currently extends to civil environments. Any surgeon or emergency room can be faced with such trauma whose management requires an understanding of wound ballistics. The aim of this retrospective is reviewing the management of ballistic trauma within the C.H.U. Saint-Pierre hospital over a period of ten years. Data recorded included demographics data, lesions, clinical parameters, imaging, treatment and outcome. It appears that the wounds of the members have a low mortality rate but a significant rate of complications. Patients should be managed according to the ATLS protocol and according hemodynamic stability and location of the injury, benefit from imaging. Unstable patients will be operated in emergency, stable patients will be treated according to the extent of damage and the type of fracture either conservatively or by external fixator and intramedullary centromedullary. Debridement and antibiotics are recommended as a nerve exploration if there is a peripheral paralysis. The management of trauma in our sample appear not optimal in light of the literature especially in terms of setting the vascular point of debridement, antibiotic and nerve repair resulting in significant consequences. Two management protocols according to patients' hemodynamic status are offered.

Human sex differences in emotional processing of own-race and other-race faces.

PubMed

Ran, Guangming; Chen, Xu; Pan, Yangu

2014-06-18

There is evidence that women and men show differences in the perception of affective facial expressions. However, none of the previous studies directly investigated sex differences in emotional processing of own-race and other-race faces. The current study addressed this issue using high time resolution event-related potential techniques. In total, data from 25 participants (13 women and 12 men) were analyzed. It was found that women showed increased N170 amplitudes to negative White faces compared with negative Chinese faces over the right hemisphere electrodes. This result suggests that women show enhanced sensitivity to other-race faces showing negative emotions (fear or disgust), which may contribute toward evolution. However, the current data showed that men had increased N170 amplitudes to happy Chinese versus happy White faces over the left hemisphere electrodes, indicating that men show enhanced sensitivity to own-race faces showing positive emotions (happiness). In this respect, men might use past pleasant emotional experiences to boost recognition of own-race faces.

Newborns' Face Recognition: Role of Inner and Outer Facial Features

ERIC Educational Resources Information Center

Turati, Chiara; Macchi Cassia, Viola; Simion, Francesca; Leo, Irene

2006-01-01

Existing data indicate that newborns are able to recognize individual faces, but little is known about what perceptual cues drive this ability. The current study showed that either the inner or outer features of the face can act as sufficient cues for newborns' face recognition (Experiment 1), but the outer part of the face enjoys an advantage…

The efficacy of self-management programmes for increasing physical activity in community-dwelling adults with acquired brain injury (ABI): a systematic review

PubMed Central

2014-01-01

Background Acquired brain injury (ABI), often arising from stroke or trauma, is a common cause of long-term disability, physical inactivity and poor health outcomes globally. Individuals with ABI face many barriers to increasing physical activity, such as impaired mobility, access to services and knowledge regarding management of physical activity. Self-management programmes aim to build skills to enable an individual to manage their condition, including their physical activity levels, over a long period of time. Programme delivery modes can include traditional face-to-face methods, or remote delivery, such as via the Internet. However, it is unknown how effective these programmes are at specifically improving physical activity in community-dwelling adults with ABI, or how effective and acceptable remote delivery of self-management programmes is for this population. Methods/Design We will conduct a comprehensive search for articles indexed on MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, Cochrane Central Register of Controlled Trials (CENTRAL), PEDro and Science Citation Index Expanded (SCI-EXPANDED) databases that assess the efficacy of a self-management intervention, which aims to enhance levels of physical activity in adults living in the community with ABI. Two independent reviewers will screen studies for eligibility, assess risk of bias, and extract relevant data. Where possible, a meta-analysis will be performed to calculate the overall effect size of self-management interventions on physical activity levels and on outcomes associated with physical activity. A comparison will also be made between face-to-face and remote delivery modes of self-management programmes, in order to examine efficacy and acceptability. A content analysis of self-management programmes will also be conducted to compare aspects of the intervention that are associated with more favourable outcomes. Discussion This systematic review aims to review the efficacy of self-management programmes aimed at increasing physical activity levels in adults living in the community with ABI, and the efficacy and acceptability of remote delivery of these programmes. If effective, remote delivery of self-management programmes may offer an alternative way to overcome barriers and empower individuals with ABI to increase their levels of physical activity, improving health and general wellbeing. Trial registration Our protocol has been registered on PROSPERO 2013: CRD42013006748. PMID:24745356

The efficacy of self-management programmes for increasing physical activity in community-dwelling adults with acquired brain injury (ABI): a systematic review.

PubMed

Jones, Taryn M; Hush, Julia M; Dear, Blake F; Titov, Nickolai; Dean, Catherine M

2014-04-21

Acquired brain injury (ABI), often arising from stroke or trauma, is a common cause of long-term disability, physical inactivity and poor health outcomes globally. Individuals with ABI face many barriers to increasing physical activity, such as impaired mobility, access to services and knowledge regarding management of physical activity. Self-management programmes aim to build skills to enable an individual to manage their condition, including their physical activity levels, over a long period of time. Programme delivery modes can include traditional face-to-face methods, or remote delivery, such as via the Internet. However, it is unknown how effective these programmes are at specifically improving physical activity in community-dwelling adults with ABI, or how effective and acceptable remote delivery of self-management programmes is for this population. We will conduct a comprehensive search for articles indexed on MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, Cochrane Central Register of Controlled Trials (CENTRAL), PEDro and Science Citation Index Expanded (SCI-EXPANDED) databases that assess the efficacy of a self-management intervention, which aims to enhance levels of physical activity in adults living in the community with ABI. Two independent reviewers will screen studies for eligibility, assess risk of bias, and extract relevant data. Where possible, a meta-analysis will be performed to calculate the overall effect size of self-management interventions on physical activity levels and on outcomes associated with physical activity. A comparison will also be made between face-to-face and remote delivery modes of self-management programmes, in order to examine efficacy and acceptability. A content analysis of self-management programmes will also be conducted to compare aspects of the intervention that are associated with more favourable outcomes. This systematic review aims to review the efficacy of self-management programmes aimed at increasing physical activity levels in adults living in the community with ABI, and the efficacy and acceptability of remote delivery of these programmes. If effective, remote delivery of self-management programmes may offer an alternative way to overcome barriers and empower individuals with ABI to increase their levels of physical activity, improving health and general wellbeing. Our protocol has been registered on PROSPERO 2013: CRD42013006748.

