Sample records for management functions include

  1. 20 CFR 641.856 - What functions and activities constitute costs of administration?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., including: (i) Accounting, budgeting, financial, and cash management functions; (ii) Procurement and purchasing functions; (iii) Property management functions; (iv) Personnel management functions; (v) Payroll... example, personnel, procurement, purchasing, property management, accounting, and payroll systems...

  2. 20 CFR 645.235 - What types of activities are subject to the administrative cost limit on Welfare-to-Work grants?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... WtW including: (i) Accounting, budgeting, financial and cash management functions; (ii) Procurement and purchasing functions; (iii) Property management functions; (iv) Personnel management functions; (v... administrative functions (for example, personnel, procurement, purchasing, property management, accounting and...

  3. Dementia

    MedlinePlus

    ... living. Functions affected include memory, language skills, visual perception, problem solving, self-management, and the ability to ... living. Functions affected include memory, language skills, visual perception, problem solving, self-management, and the ability to ...

  4. 20 CFR 641.856 - What functions and activities constitute administrative costs?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., including: (i) Accounting, budgeting, financial, and cash management functions; (ii) Procurement and... management, accounting, and payroll systems) including the purchase, systems development, and operating costs of such systems and; (6) Costs of technical assistance, professional organization membership dues...

  5. 20 CFR 641.856 - What functions and activities constitute administrative costs?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., including: (i) Accounting, budgeting, financial, and cash management functions; (ii) Procurement and... management, accounting, and payroll systems) including the purchase, systems development, and operating costs of such systems and; (6) Costs of technical assistance, professional organization membership dues...

  6. 20 CFR 641.856 - What functions and activities constitute administrative costs?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., including: (i) Accounting, budgeting, financial, and cash management functions; (ii) Procurement and... management, accounting, and payroll systems) including the purchase, systems development, and operating costs of such systems and; (6) Costs of technical assistance, professional organization membership dues...

  7. 20 CFR 641.856 - What functions and activities constitute administrative costs?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., including: (i) Accounting, budgeting, financial, and cash management functions; (ii) Procurement and... management, accounting, and payroll systems) including the purchase, systems development, and operating costs of such systems and; (6) Costs of technical assistance, professional organization membership dues...

  8. 77 FR 67653 - Statement of Organization, Functions, and Delegations of Authority; Office of the Deputy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ..., including position management, performance management, employee recognition, staffing, recruitment, employee... management activities, including recruitment, selection, position management, performance management, designated performance and incentive awards and employee assistance programs and other services to ACF...

  9. 12 CFR 711.2 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... not include: (i) A person whose management functions relate exclusively to the business of retail merchandising or manufacturing; (ii) A person whose management functions relate principally to the business... Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS MANAGEMENT OFFICIAL...

  10. Depicting individual responses to physical therapist led chronic pain self-management support with pain science education and exercise in primary health care: multiple case studies.

    PubMed

    Miller, Jordan; MacDermid, Joy C; Richardson, Julie; Walton, David M; Gross, Anita

    2017-01-01

    Previous evidence suggests self-management programs for people with chronic pain improve knowledge and self-efficacy, but result in small to negligible changes in function. The purpose of this multiple case studies design was to describe the unique responses of six participants to a new self-management program aimed at improving function, to detail each component of the program, and to explore potential explanations for the varied trajectories of each of the participants. Six participants who had been experiencing chronic pain for at least 5 years were included. All participants were enrolled 6 weeks of ChrOnic pain self-ManageMent support with pain science EducatioN and exercise (COMMENCE). Participants completed an assessment at baseline, 7 weeks (1-week follow-up), and 18 weeks (12-week follow-up). Each participant had a unique initial presentation and goals. Assessments included: function as measured by the Short Musculoskeletal Function Assessment - Dysfunction Index, how much participants are bothered by functional difficulties, pain intensity, fatigue, pain interference, cognitive and psychological factors associated with pain and disability, pain neurophysiology, self-efficacy, satisfaction, and perceived change. The self-management program was 6-weeks in length, consisting of one individual visit and one group visit per week. The program incorporated three novel elements not commonly included in self-management programs: pain neurophysiology education, individualized exercises determined by the participants' goals, and additional cognitive behavioural approaches. Participants were all satisfied with self-management support received. Change in function was variable ranging from 59% improvement to 17% decline. Two potential explanations for variances in response, attendance and social context, are discussed. Several challenges were identified by participants as barriers to attendance. A primary care self-management intervention including pain education and individualized exercise has potential to improve function for some people with chronic pain, although strategies to improve adherence and reduce barriers to participation may be needed to optimize the impact.

  11. Linking Changes in Management and Riparian Physical Functionality to Water Quality and Aquatic Habitat

    EPA Science Inventory

    Wildlife and aquatic habitats are dependent on the development of riparian area management strategies. Land management strategies consider certain basic ecological and economic relationships. These relationships are functions of riparian and te rrestrial ecosystems, which include...

  12. 24 CFR 891.400 - Responsibilities of owner.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES Project Management § 891... unleased units or residential spaces. (b) Management and maintenance. The Owner is responsible for all management functions. These functions include selection and admission of tenants, required reexaminations of...

  13. 24 CFR 891.400 - Responsibilities of owner.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES Project Management § 891... unleased units or residential spaces. (b) Management and maintenance. The Owner is responsible for all management functions. These functions include selection and admission of tenants, required reexaminations of...

  14. Perceived Self-Efficacy: A Concept Analysis for Symptom Management in Patients With Cancer
.

    PubMed

    White, Lynn L; Cohen, Marlene Z; Berger, Ann M; Kupzyk, Kevin A; Swore-Fletcher, Barbara A; Bierman, Philip J

    2017-12-01

    Perceived self-efficacy (PSE) for symptom management plays a key role in outcomes for patients with cancer, such as quality of life, functional status, symptom distress, and healthcare use. Definition of the concept is necessary for use in research and to guide the development of interventions to facilitate PSE for symptom management in patients with cancer.
. This analysis will describe the concept of PSE for symptom management in patients with cancer.
. A database search was performed for related publications from 2006-2016. Landmark publications published prior to 2006 that informed the concept analysis were included.
. Greater PSE for symptom management predicts improved performance outcomes, including functional health status, cognitive function, and disease status. Clarification of the concept of PSE for symptom management will accelerate the progress of self-management research and allow for comparison of research data and intervention development.

  15. 7 CFR 3565.304 - Lender loan processing responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., management and disposition. Unless otherwise permitted by the Agency, the originating lender must perform all loan functions during the period of the guarantee. These functions include servicing, asset management...

  16. Positive Approaches to Business Management: Conference Proceedings.

    ERIC Educational Resources Information Center

    LaVire, Willis A., Ed.

    In August 1970, an institute for newly appointed junior college business managers was planned around the business management function. This function would include purchasing, physical plant, personnel, auxiliary services, and financial records. The following seven speeches from the proceedings are presented: Evolution of Responsibility in the…

  17. Principles of disaster management lesson. 12: structuring organizations.

    PubMed

    Cuny, F C

    2001-01-01

    This lesson discusses various structures for organizations that have functional roles in disaster responses, relief, and/or management activities. It distinguishes between pyramidal and matrix structures, and notes the advantages and disadvantages of each in relation to disasters. Span of control issues are dissected including the impact of the "P" factor on the performance of disaster managers and workers including its relationship to the coordination and control function. The development of a Table of Organization and how it relates to departmentalization within an organization also is provided.

  18. SLURM: Simple Linux Utility for Resource Management

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

    Jette, M; Dunlap, C; Garlick, J

    2002-07-08

    Simple Linux Utility for Resource Management (SLURM) is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for Linux clusters of thousands of nodes. Components include machine status, partition management, job management, scheduling and stream copy modules. The design also includes a scalable, general-purpose communication infrastructure. This paper presents a overview of the SLURM architecture and functionality.

  19. Project resources planning and control

    NASA Technical Reports Server (NTRS)

    Sibbers, C. W.

    1984-01-01

    This report contains instructional guidelines for the resources planning and control of research and development (R&D) projects managed by NASA's Langley Research Center (LaRC). Although written to serve primarily as a practical guide and reference for those LaRC personnel who perform resources planning, analysis, control, and reporting functions, it should also be meaningful to other NASA personnel who are directly or indirectly involved in or affected by these functions, especially project technical managers whose responsibilities include resources management. Certain sections should help Contractor personnel to better understand what resources information must usually be submitted on LaRC projects and what use is made of such information. The Project Manager of a large R&D project typicaly receives support from an Analyst in the area of resources management. The Analyst provides assistance in four functional areas: Planning, Analysis/Control, Administration, and Reporting. Each of these functions are discussed in detail. Examples of techniques used effectively on LaRC projects have been included where applicable. A considerable amount of information has been included on the use of Performance Measurement (Earned Value) Systems for contract cost control and reporting as little information is currently available on this subject in NASA publications.

  20. Finance and supply management project execution plan

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

    BENNION, S.I.

    As a subproject of the HANDI 2000 project, the Finance and Supply Management system is intended to serve FDH and Project Hanford major subcontractor with financial processes including general ledger, project costing, budgeting, and accounts payable, and supply management process including purchasing, inventory and contracts management. Currently these functions are performed with numerous legacy information systems and suboptimized processes.

  1. Technologies for unattended network operations

    NASA Technical Reports Server (NTRS)

    Jaworski, Allan; Odubiyi, Jide; Holdridge, Mark; Zuzek, John

    1991-01-01

    The necessary network management functions for a telecommunications, navigation and information management (TNIM) system in the framework of an extension of the ISO model for communications network management are described. Various technologies that could substantially reduce the need for TNIM network management, automate manpower intensive functions, and deal with synchronization and control at interplanetary distances are presented. Specific technologies addressed include the use of the ISO Common Management Interface Protocol, distributed artificial intelligence for network synchronization and fault management, and fault-tolerant systems engineering.

  2. Integrating QoS and security functions in an IP-VPN gateway

    NASA Astrophysics Data System (ADS)

    Fan, Kuo-Pao; Chang, Shu-Hsin; Lin, Kuan-Ming; Pen, Mau-Jy

    2001-10-01

    IP-based Virtual Private Network becomes more and more popular. It can not only reduce the enterprise communication cost but also increase the revenue of the service provider. The common IP-VPN application types include Intranet VPN, Extranet VPN, and remote access VPN. For the large IP-VPN market, some vendors develop dedicated IP-VPN devices; while some vendors add the VPN functions into their existing network equipment such as router, access gateway, etc. The functions in the IP-VPN device include security, QoS, and management. The common security functions supported are IPSec (IP Security), IKE (Internet Key Exchange), and Firewall. The QoS functions include bandwidth control and packet scheduling. In the management component, policy-based network management is under standardization in IETF. In this paper, we discuss issues on how to integrate the QoS and security functions in an IP-VPN Gateway. We propose three approaches to do this. They are (1) perform Qos first (2) perform IPSec first and (3) reserve fixed bandwidth for IPSec. We also compare the advantages and disadvantages of the three proposed approaches.

  3. Training: The No. 1 Manpower Management Function

    ERIC Educational Resources Information Center

    Lippert, Frederick G.

    1977-01-01

    Reports results of a University of Connecticut study in which business administration graduate students in a manpower management course ranked six major functions of a competent personnel department according to perceived importance. A description of the course is included. (TA)

  4. Automated Rocket Propulsion Test Management

    NASA Technical Reports Server (NTRS)

    Walters, Ian; Nelson, Cheryl; Jones, Helene

    2007-01-01

    The Rocket Propulsion Test-Automated Management System provides a central location for managing activities associated with Rocket Propulsion Test Management Board, National Rocket Propulsion Test Alliance, and the Senior Steering Group business management activities. A set of authorized users, both on-site and off-site with regard to Stennis Space Center (SSC), can access the system through a Web interface. Web-based forms are used for user input with generation and electronic distribution of reports easily accessible. Major functions managed by this software include meeting agenda management, meeting minutes, action requests, action items, directives, and recommendations. Additional functions include electronic review, approval, and signatures. A repository/library of documents is available for users, and all items are tracked in the system by unique identification numbers and status (open, closed, percent complete, etc.). The system also provides queries and version control for input of all items.

  5. Oak Ridge Environmental Information System (OREIS) functional system design document

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

    Birchfield, T.E.; Brown, M.O.; Coleman, P.R.

    1994-03-01

    The OREIS Functional System Design document provides a detailed functional description of the Oak Ridge Environmental Information System (OREIS). It expands the system requirements defined in the OREIS Phase 1-System Definition Document (ES/ER/TM-34). Documentation of OREIS development is based on the Automated Data Processing System Development Methodology, a Martin Marietta Energy Systems, Inc., procedure written to assist in developing scientific and technical computer systems. This document focuses on the development of the functional design of the user interface, which includes the integration of commercial applications software. The data model and data dictionary are summarized briefly; however, the Data Management Planmore » for OREIS (ES/ER/TM-39), a companion document to the Functional System Design document, provides the complete data dictionary and detailed descriptions of the requirements for the data base structure. The OREIS system will provide the following functions, which are executed from a Menu Manager: (1) preferences, (2) view manager, (3) macro manager, (4) data analysis (assisted analysis and unassisted analysis), and (5) spatial analysis/map generation (assisted ARC/INFO and unassisted ARC/INFO). Additional functionality includes interprocess communications, which handle background operations of OREIS.« less

  6. About the Principal Deputy Assistant Administrator of EPA’s Office of Administration and Resources Management

    EPA Pesticide Factsheets

    Donna Vizian manages essential support functions, including human resources management, diversity and inclusion, acquisition (contracts), grants management, and the protection of EPA’s facilities and other critical assets nationwide.

  7. Utility of Functional Hemodynamics and Echocardiography to Aid Diagnosis and Management of Shock.

    PubMed

    McGee, William T; Raghunathan, Karthik; Adler, Adam C

    2015-12-01

    The utility of functional hemodynamics and bedside ultrasonography is increasingly recognized as advantageous for both improved diagnosis and management of shock states. In contrast to conventional "static" measures, "dynamic" hemodynamic measures and bedside imaging modalities enhance pathophysiology-based comprehensive understanding of shock states and the response to therapy. The current editions of major textbooks in the primary specialties--in which clinicians routinely encounter patients in shock--including surgery, anesthesia, emergency medicine, and internal medicine continue to incorporate traditional (conventional) descriptions of shock that use well-described (but potentially misleading) intravascular pressures to classify shock states. Reliance on such intravascular pressure measurements is not as helpful as newer "dynamic" functional measures including ultrasonography to both better assess volume responsiveness and biventricular cardiac function. This review thus emphasizes the application of current functional hemodynamics and ultrasonography to the diagnosis and management of shock as a contrast to conventional "static" pressure-based measures.

  8. Cardiac rhythm management devices

    PubMed

    Stevenson, Irene; Voskoboinik, Alex

    2018-05-01

    The last decade has seen ongoing evolution and use of cardiac rhythm management devices, including pacemakers, cardiac resynchronisation therapy, implantable cardioverter defibrillators and loop recorders. General practitioners are increasingly involved in follow-up and management of patients with these devices. The aim of this article is to provide an overview of different cardiac rhythm management devices, including their role, implant procedure, post-procedural care, potential complications and follow‑up. We also include practical advice for patients regarding driving, exercise, sexual intimacy and precautions with regards to electromagnetic interference. Cardiac rhythm management devices perform many functions, including bradycardia pacing, monitoring for arrhythmias, cardiac resynchronisation for heart failure, defibrillation and anti-tachycardia pacing for tachyarrhythmias. Concerns regarding potential device-related complications should be discussed with the implanting physician. In the post-implant period, patients with cardiac rhythm management devices can expect to lead normal, active lives. However, caution must occasionally be exercised in certain situations, such as near appliances with electromagnetic interference. Future innovations will move away from transvenous leads to leadless designs with combinations of different components on a 'modular' basis according to the function required.

  9. The multiscale classification system and grid encoding mode of ecological land in China

    NASA Astrophysics Data System (ADS)

    Wang, Jing; Liu, Aixia; Lin, Yifan

    2017-10-01

    Ecological land provides goods and services that have direct or indirect benefic to eco-environment and human welfare. In recent years, researches on ecological land have become important in the field of land changes and ecosystem management. In the study, a multi-scale classification scheme of ecological land was developed for land management based on combination of the land-use classification and the ecological function zoning in China, including eco-zone, eco-region, eco-district, land ecosystem, and ecological land-use type. The geographical spatial unit leads toward greater homogeneity from macro to micro scale. The term "ecological land-use type" is the smallest one, being important to maintain the key ecological processes in land ecosystem. Ecological land-use type was categorized into main-functional and multi-functional ecological land-use type according to its ecological function attributes and production function attributes. Main-functional type was defined as one kind of land-use type mainly providing ecological goods and function attributes, such as river, lake, swampland, shoaly land, glacier and snow, while multi-functional type not only providing ecological goods and function attributes but also productive goods and function attributes, such as arable land, forestry land, and grassland. Furthermore, a six-level grid encoding mode was proposed for modern management of ecological land and data update under cadastral encoding. The six-level irregular grid encoding from macro to micro scale included eco-zone, eco-region, eco-district, cadastral area, land ecosystem, land ownership type, ecological land-use type, and parcel. Besides, the methodologies on ecosystem management were discussed for integrated management of natural resources in China.

  10. 16 CFR 16.2 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... incidental and inseparable from other (e.g., operational or management) functions, the provisions of this... MANAGEMENT § 16.2 Definitions. For purposes of this part: (a) Administrator means the Administrator of the... operational in nature (e.g., has functions that include making or implementing decisions, as opposed to the...

  11. Application of SNMP on CATV

    NASA Astrophysics Data System (ADS)

    Huang, Hong-bin; Liu, Wei-ping; Chen, Shun-er; Zheng, Liming

    2005-02-01

    A new type of CATV network management system developed by universal MCU, which supports SNMP, is proposed in this paper. From the point of view in both hardware and software, the function and method of every modules inside the system, which include communications in the physical layer, protocol process, data process, and etc, are analyzed. In our design, the management system takes IP MAN as data transmission channel and every controlled object in the management structure has a SNMP agent. In the SNMP agent developed, there are four function modules, including physical layer communication module, protocol process module, internal data process module and MIB management module. In the paper, the structure and function of every module are designed and demonstrated while the related hardware circuit, software flow as well as the experimental results are tested. Furthermore, by introducing RTOS into the software programming, the universal MCU procedure can conducts such multi-thread management as fast Ethernet controller driving, TCP/IP process, serial port signal monitoring and so on, which greatly improves efficiency of CPU.

  12. Sub-Network Access Control Technology Demonstrator: Software Design of the Network Management System

    DTIC Science & Technology

    2002-08-01

    Canadian Operational Fleet. Requirements The proposed network management solution must provide the normal monitoring and configuration mechanisms generally...Joint Warrior Inter- operability Demonstrations (JWID) m and the Communication System Network Inter- Operability (CSNI) Navy Network Trials. In short...management functional area normally includes two main functions: fault isolation and diagnosis, and restoration of the system . In short, an operator

  13. Systems Analysis Directorate Activities Summary August 1977

    DTIC Science & Technology

    1977-09-01

    are: x a. Cataloging direction b. Requirements computation c. Procurement direction d. Distribution management e. Disposal direction f...34inventory management," as a responsibility of NICP’s, includes cataloging, requirements computation, procurement direction, distribution management , maintenance...functions are cataloging, major item management, secondary item management, procurement direction, distribution management , overhaul and rebuild

  14. Human land-use and soil change

    USGS Publications Warehouse

    Wills, Skye A.; Williams, Candiss O.; Duniway, Michael C.; Veenstra, Jessica; Seybold, Cathy; Pressley, DeAnn

    2017-01-01

    Soil change refers to the alteration of soil and soil properties over time in one location, as opposed to soil variability across space. Although soils change with pedogensis, this chapter focuses on human caused soil change. Soil change can occur with human use and management over long or short time periods and small or large scales. While change can be negative or positive; often soil change is observed when short-term or narrow goals overshadow the other soil’s ecosystem services. Many soils have been changed in their chemical, physical or biological properties through agricultural activities, including cultivation, tillage, weeding, terracing, subsoiling, deep plowing, manure and fertilizer addition, liming, draining, and irrigation. Assessing soil change depends upon the ecosystem services and soil functions being evaluated. The interaction of soil properties with the type and intensity of management and disturbance determines the changes that will be observed. Tillage of cropland disrupts aggregates and decreases soil organic carbon content which can lead to decreased infiltration, increased erosion, and reduced biological function. Improved agricultural management systems can increase soil functions including crop productivity and sustainability. Forest management is most intensive during harvesting and seedling establishment. Most active management in forests causes disturbance of the soil surface which may include loss of forest floor organic materials, increases in bulk density, and increased risk of erosion. In grazing lands, pasture management often includes periods of biological, chemical and physical disturbance in addition to the grazing management imposed on rangelands. Grazing animals have both direct and indirect impacts on soil change. Hoof action can lead to the disturbance of biological crusts and other surface features impairing the soil’s physical, biological and hydrological function. There are clear feedbacks between vegetative systems and soil properties; when vegetation is altered because of grazing or other disturbances, soil property changes often follow. Some soils are very sensitive to management and disturbance and can undergo rapid change: cropping led to massive gully formation in the southeastern USA, exposure of acid-sulfate soils led to irreversible changes in soil minerology and thawing of cold soils has created thermokarst features. These soil changes alter soil properties and functions and may impact soil ecosystem services far into the future.

  15. 24 CFR 880.601 - Responsibilities of owner.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.601... units. (b) Management and maintenance. The owner is responsible for all management functions, including... financial interest and to uphold its program responsibilities where no alternative management agent is...

  16. 24 CFR 880.601 - Responsibilities of owner.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.601... units. (b) Management and maintenance. The owner is responsible for all management functions, including... financial interest and to uphold its program responsibilities where no alternative management agent is...

  17. 24 CFR 880.601 - Responsibilities of owner.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.601... units. (b) Management and maintenance. The owner is responsible for all management functions, including... financial interest and to uphold its program responsibilities where no alternative management agent is...

  18. 24 CFR 880.601 - Responsibilities of owner.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.601... units. (b) Management and maintenance. The owner is responsible for all management functions, including... financial interest and to uphold its program responsibilities where no alternative management agent is...

  19. Quality and Usability of Arthritic Pain Self-Management Apps for Older Adults: A Systematic Review.

    PubMed

    Bhattarai, Priyanka; Newton-John, T R O; Phillips, Jane L

    2018-03-01

    To appraise the quality and usability of currently available pain applications that could be used by community-dwelling older adults to self-manage their arthritic pain. A systematic review. Searches were conducted in App Store and Google Play to identify pain self-management apps relevant to arthritic pain management. English language pain management apps providing pain assessment and documentation function and pain management education were considered for inclusion. A quality evaluation audit tool based on the Stanford Arthritis Self-Management Program was developed a priori to evaluate app content quality. The usability of included apps was assessed using an established usability evaluation tool. Out of the 373 apps that were identified, four met the inclusion criteria. The included apps all included a pain assessment and documentation function and instructions on medication use, communication with health professionals, cognitive behavioral therapy-based pain management, and physical exercise. Management of mood, depression, anxiety, and sleep were featured in most apps (N = 3). Three-quarters (N = 3) of the apps fell below the acceptable moderate usability score (≥3), while one app obtained a moderate score (3.2). Few of the currently available pain apps offer a comprehensive pain self-management approach incorporating evidence-based strategies in accordance with the Stanford Arthritis Self-Management Program. The moderate-level usability across the included apps indicates a need to consider the usability needs of the older population in future pain self-management app development endeavors.

  20. 46 CFR 501.5 - Functions of the organizational components of the Federal Maritime Commission.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... and recommends policies for activities designed to promote economy, efficiency, and effectiveness in...(8) of the Shipping Act of 1984 (46 U.S.C. 40102(8)), researches their status, and makes... Commission. The Office's functions include: Conducting IT management studies and surveys; managing data and...

  1. Arthroscopic management of suprascapular neuropathy of the shoulder improves pain and functional outcomes with minimal complication rates.

    PubMed

    Memon, M; Kay, J; Ginsberg, L; Simunovic, N; Bak, K; Lapner, P; Ayeni, O R

    2018-01-01

    The purpose of this study was to systematically assess the arthroscopic management of suprascapular neuropathy, including the aetiology, surgical decision-making, clinical outcomes, and complications associated with the procedure. Three databases [PubMed, Ovid (Medline), and Embase] were searched. Systematic literature screening and data abstraction was performed in duplicate to present a review of studies reporting on arthroscopic management of suprascapular neuropathy. The quality of the included studies was assessed using level of evidence and the MINORS (Methodological Index for Nonrandomized Studies) checklist. In total, 40 studies (17 case reports, 20 case series, 2 retrospective comparative studies, and 1 prospective comparative study) were identified, including 259 patients (261 shoulders) treated arthroscopically for suprascapular neuropathy. The most common aetiology of suprascapular neuropathy was suprascapular nerve compression by a cyst at the spinoglenoid notch (42%), and the decision to pursue arthroscopic surgery was most commonly based on the results of clinical findings and investigations (47%). Overall, 97% of patients reported significant improvement in or complete resolution of their pre-operative symptoms (including pain, strength, and subjective function of the shoulder) over a mean follow-up period of 23.7 months. Further, there was a low overall complication rate (4%) associated with the arthroscopic procedures. While most studies evaluating arthroscopic management of suprascapular neuropathy are uncontrolled studies with lower levels of evidence, results indicate that such management provides patients with significant improvements in pain, strength, and subjective function of the shoulder, and has a low incidence of complications. Patients managed arthroscopically for suprascapular neuropathy may expect significant improvements in pain, strength, and subjective function of the shoulder. Level IV, systematic review of level II to IV studies.

  2. Soil health paradigms and implications for disease management.

    PubMed

    Larkin, Robert P

    2015-01-01

    Soil health has been defined as the capacity of soil to function as a vital living system to sustain biological productivity, maintain environmental quality, and promote plant, animal, and human health. Building and maintaining soil health are essential to agricultural sustainability and ecosystem function. Management practices that promote soil health, including the use of crop rotations, cover crops and green manures, organic amendments, and conservation tillage, also have generally positive effects on the management of soilborne diseases through a number of potential mechanisms, including increasing soil microbial biomass, activity, and diversity, resulting in greater biological suppression of pathogens and diseases. However, there also may be particular disease issues associated with some soil health management practices. In this review, research and progress made over the past twenty years regarding soil health, sustainability, and soil health management practices, with an emphasis on their implications for and effects on plant disease and disease management strategies, are summarized.

  3. Contracting in the National Health Service (NHS): recognizing the need for co-operation.

    PubMed

    Joslyn, E

    1997-05-01

    Within the reorganized National Health Service hierarchical relationships between Health Authorities and Trusts have been replaced by functional differentiation. However, differentiation of function cannot be seen as an end in itself and management of the relationship between purchasers and providers must include managing the differentiation as well as the function. This paper suggests that collaborative and administrative activities have a distinct role to play in health service management. The paper suggests that in health service management market strategies are likely to dominate in relation to resource allocation activities. The paper also argues that administrative strategies are likely to be necessary within the internal market system--to bridge the gap resulting from the differentiation of function.

  4. Functional Land Management: Bridging the Think-Do-Gap using a multi-stakeholder science policy interface.

    PubMed

    O'Sullivan, Lilian; Wall, David; Creamer, Rachel; Bampa, Francesca; Schulte, Rogier P O

    2018-03-01

    Functional Land Management (FLM) is proposed as an integrator for sustainability policies and assesses the functional capacity of the soil and land to deliver primary productivity, water purification and regulation, carbon cycling and storage, habitat for biodiversity and recycling of nutrients. This paper presents the catchment challenge as a method to bridge the gap between science, stakeholders and policy for the effective management of soils to deliver these functions. Two challenges were completed by a wide range of stakeholders focused around a physical catchment model-(1) to design an optimised catchment based on soil function targets, (2) identify gaps to implementation of the proposed design. In challenge 1, a high level of consensus between different stakeholders emerged on soil and management measures to be implemented to achieve soil function targets. Key gaps including knowledge, a mix of market and voluntary incentives and mandatory measures were identified in challenge 2.

  5. SLURM: Simple Linux Utility for Resource Management

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

    Jette, M; Grondona, M

    2002-12-19

    Simple Linux Utility for Resource Management (SLURM) is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for Linux clusters of thousands of nodes. Components include machine status, partition management, job management, scheduling and stream copy modules. This paper presents an overview of the SLURM architecture and functionality.

  6. SLURM: Simplex Linux Utility for Resource Management

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

    Jette, M; Grondona, M

    2003-04-22

    Simple Linux Utility for Resource Management (SLURM) is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for Linux clusters of thousands of nodes. Components include machine status, partition management, job management, scheduling, and stream copy modules. This paper presents an overview of the SLURM architecture and functionality.

  7. Western Juniper Field Guide: Asking the Right Questions to Select Appropriate Management Actions

    USGS Publications Warehouse

    Miller, R.F.; Bates, J.D.; Svejcar, T.J.; Pierson, F.B.; Eddleman, L.E.

    2007-01-01

    Introduction Strong evidence indicates that western juniper has significantly expanded its range since the late 1800s by encroaching into landscapes once dominated by shrubs and herbaceous vegetation (fig. 1). Woodland expansion affects soil resources, plant community structure and composition, water, nutrient and fire cycles, forage production, wildlife habitat, and biodiversity. Goals of juniper management include an attempt to restore ecosystem function and a more balanced plant community that includes shrubs, grasses, and forbs, and to increase ecosystem resilience to disturbances. Developing a management strategy can be a difficult task due to uncertainty about how vegetation, soils, hydrologic function, and wildlife will respond to treatments.

  8. NOAA Workforce Management Office - About Us

    Science.gov Websites

    * WorkLife Center * WebTA * New Employee Info * Separation Info Workforce Management Office (WFMO) Serving accomplishment of the NOAA mission and the Nation's interests. The NOAA Workforce Management Office (WFMO Agency's mission. The WFMO provides NOAA-wide leadership to workforce management functions including

  9. 24 CFR 208.112 - Cost.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .../or software is not cost effective may contract out the electronic data transmission function to organizations that provide such services, including, but not limited to the following organizations: local management agents, local management associations and management agents with centralized facilities. Owners of...

  10. Effects of Neurosurgical Management of Parkinson's Disease on Speech Characteristics and Oromotor Function.

    ERIC Educational Resources Information Center

    Farrell, Anna; Theodoros, Deborah; Ward, Elizabeth; Hall, Bruce; Silburn, Peter

    2005-01-01

    The present study examined the effects of neurosurgical management of Parkinson's disease (PD), including the procedures of pallidotomy, thalamotomy, and deep-brain stimulation (DBS) on perceptual speech characteristics, speech intelligibility, and oromotor function in a group of 22 participants with PD. The surgical participant group was compared…

  11. Regeneration responses in partially-harvested riparian management zones in northern Minnesota

    Treesearch

    Douglas N. Kastendick; Brian J. Palik; Eric K. Zenner; Randy K. Kolka; Charles R. Blinn; Joshua J. Kragthorpe

    2014-01-01

    Trees serve important functions in riparian areas. Guidelines often suggest how riparian forests should be managed to sustain functions, including tree retention and increasing the component of conifers and later-successional species. While regeneration of early successional species is not discouraged, there is uncertainty about the ability to regenerate the latter...

  12. Family Ranching and Farming: A Consensus Management Model to Improve Family Functioning and Decrease Work Stress.

    ERIC Educational Resources Information Center

    Zimmerman, Toni Schindler; Fetsch, Robert J.

    1994-01-01

    Notes that internal and external threats could squeeze ranch and farm families out of business. Offers six-step Consensus Management Model that combines strategic planning with psychoeducation/family therapy. Describes pilot test with intergenerational ranch family that indicated improvements in family functioning, including reduced stress and…

  13. Managing Student Behavior with Class-Wide Function-Related Intervention Teams: An Observational Study in Early Elementary Classrooms

    ERIC Educational Resources Information Center

    Caldarella, Paul; Williams, Leslie; Hansen, Blake D.; Wills, Howard

    2015-01-01

    Comprehensive evidence-based interventions are needed to help early childhood educators manage challenging student behaviors. One such intervention, class-wide function-related intervention teams (CW-FIT), is a multi-tiered behavioral intervention program based on positive behavior support principles, including four main elements: (a) teaching…

  14. Software design specification. Part 2: Orbital Flight Test (OFT) detailed design specification. Volume 3: Applications. Book 2: System management

    NASA Technical Reports Server (NTRS)

    1979-01-01

    The functions performed by the systems management (SM) application software are described along with the design employed to accomplish these functions. The operational sequences (OPS) control segments and the cyclic processes they control are defined. The SM specialist function control (SPEC) segments and the display controlled 'on-demand' processes that are invoked by either an OPS or SPEC control segment as a direct result of an item entry to a display are included. Each processing element in the SM application is described including an input/output table and a structured control flow diagram. The flow through the module and other information pertinent to that process and its interfaces to other processes are included.

  15. Kidney function tests

    MedlinePlus

    Kidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include: ... Oh MS, Briefel G. Evaluation of renal function, water, electrolytes ... and Management by Laboratory Methods . 23rd ed. Philadelphia, ...

  16. Landscape moderation of biodiversity patterns and processes - eight hypotheses.

    PubMed

    Tscharntke, Teja; Tylianakis, Jason M; Rand, Tatyana A; Didham, Raphael K; Fahrig, Lenore; Batáry, Péter; Bengtsson, Janne; Clough, Yann; Crist, Thomas O; Dormann, Carsten F; Ewers, Robert M; Fründ, Jochen; Holt, Robert D; Holzschuh, Andrea; Klein, Alexandra M; Kleijn, David; Kremen, Claire; Landis, Doug A; Laurance, William; Lindenmayer, David; Scherber, Christoph; Sodhi, Navjot; Steffan-Dewenter, Ingolf; Thies, Carsten; van der Putten, Wim H; Westphal, Catrin

    2012-08-01

    Understanding how landscape characteristics affect biodiversity patterns and ecological processes at local and landscape scales is critical for mitigating effects of global environmental change. In this review, we use knowledge gained from human-modified landscapes to suggest eight hypotheses, which we hope will encourage more systematic research on the role of landscape composition and configuration in determining the structure of ecological communities, ecosystem functioning and services. We organize the eight hypotheses under four overarching themes. Section A: 'landscape moderation of biodiversity patterns' includes (1) the landscape species pool hypothesis-the size of the landscape-wide species pool moderates local (alpha) biodiversity, and (2) the dominance of beta diversity hypothesis-landscape-moderated dissimilarity of local communities determines landscape-wide biodiversity and overrides negative local effects of habitat fragmentation on biodiversity. Section B: 'landscape moderation of population dynamics' includes (3) the cross-habitat spillover hypothesis-landscape-moderated spillover of energy, resources and organisms across habitats, including between managed and natural ecosystems, influences landscape-wide community structure and associated processes and (4) the landscape-moderated concentration and dilution hypothesis-spatial and temporal changes in landscape composition can cause transient concentration or dilution of populations with functional consequences. Section C: 'landscape moderation of functional trait selection' includes (5) the landscape-moderated functional trait selection hypothesis-landscape moderation of species trait selection shapes the functional role and trajectory of community assembly, and (6) the landscape-moderated insurance hypothesis-landscape complexity provides spatial and temporal insurance, i.e. high resilience and stability of ecological processes in changing environments. Section D: 'landscape constraints on conservation management' includes (7) the intermediate landscape-complexity hypothesis-landscape-moderated effectiveness of local conservation management is highest in structurally simple, rather than in cleared (i.e. extremely simplified) or in complex landscapes, and (8) the landscape-moderated biodiversity versus ecosystem service management hypothesis-landscape-moderated biodiversity conservation to optimize functional diversity and related ecosystem services will not protect endangered species. Shifting our research focus from local to landscape-moderated effects on biodiversity will be critical to developing solutions for future biodiversity and ecosystem service management. © 2012 The Authors. Biological Reviews © 2012 Cambridge Philosophical Society.

  17. Automated support for experience-based software management

    NASA Technical Reports Server (NTRS)

    Valett, Jon D.

    1992-01-01

    To effectively manage a software development project, the software manager must have access to key information concerning a project's status. This information includes not only data relating to the project of interest, but also, the experience of past development efforts within the environment. This paper describes the concepts and functionality of a software management tool designed to provide this information. This tool, called the Software Management Environment (SME), enables the software manager to compare an ongoing development effort with previous efforts and with models of the 'typical' project within the environment, to predict future project status, to analyze a project's strengths and weaknesses, and to assess the project's quality. In order to provide these functions the tool utilizes a vast corporate memory that includes a data base of software metrics, a set of models and relationships that describe the software development environment, and a set of rules that capture other knowledge and experience of software managers within the environment. Integrating these major concepts into one software management tool, the SME is a model of the type of management tool needed for all software development organizations.

  18. Implementation of Advanced Inventory Management Functionality in Automated Dispensing Cabinets

    PubMed Central

    Webb, Aaron; Lund, Jim

    2015-01-01

    Background: Automated dispensing cabinets (ADCs) are an integral component of distribution models in pharmacy departments across the country. There are significant challenges to optimizing ADC inventory management while minimizing use of labor and capital resources. The role of enhanced inventory control functionality is not fully defined. Objective: The aim of this project is to improve ADC inventory management by leveraging dynamic inventory standards and a low inventory alert platform. Methods: Two interventional groups and 1 historical control were included in the study. Each intervention group consisted of 6 ADCs that tested enhanced inventory management functionality. Interventions included dynamic inventory standards and a low inventory alert messaging system. Following separate implementation of each platform, dynamic inventory and low inventory alert systems were applied concurrently to all 12 ADCs. Outcome measures included number and duration of daily stockouts, ADC inventory turns, and number of phone calls related to stockouts received by pharmacy staff. Results: Low inventory alerts reduced both the number and duration of stockouts. Dynamic inventory standards reduced the number of daily stockouts without changing the inventory turns and duration of stockouts. No change was observed in number of calls related to stockouts made to pharmacy staff. Conclusions: Low inventory alerts and dynamic inventory standards are feasible mechanisms to help optimize ADC inventory management while minimizing labor and capital resources. PMID:26448672

  19. TERSSE: Definition of the Total Earth Resources System for the Shuttle Era. Volume 5: Detailed system requirements: Two case studies

    NASA Technical Reports Server (NTRS)

    1974-01-01

    Major resource management missions to be performed by the TERSSE are examined in order to develop an understanding of the form and function of a system designed to perform an operational mission. Factors discussed include: resource manager (user) functions, methods of performing their function, the information flows and information requirements embodied in their function, and the characteristics of the observation system which assists in the management of the resource involved. The missions selected for study are: world crop survey and land resources management. These missions are found to represent opposite ends of the TERSSE spectrum and to support the conclusion that different missions require different systems and must be analyzed in detail to permit proper system development decisions.

  20. Functional Specifications for Computer Aided Training Systems Development and Management (CATSDM) Support Functions. Final Report.

    ERIC Educational Resources Information Center

    Hughes, John; And Others

    This report provides a description of a Computer Aided Training System Development and Management (CATSDM) environment based on state-of-the-art hardware and software technology, and including recommendations for off the shelf systems to be utilized as a starting point in addressing the particular systematic training and instruction design and…

  1. Materials management information systems.

    PubMed

    1996-01-01

    The hospital materials management function--ensuring that goods and services get from a source to an end user--encompasses many areas of the hospital and can significantly affect hospital costs. Performing this function in a manner that will keep costs down and ensure adequate cash flow requires effective management of a large amount of information from a variety of sources. To effectively coordinate such information, most hospitals have implemented some form of materials management information system (MMIS). These systems can be used to automate or facilitate functions such as purchasing, accounting, inventory management, and patient supply charges. In this study, we evaluated seven MMISs from seven vendors, focusing on the functional capabilities of each system and the quality of the service and support provided by the vendor. This Evaluation is intended to (1) assist hospitals purchasing an MMIS by educating materials managers about the capabilities, benefits, and limitations of MMISs and (2) educate clinical engineers and information system managers about the scope of materials management within a healthcare facility. Because software products cannot be evaluated in the same manner as most devices typically included in Health Devices Evaluations, our standard Evaluation protocol was not applicable for this technology. Instead, we based our ratings on our observations (e.g., during site visits), interviews we conducted with current users of each system, and information provided by the vendor (e.g., in response to a request for information [RFI]). We divided the Evaluation into the following sections: Section 1. Responsibilities and Information Requirements of Materials Management: Provides an overview of typical materials management functions and describes the capabilities, benefits, and limitations of MMISs. Also includes the supplementary article, "Inventory Cost and Reimbursement Issues" and the glossary, "Materials Management Terminology." Section 2. The MMIS Selection Process: Outlines steps to follow and describes factors to consider when selecting an MMIS. Also includes our Materials Management Process Evaluation and Needs Assessment Worksheet (which is also available online through ECRInet(TM)) and a list of suggested interview questions to be used when gathering user experience information for systems under consideration. Section 3A. MMIS Vendor Profiles: Presents information for the evaluated systems in a standardized, easy-to-compare format. Profiles include an Executive Summary describing our findings, a discussion of user comments, a listing of MMIS specifications, and information on the vendor's business background. Section 3B. Discussion of Vendor Profile Conclusions and Ratings: Presents our ratings and summarizes our rationale for all evaluated systems. Also includes a blank Vendor Profile Template to be used when gathering information on other vendors and systems. We found that, in general, all of the evaluated systems are able to meet most of the functional needs of a materials management department. However, we did uncover significant differences in the quality of service and support provided by each vendor, and our ratings reflect these differences: we rated two of the systems Acceptable--Preferred and four of the systems Acceptable. We have not yet rated the seventh system because our user experience information may not reflect the vendor's new ownership and management. When this vendor provides the references we requested, we will interview users and supply a rating. We caution readers against basing purchasing decisions solely on our ratings. Each hospital must consider the unique needs of its users and its overall strategic plans--a process that can be aided by using our Process Evaluation and Needs Assessment Worksheet. Our conclusions can then be used to narrow down the number of vendors under consideration...

  2. 36 CFR 1223.2 - What definitions apply to this part?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ADMINISTRATION RECORDS MANAGEMENT MANAGING VITAL RECORDS § 1223.2 What definitions apply to this part? (a) See... activities. Examples include accounts receivable records, social security records, payroll records... citizens. This is a program element of an agency's emergency management function. ...

  3. 36 CFR 1223.2 - What definitions apply to this part?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... ADMINISTRATION RECORDS MANAGEMENT MANAGING VITAL RECORDS § 1223.2 What definitions apply to this part? (a) See... activities. Examples include accounts receivable records, social security records, payroll records... citizens. This is a program element of an agency's emergency management function. ...

  4. 36 CFR 1223.2 - What definitions apply to this part?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... ADMINISTRATION RECORDS MANAGEMENT MANAGING VITAL RECORDS § 1223.2 What definitions apply to this part? (a) See... activities. Examples include accounts receivable records, social security records, payroll records... citizens. This is a program element of an agency's emergency management function. ...

  5. 47 CFR 0.15 - Functions of the Office.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Manage the FCC's Internet site and oversee the agency's Web standards and guidelines. (e) Maintain... assistance and information including informal consumer complaints. (f) Manage the FCC's audio/visual support...

  6. 47 CFR 0.15 - Functions of the Office.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) Manage the FCC's Internet site and oversee the agency's Web standards and guidelines. (e) Maintain... assistance and information including informal consumer complaints. (f) Manage the FCC's audio/visual support...

  7. 47 CFR 0.15 - Functions of the Office.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Manage the FCC's Internet site and oversee the agency's Web standards and guidelines. (e) Maintain... assistance and information including informal consumer complaints. (f) Manage the FCC's audio/visual support...

  8. 47 CFR 0.15 - Functions of the Office.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Manage the FCC's Internet site and oversee the agency's Web standards and guidelines. (e) Maintain... assistance and information including informal consumer complaints. (f) Manage the FCC's audio/visual support...

  9. Evaluation Methodologies for Information Management Systems; Building Digital Tobacco Industry Document Libraries at the University of California, San Francisco Library/Center for Knowledge Management; Experiments with the IFLA Functional Requirements for Bibliographic Records (FRBR); Coming to Term: Designing the Texas Email Repository Model.

    ERIC Educational Resources Information Center

    Morse, Emile L.; Schmidt, Heidi; Butter, Karen; Rider, Cynthia; Hickey, Thomas B.; O'Neill, Edward T.; Toves, Jenny; Green, Marlan; Soy, Sue; Gunn, Stan; Galloway, Patricia

    2002-01-01

    Includes four articles that discuss evaluation methods for information management systems under the Defense Advanced Research Projects Agency; building digital libraries at the University of California San Francisco's Tobacco Control Archives; IFLA's Functional Requirements for Bibliographic Records; and designing the Texas email repository model…

  10. Disease management, coping, and functional disability in pediatric sickle cell disease.

    PubMed

    Oliver-Carpenter, Gloria; Barach, Ilana; Crosby, Lori E; Valenzuela, Jessica; Mitchell, Monica J

    2011-02-01

    Youth with sickle cell disease (SCD) experience chronic symptoms that significantly interfere with physical, academic, and social-emotional functioning. Thus, to effectively manage SCD, youth and caregivers must work collaboratively to ensure optimal functioning. The goal of the current study was to examine the level of involvement in disease management tasks for youth with SCD and their caregivers. The study also examined the relationship between involvement in disease management tasks, daily functioning, and coping skills. The study utilized collaborative care and disease management theoretical frameworks. Youth and caregivers participated in the study during an annual research and education day event. Forty-seven patients with SCD aged 6 to 18 years and their caregivers completed questionnaires examining level of involvement in disease management tasks, youth functional disability, and youth coping strategies. Caregivers also completed a demographic and medical history form. Parents and youth agreed that parents were significantly more involved in disease management tasks than youth, although level of involvement varied by task. Decreased parent involvement was related to greater coping strategies used by patients, including massage, prayer, and positive thinking. Higher functional disability (lower functioning) was related to greater parent involvement in disease management tasks, suggesting that greater impairment may encourage increased parent involvement. Health professionals working with families of youth with SCD should discuss with parents and youth how disease management tasks and roles will be shared and transferred during adolescence. Parents and youth may also benefit from a discussion of these issues within their own families.

  11. A conceptual persistent healthcare quality improvement process for software development management.

    PubMed

    Lin, Jen-Chiun; Su, Mei-Ju; Cheng, Po-Hsun; Weng, Yung-Chien; Chen, Sao-Jie; Lai, Jin-Shin; Lai, Feipei

    2007-01-01

    This paper illustrates a sustained conceptual service quality improvement process for the management of software development within a healthcare enterprise. Our proposed process is revised from Niland's healthcare quality information system (HQIS). This process includes functions to survey the satisfaction of system functions, describe the operation bylaws on-line, and provide on-demand training. To achieve these goals, we integrate five information systems in National Taiwan University Hospital, including healthcare information systems, health quality information system, requirement management system, executive information system, and digital learning system, to form a full Deming cycle. A preliminary user satisfaction survey showed that our outpatient information system scored an average of 71.31 in 2006.

  12. PREMChlor: Probabilistic Remediation Evaluation Model for Chlorinated Solvents

    DTIC Science & Technology

    2010-03-01

    Council O&M Operation & Management PAT pump-and-treat PCE tetrachloroethylene PDFs Probability density functions PRBs Permeable reactive barriers...includes a one-time capital cost and a total operation & management (O&M) cost in present net value (NPV) for a certain remediation period. The...Generally, the costs of plume treatment include the capital cost (treatment volume multiply by the unit cost) and the annual operation & Management (O&M

  13. Analysis of good practice of public health Emergency Operations Centers.

    PubMed

    Xu, Min; Li, Shi-Xue

    2015-08-01

    To study the public health Emergency Operations Centers (EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Literature review was conducted to explore the EOCs of selected countries. The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management. Copyright © 2015 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.

  14. Design distributed simulation platform for vehicle management system

    NASA Astrophysics Data System (ADS)

    Wen, Zhaodong; Wang, Zhanlin; Qiu, Lihua

    2006-11-01

    Next generation military aircraft requires the airborne management system high performance. General modules, data integration, high speed data bus and so on are needed to share and manage information of the subsystems efficiently. The subsystems include flight control system, propulsion system, hydraulic power system, environmental control system, fuel management system, electrical power system and so on. The unattached or mixed architecture is changed to integrated architecture. That means the whole airborne system is regarded into one system to manage. So the physical devices are distributed but the system information is integrated and shared. The process function of each subsystem are integrated (including general process modules, dynamic reconfiguration), furthermore, the sensors and the signal processing functions are shared. On the other hand, it is a foundation for power shared. Establish a distributed vehicle management system using 1553B bus and distributed processors which can provide a validation platform for the research of airborne system integrated management. This paper establishes the Vehicle Management System (VMS) simulation platform. Discuss the software and hardware configuration and analyze the communication and fault-tolerant method.

  15. X-wing fly-by-wire vehicle management system

    NASA Technical Reports Server (NTRS)

    Fischer, Jr., William C. (Inventor)

    1990-01-01

    A complete, computer based, vehicle management system (VMS) for X-Wing aircraft using digital fly-by-wire technology controlling many subsystems and providing functions beyond the classical aircraft flight control system. The vehicle management system receives input signals from a multiplicity of sensors and provides commands to a large number of actuators controlling many subsystems. The VMS includes--segregating flight critical and mission critical factors and providing a greater level of back-up or redundancy for the former; centralizing the computation of functions utilized by several subsystems (e.g. air data, rotor speed, etc.); integrating the control of the flight control functions, the compressor control, the rotor conversion control, vibration alleviation by higher harmonic control, engine power anticipation and self-test, all in the same flight control computer (FCC) hardware units. The VMS uses equivalent redundancy techniques to attain quadruple equivalency levels; includes alternate modes of operation and recovery means to back-up any functions which fail; and uses back-up control software for software redundancy.

  16. Conservative, minimally invasive and open surgical repair for management of acute ruptures of the Achilles tendon: a clinical and functional retrospective study.

    PubMed

    Maffulli, Gayle; Buono, Angelo Del; Richards, Paula; Oliva, Francesco; Maffulli, Nicola

    2017-01-01

    At present, it is unclear which is the best management for Achilles tendon rupture. We assess the clinical, functional and imaging outcomes of active patients undergoing 3 different types of management for acute subcutaneous rupture of the Achilles tendon, including conservative cast immobilization, traditional open surgery and percutaneous repair. 26 active patients were managed for a rupture of the Achilles Tendon from January 2007 to March 2008. Anthropometric measurements, Functional assessment, Isometric strength, Ultrasonographic assessment, Patient satisfaction, Working life, Physical activity, Functional score and Complications were recorded retrospectively. All 23 (21 men, 2 women) patients were reviewed at a minimum follow-up of 24 months (average 25.7, range 24 to 32 months, SD: 6.3) from the index injury. Thermann scores and patient satisfaction were significantly higher following surgery than conservative management with no significance between open and minimally invasive operated patients. Sensitive disturbances occur in up to 12% of open repairs and 1.8% of patients managed nonsurgically. Clinical and functional outcomes following surgical repair, percutaneous and open, of the Achilles tendon are significantly improved than following conservative management. Level III.

  17. Financial risk management of pharmacy benefits.

    PubMed

    Saikami, D

    1997-10-01

    Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.

  18. 36 CFR § 1223.2 - What definitions apply to this part?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... ADMINISTRATION RECORDS MANAGEMENT MANAGING VITAL RECORDS § 1223.2 What definitions apply to this part? (a) See... activities. Examples include accounts receivable records, social security records, payroll records... citizens. This is a program element of an agency's emergency management function. ...

  19. Introduction to Software Packages. [Final Report.

    ERIC Educational Resources Information Center

    Frankel, Sheila, Ed.; And Others

    This document provides an introduction to applications computer software packages that support functional managers in government and encourages the use of such packages as an alternative to in-house development. A review of current application areas includes budget/project management, financial management/accounting, payroll, personnel,…

  20. Occupational therapy and physiotherapy for the patient with burns: principles and management guidelines.

    PubMed

    Simons, M; King, S; Edgar, D

    2003-01-01

    Clinical practice guidelines are a tool to assist with clinical decision making. They provide information about the care for a condition and make recommendations based on research evidence, which can be adapted locally. A focus group within the Allied Health Interest Group of the Australian and New Zealand Burn Association has compiled the "Occupational Therapy and Physiotherapy for the Patient with Burns--Principles and Management Guidelines." These guidelines are designed as a practical guide to the relevant clinical knowledge and therapy intervention techniques required for effective patient management. Content areas include respiratory management, edema management, splinting and positioning, physical function (mobility, function, exercise), scar management, and psychosocial and mutual elements. The document has undergone extensive review by members of the Australian and New Zealand Burn Association to ensure clarity, internal consistency, and acceptability. The guidelines have been endorsed by the Australian and New Zealand Burn Association. An abridged version of the guidelines is included in this article, with the full document available from www.anzba.org.au.

  1. Food and waste management biotechnology for the space shuttle

    NASA Technical Reports Server (NTRS)

    Murray, R. W.; Schelkopf, J. D.; Hunt, S. R.; Sauer, R. L.

    1979-01-01

    Space-crew facilities for preparation, eating, personal hygiene and waste management are contained in one small area of the Shuttle Orbiter Mid-Deck, all the functional systems being interconnected. The paper discusses three major systems: (1) the Galley, which includes the personal hygiene station and food packages; (2) the Waste Collector, which includes provisions for male and female users, urine, feces and emesis collection in both a normal and contigency mode of operation; and (3) Biowaste Monitoring, which includes mass measurement and sampling. The technology improvement continues by assuring that the Orbiter systems have sufficient design flexibility to permit later improvements in operation and in function.

  2. Update Money Management Units in Terms of New Legislation.

    ERIC Educational Resources Information Center

    Manzer, John P.

    1981-01-01

    Provides basic business teachers with a current analysis of the rapidly changing topic of financial institutions and related functions. Elements discussed include recent financial legislation and students' money management decisions. (CT)

  3. 24 CFR 904.304 - Functions of the HBA.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... other matters pertaining to operation and management of the development; (3) Recommending policies and rules to the LHA for operation and management including rules concerning use of the common areas and... situations; and (10) Performing management services as specified under contract with the Authority or with...

  4. A lightweight sensor network management system design

    USGS Publications Warehouse

    Yuan, F.; Song, W.-Z.; Peterson, N.; Peng, Y.; Wang, L.; Shirazi, B.; LaHusen, R.

    2008-01-01

    In this paper, we propose a lightweight and transparent management framework for TinyOS sensor networks, called L-SNMS, which minimizes the overhead of management functions, including memory usage overhead, network traffic overhead, and integration overhead. We accomplish this by making L-SNMS virtually transparent to other applications hence requiring minimal integration. The proposed L-SNMS framework has been successfully tested on various sensor node platforms, including TelosB, MICAz and IMote2. ?? 2008 IEEE.

  5. Standardized emergency management system and response to a smallpox emergency.

    PubMed

    Kim-Farley, Robert J; Celentano, John T; Gunter, Carol; Jones, Jessica W; Stone, Rogelio A; Aller, Raymond D; Mascola, Laurene; Grigsby, Sharon F; Fielding, Jonathan E

    2003-01-01

    The smallpox virus is a high-priority, Category-A agent that poses a global, terrorism security risk because it: (1) easily can be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential for a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. In recognition of this risk, the Los Angeles County Department of Health Services (LAC-DHS) developed the Smallpox Preparedness, Response, and Recovery Plan for LAC to prepare for the possibility of an outbreak of smallpox. A unique feature of the LAC-DHS plan is its explicit use of the Standardized Emergency Management System (SEMS) framework for detailing the functions needed to respond to a smallpox emergency. The SEMS includes the Incident Command System (ICS) structure (management, operations, planning/intelligence, logistics, and finance/administration), the mutual-aid system, and the multi/interagency coordination required during a smallpox emergency. Management for incident command includes setting objectives and priorities, information (risk communications), safety, and liaison. Operations includes control and containment of a smallpox outbreak including ring vaccination, mass vaccination, adverse events monitoring and assessment, management of confirmed and suspected smallpox cases, contact tracing, active surveillance teams and enhanced hospital-based surveillance, and decontamination. Planning/intelligence functions include developing the incident action plan, epidemiological investigation and analysis of smallpox cases, and epidemiological assessment of the vaccination coverage status of populations at risk. Logistics functions include receiving, handling, inventorying, and distributing smallpox vaccine and vaccination clinic supplies; personnel; transportation; communications; and health care of personnel. Finally, finance/administration functions include monitoring costs related to the smallpox emergency, procurement, and administrative aspects that are not handled by other functional divisions of incident command systems. The plan was developed and is under frequent review by the LAC-DHS Smallpox Planning Working Group, and is reviewed periodically by the LAC Bioterrorism Advisory Committee, and draws upon the Smallpox Response Plan and Guidelines of the Centers for Disease Control and Prevention (CDC) and recommendations of the Advisory Committee on Immunization Practices (ACIP). The Smallpox Preparedness, Response, and Recovery Plan, with its SEMS framework and ICS structure, now is serving as a model for the development of LAC-DHS plans for responses to other terrorist or natural-outbreak responses.

  6. Function Model for Community Health Service Information

    NASA Astrophysics Data System (ADS)

    Yang, Peng; Pan, Feng; Liu, Danhong; Xu, Yongyong

    In order to construct a function model of community health service (CHS) information for development of CHS information management system, Integration Definition for Function Modeling (IDEF0), an IEEE standard which is extended from Structured Analysis and Design(SADT) and now is a widely used function modeling method, was used to classifying its information from top to bottom. The contents of every level of the model were described and coded. Then function model for CHS information, which includes 4 super-classes, 15 classes and 28 sub-classed of business function, 43 business processes and 168 business activities, was established. This model can facilitate information management system development and workflow refinement.

  7. GENASIS Basics: Object-oriented utilitarian functionality for large-scale physics simulations (Version 2)

    NASA Astrophysics Data System (ADS)

    Cardall, Christian Y.; Budiardja, Reuben D.

    2017-05-01

    GenASiS Basics provides Fortran 2003 classes furnishing extensible object-oriented utilitarian functionality for large-scale physics simulations on distributed memory supercomputers. This functionality includes physical units and constants; display to the screen or standard output device; message passing; I/O to disk; and runtime parameter management and usage statistics. This revision -Version 2 of Basics - makes mostly minor additions to functionality and includes some simplifying name changes.

  8. Disease Management, Coping, and Functional Disability in Pediatric Sickle Cell Disease

    PubMed Central

    Oliver-Carpenter, Gloria; Barach, Ilana; Crosby, Lori E.; Valenzuela, Jessica; Mitchell, Monica J.

    2016-01-01

    Background Youth with sickle cell disease (SCD) experience chronic symptoms that significantly interfere with physical, academic, and social-emotional functioning. Thus, to effectively manage SCD, youth and caregivers must work collaboratively to ensure optimal functioning. The goal of the current study was to examine the level of involvement in disease management tasks for youth with SCD and their caregivers. The study also examined the relationship between involvement in disease management tasks, daily functioning, and coping skills. The study utilized collaborative care and disease management theoretical frameworks. Methods Youth and caregivers participated in the study during an annual research and education day event. Forty-seven patients with SCD aged 6 to 18 years and their caregivers completed questionnaires examining level of involvement in disease management tasks, youth functional disability and youth coping strategies. Caregivers also completed a demographic and medical history form. Results Parents and youth agreed that parents are significantly more involved in disease management tasks than youth, although level of involvement varied by task. Decreased parent involvement was related to greater coping strategies used by patients, including massage, prayer, and positive thinking. Higher functional disability (lower functioning) was related to greater parent involvement in disease management tasks, suggesting that greater impairment may encourage increased parent involvement. Conclusions Health professionals working with families of youth with SCD should discuss with parents and youth how disease management tasks and roles will be shared and transferred during adolescence. Parents and youth may also benefit from a discussion of these issues within their own families. PMID:21443065

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

    DOE PAGES

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

    2016-01-01

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

  10. IPG Job Manager v2.0 Design Documentation

    NASA Technical Reports Server (NTRS)

    Hu, Chaumin

    2003-01-01

    This viewgraph presentation provides a high-level design of the IPG Job Manager, and satisfies its Master Requirement Specification v2.0 Revision 1.0, 01/29/2003. The presentation includes a Software Architecture/Functional Overview with the following: Job Model; Job Manager Client/Server Architecture; Job Manager Client (Job Manager Client Class Diagram and Job Manager Client Activity Diagram); Job Manager Server (Job Manager Client Class Diagram and Job Manager Client Activity Diagram); Development Environment; Project Plan; Requirement Traceability.

  11. Phase 111A Crew Interface Specifications Development for Inflight Maintenance and Stowage Functions

    NASA Technical Reports Server (NTRS)

    Carl, John G.

    1973-01-01

    This report presents the findings and data products developed during the Phase IIIA Crew Interface Specification Study for Inflight Maintenance and Stowage Functions, performed by General Electric for the NASA, Johnson Space Center with a set of documentation that can be used as definitive guidelines to improve the present process of defining, controlling and managing flight crew interface requirements that are related to inflight maintenance (including assembly and servicing) and stowage functions. During the Phase IIIA contract period, the following data products were developed: 1) Projected NASA Crew Procedures/Flight Data File Development Process. 2) Inflight Maintenance Management Process Description. 3) Preliminary Draft, General Specification, Inflight Maintenance Management Requirements. 4) Inflight Maintenance Operational Process Description. 5) Preliminary Draft, General Specification, Inflight Maintenance Task and Support Requirements Analysis. 6) Suggested IFM Data Processing Reports for Logistics Management The above Inflight Maintenance data products have been developed during the Phase IIIA study after review of Space Shuttle Program Documentation, including the Level II Integrated Logistics Requirements and other DOD and NASA data relative to Payloads Accommodations and Satellite On-Orbit Servicing. These Inflight Maintenance data products were developed to be in consonance with Space Shuttle Program technical and management requirements.

  12. System and method of self-properties for an autonomous and automatic computer environment

    NASA Technical Reports Server (NTRS)

    Sterritt, Roy (Inventor); Hinchey, Michael G. (Inventor)

    2010-01-01

    Systems, methods and apparatus are provided through which in some embodiments self health/urgency data and environment health/urgency data may be transmitted externally from an autonomic element. Other embodiments may include transmitting the self health/urgency data and environment health/urgency data together on a regular basis similar to the lub-dub of a heartbeat. Yet other embodiments may include a method for managing a system based on the functioning state and operating status of the system, wherein the method may include processing received signals from the system indicative of the functioning state and the operating status to obtain an analysis of the condition of the system, generating one or more stay alive signals based on the functioning status and the operating state of the system, transmitting the stay-alive signal, transmitting self health/urgency data, and transmitting environment health/urgency data. Still other embodiments may include an autonomic element that includes a self monitor, a self adjuster, an environment monitor, and an autonomic manager.

  13. DMS Advanced Applications for Accommodating High Penetrations of DERs and Microgrids

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

    Pratt, Annabelle; Veda, Santosh; Maitra, Arindam

    Efficient and effective management of the electric distribution system requires an integrated approach to allow various systems to work in harmony, including distribution management systems (DMS), distributed energy resources (DERs), distributed energy resources management systems, and microgrids. This study highlights some outcomes from a recent project sponsored by the US Department of Energy, Office of Electricity Delivery and Energy Reliability, including information about (i) the architecture of these integrated systems and (ii) expanded functions of two example DMS applications to accommodate DERs: volt-var optimisation and fault location, isolation, and service restoration. In addition, the relevant DER group functions necessary tomore » support communications between the DMS and a microgrid controller in grid-tied mode are identified.« less

  14. 77 FR 47397 - Statement of Organization, Functions and Delegations of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-08

    ...). Office of Management (RB4) Provides HRSA-wide leadership, program direction, and coordination of all... of HRSA, and the governance and management needs of HRSA leadership; and (10) evaluates employee... both the Office of Operations (RB) and the Office of Management (RB4) to include the human resources...

  15. Competencies Development and Self-Assessment in Maintenance Management E-Training

    ERIC Educational Resources Information Center

    Papathanassiou, Nikos; Pistofidis, Petros; Emmanouilidis, Christos

    2013-01-01

    The maintenance management function requires staff to possess a truly multidisciplinary set of skills. This includes competencies from engineering and information technology to health and safety, management and finance, while also taking into account the normative and legislative issues. This body of knowledge is rarely readily available within a…

  16. JMS: An Open Source Workflow Management System and Web-Based Cluster Front-End for High Performance Computing.

    PubMed

    Brown, David K; Penkler, David L; Musyoka, Thommas M; Bishop, Özlem Tastan

    2015-01-01

    Complex computational pipelines are becoming a staple of modern scientific research. Often these pipelines are resource intensive and require days of computing time. In such cases, it makes sense to run them over high performance computing (HPC) clusters where they can take advantage of the aggregated resources of many powerful computers. In addition to this, researchers often want to integrate their workflows into their own web servers. In these cases, software is needed to manage the submission of jobs from the web interface to the cluster and then return the results once the job has finished executing. We have developed the Job Management System (JMS), a workflow management system and web interface for high performance computing (HPC). JMS provides users with a user-friendly web interface for creating complex workflows with multiple stages. It integrates this workflow functionality with the resource manager, a tool that is used to control and manage batch jobs on HPC clusters. As such, JMS combines workflow management functionality with cluster administration functionality. In addition, JMS provides developer tools including a code editor and the ability to version tools and scripts. JMS can be used by researchers from any field to build and run complex computational pipelines and provides functionality to include these pipelines in external interfaces. JMS is currently being used to house a number of bioinformatics pipelines at the Research Unit in Bioinformatics (RUBi) at Rhodes University. JMS is an open-source project and is freely available at https://github.com/RUBi-ZA/JMS.

  17. JMS: An Open Source Workflow Management System and Web-Based Cluster Front-End for High Performance Computing

    PubMed Central

    Brown, David K.; Penkler, David L.; Musyoka, Thommas M.; Bishop, Özlem Tastan

    2015-01-01

    Complex computational pipelines are becoming a staple of modern scientific research. Often these pipelines are resource intensive and require days of computing time. In such cases, it makes sense to run them over high performance computing (HPC) clusters where they can take advantage of the aggregated resources of many powerful computers. In addition to this, researchers often want to integrate their workflows into their own web servers. In these cases, software is needed to manage the submission of jobs from the web interface to the cluster and then return the results once the job has finished executing. We have developed the Job Management System (JMS), a workflow management system and web interface for high performance computing (HPC). JMS provides users with a user-friendly web interface for creating complex workflows with multiple stages. It integrates this workflow functionality with the resource manager, a tool that is used to control and manage batch jobs on HPC clusters. As such, JMS combines workflow management functionality with cluster administration functionality. In addition, JMS provides developer tools including a code editor and the ability to version tools and scripts. JMS can be used by researchers from any field to build and run complex computational pipelines and provides functionality to include these pipelines in external interfaces. JMS is currently being used to house a number of bioinformatics pipelines at the Research Unit in Bioinformatics (RUBi) at Rhodes University. JMS is an open-source project and is freely available at https://github.com/RUBi-ZA/JMS. PMID:26280450

  18. Family Management Style Framework: a new tool with potential to assess families who have children with brain tumors.

    PubMed

    Deatrick, Janet A; Thibodeaux, Annaka G; Mooney, Kim; Schmus, Cynthia; Pollack, Rosanna; Davey, Barbara Hieb

    2006-01-01

    Qualitative studies of families with children who have cancer or other serious illnesses have found that families often come to view their child and their lives as normal. They manage illness-related demands using family management styles that sustain usual patterns of family and child functioning. Few studies have addressed the family management styles of families who express less satisfaction with family and child functioning or who are identified by health care professionals as having difficulty with family functioning. Such families are likely to be overrepresented among those whose children are being treated for brain tumors that entail extremely burdensome treatments as well as a range of unfavorable prognoses and long-term sequelae. In fact, little is known about how these families manage on a day-to-day basis and how the interdisciplinary team can best provide supportive care to optimize their functioning. The purpose of this article is to present the Family Management Styles Framework as a tool that is useful in both clinical practice and research for assessing families who have children with cancer, including those with brain tumors.

  19. 48 CFR 342.302 - Contract administration functions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... functions. 342.302 Section 342.302 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CONTRACT MANAGEMENT CONTRACT ADMINISTRATION Contract Administration Office Functions 342.302 Contract administration... services), will take place on HHS-owned or controlled properties. The clause shall not be included if...

  20. 48 CFR 342.302 - Contract administration functions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... functions. 342.302 Section 342.302 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CONTRACT MANAGEMENT CONTRACT ADMINISTRATION Contract Administration Office Functions 342.302 Contract administration... services), will take place on HHS-owned or controlled properties. The clause shall not be included if...

  1. 48 CFR 342.302 - Contract administration functions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... functions. 342.302 Section 342.302 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CONTRACT MANAGEMENT CONTRACT ADMINISTRATION Contract Administration Office Functions 342.302 Contract administration... services), will take place on HHS-owned or controlled properties. The clause shall not be included if...

  2. 48 CFR 342.302 - Contract administration functions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... functions. 342.302 Section 342.302 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CONTRACT MANAGEMENT CONTRACT ADMINISTRATION Contract Administration Office Functions 342.302 Contract administration... services), will take place on HHS-owned or controlled properties. The clause shall not be included if...

  3. Variable density management in riparian reserves: lessons learned from an operational study in managed forests of western Oregon, USA.

    Treesearch

    Samuel Chan; Paul Anderson; John Cissel; Larry Lateen; Charley Thompson

    2004-01-01

    A large-scale operational study has been undertaken to investigate variable density management in conjunction with riparian buffers as a means to accelerate development of late-seral habitat, facilitate rare species management, and maintain riparian functions in 40-70 year-old headwater forests in western Oregon, USA. Upland variable retention treatments include...

  4. Studies on combined model based on functional objectives of large scale complex engineering

    NASA Astrophysics Data System (ADS)

    Yuting, Wang; Jingchun, Feng; Jiabao, Sun

    2018-03-01

    As various functions were included in large scale complex engineering, and each function would be conducted with completion of one or more projects, combined projects affecting their functions should be located. Based on the types of project portfolio, the relationship of projects and their functional objectives were analyzed. On that premise, portfolio projects-technics based on their functional objectives were introduced, then we studied and raised the principles of portfolio projects-technics based on the functional objectives of projects. In addition, The processes of combined projects were also constructed. With the help of portfolio projects-technics based on the functional objectives of projects, our research findings laid a good foundation for management of large scale complex engineering portfolio management.

  5. The Ecosystem Approach of Wanatani Semi Arid Equatorial to Sustainable Agriculutral Management (in Amarasi District, Kupang Regency, NTT)

    NASA Astrophysics Data System (ADS)

    Yanti, Rinda; Basukriadi, Adi; Hasroel Thayib, Moh.; Edhie Budhi Soesilo, Tri

    2016-01-01

    The existing condition of the wanatani management in Amarasi District, Kupang Regency, NTT, has not optimized the welfare of the farmers yet, and the land degradation keeps happening. The objectives of this research was to analyze and obtain information on the ecological, social, and economic benefits of sustainable wanatani in dry land management. The research result shows that based on the observation from the ecological function including vegetation, land fertility, micro climate, erotion, and land suitability, wanatani is at present not optimal and not sustainable in supporting productivity and land conservation. From the economic function, the productivity in wanatani should be optimal, but the lack of institutional support and social function causes the agricultural management to be not optimal and not sustainable.

  6. 34 CFR 76.568 - Occupancy and space maintenance costs-restricted rate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... organization-wide service functions (accounting, payroll, personnel) may be included as general management... costs associated with functions that are not organization-wide must be included with other expenditures... advance by the Secretary. (Authority: 20 U.S.C. 1221e-3(a)(1), 2831(a), 2974(b), and 3474) [59 FR 59584...

  7. 33 CFR 155.1035 - Response plan requirements for manned vessels carrying oil as a primary cargo.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... be used to manage the response actions. This structure must include the following functional areas and must further include information for key components within each functional area: (i) Command and... operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The responsibilities of, duties...

  8. 33 CFR 155.1035 - Response plan requirements for manned vessels carrying oil as a primary cargo.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... be used to manage the response actions. This structure must include the following functional areas and must further include information for key components within each functional area: (i) Command and... operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The responsibilities of, duties...

  9. 33 CFR 155.1035 - Response plan requirements for manned vessels carrying oil as a primary cargo.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... be used to manage the response actions. This structure must include the following functional areas and must further include information for key components within each functional area: (i) Command and... operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The responsibilities of, duties...

  10. 33 CFR 155.1035 - Response plan requirements for manned vessels carrying oil as a primary cargo.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... be used to manage the response actions. This structure must include the following functional areas and must further include information for key components within each functional area: (i) Command and... operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The responsibilities of, duties...

  11. An Integrated Hydrologic-Economic Modeling Tool for Evaluating Water Management Responses to Climate Change in the Boise River Basin

    NASA Astrophysics Data System (ADS)

    Schmidt, R. D.; Taylor, R. G.; Stodick, L. D.; Contor, B. A.

    2009-12-01

    A recent federal interagency report on climate change and water management (Brekke et. al., 2009) describes several possible management responses to the impacts of climate change on water supply and demand. Management alternatives include changes to water supply infrastructure, reservoir system operations, and water demand policies. Water users in the Bureau of Reclamation’s Boise Project (located in the Lower Boise River basin in southwestern Idaho) would be among those impacted both hydrologically and economically by climate change. Climate change and management responses to climate change are expected to cause shifts in water supply and demand. Supply shifts would result from changes in basin precipitation patterns, and demand shifts would result from higher evapotranspiration rates and a longer growing season. The impacts would also extend to non-Project water users in the basin, since most non-Project groundwater pumpers and drain water diverters rely on hydrologic externalities created by seepage losses from Boise Project water deliveries. An integrated hydrologic-economic model was developed for the Boise basin to aid Reclamation in evaluating the hydrologic and economic impacts of various management responses to climate change. A spatial, partial-equilibrium, economic optimization model calculates spatially-distinct equilibrium water prices and quantities, and maximizes a social welfare function (the sum of consumer and producers surpluses) for all agricultural and municipal water suppliers and demanders (both Project and non-Project) in the basin. Supply-price functions and demand-price functions are exogenous inputs to the economic optimization model. On the supply side, groundwater and river/reservoir models are used to generate hydrologic responses to various management alternatives. The response data is then used to develop water supply-price functions for Project and non-Project water users. On the demand side, crop production functions incorporating crop distribution, evapotranspiration rates, irrigation efficiencies, and crop prices are used to develop water demand-price functions for agricultural water users. Demand functions for municipal and industrial water users are also developed. Recent applications of the integrated model have focused on the hydrologic and economic impacts of demand management alternatives, including large-scale canal lining conservation measures, and market-based water trading between canal diverters and groundwater pumpers. A supply management alternative being investigated involves revising reservoir rule curves to compensate for climate change impacts on timing of reservoir filling.

  12. Objective Measures of Visual Function in Papilledema

    PubMed Central

    Moss, Heather E.

    2016-01-01

    Synopsis Visual function is an important parameter to consider when managing patients with papilledema. Though the current standard of care uses standard automated perimetry (SAP) to obtain this information, this test is inherently subjective and prone to patient errors. Objective visual function tests including the visual evoked potential, pattern electroretinogram, photopic negative response of the full field electroretinogram, and pupillary light response have the potential to replace or supplement subjective visual function tests in papilledema management. This article reviews the evidence for use of objective visual function tests to assess visual function in papilledema and discusses future investigations needed to develop them as clinically practical and useful measures for this purpose. PMID:28451649

  13. The PCP SYS IV Management System: Educational Overview.

    ERIC Educational Resources Information Center

    Siegel, Martin A.; Davis, Dennis M.

    This paper describes the structure and function of the SYS IV PLATO Curriculum Project's (PCP) computer-based management system and justifies the system design. A consideration of features most critical in the design of management systems provides the context for a discussion of specific SYS IV features, which include its ability to deliver any…

  14. Management Information System for ESD Program Offices.

    DTIC Science & Technology

    1978-03-01

    Management Information System (MIS) functional requirements for the ESD Program Office are defined in terms of the Computer-Aided Design and Specification Tool. The development of the computer data base and a description of the MIS structure is included in the report. This report addresses management areas such as cost/budgeting, scheduling, tracking capabilities, and ECP

  15. 24 CFR 964.18 - HA role in activities under subparts B & C.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., including the management of specific functions of a public housing development that may be mutually agreeable to the HA and the resident council/resident management corporation. (4) A HA shall provide the... participation in management. (5) If requested, a HA should provide a duly recognized resident council office...

  16. SLURM: Simple Linux Utility for Resource Management

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

    Jette, M; Dunlap, C; Garlick, J

    2002-04-24

    Simple Linux Utility for Resource Management (SLURM) is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for Linux clusters of thousands of nodes. Components include machine status, partition management, job management, and scheduling modules. The design also includes a scalable, general-purpose communication infrastructure. Development will take place in four phases: Phase I results in a solid infrastructure; Phase II produces a functional but limited interactive job initiation capability without use of the interconnect/switch; Phase III provides switch support and documentation; Phase IV provides job status, fault-tolerance, and job queuing and control through Livermore's Distributed Productionmore » Control System (DPCS), a meta-batch and resource management system.« less

  17. Hospital-Level Variation in Practice Patterns and Patient Outcomes for Pediatric Patients Hospitalized With Functional Constipation.

    PubMed

    Librizzi, Jamie; Flores, Samuel; Morse, Keith; Kelleher, Kelly; Carter, Jodi; Bode, Ryan

    2017-06-01

    Constipation is a common pediatric condition with a prevalence of 3% to 5% in children aged 4 to 17 years. Currently, there are no evidence-based guidelines for the management of pediatric patients hospitalized with constipation. The primary objective was to evaluate practice patterns and patient outcomes for the hospital management of functional constipation in US children's hospitals. We conducted a multicenter, retrospective cohort study of children aged 0 to 18 years hospitalized for functional constipation from 2012 to 2014 by using the Pediatric Health Information System. Patients were included by using constipation and other related diagnoses as classified by International Classification of Diseases, Ninth Revision . Patients with complex chronic conditions were excluded. Outcome measures included percentage of hospitalizations due to functional constipation, therapies used, length of stay, and 90-day readmission rates. Statistical analysis included means with 95% confidence intervals for individual hospital outcomes. A total of 14 243 hospitalizations were included, representing 12 804 unique patients. The overall percentage of hospitalizations due to functional constipation was 0.65% (range: 0.19%-1.41%, P < .0001). The percentage of patients receiving the following treatment during their hospitalization included: electrolyte laxatives: 40% to 96%; sodium phosphate enema: 0% to 64%; mineral oil enema: 0% to 61%; glycerin suppository: 0% to 37%; bisacodyl 0% to 47%; senna: 0% to 23%; and docusate 0% to 11%. Mean length of stay was 1.97 days (range: 1.31-2.73 days, P < .0001). Mean 90-day readmission rate was 3.78% (range: 0.95%-7.53%, P < .0001). There is significant variation in practice patterns and clinical outcomes for pediatric patients hospitalized with functional constipation across US children's hospitals. Collaborative initiatives to adopt evidence-based best practices guidelines could help standardize the hospital management of pediatric functional constipation. Copyright © 2017 by the American Academy of Pediatrics.

  18. Evaluation of a Dynamic Load Transfer Function Using Grassland Curing Data

    Treesearch

    Patricia L. Andrews; Stuart A.J. Anderson; Wendy R. Anderson

    2006-01-01

    Understanding and calculating fire behaviour in various fuel types is essential for effective fire management, including wildfire suppression and fuels management. Fire spread in grassland fuel is affected by the curing level, the amount of dead fuel expressed as a percentage of the total (live and dead fuel combined). The influence of live fuel is included in various...

  19. Nonnative plant response to silvicultural treatments: A model based on disturbance, propagule pressure, and competitive abilities

    Treesearch

    Steve Sutherland; Cara R. Nelson

    2010-01-01

    Invasion by nonnative plants can result in substantial adverse effects on the functions of native forest ecosystems, including nutrient cycling and fire regimes. Thus, forest managers need to be aware of the potential impacts of management activities, including silvicultural treatments, on nonnative vegetation. To aid in that effort, we created a conceptual model of...

  20. 29 CFR 405.1 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT STANDARDS... part. (b) Corresponding principal officers shall include any person or persons performing or authorized to perform principal executive functions corresponding to those of president and treasurer, of any...

  1. 29 CFR 408.1 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT STANDARDS LABOR ORGANIZATION TRUSTEESHIP REPORTS § 408.1 Definitions. (a) Corresponding principal officers shall include any person or persons performing or authorized to perform principal executive functions corresponding to...

  2. Advanced Inverter Functions and Communication Protocols for Distribution Management

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

    Nagarajan, Adarsh; Palmintier, Bryan; Baggu, Murali

    2016-05-05

    This paper aims at identifying the advanced features required by distribution management systems (DMS) service providers to bring inverter-connected distributed energy resources into use as an intelligent grid resource. This work explores the standard functions needed in the future DMS for enterprise integration of distributed energy resources (DER). The important DMS functionalities such as DER management in aggregate groups, including the discovery of capabilities, status monitoring, and dispatch of real and reactive power are addressed in this paper. It is intended to provide the industry with a point of reference for DER integration with other utility applications and to providemore » guidance to research and standards development organizations.« less

  3. Documentation of Functional Medication Management in Older Adults: A Retrospective Chart Review in Acute Care Hospitalization.

    PubMed

    Bolina, Monika; Jones, C Allyson; Koshman, Sheri; Heintz, Erin; Sadowski, Cheryl A

    2016-12-01

    Functional skills can affect the ability of older adults to appropriately manage their medication regimens. Research evaluating a patient's functional ability or the assessment of medication management is limited. Our objective was to describe the documented components of functional medication management (FMM) in adults aged ≥65 years during an acute hospital stay. The secondary objective was to describe the characteristics of the healthcare providers (HCP) who document FMM. This study was a retrospective chart review of a sample of patients aged ≥65 years admitted to medical units in a tertiary hospital from January 2013 to October 2014. FMM was defined as the steps required to take medications-including ordering, picking up, organizing, preparing, administering, and monitoring medications-and the functional abilities necessary to perform these tasks. The mean (standard deviation [SD]) age of patients was 78.9 (8.4) years; 72 (52 %) were female. Of the 190 charts screened, 140 were eligible for inclusion. The mean (SD) number of documented scheduled oral medications was eight (3.1) per patient, and 108 (77.1 %) charts contained documented FMM-related information. Commonly documented FMM components included whether the patient could administer medications independently (73 [52 %]) or schedule medication (46 [33 %]). These activities were most frequently documented by physicians (124 [39 %]) and occupational therapists (108 [34 %]). FMM assessments for older adult inpatients with multiple comorbidities and complex medication regimens were not documented comprehensively or frequently. Given the complexity of medication regimens and the functional skills required to manage medications at home, failing to document these assessments when evaluating patients in hospital reflects a lost opportunity.

  4. 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.

  5. Asset management to support urban land and subsurface management.

    PubMed

    Maring, Linda; Blauw, Maaike

    2018-02-15

    Pressure on urban areas increases by demographic and climate change. To enable healthy, adaptive and liveable urban areas different strategies are needed. One of the strategies is to make better use of subsurface space and its functions. Asset management of the Subsurface (AMS) contributes to this. Asset management provides transparency of trade-offs between performance, cost and risks throughout the entire lifecycle of these assets. AMS is based on traditional asset management methods, but it does not only take man-made assets in the subsurface into account. AMS also considers the natural functions that the subsurface, including groundwater, has to offer (ecosystem services). A Dutch community of practice consisting of national and municipal authorities, a consultancy-engineering and a research institute are developing AMS in practice in order to 1) enhance the urban underground space planning (using its benefits, avoiding problems) and 2) use, manage and maintain the (urban) subsurface and its functions. The method is currently still under development. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Effects of weight management program on postural stability and neuromuscular function among obese children: study protocol for a randomized controlled trial.

    PubMed

    Sun, Fenghua; Wang, Li-Juan; Wang, Lin

    2015-04-10

    Childhood obesity is one of the most critical public health problems in the world. It is associated with low neuromuscular function and postural deformities. Whether weight loss can improve postural stability and neuromuscular control, benefit daily activities, or prevent injury is unknown. Therefore, this study attempts to investigate the effect of a 6 month weight management program on postural stability and neuromuscular control among obese children. We will conduct a prospective, single-blind, randomized controlled trial with 120 prepubescent obese children. Participants will be randomly assigned to a weight management group or a control group. The weight management group will participate in a dietary and exercise program. The control group will receive health education. After the intervention, participants will be followed for 6 months with no active intervention. The primary and secondary outcomes will be assessed at the baseline, and after 6 months and 12 months. Primary outcome measures will include body weight, body height, body mass index, waist circumference, hip circumference, and body fat percentage. Secondary outcome measures will include three-dimensional functional biomechanics in different tasks, proprioception tests of the knee and ankle, neuromuscular response of the leg muscles, and muscle strength tests of the knee and ankle. Furthermore, adverse events will be recorded and analyzed. An intention-to-treat analysis will be performed if any participants withdraw from the trial. The important features of this trial include the randomization procedures and large sample size. This study attempts to estimate the effect of weight loss intervention on outcomes, including daily life function, postural stability, and neuromuscular control in prepubescent obese children. Therefore, our results can be useful for obese children, medical staff, and healthcare decision makers. Chinese Clinical Trial Registry ChiCTR-IOB-15005874.

  7. Methodology of functionality selection for water management software and examples of its application.

    PubMed

    Vasilyev, K N

    2013-01-01

    When developing new software products and adapting existing software, project leaders have to decide which functionalities to keep, adapt or develop. They have to consider that the cost of making errors during the specification phase is extremely high. In this paper a formalised approach is proposed that considers the main criteria for selecting new software functions. The application of this approach minimises the chances of making errors in selecting the functions to apply. Based on the work on software development and support projects in the area of water resources and flood damage evaluation in economic terms at CH2M HILL (the developers of the flood modelling package ISIS), the author has defined seven criteria for selecting functions to be included in a software product. The approach is based on the evaluation of the relative significance of the functions to be included into the software product. Evaluation is achieved by considering each criterion and the weighting coefficients of each criterion in turn and applying the method of normalisation. This paper includes a description of this new approach and examples of its application in the development of new software products in the are of the water resources management.

  8. Research on the full life cycle management system of smart electric energy meter

    NASA Astrophysics Data System (ADS)

    Chen, Xiangqun; Huang, Rui; Shen, Liman; Guo, Dingying; Xiong, Dezhi; Xiao, Xiangqi; Liu, Mouhai; Renheng, Xu

    2018-02-01

    At present, China’s smart electric energy meter life management is started from the procurement and acceptance. The related monitoring and management of the manufacturing sector has not yet been carried out. This article applies RFID technology and network cloud platform to full life cycle management system of smart electric energy meters, builds this full life cycle management system including design and manufacturing, process control, measurement and calibration testing, storage management, user acceptance, site operation, maintenance scrap and other aspects. Exploring smart electric energy meters on-line and off-line communication by the application of active RFID communication functions, and the actual functional application such as local data exchange and instrument calibration. This system provides technical supports on power demand side management and the improvement of smart electric energy meter reliability evaluation system.

  9. Influence of personality and neuropsychological ability on social functioning and self-management in bipolar disorder.

    PubMed

    Vierck, Esther; Joyce, Peter R

    2015-10-30

    A majority of bipolar patients (BD) show functional difficulties even in remission. In recent years cognitive functions and personality characteristics have been associated with occupational and psychosocial outcomes, but findings are not consistent. We assessed personality and cognitive functioning through a range of tests in BD and control participants. Three cognitive domains-verbal memory, facial-executive, and spatial memory-were extracted by principal component analysis. These factors and selected personality dimensions were included in hierarchical regression analysis to predict psychosocial functioning and the use of self-management strategies while controlling for mood status. The best determinants of good psychosocial functioning were good verbal memory and high self-directedness. The use of self-management techniques was associated with a low level of harm-avoidance. Our findings indicate that strategies to improve memory and self-directedness may be useful for increasing functioning in individuals with bipolar disorder. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. 32 CFR 199.15 - Quality and utilization review peer review organization program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Director, OCHAMPUS. These contractors may include contractors that have exclusive functions in the area of utilization and quality review, fiscal intermediary contractors (which perform these functions along with a... functions concerning management of the delivery and financing of health care services under CHAMPUS...

  11. Identifying factors related to family management during the coping process of families with childhood chronic conditions: a multi-site study.

    PubMed

    Zhang, Ying; Wei, Min; Shen, Nanping; Zhang, Yaqing

    2015-01-01

    This study was designed to determine the key predictors for each aspect of family management of families with children who have chronic conditions in China. The participants included 399 caregivers whose children have chronic illnesses. We used the following instruments: Child Behavior Checklist; Feetham Family Functioning Survey; and Family Management Measures. The final modes of the hierarchical regression explained 29-48% of the variance in aspects of family management. More family support should be provided for those with low family income, children with renal and genetic disorders and rheumatic diseases and those living in rural areas. Child and family functioning affects family management. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Integrated billing and accounts receivable management system needed to maximize payments and cope with managed care.

    PubMed

    Sanders, J; Wold, D; Sullivan, T

    1999-01-01

    The billing and accounts receivable management process in medical practices today has evolved into a multidisciplinary function. This function requires efficient, coordinated performance by physicians and all staff members, from the point of initial patient contact through aggressive follow-up on delinquent payments for services rendered. Offices with deficient or nonexistent billing and accounts receivable management systems typically experience collection ratios that are less than industry norms. They also experience poor cash flow and unnecessary overhead costs. To avoid costly inefficiencies and ensure that it maximizes payments from third-party payors and patients, a medical practice must have an integrated billing and accounts receivable management system that includes components outlined in this article.

  13. 47 CFR 0.61 - Functions of the Bureau.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... those relating to rates, technical standards, customer service, ownership, competition to cable systems... federal-state/local regulatory relationships. This includes: acting, after Commission assumption of... security, emergency management, disaster management, and related issues. [67 FR 13217, Mar. 21, 2002, as...

  14. Safety and Mission Assurance (SMA) Automated Task Order Management System (ATOMS) Operation Manual

    NASA Technical Reports Server (NTRS)

    Wallace, Shawn; Fikes, Lou A.

    2016-01-01

    This document describes operational aspects of the ATOMS system. The information provided is limited to the functionality provided by ATOMS and does not include information provided in the contractor's proprietary financial and task management system.

  15. 7 CFR 1709.117 - Application requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and the eligible extremely high energy cost communities to be served. (6) Project management. The... perform project management functions. If the applicant proposes to use the equipment or design.... Each application must include a narrative proposal describing the proposed project and addressing...

  16. 7 CFR 1709.117 - Application requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... and the eligible extremely high energy cost communities to be served. (6) Project management. The... perform project management functions. If the applicant proposes to use the equipment or design.... Each application must include a narrative proposal describing the proposed project and addressing...

  17. 47 CFR 0.61 - Functions of the Bureau.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... those relating to rates, technical standards, customer service, ownership, competition to cable systems... federal-state/local regulatory relationships. This includes: acting, after Commission assumption of... security, emergency management, disaster management, and related issues. [67 FR 13217, Mar. 21, 2002, as...

  18. 47 CFR 0.61 - Functions of the Bureau.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... those relating to rates, technical standards, customer service, ownership, competition to cable systems... federal-state/local regulatory relationships. This includes: acting, after Commission assumption of... security, emergency management, disaster management, and related issues. [67 FR 13217, Mar. 21, 2002, as...

  19. 47 CFR 0.61 - Functions of the Bureau.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... those relating to rates, technical standards, customer service, ownership, competition to cable systems... federal-state/local regulatory relationships. This includes: acting, after Commission assumption of... security, emergency management, disaster management, and related issues. [67 FR 13217, Mar. 21, 2002, as...

  20. 47 CFR 0.61 - Functions of the Bureau.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... those relating to rates, technical standards, customer service, ownership, competition to cable systems... federal-state/local regulatory relationships. This includes: acting, after Commission assumption of... security, emergency management, disaster management, and related issues. [67 FR 13217, Mar. 21, 2002, as...

  1. Development of a front end controller/heap manager for PHENIX

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

    Ericson, M.N.; Allen, M.D.; Musrock, M.S.

    1996-12-31

    A controller/heap manager has been designed for applicability to all detector subsystem types of PHENIX. the heap manager performs all functions associated with front end electronics control including ADC and analog memory control, data collection, command interpretation and execution, and data packet forming and communication. Interfaces to the unit consist of a timing and control bus, a serial bus, a parallel data bus, and a trigger interface. The topology developed is modular so that many functional blocks are identical for a number of subsystem types. Programmability is maximized through the use of flexible modular functions and implementation using field programmablemore » gate arrays (FPGAs). Details of unit design and functionality will be discussed with particular detail given to subsystems having analog memory-based front end electronics. In addition, mode control, serial functions, and FPGA implementation details will be presented.« less

  2. A comparison of strength-training, self-management and the combination for early osteoarthritis of the knee

    PubMed Central

    McKnight, Patrick E.; Kasle, Shelley; Going, Scott; Villaneuva, Isidro; Cornett, Michelle; Farr, Josh; Wright, Jill; Streeter, Clara; Zautra, Alex

    2010-01-01

    Objective To assess the relative effectiveness of combining self-management and strength-training for improving functional outcomes in early knee osteoarthritis patients. Methods A randomized intervention trial lasting 24 months conducted at an academic medical center. Community dwelling middle-aged adults (N=273), aged 34 to 65 with knee osteoarthritis, pain and self-reported physical disability completed a strength-training program, a self-management program, or a combined program. Outcomes included five physical function tests (leg press, range of motion, work capacity, balance, and stair climbing) and two self-reported measures of pain and disability. Results A total of 201 (73.6 %) participants completed the 2-year trial. Overall compliance was modest - strength-training (55.8 %), self-management (69.1 %), and combined (59.6 %) programs. The three groups showed a significant and large increase from pre- to post-treatment in all physical functioning measures including leg press (d =.85), range of motion (d=1.00), work capacity (d=.60), balance (d=.59), and stair climbing (d=.59). Additionally, all three groups showed decreased self-reported pain (d=-.51) and disability (d=-.55). There were no significant differences among groups. Conclusions Middle-aged, sedentary persons with mild early knee osteoarthritis benefited from strength-training, self-management, and the combination. These results suggest that both strength-training and self-management are suitable treatments for early onset of knee osteoarthritis in middle-aged adults. Self-management alone may offer the least burdensome treatment for early osteoarthritis. PMID:20191490

  3. Information management system: A summary discussion. [for use in the space shuttle sortie, modular space station and TDR satellite

    NASA Technical Reports Server (NTRS)

    Sayers, R. S.

    1972-01-01

    An information management system is proposed for use in the space shuttle sortie, the modular space station, the tracking data relay satellite and associated ground support systems. Several different information management functions, including data acquisition, transfer, storage, processing, control and display are integrated in the system.

  4. Environmental Control and Life Support System

    NASA Technical Reports Server (NTRS)

    Ray, Charles; Adams, Alan

    1990-01-01

    Viewgraphs on the Environmental Control and Life Support System (ECLSS) for the space station are presented. The ECLSS is divided into six subsystems: temperature and humidity control (THC), atmosphere control and supply (ACS), atmosphere revitalization (AR), fire detection and suppression (FDS), water recovery management (WRM), and waste management (WM). Topics covered include: ECLSS subsystem functions; ECLSS distributed system; ECLSS functional distribution; CO2 removal; CO2 reduction; oxygen generation; urine processor; and potable water recovery.

  5. Leadership and Its Functions in Further and Higher Education. Mendip Papers.

    ERIC Educational Resources Information Center

    Marsh, D. T.

    This paper examines the nature and function of leadership in the management of postsecondary educational institutions. It explains the need for studying educational leadership and reviews various theories on the nature of leadership. These include the trait, situational, social influence, functional (or action-centered), contingency, contextual,…

  6. REGIONAL PRIORITIZATIONS OF BIODIVERSITY AND SEDIMENT RETENTION FUNCTIONS: FINDINGS AND MANAGEMENT RELEVANCE

    EPA Science Inventory

    The synoptic approach is a landscape-level assessment tool for geographic prioritization of wetland protection and restoration efforts. Prioritization becomes necessary when effort ? including time and money ? is limited, forcing managers to select a subset of locations. The ap...

  7. Rhetorical Tension in the Bureaucratic University

    ERIC Educational Resources Information Center

    Cunningham, Joseph

    2017-01-01

    The managed university functions as the prominent organizational paradigm in higher education. Returning to Max Weber's original analysis of bureaucracy, several fundamental characteristics of the managed university come to surface, including the emphasis on specialization, hierarchy, and secrecy. Among these characteristics is the importance of…

  8. Channel Access in Erlang

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

    Nicklaus, Dennis J.

    2013-10-13

    We have developed an Erlang language implementation of the Channel Access protocol. Included are low-level functions for encoding and decoding Channel Access protocol network packets as well as higher level functions for monitoring or setting EPICS process variables. This provides access to EPICS process variables for the Fermilab Acnet control system via our Erlang-based front-end architecture without having to interface to C/C++ programs and libraries. Erlang is a functional programming language originally developed for real-time telecommunications applications. Its network programming features and list management functions make it particularly well-suited for the task of managing multiple Channel Access circuits and PVmore » monitors.« less

  9. Integrating Personalized and Community Services for Mobile Travel Planning and Management

    NASA Astrophysics Data System (ADS)

    Yu, Chien-Chih

    Personalized and community services have been noted as keys to enhance and facilitate e-tourism as well as mobile applications. This paper aims at proposing an integrated service framework for combining personalized and community functions to support mobile travel planning and management. Major mobile tourism related planning and decision support functions specified include personalized profile management, information search and notification, evaluation and recommendation, do-it-yourself planning and design, community and collaboration management, auction and negotiation, transaction and payment, as well as trip tracking and quality control. A system implementation process with an example prototype is also presented for illustrating the feasibility and effectiveness of the proposed system framework, process model, and development methodology.

  10. Chest Wall Trauma.

    PubMed

    Majercik, Sarah; Pieracci, Fredric M

    2017-05-01

    Chest wall trauma is common, and contributes significantly to morbidity and mortality of trauma patients. Early identification of major chest wall and concomitant intrathoracic injuries is critical. Generalized management of multiple rib fractures and flail chest consists of adequate pain control (including locoregional modalities); management of pulmonary dysfunction by invasive and noninvasive means; and, in some cases, surgical fixation. Multiple studies have shown that patients with flail chest have substantial benefit (decreased ventilator and intensive care unit days, improved pulmonary function, and improved long-term functional outcome) when they undergo surgery compared with nonoperative management. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Medical Writing Competency Model - Section 1: Functions, Tasks, and Activities.

    PubMed

    Clemow, David B; Wagner, Bertil; Marshallsay, Christopher; Benau, Dan; L'Heureux, Darryl; Brown, David H; Dasgupta, Devjani Ghosh; Girten, Eileen; Hubbard, Frank; Gawrylewski, Helle-Mai; Ebina, Hiroko; Stoltenborg, Janet; York, J P; Green, Kim; Wood, Linda Fossati; Toth, Lisa; Mihm, Michael; Katz, Nancy R; Vasconcelos, Nina-Maria; Sakiyama, Norihisa; Whitsell, Robin; Gopalakrishnan, Shobha; Bairnsfather, Susan; Wanderer, Tatyana; Schindler, Thomas M; Mikyas, Yeshi; Aoyama, Yumiko

    2018-01-01

    This article provides Section 1 of the 2017 Edition 2 Medical Writing Competency Model that describes the core work functions and associated tasks and activities related to professional medical writing within the life sciences industry. The functions in the Model are scientific communication strategy; document preparation, development, and finalization; document project management; document template, standard, format, and style development and maintenance; outsourcing, alliance partner, and client management; knowledge, skill, ability, and behavior development and sharing; and process improvement. The full Model also includes Section 2, which covers the knowledge, skills, abilities, and behaviors needed for medical writers to be effective in their roles; Section 2 is presented in a companion article. Regulatory, publication, and other scientific writing as well as management of writing activities are covered. The Model was developed to aid medical writers and managers within the life sciences industry regarding medical writing hiring, training, expectation and goal setting, performance evaluation, career development, retention, and role value sharing to cross-functional partners.

  12. Managing Water-Food-Energy Futures in the Canadian Prairies

    NASA Astrophysics Data System (ADS)

    Wheater, H. S.; Hassanzadeh, E.; Nazemi, A.; Elshorbagy, A. A.

    2016-12-01

    The water-food-energy nexus is a convenient phrase to highlight competing societal uses for water and the need for cross-sectoral policy integration, but this can lead to oversimplification of the multiple dimensions of water (and energy) management. In practice, water managers must balance (and prioritize) demands for water for many uses, including environmental flows, and reservoir operation often involves managing conflicting demands, for example to maximize retention for supply, reduce storage to facilitate flood control, and constrain water levels and releases for habitat protection. Agriculture and water quality are also inextricably linked: irrigated agriculture requires appropriate water quality for product quality and certification, but agriculture can be a major source of nutrient pollution, with impacts on human and ecosystem health, drinking water treatment and amenity. And energy-water interactions include energy production (hydropower and cooling water for thermal power generation) and energy consumption (e.g. for pumping and water and wastewater treatment). These dependencies are illustrated for the Canadian prairies, and a risk-based approach to the management of climate change is presented. Trade-offs between economic benefits of hydropower and irrigation are illustrated for alternative climate futures, including implications for freshwater habitats. The results illustrate that inter-sector interactions vary as a function of climate and its variability, and that there is a need for policy to manage inter-sector allocations as a function of economic risk.

  13. 12 CFR 26.2 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... exclusively to the business of retail merchandising or manufacturing; (ii) A person whose management functions... Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY MANAGEMENT OFFICIAL INTERLOCKS § 26.2... section 202, shares held by an individual include shares held by members of his or her immediate family...

  14. A Database Management System for Interlibrary Loan.

    ERIC Educational Resources Information Center

    Chang, Amy

    1990-01-01

    Discusses the increasing complexity of dealing with interlibrary loan requests and describes a database management system for interlibrary loans used at Texas Tech University. System functions are described, including file control, records maintenance, and report generation, and the impact on staff productivity is discussed. (CLB)

  15. Concept for a Satellite-Based Advanced Air Traffic Management System : Volume 4. Operational Description and Qualitative Assessment.

    DOT National Transportation Integrated Search

    1974-02-01

    The volume presents a description of how the Satellite-Based Advanced Air Traffic Management System (SAATMS) operates and a qualitative assessment of the system. The operational description includes the services, functions, and tasks performed by the...

  16. Perspective on Physical Therapist Management of Functional Constipation.

    PubMed

    George, Susan E; Borello-France, Diane F

    2017-04-01

    Functional constipation is a common bowel disorder leading to activity restrictions and reduced health-related quality of life. Typically, this condition is initially managed with prescription of laxatives or fiber supplementation, or both. However, these interventions are often ineffective and fail to address the underlying pathophysiology and impairments contributing to this condition. Physical therapists possess the knowledge and skills to diagnose and manage a wide range of musculoskeletal and motor coordination impairments that may contribute to functional constipation. Relevant anatomic, physiologic, and behavioral contributors to functional constipation are discussed with regard to specific constipation diagnoses. A framework for physical therapist examination of impairments that can affect gastrointestinal function, including postural, respiratory, musculoskeletal, neuromuscular, and behavioral impairments, is offered. Within the context of diagnosis-specific patient cases, multifaceted interventions are described as they relate to impairments underlying functional constipation type. The current state of evidence to support these interventions and patient recommendations is summarized. This perspective article aims not only to heighten physical therapists' awareness and management of this condition, but also to stimulate clinical questioning that will open avenues for future research to improve patient care. © 2016 American Physical Therapy Association.

  17. Service Contract Compliance Management in Business Process Management

    NASA Astrophysics Data System (ADS)

    El Kharbili, Marwane; Pulvermueller, Elke

    Compliance management is a critical concern for corporations, required to respect contracts. This concern is particularly relevant in the context of business process management (BPM) as this paradigm is getting adopted more widely for-designing and building IT systems. Enforcing contractual compliance needs to be modeled at different levels of a BPM framework, which also includes the service layer. In this paper, we discuss requirements and methods for modeling contractual compliance for an SOA-supported BPM. We also show how business rule management integrated into an industry BPM tool allows modeling and processing functional and non-functional-property constraints which may be extracted from business process contracts. This work proposes a framework that responds to the requirements identified and proposes an architecture implementing it. Our approach is also illustrated by an example.

  18. Space Station overall management approach for operations

    NASA Technical Reports Server (NTRS)

    Paules, G.

    1986-01-01

    An Operations Management Concept developed by NASA for its Space Station Program is discussed. The operational goals, themes, and design principles established during program development are summarized. The major operations functions are described, including: space systems operations, user support operations, prelaunch/postlanding operations, logistics support operations, market research, and cost/financial management. Strategic, tactical, and execution levels of operational decision-making are defined.

  19. Assessing the efficacy of the SWAT auto-irrigation function to simulate Irrigation, evapotranspiration and crop response to irrigation management strategies of the Texas High Plains

    USDA-ARS?s Scientific Manuscript database

    The Soil and Water Assessment Tool (SWAT) model is widely used for simulation of hydrologic processes at various temporal and spatial scales. Less common are long-term simulation analyses of water balance components including agricultural management practices such as irrigation management. In the se...

  20. Discovery management workshop

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Two dozen participants assembled under the direction of the NASA Solar System Exploration Division (SEED) April 13-15, 1993. Participants supported the goals of cheaper and faster solar system exploration. The workshop concluded that the Discovery Program concept and goals are viable. Management concerns are articulated in the final report. Appendix A includes lists of participants in alphabetical order, by functional area, and by organization type. Appendix B includes the agenda for the meeting.

  1. Harvesting influences functional identity and diversity over time in forests of the northeastern U.S.A.

    Treesearch

    M.T. Curzon; A.W. D' Amato; S. Fraver; B.J. Palik; A. Bottero; J.R. Foster; K.E. Gleason

    2017-01-01

    Concern over global environmental change and associated uncertainty has given rise to greater emphasis on fostering resilience through forest management. We examined the impact of standard silvicultural systems (including clearcutting, shelterwood, and selection) compared with unharvested controls on tree functional identity and functional diversity in three forest...

  2. 75 FR 22416 - Statement of Organization, Functions, and Delegations of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-28

    ... Document Management System; (13) develops and distributes leadership reports, including the Secretary's 90... principal advisor to the Director, CDC, on internal and external affairs of CDC; (2) convenes key leadership for assessment, management, mitigation options, and resolution of issues and initiatives affecting CDC...

  3. 75 FR 81280 - Office of Head Start; Statement of Organization, Functions, and Delegations of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... Head Start). OHS develops legislative and budgetary proposals; identifies areas for research... systems, and electronic mail requests; (c) providing management and administrative services and advice, by... support through: (a) The oversight of information resources management (IRM) systems, including the Early...

  4. WATERSHED HEALTH ASSESSMENT TOOLS-INVESTIGATING FISHERIES (WHAT-IF): A MODELING TOOLKIT FOR WATERSHED AND FISHERIES MANAGEMENT

    EPA Science Inventory

    The Watershed Health Assessment Tools-Investigating Fisheries (WHAT-IF) is a decision-analysis modeling toolkit for personal computers that supports watershed and fisheries management. The WHAT-IF toolkit includes a relational database, help-system functions and documentation, a...

  5. Maximizing the Independence of Deaf-Blind Teenagers.

    ERIC Educational Resources Information Center

    Venn, J. J.; Wadler, F.

    1990-01-01

    The Independent Living Project for Deaf/Blind Youth emphasized the teaching of home management, personal management, social/emotional skills, work skills, and communication skills to increase low-functioning teenagers' autonomy. The project included an independent living apartment in which a video monitoring system was used for indirect…

  6. Choosing the Right Database Management Program.

    ERIC Educational Resources Information Center

    Vockell, Edward L.; Kopenec, Donald

    1989-01-01

    Provides a comparison of four database management programs commonly used in schools: AppleWorks, the DOS 3.3 and ProDOS versions of PFS, and MECC's Data Handler. Topics discussed include information storage, spelling checkers, editing functions, search strategies, graphs, printout formats, library applications, and HyperCard. (LRW)

  7. Anatomy, diagnosis and management of disorders of the tongue.

    PubMed

    Lobprise, H B; Wiggs, R B

    1993-03-01

    The tongue is an integral and functional part of the oral cavity. This article reviews and describes various disorders of the tongue. A comprehensive description of diagnosis and management of tongue problems is included. A review of the anatomy related to the tongue is described.

  8. Should School Administrators Be Leaders or Managers?

    ERIC Educational Resources Information Center

    Burke, W. Warner

    Research in leadership relevant to school administrators is reviewed and summarized here. The author maintains that most previous authors identified two primary leader functions, concerns, types, or dimensions. These authors include Wortman, who, following in the footsteps of Zaleznick, saw a dichotomy between leaders and managers; Burns, who…

  9. 24 CFR 904.304 - Functions of the HBA.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... their relationships with the LHA and others in regard to financial matters such as monthly payments... other matters pertaining to operation and management of the development; (3) Recommending policies and rules to the LHA for operation and management including rules concerning use of the common areas and...