Health literacy and asthma.

PubMed

Rosas-Salazar, Christian; Apter, Andrea J; Canino, Glorisa; Celedón, Juan C

2012-04-01

The report "Healthy people" from the US Department of Health and Human Services defines health literacy (HL) as follows: "The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." The same report identifies asthma as a public health problem of high priority. Unfortunately, impaired HL is prevalent in our society, and patients with low HL and asthma face multiple challenges as they attempt to manage their disease. Indeed, the National Asthma Education and Prevention Program's current guidelines require patients to have considerable HL and self-management skills. Numerous studies have linked inadequate literacy with poor health outcomes. Unlike many sociodemographic variables, HL can potentially be addressed in the health care setting. The purpose of this review is to raise awareness of the problem, summarize the current evidence linking HL and asthma, and offer strategies to strengthen the communication between patients and health care providers to decrease asthma health disparities. In addition, we discuss potential future directions for research in this field. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

A method for estimating cost savings for population health management programs.

PubMed

Murphy, Shannon M E; McGready, John; Griswold, Michael E; Sylvia, Martha L

2013-04-01

To develop a quasi-experimental method for estimating Population Health Management (PHM) program savings that mitigates common sources of confounding, supports regular updates for continued program monitoring, and estimates model precision. Administrative, program, and claims records from January 2005 through June 2009. Data are aggregated by member and month. Study participants include chronically ill adult commercial health plan members. The intervention group consists of members currently enrolled in PHM, stratified by intensity level. Comparison groups include (1) members never enrolled, and (2) PHM participants not currently enrolled. Mixed model smoothing is employed to regress monthly medical costs on time (in months), a history of PHM enrollment, and monthly program enrollment by intensity level. Comparison group trends are used to estimate expected costs for intervention members. Savings are realized when PHM participants' costs are lower than expected. This method mitigates many of the limitations faced using traditional pre-post models for estimating PHM savings in an observational setting, supports replication for ongoing monitoring, and performs basic statistical inference. This method provides payers with a confident basis for making investment decisions. © Health Research and Educational Trust.

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

PubMed

Weinstock, Beth

2011-01-01

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

What is a virtual multidisciplinary team (vMDT)?

PubMed Central

Munro, A J; Swartzman, S

2013-01-01

Background: Multidisciplinary team meetings (MDTs), also known as tumour boards or multidisciplinary case conferences, are an integral component of contemporary cancer care. There are logistical problems with setting up and maintaining participation in these meetings. An ill-defined concept, the virtual MDT (vMDT), has arisen in response to these difficulties. We have, in order to provide clarity and to generate discussion, attempted to define the concept of the vMDT, outline its advantages and disadvantages, and consider some of the practical aspects involved in setting up a virtual MDT. Methods: This is an unstructured review of published evidence and personal experience relating to virtual teams in general, and to MDTs in particular. Results: We have devised a simple taxonomy for MDTs, discussed some of the practicalities involved in setting up a vMDT, and described some of the potential advantages and disadvantages associated with vMDTs. Conclusion: The vMDT may be useful for discussions concerning rare or unusual tumours, or for helping guide the assessment and management of patients with uncommon complications related to treatment. However, the vMDT is a niche concept and is currently unlikely to replace the more traditional face-to-face MDT in the management of common tumours at specific sites. PMID:23756866

Blended Online and Face-to-Face Learning: A Pilot Project in the Faculty of Education, Eduardo Mondlane University

ERIC Educational Resources Information Center

Muianga, Xavier

2005-01-01

This paper is about the introduction of blended online and face-to-face learning to the Faculty of Education at Eduardo Mondlane University (EMU) in Mozambique. The main objective of the intervention was to explore the use of a course management system (CMS) within a flexible, student-centred teaching and learning strategy. The author selected two…

Finding Support in Moodle: A Face-to-Face Chemistry Course for Engineers

ERIC Educational Resources Information Center

de Vega, Carolina Armijo; McAnally-Salas, Lewis

2011-01-01

The aim of this paper was to know the students' perceptions of using online support in a chemistry course. To achieve this objective, a qualitative research was conducted over a chemistry course that was imparted in a face-to-face modality using a LMS (learning management system) for on-line support. The supports available in the LMS were forums,…

A multi-staged approach to the reconstruction of a burnt Asian face

PubMed Central

Joethy, Janna; Tan, Bien-Keem

2011-01-01

This article describes the management of chemical burns to the Asian face with resultant full thickness loss to the right side of the face including the eyelid and nose. We detail the techniques used to reconstruct the face which include skin grafting according to the aesthetic units of the face, accurate placement of junction lines, use of a chondrocutaneous graft to reconstruct the alar grove and scalp strip grafting for eyebrow reconstruction. We obtained a successful result that minimised scar formation in the burnt Asian face. PMID:21713203

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

PubMed Central

Moise, Imelda K.; Mulhall, Peter F.

2016-01-01

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

The development of norm-based coding and race-specific face prototypes: an examination of 5- and 8-year-olds' face space.

PubMed

Short, Lindsey A; Hatry, Alexandra J; Mondloch, Catherine J

2011-02-01

The current research investigated the organization of children's face space by examining whether 5- and 8-year-olds show race-contingent aftereffects. Participants read a storybook in which Caucasian and Chinese children's faces were distorted in opposite directions. Before and after adaptation, participants judged the normality/attractiveness of expanded, compressed, and undistorted Caucasian and Chinese faces. The method was validated with adults and then refined to test 8- and 5-year-olds. The 5-year-olds were also tested in a simple aftereffects paradigm. The current research provides the first evidence for simple attractiveness aftereffects in 5-year-olds and for race-contingent aftereffects in both 5- and 8-year-olds. Evidence that adults and 5-year-olds may possess only a weak prototype for Chinese children's faces suggests that Caucasian adults' prototype for Chinese adult faces does not generalize to child faces and that children's face space undergoes a period of increasing differentiation between 5 and 8 years of age. Copyright © 2010 Elsevier Inc. All rights reserved.

Helpful self-management strategies to cope with enduring depression from the patients' point of view: a concept map study.