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

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

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

  11. [Crisis management in pediatric anesthesia].

    PubMed

    Takeuchi, Mamoru; Otsuka, Yoji; Taga, Naoyuki; Sato, Yuki; Iwai, Hidetaka; Okada, Osamu

    2009-05-01

    We describe the risk management of pediatric anesthesia. The most important risk management of pediatric anesthesia is airway and temperature management. Neonates and infants easily become hypoxic due to their insufficient functional residual capacity. Therefore airway management is most important not only during induction of anesthesia but also during maintenance of anesthesia and extubation. The management of patients' temperature, including control of room temperature should be taken into consideration. In addition, careful attention should be paid not to introduce air bubbles in any lines, especially in patients with congenital heart diseases.

  12. Creep life management system for a turbine engine and method of operating the same

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

    Tralshawala, Nilesh; Miller, Harold Edward; Badami, Vivek Venugopal

    A creep life management system includes at least one sensor apparatus coupled to a first component. The at least one sensor apparatus is configured with a unique identifier. The creep life management system also includes at least one reader unit coupled to a second component. The at least one reader unit is configured to transmit an interrogation request signal to the at least one sensor apparatus and receive a measurement response signal transmitted from the at least one sensor apparatus. The creep life management system further includes at least one processor programmed to determine a real-time creep profile of themore » first component as a function of the measurement response signal transmitted from the at least one sensor apparatus.« less

  13. Perspectives on Self-Management in Multiple Sclerosis

    PubMed Central

    Knaster, Elizabeth S.; Johnson, Kurt; McMullen, Kara A.; Ehde, Dawn M.

    2011-01-01

    The aim of this study was to elucidate the experience of self-management among people with multiple sclerosis (MS) and gather their input to inform a self-management intervention. Twelve people with MS participated in focus groups in which they were asked open-ended questions about MS symptoms, challenges, overcoming challenges, symptom management, and treatment preferences. The results suggest four major themes: 1) “The Everyday Experience of MS,” including comments about symptoms and their impact on functioning; 2) “Motivation for Self-Management,” including descriptions of motivation originating from physical necessity, success with other management techniques, and external sources; 3) “Coping Strategies and Skills,” including descriptions of changing behaviors, expanding social support networks, finding resources, utilizing medical treatment, and monitoring symptoms; and 4) “Vision for a Self-Management Intervention,” including suggestions that an intervention be individualized, be motivating, and provide resources. The results of this study can inform the design and implementation of self-management interventions. Experiences described by participants are consistent with other qualitative reports suggesting the active role people with MS play in managing their condition. Intervention approaches must consider the complex constellation of symptoms associated with MS and provide individualized treatments that enhance the person's ability to manage their symptoms, barriers presented by such symptoms, and their health care. PMID:24453718

  14. 47 CFR 0.101 - Functions of the office.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., and assist the Commission, including all of its component Bureau/Office managers, supervisors, and... 47 Telecommunication 1 2012-10-01 2012-10-01 false Functions of the office. 0.101 Section 0.101 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Organization Office of...

  15. 47 CFR 0.101 - Functions of the office.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., and assist the Commission, including all of its component Bureau/Office managers, supervisors, and... 47 Telecommunication 1 2011-10-01 2011-10-01 false Functions of the office. 0.101 Section 0.101 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Organization Office of...

  16. 47 CFR 0.101 - Functions of the office.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., and assist the Commission, including all of its component Bureau/Office managers, supervisors, and... 47 Telecommunication 1 2013-10-01 2013-10-01 false Functions of the office. 0.101 Section 0.101 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Organization Office of...

  17. 47 CFR 0.101 - Functions of the office.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., and assist the Commission, including all of its component Bureau/Office managers, supervisors, and... 47 Telecommunication 1 2014-10-01 2014-10-01 false Functions of the office. 0.101 Section 0.101 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Organization Office of...

  18. Factors Affecting Tocopherol Concentrations in Soybean Seeds.

    PubMed

    Carrera, Constanza S; Seguin, Philippe

    2016-12-21

    Soybean seeds contain several health-beneficial compounds, including tocopherols, which are used by the nutraceutical and functional food industries. Soybean tocopherol concentrations are, however, highly variable. Large differences observed in tocopherol concentrations among soybean genotypes together with the relatively simple biosynthetic pathway involving few genes support the feasibility of selecting for high-tocopherol soybean. Tocopherol concentrations are also highly influenced by environmental factors and field management. Temperature during seed filling and soil moisture appear to be the main factors affecting tocopherol concentrations; other factors such as soil fertility and solar radiation also affect concentrations and composition. Field management decisions including seeding date, row spacing, irrigation, and fertilization also affect tocopherols. Knowledge of factors affecting soybean tocopherols is essential to develop management strategies that will lead to the production of seeds with consistent target concentrations that will meet the needs of the nutraceutical and functional food industries.

  19. The role of health information technology in advancing care management and coordination in accountable care organizations.

    PubMed

    Wu, Frances M; Shortell, Stephen M; Rundall, Thomas G; Bloom, Joan R

    To be successful, accountable care organizations (ACOs) must effectively manage patient care. Health information technology (HIT) can support care delivery by providing various degrees of coordination. Few studies have examined the role of HIT functionalities or the role of different levels of coordination enabled by HIT on care management processes. We examine HIT functionalities in ACOs, categorized by the level of coordination they enable in terms of information and work flow, to determine which specific HIT functionalities and levels of coordination are most strongly associated with care management processes. Retrospective cross-sectional analysis was done using 2012 data from the National Survey of Accountable Care Organizations. HIT functionalities are categorized into coordination levels: information capture, the lowest level, which coordinates through standardization; information provision, which supports unidirectional activities; and information exchange, which reflects the highest level of coordination allowing for bidirectional exchange. The Care Management Process index (CMP index) includes 13 questions about the extent to which care is planned, monitored, and supported by providers and patients. Multiple regressions adjusting for organizational and ACO contractual factors are used to assess relationships between HIT functionalities and the CMP index. HIT functionality coordinating the most complex interdependences (information exchange) was associated with a 0.41 standard deviation change in the CMP index (β = .41, p < .001), but the associations for information capture (β = -.01, p = .97) and information provision (β = .15, p = .48) functionalities were not significant. The current study has shed some light on the relationship between HIT and care management processes by specifying the coordination roles that HIT may play and, in particular, the importance of information exchange functionalities. Although these represent early findings, further research can help policy makers and clinical leaders understand how to prioritize HIT development given resource constraints.

  20. Cognitive function and living situation in COPD: is there a relationship with self-management and quality of life?

    PubMed

    Dulohery, Megan M; Schroeder, Darrell R; Benzo, Roberto P

    2015-01-01

    Cognitive impairment is increasingly being found to be a common comorbidity in chronic obstructive pulmonary disease (COPD). This study sought to understand the relationship of comprehensively measured cognitive function with COPD severity, quality of life, living situation, health care utilization, and self-management abilities. Subjects with COPD were recruited from the outpatient pulmonary clinic. Cognitive function was assessed using the Montreal Cognitive Assessment (MOCA). Self-management abilities were measured using the Self Management Ability Score 30. Quality of life was measured using the Chronic Respiratory Disease Questionnaire. Pearson correlation was used to assess the bivariate association of the MOCA with other study measures. Multivariate analysis was completed to understand the interaction of the MOCA and living situation on COPD outcomes of hospitalization, quality of life, and self-management ability. This study included 100 participants of mean age 70±9.4 years (63% male, 37% female) with COPD (mean FEV1 [forced expiratory volume in 1 second] percentage predicted 40.4±16.7). Mean MOCA score was 23.8±3.9 with 63% of patients having mild cognitive impairment. The MOCA was negatively correlated with age (r=-0.28, P=0.005) and positively correlated with education (r=+0.24, P=0.012). There was no significant correlation between cognitive function and exacerbations, emergency room (ER) visits, or hospitalizations. There was no association between the MOCA score and self-management abilities or quality of life. We tested the interaction of living situation and the MOCA with self-management abilities and found statistical significance (P=0.017), indicating that individuals living alone with higher cognitive function report lower self-management abilities. Cognitive impairment in COPD does not appear to be meaningfully associated with COPD severity, health outcomes, or self-management abilities. The routine screening for cognitive impairment due to a diagnosis of COPD may not be indicated. Living alone significantly affects the interaction between self-management abilities and cognitive function.

  1. Executive Self-Assessment and Development in the United States Air Force

    DTIC Science & Technology

    1989-05-01

    34 (Harvard Business Review, January-February 1988, pp.45-53) 056 Drucker , P. " Management and the World’s Work." (Harvard Business Review, September...professional military factors, general leadership and management factors, and functional/technical factors. The study also includes a critical review and...maintaining a comprehensive executive self-assessment and development system. The study concludes with specific recommendations for management action

  2. A robotic system for automation of logistics functions on the Space Station

    NASA Technical Reports Server (NTRS)

    Martin, J. C.; Purves, R. B.; Hosier, R. N.; Krein, B. A.

    1988-01-01

    Spacecraft inventory management is currently performed by the crew and as systems become more complex, increased crew time will be required to perform routine logistics activities. If future spacecraft are to function effectively as research labs and production facilities, the efficient use of crew time as a limited resource for performing mission functions must be employed. The use of automation and robotics technology, such as automated warehouse and materials handling functions, can free the crew from many logistics tasks and provide more efficient use of crew time. Design criteria for a Space Station Automated Logistics Inventory Management System is focused on through the design and demonstration of a mobile two armed terrestrial robot. The system functionally represents a 0 gravity automated inventory management system and the problems associated with operating in such an environment. Features of the system include automated storage and retrieval, item recognition, two armed robotic manipulation, and software control of all inventory item transitions and queries.

  3. Database Access Manager for the Software Engineering Laboratory (DAMSEL) user's guide

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Operating instructions for the Database Access Manager for the Software Engineering Laboratory (DAMSEL) system are presented. Step-by-step instructions for performing various data entry and report generation activities are included. Sample sessions showing the user interface display screens are also included. Instructions for generating reports are accompanied by sample outputs for each of the reports. The document groups the available software functions by the classes of users that may access them.

  4. An Opportunity for Positive and Creative Leadership in the Business Management of Higher Education.

    ERIC Educational Resources Information Center

    Barber, Allan W.

    1972-01-01

    Business officers should function as members of institutional management teams whose responsibilities include devising more effective ways to collect, present, and evaluate business and financial information for governing boards and academic administrators. The challenge is to find ways to encourage institutional administrations to consider the…

  5. 78 FR 33876 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing of Proposed Rule...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-05

    ... functionalities allow receiving DTC participants (``Participants'') to exercise control over which transactions to... without regard to risk management controls, the Participant that initiated the original delivery versus... Participant and to the Corporation.\\5\\ \\5\\ DTC's risk management controls, including Collateral Monitor and...

  6. Operations Management and Curriculum Design.

    ERIC Educational Resources Information Center

    Slack, Nigel

    1983-01-01

    The last few years have seen developments in the academic treatment of operations management which both broaden the subject to include a much wider range of industries in the nonmanufacturing sectors and place the operations function in a more strategic context. (MEAD Subscriptions, CSML, University of Lancaster, Lancaster LA1 4YX, England) (SSH)

  7. 77 FR 13530 - Information Collection Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ... from the Office of Management and Budget (OMB). DATES: Comments on this notice must be received by May... INFORMATION: The Office of Management and Budget's (OMB) regulation (5 CFR 1320) implementing provisions of... for the proper performance of the functions of the agency, including whether the information will have...

  8. 76 FR 15052 - Proposed Information Collection (Time Record (Work-Study Program); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... the collection of information through Federal Docket Management System (FDMS) at http://www.... 3501--3521), Federal agencies must obtain approval from the Office of Management and Budget (OMB) for... performance of VBA's functions, including whether the information will have practical utility; (2) the...

  9. Trauma Focused CBT for Children with Co-Occurring Trauma and Behavior Problems

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Berliner, Lucy; Mannarino, Anthony

    2010-01-01

    Objective: Childhood trauma impacts multiple domains of functioning including behavior. Traumatized children commonly have behavioral problems that therapists must effectively evaluate and manage in the context of providing trauma-focused treatment. This manuscript describes practical strategies for managing behavior problems in the context of…

  10. 46 CFR 501.5 - Functions of the organizational components of the Federal Maritime Commission.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... activities designed to promote economy, efficiency, and effectiveness in the administration of, and to...(8) of the Shipping Act of 1984 (46 U.S.C. 40102(8)), researches their status, and makes... include: Conducting IT management studies and surveys; managing data and voice telecommunications...

  11. Fire In South Florida Ecosystems

    Treesearch

    Dale Wade; John Ewel; Ronald Hofstetter

    1980-01-01

    This compendium of tire information for selected south Florida vegetative communities will help resource managers and policymakers to better predict the consequences of their fire management decisions. Included is a brief history of fire in south Florida, along with some associated damages and benefits. Certain natural functions fulfilled by tire are outlined. Fire is...

  12. Factors Affecting Selection of Learning Management Systems in Higher Education Institutions

    ERIC Educational Resources Information Center

    Spelke, Kenneth A.

    2011-01-01

    Learning Management Systems, or LMSs, are widely used throughout higher education to deliver a range of instructional services including content delivery, discussion boards and collaborative work space, testing tools, and gradebook functions. LMSs can be used asynchronously or synchronously in support of online learning, classroom-based learning,…

  13. Content Management Systems

    ERIC Educational Resources Information Center

    Wisniewski, Jeff; Stenstrom, Cheryl

    2007-01-01

    In this article, the authors provide a guide in acquiring content management system. They conducted a vendor survey that covers four areas: (1) general information about the product (including standards supported); (2) administration of the product; (3) functionality; and (4) contact information for readers who want to know more. A list of product…

  14. Integrating disease management into the outpatient delivery system during and after managed care.

    PubMed

    Villagra, Victor G

    2004-01-01

    Managed care introduced disease management as a replacement strategy to utilization management. The focus changed from influencing treatment decisions to supporting self-care and compliance. Disease management rendered operational many elements of the chronic care model, but it did so outside the delivery system, thus escaping the financial limitations, cultural barriers, and inertia inherent in effecting radical change from within. Medical management "after managed care" should include the functional and structural integration of disease management with primary care clinics. Such integration would supply the infrastructure that primary care physicians need to coordinate the care of chronically ill patients more effectively.

  15. Description of the SSF PMAD DC testbed control system data acquisition function

    NASA Technical Reports Server (NTRS)

    Baez, Anastacio N.; Mackin, Michael; Wright, Theodore

    1992-01-01

    The NASA LeRC in Cleveland, Ohio has completed the development and integration of a Power Management and Distribution (PMAD) DC Testbed. This testbed is a reduced scale representation of the end to end, sources to loads, Space Station Freedom Electrical Power System (SSF EPS). This unique facility is being used to demonstrate DC power generation and distribution, power management and control, and system operation techniques considered to be prime candidates for the Space Station Freedom. A key capability of the testbed is its ability to be configured to address system level issues in support of critical SSF program design milestones. Electrical power system control and operation issues like source control, source regulation, system fault protection, end-to-end system stability, health monitoring, resource allocation, and resource management are being evaluated in the testbed. The SSF EPS control functional allocation between on-board computers and ground based systems is evolving. Initially, ground based systems will perform the bulk of power system control and operation. The EPS control system is required to continuously monitor and determine the current state of the power system. The DC Testbed Control System consists of standard controllers arranged in a hierarchical and distributed architecture. These controllers provide all the monitoring and control functions for the DC Testbed Electrical Power System. Higher level controllers include the Power Management Controller, Load Management Controller, Operator Interface System, and a network of computer systems that perform some of the SSF Ground based Control Center Operation. The lower level controllers include Main Bus Switch Controllers and Photovoltaic Controllers. Power system status information is periodically provided to the higher level controllers to perform system control and operation. The data acquisition function of the control system is distributed among the various levels of the hierarchy. Data requirements are dictated by the control system algorithms being implemented at each level. A functional description of the various levels of the testbed control system architecture, the data acquisition function, and the status of its implementationis presented.

  16. Provider perspectives on essential functions for care management in the collaborative treatment of hypertension: the P.A.R.T.N.E.R. framework.

    PubMed

    Hussain, Tanvir; Allen, Allyssa; Halbert, Jennifer; Anderson, Cheryl A M; Boonyasai, Romsai Tony; Cooper, Lisa A

    2015-04-01

    Care management has become a widespread strategy for improving chronic illness care. However, primary care provider (PCP) participation in programs has been poor. Because the success of care management relies on provider engagement, understanding provider perspectives is necessary. Our goal was to identify care management functions most valuable to PCPs in hypertension treatment. Six focus groups were conducted to discuss current challenges in hypertension care and identify specific functions of care management that would improve care. The study included 39 PCPs (participation rate: 83 %) representing six clinics, two of which care for large African American populations and four that are in underserved locations, in the greater Baltimore metropolitan area. This was a qualitative analysis of focus groups, using grounded theory and iterative coding. Providers desired achieving blood pressure control more rapidly. Collaborating with care managers who obtain ongoing patient data would allow treatment plans to be tailored to the changing life conditions of patients. The P.A.R.T.N.E.R. framework summarizes the care management functions that providers reported were necessary for effective collaboration: Partner with patients, providers, and the community; Arrange follow-up care; Resolve barriers to adherence; Track treatment response and progress; Navigate the health care system with patients; Educate patients & Engage patients in self-management; Relay information between patients and/or provider(s). The P.A.R.T.N.E.R. framework is the first to offer a checklist of care management functions that may promote successful collaboration with PCPs. Future research should examine the validity of this framework in various settings and for diverse patient populations affected by chronic diseases.

  17. Functional behavioral analysis and social scripting for the older patient with schizophrenia: a staff development program.

    PubMed

    Markwick, Laura; Smith, Charlene; Mick, Diane

    2014-11-01

    Executive functioning is the ability to plan, strategize, organize, and focus on details. Impaired executive functioning plays a significant role in behavior disturbances. Lack of inhibition, impaired abstract reasoning, thought perseverance, rigidity in routine, and lack of insight disrupt social skills and daily life. Autism and schizophrenia present some similar behaviors, including impaired executive functioning, often resulting in pharmacological management as many healthcare professionals receive limited training in executive functioning. Non-pharmacological tools used in autism for behavior management include functional behavioral analysis and social scripting, which help to identify causes of behavior and teach more appropriate behavioral responses. Described here is an educational program for healthcare workers in a long-term care skilled nursing facility, to help them understand the basis for behaviors in individuals with impaired executive function, to use these same tools for behavioral modification techniques, and to help patients learn more appropriate social skills. Program evaluation suggested the educational program was successful in increasing the staff's knowledge and comfort level in addressing the behavioral issues that arise with this population and staff also reported less use of medication as first-line treatment for behavioral issues.

  18. System Engineering Analysis of Squadron Officer College

    DTIC Science & Technology

    2012-03-01

    study identified five challenges to converting to a blended learning course. The greatest challenge is getting commitment and buy -in from senior...students thru the Army and Air Force Exchange Service (AAFES) snack bar. Managers are responsible for ensuring adequate support throughout the...Administration Function The administration function allows daily tasks to operate. SOC administration functions include providing students with

  19. Exploring the Functioning of Decision Space: A Review of the Available Health Systems Literature

    PubMed Central

    Roman, Tamlyn Eslie; Cleary, Susan; McIntyre, Diane

    2017-01-01

    Background: The concept of decision space holds appeal as an approach to disaggregating the elements that may influence decision-making in decentralized systems. This narrative review aims to explore the functioning of decision space and the factors that influence decision space. Methods: A narrative review of the literature was conducted with searches of online databases and academic journals including PubMed Central, Emerald, Wiley, Science Direct, JSTOR, and Sage. The articles were included in the review based on the criteria that they provided insight into the functioning of decision space either through the explicit application of or reference to decision space, or implicitly through discussion of decision-making related to organizational capacity or accountability mechanisms. Results: The articles included in the review encompass literature related to decentralisation, management and decision space. The majority of the studies utilise qualitative methodologies to assess accountability mechanisms, organisational capacities such as finance, human resources and management, and the extent of decision space. Of the 138 articles retrieved, 76 articles were included in the final review. Conclusion: The literature supports Bossert’s conceptualization of decision space as being related to organizational capacities and accountability mechanisms. These functions influence the decision space available within decentralized systems. The exact relationship between decision space and financial and human resource capacities needs to be explored in greater detail to determine the potential influence on system functioning. PMID:28812832

  20. Hemiplegic shoulder pain: a common clinical consequence of stroke.

    PubMed

    Coskun Benlidayi, Ilke; Basaran, Sibel

    2014-04-01

    Hemiplegic shoulder pain is common in stroke survivors, developing in up to 54% of patients. The underlying mechanisms include soft tissue lesions, impaired motor function and central nervous system-related phenomena. Hemiplegic shoulder pain has many underlying causes and is challenging to manage, requiring a team approach, including physicians, therapists and caregivers. The management strategy must target the underlying causes. Preventative measures, such as positioning and handling, can reduce the risk of developing hemiplegic shoulder pain. We have reviewed the literature on hemiplegic shoulder pain, and used this to categorise the underlying mechanisms, and to explore the best management strategies.

  1. 28 CFR 0.95 - General functions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Bureau of Prisons § 0.95 General functions. The Director of the Bureau of Prisons shall direct all activities of the Bureau of Prisons including: (a) Management and regulation of all Federal penal and correctional...

  2. 28 CFR 0.95 - General functions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Bureau of Prisons § 0.95 General functions. The Director of the Bureau of Prisons shall direct all activities of the Bureau of Prisons including: (a) Management and regulation of all Federal penal and correctional...

  3. 28 CFR 0.95 - General functions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Bureau of Prisons § 0.95 General functions. The Director of the Bureau of Prisons shall direct all activities of the Bureau of Prisons including: (a) Management and regulation of all Federal penal and correctional...

  4. 47 CFR 0.81 - Functions of the Office.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... the Commission, including all of its component Bureau/Office managers, supervisors, and staff, at all... 47 Telecommunication 1 2012-10-01 2012-10-01 false Functions of the Office. 0.81 Section 0.81 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Organization Office of Workplace...

  5. 47 CFR 0.81 - Functions of the Office.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... the Commission, including all of its component Bureau/Office managers, supervisors, and staff, at all... 47 Telecommunication 1 2013-10-01 2013-10-01 false Functions of the Office. 0.81 Section 0.81 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Organization Office of Workplace...

  6. 47 CFR 0.81 - Functions of the Office.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the Commission, including all of its component Bureau/Office managers, supervisors, and staff, at all... 47 Telecommunication 1 2011-10-01 2011-10-01 false Functions of the Office. 0.81 Section 0.81 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Organization Office of Workplace...

  7. 47 CFR 0.81 - Functions of the Office.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... the Commission, including all of its component Bureau/Office managers, supervisors, and staff, at all... 47 Telecommunication 1 2014-10-01 2014-10-01 false Functions of the Office. 0.81 Section 0.81 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Organization Office of Workplace...

  8. Cardiorenal syndrome: new developments in the understanding and pharmacologic management.

    PubMed

    House, Andrew A

    2013-10-01

    Cardiorenal syndromes (CRSs) with bidirectional heart-kidney signaling are increasingly being recognized for their association with increased morbidity and mortality. In acute CRS, recognition of the importance of worsening kidney function complicating management of acute decompensated heart failure has led to the examination of this specific outcome in the context of acute heart failure clinical trials. In particular, the role of fluid overload and venous congestion has focused interest in the most effective use of diuretic therapy to relieve symptoms of heart failure while at the same time preserving kidney function. Additionally, many novel vasoactive therapies have been studied in recent years with the hopes of augmenting cardiac function, improving symptoms and patient outcomes, while maintaining or improving kidney function. Similarly, recent advances in our understanding of the pathophysiology of chronic CRS have led to reanalysis of kidney outcomes in pivotal trials in chronic congestive heart failure, and newer trials are including changes in kidney function as well as kidney injury biomarkers as prospectively monitored and adjudicated outcomes. This paper provides an overview of some new developments in the pharmacologic management of acute and chronic CRS, examines several reports that illustrate a key management principle for each subtype, and discusses opportunities for future research.

  9. Managing expectations from our land: 3 is the magic number.

    NASA Astrophysics Data System (ADS)

    Creamer, Rachel; Schulte, Rogier; O'Sullivan, Lilian; Staes, Jan; Vrebos, Dirk; Jones, Arwyn

    2017-04-01

    In recent years, sustainable food production has risen to the top of the EU policy agenda. Europe's land is now expected to provide multiple ecosystem services (soil functions) for society. These include: i) food production, ii) carbon storage, iii) the provision of clean water, iv) habitats for biodiversity and v) nutrient cycling. A tension exists between the demand for and supply of these soil functions on our land. We cannot expect all soil functions to be delivered simultaneously to optimal capacity, but with careful decision making we can optimise our soils to provide multiple functions. Our societal demands also vary in spatial extent, for example we may require nutrient cycling and food production to be focussed at local scale, but carbon sequestration may be a national target to reduce greenhouse gas emissions. Every day, farmers make decisions on how they manage their land and soil. At the same time, national and European policy makers make long-term decisions on how to manage their soil resources at larger scales. Therefore, the contemporary challenge for researchers and stakeholders is to link the decision making on land management across scales, so that the practicalities of how farmers make decisions is reflected in policy formation and that policies enable farmers to make decisions that meet EU policy objectives. LANDMARK (LAND Management: Assessment, Research, Knowledge base) is a Horizon 2020 consortium of 22 partner institutes from 14 EU countries plus Switzerland, China and Brazil. The primary objective of the LANDMARK project is to provide a policy framework for Functional Land Management at EU level. This implies the identification of policy instruments that could guide the management of soil functions at the appropriate scale. This presentation will provide an overview of the challenge faced across these scales, from local to European, it will demonstrate how local decision making must try and account for the delivery of at least three soil functions to contribute to sustainable soil management.

  10. Management mechanisms for development of personnel professional competencies at a loading and haulage company

    NASA Astrophysics Data System (ADS)

    Shishkina, S. V.; Pristupa, Yu D.; Pavlova, L. D.; Fryanov, V. N.

    2018-05-01

    The necessity for development a management mechanism for development of personnel professional competencies at a loading and haulage company in order to ensuring the compliance of competencies with labor functions, regulated by the current professional standards, is substantiated. A functional diagram of the organizational and technical system of the loading and haulage company was developed, that includes the interaction mechanism between the personnel and the objects of the main production. The problem of algorithm development to assess the correspondence of communicative competencies and labor functions of loading and haulage companies, ensuring the achievement of the management goal with a minimum risk of an emergency situation or an accident, was set and solved. The idea of management problem solving consists in the operational development and implementation of anticipatory measures at each deviation in personnel actions from normative or target indicators. The dependence of the risk of imbalance of communicative competences and labor functions in a given period of time is established. The effectiveness of the developed and implemented mechanism is confirmed by the positive dynamics of the test results.

  11. Idiopathic pulmonary fibrosis: a holistic approach to disease management in the antifibrotic age.

    PubMed

    Shaw, Jonathon; Marshall, Tracey; Morris, Helen; Hayton, Conal; Chaudhuri, Nazia

    2017-11-01

    Idiopathic pulmonary fibrosis (IPF) is the most common cause of interstitial lung disease (ILD) and carries a worse prognosis than many cancers. Until recently, there were no active treatment options available for patients with IPF, meaning palliation or lung transplantation in selected patients were the only options. The management of IPF has changed dramatically over the last decade with the advent of two antifibrotic agents; pirfenidone and nintedanib. These new agents have been shown to reduce decline in lung function and pirfenidone has been shown to reduce mortality. The changing landscape of IPF diagnosis and management present a number of issues that may be encountered including management of side effects related to antifibrotic therapy. This article aims to give an overview of the holistic approach to the management of patients with IPF, including antifibrotic management, symptom management and the invaluable role of the ILD specialist nurse.

  12. Idiopathic pulmonary fibrosis: a holistic approach to disease management in the antifibrotic age

    PubMed Central

    Shaw, Jonathon; Marshall, Tracey; Morris, Helen; Chaudhuri, Nazia

    2017-01-01

    Idiopathic pulmonary fibrosis (IPF) is the most common cause of interstitial lung disease (ILD) and carries a worse prognosis than many cancers. Until recently, there were no active treatment options available for patients with IPF, meaning palliation or lung transplantation in selected patients were the only options. The management of IPF has changed dramatically over the last decade with the advent of two antifibrotic agents; pirfenidone and nintedanib. These new agents have been shown to reduce decline in lung function and pirfenidone has been shown to reduce mortality. The changing landscape of IPF diagnosis and management present a number of issues that may be encountered including management of side effects related to antifibrotic therapy. This article aims to give an overview of the holistic approach to the management of patients with IPF, including antifibrotic management, symptom management and the invaluable role of the ILD specialist nurse. PMID:29268540

  13. [Selected aspects of computer-assisted literature management].

    PubMed

    Reiss, M; Reiss, G

    1998-01-01

    We want to report about our own experiences with a database manager. Bibliography database managers are used to manage information resources: specifically, to maintain a database to references and create bibliographies and reference lists for written works. A database manager allows to enter summary information (record) for articles, book sections, books, dissertations, conference proceedings, and so on. Other features that may be included in a database manager include the ability to import references from different sources, such as MEDLINE. The word processing components allow to generate reference list and bibliographies in a variety of different styles, generates a reference list from a word processor manuscript. The function and the use of the software package EndNote 2 for Windows are described. Its advantages in fulfilling different requirements for the citation style and the sort order of reference lists are emphasized.

  14. Optimization techniques applied to spectrum management for communications satellites

    NASA Astrophysics Data System (ADS)

    Ottey, H. R.; Sullivan, T. M.; Zusman, F. S.

    This paper describes user requirements, algorithms and software design features for the application of optimization techniques to the management of the geostationary orbit/spectrum resource. Relevant problems include parameter sensitivity analyses, frequency and orbit position assignment coordination, and orbit position allotment planning. It is shown how integer and nonlinear programming as well as heuristic search techniques can be used to solve these problems. Formalized mathematical objective functions that define the problems are presented. Constraint functions that impart the necessary solution bounds are described. A versatile program structure is outlined, which would allow problems to be solved in stages while varying the problem space, solution resolution, objective function and constraints.

  15. The Roswell Park Cancer Institute experience with extramammary Paget's disease.

    PubMed

    Zollo, J D; Zeitouni, N C

    2000-01-01

    Extramammary Paget's disease (EMPD) is a rare intraepithelial neoplasm. Common sites of occurrence include the vulva, perianal region, perineum and scrotum. Despite frequent recurrences, surgery is the standard treatment. This study examines the recurrence rate for EMPD treated by conventional surgical management. Alternative and multimodal therapeutic approaches are reviewed. This retrospective analysis included all 30 patients treated for EMPD at Roswell Park Cancer Institute (RPCI) between 1970 and 1998. Following conventional surgical treatment, 44% of our patients developed recurrence. Vulvectomy provided the lowest recurrence rate, but involved extensive tissue loss and functional debility. Multimodal treatment using Mohs' micrographic surgery and photodynamic therapy has been used at RPCI to manage EMPD with minimal tissue loss and no functional impairment. Surgical treatment offers a moderate chance of EMPD cure. Long-term multimodal approaches require close follow-up, but may conserve both tissue and function.

  16. The density management and riparian buffer study: a large-scale silviculture experiment informing riparian management in the Pacific Northwest, USA

    Treesearch

    Paul D. Anderson; Nathan J. Poage

    2014-01-01

    The advent of the Northwest Forest Plan (NWFP) in the early 1990s signaled a new paradigm for management of 9.9 million ha of federal forest lands in western Washington and Oregon, USA. The emphasis shifted from commodity timber production to ensuring sustained ecological functioning to meet a broad array of ecosystem services including economic benefits. Under interim...

  17. Perioperative Pain Management and Anesthesia: A Critical Component to Rapid Recovery Total Joint Arthroplasty.

    PubMed

    Russo, Matthew W; Parks, Nancy L; Hamilton, William G

    2017-10-01

    Multimodal pain management has become the standard of care following total hip and knee replacement. The advantages include decreasing opioid consumption and its associated side effects, facilitating earlier mobilization, and faster return to function. An effective rapid recovery protocol includes the use of multiple different types of medications targeting each area of the pain pathway, preemptive analgesia, regional nerve blockade, and local infiltration analgesia. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Goal-Function Tree Modeling for Systems Engineering and Fault Management

    NASA Technical Reports Server (NTRS)

    Johnson, Stephen B.; Breckenridge, Jonathan T.

    2013-01-01

    This paper describes a new representation that enables rigorous definition and decomposition of both nominal and off-nominal system goals and functions: the Goal-Function Tree (GFT). GFTs extend the concept and process of functional decomposition, utilizing state variables as a key mechanism to ensure physical and logical consistency and completeness of the decomposition of goals (requirements) and functions, and enabling full and complete traceabilitiy to the design. The GFT also provides for means to define and represent off-nominal goals and functions that are activated when the system's nominal goals are not met. The physical accuracy of the GFT, and its ability to represent both nominal and off-nominal goals enable the GFT to be used for various analyses of the system, including assessments of the completeness and traceability of system goals and functions, the coverage of fault management failure detections, and definition of system failure scenarios.

  19. NEXT Single String Integration Test Results

    NASA Technical Reports Server (NTRS)

    Soulas, George C.; Patterson, Michael J.; Pinero, Luis; Herman, Daniel A.; Snyder, Steven John

    2010-01-01

    As a critical part of NASA's Evolutionary Xenon Thruster (NEXT) test validation process, a single string integration test was performed on the NEXT ion propulsion system. The objectives of this test were to verify that an integrated system of major NEXT ion propulsion system elements meets project requirements, to demonstrate that the integrated system is functional across the entire power processor and xenon propellant management system input ranges, and to demonstrate to potential users that the NEXT propulsion system is ready for transition to flight. Propulsion system elements included in this system integration test were an engineering model ion thruster, an engineering model propellant management system, an engineering model power processor unit, and a digital control interface unit simulator that acted as a test console. Project requirements that were verified during this system integration test included individual element requirements ; integrated system requirements, and fault handling. This paper will present the results of these tests, which include: integrated ion propulsion system demonstrations of performance, functionality and fault handling; a thruster re-performance acceptance test to establish baseline performance: a risk-reduction PMS-thruster integration test: and propellant management system calibration checks.

  20. Strategies for Maintaining Positive Behavior Change Stemming from Functional Behavioral Assessment in Schools.

    ERIC Educational Resources Information Center

    Gable, Robert A.; Hendrickson, Jo M.

    2000-01-01

    This article discusses strategies and procedures for promoting maintenance and generalization of student behavior changes resulting from interventions based on functional behavioral assessment. Strategies include self-management techniques, cognitive mediation, self-advocacy training, use of peers, booster training, environmental modifications,…

  1. Reference Function with an On-Line Catalog

    ERIC Educational Resources Information Center

    Winik, Ruth

    1972-01-01

    The automated Experimental Library Management System (ELMS) in use at the IBM Los Gatos Laboratory has proved to offer unique advantages in fulfilling the reference function. All records of the library, including complete bibliographic descriptions, order information and circulation status, are available at the librarian's fingertips at the…

  2. Supporting scalability and flexibility in a distributed management platform

    NASA Astrophysics Data System (ADS)

    Jardin, P.

    1996-06-01

    The TeMIP management platform was developed to manage very large distributed systems such as telecommunications networks. The management of these networks imposes a number of fairly stringent requirements including the partitioning of the network, division of work based on skills and target system types and the ability to adjust the functions to specific operational requirements. This requires the ability to cluster managed resources into domains that are totally defined at runtime based on operator policies. This paper addresses some of the issues that must be addressed in order to add a dynamic dimension to a management solution.

  3. Management of chronic spinal cord dysfunction.

    PubMed

    Abrams, Gary M; Ganguly, Karunesh

    2015-02-01

    Both acute and chronic spinal cord disorders present multisystem management problems to the clinician. This article highlights key issues associated with chronic spinal cord dysfunction. Advances in symptomatic management for chronic spinal cord dysfunction include use of botulinum toxin to manage detrusor hyperreflexia, pregabalin for management of neuropathic pain, and intensive locomotor training for improved walking ability in incomplete spinal cord injuries. The care of spinal cord dysfunction has advanced significantly over the past 2 decades. Management and treatment of neurologic and non-neurologic complications of chronic myelopathies ensure that each patient will be able to maximize their functional independence and quality of life.

  4. Understanding collaborative care implementation in the Department of Veterans Affairs: core functions and implementation challenges.

    PubMed

    Lipschitz, Jessica M; Benzer, Justin K; Miller, Christopher; Easley, Siena R; Leyson, Jenniffer; Post, Edward P; Burgess, James F

    2017-10-10

    The collaborative care model is an evidence-based practice for treatment of depression in which designated care managers provide clinical services, often by telephone. However, the collaborative care model is infrequently adopted in the Department of Veterans Affairs (VA). Almost all VA medical centers have adopted a co-located or embedded approach to integrating mental health care for primary care patients. Some VA medical centers have also adopted a telephone-based collaborative care model where depression care managers support patient education, patient activation, and monitoring of adherence and progress over time. This study evaluated two research questions: (1) What does a dedicated care manager offer in addition to an embedded-only model? (2) What are the barriers to implementing a dedicated depression care manager? This study involved 15 qualitative, multi-disciplinary, key informant interviews at two VA medical centers where reimbursement options were the same- both with embedded mental health staff, but one with a depression care manager. Participant interviews were recorded and transcribed. Thematic analysis was used to identify descriptive and analytical themes. Findings suggested that some of the core functions of depression care management are provided as part of embedded-only mental health care. However, formal structural attention to care management may improve the reliability of care management functions, in particular monitoring of progress over time. Barriers to optimal implementation were identified at both sites. Themes from the care management site included finding assertive care managers to hire, cross-discipline integration and collaboration, and primary care provider burden. Themes from interviews at the embedded site included difficulty getting care management on leaders' agendas amidst competing priorities and logistics (staffing and space). Providers and administrators see depression care management as a valuable healthcare service that improves patient care. Barriers to implementation may be addressed by team-building interventions to improve cross-discipline integration and communication. Findings from this study are limited in scope to the VA healthcare system. Future investigation of whether alternative barriers exist in implementation of depression care management programs in non-VA hospital systems, where reimbursement rates may be a more prominent concern, would be valuable.

  5. Buffer strip design for protecting water quality and fish habitat

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

    Belt, G.H.; O'Laughlin, J.

    1994-04-01

    Buffer strips are protective areas adjacent to streams or lakes. Among other functions, they protect water quality and fish habitat. A typical buffer strip is found in western Oregon, where they are called Riparian Management Areas (RMAs). The authors use the term buffer strip to include functional descriptions such as filter, stabilization, or leave strips, and administrative designations such as Idaho's Stream Protection Zone (SPZ), Washington's Riparian Management Zone (RMZ), and the USDA Forest Service's Streamside Management Zone (SMZ). They address water quality and fishery protective functions of buffer strips on forestlands, pointing out improvements in buffer strip design possiblemore » through research or administrative changes. Buffer strip design requirements found in some western Forest Practices Act (FPA) regulations are also compared and related to findings in the scientific literature.« less

  6. Development of an expert system prototype for determining software functional requirements for command management activities at NASA Goddard

    NASA Technical Reports Server (NTRS)

    Liebowitz, J.

    1986-01-01

    The development of an expert system prototype for software functional requirement determination for NASA Goddard's Command Management System, as part of its process of transforming general requests into specific near-earth satellite commands, is described. The present knowledge base was formulated through interactions with domain experts, and was then linked to the existing Knowledge Engineering Systems (KES) expert system application generator. Steps in the knowledge-base development include problem-oriented attribute hierarchy development, knowledge management approach determination, and knowledge base encoding. The KES Parser and Inspector, in addition to backcasting and analogical mapping, were used to validate the expert system-derived requirements for one of the major functions of a spacecraft, the solar Maximum Mission. Knowledge refinement, evaluation, and implementation procedures of the expert system were then accomplished.

  7. Handbook on the Organization and Management of Distance Education Study Centres.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

    This handbook discusses the role, structures, organization, and management of study centers as they operate in different postsecondary settings in the Asia Pacific region. Eight chapters and a postscript are included: (1) introduction; (2) what is a study center; (3) why might an institution want study centers--functions, architectural types,…

  8. The Cocoa Shop: A Database Management Case

    ERIC Educational Resources Information Center

    Pratt, Renée M. E.; Smatt, Cindi T.

    2015-01-01

    This is an example of a real-world applicable case study, which includes background information on a small local business (i.e., TCS), description of functional business requirements, and sample data. Students are asked to design and develop a database to improve the management of the company's customers, products, and purchases by emphasizing…

  9. [Recommendations for implementing the quality policy and organisation of a quality management system].

    PubMed

    Daunizeau, A

    2013-06-01

    Preliminary issues to implement a quality management system are described. They include the definition of the structure, a hierarchical and functional organization chart and the engagement of the whole personnel to apply the requirements of the standard EN ISO 15189. The policy has to be translated into objectives.

  10. The relational neurobehavioral approach: can a non-aversive program manage adults with brain injury-related aggression without seclusion/restraint?

    PubMed

    Kalapatapu, Raj K; Giles, Gordon M

    2017-11-01

    The Relational Neurobehavioral Approach (RNA) is a set of non-aversive intervention methods to manage individuals with brain injury-related aggression. New data on interventions used in the RNA and on how the RNA interventions can be used with patients with acquired brain injury (ABI) who have differing levels of functional impairment are provided in this paper. The study was conducted over a 6-week period in a secure 65-bed program for individuals with ABI that is housed in two units of a skilled nursing facility (SNF). Implementation of the RNA was compared between two units that housed patients with differing levels of functional impairment (n = 65 adults). Since this was a hierarchical clustered dataset, Generalized Estimating Equations regression was used in the analyses. RNA interventions used to manage the 495 aggressive incidents included the following: Aggression ignored, Closer observation, Talking to patient, Reassurance, Physical distraction, Isolation without seclusion, Immediate medication by mouth, Holding patient. Different interventions were implemented differentially by staff based on level of functional impairment and without use of seclusion or mechanical restraint. The RNA can be used to non-aversively manage aggression in patients with brain injury and with differing levels of functional impairment. Programs adopting the RNA can potentially manage brain injury-related aggression without seclusion or mechanical restraint. Implications for Rehabilitation The Relational Neurobehavioral Approach (RNA) is a set of non-aversive intervention methods to manage individuals with brain injury-related aggression. RNA methods can be used to manage aggression in patients with brain injury who have differing levels of functional impairment. Successful implementation of the RNA may allow for the management of brain injury-related aggression without seclusion or mechanical restraint.

  11. Salary Management System for Small and Medium-sized Enterprises

    NASA Astrophysics Data System (ADS)

    Hao, Zhang; Guangli, Xu; Yuhuan, Zhang; Yilong, Lei

    Small and Medium-sized Enterprises (SMEs) in the process of wage entry, calculation, the total number are needed to be done manually in the past, the data volume is quite large, processing speed is low, and it is easy to make error, which is resulting in low efficiency. The main purpose of writing this paper is to present the basis of salary management system, establish a scientific database, the computer payroll system, using the computer instead of a lot of past manual work in order to reduce duplication of staff labor, it will improve working efficiency.This system combines the actual needs of SMEs, through in-depth study and practice of the C/S mode, PowerBuilder10.0 development tools, databases and SQL language, Completed a payroll system needs analysis, database design, application design and development work. Wages, departments, units and personnel database file are included in this system, and have data management, department management, personnel management and other functions, through the control and management of the database query, add, delete, modify, and other functions can be realized. This system is reasonable design, a more complete function, stable operation has been tested to meet the basic needs of the work.

  12. Data management support for selected climate data sets using the climate data access system

    NASA Technical Reports Server (NTRS)

    Reph, M. G.

    1983-01-01

    The functional capabilities of the Goddard Space Flight Center (GSFC) Climate Data Access System (CDAS), an interactive data storage and retrieval system, and the archival data sets which this system manages are discussed. The CDAS manages several climate-related data sets, such as the First Global Atmospheric Research Program (GARP) Global Experiment (FGGE) Level 2-b and Level 3-a data tapes. CDAS data management support consists of three basic functions: (1) an inventory capability which allows users to search or update a disk-resident inventory describing the contents of each tape in a data set, (2) a capability to depict graphically the spatial coverage of a tape in a data set, and (3) a data set selection capability which allows users to extract portions of a data set using criteria such as time, location, and data source/parameter and output the data to tape, user terminal, or system printer. This report includes figures that illustrate menu displays and output listings for each CDAS function.

  13. Land use change around protected areas: management to balance human needs and ecological function.

    PubMed

    DeFries, Ruth; Hansen, Andrew; Turner, B L; Reid, Robin; Liu, Jianguo

    2007-06-01

    Protected areas throughout the world are key for conserving biodiversity, and land use is key for providing food, fiber, and other ecosystem services essential for human sustenance. As land use change isolates protected areas from their surrounding landscapes, the challenge is to identify management opportunities that maintain ecological function while minimizing restrictions on human land use. Building on the case studies in this Invited Feature and on ecological principles, we identify opportunities for regional land management that maintain both ecological function in protected areas and human land use options, including preserving crucial habitats and migration corridors, and reducing dependence of local human populations on protected area resources. Identification of appropriate and effective management opportunities depends on clear definitions of: (1) the biodiversity attributes of concern; (2) landscape connections to delineate particular locations with strong ecological interactions between the protected area and its surrounding landscape; and (3) socioeconomic dynamics that determine current and future use of land resources in and around the protected area.

  14. Mechanisms and management of functional abdominal pain.

    PubMed

    Farmer, Adam D; Aziz, Qasim

    2014-09-01

    Functional abdominal pain syndrome is characterised by frequent or continuous abdominal pain associated with a degree of loss of daily activity. It has a reported population prevalence of between 0.5% and 1.7%, with a female preponderance. The pathophysiology of functional abdominal pain is incompletely understood although it has been postulated that peripheral sensitisation of visceral afferents, central sensitisation of the spinal dorsal horn and aberrancies within descending modulatory systems may have an important role. The management of patients with functional abdominal pain requires a tailored multidisciplinary approach in a supportive and empathetic environment in order to develop an effective therapeutic relationship. Patient education directed towards an explanation of the pathophysiology of functional abdominal pain is in our opinion a prerequisite step and provides the rationale for the introduction of interventions. Interventions can usefully be categorised into general measures, pharmacotherapy, psychological interventions and 'step-up' treatments. Pharmacotherapeutic/step-up options include tricyclic antidepressants, serotonin noradrenergic reuptake inhibitors and the gabapentinoids. Psychological treatments include cognitive behavioural therapy and hypnotherapy. However, the objective evidence base for these interventions is largely derived from other chronic pain syndrome, and further research is warranted in adult patients with functional abdominal pain. © The Royal Society of Medicine.

  15. Remote Ambulatory Management of Veterans with Obstructive Sleep Apnea

    PubMed Central

    Fields, Barry G.; Behari, Pratima Pathak; McCloskey, Susan; True, Gala; Richardson, Diane; Thomasson, Arwin; Korom-Djakovic, Danijela; Davies, Keith; Kuna, Samuel T.

    2016-01-01

    Study Objectives: Despite significant medical sequelae of obstructive sleep apnea (OSA), the condition remains undiagnosed and untreated in many affected individuals. We explored the feasibility of a comprehensive, telemedicine-based OSA management pathway in a community-based Veteran cohort. Methods: This prospective, parallel-group randomized pilot study assessed feasibility of a telemedicine-based pathway for OSA evaluation and management in comparison to a more traditional, in-person care model. The study included 60 Veterans at the Philadelphia Veterans Affairs Medical Center and two affiliated community-based outpatient clinics. Telemedicine pathway feasibility, acceptability, and outcomes were assessed through a variety of quantitative (Functional Outcomes of Sleep Questionnaire, dropout rates, positive airway pressure [PAP] adherence rates, participant satisfaction ratings) and qualitative (verbal feedback) metrics. Results: There was no significant difference in functional outcome changes, patient satisfaction, dropout rates, or objectively measured PAP adherence between groups after 3 months of treatment. Telemedicine participants showed greater improvement in mental health scores, and their feedback was overwhelmingly positive. Conclusions: Our pilot study suggests that telemedicine-based management of OSA patients is feasible in terms of patient functional outcomes and overall satisfaction with care. Future studies should include larger populations to further elucidate these findings while assessing provider- and patient-related cost effectiveness. Citation: Fields BG, Behari PP, McCloskey S, True G, Richardson D, Thomasson A, Korom-Djakovic D, Davies K, Kuna ST. Remote ambulatory management of veterans with obstructive sleep apnea. SLEEP 2016;39(3):501–509. PMID:26446115

  16. Chronic pain self-management support with pain science education and exercise (COMMENCE): study protocol for a randomized controlled trial.

    PubMed

    Miller, Jordan; MacDermid, Joy C; Walton, David M; Richardson, Julie

    2015-10-14

    Previous research suggests that self-management programs for people with chronic pain improve knowledge and self-efficacy but result in negligible effects on function. This study will investigate the effectiveness self-management support with pain science education and exercise on improving function for people with chronic pain in comparison to a wait-list control. A secondary objective is to determine which variables help to predict response to the intervention. This study will be an unblinded, randomized controlled trial with 110 participants comparing a 6-week program that includes self-management support, pain science education and exercise to a wait-list control. The primary outcome will be function measured by the Short Musculoskeletal Function Assessment - Dysfunction Index. Secondary outcomes will include pain intensity measured by a numeric pain rating scale, pain interference measured by the eight-item PROMIS pain interference item-bank, how much patients are bothered by functional problems measured by the Short Musculoskeletal Function Assessment - Bother Index, catastrophic thinking measured by the Pain Catastrophizing Scale, fear of movement/re-injury measured by the 11-item Tampa Scale of Kinesiophobia, sense of perceived injustice measured by the Injustice Experience Questionnaire, self-efficacy measured by the Pain Self-Efficacy Questionnaire, pain sensitivity measured by pressure pain threshold and cold sensitivity testing, fatigue measured by a numeric fatigue rating scale, pain neurophysiology knowledge measured by the Neurophysiology of Pain Questionnaire, healthcare utilization measured by number of visits to a healthcare provider, and work status. Assessments will be completed at baseline, 7 and 18 weeks. After the 18-week assessment, the groups will crossover; however, we anticipate carry-over effects with the treatment. Therefore, data from after the crossover will be used to estimate within-group changes and to determine predictors of response that are not for direct between-group comparisons. Mixed effects modelling will be used to determine between-group differences for all primary and secondary outcomes. A series of multiple regression models will be used to determine predictors of treatment response. This study has the potential to inform future self-management programming through evaluation of a self-management program that aims to improve function as the primary outcome. ClinicalTrials.gov NCT02422459 , registered on 13 April 2015.

  17. 32 CFR 855.2 - Responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... authority. All decisions are subject to the environmental impact analysis process as directed by the... instructions. The decision process includes consultation with other affected functional area managers when...

  18. 49 CFR 1011.3 - The Chairman, Vice Chairman, and Board Member.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the executive head of the Board and has general responsibilities for: (i) The overall management and functioning of the Board; (ii) The formulation of plans and policies designed to assure the effective... the Board exercises the executive and administrative functions of the Board, including: (i) The...

  19. Shuttle GPS R/PA evaluation analysis and performance tradeoff study

    NASA Technical Reports Server (NTRS)

    Booth, R. W. D.; Lindsey, W. C.

    1978-01-01

    Primary responsibility was understanding and analyzing the various GPS receiver functions as they relate to the shuttle environment. These receiver functions included acquisition properties of the sequential detector, acquisition and tracking properties of the various receiver phase locked loops, and the techniques of sequential receiver operation. In addition to these areas, support was provided in the areas of oscillator stability requirements, antenna management, and navigation filter requirements, including preposition aiding.

  20. Comprehensive care improves physical recovery of hip-fractured elderly Taiwanese patients with poor nutritional status.

    PubMed

    Liu, Hsin-Yun; Tseng, Ming-Yueh; Li, Hsiao-Juan; Wu, Chi-Chuan; Cheng, Huey-Shinn; Yang, Ching-Tzu; Chou, Shih-Wei; Chen, Ching-Yen; Shyu, Yea-Ing L

    2014-06-01

    The effects of nutritional management among other intervention components have not been examined for hip-fractured elderly persons with poor nutritional status. Accordingly, this study explored the intervention effects of an in-home program using a comprehensive care model that included a nutrition-management component on recovery of hip-fractured older persons with poor nutritional status at hospital discharge. A secondary analysis of data from a randomized controlled trial with 24-month follow-up. A 3000-bed medical center in northern Taiwan. Subjects were included only if they had "poor nutritional status" at hospital discharge, including those at risk for malnutrition or malnourished. The subsample included 80 subjects with poor nutritional status in the comprehensive care group, 87 in the interdisciplinary care group, and 85 in the usual care group. The 3 care models were usual care, interdisciplinary care, and comprehensive care. Usual care provided no in-home care, interdisciplinary care provided 4 months of in-home rehabilitation, and comprehensive care included management of depressive symptoms, falls, and nutrition as well as 1 year of in-home rehabilitation. Data were collected on nutritional status and physical functions, including range of motion, muscle power, proprioception, balance and functional independence, and analyzed using a generalized estimating equation approach. We also compared patients' baseline characteristics: demographic characteristics, type of surgery, comorbidities, length of hospital stay, cognitive function, and depression. Patients with poor nutritional status who received comprehensive care were 1.67 times (95% confidence interval 1.06-2.61) more likely to recover their nutritional status than those who received interdisciplinary and usual care. Furthermore, the comprehensive care model improved the functional independence and balance of patients who recovered their nutritional status over the first year following discharge, but not of those who had not yet recovered. An in-home program using the comprehensive care model with a nutritional component effectively improved the nutritional status of hip-fractured patients with poor nutrition. This comprehensive care intervention more effectively improved recovery of functional independence and balance for patients with recovered nutritional status. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  1. Recommended System Design for the Occupational Health Management Information System (OHMIS). Volume 1.