PubMed

van Grieken, Rosa A; Kirkenier, Anneloes C E; Koeter, Maarten W J; Schene, Aart H

2014-12-13

Despite the development of various self-management programmes that attempt to ameliorate symptoms of patients with chronic major depressive disorder (MDD), little is known about what these patients perceive as helpful in their struggle during daily live. The present study aims to explore what patients believe they can do themselves to cope with enduring MDD besides professional treatment, and which self-management strategies patients perceive as being most helpful to cope with their MDD. We used concept mapping, a method specifically designed for the conceptualisation of a specific subject, in this case patients' point of view (n = 25) on helpful self-management strategies in their coping with enduring MDD. A purposive sample of participants was invited at the Academic Medical Center and through requests on several MDD-patient websites in the Netherlands. Participants generated strategies in focus group discussions which were successively clustered on a two-dimensional concept map by hierarchical cluster analysis. Fifty strategies were perceived as helpful. They were combined into three meta-clusters each comprising two clusters: A focus on the depression (sub clusters: Being aware that my depression needs active coping and Active coping with professional treatment); An active lifestyle (sub clusters: Active self-care, structure and planning and Free time activities) and Participation in everyday social life (sub clusters: Social engagement and Work-related activities). MDD patients believe they can use various strategies to cope with enduring MDD in daily life. Although current developments in e-health occur, patients emphasise on face-to-face treatments and long-term relations, being engaged in social and working life, and involving their family, friends, colleagues and clinicians in their disease management. Our findings may help clinicians to improve their knowledge about what patients consider beneficial to cope with enduring MDD and to incorporate these suggested self-management strategies in their treatments.

Smart wearable systems: current status and future challenges.

PubMed

Chan, Marie; Estève, Daniel; Fourniols, Jean-Yves; Escriba, Christophe; Campo, Eric

2012-11-01

Extensive efforts have been made in both academia and industry in the research and development of smart wearable systems (SWS) for health monitoring (HM). Primarily influenced by skyrocketing healthcare costs and supported by recent technological advances in micro- and nanotechnologies, miniaturisation of sensors, and smart fabrics, the continuous advances in SWS will progressively change the landscape of healthcare by allowing individual management and continuous monitoring of a patient's health status. Consisting of various components and devices, ranging from sensors and actuators to multimedia devices, these systems support complex healthcare applications and enable low-cost wearable, non-invasive alternatives for continuous 24-h monitoring of health, activity, mobility, and mental status, both indoors and outdoors. Our objective has been to examine the current research in wearable to serve as references for researchers and provide perspectives for future research. Herein, we review the current research and development of and the challenges facing SWS for HM, focusing on multi-parameter physiological sensor systems and activity and mobility measurement system designs that reliably measure mobility or vital signs and integrate real-time decision support processing for disease prevention, symptom detection, and diagnosis. For this literature review, we have chosen specific selection criteria to include papers in which wearable systems or devices are covered. We describe the state of the art in SWS and provide a survey of recent implementations of wearable health-care systems. We describe current issues, challenges, and prospects of SWS. We conclude by identifying the future challenges facing SWS for HM. Copyright © 2012 Elsevier B.V. All rights reserved.

Unifying concept of serotonin transporter-associated currents.

PubMed

Schicker, Klaus; Uzelac, Zeljko; Gesmonde, Joan; Bulling, Simon; Stockner, Thomas; Freissmuth, Michael; Boehm, Stefan; Rudnick, Gary; Sitte, Harald H; Sandtner, Walter

2012-01-02

Serotonin (5-HT) uptake by the human serotonin transporter (hSERT) is driven by ion gradients. The stoichiometry of transported 5-HT and ions is predicted to result in electroneutral charge movement. However, hSERT mediates a current when challenged with 5-HT. This discrepancy can be accounted for by an uncoupled ion flux. Here, we investigated the mechanistic basis of the uncoupled currents and its relation to the conformational cycle of hSERT. Our observations support the conclusion that the conducting state underlying the uncoupled ion flux is in equilibrium with an inward facing state of the transporter with K+ bound. We identified conditions associated with accumulation of the transporter in inward facing conformations. Manipulations that increased the abundance of inward facing states resulted in enhanced steady-state currents. We present a comprehensive kinetic model of the transport cycle, which recapitulates salient features of the recorded currents. This study provides a framework for exploring transporter-associated currents.

Unifying Concept of Serotonin Transporter-associated Currents*

PubMed Central

Schicker, Klaus; Uzelac, Zeljko; Gesmonde, Joan; Bulling, Simon; Stockner, Thomas; Freissmuth, Michael; Boehm, Stefan; Rudnick, Gary; Sitte, Harald H.; Sandtner, Walter

2012-01-01

Serotonin (5-HT) uptake by the human serotonin transporter (hSERT) is driven by ion gradients. The stoichiometry of transported 5-HT and ions is predicted to result in electroneutral charge movement. However, hSERT mediates a current when challenged with 5-HT. This discrepancy can be accounted for by an uncoupled ion flux. Here, we investigated the mechanistic basis of the uncoupled currents and its relation to the conformational cycle of hSERT. Our observations support the conclusion that the conducting state underlying the uncoupled ion flux is in equilibrium with an inward facing state of the transporter with K+ bound. We identified conditions associated with accumulation of the transporter in inward facing conformations. Manipulations that increased the abundance of inward facing states resulted in enhanced steady-state currents. We present a comprehensive kinetic model of the transport cycle, which recapitulates salient features of the recorded currents. This study provides a framework for exploring transporter-associated currents. PMID:22072712

Atherosclerotic renovascular disease – epidemiology, treatment and current challenges

PubMed Central

Vassallo, Diana

2017-01-01

The neutral results of recent large randomized controlled trials comparing renal revascularization with optimal medical therapy in patients with atherosclerotic renovascular disease (ARVD) have cast doubt on the role of revascularization in the management of unselected patients with this condition. However, these studies have strengthened the evidence base for the role of contemporary intensive medical vascular protection therapy and aggressive risk factor control in improving clinical outcomes in ARVD. Patients presenting with ‘high-risk’ clinical features such as uncontrolled hypertension, rapidly declining renal function or flash pulmonary oedema are underrepresented in these studies; hence these results may not be applicable to all patients with ARVD. In this ‘high-risk’ subgroup, conservative management may not be sufficient in preventing adverse events, and indeed, observational evidence suggests that this specific patient subgroup may gain benefit from timely renal revascularization. Current challenges include the development of novel diagnostic techniques to establish haemodynamic significance of a stenosis, patient risk stratification and prediction of post-revascularization outcomes to ultimately facilitate patient selection for revascularization. In this paper we describe the epidemiology of this condition and discuss treatment recommendations for this condition in light of the results of recent randomized controlled trials while highlighting important clinical unmet needs and challenges faced by clinicians managing this condition. PMID:29056991

Anaesthesia and intensive care management of face transplantation.