    DTIC Science & Technology

    1983-04-01

    Management Information System (OHMIS). The system design includes: detailed function data flows for each of the core data processing functions of OHMIS, in the form of input/processing/output algorithms; detailed descriptions of the inputs and outputs; performance specifications of OHMIS; resources required to develop and operate OHMIS (Vol II). In addition, the report provides a summary of the rationale used to develop the recommended system design, a description of the methodology used to develop the recommended system design, and a review of existing

  2. Approaches to defining deltaic sustainability in the 21st century

    NASA Astrophysics Data System (ADS)

    Day, John W.; Agboola, Julius; Chen, Zhongyuan; D'Elia, Christopher; Forbes, Donald L.; Giosan, Liviu; Kemp, Paul; Kuenzer, Claudia; Lane, Robert R.; Ramachandran, Ramesh; Syvitski, James; Yañez-Arancibia, Alejandro

    2016-12-01

    Deltas are among the most productive and economically important of global ecosystems but unfortunately they are also among the most threatened by human activities. Here we discuss deltas and human impact, several approaches to defining deltaic sustainability and present a ranking of sustainability. Delta sustainability must be considered within the context of global biophysical and socioeconomic constraints that include thermodynamic limitations, scale and embeddedness, and constraints at the level of the biosphere/geosphere. The development, functioning, and sustainability of deltas are the result of external and internal inputs of energy and materials, such as sediments and nutrients, that include delta lobe development, channel switching, crevasse formation, river floods, storms and associated waves and storm surges, and tides and other ocean currents. Modern deltas developed over the past several thousand years with relatively stable global mean sea level, predictable material inputs from drainage basins and the sea, and as extremely open systems. Human activity has changed these conditions to make deltas less sustainable, in that they are unable to persist through time structurally or functionally. Deltaic sustainability can be considered from geomorphic, ecological, and economic perspectives, with functional processes at these three levels being highly interactive. Changes in this functioning can lead to either enhanced or diminished sustainability, but most changes have been detrimental. There is a growing understanding that the trajectories of global environmental change and cost of energy will make achieving delta sustainability more challenging and limit options for management. Several delta types are identified in terms of sustainability including those in arid regions, those with high and low energy-intensive management systems, deltas below sea level, tropical deltas, and Arctic deltas. Representative deltas are ranked on a sustainability range. Success in sustainable delta management will depend on utilizing natural delta functioning and an ecological engineering approach.

  3. Workshop on Aeronautical Decision Making (ADM). Volume 2. Plenary Session with Presentations and Proposed Action Plan

    DTIC Science & Technology

    1992-08-01

    programs have several common functional components dealing with: attention , crew, stress, mental attitude, and risk issues. The role which the five...five interrelated concept areas furnish "rules and tools" to help prevent common errors. For instance: 1. Attention management issues include...pilots must manage his/her attention in a timely manor and sequentially employ the other cockpit management tools (for controlling stress etc.). The text

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

    NASA Technical Reports Server (NTRS)

    Lanham, C. C., Jr.

    1975-01-01

    A data management system study is presented that defines, in functional terms, the most cost effective ground data management system to support Advanced Technology Laboratory (ATL) flights of the space shuttle. Results from each subtask performed and the recommended system configuration for reformatting the experiment instrumentation tapes to computer compatible tape are examined. Included are cost factors for development of a mini control center for real-time support of the ATL flights.

  5. Clinical management of scar tissue.

    PubMed

    Kasch, M C

    1988-01-01

    This paper will review the physiology of scar formation including the properties of wound healing and scar remodeling. A clinical scar management program that includes evaluation of scar adhesions and use of a variety of therapy interventions to minimize the formation of scar will be described. Use of compression, massage, splints and functional activities is included in this program. The information is applicable for the general occupational therapist who sees patients with hand dysfunction as well as a therapist specializing in hand rehabilitation. Every therapist who treats hand trauma must be familiar with the sequence and the properties of scar formation in order to reestablish tendon gliding and facilitate early remodeling of scar tissue. Many treatment techniques can be directed toward scar adhesions and no one method is totally effective when used alone; used together, these techniques can positively influence scar formation and restore maximal hand function.

  6. Technology to optimize pediatric diabetes management and outcomes.

    PubMed

    Markowitz, Jessica T; Harrington, Kara R; Laffel, Lori M B

    2013-12-01

    Technology for diabetes management is rapidly developing and changing. With each new development, there are numerous factors to consider, including medical benefits, impact on quality of life, ease of use, and barriers to use. It is also important to consider the interaction between developmental stage and technology. This review considers a number of newer diabetes-related technologies and explores issues related to their use in the pediatric diabetes population (including young adults), with a focus on psychosocial factors. Areas include trend technology in blood glucose monitoring, continuous glucose monitoring, sensor-augmented insulin pumps and low glucose suspend functions, internet applications including videoconferencing, mobile applications (apps), text messaging, and online gaming.

  7. Functional Foods and Lifestyle Approaches for Diabetes Prevention and Management

    PubMed Central

    Alkhatib, Ahmad; Tsang, Catherine; Tiss, Ali; Bahorun, Theeshan; Arefanian, Hossein; Barake, Roula; Khadir, Abdelkrim; Tuomilehto, Jaakko

    2017-01-01

    Functional foods contain biologically active ingredients associated with physiological health benefits for preventing and managing chronic diseases, such as type 2 diabetes mellitus (T2DM). A regular consumption of functional foods may be associated with enhanced anti-oxidant, anti-inflammatory, insulin sensitivity, and anti-cholesterol functions, which are considered integral to prevent and manage T2DM. Components of the Mediterranean diet (MD)—such as fruits, vegetables, oily fish, olive oil, and tree nuts—serve as a model for functional foods based on their natural contents of nutraceuticals, including polyphenols, terpenoids, flavonoids, alkaloids, sterols, pigments, and unsaturated fatty acids. Polyphenols within MD and polyphenol-rich herbs—such as coffee, green tea, black tea, and yerba maté—have shown clinically-meaningful benefits on metabolic and microvascular activities, cholesterol and fasting glucose lowering, and anti-inflammation and anti-oxidation in high-risk and T2DM patients. However, combining exercise with functional food consumption can trigger and augment several metabolic and cardiovascular protective benefits, but it is under-investigated in people with T2DM and bariatric surgery patients. Detecting functional food benefits can now rely on an “omics” biological profiling of individuals’ molecular, genetics, transcriptomics, proteomics, and metabolomics, but is under-investigated in multi-component interventions. A personalized approach for preventing and managing T2DM should consider biological and behavioral models, and embed nutrition education as part of lifestyle diabetes prevention studies. Functional foods may provide additional benefits in such an approach. PMID:29194424

  8. Functional Foods and Lifestyle Approaches for Diabetes Prevention and Management.

    PubMed

    Alkhatib, Ahmad; Tsang, Catherine; Tiss, Ali; Bahorun, Theeshan; Arefanian, Hossein; Barake, Roula; Khadir, Abdelkrim; Tuomilehto, Jaakko

    2017-12-01

    Functional foods contain biologically active ingredients associated with physiological health benefits for preventing and managing chronic diseases, such as type 2 diabetes mellitus (T2DM). A regular consumption of functional foods may be associated with enhanced anti-oxidant, anti-inflammatory, insulin sensitivity, and anti-cholesterol functions, which are considered integral to prevent and manage T2DM. Components of the Mediterranean diet (MD)-such as fruits, vegetables, oily fish, olive oil, and tree nuts-serve as a model for functional foods based on their natural contents of nutraceuticals, including polyphenols, terpenoids, flavonoids, alkaloids, sterols, pigments, and unsaturated fatty acids. Polyphenols within MD and polyphenol-rich herbs-such as coffee, green tea, black tea, and yerba maté-have shown clinically-meaningful benefits on metabolic and microvascular activities, cholesterol and fasting glucose lowering, and anti-inflammation and anti-oxidation in high-risk and T2DM patients. However, combining exercise with functional food consumption can trigger and augment several metabolic and cardiovascular protective benefits, but it is under-investigated in people with T2DM and bariatric surgery patients. Detecting functional food benefits can now rely on an "omics" biological profiling of individuals' molecular, genetics, transcriptomics, proteomics, and metabolomics, but is under-investigated in multi-component interventions. A personalized approach for preventing and managing T2DM should consider biological and behavioral models, and embed nutrition education as part of lifestyle diabetes prevention studies. Functional foods may provide additional benefits in such an approach.

  9. Asian Consensus Report on Functional Dyspepsia

    PubMed Central

    Miwa, Hiroto; Ghoshal, Uday C; Gonlachanvit, Sutep; Gwee, Kok-Ann; Ang, Tiing-Leong; Chang, Full-Young; Fock, Kwong Ming; Hongo, Michio; Hou, Xiaohua; Kachintorn, Udom; Ke, Meiyun; Lai, Kwok-Hung; Lee, Kwang Jae; Lu, Ching-Liang; Mahadeva, Sanjiv; Miura, Soichiro; Park, Hyojin; Rhee, Poong-Lyul; Sugano, Kentaro; Vilaichone, Ratha-korn; Wong, Benjamin CY

    2012-01-01

    Background/Aims Environmental factors such as food, lifestyle and prevalence of Helicobacter pylori infection are widely different in Asian countries compared to the West, and physiological functions and genetic factors of Asians may also be different from those of Westerners. Establishing an Asian consensus for functional dyspepsia is crucial in order to attract attention to such data from Asian countries, to articulate the experience and views of Asian experts, and to provide a relevant guide on management of functional dyspepsia for primary care physicians working in Asia. Methods Consensus team members were selected from Asian experts and consensus development was carried out using a modified Delphi method. Consensus teams collected published papers on functional dyspepsia especially from Asia and developed candidate consensus statements based on the generated clinical questions. At the first face-to-face meeting, each statement was reviewed and e-mail voting was done twice. At the second face-to-face meeting, final voting on each statement was done using keypad voting system. A grade of evidence and a strength of recommendation were applied to each statement according to the method of the GRADE Working Group. Results Twenty-nine consensus statements were finalized, including 7 for definition and diagnosis, 5 for epidemiology, 9 for pathophysiology and 8 for management. Algorithms for diagnosis and management of functional dyspepsia were added. Conclusions This consensus developed by Asian experts shows distinctive features of functional dyspepsia in Asia and will provide a guide to the diagnosis and management of functional dyspepsia for Asian primary care physicians. PMID:22523724

  10. Prospective Memory Deficits Are Associated With Poorer Everyday Functioning in Parkinson’s Disease

    PubMed Central

    Pirogovsky, Eva; Woods, Steven Paul; Filoteo, J. Vincent; Gilbert, Paul E.

    2013-01-01

    Although individuals with Parkinson’s disease (PD) evidence moderate deficits in prospective memory (PM), it is not known whether PM deficits confer an increased risk of poorer everyday functioning. In the current study, 33 individuals with PD and 26 demographically similar normal controls (NC) were administered performance-based and self-report measures of PM and everyday functioning, including medication and financial management. As compared to NC, PD participants demonstrated significantly lower scores on performance-based measures of PM and financial capacity, worse performance at a trend level on performance-based medication management and endorsed significantly greater self-reported declines in PM and instrumental activities of daily living (iADLs). In the PD sample, the laboratory measure of PM significantly correlated with performance-based measures of financial capacity and medication management and a self-report measure of medication management. Self-reported PM failures significantly correlated with perceived declines in iADLs, worse medication management, and poorer health-related quality of life. Although future studies are needed to examine the incremental ecological validity of PM in PD, findings from this study extend prior research by providing preliminary evidence that PM impairment may play a significant role in a range of critical everyday functions in PD. PMID:22846463

  11. Crew interface specification development study for in-flight maintenance and stowage functions

    NASA Technical Reports Server (NTRS)

    Carl, J. G.

    1971-01-01

    The need and potential solutions for an orderly systems engineering approach to the definition, management and documentation requirements for in-flight maintenance, assembly, servicing, and stowage process activities of the flight crews of future spacecraft were investigated. These processes were analyzed and described using a new technique (mass/function flow diagramming), developed during the study, to give visibility to crew functions and supporting requirements, including data products. This technique is usable by NASA for specification baselines and can assist the designer in identifying both upper and lower level requirements associated with these processes. These diagrams provide increased visibility into the relationships between functions and related equipments being utilized and managed and can serve as a common communicating vehicle between the designer, program management, and the operational planner. The information and data product requirements to support the above processes were identified along with optimum formats and contents of these products. The resulting data product concepts are presented to support these in-flight maintenance and stowage processes.

  12. Science in Emergency Response at CDC: Structure and Functions.

    PubMed

    Iskander, John; Rose, Dale A; Ghiya, Neelam D

    2017-09-01

    Recent high-profile activations of the US Centers for Disease Control and Prevention (CDC) Emergency Operations Center (EOC) include responses to the West African Ebola and Zika virus epidemics. Within the EOC, emergency responses are organized according to the Incident Management System, which provides a standardized structure and chain of command, regardless of whether the EOC activation occurs in response to an outbreak, natural disaster, or other type of public health emergency. By embedding key scientific roles, such as the associate director for science, and functions within a Scientific Response Section, the current CDC emergency response structure ensures that both urgent and important science issues receive needed attention. Key functions during emergency responses include internal coordination of scientific work, data management, information dissemination, and scientific publication. We describe a case example involving the ongoing Zika virus response that demonstrates how the scientific response structure can be used to rapidly produce high-quality science needed to answer urgent public health questions and guide policy. Within the context of emergency response, longer-term priorities at CDC include both streamlining administrative requirements and funding mechanisms for scientific research.

  13. Attentional demands and daily functioning among community-dwelling elders.

    PubMed

    Jansen, Debra A

    2006-01-01

    Everyday life is full of numerous demands for attention that can affect the ability to function. For elders, examples of these attentional demands include negotiating public transportation and driving, sensory losses, and physical discomforts and worries that make it harder to concentrate and complete tasks. The purpose of this study was to examine the relation between attentional demands and the ability to manage daily activities requiring concentration for 54 community-dwelling elders (34 women, 20 men). As theorized, attentional demands correlated (r = -.58) significantly with daily functioning: Elders with more attentional demands perceived themselves as having greater difficulty managing tasks requiring concentration. Attentional demands accounted for a significant proportion of variance in functioning (12%), even after partialling out the effects of depressive symptoms and health. Findings support the theorized relation between attentional demands and daily functioning, as well as nursing interventions aimed at decreasing attentional demands to promote effective functioning for elders.

  14. Models of community care for severe mental illness: a review of research on case management.

    PubMed

    Mueser, K T; Bond, G R; Drake, R E; Resnick, S G

    1998-01-01

    We describe different models of community care for persons with severe mental illness and review the research literature on case management, including the results of 75 studies. Most research has been conducted on the assertive community treatment (ACT) or intensive case management (ICM) models. Controlled research on ACT and ICM indicates that these models reduce time in the hospital and improve housing stability, especially among patients who are high service users. ACT and ICM appear to have moderate effects on improving symptomatology and quality of life. Most studies suggest little effect of ACT and ICM on social functioning, arrests and time spent in jail, or vocational functioning. Studies on reducing or withdrawing ACT or ICM services suggest some deterioration in gains. Research on other models of community care is inconclusive. We discuss the implications of the findings in terms of the need for specialization of ACT or ICM teams to address social and vocational functioning and substance abuse. We suggest directions for future research on models of community care, including evaluating implementation fidelity, exploring patient predictors of improvement, and evaluating the role of the helping alliance in mediating outcome.

  15. Contemporary management of voice and swallowing disorders in patients with advanced lung cancer.

    PubMed

    Brady, Grainne C; Carding, Paul N; Bhosle, Jaishree; Roe, Justin W G

    2015-06-01

    Advanced lung cancer can cause changes to swallowing and communication function. Direct tumour invasion, dyspnoea and deconditioning can all impact on swallowing function and communication. Cancer treatment, if administered, may cause or compound symptoms. In this study, the nature of swallowing and communication difficulties in patients with advanced lung cancer will be discussed, and management options including medical management, speech and language therapy (SLT) intervention, and surgical interventions will be considered. Advanced lung cancer can result in voice and swallowing difficulties, which can increase symptom burden and significantly impact on quality of life (QOL). There is a growing evidence base to support the use of injection laryngoplasty under local anaesthetic to offer immediate improvement in voice, swallowing and overall QOL. There is limited literature on the nature and extent of voice and swallowing impairment in patients with lung cancer. Well designed studies with robust and sensitive multidimensional dysphagia and dysphonia assessments are required. Outcome studies examining interventions with clearly defined treatment goals are required. These studies should include both functional and patient-reported outcome measures to develop the evidence base and to ensure that interventions are both timely and appropriate.

  16. Evolview v2: an online visualization and management tool for customized and annotated phylogenetic trees.

    PubMed

    He, Zilong; Zhang, Huangkai; Gao, Shenghan; Lercher, Martin J; Chen, Wei-Hua; Hu, Songnian

    2016-07-08

    Evolview is an online visualization and management tool for customized and annotated phylogenetic trees. It allows users to visualize phylogenetic trees in various formats, customize the trees through built-in functions and user-supplied datasets and export the customization results to publication-ready figures. Its 'dataset system' contains not only the data to be visualized on the tree, but also 'modifiers' that control various aspects of the graphical annotation. Evolview is a single-page application (like Gmail); its carefully designed interface allows users to upload, visualize, manipulate and manage trees and datasets all in a single webpage. Developments since the last public release include a modern dataset editor with keyword highlighting functionality, seven newly added types of annotation datasets, collaboration support that allows users to share their trees and datasets and various improvements of the web interface and performance. In addition, we included eleven new 'Demo' trees to demonstrate the basic functionalities of Evolview, and five new 'Showcase' trees inspired by publications to showcase the power of Evolview in producing publication-ready figures. Evolview is freely available at: http://www.evolgenius.info/evolview/. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  17. Intestinal microbiota in pathophysiology and management of irritable bowel syndrome

    PubMed Central

    Lee, Kang Nyeong; Lee, Oh Young

    2014-01-01

    Irritable bowel syndrome (IBS) is a functional bowel disorder without any structural or metabolic abnormalities that sufficiently explain the symptoms, which include abdominal pain and discomfort, and bowel habit changes such as diarrhea and constipation. Its pathogenesis is multifactorial: visceral hypersensitivity, dysmotility, psychosocial factors, genetic or environmental factors, dysregulation of the brain-gut axis, and altered intestinal microbiota have all been proposed as possible causes. The human intestinal microbiota are composed of more than 1000 different bacterial species and 1014 cells, and are essential for the development, function, and homeostasis of the intestine, and for individual health. The putative mechanisms that explain the role of microbiota in the development of IBS include altered composition or metabolic activity of the microbiota, mucosal immune activation and inflammation, increased intestinal permeability and impaired mucosal barrier function, sensory-motor disturbances provoked by the microbiota, and a disturbed gut-microbiota-brain axis. Therefore, modulation of the intestinal microbiota through dietary changes, and use of antibiotics, probiotics, and anti-inflammatory agents has been suggested as strategies for managing IBS symptoms. This review summarizes and discusses the accumulating evidence that intestinal microbiota play a role in the pathophysiology and management of IBS. PMID:25083061

  18. Technology to Optimize Pediatric Diabetes Management and Outcomes

    PubMed Central

    Harrington, Kara R.; Laffel, Lori M. B.

    2013-01-01

    Technology for diabetes management is rapidly developing and changing. With each new development, there are numerous factors to consider, including medical benefits, impact on quality of life, ease of use, and barriers to use. It is also important to consider the interaction between developmental stage and technology. This review considers a number of newer diabetes-related technologies and explores issues related to their use in the pediatric diabetes population (including young adults), with a focus on psychosocial factors. Areas include trend technology in blood glucose monitoring, continuous glucose monitoring, sensor-augmented insulin pumps and low glucose suspend functions, internet applications including videoconferencing, mobile applications (apps), including text messaging, and online gaming. PMID:24046146

  19. 23 CFR 970.212 - Federal lands safety management system (SMS).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) An inventory of safety appurtenances such as signs, delineators, and guardrails (including terminals... upgrading safety appurtenances including highway-rail crossing warning devices, signs, highway elements, and... standards) for low volume roads may be tailored to be consistent with the functional classification of the...

  20. 23 CFR 970.212 - Federal lands safety management system (SMS).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) An inventory of safety appurtenances such as signs, delineators, and guardrails (including terminals... upgrading safety appurtenances including highway-rail crossing warning devices, signs, highway elements, and... standards) for low volume roads may be tailored to be consistent with the functional classification of the...

  1. 23 CFR 970.212 - Federal lands safety management system (SMS).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) An inventory of safety appurtenances such as signs, delineators, and guardrails (including terminals... upgrading safety appurtenances including highway-rail crossing warning devices, signs, highway elements, and... standards) for low volume roads may be tailored to be consistent with the functional classification of the...

  2. 23 CFR 970.212 - Federal lands safety management system (SMS).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) An inventory of safety appurtenances such as signs, delineators, and guardrails (including terminals... upgrading safety appurtenances including highway-rail crossing warning devices, signs, highway elements, and... standards) for low volume roads may be tailored to be consistent with the functional classification of the...

  3. Do current European policies support soil multifunctionality?

    NASA Astrophysics Data System (ADS)

    Helming, Katharina; Glaesner, Nadia; de Vries, Wim

    2017-04-01

    Soils are multifunctional. Maximising one function, e.g. production of biomass, is often at the costs of the other functions, e.g. water purification, carbon sequestration, nutrient recycling, habitat provision. Sustainable soil management actually means the minimization of trade-offs between multiple soil functions. While Europe does not have a policy that explicitly focuses on soil functions, a number of policies exist in the agricultural, environmental and climate domains that may affect soil functions, in particular food production, water purification, climate change mitigation, biodiversity conservation. The objective of this study was to identify gaps and overlaps in existing EU legislation that is related to soil functions. We conducted a cross-policy analysis of 19 legislative policies at European level. Results revealed two key findings: (i) soil functions are addressed in existing legislation but with the approach to their conservation rather than their improvement. (ii) Different legislations addressed isolated soil functions but there is no policy in place that actually addressed the soil multifunctionality, which is the integrated balancing of the multitude of functions. Because soil degradation is ongoing in Europe, it raises the question whether existing legislation is sufficient for maintaining soil resources and achieving sustainable soil management. Addressing soil functions individually in various directives fails to account for the multifunctionality of soil. Here, research has a role to play to better reveal the interacting processes between soil functions and their sensitivity to soil management decisions and to translate such understanding into policy recommendation. We conclude the presentation with some insights into a research approach that integrates the soil systems into the socio-economic systems to improve the understanding of soil management pressures, soil functional reactions and their impacts on societal value systems, including resource efficiency, ecosystem services and intergenerational equity.

  4. Cancer-Related Fatigue in Cancer Survivorship.

    PubMed

    Ebede, Chidinma C; Jang, Yongchang; Escalante, Carmen P

    2017-11-01

    Cancer-related fatigue (CRF) significantly interferes with usual functioning because of the distressing sense of physical, emotional, and cognitive exhaustion. Assessment of CRF is important and should be performed during the initial cancer diagnosis, throughout cancer treatment, and after treatment using a fatigue scoring scale (mild-severe). The general approach to CRF management applies to cancer survivors at all fatigue levels and includes education, counseling, and other strategies. Nonpharmacologic interventions include psychosocial interventions, exercise, yoga, physically based therapy, dietary management, and sleep therapy. Pharmacologic interventions include psychostimulants. Antidepressants may also benefit when CRF is accompanied by depression. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Pediatric issues in disaster management, Part 1: the emergency medical system and surge capacity.

    PubMed

    Mace, Sharon E; Sharieff, Ghazala; Bern, Andrew; Benjamin, Lee; Burbulys, Dave; Johnson, Ramon; Schreiber, Merritt

    2010-01-01

    Although children and infants are likely to be victims in a disaster and are more vulnerable in a disaster than adults, disaster planning and management has often overlooked the specific needs of pediatric patients. The authors discuss key components of disaster planning and management for pediatric patients, including emergency medical services, hospital/facility issues, evacuation centers, family separation/reunification, children with special healthcare needs (SHCNs), mental health issues, and overcrowding/surge capacity. Specific policy recommendations and an appendix with detailed practical information and algorithms are included. The first part of this three-part series on pediatric issues in disaster management addresses the emergency medical system from the field to the hospital and surge capacity including the impact of crowding. The second part addresses the appropriate setup and functioning of evacuation centers and family separation and reunification. The third part deals with special patient populations: children with SHCNs and mental health issues.

  6. Commercially Available Smartphone Apps to Support Postoperative Pain Self-Management: Scoping Review

    PubMed Central

    Shah, Ushma; Birnie, Kathryn A; Davies-Chalmers, Cleo; Rivera, Jordan; Stinson, Jennifer; Campbell, Fiona

    2017-01-01

    Background Recently, the use of smartphones to deliver health-related content has experienced rapid growth, with more than 165,000 mobile health (mHealth) apps currently available in the digital marketplace. With 3 out of 4 Canadians currently owning a smartphone, mHealth apps offer opportunities to deliver accessible health-related knowledge and support. Many individuals experience pain after surgery, which can negatively impact their health-related quality of life, including sleep, emotional, and social functioning. Smartphone apps that provide remote real-time monitoring and symptom management have the potential to improve self-management skills in patients experiencing postoperative pain. Increased confidence and practice of self-management skills could contribute to decreased postoperative pain and reduce risk of developing persistent pain. Published reviews of general pain self-management apps demonstrate a lack of evidence-based content, theoretical grounding, and health care professional involvement. However, no review to date has focused on the app marketplace specific for individuals with postoperative pain. Objective The aim of this study was to characterize and critically appraise the content and functionality of commercially available postoperative pain self-management apps. Methods An electronic search and extraction was conducted between December 2016 and March 2017 of the official Canadian app stores for the three major smartphone operating systems (iPhone operating system [iOS], Android, and Windows). Stores were searched separately using predetermined search terms. Two authors screened apps based on information provided in the public app description. Metadata from all included apps were abstracted into a standard spreadsheet. Two authors verified the data with reference to the apps and downloaded apps themselves. The content and functionality of each app as it pertained to postoperative pain self-management was rated. Results A total of 10 apps met the inclusion criteria. All included apps were designed exclusively for the Android platform. Education was the most common self-management feature offered (8/10, 80%), with none of the apps offering features related to goal setting or social support. Overall, no single app was comprehensive in terms of pain self-management content. Five (50%) apps reported the involvement of a health care provider in their development. However, not a single app involved end users in their development, and none of the apps underwent scientific evaluation. Additionally, none of the apps were designed for use in pediatric patients. Conclusions Currently available postoperative pain apps for patients lack evidence-based content, goal setting, and social support functions. There is a need to develop and test comprehensive theory-based apps to support patients with pain self-management care following surgery. PMID:29061558

  7. Commercially Available Smartphone Apps to Support Postoperative Pain Self-Management: Scoping Review.

    PubMed

    Lalloo, Chitra; Shah, Ushma; Birnie, Kathryn A; Davies-Chalmers, Cleo; Rivera, Jordan; Stinson, Jennifer; Campbell, Fiona

    2017-10-23

    Recently, the use of smartphones to deliver health-related content has experienced rapid growth, with more than 165,000 mobile health (mHealth) apps currently available in the digital marketplace. With 3 out of 4 Canadians currently owning a smartphone, mHealth apps offer opportunities to deliver accessible health-related knowledge and support. Many individuals experience pain after surgery, which can negatively impact their health-related quality of life, including sleep, emotional, and social functioning. Smartphone apps that provide remote real-time monitoring and symptom management have the potential to improve self-management skills in patients experiencing postoperative pain. Increased confidence and practice of self-management skills could contribute to decreased postoperative pain and reduce risk of developing persistent pain. Published reviews of general pain self-management apps demonstrate a lack of evidence-based content, theoretical grounding, and health care professional involvement. However, no review to date has focused on the app marketplace specific for individuals with postoperative pain. The aim of this study was to characterize and critically appraise the content and functionality of commercially available postoperative pain self-management apps. An electronic search and extraction was conducted between December 2016 and March 2017 of the official Canadian app stores for the three major smartphone operating systems (iPhone operating system [iOS], Android, and Windows). Stores were searched separately using predetermined search terms. Two authors screened apps based on information provided in the public app description. Metadata from all included apps were abstracted into a standard spreadsheet. Two authors verified the data with reference to the apps and downloaded apps themselves. The content and functionality of each app as it pertained to postoperative pain self-management was rated. A total of 10 apps met the inclusion criteria. All included apps were designed exclusively for the Android platform. Education was the most common self-management feature offered (8/10, 80%), with none of the apps offering features related to goal setting or social support. Overall, no single app was comprehensive in terms of pain self-management content. Five (50%) apps reported the involvement of a health care provider in their development. However, not a single app involved end users in their development, and none of the apps underwent scientific evaluation. Additionally, none of the apps were designed for use in pediatric patients. Currently available postoperative pain apps for patients lack evidence-based content, goal setting, and social support functions. There is a need to develop and test comprehensive theory-based apps to support patients with pain self-management care following surgery. ©Chitra Lalloo, Ushma Shah, Kathryn A Birnie, Cleo Davies-Chalmers, Jordan Rivera, Jennifer Stinson, Fiona Campbell. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 23.10.2017.

  8. A Catchment Systems Engineering (CSE) approach to managing intensively farmed land

    NASA Astrophysics Data System (ADS)

    Jonczyk, Jennine; Quinn, Paul; Barber, Nicholas; Wilkinson, Mark; ODonnell, Greg

    2014-05-01

    Rural land management practices can have a significant impact on the hydrological and nutrient dynamics within a catchment which can dramatically alter the way it processes water, exacerbating nutrient losses from the system. A collaborative and holistic approach for managing potential conflicts between land management activity for food production alongside the aspiration to achieve good water quality and the need to make space for water can ensure the long-term sustainability of our agricultural catchments. Catchment System Engineering (CSE) is an interventionist approach to altering the catchment scale runoff regime through the manipulation of hydrological flow pathways throughout the catchment. By targeting hydrological flow pathways at source, such as overland flow, field drain and ditch function, a significant component of the runoff generation can be managed, greatly reducing erosive soil losses. Coupled with management of farm nutrients at source many runoff attenuation features or measures can be co-located to achieve benefits for water quality. Examples of community-led mitigation measures using the CSE approach will be presented from two catchments in Northumberland, Northern England, that demonstrate the generic framework for identification of multipurpose features that slow, store and filter runoff at strategic locations in the landscape. Measures include within-field barriers, edge of field traps and within-field sediment filters and sediment traps which demonstrate how sediment can be trapped locally (including silt and clay fractions) and be recovered for use back on the land. Deliverables from this CSE approach includes the reduction of downstream flood risk and capturing of sediment and associated nutrients. The CSE approach allows for a more natural flood and nutrient management approach which helps to restore vital catchment functions to re-establish a healthy catchment system.

  9. Speech–Language Pathology Evaluation and Management of Hyperkinetic Disorders Affecting Speech and Swallowing Function

    PubMed Central

    Barkmeier-Kraemer, Julie M.; Clark, Heather M.

    2017-01-01

    Background Hyperkinetic dysarthria is characterized by abnormal involuntary movements affecting respiratory, phonatory, and articulatory structures impacting speech and deglutition. Speech–language pathologists (SLPs) play an important role in the evaluation and management of dysarthria and dysphagia. This review describes the standard clinical evaluation and treatment approaches by SLPs for addressing impaired speech and deglutition in specific hyperkinetic dysarthria populations. Methods A literature review was conducted using the data sources of PubMed, Cochrane Library, and Google Scholar. Search terms included 1) hyperkinetic dysarthria, essential voice tremor, voice tremor, vocal tremor, spasmodic dysphonia, spastic dysphonia, oromandibular dystonia, Meige syndrome, orofacial, cervical dystonia, dystonia, dyskinesia, chorea, Huntington’s Disease, myoclonus; and evaluation/treatment terms: 2) Speech–Language Pathology, Speech Pathology, Evaluation, Assessment, Dysphagia, Swallowing, Treatment, Management, and diagnosis. Results The standard SLP clinical speech and swallowing evaluation of chorea/Huntington’s disease, myoclonus, focal and segmental dystonia, and essential vocal tremor typically includes 1) case history; 2) examination of the tone, symmetry, and sensorimotor function of the speech structures during non-speech, speech and swallowing relevant activities (i.e., cranial nerve assessment); 3) evaluation of speech characteristics; and 4) patient self-report of the impact of their disorder on activities of daily living. SLP management of individuals with hyperkinetic dysarthria includes behavioral and compensatory strategies for addressing compromised speech and intelligibility. Swallowing disorders are managed based on individual symptoms and the underlying pathophysiology determined during evaluation. Discussion SLPs play an important role in contributing to the differential diagnosis and management of impaired speech and deglutition associated with hyperkinetic disorders. PMID:28983422

  10. Riparian buffer design guidelines for water quality and wildlife habitat functions on agricultural landscapes in the Intermountain West

    Treesearch

    Craig W. Johnson; Susan Buffler

    2008-01-01

    Intermountain West planners, designers, and resource managers are looking for science-based procedures for determining buffer widths and management techniques that will optimize the benefits riparian ecosystems provide. This study reviewed the riparian buffer literature, including protocols used to determine optimum buffer widths for water quality and wildlife habitat...

  11. Management of California Oak Woodlands: Uncertainties and Modeling

    Treesearch

    Jay E. Noel; Richard P. Thompson

    1995-01-01

    A mathematical policy model of oak woodlands is presented. The model illustrates the policy uncertainties that exist in the management of oak woodlands. These uncertainties include: (1) selection of a policy criterion function, (2) woodland dynamics, (3) initial and final state of the woodland stock. The paper provides a review of each of the uncertainty issues. The...

  12. Automation of Space Station module power management and distribution system

    NASA Technical Reports Server (NTRS)

    Bechtel, Robert; Weeks, Dave; Walls, Bryan

    1990-01-01

    Viewgraphs on automation of space station module (SSM) power management and distribution (PMAD) system are presented. Topics covered include: reasons for power system automation; SSM/PMAD approach to automation; SSM/PMAD test bed; SSM/PMAD topology; functional partitioning; SSM/PMAD control; rack level autonomy; FRAMES AI system; and future technology needs for power system automation.

  13. Microcomputer-Based Detachment Administrative Management System for the LAMPS (Light Airborne Multi-Purpose System) Community. A Requirements Analysis.

    DTIC Science & Technology

    1985-09-01

    management and recurring reports generation . Included are the results of user interviews which were conducted to determine oossible system functions...9 A. GENERAL ...................... .......... 3 B. RESEARCH OBJECTIVES ............................ I0 C. SCOPE .. D... GENERAL DESCRIPTION (LAMPS) ...................... 9. LPMrOS CRGANIZAT r.N ............................... C. REPCRT>1NG RECLUIRE,’ENTS

  14. Study of solid rocket motor for space shuttle booster, Volume 3: Program acquisition planning

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The program planning acquisition functions for the development of the solid propellant rocket engine for the space shuttle booster is presented. The subjects discussed are: (1) program management, (2) contracts administration, (3) systems engineering, (4) configuration management, and (5) maintenance engineering. The plans for manufacturing, testing, and operations support are included.

  15. Predictive Mapping of Forest Attributes on the Fishlake National Forest

    Treesearch

    Tracey S. Frescino; Gretchen G. Moisen

    2005-01-01

    Forest land managers increasingly need maps of forest characteristics to aid in planning and management. A set of 30-m resolution maps was prepared for the Fishlake National Forest by modeling FIA plot variables as nonparametric functions of ancillary digital data. The set includes maps of volume, biomass, growth, stand age, size, crown cover, and various aspen...

  16. Management commitment to safety as organizational support: relationships with non-safety outcomes in wood manufacturing employees

    Treesearch

    Judd H. Michael; Demetrice D. Evans; Karen J. Jansen; Joel M. Haight

    2005-01-01

    Employee perceptions of management commitment to safety are known to influence important safety-related outcomes. However, little work has been conducted to explore nonsafety-related outcomes resulting from a commitment to safety. Method: Employee-level outcomes critical to the effective functioning of an organization, including attitudes such as job...

  17. Potential fire behavior in California: an atlas and guide for forest and brushland managers

    Treesearch

    Bill C. Ryan

    1984-01-01

    Potential fire characteristics can be estimated as functions of weather, fuel, and terrain slope. Such information is needed by forest and other land managers--especially for anticipating fire suppression needs and planning prescribed burns. To provide this information, an Atlas has been developed for California. The Atlas includes statistical analyses of spread...

  18. Attaining and maintaining data integrity with configuration management

    NASA Astrophysics Data System (ADS)

    Huffman, Dorothy J.; Jeane, Shirley A.

    1993-08-01

    Managers and scientists are concerned about data integrity because they draw conclusions from data that can have far reaching effects. Projects managers use Configuration Management to insure that hardware, software, and project information are controlled. They have not, as yet, applied its rigorously to data. However, there is ample opportunity in the data collection and production process to jeopardize data integrity. Environmental changes, tampering and production problems can all affect data integrity. There are four functions included in the Configuration Management process: configuration identification, control, auditing and status accounting. These functions provide management the means to attain data integrity and the visibility into engineering processes needed to maintain data integrity. When project managers apply Configuration Management processes to data, the data user can trace back through history to validate data integrity. The user knows that the project allowed only orderly changes to the data. He is assured that project personnel followed procedures to maintain data quality. He also has access to status information about the data. The user receives data products with a known integrity level and a means to assess the impact of past events ont he conclusions derived from the data. To obtain these benefits, project managers should apply the Configuration Management discipline to data.

  19. The Ottawa Panel guidelines on programmes involving therapeutic exercise for the management of hand osteoarthritis.

    PubMed

    Brosseau, Lucie; Thevenot, Odette; MacKiddie, Olivia; Taki, Jade; Wells, George A; Guitard, Paulette; Léonard, Guillaume; Paquet, Nicole; Aydin, Sibel Z; Toupin-April, Karine; Cavallo, Sabrina; Moe, Rikke Helene; Shaikh, Kamran; Gifford, Wendy; Loew, Laurianne; De Angelis, Gino; Shallwani, Shirin Mehdi; Aburub, Ala' S; Mizusaki Imoto, Aline; Rahman, Prinon; Álvarez Gallardo, Inmaculada C; Cosic, Milkana Borges; Østerås, Nina; Lue, Sabrina; Hamasaki, Tokiko; Gaudreault, Nathaly; Towheed, Tanveer E; Koppikar, Sahil; Kjeken, Ingvild; Mahendira, Dharini; Kenny, Glen P; Paterson, Gail; Westby, Marie; Laferrière, Lucie; Longchamp, Guy

    2018-06-01

    To identify programmes involving therapeutic exercise that are effective for the management of hand osteoarthritis and to provide stakeholders with updated, moderate to high-quality recommendations supporting exercises for hand osteoarthritis. A systematic search and adapted selection criteria included comparable trials with exercise programmes for managing hand osteoarthritis. Based on the evaluated evidence, a panel of experts reached consensus through a Delphi approach endorsing the recommendations. A hierarchical alphabetical grading system (A, B, C+, C, C-, D-, D, D+, E, F) was based on clinical importance (≥15%) and statistical significance ( P < 0.05). Ten moderate- to high-quality studies were included. Eight studies with programmes involving therapeutic exercise (e.g. range of motion (ROM) + isotonic + isometric + functional exercise) seemed to be effective. Forty-six positive grade recommendations (i.e. A, B, C+) were obtained during short-term (<12 weeks) trials for pain, stiffness, physical function, grip strength, pinch strength, range of motion, global assessment, pressure pain threshold, fatigue and abductor pollicis longus moment and during long-term (>12 weeks) trials for physical function and pinch strength. Despite that many programmes involving exercise with positive recommendations for clinical outcomes are available to healthcare professionals and hand osteoarthritis patients that aid in the management of hand osteoarthritis, there is a need for further research to isolate the specific effect of exercise components.

  20. Essential activities and knowledge domains of case management: new insights from the CCMC role and functions study.

    PubMed

    Tahan, Hussein

    2006-01-01

    The Commission for Case Manager Certification (CCMC) defines case management (CM) as "a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual's health needs. [Case management] uses communication and available resources to promote quality, cost-effective outcomes." The practice of CM spans the entire health-care spectrum, including pre-acute, acute, and post-acute settings, and the involvement of varied care providers, such as nurses, social workers, rehabilitation counselors, physicians, and other allied health professionals. So what does it mean to practice as a case manager? What roles and job functions are performed and what knowledge is required of a professional in the field for effective practice? These highly relevant questions reflect the thinking of the CCMC commissioners when the latest Case Manager Role and Functions study was undertaken. The primary purpose of this research, which is conducted every 5 years by the CCMC, is to capture the current state of CM practice. This type of in-depth research is required to support an evidence-based certification examination such as the one offered by CCMC-the certified case manager (CCM) credential. Moreover, as the first and largest nationally accredited organization to certify US case managers, the CCMC recognizes its responsibility to undertake and promote scientifically conducted research in the field of CM.

  1. Dynamic Transportation Navigation

    NASA Astrophysics Data System (ADS)

    Meng, Xiaofeng; Chen, Jidong

    Miniaturization of computing devices, and advances in wireless communication and sensor technology are some of the forces that are propagating computing from the stationary desktop to the mobile outdoors. Some important classes of new applications that will be enabled by this revolutionary development include intelligent traffic management, location-based services, tourist services, mobile electronic commerce, and digital battlefield. Some existing application classes that will benefit from the development include transportation and air traffic control, weather forecasting, emergency response, mobile resource management, and mobile workforce. Location management, i.e., the management of transient location information, is an enabling technology for all these applications. In this chapter, we present the applications of moving objects management and their functionalities, in particular, the application of dynamic traffic navigation, which is a challenge due to the highly variable traffic state and the requirement of fast, on-line computations.

  2. A Review of Function Allocation and En Route Separation Assurance

    NASA Technical Reports Server (NTRS)

    Lewis, Timothy A.; Aweiss, Arwa S.; Guerreiro, Nelson M.; Daiker, Ronald J.

    2016-01-01

    Today's air traffic control system has reached a limit to the number of aircraft that can be safely managed at the same time. This air traffic capacity bottleneck is a critical problem along the path to modernization for air transportation. The design of the next separation assurance system to address this problem is a cornerstone of air traffic management research today. This report reviews recent work by NASA and others in the areas of function allocation and en route separation assurance. This includes: separation assurance algorithms and technology prototypes; concepts of operations and designs for advanced separation assurance systems; and specific investigations into air-ground and human-automation function allocation.

  3. Development of an expert system prototype for determining software functional requirements for command management activities at NASA Goddard

    NASA Technical Reports Server (NTRS)

    Liebowitz, J.

    1985-01-01

    The development of an expert system prototype for determining software functional requirements for NASA Goddard's Command Management System (CMS) is described. The role of the CMS is to transform general requests into specific spacecraft commands with command execution conditions. The CMS is part of the NASA Data System which entails the downlink of science and engineering data from NASA near-earth satellites to the user, and the uplink of command and control data to the spacecraft. Subjects covered include: the problem environment of determining CMS software functional requirements; the expert system approach for handling CMS requirements development; validation and evaluation procedures for the expert system.

  4. Cardiorenal Syndrome: New Developments in the Understanding and Pharmacologic Management

    PubMed Central

    2013-01-01

    Summary Cardiorenal syndromes (CRSs) with bidirectional heart-kidney signaling are increasingly being recognized for their association with increased morbidity and mortality. In acute CRS, recognition of the importance of worsening kidney function complicating management of acute decompensated heart failure has led to the examination of this specific outcome in the context of acute heart failure clinical trials. In particular, the role of fluid overload and venous congestion has focused interest in the most effective use of diuretic therapy to relieve symptoms of heart failure while at the same time preserving kidney function. Additionally, many novel vasoactive therapies have been studied in recent years with the hopes of augmenting cardiac function, improving symptoms and patient outcomes, while maintaining or improving kidney function. Similarly, recent advances in our understanding of the pathophysiology of chronic CRS have led to reanalysis of kidney outcomes in pivotal trials in chronic congestive heart failure, and newer trials are including changes in kidney function as well as kidney injury biomarkers as prospectively monitored and adjudicated outcomes. This paper provides an overview of some new developments in the pharmacologic management of acute and chronic CRS, examines several reports that illustrate a key management principle for each subtype, and discusses opportunities for future research. PMID:23929925

  5. Improving Care Transitions Management: Examining the Role of Accountable Care Organization Participation and Expanded Electronic Health Record Functionality.

    PubMed

    Huber, Thomas P; Shortell, Stephen M; Rodriguez, Hector P

    2017-08-01

    Examine the extent to which physician organization participation in an accountable care organization (ACO) and electronic health record (EHR) functionality are associated with greater adoption of care transition management (CTM) processes. A total of 1,398 physician organizations from the third National Study of Physician Organization survey (NSPO3), a nationally representative sample of medical practices in the United States (January 2012-May 2013). We used data from the third National Study of Physician Organization survey (NSPO3) to assess medical practice characteristics, including CTM processes, ACO participation, EHR functionality, practice type, organization size, ownership, public reporting, and pay-for-performance participation. Multivariate linear regression models estimated the extent to which ACO participation and EHR functionality were associated with greater CTM capabilities, controlling for practice size, ownership, public reporting, and pay-for-performance participation. Approximately half (52.4 percent) of medical practices had a formal program for managing care transitions in place. In adjusted analyses, ACO participation (p < .001) and EHR functionality (p < .001) were independently associated with greater use of CTM processes among medical practices. The growth of ACOs and similar provider risk-bearing arrangements across the country may improve the management of care transitions by physician organizations. © Health Research and Educational Trust.

  6. Mobile Health to Maintain Continuity of Patient-Centered Care for Chronic Kidney Disease: Content Analysis of Apps.

    PubMed

    Lee, Ying-Li; Cui, Yan-Yan; Tu, Ming-Hsiang; Chen, Yu-Chi; Chang, Polun

    2018-04-20

    Chronic kidney disease (CKD) is a global health problem with a high economic burden, which is particularly prevalent in Taiwan. Mobile health apps have been widely used to maintain continuity of patient care for various chronic diseases. To slow the progression of CKD, continuity of care is vital for patients' self-management and cooperation with health care professionals. However, the literature provides a limited understanding of the use of mobile health apps to maintain continuity of patient-centered care for CKD. This study identified apps related to the continuity of patient-centered care for CKD on the App Store, Google Play, and 360 Mobile Assistant, and explored the information and frequency of changes in these apps available to the public on different platforms. App functionalities, like patient self-management and patient management support for health care professionals, were also examined. We used the CKD-related keywords "kidney," "renal," "nephro," "chronic kidney disease," "CKD," and "kidney disease" in traditional Chinese, simplified Chinese, and English to search 3 app platforms: App Store, Google Play, and 360 Mobile Assistant. A total of 2 reviewers reached consensus on coding guidelines and coded the contents and functionalities of the apps through content analysis. After coding, Microsoft Office Excel 2016 was used to calculate Cohen kappa coefficients and analyze the contents and functionalities of the apps. A total of 177 apps related to patient-centered care for CKD in any language were included. On the basis of their functionality and content, 67 apps were recommended for patients. Among them, the most common functionalities were CKD information and CKD self-management (38/67, 57%), e-consultation (17/67, 25%), CKD nutrition education (16/67, 24%), and estimated glomerular filtration rate (eGFR) calculators (13/67, 19%). In addition, 67 apps were recommended for health care professionals. The most common functionalities of these apps were comprehensive clinical calculators (including eGFR; 30/67; 45%), CKD medical professional information (16/67, 24%), stand-alone eGFR calculators (14/67, 21%), and CKD clinical decision support (14/67, 21%). A total of 43 apps with single- or multiple-indicator calculators were found to be suitable for health care professionals and patients. The aspects of patient care apps intended to support self-management of CKD patients were encouraging patients to actively participate in health care (92/110, 83.6%), recognizing and effectively responding to symptoms (56/110, 50.9%), and disease-specific knowledge (53/110, 48.2%). Only 13 apps contained consulting management functions, patient management functions or teleconsultation functions designed to support health care professionals in CKD patient management. This study revealed that the continuity of patient-centered care for CKD provided by mobile health apps is inadequate for both CKD self-management by patients and patient care support for health care professionals. More comprehensive solutions are required to enhance the continuity of patient-centered care for CKD. ©Ying-Li Lee, Yan-Yan Cui, Ming-Hsiang Tu, Yu-Chi Chen, Polun Chang. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 20.04.2018.

  7. Mobile Health to Maintain Continuity of Patient-Centered Care for Chronic Kidney Disease: Content Analysis of Apps

    PubMed Central

    Lee, Ying-Li; Cui, Yan-Yan; Tu, Ming-Hsiang; Chen, Yu-Chi

    2018-01-01

    Background Chronic kidney disease (CKD) is a global health problem with a high economic burden, which is particularly prevalent in Taiwan. Mobile health apps have been widely used to maintain continuity of patient care for various chronic diseases. To slow the progression of CKD, continuity of care is vital for patients’ self-management and cooperation with health care professionals. However, the literature provides a limited understanding of the use of mobile health apps to maintain continuity of patient-centered care for CKD. Objective This study identified apps related to the continuity of patient-centered care for CKD on the App Store, Google Play, and 360 Mobile Assistant, and explored the information and frequency of changes in these apps available to the public on different platforms. App functionalities, like patient self-management and patient management support for health care professionals, were also examined. Methods We used the CKD-related keywords “kidney,” “renal,” “nephro,” “chronic kidney disease,” “CKD,” and “kidney disease” in traditional Chinese, simplified Chinese, and English to search 3 app platforms: App Store, Google Play, and 360 Mobile Assistant. A total of 2 reviewers reached consensus on coding guidelines and coded the contents and functionalities of the apps through content analysis. After coding, Microsoft Office Excel 2016 was used to calculate Cohen kappa coefficients and analyze the contents and functionalities of the apps. Results A total of 177 apps related to patient-centered care for CKD in any language were included. On the basis of their functionality and content, 67 apps were recommended for patients. Among them, the most common functionalities were CKD information and CKD self-management (38/67, 57%), e-consultation (17/67, 25%), CKD nutrition education (16/67, 24%), and estimated glomerular filtration rate (eGFR) calculators (13/67, 19%). In addition, 67 apps were recommended for health care professionals. The most common functionalities of these apps were comprehensive clinical calculators (including eGFR; 30/67; 45%), CKD medical professional information (16/67, 24%), stand-alone eGFR calculators (14/67, 21%), and CKD clinical decision support (14/67, 21%). A total of 43 apps with single- or multiple-indicator calculators were found to be suitable for health care professionals and patients. The aspects of patient care apps intended to support self-management of CKD patients were encouraging patients to actively participate in health care (92/110, 83.6%), recognizing and effectively responding to symptoms (56/110, 50.9%), and disease-specific knowledge (53/110, 48.2%). Only 13 apps contained consulting management functions, patient management functions or teleconsultation functions designed to support health care professionals in CKD patient management. Conclusions This study revealed that the continuity of patient-centered care for CKD provided by mobile health apps is inadequate for both CKD self-management by patients and patient care support for health care professionals. More comprehensive solutions are required to enhance the continuity of patient-centered care for CKD. PMID:29678805

  8. Treatment alternatives of congenital hand differences with thumb hypoplasia involvement.

    PubMed

    Papadogeorgou, Ellada V; Soucacos, Panayotis N

    2008-01-01

    Congenital thumb hypoplasia is a complex and heterogeneous congenital difference that is detrimental to hand function. Apart from its' classic form, which is now considered to be part of radial dysplasia, it can occur as part of other congenital anomalies including, syndactyly, symbrachydactyly, atypical cleft hand, bifid thumb, triphalangeal thumb, mirror hand, constriction band syndrome, as well as generalized anomalies and syndromes. Management is aimed primarily at restoring basic hand function, specifically, power grasp and precision pinch, and secondarily to improve cosmoses, which inevitably is going to be impaired. Several treatment alternatives have been proposed to manage the specific disabling condition and include, 1st web space reconstruction and opponensplasty, pollicization, toe-to-hand transfer, distraction lengthening, free toe phalangeal transfer or the use of allograft, stabilization of the metacarpophalangeal joint, and surgery of "spare parts." The purpose of this study is to evaluate the various alternatives available today and propose an algorithm applicable for the appropriate management of thumb deficiency, based on their specific characteristics. Copyright 2008 Wiley-Liss, Inc. Microsurgery, 2008.

  9. Hepatic encephalopathy: cause and possible management with botanicals.

    PubMed

    Tripathi, Suyash; Tripathi, Yamini B

    2014-01-01

    Hepatic encephalopathy is a brain functional disorder, characterized by neuropsychiatric abnormalities with liver failure. High blood ammonia, causing glutamate neurotoxicity is the basic cause, finally leading to low-grade cerebral edema. Its manifestation is more likely in patients of sepsis, oxidative stress, generalized inflammation, gut mal-functioning, amoebiaesis, viral hepatitis, nervous imbalance, etc. Thus, the therapeutic goals primarily include the maintenance of proper blood supply and prevention of hypoxic condition in liver, along with management of factors responsible for high blood ammonia, oxidative stress, inflammation, and high GI- serotonin. The drugs in clinical practice include lactulose, sodium benzoate, flumazenil and rifaximin, supplementation of zinc, branched chain amino acids (BCAA), l-ornithine-l aspartate, antioxidants and iNOS inhibitors. However, herbal formulations would be of great importance as it shows multi-targeted action because it possesses a natural cocktail of secondary metabolites. It can collectively act as an antioxidant, anti-inflammatory, prebiotic, hepatoprotective and neuron-protective agents. We have briefly outlined some of these plants and also recent patents useful in the management of hepatic encephalopathy.

  10. Functional electrical stimulation equipment: a review of marketplace availability and reimbursement.

    PubMed

    Teeter, J O; Moora, C R

    2000-01-01

    Functional electrical stimulation (FES) is a rehabilitation tool that has broad application in disability management for improving consumer health and independence. This review examines the availability and delivery of electrical stimulation equipment in a managed care environment, focusing particularly on recent advances and marketplace influences. New electrical stimulation products that are unique in their ability to improve function after disease or injury over conventional drug therapy, surgical intervention, or other rehabilitation techniques are described. Research directions, including new uses for existing products to expand patient indications, are discussed. Guidelines to assist providers and developers of FES technology with managing the reimbursement process are provided. The successful introduction of recent FES products should pave the way for even more exciting developments. However, reimbursement requires careful and early planning to ensure that FES technologies are available to people who may benefit from them.

  11. Fluoroscopic lumbar interlaminar epidural injections in managing chronic lumbar axial or discogenic pain

    PubMed Central

    Manchikanti, Laxmaiah; Cash, Kimberly A; McManus, Carla D; Pampati, Vidyasagar; Benyamin, Ramsin

    2012-01-01

    Among the multiple causes of chronic low back pain, axial and discogenic pain are common. Various modalities of treatments are utilized in managing discogenic and axial low back pain including epidural injections. However, there is a paucity of evidence regarding the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. In an interventional pain management practice in the US, a randomized, double-blind, active control trial was conducted. The objective was to assess the effectiveness of lumbar interlaminar epidural injections of local anesthetic with or without steroids for managing chronic low back pain of discogenic origin. However, disc herniation, radiculitis, facet joint pain, or sacroiliac joint pain were excluded. Two groups of patients were studied, with 60 patients in each group receiving either local anesthetic only or local anesthetic mixed with non-particulate betamethasone. Primary outcome measures included the pain relief-assessed by numeric rating scale of pain and functional status assessed by the, Oswestry Disability Index, Secondary outcome measurements included employment status, and opioid intake. Significant improvement or success was defined as at least a 50% decrease in pain and disability. Significant improvement was seen in 77% of the patients in Group I and 67% of the patients in Group II. In the successful groups (those with at least 3 weeks of relief with the first two procedures), the improvement was 84% in Group I and 71% in Group II. For those with chronic function-limiting low back pain refractory to conservative management, it is concluded that lumbar interlaminar epidural injections of local anesthetic with or without steroids may be an effective modality for managing chronic axial or discogenic pain. This treatment appears to be effective for those who have had facet joints as well as sacroiliac joints eliminated as the pain source. PMID:23055773

  12. Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercise in the management of hip osteoarthritis.

    PubMed

    Brosseau, Lucie; Wells, George A; Pugh, Arlanna G; Smith, Christine Am; Rahman, Prinon; Àlvarez Gallardo, Inmaculada C; Toupin-April, Karine; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Taki, Jade; Marcotte, Rachel; Fransen, Marlene; Hernandez-Molina, Gabriela; Kenny, Glen P; Regnaux, Jean-Philippe; Lefevre-Colau, Marie-Martine; Brooks, Sydney; Laferriere, Lucie; McLean, Linda; Longchamp, Guy

    2016-10-01

    The primary objective is to identify effective land-based therapeutic exercise interventions and provide evidence-based recommendations for managing hip osteoarthritis. A secondary objective is to develop an Ottawa Panel evidence-based clinical practice guideline for hip osteoarthritis. The search strategy and modified selection criteria from a Cochrane review were used. Studies included hip osteoarthritis patients in comparative controlled trials with therapeutic exercise interventions. An Expert Panel arrived at a Delphi survey consensus to endorse the recommendations. The Ottawa Panel hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) considered the study design (level I: randomized controlled trial and level II: controlled clinical trial), statistical significance (p < 0.5), and clinical importance (⩾15% improvement). Four high-quality studies were included, which demonstrated that variations of strength training, stretching, and flexibility exercises are generally effective for improving the management of hip osteoarthritis. Strength training exercises displayed the greatest improvements for pain (Grade A), disability (Grades A and C+), physical function (Grade A), stiffness (Grade A), and range of motion (Grade A) within a short time period (8-24 weeks). Stretching also greatly improved physical function (Grade A), and flexibility exercises improved pain (Grade A), range of motion (Grade A), physical function (Grade A), and stiffness (Grade C+). The Ottawa Panel recommends land-based therapeutic exercise, notably strength training, for management of hip osteoarthritis in reducing pain, stiffness and self-reported disability, and improving physical function and range of motion. © The Author(s) 2015.

  13. Physiotherapy in the management of total knee arthroplasty: a review.

    PubMed

    Akodu, A K; Giwa, S O; Akinbo, S R A; Ahmed, U A

    2011-01-01

    Although total knee arthroplasty (TKA) is considered the treatment of choice for patients with intractable pain and substantial functional disabilities who have not had acceptable relief and functional improvement after conservative treatment. It was found out that patients with total knee arthroplasty need physiotherapy intervention for pre-operative and post-operative management. To take a critical look at the importance of TKA following destruction of the knee joint, its indications and contraindications and to ascertain the current trend involved in the physiotherapy management of TKA. The current literature materials on physiotherapy management of TKA was reviewed. The aim of treatment is to maximize functionality and independence and to minimize complication such as deep vein thrombosis and pulmonary embolism by relieving pain using cryotherapy, improving range of motion with mobilization techniques, muscle strengthening, therapeutic exercise, transfer training, gait training and training of activities of daily living. These are administered as home programme or in organized groups led by a physiotherapist and has been shown to improve outcome related to physical activity after knee joint arthroplasty. It was concluded that interventions, including physiotherapy and functional exercises after discharge, is still beneficial after TKA.

  14. Prototype Flight Management Capabilities to Explore Temporal RNP Concepts

    NASA Technical Reports Server (NTRS)

    Ballin, Mark G.; Williams, David H.; Allen, Bonnie Danette; Palmer, Michael T.

    2008-01-01

    Next Generation Air Transportation System (NextGen) concepts of operation may require aircraft to fly planned trajectories in four dimensions three spatial dimensions and time. A prototype 4D flight management capability is being developed by NASA to facilitate the development of these concepts. New trajectory generation functions extend today's flight management system (FMS) capabilities that meet a single Required Time of Arrival (RTA) to trajectory solutions that comply with multiple RTA constraints. When a solution is not possible, a constraint management capability relaxes constraints to achieve a trajectory solution that meets the most important constraints as specified by candidate NextGen concepts. New flight guidance functions provide continuous guidance to the aircraft s flight control system to enable it to fly specified 4D trajectories. Guidance options developed for research investigations include a moving time window with varying tolerances that are a function of proximity to imposed constraints, and guidance that recalculates the aircraft s planned trajectory as a function of the estimation of current compliance. Compliance tolerances are related to required navigation performance (RNP) through the extension of existing RNP concepts for lateral containment. A conceptual temporal RNP implementation and prototype display symbology are proposed.

  15. Endovascular vs medical management of acute ischemic stroke

    PubMed Central

    Ding, Dale; Starke, Robert M.; Mehndiratta, Prachi; Crowley, R. Webster; Liu, Kenneth C.; Southerland, Andrew M.; Worrall, Bradford B.

    2015-01-01

    Objective: To compare the outcomes between endovascular and medical management of acute ischemic stroke in recent randomized controlled trials (RCT). Methods: A systematic literature review was performed, and multicenter, prospective RCTs published from January 1, 2013, to May 1, 2015, directly comparing endovascular therapy to medical management for patients with acute ischemic stroke were included. Meta-analyses of modified Rankin Scale (mRS) and mortality at 90 days and symptomatic intracranial hemorrhage (sICH) for endovascular therapy and medical management were performed. Results: Eight multicenter, prospective RCTs (Interventional Management of Stroke [IMS] III, Local Versus Systemic Thrombolysis for Acute Ischemic Stroke [SYNTHESIS] Expansion, Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy [MR RESCUE], Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands [MR CLEAN], Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness [ESCAPE], Extending the Time for Thrombolysis in Emergency Neurological Deficits–Intra-Arterial [EXTEND-IA], Solitaire With the Intention For Thrombectomy as Primary Endovascular Treatment [SWIFT PRIME], and Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours [REVASCAT]) comprising 2,423 patients were included. Meta-analysis of pooled data demonstrated functional independence (mRS 0–2) at 90 days in favor of endovascular therapy (odds ratio [OR] = 1.71; p = 0.005). Subgroup analysis of the 6 trials with large vessel occlusion (LVO) criteria also demonstrated functional independence at 90 days in favor of endovascular therapy (OR = 2.23; p < 0.00001). Subgroup analysis of the 5 trials that primarily utilized stent retriever devices (≥70%) in the intervention arm demonstrated functional independence at 90 days in favor of endovascular therapy (OR = 2.39; p < 0.00001). No difference was found for mortality at 90 days and sICH between endovascular therapy and medical management in all analyses and subgroup analyses. Conclusions: This meta-analysis provides strong evidence that endovascular intervention combined with medical management, including IV tissue plasminogen activator for eligible patients, improves the outcomes of appropriately selected patients with acute ischemic stroke in the setting of LVO. PMID:26537058

  16. 49 CFR 194.107 - General response plan requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... management system including the functional areas of finance, logistics, operations, planning, and command... economically sensitive areas; (iii) Describe the responsibilities of the operator and of Federal, State and...

  17. Fetal Alcohol Spectrum Disorders (FASDs): Diagnosis

    MedlinePlus

    ... reactions. Executive functioning deficits These deficits involve the thinking processes that help a person manage life tasks. Such deficits include poor organization and planning, lack of inhibition, difficulty grasping cause ...

  18. Perfusionist

    MedlinePlus

    ... Perfusionists conduct extracorporeal circulation and ensure the safe management of physiologic functions by monitoring the necessary variables. Perfusion (extracorporeal circulation) procedures involve specialized instrumentation and/or advanced life-support techniques and may include a variety ...

  19. Use of Chemical Inventory Accuracy Measurements as Leading Indicators

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

    Quigley, David; Freshwater, David; Alnajjar, Mikhail S.

    2012-05-15

    Chemical safety and lifecycle management (CSLM) is a process that involves managing chemicals and chemical information from the moment someone begins to order a chemical and lasts through final disposition(1). Central to CSLM is tracking data associated with chemicals which, for the purposes of this paper, is termed the chemical inventory. Examples of data that could be tracked include chemical identity, location, quantity, date procured, container type, and physical state. The reason why so much data is tracked is that the chemical inventory supports many functions. These functions include emergency management, which depends upon the data to more effectively planmore » for, and respond to, chemical accidents; environmental management that uses inventory information to aid in the generation of various federally-mandated and other regulatory reports; and chemical management that uses the information to increase the efficiency and safety with which chemicals are stored and utilized. All of the benefits of having an inventory are predicated upon having an inventory that is reasonably accurate. Because of the importance of ensuring one's chemical inventory is accurate, many have become concerned about measuring inventory accuracy. But beyond providing a measure of confidence in information gleaned from the inventory, does the inventory accuracy measurement provide any additional function? The answer is 'Yes'. It provides valuable information that can be used as a leading indicator to gauge the health of a chemical management system. In this paper, we will discuss: (1) what properties make leading indicators effective, (2) how chemical inventories can be used as a leading indicator, (3) how chemical inventory accuracy can be measured, what levels of accuracies should realistically be expected in a healthy system, and (4) what a subpar inventory accuracy measurement portends.« less

  20. Is physiotherapy effective in the management of child and adolescent conversion disorder? A systematic review.

    PubMed

    FitzGerald, Tara L; Southby, Alesha K; Haines, Terrence P; Hough, Janet P; Skinner, Elizabeth H

    2015-02-01

    Child and adolescent conversion disorder has the potential to impart significant burden on health-care services and affect quality of life. Clinically, physiotherapists are involved in conversion disorder management; however, no systematic reviews have examined physiotherapy effectiveness in its management. The aim of this review is to identify the efficacy of physiotherapy management of child and adolescent conversion disorder. A search of multiple databases (Medline, CINAHL, Embase, PsychINFO, PEDro and the Cochrane Library) was completed along with manual searching of relevant reference lists to identify articles including children 0-18 years with a diagnosis of conversion disorder who received physical management. Two independent reviewers screened titles and abstracts using criteria. Data were extracted regarding study characteristics, functional outcome measures, length of stay, physiotherapy service duration and resolution of conversion symptoms. Methodological quality was assessed using a tool designed for observational studies. Twelve observational studies were included. No functional outcome measures were used to assess the effectiveness of the treatment protocols in the case studies. Resolution of symptoms occurred in all but two cases, with conversion symptoms still present at 11 months and at 2 years. Length of stay varied from 3 days to 16 weeks, with similar variation evident in length of physiotherapy service provision (2.5 weeks to 16 weeks). There was limited and poor quality evidence to establish the efficacy of physiotherapy management of child and adolescent conversion disorders. More rigorous study designs with consistent use of reliable, valid and sensitive functional outcome measures are needed in this area. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  1. Upper extremity sarcoma: impact of current practice guidelines and controversies on reconstructive approaches

    PubMed Central

    Dobke, Marek; Mackert, Gina A.

    2017-01-01

    The goals of sarcoma management include both a cure and the functional preservation of involved tissues and adjacent critical structures with common opinions favoring immediate reconstruction. The question arises whether these goals are contradictory. This paper discusses the question based on the experience of 28 patients with different types of extremity sarcoma, with 24 surgically treated by the University of California San Diego (UCSD) orthopedic and plastic surgery team (2011–2016) and the collection of evidence from published practice guidelines, reviews, case studies, and clinical trials. Included are the impact of limb-sparing and functional reconstructive concepts, efforts regarding the adequacy of surgical margins, and the rationale of immediate versus delayed reconstructive approaches, and the disease-free status of sarcoma management. PMID:28220751

  2. TQM: A bibliography with abstracts. [total quality management

    NASA Technical Reports Server (NTRS)

    Gottlich, Gretchen L. (Editor)

    1992-01-01

    This document is designed to function as a special resource for NASA Langley scientists, engineers, and managers during the introduction and development of total quality management (TQM) practices at the Center. It lists approximately 300 bibliographic citations for articles and reports dealing with various aspects of TQM. Abstracts are also available for the majority of the citations. Citations are organized by broad subject areas, including case studies, customer service, senior management, leadership, communication tools, TQM basics, applications, and implementation. An introduction and indexes provide additional information on arrangement and availability of these materials.

  3. 5 CFR 551.424 - Time spent adjusting grievances or performing representational functions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... hours of work. This includes time spent by an employee performing such functions during regular working... MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Hours of Work... shall be considered hours of work. (b) “Official time” granted an employee by an agency to perform...

  4. Special Education at the Crossroad: An Identity Crisis and the Need for a Scientific Reconstruction

    ERIC Educational Resources Information Center

    Kauffman, James M.; Anastasiou, Dimitris; Maag, John W.

    2017-01-01

    Special education is losing its identity--its visibility, distinctiveness, budget, and basic functions are all at risk. Special education functions include (a) sorting, categorizing, and labeling students who need it; (b) making the right comparisons; (c) honoring diversity but changing "particular" differences; (d) managing stigma; (e)…

  5. Administrative and Supervisory Support Functions for the Implementation of Effective Educational Programs for Low Income Students.

    ERIC Educational Resources Information Center

    Gersten, Russell; Carnine, Douglas

    An attempt to identify methods of human resource management that emerge as schools and classrooms become more effective, this literature review emphasizes the importance of administrator "support functions," which include feedback to teachers, monitoring of teacher and student performance, incentives for teachers, and visible commitment…

  6. Library of the Future: Croydon's New Central Library Complex.

    ERIC Educational Resources Information Center

    Batt, Chris

    1993-01-01

    A new library and cultural center in Croyden (England) is described. Function-based areas include library, administration, technical services, museum and galleries, museum offices and store, cinema, tourist information center, and local government offices. Information technology systems include the library management system, office automation, and…

  7. Nonsurgical management of severe esophageal and gastric injury following alkali ingestion

    PubMed Central

    Abaskharoun, Ramy D; Depew, William T; Hookey, Lawrence C

    2007-01-01

    The ingestion of caustic substances may result in significant gastrointestinal injury. Endoscopy can play a major role in the initial evaluation and subsequent therapy of such injuries. The case of a 50-year-old man who ingested an alkaline floor stripper is described, including the endoscopic management of esophageal and pyloric strictures, with good functional results. The role of endoscopy, steroids and acid suppression in the management of such patients is also explored. PMID:18026581

  8. DMS Advanced Applications for Accommodating High Penetrations of DERs and Microgrids: Preprint

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

    Pratt, Annabelle; Veda, Santosh; Maitra, Arindam

    Efficient and effective management of the electrical distribution system requires an integrated system approach for Distribution Management Systems (DMS), Distributed Energy Resources (DERs), Distributed Energy Resources Management System (DERMS), and microgrids to work in harmony. This paper highlights some of the outcomes from a U.S. Department of Energy (DOE), Office of Electricity (OE) project, including 1) Architecture of these integrated systems, and 2) Expanded functions of two example DMS applications, Volt-VAR optimization (VVO) and Fault Location, Isolation and Service Restoration (FLISR), to accommodate DER. For these two example applications, the relevant DER Group Functions necessary to support communication between DMSmore » and Microgrid Controller (MC) in grid-tied mode are identified.« less

  9. Stepwise management of asthma.

    PubMed

    Khalid, Ayesha N

    2015-09-01

    Stepwise management of asthma remains an area of evolving research. Asthma is one of the most expensive chronic diseases in the United States; stepwise management is an important area of focus, with several recent guidelines recommending management. This is a review of published English language literature, focusing on management guidelines for asthma in adult and pediatric patients. Asthma is a chronic disease whose assessment of severity allows for therapeutic goals to match the impairment noted. Good evidence exists to aid risk reduction, leading to decreased emergency room visits, preventing loss of lung function in adults and lung growth in children, and optimizing pharmacotherapy with reduced side effects profile. Recent asthma management guidelines incorporate 4 components of asthma care including: monitoring of severity, patient education, controlling external triggers, and medications, including recent attention to medication adherence. Asthma is an expensive chronic disease with preventive measures leading to reduced healthcare costs. Future targeted cytokine therapy to decrease serum and blood eosinophils may become an integral part of asthma management. © 2015 ARS-AAOA, LLC.

  10. Meteorological disaster management and assessment system design and implementation

    NASA Astrophysics Data System (ADS)

    Tang, Wei; Luo, Bin; Wu, Huanping

    2009-09-01

    Disaster prevention and mitigation get more and more attentions by Chinese government, with the national economic development in recent years. Some problems exhibit in traditional disaster management, such as the chaotic management of data, low level of information, poor data sharing. To improve the capability of information in disaster management, Meteorological Disaster Management and Assessment System (MDMAS) was developed and is introduced in the paper. MDMAS uses three-tier C/S architecture, including the application layer, data layer and service layer. Current functions of MDMAS include the typhoon and rainstorm assessment, disaster data query and statistics, automatic cartography for disaster management. The typhoon and rainstorm assessment models can be used in both pre-assessment of pre-disaster and post-disaster assessment. Implementation of automatic cartography uses ArcGIS Geoprocessing and ModelBuilder. In practice, MDMAS has been utilized to provide warning information, disaster assessment and services products. MDMAS is an efficient tool for meteorological disaster management and assessment. It can provide decision supports for disaster prevention and mitigation.

  11. Meteorological disaster management and assessment system design and implementation

    NASA Astrophysics Data System (ADS)

    Tang, Wei; Luo, Bin; Wu, Huanping

    2010-11-01

    Disaster prevention and mitigation get more and more attentions by Chinese government, with the national economic development in recent years. Some problems exhibit in traditional disaster management, such as the chaotic management of data, low level of information, poor data sharing. To improve the capability of information in disaster management, Meteorological Disaster Management and Assessment System (MDMAS) was developed and is introduced in the paper. MDMAS uses three-tier C/S architecture, including the application layer, data layer and service layer. Current functions of MDMAS include the typhoon and rainstorm assessment, disaster data query and statistics, automatic cartography for disaster management. The typhoon and rainstorm assessment models can be used in both pre-assessment of pre-disaster and post-disaster assessment. Implementation of automatic cartography uses ArcGIS Geoprocessing and ModelBuilder. In practice, MDMAS has been utilized to provide warning information, disaster assessment and services products. MDMAS is an efficient tool for meteorological disaster management and assessment. It can provide decision supports for disaster prevention and mitigation.

  12. 45 CFR 1355.57 - Cost allocation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... collection and information retrieval system described in § 1355.53 of this part shall be treated as necessary... includes functions, processing, information collection and management, equipment or services that are not...

  13. 45 CFR 1355.57 - Cost allocation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... collection and information retrieval system described in § 1355.53 of this part shall be treated as necessary... includes functions, processing, information collection and management, equipment or services that are not...

  14. Management by Trajectory Trade Study of Roles and Responsibilities Between Participants and Automation Report

    NASA Technical Reports Server (NTRS)

    Fernandes, Alicia D.; Kaler, Curt; Leiden, Kenneth; Atkins, Stephen; Bell, Alan; Kilbourne, Todd; Evans, Mark

    2017-01-01

    This report describes a trade study of roles and responsibilities associated with the Management by Trajectory (MBT) concept. The MBT concept describes roles, responsibilities, and information and automation requirements for providing air traffic controllers and managers the ability to quickly generate, evaluate and implement changes to an aircraft's trajectory. In addition, the MBT concept describes mechanisms for imposing constraints on flight operator preferred trajectories only to the extent necessary to maintain safe and efficient traffic flows, and the concept provides a method for the exchange of trajectory information between ground automation systems and the aircraft that allows for trajectory synchronization and trajectory negotiation. The participant roles considered in this trade study include: airline dispatcher, flight crew, radar controller, traffic manager, and Air Traffic Control System Command Center (ATCSCC) traffic management specialists. The proposed allocation of roles and responsibilities was based on analysis of several use cases that were developed for this purpose as well as for walking through concept elements. The resulting allocation of roles and responsibilities reflects both increased automation capability to support many aviation functions, as well as increased flexibility to assign responsibilities to different participants - in many cases afforded by the increased automation capabilities. Note that the selection of participants to consider for allocation of each function is necessarily rooted in the current environment, in that MBT is envisioned as an evolution of the National Airspace System (NAS), and not a revolution. A key feature of the MBT allocations is a vision for the traffic management specialist to take on a greater role. This is facilitated by the vision that separation management functions, in addition to traffic management functions, will be carried out as trajectory management functions. This creates an opportunity for flexibility, allowing the traffic management specialist to carry out tasks that today can only be carried out by the controller currently in contact with the aircraft. This additional tasking for the traffic management specialist comes with requirements for workload management. An increased role for the Data-side (D-side) controller relative to the Radar-side (R-side) controller is a potential approach to mitigating workload for the traffic management specialist, as the D-side controller would have similar ability to perform separation management functions in what today might be considered the "trajectory management" timeframe. This analysis did not distinguish between the D-side and R-side controllers since in many cases the R-side controller works unassisted.

  15. Advanced system functions for the office information system

    NASA Astrophysics Data System (ADS)

    Ishikawa, Tetsuya

    First, author describes the functions needed for information management system in office. Next, he mentions the requisites for the enhancement of system functions. In order to make enhancement of system functions, he states, it is necessary to examine them comprehensively from every point of view including processing hour and cost. In this paper, he concentrates on the enhancement of man-machine interface (= human interface), that is, how to make system easy to use for the office workers.

  16. Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review.

    PubMed

    Brignardello-Petersen, Romina; Guyatt, Gordon H; Buchbinder, Rachelle; Poolman, Rudolf W; Schandelmaier, Stefan; Chang, Yaping; Sadeghirad, Behnam; Evaniew, Nathan; Vandvik, Per O

    2017-05-11

    To determine the effects and complications of arthroscopic surgery compared with conservative management strategies in patients with degenerative knee disease. Systematic review. Pain, function, adverse events. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar and Open Grey up to August 2016. For effects, randomised clinical trials (RCTs) comparing arthroscopic surgery with a conservative management strategy (including sham surgery) in patients with degenerative knee disease. For complications, RCTs and observational studies. Two reviewers independently extracted data and assessed risk of bias for patient-important outcomes. A parallel guideline committee ( BMJ Rapid Recommendations) provided input on the design and interpretation of the systematic review, including selection of patient-important outcomes. We used the GRADE approach to rate the certainty (quality) of the evidence. We included 13 RCTs and 12 observational studies. With respect to pain, the review identified high-certainty evidence that knee arthroscopy results in a very small reduction in pain up to 3 months (mean difference =5.4 on a 100-point scale, 95% CI 2.0 to 8.8) and very small or no pain reduction up to 2 years (mean difference =3.1, 95% CI -0.2 to 6.4) when compared with conservative management. With respect to function, the review identified moderate-certainty evidence that knee arthroscopy results in a very small improvement in the short term (mean difference =4.9 on a 100-point scale, 95% CI 1.5 to 8.4) and very small or no improved function up to 2 years (mean difference =3.2, 95% CI -0.5 to 6.8). Alternative presentations of magnitude of effect, and associated sensitivity analyses, were consistent with the findings of the primary analysis. Low-quality evidence suggested a very low probability of serious complications after knee arthroscopy. Over the long term, patients who undergo knee arthroscopy versus those who receive conservative management strategies do not have important benefits in pain or function. PROSPERO CRD42016046242. 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/.

  17. Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review

    PubMed Central

    Brignardello-Petersen, Romina; Guyatt, Gordon H; Buchbinder, Rachelle; Poolman, Rudolf W; Chang, Yaping; Sadeghirad, Behnam; Evaniew, Nathan; Vandvik, Per O

    2017-01-01

    Objective To determine the effects and complications of arthroscopic surgery compared with conservative management strategies in patients with degenerative knee disease. Design Systematic review. Main outcome measures Pain, function, adverse events. Data sources MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar and Open Grey up to August 2016. Eligibility criteria For effects, randomised clinical trials (RCTs) comparing arthroscopic surgery with a conservative management strategy (including sham surgery) in patients with degenerative knee disease. For complications, RCTs and observational studies. Review methods Two reviewers independently extracted data and assessed risk of bias for patient-important outcomes. A parallel guideline committee (BMJ Rapid Recommendations) provided input on the design and interpretation of the systematic review, including selection of patient-important outcomes. We used the GRADE approach to rate the certainty (quality) of the evidence. Results We included 13 RCTs and 12 observational studies. With respect to pain, the review identified high-certainty evidence that knee arthroscopy results in a very small reduction in pain up to 3 months (mean difference =5.4 on a 100-point scale, 95% CI 2.0 to 8.8) and very small or no pain reduction up to 2 years (mean difference =3.1, 95% CI −0.2 to 6.4) when compared with conservative management. With respect to function, the review identified moderate-certainty evidence that knee arthroscopy results in a very small improvement in the short term (mean difference =4.9 on a 100-point scale, 95% CI 1.5 to 8.4) and very small or no improved function up to 2 years (mean difference =3.2, 95% CI −0.5 to 6.8). Alternative presentations of magnitude of effect, and associated sensitivity analyses, were consistent with the findings of the primary analysis. Low-quality evidence suggested a very low probability of serious complications after knee arthroscopy. Conclusions Over the long term, patients who undergo knee arthroscopy versus those who receive conservative management strategies do not have important benefits in pain or function. Trial registration number PROSPERO CRD42016046242. PMID:28495819

  18. Toward a social-ecological theory of forest macrosystems for improved ecosystem management

    USGS Publications Warehouse

    Kleindl, William J.; Stoy, Paul C.; Binford, Michael W.; Desai, Ankur R.; Dietze, Michael C.; Schultz, Courtney A.; Starr, Gregory; Staudhammer, Christina; Wood, David J. A.

    2018-01-01

    The implications of cumulative land-use decisions and shifting climate on forests, require us to integrate our understanding of ecosystems, markets, policy, and resource management into a social-ecological system. Humans play a central role in macrosystem dynamics, which complicates ecological theories that do not explicitly include human interactions. These dynamics also impact ecological services and related markets, which challenges economic theory. Here, we use two forest macroscale management initiatives to develop a theoretical understanding of how management interacts with ecological functions and services at these scales and how the multiple large-scale management goals work either in consort or conflict with other forest functions and services. We suggest that calling upon theories developed for organismal ecology, ecosystem ecology, and ecological economics adds to our understanding of social-ecological macrosystems. To initiate progress, we propose future research questions to add rigor to macrosystem-scale studies: (1) What are the ecosystem functions that operate at macroscales, their necessary structural components, and how do we observe them? (2) How do systems at one scale respond if altered at another scale? (3) How do we both effectively measure these components and interactions, and communicate that information in a meaningful manner for policy and management across different scales?

  19. Mobile Phone Apps for Inflammatory Bowel Disease Self-Management: A Systematic Assessment of Content and Tools.

    PubMed

    Con, Danny; De Cruz, Peter

    2016-02-01

    The rising incidence of inflammatory bowel disease (IBD) over the past decade has resulted in increased health care utilization and longer IBD outpatient waiting lists. Self-management is recognized as an important aspect of chronic disease management but its application to IBD has been limited. The age of IBD onset in a majority of patients is in their 20s to 30s. Mobile phone apps are a technology familiar to young adults and represent an opportunity to explore self-management as a new model of health care delivery for IBD. The aim of this study was to explore the content and tools of existing IBD apps to identify functionalities that may facilitate patient self-management. We systematically assessed apps targeted at IBD patients via searches of Google (Android devices) and Apple (iOS devices) app stores with pre-defined inclusion and exclusion criteria. Apps were assessed for specific functionalities; presence of professional medical involvement; consistency with international IBD guidelines based on "complete," "partial," or "absent" coverage of consensus statements derived from the European Crohn's and Colitis Organisation, American College of Gastroenterology, and the Gastroenterology Society of Australia; comprehensiveness of data that could be entered; and average pricing. Of the 238 apps screened, 26 apps were assessed, including 10 available on Android platforms, 8 on iOS platforms, and 8 on both. Over half (14/26, 54%) of the apps had diary functionalities; over a third (10/26, 39%) provided health information about IBD. None of the apps offered decision support to facilitate the self-initiation of medical therapy. Five of 26 (19%) had professional medical involvement in their design. Apps demonstrated "complete" coverage of only 38% of the international consensus statements explored. The average price of the apps was AUD$1.37. Apps may provide a useful adjunct to the management of IBD patients. However, a majority of current apps suffer from a lack of professional medical involvement and limited coverage of international consensus guidelines. Future studies and app design for IBD should include professional medical involvement, evidence-based guidelines, and functionalities with decision support that are specifically tailored to patient self-management.

  20. New Therapeutic Paradigms and Guidelines in the Management of Pulmonary Arterial Hypertension.

    PubMed

    Hill, Nicholas S; Cawley, Michael J; Heggen-Peay, Cherilyn L

    2016-03-01

    Recent and ongoing developments in the diagnosis, treatment, and management of pulmonary arterial hypertension (PAH) provide deeper insights into pathogenic mechanisms. Approvals of new pharmacotherapies that improve function and reduce morbidity and mortality risks; advances in clinical trial methods, including long-term, event-driven studies with clinically relevant and patient-centered endpoints; and trial results support a new therapeutic management strategy. This new paradigm involves initial treatment with combined therapies that act through different disease pathways. In addition, 2 new sets of clinical practice guidelines for PAH have been published since June 2014. Despite these advances, major gaps have been documented in the diagnosis, treatment, and management of patients with PAH. To present current knowledge and evidence on PAH to support managed care professionals and providers in achieving accurate differential diagnosis, promptly referring patients to specialists as necessary, and ensuring that patients receive appropriate, guideline-directed therapies. Major gaps in the quality of care provided to patients with PAH include oversights in clinicians' recognition of symptoms, delays in diagnosis, and misdiagnosis ensuing from incomplete evaluations, delays in referral of patients to centers of expertise and initiation of therapy, and inappropriate treatment regimens. To address deficiencies in PAH diagnosis, new practice guidelines emphasize the essential role of right heart catheterization in characterizing and confirming the disease, as well as referral to expert pulmonary hypertension centers to ensure appropriate evaluation and treatment. Updated disease and functional classifications of PAH, along with new research findings on prognostic factors and effects of comorbid conditions, offer key support for making effective therapy and management decisions for patients with PAH at different risk levels and stages of the disease. Since 2013, the U.S. Food and Drug Administration has approved new PAH therapies in the classes of endothelin receptor antagonists, guanylate cyclase stimulators, prostacyclin analogues, and prostacyclin receptor agonists. As demonstrated through phase 3 clinical trials, these generally well-tolerated therapies delay disease progression, improve hemodynamic and functional status, and decrease numbers of hospitalizations. Moreover, 2 sets of recently published guidelines-developed by the American College of Chest Physicians and the European Society of Cardiology/European Respiratory Society-provide evidence-based and expert consensus recommendations for achieving PAH treatment goals. The most recent guidelines include a recommendation for upfront combination therapy for patients with moderate disease, which is supported by new comparative clinical trial evidence. As addressed in this article, these advances in the field of PAH have important implications for managed care and clinical practice, including considerations of cost-benefit outcomes associated with different management strategies.

  1. Continuous Risk Management: An Overview

    NASA Technical Reports Server (NTRS)

    Rosenberg, Linda; Hammer, Theodore F.

    1999-01-01

    Software risk management is important because it helps avoid disasters, rework, and overkill, but more importantly because it stimulates win-win situations. The objectives of software risk management are to identify, address, and eliminate software risk items before they become threats to success or major sources of rework. In general, good project managers are also good managers of risk. It makes good business sense for all software development projects to incorporate risk management as part of project management. The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to implement risk management. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This is an introductory tutorial to continuous risk management based on this course. The rational for continuous risk management and how it is incorporated into project management are discussed. The risk management structure of six functions is discussed in sufficient depth for managers to understand what is involved in risk management and how it is implemented. These functions include: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions.

  2. Spatio-temporal analysis of wildfire ignitions in the St. Johns River Water Management District, Florida

    Treesearch

    Marc G. Genton; David T. Butry; Marcia L. Gumpertz; Jeffrey P. Prestemon

    2006-01-01

    We analyse the spatio-temporal structure of wildfire ignitions in the St. Johns River Water Management District in north-eastern Florida. We show, using tools to analyse point patterns (e.g. the L-function), that wildfire events occur in clusters. Clustering of these events correlates with irregular distribution of fire ignitions, including lightning...

  3. Assessing high reliability practices in wildland fire management: an exploration and benchmarking of organizational culture

    Treesearch

    Anne E. Black; Brooke Baldauf McBride

    2013-01-01

    In an effort to improve organizational outcomes, including safety, in wildland fire management, researchers and practitioners have turned to a domain of research on organizational performance known as High Reliability Organizing (HRO). The HRO paradigm emerged in the late 1980s in an effort to identify commonalities among organizations that function under hazardous...

  4. Phase 1 Development Report for the SESSA Toolkit

    DTIC Science & Technology

    2014-09-01

    data acquisition, data management, and data analysis. SESSA was designed to meet forensic crime scene needs as defined by the DoD’s Military Criminal...on the design , functional attributes, algorithm development, system architecture, and software programming include: Robert Knowlton, Brad Melton...Building Restoration Operations Optimization Model (BROOM). BROOM (Knowlton et al., 2012) was designed for consequence management activities (e.g

  5. A Study of How Young Adults Leverage Multiple Profile Management Functionality in Managing Their Online Reputation on Social Networking Sites

    ERIC Educational Resources Information Center

    McCune, T. John

    2017-01-01

    With privacy settings on social networking sites (SNS) perceived as complex and difficult to use and maintain, young adults can be left vulnerable to others accessing and using their personal information. Consequences of not regulating the boundaries their information on SNS include the ability for current and future employers to make…

  6. Medical Writing Competency Model - Section 2: Knowledge, Skills, Abilities, and Behaviors.

    PubMed

    Clemow, David B; Wagner, Bertil; Marshallsay, Christopher; Benau, Dan; L'Heureux, Darryl; Brown, David H; Dasgupta, Devjani Ghosh; Girten, Eileen; Hubbard, Frank; Gawrylewski, Helle-Mai; Ebina, Hiroko; Stoltenborg, Janet; York, J P; Green, Kim; Wood, Linda Fossati; Toth, Lisa; Mihm, Michael; Katz, Nancy R; Vasconcelos, Nina-Maria; Sakiyama, Norihisa; Whitsell, Robin; Gopalakrishnan, Shobha; Bairnsfather, Susan; Wanderer, Tatyana; Schindler, Thomas M; Mikyas, Yeshi; Aoyama, Yumiko

    2018-01-01

    This article provides Section 2 of the 2017 Edition 2 Medical Writing Competency Model that describes the knowledge, skills, abilities, and behaviors that professional medical writers need in order to perform effectively within the life sciences industry. What a medical writer should know, what they should be able to do, and how they should use this knowledge and these skills to facilitate their primary work function is a focus. Regulatory, publication, and other scientific writing as well as management of writing activities are covered. The full Model also includes Section 1, which covers the core work functions and associated tasks and activities related to professional medical writing within the life sciences industry; Section 1 is included in a companion article. The Model was developed to aid medical writers and managers within the life sciences industry regarding medical writing hiring, training, expectation and goal setting, performance evaluation, career development, retention, and role value sharing to cross-functional partners.

  7. Physiotherapy management of lower limb osteoarthritis.

    PubMed

    Walsh, Nicola E; Pearson, Jennifer; Healey, Emma L

    2017-06-01

    Osteoarthritis (OA) of the lower limb affects millions of people worldwide, and results in pain and reduced function. We reviewed guidelines and Cochrane reviews for physical therapy interventions to manage the condition. Evidence from meta-analyses and systematic reviews was included. We also identified the recommendations from guidelines relevant to practice in the UK. There is strongest evidence to support the use of exercise to improve pain, function and quality of life. There is limited evidence to support the use of some commonly utilized physiotherapy interventions. National Institute for Health and Clinical Excellence do not recommend the use of acupuncture. Programmes that include single exercise type may be more beneficial than combined strengthening and aerobic interventions. Further research is required to determine how to facilitate long-term engagement with exercise to sustain the beneficial effects on pain, function and quality of life. Studies that investigate packages of care, combining interventions require further investigation. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  8. Diagnosing gastro-oesophageal reflux disease or lactose intolerance in babies who cry a lot in the first few months overlooks feeding problems.

    PubMed

    Douglas, Pamela Sylvia

    2013-04-01

    This paper explores two areas in which the translation of research into practice may be improved in the management of cry-fuss behaviours in the first few months of life. Firstly, babies who cry excessively are often prescribed proton pump inhibitors, despite evidence that gastro-oesophageal reflux disease is very rarely a cause. The inaccuracy of commonly used explanatory mechanisms, the side-effects of acid-suppressive medications, and the failure to identify treatable problems, including feeding difficulty when the diagnosis of 'reflux' is applied, are discussed. Secondly, crying breastfed babies are still prescribed lactase or lactose-free formula, despite evidence that the problem of functional lactose overload is one of breastfeeding management. The mechanisms and management of functional lactose overload are discussed. These two problems of research translation need to be addressed because failure to identify and manage other causes of cry-fuss problems, including feeding difficulty, may have adverse outcomes for a small but significant minority of families. © 2013 The Author. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  9. Group management influences reproductive function of the male cheetah (Acinonyx jubatus).

    PubMed

    Koester, Diana C; Freeman, Elizabeth W; Wildt, David E; Terrell, Kimberly A; Franklin, Ashley D; Meeks, Karen; Crosier, Adrienne E

    2017-03-01

    Although the free-ranging cheetah is generally socially solitary, as many as 60% of males live in same-sex (usually sibling) coalitions. Under ex situ conditions, the cheetah experiences low reproductive success with only ~18% of males having ever produced young. Most male cheetahs (85%) are managed in captivity in coalitions, but with no data on the influence of social grouping on reproductive parameters. We examined the influence of singleton versus coalition management on various male cheetah physiological traits, including ejaculate quality and gonadal and adrenal hormone metabolite concentrations. We also assessed behaviour within coalitions for evidence of social hierarchy through initiation of interactions with group mates and relatedness to physiological traits. Ejaculate quality (including total motile and structurally normal spermatozoa per ejaculate) and androgen concentration profiles were higher (P<0.05) in coalition compared with singleton males. These results support the conclusion that testis function in the cheetah, specifically related to the development of normal, motile spermatozoa and androgen production, is influenced by management with same-sex conspecifics. The findings have implications for ex situ conservation breeding programs by suggesting that reproductive quality can be enhanced through group maintenance of cheetah males.

  10. Goal management training of executive functions in patients with spina bifida: a randomized controlled trial.

    PubMed

    Stubberud, Jan; Langenbahn, Donna; Levine, Brian; Stanghelle, Johan; Schanke, Anne-Kristine

    2013-07-01

    Executive dysfunction causes significant real-life disability for patients with spina bifida (SB). However, no previous research has been directed toward the amelioration of executive functioning deficits amongst persons with SB. Goal Management Training (GMT) is a compensatory cognitive rehabilitation approach, addressing underlying deficits in sustained attention to improve executive function. GMT has received empirical support in studies of other patient groups. The purpose of the present study was to determine the efficacy of GMT in treating subjects with SB, using inpatient intervention periods. We hypothesized post-intervention changes in scores on neuropsychological measures to reflect improved attentional control, including sustained attention and inhibitory control. Thirty-eight adult subjects with SB were included in this randomized controlled trial. Inclusion was based upon the presence of executive functioning complaints. Experimental subjects (n = 24) received 21 hr of GMT, with efficacy of GMT being compared to results of subjects in a wait-list condition (n = 14). All subjects were assessed at baseline, post-intervention, and at 6-month follow-up. Findings indicated superior effects of GMT on domain-specific neuropsychological measures and on a functional "real-life" measure, all lasting at least 6 months post-treatment. These results show that deficits in executive functioning can be ameliorated in patients with congenital brain dysfunction.

  11. Project Summary Report

    NASA Technical Reports Server (NTRS)

    Upchurch, Christopher

    2011-01-01

    The project, being the development of resource management applications, consisted entirely of my own effort. From deliverable requirements provided by my mentor, and some functional requirement additions generated through design reviews, It was my responsibility to implement the requested features as well as possible, given the resources available. For the most part development work consisted of database programming and functional testing using real resource data. Additional projects I worked on included some firing room console training, configuring the new NE-A microcontroller development lab network, mentoring high school CubeSat students, and managing the NE interns' component of the mentor appreciation ceremony.

  12. The role of exercise in the management of rheumatoid arthritis.

    PubMed

    Metsios, George S; Stavropoulos-Kalinoglou, Antonis; Kitas, George D

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with significant functional impairment and increased risk for cardiovascular disease. Along with pharmacological therapy, exercise seems to be a very promising intervention to improve disease-related outcomes, including functional ability and systemic manifestations, such as the increased cardiovascular risk. In this review, we discuss the physiological mechanisms by which exercise improves inflammation, cardiovascular risk and psychological health in patients with rheumatoid arthritis (RA) and describe in detail how exercise can be incorporated in the management of this disease using real examples from our clinical practice.

  13. Guidelines for the management of cognitive and behavioral problems in dementia.

    PubMed

    Sadowsky, Carl H; Galvin, James E

    2012-01-01

    Family physicians play a crucial role in the management and ongoing care of patients with Alzheimer disease (AD). This article reviews the effects of nonpharmacologic and pharmacologic interventions on the functional abilities and behavior of patients with dementia and how these can be implemented into clinical practice. Nonpharmacologic interventions are recommended as the initial strategy for managing problematic behaviors. Strategies for improving behavior include ensuring that the patient's environment is safe, calm, and predictable; removing environmental stressors; and identifying and avoiding situations that agitate or frighten the patient. Simple interventions include redirecting and refocusing the patient, increasing social interaction, establishing regular sleep habits, eliminating sources of conflict and frustration, and establishing rewards for successes. The effectiveness of long-term behavioral management is largely dependent on the caregiver; as such, it is important to assess the role and needs of the caregiver. Because currently available therapies cannot reverse the pathologic processes of AD, the primary objective of pharmacotherapy is to preserve cognitive and functional ability, minimize behavioral disturbances, and slow disease progression. Cholinesterase inhibitors represent first-line therapy for patients with mild to moderate AD, whereas a glutamate N-methyl D-aspartate antagonist is used in the treatment of moderate to severe AD. Looking forward, there are a number of therapies in development aimed at modifying the disease course; these include amyloid-lowering drugs, τ-based and neuroprotective approaches, acetylcholine agonists, and mitochondrial inhibitors.

  14. Maturity Models of Healthcare Information Systems and Technologies: a Literature Review.

    PubMed

    Carvalho, João Vidal; Rocha, Álvaro; Abreu, António

    2016-06-01

    The maturity models are instruments to facilitate organizational management, including the management of its information systems function. These instruments are used also in hospitals. The objective of this article is to identify and compare the maturity models for management of information systems and technologies (IST) in healthcare. For each maturity model, it is identified the methodology of development and validation, as well as the scope, stages and their characteristics by dimensions or influence factors. This study resulted in the need to develop a maturity model based on a holistic approach. It will include a comprehensive set of influencing factors to reach all areas and subsystems of health care organizations.

  15. Advanced Transport Operating System (ATOPS) Flight Management/Flight Controls (FM/FC) software description

    NASA Technical Reports Server (NTRS)

    Wolverton, David A.; Dickson, Richard W.; Clinedinst, Winston C.; Slominski, Christopher J.

    1993-01-01

    The flight software developed for the Flight Management/Flight Controls (FM/FC) MicroVAX computer used on the Transport Systems Research Vehicle for Advanced Transport Operating Systems (ATOPS) research is described. The FM/FC software computes navigation position estimates, guidance commands, and those commands issued to the control surfaces to direct the aircraft in flight. Various modes of flight are provided for, ranging from computer assisted manual modes to fully automatic modes including automatic landing. A high-level system overview as well as a description of each software module comprising the system is provided. Digital systems diagrams are included for each major flight control component and selected flight management functions.

  16. Automation of the space station core module power management and distribution system

    NASA Technical Reports Server (NTRS)

    Weeks, David J.

    1988-01-01

    Under the Advanced Development Program for Space Station, Marshall Space Flight Center has been developing advanced automation applications for the Power Management and Distribution (PMAD) system inside the Space Station modules for the past three years. The Space Station Module Power Management and Distribution System (SSM/PMAD) test bed features three artificial intelligence (AI) systems coupled with conventional automation software functioning in an autonomous or closed-loop fashion. The AI systems in the test bed include a baseline scheduler/dynamic rescheduler (LES), a load shedding management system (LPLMS), and a fault recovery and management expert system (FRAMES). This test bed will be part of the NASA Systems Autonomy Demonstration for 1990 featuring cooperating expert systems in various Space Station subsystem test beds. It is concluded that advanced automation technology involving AI approaches is sufficiently mature to begin applying the technology to current and planned spacecraft applications including the Space Station.

  17. Computer memory management system

    DOEpatents

    Kirk, III, Whitson John

    2002-01-01

    A computer memory management system utilizing a memory structure system of "intelligent" pointers in which information related to the use status of the memory structure is designed into the pointer. Through this pointer system, The present invention provides essentially automatic memory management (often referred to as garbage collection) by allowing relationships between objects to have definite memory management behavior by use of coding protocol which describes when relationships should be maintained and when the relationships should be broken. In one aspect, the present invention system allows automatic breaking of strong links to facilitate object garbage collection, coupled with relationship adjectives which define deletion of associated objects. In another aspect, The present invention includes simple-to-use infinite undo/redo functionality in that it has the capability, through a simple function call, to undo all of the changes made to a data model since the previous `valid state` was noted.

  18. [Design and application of user managing system of cardiac remote monitoring network].

    PubMed

    Chen, Shouqiang; Zhang, Jianmin; Yuan, Feng; Gao, Haiqing

    2007-12-01

    According to inpatient records, data managing demand of cardiac remote monitoring network and computer, this software was designed with relative database ACCESS. Its interface, operational button and menu were designed in VBA language assistantly. Its design included collective design, amity, practicability and compatibility. Its function consisted of registering, inquiring, statisticing and printing, et al. It could be used to manage users effectively and could be helpful to exerting important action of cardiac remote monitoring network in preventing cardiac-vascular emergency ulteriorly.

  19. CRC Clinical Trials Management System (CTMS): An Integrated Information Management Solution for Collaborative Clinical Research

    PubMed Central

    Payne, Philip R.O.; Greaves, Andrew W.; Kipps, Thomas J.

    2003-01-01

    The Chronic Lymphocytic Leukemia (CLL) Research Consortium (CRC) consists of 9 geographically distributed sites conducting a program of research including both basic science and clinical components. To enable the CRC’s clinical research efforts, a system providing for real-time collaboration was required. CTMS provides such functionality, and demonstrates that the use of novel data modeling, web-application platforms, and management strategies provides for the deployment of an extensible, cost effective solution in such an environment. PMID:14728471

  20. A Measurement of AFIT Contracting and Acquisition Management Program Usefulness as Perceived by Graduates and Their Supervisors.

    DTIC Science & Technology

    1982-09-01

    21 functions. The legal category covers the business, commer- cial and contract law fields, including patents and royalties, technical data, claims...Course Rankings Question # Subject Area Median Rank 55,56,59 Contract Management Theory 7.0 1 53,54 Contract Law 6.5 2 So Contracting & Acquis. Mgt...respondents ranked Contract Management Theory as the most useful course among all courses in the AFIT CAM curriculum. Graduates ranked Contract Law as

  1. Chinese Cardiovascular Disease Mobile Apps’ Information Types, Information Quality, and Interactive Functions for Self-Management: Systematic Review

    PubMed Central

    Xie, Bo; Su, Zhaohui; Zhang, Wenhui

    2017-01-01

    Background China has a large population with cardiovascular disease (CVD) that requires extensive self-management. Mobile health (mHealth) apps may be a useful tool for CVD self-management. Little is currently known about the types and quality of health information provided in Chinese CVD mobile apps and whether app functions are conducive to promoting CVD self-management. Objective We undertook a systematic review to evaluate the types and quality of health information provided in Chinese CVD mobile apps and interactive app functions for promoting CVD self-management. Methods Mobile apps targeting end users in China with CVD conditions were selected in February 2017 through a multi-stage process. Three frameworks were used to evaluate the selected apps: (1) types of health information offered were assessed using our Health Information Wants framework, which encompasses 7 types of information; (2) quality of information provided in the apps was assessed using the 11 guidelines recommended by the National Library of Medicine of the National Institutes of Health; and (3) types of interactive app functions for CVD self-management were assessed using a 15-item framework adapted from the literature, including our own prior work. Results Of 578 apps identified, 82 were eligible for final review. Among these, information about self-care (67/82, 82%) and information specifically regarding CVD (63/82, 77%) were the most common types of information provided, while information about health care providers (22/82, 27%) and laboratory tests (5/82, 6%) were least common. The most common indicators of information quality were the revealing of apps’ providers (82/82, 100%) and purpose (82/82, 100%), while the least common quality indicators were the revealing of how apps’ information was selected (1/82, 1%) and app sponsorship (0/82, 0%). The most common interactive functions for CVD self-management were those that enabled user interaction with the app provider (57/82, 70%) and with health care providers (36/82, 44%), while the least common interactive functions were those that enabled lifestyle management (13/82, 16%) and psychological health management (6/82, 7%). None of the apps covered all 7 types of health information, all 11 indicators of information quality, or all 15 interactive functions for CVD self-management. Conclusions Chinese CVD apps are insufficient in providing comprehensive health information, high-quality information, and interactive functions to facilitate CVD self-management. End users should exercise caution when using existing apps. Health care professionals and app developers should collaborate to better understand end users’ preferences and follow evidence-based guidelines to develop mHealth apps conducive to CVD self-management. PMID:29242176

  2. Chinese Cardiovascular Disease Mobile Apps' Information Types, Information Quality, and Interactive Functions for Self-Management: Systematic Review.

    PubMed

    Xie, Bo; Su, Zhaohui; Zhang, Wenhui; Cai, Run

    2017-12-14

    China has a large population with cardiovascular disease (CVD) that requires extensive self-management. Mobile health (mHealth) apps may be a useful tool for CVD self-management. Little is currently known about the types and quality of health information provided in Chinese CVD mobile apps and whether app functions are conducive to promoting CVD self-management. We undertook a systematic review to evaluate the types and quality of health information provided in Chinese CVD mobile apps and interactive app functions for promoting CVD self-management. Mobile apps targeting end users in China with CVD conditions were selected in February 2017 through a multi-stage process. Three frameworks were used to evaluate the selected apps: (1) types of health information offered were assessed using our Health Information Wants framework, which encompasses 7 types of information; (2) quality of information provided in the apps was assessed using the 11 guidelines recommended by the National Library of Medicine of the National Institutes of Health; and (3) types of interactive app functions for CVD self-management were assessed using a 15-item framework adapted from the literature, including our own prior work. Of 578 apps identified, 82 were eligible for final review. Among these, information about self-care (67/82, 82%) and information specifically regarding CVD (63/82, 77%) were the most common types of information provided, while information about health care providers (22/82, 27%) and laboratory tests (5/82, 6%) were least common. The most common indicators of information quality were the revealing of apps' providers (82/82, 100%) and purpose (82/82, 100%), while the least common quality indicators were the revealing of how apps' information was selected (1/82, 1%) and app sponsorship (0/82, 0%). The most common interactive functions for CVD self-management were those that enabled user interaction with the app provider (57/82, 70%) and with health care providers (36/82, 44%), while the least common interactive functions were those that enabled lifestyle management (13/82, 16%) and psychological health management (6/82, 7%). None of the apps covered all 7 types of health information, all 11 indicators of information quality, or all 15 interactive functions for CVD self-management. Chinese CVD apps are insufficient in providing comprehensive health information, high-quality information, and interactive functions to facilitate CVD self-management. End users should exercise caution when using existing apps. Health care professionals and app developers should collaborate to better understand end users' preferences and follow evidence-based guidelines to develop mHealth apps conducive to CVD self-management. ©Bo Xie, Zhaohui Su, Wenhui Zhang, Run Cai. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 14.12.2017.

  3. [Management for the operating room].

    PubMed

    Tschudi, O; Schüpfer, G

    2015-03-01

    Business companies, which in the current times also includes hospitals, must create customer benefits and as a prerequisite for this must sustainably generate profits. Management in the world of business means the formation and directing of a company or parts of a company on a permanent basis, whereby management in this context is not exercising power but function. This concept of management is exemplary developed in this article for the important services sector of the operating room (OR) and individual functions, such as resource control, capacity planning and materials administration are presented in detail. Some OR-specific management challenges are worked out. From this it becomes clear that the economic logic of the most efficient implementation possible is not a contradiction of medical ethics, enabling the most effective treatment possible for patients while safeguarding the highest possible levels of safety and quality. The article aims to build a bridge for medical specialists to the language and world of commerce, emphasizing the profession-based competence and hopefully to arouse interest to go into more detail.

  4. Information management systems for pharmacogenomics.

    PubMed

    Thallinger, Gerhard G; Trajanoski, Slave; Stocker, Gernot; Trajanoski, Zlatko

    2002-09-01

    The value of high-throughput genomic research is dramatically enhanced by association with key patient data. These data are generally available but of disparate quality and not typically directly associated. A system that could bring these disparate data sources into a common resource connected with functional genomic data would be tremendously advantageous. However, the integration of clinical and accurate interpretation of the generated functional genomic data requires the development of information management systems capable of effectively capturing the data as well as tools to make that data accessible to the laboratory scientist or to the clinician. In this review these challenges and current information technology solutions associated with the management, storage and analysis of high-throughput data are highlighted. It is suggested that the development of a pharmacogenomic data management system which integrates public and proprietary databases, clinical datasets, and data mining tools embedded in a high-performance computing environment should include the following components: parallel processing systems, storage technologies, network technologies, databases and database management systems (DBMS), and application services.