PubMed

Sedaghati-nia, A; Gilton, A; Liger, C; Binhas, M; Cook, F; Ait-Mammar, B; Scherrer, E; Hivelin, M; Lantieri, L; Marty, J; Plaud, B

2013-10-01

The face-grafting techniques are innovative and highly complex, requiring well-defined organization of all the teams involved. Subsequent to the first report in France in 2005, there have been 17 facial allograft transplantations performed worldwide. We describe anaesthesia and postoperative management, and the problems encountered, during the course of seven facial composite tissue grafts performed between 2007 and 2011 in our hospital. The reasons for transplantation were ballistic trauma in four patients, extensive neurofibromatosis in two patients, and severe burns in one patient. Anaesthesia for this long procedure involves advanced planning for airway management, vascular access, technique of anaesthesia, and fluid management. Preparation and grafting phases were highly haemorrhagic (>one blood volume), requiring massive transfusion. Median (range) volumes given for packed red cell (PRC) and fresh-frozen plasma (FFP) were 64.2 ml kg(-1) (35.5-227.5) and 46.2 ml kg(-1) (6.3-173.7), respectively. Blood loss quantification was difficult because of diffuse bleeding to the drapes. The management of patients with neurofibromatosis or burns involving the whole face was more difficult and haemorrhagic than the patients with lower face transplantation. Average surgical duration was 19.1 h (15-28 h). Postoperative severe graft oedema was present in most patients. Most patients encountered complications in ICU, such as renal insufficiency, acute respiratory distress syndrome, and jugular thrombosis. Opportunistic bacterial infections were a feature during the postoperative period in these highly immunosuppressed patients.

Diagnostic imaging to detect and evaluate response to therapy in bone metastases from prostate cancer: current modalities and new horizons.

PubMed

Evangelista, Laura; Bertoldo, Francesco; Boccardo, Francesco; Conti, Giario; Menchi, Ilario; Mungai, Francesco; Ricardi, Umberto; Bombardieri, Emilio

2016-07-01

Different therapeutic options for the management of prostate cancer (PC) have been developed, and some are successful in providing crucial improvement in both survival and quality of life, especially in patients with metastatic castration-resistant PC. In this scenario, diverse combinations of radiopharmaceuticals (for targeting bone, cancer cells and receptors) and nuclear medicine modalities (e.g. bone scan, SPECT, SPECT/CT, PET and PET/CT) are now available for imaging bone metastases. Some radiopharmaceuticals are approved, currently available and used in the routine clinical setting, while others are not registered and are still under evaluation, and should therefore be considered experimental. On the other hand, radiologists have other tools, in addition to CT, that can better visualize bone localization and medullary involvement, such as multimodal MRI. In this review, the authors provide an overview of current management of advanced PC and discuss the choice of diagnostic modality for the detection of metastatic skeletal lesions in different phases of the disease. In addition to detection of bone metastases, the evaluation of response to therapy is another critical issue, since it remains one of the most important open questions that a multidisciplinary team faces when optimizing the management of PC. The authors emphasize the role of nuclear modalities that can presently be used in clinical practice, and also look at future perspectives based on relevant clinical data with novel radiopharmaceuticals.

Optimizing conservation strategies for a threatened tree species: In situ conservation of white ash (Fraxinus americana L.) genetic diversity through insecticide treatment

Treesearch

Charles Flower; Jeremie Fant; Sean Hoban; Kathleen Knight; Laura Steger; Elijah Aubihl; Miquel Gonzalez-Meler; Stephen Forry; Andrea Hille; Alejandro Royo

2018-01-01

Forest resources face numerous threats that require costly management. Hence, there is an increasing need for data-informed strategies to guide conservation practices. The introduction of the emerald ash borer to North America has caused rapid declines in ash populations (Fraxinus spp. L.). Natural resource managers are faced with a choice of...

Managing Rosacea

MedlinePlus

... System Vascular Changes Demodex & Microbes Bibliography Genetics The Ecology of Your Face It Works for Me: Patient ... Tips Skin Care & Cosmetics Causes of Rosacea The Ecology of Your Face It Works for Me: Patient ...

An analysis of whether a working-age ward-based liaison psychiatry service requires the input of a liaison psychiatrist.

PubMed

Guthrie, Elspeth A; McMeekin, Aaron T; Khan, Sylvia; Makin, Sally; Shaw, Ben; Longson, Damien

2017-06-01

Aims and method This article presents a 12-month case series to determine the fraction of ward referrals of adults of working age who needed a liaison psychiatrist in a busy tertiary referral teaching hospital. Results The service received 344 referrals resulting in 1259 face-to-face contacts. Depression accounted for the most face-to-face contacts. We deemed the involvement of a liaison psychiatrist necessary in 241 (70.1%) referrals, with medication management as the most common reason. Clinical implications A substantial amount of liaison ward work involves the treatment and management of severe and complex mental health problems. Our analysis suggests that in the majority of cases the input of a liaison psychiatrist is required.

Cultural influences on the use of social support by Chinese immigrants in Japan: "face" as a keyword.

PubMed

Matsudaira, Tomomi

2003-03-01

In this study, the author demonstrates that cultural differences between China and Japan contribute to the social support relationships in the early migration stages. Twenty-two Chinese immigrants in Japan underwent semistructured interviews, the data from which were analyzed qualitatively. The author identified three impression management strategies that related to concepts of shared "face," social debt and benevolence, and independence. All three reflect the Chinese concept of face. This social context enhanced immigrants' commitment to support relationships and to the use of available support from Japanese providers. The author discusses differences between face and self-esteem in terms of impression management strategies. The findings suggest that cultural conflict must be recognized if integration of cultural differences between the two countries is to be achieved.

Thermoelectric Devices Advance Thermal Management

NASA Technical Reports Server (NTRS)

2007-01-01

Thermoelectric (TE) devices heat, cool, and generate electricity when a temperature differential is provided between the two module faces. In cooperation with NASA, Chico, California-based United States Thermoelectric Consortium Inc. (USTC) built a gas emissions analyzer (GEA) for combustion research. The GEA precipitated hydrocarbon particles, preventing contamination that would hinder precise rocket fuel analysis. The USTC research and design team uses patent-pending dimple, pin-fin, microchannel and microjet structures to develop and design heat dissipation devices on the mini-scale level, which not only guarantee high performance of products, but also scale device size from 1 centimeter to 10 centimeters. USTC continues to integrate the benefits of TE devices in its current line of thermal management solutions and has found the accessibility of NASA technical research to be a valuable, sustainable resource that has continued to positively influence its product design and manufacturing

Modifying the Balanced Scorecard for a Network Industry The Case of the Clearing Industry

NASA Astrophysics Data System (ADS)

Chlistalla, Michael; Schaper, Torsten

The Balanced Scorecard (BSC) is a well-established framework for the management of a company as it integrates financial and non-financial perspectives. Little attention has been given to its theoretical and conceptual valuation. We illustrate how the stakeholder value theory corresponds with the concept of the BSC and show the importance of underlying cause-and-effect relationships between its perspectives. For the case of clearing in Europe which is currently facing profound changes, we present our three-phased approach how to adjust and to extend Kaplan and Norton’s original concept. We modify the generic BSC by adding risk management as a separate perspective and by integrating competition and IT. Based on multiple case studies, we then validate whether the modified BSC is suited to meet the specifics of the clearing industry.

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

PubMed

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

2016-09-07

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

A new "virtual" patient pathway for the management of radial head and neck fractures.

PubMed

Jayaram, Prem R; Bhattacharyya, Rahul; Jenkins, Paul J; Anthony, Iain; Rymaszewski, Lech A

2014-03-01

Minimally displaced radial head and neck fractures are common and the outcome with conservative treatment is generally excellent. A new protocol was introduced to manage patients with these suspected fractures at a major urban hospital. Simple, undisplaced fractures without other associated injuries or instability were discharged with structured advice but no further face-to-face review. Patients with more complex injuries were reviewed at a "virtual clinic." The aim of this study was to examine the outcome of this process in terms of patient flow, satisfaction, reattendance, and reintervention. The 202 eligible patients, who presented during a 1-year period from October 2011 to October 2012, were identified retrospectively from a prospectively collected administrative database. Mason type III and IV fractures were excluded. A questionnaire was administered by mail or phone call to assess satisfaction with the process, information received, and function. Twenty (10%) patients required face-to-face review in a clinic, whereas 182 (90%) were managed with direct discharge; 155 patients responded to the survey (77%). The overall satisfaction rate was 96% in the suspected fracture group and 87% in the definite fracture group (P = .08). Satisfaction with the information provided was 95%. Two (1%) required late surgical intervention. In this study, patients with suspected Mason I or II fractures were managed with limited face-to-face follow-up with high satisfaction rates. The reintervention rate was extremely low. This process has significant benefits to patients, who have fewer hospital visits, and to orthopaedic departments, which have more time to devote to complex cases. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Small Unmanned Aerial Systems: Implications of the Evolving Legal Context for Use in Natural Resources Science and Management

NASA Astrophysics Data System (ADS)

Walker, M. J.

2016-12-01

Small unmanned aerial systems (sUAS, also known as drones) potentially provide researchers and managers with the capacity to enhance temporal and spatial resolution of data sets for natural resources science and management. sUAS have been used for many types of data collection and have a partial definition in mass of the aircraft, ranging from 0.5 to <55 lbs (0.2 to <24.9 kg). Aircraft within this range of mass can present a collision hazard to other aircraft. The Federal Aviation Administration (FAA) recently faced the challenge of removing regulatory barriers to sUAS application while minimizing risk in the national airspace. The regulatory and legal framework developed for using sUAS in natural resources science and management has evolved from a very conservative approach prior in the first decade of the 21st century. FAA's recently revised operating rules for sUAS, significantly changing pilot certification requirements and operating rules in the national airspace. The next 2-5 years will bring advances in sUAS applications for science and management, building upon the accomplishments of users who complied with the former regulatory environment. We review the current operating rules (49 CFR, part 107) that apply specifically to sUAS and discuss the implications for researchers and managers. While part 107 relaxed many restrictions, it is important to understand the regulatory framework currently in place that encourages development of applications for sUAS while adhering to the mandate that the national airspace be safe and secure. We consider potential applications for natural resources science and management in the context of the recently released operating rules, especially with respect to training requirements and protocols for use.

Herd-level animal management factors associated with the occurrence of bovine neonatal pancytopenia in calves in a multi-country study.

PubMed

Sauter-Louis, Carola; Jones, Bryony A; Henning, Jörg; Stoll, Alexander; Nielen, Mirjam; Van Schaik, Gerdien; Smolenaars, Anja; Schouten, Matthijs; den Uijl, Ingrid; Fourichon, Christine; Guatteo, Raphael; Madouasse, Aurélien; Nusinovici, Simon; Deprez, Piet; De Vliegher, Sarne; Laureyns, Jozef; Booth, Richard; Cardwell, Jacqueline M; Pfeiffer, Dirk U

2017-01-01

Since 2007, mortality associated with a previously unreported haemorrhagic disease has been observed in young calves in several European countries. The syndrome, which has been named 'bovine neonatal pancytopenia' (BNP), is characterised by thrombocytopenia, leukocytopenia and a panmyelophthisis. A herd-level case-control study was conducted in four BNP affected countries (Belgium, France, Germany and the Netherlands) to identify herd management risk factors for BNP occurrence. Data were collected using structured face-to-face and telephone interviews of farm managers and their local veterinarians. In total, 363 case farms and 887 control farms were included in a matched multivariable conditional logistic regression analysis. Case-control status was strongly associated with the odds of herd level use of the vaccine PregSure® BVD (PregSure, Pfizer Animal Health) (matched adjusted odds ratio (OR) 107.2; 95% CI: 41.0-280.1). This was also the case for the practices of feeding calves colostrum from the calf's own dam (OR 2.0; 95% CI: 1.1-3.4) or feeding pooled colostrum (OR 4.1; 95% CI: 1.9-8.8). Given that the study had relatively high statistical power and represented a variety of cattle production and husbandry systems, it can be concluded with some confidence that no other herd level management factors are competent causes for a sufficient cause of BNP occurrence on herd level. It is suggested that genetic characteristics of the dams and BNP calves should be the focus of further investigations aimed at identifying the currently missing component causes that together with PregSure vaccination and colostrum feeding represent a sufficient cause for occurrence of BNP in calves.