  5. Diagnosis and management of Duchenne muscular dystrophy, part 3: primary care, emergency management, psychosocial care, and transitions of care across the lifespan

    PubMed Central

    Birnkrant, David J; Bushby, Katharine; Bann, Carla M; Apkon, Susan D; Blackwell, Angela; Colvin, Mary K; Cripe, Linda; Herron, Adrienne R; Kennedy, Annie; Kinnett, Kathi; Naprawa, James; Noritz, Garey; Poysky, James; Street, Natalie; Trout, Christina J; Weber, David R; Ward, Leanne M

    2018-01-01

    Improvements in the function, quality of life, and longevity of patients with Duchenne muscular dystrophy (DMD) have been achieved through a multidisciplinary approach to management across a range of health-care specialties. In part 3 of this update of the DMD care considerations, we focus on primary care, emergency management, psychosocial care, and transitions of care across the lifespan. Many primary care and emergency medicine clinicians are inexperienced at managing the complications of DMD. We provide a guide to the acute and chronic medical conditions that these first-line providers are likely to encounter. With prolonged survival, individuals with DMD face a unique set of challenges related to psychosocial issues and transitions of care. We discuss assessments and interventions that are designed to improve mental health and independence, functionality, and quality of life in critical domains of living, including health care, education, employment, interpersonal relationships, and intimacy. PMID:29398641

  6. Management of Musculoskeletal Conditions in Rural South Australia: A Randomised Controlled Trial.

    PubMed

    Dent, E; Hoon, E; Karnon, J; Kitson, A; Dollard, J; Newbury, J; Harvey, G; Gill, T; Beilby, J

    2017-01-01

    With age, the prevalence of musculoskeletal conditions increases markedly. This rural-based study determined the benefits of two approaches for managing musculoskeletal conditions: a multiple-component 'Self-management Plus' intervention, and usual care. The intervention combined self-management education with physical activity and health professional support. 6-month outcomes included: Clinical Global Impression-Improvement Scale (CGI-IS) and Quality of Life (QoL). A total of 145 people were recruited; mean (SD) age was 66.1 (11.1) and 63.3 (10.9) years for intervention and control groups respectively. The intervention resulted in greater improvements in global functioning (CGI-IS mean (SD) = 3.2 (1.3)) than usual care (CGI-IS mean (SD) = 4.2 (1.5)). There was no difference in QoL improvement between study groups. A multiple-component 'Self-management Plus' intervention had a positive effect on physical functioning for older adults with musculoskeletal conditions. However, recruitment and retention of participants was problematic, which raises questions about the intervention's feasibility in its current form.

  7. Application of a Multimedia Service and Resource Management Architecture for Fault Diagnosis

    PubMed Central

    Castro, Alfonso; Sedano, Andrés A.; García, Fco. Javier; Villoslada, Eduardo

    2017-01-01

    Nowadays, the complexity of global video products has substantially increased. They are composed of several associated services whose functionalities need to adapt across heterogeneous networks with different technologies and administrative domains. Each of these domains has different operational procedures; therefore, the comprehensive management of multi-domain services presents serious challenges. This paper discusses an approach to service management linking fault diagnosis system and Business Processes for Telefónica’s global video service. The main contribution of this paper is the proposal of an extended service management architecture based on Multi Agent Systems able to integrate the fault diagnosis with other different service management functionalities. This architecture includes a distributed set of agents able to coordinate their actions under the umbrella of a Shared Knowledge Plane, inferring and sharing their knowledge with semantic techniques and three types of automatic reasoning: heterogeneous, ontology-based and Bayesian reasoning. This proposal has been deployed and validated in a real scenario in the video service offered by Telefónica Latam. PMID:29283398

  8. Application of a Multimedia Service and Resource Management Architecture for Fault Diagnosis.

    PubMed

    Castro, Alfonso; Sedano, Andrés A; García, Fco Javier; Villoslada, Eduardo; Villagrá, Víctor A

    2017-12-28

    Nowadays, the complexity of global video products has substantially increased. They are composed of several associated services whose functionalities need to adapt across heterogeneous networks with different technologies and administrative domains. Each of these domains has different operational procedures; therefore, the comprehensive management of multi-domain services presents serious challenges. This paper discusses an approach to service management linking fault diagnosis system and Business Processes for Telefónica's global video service. The main contribution of this paper is the proposal of an extended service management architecture based on Multi Agent Systems able to integrate the fault diagnosis with other different service management functionalities. This architecture includes a distributed set of agents able to coordinate their actions under the umbrella of a Shared Knowledge Plane, inferring and sharing their knowledge with semantic techniques and three types of automatic reasoning: heterogeneous, ontology-based and Bayesian reasoning. This proposal has been deployed and validated in a real scenario in the video service offered by Telefónica Latam.

  9. Motor Complications of Dopaminergic Medications in Parkinson’s Disease

    PubMed Central

    Freitas, Maria Eliza; Hess, Christopher W.; Fox, Susan H.

    2018-01-01

    Motor complications are a consequence of chronic treatment of Parkinson’s disease (PD) and include motor fluctuations (wearing-off phenomenon) and levodopa-induced dyskinesia. Both can have a significant impact on functionality and quality of life and thus proper recognition and management is essential. The phenomenology and temporal relationship of motor complications to the schedule of levodopa dosing can be helpful in characterizing them. There are several therapeutic approaches to motor complications, including pharmacological and surgical options. The current review summarizes the different types of motor complications according to phenomenology and the currently available medical treatments, including ongoing trials for management of this condition. PMID:28511255

  10. The use of locally optimal trajectory management for base reaction control of robots in a microgravity environment

    NASA Technical Reports Server (NTRS)

    Lin, N. J.; Quinn, R. D.

    1991-01-01

    A locally-optimal trajectory management (LOTM) approach is analyzed, and it is found that care should be taken in choosing the Ritz expansion and cost function. A modified cost function for the LOTM approach is proposed which includes the kinetic energy along with the base reactions in a weighted and scale sum. The effects of the modified functions are demonstrated with numerical examples for robots operating in two- and three-dimensional space. It is pointed out that this modified LOTM approach shows good performance, the reactions do not fluctuate greatly, joint velocities reach their objectives at the end of the manifestation, and the CPU time is slightly more than twice the manipulation time.

  11. ERP (enterprise resource planning) systems can streamline healthcare business functions.

    PubMed

    Jenkins, E K; Christenson, E

    2001-05-01

    Enterprise resource planning (ERP) software applications are designed to facilitate the systemwide integration of complex processes and functions across a large enterprise consisting of many internal and external constituents. Although most currently available ERP applications generally are tailored to the needs of the manufacturing industry, many large healthcare systems are investigating these applications. Due to the significant differences between manufacturing and patient care, ERP-based systems do not easily translate to the healthcare setting. In particular, the lack of clinical standardization impedes the use of ERP systems for clinical integration. Nonetheless, an ERP-based system can help a healthcare organization integrate many functions, including patient scheduling, human resources management, workload forecasting, and management of workflow, that are not directly dependent on clinical decision making.

  12. Nurse managers don't get the corner office.

    PubMed

    Paliadelis, Penny

    2013-03-01

    To provide an original perspective on the power and status of first-line nurse managers by observing their working environment. The role of first-line nurse managers includes clinical, administrative and managerial components, with their responsibilities not always reflected in their level of organizational power. The business literature suggests that an appropriately resourced workspace is not merely functional, it also confers power and status. Twenty Australian rural nurse managers' workspaces were observed, as part of a larger qualitative study that explored their role and organizational power using semi-structured interviews. The observational data consisted of detailed researcher notes that were analysed thematically. The nurse managers' workspaces were suboptimal and did not provide sufficient physical space or resources for the participants' to manage tasks effectively. These results were considered using Kanter's theory of organizational power. The findings support those reported in the business literature that inadequate physical workspaces are counterproductive in terms of both functionality and organizational power. Suggestions are made regarding the workspace needs of first-line nurse managers, based on a closer alignment between the work environment and their role responsibilities. These findings have implications for decisions regarding organizational support of first-line nurse managers. © 2012 Blackwell Publishing Ltd.

  13. Engineering study for the functional design of a multiprocessor system

    NASA Technical Reports Server (NTRS)

    Miller, J. S.; Vandever, W. H.; Stanten, S. F.; Avakian, A. E.; Kosmala, A. L.

    1972-01-01

    The results are presented of a study to generate a functional system design of a multiprocessing computer system capable of satisfying the computational requirements of a space station. These data management system requirements were specified to include: (1) real time control, (2) data processing and storage, (3) data retrieval, and (4) remote terminal servicing.

  14. Texas Christian University (TCU) Short Forms for Assessing Client Needs and Functioning in Addiction Treatment

    ERIC Educational Resources Information Center

    Simpson, D. Dwayne; Joe, George W.; Knight, Kevin; Rowan-Szal, Grace A.; Gray, Julie S.

    2012-01-01

    The TCU Short Forms contain a revised and expanded set of assessments for planning and managing addiction treatment services. They are formatted as brief (one-page) forms to measure client needs and functioning, including drug use severity and history (TCUDS II), criminal thinking and cognitive orientation (CTSForm), motivation and readiness for…

  15. Occupational health and safety management practices and musculoskeletal disorders in aged care.

    PubMed

    Oakman, Jodi; Bartram, Timothy

    2017-05-15

    Purpose The purpose of this paper is to examine whether occupational health and safety (OHS) management used to manage musculoskeletal disorders (MSDs) in the aged care sector reflects contemporary research evidence of best practice to reduce the incidence of these disorders. Design/methodology/approach In total, 58 interviews were conducted with managers and supervisors in the aged care sector across four organisations in Australia. Policies and procedures relating to MSDs were reviewed for each organisation. Findings Policies and procedures for managing MSDs do not reflect contemporary evidence, which supports a complex aetiology, related to a range of physical and psychosocial workplace factors. Despite strong evidence that psychosocial factors contribute to MSD development, these were not included in the policies and procedures reviewed. Findings from the interviews management practices including leadership and various components of HRM were functioning well but fragmentation was evident due to the challenging nature of the aged care sector. Practical implications To address the significant burden of MSDs in the aged care sector, policies and procedures need to include coverage of psychosocial and physical workplace factors. The development of systematic and integrated OHS management at the workplace level may play an important role in the effective management of MSDs. Originality/value This study offers insights into the previously unexplored area of MSD risk management and the role of management practices such as HRM in the aged care sector.

  16. Self-management of chronic low back pain and osteoarthritis.

    PubMed

    May, Stephen

    2010-04-01

    Chronic low back pain and osteoarthritis are two musculoskeletal problems that are highly prevalent in the general population, are frequently episodic and persistent, and are associated with high costs to society, both direct and indirect. This epidemiological picture provides the background that justifies the use of self-management strategies in managing these problems. For this Review, relevant systematic reviews were included that related to effectiveness; other study designs were included that addressed other aspects of the topic. The accepted definition of self-management includes liaison between health professionals and individuals with these problems, as well as independent health-promotion activities. Independent self-management strategies, such as exercise and self-medication, are practiced by individuals in the general population. Consistent evidence shows that self-management programs for osteoarthritis are effective in addressing pain and function, but effect sizes are small and might be clinically negligible. Educational programs for patients with back pain are effective in an occupational setting and if combined with an exercise program. Exercise is an effective strategy in the management of both chronic low back pain and osteoarthritis, although it is unclear what the optimum exercise is. Exercise, supported by advice and education, should be at the core of self-management strategies for chronic low back pain and osteoarthritis.

  17. Presentation and conservative management of acute calcific tendinopathy: a case study and literature review.

    PubMed

    Scibek, Jason S; Carcia, Christopher R

    2012-11-01

    The efficacy of a variety of noninvasive, conservative management techniques for calcific tendinopathy has been investigated and established for improving pain and function and/or facilitating a decrease in the size or presence of calcium deposits. Surprisingly, few have reported on the use of traditional therapeutic exercise and rehabilitation alone in the management of this condition, given the often spontaneous resorptive nature of calcium deposits. The purpose of this case is to present the results of a conservative approach, including therapeutic exercise, for the management of calcific tendinopathy of the supraspinatus, with an emphasis on patient outcomes. The patient was a self-referred 41-y-old man with complaints of acute right-shoulder pain and difficulty sleeping. Imaging studies revealed liquefied calcium deposits in the right supraspinatus. The patient reported constant pain at rest (9/10) and tenderness in the area of the greater tuberosity. He exhibited a decrease in all shoulder motions and had reduced strength. The simple shoulder test (SST) revealed limited function (0/12). Conservative management included superficial modalities and medication for pain and a regimen of scapulothoracic and glenohumeral range-of-motion (ROM) and strengthening exercises. At discharge, pain levels decreased to 0/10 and SST scores increased to 12/12. ROM was full in all planes, and resisted motion was strong and pain free. The patient was able to engage in endurance activities and continue practicing as a health care provider. The outcomes with respect to pain, function, and patient satisfaction provide evidence to support the use of conservative therapeutic interventions when managing patients with acute cases of calcific tendinopathy. Successful management of calcific tendinopathy requires attention to outcomes and an understanding of the pathophysiology, prognostic factors, and physical interventions based on the current stage of the calcium deposits and the patient's status in the healing continuum.

  18. Arthritis self-efficacy scale scores in knee osteoarthritis: a systematic review and meta-analysis comparing arthritis self-management education with or without exercise.

    PubMed

    Brand, Emily; Nyland, John; Henzman, Cameron; McGinnis, Mark

    2013-12-01

    Systematic literature review and meta-analysis. To evaluate studies that used arthritis self-management education alone or with exercise to improve Arthritis Self-Efficacy Scale scores of patients with knee osteoarthritis. Increasing self-efficacy may improve patient knee osteoarthritis symptom management and function. MEDLINE (1946-March 2013), CINAHL (1981-March 2013), and PsycINFO (1967-March 2013) databases were searched. Twenty-four studies, including 3163 subjects (women, n = 2547 [80.5%]; mean ± SD age, 65.3 ± 6.5 years), met the inclusion criteria. A meta-analysis was performed to compare the standardized mean difference effect sizes (Cohen d) of randomized controlled studies that used the Arthritis Self-Efficacy Scale pain (13 studies, n = 1906), other symptoms (13 studies, n = 1957), and function (5 studies, n = 399) subscales. Cohen d effect sizes were also calculated for cohort studies that used the Arthritis Self-Efficacy Scale pain (10 studies, n = 1035), other symptoms (9 studies, n = 913), and function (3 studies, n = 141) subscales. Both randomized controlled studies and cohort studies were grouped by intervention type (intervention 1, arthritis self-management education alone; intervention 2, arthritis self-management education with exercise), and effect sizes were compared (Mann-Whitney U tests, P<.05). Interventions that used arthritis self-management education with exercise displayed higher methodological quality scale scores (76.8 ± 13.1 versus 61.6 ± 19.6, P = .03). Statistically significant standardized effect-size differences between intervention 1 and intervention 2 were not observed. Small to moderate effect sizes were observed regardless of whether the intervention included exercise. Exercise interventions used in conjunction with arthritis self-management education programs need to be developed to better enhance the self-efficacy of patients with knee osteoarthritis. Therapy, level 2b-.

  19. Soil as a Sustainable Resource for the Bioeconomy - BonaRes

    NASA Astrophysics Data System (ADS)

    Wollschläger, Ute; Amelung, Wulf; Brüggemann, Nicolas; Brunotte, Joachim; Gebbers, Robin; Grosch, Rita; Heinrich, Uwe; Helming, Katharina; Kiese, Ralf; Leinweber, Peter; Reinhold-Hurek, Barbara; Veldkamp, Edzo; Vogel, Hans-Jörg; Winkelmann, Traud

    2017-04-01

    Fertile soils are a fundamental resource for the production of biomass and provision of food and energy. A growing world population and latest climate targets lead to an increasing demand for bio-based products which require preserving and - ideally - improving the long-term productivity of soils as a bio-economic resource. At the same time, other soil functions and ecosystem services need to be maintained: filter for clean water, carbon sequestration, provision and recycling of nutrients, and habitat for biological activity. All these soil functions result from the interaction of a multitude of physical, chemical and biological processes which are insufficiently understood. In addition, we lack understanding about the interplay between the socio-economic system and the soil system and how soil functions benefit human wellbeing, including SDGs. However, a solid and integrated assessment of soil quality requires the consideration of the ensemble of soil functions and its relation to soil management. To make soil management sustainable, we need to establish a scientific knowledge base of complex soil system processes that allows for developing models and tools to quantitatively predict the impact of a multitude of management measures on soil functions. This will finally allow for the provision of options for a site-specific, sustainable soil management. To face this challenge, the German Federal Ministry of Education and Research (BMBF) recently launched the funding program "Soil as a Sustainable Resource for the Bioeconomy - BonaRes". In a joint effort, ten collaborative projects and the coordinating BonaRes Centre are engaged to close existing knowledge gaps for a profound and systemic assessment and understanding of soil functions and their sensitivity to soil management. In BonaRes, the complete process chain of sustainable soil use in the context of a sustainable bio-economy is being addressed: from understanding of soil processes using state-of the art and novel measurement and modelling techniques towards soil functions and ecosystem services driving the development of assessment and decision support tools for a sustainable soil management. To this end, soil scientists and researchers from several other disciplines including social sciences are collaborating closely. Besides a better understanding of fundamental soil processes from each of the collaborative projects and the development of novel measurement techniques and models, the outcome of the joint BonaRes programme will be a web-based portal (www.bonares.de) providing information, knowledge, models, a data repository with doi-referenced, internationally available, open soil data from the BonaRes funding initiative and beyond, as well as decision support options for a sustainable soil management. This presentation will provide an overview about the BonaRes funding initiative and the research conducted therein.

  20. Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes.

    PubMed

    Dyson, P A; Twenefour, D; Breen, C; Duncan, A; Elvin, E; Goff, L; Hill, A; Kalsi, P; Marsland, N; McArdle, P; Mellor, D; Oliver, L; Watson, K

    2018-05-01

    A summary of the latest evidence-based nutrition guidelines for the prevention and management of diabetes is presented. These guidelines are based on existing recommendations last published in 2011, and were formulated by an expert panel of specialist dietitians after a literature review of recent evidence. Recommendations have been made in terms of foods rather than nutrients wherever possible. Guidelines for education and care delivery, prevention of Type 2 diabetes, glycaemic control for Type 1 and Type 2 diabetes, cardiovascular disease risk management, management of diabetes-related complications, other considerations including comorbidities, nutrition support, pregnancy and lactation, eating disorders, micronutrients, food supplements, functional foods, commercial diabetic foods and nutritive and non-nutritive sweeteners are included. The sections on pregnancy and prevention of Type 2 diabetes have been enlarged and the weight management section modified to include considerations of remission of Type 2 diabetes. A section evaluating detailed considerations in ethnic minorities has been included as a new topic. The guidelines were graded using adapted 'GRADE' methodology and, where strong evidence was lacking, grading was not allocated. These 2018 guidelines emphasize a flexible, individualized approach to diabetes management and weight loss and highlight the emerging evidence for remission of Type 2 diabetes. The full guideline document is available at www.diabetes.org.uk/nutrition-guidelines. © 2018 Diabetes UK.

  1. Management of a Statewide Textbook and Materials Center for the Visually Impaired.

    ERIC Educational Resources Information Center

    Rossi, Peter

    1979-01-01

    The activities described include production and/or procurement of special media textbooks (tape, large print, and braille) and specialized equipment, as well as the administrative service function. (Author)

  2. Safety performance functions for intersections : final report, December 2009.

    DOT National Transportation Integrated Search

    2009-12-01

    Road safety management activities include screening the network for sites with a potential for safety improvement (Network : Screening), diagnosing safety problems at specific sites, and evaluating the safety effectiveness of implemented : countermea...

  3. [Changing economic environment of hospitals: management challenges of the 1990s].

    PubMed

    Rotstein, Z; Noy, S; Goldman, B; Shani, M

    1990-12-16

    The modern hospital is an organization which is influenced by the external environment in which it functions. A major relevant area is the economic environment. In recent years the western world has been facing the challenge of rising costs of health care and an increase in their proportion to the gross national product of most countries. Consequently, hospitals as major providers of health care are under pressure from governments and health insurance companies to cut costs and to "produce" more efficiently. Since hospitals worldwide are finding it hard and painful to function in the new environment in which attitudes to hospitals are changing, a potential managerial-economic crisis may be the next phase. How can the hospital adapt to these changes? First, by adopting managerial attitudes and the tools of the business sector. These include: the strategic planning process, hospital operative autonomy, creating medical-economic responsibility centers as departments, cost-accounting for medical procedures, and case-mix budgeting. Management information systems are necessary during the transition. The hospital information system should include functions at the operative level, such as outpatient visits, and admissions and discharges of patients; and also clinical, diagnostic and laboratory procedures related to the patient case-mix. The second level is a management information system which includes salaries of personnel, case-mix budgeting with variance analysis, prices of procedures and epidemiological data. The authors believe that only the managerial approach combining medical and economic disciplines can meet the challenges of the changing modern economic environment.

  4. Revisit of Functional Tricuspid Regurgitation; Current Trends in the Diagnosis and Management

    PubMed Central

    Muraru, Denisa; Surkova, Elena

    2016-01-01

    Current knowledge of functional tricuspid regurgitation (FTR) as a progressive entity, worsening the prognosis of patients irrespective of its aetiology, has led to renewed interest in the pathophysiology and assessment of FTR. For the proper management of FTR, not only its severity, but also the mechanisms, the mode of leaflet coaptation, the degree of tricuspid annulus enlargement and leaflet tenting, and the haemodynamic consequences for right atrial and right ventricular morphology and function have to be taken into account. A better assessment of the anatomy and function of tricuspid apparatus and tricuspid regurgitation severity should help with the appropriate selection of patients who will benefit from either surgical tricuspid valve repair/replacement or a percutaneous procedure, especially among patients who are to undergo or have undergone primary left-sided valvular surgery. In this article, we review the anatomy, pathophysiology and the use of imaging techniques to assess patients with FTR, as well as the various treatment options for FTR, including emerging transcatheter procedures. The limitations affecting the current approach to FTR patients and the unmet clinical needs for their management have also been discussed. PMID:27482252

  5. Overview of practice management in child and adolescent psychiatry.

    PubMed

    Schreter, Robert K

    2010-01-01

    The manager of a psychiatric practice must create and direct a clinical delivery system, design and oversee the administrative services necessary to support the system, and guide the business operations that contribute to its success. Regardless of the size of the practice, the psychiatrist administrator must handle seven core administrative responsibilities and oversee individual functions and capabilities within each domain. These responsibilities include practice development, clinical services management, medical office operations, clinical management, information management, business management, and risk management. This article provides a roadmap for creating and sustaining successful clinical and administrative endeavors. It can also be used by existing practices as an audit instrument to provide a snapshot of current capabilities so that strengths as well as opportunities for continued growth can be identified.

  6. Functional Imaging for Prostate Cancer: Therapeutic Implications

    PubMed Central

    Aparici, Carina Mari; Seo, Youngho

    2012-01-01

    Functional radionuclide imaging modalities, now commonly combined with anatomical imaging modalities CT or MRI (SPECT/CT, PET/CT, and PET/MRI) are promising tools for the management of prostate cancer particularly for therapeutic implications. Sensitive detection capability of prostate cancer using these imaging modalities is one issue; however, the treatment of prostate cancer using the information that can be obtained from functional radionuclide imaging techniques is another challenging area. There are not many SPECT or PET radiotracers that can cover the full spectrum of the management of prostate cancer from initial detection, to staging, prognosis predictor, and all the way to treatment response assessment. However, when used appropriately, the information from functional radionuclide imaging improves, and sometimes significantly changes, the whole course of the cancer management. The limitations of using SPECT and PET radiotracers with regards to therapeutic implications are not so much different from their limitations solely for the task of detecting prostate cancer; however, the specific imaging target and how this target is reliably imaged by SPECT and PET can potentially make significant impact in the treatment of prostate cancer. Finally, while the localized prostate cancer is considered manageable, there is still significant need for improvement in noninvasive imaging of metastatic prostate cancer, in treatment guidance, and in response assessment from functional imaging including radionuclide-based techniques. In this review article, we present the rationale of using functional radionuclide imaging and the therapeutic implications for each of radionuclide imaging agent that have been studied in human subjects. PMID:22840598

  7. In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices

    PubMed Central

    Sinsky, Christine A.; Willard-Grace, Rachel; Schutzbank, Andrew M.; Sinsky, Thomas A.; Margolius, David; Bodenheimer, Thomas

    2013-01-01

    We highlight primary care innovations gathered from high-functioning primary care practices, innovations we believe can facilitate joy in practice and mitigate physician burnout. To do so, we made site visits to 23 high-performing primary care practices and focused on how these practices distribute functions among the team, use technology to their advantage, improve outcomes with data, and make the job of primary care feasible and enjoyable as a life’s vocation. Innovations identified include (1) proactive planned care, with previsit planning and previsit laboratory tests; (2) sharing clinical care among a team, with expanded rooming protocols, standing orders, and panel management; (3) sharing clerical tasks with collaborative documentation (scribing), nonphysician order entry, and streamlined prescription management; (4) improving communication by verbal messaging and in-box management; and (5) improving team functioning through co-location, team meetings, and work flow mapping. Our observations suggest that a shift from a physician-centric model of work distribution and responsibility to a shared-care model, with a higher level of clinical support staff per physician and frequent forums for communication, can result in high-functioning teams, improved professional satisfaction, and greater joy in practice. PMID:23690328

  8. Dynamic Density: An Air Traffic Management Metric

    NASA Technical Reports Server (NTRS)

    Laudeman, I. V.; Shelden, S. G.; Branstrom, R.; Brasil, C. L.

    1998-01-01

    The definition of a metric of air traffic controller workload based on air traffic characteristics is essential to the development of both air traffic management automation and air traffic procedures. Dynamic density is a proposed concept for a metric that includes both traffic density (a count of aircraft in a volume of airspace) and traffic complexity (a measure of the complexity of the air traffic in a volume of airspace). It was hypothesized that a metric that includes terms that capture air traffic complexity will be a better measure of air traffic controller workload than current measures based only on traffic density. A weighted linear dynamic density function was developed and validated operationally. The proposed dynamic density function includes a traffic density term and eight traffic complexity terms. A unit-weighted dynamic density function was able to account for an average of 22% of the variance in observed controller activity not accounted for by traffic density alone. A comparative analysis of unit weights, subjective weights, and regression weights for the terms in the dynamic density equation was conducted. The best predictor of controller activity was the dynamic density equation with regression-weighted complexity terms.

  9. Does nurse-based case management for aged myocardial infarction patients improve risk factors, physical functioning and mental health? The KORINNA trial.

    PubMed

    Hunger, Matthias; Kirchberger, Inge; Holle, Rolf; Seidl, Hildegard; Kuch, Bernhard; Wende, Rupert; Meisinger, Christine

    2015-04-01

    Older patients with acute myocardial infarction (MI) are often lacking optimal support to continue rehabilitation after discharge from hospital. The objective of the study was to examine whether a home-based case management programme led by nurses can improve atherogenic risk factors, physical functioning, and mental health in the first year following discharge. The KORINNA study is a randomized two-armed parallel group trial including 329 patients (aged 65-92 years) from the Augsburg Hospital in southern Germany. The intervention consisted of an individualized follow-up programme with a duration of 1 year, including home visits and telephone calls. The control group received usual care. Secondary outcome measures included clinical parameters (blood pressure, lipid parameters), functional status measures, cognitive status, depressive symptoms, and nutrition risk. At 1-year follow up, patients in the intervention group (n = 116) had significantly better low-density lipoprotein cholesterol levels (-8.4 mg/dl, 95% CI -16.4 to -0.4), hand grip strength (+2.53 kg, 95% CI 0.56 to 4.50), and SCREEN-II nutrition risk scores (+2.03, 95% CI 0.58 to 3.48) than patients in the control group (n = 136). The intervention group also had better mean scores with regard to self-reported disability, activities in daily living, and mental health, but differences were not always significant and meaningful. The results of the KORINNA study indicate that nurse-based case management can improve blood lipid levels, functional status, and nutrition risk of aged patients with MI. © The European Society of Cardiology 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  10. System control of an autonomous planetary mobile spacecraft

    NASA Technical Reports Server (NTRS)

    Dias, William C.; Zimmerman, Barbara A.

    1990-01-01

    The goal is to suggest the scheduling and control functions necessary for accomplishing mission objectives of a fairly autonomous interplanetary mobile spacecraft, while maximizing reliability. Goals are to provide an extensible, reliable system conservative in its use of on-board resources, while getting full value from subsystem autonomy, and avoiding the lure of ground micromanagement. A functional layout consisting of four basic elements is proposed: GROUND and SYSTEM EXECUTIVE system functions and RESOURCE CONTROL and ACTIVITY MANAGER subsystem functions. The system executive includes six subfunctions: SYSTEM MANAGER, SYSTEM FAULT PROTECTION, PLANNER, SCHEDULE ADAPTER, EVENT MONITOR and RESOURCE MONITOR. The full configuration is needed for autonomous operation on Moon or Mars, whereas a reduced version without the planning, schedule adaption and event monitoring functions could be appropriate for lower-autonomy use on the Moon. An implementation concept is suggested which is conservative in use of system resources and consists of modules combined with a network communications fabric. A language concept termed a scheduling calculus for rapidly performing essential on-board schedule adaption functions is introduced.

  11. Measuring ecological function on California's rangelands

    NASA Astrophysics Data System (ADS)

    Porzig, E.

    2016-12-01

    There is a need for a better understanding of ecosystem processes on rangelands and how management decisions influence these processes on scales that are both ecologically and socially relevant. Point Blue Conservation Science's Rangeland Monitoring Network is a coordinated effort to collect standardized data on birds, vegetation, and soils on rangelands throughout California. We work with partners, including private landowners, land trusts, state and federal agencies, and others, to measure bird and plant abundance and diversity and three soil dynamic properties (water infiltration, bulk density, and organic carbon). Here, we present data from our first two years of monitoring on over 50 ranches in 17 counties. By collecting data on the scope and scale of variation in ecological function across rangelands and the relationship with management practices, we aim to advance rangeland management, restoration, and conservation.

  12. Qualitative assessment of Diabetes-STAR: a patient portal with disease management functions.

    PubMed

    Ross, Stephen E; Nowels, Carolyn T; Haverhals, Leah M; Bull, Sheana S; Lin, Chen-Tan; Main, Deborah S

    2007-10-11

    Diabetes-STAR is a disease management program integrated with an online patient portal. Of 331 patients enrolled in a randomized trial, we interviewed 37 users about benefits, barriers and recommendations for program improvements. User preferences included 1) addressing differences in types of users, 2) sending out alerts when new information is available, and 3) providing more oversight of user diary data.

  13. Patient-centered disease management (PCDM) for heart failure: study protocol for a randomised controlled trial.

    PubMed

    Bekelman, David B; Plomondon, Mary E; Sullivan, Mark D; Nelson, Karin; Hattler, Brack; McBryde, Connor; Lehmann, Kenneth G; Potfay, Jonathan; Heidenreich, Paul; Rumsfeld, John S

    2013-07-09

    Chronic heart failure (HF) disease management programs have reported inconsistent results and have not included comorbid depression management or specifically focused on improving patient-reported outcomes. The Patient Centered Disease Management (PCDM) trial was designed to test the effectiveness of collaborative care disease management in improving health status (symptoms, functioning, and quality of life) in patients with HF who reported poor HF-specific health status. Patients with a HF diagnosis at four VA Medical Centers were identified through population-based sampling. Patients with a Kansas City Cardiomyopathy Questionnaire (KCCQ, a measure of HF-specific health status) score of < 60 (heavy symptom burden and impaired quality of life) were invited to enroll in the PCDM trial. Enrolled patients were randomized to receive usual care or the PCDM intervention, which included: (1) collaborative care management by VA clinicians including a nurse, cardiologist, internist, and psychiatrist, who worked with patients and their primary care providers to provide guideline-concordant care management, (2) home telemonitoring and guided patient self-management support, and (3) screening and treatment for comorbid depression. The primary study outcome is change in overall KCCQ score. Secondary outcomes include depression, medication adherence, guideline-based care, hospitalizations, and mortality. The PCDM trial builds on previous studies of HF disease management by prioritizing patient health status, implementing a collaborative care model of health care delivery, and addressing depression, a key barrier to optimal disease management. The study has been designed as an 'effectiveness trial' to support broader implementation in the healthcare system if it is successful. Unique identifier: NCT00461513.

  14. The prevention of mother-to-child transmission of HIV cascade analysis tool: supporting health managers to improve facility-level service delivery.

    PubMed

    Gimbel, Sarah; Voss, Joachim; Mercer, Mary Anne; Zierler, Brenda; Gloyd, Stephen; Coutinho, Maria de Joana; Floriano, Florencia; Cuembelo, Maria de Fatima; Einberg, Jennifer; Sherr, Kenneth

    2014-10-21

    The objective of the prevention of Mother-to-Child Transmission (pMTCT) cascade analysis tool is to provide frontline health managers at the facility level with the means to rapidly, independently and quantitatively track patient flows through the pMTCT cascade, and readily identify priority areas for clinic-level improvement interventions. Over a period of six months, five experienced maternal-child health managers and researchers iteratively adapted and tested this systems analysis tool for pMTCT services. They prioritized components of the pMTCT cascade for inclusion, disseminated multiple versions to 27 health managers and piloted it in five facilities. Process mapping techniques were used to chart PMTCT cascade steps in these five facilities, to document antenatal care attendance, HIV testing and counseling, provision of prophylactic anti-retrovirals, safe delivery, safe infant feeding, infant follow-up including HIV testing, and family planning, in order to obtain site-specific knowledge of service delivery. Seven pMTCT cascade steps were included in the Excel-based final tool. Prevalence calculations were incorporated as sub-headings under relevant steps. Cells not requiring data inputs were locked, wording was simplified and stepwise drop-offs and maximization functions were included at key steps along the cascade. While the drop off function allows health workers to rapidly assess how many patients were lost at each step, the maximization function details the additional people served if only one step improves to 100% capacity while others stay constant. Our experience suggests that adaptation of a cascade analysis tool for facility-level pMTCT services is feasible and appropriate as a starting point for discussions of where to implement improvement strategies. The resulting tool facilitates the engagement of frontline health workers and managers who fill out, interpret, apply the tool, and then follow up with quality improvement activities. Research on adoption, interpretation, and sustainability of this pMTCT cascade analysis tool by frontline health managers is needed. ClinicalTrials.gov NCT02023658, December 9, 2013.

  15. Commitment to and preparedness for sustainable supply chain management in the oil and gas industry.

    PubMed

    Wan Ahmad, Wan Nurul K; Rezaei, Jafar; Tavasszy, Lóránt A; de Brito, Marisa P

    2016-09-15

    Our current dependency on the oil and gas (O&G) industry for economic development and social activities necessitates research into the sustainability of the industry's supply chains. At present, studies on sustainable supply chain management (SSCM) practices in the industry do not include firm-internal factors that affect the sustainability strategies employed by different functional areas of its supply chains. Our study aims to address this gap by identifying the relevant internal factors and exploring their relationship with SSCM strategies. Specifically, we discuss the commitment to and preparedness for sustainable practices of companies that operate in upstream and downstream O&G supply chain. We study the impact of these factors on their sustainability strategies of four key supply chain functions: supplier management, production management, product stewardship and logistics management. The analyses of data collected through a survey among 81 companies show that management preparedness may enhance sustainable supply chain strategies in the O&G industry more than commitment does. Among the preparedness measures, management of supply chain operational risks is found to be vital to the sustainability of all supply chain functions except for production management practices. The findings also highlight the central importance of supplier and logistics management to the achievement of sustainable O&G supply chains. Companies must also develop an organizational culture that encourages, for example, team collaboration and proactive behaviour to finding innovative sustainability solutions in order to translate commitment to sustainable practices into actions that can produce actual difference to their SSCM practices. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Non-pharmacological management of abdominal pain-related functional gastrointestinal disorders in children.

    PubMed

    Paul, Siba Prosad; Basude, Dharamveer

    2016-11-01

    Abdominal pain-related functional gastrointestinal disorder (AP-FGID) comprises of 4 main conditions: functional dyspepsia, irritable bowel syndrome, abdominal migraine and functional abdominal pain. AP-FGIDs are diagnosed clinically based on the Rome IV criteria for FGIDs of childhood. There is limited evidence for pharmacological therapies. This review article discusses nonpharmacological management of AP-FGID based on the current literature including systematic reviews, randomized controlled trials, cohort and case control studies. We aim to provide a comprehensive overview on the available evidence for the pediatricians and pediatric gastroenterologists involved in managing children with AP-FGID. Managing AP-FGIDs can be challenging. This should follow a stepwise approach with focused history, identification of "red flag" signs and symptoms, physical examination and investigations done following initial consultation. Family needs explaining that there is nothing seriously wrong with the child's abdomen. This explanation and reassurance can achieve symptom control in large number of cases. Non-pharmacological interventions are delivered through lifestyle and dietary changes and bio-psychosocial therapies. Dietary interventions vary depending on the type of AP-FGID. Bio-psychosocial therapies such as hypnotherapy, cognitive behavioral therapy and yoga aim at stress reduction. There is increasing evidence for use of non-pharmacological interventions in children with APFGID.

  17. Teaching Case: MiHotel--Applicant Processing System Design Case

    ERIC Educational Resources Information Center

    Miller, Robert E.; Dunn, Paul

    2018-01-01

    This teaching case describes the functionality of an applicant processing system designed for a fictitious hotel chain. The system detailed in the case includes a webform where applicants complete and submit job applications. The system also includes a desktop application used by hotel managers and Human Resources to track applications and process…

  18. Leader behavior and its relationship to senior and middle marketing and production managers in a leading energy resources company

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

    Bernheim, S.R.

    1985-01-01

    This study is an investigation of rated leader behavior at Sun Company, Inc. as it relates to the situational determinants of: (a) managers' level in the authority hierarchy and (b) function of the department. In order to assess if the leadership behaviors of Sun Company, Inc.'s senior - and middle-level managers in the marketing and production functions are distinct, 110 high potential managers were selected to administer Yukl's Managerial Behavior (MBS) to at least 4 of their subordinates who had been reporting to them for 3 months or more. Factor analysis reduced Yukl's 115 questionnaire items to 10 meaningful andmore » reliable components of managerial behavior for the sample. Next, discriminant analysis combined the 10 components of managerial behavior in a way that separated the sample into 4 groups based on different managerial behaviors, including: (a) middle level marketing managers, (b) senior level marketing managers, (c) middle level production managers, and (d) senior level production managers. Analysis of variance determined that middle level production managers trained and coached significantly more than senior level marketing managers, and middle level marketing managers showed a tendency to facilitate cooperation and teamwork more than senior level production managers. In general, the study suggests that Yukl's MBS portrays ab leader behavior taxonomy that, if simplified, can still capture diversity of specific managerial roles and activities.« less

  19. Application of Risk Assessment Tools in the Continuous Risk Management (CRM) Process

    NASA Technical Reports Server (NTRS)

    Ray, Paul S.

    2002-01-01

    Marshall Space Flight Center (MSFC) of the National Aeronautics and Space Administration (NASA) is currently implementing the Continuous Risk Management (CRM) Program developed by the Carnegie Mellon University and recommended by NASA as the Risk Management (RM) implementation approach. The four most frequently used risk assessment tools in the center are: (a) Failure Modes and Effects Analysis (FMEA), Hazard Analysis (HA), Fault Tree Analysis (FTA), and Probabilistic Risk Analysis (PRA). There are some guidelines for selecting the type of risk assessment tools during the project formulation phase of a project, but there is not enough guidance as to how to apply these tools in the Continuous Risk Management process (CRM). But the ways the safety and risk assessment tools are used make a significant difference in the effectiveness in the risk management function. Decisions regarding, what events are to be included in the analysis, to what level of details should the analysis be continued, make significant difference in the effectiveness of risk management program. Tools of risk analysis also depends on the phase of a project e.g. at the initial phase of a project, when not much data are available on hardware, standard FMEA cannot be applied; instead a functional FMEA may be appropriate. This study attempted to provide some directives to alleviate the difficulty in applying FTA, PRA, and FMEA in the CRM process. Hazard Analysis was not included in the scope of the study due to the short duration of the summer research project.

  20. [Indicators of social functioning and social participation in mentally ill participants in a public health rehabilitation programme: a one year follow-up study].

    PubMed

    Kitajima, K; Kuroda, K; Tatara, K

    1996-02-01

    In order to investigate social functioning, a self-administered questionnaire was distributed to 66 participants (30 men and 36 women) in a group rehabilitation programme for the mentally ill at public health centers, and followed for 1 year to investigate their employability as an indicator of social participation. The survey included 20 items related to 5 aspects of daily life: diurnal routine, basic personal management, social activities, personal relationships, and management of illness. The major findings were as follows: 1. The group who had become employed showed significantly higher positive responses to questions concerning self-management such as conversation with others, consultation with others and when condition worsened than the unemployed group. Also the employed showed a tendency for higher positive responses to such items as cooking, keeping appointments, taking medicine, taking an active role in managing medications. 2. According to discriminant analysis by Hayashi's quantification method II, factors distinguishing 17 participants who had become employed within the year and those who remained unemployed included the following: ability to converse with others, taking an active role in managing medications, and ability to cook, male gender, co-residence with family, and a period of 3 years or less since hospital discharge. These results suggest that a public health rehabilitation program aimed at improving interpersonal skills, self-management of illness and other skills of daily living may be useful in helping the mentally ill participate socially.

  1. Systematic care management: a comprehensive approach to catastrophic injury management applied to a catastrophic burn injury population--clinical, utilization, economic, and outcome data in support of the model.

    PubMed

    Kucan, John; Bryant, Ernest; Dimick, Alan; Sundance, Paula; Cope, Nathan; Richards, Reginald; Anderson, Chris

    2010-01-01

    The new standard for successful burn care encompasses both patient survival and the burn patient's long-term quality of life. To provide optimal long-term recovery from catastrophic injuries, including catastrophic burns, an outcome-based model using a new technology called systematic care management (SCM) has been developed. SCM provides a highly organized system of management throughout the spectrum of care that provides access to outcome data, consistent oversight, broader access to expert providers, appropriate allocation of resources, and greater understanding of total costs. Data from a population of 209 workers' compensation catastrophic burn cases with a mean TBSA of 27.9% who were managed under the SCM model of care were analyzed. The data include treatment type, cost, return to work, and outcomes achieved. Mean duration of management to achieve all guaranteed outcomes was 20 months. Of the 209 injured workers, 152 (72.7%) achieved sufficient recovery to be released to return to work, of which 97 (46.8%) were both released and competitively employed. Assessment of 10 domains of functional independence indicated that 47.2% of injured workers required total assistance at initiation of SCM. However, at termination of SCM, 84% of those injured workers were fully independent in the 10 functional activities. When compared with other burn research outcome data, the results support the value of the SCM model of care.

  2. Greenhouse gas balances in low-productive drained boreal peatlands - is climate-friendly management possible?

    NASA Astrophysics Data System (ADS)

    Ojanen, Paavo; Minkkinen, Kari; Heikkinen, Tiina; Penttilä, Timo

    2016-04-01

    Five million hectares of peatland has been drained for forestry in Finland. About 20% of that, i.e. one million hectares, has been estimated to be so low-productive that the profitability of keeping them in forestry is questionable. At the same time, drainage has introduced changes in the ecosystem functions of these peatlands, including fluxes of greenhouse gases. Options to manage such peatlands include for example 1) no measures, i.e. leaving the drained peatlands as they are 2) increasing intensity by e.g. repetitive fertilisations and 3) restoration back to functional peatlands. Here we estimate the greenhouse gas impacts of these three management options. We collected GHG and organic carbon flux data from 50 low-productive peatlands under these management options over two years 2014-2015. Gas fluxes (CO2, CH4, N2O) were measured with closed chambers. Litter production rates of different plants above and below ground were estimated using litter traps (trees), biomass sampling (roots), through-grow nets (mosses), allometric biomass models (other vasculars) and published turnover rates (roots, other vasculars). Characteristics for estimating tree stand biomass increment were measured at each site from circular sample plots. In this presentation we will estimate the GHG impacts for the different management options, and aim to find the most climate-friendly options for the management of low-productive peatlands in the short and long term. This work was funded by Life+ LIFE12/ENV/FI/150.

  3. Habitat management of organic vineyard in Northern Italy: the role of cover plants management on arthropod functional biodiversity.

    PubMed

    Burgio, G; Marchesini, E; Reggiani, N; Montepaone, G; Schiatti, P; Sommaggio, D

    2016-12-01

    The effect of cover plants on arthropod functional biodiversity was investigated in a vineyard in Northern Italy, through a 3-year field experiment. The following six ground cover plants were tested: Sweet Alyssum; Phacelia; Buckwheat; Faba Bean; Vetch and Oat; control. Arthropods were sampled using different techniques, including collection of leaves, vacuum sampling and sweeping net. Ground cover plant management significantly affected arthropod fauna, including beneficial groups providing ecosystem services like biological control against pests. Many beneficial groups were attracted by ground cover treatments in comparison with control, showing an aggregative numerical response in the plots managed with some of the selected plant species. Alyssum, Buckwheat and 'Vetch and Oat' mixture showed attractiveness on some Hymenoptera parasitoid families, which represented 72.3% of the insects collected by sweeping net and 45.7 by vacuum sampling. Phytoseiidae mites showed a significant increase on leaves of the vineyard plots managed with ground covers, in comparison with control, although they did not show any difference among the treatments. In general, the tested ground cover treatments did not increase dangerous Homoptera populations in comparison with control, with the exception of Alyssum. The potential of ground cover plant management in Italian vineyards is discussed: the overall lack of potential negative effects of the plants tested, combined with an aggregative numerical response for many beneficials, seems to show a potential for their use in Northern Italy vineyards.

  4. Role of extracorporeal shock wave therapy in management of Peyronie's disease: A preliminary report

    PubMed Central

    Shimpi, Rajendra Kashinath; Jain, Ravi Jineshkumar

    2016-01-01

    Introduction: Peyronie's Disease (PD) is a disease causing psycho social trauma to the patient. Multiple treatment options are available with variable results. Extra Corporeal Shock Wave Therapy (ESWT) is a new insight into the non invasive modality of management. It focuses on the mechanism of inducing angiogenesis in the penile cavernous tissue. Materials and Methods: The aim of the study is to determine the role of ESWT in the management of PD. The objectives include demonstrating the improvement in mean International Index of Erectile Function Score (IIEFS), improvement in pain score by Visual Analogue Scale (VAS), change in cavernosal artery flow on colour penile Doppler, reduction in plaque size, and improvement in penile curvature degree after the therapy. 30 patients, between 25-65 years, who were non responders to conservative line of management, were treated with ESWT. The results were evaluated at baseline and 18-24 weeks after the therapy. Results: ESWT significantly improves the cavernosal artery velocity, thereby supporting the theory of angiogenesis. ESWT improves all the domains of IIEF including Erectile Function, Sexual Desire, Sexual Satisfaction, Orgasm and Overall Satisfaction. There is a significant improvement in the pain and penile curvature, and reduction in the plaque size. No adverse effects have been recorded. Conclusion: ESWT offers a safe, minimally invasive, OPD based option to the management of the patients of PD in the stable phase of the disease. Patients who do not respond to the conservative line of management can be really benefited by ESWT. PMID:28057983

  5. 29 CFR 541.201 - Directly related to management or general business operations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., PROFESSIONAL, COMPUTER AND OUTSIDE SALES EMPLOYEES Administrative Employees § 541.201 Directly related to... operations includes, but is not limited to, work in functional areas such as tax; finance; accounting...

  6. 29 CFR 541.201 - Directly related to management or general business operations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., PROFESSIONAL, COMPUTER AND OUTSIDE SALES EMPLOYEES Administrative Employees § 541.201 Directly related to... operations includes, but is not limited to, work in functional areas such as tax; finance; accounting...

  7. 29 CFR 541.201 - Directly related to management or general business operations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., PROFESSIONAL, COMPUTER AND OUTSIDE SALES EMPLOYEES Administrative Employees § 541.201 Directly related to... operations includes, but is not limited to, work in functional areas such as tax; finance; accounting...

  8. 29 CFR 541.201 - Directly related to management or general business operations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., PROFESSIONAL, COMPUTER AND OUTSIDE SALES EMPLOYEES Administrative Employees § 541.201 Directly related to... operations includes, but is not limited to, work in functional areas such as tax; finance; accounting...

  9. Intelligent Transportation Systems (ITS) plan for Canada : en route to intelligent mobility

    DOT National Transportation Integrated Search

    1999-11-01

    Intelligent Transportation Systems (ITS) include the application of advanced information processing, communications, sensor and control technologies and management strategies in an integrated manner to improve the functioning of the transportation sy...

  10. Software Review. Macintosh Laboratory Automation: Three Software Packages.

    ERIC Educational Resources Information Center

    Jezl, Barbara Ann

    1990-01-01

    Reviewed are "LABTECH NOTEBOOK,""LabVIEW," and "Parameter Manager pmPLUS/pmTALK." Each package is described including functions, uses, hardware, and costs. Advantages and disadvantages of this type of laboratory approach are discussed. (CW)

  11. 78 FR 43848 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-22

    ... performance of the functions of the agency, including whether the information will have practical utility; (b... and gender from the Minority Farm Register permission form, AD-2035. FSA manage the register and the...

  12. Bilateral vocal fold immobility: a 13 year review of etiologies, management and the utility of the Empey index.

    PubMed

    Brake, Maria K; Anderson, Jennifer

    2015-06-26

    Bilateral vocal fold immobility (BVFI) is a rare diagnosis causing dyspnea, dysphonia and dysphagia. Management depends on respiratory performance, airway patency, vocal ability, and quality-of-life priorities. The authors review the presentation, management and outcome in patients diagnosed with BVFI. The utility and efficacy of the Empey index (EI) and the Expiratory Disproportion Index (EDI) are evaluated as an objective monitoring tools for BVFI patients. A 13-year retrospective review was performed of BVFI patients at St. Michael's Hospital, University of Toronto, a tertiary referral centre for laryngology. Forty-eight patients were included; 46 presented with airway obstruction symptoms. Tracheotomy was required for airway management in 40% of patients throughout the course of their treatment, which was reduced to 19% at the end of the study period. Twenty-one patients underwent endoscopic arytenoidectomy/cordotomy. Non-operative management included continuous positive airway pressure devices. Pulmonary function testing was carried out in 29 patients. Only a portion of the BVFI patients met the defined upper airway obstruction criteria (45% EI and 52% EDI). Seven patients had complete pre- and post-operative PFTs for comparison and all seven had ratios that significantly improved post-operatively which correlated clinically. The EI and EDI have limited use in evaluating patients with who have variable upper airway obstruction, but may be helpful in monitoring within subject airway function changes.

  13. Management of sexual disorders.

    PubMed

    Kok, L P

    1993-12-01

    Sexual disorders comprise (a) disorders of function in which sexual functioning is disturbed leading to problems during sexual intercourse, (b) disorders of orientation whereby a non heterosexual partner or object is sought, and (c) other disorders involving aberrant psychosexual behaviour. In managing such problems a thorough psychosexual assessment is required in order to ascertain the exact nature of the problem and what the precipitating, predisposing and prolonging factors are. In disorders of orientation and disorders involving aberrant sexual behaviours, the developmental history and early childhood relationships must be looked into carefully. Laboratory investigations are usually indicated in erectile dysfunction as up to 80% would have an organic aetiology--vascular, neurological and endocrine disorders have to be ruled out. Treatment of the various conditions involves general sexual counselling, behaviour therapy including stress management, psychotherapy, marital therapy and drug therapy as indicated. However, in erectile dysfunction, drug treatment (including intracavernosal injections), mechanical aids, or surgery may be indicated; and in transsexualism--for those who are unable to revert to accepting their natural status--a sex reassignment operation is the treatment of choice.

  14. [Establishement for regional pelvic trauma database in Hunan Province].

    PubMed

    Cheng, Liang; Zhu, Yong; Long, Haitao; Yang, Junxiao; Sun, Buhua; Li, Kanghua

    2017-04-28

    To establish a database for pelvic trauma in Hunan Province, and to start the work of multicenter pelvic trauma registry.
 Methods: To establish the database, literatures relevant to pelvic trauma were screened, the experiences from the established trauma database in China and abroad were learned, and the actual situations for pelvic trauma rescue in Hunan Province were considered. The database for pelvic trauma was established based on the PostgreSQL and the advanced programming language Java 1.6.
 Results: The complex procedure for pelvic trauma rescue was described structurally. The contents for the database included general patient information, injurious condition, prehospital rescue, conditions in admission, treatment in hospital, status on discharge, diagnosis, classification, complication, trauma scoring and therapeutic effect. The database can be accessed through the internet by browser/servicer. The functions for the database include patient information management, data export, history query, progress report, video-image management and personal information management.
 Conclusion: The database with whole life cycle pelvic trauma is successfully established for the first time in China. It is scientific, functional, practical, and user-friendly.

  15. Critical Care Management Focused on Optimizing Brain Function After Cardiac Arrest.

    PubMed

    Nakashima, Ryuta; Hifumi, Toru; Kawakita, Kenya; Okazaki, Tomoya; Egawa, Satoshi; Inoue, Akihiko; Seo, Ryutaro; Inagaki, Nobuhiro; Kuroda, Yasuhiro

    2017-03-24

    The discussion of neurocritical care management in post-cardiac arrest syndrome (PCAS) has generally focused on target values used for targeted temperature management (TTM). There has been less attention paid to target values for systemic and cerebral parameters to minimize secondary brain damage in PCAS. And the neurologic indications for TTM to produce a favorable neurologic outcome remain to be determined. Critical care management of PCAS patients is fundamental and essential for both cardiologists and general intensivists to improve neurologic outcome, because definitive therapy of PCAS includes both special management of the cause of cardiac arrest, such as coronary intervention to ischemic heart disease, and intensive management of the results of cardiac arrest, such as ventilation strategies to avoid brain ischemia. We reviewed the literature and the latest research about the following issues and propose practical care recommendations. Issues are (1) prediction of TTM candidate on admission, (2) cerebral blood flow and metabolism and target value of them, (3) seizure management using continuous electroencephalography, (4) target value of hemodynamic stabilization and its method, (5) management and analysis of respiration, (6) sedation and its monitoring, (7) shivering control and its monitoring, and (8) glucose management. We hope to establish standards of neurocritical care to optimize brain function and produce a favorable neurologic outcome.

  16. Outcome Measures Used to Report Kidney Function in Studies Investigating Surgical Management of Kidney Tumours: A Systematic Review.