Still a difficult business? Negotiating alcohol-related problems in general practice consultations.

PubMed

Rapley, Tim; May, Carl; Frances Kaner, Eileen

2006-11-01

This paper describes general practitioners' (GPs) experiences of detecting and managing alcohol and alcohol-related problems in consultations. We undertook qualitative research in two phases in the North-East of England. Initially, qualitative interviews with 29 GPs explored their everyday work with patients with alcohol-related issues. We then undertook group interviews--two with GPs and one with a primary care team--where they discussed and challenged findings of the interviews. The GPs reported routinely discussing alcohol with patients with a range of alcohol-related problems. GPs believed that this work is important, but felt that until patients were willing to accept that their alcohol consumption was problematic they could achieve very little. They tentatively introduced alcohol as a potential problem, re-introduced the topic periodically, and then waited until the patient decided to change their behaviour. They were aware that they could identify and manage more patients. A lack of time and having to work with the multiple problems that patients brought to consultations were the main factors that stopped GPs managing more risky drinkers. Centrally, we compared the results of our study with [Thom, B., & Tellez, C. (1986). A difficult business-Detecting and managing alcohol-problems in general-practice. British Journal of Addiction, 81, 405-418] seminal study that was undertaken 20 years ago. We show how the intellectual, moral, emotional and practical difficulties that GPs currently face are quite similar to those faced by GPs from 20 years ago. As the definition of what could constitute abnormal alcohol consumption has expanded, so the range of consultations that they may have to negotiate these difficulties in has also expanded.

Herd-level animal management factors associated with the occurrence of bovine neonatal pancytopenia in calves in a multi-country study

PubMed Central

Jones, Bryony A.; Henning, Jörg; Stoll, Alexander; Nielen, Mirjam; Van Schaik, Gerdien; Smolenaars, Anja; Schouten, Matthijs; den Uijl, Ingrid; Fourichon, Christine; Guatteo, Raphael; Madouasse, Aurélien; Nusinovici, Simon; Deprez, Piet; De Vliegher, Sarne; Laureyns, Jozef; Booth, Richard; Cardwell, Jacqueline M.; Pfeiffer, Dirk U.

2017-01-01

Since 2007, mortality associated with a previously unreported haemorrhagic disease has been observed in young calves in several European countries. The syndrome, which has been named ‘bovine neonatal pancytopenia’ (BNP), is characterised by thrombocytopenia, leukocytopenia and a panmyelophthisis. A herd-level case-control study was conducted in four BNP affected countries (Belgium, France, Germany and the Netherlands) to identify herd management risk factors for BNP occurrence. Data were collected using structured face-to-face and telephone interviews of farm managers and their local veterinarians. In total, 363 case farms and 887 control farms were included in a matched multivariable conditional logistic regression analysis. Case-control status was strongly associated with the odds of herd level use of the vaccine PregSure® BVD (PregSure, Pfizer Animal Health) (matched adjusted odds ratio (OR) 107.2; 95% CI: 41.0–280.1). This was also the case for the practices of feeding calves colostrum from the calf’s own dam (OR 2.0; 95% CI: 1.1–3.4) or feeding pooled colostrum (OR 4.1; 95% CI: 1.9–8.8). Given that the study had relatively high statistical power and represented a variety of cattle production and husbandry systems, it can be concluded with some confidence that no other herd level management factors are competent causes for a sufficient cause of BNP occurrence on herd level. It is suggested that genetic characteristics of the dams and BNP calves should be the focus of further investigations aimed at identifying the currently missing component causes that together with PregSure vaccination and colostrum feeding represent a sufficient cause for occurrence of BNP in calves. PMID:28678850

Towards Sustainable Water Management in a Country that Faces Extreme Water Scarcity and Dependency: Jordan

NASA Astrophysics Data System (ADS)

Schyns, J.; Hamaideh, A.; Hoekstra, A. Y.; Mekonnen, M. M.; Schyns, M.

2015-12-01

Jordan faces a great variety of water-related challenges: domestic water resources are scarce and polluted; the sharing of transboundary waters has led to tensions and conflicts; and Jordan is extremely dependent of foreign water resources through trade. Therefore, sustainable water management in Jordan is a challenging task, which has not yet been accomplished. The objective of this study was to analyse Jordan's domestic water scarcity and pollution and the country's external water dependency, and subsequently review sustainable solutions that reduce the risk of extreme water scarcity and dependency. We have estimated the green, blue and grey water footprint of five different sectors in Jordan: crop production, grazing, animal water supply, industrial production and domestic water supply. Next, we assessed the blue water scarcity ratio for the sum of surface- and groundwater and for groundwater separately, and calculated the water pollution level. Finally, we reviewed the sustainability of proposed solutions to Jordan's domestic water problems and external water dependency in literature, while involving the results and conclusions from our analysis. We have quantified that: even while taking into account the return flows, blue water scarcity in Jordan is severe; groundwater consumption is nearly double the sustainable yield; water pollution aggravates blue water scarcity; and Jordan's external virtual water dependency is 86%. Our review yields ten essential ingredients that a sustainable water management strategy for Jordan, that reduces the risk of extreme water scarcity and dependency, should involve. With respect to these, Jordan's current water policy requires a strong redirection towards water demand management. Especially, more attention should be paid to reducing water demand by changing the consumption patterns of Jordan consumers. Moreover, exploitation of fossil groundwater should soon be halted and planned desalination projects require careful consideration on the sustainability of their energy supply.

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

PubMed

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

2005-01-01

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

Electromagnetic navigation technology for more precise electrode placement in the foramen ovale: a technical report.

PubMed

Van Buyten, Jean-Pierre; Smet, Iris; Van de Kelft, Erik

2009-07-01

Introduction. Interventional pain management techniques require precise positioning of needles or electrodes, therefore fluoroscopic control is mandatory. This imaging technique does however not visualize soft tissues such as blood vessels. Moreover, patient and physician are exposed to a considerable dose of radiation. Computed tomography (CT)-scans give a better view of soft tissues, but there use requires presence of a radiologist and has proven to be laborious and time consuming. Objectives. This study is to develop a technique using electromagnetic (EM) navigation as a guidance technique for interventional pain management, using CT and/or magnetic resonance (MRI) images uploaded on the navigation station. Methods. One of the best documented interventional procedures for the management of trigeminal neuralgia is percutaneous radiofrequency treatment of the Gasserian ganglion. EM navigation software for intracranial applications already exists. We developed a technique using a stylet with two magnetic coils suitable for EM navigation. The procedure is followed in real time on a computer screen where the patient's multislice CT-scan images and three-dimensional reconstruction of his face are uploaded. Virtual landmarks on the screen are matched with those on the patient's face, calculating the precision of the needle placement. Discussion. The experience with EM navigation acquired with the radiofrequency technique can be transferred to other interventional pain management techniques, for instance, for the placement of a neuromodulation electrode close to the Gasserian ganglion. Currently, research is ongoing to extend the software of the navigation station for spinal application, and to adapt neurostimulation hardware to the EM navigation technology. This technology will allow neuromodulation techniques to be performed without x-ray exposure for the patient and the physician, and this with the precision of CT/MR imaging guidance. © 2009 International Neuromodulation Society.

Increased amygdala responses to sad but not fearful faces in major depression: relation to mood state and pharmacological treatment.

PubMed

Arnone, Danilo; McKie, Shane; Elliott, Rebecca; Thomas, Emma J; Downey, Darragh; Juhasz, Gabriella; Williams, Steve R; Deakin, J F William; Anderson, Ian M

2012-08-01

Increased amygdala response to negative emotions seen in functional MRI (fMRI) has been proposed as a biomarker for negative emotion processing bias underlying depressive symptoms and vulnerability to depressive relapse that are normalized by antidepressant drug treatment. The purpose of this study was to determine whether abnormal amygdala responses to face emotions in depression are related to specific emotions or change in response to antidepressant treatment and whether they are present as a stable trait in medication-free patients in remission. Sixty-two medication-free unipolar depressed patients (38 were currently depressed, and 24 were in remission) and 54 healthy comparison subjects underwent an indirect face-emotion processing task during fMRI. Thirty-two currently depressed patients were treated with the antidepressant citalopram for 8 weeks. Adherence to treatment was evaluated by measuring citalopram plasma concentrations. Patients with current depression had increased bilateral amygdala responses specific to sad faces relative to healthy comparison subjects and nonmedicated patients in stable remission. Treatment with citalopram abolished the abnormal amygdala responses to sad faces in currently depressed patients but did not alter responses to fearful faces. Aberrant amygdala activation in response to sad facial emotions is specific to the depressed state and is a potential biomarker for a negative affective bias during a depressive episode.

Assessing and Managing the Current and Future Pest Risk from Water Hyacinth, (Eichhornia crassipes), an Invasive Aquatic Plant Threatening the Environment and Water Security.

PubMed

Kriticos, Darren J; Brunel, Sarah

2016-01-01

Understanding and managing the biological invasion threats posed by aquatic plants under current and future climates is a growing challenge for biosecurity and land management agencies worldwide. Eichhornia crassipes is one of the world's worst aquatic weeds. Presently, it threatens aquatic ecosystems, and hinders the management and delivery of freshwater services in both developed and developing parts of the world. A niche model was fitted using CLIMEX, to estimate the potential distribution of E. crassipes under historical and future climate scenarios. Under two future greenhouse gas emission scenarios for 2080 simulated with three Global Climate Models, the area with a favourable temperature regime appears set to shift polewards. The greatest potential for future range expansion lies in Europe. Elsewhere in the northern hemisphere temperature gradients are too steep for significant geographical range expansion under the climate scenarios explored here. In the Southern Hemisphere, the southern range boundary for E. crassipes is set to expand southwards in Argentina, Australia and New Zealand; under current climate conditions it is already able to invade the southern limits of Africa. The opportunity exists to prevent its spread into the islands of Tasmania in Australia and the South Island of New Zealand, both of which depend upon hydroelectric facilities that would be threatened by the presence of E. crassipes. In Europe, efforts to slow or stop the spread of E. crassipes will face the challenge of limited internal biosecurity capacity. The modelling technique demonstrated here is the first application of niche modelling for an aquatic weed under historical and projected future climates. It provides biosecurity agencies with a spatial tool to foresee and manage the emerging invasion threats in a manner that can be included in the international standard for pest risk assessments. It should also support more detailed local and regional management.

Assessing and Managing the Current and Future Pest Risk from Water Hyacinth, (Eichhornia crassipes), an Invasive Aquatic Plant Threatening the Environment and Water Security

PubMed Central

Brunel, Sarah

2016-01-01

Understanding and managing the biological invasion threats posed by aquatic plants under current and future climates is a growing challenge for biosecurity and land management agencies worldwide. Eichhornia crassipes is one of the world’s worst aquatic weeds. Presently, it threatens aquatic ecosystems, and hinders the management and delivery of freshwater services in both developed and developing parts of the world. A niche model was fitted using CLIMEX, to estimate the potential distribution of E. crassipes under historical and future climate scenarios. Under two future greenhouse gas emission scenarios for 2080 simulated with three Global Climate Models, the area with a favourable temperature regime appears set to shift polewards. The greatest potential for future range expansion lies in Europe. Elsewhere in the northern hemisphere temperature gradients are too steep for significant geographical range expansion under the climate scenarios explored here. In the Southern Hemisphere, the southern range boundary for E. crassipes is set to expand southwards in Argentina, Australia and New Zealand; under current climate conditions it is already able to invade the southern limits of Africa. The opportunity exists to prevent its spread into the islands of Tasmania in Australia and the South Island of New Zealand, both of which depend upon hydroelectric facilities that would be threatened by the presence of E. crassipes. In Europe, efforts to slow or stop the spread of E. crassipes will face the challenge of limited internal biosecurity capacity. The modelling technique demonstrated here is the first application of niche modelling for an aquatic weed under historical and projected future climates. It provides biosecurity agencies with a spatial tool to foresee and manage the emerging invasion threats in a manner that can be included in the international standard for pest risk assessments. It should also support more detailed local and regional management. PMID:27513336

The role of alternative therapy in the management of partial thickness burns of the face--experience with the use of moist exposed burn ointment (MEBO) compared with silver sulphadiazine.