    PubMed

    Ellis, Robert J; Cho, Yeoungjee; Del Vecchio, Sharon J; McStea, Megan; Morais, Christudas; Coombes, Jeff S; Wood, Simon T; Gobe, Glenda C; Francis, Ross S

    2018-05-01

    Most practice decisions relevant to preserving kidney function in patients managed surgically for kidney tumours are driven by observational studies. A wide range of outcome measures are used in these studies, which reduces comparability and increases the risk of reporting bias. To comprehensively and succinctly describe the outcomes used to evaluate kidney function in studies evaluating surgical management of kidney tumours. Electronic search of the PubMed database was conducted to identify studies with at least one measure of kidney function in patients managed surgically for kidney tumours, published between January 2000 and September 2017. Abstracts were initially screened for eligibility. Full texts of articles were then evaluated in more detail for inclusion. A narrative synthesis of the evidence was conducted. A total of 312 studies, involving 127905 participants, were included in this review. Most were retrospective (n=274) studies and conducted in a single centre (n=264). Overall, 78 unique outcome measures were identified, which were grouped into six outcome categories. Absolute postoperative kidney function (n=187), relative kidney function (n=181), and postoperative chronic kidney disease (n=131) were most frequently reported. Kidney function was predominantly quantified using estimated glomerular filtration rate or creatinine clearance (n=255), most using the modification of diet in renal disease equation (n=182). Only 70 studies provided rationale for specific outcome measures used. There is significant variability in the reporting and quantification of kidney function in studies evaluating patients managed surgically for kidney tumours. A standardised approach to measuring and reporting kidney function will increase the effectiveness of outcomes reported and improve relevance of research findings within a clinical context. Although we know that the removal of a kidney can reduce kidney function, clinical significance of various approaches is a matter of debate. This article demonstrates significant variability in the way kidney function was reported across all studies of patients with kidney cancer undergoing surgery, indicating a need for standardisation. Copyright © 2018 European Association of Urology. All rights reserved.

  17. Modeling the Effects of Hydrogeomorphology and Climactic Factors on Nitrogen, Phosphorus, and Greenhouse Gas Dynamics in Riparian Zones.

    NASA Astrophysics Data System (ADS)

    Hassanzadeh, Y.; Vidon, P.; Gold, A.; Pradhanang, S. M.; Addy, K.

    2017-12-01

    Vegetated riparian zones are often considered for use as best management practices to mitigate the impacts of agriculture on water quality. However, riparian zones can also be a source of greenhouse gases and their influence on water quality varies depending on landscape hydrogeomorphic characteristics and climate. Methods used to evaluate riparian zone functions include conceptual models, and spatially explicit and process based models (REMM), but very few attempts have been made to connect riparian zone characteristics with function using easily accessible landscape scale data. Here, we present comprehensive statistical models that can be used to assess riparian zone functions with easily obtainable landscape-scale hydrogeomorphic attributes and climate data. Models were developed from a database spanning 88 years and 36 sites. Statistical methods including principal component analysis and stepwise regression were used to reduced data dimensionality and identify significant predictors. Models were validated using additional data collected from scientific literature. The 8 models developed connect landscape characteristics to nitrogen and phosphorus concentration and removal (1-4), greenhouse gas emissions (5-7), and water table depth (8). Results show the range of influence that various climate and landscape characteristics have on riparian zone functions, and the tradeoffs that exist with regards to nitrogen, phosphorous, and greenhouse gases. These models will help reduce the need for extensive field measurements and help scientists and land managers make more informed decisions regarding the use of riparian zones for water quality management.

  18. Gradual weaning and oral care management of prolonged breast-feeding based on family preferences.

    PubMed

    Hernandez, Purnima; Kisamore, April N

    2017-06-01

    There are no guidelines about when breast-feeding (BF) should be discontinued. In addition, investigators have not examined patient-provider communication regarding weaning strategies based on function and oral care management during prolonged BF. Suggestions to wean do not include strategies about how to achieve discontinuance. The authors conducted this case study to assist care providers in facilitation of such discussions with parents to minimize the risk of developing dental caries in older children who are breast-fed. The authors conducted a functional behavior assessment of BF and used the results to inform strategy development. The parent successfully implemented the suggested strategies to wean the child from BF with minimal problem behavior by the child. From the outcome of this case report, the authors developed an algorithm based on family preferences and behavioral functions to assist parents with gradual weaning and oral care management during prolonged BF. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  19. Understanding patient portal use: implications for medication management.

    PubMed

    Osborn, Chandra Y; Mayberry, Lindsay Satterwhite; Wallston, Kenneth A; Johnson, Kevin B; Elasy, Tom A

    2013-07-03

    The Internet can be leveraged to provide disease management support, including medication adherence promotion that, when tailored, can effectively improve adherence to medications. The growing adoption of patient portals represents an opportunity to support medication management and adherence more broadly, but virtually no data exist about the real and potential impact of existing portals on these outcomes. We sought to (1) understand who uses an existing patient portal and reasons for use and nonuse, (2) understand how portal users are using a portal to manage their medications, and (3) explore participants' ideas for improving portal functionality for medication management and adherence support. A total of 75 adults with type 2 diabetes participated in a mixed-methods study involving focus groups, a survey, and a medical chart review. We used quantitative data to identify differences between portal users and nonusers, and to test the relationship between the frequency of portal use and glycemic control among users. We used qualitative methods to understand how and why participants use a portal and their ideas for improving its medication management functionality. Of the enrolled participants, 81% (61/75) attended a focus group and/or completed a survey; portal users were more likely than nonusers to participate in that capacity (Fisher exact test; P=.01). Users were also more likely than nonusers to be Caucasian/white (Fisher exact test; P<.001), have higher incomes (Fisher exact test; P=.005), and be privately insured (Fisher exact test; P<.001). Users also tended to have more education than nonusers (Mann-Whitney U; P=.05), although this relationship was not significant at P<.05. Among users, more frequent use of a portal was associated with better A1C (Spearman rho =-0.30; P=.02). Reasons for nonuse included not knowing about the portal (n=3), not having access to a computer (n=3), or having a family member serve as an online delegate (n=1). Users reported using the portal to request prescription refills/reauthorizations and to view their medication list, and they were enthusiastic about the idea of added refill reminder functionality. They were also interested in added functionality that could streamline the refill/reauthorization process, alert providers to fill/refill nonadherence, and provide information about medication side effects and interactions. Although there are disparities in patient portal use, patients use portals to manage their medications, are enthusiastic about further leveraging portals to support medication management and adherence, and those who use a portal more frequently have better glycemic control. However, more features and functionality within a portal platform is needed to maximize medication management and adherence promotion.

  20. Administrative skills for academic physicians.

    PubMed

    Aluise, J J; Scmitz, C C; Bland, C J; McArtor, R E

    1989-01-01

    To function effectively within the multifaceted environment of the academic medical center, academic physicians need to heighten their understanding of the economics of the health care system, and further develop their leadership and managerial skills. A literature base on organizational development and management education now exists that addresses the unique nature of the professional organization, including academic medical centers. This article describes an administration development curriculum for academic physicians. Competency statements, instructional strategies and references provide the academic physician with guidelines for expanding their professional expertise to include organizational and management skills. The continuing success of the academic medical center as a responsive health care system may depend upon the degree to which academic physicians gain sophistication in self-management and organizational administration.

  1. Japanese experiment module data management and communication system

    NASA Astrophysics Data System (ADS)

    Iizuka, Isao; Yamamoto, Harumitsu; Harada, Minoru; Eguchi, Iwao; Takahashi, Masami

    The data management and communications system (DMCS) for the Japanese experiment module (JEM) being developed for the Space Station is described. Data generated by JEM experiments will be transmitted via TDRS (primary link) to the NASDA Operation Control Center. The DMSC will provide data processing, test and graphics handling, schedule planning support, and data display and facilitate subsystems, payloads, emergency operations, status, and diagnostics and healthchecks management. The ground segment includes a mainframe, mass storage, a workstation, and a LAN, with the capability of receiving and manipulating data from the JEM, the Space Station, and the payload. Audio and alert functions are also included. The DMCS will be connected to the interior of the module with through-bulkhead optical fibers.

  2. The Role of Semantics in Open-World, Integrative, Collaborative Science Data Platforms

    NASA Astrophysics Data System (ADS)

    Fox, Peter; Chen, Yanning; Wang, Han; West, Patrick; Erickson, John; Ma, Marshall

    2014-05-01

    As collaborative science spreads into more and more Earth and space science fields, both participants and funders are expressing stronger needs for highly functional data and information capabilities. Characteristics include a) easy to use, b) highly integrated, c) leverage investments, d) accommodate rapid technical change, and e) do not incur undue expense or time to build or maintain - these are not a small set of requirements. Based on our accumulated experience over the last ~ decade and several key technical approaches, we adapt, extend, and integrate several open source applications and frameworks to handle major portions of functionality for these platforms. This includes: an object-type repository, collaboration tools, identity management, all within a portal managing diverse content and applications. In this contribution, we present our methods and results of information models, adaptation, integration and evolution of a networked data science architecture based on several open source technologies (Drupal, VIVO, the Comprehensive Knowledge Archive Network; CKAN, and the Global Handle System; GHS). In particular we present the Deep Carbon Observatory - a platform for international science collaboration. We present and discuss key functional and non-functional attributes, and discuss the general applicability of the platform.

  3. A descriptive study on evaluation of bio-medical waste management in a tertiary care public hospital of North India

    PubMed Central

    2014-01-01

    Background Proper management of Biomedical waste (BMW) generated in a healthcare facility is one of the most important functions of a healthcare worker (HCW) as its improper management not only poses risk to human beings and environment, but may also invite legal action against HCW as well as hospital administration. This study was carried out to evaluate quality of BMW management in 1100-bedded hospital attached to a tertiary care public institute in North India. Methods A checklist, including 29 parameters related to various functions to be carried out at source of generation by a HCW for BMW management was prepared by researcher and used after validation to record observations in all the 70 areas of hospital. A total of 6 visits were made to each area and mean percentage score was calculated for each area and each category of waste management. Results It was found that summated mean percentage score of ‘Treatment Room of Wards’, which were used exclusively by resident doctors, was significantly lower than Operation Theatres (p value: 0.033) and ‘Central Waste Collection Points of Wards’ (p value: 0.018) for the function of ‘mutilation of recyclable waste’ and it was significantly lower than all other areas (p value: 0.006 to 0.017) for the function of ‘disinfection of waste’. Conclusion It is concluded that more emphasis needs to be laid on ‘mutilation of recyclable waste’ and disinfection of waste’ by HCWs especially resident doctors. PMID:24742274

  4. Effects of a 3-year nurse-based case management in aged patients with acute myocardial infarction on rehospitalisation, mortality, risk factors, physical functioning and mental health. a secondary analysis of the randomized controlled KORINNA study.

    PubMed

    Kirchberger, Inge; Hunger, Matthias; Stollenwerk, Björn; Seidl, Hildegard; Burkhardt, Katrin; Kuch, Bernhard; Meisinger, Christa; Holle, Rolf

    2015-01-01

    Home-based secondary prevention programs led by nurses have been proposed to facilitate patients' adjustment to acute myocardial infarction (AMI). The objective of this study was to conduct secondary analyses of the three-year follow-up of a nurse-based case management for elderly patients discharged from hospital after an AMI. In a single-centre randomized two-armed parallel group trial of hospitalized patients with AMI ≥65 years, patients hospitalized between September 2008 and May 2010 in the Hospital of Augsburg, Germany, were randomly assigned to case management or usual care. The case-management intervention consisted of a nurse-based follow-up for three years including home visits and telephone calls. Study endpoints were time to first unplanned readmission or death, clinical parameters, functional status, depressive symptoms and malnutrition risk. Persons who assessed three-year outcomes and validated readmission data were blinded. The intention-to-treat approach was applied to the statistical analyses which included Cox Proportional Hazards models. Three hundred forty patients were allocated to receive case-management (n = 168) or usual care (n = 172). During three years, in the intervention group there were 80 first unplanned readmissions and 6 deaths, while the control group had 111first unplanned readmissions and 3 deaths. The intervention did not significantly affect time to first unplanned readmission or death (Hazard Ratio 0.89, 95% confidence interval (CI) 0.67-1.19; p = 0.439), blood pressure, cholesterol level, instrumental activities of daily life (IADL) (only for men), and depressive symptoms. However, patients in the intervention group had a significantly better functional status, as assessed by the HAQ Disability Index, IADL (only for women), and hand grip strength, and better SCREEN-II malnutrition risk scores than patients in the control group. A nurse-based management among elderly patients with AMI did not significantly affect time to unplanned readmissions or death during a three-year follow-up. However, the results indicate that functional status and malnutrition risk can be improved. Current Controlled Trials ISRCTN02893746.

  5. Hypnotic Approaches for Chronic Pain Management

    PubMed Central

    Jensen, Mark P.; Patterson, David R.

    2015-01-01

    The empirical support for hypnosis for chronic pain management has flourished over the past two decades. Clinical trials show that hypnosis is effective for reducing chronic pain, although outcomes vary between individuals. The findings from these clinical trials also show that hypnotic treatments have a number of positive effects beyond pain control. Neurophysiological studies reveal that hypnotic analgesia has clear effects on brain and spinal-cord functioning that differ as a function of the specific hypnotic suggestions made, providing further evidence for the specific effects of hypnosis. The research results have important implications for how clinicians can help their clients experience maximum benefits from hypnosis and treatments that include hypnotic components. PMID:24547802

  6. GSE, data management system programmers/User' manual

    NASA Technical Reports Server (NTRS)

    Schlagheck, R. A.; Dolerhie, B. D., Jr.; Ghiglieri, F. J.

    1974-01-01

    The GSE data management system is a computerized program which provides for a central storage source for key data associated with the mechanical ground support equipment (MGSE). Eight major sort modes can be requested by the user. Attributes that are printed automatically with each sort include the GSE end item number, description, class code, functional code, fluid media, use location, design responsibility, weight, cost, quantity, dimensions, and applicable documents. Multiple subsorts are available for the class code, functional code, fluid media, use location, design responsibility, and applicable document categories. These sorts and how to use them are described. The program and GSE data bank may be easily updated and expanded.

  7. Laboratory Information Systems.

    PubMed

    Henricks, Walter H

    2015-06-01

    Laboratory information systems (LISs) supply mission-critical capabilities for the vast array of information-processing needs of modern laboratories. LIS architectures include mainframe, client-server, and thin client configurations. The LIS database software manages a laboratory's data. LIS dictionaries are database tables that a laboratory uses to tailor an LIS to the unique needs of that laboratory. Anatomic pathology LIS (APLIS) functions play key roles throughout the pathology workflow, and laboratories rely on LIS management reports to monitor operations. This article describes the structure and functions of APLISs, with emphasis on their roles in laboratory operations and their relevance to pathologists. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. The role of skeletal muscle in the pathophysiology and management of knee osteoarthritis.

    PubMed

    Krishnasamy, Priathashini; Hall, Michelle; Robbins, Sarah R

    2018-05-01

    The role of skeletal muscle in the pathophysiology of knee OA is poorly understood. To date, the majority of literature has focused on the association of muscle strength with OA symptoms, disease onset and progression. However, deficits or improvements in skeletal muscle strength do not fully explain the mechanisms behind outcome measures in knee OA, such as pain, function and structural disease. This review aims to summarize components of skeletal muscle, providing a holistic view of skeletal muscle mechanisms that includes muscle function, quality and composition and their interactions. Similarly, the role of skeletal muscle in the management of knee OA will be discussed.

  9. Role of strategic planning in engineering management

    NASA Technical Reports Server (NTRS)

    Krishen, Kumar

    1993-01-01

    Today, more than ever before, engineers are faced with uncertain and sometimes chaotic environments in which to function. The traditional roles of an engineer to design, develop, and streamline a manufacturing process for a product are still valued and relevant. However, the need for an engineer to participate in the process of identifying the product to be developed, the schedule and resources required, and the goal of satisfying the customer, has become paramount to achieving the success of the enterprise. When we include these endeavors in the functions of an engineer, management of 'engineering' takes on a new dimension. In this paper, the ramifications of the changing and increased functions of an engineer and consequent impacts on engineering management are explored. The basic principles which should be invoked in order to embrace the new environment for engineering management are outlined. The ultimate finding of this study is that the enterprise strategic plan should be developed in such a way as to allow engineering management to encompass the full spectrum of the responsibilities of engineers. A consequence of this is that the fundamental elements of the strategic process can best be implemented through a project team or group approach. The paper thus concentrates on three areas: evolving environment, strategic plan, and ways to achieve enterprise success.

  10. Applying business management models in health care.

    PubMed

    Trisolini, Michael G

    2002-01-01

    Most health care management training programmes and textbooks focus on only one or two models or conceptual frameworks, but the increasing complexity of health care organizations and their environments worldwide means that a broader perspective is needed. This paper reviews five management models developed for business organizations and analyses issues related to their application in health care. Three older, more 'traditional' models are first presented. These include the functional areas model, the tasks model and the roles model. Each is shown to provide a valuable perspective, but to have limitations if used in isolation. Two newer, more 'innovative' models are next discussed. These include total quality management (TQM) and reengineering. They have shown potential for enabling dramatic improvements in quality and cost, but have also been found to be more difficult to implement. A series of 'lessons learned' are presented to illustrate key success factors for applying them in health care organizations. In sum, each of the five models is shown to provide a useful perspective for health care management. Health care managers should gain experience and training with a broader set of business management models.

  11. Relative value of managed wetlands and tidal marshlands for wintering northern pintails

    USGS Publications Warehouse

    Coates, Peter S.; Casazza, Michael L.; Halstead, Brian J.; Fleskes, Joseph P.

    2012-01-01

    Northern pintail Anas acuta (hereafter, pintail) populations have declined substantially throughout the western US since the 1970s, largely as a result of converting wetlands to cropland. Managed wetlands have been developed throughout the San Francisco Bay estuaries to provide wildlife habitat, particularly for waterfowl. Many of these areas were historically tidal baylands and plans are underway to remove dikes and restore tidal action. The relationship between tidal baylands and waterfowl populations is poorly understood. Our objective was to provide information on selection and avoidance of managed and tidal marshland by pintails. During 1991–1993 and 1998–2000, we radio-marked and relocated 330 female pintails (relocations, n =11,574) at Suisun Marsh, the largest brackish water estuary within San Francisco Bay, to estimate resource selection functions during the nonbreeding months (winter). Using a distance-based modeling approach, we calculated selection functions for different ecological communities (e.g., tidal baylands) and investigated variation explained by time of day (day or night hours) to account for differences in pintail behavior (i.e., foraging vs. roosting). We found strong evidence for selection of managed wetlands. Pintails also avoided tidal marshes and bays and channels. We did not detect differences in selection function between day and night hours for managed wetlands but the degree of avoidance of other habitats varied by time of day. We also found that areas subjected to tidal action did not influence the selection of immediately adjacent managed wetlands. If current management goals include providing habitat for wintering waterfowl populations, particularly pintail, then we recommend wildlife managers focus tidal restoration on areas that are not currently managed wetland and/or improve conditions in areas of managed wetlands to increase local carrying capacities

  12. An evaluation of diabetes targeted apps for Android smartphone in relation to behaviour change techniques.

    PubMed

    Hoppe, C D; Cade, J E; Carter, M

    2017-06-01

    Mobile applications (apps) could support diabetes management through dietary, weight and blood glucose self-monitoring, as well as by promoting behaviour change. The present study aimed to evaluate diabetes apps for content, functions and behaviour change techniques (BCTs). Diabetes self-management apps for Android smartphones were searched for on the Google Play Store. Ten apps each from the following search terms were included; 'diabetes', 'diabetes type 1', 'diabetes type 2', 'gestational diabetes'. Apps were evaluated by being scored according to their number of functions and BCTs, price, and user rating. The mean (SD) number of functions was 8.9 (5.9) out of a possible maximum of 27. Furthermore, the mean (SD) number of BCTs was 4.4 (2.6) out of a possible maximum of 26. Apps with optimum BCT had significantly more functions [13.8; 95% confidence interval (CI) = 11.9-15.9] than apps that did not (4.7; 95% CI = 3.2-6.2; P < 0.01) and significantly more BCTs (5.8; 95% CI = 4.8-7.0) than apps without (3.1; 95% CI = 2.2-4.1; P < 0.01). Additionally, apps with optimum BCT also cost more than other apps. In the adjusted models, highly rated apps had an average of 4.8 (95% CI = 0.9-8.7; P = 0.02) more functions than lower rated apps. 'Diabetes apps' include few functions or BCTs compared to the maximum score possible. Apps with optimum BCTs could indicate higher quality. App developers should consider including both specific functions and BCTs in 'diabetes apps' to make them more helpful. More research is needed to understand the components of an effective app for people with diabetes. © 2016 The British Dietetic Association Ltd.

  13. Operative versus nonoperative treatment of unstable lateral malleolar fractures: a randomized multicenter trial.

    PubMed

    Sanders, David W; Tieszer, Christina; Corbett, Bradley

    2012-03-01

    To compare clinical and functional outcomes after operative and nonoperative treatment of undisplaced, unstable, isolated fibula fractures. Randomized multicenter clinical trial. Six level 1 trauma centers. Eighty-one patients with undisplaced, unstable, isolated fibula fractures as confirmed by an external rotation stress examination demonstrating an increase in medial clear space to 5 mm or greater were followed for 12 months after treatment. Forty-one patients were treated operatively by open reduction and internal fixation of the fibula. Forty patients underwent nonoperative treatment, which included the use of a short leg cast or brace and protected weight bearing for 6 weeks. Functional outcomes determined using the Olerud-Molander Ankle Score and the Short Form 36. Radiographic outcomes included measurement of union and displacement at each visit. There were no statistically significant differences in functional outcome scores or pace of recovery between the operative and nonoperative groups at any time interval (β = -0.28, 3.49; P = 0.936). Complications in the nonoperative group included 8 patients with a medial clear space ≥5 mm and 8 patients with delayed union or nonunion. In the operative group, 5 patients had a surgical site infection and 5 patients required hardware removal. Patients managed operatively had equivalent functional outcomes compared with nonoperative treatment; however, the risk of displacement and problems with union was substantially lower in patients managed with surgery.

  14. Managing cognitive difficulties after traumatic brain injury: a review of online resources for families.

    PubMed

    Poulin, Valérie; Dawson, Deirdre R; Bottari, Carolina; Verreault, Cynthia; Turcotte, Samantha; Jean, Alexandra

    2018-03-22

    To identify and critically appraise the content, readability, reliability and usability of websites providing information for managing cognitive difficulties in everyday life for the families of adults with moderate to severe traumatic brain injury. Systematic searches on the Internet for relevant websites were conducted using five search engines, and through consultation of the lists of resources published on websites of traumatic brain injury organizations. Two team members assessed eligibility of the websites. To be included, they had to provide information related to management of cognitive difficulties following moderate to severe traumatic brain injury, to be in English or French and available free of charge. Two reviewers evaluated each website according to: (1) its readability using Flesch-Kincaid Grade Level; (2) the quality of its content using a checklist of eight recommendations for managing memory, attention and executive function problems; (3) its usability (e.g., clear design) and reliability (e.g., currency of information) using the Minervation Validation Instrument for Health Care Web Sites. Of the 38 websites included, 10 provide specific tips for families that cover several domains of cognitive function, including memory, attention and executive function. The most frequent recommendations focused on the use of environmental supports for memory problems (n = 33 websites). The readability of information is below the recommended grade 7 for only nine of the websites. All sites show acceptable usability, but their quality is variable in terms of reliability of the information. This review provides useful information for selecting online resources to educate families about the management of cognitive difficulties following moderate to severe traumatic brain injury, as a complement to information and training provided by the rehabilitation team. Implications for rehabilitation This review describes standardized criteria for the evaluation of the content, readability, reliability and usability of websites for family education post-TBI. Given the variability in the content, the readability and the reliability of websites providing information for families about the management of cognitive difficulties post-TBI, careful attention to the selection of appropriate resources is required. Findings from this review may facilitate clinicians' identification of relevant websites to educate families about the management of cognitive difficulties post-TBI, as a complement to other information and training from the rehabilitation team.

  15. Representing functions/procedures and processes/structures for analysis of effects of failures on functions and operations

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.; Leifker, Daniel B.

    1991-01-01

    Current qualitative device and process models represent only the structure and behavior of physical systems. However, systems in the real world include goal-oriented activities that generally cannot be easily represented using current modeling techniques. An extension of a qualitative modeling system, known as functional modeling, which captures goal-oriented activities explicitly is proposed and how they may be used to support intelligent automation and fault management is shown.

  16. Towards an Autonomic Cluster Management System (ACMS) with Reflex Autonomicity

    NASA Technical Reports Server (NTRS)

    Truszkowski, Walt; Hinchey, Mike; Sterritt, Roy

    2005-01-01

    Cluster computing, whereby a large number of simple processors or nodes are combined together to apparently function as a single powerful computer, has emerged as a research area in its own right. The approach offers a relatively inexpensive means of providing a fault-tolerant environment and achieving significant computational capabilities for high-performance computing applications. However, the task of manually managing and configuring a cluster quickly becomes daunting as the cluster grows in size. Autonomic computing, with its vision to provide self-management, can potentially solve many of the problems inherent in cluster management. We describe the development of a prototype Autonomic Cluster Management System (ACMS) that exploits autonomic properties in automating cluster management and its evolution to include reflex reactions via pulse monitoring.

  17. [Health management system in outpatient follow-up of kidney transplantation patients].

    PubMed

    Zhang, Hong; Xie, Jinliang; Yao, Hui; Liu, Ling; Tan, Jianwen; Geng, Chunmi

    2014-07-01

    To develop a health management system for outpatient follow-up of kidney transplant patients. Access 2010 database software was used to establish the health management system for kidney transplantation patients in Windows XP operating system. Database management and post-operation follow-up of the kidney transplantation patients were realized through 6 function modules including data input, data query, data printing, questionnaire survey, data export, and follow-up management. The system worked stably and reliably, and the data input was easy and fast. The query, the counting and printing were convenient. Health management system for patients after kidney transplantation not only reduces the work pressure of the follow-up staff, but also improves the efficiency of outpatient follow-up.

  18. Handling Uncertain Gross Margin and Water Demand in Agricultural Water Resources Management using Robust Optimization

    NASA Astrophysics Data System (ADS)

    Chaerani, D.; Lesmana, E.; Tressiana, N.

    2018-03-01

    In this paper, an application of Robust Optimization in agricultural water resource management problem under gross margin and water demand uncertainty is presented. Water resource management is a series of activities that includes planning, developing, distributing and managing the use of water resource optimally. Water resource management for agriculture can be one of the efforts to optimize the benefits of agricultural output. The objective function of agricultural water resource management problem is to maximizing total benefits by water allocation to agricultural areas covered by the irrigation network in planning horizon. Due to gross margin and water demand uncertainty, we assume that the uncertain data lies within ellipsoidal uncertainty set. We employ robust counterpart methodology to get the robust optimal solution.

  19. Home energy management (HEM) database: A list with coded attributes of 308 devices commercially available in the US.

    PubMed

    Pritoni, Marco; Ford, Rebecca; Karlin, Beth; Sanguinetti, Angela

    2018-02-01

    Policymakers worldwide are currently discussing whether to include home energy management (HEM) products in their portfolio of technologies to reduce carbon emissions and improve grid reliability. However, very little data is available about these products. Here we present the results of an extensive review including 308 HEM products available on the US market in 2015-2016. We gathered these data from publicly available sources such as vendor websites, online marketplaces and other vendor documents. A coding guide was developed iteratively during the data collection and utilized to classify the devices. Each product was coded based on 96 distinct attributes, grouped into 11 categories: Identifying information, Product components, Hardware, Communication, Software, Information - feedback, Information - feedforward, Control, Utility interaction, Additional benefits and Usability. The codes describe product features and functionalities, user interaction and interoperability with other devices. A mix of binary attributes and more descriptive codes allow to sort and group data without losing important qualitative information. The information is stored in a large spreadsheet included with this article, along with an explanatory coding guide. This dataset is analyzed and described in a research article entitled "Categories and functionality of smart home technology for energy management" (Ford et al., 2017) [1].

  20. Nanomaterials for Space Exploration Applications

    NASA Technical Reports Server (NTRS)

    Moloney, Padraig G.

    2006-01-01

    Nano-engineered materials are multi-functional materials with superior mechanical, thermal and electrical properties. Nanomaterials may be used for a variety of space exploration applications, including ultracapacitors, active/passive thermal management materials, and nanofiltration for water recovery. Additional applications include electrical power/energy storage systems, hybrid systems power generation, advanced proton exchange membrane fuel cells, and air revitalization. The need for nanomaterials and their growth, characterization, processing and space exploration applications is discussed. Data is presented for developing solid-supported amine adsorbents based on carbon nanotube materials and functionalization of nanomaterials is examined.

  1. Real-time contingency handling in MAESTRO

    NASA Technical Reports Server (NTRS)

    Britt, Daniel L.; Geoffroy, Amy L.

    1992-01-01

    A scheduling and resource management system named MAESTRO was interfaced with a Space Station Module Power Management and Distribution (SSM/PMAD) breadboard at MSFC. The combined system serves to illustrate the integration of planning, scheduling, and control in a realistic, complex domain. This paper briefly describes the functional elements of the combined system, including normal and contingency operational scenarios, then focusses on the method used by the scheduler to handle real-time contingencies.

  2. Community-Oriented Policing and Counterinsurgency: A Conceptual Model

    DTIC Science & Technology

    2007-01-01

    between security and reform, ideas on how to manage assistance to police forces, how to evaluate the impact of police development assistance and makes...its own history, demographics, cultural and economic mix, region, tax base, management , civic leadership, public perception, and numerous other...percent.97 Efforts to curb crime have included the training and employment of 1,500 Special Police Officers in Dehli who perform some of the functions a

  3. JPRS Report. Soviet Union: Political Affairs.

    DTIC Science & Technology

    1990-07-10

    following three essential features: voluntary member- ship; self -management; and a permanent nature. All NATIONAL PARTY AND STATE AFFAIRS JPRS-UPA-90-040...voluntary, self -managed, permanently functioning association of citizens organized on a not- for-profit basis. This wording, which takes in the basic...problems which had long been present in the depths of society, including a most serious one—national self -preservation. As soon as the possibility of

  4. The ZOG Technology Demonstration Project: A System Evaluation of USS CARL VINSON (CVN 70)

    DTIC Science & Technology

    1984-12-01

    part of a larger project involving development of a wide range of computer technologies, including artifcial intelligence and a long-range computer...shipboard manage- ment, aircraft management, expert systems, menu selection, man- machine interface, artificial intelligence , automation; shipboard It AWM...functions, planning, evaluation, training, hierarchical data bases The objective of this project was to conduct an evaluation of ZOG, a general purpose

  5. Utilizing an Energy Management System with Distributed Resources to Manage Critical Loads and Reduce Energy Costs

    DTIC Science & Technology

    2014-09-01

    peak shaving, conducting power factor correction, matching critical load to most efficient distributed resource, and islanding a system during...photovoltaic arrays during islanding, and power factor correction, the implementation of the ESS by itself is likely to prove cost prohibitive. The DOD...These functions include peak shaving, conducting power factor correction, matching critical load to most efficient distributed resource, and islanding a

  6. Data management system DIU test system

    NASA Technical Reports Server (NTRS)

    1976-01-01

    An operational and functional description is given of the data management system. Descriptions are included for the test control unit, analog stimulus panel, discrete stimulus panel, and the precision source. The mechanical configuration is defined and illustrated to provide card and component location for modification or repair. The unit level interfaces are mirror images of the DIU interfaces and are described in the Final Technical Report for NASA-MSFC contract NAS8-29155.

  7. Cognitive Impairment in Adults with Non-CNS Cancers (PDQ®)—Health Professional Version

    Cancer.gov

    Cognitive impairment in adult cancer survivors may include problems with memory, concentration, information processing, and executive function. Get comprehensive information about assessing and managing cognitive impairment in this summary for clinicians.

  8. 77 FR 61624 - Patuxent Research Refuge, Prince George's and Anne Arundel Counties, MD; Draft Comprehensive...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-10

    ... comments on topics such as the potential effects of climate change, habitat management, reforesting... forest biodiversity and ecosystem function. This includes the restoration of a number of impoundments and...

  9. Improving access to psychological therapies in voice disorders: a cognitive behavioural therapy model.

    PubMed

    Miller, Tracy; Deary, Vincent; Patterson, Jo

    2014-06-01

    The improving access to psychological therapies initiative has highlighted the importance of managing mental health problems effectively, and research has shown excellent outcomes from cognitive behavioural therapy (CBT) interventions. Patients presenting with functional dysphonia will often also describe psychological distress including anxiety, depression and reduced general well-being, and it is felt that effective voice therapy needs to include the management of psychological well-being. The evidence for the use of CBT enhanced voice therapy is limited to date. Recent research has only started to identify the benefits of this approach and questions regarding how to achieve and maintain competence are essential. Voice therapy outcomes are positive and patients receiving CBT with voice therapy have shown more improvement in their general well-being and distress. CBT is a very well evidenced therapy and recommended by The National Institute for Health and Care Excellence (NICE) as the treatment of choice for mental health difficulties and medically unexplained symptoms. Allied health professionals are increasingly being trained to use CBT skills in the management of a number of symptoms/illnesses, and this should be considered for the management of functional dysphonia. However, there is a need for more research and detailed consideration of how therapists should be trained and supervised and how cost-effective this approach may be.

  10. The Role of Thoracic Medial Branch Blocks in Managing Chronic Mid and Upper Back Pain: A Randomized, Double-Blind, Active-Control Trial with a 2-Year Followup

    PubMed Central

    Manchikanti, Laxmaiah; Singh, Vijay; Falco, Frank J. E.; Cash, Kimberly A.; Pampati, Vidyasagar; Fellows, Bert

    2012-01-01

    Study Design. A randomized, double-blind, active-control trial. Objective. To determine the clinical effectiveness of therapeutic thoracic facet joint nerve blocks with or without steroids in managing chronic mid back and upper back pain. Summary of Background Data. The prevalence of thoracic facet joint pain has been established as 34% to 42%. Multiple therapeutic techniques utilized in managing chronic thoracic pain of facet joint origin include medial branch blocks, radiofrequency neurotomy, and intraarticular injections. Methods. This randomized double-blind active controlled trial was performed in 100 patients with 50 patients in each group who received medial branch blocks with local anesthetic alone or local anesthetic and steroids. Outcome measures included the numeric rating scale (NRS), Oswestry Disability Index (ODI), opioid intake, and work status, at baseline, 3, 6, 12, 18, and 24 months. Results. Significant improvement with significant pain relief and functional status improvement of 50% or more were observed in 80% of the patients in Group I and 84% of the patients in Group II at 2-year followup. Conclusions. Therapeutic medial branch blocks of thoracic facets with or without steroids may provide a management option for chronic function-limiting thoracic pain of facet joint origin. PMID:22851967

  11. Time management strategies for research productivity.

    PubMed

    Chase, Jo-Ana D; Topp, Robert; Smith, Carol E; Cohen, Marlene Z; Fahrenwald, Nancy; Zerwic, Julie J; Benefield, Lazelle E; Anderson, Cindy M; Conn, Vicki S

    2013-02-01

    Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress.

  12. Oak Ridge National Laboratory Health and Safety Long-Range Plan: Fiscal years 1989--1995

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

    Not Available

    1989-06-01

    The health and safety of its personnel is the first concern of ORNL and its management. The ORNL Health and Safety Program has the responsibility for ensuring the health and safety of all individuals assigned to ORNL activities. This document outlines the principal aspects of the ORNL Health and Safety Long-Range Plan and provides a framework for management use in the future development of the health and safety program. Each section of this document is dedicated to one of the health and safety functions (i.e., health physics, industrial hygiene, occupational medicine, industrial safety, nuclear criticality safety, nuclear facility safety, transportationmore » safety, fire protection, and emergency preparedness). Each section includes functional mission and objectives, program requirements and status, a summary of program needs, and program data and funding summary. Highlights of FY 1988 are included.« less

  13. Clinical Management of Salivary Gland Hypofunction and Xerostomia in Head-and-Neck Cancer Patients: Successes and Barriers

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

    Vissink, Arjan; Mitchell, James B.; Baum, Bruce J.

    The most significant long-term complication of radiotherapy in the head-and-neck region is hyposalivation and its related complaints, particularily xerostomia. This review addresses the pathophysiology underlying irradiation damage to salivary gland tissue, the consequences of radiation injury, and issues contributing to the clinical management of salivary gland hypofunction and xerostomia. These include ways to (1) prevent or minimize radiation injury of salivary gland tissue, (2) manage radiation-induced hyposalivation and xerostomia, and (3) restore the function of salivary gland tissue damaged by radiotherapy.

  14. Surgical management of penile fracture and long-term outcome on erectile function and voiding.

    PubMed

    Hatzichristodoulou, Georgios; Dorstewitz, Annika; Gschwend, Jürgen E; Herkommer, Kathleen; Zantl, Niko

    2013-05-01

    Penile fracture is an emergency in urology. Surgical management is recommended, but objective data of postoperative long-term effects, especially regarding voiding and erectile function, vary. To assess long-term results of patients undergoing surgical therapy for penile fracture. Patients presenting with suspicion of penile fracture were included in this study. Diagnosis of penile fracture was made by clinical assessment and surgery performed thereafter. The defect of the tunica albuginea was closed by absorbable suture. In case of concomitant urethral lesion, the defect was repaired simultaneously. Voiding and erectile function were evaluated at long-term follow-up by mail. Patients' status before penile fracture was assessed retroactively. Erectile function was assessed by the International Index of Erectile Function questionnaire and voiding function by the International Prostate Symptom Score questionnaire. N = 34 patients were included. Penile fracture was suspected in 28/34 (82.4%) patients. Twenty-six of the 28 (92.9%) patients underwent surgery. Only less than half of confirmed fracture patients presented with the classical triad of an audible crack, detumescense, and hematoma. Fourteen of the 26 (53.8%) patients after surgery were available for follow-up. Mean follow-up was 45.6 months (range: 3.6-128.4). In 13/14 (92.9%) patients, penile fracture was confirmed by surgery. At follow-up, 7/13 (53.8%) patients had impaired erectile function, with 3/13 (23.1%) patients needing medical treatment. Four of the 13 (30.8%) patients showed deterioration of voiding including occurrence of urethral fistula. Penile fracture is an emergency for which surgery should be offered. Clinical suspicion of fracture should be high even with hematoma alone. Concomitant urethral injury is common, particularly with bilateral corporal rupture and/or initial hematuria. Preoperative counseling should include discussion of long-term erectile and voiding dysfunction, penile deformity, and urethral fistula both with and without surgery. Close patient follow-up is required. © 2013 International Society for Sexual Medicine.

  15. Ecological Intensification Through Pesticide Reduction: Weed Control, Weed Biodiversity and Sustainability in Arable Farming.

    PubMed

    Petit, Sandrine; Munier-Jolain, Nicolas; Bretagnolle, Vincent; Bockstaller, Christian; Gaba, Sabrina; Cordeau, Stéphane; Lechenet, Martin; Mézière, Delphine; Colbach, Nathalie

    2015-11-01

    Amongst the biodiversity components of agriculture, weeds are an interesting model for exploring management options relying on the principle of ecological intensification in arable farming. Weeds can cause severe crop yield losses, contribute to farmland functional biodiversity and are strongly associated with the generic issue of pesticide use. In this paper, we address the impacts of herbicide reduction following a causal framework starting with herbicide reduction and triggering changes in (i) the management options required to control weeds, (ii) the weed communities and functions they provide and (iii) the overall performance and sustainability of the implemented land management options. The three components of this framework were analysed in a multidisciplinary project that was conducted on 55 experimental and farmer's fields that included conventional, integrated and organic cropping systems. Our results indicate that the reduction of herbicide use is not antagonistic with crop production, provided that alternative practices are put into place. Herbicide reduction and associated land management modified the composition of in-field weed communities and thus the functions of weeds related to biodiversity and production. Through a long-term simulation of weed communities based on alternative (?) cropping systems, some specific management pathways were identified that delivered high biodiversity gains and limited the negative impacts of weeds on crop production. Finally, the multi-criteria assessment of the environmental, economic and societal sustainability of the 55 systems suggests that integrated weed management systems fared better than their conventional and organic counterparts. These outcomes suggest that sustainable management could possibly be achieved through changes in weed management, along a pathway starting with herbicide reduction.

  16. Ecological Intensification Through Pesticide Reduction: Weed Control, Weed Biodiversity and Sustainability in Arable Farming

    NASA Astrophysics Data System (ADS)

    Petit, Sandrine; Munier-Jolain, Nicolas; Bretagnolle, Vincent; Bockstaller, Christian; Gaba, Sabrina; Cordeau, Stéphane; Lechenet, Martin; Mézière, Delphine; Colbach, Nathalie

    2015-11-01

    Amongst the biodiversity components of agriculture, weeds are an interesting model for exploring management options relying on the principle of ecological intensification in arable farming. Weeds can cause severe crop yield losses, contribute to farmland functional biodiversity and are strongly associated with the generic issue of pesticide use. In this paper, we address the impacts of herbicide reduction following a causal framework starting with herbicide reduction and triggering changes in (i) the management options required to control weeds, (ii) the weed communities and functions they provide and (iii) the overall performance and sustainability of the implemented land management options. The three components of this framework were analysed in a multidisciplinary project that was conducted on 55 experimental and farmer's fields that included conventional, integrated and organic cropping systems. Our results indicate that the reduction of herbicide use is not antagonistic with crop production, provided that alternative practices are put into place. Herbicide reduction and associated land management modified the composition of in-field weed communities and thus the functions of weeds related to biodiversity and production. Through a long-term simulation of weed communities based on alternative (?) cropping systems, some specific management pathways were identified that delivered high biodiversity gains and limited the negative impacts of weeds on crop production. Finally, the multi-criteria assessment of the environmental, economic and societal sustainability of the 55 systems suggests that integrated weed management systems fared better than their conventional and organic counterparts. These outcomes suggest that sustainable management could possibly be achieved through changes in weed management, along a pathway starting with herbicide reduction.

  17. NASA Shuttle Logistics Depot (NSLD) - The application of ATE

    NASA Technical Reports Server (NTRS)

    Simpkins, Lorenz G.; Jenkins, Henry C.; Mauceri, A. Jack

    1990-01-01

    The concept of the NASA Shuttle Logistics Depot (NSLD) developed for the Space Shuttle Orbiter Program is described. The function of the NSLD at Cape Canaveral is to perform the acceptance and diagnostic testing of the Shuttle's space-rated line-replaceable units and shop-replaceable units (SRUs). The NSLD includes a comprehensive electronic automatic test station, program development stations, and assorted manufacturing support equipment (including thermal and vibration test equipment, special test equipment, and a card SRU test system). The depot activities also include the establishment of the functions for manufacturing of mechanical parts, soldering, welding, painting, clean room operation, procurement, and subcontract management.

  18. Functional Analysis for an Integrated Capability of Arrival/Departure/Surface Management with Tactical Runway Management

    NASA Technical Reports Server (NTRS)

    Phojanamongkolkij, Nipa; Okuniek, Nikolai; Lohr, Gary W.; Schaper, Meilin; Christoffels, Lothar; Latorella, Kara A.

    2014-01-01

    The runway is a critical resource of any air transport system. It is used for arrivals, departures, and for taxiing aircraft and is universally acknowledged as a constraining factor to capacity for both surface and airspace operations. It follows that investigation of the effective use of runways, both in terms of selection and assignment as well as the timing and sequencing of the traffic is paramount to the efficient traffic flows. Both the German Aerospace Center (DLR) and NASA have developed concepts and tools to improve atomic aspects of coordinated arrival/departure/surface management operations and runway configuration management. In December 2012, NASA entered into a Collaborative Agreement with DLR. Four collaborative work areas were identified, one of which is called "Runway Management." As part of collaborative research in the "Runway Management" area, which is conducted with the DLR Institute of Flight Guidance, located in Braunschweig, the goal is to develop an integrated system comprised of the three DLR tools - arrival, departure, and surface management (collectively referred to as A/D/S-MAN) - and NASA's tactical runway configuration management (TRCM) tool. To achieve this goal, it is critical to prepare a concept of operations (ConOps) detailing how the NASA runway management and DLR arrival, departure, and surface management tools will function together to the benefit of each. To assist with the preparation of the ConOps, the integrated NASA and DLR tools are assessed through a functional analysis method described in this report. The report first provides the highlevel operational environments for air traffic management (ATM) in Germany and in the U.S., and the descriptions of the DLR's A/D/S-MAN and NASA's TRCM tools at the level of details necessary to compliment the purpose of the study. Functional analyses of each tool and a completed functional analysis of an integrated system design are presented next in the report. Future efforts to fully develop the ConOps will include: developing scenarios to fully test environmental, procedural, and data availability assumptions; executing the analysis by a walk-through of the integrated system using these scenarios; defining the appropriate role of operators in terms of their monitoring requirements and decision authority; executing the analysis by a walk-through of the integrated system with operator involvement; characterizing the environmental, system data requirements, and operator role assumptions for the ConOps.

  19. Exploring the Functioning of Decision Space: A Review of the Available Health Systems Literature.

    PubMed

    Roman, Tamlyn Eslie; Cleary, Susan; McIntyre, Diane

    2017-02-27

    The concept of decision space holds appeal as an approach to disaggregating the elements that may influence decision-making in decentralized systems. This narrative review aims to explore the functioning of decision space and the factors that influence decision space. A narrative review of the literature was conducted with searches of online databases and academic journals including PubMed Central, Emerald, Wiley, Science Direct, JSTOR, and Sage. The articles were included in the review based on the criteria that they provided insight into the functioning of decision space either through the explicit application of or reference to decision space, or implicitly through discussion of decision-making related to organizational capacity or accountability mechanisms. The articles included in the review encompass literature related to decentralisation, management and decision space. The majority of the studies utilise qualitative methodologies to assess accountability mechanisms, organisational capacities such as finance, human resources and management, and the extent of decision space. Of the 138 articles retrieved, 76 articles were included in the final review. The literature supports Bossert's conceptualization of decision space as being related to organizational capacities and accountability mechanisms. These functions influence the decision space available within decentralized systems. The exact relationship between decision space and financial and human resource capacities needs to be explored in greater detail to determine the potential influence on system functioning. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

    PubMed

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

    2016-09-01

    Burns can have both physical and psychological effects on individuals. Pressure garments and silicone gels are used to improve the aesthetic appearance and functions of the skin, but these treatments have been associated with various physical, emotional, sexual and social difficulties. Interpretative phenomenological analysis (IPA) was used to explore participants' experiences of scar management. IPA examines individual experiences before comparing results across cases, and is suited to capture the different ways in which individuals experience a phenomena as well as cautiously looking at patterns across cases. Eight burn patients who had experienced scar management, including pressure garments, were interviewed. Two superordinate themes were identified: Assimilation of Pressure Garment Identity, and Psychosocial Functions of the Pressure Garments. The findings offered insight into the positive and negative experiences of scar management, describing the diverse personal and social functions of the pressure garments and how they became integrated into participants' identities. By understanding the individual nature of these experiences, healthcare professionals can enhance support around these issues and potentially aid adherence to treatment. Further research with different demographic groups as well as for other burn treatments would be useful to develop and contextualise these findings. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  1. Providing image management and communication functionality as an integral part of an existing hospital information system

    NASA Astrophysics Data System (ADS)

    Dayhoff, Ruth E.; Maloney, Daniel L.

    1990-08-01

    The effective delivery of health care has become increasingly dependent on a wide range of medical data which includes a variety of images. Manual and computer-based medical records ordinarily do not contain image data, leaving the physician to deal with a fragmented patient record widely scattered throughout the hospital. The Department of Veterans Affairs (VA) is currently installing a prototype hospital information system (HIS) workstation network to demonstrate the feasibility of providing image management and communications (IMAC) functionality as an integral part of an existing hospital information system. The core of this system is a database management system adapted to handle images as a new data type. A general model for this integration is discussed and specifics of the hospital-wide network of image display workstations are given.

  2. Irritable bowel syndrome in quiescent inflammatory bowel disease: a review.

    PubMed

    Burgell, R E; Asthana, A K; Gibson, P R

    2015-12-01

    Ongoing troublesome bowel symptoms despite quiescent inflammatory disease are a frequent management challenge when caring for patients with inflammatory bowel disease (IBD). Even when active disease has been excluded the prevalence of residual gastrointestinal symptoms is surprisingly high and the cause often obscure. The presence of a concurrent functional disorder such as irritable bowel syndrome (IBS) is associated with worse quality of life, worse physical functioning, higher prevalence of anxiety and greater health care utilization. Potential etiological mechanisms leading to the development of IBS like symptoms include the development of visceral hypersensitivity following the original inflammatory insult, alteration in cortical processing, dysbiosis and residual subacute inflammation. Therapeutic options for managing IBS in patients with IBD include dietary modification, interventions targeted at correction of visceral sensory dysfunction or cortical processing and modulation of the gut microbiota. As there are few studies specifically examining the treatment of IBS in patients with IBD, the majority of therapeutic interventions are extrapolated from the IBS literature. Given the frequency of residual functional symptoms in IBS, significantly more research is warranted in this field.

  3. Medical & Surgical Management of Pelvic Floor Disorders Affecting Defecation

    PubMed Central

    Schey, Ron; Cromwell, John; Rao, Satish S.C.

    2014-01-01

    Pelvic floor disorders that affect stool evacuation include structural (example: rectocele) and functional disorders (example: dyssynergic defecation). Meticulous history, digital rectal examination, and physiological tests such as anorectal manometry, colonic transit study, balloon expulsion and imaging studies such as anal ultrasound, defecography, and static and dynamic MRI can facilitate an objective diagnosis and optimal treatment. Management consists of education and counseling regarding bowel function, diet, laxatives, most importantly behavioral and biofeedback therapies, and lastly surgery. Randomized clinical trials have established that biofeedback therapy is effective in treating dyssynergic defecation. Because dyssynergic defecation may co-exist with conditions such as solitary rectal ulcer syndrome (SRUS), and rectocele, before considering surgery, biofeedback therapy should be tried and an accurate assessment of the entire pelvis and its function should be performed. Several surgical approaches have been advocated for the treatment of pelvic floor disorders including open, laparoscopic and trans-abdominal approach, stapled transanal rectal resection (STARR), and robotic colon and rectal resections. However, there is lack of well controlled randomized studies and efficacy of these surgical procedures remains to be established. PMID:22907620

  4. Multimodal evaluation and management of children with concussion: using our heads and available evidence.

    PubMed

    Gioia, Gerard A

    2015-01-01

    Significant attention has been focused on concussions in children, but a dearth of research evidence exists supporting clinical evaluation and management. The primary objective of this review paper is to describe a multimodal, developmentally adapted, standardized concussion assessment and active rehabilitation approach for children as young as 5 years old. This study reviews the CDC-funded research programme, including the development of tools for post-concussion symptom assessment involving the child and parent, measurement of specific neurocognitive functions and assessment of dynamic cognitive exertional effects. A clinical approach to active, individualized, moderated concussion rehabilitation management is presented, including a 10-step guide to symptom management, with a specific focus on the school challenges faced by the recovering student. To better inform concussion practice across the developmental age spectrum, a significant need exists for further research evidence to refine clinical assessment methods and develop effective treatment approaches.

  5. Vehicle management and mission planning systems with shuttle applications

    NASA Technical Reports Server (NTRS)

    1972-01-01

    A preliminary definition of a concept for an automated system is presented that will support the effective management and planning of space shuttle operations. It is called the Vehicle Management and Mission Planning System (VMMPS). In addition to defining the system and its functions, some of the software requirements of the system are identified and a phased and evolutionary method is recommended for software design, development, and implementation. The concept is composed of eight software subsystems supervised by an executive system. These subsystems are mission design and analysis, flight scheduler, launch operations, vehicle operations, payload support operations, crew support, information management, and flight operations support. In addition to presenting the proposed system, a discussion of the evolutionary software development philosophy that the Mission Planning and Analysis Division (MPAD) would propose to use in developing the required supporting software is included. A preliminary software development schedule is also included.

  6. Multimodal Evaluation and Management of Children with Concussion: Using our heads and available evidence

    PubMed Central

    Gioia, Gerard A.

    2015-01-01

    Significant attention has been focused on concussions in children but a dearth of research evidence exists supporting clinical evaluation and management. The primary objective of this review paper is to describe a multimodal, developmentally adapted, standardized concussion assessment and active rehabilitation approach for children as young as age five. We review our CDC-funded research program including the development of tools for post-concussion symptom assessment involving the child and parent, measurement of specific neurocognitive functions, and assessment of dynamic cognitive exertional effects. A clinical approach to active, individualized, moderated concussion rehabilitation management is presented, including a ten step guide to symptom management, with a specific focus on the school challenges faced by the recovering student. To better inform concussion practice across the developmental age spectrum, a significant need exists for further research evidence to refine our clinical assessment methods and develop effective treatment approaches. PMID:25356518

  7. The Impact of Health Behaviors and Health Management on Employment After SCI: Physical Health and Functioning.

    PubMed

    Meade, Michelle A; Reed, Karla S; Krause, James S

    2016-01-01

    Background : Research has shown that employment following spinal cord injury (SCI) is related to health and functioning, with physical health and functioning after SCI frequently identified as a primary barrier to employment. Objective: To examine the relationship between employment and behaviors associated with the management of physical health and functioning as described by individuals with SCI who have been employed post injury. Methods: A qualitative approach using 6 focus groups at 2 sites included 44 participants with SCI who had worked at some time post injury. Heterogeneous and homogeneous groups were created based on specific characteristics, such as education, gender, or race. A semi-structured interview format asked questions about personal, environmental, and policy-related factors influencing employment after SCI. Groups were recorded, transcribed, and entered into NVivo before coding by 2 reviewers. Results: Within the area of behaviors and management of physical health and functioning, 4 overlapping themes were identified: (1) relearning your own body and what it can do; (2) general health and wellness behaviors; (3) communication, education, and advocacy; and (4) secondary conditions and aging. Specific themes articulate the many types of behaviors individuals must master and their impact on return to work as well as on finding, maintaining, and deciding to leave employment. Conclusions: Individuals with SCI who are successfully employed after injury must learn how to perform necessary behaviors to manage health and function in a work environment. The decision to leave employment often appears to be associated with secondary complications and other conditions that occur as persons with SCI age.

  8. 20 CFR 667.220 - What Workforce Investment Act title I functions and activities constitute the costs of...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... cash management functions; (ii) Procurement and purchasing functions; (iii) Property management functions; (iv) Personnel management functions; (v) Payroll functions; (vi) Coordinating the resolution of... for official business in carrying out administrative activities or the overall management of the WIA...