PubMed

Ang, E S; Lee, S T; Gan, C S; See, P; Chan, Y H; Ng, L H; Machin, D

2000-01-01

Conventional management of partial thickness facial burn wounds includes the use of silver sulphadiazine dressings. Silver sulphadiazine forms an overlying slough that makes wound healing assessment difficult. Moist exposed burn ointment (MEBO) has been proposed as the ideal burn wound dressing both for burns of the face and other sites. Proponents of MEBO claim that it accelerates wound healing and results in scarless wound healing and at the same time reduce bacterial colonisation and the need for analgesics. We present here our experience with MEBO in the management of partial thickness burns of the face. One hundred and fifteen patients with partial thickness burns were randomly assigned to conventional treatment or MEBO. Out of this, 112 were analysed. Thirty-nine patients sustained facial burns; 17 received MEBO and 22 received silver sulphadiazine. Patients were followed up daily until the burn wounds were reduced by 75% of original body surface area (BSA). In patients with facial burns, MEBO was similar to silver sulphadiazine therapy with respect to rate of wound healing. Minimal slough was present over the wounds in MEBO-treated wounds resulting in clearer assessment of healing progression. Advantages of MEBO as compared to silver sulphadiazine in the management of partial thickness burns of the face include convenient change of dressing and easier assessment of healing progression. This suggests that MEBO is a useful alternative therapy for partial thickness burns of the face.

Evaluation of ISO CRS Envelopes Relative to U.S. Vehicles and Child Restraint Systems.

PubMed

Hu, Jingwen; Manary, Miriam A; Klinich, Kathleen D; Reed, Matthew P

2015-01-01

The objectives of this study are to use computer simulation to evaluate the International Organization for Standardization (ISO) 13216-3:2006(E) child restraint system (CRS) envelopes relative to rear seat compartments from vehicles and CRSs in the U.S. market, investigate the potential compatibility issues of U.S. vehicles and CRSs, and demonstrate whether necessary modifications can be made to introduce such a system into compatibility evaluations between U.S. vehicles and CRSs. Three-dimensional geometry models for 26 vehicles and 16 convertible CRS designs developed previously were used. Geometry models of 3 forward-facing and 3 rear-facing CRS envelopes provided by the ISO were built in the current study. The virtual fit process closely followed the physical procedures described in the ISO standards. The results showed that the current ISO rear-facing envelopes can provide reasonable classifications for CRSs and vehicles, but the forward-facing envelopes do not represent products currently in the U.S. market. In particular, all of the selected vehicles could accommodate the largest forward-facing CRS envelope at the second-row seat location behind the driver seat. In contrast, half of the selected CRSs could not fit within any of the forward-facing ISO CRS envelopes, mainly due to protrusion at the rear-top corner of the envelope. The results also indicate that the rear seat compartment in U.S. vehicles often cannot accommodate a large portion of convertible CRSs in the rear-facing position. The increased demand for vehicle fuel economy and the recommendation to keep children rear-facing longer may lead to smaller cars and larger CRSs, which may increase the potential for fit problems. The virtual classifications indicated that contact between the forward-facing CRSs and the head restraints in the rear seats as well as that between the rear-facing CRSs and the back of the front seats is a main concern regarding the compatibility between the vehicles and the CRSs. Therefore, modification of the current ISO forward-facing CRS envelopes will likely to be necessary to ensure that they are useful for the U.S. market.

The business case for quality: combining medical literature research with health plan data to establish value for nonclinical managers.

PubMed

Fetterolf, Donald; West, Rebecca

2004-01-01

Clinical managers face a growing need to communicate the value of what they do in terms that can be interpreted by nonclinical financial managers. We have sought to link the evidence basis of current guidelines to variables that will demonstrate in more financial terms the very real benefit of treating diseases aggressively. We have developed an approach using the medical literature that is designed to describe clinical initiatives in more concrete terms as desired by senior management. This becomes specifically critical during budget time and when justification for various clinical programs is needed. The approach uses medical research from the peer-reviewed literature to estimate the economic impact of various initiatives and then combines the analysis with an organization's actual data to impute potential benefit. A sample grid for developing the analysis is attached. A comprehensive bibliography that will assist others with similar endeavors has been included. Although not as rigorous as formal methods, actuarial analyses, or health services research activities, it presents a beginning framework around which an organization can create operational estimates of initiative effectiveness.

Resource-Based Capability on Development Knowledge Management Capabilities of Coastal Community

NASA Astrophysics Data System (ADS)

Teniwut, Roberto M. K.; Hasyim, Cawalinya L.; Teniwut, Wellem A.

2017-10-01

Building sustainable knowledge management capabilities in the coastal area might face a whole new challenge since there are many intangible factors involved from openness on new knowledge, access and ability to use the latest technology to the various local wisdom that still in place. The aimed of this study was to identify and analyze the resource-based condition of coastal community in this area to have an empirical condition of tangible and intangible infrastructure on developing knowledge management capability coastal community in Southeast Maluku, Indonesia. We used qualitative and quantitative analysis by depth interview and questionnaire for collecting the data with multiple linear regression as our analysis method. The result provided the information on current state of resource-based capability of a coastal community in this Southeast Maluku to build a sustainability model of knowledge management capabilities especially on utilization marine and fisheries resources. The implication of this study can provide an empirical information for government, NGO and research institution to dictate on how they conducted their policy and program on developing coastal community region.

Integrated Pest Management of Coffee Berry Borer: Strategies from Latin America that Could Be Useful for Coffee Farmers in Hawaii.

PubMed

Aristizábal, Luis F; Bustillo, Alex E; Arthurs, Steven P

2016-02-03

The coffee berry borer (CBB), Hypothenemus hampei Ferrari (Coleoptera: Curculionidae: Scolytinae) is the primary arthropod pest of coffee plantations worldwide. Since its detection in Hawaii (September 2010), coffee growers are facing financial losses due to reduced quality of coffee yields. Several control strategies that include cultural practices, biological control agents (parasitoids), chemical and microbial insecticides (entomopathogenic fungi), and a range of post-harvest sanitation practices have been conducted to manage CBB around the world. In addition, sampling methods including the use of alcohol based traps for monitoring CBB populations have been implemented in some coffee producing countries in Latin America. It is currently unclear which combination of CBB control strategies is optimal under economical, environmental, and sociocultural conditions of Hawaii. This review discusses components of an integrated pest management program for CBB. We focus on practical approaches to provide guidance to coffee farmers in Hawaii. Experiences of integrated pest management (IPM) of CBB learned from Latin America over the past 25 years may be relevant for establishing strategies of control that may fit under Hawaiian coffee farmers' conditions.