  9. Mobile Phone Apps for Inflammatory Bowel Disease Self-Management: A Systematic Assessment of Content and Tools

    PubMed Central

    Con, Danny

    2016-01-01

    Background The rising incidence of inflammatory bowel disease (IBD) over the past decade has resulted in increased health care utilization and longer IBD outpatient waiting lists. Self-management is recognized as an important aspect of chronic disease management but its application to IBD has been limited. The age of IBD onset in a majority of patients is in their 20s to 30s. Mobile phone apps are a technology familiar to young adults and represent an opportunity to explore self-management as a new model of health care delivery for IBD. Objective The aim of this study was to explore the content and tools of existing IBD apps to identify functionalities that may facilitate patient self-management. Methods We systematically assessed apps targeted at IBD patients via searches of Google (Android devices) and Apple (iOS devices) app stores with pre-defined inclusion and exclusion criteria. Apps were assessed for specific functionalities; presence of professional medical involvement; consistency with international IBD guidelines based on “complete,” “partial,” or “absent” coverage of consensus statements derived from the European Crohn’s and Colitis Organisation, American College of Gastroenterology, and the Gastroenterology Society of Australia; comprehensiveness of data that could be entered; and average pricing. Results Of the 238 apps screened, 26 apps were assessed, including 10 available on Android platforms, 8 on iOS platforms, and 8 on both. Over half (14/26, 54%) of the apps had diary functionalities; over a third (10/26, 39%) provided health information about IBD. None of the apps offered decision support to facilitate the self-initiation of medical therapy. Five of 26 (19%) had professional medical involvement in their design. Apps demonstrated “complete” coverage of only 38% of the international consensus statements explored. The average price of the apps was AUD$1.37. Conclusions Apps may provide a useful adjunct to the management of IBD patients. However, a majority of current apps suffer from a lack of professional medical involvement and limited coverage of international consensus guidelines. Future studies and app design for IBD should include professional medical involvement, evidence-based guidelines, and functionalities with decision support that are specifically tailored to patient self-management. PMID:26831935

  10. Patient-centered disease management (PCDM) for heart failure: study protocol for a randomised controlled trial

    PubMed Central

    2013-01-01

    Background Chronic heart failure (HF) disease management programs have reported inconsistent results and have not included comorbid depression management or specifically focused on improving patient-reported outcomes. The Patient Centered Disease Management (PCDM) trial was designed to test the effectiveness of collaborative care disease management in improving health status (symptoms, functioning, and quality of life) in patients with HF who reported poor HF-specific health status. Methods/design Patients with a HF diagnosis at four VA Medical Centers were identified through population-based sampling. Patients with a Kansas City Cardiomyopathy Questionnaire (KCCQ, a measure of HF-specific health status) score of < 60 (heavy symptom burden and impaired quality of life) were invited to enroll in the PCDM trial. Enrolled patients were randomized to receive usual care or the PCDM intervention, which included: (1) collaborative care management by VA clinicians including a nurse, cardiologist, internist, and psychiatrist, who worked with patients and their primary care providers to provide guideline-concordant care management, (2) home telemonitoring and guided patient self-management support, and (3) screening and treatment for comorbid depression. The primary study outcome is change in overall KCCQ score. Secondary outcomes include depression, medication adherence, guideline-based care, hospitalizations, and mortality. Discussion The PCDM trial builds on previous studies of HF disease management by prioritizing patient health status, implementing a collaborative care model of health care delivery, and addressing depression, a key barrier to optimal disease management. The study has been designed as an ‘effectiveness trial’ to support broader implementation in the healthcare system if it is successful. Trial registration Unique identifier: NCT00461513 PMID:23837415

  11. Managing biotechnology in a network-model health plan: a U.S. private payer perspective.

    PubMed

    Watkins, John B; Choudhury, Sanchita Roy; Wong, Ed; Sullivan, Sean D

    2006-01-01

    Emerging biotechnology poses challenges to payers, including access, coverage, reimbursement, patient selection, and affordability. Premera Blue Cross, a private regional health plan, developed an integrated cross-functional approach to managing biologics, built around a robust formulary process that is fast, flexible, fair, and transparent to stakeholders. Results are monitored by cost and use reporting from merged pharmacy and medical claims. Utilization management and case management strategies will integrate with specialty pharmacy programs to improve outcomes and cost-effectiveness. Creative approaches to provider reimbursement can align providers' incentives with those of the plan. Redesign of member benefits can also encourage appropriate use of biotechnology.

  12. Package research based on COM+ technical of web service

    NASA Astrophysics Data System (ADS)

    Liu, Xiaoyue; Du, Liang

    2011-10-01

    Early information management systems are established for realization of specific business functions ordered by enterprise, including the control and management of production, supply, sales and customer service and so on. Enterprises in accordance with their various departments establish a variety of enterprise information systems used by them, and in the actual work play a huge role in the production. In this paper, from the overall view a variety of enterprise information management systems is considered, thereafter according to specific business needs to unify arrangement of these systems, and use a suitable platform for the organic integration of existing enterprise information management systems, so that the "information islands" link.

  13. Formation of power management strategy at the industrial enterprises

    NASA Astrophysics Data System (ADS)

    Akimova, Elena

    2017-10-01

    The article is dedicated to energy efficiency problems. The main recommendations about the development of the system of strategic power management at the industrial enterprise offered in the research include a number of the principles, aimed at the increase of the importance of human resources in information-and-analytical and innovative functions of power management. According to the results of the current situation analyses, the author suggests using some specific indicators of human resources, as they can contribute to the energy efficiency formation. The system of standardization is considered to be the basis for the implementation of strategic power management at the enterprises.

  14. A rapid evidence assessment of immersive virtual reality as an adjunct therapy in acute pain management in clinical practice.

    PubMed

    Garrett, Bernie; Taverner, Tarnia; Masinde, Wendy; Gromala, Diane; Shaw, Chris; Negraeff, Michael

    2014-12-01

    Immersive virtual reality (IVR) therapy has been explored as an adjunct therapy for the management of acute pain among children and adults for several conditions. Therapeutic approaches have traditionally involved medication and physiotherapy but such approaches are limited over time by their cost and side effects. This review seeks to critically evaluate the evidence for and against IVR as an adjunctive therapy for acute clinical pain applications. A rapid evidence assessment (REA) strategy was used. CINAHL, Medline, Web of Science, IEEE Xplore Digital Library, and the Cochrane Library databases were screened in from December 2012 to March 2013 to identify studies exploring IVR therapies as an intervention to assist in the management of pain. Main outcome measures were for acute pain and functional impairment. Seventeen research studies were included in total including 5 RCTs, 6 randomized crossover studies, 2 case series studies, and 4 single-patient case studies. This included a total of 337 patients. Of these studies only 4 had a low risk of bias. There was strong overall evidence for immediate and short-term pain reduction, whereas moderate evidence was found for short-term effects on physical function. Little evidence exists for longer-term benefits. IVR was not associated with any serious adverse events. This review found moderate evidence for the reduction of pain and functional impairment after IVR in patients with acute pain. Further high-quality studies are required for the conclusive judgment of its effectiveness in acute pain, to establish potential benefits for chronic pain, and for safety.

  15. Integrating the provision of ecosystem services and trawl fisheries for the management of the marine environment.

    PubMed

    Muntadas, Alba; de Juan, Silvia; Demestre, Montserrat

    2015-02-15

    The species interaction and their biological traits (BT) determine the function of benthic communities and, hence, the delivery of ecosystem services. Therefore, disturbance of benthic communities by trawling may compromise ecosystem service delivery, including fisheries' catches. In this work, we explore 1) the impact of trawling activities on benthic functional components (after the BTA approach) and 2) how trawling impact may affect the ecosystem services delivered by benthic communities. To this aim, we assessed the provision of ecosystem services by adopting the concept of Ecosystem Service Providers (ESP), i.e. ecological units that perform ecosystem functions that will ultimately deliver ecosystem services. We studied thirteen sites subjected to different levels of fishing effort in the Mediterranean. From a range of environmental variables included in the study, we found ESPs to be mainly affected by fishing effort and grain size. Our results suggested that habitat type has significant effects on the distribution of ESPs and this natural variability influences ESP response to trawling at a specific site. In order to summarize the complex relationships between human uses, ecosystem components and the demand for ecosystem services in trawling grounds, we adapted a DPSIR (Drivers-Pressures-State Change-Impact-Response) framework to the study area, emphasizing the role of society as Drivers of change and actors demanding management Responses. This integrative framework aims to inform managers about the interactions between all the elements involved in the management of trawling grounds, highlighting the need for an integrated approach in order to ensure ecosystem service provision. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Scientific assessment of animal welfare.

    PubMed

    Hemsworth, P H; Mellor, D J; Cronin, G M; Tilbrook, A J

    2015-01-01

    Animal welfare is a state within the animal and a scientific perspective provides methodologies for evidence-based assessment of an animal's welfare. A simplistic definition of animal welfare might be how the animal feels now. Affective experiences including emotions, are subjective states so cannot be measured directly in animals, but there are informative indirect physiological and behavioural indices that can be cautiously used to interpret such experiences. This review enunciates several key science-based frameworks for understanding animal welfare. The biological functioning and affective state frameworks were initially seen as competing, but a recent more unified approach is that biological functioning is taken to include affective experiences and affective experiences are recognised as products of biological functioning, and knowledge of the dynamic interactions between the two is considered to be fundamental to managing and improving animal welfare. The value of these two frameworks in understanding the welfare of group-housed sows is reviewed. The majority of studies of the welfare of group-housed sows have employed the biological functioning framework to infer compromised sow welfare, on the basis that suboptimal biological functioning accompanies negative affective states such as sow hunger, pain, fear, helplessness, frustration and anger. Group housing facilitates social living, but group housing of gestating sows raises different welfare considerations to stall housing, such as high levels of aggression, injuries and stress, at least for several days after mixing, as well as subordinate sows being underfed due to competition at feeding. This paper highlights the challenges and potential opportunities for the continued improvement in sow management through well-focused research and multidisciplinary assessment of animal welfare. In future the management of sentient animals will require the promotion of positive affective experiences in animals and this is likely to be a major focus for animal welfare science activity in the early twenty-first century.

  17. Description of data base management systems activities

    NASA Technical Reports Server (NTRS)

    1983-01-01

    One of the major responsibilities of the JPL Computing and Information Services Office is to develop and maintain a JPL plan for providing computing services to the JPL management and administrative community that will lead to improved productivity. The CISO plan to accomplish this objective has been titled 'Management and Administrative Support Systems' (MASS). The MASS plan is based on the continued use of JPL's IBM 3032 Computer system for administrative computing and for the MASS functions. The current candidate administrative Data Base Management Systems required to support the MASS include ADABASE, Cullinane IDMS and TOTAL. Previous uses of administrative Data Base Systems have been applied to specific local functions rather than in a centralized manner with elements common to the many user groups. Limited capacity data base systems have been installed in microprocessor based office automation systems in a few Project and Management Offices using Ashton-Tate dBASE II. These experiences plus some other localized in house DBMS uses have provided an excellent background for developing user and system requirements for a single DBMS to support the MASS program.

  18. Study of space shuttle orbiter system management computer function. Volume 2: Automated performance verification concepts

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The findings are presented of investigations on concepts and techniques in automated performance verification. The investigations were conducted to provide additional insight into the design methodology and to develop a consolidated technology base from which to analyze performance verification design approaches. Other topics discussed include data smoothing, function selection, flow diagrams, data storage, and shuttle hydraulic systems.

  19. Prototype development and demonstration for response, emergency staging, communications, uniform management, and evacuation (R.E.S.C.U.M.E.) : R.E.S.C.U.M.E. final functional and performance requirements.

    DOT National Transportation Integrated Search

    2014-01-01

    This document provides the high-level functional and performance requirements for the Prototype Development and Demonstration of a R.E.S.C.U.M.E. system. The requirements included in this document are based upon those that can be found in previous R....

  20. Design and engineering analysis of material procurement mobile operation platform

    NASA Astrophysics Data System (ADS)

    Ding, H.; Li, J.

    2014-03-01

    The material procurement mobile operation platform (MPMOP) consists of six modules, including network operation, truck transportation, remote communication, satellite positioning, power supply and environment regulation. The MPMOP is designed to have six major functions, including online procurement, command control, remote communication, satellite positioning, information management and auxiliary decision. The paper implements an engineering analysis on the MPMOP from three aspects, including transportation transfinite, centroid, and power dissipation.

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

    None

    The Office of Legacy Management (LM) is an integral part of the U.S. Department of Energy’s (DOE’s) strategy to ensure that legacy liabilities of former nuclear weapons production sites are properly managed following the completion of environmental cleanup activities. LM will work with each site using an integrated team approach to ensure a successful transition. Part of this process will include transition of Government records and information. The Office of Legacy Management Information and Records Management Transition Guidance focuses on LM’s goal to preserve and protect legacy records and information. This guidance document establishes a framework for the transfer ofmore » records management responsibilities for sites transferring to LM. It describes the requirements, responsibilities, and procedures for the efficient and cost-effective transfer of custody, ownership, and management of records and other information products from the transfer site to LM. Records management practices are critical to the functions of Federal agencies because records provide information about, or evidence of, the organization, functions, policies, decisions, procedures, operations, or other activities. Therefore, the information generated by an agency is created, maintained, and dispositioned through records management processes that ensure the appropriate preservation and retrieval of essential information. Because of their intrinsic value, best practices to preserve information and records should be utilized when records are transferred from one organization to another. As the transfer program completes cleanup activities at closure sites, a transitional process will facilitate the transparent shift in the management of site records activities to LM. The roles and responsibilities of the transfer site and/or program and LM described in this document are a necessary foundation for cooperation and coordination and are essential to the successful transition of records and information responsibilities. The DOE Office of the Chief Information Officer (OCIO) has a central role in DOE records management by providing guidance, expertise, and coordination to all DOE offices and organizations and coordination with the National Archives and Records Administration (NARA). LM and the transfer site will complete an integrated transition plan which will integrate all transition elements including information and records. As part of the overall transition plan, an Information and Records Transition Plan will be developed consistent with the integrated transition plan for the site transfer and included as an attachment. The Information and Records Management Transition Plan will be developed to assist both organizations in organizing the tasks; establishing a timetable and milestones for their completion; and identifying manpower, funding and other resources that will be needed to complete the ownership transfer. In addition, the plan will provide a valuable exchange of institutional knowledge that will assist LM in meeting the obligations of responsibly managing legacy records. Guidance for the development of the plan is included in this document. Records management concerns that may arise during site closure, such as management support, contract language and agreements, interactions with the OCIO and NARA, resource and budget considerations, and procedures to safeguard records are addressed. Guidelines and criteria for records management transition activities are also provided. These include LM expectations for the inventory, scheduling, and disposition of records; the management and transfer of electronic files, including databases and software; records finding aids, indices, and recordkeeping systems; and the process for the transfer of hard copy and electronic records to LM.« less

  2. 25 CFR 1000.462 - When must a Tribe/Consortium regulate its employees or subcontractors to avoid a personal...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SELF-GOVERNMENT ACT AMENDMENTS TO THE INDIAN SELF-DETERMINATION AND EDUCATION ACT Conflicts of Interest..., employees, and agents (including subcontractors) engaged in functions related to the management of trust...

  3. Development of a new Clinical Engineering Management Tool & Information System (CLE-MANTIS).

    PubMed

    Panousis, S G; Malataras, P; Patelodimou, C; Kolitsi, Z; Pallikarakis, N

    1997-01-01

    The evolution of the field of biomedical technology has led to the diffusion of an impressive number of medical devices into healthcare institutions. In this environment, Clinical Engineering Departments (CEDs) are expanding their role in healthcare technology management, by changing their structure and introducing quality systems in order to improve their services and monitor the outcomes. In the framework of the national project BIOTECHNET II, a software tool for the management of biomedical technology, named CLE-MANTIS, has been developed, with the aim to assist CEDs in their tasks. CLE-MANTIS functions include the upkeep of an inventory, the support and monitoring of scheduled maintenance, corrective maintenance, vigilance, equipment acquisition and replacement, service contract management and user training. The system offers clinical engineers the possibility to monitor and evaluate the quality and cost-effectiveness of their departments through the monitoring of quality and cost indicators. This paper presents the main features and functions of the system.

  4. Space Station needs, attributes and architectural options. Volume 2, book 2, part 2, Task 2: Information management system

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Missions to be performed, station operations and functions to be carried out, and technologies anticipated during the time frame of the space station were examined in order to determine the scope of the overall information management system for the space station. This system comprises: (1) the data management system which includes onboard computer related hardware and software required to assume and exercise control of all activities performed on the station; (2) the communication system for both internal and external communications; and (3) the ground segment. Techniques used to examine the information system from a functional and performance point of view are described as well as the analyses performed to derive the architecture of both the onboard data management system and the system for internal and external communications. These architectures are then used to generate a conceptual design of the onboard elements in order to determine the physical parameters (size/weight/power) of the hardware and software. The ground segment elements are summarized.

  5. Space Station needs, attributes and architectural options. Volume 2, book 2, part 2, Task 2: Information management system

    NASA Astrophysics Data System (ADS)

    1983-04-01

    Missions to be performed, station operations and functions to be carried out, and technologies anticipated during the time frame of the space station were examined in order to determine the scope of the overall information management system for the space station. This system comprises: (1) the data management system which includes onboard computer related hardware and software required to assume and exercise control of all activities performed on the station; (2) the communication system for both internal and external communications; and (3) the ground segment. Techniques used to examine the information system from a functional and performance point of view are described as well as the analyses performed to derive the architecture of both the onboard data management system and the system for internal and external communications. These architectures are then used to generate a conceptual design of the onboard elements in order to determine the physical parameters (size/weight/power) of the hardware and software. The ground segment elements are summarized.

  6. Evaluation of functional outcomes of physical rehabilitation and medical complications in spinal cord injury victims of the Sichuan earthquake.

    PubMed

    Li, Yongqiang; Reinhardt, Jan D; Gosney, James E; Zhang, Xia; Hu, Xiaorong; Chen, Sijing; Ding, Mingpu; Li, Jianan

    2012-06-01

    To characterize a spinal cord injury (SCI) population from the 2008 Sichuan earthquake in China; to evaluate functional outcomes of physical rehabilitation interventions; to assess potential determinants of rehabilitation effectiveness; and to assess medical complications and management outcomes. A total of 51 earthquake victims with SCI were enrolled and underwent rehabilitation programming. Functional rehabilitation outcomes included ambulation ability, wheelchair mobility and activities of daily living (ADL) assessed with the Modified Barthel Index at the beginning and end of rehabilitation. Effectiveness of rehabilitation and the effect of other predictors were evaluated by mixed effects regression. Outcomes of medical complication management were determined by comparison of the incidence of respective complications at the beginning and end of rehabilitation. Ambulation, wheelchair mobility and ADL were significantly improved with rehabilitation programming. Both earlier rescue and earlier onset of rehabilitation were significant positive predictors of rehabilitation effectiveness, whereas delayed onset of rehabilitation combined with prolonged time to rescue resulted in a lesser positive effect. Medical complications were managed effectively in 63% (pressure ulcers) to 85% (deep vein thrombosis) of patients during rehabilitation. Earthquake victims with SCI may achieve significantly improved functional rehabilitation functional outcomes on a formal, institutional-based physical rehabilitation programme.

  7. A context management system for a cost-efficient smart home platform

    NASA Astrophysics Data System (ADS)

    Schneider, J.; Klein, A.; Mannweiler, C.; Schotten, H. D.

    2012-09-01

    This paper presents an overview of state-of-the-art architectures for integrating wireless sensor and actuators networks into the Future Internet. Furthermore, we will address advantages and disadvantages of the different architectures. With respect to these criteria, we develop a new architecture overcoming these weaknesses. Our system, called Smart Home Context Management System, will be used for intelligent home utilities, appliances, and electronics and includes physical, logical as well as network context sources within one concept. It considers important aspects and requirements of modern context management systems for smart X applications: plug and play as well as plug and trust capabilities, scalability, extensibility, security, and adaptability. As such, it is able to control roller blinds, heating systems as well as learn, for example, the user's taste w.r.t. to home entertainment (music, videos, etc.). Moreover, Smart Grid applications and Ambient Assisted Living (AAL) functions are applicable. With respect to AAL, we included an Emergency Handling function. It assures that emergency calls (police, ambulance or fire department) are processed appropriately. Our concept is based on a centralized Context Broker architecture, enhanced by a distributed Context Broker system. The goal of this concept is to develop a simple, low-priced, multi-functional, and save architecture affordable for everybody. Individual components of the architecture are well tested. Implementation and testing of the architecture as a whole is in progress.

  8. Radial basis function and its application in tourism management

    NASA Astrophysics Data System (ADS)

    Hu, Shan-Feng; Zhu, Hong-Bin; Zhao, Lei

    2018-05-01

    In this work, several applications and the performances of the radial basis function (RBF) are briefly reviewed at first. After that, the binomial function combined with three different RBFs including the multiquadric (MQ), inverse quadric (IQ) and inverse multiquadric (IMQ) distributions are adopted to model the tourism data of Huangshan in China. Simulation results showed that all the models match very well with the sample data. It is found that among the three models, the IMQ-RBF model is more suitable for forecasting the tourist flow.

  9. Impact of a Stress Management Intervention Program on Sexual Functioning and Stress Reduction in Women with Breast Cancer

    PubMed Central

    Shayan, Arezoo; Jamshidi, Farkhondeh; Tahmasebiboldaji, Vahid; Khani, Somayeh; Babaei, Maryam; Havasian, Mohamad Reza; Masoumi, Seyedeh Zahra

    2017-01-01

    Breast cancer as the most common cancer among women endangers various aspects of their sexual lives and is a major culprit regarding health impairment and low life quality. The aim of this study was to examine the effect of a stress management intervention program on sexual functioning and stress reduction in women with breast cancer. This study employed a quasi-experimental pre-test, post-test design which included follow-up checks and a control group. To this end, 104 women with breast cancer referring to Hamadan’s Mahdiyeh MRI Center at the time of data collection were conventionally selected in 2015. Using permuted blocks, they were randomly divided into experimental and control groups (n= 52), only the former receiving stress management counseling for 18 hours. Data were collected through a demographic questionnaire, the Female Sexual Function Index (FSFI) questionnaire, and Harry’s stress questionnaire, filled out by patients before and after the intervention. To analyze the data, descriptive statistics and two-way ANOVA were used. The results showed that cognitive - behavioral stress management group therapy improved total sexual functioning and its subscales. After the treatment, there was a significant difference in mean scores between the groups (p=0.01). Moreover, significant differences were observed in the mean scores for stress with improvement in the experimental group in post-test results. Cognitive - behavioral group therapy for stress management was thuis found to improve total sexual functioning and its subscales and reduce the level of stress in the experimental group after the intervention and follow-up period with an interval of two weeks. Therefore, this method can be used as a complementary therapy along with medical treatment in oncology centers. PMID:29072415

  10. Interactive Digital e-Health Game for Heart Failure Self-Management: A Feasibility Study.

    PubMed

    Radhakrishnan, Kavita; Toprac, Paul; O'Hair, Matt; Bias, Randolph; Kim, Miyong T; Bradley, Paul; Mackert, Michael

    2016-12-01

    To develop and test the prototype of a serious digital game for improving community-dwelling older adults' heart failure (HF) knowledge and self-management behaviors. The serious game innovatively incorporates evidence-based HF guidelines with contemporary game technology. The study included three phases: development of the game prototype, its usability assessment, and evaluation of the game's functionality. Usability testing included researchers' usability assessment, followed by research personnel's observations of participants playing the game, and participants' completion of a usability survey. Next, in a pretest-post-test design, validated instruments-the Atlanta Heart Failure Knowledge Test and the Self Care for Heart Failure Index-were used to measure improvement in HF self-management knowledge and behaviors related to HF self-maintenance, self-management, and self-efficacy, respectively. A postgame survey assessed participants' perceptions of the game. During usability testing, with seven participants, 100%, 100%, and 86% found the game easy to play, enjoyable, and helpful for learning about HF, respectively. In the subsequent functionality testing, with 19 participants, 89% found the game interesting, enjoyable, and easy to play. Playing the game resulted in a significant improvement in HF self-management knowledge, a nonsignificant improvement in self-reported behaviors related to HF self-maintenance, and no difference in HF self-efficacy scores. Participants with lower education level and age preferred games to any other medium for receiving information. It is feasible to develop a serious digital game that community-dwelling older adults with HF find both satisfying and acceptable and that can improve their self-management knowledge.

  11. Interactive Digital e-Health Game for Heart Failure Self-Management: A Feasibility Study

    PubMed Central

    Toprac, Paul; O'Hair, Matt; Bias, Randolph; Kim, Miyong T.; Bradley, Paul; Mackert, Michael

    2016-01-01

    Abstract Objective: To develop and test the prototype of a serious digital game for improving community-dwelling older adults' heart failure (HF) knowledge and self-management behaviors. The serious game innovatively incorporates evidence-based HF guidelines with contemporary game technology. Materials and Methods: The study included three phases: development of the game prototype, its usability assessment, and evaluation of the game's functionality. Usability testing included researchers' usability assessment, followed by research personnel's observations of participants playing the game, and participants' completion of a usability survey. Next, in a pretest–post-test design, validated instruments—the Atlanta Heart Failure Knowledge Test and the Self Care for Heart Failure Index—were used to measure improvement in HF self-management knowledge and behaviors related to HF self-maintenance, self-management, and self-efficacy, respectively. A postgame survey assessed participants' perceptions of the game. Results: During usability testing, with seven participants, 100%, 100%, and 86% found the game easy to play, enjoyable, and helpful for learning about HF, respectively. In the subsequent functionality testing, with 19 participants, 89% found the game interesting, enjoyable, and easy to play. Playing the game resulted in a significant improvement in HF self-management knowledge, a nonsignificant improvement in self-reported behaviors related to HF self-maintenance, and no difference in HF self-efficacy scores. Participants with lower education level and age preferred games to any other medium for receiving information. Conclusion: It is feasible to develop a serious digital game that community-dwelling older adults with HF find both satisfying and acceptable and that can improve their self-management knowledge. PMID:27976955

  12. Surgical management of facial nerve paralysis in the pediatric population.

    PubMed

    Barr, Jason S; Katz, Karin A; Hazen, Alexes

    2011-11-01

    In the pediatric patient population, both the pathology and the surgical managements of seventh cranial nerve palsy are complicated by the small size of the patients. Adding to the technical difficulty is the relative infrequency of the diagnosis, thus making it harder to become proficient in the management of the condition. The magnitude of the functional and aesthetic deficits these children manifest is significantly troubling to both the patient and the parents, which makes immediate attention, treatment, and functional restoration essential. A literature search using PubMed (http://www.pubmed.org) was undertaken to identify the current state of surgical management of pediatric facial paralysis. Although a multitude of techniques have been used, the ideal reconstructive procedure that addresses all of the functional and cosmetic needs of these children has yet to be described. Certainly, future research and innovative thinking will yield progressively better techniques that may, one day, emulate the native facial musculature with remarkable precision. The necessity for surgical intervention in children with facial nerve paralysis differs depending on many factors including the acute/chronic nature of the defect as well as the extent of functional and cosmetic damage. In this article, we review the surgical procedures that have been used to treat pediatric facial nerve paralysis and provide therapeutic facial reanimation. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. iCanCope with Pain™: User-centred design of a web- and mobile-based self-management program for youth with chronic pain based on identified health care needs

    PubMed Central

    Stinson, Jennifer N; Lalloo, Chitra; Harris, Lauren; Isaac, Lisa; Campbell, Fiona; Brown, Stephen; Ruskin, Danielle; Gordon, Allan; Galonski, Marilyn; Pink, Leah R; Buckley, Norman; Henry, James L; White, Meghan; Karim, Allia

    2014-01-01

    BACKGROUND: While there are emerging web-based self-management programs for children and adolescents with chronic pain, there is currently not an integrated web- and smartphone-based app that specifically addresses the needs of adolescents with chronic pain. OBJECTIVES: To conduct a needs assessment to inform the development of an online chronic pain self-management program for adolescents, called iCanCope with Pain™. METHODS: A purposive sample of adolescents (n=23; 14 to 18 years of age) was recruited from two pediatric chronic pain clinics in Ontario. Interdisciplinary health care providers were also recruited from these sites. Three focus groups were conducted with adolescents (n=16) and one with pediatric health care providers (n=7). Individual adolescent interviews were also conducted (n=7). RESULTS: Qualitative analysis uncovered four major themes: pain impact; barriers to care; pain management strategies; and transition to adult care. Pain impacted social, emotional, physical and role functioning, as well as future goals. Barriers to care were revealed at the health care system, patient and societal levels. Pain management strategies included support systems, and pharmacological, physical and psychological approaches. Transition subthemes were: disconnect between pediatric and adult systems; skills development; parental role; and fear/anxiety. Based on these identified needs, the iCanCope with Pain™ architecture will include the core theory-based functionalities of: symptom self-monitoring; personalized goal setting; pain coping skills training; peer-based social support; and chronic pain education. CONCLUSIONS: The proposed iCanCope with Pain™ program aims to address the self-management needs of adolescents with chronic pain by improving access to disease information, strategies to manage symptoms and social support. PMID:25000507

  14. Documentation for the State Variables Package for the Groundwater-Management Process of MODFLOW-2005 (GWM-2005)

    USGS Publications Warehouse

    Ahlfeld, David P.; Barlow, Paul M.; Baker, Kristine M.

    2011-01-01

    Many groundwater-management problems are concerned with the control of one or more variables that reflect the state of a groundwater-flow system or a coupled groundwater/surface-water system. These system state variables include the distribution of heads within an aquifer, streamflow rates within a hydraulically connected stream, and flow rates into or out of aquifer storage. This report documents the new State Variables Package for the Groundwater-Management Process of MODFLOW-2005 (GWM-2005). The new package provides a means to explicitly represent heads, streamflows, and changes in aquifer storage as state variables in a GWM-2005 simulation. The availability of these state variables makes it possible to include system state in the objective function and enhances existing capabilities for constructing constraint sets for a groundwater-management formulation. The new package can be used to address groundwater-management problems such as the determination of withdrawal strategies that meet water-supply demands while simultaneously maximizing heads or streamflows, or minimizing changes in aquifer storage. Four sample problems are provided to demonstrate use of the new package for typical groundwater-management applications.

  15. Development of management information system for land in mine area based on MapInfo

    NASA Astrophysics Data System (ADS)

    Wang, Shi-Dong; Liu, Chuang-Hua; Wang, Xin-Chuang; Pan, Yan-Yu

    2008-10-01

    MapInfo is current a popular GIS software. This paper introduces characters of MapInfo and GIS second development methods offered by MapInfo, which include three ones based on MapBasic, OLE automation, and MapX control usage respectively. Taking development of land management information system in mine area for example, in the paper, the method of developing GIS applications based on MapX has been discussed, as well as development of land management information system in mine area has been introduced in detail, including development environment, overall design, design and realization of every function module, and simple application of system, etc. The system uses MapX 5.0 and Visual Basic 6.0 as development platform, takes SQL Server 2005 as back-end database, and adopts Matlab 6.5 to calculate number in back-end. On the basis of integrated design, the system develops eight modules including start-up, layer control, spatial query, spatial analysis, data editing, application model, document management, results output. The system can be used in mine area for cadastral management, land use structure optimization, land reclamation, land evaluation, analysis and forecasting for land in mine area and environmental disruption, thematic mapping, and so on.

  16. Cumulative environmental impacts and integrated coastal management: the case of Xiamen, China.

    PubMed

    Xue, Xiongzhi; Hong, Huasheng; Charles, Anthony T

    2004-07-01

    This paper examines the assessment of cumulative environmental impacts and the implementation of integrated coastal management within the harbour of Xiamen, China, an urban region in which the coastal zone is under increasing pressure as a result of very rapid economic growth. The first stage of analysis incorporates components of a cumulative effects assessment, including (a) identification of sources of environmental impacts, notably industrial expansion, port development, shipping, waste disposal, aquaculture and coastal construction, (b) selection of a set of valued ecosystem components, focusing on circulation and siltation, water quality, sediment, the benthic community, and mangrove forests, and (c) use of a set of key indicators to examine cumulative impacts arising from the aggregate of human activities. In the second stage of analysis, the paper describes and assesses the development of an institutional framework for integrated coastal management in Xiamen, one that combines policy and planning (including legislative and enforcement mechanisms) with scientific and monitoring mechanisms (including an innovative 'marine functional zoning' system). The paper concludes that the integrated coastal management framework in Xiamen has met all relevant requirements for 'integration' as laid out in the literature, and has explicitly incorporated consideration of cumulative impacts within its management and monitoring processes.

  17. USAF Aircraft Maintenance Officer Knowledge, Skills and Abilities and Commonalities among the Logistics Officer Corps

    DTIC Science & Technology

    2013-02-01

    distribution managemen t operations to include managing cargo distribution functions such as receiving, inspecting, tracing, tracking, packaging, and...Production Management DE CDE ABCDEFG Scheduling DE ADEF ABCDEF T ie r 2 Flightline Operations E BDE Systems Engineering D ABDEG Table 19: 21R...logistics units/ elements and as members of general or executive s t affs in t he operating forces, supporting establishment, and joint staffs . They

  18. Phylogenetic and Functional Diversity of Total (DNA) and Expressed (RNA) Bacterial Communities in Urban Green Infrastructure Bioswale Soils.

    PubMed

    Gill, Aman S; Lee, Angela; McGuire, Krista L

    2017-08-15

    New York City (NYC) is pioneering green infrastructure with the use of bioswales and other engineered soil-based habitats to provide stormwater infiltration and other ecosystem functions. In addition to avoiding the environmental and financial costs of expanding traditional built infrastructure, green infrastructure is thought to generate cobenefits in the form of diverse ecological processes performed by its plant and microbial communities. Yet, although plant communities in these habitats are closely managed, we lack basic knowledge about how engineered ecosystems impact the distribution and functioning of soil bacteria. We sequenced amplicons of the 16S ribosomal subunit, as well as seven genes associated with functional pathways, generated from both total (DNA-based) and expressed (RNA) soil communities in the Bronx, NYC, NY, in order to test whether bioswale soils host characteristic bacterial communities with evidence for enriched microbial functioning, compared to nonengineered soils in park lawns and tree pits. Bioswales had distinct, phylogenetically diverse bacterial communities, including taxa associated with nutrient cycling and metabolism of hydrocarbons and other pollutants. Bioswale soils also had a significantly greater diversity of genes involved in several functional pathways, including carbon fixation ( cbbL-R [ cbbL gene, red-like subunit] and apsA ), nitrogen cycling ( noxZ and amoA ), and contaminant degradation ( bphA ); conversely, no functional genes were significantly more abundant in nonengineered soils. These results provide preliminary evidence that urban land management can shape the diversity and activity of soil communities, with positive consequences for genetic resources underlying valuable ecological functions, including biogeochemical cycling and degradation of common urban pollutants. IMPORTANCE Management of urban soil biodiversity by favoring taxa associated with decontamination or other microbial metabolic processes is a powerful prospect, but it first requires an understanding of how engineered soil habitats shape patterns of microbial diversity. This research adds to our understanding of urban microbial biogeography by providing data on soil bacteria in bioswales, which had relatively diverse and compositionally distinct communities compared to park and tree pit soils. Bioswales also contained comparatively diverse pools of genes related to carbon sequestration, nitrogen cycling, and contaminant degradation, suggesting that engineered soils may serve as effective reservoirs of functional microbial biodiversity. We also examined both total (DNA-based) and expressed (RNA) communities, revealing that total bacterial communities (the exclusive targets in the vast majority of soil studies) were poor predictors of expressed community diversity, pointing to the value of quantifying RNA, especially when ecological functioning is considered. Copyright © 2017 American Society for Microbiology.

  19. Phylogenetic and Functional Diversity of Total (DNA) and Expressed (RNA) Bacterial Communities in Urban Green Infrastructure Bioswale Soils

    PubMed Central

    Lee, Angela; McGuire, Krista L.

    2017-01-01

    ABSTRACT New York City (NYC) is pioneering green infrastructure with the use of bioswales and other engineered soil-based habitats to provide stormwater infiltration and other ecosystem functions. In addition to avoiding the environmental and financial costs of expanding traditional built infrastructure, green infrastructure is thought to generate cobenefits in the form of diverse ecological processes performed by its plant and microbial communities. Yet, although plant communities in these habitats are closely managed, we lack basic knowledge about how engineered ecosystems impact the distribution and functioning of soil bacteria. We sequenced amplicons of the 16S ribosomal subunit, as well as seven genes associated with functional pathways, generated from both total (DNA-based) and expressed (RNA) soil communities in the Bronx, NYC, NY, in order to test whether bioswale soils host characteristic bacterial communities with evidence for enriched microbial functioning, compared to nonengineered soils in park lawns and tree pits. Bioswales had distinct, phylogenetically diverse bacterial communities, including taxa associated with nutrient cycling and metabolism of hydrocarbons and other pollutants. Bioswale soils also had a significantly greater diversity of genes involved in several functional pathways, including carbon fixation (cbbL-R [cbbL gene, red-like subunit] and apsA), nitrogen cycling (noxZ and amoA), and contaminant degradation (bphA); conversely, no functional genes were significantly more abundant in nonengineered soils. These results provide preliminary evidence that urban land management can shape the diversity and activity of soil communities, with positive consequences for genetic resources underlying valuable ecological functions, including biogeochemical cycling and degradation of common urban pollutants. IMPORTANCE Management of urban soil biodiversity by favoring taxa associated with decontamination or other microbial metabolic processes is a powerful prospect, but it first requires an understanding of how engineered soil habitats shape patterns of microbial diversity. This research adds to our understanding of urban microbial biogeography by providing data on soil bacteria in bioswales, which had relatively diverse and compositionally distinct communities compared to park and tree pit soils. Bioswales also contained comparatively diverse pools of genes related to carbon sequestration, nitrogen cycling, and contaminant degradation, suggesting that engineered soils may serve as effective reservoirs of functional microbial biodiversity. We also examined both total (DNA-based) and expressed (RNA) communities, revealing that total bacterial communities (the exclusive targets in the vast majority of soil studies) were poor predictors of expressed community diversity, pointing to the value of quantifying RNA, especially when ecological functioning is considered. PMID:28576763

  20. Preparing health care organizations for successful case management programs.

    PubMed

    Bonvissuto, C A; Kastens, J M; Atwell, S R

    1997-01-01

    This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program.

  1. Study of space shuttle orbiter system management computer function. Volume 1: Analysis, baseline design

    NASA Technical Reports Server (NTRS)

    1975-01-01

    A system analysis of the shuttle orbiter baseline system management (SM) computer function is performed. This analysis results in an alternative SM design which is also described. The alternative design exhibits several improvements over the baseline, some of which are increased crew usability, improved flexibility, and improved growth potential. The analysis consists of two parts: an application assessment and an implementation assessment. The former is concerned with the SM user needs and design functional aspects. The latter is concerned with design flexibility, reliability, growth potential, and technical risk. The system analysis is supported by several topical investigations. These include: treatment of false alarms, treatment of off-line items, significant interface parameters, and a design evaluation checklist. An in-depth formulation of techniques, concepts, and guidelines for design of automated performance verification is discussed.

  2. Natural Resource Information System. Volume 1: Overall description

    NASA Technical Reports Server (NTRS)

    1972-01-01

    A prototype computer-based Natural Resource Information System was designed which could store, process, and display data of maximum usefulness to land management decision making. The system includes graphic input and display, the use of remote sensing as a data source, and it is useful at multiple management levels. A survey established current decision making processes and functions, information requirements, and data collection and processing procedures. The applications of remote sensing data and processing requirements were established. Processing software was constructed and a data base established using high-altitude imagery and map coverage of selected areas of SE Arizona. Finally a demonstration of system processing functions was conducted utilizing material from the data base.

  3. Challenging paradigms in estuarine ecology and management

    NASA Astrophysics Data System (ADS)

    Elliott, M.; Whitfield, A. K.

    2011-10-01

    For many years, estuarine science has been the 'poor relation' in aquatic research - freshwater scientists ignored estuaries as they tended to get confused by salt and tides, and marine scientists were more preoccupied by large open systems. Estuaries were merely regarded by each group as either river mouths or sea inlets respectively. For the past four decades, however, estuaries (and other transitional waters) have been regarded as being ecosystems in their own right. Although often not termed as such, this has led to paradigms being generated to summarise estuarine structure and functioning and which relate to both the natural science and management of these systems. This paper defines, details and affirms these paradigms that can be grouped into those covering firstly the science (definitions, scales, linkages, productivity, tolerances and variability) and secondly the management (pressures, valuation, health and services) of estuaries. The more 'science' orientated paradigms incorporate the development and types of ecotones, the nature of stressed and variable systems (with specific reference to resilience and redundancy), the relationship between generalists and specialists produced by environmental tolerance, the relevance of scale in relation to functioning and connectivity, the sources of production and degree of productivity, the biodiversity-ecosystem functioning and the stress-subsidy debates. The more 'management' targeted paradigms include the development and effects of exogenic unmanaged pressures and endogenic managed pressures, the perception of health and the ability to manage estuaries (related to internal and external influences), and the influence of all of these on the production of ecosystem services and societal benefits.

  4. Evidence-based management - healthcare manager viewpoints.

    PubMed

    Janati, Ali; Hasanpoor, Edris; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun

    2018-06-11

    Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

  5. [Impact of traditionally managed forest units on the landscape connectivity of Sierra de Los Tuxtlas, Mexico].

    PubMed

    Aguilar Vásquez, Yunin; Aliphat Fernández, Mario Manuel; Caso Barrera, Laura; Del Amo Rodríguez, Silvia; Sánchez Gómez, Maria De Lourdes; Martínez-Carrera, Daniel

    2014-09-01

    The ever-increasing establishment of landscape mosaics is expressed as a surrounding matrix of agricultural activities, which frames patches or remnants of the original vegetation cover. Conservation actions should be aimed to establish or to increase those interactive systems, which help to maintain the land- scape flow through linkages. Spaces occupied by traditional management systems retain and support this func- tion. In this paper, we used Geographic Information Systems to evaluate the importance of traditionally managed forest units ('acahuales'-coffee plantations) and to assess landscape connectivity in the indigenous Popoluca area of Sierra de los Tuxtlas, Mexico. The cartographic material used to establish the types of vegetation and their coverture included the period 1991-2008. At landscape level, four indices were used to assess the general situation of the habitat network, and to identify the patches of high priority. Individually, indices evaluated if patches were important for their area, their potential flow or their connecting function. Results showed that the landscape is functioning as a single system, but having low connectivity. Values improved when traditionally managed forest patches were considered as viable habitat. We detected 367 patches of very high priority, 80% belonging to forests managed traditionally. Patches were important for their potential flow (size and topologi- cal relationships). Only 70 patches were significant for their function as biological corridors between largest forests located at the top of the volcanoes, and are mostly managed forest (75%). We concluded that the units of traditionally managed forest play a significant role in landscape connectivity maintenance.

  6. Structuring Education for Business Management.

    ERIC Educational Resources Information Center

    Whitt, Robert L.

    Studies of school district organization generally include an examination of enrollments, average daily attendance, assessed valuation, potential and predicted growth rate, bonded indebtedness, school district boundaries, transportation, special services, and other factors, but little concern or attention is given to the business functions because…

  7. The Vendors' Corner: Biblio-Techniques' Library and Information System (BLIS).

    ERIC Educational Resources Information Center

    Library Software Review, 1984

    1984-01-01

    Describes online catalog and integrated library computer system designed to enhance Washington Library Network's software. Highlights include system components; implementation options; system features (integrated library functions, database design, system management facilities); support services (installation and training, software maintenance and…

  8. PRE-QUALITY ASSURANCE PROJECT PLAN (QAPP) AGREEMENT (PQA) (HANDOUT)

    EPA Science Inventory

    The Land Remediation and Pollution Control Division (LRPCD) QA Manager strives to assist LRPCD researchers in developing functional planning documents for their research projects. As part of the planning process, several pieces of information are needed, including information re...

  9. 75 FR 12540 - Notice of Public Information Collection Being Submitted to the Office of Management and Budget...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-16

    ..., including the use of automated collection techniques or other forms of information technology and (e) ways... on an identical security function without the additional costs of physical separation inherent in the...

  10. Position Paper: Dental General Practice Residency Programs: Financing and Operations.

    ERIC Educational Resources Information Center

    Hanson, Paul W.

    1983-01-01

    A discussion of changeable economic issues that can affect dental general practice residency program planning includes costs and resource allocation, maximizing efficiency and productivity, ambulatory and inpatient revenue sources, management functions, faculty as practitioners, faculty appointments, and marketing. (MSE)

  11. 78 FR 64503 - Subcommittee for Dose Reconstruction Reviews (SDRR), Advisory Board on Radiation and Worker...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... in the official record of the meeting. The public is also welcome to listen to the meeting by joining... implement and effectively manage the new compensation program. Key functions of the Advisory Board include...

  12. The NASA computer science research program plan

    NASA Technical Reports Server (NTRS)

    1983-01-01

    A taxonomy of computer science is included, one state of the art of each of the major computer science categories is summarized. A functional breakdown of NASA programs under Aeronautics R and D, space R and T, and institutional support is also included. These areas were assessed against the computer science categories. Concurrent processing, highly reliable computing, and information management are identified.

  13. Intrinsic and extrinsic factors affecting patient engagement in diabetes self-management: perspectives of a certified diabetes educator.

    PubMed

    Rodriguez, Kellie M

    2013-02-01

    Patients with diabetes are responsible for the vast majority of management requirements of their condition. However, their ability and motivation to engage in required self-management behaviors may be mitigated by multiple intrinsic and extrinsic factors. Intrinsic barriers include attitudes and health beliefs, limited diabetes knowledge and technical skill, reduced functional health literacy, and inadequate self-efficacy to promote positive behavior change. Extrinsic barriers include financial considerations, inadequate family and community support systems, ineffective clinical relationships, and limited access to effective diabetes health care delivery. Diabetes providers have opportunities for enhancing patient engagement with clinical recommendations and diabetes self-management through effective communication, including efforts to contextually assess patients' perceptions of diabetes and how the condition fits within the context of their changing lives. This article provides a conceptual framework for establishing and building an effective clinical alliance with patients with the goal of empowering them to take more control of their diabetes and reduce their risks for poor diabetes outcomes. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

  14. Sustainable data and metadata management at the BD2K-LINCS Data Coordination and Integration Center

    PubMed Central

    Stathias, Vasileios; Koleti, Amar; Vidović, Dušica; Cooper, Daniel J.; Jagodnik, Kathleen M.; Terryn, Raymond; Forlin, Michele; Chung, Caty; Torre, Denis; Ayad, Nagi; Medvedovic, Mario; Ma'ayan, Avi; Pillai, Ajay; Schürer, Stephan C.

    2018-01-01

    The NIH-funded LINCS Consortium is creating an extensive reference library of cell-based perturbation response signatures and sophisticated informatics tools incorporating a large number of perturbagens, model systems, and assays. To date, more than 350 datasets have been generated including transcriptomics, proteomics, epigenomics, cell phenotype and competitive binding profiling assays. The large volume and variety of data necessitate rigorous data standards and effective data management including modular data processing pipelines and end-user interfaces to facilitate accurate and reliable data exchange, curation, validation, standardization, aggregation, integration, and end user access. Deep metadata annotations and the use of qualified data standards enable integration with many external resources. Here we describe the end-to-end data processing and management at the DCIC to generate a high-quality and persistent product. Our data management and stewardship solutions enable a functioning Consortium and make LINCS a valuable scientific resource that aligns with big data initiatives such as the BD2K NIH Program and concords with emerging data science best practices including the findable, accessible, interoperable, and reusable (FAIR) principles. PMID:29917015

  15. Conciliation biology: the eco-evolutionary management of permanently invaded biotic systems

    PubMed Central

    Carroll, Scott P

    2011-01-01

    Biotic invaders and similar anthropogenic novelties such as domesticates, transgenics, and cancers can alter ecology and evolution in environmental, agricultural, natural resource, public health, and medical systems. The resulting biological changes may either hinder or serve management objectives. For example, biological control and eradication programs are often defeated by unanticipated resistance evolution and by irreversibility of invader impacts. Moreover, eradication may be ill-advised when nonnatives introduce beneficial functions. Thus, contexts that appear to call for eradication may instead demand managed coexistence of natives with nonnatives, and yet applied biologists have not generally considered the need to manage the eco-evolutionary dynamics that commonly result from interactions of natives with nonnatives. Here, I advocate a conciliatory approach to managing systems where novel organisms cannot or should not be eradicated. Conciliatory strategies incorporate benefits of nonnatives to address many practical needs including slowing rates of resistance evolution, promoting evolution of indigenous biological control, cultivating replacement services and novel functions, and managing native–nonnative coevolution. Evolutionary links across disciplines foster cohesion essential for managing the broad impacts of novel biotic systems. Rather than signaling defeat, conciliation biology thus utilizes the predictive power of evolutionary theory to offer diverse and flexible pathways to more sustainable outcomes. PMID:25567967

  16. [Evaluation of asthma management from the surveys in 30 provinces of China in 2015-2016].

    PubMed

    Wang, W Q; Lin, J T; Zhou, X; Wang, C Z; Huang, M; Cai, S X; Chen, P; Lin, Q C; Zhou, J Y; Gu, Y H; Yuan, Y D; Sun, D J; Yang, X H; Yang, L; Huo, J M; Chen, Z C; Jiang, P; Zhang, J; Ye, X W; Liu, H G; Tang, H P; Liu, R Y; Liu, C T; Zhang, W; Hu, C P; Chen, Y Q; Liu, X J; Dai, L M; Zhou, W; Huang, Y J; Xu, J Y

    2018-01-01

    Objective: To evaluate the general level of asthma management in urban areas of China and further promote the national asthma management plan. Methods: A multi-center, cross-sectional survey was carried out in 30 provinces of China (except for Tibet) during Oct 2015 to May 2016. It's a questionnaire-based face-to-face survey which included asthma management using peak flow meter (PFM) and pulmonary function test, medication choice of maintenance therapy and asthma education. Results: A total of 3 875 asthmatic outpatients were recruited including 2 347(60.6%) females and 1 528(39.4%) males. The mean age was (50.7±16.7) years ranging from 14 to 99. Only 10.1%(388/3 837) patients used PFM as monitoring, whereas 62.1%(2 405/3 874) patients underwent pulmonary function test during the past year. There were 57.4%(2 226/3 875) patients treated with inhaled cortical steroid plus long-acting β(2)-agonist combinations (ICS+LABA) as daily medication. 43.3%(1 661/3 836) patients were followed up by physicians. Among this population, 1 362 asthmatic outpatients were recruited, who also took part in the asthma control survey in 2007-2008 in 10 cities. In this subgroup, 17.9%(244/1 360) were tested by PFM and 66.6%(907/1 362) by pulmonary function test during last year. As to the medication, 63.1%(860/1 362) selected ICS+LABA for daily control. There were 50.4%(685/1 359) patients in the follow-up cohort by physicians. Compared to the similar survey conducted in 2007-2008, the proportion of patients with ICS+LABA regimen and follow-up by physicians were markedly higher, while the rate of PFM use did not have significant improvement. Conclusion: Although the present level of asthma management in China is still far from ideal, asthma management has improved compared to 8 years ago. Yet the use of PFM does not significantly improve. Asthma action plan and application of PFM should be further promoted to improve the level of asthma management.

  17. [Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness].

    PubMed

    Park, Chorong; Song, Misoon; Cho, Belong; Lim, Jaeyoung; Song, Wook; Chang, Heekyung; Park, Yeon-Hwan

    2015-04-01

    The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.

  18. A Distributed Trajectory-Oriented Approach to Managing Traffic Complexity

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

    In order to handle the expected increase in air traffic volume, the next generation air transportation system is moving towards a distributed control architecture, in which ground-based service providers such as controllers and traffic managers and air-based users such as pilots share responsibility for aircraft trajectory generation and management. While its architecture becomes more distributed, the goal of the Air Traffic Management (ATM) system remains to achieve objectives such as maintaining safety and efficiency. It is, therefore, critical to design appropriate control elements to ensure that aircraft and groundbased actions result in achieving these objectives without unduly restricting user-preferred trajectories. This paper presents a trajectory-oriented approach containing two such elements. One is a trajectory flexibility preservation function, by which aircraft plan their trajectories to preserve flexibility to accommodate unforeseen events. And the other is a trajectory constraint minimization function by which ground-based agents, in collaboration with air-based agents, impose just-enough restrictions on trajectories to achieve ATM objectives, such as separation assurance and flow management. The underlying hypothesis is that preserving trajectory flexibility of each individual aircraft naturally achieves the aggregate objective of avoiding excessive traffic complexity, and that trajectory flexibility is increased by minimizing constraints without jeopardizing the intended ATM objectives. The paper presents conceptually how the two functions operate in a distributed control architecture that includes self separation. The paper illustrates the concept through hypothetical scenarios involving conflict resolution and flow management. It presents a functional analysis of the interaction and information flow between the functions. It also presents an analytical framework for defining metrics and developing methods to preserve trajectory flexibility and minimize its constraints. In this framework flexibility is defined in terms of robustness and adaptability to disturbances and the impact of constraints is illustrated through analysis of a trajectory solution space with limited degrees of freedom and in simple constraint situations involving meeting multiple times of arrival and resolving a conflict.

  19. 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.

  20. Preventive home care of frail older people: a review of recent case management studies.

    PubMed

    Hallberg, Ingalill Rahm; Kristensson, Jimmie

    2004-09-01

    Preventive actions targeting community-dwelling frail older people will be increasingly important with the growing number of very old and thereby also frail older people. This study aimed to explore and summarize the empirical literature on recent studies of case/care management interventions for community-dwelling frail older people and especially with regard to the content of the interventions and the nurse's role and outcome of it. Very few of the interventions took either a preventive or a rehabilitative approach using psycho-educative interventions focusing, for instance, on self-care activities, risk prevention, health complaints management or how to preserve or strengthen social activities, community involvement and functional ability. Moreover, it was striking that very few included a family-oriented approach also including support and education for informal caregivers. Thus it seems that the content of case/care management needs to be expanded and more influenced by a salutogenic health care perspective. Targeting frail older people seemed to benefit from a standardized two-stage strategy for inclusion and for planning the interventions. A comprehensive geriatric assessment seemed useful as a base. Nurses, preferably trained in gerontological practice, have a key role in case/care management for frail older people. This approach calls for developing the content of case/care management so that it involves a more salutogenic, rehabilitative and family-oriented approach. To this end it may be useful for nurses to strengthen their psychosocial skills or develop close collaboration with social workers. The outcome measures examined in this study represented one of three perspectives: the consumer's perspective, the perspective of health care consumption or the recipient's health and functional ability. Perhaps effects would be expected in all three areas and thus these should be included in evaluative studies in addition to measures for family and/or informal caregiver's strain and satisfaction.

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